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MASTER PERMIT
CITY OF T I G A R D PERMIT#: MST2001-00499
DEVELOPMENT SERVICES DATE ISSUED: 10/25/01
13,125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 12992 SW 116TH PL PARCEL: 2S103BD-09100
SUBDIVISION: HUNTER'S WOODLAND ZONING: R-4.5
BLOCK: LOT:003 JURISDICTION: TIG
REMARKS: New SF detached dwelling.Path 1
BUILDING
STORIES: 2 FLOOR AREAS REQUIRED SETBACKS R-OUIRED
C1.ASS of WORK nt A' HEIGHT: 24 FIRST: 1.159 of BASEMENT: at LEFT: 5 SMOKE DETECTORS-
IYPE or USE SF FLOOR LOAD: 40 SECOND: 654 of GARAGE: 548 at FRONT: 15 PARKING SPACCb: 2
TYPE OF CONST: 5N DWELLING UNITS: I FINBSMENT: of RIGHT: 5
VALUE: S 100,038,60
OCCUPANCY GRP* R3 BDRM. 3 BATH: 2 TOTAL: 1,81300 at REAR: 20
PLUMC'NG
SINKS: 1 WATER CLOSETS: 2 WASHING MACH: I LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUBISHOWERS: 3 GARBAGE DISP: I WATER HEATERS: I WATER LINES: 100 BCKFLW PREVNTR: I GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
_ FUEL TYPES FURN-10nK, I BOIUCMp<3HP VENT FANS: 4 CLOTHES DRYER: I
GA; FURN>•100K: UNIT HEATERS: HOODS: I OTHER UNITS: I
MAX INP: btu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: I
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp: 0 200 amp: WISVC OR FDR: PUMP/IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 3 201 •400 amu: 201 400 amp: 19t W/O SVC/FDR: 00 SIGN/OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 600 amp: EA AUUL BR Clk SIGNALJPANEL: IN PLANT.
MANU HMISVCIFDR: 801 • 1000 amp: 6014amps•1000v: MINOR LABEL:
10004 enlplvoll:
PLAN REVIEW SECTION
Reconnect only:
>■4 RES UNITS: SVCIFDR>•225 A. >600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL-RESTRICTED ENERGY
A.SF RESIDENTIAL _ B COMMERCIAL _
AUDIO&STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRF A',RM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 6,612.79
This permit Is subject to the regulations contained In the
DAVE AMATO&ASSC.LTD DAVE AMATO AND ASSOC LTD Tigard Municipal Code,Stvle of OR. Specialty Cortes and
P.O.BOX 19576 4351 SW CULLION BLVD all other applicable laws. All wo,k will be done in
PORTLAND,OR 97280 PORTLAND,OR 97221 accordance with approved plans. This permit will expire 9
work is not started within 180 days of issuance,or If the
work is suspended for more than 180 days. Al TENTION!
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Reg N: LIC 00206092 forth In OAP,952-001-0010 through 952-001-0080. You
may obtain copies of these rules or direct questions to
OUNC by calling(503)2 1.6.1987,
REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam Mechanica PLMIUnderfloor Shear Wall snap Insulation Insp Mechanical Final
Sewer Inspection Underfloor insulation Mechanical Irisp Exterior Sheathing Inst Rain drain Insp Plumb Final
Footing Insp Crawl Drain/Backwater Plumb Top Out Low Voltage Water Line Insp Final inspection
Foundation Insp Footing/Foundation Dr1 Electrical Service Gas Line Insp Appr/Sdwlk Insp
Post/Be;lnt Structural Plmlundslab Insp Framing lose Gas Preplace, Electrical Fin,.l
Issued B y : l% Perm9ittee 5i nature
- --- ---
Call (563)639-4175 by 7:00 p.m. for an inspection needed the next business day
CITYOF TIGAiR D _ SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2001-00265
13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171
DATE ISSUED: 1025/01
PARCEL: 2S1033D-09100
SITE ADDRESS; 12992 SW 1 161"H PL ZONING: R 4.5
SUBDIVISION: HUNTER'S W')ODLAND
BLOCK: _ LOT: 003 .JURISDICTION: TIG
TENANT NAME:
USA NO: FIX1-URE UNITS:
DWELLING UNITS:
CLASS OF WORK. NEW 1
TYPE OF USE, SF NO. OF BUILDINGS: 1
INSTALL 1 Yrii: I TPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF detached dwelling.
