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13295 SW KINGSTON PLACE w N RD N N C 7 N O iy n �1 9 I I i 13295 SW Kingston Place .rr.r.�rrrr MASTE ERMIT CITY OF TIGARD PERMIT - MST2 HERMIT#: MST2UO2-00069 DEVELOPMENT SERVICES DATE ISSUED: 3/6/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRES_: 13295 SW KINGSTON PL PARCEL: 2S104DA 19400 SUBDIVISION: QUAIL HOLLOW - SOUTH ZONING: R-4.5 BLOCK: LOT: 020 JURISDICTION: -TIG REMARKS: SF rowhouse,Unit#20,Rldg 3, AS plan BUILDING REISSUE: STORIES. i _FLOOR AREAS REQUIRED SETBACKS__ REQUIRED CLASS Or WORK: NEW HEIGHT: FIRST: 11 if BASEMENT: if LEFT: SMOKE DETECTORS: Y TYPE OF USE: SFA FLOOR LOAD: 5u SECOND: 733 of GARAGE: 'Al sf FRONT: PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS, I THIRD 733 of RIGHT. VALUE- ,IC1 h0 OCCUPANCY GRP: R3 BORM. 2 BATk TOTAL. 1.638 e1 REAR. PLUMBING -� — SINKS: i (NATER CLOSETS: 2 WASHING MACH: I LAUNDRY TRAYS: RAIL'DRAIN: TRAPS: LAVATORIE,• DISHWASHFRS: I FLOOR DRAINS, SEWER LINES: SF RAIN DRAINS: CATCH BASINS: T1M'�,tijWERS: GARBAGE DISP: I WATER HEATERS: I WATER LINES: BCKFLw PR"VNTR GREASE TRAPS: OTHER FIXTURES: MECHANICAL I FUEL TYPES _ FURN i 100K: BOIL/Cr'^ 3HP-. VENT FANS. 7 CLOTHES DRYER 1 LPG FURN-100K UNIT HEATERS: HOODS I OTHER UNITS: MAX INP: bt FLOOR PURNANCES. VENTS 1 WOODS10'0 S: GAS OUTI ETS: I _ELECTRICAL RESIDENTIAL lIN1T __SERVICE FEF-DER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANr:OUS ADD'L INSPECTIONS_ 1000 SF OR LESS 1 0 200 amp: 1 0 - 200 amp. WISVC OF rn R: PUMPIIRRIGATION'. PER INSPECTION. EA ADD'L 500SF: 1 701 400 amp. 201 400 amp: 1st WIO SVC.F DR- SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY. 4,01 600 anlp' 401 600 amp. F-AADCL BR Cli'. SIGNALIPAKF' IN PLANT. MANU HMISVCIFDR: 861 1000 amp. 801 ramps-t000v MINOR LABEL loon.amplvoll PLAN REVIEW SECTION Reconnect only: azo RES UNITS: SVC/FDR-225 A: >600 V NOMINAL: CLS AREAlSPC OCD. ELECTRICAL-RESTRICTED ENERGY ._ SF RESIDENTIAL B COMMERCIAL AUDIO R STEREO: VACUUM SYSTEM: AUDIO R STEREO: FIRE ALARM: INTERCOMIPAGING. OUTDOOR LNDSC LT. BURGLAR ALARM OTH: BOILER: HVAC: LANDSCAPEIiRRIG. PROTECTIVE SIGNL GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC. DATA/TELE COMM NURSE CALLS: TOTAL N SYSTEMS TOTAL FEES: $ 5,500.08 Owner: Contractor. This permit is suhle(l to the rngulations contained in the BROWNSTONE QUAIL HOLLOW LLC BROWNST(INE HOMES, LLC Tigard Municipal Lode. State of OR Specialty Codes and 12670 SW 68'1'H PKWY STE 200 12670 SW F3TH PK'NY all other applicable laws All work will be done In PORTLAND OR 97223 PORTLANr),OR 97223 accordance with approved plans This permit will expire 0 work is not started with n 180 days of issuance,or if the work is suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Phone: 503-598-7565Phone: 503-598-7565 Oregon Utility Notificatior,Center Those rules are set forth in")AR 952.001-0010 through 952-001-0080 Yoll Rep N• LIC l�4(i'7 may ubtaln copies of these rules or direct questions to OUNC by calling(503)246-19E7 REQUIRED INSPECTIONS r- I osion Control Insp 8, Plm/Underfloor Mbr.hanical Insp Shear Wall Insp Smoke Detector Final Inspection sewer Inspection Slab Insp Pluming Top Out Exterior Sheathing Ins{ Electrical Final Footing Insp Plm/undslb Insp Framing:nsp Firewall Insp Plumb Final Foundation insp Electrical Service Gas Line Insp Gyp Board Insp Mechanical Final Wlr Proofing Bsm't Wa Electrical Rough-in Insulation Insp Water Line Insp Building Final ssued By : r� l` �t �� - �r�r_� Permittee Signature : Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGARD _EWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT*: swR2oo2-00044 DATE ISSUED: 3/6/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS; 13295 SW KINGSTON PL PARCEL: 2S 104DA-19400 SUBDIVISION: Q('All- I I0LL0kV-SOUTH ZONING: It-4 BLOCK: LOT: 020 JURISDICTION: I I(i TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE Or USE: SFA NO. OF BUILDINGS: INSTALL. rYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for ne;/ SF rowhouse. Owner: -- - __ FEES BROWNSTONE QUAIL_ HOLLOt,�V LLC Description _ Date Amount 12670 SW 681 H PKWY STE 200 PORTLAND, OR 97223 1SWtISAj Swr Connect 3/5/03 $2,300.00- 1SWUSAj Swr Connect 3/5/03 $0.00 Phone: 503-598-7565 1SWINS}1] Swr Inspect 3/5/0:3 $35.00 ISWINSP] Swr Inspect 3/5/03 $0.00 Contractor: --- — - ---- 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 vjill be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals If the sewer is riot located at the measuremert 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 requ;res 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) 246-9)699. Issued by: Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next lousiness day Building Permit Application "elm City of Tigarc' Date receierd:�✓'>✓�o� Permitno.:�;��o .e0440 � — — Address: 13125 SW IlAll 1'roject/appl.no.: Expire date: City of'rigard -- REC EIVED Phone: (503) 639-4171 Date',sued: - y:k SIJ Receiptno.: Fax: (503) 598-1960 Case file no.: Payment type. Land use approval: 1&2 family:Simple Complex: 1 U I & 2 family dwelling or accessory U Commercial/industrial U Muln-family U New amstruction U Demolition U Addition/alleratioii/replacement U Tenant improvement U Fret sprinkler/alarnt U Other:I JOB SITE INFOR4ATION Job address: /' ' _ Bld* no.: Suite no.: _ .- S l i� !" �- L 6 - L �Q Block: Subdivision: jo ,ul4 � f:!Z1Gc.c'Ic% - S'rcr ITax mapii,x lot/account Project name: - -- — - - - Description and location of work on premises/srx;cial conditions: OWNER FOR SPEXIAL INFORNIATION, Name: Su` (1S Arn t"i, s , Elm (Floodplain,Aepticqupacity,solar,etc.) Mailing address: LZ _ 1 do 2 family dwehirrg: City: , .� �-cti s Staw:(n)R JZIR_-tqr) - Valuation of work ........... $ Pl►on, Fax:62 p f:-mail: No.of bedrooms/baths................................. -�--- Owner., presentative: ' Total number of floors................................. - Phone: - ,g Fax: E-mail: New dwelling area(sq. ft.) Garagc/carport area(sq. ft.)......................... --- Name: f'6 Sc }.� V Covered porch area(sq. ft.) ......................... �_ _ - Mailing address: I Deck area(sq. ft.) ........................................ structure area(sq.ft.)......................... Phone: 6 Fax: F-mail: Commercial/industrial/multi-family: 1 Valuation of work........................................ $ Business name �1 Existing bldg.area(sq. ft.) .............. ........... _ .4� 4 �_ -- - �'C� � New bldg.arca(sq. ft.) ................................ Address: 1 � ` Number of stories City: �- n�� _ Stalcrp� Zl ........................................ —____--- Typeof construction......................I............. Phonci_ � �S Fax'o:2C� .c -mail: ----- - Occupancy group(s): Existing: CCB no.: �4 t t -- - ---- New: ----- _ City/metro lic.no.: — Notice:All contractors and subcontractors are required to be licensed with the Oregon Constriction Contractors Board under Name: ( 6 (.o provisions of URS 701 and may be required to be licensed in the• -- - jurisdiction whero work is being performed. If the applicant is Address:(�1 1t1 rye. -S c... . Oma( State LIP: - exempt from licensing,the following reason applies: Contact person-�N � j Plan no.: Phone: ".401 X: E-mail: Nam_L.- r��- }_J 17ontact person: ��— Fees due upon application ........................... $._-- Address: 69 tom) �, c�� Date received: r 4 -- City: cti ��-- _ tate:Q t?11��3 Amount received ......................................... -- Pho:re Fax: v-�E-mail:__ Pleasc refer to fee schedule. - hereby certify I have read and examined this applicat on and the f Not all jurisdictions accco m-dit cud.,pteare can jurisdiction rur nui r infmtutioo attached checklist. All provisions of laws and ordinances governing this d visa O Mastetcard work will be complier(rit�,�wlheduie�t!qNcd or 7(,t. Cwt card number:,-__ .-__._ / / raptraAuthorized sign cure: `'= - Name d c lda a shown ria crrt;t card` -Print natt(c: - --- - _-- _$ Cardholder slanuure 11 Amaral Notice:This permit application expires if a permit is not obtained within 180 days after it has been acctpttd as complete. 4404611(61MCOM) Plumbing Permit Application omet°eCived: Permit Do.: City of Tigard Address" 13125 SW Hall Blvd,Tigard,OP 97223 Sewerpermit no.: Building permit no.: City of Tigard Phone: (503) 6394171 Project/appl.no.: Exoiredate• Fax: (503)598-1960 Date issued: By _Titoceipr Land use approval: (ase rile Payment type: O 1 &2 family dwelling or accessory 0 Cotnmercial/industrial O Multi-family O Tenant improvement 0 New construction ❑Addition/alteraticn/rrplacemtnt 0 Food service 0 Other:-�- Job address: 1322-5-�1s $W I<- �,. �e y L a_c Description Qty. Fee ea. Tota] Bldg.no.: _ Suite _ -� 1-and 2-faatfly dneUioga y: (indud-%100 R.for each utility connection) Tax map/tax lot/accot nt no.: --_--- SFR(')bath Lot: n Block: _ Subdivision: SFR(2)bath - - "lmjcct name: _ _ SFR(7)bath 'ity/county: ZIP: - Eacn additional bath/kitchen Description and location of work on premises: Siteoutles: Catch basin/area drain _ -"- Est.daDrywells/leach line/trench drain _ date of completion/inspection: drain(no. lin.ft.) Manufactured home utilities - Manholes Wolcott 1'lumhillg _Rain drain connector PO Dox 2007 Sanitary sewer(no. lin. ft.) Gresham 01Z 97030-0594 Storm sewer(no.lin.ft.) - -_- 503-667-1781 Water service(no.lin.ft.) _ CCB-23847 I'LM #:26-208PB Fixture or Nem: r Contractor's representative,signature: - _--- Absorption valve - -- - - ------ Back flowprreventer - Print name: Date: Backwater valve - - Basins/lavatory — Name: Clothes washer - - --- -- - - Dishwasher Address: Chinking fountain(s) City: _ Stalk: FLIP: -_ _ Ejectors/sump --- - --- Phone: - Fax: &mail: Expansion tank ---_ - FFixturdsewer cap -- _ Name(print): floor drains/floor cinks/hub Mailing address: -- — - Garbage disposal T Hose bibb City: - �-�-� Ice maker Phone: . 'Lax E-mail: Interco odgrrase trap IOwner installation/residentW maintenance only: The actual installation Primers)wil ly me or the.maintenance and repair made by my regular Roof drain(commercial) x property 1 own as per ORS Chapter 447. Sink(s),basin(s),lays(s) _ure:_ Date: Sump - - - Tubs/shower/shower pan _Name: Urinal - - --- ---- -- -- Water closet Address: _ Water heater City: State: ZIP: CKher. - Phone:-- _ �Fax� -mail: --- - Total - --- - -- Minimum fee....... ...$ _ Na all*is&:Uami WAVO C"&I C-Vdk please Call jtKWAe an to man kfa;;A m- Notice:This permit application - O Vin Q MasterCard expires if a permit is nut obtained Plan review(al - CM&a.d e mober._.---_------. -- within 180 days after it has been State surcharge(8%) ....$ _�—Nwe d eerdho4lcr d sdoaa a creda eatd accepted as complete. TOTAL .......................$ -_�-- --——C d+dRnt — __ Aens1 416-616(WYMM) mechmcal'Permit Application i_if'j&AM Date received: Permit Clo.: City of Tigard Project/appl.no.: Expire date: -- L'iryoJTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: Ity: Receiptno.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: Building permit no.: _ OF PERMIT A U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Addition/alteration/replacernent U Other. _-- 1 1 ' 1 1 1SCHEDULE Job address:l jt_5- W -��_ �, -� i c Indicate equipment quantities in boxes below.lndica.t the doll.r Bler • •,.: - - I Swte no.: — value of all mechanical materials,equipment,labor,overhead, 711 map/tax IoUaccount no.: pro6l. Value$ i3lock _ Subdivision: -- 'See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/c:ounty: I 1ULE Description and loc..,on of work on premises: - t t 1 Fee(ea.) Total EsL date of compledon/inspection: motion Rps onlyl Res.only Tenant improvement or change of use: -nVAT.- Is existing space heated or conditions.?U Yes U No Air handling unit - CFM — Is existingspace insulated?U Yes U No Air cons hionning(jre plan requiiia) p Alteration of exist kg 11 VAC Fyrtem CONTRACII-01111 toile co�r., -- - ---- State boiler permit no.: J EROME EI-EC•I k l l HP _—Tons__BTU/H PO BOX 751 irclstrlo a amper ke3etecwrs —_ HILLSBOROOR 97123 `Tnstalrepececa-nac-- u-mcr�fiT1 -503-648-5144 Including ductworldvent linet U Yes U No CCB: 3 3051 ELC: 34-1190 SUP: 28775 nail,or floor relocate esters-auspenr wall,or(lour nxwnted Name,(please print): Vent for a 1 lance- oo er 1T&n_Tiirnace --- Absorptfon:nits____- BTU/II Name: Chillers-_ _--- Hp --_ Address: ------ --- '- Co. rrssors_ _ HP anmeM last wW ventilation: City_ - Stare: IIP: Appliance vent Phone: Fax: F.-an til: yaZrhaust --` 1 s^Iyy1 e u Iu,,es,Ut heiWammat - --t hood fire suppression system Name: _ Exhaust fan with single duct(bath fans) Mailing address: Exhaust system apartomTir�nr or -TW-- p p '�als[r��trdup t on 1T o outlets) City: _ Stale: _ ZIP:- _- T LPG -- NG t--)it Phone: - Fax: L-mail: ue ring eac ad nal over .outlets --- - roceasplp (sc emit-lurequt ) - Narne: Number of outlets __�.-__-__---------------__-_-- ter ■pp aT-rcc or_egalpmmt:-- Address:-----------------_ �� _ _ Decorative fireplace City: —.--- -- J''tatr: —�7,I1'_-- art-tYPe — Phone: Fax: E-mail: stovelliclietsiovc A pplicant's signature: Date: : --- — (print): --___—`_--__�_--_—_— — ----- —. —1 run Nal dl hri�dictiaro.ceepr crrdir r.�rds, roe all htriidicfian GKe Wrm aatian Notice:71115 permit application 'etmtt fee.....••••••••••••••• ---�_-- a YIL U MeorrCarcr expirr<if a permit is not obtained Minimum fee................$ _ c:Tdr c.d aumber:------ ---- --- -..1--1Ilan review(at _.%) $ t,x am within 180 days after it has been r State surrttarge(1396)....$ ted as complete. -- .-" Named u m aeMl cane---- _ �P P TOTAL $ -•—`--ca�mK+laer a�nu�__—__- —��r ---- — — 440-4617(60Y)DW �alaa Electrical Permit Application �� + Datcreceived: Permit no.: City o`f Tigard app I.no.: Expire date: Cir o r Address: 11125 SW Hall Blvd,Tigard,OR 9- -- �-- } f Tigard [rate. usd: By:_ -;x .i t no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: _ TVVE OF U I &2 family dwelling cr accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Addition/alteiatiori/replacement U Outer: _ J Partial JOB Sill.INFOOMATION Joh address: l S - Pim Bldg. no.: Suite no.: Tax map/tax iot/account no.: Block: Su ivision: - --- Project name: Description and location of wo,k on prems,.