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CITY
OF TIGARD MASTER PERMIT
PERMIT#: MST2001-00498
DEVELOPMENT SERVICES DATE ISSUED: 10/25/01
13125 SVV Hall Blvd., Tigard, OF: 97223 (503) 639-4171
SITE ADDRESS: 12994 SVS' 116TH FL P!'.KCEL: 2S103BD-09000
SUBDIVISION: HUNTER'S WOODLAND ZONING: R-4.5
BLOCK: LOT:002 JURISDICTION: TIG
REMARKS: New SF detached dwelling. Path 1
BUILDING _
REISSUE STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED _
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1.230 of BASEMENT: of LEFT: 5 SMOKE DETECTORS. Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 600 of GARAGE: 545 of FRONT- 15 r RKINC oPACES: 2
TYPE OF CONST: 5N DWELLING UNITS: I FINSSMENT: of RIGHT: 5
VALUE; $102,232.20
OCCUPANCY GRP: R3 BORM: 3 BATH: 2 TOTAL: 1.03000 of REAR: 20
PLUMBING
SINKS' 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB/SHOWERS: 3 GARBAGE DISP: I WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: I GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL.
FUEL TYPES FURN�100K: 1 90ILlCMP c 3HP: VENT FANS: 4 CLOTHES DRYER: 1
GAS FURN>•100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: I
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 •200 amp: 0 200 amp: W13VC OR FOR: 1 PUMP/IRRIGATION: PER INSPECTION:
EA ADD'L 50OBF: 3 201 400 amp: 201 400 amp: tel W/O SVC/FDR: 00 SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL aR CIR: SIGNALIPANEL: IN PLANT:
MANU HM19VCIFDR: 001 1000 amp: 601+ampa•1000v: MINOR LABEL:
1000•amplvolt: PLAN REVIEW SECTION
Reconi•ul only: >-4 RES UNITS: SVCIFDR>-22°^. >600 V NOMINAL: CLS AREAISPC OCC:
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO d STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM: INTERCOMIPAG NG: OUTDOOR LNDSC LT:
BURGLAR ALARM: 0TH: BOILER: HVAC: LANDSCa-�E',RRIG: PROTECTIVE 51GNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS:
"OTAL FEES: $ 6,625.89
Owner: Contractor: This permit IS Subject to the regulations contained it the
DAVE AMATO 8 ASSOC,LTD DAVE AMATO AND AS'.,UC LTD Tigard Municipal Code,State of OR. Specialty Codes and
P.O.BOX 19576 4351 SW CULLION BLVD all other applicable laws. All work will be done in
POR'IAND.OR 97280 PORTLAND,OR 97221 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
Phone: phone• Oregon I,r.v requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Reg 0: LIC 00208092 forth in OAF,552-001-0010 through 952-001-0080. You
may obtain coplss of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam Mealanica PLM/Underfloor Electrical Rough In Gas Line Insp Water Line Insp
Sewer Inspection Underfloor Insulat,,n Ftng Drain Bsm't Walls Framing Insp Gas Fireplace Appr/Sdwlk.losp
Footing Insp Crawl Drain/Backwater Mechanical Insp Shear Wall Insp Insulation Insp Electriczi Final
Foundation Insp Footing/Foundation Dr1 Plumb Top Out Exterior Sheathing Inst Rain drain Insp Mech,,lical Final
Post/Beam Structural Plrniundslab Insp Electrical Service Low Voltage Rain drain Insp Plt,mb Final
Issued By : Permittee Signature
Ca11 (503)'639-4175 by 7:00 p.m. for an Inspection needed the next ejaslnbss day
/ \ CITY OF Ti GAR® __ SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2001-00264
13125 SW Hail Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/25/01
PARCEL: 2S103BD-09000
SITE ADDRESS; 12994 SW 116TH Pl.
SUBDIVISION: HUNTER'S WOODLAND ZONING: R-4.5
BLOCK: _, LOT: 002 _ _ JURISDICTION: TIG
.10
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEVV DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: l_TPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF detached dwelling.
Owner: _ — _ FEES
DAVE &ATO& ASSOC. LTD
P.Ci. BOX 19576 Type By Date Amours Receipt
PORTLAND, OR 97280 PRMT CTR 10/25/01 $2,300.00 27200100000
INSP CTR 10/25/01 $35.00 27200100000
Phone: 503-245-2117 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
1 his 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 r3ermit expires. The Agency does not guarantee
the accuracy of the side sewer laterals. If the sewer is not located at the measurement given the insta ler 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
Issued by: X Permittee Signature:
Call (5031639-4175 by 7:00 P.M. for an inspection rmeeded the next business day
DAAL HOMES FEL H0 .2452117 Nov 12 .5< 0 : 19 P .02
p8/19i2001 M'2n rAX soisesipon cTTY t:r>= M-ART) /rfdl00�13
Radingperadt Application
Date lved� �-,.'
cry of Tigard Projeetlapp' I Exp►rc date
Address! 1312-5 SW HRll Blvd.'I igard,OR 97?21 -- �'�"Reeorptnu.:
Diiie issued 13 Y.-
City°fQ1 phe rllh;
one: (503) 639.4171 —
Case
591960
Fax: (503) R- _ - !_
i k•7(srn� � r.�mpie Cempl�x, .....
I and use approvrl l _-- — — ---- �
ew con9tnlcuc n U I Mn�bltuon
1 &2 family dwtslling or:tccescory Cl Commerc sal/Industrial O Multi.famijyr/yl� 1` Otho!. --
C Addit►t+Nalteradon/relllaCemcnt 7 TCn.rnr im n�>vtmcnt U 1'nr .P
t '
_ _ _ Sure nn_� _
d . +
„p b a�MSS fax map/tax 10VRCCOunt u,
/1`it _ BlocJc: _ Subdlvisiotl: ULt�oCo.�,o'�! l _' �l.�c'�- T
Project name• _- --.- -'—
Uewriptinn end Incadon of work on pretnilel/lpeclal conditir.nts.
Name; �L3U.7a�7 L�• —. (�
I K 2 famil) duelling:
Mailing a dtesl: -Cit Valuation of work -
: - st— _ _._
Phone:j 1 Fo%; - N. e;l: No,of bedrooms/baths. _
- ' '—� 'Total number of floors ..",•.
owner's rearntative: -- -
- &mW,, Nt.w dwelling.area(tq.fl,) ... ... ....... _. _
E'hvnc: '
OaraRt:/ctupottarta(sq. ft.)....., tab
_ t (-'vvet'vd porch atett(sq 11.)
Name --- -- darkrea a (w,ft.) ........
MatUn add
rely g?->Q ;�_�.� ?�P.-�r--- Other 6trilcwre arrft(sq.ft.).....,. ..,. �►�' —
state
C.�ti� dommprclal/ltnduslriallmulfi-taatllyt
Phtana; \` Ysx: E marl. n of w6ek a ..
Yaluutio
Existing bldg, area(sq.ft.) — --
t3usiness ours,:: f►1����, —��' 1' �
New bldg,area(� 1�.) ....... -
Addiwac Number of etoriea ..•......,..... .. .............Cl State:aYt aZ��d Typo of conetructlon.............N.
116:2 S,2.11 I Fxx: !�S Frma'1:— Occupancy ptoup(s) Fxisdnp: _—_.-� • ---
New-
City/metro tic. m --^ Nnfleei AM contractors and phertrip Blur are tcquird4 to Iw
licxnsed with the Oregon Construction Cr nitd,turn Board under
pluviiions of ORS 701 and may be requlied to be licensed in dtc
Name: �r _. fit — jntisditbf+n whet.wnrk is being perfulmcd II the applicant is
Addt . 'i ;jAr?.tom. _1`� ry' - - exempt from licenting,the f-illowing res%on
t''ity: nl+plies
�t� State 7V': ---- �.. -- -
('ontact persn_n _ t
rlirin�. ru•.'
Contact tletAOh; _ Fees due upon appllc+ttdnn ......•... . .............
Name: r"!-1 - 3.
Addroaet 1 {}t.l.v�1 Datr rr.ceived: _
Clt slate, ZIP, 7.'t Atimunt received ...................•........ ..
�� -
-- Please trtbt to lac ochedulc.
Phnnc; F'ax��� !i•mall: .-_._. .�.,....,..- _
Nrµqu turluWUWA WIPP("Td$t wnU,Pkw4 td:)urlptl04bn for w—irin nmuua�
1 hereby cectlty 1 have read and rxanilned this application MW tht+ rrn o M
attached cheaklilt. All provisi a of laws and ordinances governitil Up ren++� nun,
work will tw compllyd with, th�r l IW a III III not. uod .arp'^
"
r27-
late: ,
Authetited a
I
91
Print name. - - 440A613 arnKrtsn
1Jadce 7 hie pettMN applimtlon ottplres If a permit Iv not obtained within Ilio days after it has been aec*prPA nR oompler+-
Mechanical Permit Application
Date received: Petmitno.;�'S`T
City of Tigard Project/appl.no.: Expire date:
City of Ti-ard Address: 13125 SW Nall Blvd,Tigard,OR 97223 [late issued: By: Receipt no.:
Phone: (503) 639-4171 -
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: t3nildinl permit no.:
1
TN
&2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
cw construction U Addition/alteration/replaccrnrnt U Other:
1B SITF,"INFORMATION COMMERCIAL
Job address: ' Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment,lahor..overhead,
Tax map/tax lot/account no.: profit.Value$
Lot: Block: Subdivision: *See checklist for important application information and
Proiect name: jurisdiction's fee schedule For rcsidenlial permit fee.
City/county: ZIP: II
Description and location of work on premises: ► 1 I 01 11611,1 al I I
hee(ea.) Total
E.-.t.date of completion/inspection: L____04
,iriA Qty. Res.only Rc�c.only
Tenant improvement or change of use: Air handling unitCFM
Is existing space healed or conditioned?U Yes dNo Air conditioning(site plan required)
Is existing;space in,ulated?U Y, U No A Iteration of existing HVAC system
1 1 of er c impressors
State boiler permit no.:
Business name:
A.AN J6 NP Tons,_BTU/H
Address: p,�, Fir smoke amper uct smoke detectors
City: ��,_ State 7.1P: C1.'12AD rat pump(Mtte plan requirf.dTj
Phone _� Fax: '1"(�;-(� E-mail: Hata /rep ac- urnare/buner � 07{
Including ductwork/vent liner U Yes O No
CCB no.: Lnsta rep ac re ocate ears-suspen c ,
City/metro lic.no.: wall,or floor mounted —
Name(please print): r ` �� Vent for appl tante other than furnace
1 NTACT 1 e eral on:
Absorption unitsBTUIII _
Name: Chillers Ill'
----- — - ('um rrssor' __-- HI'
Address_ — Environmental rxtrausl an vent al nn:
City: Slate: ZIP: Applianctvcnt
Phone: Fax: E-mail: Dryer exhaust _
Mods,Type res.kitchenthaznint
hood lire suppression system
Nance: _ _ Exhaust fan with single duct(bath fans) _
Mailing address: — fix rW ousts stem a arl from eating or AC
('icy: �7St�ale: LIP: Fuelpiping an distribution(up to out etc)
—__. L_ Type: LPG NO Oil
Mimic: Fax: l Fucl pipingeach additional over 4 outlets
Process piping(sc ema(icrequirc )
Number of outlets
Name: —_ 1 ersl a p1lance orpmenl:
Address: ___ Decorative fireplace _
City: r _ Stair: 'T.IF': nsert-t e
moo stov
Phone: — Fax: E-mail: ---- pe et stove
other:
Applicant's signature: Date: Other-
Name(print):
Not all turiediclions accept cmlit cards,pletue can Jurisdiction fm attar Infortna0on Permit fee.....................$
U Visa U MasterCard Notice:This permit application Minimum fee................$
expires If a permit is not obtained Plan review(at __ %) t
credo rmd namher __—.__ ___ " �a within INO days after it has been —�
—on ,e��,3�-'— accepted as complete. State surcharge(R96) ....$
s TOTAL .......................S
— ( t1er sipnaltue T Amount 4404617(6010A'OM)
Electrical Pernut Application
`- - --- ,I,ucreceived: _-- Permit no713
..f
ij 11111 WUMM
City of Tigard Project/appl.no.: Expire date: Y ��
m of7igard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: - By: Receipt no.:
Phone (503) 639-4171
Fax: (303) 599-1960 1 Case file no.: Payment type: —`
Land use approval:
1
J I &2 family dwelling or accessory J Cornntercial/industnal J Multi-family J Tenant improvement
J New construction J111diIIon/allcration/rn•plac('nu•fit U Other: _ J Partial
11 SITF IINFORMAnON
Jot)address: Bldg.nu.: Suite no.: Tax map/tax lot/account no.:
-- - -- --
LAW Itl I. Suhdivislon:
Project name: Description and location of t+rrrk -
Estimated date of completion/inspection:-CQNTkA(-1'01R APPLICATION' 11-414" SCHMULE
Joh 110: fLr Mav
- Ilcscription Vty. (ca.) 1'olal nu.itis.
