Permit CIT 1 OF TIGARD
MASTER PERMIT
PERMIT #: MST2001 -00173
1
� i1i, DEVELOPMENT SERVICES DATE ISSUED: 10/30/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 13010 SW RAPTOR PL PARCEL: 2S104DA -07500
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5
BLOCK: • LOT: 061 JURISDICTION: TIG
REMARKS: New SF detached rowhouse in Building #5.Setbacks as per A10.10
Plan C -SB
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 31 FIRST: 324 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 727 sf GARAGE: 410 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: 567 sf RIGHT:
VALUE: $ 149,440.00
OCCUPANCYGRP: R3 BDRM: 3 BATH: 2 TOTAL: 1,618.00 sf REAR:
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: 2 CATCH BASINS:
TUB /SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
. OTHER FIXTURES: 1
MECHANICAL
FUEL TYPES FURN < 100K: 1 BOILJCMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1
GAS FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1
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: 0 - 200 amp: W /SVC OR FDR: 2 PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 3 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 00 SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: 1 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 & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: ALL ENCOMB BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: . NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 5,729.82
BROWNSTONE HOMES BROWNSTONE HOMES, LLC This permit is subject to the regulations contained in the ,_.
12670 SW 68TH PKWY #200 12670 SW 68TH PKWY Tigard Municipal Code, State of OR. Specialty Codes and
PORTLAND, OR 97223 PORTLAND, OR 97223 all other applicable laws. All work will be done i
accordance with approvved 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 #: LIC 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
Erosion Control Insp 8 Underfloor insulation Electrical Service Low Voltage Firewall Insp Appr /Sdwlk Insp
Sewer Inspection Plm /undslab Insp Electrical Rough In Gas Line Insp Rain drain lnsp Electrical Final
Footing Insp PLM /Underfloor Framing Insp Gas Fireplace Roof Nailing Mechanical Final
Foundation Insp Mechanical lnsp Shear Wall Insp Insulation lnsp Water Line Insp Plumb Final
Slab lnsp Plumb Top Out Exterior Sheathing Ins; Gyp Board Insp Water Service Insp Final inspection
Z : ' ::::::::22‘
Issued By : __ i. .—e_ -al" _ t Permittee Signature :
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
, &g .z40/ — ®o //S
. Building Permit Application
Date received: gftevo, Permit no.: kfr2O® / ?win
�� „° i i City of Tigard
• Project/appl. no.: Expire date:
City ojTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By4617 Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1 &2 family: Simple complex: /
TYPE OF PERMIT
Eri & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family rr4 New construction Cl Demolition
0 Addition/alteration /replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION
Job address: / /O 5 co , 1,, , 4 G. Bldg. no.: ,s Suite no.:
Lot: • , Block: Subdivision: ” AI L 1 0 , 0 ".... Tax map /tax lot/account no.:
Project name: Ca A L + 1 u LIM—VME
Description and location of work on premises/special conditions: 17C5L.6 E- 1f)uSE_ P. ppilt 0.I`tt3'7
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: f 3a-13A-SMbrOt■I1 F1c3 M ers (Floodplain, septic capacity, solar, etc.)
Mailing address: 12(0/0 %-w (08t' '1' 2tit ua,' ZOO I & 2 family dwelling: �
City: p et - / State: Cr ZIP: ' 71_2-3 Valuation of work $ 24_7,r °C r)
Phone: 'S •I_ 5 Fax: cc/ $ lo$ t E- mail:: No. of bedrooms/baths
Owner's representative: • yl 0AOE`S . Total number of floors 3
Phone: 4 /35775 Fax: 57'1399'L- E -mail: New dwelling area (sq. ft.) I ` �-.
APPLICANT Garage/carport area (sq. ft.) i
Name: ,QE- /fir �,, ;., Covered porch area (sq. ft.) --
Mailing address: Deck area (sq. ft.) 40 56' Fl
City: State: ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial /industriallmulti- family:
CONTRACTOR Valuation of work $
Existing bldg. area (sq. ft.)
Business name: , ,,,,, • 1 , A- r� . New bldg. area (sq. ft.)
Address:
City: State: ZIP: Number of stories
Type of construction
Phone: Fax: E -mail:
Occupancy group(s): Existing:
CCB no.: 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: e, GI , el provisions of ORS 701 and may be required to be licensed in the
Address: \ k� f Ot.� a - E, -- , (off jurisdiction where work is being performed. If the applicant is
exempt from licensing, the following reason applies:
State: W A ZIP: (o 101 -
Contact person: ■ 4E Plan no.:
Phone:766 - 40-- -.: Fax:I bcit7 -, ,, E -mail:
ENGINEER
Name: W Q' t 1( Contact person: '; EN win, I, Fees due upon application $
Address: ♦ . ' a 1l1 i Wt t3 U5 Date received:
m . vo State Or ZIP: 722.3 Amount received $
Phone:ft- - et 6 33 Fax: E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of la s and ordinances governing this ❑ Visa ❑ MasterCard
work will be compli i , whe ified herein or not. Credit card number: / /
�
Authorized signature: \ t Date: �/ /,� /O i Name of cardholder as shown on credit card Expires
Print name: Ih V\A` A cardholder signature $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6ro0/COM)
A ,_ Mechanical Permit Application
Date received: Permitno.: /VISTA CO 1 3
City of Tigard si,L ' ..•� �! � J g Project/appl. no.: Expire date:
o Ti and Address: 13125 SW Hall Blvd, Tigard OR 97223
City f 8 Phone: (503) 639 - 4171 Date issued: By: l Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
m & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
® New construction 0 Addition/alteration /replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE 1
Job address: /30/o $ c) ,Q. ) , „ pc. Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: .5 I Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Valu $ 3� •
Lot: ,/ IBlock: I Subdivision: Qv Ai I R i w e r *See checklist for important application information and
Project name: Quti\ EIdi 10t3 TUKI\)1301kAE. jurisdiction's fee schedule for residential permit fee.
City /county: 71(14LD )AP ZIP: at 1 223 1 & 2 FAMILY DWELLING PERMIT FEE SCIIEDULE
• . Description and location of work on premises: l.- -t) 7LUCti AND COMMERICALIINDUSTRIAL EQUIPMENTSCHEDULE
Fee(ea.) Total
Est. date of completion/inspection: Description Qty. Res. only Res.only
Tenant improvement or change of use: HVAC: �o I
Is existing space heated or conditioned? 0 Yes 0 No Air handling unit CFM
Air conditioning (site plan required)
Is existing space insulated? U Yes 0 No Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
Business name: T UV_ G j # \1c1 A- Fool irt.r1 State boiler permit no.:
HP Tons BTU/H
Address: f',O, (o (o )4 cl Fire/smoke dampers/duct smoke detectors
City: .'c3(2..1` I Roo I Statetpr-E- I ZIP: C(7 7m o Heat pump (site plan required)
Phone: 7/.5 - s' ) 9 I Fax: 775 1141 I E - mail: ---- Install/replace furnace/burner BTU/H
Including ductwork/vent liner 0 Yes 0 No
CCB no.: 4 t 2-453 Install/replace/relocate heaters- suspended,
City/metro lic.no.: DDp01 wall, or floor mounted
Name (please print): ' 1 /Y101+40 - Vent for appliance other than furnace I
CONTACT PERSON Refrigeration:
• Absorption units BTU/H
Name: - I AJ■ \A M.1�0 Chillers HP
Address: < r'L\,e ,k_s ` Compressors HP
Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent 1
Phone: Fax: E -mail: Dryer exhaust I
OWNER Hoods, Type U II/res. kitchen/hazmat
p hood fire suppression system
Name: /( is At j led _ r Exhaust fan with single duct (bath fans) 3
Mailing address: Exhaust system apart from heating or AC
_
City: I State: I ZIP: Fuel piping and distribution (up to 4 outlets)
Type: LPG NG X Oil
Phone: Fax: E -mail: Fuel piping each additional over 4 outlets
Process piping (schematic required)
Name: �►�11A re- - {{�ei� e E i Other of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I ZIP: Insert -type
Phone: I Fax: I E -mail: Woodstove/pellet stove
Other:
Applicant's signature: I Date: Other:
Name (print):
Not an jurisdictions accept edit cards, please call jurisdiction for more information. Permit fee $ F 1' 5
0 Visa Cl MasterCard Notice: This permit application Minimum fee $
ex if a permit is not obtained c
Credit card number / / Plan review (at _ %) $
Expires within 180 days after it has been State surcharge (8%) .... $ � �
Name of cardholder as shown on credit card accepted as complete. TOTAL $ 7 7
- Cardholder signature Amount 440 (6/00/COM)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 9 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: FEE: Description: Price Total
$1.00 to $5,000.00 Minimum fee $72.50 Table 1A Mechanical Code Qty (Ea) Amt
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and 1) Fumace to 100,000 BTU
$1.52 for each additional $100.00 or including ducts &vents 14.00
fraction thereof, to and including 2) Furnace 100,000 BTU+
$10,000.00. including 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
fraction thereof, to and including 4) Suspended heater, wall heater
$25,000.00. or floor mounted heater 14.00
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and 5) Vent not included in appliance permit
$1.45 for each additional $100.00 or 6.80
fraction thereof, to and including 6) Repair units
$50,000.00. 12.15
Check all thata' l :�, ;.=
: 'Boiler:, , Hz� Air ;- ,:}`r ;�s,:
$50,001.00 and up $742.00 j 0 for each additional $100.00 or For rte s;7-11 see ,' orr - 0:46:0 - -?,, , eat Conde : �
fraction thereof. -footnotes below ,y. , Comp* + ., _ r "',` .
7) <3HP;absorb unit
to
ASSUMED VALUATIONS PER APPLIANCE: 8) 3-1 BTU 14.00
8) 3 -15 HP; absorb
Value Total unit 100k to 500k BTU 25.60
Description: Qty (Ea) Amount 9) 15-30 HP; absorb
Furnace to 100,000 BTU, including 955 unit .5-1 mil BTU 35.00
ducts &vents 10) 30 -50 HP; absorb
Furnace > 100,000 BTU including 1,170 unit 1 -1.75 mil BTU 52.20
ducts & vents 11) >50HP: absorb
Floor furnace including vent 955 unit >1.75 mil BTU 87.20
Suspended heater, wall heater or 955 12) Air handling unit to 10,000 CFM
floor mounted heater I 10.00
Vent not included in applicance' 445 13) Air handling unit 10,000 CFM+
permit 17.20
Repair units 805 14) Non - portable evaporate cooler
< 3 hp; absorb. unit, 955 10.00
to 100k BTU 15) Vent fan connected to a single duct �1
3 -15 hp; absorb. unit, 1,700 4 6.80
101k to 500k BTU 16) Ventilation system not included in
15-30 hp; absorb. unit, 501k to 1 2,310 appliance permit 10.00
mil. BTU 17) Hood served by mechanical exhaust
30-50 hp; absorb. unit, 3,400 10.00
1 -1.75 mil. BTU 18) Domestic incinerators
>50 hp; absorb. unit, 5,725 17.40
>1.75 mil. BTU 19) Commercial or industrial type incinerator
Air handling unit to 10,000 cfm 656 r 69.95
Air handling unit >10,000 cfm 1,170 20) Other units, including wood stoves
Non - portable evaporate cooler 656 10.00
_ Vent fan connected to a single duct 446 21) Gas piping one to four outlets
Vent system not included in 656 ( 5.40
appliance permit 22) More than 4 -per outlet (each)
Hood served by mechanical exhaust 656 1.00
Domestic incinerator 1,170 Minimum Permit Fee $72.50 SUBTOTAL: z . s . 'f X $ q aC
Commercial or industrial incinerator 4,590 t fry ;; / Z _
Other unit, including wood stoves, 656 8% State Surcharge } r*, " <F $
inserts, etc. ;;<`
Gas piping 1-4 outlets 360 25% Plan Review Fee (of subtotal) q Wit ti $$
Each additional outlet 63 �
Required for ALL commercial permits only P = xrr :: l ' ,
q Pe Y x:
TOTAL COMMERCIAL $ <,,r tar�..ri
s ; . t -. = TOTAL RESIDENTIAL PERMIT FEE: � 4
$
VALUATION: _.. y . .,:�
Other Inspections and Fees:
1. Inspections outside of normal business hours (minimum charge -two hours)
$72.50 per hour.
2. Inspections for which no fee is specifically indicated (minimum charge -half hour)
$72.50 per hour
3. Additional plan review required by changes, additions or revisions to plans (minimum
charge-one-half hour) $72.50 per hour
* State Contractor Boiler Certification required for units >200k BTU.
"`Residential A/C requires site plan showing placement of unit.
i:\dsts\forms\rnech- fees.doc 10/11/00
•Mdr -06 -01 03:05P Wolcott Plumb 503 667 9891 P.01
03/0E1/01 TUE 14:41 FAX 503 598 1960 cl'Cy ()t' TI CARD
VI 002
Plumbing Permit Application _
ACTI CI of Datc rcceived: Permit no.: ST�aza / -dal7
' ntidCc:a: 13125 SW Hall filed, Tiger 1, OR 97213 Sewer permit no.: Building pe no.:
City afTigard Phone: (503) 639 -417] ProjecVappl.no.: Ea
pee dace:
Fax: (503) 59S-1960 Date issued: By: Receipt no.: —
Land use approval: __ Ccse file no.: Payment type:
. 1Y1PF OI PERMIT f -.
U 1 & 2 family dwelling or accessory U Contrnu rcia /industrial ()Multi- family CI Tenant improvement
Q New construcuon Q Addidr n/altcranoclreplacement U Food acty Q Other:
. JOEL SITGINI•UR'IXTI0% • 'I'LE Sl'Ilf0I (Ilia p mt h I lnloatnutinn roc clicektist)
Job address; �, (� 5(3 /0,6
Deaerlptlon Qty. Fee(ea) Total
B ldg. no.: _ uitts no.: - Net l- and 2-tanilly dwellings Daly: '
_ Twat map/tax loUaccouut no.: (includes 100tt.foret uhilitycot>oeedom)
SFR (l) bath
Lot: T / Block Su #
bdivision: S • (2) bath IMW r
Projec n ttTte: SFR (3) bath _ 11111.1
City /county: ZIP: Each additions ath/ki
Description and location of work on premises: Site utilities:
- -- Catch basic/area drain
Est, date of - Dtywclls/leach line /trench drain
' t't'.11NIIIING .CONtILU(i.VR Footing drain (no. lin. ft.)
Man s need home utilities � �
Business name: l>J pl co r-.• b i „� • _ anholes
AddresF: , O, o 2.0 0 -) Ra drain connector _
City: 6 Cc skd., w StatcQ R - 411": Sanitary sewe( (no, do ft.) M
-
Phone: 503- 44,-1 - 1') .61 IF 6 41 - 91y 1 I E•mnatl: 6....st.Dt &- o•tiY Storm sewer (no. lin. ft.)
i n
CCB no.: 23 till Plumb. bus. reg. no: 24- 2 o 4i' eG Water service (no. lin. ti)
lie. Fixture or lteitem: Contractor 's re no.: presentative signature: Back tion valve EMI�
� Back flow preventer
Print name: Go,- x..; - o D r
Backwater valve MN
(ONT, E'l ;R U 111111111111111111111111
Basins lavatory
Nance Clothes washer ail
—
Address: Dishwsher MEM
Drirtlda: fountain(s)
City: Slate: 1 : :IP: Ejecto sump
Phone: Far: E- fruit, Expansion lank
OWNER' ♦I R ,. Fixture/sewer cap E —
Name (print): Floor drains/floor ainks/bub
Mailing address: Garb ; e tiffs • • al
City: - TStatc: 1r.lp; Hose bibb
NMI
ce maker
Phone: ! l sx: I E -mail Intcrce.tor /_eerie trap
Owner installation/residential maintenance only: Thr actual installation l'nmer(s)
will be made l-y me or the maintenance and repair (hit de by my regular Roof d in (commercial) _ .
employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s)
Owner's signature ,_ Date .._ Sump
- - -1
Jf \1GISS 1w M:R T u bs/shower /shower pan
•
Urinal
None: — -- Water closet
Address: Water heater
City State: ZIP: Other:
Phone: -- 1 — F;(a: E -mail: Total ', T
— _ -...,.
Nw rw all jo dicoO Kiwi credit ca rdr, plrx rUc
c call �urit;on kr mart: in «,anion. Notice: This permit appl ication Minimum - 3
U visa O ber: set's i expires i f a perrnil is nut obtained Plan revi fCew ( ........... '3bJ 65
(at — , $ "-It .
eft U' ""° Dumber: _I_ , 1 within 180 days after it has been State $urchxrgc (8%) .... $
1'OTAI, $ 3
Yaree of ca tit Mtn, nn nWir urn uca:pter� as oompkta.
- - rdbolaer tignalure s trtpifel a1 AfY011 -r
(.� 4440 tp(OAXYCCV)
r �f
t/tt 1 00
r7)l 6
Mar -O6 -01 03 :05P Wolcott Plumbing 503 667 9891 P •
03/06/01 'I'GE I4:42 FAX 503 598 1 CITY OF 1'IC:,gkl) i
e 063
PLUMBING PERMIT FEES:
d e ng s Q
{,FiXT ,:, � . `. „RRIQ ' y '7DT i44. New.S and 2 �J$ml ►Y ...W,')fi niyc. „, ' , ,, ' , ,',.
Ui�E3 • (individual) : ; QTY h: . (ealr MO
AU NT . (IgFlude's atl'ptumbinp'.�ixitu(es •in . P.�}ICE !"TOTAL
I Shit -t 1661 J b t•o the dwelltng.and t flrEt10C fti ' - QTY I (ea AMOUNT
- x 2 Ter em'eh utillt .00rtnaction '
Lavatory V 16.e) l> 2f2 1 I
J • Ono (1) bath 1249
L Tub or Tub /Shower Comb. i 1 16.6) n e ? T,: P Two (2) bath �1 $350.G0 � ,
_
Shower Onty Y 16.6) Three {3) bath 5399.00 . •
N,'atePCic*et 16.6) jl SUBTOTAL "'GT?_ J�
Urinal � 16,6) 7 } 6 %STATE $URCIIARG , 1 -�-
•`I ^�
Cishwa: a .ner I 16 .6 7 1 (p (°I) 7 PLAN REVIEW 25'/. OF SUBTOTAL 1-
Garbage Eiaposal ' ( 16.07 — t 410 TOTAL
Laund Cray 16.ED
Washing Machine I 16.80 1 (O bd
Floor Dra iniF lour Slik 2" 16 E0
3" 16 E0 __ PLEASE COMPLETE:
4" 16.f 0
water Heater 0 conversion 0 like kind 16 f 0 I.il, f�tr ;b Wor)i;P,erforrned... ,_
V
Gas piping requires a separate mechanical I ' /n om' ;. Fix,tu Type:! .` ! j :New' e iMlor, d , • Rep)aeed • i Removedl
r Fermi. (Y Capped•.
MFG Homo New Witter Service 46.0 $ink
MFG Home hew Sent torm Sevier 46 r 0 Levato --
abs 7 T 18.10 ZV Tub or Tub/Shower
Hose '�
r Combination
Root 0 - a1i1e 16,1.0 Showor On1 • _
- Onnit!ng Fountain -- I 16.110 Water Closet M
Uish _other Fixtures (Specify) 15.Z Dlshwaaher
_ Garba.c Qis oral r—I
�� I Laundry Room Tray
Washing Machine __
Floor grain /Sink' 2
Sewer - 1st 100' 55. 10 �7 r C$ 3"
Sower • each additional 100' �~ 46. i0 4•
MI
Water Scrv,cd • 14t 100' i 55.5c , Water Heater _ -
Wa :er Service - each aodltionat 200 46.10 — Other Fixtures
S •=
SfOrM & Rain Drain • 1st 100' ' 55, 50
-!--
Storm & Rain Drain - each additional 100' 46.10 _
a
Co rnerciat Back Flow Prevention Device 46.40
Reaid6nlial 6accflew Prevention Cevice• 27.55 _]
Gatech Basin 16 60 I )
Inspection of Existing Plumping or Specially 72 50
Requested Inspections • lihr } COMMENTS REGARDING ABOVE:
Rain Drain, single family dwelling ' 65 25 /.5"2.5 . _
Grease Traps -- 16 60 -
QUANTITY TOTAL ..
la arwtric or 4ser diagram Is required It
Own Gh' Yotil in o , '�'I . . - - —
'� " SUBTOTAL —
8•/. STATE SURCHARGE •': --
"PLAN REVIEW 25% OF SUBTOTAL 1 ,
Rrquhed or lr if rrxture q y total is . 5
TOTAL $
'Minimu p•rtnit lee Is $72.50 • a% carp surcharge, sacapt Rcsid meal eacIIPOW
PrevaniOn Onvice, w n;c11 la 5)6.15' a% Stare surcharge.
"All New Cernm.rpial 8 umines require pla is with Isomel'ic or A.17r diagram and
plan rrrew.
I \fists \rormslplrn- iees.doc 10/10/00 .
Electrical Permit Application
'at, , :. Date received: Perron no.: Sr . • 1.- MI 173
,.�,�.' l i ' City of Tigard ProjoWepp!.no.: Expire date:
Ch, °m Address: 1312S SW Hall Blvd, `l`lgard, OR 97323 Date hived: 13y: -
Phone: (503) 639 -4171
Pcc (503) 598.1960
Land use approval:
fl Pti oil ri limit
A-2 family dwelling at memory 0 Commercial/industrial 0 Muhl - family 0 Tenant improvement
New construction Cl Addition/alteration/replacement 0 Other: 0 Partial
,It111ti1 II 1\101t1111t0 \
Job a • G i • . - Aid no. :5 Suite no.; Tax m lot/account no.:
Lot: , Mock: Subdivision: 6tutv11. 14o lima tA1C'ST
Project name: d Ad/ pie I I ow) DeAcd. ion and location of waft on remises: t- € j ea./
Estimated date of com • etioali , . - • :
1 (1 \ ill 11 ililt \1'Y1:11 21111 \ ill .st!lll)t II l
1 to - . *MeeO , Par . a tlt>eal Rises ndhrthe r .011:4 1nes
City! V - ncouv - r State: WA VP: 98661
Phrne: 993 -508+ CiZarlintEMMIMME1111111 loo° ..anti"
Cf'`� no.: ? 1 6 51 4 Eke. bus. lie. 00. 3 4 — 4 3 2 C s whited son .. rt, or • . . red ■ Ir, � al�9
m- reaidentiul M
Limited ems he IIIIIMI KM
or • „, 411u1 -v Doe - .. I ■11111111
.r relent... idlrll,
Audio* or Moodie&
l'Itl►F't It 11 tttt `I' It 3 00 • orlon Ilia
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Thom — .� ,. •da=l E-mail; r■11■w111111111rrlu
Owner p ion: installation a . inn made on ptopofty Own try Of kooks, • 1111111111 which is pot intended for sale. I eschew , or escha aOeOt'ditl$ to bftaAltllea,allay11111o,.r
ORS 447, 415, 419, • t. ►1• y 200 aside
Mini= 2
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Addles!: amok. or food" each brooch etroih 2
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q service 0II1I �+
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san d it 411,100 t o HolltWy OW la000*Win bet .C41$ ae
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0 Dvdditljersnnee mein D Hendee,.400 mope sr mote *Altai • . _ _
0 Oscopret load w 99 imams 0 Mandlotored sti to to or 1W pork Sock _ 1 Meer thee' May of
a 141414411103011014s 0 O th e r . - - P. Ms OR - -ONS Min
1,1119it Mb of phr with say Odle above.
.'>i'(tn Ahem Newt . Ye Wee essolmese serr6d0. `
Permit „.
.
fee f... ........._... $ -7 "
tta an aterpr e.. ante p_ t�ll.rdteeoa fa.. ild Notice: Thty permit ep�plicatioa P1wd r fee . %) S
O Ma 0 Mesa 2 0 9 4 1 e m p i r e s if • roman is not obtained s 'i'te( .. S .. �
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accepted as complete. TOTAL _ .. $
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10/10 39dd 9Ic110313 3NI1WV3d1S ZE0 6Z :LL T00i;l90 /60
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
STREAMLINE ELECTRICAL
6025 EAST 18TH STREET
VANCOUVER, WA 98661
Electrical Signature Form
Permit #: MST2001 -00173
Date Issued: 10/30/01
Parcel: 2S104DA -07500
Site Address: 13010 SW RAPTOR PL
Subdivision: OU!A!L HOLLOW - WEST
Block: Lot: 061
Jurisdiction: TIG
Zoning: R-4.5
Remarks: New SF detached rowhouse in Building #5.Setbacks as per A10.10
Plan C -SB
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 Signature Form prior to the
start of the work to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
BROWNSTONE HOMES STREAMLINE ELECTRICAL
12670 SW 68TH PKWY #200 6025 EAST 18TH STREET
PORTLAND, OR 97223 VANCOUVER, WA 98661
Phone #: 503 - 598 -7565 Phone #: 360- 993 -5080
Reg #: L'c 116514
ELE 34 -432C
SUP 4081S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
x 73
Signature of Supervising Electrician
If you have any questions, please call (503) 639 -4171, ext. # 310
t,a,(.__
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, i.
. i SEF� ) � ��� �- UPS l.�^" . ,.rSERU10E'i)ATE ,r S RUICE REEtUESI t L)WSEfl''
o f?REFEREPa�E.
,� � CO 39513
Empire Pacific Indus V CCARRIE:R r
, _. i
p _ ROU7E GOOE : DATE WRITTEN VUii11'EN BY:.._
t 2-683-- ORDER # -� t ' _ OUR TRUCK I/90-
J
' CONTRACTOR / DLR ! ADDRESS SALESMAN 3 ORDER DATE: GLASS: SCREENS:
� .ulrr7�� CONTAfi } ' , PHOP4 / -^
FIRST OWNER i WARRANTY LIFETIME TEMPLATE
"e -'� - -6/ � ��j(2� y 1�
YES 140❑ YES NO YES Li N0
SU IS14N: L O T I —
�' CHARGEAULE-
2-MAN CREW YES D NO ® HEIGHT TO SitL: IA , SHIP DATE _______/_____/_____ ¥ES �� ❑
" �1h1E0VdNEf� - Df :
RUDRESS / j) 0 f /7 . HOME PHONE H - S 1 .10
CIT STATE ( ZIP WORK PHONE
A LC CAIlO OW WIN0 QUANTITY SIZE SERIES & FINISH O.A. J MR SPACE; GRIDS & COLOR ARGON COMMENTS
� + t i SPACER TYPE
2 - _0( = I 21: c: in C fe / - J I Sgt 7j a.,9--e e [1" ' l 'if,.! -re e",! -9-c
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Li ALUM, + NYL l ® ORZ_ U ALM VERIFY: TEMP Li EGRESS U COMMErdTS:
r dd+.FT ® U- VALUE: U ALIGN GRIDS 0
ow SERIES TYPE FINISH GLASS GRID GRID ARGON i SIZE ROUGH INE1 - OPTIONS / CGMMENTS UNIT TOTAL
FIN15R PATTERN PRICE
1 __________4________± .
N 1 1 F
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c a _ SATISFACTORILY COMPLETE& YES CI Na L --
CJ
'` 11SFGME.R SIGNATURE
� 1T:CHIJICIA SCG9A4TI1RE
o DATE t t
- SSTV DM
04/23/2002 08:36 FAX 5.03 692 3075 EPI Z 003/003
Pri dat In
Empi racifir Industries
..„...-„,„.„..
P82852 !,,,..,,,,,„,,. 1 ' or
,:r•...44`22 M. %1 t!'1; '''; 'i
Acet* 1E685 Cus jOb#: El.ri.- -61 Delivery Addresz:
Cu. ShiL7„. Date: 04-26-02 12 SW RAPTOR
BROWNSTONE HOMES LL:* , S1 p Via: OT / (:)(,) - TICRD, OR
12670 SW 4Th PARVWY 4'.20 NOE SCR.7.N;:3
PORTLA1D OR 7EES-S?3,9
Jcb NamstOIL 1 i:J £.1
acb Addrees;
7;ohtact: RANDALL MYERS - 130'10 •E'' ;;:APTOR pf_
p HOUSE Taker: 395L3 F1 tI0? F:::: :503-62a-9965 I:CAWD, OR
)unte 4: F10 21401 CIrdEr Data; Mb PS22.32
•
IT
GTVIDELBE SERI Ga TYPE 1 F 1 ) i Si '..E 0:7
;c2LAEE ikoRIUir"Al;:„A OPTION ;- '...p.:Nr.slut;
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SPLINETR 1 rLEASE CHEEV FP50 SI', hEEDIN5 AD2U8TMEI:T I p I
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t I 1 I 1_ ._ , _L ■ L —
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in St.! ail can ! te :gt:1.7,e";19d o t angQd once fa±ricatior, hal te.gun SUBTOTAL : 1.. DO
- lease ths7.::: tilts :rnf rTzti on ;c.10 at:curacy, Any ni-e'scti,Ns or SRAT1N6
:LI5i
b 'ilia: NI t e4 hours • or p1:-.....ellerit. EH:PPING : 0.00
0,1)0 DR I EA■ ;:i` TAX
CIRDER TEITAL 2 1
DEPOSIT
SAL,ANDT. Di„TS g 162,t
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04/23/2002 08:35 FAX 503 692 3075 EPI Z001/003
Empfre ,Paci is Windows
SERVICE DEPARTMENT
10255 SW SPOKANE COURT
TUALATIN, OR 97962
503 - 692 -6167
503 -885 -1437 FAX
DATE 1 1; ^42__
COMPANY _2r a._, ,
—
RE: Bolo Sa .0 R
TOTAL PAGE: g
(including covey page)
61‘3_4 PeigsA.
A 4 ' /1 L se's
•
THANK YOU,
c t _uiI -LL I c / L.C'!C: s, (...'_ _ _ , ,
COI)I `)` / C._..
PERMIT NO. _ , _ ; ' r - E R O S I O N CONTROL INSPECTION R P 1 ' T
�i -- 1t< INSPECTOR `v ' �.'
DATE ��.�. � � —; ,:i � ..
/ 3
CleanWater ...,1 i ,u, -,- l �<
CleanWater Services -°
SUBDIVISION 3 u,,...2.:,1 /(, W- 1= -7 LOT
Our commitment is clear.
SITE ADDRESS I. 307-S',. ( -306.6 13C Sit', (30 C1" _, C ':
1_ Sc_.;"?2, I CSC 0 ' <, -c
E
^" tea . .
t ^ 'e 'r £ < _ i i :t y l ,, n : .- h � . . T. z h
i.
1 1b n F a 's p 4 tl
“a_ WA, �'"V }.^':i �, zN,I, )A , _ -. ; '1R:., f ae„ P~ • ' � Ji1 b ,.n.L".�'i &` <l uuW
w r . -v- i �'� ' Y ' '11_ L ' � 4 ' t '' 1 .
. ti "J 3 y
,
4
s -
THIS SITE MEETS THE POST - CONSTRUCTION
EROSION CONTROL REQUIREMENTS SET
FORTH IN CLEAN WATER SERVICES
RESOLUTION AND ORDER
NOTE: IF POST - CONSTRUCTION EROSION CONTROL MEASURES ARE STILL BEING EMPLOYED
ON THIS SITE TO MEET CRITERIA FOR AN APPROVED FINAL INSPECTION, THE MEASURE(S)
MUST REMAIN IN PLACE UNTIL LANDSCAPING IS COMPLETE OR PERMANENT GROUND
COVER IS ESTABLISHED.
A COPY OF THE FINAL EROSION CONTROL INSPECTION REPORT MUST BE FORWARDED
TO THE NEW OWNER, AT WHICH TIME THE NEW OWNER ASSUMES THE RESPONSIBILITY
FOR MAINTENANCE, REPAIR AND REMOVAL.
OTHER
THANK YOU FOR YOUR COOPE'RA TION I
DATE ir( - i6.. - - C , L- INSPECTOR % 7 PHONE : �� // C,
i;
.-
•
CITY TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST 2®, Oo � 73
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received > Date Requ-sted 7 a I AM _ PM BUP
Location / Q /Z I / �� Suite _ MEC
Contact Person � At, _ Ph ( ) 7 q 3 S. 3�¢s PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain II ELR
Crawl Drain / 1A✓S /2 L L- a= p lAirc-
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath /Shear
•
Framing
Insulation 1p \_ ' % -4> ■S.N Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
— Other:
Rnal
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
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire ,Alarm
❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PA SS PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date G Inspector �- - ��•+` Ext
Other:
Final DO NOT REMOVE this inspection record fro - e job site.
PASS PART FAIL
CITY -OF TIGARD 24 -Hour
BUILDING # Inspection Line: (503) 639 -4175#
4____M_ ST 2eXi" a
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested 1 1 - AM PM ZOO BUP
Location 13/, /C7 Suite MEC
Contact Person 9' i Ph ( ) 7 3 3'3 y PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
•
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain •
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing r
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
PART FAIL
�" BI
(1
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
alp PART FAIL
CTRICAL
Rough -1n
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA Approach/Sidewalk Dat v =t2
Inspector Ext�
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL