13320 SW KINGSTON PLACE �I
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13320 SW Kingston Place
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION VIVISION Business Line: (503) 639-4171 MUT
BUP
Received Date 171quested AM--' - PM--- BLIP —
Location . 3 3 Z" ` Z Suite MEC
Contact Person -- Ph( ) '22 3-_s 3 �-�. PLM
Contractcr _-_______-- — Ph( ) __- SWR
BULDING Tenant/Owner __ -__ - -___ E,LC
Footing ��:LC _-�-
Fow idation Accesc:
Fty Drain I I ELR ....._--------_-..._____--
(:riwl Drain
si:_b Irspection Notes: --_-- SIT
Post B Beam --
Shear Anchors
Ext Sheath/Shear _
Int Sheath/Shear - --
Framing , f-- —
Insulation -� �4t S 2G_1���'► C�.�� C•� � � ,
Drvwall Nailing
Firewall
Fire Sprinkler --- -�—` -
Fire Alarm
Susp'd Ceiling — - --
Roof -j
Other:. iAA ----
Final
S PART FAIL
IYMM_BING_
Post& Beam
Under Slab _ - --- - - - - — — —
Rough-In
Water Service - - - --
Sanitary Sewer
Rain Drains - -
Catch 3asin/Manhole
Stoim Drain - -- -- - -
Snower ran
Other: - -- _-
Final
PASS F AT FAIL - - - -
MECKOW 'AL _
Past 3 E .m
Rou jh
Gas I J.
Smol, Damders - -- -- ._ - - ---- -- --- - --- - - ---
Fn
PART FAIL _ — - --- - --- — - -- - ----- -- — - -
_1H i RICAL
Rouf In
UGii b ---
I_ow iltage
Fire Farm
Fin; Reinspection fee of$__ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
P, .8 PART FAVI
St c C� Please call for reinspection RE: - _-_ ___-____ _ L I Unable to inspect -no access
Fi Supply Line n
Approach/Sidewalk Date _ _.- Inspector__ _Xf .. --- _ Exit ._.-_-_—
LFInal
DO NOT REMOVE this inspection record fro�rr, the Jots Mite.
PART FAIL
CITY OF TIGARD 24-Hour 01)
BUILDING 1'
-pection Line: (503)639-4175 MST D` 6QO tJ---�
INSPECTION DIVISION tusiness Lire: (503) 639-4171 BLIP _
R-ceived ___-_ - --.Date Relquested_— AM^_—___ PM BUP
Suite MEC
Ln
Locai, - - s —
Contact Person - - — Ph t ) �_
�3� 5• PLNI
Contractor SWR
FroBUILDING Tenant/Uwnor — — — ELC _—
Footing� -- ELC _ ---------
ooundation Access:
tg Drain ELR _—
Crawl Dram - -- SIT --_T
Slab Inspection Notes: —
Post&Bearn -
Shnar Anchors
Ext Sheath/Shear -- -- - "
Int Sheath/Shear
Framing --- —-
Insulation
Drywall Nailing
Firewall _—
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Otter:
Final
PASS PART FAIL_
PLUMBING _ --- --
Post&Ream —
Under Slab -
Rough-In
Water Service J —�-
Sanitary Sewer _—
Rain Drains -
Catch Basin/Manhole
Storm Drain
Shower Pan
Other...
Film*
[ ASS)
PART L
-
Post& Beam
Rough-In
Gas dine
Smoke Dampers
Final
PASS PART FAIL —-- -- -
ELECTRICAL
Service ---
Rough-In --
UG/Slab
Low Voltage ---
Fire Alarm
Final �1 Reinspection fee of$ required before next inspection. Pay at Citv Hall, 13125 SW Hall Blvd
PASS PART FAIL
Please call for reinspection RE: -%� Unable to inspect-no access
Fire Supply Line ��J ��..�-
ADA Date--7-7--
1 v inspector Ext
Approach/Sidewalk -�' �'�'�"';, -
Other: _ /
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGiARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
BLIP
Deceived _— __ Date Requested Co 3 AM ___ I'M __ BUP
Location .. 3 3✓' Z l% _..—may_ ---- - Suite — - ..._ -- - MEC
PLM
Contact Person _.— h(_---_ . -) -- ---------- __---- . _.... --
Contractor _ Ph(_-_ _) SWR —
BUILDING _ Tenant/Owner —.. .____ __-___ __ ELC
Footing —__ ELC
Foundation Access:
Ftg Drain ELR _
Crawl Drain
Slab Inspection Notes: SIT --
Post& Beam
Shear Anchors _
Ext Shea:h/Shear
Int Sheath/Shear ------__—_._
Framing -- --- ---- --- —
Insulation
Drywall Nailing -- --- - — - — — —
Pirewall
Fire Sprinkler
Fire Alann
uspCeiling �� ---- - ----
Roof
Other: - »_
Final
PASS PART FAIL ----- _-- -------- _ _ - ----------- ------
PLUM8ING
Post& Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains -- - - - - - -
Catch Basin/Manhole
,,form Drain
------
St,�jwmr Pan
Other: -
Final
PASS PART FAIL
MECHANICAL—_-.
Post& Beam
Rough-In - -
Gas Line
Smoke Dampers -
Final
PASS PART FAIL --- -
1.ECTRICAL
Service --- -�_ --- ----
Rough-In
UG/Slab
')w voltaa'e) -
t Fire AGarfn'
Ftw
Reinspection fee of$-- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
ASS PART FAIL_
SI Please call for reinspection RE--- _ L1 Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Data _ Insp�cto
--
Other'----- `�
Final DO NOT REMOVE this Inspection record from the ob site.
PASS PART FAIL
OF 6ARD —• MASTER PERMIT -
PERMIT#: MST2002-00052
DEVELOPMENT SERVICES DATE ISSUED: 1/13/03
13125 SW Hall Bled.,Tigard,OR 97223 (503)639.4171
SITE ADDRESS: 13320 S%A' KINGSTON PL PARCEL: 2S104DA-18200
S'+ SION: QUAIL HOLLOW - SOUTH ZONING: R-4.5
t !..00K: LOT: clos JURISDICTION: 110
AL",- :2KS: SF rowhouse,Unit 8,Bldg 4, bs plan with a deck. STRUCTURAL FILL, REQUIRES GEO- ECH
INSPECTION AND REPORT
BUILDING
REISSUE: ^^ Y^ STORIES: 3 FLOOR AREAS REQUIRED SETBACKS - REQUIRED
CLASS OF WORK: NEW HEIGHT: FIRST: 172 if BASEMENT: }t LEFT: SMOKE DETECTORS:
TYPE OF USE: SFA FLOOR LOAD: So SECOND: 735 of GARAGE: 5,47 of FRONT PARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS: l TWO 735 of RIGHT:
VALUE 162 555 Zu
OCCUPANCY GRP: R3 BDRL 2 BATH: TOTAL. 1.;4: 0 REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: 2 WASHING MACH: l LAUNDRY 1 RAYS: RAIN DRAIN: TRAPS:
LAVATORIES: 2 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUBISHOWEP4• 2 GAR13AGE DISP: l WATER HEATERS: 1 WATER LINES. BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES.
MECHANICAL
FUEL TYPES FURN<100K: BOIUCMP<THP: VENT rANS: 3 CLOTHES DRYER: 1
(AS FURN>=100W UNIT HEATERS: HOODS: 1 OTHER UNITS:
MAX INP: btu FLOOR FURNANCEs: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT u SERVICE FEEDr R TEMP SRVCIFEEDERS BRANCH CIRCUITY MISCELLANEOUS ADD•L INSPECTIONS
1000 SF OR LESS: l 0 200 Amp, 1 0 200 Amp. W/SVC OR FOR PUMP/IRr:,UATIUN: PER INSPECTION:
EA AnD'L 5003F: 3 201 • 400 amp: 201 400 Amp: 1st W/O SVC/FDR: SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 • 800 amp 401 WO Amp: FAADDL SR CIR: SIGNAL/PANEL: IN PLAN i
MANU HMISVf:IFDR: en1 - 1000 amp: 601+amps•11000v MINOR LABEL:
1000-amolvolt
PLAN REVIEW SECTION
Reconnect only:
>=4 RES UNITS: SVCIFDR?=225 A.: >800 V NOMINAL: CLS AREAISPC OCC:
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL _ B.COMMERCIAL
AI1D10&STEREO: VACUUM SYST dM: AUDIO&STEREO. FIRE ALARM: IN7ERCOMIPAGING: OUTDOOR I.NDSC LT:
BURGLAR ALARM: 0TH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK 'NSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL a SYSTrMS:
Owner: Contractor: TOTAL FEES: $ 5,693.37
BROWNSTONE QUAIL HOLLOW LLC BROWNSTONE HOMES,t.LC This permit isto the regulations contained In the
Tlyard Municipal
Cod Code,State of OR. Specialty Codes and
12670 SW 68TH PKWY STE 200 12670 SW 68TH PKWY all other applicable laws. All work will be done in
PORTLAND,OR 57223 PORTLAND,OR 97223 accordance with approved plans. This permit will expire if
work is not started within 180 days of issuance,or If the
work is suspended for more than 180 days. ATTENTION:
Oregon law requires you to follow rules adopted by the
Phone: 593-598-7565 Phone: 503-598-7565 Oregon Utility Notification Center. Those rules are set
forth in OAR 952-001-00113'through 952-001-0080. You
Rao r: LIC 124627 may obtain copies of th�3e rules or direct questions to
OUNC by calling(502)246-1987
REQUIRED INSPECTIONS
Plumb Top Out Foundation Insp Mechanical Insp Plumbing Top Out Framing Insp Insulation Insp
Sewer Inspection Slab Insp Mechanical Insp Framing Insp Gas Lit o Insp Insulation Insp
Sewer Inspection Plm/undslb Insp Mechanical Insp Framing Insp Insulation Insp Insulation Insp
Footing Insp Electrical Service Mechanical Inas Framing Insp Insulation Insp losulalion Insp
Footing Insp Electrical Rough-in Plumbing Top Out Framing Insp Insulation Insp Insulation Insp
Issued By : ��- Permittee Signature
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
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CITYO F TI GARD _ SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2002 0(1031
DATE ISSUED: Ii13l03
13125 SW Hall Blvd., Tigard, OR 971223 (503) 639-4171
;
PARCEL: 2S 104DA-16200
SITE ADDRESS: 13320 SW KINGSTON PL
SUBDIVISION: QUAIL HOLLOW -5Ot ill i ZONING: R-4.5
BLOCK: LOT: JURISDICTION: '11G
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SFA NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF rowhouse.
Owner: _ FEES
BROWNSTONE QUAIL HOLLOW I-LC (Description � Date �T Amount
12670 SW 68TH PKWY STE 200 — -- --
PORTLAND, OR 97223 JSWUSAI S%� 1/10/03 $0.00
ISWUSAI SN%i c unncct 1/10/03 $2,300.00
Phone: 503-598-7565 1SWINSP) Swr Inspect 1/10/03 $0.00
jSWINSI'j S\\r Irishc0 1/10/0\3 $35.00
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 will he forfeited if the permit expires. The Agency does not guarantee
the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect
3 feet in all direction; from the distance given. If not so located, the installer shall pur,:hase a "Tap and Side Sewer" Perm
Issue y: ! - '` � Permittee Signature:� r r��
Call (503) 39-4175 by 7:00 P.M. for an inspection needed the next business day
Building Permit kpplication
"—'� � Feceived:. ��� Permit no.:/�ls{�y7�, �a
City of 25 WH Tigard � Projf-ct/appl.no.: F�xpire date:
CiryofTigard Address: 13125 SW Hall f31vd �� ;J
Phone: (503) 639-4171 �' Date issuedme _
By;, - Receipt no.:
Fax: (503) 598-1960 ! / Case File no': Payment type - -
Land use approval: _ 1&2 family:Simple Complex:
U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition
U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other: —
JOB SITE INFORMATION
Job address: ) tic r L• Bldg.no.: I Suite no.-
Block_ Subdivision: c/ / y, rZ. ' �u , Tax map/tax IoUaccount no,: A5/m/yA
Project nam
c:
Description and location of work on premises/special conditions: ---
1 ORMATION,USE CHECKLIST
ivvnc:
R�4 LAOU s
Mailing address: I — 1 &2 family dwelling:
Cit ,� s. State:OlQ ZIP Valuation of work $
Phe. r S Fax: E-mail: No.of bedrooms/baths................................. --- --—
Owi►er's represen'ativc: Total number of floors................................. r_
Ph,,,,e: Fax: E-mail: New dwelling area(sq.ft.) ................. ........ _
Clarage/carport area(sq.ft.)......................... -----
Name: ��Q - Covered porch area(sq, ft.) ......................... �.
Mailing address: s W ]� _S�'�s- Deck area(sq, ft.) ........................................ --
State: LIW q' Other structure area(sq.ft.)...... .................. —
Crty. '- � � Commercial industrial/multi-family:
Phone: Fax. E-mail:
'ONTRACtOR Valuation of work........................................ $
Existing bldg.area(sq.ft.) ..........................
New bldg,area(sq,ft.) ................................ --
Address: Number of stories ............................
City: C, StateO ZI Type of construction.................................... -
Phone• — Fax:620 -mail: Occupancy gmup(s): Existing. _—
CCB no.: 11 New:
City/metro lic.no Notice:All contractors and subcontiaetors ire required to be
licensed with the Oregon Construction Contractors Board under
Name: 6 LD _ provisions of ORS 701 and may be required to be licensed in the
/ O -- _ _ k_ -_l jurisdiction where work is being performed.If the applicant is
Address: ry c, C> exempt from licensing,the following rea4on applies:
City; t StateZIPf�
Contact person: Plan no.:
Phone: x: E-mail: -
Name: I w. L _� Contact person: Fees due upon application ........................... $ --
Address: s W Date received: —_
City: r cam — _ tate: ZIP: 3 Amount received ......................................... $ _,----
Phone: _ Fax: E-ntti!: Please refer to fee schedule.
1 hereby certify I have read and examined this application and the Not all)arisdcdow.xt credo cwds,plew eau 1a,t,elcaon tar mom warmadm.
attached checklist.All provisions of laws and ordinances governing diic p VISA o M,stetcaM
work will be complied whetite ed herein or not. Credit cad numtr _ _ I L_
r.>;u,frr
Authorized sign tire: ate: _ - NAM �,rm,otea� -
[� s
Print name: � L _— — —_carat>otda sit"Me
Notice:Ibis permit application expires if a permit is not obtained within 180 days alter it It as been accepted as complete. 4444617(&%"M)
Plumbing Permit Application
Date roaived: �.my Penrtit no.
City of Tigard Sewer permit Building rerm;t no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223
City ofTigard Phone: (503) 6394171 Project/appl.no.: Eaepircda e:
Fax: (503)598-1960 Date issued: By rReceipt no..-
Land
o.:Land use approval: _ --- Case fiilc no.: Payment type:
O 1 &2 family dwelling or accessory v CommenciaVindustrial O Multi-family O Tenant improvement
(.7 New construction U Add ition/al tetatiordreplace ment ❑Food service ❑Other.
JOI1 Sl 11'.INFOHNIAI ION FFE Si-I I Fill TE(for special information use clieckli%l)
Job addressl 334V Svi (� • _ ti P(a c c Desert Nod Fee(ea.) Total
Bldg.no.: Suite no.: - New i-mad 2-family dwlf<rgs only:
Tax map/tax lot/account no.: (includes 1001t.foreachudlftyconnxtJon)
- SFR(1)hath
Block:. Subdivisions -SM(2)bath ---- ----- -
Pmjcct name: SllR(3)bath
City/county: _ _ ZIP: Each additional bath!-_;hen
Description and location of work on premises: - Siteatilities:
Catch basin/&ea drain
Est.date of completion/insptxtion: - - _Drywells/leach i.n6urrich drain
Footing drain(no.i.n. ft.)
Manufactured home utilities
Wolcott Plumbing Manholes — -
PO Box 2007 Rain drain connector - -
Gresham OR 97030-0594 Sanitary sewer(no.lin. ft.) --
Storm sewer(no.lin.ft.)
503-6(i7-1781 'f Water service(no. lin.ft.)
CC[3:23H47 PLM N:2G-2U8PI3 IFIxture or hem:
(contractors representative signature: - Absorption valve -
Ptint name: Date: _ Back flow preventer -- _-- -
Backwater valve _
1 1 Basins/lavato
Name: Clothes washer --v�
Address: -- -------- �_ --- Dishwasher - �— —
at _ ---- - State: zip: - �;cking fountain(s) — ---
Ejectors/sump _
Phone: Fax: E-mail: Expansion tank _
` Fixtute./sewer cap
Name(print): 11,vt drains%floor sinks./hub
Mailing address: --- �- Garbge disposal - —_
-- --- Hose hibb _
City: — State: Zip:— -_— ;ceemmaker — _ -
Phone: Fax: J E-mail: Intercerxot/grease trap —
Owner installation/residential maintenance only: The actual installmion Pnmer(s) _
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 ORIS Chapter 447- Sink(s),basin(%),lays(s) -
Owner's signature: _ Irate: Sum -
'Ibbs/showe_r/sJtowcr pan -
Narne: Urinal
-----------------.- Water closet
Address: Water heater
City: ---� State: ZIP: _ OtJ►cr. --- - —
�� �_
fione. E-mail: 7'oW
Na W}aia&cdm wce"credit cards pleaw nn rci.dictim fv mare Yutaka; Minimum fee................ _ --- _
Notice:les permit application
❑Via U MasteYCa-d expires if a permit is nM obtained Plan review(al -- %) $
Cwdt`wd ma" _— -- ---L—L_ within 180 days after it has been State surcharge(8%)... $ —
t sped ted as r
accepted aroc d eardMldc n r6ow i a.�— letTOTAL .......................
s - .."----
f
Grdha&, AaoaM—
4"I6(tirOdOOAf)
Mechanical Permit Application
r^ j.
"Dateceived: �' � (��� Prrmi t no.:J;
City of Tigard Project/appl.no.: Expire date.:
City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued. Hy:_ Receipt no.:
Fax: (503) 598-1960 Case Glc no Payment type:
Land use approval: —_ — Buildingprrmitno.:
TYPE OF PA01
❑ 1 &2 family dwelling or accessory U Commercial/industrial U Mulb-family ❑Tenant improvement
U New construction U Addition/alteration/replacement U(hher:__—�—
II 1 119comfMN1 k1
Job address: ' ( utj << Indicate equipment quantities in boxes halo Indicate dip.dolly
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,ovethead,
Tax map/tax lot/account no.: profit.Value b
Lot; ;' Tlock: Subdivision: *See checklist for important application information and
Prr�ject name: - -- jurisdiction's fee schedule for repermit residential peit fee.
City/county: 'Z.I P: 1Igo1
Description and location of work on premises:._ t 1 1 1 I&II oil III 1
Fee(m) Total
Est.date of C:
corn — jOO Qt ' Ra'O1 Res•oaly
Tenant improvement or change of use: Air handling unit _ CFM
Is existing space heated or conditioned?❑Yes ❑N° it condi ioni� —ng(site pramrequ�
existing space insulated"U Yes U No Alterationo existing WA 'system
MUCIIANICAL COR-1 1"3uiler/compressars I
State boiler permit no.
HP Tons BTU/11
Four Seasons Heating&A/C Service In, :,rc/smo car am--uct smokedetectori- _ _ �_
►'()Box 66409 eat'pump(sitc p an required)
Portland OR 97290-6409 ossa Ureplact umace/bumer— 1`1LI/H
503-775-5919 Including ductwor: 'vent liner U 1 U No
CCD: 48283 nstalUrepla�e relocate heaters-suspended,
_ wall,or floor mounted
NtunC lease print): cnl�r a Isance oer than furnace
e ens
1 1 Absorption units BTU/11
Name: ---
Co ressm.
Address: oma exhano and yen ton:
City: _State: ZIP: Applianceveni
Phone: — Fax: E-rnail: Dryer exhaust
s,
qWl/lureslutchen larmat
hood fire suppress,mn system
Name: Exhaust fan with single duct(bath iar.$)
Mailing ad Exhaust sysste_mm art from-heating or
xh
Slate: 7.IP: Kp �""""st on up to outlets)
City: _ _ Type: _IPG .` NG (til —
Phone: Fax: E-mail - .Ue iieach a iticnal over outlets
rvres>Ip p (schematic requlre )
Number of outlets
_Name: ler applGecc o-r eq�pmcot:
Address: __ _ Decorativefueplace __—
City: ZIP — insert-type ---
lov pellet stove _
Phone: Fax: 1: mail: --
er:
Applicant's signature: Date: —� other:
Nd VI tulicliom accgt credif cards,rae'ar call fwiuseetim fa rx+r ierorm�tir+n Permit fee.....................$ _ .---
Notice This prmit application Minimum fee......... $
U Visa O MuterCard expires if a per nit is not obtained , --
c -L— Plan review(at ,%) $
ex rr, within 180 day:eller it has lxxn State surcharg^(8%)....$
Now an .ere ee tioQit cad auoepted its ca—Mete. -
--GrtUroWa slpo a Amort 4404617(6K*KXW)
Electrical Permit Application _
Date received: r`. PcrmiInu.: � f%f i 17
City of Tigard Project/appl.no.: r-spiredate:
�1n(if Tigard Address: 13125 SW Hall Blvd,Tigard,W'. 97223 vete issued: [y: Receifittio.:
Phone: (503) 639-4171 Case file no.: Payment type:
Fax. (503) 598-1960
Land use approval:
1
U 1 &2 family dwelling or accessory U CommctciaVtndustrial
U Multi-family U Tenant improvement
U New construction U Additionlalte'.,.,)n/reptacement U Other: U Partial
r= 1 1
Job address: ^.1 C ,r c®,Bldg.no` Suite nn.: Tax map/tax IDU:ct Dunt to.:
Lot: �� Block: S�ivision
---
Project name: — Description and location of worE.on premises: —_
Estimated date of completion/inspection:
1 1
Fee Max
Job no: _- Description Qty. (cal Tural no.fox
ulti-family per
New reiideratl:::-dark orrn
Streamline Electric dwelling unit.Inclwkstn,clwdrun-e
DBA LaValley Corporation Servlceinclaetd
6025 East 1811'St 1000 sq ft or less _ ___ "—
Vancouver WA 98661 Each additional SW sq ft.or noon thereon _
360-993 5080 Limited energy.residential 2
Limited energy,non residential 2
CCB: ELC#: 34-4320 S()P#: Each manufactured home or modular dwelling
__ — -- - Service and/or feeds_ 2
Signature of su rvismg electrician(requued) _ Date -_-_
B �111
� 5,ervlceaorteaden-ttmullaHon,
Sup License no alteration or relocation:
200 amps or less __ 2_
201 amps to 400 amps _ _ 2
Name(print): 401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps _ 2
`� State: ZIP: over i0o0 amps or volts 2
C
ity: 1
Phone: — Rec2nnectonl
_— f:ex^ E-mail
l emponryutTfces or lerden-
Owner installatit n:The installation is being made on property I own bntaUsBon aheration,orrekKation:
which is not inti nded for sale,lease,rent,or exchange according to too amps or hxs --- 2
ORS W.455,4.9,670,701. 201 amps io LOO Imps __ _ 2
Date a01 to 600 a,, s — 2
Owner's signature: --
Bench clrrelrs-nen,alteration.
ne
or extensor per pal:
Name: A Fee for hooch tumult,with purchase of
_ servi,x or feeder fee,each branch circuit 2
Address: _
Stale: ZIP: B. Fee for branch circuits without purchase
City: -- of service or feeder fee,first branch circuit:
1'1t<tttr: - Fa X: f?-mail: Each additional branch circuit
MK.(. rrtceorfr_.-dernotincluded):
Eseh pun.p a Irrigation 2
U Service over 225 amps-cornnxrcial U Health-care facility Fjch sign or outline lighting
U Service over 320 amps-ruing of 1&2 U Hazardous location Signal circuit(s)in a limited energy panel
family dwellings U Building over 10,000 squae feet four or R ,
U System over 600 volts!ruminal more residential units in one structure @iteration.or extension' J — 2
U Building over three stories U Feeders,400 amps or more •Descri tion:_ --
•Occupant load over 99 persons U Manufactured structures or RV port Fjch sdditioaal kwpeclkn over the allowable M say of ale above:
U EgressAightlngplan U Dhu: ---.—. Putts an =_=
Submit-____sets of plans aith any of the above. luvestigs6onfee --
71te above are trot applicable to temporary construction service. Weer -
_ Permit fee.....................$
No,all juriadi-tion accepr credit cads,pkaar call jurisdiction for rotate irdoonatlon Notice:This permit application plan review(al `.%) S
U Visa U MasterCard expires if a permit is not obtained ....State surcharge(8%) S
within 180 days after it has been _--
Credit card oumtrn --- xpiru TOTAL. .......................S
accepted to complete. —
—Fame-oT�ardholder u ah.on credit card =
Cllydhdder�:goaoaR Afnoaat 4Mr-�niti H�rin n+.0
i
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOT;CE
WOLCOTT PLUMBING CONTRACTORS
PO BOX 2007
GRESHAM, OR 97030
Plumbing Signature Form
Permit #: MST2002-00052
Date Issued: 1/13/03
Parcel: 2S104DA-18200
Site Address: 13320 SW KINGSTON PL
Subdivision: QUAIL HOLLOW - SOUTH
Block: Lot: 008
Jurisdiction TIG
Zoning: R-4.5
Remarks: SF rowhouse,Unit 8,Bldg 4, bs plan with a deck. STRUCTURAL FILL, REQUIRES
GEO-TECH INSPECTION AND REPORT
Your company has been indicated as the plumbing contractor for the permit indicated above. In order nor th-.
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 ft-rm is received
OWNER: PLUMBING CONTRACTOR:
BROWNSTONE QUAIL HOLLOW LLC WOLCOTT PLUMBING CONTRACTOR!
12670 SW 68TH PKWY STE 200 PO BOX 2001
PORTLAND, OR 97223 GRESHAM, OR 97030
Phone #: 503-598-7565 Phone 4/ 667-1781
Reg #: LIC 23847
PLM 26-208PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signa ure`o 6fho'rikff Plumber
If you have any questions, please call (503) 639-4171 , ext. # 310
CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: M12/0 00104
3
2510 3
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED:
PARCEL: 25104DA-18200
SITE ADDRESS: 13320 SW KINGSTON PL
SUBDIVISION: QUAIL HOLLOW - SOUTH ZONING: R-4.5
BLOCK: LOT: 008 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SFA UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS _ HOODS:
FUELTYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 -50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfin:
Remarks- Installation of gas fireplace anti gas piliink.
Owner: _ _ FEES
BROWNSTONE QUAIL HOLLOW LLC Description Date Amount
i2670 SW 68TH PKWY STE 200 %11 ('111 I'crnut 122' 3/12/03 $72.50
PORTLAND, CR 97223 1 AX 8State I az 3/12/03 $580
Phone: 503-598-7565 —Total $78.30— --
Contractor:
THERMAL FLO
14865 SW 74TH AVE. #190
TIGARD, OR 97224 _ :EQUIRED INSPECTIONS —_
Gas Line Insp
Phone: 503-670-8383 Mechanical Insp
Reg#: LIC 151847 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
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 in 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 By: !%4�•L� �, -1 IrP_-� Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application FOR 01410E USE ONLY
Received Mechanical
Dare/By: Permit No.:
CII Of Tigard Planning App val Building
Y Date/By:
13125 SW Ifall Blvd. Plan Review other
Tigard,Oregon 97223 Datc/By: Pcrmit No
Phone: 503-639-4171 Fax: 503-598-1960 Post-Review land Use
Date/By: Case No..
Internet: www.cl.tlgard.or.us Contact Juris See Page 2 for
24-hour Inspection Request: 503-639-4175
P q Namc/Method_ _ _ _ Supplementallnformation.
TYPE OF WORK COMMERCIAL FEE*SCHEDULE-USE CHECKLIST
ENew construction I M Demolition Mechanical permit fees*are based on the total value of the work
Addition/alteration/re lacement I LJ Other: performed. Imticate the value(rounded to the nearest dollar)of all
CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead and profit.
❑ 1 & 2-Family dwelling Commercial/Industrial value: S See Page 2 for Fee Schedule
_ AccessoryBuildt'ng _- Multi-Family RESIDENTIAL E UIPMENT/SYSTEMS FEE*SCHEDULE
Description t Fee ea. Total
Master Builder Otter: -- is--- -- 1 -9- 1
Well up/Coolin
JOB SITE INFORMATION u d LOCA ON Furnace-add-on air conditionin 14.00
Job site address: Gas heat pump I4.00
Suite#: Bld ./A t.#. Duct work14.00
Project Name: Nydronic hot water system 14.00
-
Cross street/Directions to job site: Residential boiler(for radiator or hydronic system) 14.00
Unit heaters(fuel,not electric)
(in wall, in-duct,suspended,etc.) _ - 14.00
Flue/vent(for any of above) 10.00
Subdivision: --- ( ,;t#: Repair units 12.15 --
- -` --
Tax mOther Fuel A Ilancaa / arcel #: Water heater 10.00 _
_
DL'CRIPTION OF WORK Gas fireplace 10.00 -
Flue vent(water heater/gas fireplace' 10.00 _
Log lighter as _ 10.00 -
----_ — - — Wood/Pellct stove — 10.00
- ---- --- - - -- --_-- _ Wood fireplace/insert 10.00 1 _---
_ Chimney/liner/flue/vent 10.00
fI'„ROPERTY OWNER 10TENANT _ Other: _ 10.00
Name: _ i1JIUA 11Z Environmental Exhaust&ventilation
Addre� :
_�`:_ 2 PKO fit)&9-41 M 5tJ Z U Range hood/other kitchen equipment 10.00
_
Cit /StatC/Zi
ZZ -- Clothes dryer exhaust 10.00
Single duct exhaust
Phone: ax: (bathrooms,toilet compartments,
` PPLICANT I ONTACT PERSON -utility rooms) 6.80 _
Name: Attic/crawl space fans 10.00
Address: — -- - Other: --- -- 10.00 --
Fuel Piping
Cit y/State%: SSA0 for lustal
Phone. Fax: 4,$1.00 each addition
Furnace,etc. ••
—
----._----- ----------- - Gas heat um ++ -- -
E-mail: — Wall/suspended/unit heater +►
CONTRACTOR. Water heater •« — _
Business Name: t '`%� 4_ .l, Fireplace ••
Address: Zf Range
Cit /State/Zi BB -- `"
-� : /�� AZZ Clothes dryer as — __ +•
Phcne: 'per - Fac: 0 l)(,),V-- Other: � •«
CCB Lic. #. _ Ff TY Total:
Authorized _ Mechanical Permit Fees*
Signature: _ — Date: �� __ a Subtotal: S
_T Minirnim Permit Fee$72.50 S 5 O
_ Plan Review Fee(25%of Permit Fee) S
(Please print name) — State Surcharge 13%of Permit Fee S 6- ---
__ TOTAL PERMIT FEE $
Notice: Thls permll application expires ire permFl Is not obtained Nithin *Fee methodology set by Tri-County Building Industry Service Board.
ICO days after It loss been accepted as cor.rplele. *"Site plan required for exterior A/C units.
i:lDstsTer"0 horrns\MccPermitApp.dcx 01103
CITY OF TIGARD
13125 S.W. HALL BLV 3.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
DAVID JEROME ELECTRIC
PO BOX 751
HIL.LSBORO, OR 97123
Electrical Signature Form
Permit#. MST2002-00052
Date Issued: 1/13103
Parcel: 2S104DA-18200
Site Address: 13320 SW KINGSTON PL
Subdivision: QUAIL HOLLOW- SOUTH
Block; Lot: 008
Jurisdiction: TIG
Zoning: R-4.6
Remarks: SF rowhouse,Unit 8,Bld9 4, ba plan with a deck. STRUCTURAL FILL, REQUIRES
QEO-TECH INSPECTION AND REPORT
Your company has been indicated as the electrical con ractor for the permit indicated above. In ord.er for the
electrical permit to be valid,the signature of the supervising electrician is required. Please have the
appropriate individual fmrn 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 HIL.LSBORO, OR 97123
Phone# 503-698-7885 hone#; 848-6144
Reg # Lic 36051
SUP 29777
FT'F? 3d-]19C
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature Supervising ecfririan
It you have any questions, please call 503.718.2433.
70012 Id3a gcno QT'1"zi do uj3 TOOM0009 Pa WF,T 11BS CO 07, to
CITY OF TIGARD MECHANICAL PERMIT _
DEVELOPMENT SERVICES PERMIT#: MEC2003-00160
DATE ISSUED: 4/1/03
13125 SW Hall Blvd., Tigai.' OR 97223 (503) 639-4171 PARCEL: 2S104DA-18200
SITE ADDRESS: 13320 SW KINGSTON PL ZONING: R-4.5
SUBDIVISION: QUAIL HOLLOW - SOUTH JURISDICTION: TIG
BLOCK: LOT: 008
CLASS OF WORK: NEW FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS , HOODS:
FUEL TYPES _ 0 - 3 HP: 1 DOMES. INCIN:
3 15 HP: COMML. INCIN:
MAX INPUT: BTI1 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN >=10PK BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remark--Installati�m ul rstrri�u !� (' unit. 1'mit cannel he hlacr�l ill)ill the requurd "cihack,.
FEES
Owner: --
BROWNSTONE QUAIL HOLLOW LLC Description Date Amount
12670 SW 68TH PKWY STE 200 [ML:C:H] 11C111111Fcc 4/1/03 $72.50
PORTLAND,OR 97223 I'FAX1 `;° titntc"Foy 4;1/03 $5.80
Total $78.30 _
Phone: 503-599-7565
Contractor:
THERMOTECH
26716 S. BOLLAND RD.
CANBY, OR 97013 __ REQUIRED INSPECTIONS
Mechanical Insp
Phone: 503-263-8900 Final Inspection
Reg#: LIC 118695
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00
Issued By: Permittee Signature: —
Call (503) 639-4175 by 7:00 P.M. for Inspections needed the ne t business day
Mechanical Phii-40011cation ' '
NLY
� � Received Mechanical
Date/By-�// D_; Permit No.:�E�' �J_�
Planning Ap oval Building
Cit of Tigard -Date/By:: Permit No.:
13125 llU 1 2003
SW Hall Blvd. APR Plan Rev- — Other
Tigard,Oregon 97223 ITY OP TIGARn Datc/By Permit No.
Post-Phone: 503-639-4171 FOW:l!SOd.598-1!960' Datc/B: land Use
Date/Dy: Case No.:
Internet: w vw.ci.tigard.or.us Contact luris.: See Page 2 for
24-hour Inspection Request: 503-639-4175 Name/Mclhod: _— Su Icmental Information.
TYPE OF WORK 'COMMERCIAL FEE*SCHEDULE-USE CHECKLIST
New construction �— Demolition Mechanical permit tires'are based on the total value of the work
New
Others performed. Indicate the value(rounded to the nearest dollar)of all
CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead and profit.
qI &2-Family dwelling CommerciaVIndustrial Value: S_ A _ See Page 2 for Fee Schedule
Accessory Building _ Multi-Family RESIDENTIAL EQUIPMEN'r/SYSTEMS FI;E*SCHEDULE
Master Builder Other: DescriptionIlestin co init Fec(ea.) Total—
JOBfi1TE'INFORMATION and LOJCJ ' Furnace-add-on air conditioning 14.00
Job site address: - Gas heat um - 14.00 --—-
Suite#: I 10g./Ap A Duct work 14.00
dn ter system 14.00
Project Name: 1. N - Residential boiler
Cross street/Directions to job site: for radiator orhydronic system 14.00
Unit heaters(fuel,not electric)
in wall in-duct suspended,etc. 14.00
Flue/vent for any of above 10.00 -
Subdivision: _ Lot#: Repair units_ 12.15 _
-- - -- ---- Other Fuel A Ilancq
Tax map/parcel ti: _ Water heater 10.00
DESCRIPTION OF WORK Gas fireplace 10.00
7— Flue vent water heater/ as fireplace) 10.00
Log li hter as 10,00
-- --- — Wood/Pellet stove 10.00
Wood fire lace/insert10.00
r Chimney/liner/flue/vent _— 10.00
YROPEVY T N JT., -- Other: 10.00
Environmental Fithaust&Ventilation
Nan1C: F t'� Range hood/uther kitchen equipment 10.00
Address: /04 t�1 /C' 1') Clothes dryer exhaust 10.00
City/State/Zip: Single duct exhaust
Phone: r 9'P - � ter. Fax: (bathrooms,toilet compartments,
-OWP CAiNT_ w OON'rAC'I'PERM utility rooms) 6.80
Name: Attic/crawl space fans _ 10.00
- - - -- - Other 10.00
Address: -- - __ FuelEjping__�_
City/State/Zip: **($.5.40 for first 4,$1.00 each additional
Phone: _Fax.. Furnace,etc.
�_.. — _ Gas heat pump •► ___
E-mail: wall/suspended unit heater
0 ITRACTOI2 Water heater •'
Business Name. U1M1�,.1 ' �* Fireplace -- _ --- •• __ __
Address: 02 ii 3e1, Range —_._—
Cit /State/Zi C•to►vd x- y�'�0%3 B°
p� Clothes dryer as
Phone: *1` Lf o 'Fax: Other: "• ____
CCB Lic. #: __ Total: -
' / Mechanicall Permit Subtotal:
tai:
S
Signature: — Date:_ Subtotal:
Minimum Permit Fee$72.50 S
�rA Q Plan Review Fee(25%of Permit Fee) S
(Please print name) ��— State Surcharge 8%of Permit Fee S
TOTAL PERMIT FEE $
Notice: This permit application expires If a permit Is not obtained within I *Fee methodology set by Trl-County Building Industry Service Board.
180 days after It has been accepted as complete.
i\I)sls\Permit Form%\MecPermitApp dtx 01/01
Mechlanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule: _
Total Valuation: _Permit Fee:
$1.00 to$5,000.00 Minimum fee$72.50
(X)
$5,001.00 to$10,000. $72 50 for the first S5,(N)0.(N3 and$1.52
for each additional$100.00 or fraction
___ thereof,to and including$10,000.00.
$10,001.00 to$25,000.00 $148 50 for the first$10,000.00 and
$1.54 for each additional$100.00 or
fraction thereof,to and including
_ $25,000.00.
$25,001.00 to$50,000.00 v $379.50 for the-first$25,0)0.01 and
$1.45 for each additional$1(X),(X)or
fraction thereof,to and including
$50,000.00.
$50,001.00 and up S742.00 for the first$50,000.00 and
$1.20 for each additional$100 00 or
fraction thereof.
Assumed_Valuati_o_ns Per Appliance:
Value Total
I)e8cnpt12t __ Qty (lia) Amount
Furnace to 100,(M BTI1,including 955
ducts&vents
Furnace 101,010 BTI I including ducts u 1,170
&vents
Floor furnace including vent 95.5
Suspended heater,wall heater or floor 955
_mounted heater
Vent not included in appliance Ermit 445
Repair units 805
3 hp;absorb unit, --- - 955
to 100k 13TU _
3-15'ip;absorb.unit,~ 1,700
10!k to 500k BTU
15.30 hp;absorb.unit,501 k to I mil. 2,310
BTU
30-50 hp;absorb.unit, 3,400
1-1.75 mil.BTU
>50 hp;absorb.unit, 5,725
>1.75 mil.BTU
Air handlint unit to 10,000 cfm 656
Air handling unit>10,000 cfm _ 1,170
Non- ortableemirate cooler 656
Vent fan connected to a single duct 446
Vent system not included in appliance 656
-Permit _
Hood served by mechanical exhaust 656
Domestic incinerator 1 170
Commercial or industrial incinerator _ 4,590 _
Other unit,including wood stoves, 656
inserts,rtc. _
Cias p 360
Each additional outlet 63
TOTAL COMMERCIAI. $
VALUATION:
0I)s Permit�oirms\M:cPermitAppPg2.doc 01103
RECEIVED
APR 01 2001
CITY OF TIGARD
BUILDING DIVISION
r
�� u
ELECTRICAL -
CITY OF TIGARD RESTRICTED ENRIGY
DEVELOPMENT SERVICES PERMIT#: ELR2003-00097
13125 SW Hall Blvd., Tiqard. OR 97223 (503)639-4171 DATE ISSUED: 3/31/03
SITE ADDRESS: 13320 SW KINGSTON PL PARCEL: 2S104DA-18200
SUBDIVISION: QUAIL HOLLOW- SOUTH ZONING: R-4.5
BLOCK: LOT: 008 JURISDICTION: TIG
Prolect Desr•ription:All encompassing low voltage.
A.RESIDENTIAL B.COMMERCIAL
AUDIO& STEREO: AUDIO& STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: ALL ENCOMP : X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL#OF SYSTEMS:
Owner: Contractor:
BROWNSTONE QUAIL HOLLOW LLC AZIMUTH COMMUNICATIONS INC
12670 SW 68TH PKWY STE 200 P.O. BOX 508
PORTLAND, OR 972.23 WILSONVILLE, OR 97070
Phone: 503-598-7565 Phone: 503-639-0110
Reg#: ELE? 3r;-94C'LE
SUI' 23121,FA
_ LIC 145828
FEES Required Inspections
Description Date Amount Low Voltage Inspection
11 1.1'IZM'I'j ELR Permit 3/31/03 $75.00 — Elect'I Final
1 AXj 8'% Statc'I,n 3/31/03 $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 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. 1"hose rules are set forth in OAR 952-001-0010 throuc
II
Iss ed by `` _ 1/1 /41-; — Permittee Signature
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:---
CONTRACTOR
ATE:CO T ACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N
LICENSE NO:
Cali 639-4175 by 7:00 P.M. for an inspection needed the next business day
Electrical Permit Application
--- �Datereccived�Wj 0 �Pemito,:
City of Tigard Project/appl,no.: Expire date:
Address: 13125 SW Hall Blvd.Tigard,OR 97223 Date issued: By: I Receipt no.:
Phone: (503) 639-4171 --
Fax: (503) 598-1960 Case file no.: Payment type:
Land usC approval: .
U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U'renant iniprovt•nt^nt
DkNew construction U Addition/alteration/rcplacrment U Other: _ U Parlial
o JOB SITE INFORMATION
lob address ��J s, �IDI� L
lilag. Ili. Swtr. no.: Tax map/tax lot/account no.:
Lor. Block: Subdliv,sion: _�f�(L St.`tt IN
Project name: �LLr}I� 1+ Description and location of work on premises: /h �
Estimated date of comp letion/inspection:
CONTRACIOR APPLICATION FEE SUIEDULE
Job no: Fee Max
Description Qty. (ca.) 'Total no.insp
Business name: '-, n I
--- M1'cw rrsbkntlal-slt:gle or multi•fnndly per
Address: ' S _ dwellhrgtmll.Includesattaclrrslgarage.
City: N ;LL State: ZIP: �' Service Included: I
Phonc: ,-'r ',i Fax: , ' . n E-mail: loouad ft or ll 55 _t - -- a._._--
Each additional S00 sq,It or uruiui therein
CCB nc_.: I`f SYS k" Elec.bus.lic.no: g&(j c/ C C t- Limited energy,residential
City/met o lic.no.: j q 5 C<Z.( Limited energy,non-residential _ =
Each manufactured home or modular dwelling
Signature of superyising electrics equircd) _ Itat � _
-- Service and/or feeder
Sup.elemnarne(prinu Lncense no: Setrlceaorfeeden—Inatallatlon,
L tdterationorrelocation:
200 amps of Icss _
Name(print): 115 )'r 201 amps to 400 amps 2
401 amps to 600 amps -'
Mailing address_ 601 amps to 1000 amps 2
City: State: ZIP; — Over low amps or volts 2
I'horte: I Fax: I E-mail: Reconnectonly I
Owner installation:The installation is being made on property I own Temporaryservlcesorfeederv-
which is not intended for sale,lease,rent,or exchange according to Inonllatlon,alteraU,m,orrelocatlon:
200 amps or
ORS 447,455,479,670,701. i 2
2{)I amps to 4U000 amps 2
Owner's signature: _ Dille: 4011 to 600 ams —
Branch circuits-new,alteration
or extension per panel:
Name: _ A Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit 2
City: ,—_— Stale: ZIP: B. Fee for branch circuits without purchase
—— — -- — of service or feeder fee,first branch circuit 2
Phone: Fax. F-ItLtil: Each additional branch circuit
Misc.(Service or feeder not Included):
U Service over 225 amps-commercial U Henitlrcure facility Each pump or irrigation circle 2
OServiceover320amps-rating of 1&2 UHazardouslocation Each sign nr outline lighting _ _ 2
familydwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel,
U System over600 volts nominal more residential units in one atnicture alteration,or extension* y� '-
U Building over three stones U Feeders.400 limps or more 'Description —
U Occupant load over 99 persons U Manufactured structures or 12V park Fach additional Inspection over the allowable In any of the above:
U Egress/lightingplan U Other Per inspection _Y
Submit sett or plans with any of the above. Investigation fee _
71te above are not applicable to temporary const:action service. Other
— Permit fee. .................$
LCreditcaidliumbet
l jurisdictions accept credit cards,pleave call jurisdiction for more inforrnmion Notice:This permit application
sa U MasterCard expires if*a permit is not obtained Plan review(at _ %) $
-_ _�__.—_ _L_.L_— ssithin 180 days aper it has been State surcharge(8%) ....$r:,pire` accepted as complete.-- TOTAL .......................$ _
Name of car older u shown on credit card
_ S _
Cardholder signature Amoum 4441613(bt10/COM)
April 29, 9003 CITY OF�TIGARD
OREGON
Ron Estey
12670 SW 68�h 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
buildi^:� 44, 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 1'0 adequate
wring for this load at lot- 7, 9, 59, 60, 61, 62, and 63. Or, you !right contact
your engineer to address the footing pad issue.
Lot 24 was approved and lots 2, 3, 4, and 5 have not been poured.
Lot 19 has been revised to reflect storage space in lieu of the original bedroom.
The bay was also credited and 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, and 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.
Sincerely,
Darrel "Hap" Watkins
Inspection Supervisor
13125 SW Hall Blvd., Tigard, OR 97223(503)639-4171 TDD(503)684-2772 — -