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13290 SW Bigleaf Drive
CaTY OF TIGARD BUILDING INSPECTION DIVISION MST 2V6V
24-Hour Inspection Line: 639-4176 Business Line: 639-4171 — --
BUP _
Date Requested AM _PM BLD
LocationA�f U �S+-✓ "6/! lea �f,� L _ Suite MEC _
Contact Person Ph -(�3/�3 _ PLM — —
Contractor Ph SWIR —.
`BUILDING Tenant/OwnerELC
Retaining Wall .� ELR
Footing Access: — —
Foundation FPS
Ftg Drain -_----- SGN
Crawl Drain Inspection Notes: - --
Slab _- SIT
Post& Beam - -
_xt Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing - ----- -- ------ - ---------
Firewall
Fire Sprinkler - _--- - - --. -_�- -__-- ---------------- ---
Fire Alarm
Susp'd Ceiling
Roof
Misc: - ------------- ----- -
Final
PASS PART FAIL - ----------- ------- --- - ----------
si& Beare
Under Slab
TopOut __ --- --- -- --------_------------------ --
Water Service
Sanitary Sewer
Rain Drains
WS PART FAIL _
FIANICAL
Post& Beam - --- - ---- --..._...__..__.. ----------- -----
Rough In
Gas Line ---- --- ------- _- --
Smoke Dampers
Final ---
PASS PART FAIL
ELECTRICAL ------- __--.-- ___ — —_ _-- _-_ —
Service -------.—.��_-- ------- -- --._—T— --- --
Rough In
UG/Slab - -------- -- - -- ---- ---- -- ------
Low Voltage
Fire Alarm --
Final
PASS PART FAIL --.-.__--
SITE
Backfill/Grading ------ -----` ----- -.-- -_- ' --Sanitary Sewer
Sewer
Storm Drain [ ]Reinspection fee of$- _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin t J Please call for reinspection RE:
Fire Supply Line ease _-_-__- -__- [ J Unable to inspect no access
ADA
Approach/Sidewalk
tither Date l Inspector
_ Ext
- p -L!�`-_- -._- _
inal
FPASS PART FAIL I DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspertion Line: 639-4175 Business Line: 639-4171 MST G'L)/ 3
_ Date Requested / AM PMBLIP
`-
Location / G -54.1 71' j — -- BLD
�� Suite MEC
Contact Person Ph
PLM
SWR
Contractor <c "I(`6 < < <� ( „a SPh — ----
BUlLOING Tenant/Owner _ El_C —` —
Retaining Wall - - — ---
Footing -----__�...�. E L R
Foundation Access: -
Ftg Drain / �r FPS
Crawl Drain Inspection Notes: SGN
Slab
Post&Beam --- ---..- SIT -
Ext Sheath/Shear --- --
Int Sheath/Shear
Framing -------------- —
Insulation
Drywall Nailing ------ --- -
Firewall --� -_-- --
Fire Sprinkler
Fire Alarm
Susp'd Ceiling —
Roof
Misc:
Final - - ---- --- - --� - ----- - - -
PASS PART FAIL
PLUMBING
Post& Beam ----__
Loder Slab -_ — -------
Top Out _
Water Service
Sanitary Sewer - ---
Rain Drains ----- — --
Final ------- -
PASS PART FAIL — --
MECHANICAL
Post& Beam
Rough In ----------- -- _ ---.
Gas Line
Smcke Dampers -�-- -T` -- -.-_
Final --
P FAIL - ---- _-
ice --------- _- _
Rough In - - -_--
UG/Slab -- --
Low Voltage _~ --------- -
Fire Alarm - - -
A. PART FAIL —
E o
Backfill/Grading ---
Sarntary Sewer
Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin -
Fire Supply Line [ ]Please call for reinspection RE:
ADA ----- ------_ I Unable to inspect- no access
Approach/Sidewalk - ` �
Other _ _ Date %� 3 �'/ Inspector L,�/
Final — �� ---_._.__.___ Fxt
PASS PART FAIL DO NOT REMOVE this inspection record frorn the job site.
