Permit '
CITY OF T I G A R D MASTER PERMIT
PERMIT #: MST2002 -00443
DEVELOPMENT SERVICES DATE ISSUED: 1/7/03
cI 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 14264 SW 132ND PL PARCEL: 2S109AB -09600
SUBDIVISION: RAVEN RIDGE ZONING: R -7
BLOCK: LOT: 025 JURISDICTION: TIG
REMARKS: Const. new SF Detached residence.Path 1
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 29 FIRST: 1,245 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,128 sf GARAGE: 440 sf FRONT: 30 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: 945 sf RIGHT: 5 •
VALUE: 322,935.80
OCCUPANCY GRP: R3 BDRM: 4 BATH: 4 TOTAL: 3,318 sf REAR: 37
PLUMBING
SINKS: 1 WATER CLOSETS: 4 WASHING MACH: 2 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN <100K: BOIL/CMP < 3HP: VENT FANS: 7 CLOTHES DRYER: 3
GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 W00DSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: 1 W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 6 201 - 400 amp: 201 - 400 amp: 1st W /OSVC /FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EAADDL BRCIR: SIGNAL/PANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: X VACUUM SYSTEM: X AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: X OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: X CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: X DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 8,223.00
DECAL CUSTOM HOMES DECAL CUSTOM HOMES LLC This permit is subject to the regulations contained in the
DEC
DEC L 6TH CUSTOM DEC SIXTH TOM HOMES Tigard Municipal Code, State of OR. Specialty Codes and
2345 COLUMBIA CITY, OR 97018 COLUMBIA CITY, OR 97018 all other applicable laws. All work will be done i
accordance with approved plans. This permit will expire if
work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days. ATTENTION:
Oregon law requires you to follow rules adopted by the
Phone: 503 366 - 0797 Phone: 503 366 - 0797 Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
Reg #' LIC 147174 may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8 Post/Beam Structural PLM /Underfloor Framing Insp Gas Fireplace Sprinkler Final
Grading Inspection Post/Beam Mechanical Mechanical Insp Shear Wall lnsp Insulation lnsp Appr /Sdwlk lnsp
Sewer Inspection Underfloor insulation Plumb Top Out Exterior Sheathing Inst Rain drain Insp e ' -- -:
. Footing Insp Crawl Drain /Backwater Electrical Service Low Voltage Water Line I :,hanical Fin..
Foundation Insp Footing /Foundation D Electrical Rough In Gas Line Insp S. ' -- - o g •mb Fin.
/
Issued By : �! /. i 'i/( -O, _, /,' Permittee Signatu e : ' ...........~
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
7 "
• •
' Building Permit Application
• r `)�r'1 City of Tigard Date received: / .-(J 2 Permit no. j a09 ••),... 190 ` Project/appl.no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 - -
Phone: (503) 639 -4171 ( � . _ Date issued: B Receipt no.:
Fax: (503) 598 - 1960 ; - Z11,6-- , � , Case file no.: Pa ment t e:
1 l J Y )p � /
Land use approval: 1&2 family: Simple Complex: (((///
., fln'l -- ----- d
TYPE OF PERMIT L
_ ❑ I & 2 family dwelling or accessory ❑ Commerct_ar/iridustrial' ,O:Multi- family ❑ New construction El Demolition
m
❑ Addition /alteration/replacement ❑ Tenant provemen . O F sprinkler /alarm ❑ Other:
r...-
l:k.r --
JOB SITE INFORMATION . -
Job address: / � A- j
1��0 � / roc L, Bldg. no.: Suite no.:
Lot � Block: Subdivision: E.Atbt,A) 0,,66. Tax map /tax lot/account no.:A5/0946 - 056,66
Project name: A ait(A PALv /' - 1.` /_3 / ---
Description and location of work on premises/special conditions: (SOW "4 Q )C E WO .)/A)544"... /t/+� � ,��+7 -
•
' , OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: 11 t(,AL- ..en, . d£,S LLL (Floodplain, septic capacity, solar, etc.) -,
Mailing address: 23 St's- , S M -• 1 & 2 family dwelling: $U
City: C -•.)l 01' _ i
�{ Y (State js IZIP:V / lc Valuation of work $ Z 3
Phone: --C>') S -) Fa G 4 1)a/el E -mail: No. of bedrooms/baths _ J. S •
Owner's representative: "AV(_ w 44 G 1- _ Total nwnber of floors • 3
Phone 61'-- 7 Fax: C. -MO E-mail: New dwelling area (sq. ft.) c3 3 ( ____
APPLICANT Garage/carport area (sq. ft.) i i?()
Name: ill' -CA L �A..I• Covered porch area (sq. ft.) 85
Mailing address: 64-6... ,-. Deck area (sq. ft.) .2$6
Cit ((, 6 Cilk State:et I ZIP: cr7Oda Other structure area (sq. ft.) _
Phone: 3(,6,- O')°/' . Fax:C(, E -mail: Commercial/industrial /multi - family:
CONTRACTOR Valuation of work $
� � Existing bldg. area (sq. f .
name: - ,_
Business New bldg. area (sq. ft) _
Address:0. L ft S ( A cat . Number of stories
City_�",(�, Sta a / ZIP: ' •
Phone:344. •p Fax: w E -mail; Type of construction � —
—
CCI3 no.: i1i�>� Occupancy group(s): ExiNew:
City /metro lie. no.: /41 (tv Notice: All contractors and subcontractors are required to be
ARCIIITECT/DESIGNER '/
re licensed with the Oregon Construction Contractors Board under
Name: S /Cf 5P$1A �'f' Nei %.6 c e JIva0 s provisions of ORS 701 and may be required to be licensed in the
Address: 'jr') S(,...5 /VG� C1F , jurisdiction where work is being performed. If the applicant is
City: 1,0 . /7 State:0e. ZIP: exempt from licensing, the following reason applies:
Contact person: [NAIL 1_, Plan no.:
Phone: & cl 7 — O , Fax: E-mail:
Name: h (,_ • MA" . ( mptglr Contact person: - Fees due upon application $
Address: y AyZ CI V / Date received:
City: St iV 4.4000 - en Mil ZIP: - • ( , Amount received
Phoil 23,-`/(54.1 Fax$73- 4)7 E -mail: Please refer to fee schedule.
I hereby certify I have read and ex. •'6" - " pplicatio and the 'Not all jurisdiaioas accept credit cards, please call jurisdiction for more information.
attached checklist. All provisi
�a s and ordinance :oveming this 0 Visa 0 MasterCard
work will be complied wi t, specif • • herein • not Credit card Dumber. • , r� Expires Authorized 11 I ature - • at 0 2 0 e_ Name of cardholder as .bowo 0o credit card
Print name:. _ '�� - — � Cmf&otde, cignnitac - - $ Amtxmt
TT -- - -- -_.
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. a4o- (bva'COM)
•
VIi di/ GUVG lU. G1 l'flA UUdvU'tI LJI T--• --
Electrical Permit Application
4 41% Date received: Permit no:: fa, jh "_.„.- 4(,/4
,y, :411 City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: •
TYPE OF PERMIT
& 2 family dwelling or accessory 0 Commercial/industrial Cl Multi family ❑ `Tenant improvement
- New construction ❑ Addition/alteration/replacement 0 Other. ❑Partin]
JOB SITE INFORMATION
Job address: / a,ai4 S w I32." jc_ Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: (Subdivision: 4I/4A,J —
Project name: 24) *J 2+:XTc I Descri•tion and location of work on premises: A4''w 604#Qc.)G144x
Estimated date of completion/inspection: d) Z
CONTRACTOR APPLICATION FEE SCIIED LE
Job no: Fee Max
Business name: (i) 6, i ,F ae L ? _, Ju ( - , • Description Qty. (ea.) Total no. map
New residential - single or multi- family per
Addre s: 2$6,6 Sy, f e $4. /3s''N` dwelling unit Includes attached garage.