* Estimated date of completiotJins coon: CONI IIAV(011 APPLICATION FEE SCIMDULE Job do: Fee Max Description Qty. (ea.) Total no.ins Stl'calnlutc Flectri.: New re er,rial sin korsouni-f •dlyper D13A I aValley Corporation dnell;oarolt.loclndesatb0tedRarage- 6025 East 18`x'Sl SrxviceYsdaded: Vancouver WA 98661 1000sq It orless 4 360.991-5090 Each additional 500 sq ft.or porus.-thereof ('Cil:1 16514 TLC#: 34-432C SUP#: Limited energy.residential _ 2 _ Limited energy,nnn-resulentral 2 _ Each ma,wlaciured tiome or modular dwelling -' Signature of supervising electrician(required) Date - Service and/or feeder 2 Sup elect name(pont); License no Services orferdrrv-installation, lteration or relocation: 200 amps or less 2 Name(print): 201 amps to 400 amps v —� 2 —7-.'Reconnect 101 amps o 6(X1 amps 2 Mailing as tress, WIamps to 1000 ampsCity: Sta(C: ZIP: ,ver I(XlOampsof volts 2 Phone: fax: E-mail: only, Owner installation:The installation is heing made on propeny I own 7empnraryservices orfeeders- which is not intended for sale,lease,rent,or exchange according to AuUllation,sheration,orrelocatiom ORS 447,455,479,670,701. 2(111 amps or less 2 201 amps to 400 amps 2 Owner's signature: Datc: -- 401 tv 600 s- ----__. 2 11011-1 N Branch eirmitr-PC",alter•alIon, or extemloa per panel: _Name: -^ _ A Fee for litanch rucurls with purchase of Address: _ _ _ s<r,ice or feeder fee,each branch circuit _ 2 City: _ Stale: ZIP; H. Fox for branch circuits without purchase Phone: L-ax: of service or feeder fee,first branch circuit 2 b-mall: Ear additional branch circuit --- - Misc.(Service or freder not Included): U Service over 225 amps-rx,mmercial U Hcalthrare facility Foch pump or irrigation cinae 2 U Service over 320 amps rating of 1&2 U Hazardous location FAch Sig nortwtfine hghhng family dwellings U Building over ROW situate feet four or Signal ciicuitlsl ar a limited energy parer, U System over 600 volts nominal more msidential units in one structure alteration,or extension• 2 U Bu ildi rig over three stories 0 Feeders.400 amps or more 'Description - U(kcupant load over 99 persons U Manufactured structures or RV park Fich additie-.rl(nspMfarr over theallnwabk In any of die above: U Egress/lightingplan ](hh•r. perie;pertion -_ r� —� Submit___-. sets of plans with any of the above. imesugarinnfa_ -- 'Ihe above Pre not applicable to Temporary construction service. t7thcr Na all p,nsdicaaro►-sept credit cards,pirau call jurisdiction for more it f(r;i tiaa Notice:This permit application Permit fee.....................$ U Visa U MrsterCard expires if a permit is not obtained Platt review(al — %) $ ('red.,card numbers—__ _— ._ -._��_ within I80 days titter it has been State surcharge(8%)....$ Fxpirer accepted as complete. TOTAL . $ - Name of crdhalder u shown on credit card Cardboider signature -- — Amount - 440.46I 5 1W1C'Ohl) CITY OF TIGARD 13125 S.W. HALL. BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE DP%1ID JEROME ELECTRIC PO BOX 751 HILLSBORO, OR 97123 Electrical Signature Form Permit #: MST2002-00069 Date Issued: 316/03 Pa,cel: 2S104DA-19400 Site Address: 13295 SW KINGSTON PL Subdivision: QUAIL HOLLOW - SOUTH Block: Lot: 020 Jurisdiction: TIG Zoning: R-4.5 Remarks: SF rowhouse,Unit #20,Bldg 3, AS plan Your company has been indicated as the electrical contractor for the permit indicated above. In order nor 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 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 PORTLAND, OR 97223 HILLSBORO, OR 97123 Phone #: 503-598-7565 Phone #: 648-5144 Req #: LIC 30051 Slip 28775 ELE i4-119C AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Supervising Electrician It you have any questions, please call 503.718.2433. CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 iiviPORTANT PERMIT NOTICE WO! .COTT PLUMBING CONTRACTORS PO 1 3OX 2007 GRESHAM, OR 97030 Plumbing Signature Form Permit #: MST2002-00069 Date Issued: 316103 Parcel: 2S104DA-19400 Site Address: 13295 SW KINGSTON PL Subdivision. QUAIL HOLLOW - SOUTH Block: Lot: 020 Jurisdiction: TIG Zoning: R-4.5 Remarks: SF rowhouse,Unit #20,Bldg 3, AS plan 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: Building Division. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CON-rRACTOR: BROWNSTONE QUAIL_ HOLLOW LLC WOLCOTT PLUMBING CONTRACTOR; 12670 S`,'V 68TH PKWY STE 200 PO BOX 2007 PORTLAND, OR 97223 GRESHAM, OR 97030 Phone #: 503-598-7565 Phone #: 667-1781 Reg #: LIC 23847 PLM 26-208PB AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature o i orize Plumber If you have any questions, please call 503.718.2433. ELECTRICAL MIT / CITY OF TIGARD RESTRICTEDE ERG —^ RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2003-00165 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 6/17/03 SITE ADDRESS: 13295 SW KINGSTON PL PARCEL: 2S104DA-19400 SUBDIVISION: QUAIL HOLLOW- SOUTH ZONIING: R-4.5 BLOCK: LOT: 020 JURISDICTION: TIG Proiect Description: All encompassing low voltage. A. RESIDENTIAL _ B.COMMERCIAL AUDIO & STEREO: X AUDIO 9, STEREO: INTERCOM & PAGING: BURGLAR ALARM: X BOILER: 1_ANDSCAPE(IRRIGAT: GARAGE OPENER: X CLOCK: MEDICAL: HVAC: X DATAITELE COMM: NURSE CALLS: VACUUM SYSTEM: X FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: ALL ENCOMP X HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: C i HER: _ TOTAL_# OF SYSTEMS: Owner Contractor: BROWNSTONE QUAIL HOLLOW LLC AZIMUTH COMMUNICATIONS INC 12.670 SW 68TH PKWY STE 200 P.O. BOX 508 PORTLAND, OR 97223 WILSONVILLE, OR 97070 Phone: S03_598-7565 Phone: 503-639-0110 Reg #: ELE 36-94('LE SUP 2312LF_A LIC 145825 FEES Required Inspections Description Date Amount _ IFleet'I Final 1111,RNITj E'LR Permit 6/17103 $75.00 JAN 18",,State Tar 6/17/03 $6.00 Tota! $81.00 This Permit is issued subject to the r9gulations 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 permit 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 rules adopted by the Oregon Utility Notification Center. Those nines are set forth in OAR 952-001-0010 lhrouc / f" Issued by �,1 �.�,,--t�. ." ,! �,� tri, .(; Permittee Signature 'k)— C,c-fG,L-L.; OWNER INSTALLATION ONLY The installatioi is being maL:e on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATILA ONLY SIGNATURE OF SUPR. ELEC'N DATE: LICENSE NO: Call 639-4175 by 7:00 P.M. fog an Inspection needed the next business day Electrical Permit Application 7Dateissued: (C-�J-p7,eyr mit no.: _ �� City of Tigard o.: pire date City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 : Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 1Case file no.: Payment type: Land LlW approval: IEW�W PERMIT =AdNew ily dwelling or accessory O Commercial/industrial J Multi-family 0 Tenant improvement truction ❑Additionlalteratitmheplacenn ni J Uther: U Partial 5V INIbRMATION Job address: 132—q 5 S 1j. flL 13ldg. no.: Suite no.: Tax map/tax lin/acciutnt no_ Lot: tJ 1 Block: Subdivision: Project name: 0."1 crtr" Description and loca ion of work on premises- i✓r(•)iCE 0t D4Z-L, _ Estimated date of completion/inspection: 1 Job no: Descripliun Ql'. (ea.) I I.,tal 1 m, 's BltiltllSSlaTC ^^iiMtA p _ No"rsidential-single or multi-'iarnllyper Address: ' cj �s nj't r _ lr}(1 dinellingunk,Includes altachetl garage. City: Sate ) ZIP: < Service included: Phone: ri t �, Fax:4tyy-�tt 15 Email: 1000 sq ft.or less _ 4 Each additional S00 sq ft.or portion thereof CCB no.: 1 ►�5 g Elec.bus. Ile.no: r Ct r Limited energy,residential 2 City/metrolic.no.: 6 S'119 Limited energy,non•residenlial 03 Each manufactured home or modular dwelling Signature of supervis6&�i (required) __ Date Service and/or feeder Su,.ele�namerinQI License no: 23 12 -"Z Services orfeeders—installation, alteration or relocation: 200 amps or less 201 amps to 400 amps Name (print); —_ 2 401 amps to 600 an ps Mailing address: 601 amps to 1000 ataps City: Stale: Z1Y: Over 1000 amps or vults 2 f tnntc: Fax: �I? mail: Reconnect only I Otsnrr installation:The installation is being made on property i own Temporary services or feeders- whr h is not intended for sale, lease,rent,or exchange according to Installation,alteration,orrelocation: URS 447,455,479,670,701. 200.ntps or less 201.nips to 400 amps ()tuner's signature: Dale: 401 to bon allies ' Branch cirruils•tie",alteration, or extension per panel Nil 1tte: A Fee for branch circuits .vith purchase of Add fess 7service or feeder fee,ea:h branch circuit 2 City: Slap: 'LIP: _ e Fee for brunch cucuus without purchase Phony — Fa---- of service or feeder fee first branch circuit : E•nutil. Each additional branch circum. Mloc.(Se rviceorfeeder not Included): U Service over 225 nrnps-cummerct.l U Hcnith-carefacihty Each um or irrigation circle 2 _ J Service over 320 nmps-rating of 1&2 U Ha2afdous location Each sign or outline lighting 2 'anulydwellings U Building over 10,000 square feet four or Signal circuit(s)or a linuted energy panel. U ystern over 6(111 volts nominal more residential units in one structure alteration,or extension" _ 2 U Building over three stories U Feeders,400 amps or more •Description' J o"upant load over 49 persons 0 Manufactured structures or R v park Each additional Inspection over the allowable In any of file abote: J figres lhghungplat ❑Other — 1,:111s ectioll �— ,submit cels of pians with any of Ilse above. _Investigation fee '11 fie above are not applicable to temporary construction se-vice. Other j No all junsdicuum se accept credit cards,pleacull jurisdiction lot more Information Notice:This permit application Permit fat ..................... 0 visit U MasterCard expires 11'a pennit i.,not obtained Plan review(at cretin cord number _ —LAl within I80 days after it has been State surcharge(8%) ....$ r.xpues accepted as complete. mortar. .... ..................$ — Name of cu o r u shown nn credit cud -- — — Cudholder signature Amoum 4404bls iMSUCU\,i CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)619-4171 ! BUP –. Received ___ - Date Requested `7 '" _ AM_—_ PM_-_._.____._ BLIP _ Location __..._..-- .3 �`1 MEC -- Contact Person __ _—__ Ph PLM Contractor -_-_ __ __ ___.—__ Ph SWR BUILDING Tenant/Owner ELC Footing Foundation � ELC — Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes. SIT ______ Post& Beam Shear Anchors - ---- ----- - Ext Sheath/Shear Int Sheath/Shear Framing -- - -- -- -- - —...----- --- Insulation Drywall N.'.:'ng --_- - — -- Fire Sprinkler --- Fire Alarm Susp'd Ceiling - -- - - - - ------ -- ------- Roof Other: - - Final PASS PART FAIL Post f Beam Under Slab Rough-In Water Service -- - - Sanitary Sewer -lain Drains _ - - - - -- - - - - -- - Catch Basin/Manhole Storm Drain - - --- ------ - - Shower Pan Other: F. I• - PA PART FAIL_ _C_HANICA_L__ Post& Beam Rough-In Gas Line Smoke Dampe,s Final PASS PARI FAIL -- ELECTRICAL Service ----- - Rough-In UG/Slab ---- ---- -- -------- - Low Voltage Fire Alarm Final n Reinspection fee of$_ required before next inspection. Pay at City Hall, 13126 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RL:__ _-___ -_ LJ Unable to inspect--no access SITE - Fire Supply Line ADA I Date ,� Inspector ) � __ Ext Approach/Sidewalk -. Other- Final ther -� -� Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILD!NG Inspection Line: (503)639-4175 ?_QQQ INSPECTION DIVISION Business Line: (503)639-4171 BLIP --_ �/ `� C! Received ______—_ Date 1Requested�_.� -�____ AM__—�_ PM_ __ BLIP Location I 2�� 6,1�X C�1-- Suite MEC Contact Person __ -_ _____ Ph PLM ' Contracto _ __ Ph( ) __...—__ ___ _ SWR UILDIN Tenant/Owner _ —_ _ ELG Footing ---- �— ELG Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam ------ Shear Anchors - Ext Sheath/Shear Int Sheath/Shear ' f r <- Framing l: --- Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm - • Susp'd Ceiling — Root Other: -it 1 ASS/PART FAIL _PWRIBING _ Post& Beam Under Slab 2Roug Wate Se c Water Service - Sanitary Sewer ZA Rain Drains - — Catch Basin/Manhole J C Storm Drain ��''�� `� �'� --�✓�`'' Shower Pan �� 3 0'�► ~ Other: Final P S__ ART FAIL ECHA "`... .._._.._-- -- Post&Beam Rough-In — Gas Line Dampers -- --— Fin &ART FAILift _ ----_—_ .— -- ------- � _ _ AL Service _ ___. _. — -- —• -- -- ---- Rough-In UG/Slab Low Voltage Fire Alarm — Final Reinspection fee of$_ .._.—required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE:__ — Unable to inspect-no access Fire Supply Lire ADA Dat• ( G Inspector Approach/Sidewalk -�✓ __ Other. I-n'll DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour , BUILDING Inspection Line, (503)639.4175 INSPECTION DIVISION Business Line: (503)639-4171 MST --�— BUP Received � — Date Requested._ _ Z �'__ Ah_---_ PM BUP Location13�`'� � J Suite _ MEC Contact Person Ph PLM Contractor _ Ph( ) SWR —_ BUILDING — Tenant/Owner _ `J"- S T��Y � ELC _--_ Footing Foundation ELC Fig Drain ACC@SS: - Crawl Drain ELR — Slab Inspection Notes: SITV— Post& Beam Shear Anchors ---_ _...- ---.----_---- __- _ - ---- Ext Sheath/Shear Int Sheath/Shear - Framing _ - ----- _- - ----- _ Insulation - Drywall Nailing Firewall Fire Sprinkler - Fire Alarm Susp'i Ceiling - - __ ---------------- - Root Other: _ - — _ ---- - ---� - -- ---- _- - Final PASS PART FAIL _--- --- --- - - - PLUMBING _ ___ Post& Beam - Under Slab Rough-In Water Service ---_- _- --__— Sanitary Sewer Rain Drains Catch Basin/Manhole Ston,, Drain -,- --- - -- - - - — --. ShowFr Pan Other: -- --- --- -- .--- - -..-_.--__-- --- Final __ - --- PASS PART FAIL -- --__ . -- -------_ MFCHANICAL Post& Beam - ---- - Rough-In _ -- ------- ----- Gas Line Smoke Dampers Final PASS PART FAIL - __1` -- ----- - _ -ELECTRICAL �.r Service— ' --�--- ------- - Rough-In UG/Slab --- ---^_ rr-_ ?_73--=-Q n G n Fire Alarm -- Reinspection fee of�___-____required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ASS PART FAIL pect Unable to ins E �� Please call for reinspection RE:--. - _ �� -no access -- - - Fire Supply Line ADA , •2 _ 0 ,7 Approach/Sidewalk Date - --- ------__ Inspector _.�", t2_� l - Ext ____ O,hur: -- Final DO NOT REMOVE thls Inspection record from the job site. PASS PART FAIL CITY Of TIOARD Residential Certificate of Occupancy v ,�'��U d 1 i Permit No.. Addre��: Owner/Contractor: —_ —_.._------ --- Date of Final Inspectic 6 Inspector: ` — --- `Phis structure has been found to i.c in substantial compliance with the provisions of the State of Oregon One& Two Family Dwelling Specialty Code and is hereby approved for occupancy. _ — -