13173 SW RAPTOR PLACE 13173 SW Raptor Place
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
STREAMLINE ELECTRICAL_
6025 EAST 18TH STREET
VANCOUVER, WA 98661
Electrical Signature Form
Permit #: MST2001-00182
Date Issued: 8/6/01
Parcel: 2S104DN-08500
Site Address: 13173 SW RAPTOR PL
Subdivision: QUAIL HOLLOW - WEST
Block: Lot: 075
Jurisdiction: TIG
Zoning: R-4.5
Remarks. New SF detached rowhouse in Building #3. Setbacks as per Beet A10.10
Plan B-S
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 Signature Form prior to thy,
start of the work to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
BROWNSTONE HOMES STREAMLINE ELECTRICAL_
12670 S1,N 68TH PKWY #200 6025 EAST 18TH STREET
PORTLAND, OR 972.23 VANCOUVER. WA 98661
Phone #: 503-598-7565 Phone #: 360-993-5080
Reg #: LIC 116514
ELE 34-432C
SUP 4061S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X4 �� r
Signature of Supervising Electrician
If you have any questions, please call (503) 639-4171, ext. # 310
�� �� �I���� MASTER PERMIT
PERMIT #: MST2001-00182
DEVELOPMENT SERVICES DATE ISSUED: 8/6/01
13125 SW Hall B vd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 13173 SW RAPTOR PL PARCEL.: 2S104DA-08900
SUBDIVISION: QUAIL HOLLOW -WEST ZONING: R-4.5
BLOCK: LOT: 075 JURISDICTION: TIG
REMARKS. New SF detached rowhouse in Building#3. Setbacks as per seet A10.10
Plan B-S
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS RFOUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 31 FIRST: 173 at BASEMENT: al LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 735 of GARAGE: 410 of FRONT PARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: 567 of VALUE: $138,630 00 RIGHT.
OCCUPANCY GRP: R3 BDRM: 3 BATH: 2 TOTAL: 1,475.00 of REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN 1)02 TRAPS:
LAVATORIES: 4 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS CATCH BASINS.
TUBISHOWERS 2 GARFIAGE DISP: I WATER HEATERS. I WATER LINES: 100 BCKFLW PREVNTR GREASE TRAPS:
OTHER FIXTURES: I
MECHANICAL
FUEL TYPES FURN<100K: I BOILICMP<3HP: VENT FANS. 3 CLOTHES DRYER: 1
GAS FURN 3-100K: UNIT HEATERS: 140ODS: OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BnANC 'SITS _ MISCELLANEOUS ACD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp: 0 200 amp: W Dk. PUMP/IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 3 201 400 amp. 201 •400 amp. lot W,.. .' .WOR: o2 SIG VOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 •600 amp: EA ADDL OR CIR: I SIGNAUPANFL: IN PLANT:
MANU HMISVCIFDR. 601 • 1000 amp: 601+ampe-1000v: MINOR LABEL:
10004 ompfvolt: PLAN REVIEW SECTION
Reconnect only: ,.4 RES UNITS: SVCIFDR>•225 A.: >600 V NOMINAL CLS AREAISPC OCC:
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO R STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNOSC LT:
BURGLAR ALARM: 0TH: ALL ENCOMA BOILER: HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK•. INSTRUMENTATION: MEDICAL OTHR:
HVAC: DATA/TELE COMM: rWRSE CALLS: TOTAL 0 SYSTEMS.
Contractor: TOTAL FEES: $ 5,683.49
Owner: This permit is subject to the regulations contained in the
BROWNSTONE HOMES BROWNSTONE HOMES,LLC 'Tigard Municipal Code,State of OR Specialty Codes and
12670 SW 68TH PKWY 0200 12670 SW 68Th PKWY all other applicable laws. All work will be done in
PORTLAND,OR 97223 PORTLAND,OR 97223 accordance with approved plans. This permit will expire if
work I-,not started within 180 days of issuance,or if the
work is suspended for more than 180 days. ATTENTION.
