Permit fr
ilk, CITY OF TIGARD PLUMBING PERMIT
4g l4 DEVELOPMENT SERVICES PE
DEVELOPMENT PLM2000 -00137
£` 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 05/04/2000
SITE ADDRESS: 10145 SW WASHINGTON SQUARE RD ad PARCEL: 1S135BA -00102
SUBDIVISION: OAKBURG ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; 6 TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB /SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Remove and replace two (2) 2" and four (4) 3" floor drain /floor sinks within an existing tenant space.
FEES
Owner:
Type By Date Amount Receipt
PPR SQUARE TOO LLC PRMT KJP 05/04/200C $69.00 0001912
BY MACERICH COMPANY 5PCT KJP 05/04/200C $5.52 0001912
ATTN: JANET FISHER, ASSET MGMT
SANTA MONICA, CA 90407 Total $74.52
Phone 1:
Contractor:
APOLLO DRAIN + ROOTER SERVICE ,
2208 NW BIRDSDALE #8
GRESHAM, OR 97030 REQUIRED INSPECTIONS
Phone 1: 239 -8801 Rough -in Insp
Underfloor /Underslab
Reg #: LIC 00049418
Top -out Insp
PLM 26 -533pb
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 ies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Issued By: Permittee Signature: 2
Call (503) 639 -4175 by 7:00 P.M. for an inspection neede a next business day
CITY OPTIGARD Plumbing Permit Application Plan Check#
13125 SW HALL BLVD. Commercial and Residential Rec'd By
TIGARD, OR 97223 Date Rec'd
(503) 639 -4171 Date to P.E.
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit # RCM ROW - et)/3 - 7 -
Related SWR #pZD6Q -oo0 3
Called
la of De Iopment/Project FIXTURES (individual) QTY PRICE AMT
Job I b % ( . % LA Cby S Sink 11.50
Address Street Address l Suite Lavatory 11.50
/O/5< 1.%S Sr{ a f Tub or Tub /Shower Comb. 11.50
Bldg # City/State Zip Shower Only 11.50
C
Name ` ,-r1 Water Closet 11.50
FM S Tana Too L("I2 Urinal , 11.50
Owner Mailing Address Suite Dishwasher 11.50
Garbage Disposal 11.50
City/State Zip Phone Laundry Tray 11.50
Washing Machine /Laundry Tray 11.50
Name ✓ r/ ' PI97 5 Floor Drain/Floor Sink 2" .Z. 11.50 2?
Occupant Mailing Address / Suite 3" .// 11.50 Vac()
4" 11.50
City/State Zip Phone
Water Heater 0 conversion 0 like kind 11.50
t` Gas piping requires a separate mechanical permit.
Name 'S 4pca-0 ) 9 MFG Home New Water Service 32.00
Contractor Mailing Address / Suite /`��' MFG Home New San/Storm Sewer 32.00
. 1 ) 08 Se JP, r,5i/4Le, Hose Bibs 11.50
Prior to permit City/State Zip Phone Roof Drains 11.50
issuance, a copy ('e 5b.4110-" q) a(00
Drinking Fountain 11.50
of all licenses are Oregon C nt. Board Uc.# Exp. Date
required if 4 U_ , " j "-0/ A Other Fixtures (Specify) 15.00
expired in COT Plu ing Lic. # 553p(f Ex . Da I ,
database m - ID 13 `'
Name
Architect Sewer - 1st 100' 38.00
or Mailing Address Suite Sewer - each additional 100' 32.00
Water Service -1st 100' 38.00
Engineer City /State Zip Phone Water Service - each additional 200' 32.00
Describe work to be done: Storm & Rain Drain - 1st 100' 38.00
New 0 Repair 0 Replace w'th - like kind: Yes A' No 0 Storm & Rain Drain - each additional 100' 32.00
Residential 0 Commercial P
Additional description of work: Commercial Back Flow Prevention Device 32.00
� Residential Backflow Prevention Device' 19.00
eye 4 7 j / ,.� . i n hh),- ,0/'G � , � 1(0 ( - n C 0/ 4 e Catch Basin 11.50
Ar you capping, mcg,Arfrreplacing any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00
Yes No 0 Inspections per/hr
If yes, see back of form to indicate work performed by Rain Drain, single family dwelling 45.00
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL
I hereby acknowledge that I have read this application, that the information Isometric or riser diagram is required if Quantity Total Is > 9
given is correct, that I am the owner or authorized agent of the owner, and "SUBTOTAL // /
ans submitted are in compliance with Oregon State Laws. Cp
Sig of Ovyger /Age Y70
/�v 8% SURCHARGE �•
ontact Person Phone 7
- 10 rCk .,234_ ee0/ *"PLAN REVIEW 25% OF SUBTOTAL
L 1tr' , ; 7 0O Required only if fixture qty total is > 9
Q1 S lti i TOTAL
O'er 285.00. F i
( c des tin . umbiDg f'r:COCtill aDdw li i g and the (1.; *Minimum permit fee is $50 + 8% surcharge, except Residential Backflow Prevention
r ' ' 3, GA QW) 4 ,) Device, which Is $25 + 8% surcharge
"All New Commercial Buildings require plans with isometric or riser diagram and
plan review.
IAdstsVorms\plumapp.doc 11/18/99
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved I Replaced Removed /Capped
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet
Urinal
Dishwasher
Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain /Floor Sink 2"
3" 7
4"
Water Heater
Other Fixtures (Specify)
•
COMM NTS REGARDING ABOVE:
I:ldstsformslplumapp doc 11/18/99
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
, � j - BUP
Date Requested r C� AM PM BLD
Location /rs /ys -Cc?) Suite MEC
Contact Person Ph PLM .. 261.7° - 6(5 (37
Contractor Ph SWR
BUILDING 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 df4f.,/. A L . / _ 1.��� �� ! - L ��
Fire Alarm :I - /e
Susp'd Ceiling - - - a
Roof
Misc:
Final
PASS PART FAIL
LUMBINN
Post & Beam
_ Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
4I ''
A = 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 Other Date 57 o Inspector � ` Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.