City:iikiatA,vp I stateoe I ZIP: 17. (. Service included:
Phone: "0_ g'Z . I Fax: 76Z • /823 E -mail: 1000 sq. ft. or less I 4
CCB no.: "r !" 1 S Elec. bus. lic. n0: �.3 -33 z Each additional 500 sq. ft. or portion thereof 3 2
Limited energy, residential
City /metro lic. no.: Limited energy, non- residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder 2
Sup. elect name (print): 0.i , S ,I , License no: W S Services or feeders — installation
{�
alteration or relocation: 1
PROPERTY O11'NER . 200 amps or less 2 ,
L
Name (print): , t C US4-t 4A. i-1 (M41(s LL-L, 201 amps to 400 amps 2 ,
401 amps to 600 amps 2
Mailing address: f S' _ ,i- . 601 amps to 1000 amps 2 ,
City: cif y I State: I ZIP97Q/8 Over 1000 amps or volts 2
Phone: 7 I Fax: 1E-mail: I Reconnect only l
Owner installation: The installation is being made on property I own Temporary cerncesor feeders -
which is not intended for sale, lease, rent, or exchange according to irtstallatian , orrelocation: !
I
ORS 447, 455, 479, 670, 701. 200 amps or teas 2
201 amps to 400 amps ,
Owner's signature: Date: I 401 to 600 amps • 2
ENGINEER - Branch circuits - new, alteration,
or extension per panel:
Name: S 60,-) t/w� r A. Fee for branch circuits with purchase of
Address: J" / �� "'" � J service or feeder fee, each branch circuit 2
City: State: ZIP: ,i . ti B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2 ,
Phone: Fax: E -mail:
Each additional branch circuit:
Misc. (Service or feeder not included):
O Service over 225 amps - commercial 0 Health -care facility Each pump or irrigation circle 2
0 Service over 320 amps•rating of 1&2 0 Hazardous location Each sign or outline lighting 2 ,
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
0 System over 600 volts nominal more residential units in onestructure alteration, or extension' • - 2
0 Building over three stories 0 Feeders, 400 amps or more *Description.
0 Occupant load over 99 persons 0 Manufactured structures or RV part: Each additional inspection over the allowable in any of the above:
O Egressllightingplan O Other. Per inspection [ I I I ,
Submit _ sets of plans with any of the above. ; Investigation fee
The above are not applicable to temporary construction service. Other •
Not all jurisdictions xrept medic cards, please call jurisdiction for more information. Notice: This permit application Permit fee ... $ •
0 visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number. / / within 180 days after it has been State surcharge (8%) $
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card
$
Cardholder d lu
nate Amount 440-4615 (6100/COM)
A
U / J1 /LUUL 10.Ll 1 JVJV, 1'-.,. -- -
. Plumbing Permit Application
� ' Date received: Permit no.: ph 0060,"00 44.0
-�,. City of Tigard
: - y J g Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd, Tigard, OR 97223
City of Tigard Phone: (503) 639 -4171 Project/appl. no.: Expire date:
Fax: (503) 598 -1960 Date issued: By: Receipt no.:
Land use approval: Case file no.: Payment type:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
- Kew construction 0 Addition/alteration /replacement 0 Food service 0 Other:
JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist)
Job address: i yap S , 13 J> Description Qty. Fee(ea.) Total
y a New 1- and 2 -family dwellings only:
Bldg. no.: I Suite no.: (includes 100 ft, for each utility connection)
Tax map /tax lot/account no.: SFR (1) bath
Lot: Block: Subdivision: ?AMA) P../Ce SFR (2) bath It
Project name: A i /yjtj L7 ! k_ , SFR (3) bath / ,
City/county: i ',,4 h 4 ZIP: Each additional bath/kitchen ,
Description and location of work on premises: Site utilities:
It it, CAms-t'it r Ala.) Catch basin/area drain
Est- date of completion/inspection: Drywells/leach line/trench drain
PLUMBING CONTRACTOR ,
drain (no. lin. ft.) .ZS ,
Manufactured home utilities
Business name: COM64.4 $ S. .L7C_ . Manholes
Address: 60 C 4J. (,1 ,4thrM/+L Rain drain connector
City: / 6„,44, 4 p r I State t � I ZIP: 9?22 3 Sanitary sewer (no. lin. ft.) 7 C
Phone: $-9t - cfn0 I Fax43f C)9 IEE -mail: Storm sewer (no. lin. ft.) 3