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center Those rules are set
ROD 0: tic' :+e,r forth ie OAR 952-001-0010 through 952-001-0080 You
may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp& Underfloor Insulation Electrical Service Low Voltage Firewall Insp Electrical Final
Sewer Inspection Pimiundslab Insp Electrical Rough In Gas Line Insp Roof Nailing Mechanical Final
Footing Insp PLM/Underfloor Framing Insp Gas Fireplace Water Line Insp Plumb Final
Foundation Insp Mechanical Insp Shear Wall Insp Insulation Insp Water Service Insp Final inspection
Exterior Sheathing Ins{ Gyp Board Insp Appr/Sdwlk Insp
Slab Insp Plumb Top Out
Issued By : E-- T __ Permittee Signature
Call (503) 639.4175 by 7:00 p.m. for an inspection needed the next business day
CITY OF TIGARD _SEWER CONNECTION PERMIT
/ PERMIT#: SWR2001-00124
DEVELOPMENT SERVICES DATF ISSUED: 8/6/01
'13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
PARCEL: 2S104DA-08900
SITE ADDRESS; 13173 SW RAPTOR PL
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R-4 5
JURISDICTION: TIG
BLOCK: _ LOT: 075
TENANT NAME:
FIXTURE UNITS:
USA NO:
CLASS OF WORK: NEW DWELLING UNITS: 1
NO. OF BUILDINGS: 1
TYPE OF USE: SF
INSTALL TYPE: LTPSWR IMPFRV SURFACE:
r
Remarks: Sewer connection for new SF detached rowhouse.
Owner: ___ — FEES
BROWNSTONE HOMES Type By Date Amount Receipt
12670 SW 68TH PKWY#200 PRMT CTR 8/6/01 $2,300.00 27200100000
PORTLAND,OR 97223 INSP CTR 8/6/01 $35.00 272.00100000
Phone: 503-598-7565 Total $2,335_00
Contractor:
Phone:
Reg #:
Required Inspections
This Appli^.ant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires
180 days from the date issued. The total amount paid will be forfeited if the 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 directions from tie 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 requires you to follow rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You nay obtain copies of these rules or direct questions to OUNC by calling(503)
-1987.
by:
Permittee Signature:
Issued
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Building Permit Application
Date received: Q/ Permit no.:/-/'r.,.l,;
Chy of Tigard
City of Tigard
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: Expire date:
Phone: (503)6394171 Date issued: Byi.'). Receipt no.:
Fax: (503) 598-1960 Case file no.: _ Payment type:
Land use approval: 1&2 family:Simple Complex:
f'fl &2 family dwelling or accessory U Commercial/industrial U Multi-family New construction U Demolition
U Addition/alterttion/replacement U Tenant improvement U Fire sprinkler/alarm U Other:
O' ON
Job address: ;,) /Eyj,.0 t L /4 Nc� Bldg,no.: �� Suite na.:
l ot: 1 Block: Subdivision: p&j L txr� >Y ST , Tax map/tax lot/account no.:
Project name: Q ALL Mc,tIt to _
Description and location of work on premises/special conditions: Elst_'\ _ I_► _ i+�POltt At1t}►J
Name: TCA►J = u M li;:s MIN55FIMN7717=1
Mailing address: lq.,6?0 yw Jgth PAqktuqp 1 dt 2 family dncllin{;:
City: p -1 A State:i ZIP 87223 Valuation of work........................................ $
Phone: Fax: 8 go111 E-mail: No.of bedrooms/baths.........................
Owner's representative: /vl /2 ()Apc`5 Total number of floors................3..............
7`I Fax:57q '19'L Gmail:
New dwelling area(sq.ft.) .....�..`.�..�......
Garage/carport area(sq.ft.).......� �...;........
Name:" `r1F A' gJWV6 , Covered porch area(sq.ft.) —
.........................
<..� a..
Mailing address: Deck arca(sq.fl.)................. .4......... ....
City: State: ZIP: Other structure area(sq. ft.).............. .......... _
Phone: Fax: E-mail; CommerciaUlndwstrial/multi-family:
Valuation of work............. .......................... $
Existing bldg.area(sq. ft.) ..........................
Businrss name: -New bldg.area(sq,ft.).......................I........ --
Address: -
Number of stories........................................
State: ZIP: -- _
City: Type of construction
....................................
Phone: Fax: E-mail: -
Occupancy group(s): Existing:
CCB no.: — --
New: _
City/metro lie.no.: Notice:All contractors and subcontractors arc required to he
licensed with the Oregon Construction Contractors Board under
"Naine: r-j'\ d provisions of ORS 701 and may be required to be licensed in the
Address: \kq\ tAF(ot lm t ti (oSZ jurisdiction where work is being performed.if the applicant is
city: Sta1e:W ZIP: I(OlDl exempt from licensing,the following reason applies:
Contact person: AmPlan no.: —
Phone:766- 4(a Fax: 4j.7- E-mail: — —
Nanie:WQ er-,tW. Contact person: tN Dill,pK4,5 Fees due upon application
Address: '5 Lo Q kt9U Date received:
City: k Stateor" ZIP: 2223 Amount received ...................................... $
PhoneLft -1 b,3'3 Fax: I E-mail: — Please refer to fee schedule.
1 hereby certify 1 have read and examined this application and the Not all juttadictiotn aha cmdh tarda,Please call judwicom for more infomWion.
attached checklist. All provisions of lays and ordinances governing this U Visa U MasterCard
work will he compli whe if led herein or not. Credit para numbs:
Expires
Authorized signature: _ Date: �/s/c( Name of c older as shown on ctcud
Print name: 'tr. ►Vt Q-1 G A it:Ns
c'ardholderr 11pature Amount
Notice:This permit application expires if a permit is not obtained within 180 days after it has hcen accepted as complete. 440-4613(60WCOM)
/ Mechanical Permit Application
Date received: Pam itno.
:/'lff'?Q(J/-
City of Tigard Pro*t/appl.no.: --- Expire date:
City ofTigard Address: 131'.5 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.;
Phona: (503) 639-4171 _
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: _ Building permit no.:
1
&2 family dwelling or accessory U Commercial/industrial 0 Multi-family 0 Tenant improvement
C New construction U Addition/alteration/replacement U Other:
JORSITE INFORMATION 1 1
Job address: 4 ���. Indicate equipment quantities in boxes 1-wlow. Indicate the dullaf
Bldg.no.: ` Suite no.: value of all mechanical mateli_als,equipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$ LT�(7
Lot: Block: Subdivision:Q A,I ow *Ste checklist for important application information and
Project name: (,-kA 1i El LO -1(ALW04MUE- jurisdiction's fee schedule for residential permit fee.
City/county: I ICjAt V fLSH ZIP: 22 1
Description and location o work on premises: --W1 1 10 191 ri 10 111161 1
Fee(ra.) Total
Est.date of complction/inspection: Description Qty. _Res.only Res.only�
Tenant imptovement or change of use:
Is existing space heated or conditioned?U Yes U No Air Airconditioning
unit _ CFM
(site plan required)
6
Is existing space insulated?U Yes U No tcrauon o existing system
Boiler/compressors
Business name:
State boiler p.,,�Jt no.:
�UrL '�� A lU�i C�Ina _ tip Tons BTU/H
Address: U to(e itsmo a dampers/duct smoke detectors
City: c-alpoly StatetNr tZ.IP:Gt7 Z-90 eat pump(site plan required)
Phone: e - Fax:' nsta replace urnac umer —-
� S`) 775 1141 E-mail: _
CCB no.:
,Lt6 Including ductwork/vent liner U Yes U No
nsta replac to ovate heaters-suspen ,
City/metro lie.no.: 1'0 bo 1 0?-S wall,or floor mounted
Name(please print): '� tv M! O*LD ent forappliance other t an furnace
e
Absorption units BTU/H
Name: -1 LA _"AV Chillers v_ HP
Address: !! rtWtC A" ft/� Com ressors — HP
Environmental exhaust aiR ventilation:
