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13003 SW Caddy Place
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
B'J P _
—Date Requested `, _ Z —AM---PM _ BLD
L•cation_ l 3DD.3 'J�%�/��` — Suite — MEC
Contact Person — :E Ph ���3 ��--PLM _
Contractor 6 Ph SWR
BUILDING Tenant/Owner LLC --- —
Retaining''Nall EI_R
Footing Access: / —
Foundation �` m 6 o FPS
Ftg Drain J v SGN
Crawl Drain Inspection Notes
Slab - - -_ SIT
Post& Beam -~-- -
Ext Sheath/Shear
Int Sheath/Shear
Framino
Insulation ---' �— -- --------- __
Drywall Nailing ------ — --- ------ ------ -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof ✓� /�
LFPART
All_ - ---- _
ING - \
Post& Beam `-- - —
Under Slab
Top Out
Water Service
Sanitary Sewer,Ra - - -- ---- --- - -
iu,Drains
Feal)
ASS PART FAIL
MEMANICAL
Fust& Beam ---- - --
Rough In
Gas Line - -- - -----
Smol•:r,I:,ampers
Final - --- -- – ---- _.___.--- -------- ---
PASS PART FAIL
ELECTRICAL —
Serv,,,e
Rough In
UG/Slab
Low Voltage
�15
iin! �
S RT FAIL
SITE
Backfill/Grading -------------
Sanitary Sewer
Storm Drain ( Reinspection fee of$ required before nezi inspection. Pay at City Hall. 13125 SW Hall Blvd
Cdtch Basin
Fire Supply Line ( )Please call for reinspection RE. _ — - [ Unable to inspect-no access
ADA /
Approach/Sidew31k
Other Date /'/ Z Inspector — _ Ext
Final
PASS PART FAIL DO NOT RE 01OWE this inspection record from the job sito.
�� �� � ����� MASTER PERMIT
PERMIT#: MST2001-00219
DEVELOPMENT SERVICES DATE ISSUED: 4/10/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 13003 SW CADDY PL PARCEL: 2S104DA-13800
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: K 4.5
BLOCK: LOT: 124 JURISDICTION: TIG
REMARKS: New SF detached rc wh011se in Building#14. Setbacks as per sheet A10.10
Plan C-S
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 31 FIRST: 324 at BASEMENT. at LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 747 at GARAGE.: 410 at FRONT: PARKING SPACES.
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: 561 at RIGHT:
VALUE: S 151.166 00
OCCUPANCY GRP: R3 BDRM: 3 BATH: 2 TOTAL: 1.63800 of NEAR:
PLUMBING
SINKS: 1 WATER CLOSETS: WASHING MACH 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS.
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: IOu SF RAIN DRAINS. CATCH BASINS-
TUB/SHOWERS: GARBAGE DISP. 1 WATER HEATERS: 1 WATER LINES: 100 BCKFI_W PREVNTR. GREASE TRAPS:
OTHER FIXTURES: 1
MECHANICAL
FUEL TYPES FURN<100K: 1 BOIL/CMP c OHP: VENT FANS: 3 Y CLOTHES DRYER: I
GAS FURN>-100K: UNIT HEATERS. HOODS: OTHER UNITS. I
MAX INP: blu FLOOR FURNANCES: VENTS: 1 WOODSTJVES: GAS OUTLETS:
ELECTRICAL _
RESIDENTIAL UNIT SERVICE FEEDER TEMP Si JCIFLEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp. 0 200 amp: WISVC OR FOR: 2 PUMP/IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 3 2 1l -400 amp: 201 400 amp: tat WIO SVCIFDR: 00 SIGNIOIIT LIN LT: PER HOUR:
LIMITED ENERGY: 4r 1 600 amp: 401 600 amp: EA ADDL OR CIR: I SIGNALPANEL: IN PLANT:
MANU HMISVC/FDR: 601 • 1000 amp: 601+8mpa•1000v: MINOR LABEL:
1000+amplvolt
PLAN REVIEW SECTION
Reconnect only: --`-
>�1 RES UNITS: SVCIFDR>=i:S 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: INTF.RCOMIPAGING: OUTDOOR LNDSC LT
BURGLAR ALARM: OTH: ALL ENCOMB BOILER: HVAC: LANDSCAPERRRIG: PROTECTIVE SIGNI..
GARAGE OPENER: CLOCK: INSTRUMENTATION. MEDICAL. OTHR:
HVAC: DATA7TELE COMM: NURSE CALLS TOTAL a SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 3,608.25
BROWNSTONE HOMES LLC BROWNSTONE HOMES, LLC This permit is subject to the regulafons contained in the
12670 SW 68TH PKWY#200 12670 SW 68TH PKWY Tigard Municipal Code,State o k w Specialty done Codes and
PORTLAND,OR 97223 PORTLAND.OR 97223 all other applicable laws. All work will p done it
accordance with approved plans. This permit will expire N
v.ork is not started within 180 days of Issuance,or if the
work is suspended fol more than 180 days ATTENTION
Prone: Phone: Oregon law requires you to follow rules adopted by the
Otegon Utility Notification Center. Those rules are set
Rep 6: 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 sp Electrical Final
Sewer Inspection Plmlundslab Insp Electrical Rough In Gas Line Insp Rain dr n Insp Mechanical Final
Footing Insp PLM/Underfloor Framing Insp Gas Fireplace Roof Na Ing Plumb Final
Foundation Insp Mechanical Insp Shear Wall Insp Insulation Insp at a Insp Final Inspection
Slab Insp Plumb Top Out Exterior Sheathing Insl Gyp Board Insp Ap r k Insp
Issued By :` Permittee Signature
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITYOF TIGARD _SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2001-00147
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/10/01
SITE ADDRESS; 13003 SW CADDY PL
PARCEL: 2S104DA-13800
SUBDIVISION: QUAIL HOLLOW- WEST ZONING: R-4.5
BLOCK: LOT: 124 JURISDICTION: TIG
TENANT NAME:
USA NO: o•IXTt1RE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF 13UILDINGS: 1
!NSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF detached rnwhouse.
Owner: —— -�
---- --- - FEES
BROWNSTONE HOMES LLC Type By Date Amount Receipt
12670 SW 68TH PKWY#200 —
PORTLAND. OR 97223 PRMT CTR 4/10/01 $2,300.00 27200100000
INSP CTR 4/10/01 $35 00 27200100000
Phone: 503-598-7565 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
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 1'he Agency does not
guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the instal ler
shall prospect 3 feet in al' _.;ections from the distance given If not so located, the installer shall purchase a"Tap and
Side Sewer" Permit and the Agency will install a lateral ATTENTION Oregon IavW r uires youollow rules adopted
by the Oregon Utility Notification Center Those rules are set forth in OAR 95"r_-001-00 lhroug p, R 952-001-0080
You may obtain copies of these rules or direct questions to OU JC by calling (503)'\246- 1 87 I
\A
Issued by: J+ Signature:
Permittee
Call (u03) 639-4175 by 7:00 P.M. for an inspection needed the next'Ibusiness day
Building_Permit Application
City of Tigard Date recci ved:
CityojTigard Address: 13125 SW Ifall Blvd,I igard,OR 97223 Pr-jecUappl.no.: Expirrdatc:
Phone: (503) 639-4171 Date issued: 13y:, Receipt no.:
Fax: (503) 598-1960 Case.'ilc no.: Payment type:
Lan I use approval: 1&2 family:Simple Complex:
1
U 1 &2 family dwelling or accessory O Commercial/industrial U Mult-family CWf cw consuuction U Demolition
U Addition/alters:tiontrcplaccw.ent O Tenant improvement CJI Fire sprinkicr/alarm ❑OdKtr..
1 1
Job address: �. r 1 X!f)1� '' I _ Bldg.no.: Suite nu.:
Lot: I,r .I I Block: Subdivision: G?va.;\ t 'q . Tax map/tax kit/account no.: _
Project name: up,,' Hu llovv C'r-'-.a
Description and location of work on premises/special conditions:_may hlt3%,kb& I,t_IAJ e0"ST12.Ut_F1
�Namc: ar.tr
Mailing address: GW L,, CW 1 &7 family duelling:
City: har I Statc:rValuation of work........................................ $
F'trone::"Ip 7 .5 Fax: tf-9 06 f E-mail: -- No.of bedmoms/baths.................................
Owner's_representative: %
Total number of floors...............� . ....
Phone: -1 -5'7 5 Fax:'9 X
5992 F-mail -- New dwelling area(sq.ft, 1 . .. —
...........
Garage/carport area(sq.ft)..... ,1.4..... -
Coveted porch area(sq.ft)
Name: !/) �1 t= /4 A n 3� ---
Mailing address: Deck area(sq.ft) ............. ........�.. -_.-- _--,
City: State:_ ZIP: Other structure arca( .fIJ............"'-........
Phone: Fax 1;mail. Commereial/indastri&Umlti-family:
swiltmillit Valuation of work....................................... $_ --
Business name: Vi,µ_ -� ,4� E Existing bldg.area(sq.ft.) ..... ..................
1
Address: New bldg.area(sq.ft)
................................
City: _ State: ZIP: Number of stories........................................ -
Phone: Fax: E-mail: Type of construction....................................
CCB no.: Occupancy group(s): Existing:
- New:
City/meta lic.no.:
Notice:All contactors ar-'subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: Oct,)O` _ provisions of ORS 701 and may be required to be licensed.a the
Address: I y �[tiN /N jurisdiction where work is being performed.If the applicant is
Cit : Q - •TT t State: W ZIP:q it .�9[� exempt from licensing,the following reason applies:
Contact person: ANOE Plan no.. -
r`honc:71`0 A,15f if', I Fax: ba'CG Z E-mail: ------- — -
Name: j(t" !!I J Contact person: &ulU I1, Fees due ufon application ........................... $_
Address: I h v t Date received: _
City: BQ 0, Stateur- ZIP: 9722. Amount received ............................. .......... $�
Phone: ee� E-mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Na vt Junw.ctimc accep credit cards,Oem can JwWk<+a+for mac i dwnatim
attached checklist.All provisions of laws d ordinances governing this o visa t]MasterCard
work will be complied wttlt whether s i ed herein or not. r mda card mamba
Authorized signature:-_•,i __ Date: �d /d I — tJ.me of cardholder as riorvn or.credit card Fs res
Print name:_�Yhtit 1 -� -- s
Gar�rrida aiXrWore Arnow
Notice:This permit application expires if a pemrit is not obtained within 190 dais afler it has been accepted as omplete. 40*11(tyooMM)
Mechanical Permit Application
Date-cceived: Permit
(City of Tigard ProjeuNappl.no.: Expire date:
Cryof Tigard Address: 13125 SW Hall Blvd.Tigard,OR 97223 Date issued: — By: Receiptno.:
Phone: (503) 6394171 —
Fax- (503) 598-1960 Case file no.: Payment type:
Land use approval: A Building permit o.:
U I & 2 family dwelling or accessory U Commercial/industrial U Multi farnify U Tenant improvement
U New construction U Additiott/alicratiorl/replacement U Other. —`
Job address: �. t �L Indicate equipment quantities in boxes below.indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$ 2a-'ex`!V
L,ot: Block: Subdivision: l Ila,.,I o- r •See checklist for important application information and
Project name: tjurisdiction's fee schedule for residential permit fee.
City/county: 'LIP: D Z
Desctiptiou and location of work on premises:
Fee(ea.) Trial
Est.date of completion inspection: Demi0on Qfy. Res.only Rcs.only
Tenant improvement or change of use: Air handling unit _ChM
Is existing space heated or conditioned O Yee 0 No Air conditioning(site pan required)
Is existing space insulated?U Yes U Noterata ion o)existing IiVAC system
Te r compressors
Business name: r'U State boiler permit no.:
_ HP Tons BTU/H
Address: 110(p(P C) _ i smo a amper duct imokc detectors
CiP: r— Beat pump(site plan required) _
Phone: e/►Cj Fax:7'5' /)q/ E-mail: Insialureplacc umac urner`H FTU
Including ductwork/vent liner U Yes U No _
CCB no.: I- j nsta rep acereocate heaters-suspende , _
City/metro lic.no.:O OM N(�Z.`� _ wall,or floor mounted
Name(please print): tk l Vin Vent Tor app anee other than furnace
c .
Absorption units BTU/fl —
7NM
AA�: kJ /,601(0 Chillus � HP Cot ressors Hl'
�r roame exhaast ven-i& on:
City: _— Slate: ZIP: Appliance vent
Phone: Fax: I E-mail: hyerex—haus) I
s, ypc res.kite a azmat
n hood fire suppression system
Name: G` /tti( _ AS AAA) _ Exhaust fan with single duct(bath fans) aL
Mailing address: Exhaust system—t art tram eatin or A
City: State: Z1P: p-fTR and distribution(up to 4 outlets)
Type:
.—.^LPG N(7 Oil
Phone: Fax: E-mail: ue t m each additional over 4 outlets
Proem pip (sc lematic:required)
f} Number of outlets
Name:
r j ' �' app or egr�mmll:
Address: Decorativefireplace
City: State: ZIP: Insert-type
Phone: Fax: I E-mail: 7Woo&tov-i7pelet stove _
Applicant's signature: i — Date: 4 V Othter:
Name(print):
Na VI Jtnirlkllam accepr credit cartla,plane call jrnaAicYim for mom lurarroarian.
Permit fee.....................$ y
U Visa U MasterCard Notice:This permit application Minimum fee.......... $
expires if a permit is not obtained Plan review at — %) $
credit card nnmha: �_—__--- —_ F� within Igo days after it has been ( ►
of car
me dMMer as ih,.,�,o crcd��md �- cepplete. She surcharge(896)....$
Na
$ acted as complete. TOTAL. .......................$
Cardholder signanue— ,-- Anions 4461517(GMWOM)
6Ci9935(8�' STREAHL.INE ELECTRIC FAGE 0: 0
Electrical FermitApplication
_--dere-........ Datnalred: _
Plannitaa.;l�/
City of T191H .momhppo.ft;
CUyW-r4sIJ Addles: 13125 SW Hatt Dlvd,T10m,oR 972.2? Dote isrim, by t10.:
Fhmw- ($03)639-J171 --- —
Put:(503)395-190c1 Cam fit$ao.:
Lund use appmal.
4 I A 2 htttttity dwelling(o alaot mey 0 Cwmtrd&1Am&flr1al U Mum-famol, U TenMt improvortunt
U New conjbwion CJ A�didor✓,tlttndorl/roplr?c :tttrnt U other:
lob tart WO: i 61 .rto,t i Suite no.: Tu ma let/KptywK we,;
Lac: 17'1 Blcx:M: bdiv Nt�►�_F►011wa Wt!'« -...----._.._...
Prnlset_ aunt' kt fIo i Iota Dolrtl;ion uM(wdm of wa'1c on pramttea. New eco% wnen.,+
Cetimslyd Cott of o011t etioel:nt. tion:
Job wot /ss Mo
Buono"nar++s. S t e$ leing F1pl;:t r i r (is) fewtM
Add— (; �, _F� F
.• �, dwa�tttldthle11Md-40dtlarm-
City V4rigouyer WA JVF 98661 _ 151d
11et1a1e"
Plwrte: 9 -•5 D b Psa: _ mall: 1ffWW&jF'
N
S'CB rto,- 1 j 51 b1ec.bat+.lice no: 34-432C
s_oo K—ri.dgmjlj
Cltt r/rtww Ilr.no.: - ►A R4 cnery nta►.e�idena.i
Balt mmwfumn or" tar dwNl1r6
�aiwn t _ ,In eoir O;xc raga►d'f"_ ggrv"Ludo.red.. -
wp INR Rare 100 LWaa/a Ow N Ik�bn.
ttAaem wrstomfltwt
zoo Wr rn tdelfee 2
Name n0.
_filen Imm". w i tr�++e w t.UO twrtte
Cl t
f'howk - Pub 6 mUl: Aemwaa, � _
()yrKr ittatsllsdort:111111111 ftsw1ad" 6 y 1 Own TeagerrryeNvl�.M�i�er+'
w
hich is ad IMtndsd for sale I /M,or aaohmp twcordcnr to 0~aN°'t�s°wr'M1"Mattt
CIRS"7,d 1�,479, f1�ln 1 2t10'R7r r M.�
io�3 us+! 7
OwrneY, 1ti stun: [Tate, 171' 01 z too -- _
M itlii"I"pm Herat:
Nttfna A FK nx brtrlea e4mWIb WO P"heee of
A.ddteat: _ alrw,or n MIN'bot+�braaott e;_m,r, '►
.+. ha' arallb wi�ettl rMl's7rne
C�..- IIM. ZIP'S_---- of tervl�w Iwt1w tot,IirN ttranc:l,urrett �
PWM ARn' fi-mIU :49 Isoatl n�wir,
M (%WONW Famili I w+belz;T
U 90 14 VFW I?.esr}w.ai+witwrclso Qeach ImW m1M einrV
Q jvv"owrr 120"rpftM 1tk1I Q H+arlomIootMets toowlair,N�b,U� _ - _ 2
twilydWinp UBall/.a par 10,000nnmveuakmer RIpu tlOmeliftld"enyp4M.
O"M twar 100 wn to tte"PA; neere nekINMRN enln!n nna 91—tore 0001119,er et uw IONO
'J tl�l!IIRI ever MM stove U Node'1.4W argot n.nr.!w •�M
l.1(aepllparl Ined ow.in WWm '_t MtN11/Mvw1►re4NnN rw♦V Art �� !Mer tMly of IM■
J►yeseAelr+Me/plan U -
r "Mm..,_Mlle wf pan Wob my Of the A&W. I�w�t_ Ribr
--.�- -
l.- 11M tlbp,%on si M wpOtabM to towass7_satiM WOM tw..le/y
(tM�NtraAAw�rMl.�IMlew ott NrlaeHr A..w leruwwe.l Nano* •fAir pernk appllcatitat ptV.1,11 few
vIM U A/onrC.rd I ea►irm 1f a rem*ie root 6b%innd Man review,a %1 S
,ela rare ewe. � _/_ I within 110 daye after d has bm 9tue t(n!Orge
MVIINOWAN XMMV ova ONacaA+ta01r rnRtplNe. I OrTA L ...... ........ ...S ,_ _
I�
Plumbing Permit Application
Date rc..ewed: Permit no.: 'r�
City of Tigard - -
Sewer permit no.: Building permit no.-
Address: 13125 SW Hall Blvd,Tigard,OR 97223 -
Cityoj7u,ard Phone: (503) 6394171 Project/appl.no.: - Expiredatc:
Fax: (503) 598-1960 Date issued: By eceiptno.•
Land use approval: Case filen.: Paymtrnitype:
e
family dwelling or..ccessory U Conunen ial/industrial U Multi-family U Tenant improvement
M�Jew construction U Addition'alteiatioli/rel,I;icrnient U Food service U Other-
.10, 111 SITE
INFORIM 1-16N
_Job address: 2 ( Iltescription (My. Fee ea. Total
Bldg.no.: _^- Suite.no.: - New 1-turd 2-family dwellings only:
Tax map/tax lot/account no.: (lnclodes100ft.foreachudlityconnection)
-�-- _ SFR(1)hath
Lot: I ! :` Block Suhdivision. CXV A u r. >-�lkn„t~r-.5t SFR(2)hath-- —Projectname: UuA i I 11 to-3 SIR(3)bath
City/county: PrW WMA. I ZIP: 'rjj W Lich additional hatil/kitchcn
Description and location of work on premises:_. _ Siteutilities:
Catch basin/area drain _
Est.date of completion/inspection: Drywellsneach line/trench drain _
(7ONT[W711,01i Footing drain(no.lin.ft.)
Manufactured home utilities
llusiness name: 1J�p\c US�_ (VnnY3n r aG-i Manholes --
Address: Rain drain connector _
City: --)12r_`5 N State: ZIP: Sanitary sewer(no.lin.ft-)
PhoE-mail:— Storm sewer(no.lin.ft.) -- -
CCB no.: _ Plumb.bus.reg.no: Water service(no.lin.ft.
City/metro lic.no.: — Fixture or Nem'
Contractor's representative signature: Absorption valve
Back(low preventer _
Print name: Date: Backwater valve _
Basins/lavatory
Name: Clothes washer
Dishwasher
Address: Drinking fountain(s) ---- -
City: State: _ ZIP: Ejectors/sump -
Phone: Fax: E-mail: Expansion tank
Fixture/sewer cap _
Name(print): Floor drains/floor sinks/hub
Mailing address: - Garbage disposal
City: State: ZIP: Hose bibb
Ice maker
Phone.: Fax: E-alail: Interceptor/Interceptor/greasc trap
Owner instal lation/residential maintenance only: The actual installation er(s) _
will be made by me or the maintenance and repair made by my regular Roof drtin(commercial)
employee;on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s)
Owner's signature: Date: Sum
Tubs/shower/shower pan _
Urinal
Name: _ _ Water closet
Address: Waterhe.aer _
City: State— r ZIP Other:
Phone: xx E-mail: TOW
Not all Jurt"caom WMM cm(it cards,OEM all Jurisdiction far Moir information' Notice:This permit application Minlmum fee................$
U Vtaa U MsataCatd expires if a permit is not obteined Plan review(at_%) $
credit card number. _--F� accepted m complete. TOTAL. .......................$within 180 days atter it has been State surcharge(8%)....$
- —Nutx o/cardtnldn u sMrwn oo rnrdir card �p p —
Cardholdd signsturr AnMwm
�_. — 414.616(60001MM)
Mar-06-01 03:05P Wolcott Plumbing 503 667 9891 P.02
9Jr'O6,'fli I'Ll' 14'1: F.IiA 503 SDA 19(;) CYrY OF N.0
:Q 403
PLUMBING PERMIT FEES:
�.��.� -- — r Rl T,. �, Nt.: , and246milydwe I ps@nfy: --,
FIXTRE4 Cedlvrdua ear AMt r .', •os alhp(umbinp' ittu(sa In PIT TOTAL
Z<1rk e.l�I lh :e llfnp arlb thli 111100 F1' QTY (� AMOUNT
nlor� — -- - 16.0) 1'or cNul n_f
Lrct n
On, 11 b6F 5241?20
Tub or'ubfStxtwe(Umb 16.®> v. i1 bath _ 0A0
Sh-warony 6.6) Tp, L(ufth _ i.1vo
1lnnat �6� 41RSTATIRSURG11AR0! . ._J
C1a osner -�+ 1e.ea �21,- REVIRW ZSY.OF SUBTOTAL 1
Garbage Gispoaal i — — b L
L.aundrytray 1e eo
asNng Mal�,ne 1 r
Floor ONi our,gtnk 2` 1610
PLEASE COMPLETE:
•.
�a.ter tuns O conwro on like Kind 113( urn Or I_Mer�lirtned•
C:aa pipmp tequun a aepafete mrNh•r»cal ( �` Pixr,'re Type; New ' >tilov d.. Rep hoed Removed)
MFG l+or-m 46•0 $.n• ��� I
Mho Horne Neal S•N510rm ewer 48,0
Hose B b• u �IE.1,0 lift or uWShower
� Cer•nlnaUen __�
400l0vnr6� 16dQ0 howor nl Oe'K'np Fountain 16.1,0 Water cleSel -- — --
Oh•r Fit:�re.lepeolFy) 16.110 ural
Dishwasher
Galbar it Disposal
Leundry Room Tr
—
Washirli NI elle
loor r*inf
Sewer•1al 100 67 !0 e — 3.
Sower•sac odotlovt 100' �B t0 4'
Weler 3crvC8•W MO Watt Mester —� —
wstmservice•each wjdl'onal 40 46 to oche,r.rores
$ a-
arm 6 R•tn Oraln• 'n 100'
Slarn 6-Rain fair-lith allr)11 and 100' 46.10
ffom—merciu Back Flow rewnoon 0sivTce b —
Residential Nxxiiyrevent on cs' 27 --
Galah 9;un ye 60
Inspection d Erlitf5j Flum6in0 or peso/y 250
Ra ueered.Inapectioofill 14,, COMMENT!REOARdINO ABOVC
R•tn Oram,sinqu far*4y dwellnp $625
urease Trips _..} 14110 ---
QUANTITY TOTAL I -
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CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
STREAMLINE ELECTRICAL
6017-B EAST 18TH STREET
VANCOUVER, WA 98
Electrical Signature Form
Permit #: MST2001-00219
Date Issued: 4/10/01
Parcel: 2S,104DA-13800
Site Address: 13003 SW CADDY PL
Subdivision: QUAIL HOLLOW - WEST
Block: Lot: 124
.Jurisdiction: TIG
Zoning: R-4.5
Remarks: New SF detached rowhouse in Building #14. Setbacks as per sheet A10.10
Plan C-S
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 LLC STREAMLINE ELECTRICAL
12670 SW 68TH PKWY #200 6017-B EAST 18TH STREET
PORTLAND, OR 97223 VANCOUVER, WA 98
Phone #: 503-598-7565 Phone #: 360-993-5080
Req #: LIC 116514
ELE 344320
SUP 249;`6 I82J� S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
x --
Signature of Supervising Electrician
If you have any questions, please c ;II (603) 639-4171, ext. # 310
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
WOLCOTT PLUMBING CUNT. INC
PO BOX 2007
GRESHAM, OR 97030
Plumbing Signature Form
Permit #: MST2001-00219
Date Issued: 4110101
Parcel: 2S104DA-13800
Site Address: 13003 SW CADDY PL
Subdivision: QUAIL. HOLLOW - WEST
Block: Lot: 124
Jurisdiction: TIG
Zoning: R-4.5
Rcmarks: New SF detached rowhouse in Building #14. Setbak.Rs as per sheet A10.10
Plan C.-S
Your company has been indi;.ated as the plumbing contractor for the permit indicated above. In order for the
phimbing permit to be valid, ple6se have the appropriate individual from your company sign bc-iow and return
t► is 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
C)WNLR: PLUMBING CONTRACTOR:
BROWNST014E HOMES LLC VVGLCOTT PLUMBING CONT. INC
12670 SW 68TH PKWY #200 PO BOX 2007
PORTLAND, OR 97223 GRESHAM, OR 97030
Phone #: 503-5913-756" Phone #: 667-1781
Reg #: 1 1r. 23847
PI M 26-208PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signatlr Authorized Plumber
If you have any questions, please call (5(13) 639-4171, ext. # 310
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