CITY OF TiCARD MASTER PERMIT
PERMIT#: MST2000-00183
DEVELOPMENT SERVICES DATE ISSUED: 8/2/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 13290 SW BIGLEAF DR PARCEL: 2S104DA-04700
SUBDIVISION: QUAIL HOLLOW-WEST ZONING: R-4.5
BLOCK: LOT:033 JURISDICTION: TIG
REMARKS: PATH I: New single family dwelling w/attached garage
BUILDING
REISSUE: STORIES: FLOOR AREAS _ REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: FIRST: of BASEMENT: of LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: SECOND: of GARAGE: of FRONT: PARKING SPACES
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: at RIGHT:
VALUE: $1;7,419 73
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL, 000 of REAP:
PLUMBING _
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS,
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS'
TU8I3HOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS'
OTHER FIXTURES
MECHANICAL
___FUEL TYPES FURN c 100K: BOIL/CMP<3HP: VENT FANS: CLOTHES DRYER:
FURN>-100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL _
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEOERS BRANCH CIRCUITS_ MISCEL-LANEOUS_ ADD'L INSPECTIONS
1000 SF OR LESS: 0 200 amp: 0 200 amp: W/SVC OR FDR: PUMPIIRRIGATION: PER INSPECTION,
EA ADO'L 500SF: 201 400 amp: 201 400 amp: 1st W/O SVC1FDR. 9IGNIGUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 $00 amp. 401 600 amp: EA ADDL BR CIR: SIGNALIPANEL: IN PLANT.
MANU HMISVCIFDR: $01 • 1000 amp: 601-amps-11000v: MINOR LABEL:
1000-amplvolt
PLAN REVIEW SECTION
Reconnect only.
>=4 RES UNITS: SVCIFDR>•225 A.: >800 V NOMINAL. CLS AREA/SPC OCC:
ELECTRICAL•RESTRICTED ENERGY
_ A.SF RESIDENTIAL _ _ S.COMMERCIAL
AUDIO d STEREO: VACUUM SYSTEM: Al IDIO 6 STEREO, FIRE ALARM: INTFRCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNI-:
GARAGE OPENER: CLOCKS INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATAITELE COMM: NURSE CALLS: TOTAL a SYSTEMS.
Owner: Contractor: TOTAL FEES: $ 3,420.23
This permit is subject to the regulations contained in the
BRIAN MAT TEONI BROOKFIELD DEVELOPMENT INC Tigard Municipal Code.State of OR Specialty Codes and
PO BOX 33468 5335 SW MEADOW ROAD all other applicable laws All work will be done in
SUITE 365 accordance with approved plans This permit will expired
LAKE OSWEGO,OR 97035 work is not started within 180 days of issuance,or if the
work is suspended for more than 180 days ATTENTION
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center These rules are set
Reg tr: I iC 11222Q forth in OAR 952-001-0010 through 952-001-0080 You
may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987
REQUIRED INSPECTIONS
Erosion 844-8444 Underfloor insulation Mechanical Insp Shear Wall Insp Rain drain Insp Plumb Final
Footing Insp Crawl train/Backwater Plumb Top Out Low Voltage Water Line Insp Final inspection
Foundation Insp Footing'Foundation Dr; Elect,ical Service Gas Line Insp Apr./Sdwlk Insp Building Final
Post/Beam Structural PLM/Unlerfloor Electrical Rough In Gas Fireplace Electrical Final
Post/Beam Mechanica Mechanil.al Insp Framing Insp Insulation Insp Mechanical Final
1
Permittee Signature
Issued B - _
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2000-00148
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/2/00
SITE ADDRESS; 13290 SW BIGLEAF DR
PARCEL: 2S 104DA-04700
SUBDIVISION: QUAIL HOLLOW-WEST ZONING: R-4.5
BLOCK: LOT: 033 JURISDICTION: TIG
TENANT NAME: BRIAN NIATtEONI
USA NO: FIXTURE UNITS: 0
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWP IMPERV SURFACE:
Remarks: Sewer connection for new single family dwelling.
Owner_ —
_ FEES
BRIAN MATTEONI Type By Date Amount Receipt
PO BOX 33468 �.
PRMT DEB 8/2/00 $2,300.00 0004180
INSP DEB 8/2/00 $35.00 0004180
Phone: Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
Sewer Inspection
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires
180 days from the date issin-cl. 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 gi%en If riot so located, the installer shall purchase a"Tap and
Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Orogon 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 952-001-0080
You mons to OUNC by calling (503) 246-1987.
