Permit 4 li CITY OF TIGARD PLUMBING PERMIT
� DEVELOPMENT SERVICES PERMIT #: PLM2005 -00470
.� ° 1 3125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/29/2005
PARCEL: 1512600 -00300
SITE ADDRESS: 09546 SW WASHINGTON SQUARE RD H - 16 ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Other fixtures: (1) primer.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: M FLOOR DRAINS; 1 TRAPS:
STORIES: WATER HEATERS: 1 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: 1 OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: 1 WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Owner: FEES
WASHINGTON SQUARE LLC
BY THE MACERICH COMPANY Description Date Amount
9585 SW WASHINGTON SQUARE RD [PLUMB] Permit Fee 9/20/2005 $83.00
TIGARD, OR 97223 [TAX] 8% State Surcha 9/20/2005 $6.64
•
Phone : 503- 639 -8865 Total $89.64
Contractor:
JAMES ROOD PLUMBING
2459 SE TV HWY PMB #168
HILLSBORO, OR 97123 REQUIRED ITEMS AND REPORTS
Phone : 503- 648 -3907
Reg #: LIC 57355
PLM 34 -199PB
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: 0, _ Permittee Signature: ... ,-C_ ss\`
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
FROM :.JAMES ROOD PLUMB I N G F A X NO. : 503 6483 \ � Y Sep 20 20 0 9 :
I 13uilaing Fixtures U■YaS FOR OFFICE USE ONLY
Plumbin Permit A lication Received z.3 ;ZOt�2'L Plumbing \
RECE' Date/13y. I �A7 q
nning Permit No )1
Planning Approval Sewer
City of Tigard Date/By: Pertri Ne, SW iIOS '
1 3125 SW Hall Blvd. SE? Plan Review Other 0X005 Datc/11, PcrmitNo -:
Tigard, Oregon 97223 Post•Rcview Land Use
Phone 503 - 639 - 4171 Fax: 503 - 598 -1960 �, ;
,. t ..
CITY OF r ��+�{ 'll ConnY Case No.:
Y F TI
GAR lu ' Contact ® sec Page 2 for
Internet: www.ci_tigard.or.us G r . 4 c � �
24 -hour Inspection Request: 5 A 1Q Name/Method: Supplemental Information.
TYPE OF WORK . FEE * fors cc ial' informatfon use checklist) ,
Description Qt Fte(ea.) Total
121 New construction 0 Demolition ew •1= &- z- fanally_.dw.
/j Addltion/altcration/re•lacement • Other: ;( ..... oy•1• lair ami ntihty'con
CATEGORY OF CONSTRUCTION SFR (1) bath _ _ 249.20
1 . 2 -F: 1 .. ell 4 pu Commercial/Industria SFR (2) bath 350.00
f Ae L. , B • ld 1111 n Multi-Family SFR (3) bath Other: 399.00
❑ Master Builder • Each additional bath/kitchen 45.00
a •
V' L. JOB' S)TE•WFORMATION•and LOCATION Fire sprinkler f 1 P g e 2
'' Site Utilities : ; r
Job site address: t ► ;; Catch basin/area drain 16.60
Suite #: if Irjr /Apt•# ^ Dr ell/leach line/trench drain 16.60
Project Name: 1-4. T `° ?j " c "e Footi • dr a in sno. l ft.) _ Page 2
Cross strcct/Dircctions to job site: Manufactured home utilities . 110.00 _
Manholes 16.60
Rain drain connector _ 16.60
San sewer,no. linear ft.) Page 2
St sewer (no. linear ft.) Page 2 ' -
Subdivision: Lot #:
Water service no. linear ft. Pa e 2
Tax ma /parcel it: •
. ; ;• • . ;_ ;. : =^a �
- _ ��:':Fixiure''or.iItem: "'�: •�
' DESCRIPTION OF WORK 16.60 1
Absorption valve _
c L / �D,„ n b ,a.� _ Absor ow pr valve r Page 2
r_ Backwater valve 16.60
Clothes washer 16.60
Dishwasher _ 16.60
Drinking fountain _ 16.60
IS PROPERTY OWNER • ' Il TENANT: • Ejectors/sump 16.60
Name: Expansion tank 16.60
Fixture/sewer cap 16.60
Address: Floor drain floor sink/hub - ' 1 16 -60
Cit /State/Zip: Garbage disposal 16.60
Phone: Fax: Hose bib - 16.60
...APPLIOANT• 0 .CONTACT:PERSON ' " !cc maker 16.60
Name:
I /grease trap 16.60
-
Medical gas - value: $ Page e z
Address: Primer Y 16.60
Cit /State /Li • : Roof drain (commercial) 16.60
Fax: Sink/basin/lavatory - I
Phone: 16.60
-
E -mail: Tub /shower /shower pan 16.60
r , - -, - . Urinal 16.60
• ' .CONTRACTOR ' : Water closet � 16.60
Business Name: Ja L • i; Water heater 0 16.60
Address cy r ' se 7-te , 1Jy P;, 41 `/6 e ) Other.
City State /Z) : DILLS At 01.0 I '7/ Other: t
Phone. t � :: ,y
_ • , • • .. ,. • • .:.FluinbingLPer`)til Fees'_ ; : „a.,, : =' : .
- - - Subtotal $ �. !iW
CCB Lie. #: 7 ^ $ Plumb. Lic.#: i M Permit Fcc $72.50 $
Authorized Aiti .
Residential l Baekflow Minimum Fcc $36.25
Signature: -Air - / ` . Date .1/55 Plan Review (25% of Permit Fee) $
// State Surcharge (8% of Permit Fee) $ {, . 6
(Please print Oat - TOTAL PERMIT FEE $ ' ) e), 6
Notice: This permit application expires if a permit is not obtained within All new commercial bulldings require 2 sets of plans with isometric or
ltfo days after it has been accepted as complete- riser diagram for plan review.
*Foe methodology set by Tri -County Building industry Service Board -
i,eDsts\Perm:t Forms■PlmPermitApp .doe 01 /03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2005`00470
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/29/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/3/2005 TIME: 7:07AM PAGE: 71
SITE ADDRESS: 09546 SW WASHINGTON SQUARE RD H - 16 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: BERGMAN TRAVEL SHOP
DESCRIPTION: Other fixtures: (1) primer.
OWNER: WASHINGTON SQUARE LLC, PHONE #:. 503- 639 -8865
CONTRACTOR: JAMES ROOD PLUMBING PHONE #: 503 -648 -3907
Inspection Request Scheduled For: Date: 10/3/2005 Pour Time:
Code # Inspection Description Confirm # ' • - • Message
320 Plumbing rough -in 017201 -01 971 -221 -4616 Y
Corrections /Comments /Instructions:
r /5(V
•
•
V ILF*5s1 ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date:i ,) Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: PLM2005 -00470
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/29/2005
Phone: (503) 639 -4171 VA
Inspection Requests (24 Hrs.): (503) 639 -4175 •'I ��
INSPECTION WORKSHEET FOR DATE: 11/4/2005 TIME: 7:08AM PAGE: 53
SITE ADDRESS: 09546 SW WASHINGTON SQUARE RD H - 16 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: BERGMAN TRAVEL SHOP
DESCRIPTION: Other fixtures: (1) primer.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 603 - 639.8865
CONTRACTOR: JAMES ROOD PLUMBING PHONE #: 503- 648 -3907
•
Inspection Request Scheduled For: Date: 11/4/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
• 399 Plumbing final , • 020368 -01 503-939-4169 N
Corrections /Comments /Instructions:
•
•
p 'ASS ❑ PARTIAL APPROVAL . ❑ CANCEL ❑ NO ACCESS
II FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1P Date: // / 41 / 61 Phone #: (503) 718 -