Business name: �l ' v��� tL CjS-%v•lC'_ — No"res ldential-singleorrnal0-familvper
Address: duelling unit.Includes stenciled garage.
City:" t Slatl�''y�, 7.1 P: tierticrhtcluderl:
—
• 1111a1. It .n I .�
Phone: . c i Fax:��' l: mall: y - - --- -- - - - -
I.i,! rllowiml51x)sit ttmportion lhcreot
CCB no.: lilec,hos. lie.no: _ I,Ill,;ii,leuetgy.residential
City/inetro,lie.tto.: -_ - Limiledencigy,non-residemial 2
Bach manufactured home or modular dwelling
Service and/tit feeder
signature or supervising electrician(required) hate
n
Sup.elcct.nante(prino: License no Serrlcesorfeede -Installstfon,
alteratlon or relocation:
fitOPERIA'011200 amps or less 2
Name( rint): 201 antes to 410 amps 2
401 amps to 600 amps _ 2
MA11ing address: _ (i01 amps to I(W amps 2
City: - State: ZIP_ (hvr10(10arnpt.(it volts — - — ?—
Phone: Fax: E-mail: Rcc uuirctoltly
owner installation:The installation is b inF made on property I own Temporary we ekes orfeeder-
which is not intended for sale,lease,rent.or exchange according to Installation,auerauun.orrelocation.
2fx)amps of Icss 2
QRS 447,4.55,479,670,701. -�- -
2(1{nntps 1o4-00 2
Q'Aner's signature: Date: 401 In(0)amps - _ -- 2
Branch circuits-new,sllerstion,
or eitenalon per panel:
Nanw: — A Fee for hranch cnctnts wah purchase of
Address: service or feeder fee,cath branch circuit 2
Cit - - -- State: 7,IP: H I-ee for hranch circuits without puichnse
City: _of service or feeder fee.First branch cucuil: 2
Photll• I .I 1'.-mail: Luck ndchtional hnuuh citcuH.
Misc.(Service or feeder not Included):
U Servicem :.•• MW veflicilily Each pump ar irrigation circle 2 _
U Service over 120 amps-ratrtigol I&2 1 Ilaruduuslocation Gachsign tit oullinelig htiug 2
for iflydwellings J Hml(ling over Ituelm)squate feel lnur of Slgnal c0cuulvJ or a hilwed enelF s panel,
U System overfiM volt'nonoral nacre residennal units to one slmctrne nhelnuou.or extension' — 2
U Building over thtm stones U feeders,400 amps of nxire +I x u np,l.m
U(kcupant load over 9w Nelsons U Manufactured strucl,ires of RV pack F/ch additional Inspection Mer the allo"ahle In anv of the above:
U 1'-1, 'li,hurt Ian U i Iduvet -.
.suhenil see,of plans with any or the shove. htv,•.uI•.,u��,,Ire - _._-__-,._- _—_
he alrreve are met applicable to icrnnore ry constr'urtion service.
Nnl ani
ll Pwhair accn( cept credil cmtk,plraw call lutiat'linn 11"Inrne uif.,in- ai Notley: I'leia flan rpermit application 1't'rr fee.....................
U Visa U MasletCard expires if a permit is not ohtamcd review(al
Or&cold number -___.-_...___ 1_- within Igo days alley it haN been Slate surcharge(M%,) .... _ _--
I.splres accepted ascomplcic TOTAL $ _
-- Nitrii d arrl"flnlrTit u I i'�own nn c�tl card
s
('rrdhrdder Ulnuure Amount s i hA NUCOM)
Plumbing Permit Application
City of TigardDate received: Permit no. 0
—
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Sewer permit no.: Building permit no.:
Phone: (503) 639-4171 Project'appl.no.: Expire date:
Fax: (503) 598-1960 Date issued: By: Recciptno.: i
Land use approval: Case file no.: Payment type:
1
❑ 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction U Add ition/alteration/replaceinenl U Food service U Other:
1 �
Job address: //'I�LVV 5k) - Description QtY. Fce(ea. Total
Bldg.no.: I Suite no.: Nc%% I-and 2-family dr►cllings(pill%:
(lttcludes I(10ft.for cacbn
ulililcconccliun)
Tax map/tax lot account no.: _. SIT I I)b
Lot: Block: Subdivision: 5 1a ;S—FR(2j Saul
Project name: SFR(3)bath -
City/county: ZIP: _ Each additional bath/kitchcn
Description and location of work on premises: Slteutililles:
Catch basin/area drain
Est.date of completion/insp,",l i II — brywells/Icach line/trench drain
PLUMPING CONTRWt011f Faxing drain(no.lin.ft.)
Business name: Manufactured home utilities
Address: _ Manholes
Rain drain connector
City: State: 7_,IP: Sanitary sewer(no.lin. ft.)
Phone: Fax:4: 0 -" E-m:i1; Storm sewer(no.lin.ft.)
CCB au.. 1®ZS Z.1 Plumb.bus.reg.no: '' _ � Water service(no.lire.ft.) r-
City/metro lie.no.: nVure or Item:
Contractor's representative signature: UC�' Absorption valve
Print name: Back flow reventer
Dale: Backwater valve
t Baginshavatory
Name: Clothes washer
Address: - Dishwasher
Idnkin fountain(s)City: State• ZIP: osumPhrme: Fax: E-mailpansion tank
Fixture/sewer cap _
Name(print): C7tior drains/Iloor sinks/hub --
Mailing address: --' Oarba 1,e dhipogal
Citzip:-
-gone:
Hose bibb
- Y State: ZIP: Ice maker -
Phone: Fax: Email: Interceptor/grease tray
(honer instal lation/residential maintenance only: The actual installation Pn cr(s)
will be made by me or the maintenance and!rpair made by my regular Roof drain(commercial)
employee on die property I own as per ORS Chapter 447. Sink( asin(s),lays(s)
Owner's signature: Date: Sump
Tubs/shower/shower pan
Name: (mal
Address^--_ --•--- --�-�- Water closet -�---
Water heater
City: ,y _ State: L1P: Other:
Phony_ Tax: I E-mail: - otal
Not dl J rtiaiictiora accept credit cards.please call Jurisdiction for more infarnallun Minimum fee................$ _
U V:a U MutetCitrd Notice: This permit application
expires if a permit isnot obtained Plan review(al _ %) $ _
Credit card number___________ 1 within I NO days after it has been State surcharge(8%)....$
-
....._ __.
accepted its complete. TOTAL .• $
None of car hail ri u shown nn reedit e�-- p .. ......•...•......
_ radhd�er iisnuwe Amowri
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A,AV IAASCMTIN et YOY Asiocurts tlt is Igor I ipARG. OR 2193
1
IONV Fp•11(AIK 00IACI rr nr roliv of Ir SUBDIVISION HUNTERS WOODLAND `�
nr orVArgll.r•IK ear IrEaDWeNr�rr or r•-
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• • A<�!!utfMwe>toreAaxun� ne DAVE AMATO 6 ASSOCIATES Lf
!rl/.eA� . IrLl.l Mllu
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
ENDERS ELECTRIC
PO E OX 1661
BEAVERTON, OR 97075
Electrical Signature Form
Permit #: MST2001-00498
Date Issued: 10/25/01
Parcel: 28103BD-09000
Site Address: 12994 SW 116TH PL
Subdivision: HUNTER'S WOODLAND
Block: Lot: 002
Jurisdiction: TIG
Zoning: R-4.5
Remarks: New SF detached dwelling. Path 1
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical pe:mit 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: Buiiding Dept.
No electrical inspections will be authorized until this completed form 's received
OWNED ELECTRICAL CONTRACTOR:
DAVE A°MATO & ASSOC. LTD ENDERS ELECTRIC
11.0. BOX 19576 PO BOX 1661
nnp rt anis np 97280 BEAVERTON OF? g7n75
Phone # 503-245-2117 Phone #: 626-4813
Reg #: uc 00028x28
SUP 2028S
ELE 34-265C
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of Suoervising Electrician
If you 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 PI_UMB!NG INC
6536 NE 63RD
PORTLAND, OR 97218
Plumbing Signature Form
Permit #- MST2001-00498
Date Issued: 10/25/2001
Parcel. 2S103BD-09000
Site Address. 12994 SW 116TH PL
Subdivision: HUNTER'S WOODLAND
Block. Lot. 002
Jurisdiction: TIG
Zoning: R-4.5
Remarks New SF detached dwelling. 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 Si,,,ature Form prior to the start of the work to the address above, A TTN. Building
Dept.
No plumbing inspections will be authorized until this completed form is received
OWNFR PLUMBING CONTRACTOR:
DAVE AMATO & ASSOC. LTD EAST WEST PLUMBING INC
P.O. BOX 19576 6536 NE 63F.D
PQRTLAND, OR 97230 PORTLAND, OR 97218
Phone # 503-245-2117 Phone #: FAX 590-6226
Reg #: L.IC 102521
PI_M 26-532PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X / /��-
Signature of Aut 'izeJ Plumber
if you have any questions, please call (503) 539-4171, ext. # 310
DAHL HOME' TEL NQ .2452117 Mar 23 ,8 ; 5 :57 P .03
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CITE( OF TIGARD 24-Hour
BUILDING Inspection line: (503) �-.4-417 MST
INSPECTION DIVISION Business Line: (503) :39-417
BUP -
Received ___- -Date Requested �`G AM BUP __--_-
Location _- f / �l ._ l�� 44, f'Z-- -Suite MEC
Contact Person — '--e--� Ph( �) S� ( t ! PLM
Contractor_ - Ph( T S; �� �� SWR — _---
BUILDINr —� TenantiOwner _ ELC
Footing ELC
Foundation Access:
Ftg Drain (__ /-� �'� l l3 b J( `2 FLR
- _
Crawl Drain _—LJ
Slab I Inspection Notes: SIT
Post& beam
Shear Anchors
Ext Sheath/Shear _ _-
Int Sheath/.near l ^
Framing -- - -�� - - - ---
Insulation
Drywall Nailing - -
Firewall
Fire Sprinkler '-
Fire Alarm
Susp'd Ceiling --- _ --- --
Roof
Other: —
maf`
-PASS PART -----
y PLUMBING__
Post&Beam
Under Slab ----- - ------ ---- ------
Rough-In I -
Water Service -------- -- - - - ----
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain - _ ___.. ._...- ---. -
Shower Pan
. -gar: _ --------------__._._ _.------ --
JA88 ART FAIL ----- _ _- - ------ --
k115"C-HAUMAL --
Post& Beam -
Rough-In - ----- -- -- - - ----- - --- - -- -
Gas Line
Smoke Dampers --------- __ _ --- —
Final
S PART FALL - - - -- --` --
.. ECTRICAL
Service
Rough-In
UG/Slab
Low Voltage - - --------- - _ ----- -- ----
Fire Alarm
Final Reinspection fee of$ required hefore 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
Approach Sidewalk
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour -
BUILDINOc Inspection Line: (503)639-4175 MST ���� _ G�-��99INSPECTION DIVISION Business Line: (503)639-41 1
BUP _
Received — Date Requested /� 7 AM �>PM_ BUP
Location —_l L. 9 �� ��L- Suite MEC
Contact Person ph( ) _ Y.5— / /:Z PLM
Contractor _ -- Ph(--) IK-7-03d SWR
BUILDING Tenant/Owner _ __-- ELC
Footing
Foundation --�-- --- ELC
Access: _
Ftg Drain I -'� �.. ELR
Crawl Drain ----
Slab Inspection Notes: _ SIT
Post&Beam —
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear ----
Framing � - --
Insulation T
Drywall Nailing i � �f1 _ +�L�
Firewall
Fire Sprinkler ____/ 4S_ �V�_Vt l�/ J 0 q, v
-
Fire AlarmN
Susp'd Ceiling
Roof
Other:__ ---- --- - --- ----
Final
PASS _PART FAIL -- Y ---
PLUMBING _ iy ��t:- 'V
Post Beam
Under
Sleb
Rough-In
Water Service ---- _ _ —
Sanitary Sewer —
Rain Drains
Catch Basin/Manhole
Storm Drain - �'` — ----��`�`/
Shower Pan
Other: ----- -— -- — -
PART FAIL
W4_ HANIC_AL —
Post&Beam ---- ------ --- ---- --_�—._ -- _.---
Rough-In
Gas Line ---
Smoke C iers _---
Final -----____--.- — -
PASS PART FAIL.
ELECTRICAL
Service — -------- -- -- --
Rough-In
UG/Slab — -- -- --- --- -- —. -
Low Voltage
Fire Alarm _--_.___ _--___-- ------_----- --.---.__. _
Final Reinspection fee of$-._ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd-
PASS PART FAIL
SITE _— _—_ __ �� Please call for reinspection RE: Jnable to Inspect no access
Fire Supply Line
ADA ( �C✓�
Approach/Sidewalk DateO?� Inspreter Z
7
Other:
Final —_---�- DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour ,Q
BUILDING Inspection Line: (503) 639-4175 MST
INSPECTION DIVISION Business Line: (503) 639-4171
7 BUP
Received -_ Ca a Requested / AM- _ _ PM BUP -_
LocationW� _.Suite._ _---- MEC
Contact Person -- Ph(— —) -_ -- - __ _ ___ PLM
Contractor —_—___—, _— Ph(---) SWR
BUILDING Tenant/Owner _____._____--.-_- —._ - _ ELC
Footing ELC _- - -
Foundation Access:
Fig Drain ' ' 4 ( ..� �r v �/ 4121.(, - ELR
Crawl Drain
SIT
Slab Inspection Note
s
Post&Beam
Shear Anchors _ ,r
Ext Sheath/Shear d 64c
Int Sheath,'Shear
Framing — --- - - - -
Insulation
Drywall Nailing - - -- -_
Firewall
Fire Sprinkler - -- - -- _-- -
Fire Alarm
Susp'd Ceiling
Roof
Othar --
Final
PASS PART FAIL _—
PLUM SING __7Z_
UnderPost 8 Beam
Under Slab
Rough-In
Water Service --- --------- - -- -
Sanitary Sewer
Rain Drains -- - — ——
Catch Besin/Manhole
Storm Drain -- - - —
Shower Pen
Other: -------------- ----. -
-------------------
Final
PASS PART' FAIL
MECHANICAL - -- - _ - - — ----- - -
frost& Beam
--
Gas Line
Smoke Dampers -
Final
rL�q7PA FAILCTRIC4
Rough-In —
UG/Slab
Low Voltage - --- --�.�._ -- - ---- -- _.
Fire Alarm
ZS
Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL---
Please cell for reinspection RE: — _ Unable to inspect-no access
Fire Supply Supply Line
ADA
Date __� � � �'11Riictor ---- ___- ___fit.._..-�
Approach/Sidewalk -- - -
Other. ------._._
Final QLD NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL