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12996 SW 116TH PLACE cn ca N J V n 12996 S!N 116'x' Place CITY OF TIGARD _ PERMERM TR HERMIT IT #: MST2001-00496 DEVELOPMENT SERVICES DATE ISSUED: 1116/01 13125 5W Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: '12996 SW 116TH PL PARCEL: 2S103BD-08900 SUBDIVISION: HUNTER'S WOODLAND ZONING: R-4.5 BLOCK: LOT:001 JURISDICTION: TIG REMARK: New SF detached dwelling. Patti 1 BUILDING _ REISSUE: STURIES: 2 FLOOR AREAS REQUIRE^SETPACKS REQUIRED - CLASS OF WORK: NEW HEIG-" 23 FIRST: 1 108 at BASEMENT: at I Er': 24 SMOKE DETECTORS Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,160 at GARAGE: 528 of FP,,NT: 21 PARKING SPACES: TYPE OF CONST: 5N DWELLING U JITS: 1 FINBSMENT: el RI'11T 4 VALUE: $218,04720 OCCUPANCY GRP: R3 BORM: 3 HATH: 3 TOTAL: 2.26800 at REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: i LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAI 4 DRAINS: I CATCH BASINS: TUB/SHOWERS: 3 GARBAGE DISP: I WATER HEATERS' I WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS OTHER FIXTURES. MECHANICAL. FUEL TYPES FURN t 100K: BOIL/CMP<3HP: VENT FANS: 4 CLOTHES DRYER: 1 As FURN>•100K: I UNIT HEATERS: HOODS: I OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL _ RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDER9 BRANCH CIRCUITS MISCELLANEOUS ADO'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 0 200 amp: WISVC OR FOR: 1 PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: 4 201 400 amp: 201 400 amp: let WIO SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL OR CIR: SIGNAL/PANEL. IN PLANT: MANU HMISVCIFDR: 401 • 1000 amp: 801+8mpa•1000v. MINOR LABEL: 1000+amolvolt PLAN kV/IEW SECTION Rncormect only: >•4 RES UNITS: 9VCIFOR>•22S A.: >600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B COMMERCIAL AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNOSC LT. BURGLAR ALARM: 0TH. BOILER: HVAC: LANDSCAPE/IRRIG: f'ROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTROM NTA110N: MEDICAL: OTHR: HVAC: DATA/1 , COMM: NURSE CALLS: TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 7,001.44 This permit is subject to the regulations contained In the DAVE AMATO&ASSOU.LTD DAVE AMATO AND ASSOC 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 PORTLAND,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 law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Pati 0: LIC 002080a2 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 Control Insp 8, Post/Beam Mechanica Mechanical Insp Shear Wall Insp Rain drain Insp dumb Final S-awer Inspection UndeNtnor Insulation Plumb Top Out Exterlo•Sheathing Insl Water Line Insp clnal Inspection F-)oling Insp Crawl Dralrl/Bad,water Eitctrical Service Low Voltage Appr/Sdwlk Insp Foundation Insp Footing/Foundation Dr Electrical Rough In Gas Line Insp Electrical Final Po-t/Beam Structural PI-M/Underfloor Framing Insp Insulation Insp Mechanical Final Issued By : �,1_ Permittee Signature: Call (503) 639-4175 by 7:00 p.m. for an Inspection needed the next business day DRRL HOMES TEL NO .2451117 Nov 12 ,5< 0 :20 P .03 09 19/2001 itt:2t1 FAX 50A5981961) CITY 1..F TIGARD fQ1q(12 Building Permit Application Iftialk Li of Tigard ---- _ — _ 6 ltojecHappl.nn.; I:xr�ire date. - Cirynj -ML Addrebs: 13125 SSV Hall Blvd,Tigard,OR 97223 - Phone: (503) 639 4171 Duteissuad: — nY Rcccip ne. Fax: (303) a98-1960 ...rscfilcno I`ayn,c LCfO f.,mf1Y Sln'.(ae Cunrplca L band use approval: i &2 family dwellmr,or ecceisory CI Commercial/industrial U Multifamily Grillew eonstmCU011 -►1,'n I tion U AddidrnValteretiorVrCpincetnGnt CI Tenatlt improvement ❑1•ne ,rritillici/alami 1_1 Other, r; r t rte, Job address: � �. Lot; -'�lock- V1 slot) •�-�4.:/�,, '�--- Tax /tajx lot/accuuut no_: :�y , f ..Pto)trt nt+rnr Description and liLahon of work on premisawspeciliJ conditiollk ____ '1 �= ----- ••_- __.._ -- h.. taki U 11,Will, Name�"L.11'- +�l�zt L X�_•cam _. L� , fill 1114t.1% MaJlin nddrops, _jC� I &2 fatally dwel ilig: •at, State #V?— ZIP:c VAIllation of work. ...._.................. ... .. ..... Y. D �2 . Phene: •�L�r�•L Fax: • F-n L NO hl'helirtxima/baths..... ................ .. . _ ---- Ownor's tr r�rose;ttlttive; ( fore/number of floors ............ . . _ E-marl: area dwrllin (s New .�.�. • -" Phone: lhlx' tt '�.A.) .... . C,arnye/carlan arra(sq.R.)... . .. - Name: A�-.�,r�[�. Covered PQrrh a•ea(Sq ft.) _ AU 1Io'�4,Yi beck area(sq ft,l r-- Mailin addreov Vj3. G IcLLJ �c ......,,._ ....... -- _- -- -- - Other suucaarr area,sq. fl.j. ... sutc� city: - +. - Cotntnet•Clal/itldwh'iaUmultfi-family! p�,,,,r - tu: a•mail: S Valuation of work..,,...,. .. ..••..... ....... --- -- Existing Wt., arca(trq.ft.) ,. suslneas name, 6 frY'�IA'O ,�► ;�1-'R�'---_.__. . New bldg arra(sq.fl.) -- Ad(treea ��.Q. -lea-- -------- Wrfber of stories ............ ...... ....... _.---- (^,lt -eTldN ✓L�_ Stat6:0Y1_ UP; � 1 =�_-- ;ype of cont;rmcdon....... ...... _—_-- ann:l " 1ax:��S:2�3 1�•MaIL ----- Occupancy Ettnup(r): C -- City/metro list, no.! - --•__.__-. Notice:All r,)ntrnctbrs and subrotiutic tore arc tcquired ft,I,,! licensed Wilt the Clrcgon ConstiltrNnn cnnttHoom board undo Nutlet provisions M URS 701 anti may be tequhe,I t„Ix;licensed in the - -(�.�-.� - . _-_.......__—_- jurisdictlon where work is heinl+ir_riormed. If the applicant i t Address: Lie.)w_ V _ ZIP exempt from licensing,the follrwutP Witt")ehphe.� city:_y 1.1.1,_—_. Statepa. - Gonuct�etson:�,yt I J tan nu.: Phone Frw(: F•mrul. _ _.- - Name: C Conjoel.q Mon,'�5+�._..—_ Fees due uhor,appllcauon ... ...... . ... S .... ..--.------_- Date receivrd, CI;y (rwz �fttctr , 'l!P ��1"ZZ� Atnaunt reserved "rle+sc cerci to fee al(cdur. Phrne,�. •Z Fa,�: p=1'��s1"�"marl: :�l-- -.------ - .. . I hereby eemlN 1 hnvr,read raid exuninad this applItAtlon and the Nei�tt,,�w u^N Wept t,�, pteee call inn, r.r,n•re InCwtNaaon attached checklist All rnwls a of ittwa and ordinances governing thle 1i��9eo cl work will be,complied with, they s ed he In or not eetAll e.nr"uAA1) Author iced signature t u,fnni �.,i:.•^ a��rf A » Print name, .�►. r , Iirrtiom ez p! n s ted as complete r Mrs�tiID tNtRKr' Nnrlrv-�'ff,i� ermh al r rl�+t a rtt+h It not ebtritterl within 180 days after it has btrr,ttcvcp D "y' Mechanical Permit Applicw<ion -- r. ed: Permitno.:/. City of Tigard pl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd,'rigard,OR 97223 Phone: (503) 639-4.71 Date issued: By: Receipt no.: Fax: (.503) 598-19tt0 Case file.to.: Payment type: Land use approval: liudding l,crmit no.: Wall C ly dwelling or accessory U Commercial/industrial al Multi-family U Tenant impmvemenl YI &2 fami Cid New construction U Addilium/;iltt r;nitm/rcplaccn,rnt U Other: JOB kl)rE INFORMATION COMMERCIAL VALUATION SUIIF�DULE lob address: _ Indicate equipment quantities in boxes below. Indicate the•doll,u Bldg.no.: Suite no,: value of all mechanical materials,er•lipment,labor,overhead, Tax map/tax lot/account no.: profit. Value$ Lot: ' j Bloc:k: Subdivision. 'See checklist for important application infirrmaticn and Project none: jur; ii,ton's lee schedule for residential permit ''ire. City/county: ZIP: �- 11 as Q Irr j r Description and location of work on premises: l 1 r 1 r -- - Fee(".) '14)181 _Est.date of completion/inspection: _IMuri Ni4)n - OIC. Res.onis Res.onl Tenant improvement or change of use: r I AC: Is existing space heated or conditioned?U Yes U Norr conditionind i Aii handling unit ._ c't I - g(site p an require Is existing space insulated'!U Yes U No A a:retion of existing C system— -- oi er compressors -— Business name: �� j C = _ Slate boiler perini:no.:- t -- HI' Tons Address: BTU/BTU/14,p;� v-" - Pire smo c ampers/ uct smoke detectors Cit y: �C Slate 7111: r t_I�c� cat pump(site p an rare uirecT— — Phone: 1-r, Fax: E-mail: - -- Install/replace urnac urner i'r - CCB no.: I �— - Including duclwork/vent liner U Yet;U No _- �- nsta rcp ac re ocnte heaters- suspen e , City/metro lie.no•: wall,or floor mounted Nance(please print): '-- Cnt fou a) IMth c of er 1 ian furnace - e genal on: Absorpfionunu� _ STUM Name: Chillers—___ III' - AddrCse,. - Com tressors.-__-- - III -- nv ronmenial ex taucl and ventilation: City: -- _-- -_ State: LIPS Appliance vent Phone: Fax: E-mail: )ryercx aust - Floods,Type / res.kitcTn/Ifnzmnt - hood fire suppression system Nerve: — :F- lixhaust fan with single duct(bath fans) Mailing address: ,iausl s stem amet from ieCity, St -2: �_P P ng an st ailon(up to out ets) Type: LPG __ Ner _ Oil Pltonc: Fax: ail: �cl piping each a(Rdifional over 4 outlets -- "- Process piping g(sciematicrequirc ) Number of outlets Name: er FaW a p ince or equipment: Address: Ikcoralivefireplace City: _ State: ZIP: nscrt -type_ - ---_ Phone: Fax: - Email Woo sloe pe let stove Applicant's signature: Date: -Wirer- Name 61 e'-1 r — - ---� 1 er: Nance (print): - - Nal alljnNsdislions wt co ciedh cards,pleas<call juriiulictirm fia nuur htnutnati,m Permit fee.....................$ lUviau iUMusterCarrl Notice:IfI�is permit application Minimum fee................$ expires if a permit isnot uhtained Crcdlt card aanAber -__L1�. Plan review(at _ '��) E:apims within 18()days alter it has been State surcharge(8%)....$ WWW of carttho r as�hnwn on c It car accepted as complete. - -�-- Cardholder signature — Anmin- 410J617 1tiNORY1Mt MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE; 1 & 2 FAMILY DWELLING FEE SCHEDULE: Price Total TOTAL VALUATION: PERMIT FEE: Description: Table 1A Mechanical Code Qty (Ea) Amt $1.00 to$5,000.00 Minimum fee$72.50 1) Furnace to 100,000 BTU $5,001.00 to$10,000.00 $72.50 for the first$5,000,00 and Including ducts&vents 14.00 $1.52 for each additional$100.00 or F 100,000 BTU+ $10000.00. fraction thereof,to and including 2) Furnace ducts&vents 17.40---- $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace $1.54 for each additional$100.00 or including vent 14.00 frartion thereof,to and including 4) Suspended heater,wall heater $25,000000. or floor mounted heater $25,001.0-0-t 0$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not included in appliance permit 6.80 $1.45 for each additional$100.00 or fraction thereof,to and Including 6) Repair units $50 000.00. 12.15 $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Bonar Heat Air $1.20 for each addittonat$100.00 or For Items 7-11,see or Pump Cond frgction thereof, footnotes below. _ 7)<3HP;absorb unit Minimum Permit Fee$72.50 SUBTOTAL. $ to 100K BTU 14.00 8)3-15 HP;absorb w 8%State Surcharge $ unit 100k to 500K BTU 25.60 9)15-30 HP;absorb 25%Plan Review Fee(of subtotal) $ unit.5-1 mil BTU 35.00 - Required for ALL commercial Nsrmits only 10)30-50 HP;absorb TOTAL COMMERCIAL PERMIT FEE: $ unit 1.1.75 mil BTU 52.20 11)>50HP:absorb - --- - unit>1.75 mil BTU 87.20 12)Air handling unit l0 10,000 CFM ASSUMED VALUATIONS PER APPLIANCE: 10.00 Value Total 13)Air handling unit 10,000 CFM+ Descr�l tlon. of Ea Amount 17'20 %mace to 100,000 BTU,including 955 14)Non-portah')evaporate cooler 10.00 ducts&vents - Fumace>100,000 BTU Including 1,170 15)Vent Lan wnnected to a jingle duct ducts&vents 6.80 Floor furnace includingv_ent 955 _ 16)Ventilation system not included In Suspended heater,wall heater or 955 appliance permit 10.00 floor mounted heater _ 17)Hood served by mechanical exhaust Vent not Included in applicance 445 _ 10.00 10.00 permit_ 18)Domestic incinerators Ria air units _ 805 17.40 <3 hp;absorb.unit, 955 19)Commercial or Industrial type incinerator to 100k BTU 69,95 3-15 hp;absorb.unit, 1,700 20)Other units,Including wood stoves 101k to 500k BTU 10.00 -15-30 hp;absorb.unit,501k to 1- 2,310 21)Gas piping one to four outlets mil.BTU 5.40 30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each) 1-1.75 mil.BTU - - 1.00 absorb,Unit, 5,725 Mini_ __mum Permit Fee$72.50 SUBTOTAL: $ >50 hp; >1.75 mil.BTU Air handling unit to 10,000 cfm _ _ 656 8%State Surcharge $ Air handlin unit>10,000 efts _1,170 Non-portable evaporate cooler _ 056 TOTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to;.3 single duct _ 446 Vent system not Included in 656 appliance ermit Other inspe0ons and Fees: Hood served by mechanical exhaust 656 1 Inspections outside of normal business hours(minimum charge-two hours) Domestic Incinerator _ 1,170 _- $72 50 par hour Commercial or Industrial incinerator 4,590 2 Inspections for which no fee is specifically Indicated (minimum charge-halt hour) $72 50 per hour Other unit,Including wood stoves, 656 3 Additional plan review required by changes,additions or revisinns to plans(minimus Insetis etc. _ -, �, serge-one-half hour)$72 50 per hour C3as ii in 1.4 outlets 380 -_... Each addltlonal outlet 63 "Stale Contractor Boller Certiilcatlan required for units>200k 81'J. "Residential A/C requires site plan showing placement of unit. TOTAL COMMERCIAL >� iAdsts\forms\rnecfl-fees.doc 08/06/01 Electrical hermit Application Date received: Pcrnut no.: City of Tigard Project/appl.no.: Expire date: Ciryu(Tioarnf Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receiptno.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: 1 U 1 ,4- 2 family dwelling or accessory U Commercial/industrial J Multi-family U Tenant improvement 'J New construction ❑Additicm/alteration/n plat cnit'n1 J Other: U Partial 1 Joh address: `? - �� / ' lilrlg. 1)(11: JuneTax map/tax lot/account no.: Low: J Bloch: _Subdivision: Project name: _ _ Description and location of work on premises: Estimated date of conlpletionhnspection: Job no: -- I Fee Max Business name: L.:.Lj YtS �,�,��r Uehcription Qty. (ea) Total nu.insp Address: New residential single ur multi-family per_--1-- - dwelfing unit.Inrlmfes attached garage. City: 1 St ZIP: Service Included: Phone: z Fax:6 E-mail: 100()sq.ft.of doss 4 �` Each additional SW sr.ft.or portion thereof CCB no,: .%I /I7 Elec.hus.lic.no: 3t.( Limited energy,residential 2 City/metro hc.no.: iC C, c'J Limited energy.non-residential - _-- 2 Each numulacotred home or modular dwelling Signature of supervising.electriciar.(requited) Date Service and/or leerier 2 Sup.elect.name(print); l,ic.,.r„t.r,, l; )� S Services or feeders-installation, eration or relocation: 1 I amps or less 2 Name(print): 1 amps to 4W amps _ 2 1 arnps to 600 amps 2 Mailing address: 7-74 1 nmpN to IWofliops 2 City: State: ZIP; er 1000 amps or volts 2 Phone- FitX: E-111aiI: Reconnectonly I owner installation:The installation is being made on property I own Temporary services or("derx- which is not intended for sale.,lease,rent,or exchange according to Installation,alteration,or relocation: ORS 447,455,479,670,701. 200 amp.or less 201 amps to 400 amps -- 2 Ownces si nalurv_: Date: 40o 6a)amu - - - -- 2 Bnrnch circuits-new,alteration, Na or extension per panel: A Fee fur hranch circuits with purchase of Address:� service or feeder fee,each branch circuit 2 me: City' State: l_IP: H. Pee for trench rircultswithout purchase of service or feeder fee,first branch circuit: 2 Phot” I I e I' rtt,irl Nae•hadditional branch circuit: 11M I III I Misc.(Service or feeder not Included): U Service over 225 amps-eniomercial _1 1 10111-care facildv I-arch pump r.,irrigation circle 2 U Service over 320 amps-rating of I&2 U Ilurardous kwation Each sign or outline lighting 2 familydwellings U Buildup over I00)0square feet four or Signal rircuu(s)ur a limited energy panel, U System over(0X)volts nominal more residential units in one sltvcture alteration,or extension' 2 U Building over three stories U Feeders,41K)amps or more Descri lion: — U occupant load over q4 persons U Manufactured structures or RV park Fach additional Inspection over the allowable In any of the above: U Egress/lightingpdan U Other __.-._._.__. l'etInspection T—Submit,ra'rN of plans with any of the above Investigation fee The above are not applicable(o(emporary construction vers ice. Other _ Not all furisdiolou srcept credit card.+,please call)utiulicunn for mote InGlrolawm Notice:'Phis permit application Permit fee..................... U Visa U MasterCard expires if a permit is not obtained Plan review(at — IN') $ �— cmdii card number,_ _., i �-__f within 180 days alter it has been Stale surcharge(8%) ... $ _ Expire+ accepted as complete. TOTAL .......................$ Name of ca R n nl r an shown air credit r - — _ S CWAohfet�iRnnmre -�� -- Airounr� 4404615 tMM'oMl ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY Com Tete Fee Schedule Below: --- P Restricted Energy Fee...............•............................ ....... $75.00 Number of Inspections per pe rnil allowed (FOR ALL SYSTEMS) Service included: Items Cost Total _ Check Type of Work Involved: Residential-per unit 1000 sq.ft.or less $145 15 4 ❑ Audio and Stereo Systems" Each additional 500 sq.il.or portion thereof — $33.40 _ 1 ❑ Burglar Alarm Limited Energy $75.00 Each Manuf U Home or Modular El Garage Door Opener' Dwelling Service or Feeder $9090 Services or Feeders ❑ Heating,Ventilation and Air Conditiuning System' Installation,alteration,or relocation 200 amps or less _ $80.30 2 ❑ 201 amps to 40U amps $106.85 2 Vacuum Systems' 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 ❑ Other Over 1000 amps or volts $454.65 7. Reconnect only $66,85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Installation,alteration,or relocation Fee for each system.......................................................... $75.00 200 amps or less $66.85_ 2 (SEE CAR 918-260-260) 201 amps to 400 amps _ $100.70_ 2 401 amps to 600 amps _ $133.75 7. Check Type of Work Involved: Over 600 amps to 1000 volts, ❑ see"b"above. Audio and Stereo Systems Branch Circuits ❑ Boller Controls New,alteration or extension per pan I a)The fee for braich circuits with purchasr,of service or L C7 Clock Systems feeder fee. Each branch circuit _ $665 ❑ Data Telecommunication Installation h)The foe for branch circuits without purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $4685 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous ❑ Instrumentation (Service or feeder not Included) Each pump or irrigation circle $53.40 _ ❑ Intercom and Paging Systems Each sign or outline lighting $53.40 Signal circuit(s)or a limited energy �!— panel,alteration or extension $75.00 ❑ Landscape Irrigation Control Minor Labels(10) $125.00 _ Medical Each additional Inspection over ❑ the allowable In any of the above ❑ Per Inspection $62.50 _ Nurse Calls Per hour _ $62.50 _ In Plant $73.75_ ❑ Outdoor Landscape Lightrig' Fees: ❑ Prntective Signaling Enter total of above fees $ ❑ Other - 8%State Surcharg,+ $ ---------Number of Systems 25%Plan Review Fee ' No licenses are required Licenses are required for all other installations See'Plan Review"section on fruit of apldication - — — Fees: Total Balance Vue Enter total of above tees $_ Trust Account N _._- 8%Stale Surcharge $ i Total Balance Due : All New Commercial Buildings require 2 sets of plans. i fists\formgklc-fees.doc 08/30/01 Plumbing Per>init Application Datereceived: Permit no.: City of Tigard Address. 13125 SW Hall Blvd,Tigard,OR 97223 Sewer permit no.: Building permit no.: 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: 7&2 y dwelling or accessory U Commercial/industrial O Multi-family U Tenant improvement uction U A,Iditiotl/alteration/replacement U Food service U Olhcr: _*8,81A INFORM&ION1 t t Job address: — _ De_wri .ion �011. 1,ee(cit.) Total Bldg.no.: Suite no.: New 1-anti 2-famIIN dNsvIIiog%o I% Tax map/tax lot/accoun:no.: �— (includes 100 ft.for eachatilit r -m mt•ru.ut; SFR(1)bath Lot: ) Block: Subdivision: �U�,+V, `y l�Lro��tx SFR(2)bath — -- — Project name: — SFR(1)bath — -- —City/county: ZIP: Each additional bath/kitchen _ Description and location of work on premises:.___ a Siteutilitlres: Catch basin/area drain _ fist.date of completion/inq)ection: Drywells/leach lineitrench drain _ Footing drain(no.tint fl.) Manufactured home utilities Business name: (�1:�t ,z ,Ua Manholes Address: _ R•!.in drain-:Prnrctor — _City: State: ZIP: Sanitary sc%,,!r(no. lin.fl.) — — Phone: Skb I Fax:: c0 u(, E-mail: Storm sewer(no.lin. ft.) CCB no.: Plumb.bus.reg.no: Water service(no. lin.ft. �� ' z�e-5'SL City/metro lic.no.: Fixture or iters: Contractor's representative signature: Absorptiun valve Print name: bate: Back flow reventer Backwater valve Basins/lavatory Nalnc: Clothes washer _ ----- Adldress.— Dishwasher - ---1 Drinking fountain(s) - ( ity: State: ZIP: Ejectors/sump -- Phone: Fax: E-mail: Expansion tank _ Fixture sewer cam_ _ Name(print): Floor drains/tloor sinks.1tuh Mailing addnes;— Garbage d�is~iosal -- I lose hibb City_!---__ � State: ZIP: Ima Phone Fax: Ice ker E-mail: Ice ma nor/grease trap _ Ownrr instal lation/residentiat 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 paotwrty I own as per ORS Chapter 447. Sink(s), usin(s), ays(s) Owner's si nature: I)atc: Sum Tubs/shower/showcr pan Name: Urinal - ------ ---- Water closet Address: __ —— — —Water heater — City: —�_ State: ZIP: Other: — — Phone: Fax: _ l?-mall: -- • otal Not all Judadtctiarts accept ctedit cards•please cell Jurisdiction fro oars InformationMinimum fee................$ Notice: Iltis permit application —' U Visa U MasterCard expires it a permit is not obtained Plan review(al — %) $ Credit card nurnhcr _ — –J within 180 days after it has heen State surcharge(8%)....$ —_ FlPlrea Nene of cardhnlrkr as shown on credit crud — accepted as complete. TOTAL .. ....................$ s --- Cardhohkr signature _ -- — – Amount 44-M16(6000/COM) PLUMBING PERMIT FEES: - - - PRICE TO'fA,L OTAL New 1 and 2-family dwellings only: f FIXTURES individual))-- _ QTY _ ea AMOUNT (includes all plumbing fixtures in PRICE e,0UNT Sink t6.60 the dwelling and the first100 ft. QTY (ea) 1G.60 for each uqy- _nnection I Lavatory _ _ - One 1 bath 3249.20 _ Tub or Tub/Shower Comb 16.60 Two 2 bath $350.00 16.60 Three 3 bath 3399.00 _ Shower Only '--- Water Closet 1660 OTAL Urinal 16.60 8Y.STeTE SURCHARGE Dishwasher 16.60 PLAN RF.VIEW 2a'/�OF SUB 10TAL TOTAL Garbage Disposal 16.60 _ --- - Laundry Tray 16.60 - Washing Machine - 16.60 FloorDmin/Floor Sink, 2'- --16 60 PLEASE COMPLETE: 3- 16.60 4" 1660 _--- ---- Ouantir b Work Performed _ Watereat Her ir conversion O like kind 16.60 Fixture Type: New Moved Peplaced Removed/ Gas piping requires a separate mechanical j,�ppe _ _permit. Sink NIFG Home New Water Eervice 46.40 Lavatory - MFG Home New San/Storm Sewer 46.40 Tub or Tub/Shower Hose Bib: 16.60 Combination --- Roof Dfains 16.60 Shower Only Drinking Fountain 16,60 Water Closet _ Urinal Other Fixtures(Specify) 16.60 Dishwasher Garbo a Dis osal -- Laundry Room Tray _ - Washing Machine Floor Drain/Sink: 2" "ewer-1st 100' - 55.00 3" - - -_- sewW-each additlonal 100' 46.40 4" er Water Service-1st 100' 55.00 Water Heater _ Other Fixture:• Water Servll,-each additional 200' 46.40 _ (Specify) _ Storm&Rain Drain-1st 100' _ 5500 Ston:1&Rein Drain-each additional 100' 46.40 Cnmmerclal Back Flow Prevention Device 46.40 -- Resldontlal aackflow Prevention Device" 27.55 Catch Basin 16.60 _ Inspection of Existing Plumbing or Speclally 72.50 COMMENTS REGARDING ABOVE: Requested Inspectlons - or/hr -_-_ Rain Drain,single family dwelling 65.25 - Grease traps 16.60 - --- -- - _- QUANTITY TOTAL ---J� - Isometric rn riser diagram is required if ----- Ounritily Total Is-;-9 "SU9TOTAL Sols STATE SURCHARGE - --� "PLAN REVIEW 250/,OF SUBTOTAL RAquired onNif fixture qty total Is d TOTAL S "Minimum permit fes is$72 5e•8%state surcharge,except Residential Backflow Pre, .noon Device,whet Is$ae 25•P%state surcharge "All New Commercial Buildings require t sett of plans with Isometric or riser diagram for pion review. I:\dsts\forms\plm-fees.doc 08/29101 tn � G O � !0 H h � �. v "�'' Obi 2 •», n Z °a. � � � �, �' ?" � � ~' a � � o H .T '� � \� C Q• 1 a_ � ° ✓� � � "r H �V Q � '� .y-r R � �. G �� w' y �•.,�, ,� N � .- �; �` 4 � �^ � c� �• � �, c N � o � � � � \� � a 7 �, � � ,O ;, '—+� Q � �� ?, � n o a s� ''� `� � s �� b �e 5' x l__.--____--_--- _ �. --� 01 Sep 10 16'.31 14 H tt ET1HW dwp M15 o fo N 69'57'46a LA IN " " 7 56' 57 66' 9 - - I I 4" CONC. ()RIVEWAY GAHA(�1 I 13500 P.S I I E L :99 5' ~ Cn I EASTMEN( I W :I Z Z 0 IL I7 ui MAIN 1:1()OFZ ( (n :�Iv, I I 1000' I I n ( t I I I I I 1/1' WAIlN I r,ANIt ANY MAIN UNA.N I I I I � 101 1 "� i N 89'11) 18' W FILE NAME 1-1111W 9/10/2001 MIS E 1 7 0 0 ' V AN NAR AIDI, A CUNY(A C:y * 1, AA. 0s ru' I�('iARD. V11 o I UIIIE IEIA uE Accul Ac.,X let Iu1W's N') `T./ AAOAEAIION It IS IME SERE AEPO"aEltt ar tH t9DIVISION HUN1L HS WOODLAND nuEE%A 10 WNT ALL 91tE COWII01M 11IC1W t l l)1 I ANY'Al PIACID EN INE SIF ANE NEti. IME ObNENS(IF ANY Port.'JAI tt10 YOfMtCAt-an AE ANA 41!1E OESI(WASSOL1AE It INC DAVE: AMATO a ASSOCIATES LTD 569? 5O 11) CITY OF TICSH RD SEWER CONNECTION PERMIT PERMIT#: SWR2001-00263 DEVELOPMENT SER%IICES DATE ISSUED: 11/6/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S103BD-08J00 SITE ADDRESS; 12996 SW 116TH PL SUBDIVISION: HUNTER'S WOODLAND ZONING: BLOCK: LOT: 001, ,;tJRISDICTION:_TIG IG _ TENANT NAME: FIXTURE UNITS: USA NO: CLASS OF WORK: NEW DWELLING UNITS: 1 NO. OF BUILDINGS: 1 "TYPE OF USE: SF INSTALL TYPE: LTPSWR lMPERV SURFACE: Remarks: Sewer connection for new SF detached dwelling. _—_ Owner__ — — _ FEES DAVE AMATO& ASSOC. LTD Type By Date Amount Receipt P.O. BOX 19576 PRMT CTR 11I0I01 $2,300.00 27200100000 PORTLAND, OR 97280 INSP CTR 11/6/01 $35.00 27200100000 Phone: 503-590-7636 Total _$2,335.00 Contractor. Phone: Reg#: Required Innpections 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 trom the distance given. If not so located,the installer shall purchase a"Tap and Side Sewer' Perm Issued by: �639-475 Permittee Signature' 1 Cali (50 :00 P.M. for an Inspection needed the next business day CITY OF T.IGARD 13125 S.W. HALL BLVD. TIGARD, OF. 17223 IMPORTANT PERMIT NOTICE ENDERS ELECTRIC PO BOX 1661 BEAVERTON, OR 97075 Electrical Signature Farm mit IT. %,S-F2001-00496 Date Issued: i ii6i0'i Parcel: 2S103BD-08900 Site Address: 12996 SW 116TH PL Subdivision: HUNTER'S VV oODLAND Block: Jurisdiction: TIG Zoning: R-4.5 Remarks- New SF detached dwelling. Path 1 Your company has been indicated as the electrical contrac.:Dr fort electrician is it indicated above.ease have in oder for the electrical permit to be valid, the signature of the supervising he appropriate individual from your company sign belo%j and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Dept No electrical inspections will :ae authorized until this completed form is received ELECTRICAL CONTRACTOR: OVVNFR ENDERS ELECTRIC DAVE AMATO & ASSOC. LTD PO BOX 1661 _r P.O. BOX 19576 r,0rTLAND, 0 P O729C Phone #: 626-4813 Phone #: 503-59(1-76 6 LrC 00026726 Req #: sur, 202Ps ELE 34-265C AN INK SIGNA i URE IS REQUIRED ON THIS FORM x t✓��' - Signature of Supervising Electrician It you have any questions, please call (503) 639-4171, ex!. # 31G CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT rERMIT NOTICE EAST WEST PLUMBING INC 653b NE 63RD PORTLAND, OR 97218 Plumbing Signature Form Permit #: MST2001.00496 Date Issued: 111612001 Parcel: 2SI 03BD..08900 Site Address: 12996 SW 116TH PL Subdivision. HUNTER'S WOODLAND Block: Lot: 001 Jurisdiction. TiG Zoning: R-4.5 Remarks: New SF det hed dwelling. Path 1 Your company has been indicated as the plumbing heappropriate cont, r ate individual from your for the permit r cortlpar y sign below and the plumbing permorderfor it to be valid, please have PP P return this Plumulng 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: DAVE AMATO K ASSOC. LTD EAST WEST PLUMBING INC 6536 NL 63RD P.O. BOX 19576 PORT'-AND, OR 9721>3 PORTLAND, OR 97280 Prune #: 503-590-7636 Phone #: FAX 590-6226 Reg #, LIC 102521 PLM 26-532PB AN INK SIGNATURE IS REQUIRED ON THIS F RIVI X Signature of Authorize P!arnber 1 If you have any questions, please call (503) 639-4171, ext. # 310 DRf)L HOMES TEL N0 . 214r,-121 1 Mar 23 ,8 ; - -6 P ov A ) 444 . 1 ov 44 V O• i' �y w414 'v � I►. aM 44 ell Q+, 0-' M D � trf .o ►moi O 0: r) 44 Q o' ► 44lop b ► Ilk r rr��rrrrrrr��rrri►i��iii��►�r�rirrri��r�ii�� CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION BUSineS£ Line: 1503)639-4171 Jf 't BUP _- Received ___-____ Date -Requested---?—�_. — AM_ PM_- BLIP Location _ �� _ c/ �" ^��j I -1"1--- Suite------- MEC Contact Person Ph ( _---) -a I(ZPLM Contractor - __ Ph (- —) - d -- SWR ----- - - - BUILDING _ Tenant/Owner ELC -Footing Foundation ..., ELC Access. / ,/,,, r Ftg Drain _('V CYlf� / L �( 1 F 1. ELR _ Crawl Drain Slab Inspection Notesr� l � �J 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 i FA PART FAIL ---- \ — ----- PL(�BING ' Post b Beam Under Slab -- _ Rough-In Water Service - Sanitary Sewer Rain Drains -- - Catch Basin/Manhole Storm Drain ---- ------ �� -- Shower Pan Ofher: - - iria � .----- SS PART FAIL --- - ANICAL - Post&Beam Rough-In -- ---------- ---------�_-- Gas Line ' -- �Sif n keDampers - -- ---- - - ---- - - --- AS§ PART _FAIL ------- -- - --- .MTRICAL Set rice -- - - --- - - - Rou;j,i-In --- ___---- - - ----- UG/;t,ao Low Voltage Fir*A(arm AS PART FAIL Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hail Blvd. AS PART FAIL — Please call for reinspection RE: - Unable to inspect- no access Fire Supply Linu ADA Approach/Sidewalk Data _-- _ � U _-- Inspector ...-.-- Other:_ Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITYOF Ti GA R D __:MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2003-00325 13125 SW Hall Blvd., Tigard, OR 97223 1503) 639-4171 DATE ISSUED: 6/16/03 SITE ADDRESS: 12996 SW 116TH PL. PARCEL: 2S10313D-08900 SUBDIVISION: HUNTER'S WOODLAND BLOCK: ZONING: R-4.5 LUT: 001 _ JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN_ - - TYPE OF USE: SFUNIT HEATERS: FVAP COOLERS:OCCUPANCY GRP: R3 VENTS W/O APPL: VENT FANS: STORIES: BOILERS/COMPRESSORS VENT SYSTEMS: FUEL TYPES -- HOODS: 0 - 3 HP: 1 DOMES. INCIN: MAX INPUT: BTU 3 - 15 HP: COMML. INCIN: 15 - 30 HP: FIRE DAMPERS?: 30 -. 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: ---AIR HANDLING UNITS CLO DRYERS: FURN > 100K BTU: <= 10000 cfm: OTHER UNITS: Remarks: > 10000 cfm• GAS OUTLETS- Owner. ..t ,i r unu Owner: JASON FENTON -� a - _ FEES 12996 SW 116TH PL Description Date 'Amount DGARD. OR 97223 �nn:c'FI I'cnnil I rr 6/16/03 I.\XJ 8 titorrl � $72.50 _ 6/16/03 $5.80 Phone: 501-590-8093 — Tota! $78.30 Contractor: CHASE HEATING CO 1845 NE 92ND AVE PORI LAND, OR 97220 REQUIRED INSPECTIONS Phone: 501-793-7927 Cooling Unt Insp Final Inspection Reg #: L-IC 153390 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 in the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100 You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9699. Issued By. - Permittee Signature:_ Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day r' ii ll! 09:21A FROM: TO:SG1359R196C� P:1/2 Mec"ca1 Peirmit Application `i�0��„ �� p�°6�S�xj fitoldloC .. riprd tyn; 13125 SW Han HIVd_ risn — Pernmi Ha P,gwd,orc em 9122-3 rsat l ,4 s ts5 Pb= 503-639-4111 FOX 301.5Y&190) lut==L www C.LtigwxT.usroaae+ „i•r ftp. lA htati lagp i m Re pxcgt 503 639 4115 tiTew cccctruGlwiJ I)cm iipp _ macb&"portvt 0=1 tva bamid wttu WOW vwLn of dw vvwk Ad�ibOn/II1Lt3IIlttAIIhll 1�Cllment t)thcr -- F rn� o [d Tz> the wn2ae(tot�dhd a,the een+e cr dolw)af s10 nr�tpalcs,i t�ausls4 i;q-,11�7,in�ll:lIIbor-ovcrlrrtvl afid Dro11t �_- _ -- ...._ vs,bc S__ ��<cra •�� — Smt➢ape x is 1Fa 9sQVia7e � 1&a Family dwcu . - --- �- A -b - hula-Famil-1'_ __ ,- .Y, -_Wldtng IC)t�r J Mosta lBu<1dC1 Fumwe—gs m wr rsr,cimaam -• ►4.ao Job latr addccRs li State ll: -- 1,rdmiio t►et wrla a9,�rm 14.00 1 _-- Pro oct Name' S, yt--. j n zU%I Crow ntmNf?r�aara:to job wu 16o°tt"C ar. --- L umt Acme."(Iuci,mat clo,artc) -Lin way, ------------- 6- n�:,_vrnd �at—e - 11900 Ptdeit 10.00Qr uotn i t�s --•v�sioa. Lot>Y': -- - _.•� -- - .Siillt�i _ _ _ Y�i!►•�hd�l. r14N Tera - - - warm timer_---- f1�00 �, � I _ - Al r.-��► .S,s..- °!,�r,.�ie�,reoe►trc�ed _ .a --�� .._..._. _ _- 10 00 -- - . 1000 _ �_ ,. _. _ ,•___ ...�.. a11, _.. 10AX) . mrmt Niauc. �`71 c0�1_ --_ 1z,tnPe 6a• a6"ktOthm N*Mww 10 tm 1000 c:�t Istat i1� 1�--rr �r c� c��tz_ �, - P : r _ S? Fac Q._ J4 Atttt�craM~1_r�Ce faaa_ 10.00 Nni�u.. .C�(a.G�k'��_�uf.i r% -____ l0 Citx/StrtdLip' P l7� G _aaQ - •• 4 } - - -- "MOM,eta Phan. c)3r-_ Fnx. Q '.. b -1 u. BLt1}I1�5� A�dresa: -PRO--_ Zoo Pttanc._ ram►. _ CCH 1a0.!t: ] _. ad or - n slow" _ DOW _ —�PCsm_ L Fts s nz s0 zS .-- w f,Pk.•bc mussmur+c) tvti,ru�+ttT M s K+k.a r pr..t.pirersrrn apu r n parte a n.e wMbla ."* LIC days o11sr is W bvm"`ssR*ea u-W014" **Wm pW rga�ri to.•s.1..AOC■srMs u �nrarnsv►tclrmds�ppdo� otnm I P 1 1 i c'l1t)) F R I t Vi:iNW#t t 1 JUN-16-2003 01:52P FROM: 70:5035581950 P:1/1 Chase Heating Company f ' Custom lieatulg and C;w ing.Installations ('CB{{ 153390 1845 N,E.92"d Ave Portland or, 97220 Phone (503)793-7927 �] "Your Authori7td York Dealer' i r f l 1 I I �J T F-0- tj1 r I C4. Y� Q.� CITY OF TIGARD � 24-Hour � BUILDING Inspection Line: (503)639-4175 MST _.—. INSPECTION DIVISION Business Line: (503) 639-4171 BLIP Received __— --_Date Requested _. AM __ __ PM OUP Location ----Suite MEC = 3� Contact Person _—__- /^ f Ph(—) ? 3 PLM Contractor_--- _-_ -- Ph(—) SWR BUILDING Tenant/Owner -_ _ _ — ELC _— rooting ELC F'•)undation Access: Ftg Drain -�' '� ELR - --- _.-- Crawl Drain Slab Inspection Notes: SIT _ _— Post& Beam - -- -— ------- -- _ Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing -- Insulation Drywall Nailing - ---- �— Fir-wall Fire Sprinkler -------- - - - - - --- lire 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 ABTL, FAIL Post&Beam Rough-In - --- ----- — -- -- --- ------- Gas Line .S�moke Dampers ----- --- -------- ----- — ---- ------ :3'!i] PASS PART FAIL ELECTRICAL- -- �� ' LZ �- J 2t� I W J, 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 Supp;;I.ine ADA Approach/Sidewalk Dots —�� .i Inspector ,- _r'r'-f — Ext Other:_-- -------- Final DO NOT REMOVE this Inspection record from ih a job site. PASS PART FAIL