Issuery � � �) Permittee Signature: %�—
�,�
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TI ,BARD Credit No.:
Date Issued: June 8. 2000
Engineering
Authorization
Date: June 8, 2000
TRAFFIC IMPACT FEE '
CREDIT VOUCHER Land Use
Casefile No.: 97-517-PD/S/DHA
In accordance with Ordinance 379_ Cypress Ventures
Inamo a dwaopoq
is entitled to $ 292.254.91 in Traffic Impact Fee Credits that can be applied to TIF
FAST ^+.+o
charges for development on lot(s) all of the Quail Hollowv- WEST Development3. To use
this credit, present this form at the time of issuance of the building permit.
Date Permit Numbers Lot Numbers Credit Used _ Balance
Beginning Balance $_ 292.254.91
Balance carried forward to TIF Credit No.
• Ordinance 379 provides for an expiration 7 years from authorization.
login\viola\I409 1 Use Additional pages if necessary.
r I Y UI- I IUAKU Keslaentlai tsuilainq Hermit Application Tian line
3125 5W HALL BLVD. Z _ Rec'd By
rIGARD, OR 97223 Sin )uplex) Data Recd
V 503-639-4171 Date to P.E./p oC?
F 503-684-7297 Date to DST ('0 -3 o—Y-1
Permit 0`171200-0
Called
Incomplete or illegible applications will not be accepted
Name-of Project Name
Job VQI"I STD✓� � _ ,Oe>'�-'-
Address Ske Address Architect Mailing Address A
7C S O Jj/3 7'�d
Name ky/State 7p Phone
"6wner Maili Ad ressName
City/State ip Phone Engineer Malling Address
General Name Cky/Stat — Zip Phone
Contractor ��4e ,.alt", 'G�'��9�
Descr.be work Na � Addition O Alteration O Repair O
Mailing Address to be done:
Prior to permit ,S'?3�"`�,pJG ,i
/1'� Additional Description of Work:
issuance,a copy City/State Zip Phane _
of all licenses d-Z' QQ 9, �GL7/P
are required k Oregon Const.�ContBoa:rd _ Exp. Date PROJECT
expired In COT Lk:.0database , �- ; //-411& VALUATION $ 2 /. 7 Y
Mechanical Na rne NEW CONSTRUCTION ONLY:
Sub- ~��� Sq. Ft. House: Sq. Ft. Garage
Contractor Mailing Addma f. 7 ! -�
Prior to permit Indicate the restricted energy Installation by the electrical
Issuance,a copy 60y/State Zip phone subcontractor in the following areas
of all licenses __ Restricted Audio/Stereo
are required k n C
Oregoonst.Cant.Board Exp.Date — Energy _ System _ _ Alarms
expired In COT Lic.0 installations Vacuum Irrigation
database System Plumbing Name - (check all that Other er. System
Sub- / .1/ , a XYZ--
Contractor Malll Address - Comer Lot YES NU Flag Lot YES Np
��� deck ones X
Prior to permit Cky/State Zip Phone Has the Subdivision Plat recorded? - N/A YEyS NO
issuanc a copy
of all licenses are Oregon Const Cont Board Exp.Date
required If Lic.0
expired In COT I hearby acknowledge that I have read this arplie-ation,that the
database Plumbing Lk:.ArExp. Date information given is con-ect,that I am the owirer or authorized agent
of the owner.and that plans submitted are in compliance with
- ---- _
Oregon State laws. _
Name Signature of Owner/Agent Date
(Electrical /`)H t� of Z�
Sub. Mailing Address Co.- Person Name-_ Phone#
Contractor .–_..0 � �
CkylState Zip Phone
P.ior to permit
Issuance,a copy
of all licenses are Oregon Const.Cont. Board Exp.Date FOR OFF�I;9 HE
required If Lio.N Plat#: / sag . --�
expired In COT 2o
33
database Electrical LM.N Exp.Date Setba a: )Zone:
_
Electrical Supervisor uc N Exp.Date 61gi ening A,oproval: nnin
—1/ g Approval. TIF:
G n i kists\fornns\sfaddalt doc 12/10/99 r
t �
' I
i
CITY CF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 1 BIAS
/ BUF
Date Requesteaj U AM PM _ BLD — A
Location/ Z �� ,SL,, 3i ,x y — Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall - -- ELR -
Footing -_
Foundation Access.-
Ftg Drain FPS —
Crawl Drain Inspection Notes: SGN
Slab _— SIT -
Post&Beam - ---- --_
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing CSG V\ Ci_$
Firewall ,
Fire Sprinkler
Fire Alarm --/I
Susp'd Ceiling _�_'�-� �-+ +✓1.1,.,Q �, L ✓ -Q
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post& Beam --
Under Slab
Top Out --_-- — - -
Water Service
Sanitary Sewer ---- -- - -- - -_
Rain Drains
Final _.- ------- —— ---- -
PASS PART FAIL
(,)W Post& Beam ------ ---- ----- — -
6 Rough In - �—
pV- Gas Line _-_- _--- -- --- _
Smoke4Aamers
;Fina --�_------------------------
S PART FAIL.
'EMTRICAL ---- ---------——_ ----------- --- - —
Service
Rough In ----- _ - - —— -- --
UG/Slab
Low Voltage '-
Fire Alarm
Final -------.----- ------------------ - ---------__
PASS PART FAIL
SITE - --- —
Backfill/Grading - ----- ----- — - -- --- -- _--_. _—__--
Sanitary Sewer
Storm Drain [ ] Reinspection fee of$— required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
rare Supply Line [ ]Please call for reinspection RE:_ _ [ ] Unable to inspect-no access
ADA
rhlSidewalk
Other � �j
Other Date � \ - Inspector '4- L� Ext1�
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST 623,
Date Requested �� AM PM BLIP
BLD
LocationZ
-�-- r-�✓ _ - Suites MEC
Contact Person / •� Ph �' U jj _ PLM _
Contractor _ Ph SWR _
BUIL — Tenant/Owner _ ELC -
Retaining Wall -`
Footing ELR
Foundation Access: ---- -------
FPS
Ftg Drain
Crawl Drain Inspection Notes: SIGN
Slab --------
Post&Beam -"-- - ------ SIT
Ext Sheath/Shear --
Int Sheath/Shear
Framing -
Insulation
Drywall Nailing --7
Firewall -_-
Fire Sprinkler ----
Fire Alarmc-
Susp'd Ceiling _—__-
Roof --- -- --- - --_-
Mi
it . ------•- --- - --+ /�,�--�-y------ __.- ---
AS FAIL
L BIN -
ost& Bedm -- -- ------ --- - __._
Under Slab - -
Top Out ---- --------- -�__ __
Water Service -�
Sanitary Sewer `-- - - ----_ -- _ _
Rain Drains -
Final ---- --- _ -----------
PASS PART FAIL
MECHANICAL - - -- -- _-_^--- ---__-_-_
Post&Beam _—
Rough In -- _---- --- - _- -- --
Gas Line - --- ----
Smoke Dampers ------
Final
PASS PART FAIL -
ELECTRICAL -- ------ --- _ _
Service .---
Rough In - ---- -_ -- --- --._-_-_ ---- -- ---
UG/Slab
Low Voltage ---- -- ------ _- _--
Fire Alarm
Final - - - - --- ---------
PASS PART FAIL
SITE - --
Backfill/Grading - --- ----- -- _-__ -
Sanitary Sewer -
Storm Drain [ ]Reinspection fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin -
Fire Supply Line [ )Please.call for reinspection RE:- [ ]Unable to inspect-ro access
ADA ,
Approach/Sidewalk
Other Date Inspector i
Final --- ---- ----- ____ Ext �
PASS PART FAIL_ i DO NOT REMOVE this inspection record from the job site.
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CITYOF TI GA R D PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2000-00441
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/5/00
SITE ADDRESS: 13290 SW BIGLEAF DR PARCEL: 2S104DA-04700
SUBDIVISION: QUAIL HOLLOW-WEST ZONING: R-4.5
BLOCK: LOT: 033 JURISDICTION: TICS
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES-
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
--_FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREAOE TRAPS:
LAVATORIES: OTHER I:IXTURES:
TUB/SHOWERS: SE NER LINE: ft
WATER CLOSETS: W 4TER LINE: ft
DISHWASHERS: FAIN DRAIN: ft
Remarks: Installation of residential backflow preventer valve.
Owner: _ _ FEES
BRIAN MATTEONI Type By Date Amount Receipt
PO BOX 33468 PRMT CTR 12/5/00 $36.25 27200000000
5PCT CTR 12/5/00 $2.90 27200000000
_ Total $39.15
Phone 1: 625-1305 -
Contractor:
GROVER LANDSCAPE
5005 SW MEADOWS RD
LAKE OSWEGO, OR 97035
REQUIRED INSPECTIONS
Phone 1: RP/Backflow Preventer
Reg #: LIC 7067 Final Inspection
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 OAR 952-0001-0080.
You y obtain Copies of these rules or direct questions to OUNC by caliing (503) 246-1987.
I>rsuo
Y: b\\ (/ /� Permittee Signature:
Cell(503)69.4175 by 7:00 P.M. for an inspection needed the next business day
'a
CITY OF TIOARD
Residential Certificate of Occupancy
Permit No.:5E —QD/P3 Address: 'Q-qlg eI L L '
Owner/Contractor: �'p�IUP.� C. (/
Date of Final Inspection: 1" , D Inspector:
This structure has been found to be in substantial compliance with the provisions of the State( )regon One& Two Family Dwelling
S eciaLty Code and is hereby approved for occupancy. _
Plumbing Perinit Application
—— _ Date received: /,;: 1,,9 Permit no.:y g `1// o-0�/
Citof Tigard -
`�
,,.dress: 13125 SW Hall Blvd,'figard,OR 97223 Sewer permit no.: Building permit no.:
City r JTigard 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:
U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction U Addition/alteration/replacement U Food service U Other:
Job address: I1Mscri►Non Qty. Fee ea. Total
_ .�—
Bldg.no.: Suite New 1-and 2-family dwellings only:
_ � 1.: _
(includes 100 ft.for each utility connection)
Tax map/tax lot/account no.: _ SFR(1)bath
Lot: k: _ Subdivision: SFR(2)bath -- -- - --
Project name: -�' _f
� �, SFR(3)bathCity/county: IP: Each additional batln/kilchcn
Description and looliflop of work on premises:_ Sheutilltles:
Catch basin/area drain _
Est.date of completion/inspection: -- Drywells/leach Iineltrench drain
Footing drain(no.lin. ft.)
Manufnclured home utilities
Business name: ' r (! /,,. ' llq- Marholer -- -
Address: �" /2Rain drain connector
City State: ZIP: _ Sanitary sewer(no. lin.ft.)
Phon Fax: E-mail: - Storm sewer(no.lin. ft.) -
Water service(no. lin. ft.)
CCB no.: — Plumb.bus.reg.no: �'/�� `�7 fixture or Item:
City/metro lic.no.:
Contractor's representative signature: Absorption valve _ -
-- Back flow preventer
rin
Pt name: Date: Backwater valve _
Basins/iavatory
Name: Clothes washer _- Y
— ---- Dishwasher _
Address: Drinking fountain(s) ——
City: �—_ State: ZIP: EJectors/sum
P
Fa : E-mail:Phone: Expansion tankFixturelsewer cap
Name(print): Floor drains/floor sinks/hub
Garbage dis
Mailing address: -- - std— —
liose bibb
City_— _ State: 'LIP: —_ Ice maker
Phone: Fax 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)
Owner's si nature: Date: Sum — _
Tubs/shower/shower pan —
Urinal
Name: — — Water
closet --- —
Address: Water heater
_City: State: ZIP: Other. —
M!-)nc:
Not oil lurisdictinns accept credit card.,,please call jurisdiction for mcue inr«maaon. Notice:This permit application Mininnum fee................$
U Visa U MasterCard expires if a pennit is not obtained Plan review(at _— %) $
Credit card numtwr --- ---_-- _—(�— within 180 days alter it has been State surcharge(8%)....$
Expires
---—-- ---------- accepted as complete. TOTAL .......................$
Nnme or ridholdn a+shown on credit card —
s _
--- --Cardholder signature -- — — Amaaat 4401616(6MCOM)
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2-family dwellings only:
FIXTURES lndividuaa_ QTY ea AMOUNT (includes all plumbing fixtures in PRICE TOTAL
Sink 16.60 - the dwelling and the first100 ft. QTY (ea) AMOUNT
Lavatory 16.60 for each utility connectlon
_ One 1 bath _ $249.20
Tub or Tub/Shower Comb. 16.60 Two 2 bath $350.00 -
Shower Only - 16.60 Three 3 bath $399.00
Water Closet 16.60 ------ ---
_ SUBTOTAL _
Urinal 16.60 _ 8%STATE SURCHARGE
Dishwasher - 16.60 _- PLAN REVIEW 25%OF SUBTOTAL
Garbage Disposal 16.60 -TOTAL
Laundry Tray 16.60 --
Washing Machine 16.60
Floor Drain/Fioor Sink 2" 16.60
3" - 16,60 PLEASE COMPLETE:
4" -- 16.60
Water Heanor O conversion O like kind 16.60 - - _ t�uantit b Work Performed
Gas piping requires a separate mechanical Fixture Type: New Movel Replaced Removed/
permit. _ - _ Capped
MFG Home New Water Service 46.40 Sink - -
MFG Home New San'Stoiat Sewer 46.40 Lavatory
Tub or Tub/Shower
Hose Bibs 16.60 Combination_ _
Roof Drains 16.60 Shower Only -
Drinking Fountain 16.60 Water Closet -
Other Fixtures(Specify) �- 16.60 Urinal -
- - Dishwasher
Garba-e Disposal
-- -
Laundry Room Tray -_
Washing Machine
Floor Drain/Sink: 2"
Sewer-1 at 100' 55.00 3„ --
Sewer-each additional 100' 46.40 -- _4"
Water Service-1st 100' 55.00 Water Heater _
Water Service-each addllional 200' 46.40 Other Fixtures
(Specify)_
Storm G Rain Drain-1st 100' _ 55.00
Storm&Rain Drain-each additional 100' 46.40 -- -
Commercial Back Flow Prevention Device 46.40 --- -----
Residential Backflow Prevention Device' 27.55 -
Catch Basin - 16.60
Inspection of Existing Plumbing or Specially 72.50
Requested Inspectionspet/hr COMI"ENTS REGARDING ABOVE:
Rain Drain,single family dwelling 65.25
Grease Traps 16 60 -
-�-- QUANTITY TOTAL --
Isomeldc or riser diagram is required it -�-�- --�---
Quanlfty Total is >8 - - --
`SUBTOTAL ---- --
8%STATE SURCHARGE - - ---- -- -
"PLAN REVIEW 25%OF SUBTOTAL
Required only if fixture qty total is>9
TOTAL S
"Minimum permit fee is$72 50"8%state surcharge,except Residential Backflow
Prevention Device,which is$ae 25-8%state surcharge
"`All New Commercial Buildings require plans with Isometric or riser diagram and
plan review
l:ldstslfonns\plm-fees.dor, 10/10/00
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE ~n
WOLCOTT PLUMBING CONT. INC AUG 1 0 7000
PO BOX 2007 LBY:--,.
GRESHAM, OR 97030
Plumbing Signature Form
Permit #: MST2000-00183
Date Issued: 812100
Parcel: 2S104DA-04700
Site Address: 13290 SW BIGLEAF DR
Subdivision: QUAIL HOLLOW -WEST
Block: Lot: 033
Jurisdiction: TIG
Zoning: R-4.5
Remarks: PATH I: New single family dwelling w/attached garage
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 Dept.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR.-
BRIAN
ONTRACTOR:BRIAN MATTEONI WOLCOTT PLUMBING CONT. INC
PO BOX 33468 PO BOX 2007
GRESHAM, OR 97030
Phone #: 625-1305 Phone #: 667-1781
Reg #: I Ir 00023847
PI M 26-208PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X
SignatxG of Authorized Plumber
If you have any questions, please call (503) 639-4171, ext. # 310
Electrical Innov. , Inc. 503-632-6564
P. 5
CITY OF T'—_
13125 S.W. HALL BLVD.
TIGARD, OR 97223
Ir- 'ORTANT PERMIT NOTICE
'at'c
ELECTRICAL INNOVATIONS
Ep
22300 S LEWELLEN RD SAN 1 G 2QQ
BEAVERCREEK, OR 97004-8733
pEV��pEN
Electrical Signature Form
Permit#: MST2000.00193
Date Issued: 8/2/00
Parcel: 2S104DA-04700
Site Address* 13290 SW BIGLEAF DR
Subdivision: QUAIL HOLLOW -WEST
Block: I_ot: 033
Jurisdiction: TIG
Zoning: R-4.5
Remarks: PATH I: New single family dwelling w/attar hod garage
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
elertrical 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 Dept.
No electrical inspections will be authorized until this completed form is received
OWNER: ^LECTRICAL CONTRACTOR:
BRIAN MATTEONI ELECTRICAL INNOVATIONS
PO BOX 33468 22300 S LEWELLEN RD
BEAVERCREEK, OR 97004-8733
Phone #: 625-1305 Phone #:
Req #: uc 2"99C
0066 12
SUP 36215
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signatur Supervising Electrician
I' u have any questions, please call (503) 639-4171, ext. # 310