13315 SW KINGSTON PLACE I
W
w
to
N
X
C
m
n
cfl
I
i
1
i
13315 SW Kingston Place
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4176 MST _.—clo 0
INSPECTION DIVISION Business Line: (503)639-4171
-7 - 31 BUP
Received
Date Requested - AM----- PM BUP
Location am_ Suite MEC
Contact Person Ph !P PLM
Ph ........ SWR
Tenant/Owner ELC
Footing
Foundation Access: ELC
Fig Drain
Crawl Drain ELF! ------
Slab Inspection Notes- SIT
Post & pt,,M
Shur Anchors
Ext Sheath/Shear
Int Sheath/Sheaf
Framing
Insulaticri .3pl-t
L
1A,1
Drywall Nailirg
Firewall
Piro Sprinklei
Fire Alarm
Susp'd Ceiling
Roof
Other:
3"
TA- 90s's" PART FAIL
Post 8 Beam
A
Under Slab
Rough-In
Water Servic3
Sanitary Sewer
Rain Drains
Catch Basin/MFl ihole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
NI
Post& Beam
Rough-In
.3as Line
Sm2ke Dampers
inal � a y JWY'q
S -) PART FAIL
1TRICAL
Service
Rough-In
UG/SIP,b
Low Voltage
Fire Alarm
Final Reinspection tee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
Please call for reinspection RE Unable to Inspect--no access
Fire Supply Line
ADA
Appr)ach,'Sidewalk Do% Inspoetor EM
Othe
Final DO NOT REMOVE this Inspection record from the job site.
PAS' PART FAIL
CITY OF TIGARC 24-Hour {
BUILDING Inspection Line: k-.3)635-4175 a_6o ciao
INSPECTION DIVISION Business Line: (503)639-4171 MST
tie)", ) SUP
Received �__ _Date Requested l '- - _.- AM-- -Ll--- PM _- _ BUP
Lavation _ ___ _^_ ____Suite - MEC
___
Contact Person --— ----------------__--_ - Ph PLM
Contractc, -..—.- -- -- -- --- ---- P.1( ) ---- - -- SWR ----..
BUILDING Tenal UOwner - _ _ ELC
Footing ELC
Foundation Access: �— -"-
Ftg Drain ELR
Crawl Drain
Slab Inspection Note. SIT
Post$Beam
Shear Anchors --- --
Ext Sheath/Shear
Int Sheath/Shear --
Framing -- - -- -
Insulation
Drywall Nailing - -- --- - ----- -------... _ _ _
Firewall
Fire Sprinkler -
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final ---"�
PASS- PART FAIL
PLUMBING
Post&Beam
Under Slab
Rough-In i - ---
Water Service
Sanitary Sewer
Rain Dra6oe _ .----
Catch Barin/Manhole
Storm Drain
ShowG,Pan
Other.
Fina;
PASS PART FAIL -- M -- — --- --
MEZHANICAL
Post$ Beam
Rough-In
Gas Line
Smoke Dampers _-
Final
PASS PART FAIL - _ - - - -- -- -
ELEGTRICAL
_s
Service -
Rough-In -
UG/Slab -
Fire Alarm
[ Reinspectlon fee of$ required before next inspection. Pay at City Hall, 13125 SW H01 Biwl.
PART FAIL
SITE [ [ Please call for reinspection RE-.,-- F-] Unable to Insp act-no access
Fire Supply Line
ADA
A roach/Sidewalk e = - Inspecto-
PPDat ------�-
Other:
Final DO NOT REMOVE this Inspractlon record from the Job site.
PASS PART FAIL
CITY O TIGA D MASTER PERMIT
PERMIT#: MST2002-00065
DEVELOPMENT SERVICES DATE ISSUED: 2/19/03
13125 SW Hall Blvd.,Tigard,OR 97223 (503)6394171
SITE ADDRESS: ioo15 SW KINGSTON PL PARCEL: 2S104DA-19201
SUBDIVISION: QUAIL HOLLOW -SOUTH ZONING: R-4.5
BLOCK: LOT: 01 8 JURISDICTION: "116
REMARKS: SF rowhouse,Unit 18,Bldg 2,CSB plan. 8/11/03, adding gas fireplace and a/c.
BUILDING
REIS3UE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: FIRST: 320 of BASEMENT: of LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR LOAD: 50 SECOND: 744 of GARAGE: 412 if FRONT: PARKING SPACES
TYPE OF CONST: 5N DWELLING UNITS: 1 TMRD 732 of RIGHT:
OCCUPANCY GRP: R3 BDRM: 2 BATH: 3 TOTAL: 1,796 of VALLIS. 113,66560 REAR:
PLUMBING
SINKS: I WATER CLOSETS: 3 WASHING MACH: I LAUNDRY TRAYS. RAIN DRAIN: TRAPS:
LAVATORIES: 3 DISHWASHERS, 1 FLUOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUBISHOWERS: 2 GARBAGE DISP: i WATER HEATERS: I WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN<100K: I BOIL/CMP<3HP: I VENT FANS: 4 CLOTHES DRYER: 1
LPG FURN>000K: UNIT HEATERS HOODS: I OTHER UNITS: 1
MAX INP., btu FLOOR FURNANCES: VENTS: I 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: 1 0 200 amp-. WISVC OR FDR. PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 3 201 400 amp: 201 400 amp. tot W/O SVCIF OR SIGN/OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 60o amp: EAAUDI_BR CIR. SIGNALIPANEL: IN PLANT:
MANU HMISVCIFDR: 601 1000 amp: 601-ampo•1000V.. MINOR I ABEL:
1000♦amolvolt
PLAN REVIEW SECTION
Reconnect only: >=4 RES UNITS: SVCIF7R>=225 A.: >600 V NOMINAL: CLS AREA/SPC OCC:
_ ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO 6 STEREO. VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM, INTERCOM/PAGING: OUTDOOR LNDSC LT.
BURGLAR ALARM: OTI4: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL
GARAGE OPENER CLUCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DA7AlTELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 5,724.83
This permit is subject to the regulations contained in the
BROWNSTONE QUAIL HOLLOW LLC BROWNSTONE HOME",LLC Tigard Municipal Code,State of OR. Specialty Codes and
12670 SV'/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 pe'mit will: cpire If
work is not s'arted within 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: 5(}3.5y8-7565 Phone: 503-598-7565 Oregon Utility Notification Center. Those rules are set
forth in OAR 952-001-0010 through 952-001-0080. You
Reap' I J(' l 24627 may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Electrical Service Wtr Proofing Bsn't Wo Electrical Service Plumbing Top Out Insulation Insp Firewall Insp
Electrical Rough In Fig Drain Bsm't Walls Electrical Rough-in Framing Insp Shear Wall Insp Firewall Insp
Sewer In,;pection Slab Insp Mechanical Insp Gas Line Insp Shear Wall Insp Firewall Insp
Footing Insp Slab Insp Mechanical Insp Insulation Insp Shear Wall Insp Firewall Insp
Foundat'912lnw,, Plm/undslb Insp Mechanical Insp Insulation Insp Exterior Sheathing Ins{ Gyp Board Insp
Iseed BLPermittee Signature : `t:•�Z2-� �z. �t -_-...�
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
bb, AAAA,AAAAAA AAAA ♦AA,,SAI, AAAAAAAAAAArAAAA .& A 1►1AAAAA
loop
,f
44
110.
►�, 61m lop
►
10.
�I
:' 3
W
�rTwi'�rr ��t '�R'rU +IiIEi►T'li►iis��►�► ► °� Y*7�'�Aw� i'�1
R d O "d
c�
o .
f7
y
0
� a
� n
o
ft
s t
Cgi
9
5
00
r
CITYOF TIGARD SEWER -,ONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2002-00042
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/19/03
SITE ADDRESS; 13315 SW KINGSTON PL PARCEL: 2S104DA-19200
SUBDIVISION: QUAIL HOLLOW-SOUTH ZONING- I1-4.5
BLOCK: LOT: 014 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SFA NO. OF BUILDINGS:
INSTALL i YPE: LTPSWR IMPERV SURFACE:
Remarks: S
Owner: _.
