13053 SW CADDY PLACE w
0
W
V:
:7
�Z
;1
v�
a)
n
m
F
f 1
ll!
f
i
i
i
i
l
i
'w
13053 SW Caddy Place
CITY OF TIGARD BU" GING INSPECTION DIVISION MST Z 00I
24-Hour Inspection Line: 63- 4175 Business Line: 639-a.
PUP
-_Date Requested_ AM_ _ PM _ BLD
Location. --- -�''_-- ,, Suite MEC
Contact Person _ `� � Ph PLM
Contractor Ph SWR
BUILDING Tenant/OwnerELC
Retaining Wall — ELR
Footing -------------_. ._.__
Access FPS
Foundation
Ftg Drain - - SGN
Crawl Drain Inspection Notes - — ---- -
Slab SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing
---- ------ ____- ---- _----..._...------- ----- - --- -- ---- __._..--Insulation
DrywaDrywall
ll Nailing __ -------------___ __....._.._ __.._._------------ -- - ----------__ ___...------- ...----.._-----
Firewall
Fire Snrinkler ---.___.-___.__._._... -
Fire Alsrm
Susp'd Ceiling
Roof
Mise ___ --- -- --------- - -..---- — -- ---------
Final
PASS PART FAIT_ -- --- - - - ------- ----- -
PLUMBING
PnctR Roam � _ _____ — ----—-- --_ ------ - --- _._____-----...---------------
Under Slah
Top Out
Water Service
Sanitary Sewe,
Rain Drains
m
ASS PART FAIL
ANICM_
Post&Beam ----- - - - -- --
Rough In
Gas Line -
Smoke Dampers
Final - - ----- - — - -- __.._ --- ----- ----- --
PASS PART FAIL
ELECTRICAL
Service _---- ---- - -- -- —
Rough In
UG/Slab --- - -- ---- --- _.
Low Voltage
Fire Alarm --. .- --_--- -----.___
Final
PASS FART FAIL ------_--- -_-_-- - --------
SITE
Backfill/Grading - --a ---
Sanitary Sewer
Storm Drain [ j Rellispection fee of$ __-required before-next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ( j Please call for reinspection RE: [ j Unable to inspect-no access
ADA
Approach/Sidewalk
Other Date Irysp.ector .�a lc�� Ext
Final
PASS PART FAIL DO HOT REMOVE this Inspection record from the job site.
e.
kki AAA AAAAAAAAAAAAAAAAAAAAAAAAA AAA O,AAAAAAAAAAFV
,
7 Poo.r ►
l pop.►
►
J ►
t +� n loo.
p.
14 71,
u > ►
o ° � p�J
bn 0 v -�
aj
0 L4
1-4
4 lop,
71 lot.
•a o �? om N ►
�.
CLI
►
° ►
►
�a �d ►
l ►
4.4 ►
w w ►
_ ►
i
I �
o
V
� o
0
Q N
t.' o
4 � �!I •y
u r
iN.
b o.
o v
u
� o
•C-n V O
W �
C �
O � �
e
O � N
O O [
C �
N .d
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Linc: 639.417.5 Business Line: 639-4171
BUP
Date Requested % _AM_v PM BLD
UP
-.
Location Suite ��– - MFC
Contact Person / Ph PLM
Contractor Ph SWR
BUILDING Tenant(Owner ELC -
Retaining Wall^ v_v -------�- ELR
Footing Access:
Foundation FPS
Fig Drain -�------—------
Crawl Drain Inspection Notes SGN
Slab - .---- --------------- T_�__..- - _- SIT
Post&Beam - ---- ---
Ext Sheath/Shear
Int Sheath/Shear -� - -
Framing
Insulation ----------�--------
Drywall Nailing
Firewall --
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -
Roof ---
1`0iSC: - - - -- - - ----- - -
ASS ART FAIL - - ------ --
PLUMBING
Post& Beam - -- _ --- -
Under Slfjb
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
t A' aS, PP RT FAIL
MECHANICA
19ctst{tt-i3F'3in - - -- --- -
Rough In
Gas Line - -- ---- - -
Smoke Dampers
PA55 PART FAIL
ELECTRICAL
— --
Service
- --
Rough In
UG/Slab
Low Voltage - - -
Fire Alarm
Fuel
PASS PART FAIL
SITE
Backfill/Grading ---' —`
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$ _required before next rnsper"-•n. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ]Please call for reinspection'�E:__. [ J Unable to inspect-no access
ADA
Approach/Sidewalk
Other Cate } Inspector �,M,� _Ext _
Final
PASS PART FAIL DO NOT 1131_M017E'. this- inspection record from the job site.
CITY OF TIGARD BUII DING INSPECTION DIVISION
MST -2 CL-)
24-Hour Inspection Line: 63! 175 Business Line: 639-4.
BUP
—Date Requested — 2- AM _PM BLD --^-----
Location O� C..� Suite
— -- MEC _
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall - ELf� — -----^-
Footing Access: -- --- - ---
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes SGS'
Slab —
--------_. - -- --Post&BeamSIT
Ext Sheath/Shear
Int Sheath/Shear �' — ----- ------
Framing
Insulation
Drywall Nailing
Firewall - - - - - --..
Fire Sprinkler
Fire Alarm __-- ----__---_----.-.
Susp'd Ceiling
Roof -_ -- -- ------- _. ----
Mise - ------
Final f PASS PART PART FAIL
PLUMBING IV
Post&Beam - —
Under Slab
Top Out - J
Water Service _
Sanitary Sewer -
Rain Drains
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
FilsAjarm
PAS` ART FAIL
Backfill/Grading -- ---
Sanitary Sewer
Storm Drain [ ] Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ( J Please call for reinspection RE —_ ( J Unable to Inspect-no access
ADA ^/�
Approach/Sidewalk
Other nate _ Inspector — _Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
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 Forrn
Permit #: MST2001-00214
Date Issued: 4/10101
Parcel: 2S104DA-13300
Site Address: 13053 SW CADDY PL
Subdivision: QUAIL HOLLOW - WEST
Block: Lot: 119
Jurisdiction: TIG
Zoning: R-4.5
Remarks: New SF detached rowhouse in Building #14. - Setbacks as per Sheet A10.10
Plan B-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, A I-TN: Building Dept.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
BROWNSTONE HOMES LI-C STREAMLINE ELECTRICAL
12670 SW 68TH PKWY 4200 6017-B EAST 18TH STREET
PORTLAND, OR 97223 VANCOUVER. WA 98
Phone #: 503-598-7565 Phone #: 360-993-5080
Req #: LIC 116514
EI_E 31Id32C
SUP J48;<& d'>Vl S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X
Signature of Supervising Electrician
If you have any questions, please call (503) 639-4171, ext. # 310
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
WOLCOTT PLUMBING CONT. INC
PO BOX 2007
GRESHAM, OR 97030
Plumbing Signature Form
Permit #: MST200 1-00214
Date Issued: 4/10/01
Parcel: 2S104DA-13300
Site Address: 13053 SW CADDY PL
Subdivision: QUAIL HOLLOW - WEST
Block: Lot. 119
Jurisdiction: TIG
Zoning: R-4.5
Remarks: New SF detached rowhouse in Building #14. - Setbacks as per Sheet A10.1
Plan B-S
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 pricr 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 HOMES LLC. WOLCOTT PLUMBING CONT. INC
12670 SW 68TH PKWY #200 PO BOX 2007
PORTLAND, OR 97223 GRESHAM, OR 97030
Phone 4: 503.598-7565 Phone #: 667-l-, 31
Reg #' IIr 23847
PI M 26-208PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
x
6EL2Ai�-
Si4in-aitar6idf Au horized Plumber
If you have any questions, please call (503) 639-4171, ext. # 310
CITYOF T I G A R D ___MASTER PERMIT
PERMIT#: MST2001-00214
DEVELOPMENT SERVICES DATE ISSUED: 4/10/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 13053 SW CADDY PL PARCEL: 2S104DA-13300
SUBDIVISION: QUAIL- F101-LOW - WEST ZONING: R-4.5
BLOCK: LOT: 119 JURISDICTION: TIG
REMARKS: New SF detached rowhouse in Building#14. -Setbacks as per Sheet A10.10
Plan B-S
BUILDING
REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 31 FIRST: 173 at BASEMENT: yat LEFT: SMOKE DETECTORS.
TYPE OF USE: SF FLOOR LOAD: .-, SECOND: 736 of GARAGE: 428 of FRONT. PARKINC SPACES
TYPE OF CONST: 5N DWELLING UNITS: I FINBSMENT: Seo of FIGHT:
OCCUPANCY ORP: R3 BDRM: 3 BATH: 2 TOTAi.: I nee no al VAt UE: S 138,630.00 REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: 2 WASHING MACH ' LAUNDRY TRAYS RAIN DRAIN. 00: TRAPS:
LAVATORIES: 4 DISHWASHERS: I FLOOR DRAINS: SEVIFR LINES, n,'I SF RAIN DRAINS: CATCH BASINS:
TUBISHOWEPS: 2 GARBAGE DISP: 1 WATER HEAT2RS: 1 WATER LINES. I,10 BCKFLW PREVNTR: GREASE TRAPS,
OTHER FIXTURES. I
MECHANICAL
FUEL TYPES FURN c 10011 1 BOIL/CMP c OHP: VENT FANS: 3 CLOTHES DRYER: I
GAS FURN>=100K: UNITHEATERS: HOODS. OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES. GAS OUTLETS: 1
_ ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp: 0 200 amp: WISVC OR FDR: PUMP"RRIGATION: PER INSPECTION:
EA ADD'L 500SF: 3 201 400 amp: 201 - 400 amp: lot W/O SVCIFDR: 02 SIGNIOUT LIN LT: PFR HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 600 amp: EA ADDL OR CIR: 1 SIGNALIPANEL: IN PLANT:
MANU HM/SVC/FDR: 001 - 1000 amp: 601-ampc•1nuov: MINOR LABEL:
1000♦amplvolt
PLAN REVIEW SECTION
Reconnect only:
>-4 RES UNITS: SVCIFDR>=225 A.: >600 V NOMINAL: CLS AREAISPC OCC
ELECTRICAL-RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO d STEREO: VACUUM SYSTEM: AUDIO d STEREO FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT.
BURGLAR ALARM: 0TH: At L ENCOMB BOILER: HVAC: LANDSCAPEARRIG: PROTECTIVE EIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA7TELE COMM: NURSE CALLS. TOTAL#SYSTEMS:
TOTAL FEES: $ 3,553.49
Owner Contractor: This permit is subject to the regulations contained in the
BROWNSTONE HOMES LLC BROWNSTONE HOMES, LLC Tigard Municipal Code,State of OR. Specialty Codes and
12670 SW 68TH PKWY#200 12670 SW 68TH PKWY
PORTLAND,OR 97223 PORTLAND,OR 97223 all other applicable laws. All work will be done
accordance with approved plans. This permit will expire N
work is not started within 180 days of issuance,or if the
work is suspended for more than 180 c-4ys. 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 thrOLgh 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, Underflnor insulation Electrical Ro-•7h In Gas Line Insp Rain drain Ins Electrical Final
Sewer Inspection Plm/undslab Insp Framing Insp Gas Fireplace Roof Nailing Mechanical Final
Footing Insp Mechanical Insp Shear Wall Insp Insulation Inspr Line In p Plumb Final
Foundation Insp Plumb Top Out Exterior Sheathing Insl Gyp Board Insp WatI/Te ervic Insp Final Inspection
Slab Insp Electrical Service Low Voltage Firewall Insp Appr/S wl In p
----
Issued By : - _ Permittee Signature A 6
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITE' OF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES' PERMIT#: SWR2001-00142
13125 SW Hall Blvd., Tigard, OR 97223 (503) b39-el" DATE ISSUED: 4110/01
SITE ADDRESS; 13053 SW CADDY PL PARCEL: 2S104DA-13300
SUBDWISION: QUAIL HOLLOW-WEST ZONING: R-4 5
BLOCK: LOT: 119 _ JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
GLASS OF WORK: NEW DWELLING UNITS:
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF detached rowhouse.
Owner:
-
BROWNSTONE HOMES LLC -- — -
FEES
12670 SW 68TH PKWY#200 Type By Date Amount Receipt
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. _The Agency does not
guarantee the accuracy of the side sewer laterals. If the sewer is not located at the meas eri en given,the installer
shall prospect 3 feet in all directions from the distance given. If not so lucated, the install r sh II rchase a"Tap and
Side Sewer" Permit and the Agency will install a lateral. A l?EN�TION: Orego equir s yo follow rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 9 -001-0 1 rou AR 952-001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling 50�) 246• 7.
Issued bar {_' Pprmitiee Signahir�_lW \ T
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the I'laxt busineiv.11ay
A Building Permit Application
Date.received: rf/��� / Permitno.:�f`ii,7n�?/-^('�"/
City o� Tigard -
Addrss: 1312.5 SW Ball Blvd,Tigard,OR 9':.- Projecdappl.no.: Expire date:
CityofTigard B ,'
Pltauc• (503)639-41Date issued: x'
.71 — _.�" Receipt no.:
Fax: (503)599-1950 Case file no.: Payment type: '
Land use approval: I&2 family:Simple Complex:
* I &2 family dwelling of accessory U Commercial/industrial U Multi-family wrlcw construction U Demolition
U Addition/altrmtion/t-eplacement U Tenant improvement U Fire sprinkler/alarm ❑Other.
11130111 ?
Job address: ( CYC ', i C L"� 1.� ( - Bldg.no.: 5uitr,no.:
Lot: I I Block•_ Subdivisiop: Cxuq;\ I1o�l_'�� �` Tax map/tax lotraccount no.:
-Project name:_ o.a�'( F1 u 11 n^3
Description
Description and location of work on premises/special conditions: DLy-) mctkbc OEW +STf?tJ[. , d
F0111 SPE IAL INFOICUATION,
Name• FWuE'b �� �
Mailing address: r"t r to Q,'" 11A tW i&I family dwelling:
City: 1L statex.Y ZIP: X727 3 Valuation of work........................................ $_ -----
Phonc:!IrgQ 75U5 Fax: tr1f-1ool E-mail: No.of lr-droornstbaths............. .............. _ --
Owner's representative: IN - de Total number of floors............... ............
Pnone: -1 -5-77ti !"ax:'1}�2399 Tmail: -- New dwelling area ft. 1 �
g (sq. ) .......... .............. --- --
Garage/catT-ort area(sq.ft.)....P.VA.....
_Name: -5A fiC�__A S A ofW&F Covered porch area(sq.It ... .......
Mailing address: Deck area(sq.fl_) ................................R. _
City: _ S'�te: ZIP: Other structure area(sq.ft.).........." '.......
Phone: Fax: E-mail• - CommercinUindustria!/multi-family:
Valuation of work........................................ $
Business nam': Existing hldg.area(sq.ft.) ..........................
Address: New bldg.area(sq.ft.)................................
- Numtx.r of stories........................................
City: State: ZIP:
—.�. Type of construction....................................
Phone: Fax: E-mail: - --- -
Ok,cupancy group(s): Existing:
CCB no.: — -- _-- — New: _
City/metir�lie.no.: Notice: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractor Board under
Name: � provisions of ORS 7(11 and may be required to be licensed in the
Address: e� Cl ti� 14tf� jurisdiction where work is being performed.If the appli-•ant is
City: ° tT t 4; State: W i'IP:'q 1,Zq , exempt from licensing,the following reason applies:
Contact person: AWE Plan no.: - - - -
Phone'Zt',1-4(,t75f1f: Fax: 67'Di<Z E r ,tl: --- - - -
AIMI
Name: ke_ Contact person: uw ll,' Fees due upon application
........................... --
Address: pt p c Date received: --_
City: Istateur ZIP: 972 Amount received ......................................... s; +__--
Phone: ttf,,gt'Ja�' I Fax: E-mail: Please refer to fee schedule.
1 hereby certify I have read and examined this application and the Nat sit judxktiom arcep cmht ards.please cart jodxhctton for mom idmnuton.
attached checklist.All provisions of laws a d ordinances governing this O visa O MpsterCard
work will be complied w' whether s i ed herein or not. ctxxt:r cud numba — t
Expires
Authorized signature: Date: Now of atdboldet as shown on cn% t ant
Print name: 4 9 A I --- i
_ _ t.a�alder sfpWnte Atnotmt
Notice:T,,:s permit application expires if a permit is not obtained within 180 days atter it has been aaxpted as complete. 44G46l t(emecot 1
Mechaideal Permit Application
Dateremived: 1'txrriitno.:l�Sj � �Do�/�
City of Tigard R -
AULM
�a ojecdappl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued: _- By: Receipt no.:
Fax: (503) 598.1960 Case file no.: Payment type:
Land use approval: _ [Bu dlddngpertnitno.:
7U I &2 family dwelling or accessory U Conunen.ial/industrial U Multi-family U Tenant improvement
U New constriction U Adcli►ionialteration/replacemer t U Other.------_
lob address: ! . i r 1 67 y piLZ Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: jn Suite no.: value of all mechanical materials,equipment,latxtr,overhead,
Tax map/tax lottaccount no.: profit.Value$ I-=
Lot: _ Block: Subdivision: qUAll *See checklist for important application information and
Project name jurisdiction's lie schedule fir residential permit fee.
City/county: `„ p r ►� ZIP: FIX
Description and location of work on premises: gmin ILIN
_- Fer(ea.) Total
Est.date of completion/inspection: Deirai Qly. Rec.onl y Res.only
Tenant improvement or change of use: C:
Is existing space heated or conditioned?U Yes U No Air handling unit ____CFM l
Is existing S insulated?U Yes U No Air conditioning(sitep ane an-7 required)
g'p ace teration of cxfis_tj_n_g_flVAC system
Boiler/compressors
State boiler permit no.:
Business name: (=Lr()�,. yl -t5• _ _ HP Tons B'CUf!I
Address: v(p p n smoke dampers�c uct smoke detectors -
City: ) Itllla State(t� ZIP:ry -Heat pump(sitc p a- gquua
Phonc:tel'Jtj'_Ci t ej Fax:7 11 E-mail: InstalFriplace fui5ce76urrict ti'I
CCB no.: 'L — - Including ductwork/vcnt liner U Yes U No
nsta- 11Trepiace relocate/ Faters-suspen ed.
City/metro lic.no.:Z)00D N b Z5 wall,or floor mounted
Name(please print): I V,A IIA"0"t-) Vent for appliance other than furnace
110 RN 0 11 MUM Refrigetation.
Absorption units_ _ BTU/"
Name: i A.g gdat�`Vc Chillers _— HP -
Address: — Co tessors _ HP --
CilV:� State: 7.IP: FAvIr000eata ex wd a vrn1 ahon:
Appliance vent
Phone: Fax: E-mail: hyercx dust -- ---- I
s, ypc / res.Tritchc azr�Ti h mal — -
1 hood lire suppression system
�T. _ A-A__6_ p vj Q.eJc,, _ Exhaust fan with single duct(bath fans)
Mailing address: aus�i t system as rAC
_ -
City: _ State: ZIP:
Feel pippiptag a oo up to 4 ou ets
Type: LFt, _-- NG Oil
Phone: Fax: I E-mail: -Fu-J—piping each additional over 4 outlets
rote"p p ng(sc emauc required) _
Number of outlets
Name:
_ ' rFt! tlisted-ap mace or egn�pmenl:—
Address: _ Decorativefireplace
City: State:_ 'LIP: nsert,-type
Phone: Fax: E mail: stov pe etstove
Applicant's signature: �..-- Date: 4 U, (Xher.
Name(print): JbM
Na tit joriatric iom wee"credit c tds,&.mL At iuiadktim Iv mt.e itdtxr.utinn Permit fee.....................$
U Visa U MasterCard Notice:Thi:.perrr►ii not obtain Minimum fee................$
expires if s p-emit is not obtained
Credit era raimber: — --1 - within 190 da•s aRcr it has been Plan review(at _ 96) $
Slate surcharge(8%)....$ _ S
Nm of erdWder ae dxmn on credit card— accepted as cor.iplete. TOTAL . $ -7-2 _
Crdholder siantme AmoaN
1441ti17(tiidail'OM)
C n 21:91 11:49 :613993508: STREAMLINE ELECTP.:C PAGE 0: 0:
ElcctricsJPeradtApplica!d-„>s
�••.-�"
City of Tigard Dttsrrleelvtd:
Ibt ks dtte:
(",j),(",j),q'71pnd Addptte 13125 91y Hdi Blvd,Tigard,OR 97223 Dhate IoWVappl.nn
"vet�: (303)6.19.4171 __ OY: Racrlpae
Pa:(503)1196.1900 'Caw All to., pti *tri,
Land use app'svtd:
U I A 2 farnity dwelling or acrosowy 0 C.arwMOM1 WndwWa U Muld•famlly U Ten at ImpovaMN,
U New vwnwuotion U AdditiorlalteradoNmplaCom m U 011ter: ___ O partial
Ellin vs
i0b Id4111ot: ( r r \__7(,1 I Pi .no.: Sniu no._ Tu mal loytjooatlt ao,:
Lot: �" Block. bdiv V 0%.1 t Na 1lrrvs wlnr _�_ -
Project Marro: 1e,41 flo I(dtl_�pa�jon tlld louden of varork.«r_�eml�ta V N�N C[�.r�'1talCrlt►.) .___._
CrIlmatrd date td cont leliWint Bort
Job Riot---••_--...� M vt+a
Bot» w u nuns S er D
Addrewu 1;fl l` * N
Camey_V' l St+tq: WA 8b61 ar .a r`"�war►
I4x—": 9 9 -5 0 8 Pu: mall: 1000 eq n•a Im r
"' ,achaddillonalS00 R'xpOr9onlhr•rm� — -
a'8 110.:1 1 6 51 9 B1ec.baa.llc.no: 34-432C
Lilnl,ed L�drml ku — -
�
('It h"mrvlk.11o.: Lal i tnkni rkon*rtlaenaai 1
fierh mam,techrn�Ix�we w rt»�r�dwe�lln j — -
�� �r!'Q_.� �ervks trx14.faaw _ __ _
1 ufr 1 111 x,.4.41
Up sttat.au"v wo IL no ! '�afslVtlaa.�
akerow t K nrwelea
700 or less __ 1
Nune�rint): 4001 w eta`
t alinf wwre": '"'►a
. . _. ?- Cl"' at
Phn* Pan' l ma11 � Rac�>� » 1
c►wrrtr inahlWrxl TZM Inro111al1etl a pain,Made ee Ixq"ly►0" rewww wrv-km
-which to art!tfftrtd kd for ule.I K or eacNwr twooWkng to � m610D er"a"r'reeC
"l! 2
ORS 11.170,'"1.N t
OwnWo Ii f MIA. v 1 1 0sr - -
IFFOAA e •MIr.
K ank"O a Far PWL
Ntmer_.—._ .__._,—..__ �. .�.._ _ A FseRwbnrlekr�rrrrltrwrthrurdrtseef
A64rea Mtvios K lard r be,sock bravo clrwh !
1rd 1aroufts 1""''"e.
City .te: ZIP _..�
PtiOfM' Pas h-rrlall of servica or taadw rot,nrn benchyrn,t11111-WIN
1
1 « Isetbe 1NsaC
(7kaMetamwwt.a.ra.ettrald 011x10.-raaMntry lindi akn 7r,druts-_
0/Nva o+er.w amperatl'ni M IA I O"AuR1a>t loealnl K
hru11y"011nos U 110114kilmK 10410egrtrsewobw tr sow alrfdl(a)Or*URdledr"alyPend,
O Oygnn swr W vn u rpMPt; new pelt ;rill et1)n In nee wro"Vrr ahefatloa,n.akwwlarle 1
U Ya.ldtno ever Sake etrw U nrad/t,4d1""a nen .Daae
U on""load War M nwwm ;1 mvvhwund waemEa M Rv pork Ir �. - .—.41=11f th
I llet!ntk--woof view v*b an er torr aa,". -
l.
ISO &$I meett> eaWto%am-r7O"Ouvoweon"". Nearr —
No tr hrhdAetr srr OWO seek Mean an low►dw 1w acre lrkwar�w Ivatia This permit app brAa l PCmlt for.................
C3 vin U 164~:bd mrkine If a parent to rat tbttinod 11'la ravltw(al -__, r#.) f
.wk erre skww __ withln 110 dayr aAtr it hr begirt halt tun harye(991.) S
ead i —" I MaAlrnornplNe. 7WA➢ ..... f _
���7�il _..���waifM I a�Y1v1MbCOt11
{
ri
Plumbing Permit Application
Datereceived: Permit ao.
City of Egillyd Sewer permit ao.: Building 1
Address: 13125 S W Hall Blvd,Tigard,OR 97223
C1tyoJ7ignrJ Phone: (50) 6-49-4171 Ptujrc:/appl.no--: _ Erxpireda.te:
Fax: (503)598-1960 Dataivsued: By: Rmdptno.:,
{ Land use approval: _ _ Case fi.cno. Payment type:
eM,
=EMew
arAly dwclli,lg or accessory t-'Con►mercial/industrial O Multi-family U Tenant improvement
n tructior. Ll Addition/alteration/mplacenccnt U Food service O ter
fill I LOW
Job address: Desniptlon . Fee ea. Tool ,
Bldg.no.: Suite no.: New 1-and 2-UmAy dwellings only:
(Includes 100 R.for awb atllity cemectba)
Tax malVtax
_ lYot/accountno.: SFR(1)bath
-
131ok_ lLo _
—
Pm�ect name_ rpi( olle,J SFR(3)bath
City/coun'.y: r Ar[� t�f,Tl�, Zlr: `j JZZ�-- - tech additional baMitchcn
Description and location of work on premises: "aAj Siteatilides:
_ Catch basin/area drain
Est.dale of completionlinspection: Dryweils/lea-h line/trenc!,drain
Footing drain(no.lin.ft.)
Manufacturrd home utilities -'
Business name: (j._)Okr o-N-N �Vr�tC4m t�`r 1 Manholes
Address: - kair drain coanector -
0ty: G-)P-eS N State: ZIP: Sanitary sewer(no.lin.ft.) _-
phone: - Fax:(o 7 981► E-mail: Storm sewer(no.lin.ft.) —
CCB no,: Plumb.bus.reg,no: Water service(no.lin.ft.)
City/intim he.no.: —! 1Flxture or Itna:
COatractoes representative signature: Absorption valve
Back flow preventer
Print nate: Date: Backwater valve
Basins/lavatory
Name: Clothes washer _
- -- Dishwasher
Address:
Drinkin fountain(a)
City: State:_ ZIP:
Phone: i Fax: i',-mail lax ansion tank
Fixture/sewer cap
Name(print): Floor drains/floor sinks/hut)
Mailing address: Garbage di�sal _
Hosc bibb
City State: ZIP:- Icemaker
Phone: Fax: - E-mail: Interceptor/ase trap --
Owner installation/residential maintenance only: The actual installation Primers)
will be made by me or the maintenance and repair made by my rrgular Roof drain(commercial) _
employee on the property I own as per ORS Chaph:r 447. Sink(s),basin(s),lays(s)
Owner's signature: Date: Sum
Tubs/shower/shower pan `
Urinal
Name: _- _ _ Water closet
Address: Water heater
City — State: 7..IP: Other: y-
Phone: PaA: _Email• -` Total
-— - --
Vol all paiadktiar accept crat cot*.rleex call turi.d"oo res mar udamwhi,. Notice:This permit application Minimum fee............ ) $ _
O Visa O MasterCard expires if a permit is not u'otained Plan review(at -� 96) $
Qedit csd mmeer —1 -�- within 180 days after it has been State surcharge(8%)....$
Expires accepted as complete. TOTAI(. ....................... _
Name of cWholder r ai–iorvrt an coda cad
iadholder ai(taalum —Amouat 440-4616(6 OVOM)
Mar-06-01 03 : 05P Wolcott. Plumbing 03 667 9891 P.02
13,,'06/01 111 14 42 I'•1X S0.1 598 l9(;3 CIT) 01, :f 003
PLUMBING PERMIT FEES:
i. 'TOTAL lrnlly 4W
FtumbinppnKtuGrr4oInnly: t _ICE TOTAL.AIaAt '.1
rx 16 61 rntl the 11100 111;, QTY (9ttJ AM( I�NT
"lee)
Tuba 'ub/5htlwtlr.off 16.6) -3-NOF
Showtr On)y 18.61 tit 1369 00 _—
l,rn„1� AL
- 3G ITA-R0
C anwa.ntr _ t6 e] r '” 75•R OF lUBTOTAL
�••C�arb-o--f rpoitl 1( J r - 707, I
9r
—La u-ndry rYy 16l7
1Nnth ng Mach no
Floes Drei our Slnk 2' 16 to
COMPLETE.
4• `-� - 1e`to
`haltr sutler O wnversh)n IIAe Mnd 16 t ','' 1' pan _ O,f.�.P.�r�urmed,
Cis plpnp req uuts r separate rnerhitnrcal I New ' #i ov d. ROp,4laaR�ornovtdf
ap ed
MFG FromO New 41-w Servito - - 46 0 �I
--1
Mho t{nn-w New EarVStOrm ewer 46 0
Ilose d bs - - -T6-
IA _
7001 D a ne 165 0 r ----- -
DnnK'nq Fomtsin
01h«fi,ruea4Specify) -- —r largo --y�
-----"r-,tt
stW.r- 10o ae`in a 3• V �,
;ower tact-eddillo"iel 100' 46 10 4'
tarter 3arry rd•,p ....._ 5.)L '81- r� --. -
_ - 93
Wa'er errce•etch ZATW- 100 46 s0
$prm d R81n fNr-uch addtl onl.l 100' 40.10
Cemmtrd AxA FIOW rew�lbn t)evTci 16 10 -- � `_`-"'
Itis denIV Id2csllcwPrevenlbn ev cL�.t' - 27 65 -
I:JICh Basin --r� - 16 60
n!petilOn 01 E�Mtlnq Plumping or poc�Ay 7 SO
R• a 1s 110 1n!Lecuorn __� 141' C 11EGARDING ASOVt
atom Olaf-,sln9w Isrrily dwesmq 66 2S =1
Or- 4 lops -----
-- --- QUANTITY TOTAL
4omttnc w isn dttptrn is-egm'ed It I — --
O,,anstr -
•RUSTUTAL -- -��
6•/, STATE SURCMARaLs - ��
r'PLAN REVIEW 25%OF SLRT01'AL
Re frad,r'f ilhdvrtQ lot$1 5 _
- ----�-.
TOTAL
'Minim4 n pe—A lot It 9 50.ex rnnn"rcharvr "Dots"A•`4 nmol eeo•Wr
p4vanq rn De-,.rh.cn a 114 t9•VA,Uro 6-142100
••A'A Har cemma.e lad a�nen.e,rnqura two„wNh r,oinel•a a A,.r l,atran n�
r�an'r•.ar
I\Jsb'lorms,ptm-keedoc �G,0I30