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Permit r , CITY TIGARD PLUMBING PERMIT I� DEVELOPMENT SERVICES PERMIT #: PLM2000 -00098 I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 05/15/2000 SITE ADDRESS: 09508 SW WASHINGTON SQUARE RD PARCEL: 1S126C0-01107 SUBDIVISION: ZONING: C -G BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: FLOOR DRAINS; 1 TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: 0 OTHER FIXTURES: TUB /SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Remove and replace an existing sink, 2" floor drain and water heater for tenant improvements. FEES Owner: Type By Date Amount Receipt PPR WASHINGTON SQUARE PRMT GEO 05/15/200C $50.00 0002195 BY THE MACERICH CO 5PCT GEO 05/.15/2000 $4.00 0002195 ATTN JANET FISHER, ASSET SANTA MONICA, CA 90407 Total $54.00 Phone 1: Contractor: ANCTIL PLUMBING INC 16900 SW MERLO RD BEAVERTON, OR 97008 • REQUIRED INSPECTIONS Phone 1: 503 - 642 -7323 Rough -in Insp Reg #: LIC 00000241 Underfloor /Underslab PLM 00 2 00000241 Insp existing /capped fixtures Final Inspection ORIGINAL 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 -0080. You may obtain copies oft -se rules or direct questions to OUNC by calling (503) 246 -1987. Issued By: Permittee Signature: , Call :639 -4175 by 7:00 P.M. for an inspection needed the next business day r CITY OF TIGAIID Plumbing Application Recd By - D( 2 4 13125 SW HALL BLVD. Commercial and Residential • Cate Recd 3 -zl TIGARD, OR 97223 Date to P.E. Date to DST (503) 639 -4171 Peet s peoiC' -cco ' Print or Type • Related SWR AR Oo - oc49 n 5 - Incomplete or illegible applications will not be accepted Called 3 - `t5-O6 -Q- eefr I/Aff ifess • Name of Development/Project FIXTURES (Individual) QTY PRICE AMT ( Job J �) V &A \Q, \.\ a Sink ( 9.00 tt. pp Address • RS Suite Lavatory 1 9.00 o� � " " = ` so R 1 7,001 ^V, -y Tub or Tub /Shower Comb. 9.00 G - Idg a Ci rSaate Zip Shower Only 9.00 O f \ ( MA a a 1 Water Closet 9.00 Name n 1 \A \ • „ „k` '\ cw.e-` filillIA Dishwasher I 9.00 Owner Mail Address t, ` i l Suite Garbage Disposal 9.00 13 -. Pos-r c [9 Washing Machine 9.00 City /State Zf Phone Floor Drain 2' 9.00 3" 9.00 P4rne � �,U� w�k lP ^U`u>�` 4' 9.00 Occupant mailing ddr° A uit Water Heater 9.00 1 /, k L'0 1 Nt \ Laundry Room Tray 9.00 City/State Zip �ir,l Phone O�,,f, Urinal 9.00 )Y V (M c c &. dt C L l 3W;33S - � O Other Fixtures (Specify) 9.00 ' Name U .Q- 11 O 9.00 Contractor Mailing Address Suite 9.00 9.00 City/State Zip one 9.00 Oregon Const. Cont. Boa Lic.s Exp. Date 9.00 Mad!. Copy of 9.00 Current Pumping Lic. s Exp. Date Sewer - 1st 100' 30.00 Licensee Sewer - each additional 100' 1 25.00 COT Bu ess Tax or Metros Exp. Date Water Service - 1st 100' 30.00 Name Water Service - each additional 200' 25.00 I Architect eau\ eo tma w C 1 0 ri,91/ms Storm & Rain Drain - 1st 100' 30.00 or Nailing Address 5,., ;e Storm & Rain Drain - each additional 100' I 25.00 I i I t 3a7 POST CW-e, H Mobile Home Space 25.00 I Engineer City/State Zip Phone Commercial Back Flow Prevention Device or Anti- 25.00 Y r -►'i- p 9r , 3 (o - 33s -( 0 Pollution Device Describe work New 0 Addition 0 Alteration Repair O Residential Backflow Prevention Device' I 15.00 o be done: Residential 0 Non- residential Any Trap or Waste Not Connected to a Fixture I I 9.00 Additional description of work Catch Basin • I 9.00 C d UVIUVI t' If C t (( t Y1Te y ■ 2 W1U RC�-e I - �7� 'v Insp. of Existing Plumbing a0 00 I VI C5ji i rwctll Pct c-12, , perihr Specially Requested Inspections . Existing use of . 