BROWNSTONE QUAIL HOLLOW LLC FEES
12670 SW 68TH PKWY STE 200 Description Date Amount
PORTLAND, OR 97223 ItiWUSA]Swr Connect 2/19/03
$2,300.00
JSWUSA)Swrconnect 2/19/03 $0.00
Phone: 503-598-7565I�WINSP)Swr Inspect 2/19/03 $35.00
Contractor:
11'WINSP)SNr In,pa't 2/19/03 $0.00
_
Total $2,335.00
Phone:
Reg#:
Required Inspections
This Applicant agrees io 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 permit expires. The Agency does riot guarantee
the accuracy of the side sewer laterals. If the sewer is not located at the mea,utemet t niven.. 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" Perm
Issued by:
Y d3 L � -+►- sc_t� .���1 r Permittee Signature:
Call (503) 639-4175 by 7.00 P.M. for an inspection needed the next bu5,ness day
Building Permit Application
7DatereceiveMd: A 0 Permitno.:H9T.'�,'t-oo -
City of Tigard
Address: 13125 SW Hall Blvd,Tigard.OR 97223 Project/appl.no.: Expire date:
Cirya/Tigard phone: (503) 639-4171 Date issued: By: Receiptn0.:
Fax: (503) 598-1960 RECEIVED (lase file no.: Payment type:
Land use approval: _ , 1&2 family:Simple Complex:
U 1 &2 family dwelling or accessory U Conti�l/{r�kus�t� Ae 441:1-family U New construction U Demolition
_)Additit;n/altcration/rcplaccment U I't �1Q�toM sprinkler/alarm U Other:
11 SITE INFORMATION
Job address: (v ` Bldg,no.: � Cuite no.:
Lot: Block: Subdivision: u f L� tz - S ( Tax ma /tax lot/account no.:
Project name: q. G
Description and location of work on premises/special conditions:
1FOR SPECIAL INFORMATION,
Name: (Floodphrin,septic capacity,solar,etc.)
Mailing address_( i _ f At 2 family dwelling:
Cita. p,, C, J Valuation of work........................................ F _
Phone - - Fax: E-mail: No.of bedtoonis/baths.................................
-Owner's representative: ' Total number of floors.................................
Phone: Fax:4.20- E-mail: New dwelling area(sq, ft.) _
Garage/carport area(sq. ft.)•........................
Name: Covered porch area(sq. ft.) ......................... -
Mailing address: Stj) I,- _ Deck area(sq. ft.) ........................................
City: r �. Stale: Zll . 4 ` � J Other structure area(sq.fi.).........................
Phone: Fax: Y E-mail: Commercial/industrial/multi-family:
1 t 1 , Valuation of work........................................ $
Existing bldg.area(sq.ft.) ..........................
Business name: ro w " 0� 2 New bldg,area(sq.ft.)
City: StalcmplQ. ZI Number of stories........................................
------ Type of conswcdon
Phonedle 2; _ Fax:6.2o - Occupancy group(s): Existing:-mail:
CCB no.: j �y -
City/metro lic.no.: - —�� New:
Notice:All contractors and subcontractors arra required to be
MMWfit I licensed with the Oregon Construction Contractors Board under
Name: (� 6 LI—) provisions of ORS 701 and may be requited to be licensed in the
Address: r L S 4�'Ee 01 jurisdicdun where work is being performed.If the applicant is
Cit t_ State ZIP: exempt from licensing,the following reason applies:
Contact person:A " y- Plan no.: --
1110nc:zC,6 _C x: Email: --
Name: ,,,, 421 k f L lContact person: _ Fees due upon arplication ........................... $
Address: 7 „cc4 Date received:
City: ,tate: .IP: 3 Amount received ......................................... $
Phone: 0 1 Fax: ►-mail: _ _ Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all Jurisdictions accept credit rands•please call Jurisdiction for mere information.
attached checklist. All provisions of laws and ordinances governing this Ll Visa UMasterCard
work will be complied whethe ed hrrein of not. Credo card number ___ .__ _LL
Expires
Authorized si re: = - e RAW of catrdholdet as blown on t card
Print name: �` �y -
CArdhatdu a jnattme Amotml
Notice:Ibis permit application expires if a permit is not obtained within 180 days after it has been accepted as complete, 4404613(6RJVfYM)
Plumbing Permit Application
Dateraeived: Penni'+ 2 (�paLlj
City of Tigard Sewer permit no: Building permit no.:
Address: 13125 SW Hall Blvd,Tigard.OR 97223
City of Tigard Phone: (503) 639.4171 F'roject/appl.no. Expire date:
Fax: (503)598-1960 Date issued: By: Receipt no.:
Ladd use approval: — �— _— Case file no.: payment type:
1
Ll I &.2 family dwelling or accessory ❑Commercial/industnal ❑Multi-family U Tenant improvement
0 New construction 0 Addition/alteration/replacement ❑Food service ❑Other:
1 { WE INFORMATION
Job address: 13 "_-_S, c_�]� a c c -- Description (2t l cr(ea. Total
Bldg.no.: suite no.: New 1-and 2-family dwellings 0611y:
Tax map/tax lot/account no.: (Includes 100 ft.forew+ullilftyconnection)
SPR(1)bath
Lot: I Com- - Dlock: Subdivision: SFR(2)bath ----- - -
Project name: __ _ _ SRI (3)bath _
City/county: _ 7.111: - Each additional bath/kitchen
Description and location of work on premises:, Site utilities:
Catch basin/area drain
Est-date of conpletion/inspectiow Drywells/leach lirrhrench drainPLUAI III NG COFooling drain(no. lin. ft.)
Manufactured home utilities
Wolcott 1'lunlhing Manholes
Rair drain connector
110 Box 2007 Sanitary sewer(no.lin.ft.)
Gresham OR 97030.0594 Storm sewer(no. lin. ft_.)
503-667-1741 Water service(no.lin.ft.)
CCB:23847 I'LM #:26-2081113 Flature or Item:
Contractors representative signature: --- Absorptionya,vc ^--Print name: : --- - Back flow preventer
Backwater valve
/ Basinstllavatory _ _ -
Name: Clothes washer -
-- Dishwasher
Address: Drinking faunlain(s)
City: Stater 7111: Ejectors/sump --- _-
Phone: Fax: E-nail: Expansion tank —
1 Fixture/sewer cap _
N_arnc(print): floor drains/floor sinks/hub
Mailing address: -- - -- _--� Garbage disposal -- -
Hose bibb
City_ State: ZFP: Fee maker W
Phone: s- Fax: --IE- il: ----� Interceptor/grease Ira -
Owner instal latiorJresidentW maintenance only: The actual installation Primers)
will be made by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the property 1 own as per ORS Chapter 447. Sink(s),lrasin(s),lays(s)
Owners signature: (rate: Sum
Tubs/shower/shower pan -
Urinal -! -
_Name: -_--- _ T -� Water closet
Address: Water heater i - -- -
City: �_ tate: zip: Other:
Phone: _ =.Fax: --W_ E-mail: —__----- 'Total
No oil*;dict,m wcep ae&t tarda,Vicar call petaddan for meat Wmneon1Minimwr fee.................$
___.----
Notice:This permit application %) $-_Plan review at
O Yw O Maata._ard expires if a permit is not obtained (
aeait cod minbe':---._---_-- --- _-1 _ within I80 days after it has been State surcharge(8%)....$
- - - — - accepted as complete. )TOTAL......................S
Naraac d a�rdbolder a abcnaa�eeedh toed
S
_ Anow410-4616 a.~Xrhr!
Mechanical Permit Application
Dale received: Permit no.:
7�pOC j
City of Tigard P_ject/appl.no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 —
Phonc: (503) 639-4171 Date issued: By: - Receipt no.
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: _ — Building pemut n(..-
TYPE
OF ]PERMIT
O I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction fU Ar didon/altera6orYmplacement U Other.
1 INFORMATION 1MMERCIAL VALUATION SCHEDULE
Job address: Indicate equipment quantities in boxes bcl,)w. Indicate the dollar
Suite Bldg.no.: — Se no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$
Lot [31ock: Subdivisions _ •Sec checklist for important application information and
Project name: jurisd;ctior's fee schedule for residential permit fee.
City/county: —T— ZIP: — 1 1
111
Description and location of work on premises:_--__ 1 1 t s
— -- -- - --—
Fee(m) Totai
Est, !:-te of completion/inspection: — Desai no Qty. Res.only Res.otd
Tenant improvement or change of use:
Is existing space healed or conditioned?U Yes U No _Air handling unit CFT1
Air coning(site plan required)
Is existing space insulated?D Yes U No Alteration o e- xxisuni-I AA-aystrm -
11-
11 MIANICAL 1 Woo /compressors --
State b(iler permit no.:
Four Seasons l leating&A/C:Service IncHP Tons__BTUM
PO Box 66409 Heat
a dampers/auct smoke detectors _
-Heeump(site p an ioqu- t�
Portland OR 97290-6409 nsta Urcp aaccefurnacciburner_— F /iT-
03-775-5919 Including duetwork/vent liner U Yes U No
CCB: 48283 nsta I/rep a relocate eaters-suspended,wall,or floor mountM
6w"M
enl for app iancc other an furnace —
e r em
Absorption units
Name: Hf
es — -
Addrs: Com rrssors__ _ — HP +_
-- - omenta eT x aint and v.att ton:
City: Slate: _ ZIP:_ Appliance vent
Phone: Fax: E-mail: )ryuex rause � --
1Iloods,l'ype. res. etc er lt�.mat
hood rite suppression system
Name: _ _ Exhaust fan with single duct(bath fans)
Mailing address: -Txhayst system a'trom teaun or
City: Stale: ZIP: _ re p p nr on up to outlets)
Phone: TypeUri NO Oil
7uel_techaddiiiena over Outlets
roce"p p (schematic requi )
Number of outlets
Name -------- - 7)t6ri�ticd".ppfal—orequ3pment: - --
Address: Decorative fir M. lace
City: —_-- _ State: ZIP: Insert-type — "-
N tov et stove — -
Phone: Fax: E— _Pe--- —
er
Applicant's
_ signature: Date:
Other-
Name (print): —�— -- -_-- --
Na en jraiadkYiam Weep(("at c'ardu,pMttar un jreis&ftnn fu more iefortrd6m Permit fee.....................$ _--
U Visa U MasterCard Notice:This pemul application Minimum fee................$
tWt card comber _ f expires if a permit is not obtained Plan review(at _T_ %) $
—
--` _ within 180 drys eller it has boat
�
— e_W_�a cyr dr.0 as era -- accepted as eanplete.
State surcharge(8%)....S _
------Cana�older a,��`r• -- At. i 44.4617(-S*0 W)
Electrical Permit Application
[)ate received: Permit no.:
City of Tigard Project/appl.no.: Expire date:
CiryofTigord Address: 13125 SW Hall Blvd,Tigard,OR 97223 Dale issued:
Phone: (503) 6394171 Hy Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
1
U I &.2 family dwelling or accessory U Comniercial/indusuial U Multi-family U Tenant improvement
U New construction U Addition/alteratioii/replacement U Other: U Partial
Il SITE INFORMATION.
