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'13063 SW Caddy Place IA
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 63, 175 Busioess Line: 633-4
BLIP _
Date Requested_— AAl"I PM BLD
Location L3 (o L- L. _ Suite _ MEC
Contact Person 1 �� Ph Z- SL24, PLM
Contractor _ _ Ph SWR
BUILDING Tenant/Otroner ELC
Retai;ging Wall -' --- -- -- tLR -------- --- ----
Fjo'rng rAccess: ----
Foundation FPS
Ftg Drain ------._..- -- -
Crawl Drain Inspection Notes. SGN
Slab
Post& Beam Y ------ -- ----
Ext Sheath/Shear
Int Shenth/Shear -- ----- -- ----"
Framing ------.____--
Insulation ---"-- ----- -- -
Drywall Nailing
Fire Sprinkler
Fire Alarm _
Susp'd Ceiling --
Roof
Misc:
Final ---_-------
PASS PART FAIL.
PLUMBING
Post& Heam
Under Slab
Top Out _—_--
Water Service
i
Sanitary Sewer - - - — --
Rain Drains
Final - -
PASS PART FAIL
MECHANICAL —
Post& Beam --
Rough In
Gas !Jne --- -- --- —
Smoke Dampers
Final -_ _- - ---- ---- -- — _
PASS PART_ FAIL
ELECTRICAL -- —"- -
Service e
Rough In _--- ------ -- ----- --- — ---
UG/Slab
Low Voltage --�— --- --_-- -
Fire larm
*At`Sj PART FAIL -- ---_-.- ----__--- --- --
Backfill/Grading - —_-- ------
Sanitary Sewer
Storm Drain [ J Reinspection fee of$— _ _ryquired before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ J Please call for reinspection RE:_ —_ _— ( J Unable to inspect-no access
ADA
Approach/SidewalkDatw
Other _ Z v Inspector fat
Final
PASS PART FAIL J VO NOT REMOVE this inspection record front, the job site.
CITY OF TIGARD DU111 DING INSPECTION DIVISION MST
24-Hour Inspection Line: 63: 175 Business Line: 6394, --
�/ BUP
_Date Requested / AM PM BLD
LocationSuite MEC
Contact Person _=�` Cj� Ph S 3 PLM
Contractor_ 67 Ph SWR
BUILDING Tenant/Owner EILC _—�--
Retaining Wall
El.i2
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain I,ispection Notes: -- ----
Slab
Post&Beam - ----- - .. - -- SIT - ---
Ext Sheath/Shear
Int Sheath/Shear - ----
Framinn
In.ulation
Drywall Nailing -----—_— -
Firewall - -
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: --
Final ---
PASS FART FAIL
PLUMBING
Post&Beam - - - ----
Under Slab
Top Out --
Water Seivice
Sanitary Sewer --- --"
Rain Drains
PASV PART I AIL -
HANICAL _-_..--
Post& Hoam _
Rough In
Gas Line - - - --
Smoke Dampers
Final — - ---
PASS PART FML
ELECTRICAL --
Service
Rough In -- - - - _ -- ------- ----
U '/Slab
Low Voltage _. �_ ------- --- - ------ -
Fire Alarm
Final - --_— - --- — --- ----
PASS PART FAILSITE
Backfill/Grading ---- -- - ---- --
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ -required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin Please call for reins e�'lon RE:
Fire Supply Line [ 1 P [ )Unable to inspect no access
ADA
Approach/Sidewalk
Other Date �� �/ Inspector, �-Q , --Ext
Final
PASS PART_ FAIL DSO NOT REMOVE this inspection record from the job site.
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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST
BIJIP
_Date Requested l d -�-{ AM PM BLD
Location_ jClx> 'i ' ( _ S,.iite MEC -- -- `--- _ -
Contact Person Ph _ �� '? S �.•5 PLM — —
Contractor Ph SWR
BUILDING - � Tenant/C,.,.er - ELC
Retaining Wall ELR
Footing Access: —
Foundation FPS
Fig Drain SGN —
Crawl Drain Inspection Notes: ---- --
Slab
SIT
Post& Beam -- — - ---- ---
Ext Sheath/Shear
Int Sheath/Shear ~R
Framing
Insulation -------------.. _ - ------------- -----
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
M13c: -- -- -----
PART FAIL
MWIMING
Post&Beam --___--
Under Slab
TopOut - ------------------ -- ---- ------_ ___..._..___
Water Service
SanitarySewer - _____ --- _.._..._._ ..._-------...---_ _ --------------------- ---- - -------------------.
Rain Drains
Final - -
PASS PART FAIL_ _
C ANIC
Post& Beam --.-- - - ---_-__.._
Rough In
Gas Line ---- ----- -- - _ -- ------ - - ---
Smoke Dampers
Ir
-- ---- - ---- --
hSg PART FAIT_
EL CTRICAL
Service
Rough In - ----------_--__ --.-.
UG/Slab
Low Voltage � ---- ---- --------- - -----
Fire Alarm
Final
PASS PART FAIL
SITE �—
Backfill/Gradino - - -- -- — -- — - --
Sanitary Sewer
Storm Drain [ j Reinspection fee of S required before next inspection. Pay kit City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ]Please call for reinspection RE:—� — [ ]Unable to inspect-no access
ADA
Approach/Sidewalk
Date ate —Inspector- - _7f Ext _
F'nal
PASS- PART - FAIL DO NOT REPAOVE this inspection record from the job site.
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 972?3
IMPORTANT PERMIT NOTICE
STREAMLINE ELECTRICAL
6017-B EAST 18TH STREET
VANCOUVER, WA 98
Electrical Signature Form
Permit #: MST2001-00213
Date Issued: 4/10101
Parcel: 2S104DA-13200
Site Address: 13063 SW CADDY PL
Subdivision: QUAIL HOLLOW - WEST
Block: I_ot: 118
Jurisdiction: TIG
Zoning: RA.5
Remarks: New SF detached rowhouse in Building #14. Setbacks as per Sheet A10.10
Plan C-S
11,our company hos begin indicated as the elechical contractor for the permit indicated above. In order for the
electrical permit to be vaiid, 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
OWNLR FLECTRICAL CONTRACTOR:
BROWNSTONE HOMES LLC STREAMLINE ELECTRICAL
12670 SW 68TH PKWY #200 6017-B E/,ST 18TH STREET
PORTLAND, OR 97223 VANCOUVER, WA 98
Phone #: 503-598-7565 Phos re #, 36u-993.5080
Reg #: Lrc 116514
ELE 34A32C
SUP -etBTS
AN INK SIGNA i-LIRE IS REQUIRED ON THIS FORM
Signature o 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 #: MST2001-001213
Date Issued: 4/10/01
Oarcel: 2S104DA-13200
Site Address- 13063 SW CADDY PL
Subdivision: QUAIL HOLLOW WEST
Block: Lot: 118
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 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: Puilding Dept.