Owner: - _ _ FEES
DAVE AMATO& ASSC. LTC) Type By Date Amount Receipt
P.O. BOX 19576 PRMT CTR 10/25/01 $2,30000 27200100000
PORTLAND, OR 97280
INSP CTR 10l25I01 $35.00 2720010000)
Phone: 503.245-2117 Total $2,335.00
Contractor: _
Phone:
Reg#:
Regi !red In!z7,rc6-)ns __ r
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 fcrfeited 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 installar shall purchase a"Tap and Side Sewer" Perm
Issued - Permittee Signature:
byr� �Qom_ .-
C�all (503) 639-4175 by 7:00 P M. for an ,nspection needed the next business day
DAAL HOMES TEL NO . 2452117 / Nov 1, .5! 0 : 18 F .01
psf- �•zj-GI 131
09,19/2001 l(:: 27 FAN 61/8981960 CITY OF TIGARU
Building Permit APPPil AOD v
Date ed '% ^ Pernutno.;'
City Of 'Tigard Ptojeet/appl'no.� Hxpirec:atr:
4---
city nlTigard Address: 131?.S SW Hili Blvd,Tigard,OR 97223 H ,' {tu etpt no,.
Datels�ued: Y/.;� f .
Phone: (50:4) 639.4171 I pyn,ent r r
kax: (SOt) 59A-1960 Case file no' --
1&2fOmlly:5impte Cnrnpk x ��
I-And use approval.
b Commcrctal/industrial J Multf•femily E-
(6ow construction U flamol,tion
1 &2 family dwelling or aeoeuory
Q�rtAltion/altrratlen/roplaccmcnl O Tenant improvement G Fiic srrinklet/alarm U Odter
r t r
131d .no.: Svur nu..----
Job addross: /tart lot/acr crr�ul no,:
�qq t: Block' Subdivision; gyp. S c 'trh�:��. - ...-L�_.k—
Dw.ription and location of work on prefnises/speolal
Nuns: 14L a &2 dr+nrily dwelling:
Malum dresrr __l�1 -- BV 039.
_! State' -- ZIP: Valuation of work ✓- -L�
City' e L 1 Fax: 1: No-of bcdrooms/batlts. ... .. ............. ,1� -
Phoac
Total Ountber of ftuxs. ........ ................... .—
Ottrttrc's tepresentativr.: c4� � - __
• &IqW; New dwcliinF area(sq.ft.)
c3et'ape!-arpr
out-' Fax r ,rt area(sq,f1.).. ............r... _.
Covered poir.h area(sq.
NU1tat f/c�'T�--'��+' iaeck arta s fl)
� ( u ..............................
Mallin a dress+ �, __ - - - Other atntctury areaft). .. --
Ci��i�� ... State �f � CnmmerelaVindnrAriallmulti-tamil r
lax: �. 1'. mail
Flo'e; Valuation of worir..............
Existing bldg.arra(sq.ft) . ... .
Husinras narrta: ti V _ i' L v`•." New bldg,ansa(sq.ft,) . .... _ --- --
Address: �_ ._� Number of ntofies ......... - -
Clty Type of construction..... ..
$nr,ll Cxishn
Phone:'). S�.l( Fax: _y�lt-_ _- ---- occupancy>noup(s): g: -- -- --
Cfi11 no. '�•+- 1 New: ..-- ---�-
- -
City/mean Hc.no.: Notice:All ren"ctArli and sul>400lrar Irrr.air requited to be
licensed .vith the t'rugon Construction Contim lore Board uuder
provisions of OR:101 and may M'requih•cl tic Icc licensed in the
jurisdiction where work Is turn!;performed. If th1'applicant Is
exempt from Ileensing,the following reason nlyclits:
Contact tt.un. 'Inn} nn.:
11 -WIT
---
I, , -- — —
Phone, l'nx
Few due upon appt-atiou ...... ................ ..
Naroe: - Cont+ct i,crson:'t�,�„Z, uI
- T Date recelved' _
r
___ _ Amuunt received ---
�lP rived d l --
- Sate _ 12 .. ...
Clnnt: � mall: f'l��ae refer tc. fcr .+che<lule
1 have read and examined this applICAtion lord the Nc� +l�+dicuon"i�"M U"1't�' rt°+u``u W i1r+ "ra m-� �+�MM�•+
1 hereby certit) iso ri
attached chtckllct All provis s c+t Inver-and ordinances governing this „r.ci tOWN rp Kc
work will tv compiled with thnr s ed he In or nr,t. _ r� —�•
A1P' , I �f.L..►. rrY of.
Authori94d signatures
Print name: ___.__ tu,u,r(6W'('uro
Nplim.1140 pr+rmlt Application expires it a permit is not obtained within 180 days after it 111A twtn lccrl"t!"as oompkrla.
Electrical Permit Application _
- Datereceived: Permit no.:
ity of Tigard Project/appl.no.: Expire date:
l'uI /I i rtrd Addre,,-. 1 3125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.:
Phonc. i',03) 639-4171 - ---
Fax: (5(1 t) 598-1960 ('ase tilt no. Payment type:
Land use approval:
TYPE OF PERM IT
U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction U Addiud,.i/alteration/rrl,lacc novo U other: U Partial
JOEi 91TE INFORMATION
Joh address: ) ¢`3 �t A Bldf. n•• Suite , i ,p/tax lot/account no.:
Lori: Block: Suhcfi,t.nm:
Project name: Uescriptioh.and location of work on premises:
Estimated date of ronlplruon/mslurfidm
CONTRACTORi
Job no: I Max
Description Q(.l. (ea.) total no.Imp
Business nanlc: A-: qV=, No"residential sinRkormulti-famih per
Address: dvielling unit.Includes attachett Kara{e.
Cit y:" h Y- , i StateC;_ AIR_ Seniceittcluded:
I(XI0 sq.ft.or less 4
Phone: I'ax:(s� E-mail - - — — �-
Guch at six),q fI oh purhnnh Ihewol _
CCB no.: FICC•hUs•IDL',no: IAnil led energy,Iesulenlral 2
City/metro lic,no.: _ _ Linua•denciry,m.ro residential 2
Each nhanulacmred home or modular dwel:irig
Service and/or feeder 2
Signature of supervisin electrics n(required) bale ---
Sup.elect.natne(prinQ; I.icenseno: services or feeders-Installation,
alteration or relocation:
2(X)A,lips or ICN, ^_ 2
Name(pont): 201 am s to 4(x1 amps — 2
401 amps to OW amps 2
Mailing address: _ fain amps In IWOarrips -� 2
City: Stale: 'LIP; _-_ Over 10(1(1 amps or,tolls —� _ 2
Phone: Pax: E-mail: Recorillectonly I
owner installation:The installation is being made on property I own Terapxnyry servlces or feeders-
which is not intended fur sale,lease,rent,or exchange according to Installation,alteration,orrelocation:
200 amps tit less L
ORS 447,455,479,670,701. 201 amps to AIM amps ----- - 2
Owner's si nature: Date: — _ 401 to 6(X1 anh,s f - - 2
/ranch circuits-new,alteration,
or extension per panel:
Name: A Fee for htanch cocuits with purchase of
Address: service or feeder fee•each brunch circuit 2
City: — State: ZIP:a H. Fee for hrauch crcmts without purchase
�— of service or feeder feet first branch circuit: 2
Phone: Fax: E-mail: - —
(iach additional branch creole
Mist.(Service or feeder not Included).
•Service over 225 amps-cannnw� .,l U Ifeallh-caretaulu, Dachpum,oi irtrgationcircle 2
Each sign tit oudmc h Iain 2
UService over 32(Iwnp!:rwinl!odl,sC2 UHurarduuslucnuriu g _�_.�
flintily dwellings U Ifuilding river I0,M)square feet tour tit Signal circuit(%)or a trotted eneigv panel
U System over 61X1 vnhs nornrnal nine residential units tit tine structure alictauon,or extension' -
U Huildingover three stories U Feedets,AMampsornfon "Description _
_1(kcupwa load over dldt prnom U Manufactured structures of RV park Fich additional ImpccUon(tier the alloviable In ant of flee alwse:
_I I rn•ss/hghlwp l,l,iri -1(llheh _-_.-_. PerInspectiun
Submit cels of plans with any or the al►nve. Investiga0un feel— _
11ie above are not applicable to temporary conitructi.on service. other
---------- -- - — — 1'rrnul Ice ..,•,.