Job address: �� e 131dg no.: Swte no.: Tax map/tax lot/accrruat no.:
Lot: Block: Sub_ivision: —_ --
Project name: Description and location of work on premises:
Estimated date of com letiontinspection: — —�
APPLICATION
Job no: Ma,
OMy. (ca.) Told no.ins
Streamline Electric NessrrddrrdLf isgkormuhi-lamllrper
DBA I.aValley Corporation drnitingr■,h.fach tinamzbedprage.
6025 East 18i1'St Sffvk*bu-Imird:
Vancouver WA 98661 1000 ay rt or lean 4
360-993-5080 Foch additional 500 sq.it.or portion thereof - -Limited energy,residential 2
CC3:116114 ELC#: 34-4320 SUPM Uri ked energy,non-residential 2
Each manufactured home or inndular dwelib,, ---
Signature
Si nature of supervising electrician( aired) -Dii Service and/or feeder 2
Sup.elect.name(print): License Services orreederr--I"llation,
attention or relocation:
1 200 amps or less
2
Name(print): j20T&-mp%toOMailing Hddress: amps to( amps2
amps to Ib,)amps2City: Sta[e: ZIP: er 1000 antes or volts -- -- 2
Phone: FHX: E-mail: Reconnect only —
Owner installation:The installation is being made on property I own—
which is not intended for sale,lease,rent,or exchange according m +'Ilalim aNeralion,nrrelocation:
ORS 447,455,479,670,701. 2(x)amps or less 2
201 amps to 400 amps --'� - - 2
Owner's signature - Date: _-- 401 x,600 amps -'-� - 2
Branch cis-mess,alteration,
Name: or e"feaviom per panel:
A. Fee tot branch circuits with purchase of
Address: _ service or feed"fee,each branch circuit 2
C1ty: ---- --- Stale. ZIP: B Fee for oranch circuits without purchase --
Phonr [aX: I'-mail: of service or feria fee,first hunch circuit: 2
Gch additional branch circu:
" s Misc.(Service orfeedernot lncNeled):
U Service over 225 amps commercial Ll Health-care fardiiv Each pump or irrigation circle 2
U Service over.120 amps-rating of 1&2 U Himardous location Each sign or outline lighting - 2
fanulydwellings U Building over Io,000square feet rout t Signal circuit(s)or a limited energy panel.
U System over 600 volts nominal mor,residential units in one structure altereuon,or extension' 2
-)Building over three stories U Feeders,400 amps or c i tore *Description - _ ---
U Occupant load over 99 persons U Manufactured structures or RV park Lach addiliaaal -
U F•gressAighdng plan U Other: I ildion over the Allowable(n may of Ole above:
Per inspection _ f-'-T--
Submh _ salt of plane with any of the abnre. Inveati_garionfa -.—r--.—�
The above are rKI applicable to temporary construction service. Other
Not all jusisdicuons accept credt cards.plow call jurisdiction for more information Notice:this permit application Permit fee S
U visa U MasterC std expires if a permit is not obtained P13n review(at _— %) $
CrMit card Dumber within ISO days after it bas been Slate surcharge(f(%) ....S
Expires w-ccpted as t:ompletc TO'f AL . $
_
amt d crrDrol u shown on c t card ...................... ---
f
Cardtrdder aiputurc -- — Amount
440-4615(60WDNI)
113 115 SW
21.0 Fr lz
j
91 4�4/oed
GARAGE
COO"Mom
-------------
1p
? -
i
F
I
I we a VAR-
� Y•T Y•Y
1
----�� ob
v----
•
-- - -- REVIsior1 T/•
t•T r � r•Ir�r�� __ !'•Y
FILE COPY
n
E_VEL 1
LEVEL 2
UNIT T-'-PE L-S --
~ UNIT T7FE C
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-•00065
Date issued: 2119103
Parcel: 2S104DA-19200
Site Address: 13315 SW KINGSTON PL
Subdivision: (QUAIL HOLLLW - SOUTH
Block: Lot. 018
Jurisdiction: TIG
Zoning: R-4.5
Remarks: 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: Building Division.
No plumbing inspections will be authorized until thi- completed form is received
OWNFR PLUMBING CONTRACTOR:
BROWNSTONE QUAIL HOLLOW LLC WOLCOTT PLUMBING CONTRACTOR!
12670 SW 68TH PKWY STE 2.00 PO BOX 2007
PORTLAND, OR 97223 27CCC
Phone #- 503-598-7565 Phone #: 667-1781
Reg #: LIC 23847
PLM 26-208PB
AN INK SIGNATURE I� REQUIRED ON THIS FORM
X
Sig Eure o-TA-Lithor0yd Plumber
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
DAVID JEROME ELECTRIC
PO BOX 751
HILLSBORO, OR 97123
Electrical Signature Form
Permii#: MST2002-00065
Date Issued: 2119103
Pard: 2S104DA-19200
Site Address: 13315 SW KINGSTON PL
Subdivision: QUAIL HOLLOW- SOUTH
Block: Lot: 018
Jurisdiction: TIG
Zoning: R4.5
Remarks: SF rowhouse,Unit 18,BIdg 2,CS8 plan
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 n S'rg azure Form prior to the
start of the work to the address above,ATI"N: Building Division.
No electrical Inspections will be authorised until this completed form is received
OWNER: ELEC rRICAL CONTRACTOR:
BROWNSTONE QUAIL HOLLOW LLC DAVID JEROAE ELECTRIC
12670 SW BATH PKWY STE 200 PO BOX 751
PORTLAND, OR 97223 HILLSBORO, OR 97123
Phone #: 503-598-7666 hone 0: 648-5144
Reg#: LIC 36051
SUP 29775
ELF 34-119c
AN INK SIGNATURE IS REQUIREb ON THIS FO
X i
Signature of Supero sing riclan
If YOU have any questions, please call 503.718.2433.
ROQ j JAM ')Q'T9 C VOLL 40 Alli) 1RREVZOr,OS IM SS:ZT ;]H1 f.0/07.;00
CENERG
CITY OF TIGARD ELECTRICAL -
DEVELOPMENT SERVICES - RESTRICTED ENERGY
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639-4171 PERMIT#: ELR2003-00129
DATE ISSUED: 5/8/03
SITE ADDRESS: 13315 SW KINGSTON PL PARCEL: 2S104DA-19200
SUBDIVISION:QUAIL HOLLOW- SOUTH
BLOCK: LOT: 018 ZONING: R-4.5
Project Description: Limited energy for voice/video. JURISDICTION: TIG
rA.IRIA.RESIDENTIAL B.COMMERCIAL _
AUDIO& STEREO: X AUDIO & STEREO:
BURGLAR ALARM: INTtRCOM & PAGING:
7
GARAGE OPENER: BOILER: LAN DSCAPE/IRRIGAT:
CLOCK: MEDICAL:
HVAC: DATA/TELE COMM:
VACUUM SYSTEM: NURSE CALLS:
OTHER: FIRE ALARM: OUTDOOR LANDSC LITE:
HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
Owner: — TOTAL#OF SY'iTEMS:
BROWNSTONE QUAIL HOLLOW LI-C Contractor:
12670 SW 68 FH PKWY STE 200
PORTLAND, OR 97223
Phone: 503-598-7565
Phone:
Reg#:
FEES Required Inspections _
Description Date Amount Low Voltage Inspection�—
ItLPRMTj ELR Permit 5/8/03 $75.00 Elect'I Final
ITAX X I M o State Tax 5/8/03 $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 month approvedplans. 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 rules are set forth in CAR 952-001-0010 throuc
Issued by /
(�. Permittee Signaturetll
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not Intended for sale, lease, or rent.
OWNER'S SIGNATURE:
-- —_ CONTRACTOR INSTALLATION ONLY _
SIGNATURE OF SUPR. ELEC'N _ �—
LICENSE NO: — ---- --.- _ DATE._
Call 639.417.5 by 7:00 P.M. for an inspection needed the next business day
Electrical Permit Application
-- i bate received. `J � d'" Permit n0 �
City of Tigard Project/appl. to.; edate:
('tIvrr(Tigara/ Address: 13125 SW Mali B1vd,'Tigard,OR 97223 pate issued. --- by Receipt no.
Phone: (503) 639-4171
Fax- (503) 598-1960 Case file no Payment type:
Land use approval: _
TYPE.OF PERMIT
U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
&New construction U Addition/alteration/reel icenfcnt U Other: _ U Partial
Job address: j�/� S•jsf, /� of /^� CE Bldg. no.; Suite no.: 11-ax map/tax lot/account no.:
Lot: Block: Subdivision: "�.t�.('�
Project name: t_ te N Description and location of work on premises: i/1
Estimated date of eomplct o i/inspecwm.
CONTAACTOR APPLICATION FEE SCIIEDULE
Job no: Itr Max
- -. ..- -
uo,InsBusiness name: ( t 1 LI^ e IL' r Ne"midcnth •single ormuhi-h,mir per ? c
!1_ Total
Address nQ
�C, _ _ doellingunll.Includes alraclmdgarage.
City: S State:4Z 1 ZIP:% Service Included:
Phone (,f 9 C trt) I Fax: o oor E-mail: 1000 sq ft or less 4
Each additional 500 sc ft.or portion thereof
CCB no.: / Elec.bus.lie.no: ' ' cr C[ P Linuted energy,residential p 2
City/metro lic no.: Cl6(,�A6S Iai' Limned energy,non-residential 2
0 Each manufactured home or modular dwelling
�~ T Service and/or feeder 2
Signature of supervising electrician( tired) nn Uate
Sup elect.sante(p tint, (� C-17 t E 'c(, I.icense noJ51,?/ (!a Services of feeders-Installation,
alteration or relocallow
OWNERPROPERTY 200 amps or less 2
Name(print): c (�l(d.1 j i G1 vc 201 amps to 400 ams 2
-- - - 401 amps to 600 amps
Mailing address: =-
____ 601 amps l0 1000 amps 2
City: Stale: ZIP: Over IOW amps or volt% _ 2
Phone: Fax: E-mail: Reconnect, n, I
Owner installation:The installation is being made on property I own Temporary serslcM or feeder,-
Ittirtwhich is not intended for sale,lease,rent,or exchange according to 200almps ortt,lessalte auam,nr rrlocauoa:
2(Hj amps or less
ORS 447,455,479,670,701. 201 amps to 400 amps _ y
O%%ner's Signature: Dille: 101 to 600 ams — 2
ENGINEERBranch circuits.new,alteration,
or exicnslon per panel:
Name: _ - A Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circus 2
City: ^� Slate' "LI1'. _ It Fee for branch circuits without purchase
- - of service or feeder fee,first branch circuit 2
Phone: I:iter [-.mail, --
trach additional branch circuit:
Misc.(Service or feedernot Included):
U Service over 225 amps-conunercial U Health-care facility Each pump or irrigation circle
D Service over 320 amps-rating of 1 U U Hazardous location Each sign or outline lighting 2
farnilydwellings U Building over 10.ODosquare feet fouror Signal circult(s)oralimited energy panel•
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 at more 'W'scn tion
U Occupant load over 99 persons U Manufactured structures or RV park Each additional Inspection over the allowable In arty of the alcove:
U Egress/lightingpinn U Other — per inspection
Submit_sets of plans wlth any of the above. Investigation fee
The above ore not applicable to temporary construction service. other
Not all jurisdictions accept credit cards,please call junwiction for more mfonnation Notice:This permit application Permit Cee.....................
.j visa U MasterCard expires il'a pemit is not obtained Plan review(at — %) $ _
Credit card number within 180 days after it has been State surcharge(8%) ....$
$
Name of ctudholder n shown on credo car accepted m complete. TOTAL .
S _
Ctudhol r si nature Amount
440.4615 ibtwCuxli