No plumbing inspections will be authorized until this compPeted form i�. received
OWNER: PLUMBING CONTRACTOR:
BROWNSTONE HOMES LLC WOLCOTT PLUMBING CONT. INC
12670 SW 68TH PKWY #200 PO BOX 2007
PORTLAND, OR 97223 GF:ESHAM, OR 97030
Phone #: 503-598-7565 PhG;ie #: 567-1781
Reg # G it 23847
PI M 26-208PB
AN INK SIGNATURE IS REQUIRED ON T HIS "-ORM
X
Signatur6-6TAuttkifized Plumber
If you have any questions, please call (503) 630-4171, ext. # 310
�'1�� --- MASTER PERMIT
CITY OF T i G
PERMIT #: MST2001-00213
DEVELOPMENT SERV ICES DATE ISSUED: 4110/01
13125 SW Hall Blvd., Tigar::, OR 97223 (503) 639-4171
SITE ADDRESS: 1306:3 SW CADDY PL PAp..,;EL: 2S104DA-13200
SUBDIVISION: (QUAIL HOLLOW- WEST ZONING: R-4.5
BLOCK. LOT: 118 JURISDICTION: TIG
REMARKS: New SF detached rowhouse in Building#14. Setbacks as per Sheet A10.10
Flan C-S
BUILDING
REISSUE: S''ORES 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT 31 FIRST: 324 sf BASEMEOT: of LEFT: r SMOY,F:DETECTORS: Y
TYPE OF USE: SF Ft OOP LOAD 50 SECOND: 747 sl GARAGE. 410 sf FRONT: PARKING SPACES
TYPE OF CONST: 5N DWELLING UNITS 1 FINSSMFNT: 567 sl RIGHT:
VALUE: E 151,'6600
OCCUPANCY GRP: R3 RaRM RA114 2 TOTAL: 1,636.00 at 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:
TUBISHOWERS: GARBAGE DISP, 1 WATER HEATERS: 1 WATER LINES: 1,10 BCKFI.W PREVNTR: GREASE TRAPS
OTHER FIXTURES. 1
MECHANICAL
FUEL TYPES FURN<100K: BOILICMP c 3HP: VENT FANS: 3 CLOTHES DRYER: 1
GAS FURN)•10011: UNIT HEATERS: HOODS: OTHER UNITS: +1
MAX INP: blu FLOORFURNANCES: VENTS: I WOODSTOVES: GASOUTLETS.
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: 2 VUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 3 201 400 snip: 201 400 amp: lel W/O SVC/FDR: 00 SIGN/OUT LIN LT: PER HOUR.
LIMITED ENERGY: 401 600 amp: 401 600 rmp: EA ADDL OR CIR: 1 SIGNALIPANEL: IN PLANT.
MANU HM/SVC/FDR: 601 1000 amp: 601-81 v• 000v: MINOR LABEL:
10004 amplvolt
PLAN REVIEW SECTION
Reconnect only:
>-4 RE9l+NITS• SVCIFDR>=225 A.: >600 V NOMINAL CLS AREAISPC UCC:
ELECTRICAL-RESTRICTED ENERGY
A.SF RESIDENTIAL B COAIMERCIAL
AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO 6.STEREO: FIRE ALARM. INTERrOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: ALL FNCOMB Boll FR: HVAC LANDSCAPEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: OATArTELE COMM: NURSE CALLS TOTAL N SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 3,608.25
BROWNSTONE HOMES LLC BROWNSTONE HOMES,LLC This permit is subject to the regulations contained in the
12670 SW 68TH PKWY#200 12670 SW 68TH PKWY Tigard Municipal Cade, State Specialty Codes and
PORTLAND,OR 97223 POR rLAND,OR 97223 all other applicable laws All woo rkk w will be 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
Rep 6: LIC 1246.7 fo11h in OAR 952-001-0010 through 952-001-OORO You
may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQIIIRED INSPECTIONS
Erosion Control Insp 8& PLM/Underfloor Framing In3p Gas Fire;':ice Appr/Sdwl nap
Sewer Inspection Mechanical Insp Sh=ar Wall Insp Insulatio. Insp Electri • Fin
Footing Insp Plumb Top Out Exterior Shnathirlg Insl Rain drain Insp Mecha cal FI
Foundation Insp Electrical Service Low Voltage Water Line InspPlumb anal
Underfloor Insulation Electrical Rough In Gas Line Insp Water Service Insp al I Tectio
XIssued By : _ Permittee Signature \�A ,��
Call(503)639.4175 by 7:00 p.m.for an inspection needed the xt busi ss day
CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2001 00141
'13125 SW Hall Blvd.,Tigard, OR 97223 (503) 339-4171 DATE ISSUED: 4/10/01
PARCEL: 2S 104DA-13200
SITE ADDRESS; 13063 SW CADDY F -
SUBDIVISION- QUAIL. HOLLOW - WEST ZONING: R-4.5
BLOCK: LOT: 118 JURISDICTION: TIG _
TENANT NAME:
IJSA NO: FIXTURE UNITS
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF detached rowhouse.
Ownpr: _ - — — FEES
BROWNSTONE HOMES LLC Type By Date Amount Receipt
12670 S\N 68TH PKWY#200 — -- —
PORTLAND, OR 97223 PRMT CTR 4/10/01 $2,300.00 27200100000
INSP CFR 4/10!01 $35.00 27200100000
Phone: 503-598-7565 Total $2,3"5.00
Contractor:
Phone:
Reg #:
Required Inspections
I
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency The permit expires
180 days from the date issued. The total amount paid will be forfeited if the pennit expires The Agency does not
guarantee the accuracy of the side sewer laterals If the sewer is not located at the measurement given, the installer
shall prospect 3 feet in all directions from the distance given. If not so located, the installer all purchase a"Tap and
Side Sewer" Permit and the Agency will install a lateral ATTENTION: 0.egon law requires ou to follow rules adopted
by the Oregon Utility Notification Center Those ruies are set forth in OAR 952-00 ,OQ10 t ough AR 952-001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (5246-
/ 4 Permittee Si nature;
Issued by:� '��_ fJ _ —
Call (503) 639-4175 by 7:00 P.M. for an inspection needed then xt business day
Building Permit Application
Darr,received: '/%J! Permit no.• j f.2 p � J�
/ .. _
11,
1 Cidtys�of 11 sgaHl#all t �! 'igard,OR 97221 Project/appl.no.: Expire date:
i; Cityn/Tigard
Phone: (503)6394171 Date issued: _ By:;'11H
1H Rcceiptno.:
Fax: (503)598-1960 Case file no.: Payment type-
Land
ype-Land use approval: _ 1&2 family:Simple Complex:
&I lit.2 family dwelling or accessory O Cornmetciallindustrial U Multi-family 15 cw cemstruction U Demolition
U Addition/altcration/re.placement Ll'l'crant improvement U Fire.sprinkler/alarm U Other.
Job address: _ g\1') tr _ Bldg.no.: 't r'_ Suite no.:
Lot Black__$ulxlivision: tit+A i 11v�u T" Tax map/tax lot/account no.: --
Project name: C�tlF•,'( Nu llama
Description and location of work on premiws/special conditions:� i/�' —IJt� C49NS1VU f 1 \
Mailing address:_2 e,-W 6*" ,tjCw_ 'ZW 1 &2 family dwelling:
rPh]o
yStatc:w ZIP: X727 Valuation of work.....................................ne:°1 fj Q 7"L r� Pax: LTi F oo( f;-mail: -- No.of bedrnomslbatiu.............2 . ...........
wner's representative: jRT_ok"'- _ Total number of floors............... .............
Phone: 7 -�7ri Fax•'t]r 5912- E-mail: New dwelling area(sq.ft.) ........�.:.C-.... _
112151110 Garagc/carpori arca(sq.ft.).....(e..V.4.....
Name: �p fi6 R S A 6a,; Covered porch ares(sq.ft.) .............:..........
------ — (� s to rt
Mailing address: Deck area(sq.(L)................ ...................... _
City: State: '7_Ip: Other structure area(sq.ft.)...........' .........
Phone: i ax. ii-mn't!: CommerchtUtudintrWlmulti-famlty:
111610. : Valuation of work...................... ......... ....... $_
Business name: �do(E Existing bldg.area(sq.ft.) ..........................
_ A New bldg.area(sq.ft.)................................
Address: � -
-- —City: state: ZIP: Number of stories.......................................
-- —'^
Phone:_ I?ax: �E-mail:
Type of construction....................................
tkcupancy gmup(s): Exi'ting:
CCB no.: _ New:
City/metro lie,no.: Notice:All contractors and subcontractors are required to he —
its III I KE Ij U Eli L"13 licensed with the Oregon Construction Contractors Board under
Name: 6 1,(0 —_ provisions of ORS 701 and may he required to be licensed in the
Address: ( j cy ;��rtiy� ���: jurisdiction where work is being performed. If the applicant is
Cit �' �klT"+4' _ Statc: 'uit LIP:�{r ? . cxemp, :rom licensing,the following reason applies:
Y _ -._1 -ICI 'ft{
Con"act person` N13Y_ c Planno.: ------ -- —
Phone:7tf— .U:: N7 CGZ E-mail: — —
imp
Name: /tC1—� N Contact person: bruwI),'A4, Fees due upon application ........................... $.
Address: SkO K) , _ _ Date received: __
StatcX3 ZIP:g72Z-5 Amount received ........................... $ _
Phone: k. ',JM'O Fax: — E-mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not dt)ufi+dk+ws mcce+rA,c3r&.ptexx call puiadiction for mac tnrn,�t�nl
attached checklist.All provisions of laws d ordinances governing this p visa Masts.and
w++rk will be complied w' whether s i ed herein or not. ('Ts,:,„,t TM"'Aw -- --- .—-L--L—
�� �� � Expi,cc
Authorized signature:_ _�_ Date: --h'�-'ti Nmme of mdkAkr w dw�n on c,nur cwd
1 H - ---- s
Print name: _— _ crdtwteu dtrna►we _ .— Amount
Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete W 4613(btl'0M)
Mechanical Permit Application
Date received: Perutit no. s
Cit of Tigard Y g Projcct/appl.no.: Expire dale:
CityojTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 -
Pllone: (503) 6394171 Date issued: _ By. - Rceeipt no.:
Fax: (503) 598-1960 Case 1110 no.: -� Pa finent type:
Land use approval: Y -_ Building permit no.:
U 1 &2 family dwelling or accessory U CommerciaVindustrial U IMulti-family U Tenant improvement
0 New construction C]Addition/;tltrratioN'replacement L-1 Other._
INFORMATION -----
JOB SITU
Job address: ` 1 I Indicate,equipment quantities in boxes below. Indicate the dollar
Bldg.no.: _- Suite no.: value of all mechanical materialfequipment,labor,overhead,
Tax map/tax lot/account no.:
— - profit.Value$ '7
LAX: ii Block: _ SubdJ�o � u *See checklist for important application information and
Project name: r, ` jurisdic(ion's fee schedlde for residential permit fee.
City/county: -i ZIP: -
Description and location of work on premises:_ IJP)
Fee(eL) ToW
Est.date.of completion/inspection: _ Ilcsni iotl Qt . Iaes.arly Res.only
Tenant improvement or change of use:
Air ban dlingunit CFM
Is existing space heated or conditioned?U Yes U No
Is existing space.insulated?U Yes U No Air con iuonmg�&tep a-1 nmquir�)
Alteration of existing HVAC system
1 oi�corrpressor.s —
Business name: LUlScsy.)S State boiler permit no.:
— HP Tons BTU/t1
Address: i10(0(,-'ACA - State7 i smo a am uclsmo a eectors
City: )IkW : y
ear pump t;^pTan require
Phone: .. '54f l Cj Fax: 7 J)41 E-mail: — r.st1 rep aceturiocc/burner--T3 �1(T-
Includin,g ductwork/vrnt liner U Yes U No
CCB no.: Z nsta rep ar rr ocatcM^tern-suspended,
City/metro lic.no.:d DC* wall,or floor mounted
Name(please print): I Mn t�iq —� Venfor at p lance of eri-fthan furnace
e erat :-
Absorption units. '3TU/11
Name: M A:S t�I3G'>rt:� Chtllcrc —. _---__— HP -- ---
-`- C oin ressors _ III'
Address: w ron0eota extiimt a�Tir ienITtron:
City: State: ZIP: Appliancevent
Phone: Fax: E-mail. Dryer exhaust ---
floods, 'yype VTWres. tc P azmat ---
hood fire suppression system
Name: --- G' 7 .44 x'.= Exhaust fan with single duct(bath fans)
Mailing ndd_mss: x►aust system apart in Fe
City: State: ZIP: _ P�mWdr at on(up- to outlets)
Phone: ax: �!? mail: Type. LPG _ _ NO Oil - --- -
fue inn eaeri edifititmsl ovv els
X"11041111111 Proem 4 p p (schem qr.required)
Name: ) r,.- )A, /}r, Number of outletsOtherilsiRa ^------
Address: PP egtdrmenl:_
Dmorativefireplace
City: State: ZIP: Insi7rt-type_
Phone: - Fax: I E-mail: stov pe etstove -
App!icarlt's signature: �.-- Datc: 4 v, Other:
Name(print): h& I�s�n��
Not dl jurta&dom accept credit cm1s.ple—call jwiodimicm for rrac inrametion. Permit fee.....................$ ,� –
U Visa U MasterCard Notice:This permit application Minimum fee................$
Credit card mmeer—- expires if a permit is not obtained Plan review(at __ %) $
Fa tea within IRO days atler it has been ,x-
--- Name of cerdimidrr as a wn en c eir c.d — accepted as complete. State surcharge(896)....$
$ _ TOTAL .......................$ -7
Cardholder signatureAmattit 4/0-4617(6MVOM)
i'
P.3/07,12P01 11:49 269993508: STREWILINE ELECTRIC PAGE 0:41.
Electrical Permit Application
{� �y. � - t�>rroa.ivrd: PenRltlte.c�/a•,����- �'r=
City o l ig2pY ik-AcVlpyi,n�a�— Alt Ire date:
r-iti„lnr.ra AdAleta. i 1 125 9W 4v11llvd,Turd,ON 97,29 6Mre 1..1ted
erg waip aa:
Pas.:(50-3) S98-1960 Ca.c 1`114 tto f'aywtewtyr-:
Und use Approval --- — —
4LU1,
A 2 fearnity d"11 ling or tM Oelpacy a COMMArcit LUcluarlal U Mufti-family 0 Tenat IffTmvw,teel
New caM4trtggtpn U AddtbQ Wlitemda%/mplttc nxnl U Otmr:t.no. 1,Block; uttdiv �-- .�_.__._ ._.-.�__ Kucwttt se,�--_
_ a oa tJ*!L 1�tt lov4 wt-%r
'tttlaget Rune: ICka f o I Ittt.) De1cr1 irtr&nd k A#m of WiMV c n remwui K ELxi tc,�'!•rxyGnw
'UIIM' d due(if c9m leUon/lnt tirm
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I'hopt - . 2 Pu fi n W I; R eaay4oa m!
0wrW in*. Wwdw, R1`iMd:lRNof1�i ink muse oil prapearty 1 etvn T�"'r"'�11ie`�'�'- s'�
which f1 wx I"nded for We.I Rt,M e■chuw wo me:lttb to YtMrllWea�4Rwr411w,wnMeRtlNtr
ORS 41�,d�1, 179,pir1lt)I kM,rnyw« 2
b
Qwnae'1 d ruin: Date: �f' 0 e
or
NWW
a F«OW hrtrtel,drtglN WOryrd,.R of
Ad*W: 4M41ed as.Ntv4W 1n.VWA bnWA elffmn
t:l� ����` _ $uee:~ IZIP: '— hwtxr�ieirwka« 1►IRttwr.
lalrOtM' fttlttl IrttW of trio Cr M40a Iw,(IM htt+ro C!"I' 2
Of1�ct t: -
t « r.�itrrtar�e'r'Ir--
V laNe4 mer 7?.i nrp te+�nwrrinl CJ 16MIb+yr.%rrity Wdl a tgnsoo —
f]deur a•tr i2t:tKeprndy M lA2 O F!�,treloetrcrnON of aruanr WIMPI _
hrd!r Att�llitt�, U oei*"Ofw I O a0 grfuMt ItM Aror r>r 11 4 mt• nd'atd r"Mly PU 1.
Q m m w 14(1 vn!n t1t11MmIt Area n4ddrortt4l ttdU Isnot t.W len W4nttasA•o.r ata w,an�
Q Re,kRn1dvadmrrt,fid4 lJ r4 wo 4M"Mmom • �
U oompant lo.d O-W"omm -t M WAMvtd 4Y*owmfr ma RV p4tk w ow* rdNw tw)at I* ;'"
1 G!•�,MY/h1hTb4r14n U00 r-7
!I!�...�-Mtb of/11Iw 41'!16�twf IfM�M't'r• ��..
I t t1`sAtrw arra mel W u e1rh�MIN e.Ma. ......
Pcmttt ft+e.....................f ,..
mo v ov% ow waV*W w•i,Oka w11 pe%WkSw h•rain WAwRwb+ 14wob This re'"Al lkwirtatitm
U vW U M~-'&,'d _ --- erjirp If 4 romto!I net awam 0 Moa nvftw(il 9b1 S
,.w am 600etr --11j"" within 110 d4yg afM M ha Mel gate gunhet>e(9%)....S
Art 11eo"m to°!'"'pM1e 7 OTAL ......................
,.—. -- 1�4tIa1� MFNnttl�n
l�
Plumbing Pernut AppL 'on
,1 Daterweived: Peri'
Cltv of �g 1 Sewer permit no.: Building permit no.' ,.;
Address: 13125 SW Hail Blvd,Tigard,OF 97223
Cilyof77gard Phone: (503) 639A171 Prujcct/appl.no.:— Expiredatc:
Fax: (503)598-1960 Date issued: By: JR:axiptno.:
Land use approval: _ Case file no.: Payment type:
17-01 family&fling or accessory U Cemmercialrndustrial U Multi family U Tenant improconstruction U Addition/alteration/replacement U Food service U Other:„ e% I"
Job address: ! ()(c� I t C.,ta t� )�� — [>�scr1I Qty. Fee ea. Total
Bldg.no,: t _ Suite no.: _ New 1-and 2- y wellin&ponlyt
Tax map/tax lot/account no.:
(includes 100 for each aeiury comectloto)
SIR(1)bath
Lot: 4') Block: Sulxlivisio-n �r�,it. ptu thou,u>t SIR(2)bath
Project nameiAi l lo-) _ SFR(3)bath ^—
City/county: T1( NO WMA. ZIP: `�ffZZ75- '_— Each additional bath/kitchen
D.-wription and location of work on premises:_ �O J Siteatilitles:
C!.cn basin/area drain
Est.date of completion/inspection: Drywells/leachl line/trench drain
PLUMBING t Footing drain(no.lin.ft.) - —
Manu011 factured home utilities
Busincssnanie: u�p��p� �VnnY3nlxt 4—Riain
anholes _
Address: drain connector
City. ft.�� }�rq _ State:o- Zip: initary sewer(no.lin.ft.) —
Phone: -7 r Faax•.(0(07g9; r E-mail:-- — ormsewer(no.lin.ft.) -
CCB no.: _ Plumb.bus,reg.no: Water service(no.lin.ft.)
City/metro lic.no.: -- — Oxtare or Item:
Contractor's representative signature: Absorption valve
---- Rack flow preventer _
Print name: Date: 10i:kwater valve
13mins/lavatory _
Name: Clothes washer ---
Address: ----- -- _Dishwasher -
Drinking fountain(s) _
City: ---__ Stare: ZIP: — E'ectors/sump —_
}'hone: Fax: E-mail: Eximision tank
Fixtur!sewer cap —
Name(p;1): Floor drains/floor sinks/hub
Mailing dress: Garbage dis sal
Hose bibb
Ciiy: State: -�IP: la maker —�--
Phone: Fax F-mail: Interce or/gyrase trate ---
Owner instal lation/residential maintenance only: Tire actur' installation Ptimer(s)
will he made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on on the property I own as per ORS Chapter 44/. Sink(s), in(s),lays(s) - - - -
Own,!r's ;ignaturv: Date: Sump
Tubs/shower/shower pan
Name.: Urinal -
-- - - --- --- Water closet
Addtss: Waterbe_ster
C'ly:-- _ -- State: _ ZIP: _ Othcr. —
Phone: IFtx:
ra all juritdkrieos a'ce"errdit emits,rk,ue call jtaisdiction tet ram iararmatkn Mirlinl'lm[CC................$
Notice:"lh;s per.nit application
Yiss U MasterCant expires if a permit is not obtained Plan inview(at _—%) $edit emd mmbe __—_- _ 1_�_ within I1%0 days after it has been Stale surcharge(8%)....$
teas Complete TOTAL .......................$
_J Nape d cydholda u dto,m on credit Dant"+ accepted p —_- ----.
J
Cmdtrotder sipsittue A
44U-1616(bOtN_'OM)
Mar-06-01 03 : 05P Wolcott. Plumbing 3 667 9891 P . OZ
)3 '06•ol 1'L'L•' 14 4; I'.1� 5U't S98 1Br.;3 CI?1' 0;
:�0U3
PLUMBING PERMIT FEES:
RI F TQTAL lly dill �r,pt air: _—
FIxfURt Indtvldusl •at MAU'NT, ubinp'naturrtIn p ICE TOTAL
166 ` d th�11r11 D fl ,:� QTY ep AMOURI
c inn�al'p y
Tb or u0/Srluwer�0+tb
-161
I Sh w•r Orly _ '_ $399
Lair Clwet 1 ) — _UOTOT L4 .14 l
UrinJl` 10•A] _ STATL -URGIIAIN:
CiJhwo.na T lee] —'� 25.9 OF SUBTOTAL
CarGapG GiGpotll 16.CJ -MAL
Lyondry�ray toe0 '
Wathlny Mach no
fluaD—�N�ek 1' 16110
COMPLETE:
W;7 meati O convr9 on like wrid 16( - (.--•i� utn or PGG tinned,.
C'•spipmp requtle••separvie twhanical ( I//� ` New 1r1or d Replaced mo o ew
MFG 1,orw New Sarvlcr 4!S•0
—ko HornNg
e i4w Satofm •w•f
�i4oJ• be
Pool 0title ___—_�-__i �ea•p
— .�._ -- --- --
Dflllk n9 Fo�nl:•m 181A —
r0►lufitrwk(3:'aclry)
--I
Sower ti�dd lk,'l 100' _ d6 10 4' �L
v:•Irr 9:ry
to
caster sarwce.each and ton31 loo ae to
,Iorm 6 R•In 01a1r• 'to 1l)0' �, 55.)C
81o•rt 6 ROir1Ir-uch ad1111 ontl 1U0' dE.10
CORMTI!(n L�ecA FIOW�rlWnlWn[)•XG, — 10 I - ---- --- --
ReudanT:rl ItxRncvrm enttor -1 -
GJRh I
ImpMlon of EarStlnO Pluml;lnp or�ecply /2 5D I
R•gu•atld!nom! r�cn�on! Ifi- l COARDINQ ABOVE:
aan ptal- tl—ngMZarrAy dwelling 65?5
GrtrOG ripe _--_—— — le e0 _ -- -- -------
QUANTITY TOTAL t
owwtnc m ite•illapon is•epu-•ed It i .•i -
'BUNTUTAL
SYr STATE 9URCHARGE �— �� ------
PLAN REVIEW 25'4 OP%LRTOTAL
-
�$TAL =
'Mlnitl•+m P.—A fat It$12 SO•tS Glatt,tl.charga,a1,A01 Re"d•n1111"SCRIarr
P'tv Kr.Nn Oev't e,wt,0 t»t 13 1 Gt,t$1810 nrcnelpe
11'.1,aw Cemt emial rullingt rwquue YMliG r'kh tanmel,c Of 1%it llayran.-d
den •.y..
I�iittltfornslplm-Res doe 1C11000