N u all prnxlicllMn arreDN cte• .udh,plea4 odl pmuh tion for react hnfnrnmoIm
Notice: 11us pemul application
U visa U Maslert•ard c.pires i1 a permit is not obtained Plan review (at
('redo Bard number .. .- _---_ ___ l / within 180 days oiler it has been State surcharge(9%) ...•
______ accepted as complete. TOTAL . ..
Nantr�udhcfiFrris shown nn credit-cud
s
Cedhotdet allonaluse Amount tui Uls irns,n Ia
1�G
Mechanical Permit.Applicatioi>t
Date received: Permit no.'
City of Tigard Project/appl.no.: Expire date: _
Cirynf PigruJ Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt n,
Phone: (503)639-4171 Payment e
Fax: (503) 598-1960 Case rile no.: Y YP
Building permit no.:
Land use approval: _
&/
IL&2 family dwelling or accessory U Commercial/industrial U Multi-family —U Tenant improvement —
NCN'r(mtitf-urlim„ U Addition/alteration/replacement U Other:
1 �Ulljz Mai TO R WD 1
Job address: st r'I ccs.> Indicate equipment quantities in boxes below. Indicate the dollar
Bid g no.: Suite no.: value of all mechanical materials,equipment,labor,overhead,
profit. Value$
Tax ma /tax lot/account no.:
Lot: Block: Subdivi-;ism: *See checklist for important application inkirn.ation and
Jurisdiction's t, -.chedule for residential permit fee.
Pro- name: 1 t
City/county: ZIP: I I
I 1PI 101 01,11 1 JUM11
Description and location of work on premises: hrxlea.► 7utal
Ik-scriplion only
Est.date of completion/inspection: (?tv. Res.only Res.
C:
Tenant improvement or change of use: Air handling unit
existing space heated or conditioned?U Yes U No Air con-ioning(site p an requ—.CFM--
Isre ) _
Is existing space insulated'?U Yes U No leration o existing I A system
1 of er/compressors
Stare boilcr permit no.:
Business name: y7_ �A; _!_ AAV_&__\)L16_— HI' .-_Tuns-_BTU/H _
Address: p, 'ir amo c amper. duct smo c detectors
Slate
ZIP; ct.-I AD eat pump(s tc Pi
an requirc�'
City: - _ - nsta rep acc fumacelburner
Phone: - 1 ax: 't"1� (� L alar'• -• Including ductwork/vent liner U Yes U No
CCB no.: L nsta rep ac re ocate heaters-suspenre ,
City/metro lic.no.: _wall,or floor mounted __ _
VVentora o lance 11t c t an furnace
Natre( leasc print): efiZgerat on:
CUNTACT PERSOT4Absorption units _ BTU/H
Chillers-____ VIP
Name: _ _ Com ressors T_. III'
Address: _ ary ronmenta ex aust an vent at on:
City: Slate:_ ZIP: Appliance vent
Phone:
F;,r I:-mail: )ryerex aunt
o s,hood ypc res Ttitc e azrnat
fire suppression system
Name. Exhaust fan with single duct(bath fans)
x ousts stem a an rom eatin nr
Mailing address: _ ue p p ng an st ut on(up to 4 outlets
Clty: _ _ _ Stale: ZIP: Type: �-LM NO _ OH
Phone: TF moil. T.urf',i in eac i a itiona over out els
rocewpiping(sc emalicrequited) —
Number of outlets
Name: ____ terst appliance oror—T eu mpmp nt:
Address: - -- Ikcorsuitcrireplace -
Slate: 7.iP. -sen-type
City: _ - oo slov pc let stove
Phone: Fax: 1: mail: cr
Applicant's signature:
Name( tint): - —
-- Permit fee.....................�Not all all iurisdlcuon+wcepr credit c",please call Juliubeaan frx poor inrnnnadnn Notice:This permit application Minimum fee................$
U visa U Mastercard expires if a permit is not obtained Plan review(al _ %) $ _
Credit card number _ spires within 180 days after it has been State surcharge(8%) ....$
a111e a o` wn on c .t ca eccspted as complete. '('D'I'AL ......•..•$
s
Amount 4"17(&VW'OM)
1��VkPlumbing Permit Application
-- Date received: Permilno.A)5� D/
City of Tigard ;ewer permit no.: Building permit no.:
Address: 13125 SW Nall Blvd,Tigard,OR 97223 ('roject/appl.no.: Expire date:
City of Tigard Phone: (503) 639-4171
Fax: (503) 598-1960 Date issued: By: I Receipt no.:
Land use approval: Case file no.: Payment type.
