Permit ill I CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 -00418
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/14/2007
PARCEL: 1S12600-00300
SITE ADDRESS: 09689 SW WASHINGTON SQUARE RD C - ZONING: C -
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: COACH
Project Description: Replace existing fixtures.
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: M FLOOR DRAINS; 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 D
BY THE MACERICH COMPANY Description Date Amount
9585 SW WASHINGTON SQUARE RD [PLUMB] Permit Fee 9/14/2007 $72.50
TIGARD, OR 97223
[TAX] 8% State Surcha 9/14/2007 $5.80
Phone : Total $78.30
Contractor:
D & F PLUMBING
4636 N ALBINA AVE
PORTLAND, OR 97217 REQUIRED ITEMS AND REPORTS
Contact # : PRI 503- 282 -0993
FAX 503- 288 -0604
Reg #: LIC 465
PLM 26 -23PB
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.
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Issued B i iitidt / / Permittee Signature: cS / I/ ric t in
. �P
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.
tie 41 3 -07 01 - 46P P-01
' miming 1' IALUI V3
Plumbing P FOR Or� ici: S�: ONLY i j y i � '', j �) Received • - I Plumbing a �v,�1
Date/B : /AV Permit No.• II 't.O I
Cit of Tig Planning Ap royal Sewer
Y g f�ate/B ; ____ Permit No. _ __
13125 SW Hall Blvd. CC Plan Review Other
Tigard, Oregon 97223 S 6 P 13 1UU I Date/B : _ - - Permit No.:
Phone: 503 -639 -4171 q A TO" Post- Review l and Use
1 ^� ; y , ( r \ Date/D __ _ __ Case N_o.
Internet: www.ci.tigar Wits, l �;: I I Contact
�q' _ � . � i 1 ® See Page 2 for
24 -hour inspection w ' I ' t T E 1 V Natne/Method: — 176- Supplemental Information.
i r eL / S /2 k)() — W3a)
TYPE OF WORK FEE SCI1IEDULE (for special information use checklist)
New construction ❑ Demolition Description 1 Qty. I Fee(ea.) I 'Total
Addition/alteration/re 1accment Other: New 1- & 2- family dwellings
p (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (I) bath 249.20
1 & 2- Family dwcllin n Commercial /Industrial SFR (2) bath _ 3 350.00
❑Accesso Buildin_ • Multi- Family M III _ SFR (3) bath M --- 99.00
aster Builder Other: Each additional bath/kitchcn 45 00
'JOB SITE INFORMATION and LOCATION Fire sprinkler - sq. ft. Pagc 2
Job site address: / /'/( Sv/.tr1RE9�Q // ' ' . site Utilities
Suite #: - I Bidg. /Apt. #: Catch basin/arca drain 16.60
Project Name: C'O/¢Cff Drywell /leach line/trench drain 16.60
rooting drain (no. linear ft.) Page 2 `
Cross strecl/Directions to job site: Manufactured home utilities 110.00
Aor sa.qE OF cs /E At Manholes 16.60
Rain drain connector 16,60
Sanitary scwcr (no. linear fl.) Page 2
Subdivision: I L t #: Storm scwcr (no, linear ft.) Page 2
fax map /parcel #: - Water service (rio. linear ft.) _ Page 2
DESGRIPIT ON :OF WORK F[xture or Item
Absorption valve 16.60
M / 9 /4 .,- I). ..ti /27/ %4 T, ON 4.-ii -,/, Backflow preventer Pale 2
y L e �„ 1 iznR / ____n- Backwater valve 16.60
Clothes washer 16.60
- Dishwasher _ 16.60
?,0 , , i . , +Y•O . •. i 1,10617..,..1 , Ejectors/sump fountain 16.60
E�cctors/sump 16.60
Name: - Expansion tank 1(.60
Address: Fixture/sewer cap 16.60
City /State /Zip: - --
Floordrain /floor sink/hub 16,60
Garbagc disposal 16.60
Phone: Fax: Hosc bib 16.60
'I 15 AP • ANT .: MN CONTACT•FERSON, lcc maker 16.60
Name: Interceptor /,grease trap 16.60
Address: Medical gas - value; $ Page 2
Cit City/State/Zip: Primer 16.60
Y p _. .- Roof drain (commercial) 16,60
Phone: I Fax: Sink/baiti avator / 16.0)
E -mail: '1'ub /showcr /showcr pan 16.60
CONTRACTOR . ' Urinal 16.60
Business Name: pf r p`!/I1f6 ' s • -... Water ck et / 16.60 =
Water heater ) 1 G.GO
Address: s 1/403 �P /✓• /9/�/.�/,4/4 41/� Other;
City /State /Zip: fb/[.77 -44/0 Afg 1'72- f 7 other: PlumhluR Permit Fees*
-
Phone :03 i s2_ -Di Fax: 3D3 zd-e -)G
CCB Lic. #: Plumb. Lic. #: z 2 b - PD subtotal $
��� 3
minimum Pcrntit Fcc $72.50 S '7 Z • -i
Authorised Residential Rackflow Minimum Fee $36.25
Signature: • Date: 7 `i_'O7 Plan Review (25% of Permit Fee) S ^----
State Surcharc (8% of Permit Fcc) , $ S,', D
(Please pnnt name) TOTAL PERMIT FEE $ 78.
Notice: This permit application eiplres Ifa permit Is not obtained within Ali new commercial buildings require 2 sets of plans with isometric or
IRO days after It has been accepted as complete. riser diagram for plan review.
'Fee methodology set by'L•ri- County Building Industry Service Board -
i:\DstslPennit FurmsWlrnPermitApp.doc 01/03
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: PLM2007 -00418
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/14/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 'I �..
INSPECTION WORKSHEET FOR DATE: 9/21/2007 TIME: 7:00AM PAGE: 29
SITE ADDRESS: 09689 SW WASHINGTON SQUARE RD C CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: COACH
DESCRIPTION: Replace existing fixtures.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: D & F PLUMBING PHONE #: 503-2810993
Inspection Request Scheduled For: Date: 9/21/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 056102 -01 503 -282 -0993 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
'Inspector: hrn.-A Date: 91 DA, [07 Phone #: (503) 718-