1 per/hr ' wiiding a property I� P CCLV1 l 1 l Rain Crain, single family dwelling f 30.00 1 ' Proposed use of 11 �, ; Grease Traps 9.00 budding or property PUP (>rt^utn 1 t 1� QUANTITY TOTAL I Are you Epping , moving or replacing any fixtures? Yes Il No I sometric or riser diagram reouirea it Cuanity Total is > 9 2 (H yes see back of form) "'SUBTOTAL Z 1441. I I hereby acknowledge that I have read this application, that the information given z correct. L-iat I am the owner or authorized agent of the owner. and . 5% SURCHARGE hat plans submitted are in compliance with Oregon State Laws. ; Signature of Owner/ gent l���D t PLAN REVIEW 25% OF SUBTOTAL 1 U ) 1n t Ceti all S2. d et s .041 1 I R eauirea on d fe Cry. total is 9 0(0 V MSS tivvti1 ey .Joig / v 13 IOU TOTAL I i Contact Person Name Of Phone 310 � 'Minimum permit fee is 525 + 5% surcharge. except Residential Backflow I W 1 f\ Ain (� C-10?00 Prevention Device, which is 515 • 5% surcharge i:ldstslplmapp.coc 896 Ard PLEASE COMPLETE AS APPROPRIATE TO PROJECT: Fixtures to be capped, moved or replaced Qty Sink Lavatory 1 Tub or Tub /Shower Combination Shower Only Water Closet Dishwasher Garbage Disposal Washing Machine Floor Drain 2" 3" 4" Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) COMMENTS REGARDING ABOVE: w 05f7;6/2000 07:14 5036427755 ANCTIL PLUMBING _ 9 s 1 crap CITY OF TIGAIRD Plumbing Permit Application Wan Cheat r 13125 SW HALL BLVD. Commercial and Residential Reo'd By T1GARD, OR 97223 L �l Pei ; I. It &'P 2000 - O 66 a„ Reed (503) 839 -4171 ate to DST • . Print or Type Pent 0 Incomplete or Illegible applications will not be accepted Related SwwR if / I;easd • Marne of devabpment/Pr*d f -- -. - i ifrit r.1 �I I) .... "'' ' - firl.:; -,'� " i j ' : i.. • _: - ''a.4 Job (a) �i "Vi,iknll JByl a id[ S .. M 1114 RIM Address sweet Addrsa• Sulte vatay , "Sal S I�til„' ms - I 69414` '11 - 11.50 Bldg s I n c /Stale zm Only - _ ��V . _ I "r I 3A, a Q Water Close( r"O Dishwasher Owner whiIt Mdtea Suite Garbage Disposal MEI Mal Washing Machine MEI .50 Cfty/stals Zip Phone Floor aawFaor slot UMINIMIllil r NM IWO IW r Hans LMIIIIIIIII MLA MIN Occupant . Milting aodresa Sups Water Heater 0 conversion Is kind - G■s • I s, • .. , s e .. *rate . - rival • • milt. Mil bill City/State Zip Phone laundry Room Tray _ Urinal _ N Name ���� ( �� Lint-Col • Other Fiala., (Specify) 15.00 M Contractor ' Mierp Add " ns J Suite OMNI 14110 Sul Me I. Lt Prlor to permit CI�rlslata Zip Sewer • let 100' _ 35.00 _ __ Issuance. a 00P1 (I,e.y0,,, Q 11 9 7J 6 M2. 1) 2 3 Sewer - emit sddltlonal 100• _ millai at all lkanses are Oregon Cons.. Cont. Board LW., . Dale .. required n 2 q i $ y 4 to Root Water Santos - lst 100' _ 36.00 _ embed In car Plumbing Lit 0 Water Sendai - each additional 200' _ EWA • -- database 26 P3 G So 20au Storm & Rain Drain -1st 100 _ &LAM Nair. Storm A Rain Rain - each additional 100 _ 32.00 Architect Moblie Nome Spans l or Mailing Address Suite Camerae' Bade now Preventon Device or Ana. a 32.03 Pollution Device Engineer C 2 - Mon Residardlel Baakflow ' . , • Device' • (Irrigation timing dsuas require a separate S Deserts work to be dons: restricted ., • New 0 Repot 0 Replace with like kind: Yes x No 0 Any Trap or Waste Not Corr bud to a Feb" _ Rat ResihlrrlW 0 Commsfdal Gtch Basin • 1.50 IMO Additional description of work: (nap, of Eldslh0 POsmbbg 000) r Are you capping, moving or replacing any fixtures? - • = Yes 0 No Rain Drain. single family dieing 45.00 If yes. see back of form to Indicate work performed by Greene Traps �� fixture. FAILURE TO ACCURATELY REPORT FIXTURE WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL. { '•' - �� • -,fir I hereby acknowledge that I have read this appik Deuce, that the information Isometric a riser d • Is .. • Milord. Total is a a 3 :I ,$1 given b coned, that I am the owner or authorized agent of the owner, and 'SUBTOTAL r: ° e that plans submitted are In compliance web Oregon Slate Laws. C Sig of OwnerfAgent oifs S 5% SURCHARGE . - LIZ /? Co Person era Philtre "PLAN REVIEW 25% OF SUBTOTAL " - - ... ' _ . O • -73 R • , • • . dhows •,..totslls•e L. _ l .� .. TOTAL 'Minimum penult fee Is 550 t 5% surcharge. apt R Bedd Prevention Device. which Is $25.5% surcharge "Ali New Cormrnsrelel Buildings require plans with Isarmatrlc or deer diagram end plan review tWiswrfwek nsv,dac „,• ti.,� Accumulative Sewer Tally • Tenant Name:id/PM// 1 7 E,e3 This SWR# A000 --000 ✓ 5 Address: So ? '5r.,) 5 14.Pi3) SQ a 4 eE This PLM #: aZOfop - q$'' Fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New # Value Capped off value added # added ' - #s total Count off #s count value values Baptistry/Font 4 - Bath - Tub /Shower 4 - JacuzziANhirlpool 4 . Car Wash - Each Stall 6 - Drive Through 16 Cuspidor/Water Aspirator 1 Dishwasher - Commercial 4 - Domestic 2 . Drinking Fountain 1 , Eye Wash 1 • Floor Drain/sink - 2 inch 2 -3inch 5 -4inch 6 - Car Wash Drn 6 • Garbage-Disposal 16 - Domestic (to 3/4 HP) - Commercial (to 5 HP) 32 - , - Industrial (over 5 HP) . 48 Ice Machine/Refrigerator Drains 1 . Oil Sep (Gas Station) 6 • Rec. Vehicle Dump Station - 16 - Shower - Gang (Per Head) 1 - Stall 2 . • Sink - Bar /Lavatory 2 / • vZ • - Bradley 5 . - Commercial 3 - - -” / 3 / 3 - Service 3 . Swimming Pool Filter 1 Washer - Clothes .6 - Water Extractor 6 , Water Closet - Toilet 6 Urinal 6 . , . • TOTALS a0 - . 7 a(5.Fs( Total fixture values: c)t d ' divided by 16 = )3 0 EDU Po CN/>'"A °e ' �`1 6) 8reit)C:r P HISTORY - • PLM # /wq_ aa 35 - EDU# / 3d SWR #,9yy- 0p/s,' PLM # K49 - oo /o -EDU# )30 SWR # / -C9.: PLM #iffr ee l? / EDU# /3a SWR # /qly - /34 PLM #9s -pao65 EDU# / d SWR #S`9 `/3 PLM # /y9 9 -ocs /307 EDU #. /3O SWR #01g -oeayg PLM#ff- aro36 EDU# j 3/ SWR #qy -cod _ . PLM # /fpy -e5 I/3 EDU# •,3/) SWR # /yyq -bars/ PLM #41- 60 EDU #) 3/ SWR#99- ono-3; i:'hdsts\swftaly.doc CITY OF TIGARD BUILDING INSPECTION DIVISION • MST 24 -Hour Inspection Line: 639 -417 Business Line: 639 -4171 BUP Date Requested `e / AM 1e PM BLD Location q 50 I,I ,Sk- S4 .Q1/ Z' Suite MEC Contact Person • \ 1 Ph , - • PLM - 7 ) — t" c ( Contractor Ph (2C/2733 SWR BUILDING Tenant/Owner . ���� I ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL [iMBIN Post & Beam • Under Slab Top Out • Water Service Sanitary Sewer Rain Drains •AS" PART FAIL ECHANICAL Post & Beam Rough In Gas Line Smoke Dampers - Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab • Low Voltage Fire Alarm Final • PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date / Inspector Ext Other P Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST ch 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 Date Requested (c7 /7 (JCJ AM PM BLD Location 6 /50 5. k *S V' 4� . Suite MEC Contact Person \l Ph CO 12-790 - cas>Jcoo 'O Contractor Ph 3 SWR : UILDIN Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain • SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing • Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: . 4115A)'. ''ART FAIL : ING Pos . :eam - Under Slab Top Out Water Service Sanitary Sewer R. rains PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Ext Date 6/7/0 Inspector 1 Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.