7UNew2 family dwelling or accessory U Commercial/industrial U Multi-family U'renant improvement
construction U Addition/alteratiott/replaccment U Fucxl service U Other:
1
1 o t Fcxea.) Total
/
Description f?v
Job address: I q� d- I New 1 and 2-tamily k' Alings only:
Bldg.no.: I Suite no.: (includes 10011.fureachutility connect fon)
Tax ma /tax lot/account no.: _ SFR(1)bath
fit• Block: Subdivision: S W %R(2)bath
Project name: __ SFR(3)bath _
City/county: ?.lP: Each additional batfvkitchen
Description and location of work on premises: __ Siteutilities:
_ Catch basin/area drain
D wells/leach line/trench drain
Est,date of completion/inspection: Fearing drain(no.lin.ft.)
?11,111 BING CONTRACrOR
Manufactured Dome utililieS
Business name: ���,;'C L t)C "� ����''f _ Manholes
Address: _ _ Rain drain connector
City: State: ZIP: Sanitary sewer(no.lin.ft.) _
Storm sewer(no.lin.R.)
S
Phone: Fax: cj E-mail: Wtrter service(nu.lin.ft.
CCB no.: ���Zl _ Plumb.bus.reg.no: 7 - Fixture or item:
City/metm lic.no.: Abso tion valve _
Contractor's representative signature: V0; Back flow preventer
Print name Date: Backwater valve
t 1 IT11111111111MIMUM Basiml i-tvatory
Clothes was epi r
Name: Dishwasher —
Address: Drinking fountain(s)
City: State: ZIP: _ E'ectors/sum _
Phone: _-- Fax: l -mail: Expansion tank _
Fixture/sewer cep _
Moor drains/(loor sinks/huh
Name(print): _ Uarha a disposal _
Mailing address: Horse bibb _
City: State: _ ZIP: Ice maker —
Phone: Fax: E-ma)i: Interceptor/grease trap _
Owner installation/residential maintenance only: The actual installation Primer(s)
will be made by rete or lite maintenance and repair made by my regular Roof drain(commercial)
employee on the property I own as per ORS Chapter 447. Sin (s), asin(s),lays(s)
owner's signature: ___ Date: Sum
Tubs/shower/shower prat
Urinal
Name: _ -----_-_- _ mer closet
Address: Water heater
State: _IPS Other:
Phone: Fax: E-mail: TolrA
Minimtun fee................$
Not di luriedictionn 1eceo credit earth,Pie—call iurlrdicaan for more inforn"On Notice:'this permit application Plan review(at _— %) S --
U vile U MuterCud expires if a permit is not obtained State surcharge(846). ..$
credit card numha:__----------- -- — PR are within IRO days after it has been
accepted as complete. TOTAL .................. ....$
ntre ole of r u shown on c it c�nl S
Nyuture — -- Aimm 410-1616(&MCOM)
N 83'57.46" E
59 00'
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runt ran na AccrnAAc1 a rr+. rCPoG1A►M, J
A/W11A1KIY 11 R I S(R1 ofr"m "T a 1N SUBDIVISION IIUNTERS WOODLAND
OUOIR 10 MIrYl1 Art V cm)11KN5 w?Ww; 219LOT 3
AM 141 AAct 0 am IK Siff w Y01/I IN
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DATE AMATO b ASSOCIATES LTU
A&M Wftd10 D(110M
CITY OF TIGARD
13125 S.W. KALI- BLVD.
TIGARD, OR 97223
170PORTANT PERMIT NOTICE
ENDERS ELECTRIC
PO BOX 1661
BEAVERTON, OR 9'1075
Electrical Signature Form
Permit #: MST2001-00499
Date Issued: 10125/01
Parcel: 2S 10:3BD-09109
Site Address: 12912 SW 116TH PL-
Subdivision: HUNTER'S WOODLAND
Block: Lot: 003
Jurisdic';on: TIG
Zoning: R-4.5
Remarks: New SF detached dwelling.Path 1
Your ccmpany has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical permit to be valiu, the signature of the supervising electrician is requited. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of 'tie work to the address above, ATTN: Building Dept.
No electrical inspections wiC be authorized until this completed form is received
OWNER ELECTRICAL CONTRACTOR:
DAVE AMATO & AS�,C. LTD ENDERS ELECTRIC
P.O. BOX 19576 PO BOX 1661
PORTLAND, OR 97281) RFAVERTON; OR 97075
Phone #: 503-245-2117 Phone #: 626-4813
Req #: LIC 00026728
1AP 20283
ELE 34-265C
AN INK SIGNATURE IS REQUIRED ON THIS FORM fJ
X 01,44— �— —
Signature of Supervising Electrician
If you have any questions, please call (503) 639-4171, ext. # 310
CITY OF TIGARD
13125 S.W. HAIL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
EAST WEST PLU"BING INC
6536 NE 63RD
PORTLAND, OR 97218
Plumbing Signature Form
Permit #: MST2001-00499
Date Issued: 10/25/2001
Parcel: 2S103BD-09100
Site Address: 12992 SW 116TH PL
Subdivision: HUNTER'S WOODLAND
Block: Lot: 003
Jurisdiction. TIG
Zoning: R-4.5
Rernarks: 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, p .ase have the appropriate individual from your company sign below and
return this Plumbing Signature r, rrn prior to the start of the work to the address above, ATTN: Bililding
Dept.
No plumbing inspections will be authorized until this completed form is receivad
OWNER PLUMBING CONTRACTOR-
DAVE
ONTRACTORDAVE AMATO $ ASSC. LTD EAST WEST PLUMBING INC
P.O. BOX 1957G 6536 NE 63RD
PORTLAND, OR 97280 PORTLAND, OR 977.18
Phone # 503-245-2117 Phone #: FAX 590-6226
Reg #: LIC 102521
I-M 26-532PF
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X �, _
Signature of Authorized Plumber
If you have any questions, please call (503) 639-41'1, ext. # 310
DAAL HOMES TEL NO .2452117 Mar 23 ,8 ; 5 :56 P .O-
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CITY OF TIGAND 24-Hour
BUILDING Inspection Line: (503) 639-4175 ) -U D
MST INSPECTION DIVISION Business Line: (503)639-4174
/ '"�"PNl BUS _--
Received _ Date Requested ` Zy AM - -- - --—-
BUIR
Location —____ �5 �- (e, �`' Suite — M-C - ---
Contact Parson ..- - 0-4J-e- — Ph(—) -6 PLM -- --- ---
Contractor __-- ^ Ph(--) —,-- - SWR --- -. -- -
BUILDING � Tenant/Owner -_--- --_--- _ ELC -- -- ---
Footing -- ---- _ ELC - --
Foundation Access:
Ftg Drain --- �Z c� ,� `�t �. ELR
Crawl Drain ---
Slab Inspection Notes: Std --- -
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear ��.R� ; if. `/
Framing --
Insulation
Drywall Nailing -
Firewall 4 1 /O Z
Fire Sprinkler --+-r-�f �'-�- --
Fire Alarm _
Susp'd Ceiling
Roof
Other. - -
ma
ASS PART FAIL
_PLUMBINd- --
F�.+&Beam --
Under Slab -
Rough-In
Water Service - - --
Sanitary Sewer _
Rain Drains
Catch Basin/Manhole
Storm Drain --- --
Shower Pan _-
Other. --
Final
FAIL --__ -_._-.- --.---------
Post&Beam-
Rough-In
Gas Line
Smoke Dampers ---- - -- ---- -------- - -- ....__
A PART -FAIL -- -- --- �— _ -- _----
EELECTRICAL
..Service -
Rough-In _ - ---_- -- -- -- -- --
UG/Slab
Low Voltage _- e__.__ -__-.-__ ___-_-- - -_-•_-.--____-_--- -. _
Fire Alarm
Final F-1 Reinspection fee of requ red before next ir,spection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
81?E _____ Please call for reinspection RE: Unable to inspect-no access
Fire Supply Line
ADA �/! /�
Approach/Sidewalk Dots / ��"'� Inwpector " l_� v ---�^'� Ext _
Other:
Final - DO NOT REMOVE this Inshoct'on record from the Job site.