City: !� State: _ ZIP_ Appliance vent
Phone: Fax: E-mail: hycr exhaust
Hood,.Type res.kitcheigfiazmat
hood fire suppression system
Name: !1,J Exhaust fan with single duct.(bath fans)
Mailing address: aust systema art from hearing or AC
pipT ■ distribution up to outlets)
City: Stale: ZIP: Type: .----LPG NO Oil
Phone: Fax: E-mail:
�Erul
piping each additional over 4 outlets
roved piping(schematic requr )
Number of outlets
Name: S N( ENCE, tither st ■
pp or equipment:
Address: Decorative fireplace
City: State: LIP: Insert-ty
Phone: Fax: E-mail: tov et stove
Applicant's signature: Date: Other:
Name(print):
Na dl iai wactiom wcgw ctedtt cart,please call i,uidkNon for more infanmadon. Permit fee.....................S f�50
U visa U MasterCard Notice:This permit application Minimum fee................$
expires if a permit is not obtained ,
C,edl,card numbs _ -
Plan review(at _ 96) $
Expire, within 180 days■Rea it hes been State surcharge(896) $
Now or cordbolder d shown on cn3it cud—� S accepted as compete. TOTAL .......................$ _7
Cardholder Hs aa,re A,aou■1 44GA19(t ROHM)
:atm
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: FEE: Description: Price Total
Table 1A Mechanical Code Oty (Eat Amt
$1.00 to$51000.00 _ Minimum fee$72.50 1) Furnace to 100,000 BTU
$5,001.00 to$10,000.00 $72.50 for the first=5,000.00 and Including duds&vents 14.00
$1.52 for each additional$100.00 or 2) Furnace 100,000 BTU+
fraction thereof to and Including including duds&vents 17.40
$1000.00. _
510,001.00 to$25,000.00 $148.50 for the first$10,000.00 anu 3) Floor Furnace
Including vent 14.00
$1.54 for each aaditional$100.00 or Suspended hooter,wall heater
fraction thereof,to and including 4) 14 0(i
$25,000.00. or floor mounted heater __
$25,001.00 to$50,000.00 $379.50 for the first 525,000.00-and 5) Vent not Included in appliance permit
6.80
$1.45 for each additional$100.00 or --
fraction thereof,to and Including 6) Repair units
_ 12.15
$50.00000.
$50,001.00 and up 5742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air
$1.20 for each additional$100.00 or For Items 7.11,see or Pump Gond
fraction thereof. footnotes below.
- _ 7)<3HP;absorb unit
to 100K BTU 14 00
ASSUMED VALUATIONS PER APPLIANCE: 8)3-15 HP;absorb
-- Value Total unit 100k to 500k BTU_ - 25.60
Oestri tion: Ot Eat Amount 9)15-30 HP;absorb
Furnace to 100,000 BTU,Including 955 unit.5-1 felt 13TU 3500
��-
ducts&vents 10)30-W HP;absorb
Furnace> 100,000 BTU Including 1,170 unit 1-1.�5 mil BTU 52.20 _
ducts&vents 11)>50HP:absorb
Floor furnace Includin vent 955 _ unit>1.75 mil BTU _ 87.20
Suspended heater,wall he, ter or 955 12)Air handling unit to 10,000 CFM
floor mounted heater _ 10.00
Vent not Included in appiicance- 445 13)Air handling unit 10,000 CFM*
permit 17.20
Re air units 955 --- 14)Non-portable evaporate cooler
<3 hp;absorb.unit, 10.00
to 100k BTU _ ---- 15)Vent fan connected to a single duct
3-15 hp;absorb.unit, 1,700 6.80 -
101k to 500k BTU 16)Ventilation 3yslem not included In
15-30 hp;absorb,unit,501k to 1 2,310 appliance permit 10.00
mil.BTU 17)Hood served by mechanical exhaust
30-50 hp;absorb.unit, 31400 10.00 -
1-1.75 mil.BTU 18)Domestic incinerators
>50 hp;absorb.unit, 5,725 17.40
>1.75 mil.BTU - 19)Commercial or Industrial type Incinerator
Alr handling unit to 10,000 cfm 658 89.95 -_
Alr handling unR>10 000 CfM ,1 170 20)Other unitsIncluding wood stoves
Non-portable eva orate cooler _ 656 - 10.00
Vent fan connected to a single dud 7446 ---- 21)Gas piping one to four outlets
Vent system not Included In 5.4022)More than 4-per outlet(each)
Hood served b mechanical exhaust 1.00
Domestic Incinerator Minimum Permit Fee$72.50 SUBTOTAL:
E
Gommerdal or Industrial IncneralCr 4,590
Other unit,Including wood stoveu, 656 '8%State Surcharge 5
Inserts,etc.
Gas piping 1 4 outiels 360 _ 25%Plar,Review Fee(of subtotal) $
Each additional outlet _63 Required for ALL commercial permits only
TOTAL COMMERCIAL � $ TOTAL RESIDENTIAL PERMIT FEE: 5
VALUATION: -- -- --
----� Q�har lnsan�I n E!!f:
1 Inspec, 's outside of nonnal business hours(minimum charge-tv)tours)
s72 5l:der hour
2 Inspections for which no fee is specifically indicated (minimum charge-half tour)
$72.50 per tour
I Additional plan review required by cha•iges,additions or revisions to plans(minimum
rhargeone-haff hour)$72 50 per tour
'State Contractor Boiler Certification required for units>200k BTU.
"Residential AIC requires oft@ plan showing placement of unit.
i:klstsUorms\mech-fees.dc c 10111100
Elec-trical Permit Application
au noelv.d: r*nRic no.:/
City of Tigard Pmoollow,no'. -
crntyngerd Addtese: 1312!SW Hyl Blvd,Tlpud,OR 9722 Datahmred: - ey: R4oeltxRo.
p1l"W": (101)6 9.4171
Pax. (Sf)7)39&1960 Cast free no..
Land u1C,approval: _
TA family dwelliaw m aoccunry Q ConrtrrereialAndustriat U Multi-family U Tenon inlpmvpTl w
8 Pkw sant rtion iu Addlt1oNaltem6(wVmpl6ce"w U Other U Pvtial
Joh rrc{driaa. !,x', Dld rxr Suire no, _ T'ur m Irwacao4tlt�0.:
IAX
Pt eci nal W, x^11 4#110 Of Wa*On prerniees h:t-li !A.?lr1N.11Ct1pt,1
t'atlmwoci Luff d eco etioNiru -t,0n:
job too Pw. MNew
BadanotlMU"! t eain�i 1.1_E 1F]IlI r-i r tMd M.
AwalttAttrai.tlaelderepaeird�ega
r V ncouv State: WA 1 98661 + ++
"Mo: 993-55-0 u, m.il: 100043- O,I" � 5
tl addlliO11a1�OT Q4llMM ROI -
CC Mt0.:1 1 8100.10115 ik.nol 34-432C.
l s„_ ,�a -,,;, „0ar
CI /metro Ik.Ma.: _ �s_
Conrad reery non reeldeMul
mnrwfaotu ur nvdulr dwnlliq
rwN K Mrpr"Mhl 1lM( Y Dee y SNV{q&Wm(SOMI - --2
.Mrt aMrN �Ureflse ro
Iieo+earl or I�n"�� +r�i! lafl br,
•Nert�K nlwcwtlew: !
!00 ami. len O =
a� a.., "
W addmu: f� a anlpm io 000 rqw 2
1 i —
_
C♦ 7 MP state C 1'' TJI'---1� rr m ro M 3
ft119: 1.7►T7 6 F,nurl. RmrosWairiath
oww(nwallltlon' iaaJlation a inp made on r^'Ptoy own �� • '
which i pot telesuW fcw sale.i rx n%change according to wahoome'a*"**%
ORS 447,41S,479,9!1'101 10o� � 2
l b e
(�vw!'1 Or Vale: �fr 1 401so 60 owe
.._x_. -
M-www.
r aatrMMea For peau
A. Fee fm bmwh maria with pmhow of
Adele": worm or hadar wrr nrtisoA dit%M f
City.
S1a41 173P NRxErrKedRr .iineurpwe
nt onto or beds he flow bnwh euwlt 2
f'MAil [tR>t,w1dYl eedr r.
glow ow4oe-W 377 wrpet+onyarMM 0 mMdrRew hKa ty W+r r-o! a r tis+E-w!is
q gnieevnrJbOrryte+aliagella2 O NanedomlaMen am_t1., !
brdlyd"1*V O AvIA"ova 10.000armeMw%-otos liorw ovcrrta)xa Irrowdrn;jv-pry
O tlyrrra ova 600 velrs wominW move reeMeUtlel etwu in mw ItnrA/te Mwtrlon.at rr rwlar•
U MprnlNRgorrtNeeftko n Moldwt.QM rnro«nvte •[yon
t7(kvsp"IoM Over lurY
""fwxw U MlAoNvwnd rwrnor RV prwk Fled ad2dble"I -- ..w ftn M3 e1
U tte.rrtlganlnplrtta la tier. _r_ hrleerrertlow
to N&_,wa of N&wkh ay N tie @be". Imesai'u""6
Two Mote ofs tt>•1 a�ba111t M dp��RMtr �MaM srstHts. w ^- -_.'�.....�.._..�....�.
Permit fa.-... ........_...
NM all rat'Comm no,poor wr rl ;,N,b,www Yrrnewlea N00" 11111 prnaU appUaRinw ��rrvita f M
ONo O MrtaCartl expim If•pmmlr n Iter obaWned Flkn "Je (b4F
0%80 said wrwr _. �,_.vl_. w11A14 110 days Aw it has bm � ).•..S
s o -.w.
■�e"' --r ed w onrepWA 7 OTAL ......_ ..._...,„...S
g
10/IO 3Jad JI2i1J3�3 3JI�Wd3d__ ZI AS1:6E09E 6� 1 I 10�i�.'90,'t:0
Mar-06-01 03:05P Wolcott Plumbing 503 667 9891 P.01
01/00/01 'J'Ur" 14-41 FAX 505 SAH 1960 CI'T'Y ()F TJCARf)
(QJOU2
Plumbing Permit Application
City of 'Tigard sewn p.r►nit no. lwtta,
nddrenot 13123 SW Mall Blvd,l igar i,OR 9717, ngpermit no.:
City if Tigard Phone: (S(13)630-4171 RoTecUsppl.no.: exputdate:
Fun: (10.1)SSR-1960 Dute hwed rV_ ey. Rece;pr rK,
LAW use approval: Ceac fele no. Payment ype a
U 1 &2 family dwclling ur aeces,txy U Camino O Multi-family G Trnrzt improvement
O New cwsttrucuott 0 Addidc n/altersttaniteplacerreni U Food we-Vice 4()ther
J0 addroea: lit I tf'o Qt7• 1Fte(e.. Total
Bld .nv.: Suite r,o,; - l\an 1•scat!2 Gotslly d,.elllnte ouTy�
Twt maplta+t loUeccouut no.: - (bb*Wcg loon.rcr s.ch uuuty covsectles)
SFR(1)bath
Lut. -4- :i— Block- Subdivuton: ) a
Project rlarrtc: _ _ C bath^ -
C:tylCounty; —I zip! _ - Each rel iUona T F 2 Muc n _
Description and loctsLon of work on premises: Site 4Whlea:
Catch basio/atra draws
Est date or cmripletion/itiWctum - —— tywcll leac rae ur chi
notiri dram no. n. J
Bos-ussuame: 1,)O�C4 lk� ivy anutaetu rxneublibts ��
,�ddrosr:��• 6 0 2.0 0)
a n drain connector
C:ty: I eyl,� v.. 3tateQ ,li' nr t sewer no
Iia R�
plrorte 5o3-4N i� 1 fax 6L7-9tl1) E•motl.¢,.yu px-tsrw Storm sewer so. in�
CCB no.- 1,51kil 1 Plumb.bw.MXL oo!'14-Zo y Pp Water service
Citynnetro lic no.: —� _ Fixture or Newt
Contractor's repre rdadvc ai oahue:r - Abun on v-alve
--a ack�nw ptsveotct
Ytml name Uitckwater valve
aetrt avat�cry
Nance. C otT�ea wsaircc
Mateo-
City.
ateo
tl n YU4rQ nL1 (1)-�
Phone: Fax 6 ots,1 -Gr
E.t enflon Wok
intucr ca --
_Namc(print): F;oui ,oar si u
Maillrty.rddretn: to
b, b
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will be shade 1•y me at the maintenance aria repair ms de by my regular >Roof rlru'lt kecxnotetrral - -
employee.on the pmrcny I own m per URS Chapter 147 Si (s),buirti(sT(w.i(l) -
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Phone: Tw,c; E mWlZIP.
L� Mintmrm fee... . .... ...._ •A
No dt),sM4leuw M04trdl LM&.rbrae Cori YNMutbM r«merr�n�+,esaen. 4wix.This Famit application
U Vlss U Mastercr.d expires if a pttmit is out obtained Plan review(al
wtthln Ito days after On lgsn "talc:un; arpc
t,ca�ptcd w complete 1'OT►
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Mar'-06-01 03:05P Wolcott. Plumbing 503 667 9891 P.02
U. 06101 '111' 14 4.' FAX 501 SOA 1963 CV1 U TIGARU 1Q 003
PLUMBING PERMIT FEES:
Map.. TOTAL New 1 and 246mily 0Wapinps only:
FI><T R[3 ndlvldllal) QTY" apil AMOUNT (1,ichldes all ptumbnt9Txturet In klb§ TOTAL
�5frk 16 61 the dwellfny and the tlrsllDO fl QTY I� AMQUNT
�Lrnlor� 18.61 for each U illy r?onnacllonl
-21 uTb of—ub/Shuwer,U� 10 6) One�(2 bath 50 20
wo 2 b►tn 3b0.00 _
IL S�hf^.war Ony 18.8) — Tete t3)bSth _ 13999 QO
Urinal J �-r 18• �_� SIM--
1�3_dIIARGF.
Ciehwayner
1503 —_7-W F PLAN RIV1111W 45%OF SUBTOTAL _
0arba9aGkpoNl / •.0 ,'bTKL
LY-undl�fray 1810
Floor Dns war Sink
--- TP PLEASE COMPLETE,.
WolofNtattr O convarG on Ilka Kind 15 10 4wntl.� �Aof P4 ORntd� ,__
Caf Flpfn9 raquirp o wparUtt rnM.hrirtical I �� Fhlttxe Tyye: New f/Ipv d Replaced Removed!
ar r,H Ca ed
MFG r+onto Naw 4W Service 16.0 ink
WO)-Wfne Now SorYt3t0rm rtwar 46 r G ltival 1
Hose H be - -i6aA u or Lb/Shower - 1
Combination
R001 D-arnl showar Only
RnWn9 Fountain 181.0 water closet
— 16.110
O a flstur�(SVacIN) fhwashef V
Garbo o Deal _ --
"
Laundno Room Troy
-- Washirt Maino
PA
9lwer•1• tt tp _ -40.10 _. _n- J' �.
Sower•uc odditwia'100' 46 t0 4' _ _^
Walar 3ary to•111 1100 we' HInter
.Ws:er Service•Poch and tfof,.a 100 J 46 t0 paver roluras
b Rain Draln- 'r 100' SS•
81orm 8 ROIs ralr rich-idrfll�net 100' 46.10
Gommard Bach FloW�MIon p—�V�r 46 40 -
Retld6nllal ev-91cw Pie vent evKt' 21 ac
t;,illch Bain 18 -
inspection of Ealarlrq Plumt Inq or peceiy 290
Ra u911ed l�ecbons "T COMMENTS REGARUINr7 AROVE:
Ra1n Ural sIn-'7irrlly dwslirt9 a8 2S --
aftele raps ^~ _ I6 _ --
QUANTITY TOTAL
ISOnlllnt a 4tr OlrOnm n•tgw"ad If
'13UBT07AL -- —r
8-6 SrATE SURCNAIlO! - �!
PLAN REVIEW 5T!/OF ALRTOTAL
4egylrjgz.1LJruturf _rcrtiA`S
T T AL
'hlinirnam po"rir rtt 11 N:l0 r 1%slato stadwgt•elolp Rr6a«+1161 aatalaq
PttvM7pn ok-c" a 134 15 t!Tri 11110 Wm"fgl.
"ATA Now Cat�marcfal aUllaltyl IF1YYl t11a11 wNh Ilernel'K Ot tlev"to-and
Clan•r .tw
110sts!forrrtstVlm kel.doe 10110100
CITY OF TIGARD BUI"71NG INSPECTION DIVISION MST --Z C6 r�'z
24-Hour Inspection Line: 639 . .75 Business Line: 639-41. ,
BUP --
---- --Date Requested —111AM_ PM ---
Location— -
Location_ --3 e ,� Suite - MEC _
Contact Person Ph `fid '-7 7. " _ PLM
Contractor ---_� -- Ph sz, _ SWR ----- - - -
6UILDING - Tenant/OwnerELC
Retaining Wall EL•R
Footing Access
Foundation FPS -
Ftg Drain - SGN
Crawl Drain Inspection Notes.
Slab ------- -- --- _---- - - SIT _
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler -- -- - - - _
Fire Alarm
Susp'd Ceiling -
Roof
Misc: —-
Final
PASS PART FAIL -
PLUMBING
Post& Beam
Under Slab -__—
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post& Beare -- —_ - ^- ___- ----�-- - — -
Rough In %
Gas Line _.—
Smoke Dampers
Final
PASS PART FAIL_
ELECTRICAL .---
Service --
Rough In
UG/Slab ---
I_ow Voltage
Fire Alarm
PART FAIL — . -- — —-- — ---...
alit
Backfill/Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of$ -required before next inspection. Pay at City Hall. 13125 SW Hall Blvd
Catch Basin Inspect • no access
Unable to Ins
Fire Supply Line [ ]Please call for reinspection RE: �_r [ ] P
ADA
Approach/Sidewalk Date
Inspector1 Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CIT 1 OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line. 69.4171 —
B U P ------—Date Requested Requested `" -� —AM PM BLD
Location- I 3 17 3 - �.. Suite MFC
Contact Person ���c -t-ti.� - Ph `� S 7 7`i FILM -_ - ---
Contractor Ph SWR
BUILDING Tenant/Owner ELC _
Retaining Wall ELR
Footing Access: ---— _
Foundation FPS
Ftg Drain SGN -------------_-_ -_-------
Crawl Drain Inspection Notes: - -------- - - -
Slab ----- SIT
Post&Beam -_--d_._—_.--
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc --- ----- ---
ina
A.c; . PART _ FAIL --- ------ --- -- - - - --_.-.._ ._ —��_
PLU BING
Post& Beam ----- -- ---- _�_.-... -
Under Slab
Top Out --- -
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL -
Post&Beam - -
Rough In
Gas Line -
--
Smoke Dampers
ASS) PART FAIL
ELECTRICAL a --- — - --- -- --- ---
Service -� - -
Rough In _—^—
IJG/Slab
Low Voltage
Fire Alarm _
Final
PASS PART FAIL
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain ( j Reinspection fee of$— t equired before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ( )Please call for reins ection RE:
Fire Supply Line _ ( Unable to inspect-no access
ADA _
Approach/Sidewalk r 2p`
Other Date Inspector __ � Ext
Final
PASS PART FAIL 00 NOT REMOVE this inspection record from the job site.
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