CCB no.: /3,6 & 3 I Plumb. bus. reg. no: i Water service (no. lin. ft.) 3°
Fixture or item:
City/metro lie. no.: Absorption valve
Contractor's representative signature: Back flow preventer
Print name: Date:. Backwater valve
CONTACT PERSON Basins/lavatory
Name: • rV,4(•..-�. Clothes washer
uL r Dishwasher /
Address: a3 .1 S S/ 4 c Drink fountain(s) ,
City:6°1_01"it A Ct I StateA I ZIP: 970/t . Ejectors/sump
Phonea0 `t -/ ) ) Fax:34' —08/O E -mail: Expansion tank
OWNER . Fixture/sewer cap
Floor drains/floor sinks/hub
Name (print): •• CA L_ roS -{AAA. Garbage disposal
Mailing address: S/114 4 i 5S - • Hose bibb
City: � (I ./ I State: cue I ZIP: 970/ Ice maker l
Phone_.- pro 1 Fax:3( -Og1Oi E -mail: • Interceptor /grease trap
- Owner installation/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain (commercial) ,
employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s)
- Owners signature: Date: Sump
-
Tubs/shower /shower pan •
Urinal
Name: # L VIA) • FA)544-Ct-itiNS Water closet
Address: '2.!{m SII � .M( / s IJ1C • Water heater ,f
Qty: _ 2 Sl7f/� , State(S la) ZIP: 'j ?c6 2 Other:
. Phone: X73 -3JAL/ Fax: F75-3/01E-mail: Total
Minimum fee $
Not all jurisdictions accept audit cards, please call jurisdiction fair more information. Notice: This permit application
D Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number. - / / within 180 days after it has been State surcharge (8%) $ __-
res $
accepted as complete. TOTAL
Name of cardholder u shown oo credit card
$ 440.-0616 (6/00K
Cardholder signature Amount
Mechanical Permit Application �y •
1
Date received: 1 Permit no.: ` 'J
-OD /.
t ' Ci of Ti and
r aj �� �! g Projut/appl. no.: Expire date:
CiryofTigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: _ Receipt
Phone: (503) 639 -4171 — -
• Fax: (503) 598 -1960 Case file no.: Payment type:
Land u approval: Building permit no.:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
_ 0 New construction 0 Addition/alteration/replacement 0 Other.
JOR SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: / 1 -1 ;ILA{ ‘S fu 1t3,A „ ,L_ Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ 37(.S'.00
Lot: Block: _I Subdivision: A) p, 'See checklist for important application information and
Project name: /5 154... jurisdiction's fee schedule for residential permit fee.
City /county: I L I ZIP: 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: AND COMMERJCAIJ1NDUSIRIAL EQUIPMENTSCIIEDULE
Fee(ea.) Total
Est. date of completion/inspection: Description Qty. Res.only Res. only
Tenant improvement or change of use: HVAC: /-s[ �v j
Air handling unit1 5 CFM
Is existing space heated or conditioned? 0 Yes / No Air conditioning (site plan required)
Is existing space insulated? 0 Yes • o • Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
• i � L 4A4tN G �yIS QC.-• State boiler permit no.:
Business name: I ,
1 HP Tons BTU /H
Address: ))Q $off( '3Q , Fire/smokedampers/duct smoke detectors
City: p , VJ State I ZIP: 9701.-y Heat pump (site plan required)
(095' 5 392 I Install/replacefurnacelburner BTU /H
Phone: Fax: $� , /, - mail:
Including ductwork/vent liner O Yes O No
CCB no.: fyq 077 Install/replace/relocate heaters - suspended,
City /metro lic. no.: wall, or floor mounted
Name (please print): Vent for appliance other than furnace
CONTACT PERSON Absorption units BTU/1-1 Name: 11 40 L ...... 7ilC` tOlvh_ ((0 j . AMA oat,.1) Chillers HP
Address: 23K S- S A C 5- Compressors HP
`/ Environmental exhaust anti ventilation:
.�1
City: Cot.. wt6, City I Stated I ZIP: 9)a/& Appliance vent Z
PhoneaO9 -/ , 7' Fax :3&4-br1O B-mail: .A.A-*K-) Dryer exhaust / ,
011T1ER Hoods, Type U II/res. kitcherl/hazmat
•
hood fire suppression system
Name: , • (AL GL 0,"1 LLC_ • Exhaust fan with single duct (bath fans)
Mailing address: '/ Al? c • Exhaust system a • art from beating or AC
,! Pete p p ■ g and distribution (up to 4 outlets) 3
City: C0(,u,a;I L Stale ZIP: 970/;•
Type: LPG X NG Oil
- Phone .0 - •) • Fax: -O . • E -mail: Fuel piping each additional over 4 outlets ,
ENGINEER Process _,
Number of outlets
Name: ��. • (_ uw e igi N t„ „j,,e( .
Other listed appliance or equipment:
Address: L4/. . _Si t ,Gvis 12. Decorative fireplace - ,
City: SI / Utit !` � I Stater 1 ziP:17 3 A ( Insert - type
Phone: $73 _ 4/Pit{ I Fax: ;r ; • t • ■ : •..1: Woodstove/pellet stove
■ Other.
Applicant's signature: . ∎ __ —�• : 1 Other
Name (print): wiffilwr
\,„
,. —
Not all jurisdictions accept credit cloth, please call jurisdiction for more information Permit fee $
ds
O visa GI MasterCard Notice: This permit application minimum fee $
expires if a permit is not obtained Plan review (at `30) $
Credit card Dumber: Exp within 180 days after it has been
State Surcharge (8%) .... $
Name of cardholder as shown on credit card accepted as complete.
S TOTAL $
Cardholder signature Amount 440 -4617 (6/)O/(OM)
FIXTURE UNIT WORKSHEET - WATER METERS
Contractor Name E c4C 6M-to (5
'OCT 2
Billing Address c7 23CIC -
�+ p2 ? a t e ry
Address of New Meter '.11ll
Lot # Subdivision 20,A) NL(4- •
Please fill in the number of each fixture as detailed on the plans, then multiply
quantity by the point value given to arrive at the point total. Add all point totals together
for total fixture unit points.
Fixture Unit Quantity Point Value Point Total
Bar Sink X 1
Darcy Tub X 4 =
Tub with shower stall at end of tub. They are separated by glass.
Bidet < ;. X 1 =
Clotheswasher X 4
Dishwasher X 1.5
Hose Bib 1 X 2.5 = 2.5
Hose Bib, each Adt'l X 1 =
Kitchen Sink X 1.5 =
Laundry Sink X 2
Lavatories X 1 _
Water Closet, 1.6 GPF X 2.5 =
Bathtub /Whirlpool X 4 =
Shower Stalls X 2 =
Bath/Shower Combo X 4 =
Total Fixture Points
Meter Size Meter Cost
****************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
FOR OFFICE USE ONLY
Fixture Count Verified with Plumbing Permit
Meter #
Receipt #
Emp. Name
Revised 3 -18 -02
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
MAC PLUMBING LLC
PO BOX 330
YACOLT, WA 98675
Plumbing Signature Form
Permit #: MST2002 -00443
Date Issued: 1/17/03
Parcel: 2S109AB -09600
Site Address: 14264 SW 132ND PL
Subdivision: RAVEN RIDGE
Block: Lot: 025
Jurisdiction: TIG
Zoning: R -7
Remarks: Const. new SF Detached residence.Path 1
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the
plumbing permit to be valid, please have the appropriate individual from your company sign below and return
this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Division.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
DECAL CUSTOM HOMES MAC PLUMBING LLC
2345 6TH ST. PO BOX 330
COLUMBIA CITY, OR 97018 YACOLT, WA 98675
Phone #: 503 - 366 -0797 Phone #: 360- 686 -0555
Reg #: LIC 140446
PLM 5961JP ANDY MACFARL
AN INK SIGNATURE IS REQUIRED !!• ► THIS FO - 11
Sig 'ature o ' thon - a ' 1"i�:Y r
If you have any questions, please call (503) 639 -4171, ext. V10 `{`
rf9 57) 3 - 6 3ta8(
Tuesday, July 08, 2003 9:00 AM Plugs & Switches 503- 925 -0489 p.04
07/A7/2003 13:04 FAX 5035981960 CITY OF TIGARD 21004
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE RECEIVED
PLUGS & SWITCHES AjL 0 8 2.003
P.O. BOX 111
SHERWOOD, OR 97140 CITY OF TIGARD
BUILDING DIVISION
Electrical Signature Form
Permit #: MST2002 -00443
Date Issued: 1/17/03
Parcel: 2S109AB -09600
Site Address: 14264 SW 132ND PL
Subdivision: RAVEN RIDGE
Block: Lot: 025
Jurisdiction: TIG
Zoning: R -7
Remarks: Const, new SF Detached residence.Path 1
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Division.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
DECAL CUSTOM HOMES PLUGS & SWITCHES
2345 GTH ST. P.O. BOX 111
COLUMBIA CITY, OR 97018 SHERWOOD, OR 97140
Phone #: 503 - 366 -0797 Phone #: 503 - 925 - 8450
Reg #: LIC 141529
ELE 34 -527C
SUP 4546S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X
/r ^ u
Sign re . f ' pervising Electrician
If you have any questions, please call 503.718.2433.
