Permit . t/t//
U
Y OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT PERMIT #: PLM2007 - 00118
TIGARD - . _ 13125 SW- Hall - Blvd., Tigard, OR - 97223 - 503.639.4171 DATE ISSUED: 3/26/2007
PARCEL: 2S 110DB -01200
SITE ADDRESS: 15280 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: PP1996 - 010 LOT: 001 JURISDICTION: TIG
PROJECT: DEZFULLI USED AUTO SALES
Project Description: Site utilities. Other fixture: (1) rain drain connector.
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS; TRAPS:
STORIES: WATER HEATERS: CATCH BASINS: 3
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 1
TUB /SHOWERS: SEWER LINE: 225 ft •
WATER CLOSETS: WATER LINE: 200 ft
DISHWASHERS: RAIN DRAIN: 150 ft
Owner: FEES
DEZFULLI, SHAHIN + EBRAHIM
12587 SW 133RD _ Description Date Amount
TIGARD, OR 97223 [PLUMB] Permit Fee 3/26/2007 $417.00
[TAX] 8% State Surcha 3/26/2007 $33.36
Phone : Total $450.36
•
Contractor:
CAMPBELL PLUMBING + HEATING
14755 SE 232ND DR.
BORING, OR 97009 REQUIRED ITEMS AND REPORTS
Contact # : PRI 658 -3137
FAX 503- 658 -5167
Reg #: LIC 154148 •
PLM 3 -426PB
•
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 OAR952- 0001 -0100. You may obtain copies of
these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issu d By �_ r / Permittee Signature:
f
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.
i Li 1 T 3
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Plumbing Permit Armlic ioly , - � - roli Orrice l sr ()\L\ c. / 1
City of Tigard Ld '! �`
P ° / it No' 7 - 001
:� V 13125 SW HaII Blvd., Tigard, OR, 9 3 ca '" , N B ��f ( II Phone: 503.639.4171 Fax 503��984980 Date/By. Other Permit No.:
Inspection Line: 503.639.4175
T l G A I- U �' (� 1„ !�^ Date Ready/By. 1mn RI See Page 2 for
Internet: www.tigard-or.gov -r,. , Noted/Met
ifihod Supplemental Information
TYPE OFWTt7Cp30 T FEE* SCHEDULE
New construction ❑ Demolition For speda/ Information ase checklist.
Description I Qty. I Ea I Total
❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 24920
❑ I- and 2- family dwelling Et Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
❑ Master builder Each additional bath/kitchen 45.00
❑� Fire sprinkler ( sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: /67P/re) 13�. ,, Catch basin or area drain 3 16.60 , Y
City /State/ZIP: T e.Tp (L �, p p .p 1 .1 o Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2
Cross street /directions W job site: 814 -oft A J 4eV E. Manufactured home utilities 110.00
w �� Manholes 16.60
e€1-) (kW �l l Q Lc\ �.0 r, L .cram -� Rain drain connector I 1 16.60 � 1 lop °' fk Q 3$ �er Sanitary sewer (no. linear R: _) 115 Page 2 / 7, Ye,
Storm sewer (no. linear ft: _J 44)0 Page 2 / p/ r yp
ft
linear vi
t
aer service (no. near .: Page 2
Subdivision: I Lot no.: W i$D 8 !D 1.4/0
Fixture or item
Tax map/parcel no. : 122 Q1)
0 25 , I ) Absorption valve 16.60
DESCRIPTION OF WORK • Back flow preventer Page 2
puivsE. " S iT 6 %)- ( yz 6Zme&T Backwater valve 16.60
F eka( /O J SiT6 pA . f 7 AJ(,, / ,ik S it Clothes washer - 16.60
&j 4 I S I ec i -p(-b1/416---ut.bert.612D Dishwasher 16.60
M PROPERTY OWNER I ❑ TENANT Drinking fountain 16.60
Ejectors/sump 16.60
Name: A$E PeLi I4 -I Expansion tank 16.60
Address: C 2 7- 6u3 l 31 v-i) lik16 Fixture/sewer cap 16.60
City/State/ZIP: ' f-'104, Q -27-. Floor drain/floor sink/hub 16.60
Phone: ( ) l Fax: ( ) Garbage disposal 16.60
ST APPLICANT ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: M,O a _ -y T .�}6ZcIP ef' % Interceptor /grease trap 16.60
Contact name: - , R�1/L� Medical gas (value: $ ) Page 2
Address: R (3, i07c 1 3 t s" Primer 16.60
City/State/ZIP: Ep0.4.1 0- ell- g C5::) Roof drain (commercial) 16.60
Phone: (503) y e B: J I Fax: : (,Sa3) ( � y --4 3$ Sink /basin/lavatory 16.60
' v ,� S Tub/shower/shower pan 16.60
E-mail:
p45 lMo it ) i -ri i c.. i 6:=AA Urinal 16.60
CONTRACTOR closet 16.60
Business name: , Water heater 16.60
OVA 4 f.�'S ki /J lam (' Address: / Li• ? S , 7 `�t� . Other:
city/State/ZlP: \ subtotal
�,�n�S0 9 " 1 O Q' /
7` ).6 s) 3 .? Fax: (S7 C 8' /t\ Residential backflow Minimum permit fee: $72.50
I ) ` �� dkflow minimum permit fee: $36.25 ��
Phone:9
CCB Lic.: 1 5 Li ( so Plumbing Lic. no.: 3 - 112G p13 Plan review (25% of permit fee)
/ 1 State surcharge (8% of permit fee) 3
Authorized signatu • : / f .0
✓ _ � . TOTAL PERMIT FEE
Print name: ► tk b . ` ngtalli Date: - - l This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
� �
*Fee methodology set by Tri-County Building Industry Service Board.
IABuildingTami -Pami pp.d 06/26(06 440.4616T(1u02/COM/W®) i► /O i.0--..
uM S i r
Plumbing Permit Application - City of Tigard ,
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - 1 ° 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
Sewer - 1st 100' 55.00 3,601 to 7,200 • $220.00
/ 4 j 5 7,201 and greater $309.00
Sewer - each additional 100' Z 46.40 A- 80
Water Service - 1st 100' / 55.00 pry Medical Gas Systems:
Water Service - each additional 100' / 46.40 [/(,,1.4J Valuation: Permit Fee:
Storrs & Rain Drain - 1st 100' / 55.00 7 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' / 46.40 .y 0 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
Fixture or Item Qty. Fee (ea) Total additional $100.00 or fraction thereof to and
including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Back flow Prevention Device each additional $100.00 or fraction thereof to
(minimum permit fee $36.25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
each additional $100.00 or fraction thereof; to
Inspection of existing plumbing or and including $50,000.00.
specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
Subtotal: L'0 each additional $100.00 or fraction thereof
Fixture Work: Plan Review for Plumbing Installations
Are you capping, adding or replacing fixtures? If "yes", Plan review is required for any of the following.
please indicate work performed by fixture. Failure to Please check all that apply.
accurately report fixtures could result in increased sewer fees *. ❑ Any new commercial building with water service 2" and
QaantitY by (Fixture) Work Performed greater, except systems designed and stamped by licensed
Fixture Type: Replace engineer.
Previous Capped Added Existing ❑ New exterior plumbing site utilities for any complex structure •
Baptistry/Font as defined in OAR918- 780 -0040.
Bath - Tub/Shower ❑ Medical gas and vacuum systems for health care facilities.
- Jacuzzi/Whirlpool ❑ Any multipurpose fire sprinkler system.
Car Wash - Each Stall ❑ Any complex structure as defined in OAR918- 780 -0040.
- Drive Thru
Cuspidor/Water Aspirator Submit 2 sets of plans with any of the above.
Dishwasher -Commercial
-Domestic
Drinking Fountain Isometric or Riser Diagram
Eye Wash ❑ Isometric or riser diagram is required for new buildings
Floor Drain/sink - 2" that meet the qualifications above.
-3"
Car Wash Drain Comments regarding fixture work:
Garbage -Domestic _
Disposal -Commercial
industrial
Ice Mach./Refrig. Drains
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall *Note: If the fixture work under this permit results in an
Sink - Bar/Lavatory increase of sewer EDUs, a sewer permit will be issued and
- Bradley fees assessed for the sewer increase must be paid before the
-Commercial
- Service plumbing permit can be issued.
Swimming Pool Filter
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal •
Other Fixtures:
i:u id u m a'PLM -r«,o p.doc 0W22ne
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00118
I I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/26/2007
Phone: (503) 639 -4171 / u�qur�
Inspection Requests (24 Hrs.): (503) 639 - 4175 `'I L
INSPECTION WORKSHEET FOR DATE: 4/6/2007 TIME: 7:04AM PAGE: 13
SITE ADDRESS: 16280 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: PP1996.010 LOT #: 001 TYPE OF USE:
PROJECT NAME: DEZFULLI USED AUTO SALES
DESCRIPTION: Site utilities. Other fixture: (1) rain drain connector.
OWNER: DEZFULLI, SHAHIN + EBRAHIM, PHONE #:
CONTRACTOR: CAMPBELL PLUMBING + HEATING PHONE #: 6583137
Inspection nsp Request Scheduled For: Date: 4!612007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
340 Storm drain 046123 -01 503-784 -8157 Y
Corrections /Comments /Instructions:
See j41.9 b p 1 41 b S j
j 4 PASS . PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V " n�" > �� " Date: y) L Jo-7 Phone #: (503) 718-
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: PLM2007 -00118
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/26/2007
Phone: (503) 639 -4171 41 41hlii li
Inspection Requests (24 Hrs.): (503) 639 -4175 `:_..
INSPECTION WORKSHEET FOR DATE: 3/30/2007 TIME: 7:00AM PAGE: 43
SITE ADDRESS: 15280 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: PP1996 - 010 LOT #: 001 TYPE OF USE:
PROJECT NAME: DEZFULLI USED AUTO SALES
DESCRIPTION: Site utilities.
OWNER: DEZFULLI, SHAHIN + EBRAHIM, PHONE #:
CONTRACTOR: CAMPBELL PLUMBING + HEATING PHONE #: 6533137
Inspection Request Scheduled For: Date: 3/30/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
505 Sanitary sewer 045722 -01 503-784 -8157 N
Corrections /Comments /Instructions:
•
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: CA h.-A ) I) ma_ Date: A130/10 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION _ PERMIT #: PLM2007 -00118
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/26 /2007
Phone: (503) 639 -4171 41
Inspection Requests (24 Hrs.): (503) 639 -4175 .�' `'I �..
INSPECTION WORKSHEET FOR DATE: 6/5/2007 TIME: 7:01AM PAGE: 20
SITE ADDRESS: 15280 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: PP1996 - 010 LOT #: 001 TYPE OF USE:
PROJECT NAME: DEZFULLI USED AUTO SALES
DESCRIPTION: Site utilities. Other fixture: (1) rain drain connector.
OWNER: DEZFULLI, SHAHIN + EBRAHIM, PHONE #:
CONTRACTOR: CAMPBELL PLUMBING + HEATING PHONE #: 658 - 3137
Inspection Request Scheduled For: Date: 6/5/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water service 049616.01 503. 784 -8157 N
Corrections /Comments /Instructions:
11PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /17 'LI/a Date: / Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: PLM2007 -00118
13125 SW Hall Blvd., Tigard, OR 97223 4 DATE ISSUED: 3/26/2007
Phone: (503) 639 -4171 Ai 11 i�
Inspection Requests (24 Hrs.): (503) 639 -4175 �
INSPECTION WORKSHEET FOR DATE: 7/9/2007 TIME: 7:02AM PAGE: 29
SITE ADDRESS: 15280 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: PP1996.010 LOT #: 001 TYPE OF USE:
PROJECT NAME: DEZFULLI USED AUTO SALES
DESCRIPTION: Site utilities. Other fixture: (1) rain drain connector.
OWNER: DEZFULLI, SHAHIN + EBRAHIM, PHONE #:
CONTRACTOR: CAMPBELL PLUMBING + HEATING PHONE #: 658 -3137
Inspection Request Scheduled For: Date: 7/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 051632 -01 503.784 -8157 N
Corrections /Comments / Instructions:
440 _
dr
PA SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: #: (503)
p DIN, �� Date: � � Phone ( ) 718-
�� , / $)(
, ,;\ ' : 4) 0i jck5)
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BUILDING PERMIT APPLICATION ' TIGARD DATE 's t ' ,19 , 4109
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOI' Ti ;E WORK HEPEIN INDICATED BUILDER PHONE __ j. 9-L1 }
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
T taT NO ''I C;
OWNER 3o rs Llit.o _ - JOB ADDRESS 15284 S.W. Pacific Sig war. .
- -- ARCHITECT
ENGINEER
BUILDER ; . u . . ADDRESS DESIGNER
STRUCTURE L, NEW L REMODEL 0 ADDITION J REPAIR 0 RENEWAL ❑ FIRE DAMAGE I Q DEMOLITION
l" RESIDENCE 0 COMM LT, EDUCATIONAL 0 GOV'T ❑ RELIGIOUS U PATIO ❑ CARPORT 0 GARAGE 0 STORAGE 0 SLABL. FENCE
OCCUPANCY LAND USE ZONE __ _ BLDG. TYPE FIRE ZONE PLAN CHECK BY _ HEAT
e. LI o v e existin buildin,s fro;:; Tax Lot `iti4 ail is code.
:t" line ac Dropertl 1in•: a,: purun and i.i11 existing septic Lank..
.•r "hate i.ode.
SEWER PERMIT IS ca1I. for lr.ap. izhen c °.nap1otcl _
OCC. LOAD FLOOR LOAD HEIGHT NO. STORIES _ AREA NO. BEDROOMS VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub -total RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
State Tax
SDC — t
Total 1 . . 0 ; . .
' PDCN APPLI6ANT OR AGENT
By
� t ,
Approved t ., a I ± e . Receipt ; 05� ADDRESS PHONE