13270 SW KINGSTON PLACE F
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13270 FpVV Kingston Place
MASTER PERMIT
CITY OF T I G A R D PERMIT#: MST2002-00047
DEVELOPMENT SERVICES DATE ISSUED: 4/11/03
13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171
SITE ADDRESS: 13270 SW KINGSTON PL PARCEL: 2S104DA-17700
SUBDIVISION: QUAIL HOLLOW - SOUTH ZONING: R-4.5 i
BLOCK: LOT: 003 JURISDICTION: TIG
REMARKS: SF rowhouse,unit 3,bldg 6,BS plan with a deck.STRUCTURAL FILL,REQUIRES GEO-TECH
INSPECTION AND REPORT. 4/10/03, adding a/c& gas fireplace.
BUILDING
REISSUE- STORIES: 3 FLOOR AR'-'AS REQUIRED SETBACKS REQUIRED
CLASS 01:WORK: NEW HEIGHT: FIRST: 177 sl BASLMENT st LEFT SrAOKE DETECTORS: Y
TYPE OF USE: SEA FLOOR LOAD: 50 SECOND: 135 st GARAGE. 547 st FRONT: PARKING SPA'
TYPE OF CONST: .5N DWELLING UNITS: 1 THIRD 735 sf RICHT:
OCCUPANCY GRP: R3 BDRM: 2 BATH: 2 TOTAL 1.642 e/ VALUE: 162,55b 20 REAR:
PLUMBING
SINKS: I WATER CLOSETS: •2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: 2 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUBISHOWERS. 2 GARBAGE DISP: I WATER HEAL ERS: 1 WATER LINES: BCKFI_W PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL.TYPES FURN<100K. 0 BUIL/CMP<3HP: ? VENT FANS: 3 CLOTHES DRYER I
GAS FURN>=IDOW UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: blu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLErS:
ELECTRICAL _
RESIDENTIAL UNIT— _SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS ..:SCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: I 0 2n0 amp: 1 0 -200 amp W/SVC OR ED R: PUMPIIRRIGATION: PER INSPECTION:
EA ADO'L S00SF: 1 201 - 400 amp: 201 1Ce amp: iM W/O SVC/FDR: SIGNIOUT LIN LT: PER HOUR,
LIMITED ENERGY: 401 600 amp: 401 000 amp F AADDL BR CIR SIGNALIPANEL: IN PLANT:
MANU HMISVCIFDR: 601 1000 amp: 601+amps-1000v: MINOR LABEL:
1000+8mp1volt
PLAN REVIEW SECTION
Reconnoct Only:
>-4 RES UNITS: SVCIFDR> 225 A.: >600 V NOMINAL: CLS AREAISPC OCC:
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO&STEREO: VACUUM SYSTEM: AUDIO d STEREO: FI TE ALARM: INTERCOM/PAGING OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER CLOCK: INSTRUMENTATION MEDICAL: OTHR:
HVAC: DATAITELE COMM NURSE CALLS: TOTAL N SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 5,911 74
BROWNSTONE QUAIL HOLLOW LLC BROWNSTONE HOMES,LLC This is subject to the regulations contained in the
Tigardd Municipal
Municipal Code,State of OR S;.lecialty Codes and
12670 SW 68TH PKWY STE 200 12670 SW 68TH PKWY all other applicable laws. All work will be done in
PORTLAND.OR 97223 PORTLAND,OR 97223 accordance with approved plans. This permit will expire if
work is not started within 180 dais of issuance,or if the
work is suspended for more than 180 days. ATTENTION-
Oregon
TTENTIONOregon law requires you to follow rules adopted by the
Phone: 503-598-7565 Phone: 503-598-7565 Oregon Utility Notification Center. Those n,les are set
forth In OAR 952-001-0010 through 952-001-0080. You
Rep N: 11(' 1246:7 may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Underfloor insulation Plumbing Top Out Exterior Sheathing Inst Water Line Insp Building Final
Sewer Inspection Plmlundslb Insp Framing Insp Firewall Insp Smoke Detector Final inspection
Footing Insp Electrical Service Gas Line Insp Gyp Board Insp Electrical Final
Foundation Insp Electrical Rough-in Insulation Insp Engineered grading fin Plumb Final
Slab Insp Mechanical Insp Shear Wall Insp Rain Drain Insp Mechanical Final
Icsued By`i � _,,�--a � 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#: SWR2002-00026
13125 SW Hall Blvd., Tig;ird, OR 97223 (503) 639-4171 DATE ISSUED: 4/11/03
SITE ADDRESS; 1321 70 SW KINGG FON PL PARCEL: 2S104U4-17700
SUBDIVISION: Q( AIL HOLLOW-`S )U"1 I I ZONING: k-4.5
BLr3i.K: LOT: 001 _ _ JURISDICTION: Ilr;
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS-
TYPE OF USE: SFA NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE.
Remarks- Sewer connection for new SF rowhouse.
Owner:
_
BROWNSTONE QUAIL HOLLOW LLC —_— �--- FEES — —
12670 qW 68TH PKWY STE 200 (Description Date Amount
PORTLAND, OR 97223 1SWUSA] Swr Connect 4/11/03 _ $2,300.00
1SWUSA]Swr Connect 4il1/03 $0.00
Phone: 503-598-7565 [SWINSI]Swr Inspect 4/11/03 $35.00
Contractor:
ISWINS1'] Swr Inspect 4/11/03 $0.00
_--- Total $2,335.00
Phone:
Reg #:
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 180
days from the date issued. The total amount paid will be forfeited if the pen iit 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 shall purchase a"Tap and
Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law req fires you to follow rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100.
You may obtain copies of these rules or direct questions to OUNC by calling(503) 246-6699.
Issued b �p�,,
Y �/1���� -- Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business y
i
� l�c��•�
Buildi>ng POrmit Application
ate received: ewe,A Permit no.:yhr.7"a 05/;
City of T><galyd
Address: 13125 SW Hall Blvd,';'igRrMCE . oject/appl.no.: Rx •-daI
C njTigar`f t no
Date issued: Recei .:
Phone: (503) 639-4171 Y�1•,J'• P
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: d t" ilk 1 1&2 family:Simple Complex:
1
U I &2 family dwelling or accessory U Commercial/industrial U Multi family U New constriction U Demolition
U Addition/alteration/replacement U Tenant improvement ❑Fire splinkler/alamt Q Othc,:
11 1
Job address: k --j. Bldg.no,: Suite no.:
Lot: Block_ Subdivision^ Gr P/i c CA• d1c U Tax map/tax lot/account no.: A5/o ynR �atflSc v
Project name: < .
Description and location of work on premiscs/special conditions:
1 1 r
Name: CRq- rQ 6W flL1:. r r ,
Mailing address: _n 1 &2 family dwelling:
Clty: ort ca y ,State:01ZIP�S2 Valuation of work........................................ $
Phnne - ,5 , lax: q E-mail: No.of bedrooms/baths....... .........................
_--
Owner's representative: P.0 5�'k- Total number of floors.................................
Phone: , Fax: l-mail: New dwelling area(sq.ft.) ..................... ...
-----------
,UUM[1191
(3atrge/carport area(sq.ft.).......................
Name: r 6(,, 6\ t _ t.LL, Covered porch area(sq,ft.) .......I......
.
Mailing address: SW � a Deck arca(sq. ft.) ........................................
_ ------
City: State: 7.11' Other structure area(sq.ft.)..................._..
y �"L; -famil
Phone: Fax: L;-mail: Y'
7. Existing
aluation of work........................................
Business name: bldg.area(sq. ft.) ..........................
r v. o�t s L.L —_—
Address: -2A r , _ eu bldg,area(sq. ft.) ................................
City: 4,_ State;D� umber of stories ....................... . .......... ...
Phone _ _ Fax:b�p- mail: YPe of constriction................... ... ........ ...CCB no.: ccupancy gtoup(s): Existing:- New:
City/metro lis.no.: otice:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: 6. 6 (_,0 - - provisions of ORS 701 and may be requited to be licensed in th
" �1 j r �.�, jurisdiction where work is being performed.If the applicant is
Address:
t .� -S(�� O exempt from licensing,the following reason applies:
Contact person: H� Plan no.: --- -- —_— —
Phone: _C -yr x: E-mail: — ----- ----"Naj:V0,zContact person Fees due upon application ........................... $69 LU r c cam} Date received: —
City: 1',tate: ZIPP��3 Amount received .. .............. $---___------
Phone: ;Z _ p Fax_ E-mail: Please refer to fee schrdule. J
I hereby certify I have read and e;.amined this application and the Not all Jurisdictions accept credit wa.•ptrare call iurMcaan for mare in[mWiom
attached checklist.All provisions of laws and ordinances governing this Uviss 0MasterCard
wont will be complied ej�t,whetheq' credit card nuurber.--. /ed herein or not. -- --- —
r.,ptrra
Authorized sign re: _ dune or f&"r:r shown no re
R ca --
Print name:_ ------ s
C
A Fwurt Amount
Notice:This permit application expires It's permit is not obtained within 180 days atter it has been accepted as complete 440-4613(&""M)
Plumbing Permit Application
Datereceived: ; Pexmitno.:'��,[d/c' _ �
City of Tigard Sewer permit nc. Building permit no..
Address: 13125 SW Hall Blvd,Tigard,OR 97223
Cityoj7igard Mone: (503)6394171 Pmject/appl.no.: Expiredate: —
Fax: (503)598-1960 Date issued: By: Receipt naA—_
Land useappr-.val: — CaxfiIrno.: Paymenttype-
U I &2 family dwelling or accessory U Conanerrial/industrial U Multi-family U Tenant improvement
U New construction U Addition/alteration/replacernent U Food service U Other: —_
JOB SUIT.INFORNIA11 ION 14-11] SCA1111111 JLE.(for special information t1%e.ciie0,-13
Job address: j.:?-`)C' a w c." F L a c — Descrllrtion Qty- Fee(ea. Total
Bldg.
no.: 3 rto,; — New 1-and 2-family dwellings only:
_ (Includes 100 ft.foreach utility connection)
Tax map/tax IoUaccount no.: _ __ SM(I)bath
l,ot: — Block: —Subdivision: SFR(2)bath —
Project name: SFR(3)bath
City/county: Zip: �— Each additional batlifkitchcn --' —
Description and location of work on premises: _ Siteumities:
Catch basin/area drain _
Est.date of completion/inaptxxttion: Urywellsflcach line/trench drain —
Footing drain(no.lin. ft.) _
Manufactured home .tilities
n^� Manholes
Wolcott Numbing Rain dtain connector —
PO Box 2007 Sanitary sewer(no. lin. ft.)
Gresham OR 97030-0594 Storm sewer(no.lin.ft.) -
503-667-1781 Water service(no.lin.ft.)
CCD:23847 PLM 11:26-204PI1 Flxture or Item:
Absorption valve _
Contractor's representative signature: _— Back flow preventer _—
Print name:: Date: Backwater valve
! Basins/lavatory —
Clothes washer
Na ne: Dishwasher
—
Addrpss: Drinking fountain(s) —
rity — — r�tlte' ZIP: _ E eeICNS/allmp
Phone, Fax: F mail Expansion tank -- _
1 Fixtute/sewer cap — —
Floor drains/floor sinks/hub
Ilame(print). — Garfiagr disposal
— —
ailing address- —_ Hose bibb --
City: --state. 71P. _ ---- Ice maker J----- —
i'horte: Fax: __�f mail: Interceptor/grease trap
Owner installation/residential maintenance only: The actual installation Primers) a Will be made by me or thr maintenance and repair made by my regular Roof drain(conunercial) __—
employee on thr property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s)
Owner's signature: _ __ Date: — Surrp
Tubs/shower/shower _
Urinal
Name: U
_——__- - .._—.—._--- ------- Water closet
Address. Water heater
City: --- State: ZIP:_ Other.
Phone: —y— Pax: Vi E-mail: Total
No MI jwtvumaw wee"arae Cana,oem can kziG&dm ra nae bfamrlm� Plan
Minimum fee............ ) 1s �_--_--
N�rtice:This permit application
0 Via O M.ste Card expires If a permit is not obtained Plan re�vicw(at _, �)
em&cwd enmbv — ------- -=spm within ;!n days after It has Ix-en Statr.surcharge(8%) ....$ _.—_—.—.--
_ 9,d — wldrr r a n at&and ——
accepted as c»tryade. TOTAL ............... .......$ --
__ t
-- 4taK R — Aaw.wt 440-1616(600MM)
Mechanical'Permit Application
Date received: . Permit no.:
City of Tigard Projecsppl.no.: Expire date: -
City n!Tigard Address: 13125 SW 4all Blvd,Tigard,OR 97223 Date issued: By: Receipt no,:
Phone: (503) 639.4171 -- —
Fax: (503) 598-1960 Casee file no.: _—_ payment type:
Land vse approval: — Building permitito.:
TWE Of OURMIT
U 1 8e 2 family dwelling or accessory U Commercial./industrial U Multi-family U Tenant improvement
U New constriction U Addition/alteratior✓replaccment U Other:
1 1 1CON11NIERCIAL VWLUATIO&' 1
Job address_:I'? ) w
( CC Indicate,equipment quantities in boxes below Indicate the dollar
-
Bldg.no.: Swte value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: --- profit.Value$ .._.—
Lot: Subdivision: *See checklist for important application information and
Project e.
"-- urisdiction's fee schedule for residential permit fee.
nam
City/county _-� ZIP: DWEIILING PurtmiTIrEc sollEDuu.
Description and locatie,n of work on premises: 1 •1 1 1 t
Fe+r(ea.) 'Total
Est.date of completion/inspection — -u- � Qt . Res.nal n.00l
Tenart improvement or change of use: — hVAIandling
Is existin space hratec'or conditioned?U Yes U No Air handling unit -_CFM
g P t co�uonmg(s(siie plan iequlr )
Is existing space ins,dared?U Yes U No Alicratio-n-of existiingAPAC system
WCHANICAL 1 1 ilaTpressors —
State boiler pennit no.:
(:our Seasons Beating&A/C:Service Inc HP Tons BTUM
Vie smc a am uct smoke detectors
PO Box 66409 Heat pump(pan required)
Portland Olt 97290-6409nsia rep ace furnace/burner—_)-T'iT/T
503-775-5919 Including ductwork/vent litier U Yes O No —_
CCB: 49283 inntalWi lace/rel<rauems-suspened—
wall,or fkw_r mounted
Harm;(please print): Zen t tot appliance otherai nurnac- —�
1 e era
Absorption units BTU/Fl _
Name: Chillers ___ _-- HP —
Adtiress: --� — — -` Com ressors _ HP
— �s ttm exhaust am tent t oa:
City: State:—�ZIP: Appliance vent _
Phone: Fax E-mail. I et exlausi —
oil Hoods. ypc res. tic team7mat
hood fur suppression system _
Name: Exhaust fan with single duct(bath fans) _
Mailing address: _UFau i system Apartrom 6calm— C_
Cit State: Z[P: TWI piping rrBW al up to outlets)
>': —_�— L.PG NG Oil
rnx �= -
Phone: Fat: Email uc i tin eac tF i_HtticnaTover out
reaees g p (sc ematicmquired)
Nur.i,er of outlets
Name: Uihex iislel app Ltnce or --
Address: _ Decorative fireplace —
C.ity. _ State: ZIP: Tnser--type-- ------
Phone: Fax: Email: o stov pe I let stove
()dFcr
Applicant's signature: —__ Date:Y— O(her.__� -
Name (print) —�___--- s-- ----- —
Na dl)urltdictiom nr q4 ardii cult,plew call)uritdiction fa tnme itdormuioct Permit fee fee
................$ _.—.
QYisa O MuterCar:1 Notice:this permit application Minimum fce................$
expires if a permit is not eMained Plan review(at —_, %) $
_ --
tSedit circa number --- _ _ --- --"--- within 190 days alta ii her hoer —
staff W r tea, on_�Card____ ,ted as omn plete State arge(896)....$
= TOTAALL .L.....................$
Cudtwlda dptWR u_, A tT 4#1-4617(60KIDW
Electrical Permit Application
IDatcreceivecl .2 d�' Permit no.. <1-oVa eW
City of Tigard I'roject/appl.no: Expire date:
CiryojTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 bate issued-- ^� By: �eipt n_— o.:—
Phone: (503) 639-4171 -------
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction U uirtitinn/alrcration/n place mc;u U UthCr: _.� U Partial
JOMSITIF INPORMATION
�Joo address:I `' '4 _P i_ Bldg. nee: isuite no.: Tax mI lot/account no.:
Lol: 71 Plock: Su i m: —
Project name: _ Descnpnon and location of work on premises: —
Estimated date of conlldcuon/inspection '—
CQNTIRACTOR APPLICATION
I" Max
p �e������ - Descriptlom Qty. (ea.) Total no.ins
JEROME ELECTRIC Ncpresidential-sins*(wnwhi-fanJiyper
PO BOX 751 dwelihn N.lariudesat.sch-dgarage.
.Service rlCladed:
H I LLSBORO OR 97123 1000 sq n.or less 4
503-648-5144 Each additional 500 sq ft.or portion therecif --"
Limited energy.residentialJ
CCB: 36051 EM 34-119C SUP: 28775 _Limited energy,non-residential 2
_ Each manufaaured home or modular dwelling —
SInature of supervising electrician(required) pate Service and/or feeder 2
Sup.elect.name(prim) License no Services orfeeden-Installation,
alteration or relocation:
1 1 200 amps or less 2
Name(print): 201 amps to 400 amps - —2---
401-- --- 401 amps to 600 rumps _ 2
Mailing address: 601 amps to 100 amps — 2
City: -�--- —_ — State: I ZIP: Over 1000 amps or volts — 2
Phone: _ Fax E-mail: Reconnect only
Owner installation:The installation is being made on property I own Temporary wrvtonorfeeders- --
which is not intended for sale,lease,tent,or exchange according to Installation,aNaruioa,orrelocation:
ORS 447,d55,479,670,701. 200 amps or leu — 2
201 amps to 400 apps y ~"
Owner', signature: Date: _ 401 to 600!M5
Branch circuits-new,alteration,
Name: or extenslw per panel:
_ A. Fee for branch circuits with purchase of
_Address: —_ _ service or fader fee,each brach circuit _ 2
City: Stale: ZIP: B. Fee for branch circuits without purchase — -
Pltone: Fax: E-mail: --_- of service or feeder fee,first branch circuit: _ 2_
FAch additional branch circuit:
—
Mim.(Service or feeder not Included):
PLAN RIEVIEW(I'Iea%e�lrfirck all that apply)
U;ervi a over 225 apps-conuncu.ial U Health-care facility Each pump or irrigation circle 2
L)Service over 320 amps-rating ni 1&2 U Hazardous location Foch-hgn oroutline lighting 2
fanulydwellings U Building over 10.000 square fat four or Signal circuit(s)or s bruited energy panel,
U System over 6(I(I volts nominal more residential units in one structure rltersuon,or extauion• 2
U Building over three stories U Feeders,400 amps or more •Desch limn:
U Occupant load over 99 persons U Manufactured suvoures or RV park Lich additbanl inspection over the allowable in any of tle above:
U EgressAighdngpla U Other Pennspection
Submit____acts of plans with env of the above. Inveatigatiaofee
The above are not applicable to temporary construction service. r other ——
Na all jurisdictions accept credit cants,please call funsdicunn fa mote hnfamarion Notice:This permit afpLcation Permit fete... .............s
O Visa O MuterCard expires if a permit is 11-0.obtained Plan review(at _ %) $
Cmdin card number within 1$0 days after it hats been State surcharge(8%)....$
`�re1 accepted m complete TOTAL $
Noor of o der u slhawn on cretin rad -------------
Cardboldn❑goaure � Amount
440-4615(M)WON(I
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
E C E V t
IMPORTANT PERMIT NOTICE APR l ;i 2003
F TIGARD
DAVID JEROME ELECTRIC �ult.atni _tatTY UDIVISION
PO BOX 7 51
HILLSBORO, OR 97123
Electrical Signature Form
Permit #: MST2002-00047
Date Issued: 4/11/03
Parcel: 2S104DA-17700
Site Address: 13270 SW KINGSTON PL
Subdivision: QUAIL HOLLOW - SOUTH
Block: Lot. 003
Jurisdiction: TIG
Toning: R-4.5
Remarks: SF rowhouse,unit 3,bldg 5,13S plan with a deck.STRUCTURAL FILL,REQUIRES
GEO-TECI; INSPECTION AND REPORT. 4/10/03, adding a/c & gas fireplace.
Your company has been Inaivated 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 t-) the
start of the work to the address above. ATTN: Building Division
No electrical inspections will be authorized until this completed form is received
OWNER ELECTRICAL CONTRACTOR.
BROWNSTONE QUAIL. HOLLOW LLC DAVID JEROME ELECTRIC:
12670 SW 68TH PKWY STE 200 PO BOX 751
r ORTLAND, OR. 97223 HILLSBORO, OR 97123
Phone #: 503-598-7565 Phone #: 648-5144
Req #: H( .16051
�I 1' 28775
1 1 I- 34-111)(
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of up€fivisin lec!r;cian
9
If you have any questions, please call 503.718.2433. I.
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD,, OR 97223
IMPORTANT PERMIT NOTICE
WOLCOTT PLUMBING CONTRACTORS
PO BOX 2007
GRESHAM, OR 97030
Plumbing Signature Form
Permit #: MST2002-60047
Date Issued: 4111/03
Parcel: 2S104DA-17700
Site Address: 13270 SW KINGSTON PL
Subdivision: QUAIL HOLLOW - SOUTH
Block: Lot. 003
Jurisdiction: TIG
Zoning: R-4.5
Remarks: SF rowhouse,unit 3,bldg 5,13S plan with a deck.STRUCTURAL FILL,REQUIRES
GEO-TECH INSPECTION AND REPORT. 4/10103, adding a/c & g�.s fireplace.
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, ATTW Fuilding Division.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
BROWNSTONE QUAIL HOLLOW LLC WOLCOTT PLUMBING CONTRACTOR!
12670 SW 68TH PKWY STE 200 PO BOX 2007
PORTLAND, OR 97223 GRESHAM. OR 97030
Phone #: 503-598-75615 Phone #: 667-1781
Reg ll. LIC 23847
PLM 2.6-208PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X e -
Signatui'e cif Autho ized Plumber
If you have any questions, please call 503.718.2433.
i�
April 29, 2003
CITY OF TIGARD
Ron Estey OREGON
12670 SW 681h Parkway, Suite 200 \
Tigard, OR 97223
RE: Plan review of conversions and additions.
Dear Ron,
I have completed the plan review of the 15 units that have been or are to be
converted to additional space options or have been altered for increased living
space.
I personally reviewed the pictures provided by your site superintendent for
building #4, and found that the 24" X 24" X 12" pad under the point load
transferred down through the inside bathroom wall was not installed.
You will have to arrange for a 2" core drill at that area to check for adequate
bearing for this load at ;ots 7, 9, 59, 60, 61, 62, and 63. Or, you might contact
your engineer to address the footing pad issue.
Lot 24 was approved and lots 2, 3, 4, and 5 have riot been poured.
Lit 19 has been revised to reflect storage space in lieu of the original bedroom.
The bay was also credited ar!d the added "niche" was recorded. Do insure that
there are, no headers or jambs at the "niche" so in no way can it appear to be a
closet.
Lots 7, 9, 59, 60, 61, 62, ind 63 have been flagged "no further inspections" until
the testing or design is complete for bearing pads and/or shear walls.
If you have questions, please call me at 503-718-2440.
Sin;9V
�
Darrel "Hap" Watkins
Inspection Supervisor
13125 SW Hall Blvd., Tigard, OR 97223(503)639-4171 TDD(503)684-2772 -------____
^ CITY ^ F TI GARD ELECTRICAL PERMIT-
�% RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2003-00239
13125 SW Hall Blvd.. Tiqard. OR 97223 (503) 639-4171 DATE ISSUED: 8/6/03
SITE ADDRESS: 13270 SW KINGSTON PL PARCEL: ?S104DA-17700
SUBDIVISION: QUAIL HOLLOW- SOUI-H ZONING: R-4.5
BLOCK: LOT: 003 JURISDICTION: TIG
Proiect Description: Installa 'on of limited energy for audio/stereo wiring
A.RESIDENTIAL _ B.COMMERCIAL_
AUDIO & STEREO: X AUDIO& STEREO: INTERCOM 8 PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
_TOTAL# OF SYSTEMS:
Owner: Contractor:
BROWNSTONE QUAIL HOLLOW 11C AZIMUTH COMMUNICATIONS INC
12670 SW 60TH PKWY STE 200 P.O. BOX 508
PORTLAND, OR 97223 WILSONVILLE, OR 97070
Phone: 503-51)8-750S Phone: 503-639-011()
Reg #: ELE 36-94CLE
SUP 2312LEA
_ 1,1(' 14592E
FEESRequired Inspections_ _
Description _Date _ Amount Low Voltage Inspection
[ELPRMT1 1.1.k 11cimit 8/6/03 $75.(;0 Elect'I Final
[TAXI x'%n State Tax 8/6/03 $6.00
_ Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, ,State of OR. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This pen-nit will expire if work is not
started within 180 days of issuance,or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rule's adopted by the Orenon Utility Notification Center. Those rules are set forth in OAR 952-001-0010'hrouc
i
Issued b �t �� n�0-l`1 Permittee Signat"re _
OWNER INSTALLAT113N ONLY
The installation is being made on property I own which is not in.-ended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATt1RE OF SUPR. EL.EC'N _ DATE:
LICENSE NO:
Call 639-4111 by 7:00 P.M. for an inspection needed the next business day
Electrical Perrot Application
_ —— Date received: (f >, Permit
City ,,i Tigard Project/appl.no.. Cxpirednte:
C'irvnjTigard Address. 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no,:
Phone; (503) 639-4171 --
Fax: (503) 598-1960Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
J 1 &2 family dwelling or accessory O Commercial/industrial U Multi-family U Tenant improvement
XNew construction U Additian/alteration/replac(•ment 0 f)Iher: - ._ _ ❑Partial
JOII SITE INFORMATION
Job address: /3a7V 6-0J, 1A, suite nn: Tax map/tax lot/account no.:
--- -
Lot; Block: jSubdivjsi�n: 113 l Sw 7H
Project name: )(t kI L- SU(k-cN — Description and 'ocation of work on premises: (; �' �t f
Estimated date of cornplction/inspection:
APPLICATIONI
Job no: Q TOUT n
Fee N1av
Business name: uw/ C t tJ
Description (ea.) o.Ins
� -- New residential•single or mu di•famlly per
Address: t 1, 5 6 veL dwellingunit.Includes at*—ct ed garage.
City: \L dA;JlLt J_Statcj�L ZIP: Service Included:
Phone:e 3(,3t!U(t U Fax: % Olt S I E-mail: — 1000 aq It,or less - ------ 4
1
CCB no.: ( 4 53'26- Elec. bus. lie.no: �� f L Foch additional 500 sq ft or p n t m ihcreol
`' �'�{C'=
—
Limited energy,residential 2
City/metro lic. no.: J 00I Limited energy,non-residential 2
Each manufactured home or modular dwelling
Signature oT superyisini electrics (re uited) bate Service and/or feeder 2
Stp.elect.name(prinU L TT ((-(_ tlt!_ License no: Services or feeders—Installation,
alteration or relocation:
200 amps or less
J
1 201 amps to 400 amps 2
Name(print): xlj -0ti
401 amps to 600 amps 2
Mailing address:
601 amp.to 1000 amps 2
City: State: ZIP: O,er 1000 amps or volts 2
Pltum+: Fax: — E-mail: Recnnnectonly I
Owner installation:The installation is being made on property 1 own 'Temirorsty services or feeders-
which is not intended for sale, lease,rent,or exchange according to Instailsuiun,riterstion,or relocation:
200 amps or ess ,
ORS 447,455,479,670, 701. l _
2U1 amps to 400 amps 2
Owner's si nature: _ __ Date: 401 to 600 nmris
7of
anch circuits-new,alteration,
extension per panel:
Name: _ Fee for branch circuits with nurchase of
Address: service or feeder fee,each branch circuit _ '-
City: — Stale ZIP_ Fee for brnnch circuits without purciiw e
service or feeder fee,first branc't circuit 2
Phnnr rax: [? ttlail: Each additional branch circuit:
Misc.(Service or feeder not lnclud(d):
J Service over 225 arnps-commercial J Health-care facility Each pump or inigation circle 2
U Service over 320 amps-rating of 1 de2 J Hazardous location Each sign or outline lighting 2 family dwellings J Building over 10,000 square feet four or Signal circuit(s)or a limned energy peel
U System over 600 volts nominal more residential units in one structure alteration,or extension*_ 2
U Building over three stories U Feeders,400 amps or more *Description.
U occupant load over 99 persons U Manufactured stroctures or RV park Foch additional Inspection over the allowable In any of the above:
U Egressi'llghtingplan U Other' _v per inspection
Submit__sets of plana wHh any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit carth,please call jurisdiction fw more information Notice: This permit application Permit fee.....................$
U visa U MasterCard expires it'a permit is not obtained Plan review(at _ %) $
Credit cud number / within ISO days after it has been Slate surcharge(8%) ....$
Expires accepted as complete. TOTAL $ _
Name of cu older-ushown on credit cud
Cardholder signature Amount 44r 4615(&Mk,okt
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CITY OF TIGARD 24-Hour
MS
BUILDING Inspection Line1199-4171
39-4175 z— dOC� Z
Business Line: (BU iNSPECTION DIV1310N BuBUP
tieceived ----.--Date Re uested_ 0/(Y — AM_—.____ PM_____ . BUP __-- — ---
Location Sulte MEC
Contact Person _._____— __ _ Ph(----) -------- PLM ---
Contracts _—.._--- 1�Ph( ) _ SWR __ -----._ __--
allLIAG Tenant/Owner _ !:_?�L—'!_�— _ ELC ---
Footing --- ELC -
Foundatiun Access:
Ftg Drain ELR
Crawl Drain - -- SIT _
Slab Inspection Notes: —
Post& Beam -. ---------- -- ..-- --- ..----
Shear Anchors
Ext Sheath/Shea - - -
Int Sheath/Shear
Framing __-
InsulationLOS
_-
Drywall hailing --
Firewall —-- - - - - - - -----
Fire Sprinkler .—
Fire Alarm
Susp'd Ceiling --- -----------
Roof
tBiliOthPART FAIL_G - -
Post& Beam~
Under Slab -- - -- ---- �,
Rough-In
Water Service
Sanitary Sewer
Rain Drains ------ -- -- -- - - -
Catch Basin/Manhole
Storm Drain -
Show3r Pan
Other: -
Final Ile --
PASS PART FAIL
- --------------
MIoCHANICAL - — ------ -- ---... -- - —
Post&Beam
Rough-In - -- - - - -
,ac Line _
Smoke Dampers --
r=mal
PASSPART FAIL -- ------- --_-_ __.-_ -..._---- ------ ------- -----------
ItLEd;�_RIC-AL — — -— --- ---- —
Service
Rough-In ---
UG/Slab
Low Voltage - --- ---- - -- --- - --—-- --- --- --
lre Alarm
Phial L1 Reinspection fee of$_______-_._-required before next inspection, Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
Please call for reinspection RE:.------- �.. �
-- - _ -_. r Unable to inspect -no access
SITE
_-
Fire
cupply Line i �/l /� `"� �/f .` �_
Date ( Inspector Ext
ADA
Approach/Sidewalk -- --_--- -
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
C'IT'Y OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST _'K__60 0 -�,-7
INSPECTION DIVISION Business Line: (503)63E-4171 BUP --
Received — Date Requested—_ D AM___ PM—_-- - BUP
1 ��4 Suite __ MEC --- - - -
Location - -
Contact Person _- _ -�---------- Ph�— ) ___--- - PLM
Contracior -- - --
— Ph SWR
r' Tenant/Owner ____ ______-_ _ -----
BUILDING ELCELC ---------
Footin5
Foundation Access: ELR
Ftq Drain
Crawl Drain SIT ___—.�--------
Slab Inspection Notes:
Post& Beam -_- ---- -- - - _- -- --- ---- - ---
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing _-_—�f.—.------ --------------_-_
Insulation -- -
Drywall Nailing ----j'7-----
Firewall ----
Fire Sprinkler
Fire Alarm --
Susp'd Ceiling
Pool —_
Other:
Final - / -
PASS PART FAIL
PLUMBING --- `--------
Post& Beam
Undei Slab
Rough-In
Water
Houg --
Water Service
Sanitary Sewer -- ,
Rain Drains = — � --
Catch Basin!Manhole --
Storm Drain
Shower Pan - -- �~--
Other.
r#hSS PART
EC NICA%iiL -- - -----
&Beam n _ ----- -
Rough-in 77
Gas Line --•------
Smoke Dampers - -�
(PAO PART FAIL -
CTRICAL --
Service _
Rough-In
UG/Slab
Low Voltage ----- ------^-_--
Fire Alarm
Final CJ Reinspection fee of$_.._--_--_-- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
SASS PART -FAIL_ Unable to inspect-no access
SITE^ F] Please call for reinspection RE: -_ --- _
Fire Supply Line ff
ADAllnspectorExt
Approach/Sidewalk Dot* � -
Other: site. -
-
Final -— DO NOT REMOVE this Inspection record from the job s te.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST =�DC3d C1
INSPECTION DIVISION Business Line: (503)639-4171 �f-
BUP
Received . _�. Date Requested_-- _ __ AM PM_ _ BLIP _--_—
Location _____L ---- - Suite_ �. MEC —__--__
Contact Person ___. — -- Ph( ) —_ _— PLM
Contractor_---------- __-- -_---- Ph(---- ) ---- -- - SWR _—__—
BUILDING Tenant/Owner —___— _— ____--._-- ELC — --
Footing— ELC -_-_-__--
Foundation Access:
Fig Drain ELR -_-
Crawl Drain SIT
Slab Inspection Notes: — --
Post&Beam — -- ----- --- _-- --- _ __ _
Shear Anchors --- —
Ext Sheath/Shear ------ - -- -- -
Int Sheath/Shear
Framing _._--___.--------------------------- --- -------
Insulation
Drywall Nailing ------ - ---- --- -- - -- ---__-�.__-- ---- ----
Firewall
Fire Sprinkler --_--- ---- _..._-------- — ------------------ -
Fire Alarm
Susp'd Ceilirg ---___-------- -- - - _---------------------- �------- ----__------- _ -
Roof
--
Final
PASS PART FAIL_
Post& Beam
Under Slab -
Rough 'r,
Water Service _�_---.------_---
Sanitary Sewer
Rein Drains .T--------
Catch Basin/Manhole
Storm L,rain
Shower Pan
Final ----- _ -------- ---- _----- ---- —.._
PASS PART_ FAIL
M_ECH_ANICA_L
Post& Beam
Rough-In -- - - - -------------- - ------- _ --
Gas Line
Smoke Dampers ------ --- -- - .. __-- _ _-- --- -- -
A PARI' FAILMIE -�.---- _ -- -__----------------_-_ _-_ ----------
----
C7RICAL -__--
Service
Rough-In - --- -
I.ow Voltage
Fire Alarm _
Final I Reinspection fee of$- _-_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
- Unable to ins
31TE r-_� Please call for reinspection RE inspect-no access_ __-_-__ .-__-----__----------...-_-- � P
Fire Supply Line
ADA
-- Ext
Approach/Sidewalk
Dats_ ' ---_- Inspnctor_1_ _. . _____- .._____ _
Other:,-----
Final
ther:,—____Final DO NOT RIMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Lite: (b03)b39�4175 ST
114SPECTION DIVISION Business Line: (503)639-4171 -�-
BUP —__--
Received Z_�7--Date Requested_-_/_Q- _ SAM _—PM_-_____ BUP -- —
Location - -/ ___�/ � --�`- Suite _ _ MEC
Cc ntacy
t Person ___ -__._4Pig ' ?�J S �0 PLM
Contractor _-- _ ___.__. _____-- __---___ _-- Ph SWR _--- -
BUILDING Tenant/Owner ELC -
FootingT ELC _.
Foundation
Ftg Drain Access: ELR Q Z�
Crawl Drain -�-
Slab Inspection Notes: SIT
Pn.t&Beam -- --- -- ------- - _ __ _
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing ------ ---- -- - --
insulation
Drywall Nailing - — -- - -- —-- -- �_-- --
Firewall
Fare Sprinkler -- -- - ---- --"
Fire Alarm
Susp'd Ceiling - --- -...- - — ----- - -
Roof
---
Final --- -- -- -
PASS PARI" FAIL
PLUMBIN_G_
Post&Beam
Under Slab - -- -- - -- - -- - _ -- - -_--------- --
Rough-In
Water Service ----------- --._ _ --- -- -- --- -
Sanitary Sewer
Rain Drains - --- ---- - --_v-_-__-- - ___----
C-rtch Resin/Manhole
Storm Orain ------- --- - -- -
Shower Pan
Other: ------- ------- -- --- - ----- - --__. _--------- - --..__.�
- --
Final
PASS PART FAIL - -
MECHANICAL --...-
Post& Beam
Hough-In -- -- -- -- ---- - ---
Gas Line
Smoke Dampers -- -------- - -- --- ------------ ------
Final
PASS PART FAIL _--- -- - - -- - - "- -
CT
Rough-In --_-- -- -- _ - ---- _ --- -
UG/Slab
ow Volta
YASS'
arm 1
PART FAIL --J Reinspection fee of�_�__ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
-- Please call'ror reinspection RE:__ __-_-____.___ _ __ �_T j Unable to inspect-no access
Fire Supply Line
ADA - /f
t
I
Date _ -___ nspecor `�f _�^ y'L
Approach/Sidewalk -_4 Y - ---- Ext
Other:
Final DIO NOT REMOVE this inspection record from the fob site.
PASS PART FAIL
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