Permit 1 .
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C ITY OF TIGARD SITE WORK PERMIT
4 I : COMMUNITY DEVELOPMENT PERMIT #: SIT2007 -00017
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED : 6/26/2007
PARCEL : 2S110DB -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 work for new auto sales lot.
•
CLASS OF WORK: NEW PAVING ?: Y RESO. NO:
TYPE OF USE: COM GRADING ?: VALUE: 75,000.00
EXCV VOLUME: 10 cy LANDSCAPING ?:
FILL VOLUME: cy SITE PREP ?:
ENG FILL ?: STORM DRAINS ?:
SOILS RPT REQD ?: IMPERV SURFACE: 34,000 sf
Owner: FEES
DEZFULLI, SHAHIN + EBRAHIM Description Date Amount
12587 SW 133RD [BUPPLN] Pln Rv -Valu 5/18/2007 $394.91
TIGARD, OR 97223 [FLS] FLS Pln Rv 5/18/2007 $243.02
[BUILD] Prmt Fee -Valu 6/26/2007 $607.55
[TAX] Valu 8% State Surcha 6/26/2007 $48.60
Phone: 503 - 524 - 5433 [ERPRMT] Erosion Control 6/26/2007 $80.00
Contractor: Total $1,374.08
MONTGOMERY DEVELOPMENT CO
PO BOX 1315
BORING, OR 97009 -4847
Contact #: PRI 503 - 784 -8157
FAX 503 - 658 -7138 REQUIRED ITEMS AND REPORTS
Reg #: LIC 46838
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 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B P ermittee Signature: A , �' � `-' -_ Li.
IF
Call 503.639.4175 by 7:00 a.m. for an inspection that business day. I
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.
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Site Work / (c -t �.�, (�ZgQ ` `1 ���
1
Building ermit Application FOIL orl Ice t sl ONLY
' ' "
City of Tigard � Permit No.: [�0'�7�0/7
lig Plan
131 SW Hall Blvd., Tigard, OR 9722REr � - eview ` � g Other Pe
• _ in m�i1: M 7. 041/
Phone: 503.639.4171 Fax: 503.598.1960 DateB R . ��
FIG n it t� Inspection Line: 503.639.4175 MAY 1 8 2007 Date Ready/By: (o ® See Page 2 for
Internet: www.tigard- or.gov CI �� d / / / 11 Soppte / t Information Notified/Method:
B(�CITY OF t ,
TYPE OF Vva� ts�O ®SVi R EQUIR ED DATA: 1- AND 2-IiAM1LY DWELLING
• RE New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other: • equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
❑ 1- and 2 -family dwelling ® m
Comercial /industrial Valuation: $ -4;:L-
❑ Accessory building ❑ Multi -family Number of bedrooms: .da•
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: VS Z450 ‘..v,1 't i L,l r... 1c 4.4 kij New dwelling area: -r^• square feet
City / State/ZIP: - ft (. D Garage /carport area: .,e- square feet
Suite/bldg. /apt. no.: I P r o j e c t name: p e7 F ( . 2 ( . . . u a s e p 70 SCovered porch area: 41).- square feet
Cross street/directions to job site: 13 wtse N AuN4 b �
� Deck area: ..09-- square feet
' - Cl ( 1 Rci A �E,., 6 ! '7', C Other structure area: - t®' square feet
1 REQUIRED DATA: COMMERCIAL - USE CHECKLIST
Subdivision: P? l i GJ '' 0 (0 I Lot no.: 001 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: �5 t l ODE, 0 1,00 equipment, the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF W6RtK work indicated on this application.
+ Valuation: S 7 cd06. 0 n
i'6- (►tk 4 � S t- Ao.t_ -
. C 1 `- ' Existing building area: . square feet $-
. New building area: square feet
Fit PROPERTY OWNER I ❑ TENANT Number of stories: r
Name: r gA 4 It A. 5 4Imo{ 1 L) D t 2 (A. L- C1 Type of construction:
Address: 1 2S $7 SW (%3 RD Occupancy groups:
City /State/ZIP: -' D Oa_ � 7 2 Z_ Existing:
Phone: (5D3) -zap 3 Z $ Z Fax: ( ) New:
RI APPLICANT ❑ CONTACT PERSON NOTICE
Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
• Address: jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City / State/ZIP: apply:
Phone: ( ) I Fax: : ( )
E -mail:
CONTRACTOR
Business name: ra &..d fykkatui j (6 W .re�
Mg , ,, BUILDING PERMIT FEES*
\ (Please refer to fee schedule)
Address: p_ C b l'7 Structural plan review fee (or deposit):
City /State/ZIP: a i4 pp_ c:/"? bO?
Phone: (5t3) 9B if S t 5 5t I Fax: (13) 4 g c, — 4.4 3 $ FLS plan review fee (if applicable)
3 Q Total fees due upon application:
• CCB lic.: u
Amount received:
Authorized signature: .
This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:,�. -reo- y 4,4 Date: � /-- OS • Fee methodology set by Tri-County Building Industry
Service Board.
I:\Building\Permits \SIT - PermitApp.doc 06/26/06 44046I3T(I I /02 /COM/WEB)
, City of Tigard: Site Work Permit Checklist
.
Page 2 - Supplemental Information ' '
• Commercial, Multi - Family and One and Two - Family Dwellings:
No permit is required if fill is less than 50 yards (5 dump truck loads), or less than 3 feet deep and will
not be supporting a structure. If a building will be constructed on the fill, it must be engineered fill. If
fill is in a flood plain, drainage way, or wetland, the applicant must apply for a sensitive lands review
(SLR).
Please complete all items below, unless otherwise noted.
✓ eT( - 1? P JoC,.s
Excavation Volume: � . . • cu. yds. 1 -- ti ,, 4s
Grading Volume:
(Soils report required for >5,000 cu. yds.) cu. yds.
Fill Volume:
(Fill exceeding 12" in depth shall be p' •
compacted to 90% of maximum density) ' 4 ! .)-- cu. yds.
Retaining structure? (Check one) t r ❑ Rock
to ❑ CMU
❑ Concrete
❑ Other:
*Total new impervious area including all -q '54
buildings, sidewalks, and paving: I q.
Site Utilities Plumbing Work:
Complete the Plumbing Permit Application for site utilities plumbing work.
Plans Required: See "Site Work Permit Application - Plan Submittal Requirements"‘•
attached. The following must accompany this application: Poh.ua, r PLP "2. c )o t
❑ Site Plan with Vicinity Map showing ❑ *Parking (including ADA) and
ADA compliance Lighting Plan .
❑ Grading Plan and details ❑ *Landscaping Plan
❑ Erosion Control Plan and details - ' • ❑ Soils Report (if required) ,*1,4
❑ Retaining Structures NA-
*Does not apply to One- and Two - family dwellings.
# of Plans
TYPE OF SUBMITTAL Required at
(Includes New, Additions or Alterations) Submittal
Commercial
•
•
Multi- Family R -1 Occupancy 2
•
One- & Two - Family Dwelling 2
I: \Building\Permits \SIT - PermitApp.doc 0626/06 • 2
CITY OF TIGARD
BUILDING DIVISION . #: 3lT2007 -00017
13125 SW Hall Blvd., Tigard, OR 97223 // DATE ISSUED: 6/26/2007
Phone: (503) 639 -4171 i
Inspection Requests (24 Hrs.): (503) 639 -4175 „lilt _..
INSPECTION WORKSHEET FOR DATE: 8/6/2007 TIME: 7:04AM PAGE: 37
SITE ADDRESS: 15280 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: PP1996 - 010 LOT #: 001 TYPE OF USE:
PROJECT NAME: DEZFUW USED AUTO SALES
DESCRIPTION: Site work for new auto sales lot.
OWNER: DEZFULLI, SHAHIN + EBRAHIM, PHONE #: 503- 524 -5433
CONTRACTOR: MONTGOMERY DEVELOPMENT CO PHONE #: 503 - 7848157
Inspection Request Scheduled For: Date: 8/6/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
499 Final inspection 053462 -01 503- 784 -8157 N
Corrections /Com ents /Instructions:
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❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
616(67
Inspector: VIA Date: Phone #: (503) 718 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: SIT2007 -00017
13125 SW Hall Blvd., Tigard, OR 97223 i - - DATE ISSUED: 6/26/2007
Phone: (503) 639 -4171 , ' �I
Inspection Requests (24 Hrs.): (503) 639 -4175 ..�..� `:_..
INSPECTION WORKSHEET FOR DATE: 8/10/2.007 TIME: 7:00AM PAGE: 56
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 work for new auto sales lot.
OWNER: DEZFULLI, SHAHIN + EBRAHIM, PHONE #: 503 -524 -5433
CONTRACTOR: MONTGOMERY DEVELOPMENT CO PHONE #: 5037848157
Cfi ljU L.
Inspection Request Scheduled For: Date: 8/10/2007 Pour Time: : 4 5 d - A
Code # Inspection Description Confirm # Contact # swage .
499 Final inspection 053765 -01 503-267-3282 Y
52Y 5 'f33
Corrections /Comments /Instructions: /
1 .6- -- e.JU( 40 Pr 2 1--rY A - : - (s ,
-1.,c c._ < c...__ - 7 0
V
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V` Date: V 11 0� Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT' #: SIT2007 -00017
13125 SW Hall Blvd., Tigard, OR 97223 D S ED: 6/26/2007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 °__..
INSPECTION WORKSHEET FOR DATE: 9/11/2007 TIME: 7:00AM PAGE: 30
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 work for new auto sales lot.
OWNER: DEZFULLI, SHAHIN + EBRAHIM, PHONE #: 503- 524 -5433
CONTRACTOR: MONTGOMERY DEVELOPMENT CO PHONE #: 503. 7848157
Inspection Request Scheduled For: Date: 9/11/2007 , "1� Pour Time:
Code # Inspection Description Confirm # Contact # Me a e
499 Final inspection 055475 -01 503 -267 -3282 Y
Corrections /Comments /Instructions:
fi4P-ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \ /' (/ Date: Ph one #: (503) 718-2 �l