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12833 SW 116TH AVENUE ti 00 W w C T D ti 7 C cD 12833 SW 116'x' Avenue MASTER PERMIT _ CITY O F T I G�®`R D PERMIT#: MST2002-00017 r SERVICES DATE ISSUED: 2/13/02 DEVELQPMFN 13125 SW Hall Blvd.,Tigard, OR 9722 (5G3) 639-4171 PARCEL: 2S1036D-10400 Si'rE ADDRESS: 12833 SW 116TH AVE ZONING: R-4.5 SUBDIVISION: HUNTER'S WOODLAND JURISDICTION: TIG BLOCK: LOT:016 REMARKS: Construction of new single family detached residence. Path 1 BUILDING _ -- -•— FLOOR AREAS REQUIRED SETBACKS REQUI °D REISSUE: STORIES: 2 CLASS OF WORK: NEW HEIGHT: 25 FIRST: 190 51 BASEMENT: sl LEFT: 17 SMOKED:TECI^�.+' Y TYPE OF USE: SF FLOUR LOAD: 40 SECOND 1,129 sf GARAGE: 448 5f FRONT: 26 PARKING SPACES: 2 RIGHT: 5 TYPE OF CONS1: 5N DWELLING UNITS: 1 FINSSMENT, 5f VALUE: S 1138 On7 113 OCCUPANCY GRP. R3 BORM: 4 BATH: 3 TOTAL: 1,91900 sl REAR: 15 PLUMBING TRAPS: SINKS: I WATER CLOSETS: 9 WASHING MACH: I LAUNDRY TRAYS: 1 RAIN DRAIN: IOU LAVATORIES: 4 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS, TUB/SHOWERS. 2 GARBAGE DISP I WATER HEATERS: WATER LINES: 100 BCKFLw PREVNTR: i OGREASE HER FIXTURES: RAP& MECHANICAL FUEL TYPES FURN a 10OK: I BOII.ICMP[7HP: VENT FANS: 4 CLOTHES DRYER: 1 GI FURN>-1100WS.00W UNIT HEATER HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCr:9. VENTS: I WOODSTOVES: GAS OUTLETS: I ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 0 200 amp: WISVC OR FOR: I PUMPARRIGATIOW PER INSPECTION: 1000 SF OR LESS: t 0 200 AMP: PER DOUR 1st W/O SVCIFDR: Iii SIGNIOUT LIN LT: EA ADD'I.5009F: 3 201 400 amp: 201 400 amp: IN PL ANT: LIMITED ENERGY- 401 600 Amp: 401 • 600 amn: EA ADDL BR CIR: SIGNALIPANEL: MANU HMISVCIFDR! 601 • 1000 amp. 50148mos•1000v: MINOR LABEL: 1000+amplvoll: PLAN REVIEW SECTION Reconnect only: �„4 RES UNITS: SVCIFDR-225 A. i 600 V NOMINAL: CLS AREAISPC CCC: ELECTRICAL•RESTRICTED ENERGY e.COMMERCIAL A.SF RESIDENTIAL AUDIO 8 STEREO! FIRE^' IRM: INIERCOMIPAGINO OUTDOOR LND9C LT: AUDIO P.STEREO: VACUUM SYSTEM: BURGLAR ALARM. 0TH: BOILER: HVAC: LANDSCAPURRIG: PROTECTIVE SIGNL: CLOCK. INSTRUMENTATION: MEDICAL: OTHR: GARAGE OPENER: DATAITELE COMM NURSE CALLS: TOTAL M SYSTEMS: HVAC: TOTAL FEES: $ 6,719.80 Owner Contractor: This permit is subled'J the regulations contained in the DAVE AMATO a ASSOCIATES LTD DAVE AMATO AND ASSOC LTD Tigard Mu licipal Code,Slate of OR. Specialty Codes and PO BOX 19576 4351 SW CULLION BLVD all other applicable laws. All work will be done:in PORTLAND,OR 97280 FOR rLAND,OR 97221 accordance with approved liens. This permit will expired work is not started within 180 dsys of issuance,or if the work is suspended for more than 180 days ATTENTION: Phone Oregon law rr7quires you to follow rules adopted by the Phone: Orogon Utility Notification Center. Those rules are set Rear: LIC 00,01309; 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 ktiQUIRED INSPECTIONS Shear Wall Insp Insulation Insp Mechanical Flnal Erosion Control Insp 8, Post/Beam Mechanica Mechanical Insp Plumb Final Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Insl Rain drain Insp Final inspection Footing Insp Crawl DralnlBackwaler Electrical Service Low Voltage Water Line Insp p Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Line Insp Appr/Sdwlk Insp Posb'9pvMSTruClwk PLM/Underfloor _ Framinq Insp Gas Fireplace Electrical Firal — Issue y l Permittee Signature t business day Ce 3) 639-4415 by 7:00 p.m.for an Inspection needed then CITYOF TIG ^ R D ' SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2002-00010 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/13/02 SITE ADDRESS; 12833 SVV 116TH AVE PAPI'EL: 2S103BD-10400 SUBDIVISION: HUNTER'S WOODLAND ZONING: R-4.5 BLOCK: LOT: 016 _ _JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF 1SE: SF NO. OF BUILDINGS: 1 INSTALL 'YOE: LTPSWR IMPERV SURFACE: Rema;ks: Sewer connection for new single family residence. Owner: FEES DAVE AMATO& ASSOCIATES LTD Type By Date Amount Receipt PO BOX 19576 PORTLAND, OR 97280 PRMT CTP, 2/13/02 $500.00 27200200000 PRMT CTR 2/13!02 $1,800.00 27200200000 Phone: 503-245-2117 INSP CTR 2/13/02 $35.00 27200200000 Total $2,335.00 Contractor: -- Phone: Reg#: Required Inspections This Applicant agrees to comply with all the rules and regulations 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" Perm lssUed by: 4D i ,� Permittee Signature,. �1/ � ; Call (503) 639-4175 by 7:00 P.M. for an Inspection needed the next business day �t Building Permit Application Datereceived: ',//-I i Permit nol, 'tern. City of Tigard --_ 7, Fax: Bxpircdate: Address: 13125 SW Hall Blvd,'I'igard.�R`�57223 }) City r?(Tigard bate issued: By: Receipt nu.: Phone: (503) 639-4171 Fax: (503) 598-1960 ;A / �� ('ase file no.: Payment type: I&2 family:Simple Complex: Land use approval: I ti U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition ❑Addition/alteration/replacement U I clu a imhnrvrniriil 'J Fire sprinkler/alarm U Other: .� JOWSFON Job address: Zh ` Bldg.no.: Suite no lot: Block: — Suhdivision: 11u. -;n.�. ;, �r.�,i.7 Tax map/tux loYaccount no,: LIL I !� en �i �•C� t Project name: - p Description and location of work on premiscs/special conditions: --_-- - - — _ 1 ' 1 Name: Mai lin address: Q,� 5Z� __ 1 & 2 fau►ily drellint: City: - � Statc:�Q, IIP:G��L'-04 Valuation of work..........LGT.6.��'.1........... $ _ _ y Phone: .Z i Fax: No.of hedrex�ms/paths................................. Owner's representative:' ; 'Total number of floors................................. �- Phone: jFax: Z 2 .3 1,nhail: - - New dwelling area(sq. It.) Garage/carport area(sq.ft.)......................... __ __ Covered porch area(sq. ft.) ...................... .. "- Name: Deck 3.1s1�,� _.. -- Deck area(sq. ft.).................I.........I........ .,.. Mailing address: V1' b, 1 l — city: t _ State ZIR -17 Other structure area(sq, ft.)......................... " CnmmerclaUindustrial/multi-tam0y: Phone: kk,,-,Z t Valuation of work-ma • $ 1 1 Existing bldg.area(sq.ft.) ../.. Business name: Misy�a :Y C, L --_—_-- New bldg.area(sq.ft.)C — Number of stories............... City: �'d t ti�-t�. State yt, ZIPL Type of construction................................... Phone:Zc1...]a k I Fax: q� z �� I maul: _ Occupancy group(s): fixisting: CCB no.: LCA 'Y New: City/metm lic.no.: Notice:All contractors and subcontractors are required to he t licensed with the Oregon Constniction Contractors Board under provisions of ORS 701 and may he m4uired to he licensed in the Name: 2A jurisdiction vhere work is being performed. If the applicant is Address: 1� l.J. �A`r� exempt frcam licensing,the following reason applies: Cit ' -OL"'. State: 7.IP: Contact person: NomI'lan no.: _ I'Iiunc:Z.Z'�+-�' I�ax:"1-zStfi33 Cs-mail: Name:r tDr-> y'rg, -j' _ Contact;person: Qyt, Fees due upon application ........................... $ - Address: Date received: . (City: 7 State:C j_ 'LIP: _ Amount received ......................................... $ ��—^ Please refer to fee schedule. Phone: 'Z �• `l'L,' Fax:2� -1G F-mail: - hereby certify I have read and examined this application and the t:u dl jurisdictinm wcctx crtdli cutis,pleat call juridiction fix mem infonnafi n attached checklist. Allpm 'Signs of laws and ordinances goveming this J Vjsa U MasterCard i'redit card numi><t work will he complied w whet cifie herein or not. iplrcs Authorized signature: , _ Date: .I I O t _ Nurse of cudholder a shown on end"cad _ S t Print name: ___. A*1A VD -�----cudholdtr eignature Amouni 4404611]ifJ"tYr oMt Notice:Ibis pennit application expires if a permit jc not obtained within 180 days after it has been accepted as complete. Plumbing Permit Application) \ _ Datereceived: I f/'] C 7 Permit no.: (ity Of �i,llga rd Sewer permit no.: Building permit no.: Address: 13125 SW Nall B1,,j,"!irmd,OR 97223 Project/appl.no.: Expire date: Phone: (503) 639-4171 Fax: (503) 598-1960 Date issued: By: Receipt no.: — Case file no.: Payment type: Land use approval: U Multi-family U Tenant improvement U I &2 family dwelling or accessory U Commercial/indusu wl ()cher. v New constnictio,n U Add ition/al terationlreplacement U Food service 1 , ffm 1 i t Ucscription Qty. I•ee(ea.) Total � Jul address: L�L� -- - New 1-and 2-family dayellings only: Bldg.no.c — (locludes101)ft.lot.K1,utiliiyconnect ion) Tax map/tax IoUaccount no.: _ SFR(1)bade -- Lot. Block: Subdivision:_ SFR(2)bath _ SFR(3)bath Project name: Each additional hatlknchcn City'county: _ ZIP: citeutllitles: Description and location of work on premises:e --- Catch titles. drain _ Drywells/lea line/trench drain — Est.slate of completion/insPectitm Footin drain(no.lin.ft.) Manufactured home utilities -- Business name:t� (...+ems__,1L4,t+t t''t r,— -- Manholes —. Rain drain connect(r Address: /I P: Snnita sewer(no.Iln.It.l City: , ►s� State r, E-mall: Storm sewer(no.lin.ft.) Phone: _{�.2ta Fax: - fo12b Water service(no.lin.ft,) CCB no.: 1Plumb.bus.reg.no: Fixture or Item— City/metro tic.no.: Absorption valve Contractor's representative signature: Back flow reventer _ Print name: ►),tt' Backwater valve t Basins/lavatory CIO es washer _— Name: -- is washer _ Address: Drinking fountain(s) '—---- State: ZIP: Ejectors/sum City: —,_ ----- Expansion tank — Phone: Fax: E-mail: ixture sewer ca —. Floor dminsilloor stnks/huh— — Name(print): - Garbage disj_oc_al -- Mailing address: _— Huse bibb State: ZD': ice m er _ City: - -- Phone: Fax: E-mail: Interce tor! tease tra 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 praperty I own as per ORS Chapter 447. S nk(s), asin(s),lays(s) — TR Owner's signature; Date'------ - Tubs/shower/shower an rinal Name: — Water closet Address: _ _� ater neater _ -- City, State: ZIP: T — Other: - ota Phone: Fax: Email: - Minimum fee......... ... � Na dl Jurl.dktlam dlt,-.Wdi.P ew colt)uriK -t1cm rot mare Wmnattm Notice.This permit application Plan review(at NViu O Mu scud expires if a permit is not obtained State surcharge(896) .... a �t and twmea: _ _ L__LP_ within 18Q days after it hes been Expirra TOTAL et..epted es complete. Num . �s�to�vn m dedlt—�— s meAmove� 1141ti16(6R10RY1M) it am Electrical Permit Application -- — "Datereccived: I /� p2 Permit no.: Joao 17 . city o j ogard Project/appl.no.: -- Expire date: n, r li u,l Address: 13125 SW Ifall BiNd. I iymd,OR 9722; Italcissucd: — fly: - Rccciptno.: Phone: (503) 039-4171 FIX: (503) 599-196(1 "file no � Paymcnitype - Land use approval: *01 51j 7 17 1 J I N I.unlly dwr•Itiug or accessory U Comrnercial/unlu,uial U Multi-lanuly I 1, imil improvement U Nrty construction U Atidiliott/allrr;uU nt/tepl;l"111,1111U Other: joh address: ?'> �,� Il(o� �,hr tilde. nu. SuUe nu.: fax map/Inx lot/account no.: Lot: I Block: Subdivision: Proicct name: [)�cripri,nt anal l,ir,lu„n of work on prenu`rs: Estimated date of completion/inspeclion: - -- - -CONTRACtORAPPLICATION FEE SdiiEDME � Job no: � I,�• I xl:,v - ---- - _ Description tlly. (ea► total on.io%p Business name: I 'L. ' _d-•i K 0LCC6z,,_L_ —__ __ Newredldential single ormuhi-famil.%per - Address: _ dwellingunit.hlrlmk%atlaelavl{aro{e. dater:'-' %If': seniceinclurkr Phone: (� I:,tx: tib GrnluL Inuns,l h ..r Ic _. ------ I:ac h nddiUou 11 511(1 sy.11 lir Iwn n 11 11u n„I CCB no.: ?4 ��.._ -- lilec. hos. lie.no: 3�1- I.innn•denerpy residential City/melro lie.no,. — _ Lunnedenergy,non tesudrnrral __ -- - -- ------- I•.ach manufactured home tit nodular it elhnp Si nature of su rvismg electnciau(rcquuc 11 Serviceand/m leeder —— — Su,.clect.name(printl -, ,�; (icrn�en" 2c�rt.�. Servlcexorfeedcn-Installation, I alteration or relocation: III RU III a'If blaoillei I t+ 24x1 maps of less — Name(print►: - — "I says a,4410 nnrps m 2 ,11)1 amps to(ion amps 2 Mailin8 address_ -- -- _ 1,u1 maps►„lotluamps f'il tilalr: ill' liverl(Manlpsorvolts — _ 2 Y: ' — - �__ _-...- - - Phone: I'a.x: - -- -11? tttail: Itecurulrctonl Owner installation:The installation is being made on property I uvsll 7•emporaryservi orteeders- In%Iallanon.alteratieration,or relora0on: which is not intended for sale,lease,rent,or exchange according In 2 2(9).11111u or less - ORS 447,455,479,610,701. 201 amps to 41x1 amps - --- 2 Owner's si'naturc; Uatc: _——�_ 401 to MN)mo,� 2 I Branch circuit%-m• ,alleratlon. or extension per panel: Name: n bee for branch crcurts with purchase of __ ---- ----..._ Address: service lir feeder lee,each hrandr eircutt ' City— State: IIP: it Nee for branch circuits without purchase - ----- ------ of service or feeder fee,first bnulch cirortt Phone. I aK: I'. tIL'lll: Each additional branch circuit Misc.(Service or feeder not Included): pump or,rri ationcncle 2 U Serviceo%rr 225anq,s c,nnnu•rc,a1 Jhealth can•luclhr p B ----___ --- _ ---- OServiceover t20napscanna„I IX'1 U Ilararit,it]sl ,all„Ir Fn.hsignun,utlinrllghon� -- _ - family dwelhnQe U Nuildrrlk over IU,INNI squuu Irrl lata„r signal chcurosl ora linulyd vnetgy paurl m,minal mote residential utiils in line sruc•tute uhrraunu,,n v%u•usuul• 2 U Syalem ovrr6tN1%ohs U lWildinRliver three%torle, U Feeders,4(Mlamit,.n•,wtc •(tpacrr,uon U(kcupmn Inad liver IN I„n,"w J Manulacurrrd su u.nm s or It K'I,:ul. Eich additional Inspection mer the allowable In any of the above: U I•'reWlIghtin! Inn U rnhr f- f` F p 1'r1 ulsprcuun Submit %eh of plans with any of the above, Investigmton fee -- 11se above are not applicable to temporary construction service. Other Not all juNulicuons arcry9 clydir cafd%,pleas Ball Jurialirlion Iro n,urr mhxmallar Notice 11115 pCI'Ittll application Permit fee.... ...............$ U Visa U Mastercard expires it a pennil is wit obtained Plan review(al — %) $ rredh road number __ _._ —J- %s%vithin 180 days after it has been Slue surcharge(8%) ....$ I'%plfev accepted as comph;'c TOTAL ........................ Name of Can�ioller u shown an credit cv -—v- carit�trdder d�rttltute-- -__ —_Amount 440-46111 I6Itl01f'UMI Mechanical Permit Application 71)atereceived: /� t. Permit no.:City of Tigard .ect/appl.no.: Expire date. city ofngard Address: 13125 SW Hall Blvd,Tigard,OR 97223Phone: (503) 639-4171 e issued: — By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ HuildinF permit no.: TVPE OF PERMIT ❑ I &2 family dwelling or accessory U Commercial industrial U Multi-family U Tenant improvement U New construction J Ad(Iitiru,/altcration/replacement U Other: _ — 1t - - - i Job address: I t K'Ate Indicate equipment quantities in boxes Ixlow. Indicate the dollar Bldg.no.: I Suite no.: A- value of all mechanical materials,equipment,labor,overhead, fax map/tax lot/account no.: profit. Value$ , Lot: Block: Subdivision: _ *See checklist for important application information anti Project name: jurisdiction's fee schedule for residenti,l permit fee City/county: ZI P: = r l EX-scription and location of work on premises: r 1 ► t l F-st.date of completion/inspection: Ilrariplio,t Cr). RM.onlr tttc.only 'tenant improvement or change of use: C.c Is existing space heated or conditioned?'J Yes U No Air handling unn cFM— „4 conditioning(site ,Ian required,, Is existing space insulated'. U Yes ❑N") Alteration of existing HVAC system 1111 Wallin I TO it]I Boiler/compressors - Business name: ' State boiler permit no.: Address: p.�j -- HP -_Tons- BTU/H - _ Fire/smoke dampers/ uct smoke ctecters City: l Q Y,,�KT �- Stag 1; I I' q-17 qp eat pum(she plan require ) - Phone: S- kr Fax: 1�-t(:� Email nits repace urnac urner - CCB no.: tar - Including ductwork/vent liner U Yes U No -- nits replsr,/relocate eaters-suspen e , City/metro lir.no.: wall,or Ikmr mount^.d Name(please print): eL t vent for o p iancc other than urnace — e eratlon: Absorption units Name: Chillers__ III' Address: Com,re%sors -__,..__an rent III' ton: .nr ronmenta ex tut City: _ State: ZIP: Appliancevem Phone: Fax: E-mail: Dryerexhaust - -- s, ype If I Ures. itc c azrrlat --- hood fire suppression system - Name: Exhaust fan with single duct(hath fans) Mailing address: Exhaust system a an from eal,n or C - - Fuelp p ng an M ut on up to out ets) City: State: LIP: Type:-- HU �. NU w,.-- oil - -_ Phone: Fax is-mail: FuTri tin each-additional over „u ets Process piping(sc ematicrequirr ) Name: Number of outlets _ - --- — t appliance or equ pmf nl: -- - Address: _— Decorative fireplace City: _ State Phone: i Fax:--- F-mail: Other: ov pc et stoveAppli - Other: -- - Name ant's(prim signature: —_- Date: Other- Name �; _ Narne (prinq: Not all)udwicllmn accept cmihl cards,please call Iurik*00n rix nwte ittrormaritxr Permit fee.....................$ u Visa U MasterCard Notice:This permit application Minimum fee.......... .....$ Cradh cid rwMber. "---_ expires if a permit is not obtained Plan review(at -- %) $ —_ within Igo days after it htu been surcharge h 8% — atne r on a t -- accepted as complete �a. )....$ --- Cardlt"t Npunre�--_ — Amami --`-- "(14611 It40rDCr)M) 02 Jan 11 11:41:17 R-.'IT LI I 611 tlwy N1RH ,0 N 0*45 17 E_ _ ��N 0°222_7' W %L% ` 4322' 1698 1 rn5i� 1 �r!c� k ' I MAIN FLOOR EL :229 0' I 1 I t0 �l 1 I, • I 1 4., CONC'.. DRIVEWAY r: ` 13500 P S1I Nvl II' 1 �^� ■ ■ iti Yl 11• e/ 1 �1:/�a■a■rr !/ I 01/17/02 MRP AIAN YASC IR)o'Oto g t[:,11 UAW!rr,1q INE ACCUNACr I'4 IJI'UgCuc nl Y �i- IIiJQR�I NTOL 1 FOR II If CNF fplf aEsvoaslBAll.pF INE HUNTERS WOODLAND2198 ntN pFA Ip YEasv All 51CF rpNp hpNf NCl U0W0 L ANr E�.l PtAcu oN"R '.'I AN NOIIE�INF LOT 1� N'w or AN.np1ENl A �!Yppc ICAtioNf A/AN YA6CORD Of4010 ASSOCIATES INC 9Y DAVE I. Fr CITY OF -IGARD 13125 S.W. HAL7- BLVD. TIGARD, OR 97223 WwORTANT PERMIT NOTICE ENDERS ELECTRIC PO BOX 1661 BEAVERTON, OR 97075 Electrical Signature Form Permit #- MST2002 00017 Date Issued: 2l-i 3102 Parcel: 2a1 u G-10100 Site Address: 12833 SW 116TH AVE. Subdivision: HUNTL=R'S WOODLAND Block: Lot: 016 Jurisdiction: TIG Zoning: R-4.5 Remarks: Construction of new single family 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 va;,cl, the signature of the supervising electrician is required. Please have the appropriate individual from your company siqn below and return this Electrical Signature Form prior to the stait o,'the woik.. to the address above, ATTN: Building Dept. No electrical inspections r01 be authorized until this completed form is received UWNI-R ELECTRICAL CONTRACTOR: DAVE AMATO & A`:SOCIATES LTD ENDERS ELECTRIC PO BOX 19576 PO BOX 1661 PORTLAND, OR 97280 BEAVERTON, OR 97075 Phone #: 503-2.45-2117 Phone #: 626-4813 Req #: LIC 00026726 SUP 2028S ELE 34-265C AN INK SIGNATURE IS REQUIRED ON THIS FORM � X _ Signature of Supervising Electrician If yuu have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE EAST WEST PLUMBING INC 6536 NE 63RD PORTLAND, OR 97218 Plumbing Signature Form Permit #: MST2002-00017 Date Issued. 2113,2002 Parcel: 2S103BD-'10400 Site Address. 12833 SW 116TH AVE Subdivision: HUNTER'S WOODLAND Block: I of 016 JurisdictionTIG Zoning: R-4.5 Rerrarks: Construc'iion of new single family detached residence. Path 1 Your company has been indicate 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 bc:ow 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 autl.orized until this completed form is received OVVNE"R Pt_UMBING CONTRACTOR DAVE AMATO & ASSOCIATES I.TD EAST WEST PLUMBING INC PO SOX. 19576 6536 NE 63RD PORTLAND, OR 97280 PORTLAND, OR 97218 Phone # 503-245-2117 Phone # FAX 590-6226 Reg #: LIC 102521 PLM 26-532PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X'' X , :� Signature of Authorized Plumber If you have any questions, please call (503) 639-4171, ext # 310 CITY OF TIGARD 24-Hour BUILDING Inspec''on Line: (503)639-4175 MST O 7_ INSPECTION DIVISION Business Line: (503)639-4171 BUP Received __ Date Requested i �' AM-- PM BUP Location _ ,�� "L- Suite MEC Contact Person _ _— — Ph( ) FLM Contractor —___. Ph(.—._—) —_ SWR _ — _-_— BUILDING Tenant/Owner _ _—_ __.— —_— ELC Footing ELC Foundation Access: Ftg Drain / o Ctj C� m� ELR _—_--. Ciawl Drain L. Slab Inspection Notes: SIT Pust✓I<Beam _-__.---� ✓1_� �Z�� Shear Anchors j - Ext Sheath/Shear Int Sheath/Shear Framing ---.._..-- - --- ---- - Insulation Drywall Nailing -—-------- --- -----�-- Firewall Fire Sprinkler - Fire Alarm Susp'd Ceiling Roof - ----- - -- - Other: n S PART FAIL --- -- - - PLUMBING_ Poet 8 Beam - Under Slab Rough-In Water Sk.rvice ---- - ----- — - Sanitary Sewer Rain Drains --__- Catch Basin/Manhole Storm Drain ----.____- _--___-- _ _-- - ----- Shower Pen Other: Final -_._----------_._.__ - PASS PART FAIL MECHANICAL Post 8 Beam — Rough-In Gee Line - ------ - Smoke Dampers _---�__-- Final PASS PART FAIL ELECTRICAL�— Service -•- ---------- ------------.__-____--..- -- --- Rough-In UG/Slab — — Low Voltage Fire Alarm — Final Reinspection fee of$ -required before next inspection. Pay at City Will i a tW Hall Blvd. PASS PART FAIL SITE -__ [� Please call for reinspection RE: _ _ Unable to inspect-no access Fire Supply Line ADA �-^ I 12251 Approach/Sidewalk Oto-- ` �Z - Inspootoir Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PAW t FAIL CITY Gr TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST I BLIPReceived Date Requested //_ SAM PM___ BUP Location _.__ a' 3 3 Ll 1R Suite MEC Contact Person ___ _— Ph(—) _—._—__—.__ __, PLM Contractor Ph( ) —__.___ _ _ ______ SWR DUILDING Tenant/Owner _____ ________ — —e ELC — Footing — Foundation X ELC Ftg Drain Access: (f JrbS S /L�/v� / �� --- ELR _-_— Crawl Drain Slab Inspection Notes: SIT — Post&Beam Shear Anchors - Ext Sheath/Shear Int Sheath/Shear Framing — Insulation ,- -- nriwall Nailing !y �C�-- / Z L Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling -- Roof ✓� �� /' �.._ G Other:----------- a SS PART FAIL PLUMBING -- - Post&Beam -�-- Under Slab -----_--_ �`.- -- Rough-I-, Wate,Service — — — --- - — 1 Se,idary Sewer Pain Drains — Catch Basin/Manhole Storm Drain --- -— ---- Shower Pan Other: _.-- Final _PASS PART FAIL MECHANICAL Post&Beam Rough-In _......... __---— Gas Line Smoke Dampers PASS I PART FAIL ---- ---- _�.—_— _ _ _ ICAL �- 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 Approach/Sidewalk Dago .__ U—__._ Inspector �__ _ _. Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILIUING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 _ BUP _ Received Date Requested > AM__ PM buP _ Location _--/- 3—1 S w l�� v� Suite— MEC Contact Person __ Ph( _) -�Y S Z 7 PLM Contractor------- -- _ Ph( —_—) —�_ SWR __----___--- BUILDING__ TenanUOwrc, __ ELC Footing Foundation Access: ELC Fig Drain �'^ `�c c"' 'I �` ELR Crawl Drain C. /3 G��F�r� — �— 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: - -- - Finalt- PASS PART FAIL � -- Post&Bearn Under Slab Rough-In Water Service - Sanitary Sewer Rain Drains _— Catch Basin/Manhole Stun^Drain - Shower Par) PAH, _ FAIL _ --- HANI_CA L Post&Beam Rough-In Gas Line Smoke Dnmpers Final PASS PART FAIL - - - ELECTRICAL_ 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 L1 Please call for reinspection RE:_._. _ C� Unat1e to inspect-no access Fire Supply Line ADA A roach/sidewalk i Date � des i" PP praetor Other: Final PARS PARI FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 _ 7 MST INSPECTION DIVISION Business Line: (503)539-4171 BUP - Received Date Requested . PQM __ _- - PM_ BUP Location �' � = Suite_ MEC _ Contact Pelson + _ / � Ph —) �� _ PLM _ Contractor �+ tr�l. -- , L'i` "pG_ y� ) �� _ SWR _ BUILDING Tenant/Owner -_ _-- ELC --- -- -- Footing ELC Foundation Access: Fig Drain ELR --- __---- ----_ - _.-- Crawl Drain Slab Inspection Notes- / I SIT --- Post&Beam Shear Anchors Ext Sheath/Shear - ----_ -_- Int Sheath/Shea, Framing �4. Insulation Drywall Nailing -- ----- — -Firewall Fire Sprinkler — Fire Alam Susp'd Ceiling -- Roof Other. - Final PASS PART FAIL PLUMBING - _ _ _.�� Post&Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/lk,ianhole Storm Drain Shower Pan Other. - - - - - Final _PASS PART FAIL_ _MECHANICAL _�-- Post&Beam Rough-hi -- --- Gas Line Smoke Dampers - -- -- Final PASS PART FAIL ELECTRICAL Service Rough-In UG/Slab Low Voltage — Fire Alarm ?Ina I PART- FAIL Reinspection fee of$ _ required beforo noxi iw;po,hon. Pay at Carty Hall, 13125 SW Hall Blvd. SITE._ —__ [] Please call for reinspection RE:--_- Unable to Inspect-no access Fire Supply Line ADA Approac!v`Sidewaik Date Inspector �� Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL WINSTE-AD AND ASSOCIATES ARCHITECTURE AND BUILDING CODE SERVICES,PC. Phone:503-723-8003 P.O.[lox 2198 Fax 503-723-8234 oregon city,Orcgon 97045 Email:swinsteadra)Pkfamily.com Hap Watkins, Chief building Inspector City of Tigard 13125 SW Hall Blvd. 1�7'G Tigard, Oregon 97223 Subject: POST AND BEAM INSPECTION FOR A SINGLE FAMILY RESIDENCE LOCATED A 12833 SW 1 16111 ,TIGARD, OREGON Dear Mr. Watkins, On 13 May 2002. Winstead and Associates conducted a post and beam inspection fcr General Contractor, Dave Amato Associates Ltd., at 12833 SW 116"'. The following items were observed: 1. There was a significant amount of construction debris that was thrown into the crawl space. This will need to be removed prior to final inspection. 2. There wore no other discrepancies. We recommend approval of the post and beam inspection with the correc!ions listed above. it is important to note the recommendation 11oofthe Oregon Onepost and Two Famil yDwelling shall Sper.ialty authorize the violation of any provisions Code. Permits presuming to give authority to violate or cancel provisions of the OTFDSC are not valid. The recommendation for approval shall not prevent the building official hereafter from requiring the correction of errors in plans, specifications and related material or ftom preventing g operated in violation. Please contact us if you have any questions or the building from bein concerns. Respect fill Iv, r -,n 1n z' Stepan lnstead. Architect Winstead and Associates Copy to: Dave Amato A♦AAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA, i o e i i � a i ► � Pb. drD cfq A> ' v c ,—r ► "� ►�'� '� J 1. r, ! rn C, •- ► ! fDQ , y ► • rt o o � � ► N ► �. . old ► 0 441 h y^ ► y 44 ► ,4 ► a• � c � r O h a ° ti a� o _ � Q COD I� o � O C 3