Job No.
WCG / West Coast Geotech, Inc.
GEOTECHNICAL CONSULTANTS
P.O. Box 388
West Linn, Oregon 97068 MEMORANDUM
(503) 655-2347 FAX 655-0642
Day NorJOAY Date 2 /2)4 0 3
JE] Field Report Page I of
Project:
Attn:
LD L-1:108 5 U3 Ict.
2 26 1 - 2 - 5tA) 13 2v,
/*-{1 , - 1,;(•-•&1. ovvx T •
s
FO0. 0 Lo •vx,reA_____ava_Co___\
\rC",\CtA r-c. -k, 24 ct Lo (0 he vw:4-
_lace,J. Fo
• c,rj le
4-1.12 wiw - Jae I _c)cr 4-o
In r■e • ilifrIntoi gc-k D 195 e_rJvci 0 /la 0 4-4_12._
• ( *A. in a
-
P-ro rv Pe.e.4- \iari--- 7 So r-&---fz+
mo or T A . - f-te, • _
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• ADDRESS: IL) 2-67 LI s _ (3 2 R _ —
U
r
• LOT: AIL 25 SUBDIVISION: ` pa,,p S t Ld e 0-
• B ' : DATE: f i iZ h7)
RECEIVE BY: _ 1 /. i 1, / , ; ,,�_ ,� DATE: // / ,-/
CITY OF TIGARD 24 -Hour
BUILDING InspectionrLine: (503) 639 -4175 MST c71 do i Z
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested ' i Yv v�° f BUP
Location L 7/. Co /3a Suite MEC
Contact Person Ph ( ) 9 4/ r/ 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Fogundation Off ' f rn ` ,� ,
Drain Access:
Ft 1 J � � � ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing •
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof •
Other:
+�Y
T FAIL
1 =-am
Under Slab .
Rough -In •
Water Service —
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other
PART FAIL
4
CHANICAL
Post& Beam
Rough -In
Gas Line
S�� • - Dampers
AS PART FAIL
ECTRI
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line
ADA Date /(((3 / Inspector Eat
Approach /Sidewalk
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour -
•
BUILDING � Inspection Line: (503) 639 -4175 1 MST —00 'b3
INSPECTION DIVISION ° '. Business Line: (503) 639 -4171
BUP
Received Date Requested 1 - AM PM BUP
Location j 4 2 4 1 j 1- ~� Suite MEC
Contact Pers.. Ph ( ) / -L S 7 PLM
VIR0 42;e'
Contractor x.3a - L A., * r Ph ( SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
•
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole .
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post& Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
- .rm
AS PART FAIL
El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date /hi /. f i 03 Inspector /-2_.J, yd Ext
Other: �/
Final. DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour .
BUILDING Inspection Line: (503) 639 -4175 MST ?"--- 0° 3
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested // AM PM BLIP
Location / L 9 / 3 a 4 ,0L- Suite MEC
Contact Person Ph ( ) ' ? ( g35 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
• Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling (�
•
Roof REGo} 1 NS P E€V.
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post& Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage 191-/- &n/C)
Fi a larm
anal
ASS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE El Please call for reinspection RE: LI Unable to inspect — no access
Fire Supply Line Q MoRLE ADA 1 '� 0 3 �I �`
Ext
Approach /Sidewalk Date Inspector
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL