Permit CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2019-00138
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ' Date Issued: 04/22/2019
IPc : 8101 BC00700
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Jurisdiction: Tigard
Ti and
Site address: 12280 SW HALL BLVD
Project: Just Compassion Subdivision: KNOLL ACRES Lot: 2
Project Description: CAP(1)tub/shower, (1)domestic dishwasher;ADD(1)commercial dishwasher, (2)2"floor drains, (1)2"floor sink,
(1)shower stall, (1)lay, (1)hand wash sink, (1)water closet; RELOCATE(1)garbage disposal, (2)lays, (1) laundry
sink, (1)clothes washer and (2)water closets. 8/1/2019: REPRINTED permit to include(1)sump pump.
Contractor: Owner: GHAFFARI,ZABI & FARIBA M
15580 SW SNOWY OWL LN
BEAVERTON, OR 97007
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Clothes Washer 04/22/2019 $25.02
Specifics: 1 ea Dishwasher 04/22/2019 $25.02
1 ea Ejectors/Sump 04/22/2019 $25.02
Type of Use: COM 2 ea Fixture/Sewer Cap 04/22/2019 $50.04
Class of Work: ALT 3 ea Floor Drain/Floor Sink/Hub 04/22/2019 $75.06
Type of Const: 1 ea Garbage Disposal 04/22/2019 $25.02
Occupancy Grp: 1 ea Hose Bib 04/22/2019 $25.02
Stories: 1 ea Ice Maker 04/22/2019 $12.51
1 ea Interceptor/Grease Trap 04/22/2019 $25.02
1 ea Primer 04/22/2019 $12.51
1 ea Sink 04/22/2019 $25.02
1 ea Laundry Tray 04/22/2019 $25.02
3 ea Lavatories 04/22/2019 $75.06
1 ea Tub/Shower/Shower Pan 04/22/2019 $12.51
3 ea Water Closet 04/22/2019 $75.06
1 ea Water Heater 04/22/2019 $37.52
Total $788.36
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 041.410 Permittee Signature:
- 4050
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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.
Plutibing.Perniit Application
Building Fixtures RECEIVED .>9 (amCE LSE ONLY
City of TigltCti i tYccetsed
13125 SW Hall Blvd.,Tigard,OR 9722, r R 0 4 2019 Pta.t'Ke<,e.r y//� �V ' ernat N L/�l/�/�.- / (2
i 13.:• Phone: 503.71$2439 Fax:> 503.598.1..a DarcBy -19-1 q 0. Chhcr Permit-` !t/,4 -oe r �j
Inspection Line: 503.639.4175 �fd�/c UDS I
-1.G A i.l') CITY OF TIGARD P Date Ready/By: „Act_ ,nm: RI seer' a 2.for
Internet: www.aigard-or.gov �f ! '
ILDING DIVISION Nutif rted>od: sr aemeaatiaformatba
or W /e_L'eeit 5FEE.santieLE
❑New construction 0 Demolition For special information use checklist
Description 1 Qty. 1 Ea. 1 Total
aeAddition/alte tion/replaceanent 0 Other: New I-24aan y dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR I i bath 312.70
0 1-and 2-family dwelling �Cottunercial/iruhrstriaG SFR(2)hath 437.78
I
❑Accessory building 0 Multi-family SFR.(3)bath 500.32
0 Master builder
+ Each additional bath4citchen 25.02 ,
0 O her: Fire sprinkler( sq.fl.) Page 2
.108 SITE INFORMATION AND LOCATION r.Site utilities:.
_
Job site address: tZ24310 SW µq 1t c{\., l I 0.,x,1 Catch basin or area drain 1816
�l Drywell,leach line,or trench drain 18.76
City/State/ZIP: T\4�V.6 off. T1 Z
J / Footing drain(no.linear It.: ) Page 2
Suite/bldg./apt.no.: 1 Project e (sS ( b 1 name. S Civ Manufactured home utilities 50.03
Cross street/directious.to job site: 5 4 Kip p ii 51-, Manholes 18:76
Rain drain connector 18.76
re v ��� r_ Sanitary sewer(no.linear 8::_) Page 2
' "dort CI ',SCS Storm sewer(no.linear ft.:_) Page 2
Water service(no.Linear ft.:. ) Page 2
Subdivision: I Lot no.: Fixture or item-
Tax map/parcel no.: BackflauPceventer 31,27
1JESCRIP ITON OF•WOR Backwater valve 12.51
Clothes washer 1 25.02 (3 a
e etre, it }"L l/U(DO'r'14 J J✓ I �., 1/ Dishwasher . 25.02 �j C)il
6�1 i, S e IA)r�1"M`r:"l Tl •e-C',,CJ�, o�:f�,� crje Drinking fountain 25.02
i
tel" '£. ,4 A P Y'S Ejectorsisump j 25.02
L S .``fin. ,5.va.
J PROPERTY OWNER 0 TENANT Expansion tank 12.51
Name: V 1454- Cdtf.Mir Fixture/sewer cap �'+ 25.02 5t).(,tt {'`' FEbor drain/floor sink/hub3 25.02Address: 1ZZ�0 SVIr
Garbage disposal i ✓ 25.02 .25/tl`,�
City/State/ZIP: d f V,p�may/ o i? q)2 2 3 Bose b 25.02
I , 25,02
Phone:( )Fax:
( ) Ice maker /,J /1G'G. 12.51 :1 /g, s
0 APPLICANT i g..,COPITACI'PERSON 5 Interceptor/grease trap f 25.02
Business name: Q t - Ft V t,,,\Nji yt et Medical gas(value:S ) Page 2
Contact name: .S Alm0.A v. G Primer 12.51 j . 5 I
K Roof drain(commercial) 12.51
Address: "'7C. Z se_ A.f6fA Stnk.1asin/lavatory 25.02 /.2 5.10
City/State/ZIP: ci r •e S t.."`, A \ ;{j7r�, Solar units(potable water) 62.54
Phone:(11t) -t_- ".6 i Fax::( ) Tublsbower'shower pan 1 V 12.51 #9.,5 i I
E-mail:' 02-560 Urinal 25.02
`��CUN7
CONTRACTOR
Warty closet i � 25.02 ` IS. d
C ( � )� Water heater b ,i 37.52"j 39,52
Business name: u ICI t Ki t Yl.� Water t in /DWV 56.29
_ _ P�P� g
Address: -t �/�
�a L 5 k Tc,-,/b l�S� Other: 25.02
City/State/ZIP: A 04 ,j/ � 76 S 0 -- - Subtotal S..50443
Phone:(c 03) i 7,- D7 S- 6 Fax:( ) Minimum permit fee: 572.50
2 O 1 / Plan review (25%of permit fee) 139. 6 1
CCB Lic.: 1 111 ` Plumbing Lic.no.:
State surcharge(12%of permit fee) . t 6.05
Authorized signaiur: M{-
� - A(i�/}^.02XG TOTAL PERMIT FEE 175'4 elI
Print nante: ,K i„,_ A t'e-r AVS CJ-e r Date 3/2 j ei T1ss per>ot appbc Raerm&Las beta accepted as completed whbt r80 dry s
/ *Fee methodology set by Tri-Camty Building lockstry Service Board.
I:;Duilding'Pem scs\PLMU-l'rmaApp.dne 1041:19 .410-4616111U•0zCOYLWF1tj
tilitil/I ci ,1 3/1.g7 '
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT Permit#: PLM2019 00138
T f+G A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/22/2019
Parcel: 2S 101 BC00700
Jurisdiction: Tigard
Site address: 12280 SW HALL BLVD
Project: Just Compassion Subdivision: KNOLL ACRES Lot: 2
Project Description: CAP(1)tub/shower,(1)domestic dishwasher;ADD(1)commercial dishwasher,(2)2"floor drains, (1)2"floor sink,
(1)shower stall, (1)lay, (1)hand wash sink, (1)water closet; RELOCATE(1)garbage disposal, (2)lays, (1)laundry
sink, (1)clothes washer and (2)water closets.
Contractor: Owner: GHAFFARI,ZABI & FARIBA M
15580 SW SNOWY OWL LN
BEAVERTON, OR 97007
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Clothes Washer 04/22/2019 $25.02
Specifics: 1 ea Dishwasher 04/22/2019 $25.02
1 ea Ejectors/Sump 04/22/2019 $25.02
Type of Use: COM 2 ea Fixture/Sewer Cap 04/22/2019 $50.04
Class of Work: ALT 3 ea Floor Drain/Floor Sink/Hub 04/22/2019 $75.06
Type of Const: 1 ea Garbage Disposal 04/22/2019 $25.02
Occupancy Grp: 1 ea Hose Bib 04/22/2019 $25.02
Stories: 1 ea Ice Maker 04/22/2019 $12.51
1 ea Interceptor/Grease Trap 04/22/2019 $25.02
1 ea Primer 04/22/2019 $12.51
1 ea Sink 04/22/2019 $25.02
1 ea Laundry Tray 04/22/2019 $25.02
3 ea Lavatories 04/22/2019 $75.06
1 ea Tub/Shower/Shower Pan 04/22/2019 $12.51
3 ea Water Closet 04/22/2019 $75.06
1 ea Water Heater 04/22/2019 $37.52
Total $754.09
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
OP
Issued By: •: mittee Signature: O \,01.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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.
Phisibing.rermit* Application
Building Fixtures RECEIVED FOR t)Eric-, 1 'SF i 1N1 \
City of Tigard Received z„,Am,,
Dales , 7Arf/ 4All,-;,;ii. 'enniiN9et/g-7 / 9-e9o/_cp
13125 SW Hall Blvd..Tigard.OR 9722 A 9 ip 0 4 zol9
Plan Review
Phone: 503.718.2439 Fax: 503.598c.I i'T',Pyt''OF
Lnspection Line: 503.639.4175 RD
Datg ReadyBy: a jy 1 ci 4, Juns: 1l Set Page 2 for
Internet: www.tigard-or.gov -TIGA aatelliv: 4--19-14i C)44 °therPcmit l'Witi+4920/9.--
VI SiON NotifiedAdethod- f I Supplemental Information
ItUiLDING DMSON ' . f
TYPE OF WOMIL illOptigfie-eftiZIS FEE* SCINDELE
El New construction 0 Demolition For special information use checklist
Description i Qty. 1 Ea. 1 Total
a/Addition/alteration/replacement 0 Other. New 1-2-tatittly dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
0 1-and 2-family dwelling M Commercial/industrial. SFR(2)bath 437.78
1 SFR(3)bath 500.32
0 Accessory building .0 Multi-family --'
Each additional bath/kitchen 25.02
0 Master builder 0 Other:
Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
I
Catch basin or area drain 18.76
Job site address: ‘LVO svJ pa‘k z\;...-)
Drywell,leach line,or trench drain 18.76
City/State/ZIP: "T\t cv6 oNit.., ii z Z
Footing drain(no.linear ft: ) Page 2
) , .
Suite/bldg./apt.no.: ,
I Project name: 11.9A Footing
Manufactured home utilities 50.03
Cross street/directions to job site: 5w I v.,0 i 5f, Manholes 1 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear R.: ) Page 2
= Storm sewer(no.linear ft.: ) , Page 2
Water service(no.linear ft.: ) , Page 2
Subdivision: Lot no.: Fixture or item:
Backflow preventer 3L27
Tax map/parcel no.:
Backwater valve 12.51
DESCRIPTION OF WORK
Clothes washer i 4,/' 25.02
u)e- CW 41(i(1,1. 2 tx+tioroovvis il, [ ei.A.ve\i)v-y ' Dishwasher t /' 25.02 5,02
1 6)17 ,1 5 , . ,
f,,,,,,,61,e, 1 j,,,...c. c„,..,
Drinking fountain25.02 I
Efr . i(,e;-);4 LA_ps.k--4,I'S 106L IA-4) Ejectors/sump i tei 25.02 1 5.0 a I
ix PROPERTY OWNER 9 TENANT Expansion tank 12.51
Name: 3, 4- Coo. ••7 Fixture/sewer cap
02.-- / 25.02 ; 50,414
Floor drain/floor sink/hub 3. ,, 25.02 05,0‘
Address: 2 ; • „.. \iv KIR )1/4/A
Garbage disposal 1 V 25.02 25,,el
City/State/ZIP: 1 (0 e4 OR 1)22 ' Hose bib )
I " 25.02 1 2 5.0 2
i
Phone:( ) Fax:( I 4 Ice maker // R..CC.. 1 V 12.51 La, s I
El APPLICANT Rg.CONTACT PERSON Interceptor/grease trap ( if 25.02 1,2 5,0,,
Medical gas(value:S ) Page 2 I
Business name: 4(Fr 1 IIWOOt in
' Primer ‘ 4/ 12.51 j,;1. 5 I
Contact name: ,.S AWlt S ?AA le CIS --, . Roof drain(commercial) 12.51
Address: --2 0 z_ gse.„ rip 06..to FA_ Aut.
J Sinklbashvgavatory 5-,,i 25.02 / 5,10
City/State/ZIP: CI ye 1,v kit& CD let Solarunits(potable water) 62.54
Phone:ell I) Lz.z.,L-49+1-6 I Fax::( )
iTub/showershower pan if 1 12.51 I a a S i
Urinal 25.02
E-mail: 01--%
Water closet 6' 25.02 1)5;(/6
CONTRACTOR "\
Water heater 1 i.lf 37.52 i 3 9 i 5
Business name: if C 7: 'Pt a_04 b i lit, itz.....
-.1 Water piping/DWV 56.29
Address: „. A1o e, Other 25.02 •
City/State/Lfpi_ ettelia.._ --/-O S 0 Subtotal s50.43
Phone:(S031 CT i a-- 07 C 6 I Fax:( ) Minimum permit fee: 572.50
Plan review (25%of permit fee) )39. 4,
CCB Lie.: 2,09 t to c , Plumbing Lie,no.:
State surcharge(12%of permit fee) 46.05
Authorized signatur(00m-La;COO-i24_,.. I TOTAL PERMIT FEE /rigy.acti
1 on
- slei (C{ Thispermit applicatiexpo
.'es Ka permit is not obtained within ISO days
Print natnet)eck, 1,4(.f....4$&KC)-e r trate..
after it has been accepted as complete.
*Fee methodology set by TO-County Building Industry Service Board.
Pnuddingreimarmou-reomuipprioe 10,01,09 440-46161(10 02.COM:WEB t
Plumbing'Permit Application City of Tigard
Page 2 -Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) ' Total i Square Footage: `Permit Fee:
Footing drain-,15 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 1 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service 1st 100' 62.54 Medical Gas Systems:
Water Service-each additional 100' 37.52
Valuation: Permit Fee:
Storm&Rain Drain-1st 100' 62.54 S I. o 55;000.00 Minimum fee$7250
Storm&Rain Drain-each additional 100' 37.52 S5,,03(C)11t.005 to$10,000.00 $72.50 for the fust 55,000.00 and$1.52 for
Other Inspections or Fees Qty. Fee(ea) . Totem ? each additional$100.00 or fraction thereof,to
and including$10.000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-112 hour) and including 525,000.00.
Inspections outside of normal business 1 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge--2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees I 90.00/hr and including$50;000.00.
Additional plan review for revisions . 90.00/hr ,, $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional$I00.00 or fraction thereof
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? if"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
Quail' by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/ Plan review isr wired for anyoffollowing.
Performed: lapped Added Relocate ixl the
Baptistry/Font Please check all that apply.
Bath -Tub/Shower 0 Any new commercial building with water service 2"and
Jacuzzi/Whiripool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru Q New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial j 0 Medical gas and vacuum systems for health care facilities.
-Domestic j fl Any multipurpose fire sprinkler system.
Drinking Fountain CI Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" 3 -°'„Z FL,--ng-.442-4-N Cj Submit 2 sets of plans with any(tithe above.
3,. N , I ' $iair(i
4.. Isometric or Riser Diagram
Car Wash Drain
Garbage Domestic-non-food 0 Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-industrial-food related A
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station 6/ /fi'/1/.6 4/eXff .S'/'✓/L- /1/----A)
Shower -Gang
-Stall I- `0- ) / 4471.-^43-12->" S(A✓// /2-6-7.-C. (_4---r-c.
Sink/Lav -Non-foodE+}+/related a, L . vr4$ 0� _-` ' - RSL
-Bradley PLA149./1= L) r2) i 'lb's /'L6-2-e('. TF-
Commercial-food related air Ar LR44/if
-Service 4 .."
Swimming Pool Filter *Note: lithe fixture work under this permit results in an
Washer-Clothes
Water Extractor 1 increase of sewer FDUs,a sewer permit will be issued and
Water Closet Toilet i 'L fees assessed for the sewer increase must be paid before the
Urinal 1 plumbing permit can be issued.
Other Fixtures:
/✓e% ' cert f Kru/-as
'
C:\Users\Owner\Downloads\PLMF_PernitApp(1).doc 2 vi^rwy 6j CO, 6'19 ,
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-
Dianna Howse ` " ( '`
From: Dianna Howse
Sent: Wednesday,April 17, 2019 3:47 PM
To: chrism@hbapdx.org
Cc: greg@olsonandjones.com;#Building Permit Technicians; Mark VanDomelen
Subject: RE:Just Compassion Permits Ready
Attachments: BUP2019-00064_JustCompassion.pdf
Hi Chris,
I also noticed that the building permit BUP2019-00064 is in ready to issue status so I have revised the list of permits/fees
below and attached a copy of the invoice so that Mark can include this in his presentation to council.
Thank you.
Dianna L. Howse
Building Division Services Supervisor
City of Tigard I Community Development
13125 SW Hall Blvd I Tigard,OR 97223
503-718-2430 Direct 1503-718-2439 Permits
From: Dianna Howse
Sent:Wednesday,April 17, 2019 3:35 PM
To:chrism@hbapdx.org
Cc:greg@olsonandjones.com;#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>; Mark VanDomelen
<markv@tigard-or.gov>
Subject:Just Compassion Permits Ready
Hello Chris,
The following permits are ready to issue and invoices are attached:
Permit# Fees Due
MEC2019-00214 $ 126.06
ELC2019-00222 $ 237.44
PLM2019-00138 $ 754.09
SWR2019-00099* $ 2,147.00
BUP2019-00064 $ 1,902.26
Total: $ 5,166.85
*Note: The sanitary sewer system development charges must be paid prior to issuance of the plumbing permit.
I have copied Mark VanDomelen, Building Official,on this email so that he has a list of the permit fees to present to
council for approval to waive building permit fees. Please note that system development charges for the sanitary sewer
permit cannot be waived as these are fees that we collect for Clean Water Services. Once we have approval to waive
permit fees,we will process a refund and mail a check to the payor of the permit fees listed above.
Permit fees can be paid online at https://aca.accela.com/TIGARD/Default.aspx by searching for the permit record
number under the Building tab,or in person when you pick up the permits Monday-Thursday,8:00 am to 4:00 pm. We
are closed on Fridays.
Thank you and please let me know if you have any questions.
Dianna L. Howse
Building Division Services Supervisor
City of Tigard I Community Development
13125 SW Hall Blvd I Tigard, OR 97223
503-718-2430 Direct 1503-718-2439 Permits
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail
may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained
by the City of Tigard in compliance with the Oregon Administrative Rules"City General Records Retention Schedule."
2