Permit .4 CITY OF TIGARD
i , DEVELOPMENT SERVICES SEWER CONNECTION
- ...— 1 3125 SW Hall Blvd.,Tigard,OR97223 (503) 639 -4171 PERMIT #PERMIT o SWR98-0035
DATE ISSUED: 04/03/98
PARCEL: 1S134BC -00600
SITE ADDRESS. ..:1239O SW SCHOLLS FERRY RD
SUBDIVISION •MLP93 -0006 ZONING: C —G
BLOCK LOT •002 JURISDICTION: TIG
TENANT NAME •PACIFIC CAR WASH
USA NO • FIXTURE UNITS...: 29
CLASS OF WORK... :NEW DWELLING UNITS..: 2
, TYPE OF USE •COM NO. OF BUILDINGS: 0
INSTALL TYPE •BUSWR IMPERV SURFACE: 0 sf
Remarks: Construction of a 1,948 square foot car wash automated car wash facilit
y.
Owner: FEES
THOMPSON & DAVIDSON LEASE type amount by date recpt
12475 SW MAIN STREET PRMT $ 4400.00 B 04/03/98 98- 304649
TIGARD OR 97223 INSP $ 45.00 B 04/03/98 98- 304649
Phone #:
Contractor:
OWNER
Phone #: $ 4445.00 TOTAL
Reg #.. .
REQUI RED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspecti
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a °Tap and Side Sewer' Permit and the Agency will install a lateral.
ATTENTION: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR
952-001 -0010 through OAR 952 - 0001-0080. You may obtain copies of
these rules or direct questions to OUNC by calling (503)246 -1987.
Issued by: • • / QAr` Permittee Signature Al /i`--
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
IF' IGARD Recd By
Commercial Building Permit
1 31,5 S H ALL BLVD. T enant Improvement Date Recd
TIGARD, OR 97223 Date to P.E.
Date to DST
(503) 639 -4171 Permit* ( 71.0 e - :) 3S
Print or Type Related CUIWA1 - A . F)w,
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Existing Building ❑ New Building ❑
Job - PaCACAc C:-, k
Address Street Address Suite Building
I7,3,'0 �-o <1 l :,ce,rf.- 0 Data
Bldg # City/State , �� zi 77 p Existing Use of Building or Property:
1 t-n'r� 49I`�y JY2. "a
Name J
Property Proposed Use of Building or Property:
Owner Mailing Address Suite
No. Of Stories:
City/State Zip Phone
Sq. Ft. Of Project
Occupant Name
_ _ - . Occupancy Class(es)
Name
, Contractor Type(s) of Construction
• Prior to permit Mailing Address Suite
issuance, a copy Will this project have a Fire Suppression System?
of all licenses Yes ❑ No ❑
are required if City /State Zip Phone Americans with Disabilities Act (ADA) in C.O.T. ( )
database Valuation X 25% = $ Participation
Oregon Const. Cont. Board Lic.# Exp. Date Complete Accessibility Form
Project $
Name Valuation
Architect Plans Required: See Matrix for number of sets to submit
Mailing Address Suite on back
City/State Zip Phone I hereby acknowledge that I have read this application, that the information
given is correct, that I am the owner or authorized agent of the owner, and
Engineer Name
that plans submitted are in compliance with Oregon State Laws.
Signature of Owner /Agent Date
Mailing Address Suite
Contact Person Name Phone
City/State Zip Phone
FOR OFFICE USE ONLY
Indicate type of work: New 0 Addition 0 Demolition 0 Map/TL# Land Use:
Accessory Structure 0 Foundation Only 0 Alteration 0
Repair 0 Other 0 Notes:
Description of work:
TIF:
i Parks: Estimated # of Employees
I
te: Site Work Permit Application must precede or accompany Building
rmit Application
'COMNEW.DOC (DST) 8/97
"Iir
,. ,.... i
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
DISTRIBUTION TO PLANS OUT TO DST
EXAMINERS (Note a.)
TYPE OF SUBMITTAL TOTAL CPE PPE EPE CPE PPE EPE
SITE 1 1 -- -- 3 (j,o,u) -- --
B (New or Add) 1 1 -- -- 3 (j,o,w) -- --
F (New or Add or Alt.) 3 3 -- -- 3 (j,o,f)
M (New or Add. or Alt) 1 1 -- -- 2 (j,o) -- --
B & M (New or Add) 1 1 -- -- 3 (j,o,w) -- --
P (New, Add. or Alt) . 2 - - -- 2 -- -- 2(j,o) --
B & M & P (New or Add.) 2 1 1 -- 3 (j,o,w) 2(j,o) --
E (New, Add, or Alt) 2 -- -- 2 -- -- 20,0)
B & M & P & E (New, Add) 3 1 1 1 3 (j,o,w) 2(j,o) 2 (j,o)
:flB & . Alt <:._,
:B % &:
_-•
.&:i:P: A it
B . :&: M 8 c F.� E , ......3 - ..:.... I . '.-;:::::::,.t.:' < - ..;. ... .... :�� . � °`��� ��
NOTES: KEY
a. Before returning to DST, Plans examiner gets appropriate j = Job B = BUP
number of revised plans from applicant, stamps and completes, o = Office M = MEC
updates and adds actions. f = Fire P = PLM
u = USA E = ELC
b:. :;Shadedi eas des *gnate a sv ittls :,:::> ::: ;' :::.:.....:;.:< ' '.:: w= Wash. County F = FPS
c. FPS is a new permit category set aside for fire sprinklers and fire alarms.
d. Effective August 15, 1997, Tualatin Valley Fire and Rescue no longer requires a set of
approved plans to be forwarded to their office.
Exception, continue to forward a copy of approved fire sprinkler and fire alarm plans with
calculations.
h:Vmatnc.Doc
,� ��� Accumulative S er Tally
Tenant [Tame? c C GW 1/�/��:k This SWR# qh — 003S
Address: 17, St,L) S y IA • This PLM#: G (b — 10
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
- Jacuzzi/Whirlpool 4
Car Wash - Each Stall 6
- Dnve Through 16 ( ' (Q ( ( (o
Cuspidor/Water Aspirator 1
Dishwasher - Commercial 4
- Domestic 2
Drinking Fountain 1
Eye Wash 1
Floor Drain /sink - 2 inch 2
-3inch 5 1 S
- 4 inch 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 — ' 2 I Z
- Bradley 5
- Commercial 3
- Service 3
Swimming Pool Filter 1
Washer - Clothes 6
Water Extractor 6
Water Closet - Toilet 6 ) to / (p
Urinal 6
TOTALS 71I
Total fixture values: 7 1I divided by 16 = L' ) Z EDU �� -
HISTORY
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
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