PASS PART FAIL
CITY OF TIGA►RD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business, Line: (503) 639-4171 MST
6BUP _
If Received _ Date Requested _ AM —__ PM BLIP _
Location . c C " L Suite
- MEC
Contact Person ,�` Ph( ) �! I _ PLM
Contractor_ _ Ph SWR
BUILDING Tenant/Owner ELC
Footing - -
Foundation
AccELC
ess:L
Ftg Drain �,( �ry1 -
Crawl Drain C U ni ELR
Slab Inspection Notes: SIT
------ ---------
ost& Beam
Shear Anchurs _-
Fxt Sheath/Shear
Int Sheath/Shear - --.
Framing L L �-�-
__ __—
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling --- - _ •�
Roof
Other. - -
Final — ----
PASS PART FAIL
_PLUMBING ___�-- �'� G����'�-•�'' �' ���._ � ------
-- — S
Post& Beam
Under Slab `� C+r-.c---,i 5- _
Rough-In -- ----
Water Service _
Sanitary Sewer �((
Rain nrains
Gawh Basin!Manhole
Storm Drain
ower Pan
Ot o ���� j -���L�✓�'•�'�-cr-� r - -
- -- Com. -• �_
PART
HANICAL -- -
Post& Beam — — - -
Rough-In
Gas Line /"�-�C ✓ -,�� jc G/l
Smoke Dampers
Final
PASS PART _FAIL
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.
P/ASS PART FAIL
SITE �-i Please call for reinspection RE:__ __-_- Unable to inspect-no access
Fire Supply Line
ADA Das
!, Z _I.-jDpproarh/Sidewalk Inspector
Other: s,�
--
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour c�
BUILDING Inspection Line: (503) 639-4175 MST
INSPECTION DIVISION Business Line: (503) 639-4171 —'
>-- BUP --
Received ____ ____ Date Requested__ _ !.. AM _--_ PM _ BUP __—
Location ___—_� �`� ��� f f L Ci4k #' __ Suite MEC
Contact Person ___..__._ –A � _- _ Ph (_—__-)C� ?_Cod�_ PLM
Contractor _- __--_ Ph ( ) 3_ SWR --
BUILDING Tenant/Owner --_ _ -_ _ - ELC __—
`Footing
Foundation ELC
Ftg Drain e f �-(�f'c L c H4 ELR
Crawl Drain
Slab Inspection Notes: SIT _
Post& Beam I� r
Shear Anchors j ---- - -
Ext Sheath/Shear ou
Int Sheath/Shear
Framing
Insulation
Drywall Nailing - -- .-- -.---__-_-
Firewall Q rC �'
Fire Sprinkler ��4�!
Fire Alarm
Susp'd Ceiling _ -----��__— --
Roof
'Other: -- �p LJ �.� Q �- -
Final
�(J - !�
PASS PAHA' FAIL �
� -
PLUMBING
Post& Beam
Undnr;lab ------ f --
Rough-In
Water Service - - _—
Sanitary Sewer
RainDrains ---- -- ------- �-
Catch Basin/Manhole
Storm Drain
Shower Pan
Other. --- --------- -
Final
PASS PART FAIL
MECHANICAL
Post&Beam ,
Rough-In ---
Gas Line -
Smoke Dampers
Final
PASS _ T FAIL
^ .CTRICA •
Rough-In
UG/Slab
Low Voltage
Fire Alarm
PART FAIL Reinspection fee of$__ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
ST; — I Please call for re!nspection RE: Unable to inspect-no access
Fire Su!-,ply Line
ADA
Date C L'_ Inspector
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL