Permit w
f
A
CITY OF T I G A R D MASTER PERMIT
II
PERMIT #: MST2002 -00076
rin DEVELOPMENT SERVICES DATE ISSUED: 8/29/02
r � J 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 •
SITE ADDRESS: 13088 SW PRINCETON LN PARCEL: 2S104DA -20100
- SUBDIVISION: QUAIL HOLLOW - SOUTH ZONING: R -4.5 .
BLOCK: LOT: 027 JURISDICTION: TIG
REMARKS: SF rowhouse,Unit #27, Bldg 6, CSB Plan.STRUCTURAL FILL, REQUIRES GEO -TECH •
INSPECTION AND REPORT •
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: FIRST: 320 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR LOAD: 50 SECOND: 744 sf GARAGE: 412 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: 732 sf RIGHT:
VALUE: $ 173,305.60
OCCUPANCY GRP: R3 BDRM: 2 BATH: 3 TOTAL: 1,796.00 sf REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: 3 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: 1 BOIUCMP < 3HP: VENT FANS: 4 CLOTHES DRYER: 1
LPG FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 1 0 • 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 3 201 - 400 amp: 201 • 400 amp: 1st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 • 600 amp: 401 • 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM/SVC /FDR: 601 • 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ ampNolt :
PLAN REVIEW SECTION
Reconnect only:
>=4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL • RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 5,599.33
This
BROWNSTONE QUAIL HOLLOW LLC BROWNSTONE HOMES, LLC Tigard Mu n c the re OR. S edolt ec i the
y Codee s and
12670 SW 68TH PKWY STE 200 12670 SW 68TH PKWY l o h Munici paal l Code, State work k w l be done C
a
PORTLAND, OR 97223 PORTLAND, OR 97223 all other applicable laws. All work will permit done i
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
Reg #: Llc 124627 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
Sewer Inspection Electrical Service Gas Line Insp Gyp Board Insp Plumb Final
Footing Insp Electrical Rough -in Insulation Insp Rain Drain Insp Mechanical Final
Foundation Insp Mechanical Insp Shear Wall Insp Water Service Insp Building Final
Slab Insp Plumbing Top Out Exterior Sheathing Ins; Smoke Detector Final inspection
Plm /und Ih1asn Framing Insp Firewall Insp Electrical Final
I ' • ,,.. 9
Iss d By : .■ ' !•t ! I mo: _ / �/k_11. -n _ Permittee Signature : r `, A.
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
, . - E.; iod,-oco - )
Buildin •Permit Application
� PP
City of Tigard Date received: y Do {�1j�
Permit no.:� p0;{ —I ,f 2
= Project/appl.no.: - • date:
City ofTigard Address: 13
Phone: (503 ) 25 SW 639 -417 1V Er) L�� � - w ) V Date issued: 3 R T iIJ Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: FEB ° 4 2002 1 &2 family: Simple Complex:
rra - -. • , a .
'' I' OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address: 0 g Ski C 8 To/) _ Bldg. no.: ' Suite no.:
Lot: Block: Subdivision: T ma!/tax I _t/account no.:, a 4 .in i i, l h
i
Project name: IT ,S' C)
Description and location of work on premises/special conditions:
•
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
E _ �� _ ( Floodplain ,septiccapacity,solar,etc.)
Mailing address: - - 0 . , IN WIffeff5WCIM.18, 2 family dwelling:
City: l 'o „,..-k- u , State:c g ZIP: - Valuation of work $
Phone• - ; - E-mail: No. of bedrooms/baths
Owner's representative: MEW Total number of floors
Phone: a, 8' r '; . y E-mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
IIMEIMMINMEIN
Covered porch area (sq. ft.)
Mailing address: . . i ..S'CV _ _ E. ta_ . w1Y ,L Deck area (sq. ft.)
EI2M2IMMILIIIIIIII MM. z t' 9 ii Other structure area (s a . ft.)
Phone: - 8-- ` 65 Fax: E- mail: Commercial/industriallmulti- family:
CONTRACTOR Valuation of work $
Business name: Existing bldg. area (sq. ft.)
�' �^ O �- ' - New bldg. area (sq. ft.)
Address: .... . g� . qtr
m Stared 1: a Number of stories
• m�- w Type of construction
Phone. s - - _ - Fax:6 20 - ._I .
no.:
mLf� Occupancy group(s): Existing:
New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: 6. tSr LD provisions of ORS 701 and may be required to be licensed in the
Address: Q — : A v (., _ 5 c..,..Lte D jurisdiction where work is being performed. If the applicant is
AI': � exempt from licensing, the following reason applies: rw
Contact person: . , t j t •, • Plan no.:
__i__)_ _ E -mail:
ENGINEER
IIMENIEMIMMIll Contact person: • ,. • Fees due upon application $
Address: • .• S W , • • 4rcc Date received:
j ZIP: -Aril Amount received $
Phone: _ p Fax: E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not as Jurisdictions accept credit cards, please call Judsdiedoo for more information
attached checklist. All provisions of laws and ordinances governing this Ovisa O MasterCard
work will be complied • ' • , whether . .,;6 ed herein or not. credit card number:
Authorized . sign re: _____ ' _: Name oceudhotaa u shown on credit card
Print name: a -- .. Cardholder dg- atone Arnaud
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6iVUWM)
•
•
•
r • Plumbing' Permit Application
, Date received: Permit no.: 15fu)o l
N-� Ai' City of Tigard
Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd, Tigard, OR 97223
City o gard Phone: (503) 639 -4171 Projed/appl no.: Expire date:
Fax: (503) 598 -1960 Date issued: By: 1 Receipt no.:
Land use approval: Case file no.: Payment type:
TYPE OF PERMIT
O 1 & 2 family dwelling or accessory 0 Commercial/Industrial 0 Multi - family 0 Tenant improvement
O New construction O Addition/alteration/replacement 0 Food service 0 Other.
JOB SITE INFORMATION FEE SCIIEDULE (for special information use checklist)
Job address: 1 3 0 S W Al in r P.-i-o ti, Let. IAA- Description Qty. Fee (ea.) Total
Bldg. no.: (Suite no.: New 1 - and 2- family dwellings only:
Tax map/tax lot/account no.: ( 100 ft. for each adlityconnection)
SFR (1) bath
Lot: aI7 (Block: (Subdivision: SFR (2) bath .
Project name: SFR (3) bath
City/county: ( ZIP: Each additional bath/kitchen
Description and location of work on premises: Site utilities:
Catch basin/area drain
-
Est. date of completion/inspection: Drywells/leach line/trench drain
PLUMBING CONTRACTOR Footing drain (no. lin. ft.)
Manufactured home utilities -
Manholes _
Wolcott Plumbing Rain drain connector
PO Box 2007 Sanitary sewer (no. lin. ft.)
Gresham OR 97030 -0594 Storm sewer (no. lin. ft.)
503- 667 -1781 Water service (no. lin. ft.)
CCB:23847 PLM #:26 -208PB Fixture or Item:
Absorption valve
Contractor's representative signature: Back flow preventer
Print name: Date: Backwater valve -
CONTACT PERSON Basins/lavatory
Name: Clothes washer
Dishwasher
Address: Drinking fountain(s)
City: ( State: . I ZIP: Ejectors/sump
Phone: Fax: E -mail: Expansion tank
OWNER Fixture/sewer ..
Floor drains/floor sinks/hub
Name (print): Garbage disposal
Mailing address: Hose bibb
City: I State: I ZIP: Ice maker
Phone: I Fax: I E -mail: - Interceptor/grease trap
Owner installation/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain (commercial)
employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s)
Owner's signature: Date: Sump .
IIIIIIIMIMIIIEEZgZEIIIMMIIIIIII Tubs/shower/shower pan -
Urinal I.
Name: Water closet
Address: Water heater
City: I State: ( ZIP: meter: • .
Phone: ( Fax: (E -mail: Total
•
Na as ei accept ae C. please eu Prisdiedon for awte inf«m431L Notice: This permit application Minimum fee $
O Vus O MasterCard expires if a permit is not obtained Plan review (at _ 96) $
oast card amber —I- within 180 days after kites been State surcharge (8%) •••• $
Name ce cardholder as down m seat std
Expires accepted as complete. TOTAL ..... $
S
Cardholder dameAmomt 4404616 (6K10/03I4)
, ; „..,
. _ , MechanicalPermit Application
Date received: Permit no.: /1<f-.49 2 .0007lo
' 111 City of Tigard 11_x- �__.. � g pro1ect/aPPl•no•: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 —
Phone: (503) 639171 Date issued: By: I Receipt no.:
Fax: (503) 598 -1960 - • Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family • 0 Tenant improvement
0 New construction 0 Addition/alteration/replacement 0 Other.
. JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: R O$$" so-) Pr' CtAcc - Vo v (_.awc, Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map/tax lot/account no.: profit. Value $ -
L.ot: 2t) Block: I Subdivision: *See checklist for important application information and
_ Project name: jurisdiction's fee schedule for residential permit fee.
•
City /county: I ZIP: 1 & 2 FAMILY DWELLING PERMIT HI SCHEDULE
Description and location of work on premises: AND COMMERICALIINDUSTRIAL EQUIPA ENT SCHEDULE
Fee(ea.) Total
Est. date of completion/inspection: Desaiption Qty. Res.only Res.only
Tenant improvement or change of use: Ii Air tan
space heated or conditioned? 0 Y es - 0 No Air handling unit CFM
Is existing P Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
• MECHANICAL CONTRACTOR "d- compressors •
State boiler permit no.:
HP Tons BTU/H
- Four Seasons Heating & A/C Service Inc Fire /smokedampers/duct smoke detectors
- PO Box 66409 Heat pump (site plan required)
Portland OR 97290 - 6409 Install/replace furnace/burner BTU/H
- 503 775 - 5919 Including ductwork/vent liner 0 Yes 0 No
CCB: 48283 YnstalUreplace/relocateheaters– suspended,
wall, or floor mounted
Name (please print): Vent for appliance other than furnace
•
CONTACT PERSON R
Absorption units BTU/H
Name: ` Chillers HP
Address: Compressors HP
bt exhaust and ventilation:
Qty: ( State: 1 ZIP: Appliance vent
Phone: Fax: E-mail: Dryer exhaust
OWNER Hoods, Type U Ilhes. kitchen/hazmat
hood fire suppression system
Name: Exhaust fan with single duct (bath fans)
Mailing address: Exhaust • stem : ' - from heating or AC
St ZIP: p ' ' ' ' ' , . ' on up to 4 outlets
City: Type: LPG NG Oil
Phone: Fax: E-mail: Fuel i ing each additional over 4 outlets
p p (schematic required)
• Number of outlets
Name: Other listed appliance or equipment:
Address: Decorative fireplace
City: • I State: I ZIP: Insert –type
Phone: I Fax: ( E-mail: Woodstove/pellet stove
tt Other.
Applicant's signature: . 1 Date: Other:
Name (print):
Not all Jurisdictions accept «edit cards, please all jurisdiction for more inrecmadco Permit fee $
Yea 0 Notice: 'This permit application Minim fee $
o expires if a permit is not obtained Plan review (at _ %) $
(aeodit care number: Expires within 180 days after it has been
accepted as complete. State surcharge (8%) .... $
Name or cardholder as shown on =lit wrd $ TO'T'AL ....... $
Cardholder slow= Amoom 440.4617 (6Vn: M)
•
•
CITY OF TIGARD
• 13125 S.W. HALL BLVD.
TIGARD, OR 97223
•
•
IMPORTANT PERMIT NOTICE
DAVID JEROME ELECTRIC
PO BOX 751
HILLSBORO, OR 97123
Electrical Signature Form
Permit #: MST2002 -00078
Date Issued: 8129/02
Parcel: 2S104DA -20100
Site Address; 13088 SW PRINCETON LN
Subdivision: QUAIL HOLLOW - SOUTH • •
Block: Lot 027
Jurisdiction: TIG
Zoning: R-4.5
Remarks: SF rowhouse,Unit #27, Bldg 6, CSB PIan.STRUCTURAL FILL, REQUIRES
GEO -TECH INSPECTION AND REPORT
Your company has been indicated as the electrical contractor for the permit Indicated above. In order for the
electrical permit to be valid, the signature of the supervising electrician Is required. Please have the
appropriate individual from your company sign below and return this Electrical Signaure Form prior to the
start of the work to the address above, ATTN: Building Division.
No electrical inspections will be authorized until this completed form Is received
OWNER: ELECTRICAL. CONTRACTOR: •
BROWNSTONE QUAIL HOLLOW LLC DAVID JEROME ELECTRIC
12670 SW 68TH PKWY STE 200 PO BOX 761
PORTLAND, OR 97223 HILLSBORO, OR 97123
Phone #: 503. 598 -7565 • hone #: 648 -5144
Reg #: LTC 36051
SUP 28775
ELB 34 -119C •
AN INK SIGNATURE IS REQUIRED ON THIS F
• X
• Signature of Supervising Electrician
If you have any questions, please call (503) 639.4171, ext. # 13 7
• Zo 0in 3430 $010 Q>DIL 30 ALLI3 I99C6Z9CO5 IV3 99!PT I2id CO /OT /TO
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
WOLCOTT PLUMBING CONTRACTORS
PO BOX 2007
GRESHAM, OR 97030
Plumbing Signature Form
•
Permit #: MST2002 -00076
Date Issued: 8,29/02
Parcel: 2S104DA -20100
Site Address: 13088 SW PRINCETON LN
Subdivision: QUAIL HOLLOW - SOUTH
Block: Lot: 027
Jurisdiction: TIG
Zoning: R-4.5
Remarks: SF rowhouse,Unit #27, Bldg 6, CSB Plan.STRUCTURAL FILL, REQUIRES
GEO -TECH INSPECTION AND REPORT
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the
plumbing permit to be valid, please have the appropriate individual from your company sign below and return
this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
BROWNSTONE QUAIL HOLLOW LLC WOLCOTT PLUMBING CONTRACTOR:
12670 SW 68TH PKWY STE 200 PO BOX 2007
PORTLAND, OR 97223 GRESHAM, OR 97030
Phone #: 503 - 598 -7565 Phone #: 667 -1781
Reg #: LIC 23847
PLM 26 -208PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
x
Signature 'r Aut j i: w ed Plumber
If you have any questions, please call (503) 639 -4171, ext. # 310
' 7-- ZC7 - 0`ao
••••••••••••••••••••••••••••••••AAAAAAAAAAAAAAAAAAAAAAAAAAA V . ■
A -►
• T EE CERTIFICATION
R STREET
• .
• .
• a'ib7 Owner /A ent for .. )j I k �.1 r g' 4 1 .
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• (PLEASE PRINT) (PERMIT HOLDER) ■
• ►
• ►
• ►
•
• ►
• Do hereby certify that the following location ■
• • meets City' of TigardAVashington County ■ ■
• land use and development standards for street tree installation. ■
■
j ■
• ■
• ADDRESS: l C*J
•
• •
• • LOT: Z SUBDIVISION: (II titt lyE5 • ►
• .
•
• BY: VAULA DATE: &5 Z j •
•
• •
• •
Al RECEIVED BY: DATE: • •
lir •••••••••••••••••••••••••••••■••••••••■•••••••••••••••••••■ •
CITY r 24 -Hour
BUILT... Inspection Line: (503) 639 -4175 MST 2 ' "U
INSPECTION DIVIS v Business Line: (503) 639 -4171
BUP
Received Date Requested AM PM BUP
Location /3'V /vi ;46d Suite MEC
Contact Person 12-1A,1 Ph ( ) - 7 4 5 � � PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
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:
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 PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
C
Service
Rough -In
UG/Slab
Low Voltage V � fraP11.�' 3 J' . ' 1'a% t =3>a GAO
Alarm
PASS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspection RE: LI Unable to inspect — no access
Fire Supply Line /
ADA
Approach/Sidewalk Date-- Inspe r - . A Ext
Other:
Final DO NOT REMOVE this inspection record from t ob site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 63 175 MST 62- a
INSPECTION DIVISION Business Line: (503) 1
BUP
Received Date Requested — AM PM BUP
Location / 3o 81 VA14 Suite MEC
Contact Person Ph ( ) 71 - b — s3 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: a SIT
Post & Beam C.
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
(
Roof
Ot :
o '- PART FAIL
PL MBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
S • _ tampers
•` i PART FAIL
EL CTRICAL
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 111 Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date ��� �3 I nspector \V( .; Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL