13189 SW RAPTOR PLACE 13189 SW Raptor Place
CITY OF TIGARD BiJI' DING INSPECTION DIVISION MST 2aoi
24-Hour Inspection Line: 639 .75 Business Line: 639-41 - -
BLIP
Date Requested_ .1 �J AM PM
_ — BLD
Location / 3/ Suite MEG
Contact Person _ _ Ph 3(vC)- 77 Z PLM
Contractor _ —� Ph -2 SWR
BUILDING J Tenant/Owner _ _ ELC
Retaining Wall ELR _- -
Footing Access,
FPS
Ftg Drain _ -
Crawl Drain Inspection Notes SGN
Slab SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall — - --- -- -
Fire Sprinkler
Fire Alarm —
Susp'd Ceiling
Misc
Roof
Final
PASS FART FAIL_ - _-•---- -..,__. �.__®.. —
PLUMBING
Post& Beam �
---- -- -
Under Slab
Top Out - — --
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL — _---- _� �---�
Post & Beam
Roup In
Gas I-111c. -- ---------
Smoke Dampers
Final
PASS PART FAIL
Service
Rough In -
UG/Slab
Low Voltage
Fire Alarm
;in
Fsv PART FAIL
sw
Backfill/Grading —— --- -- —�
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$ _ required before next inspection Pay at City Hall, 13125 SW Hail Blvd
Catch Basin
Fire Supply Line ( ]Please call for reinspection RE'._ _ — — [ ]Unable to inspect-no acce-�
ADA
Approach/Sidewalk
Other Date -,C) _ Inspector_,_ ` _ Ext
Final _.
PASS PART FAIL IDO NOT REMOVE this inspection record from :he job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-417.5 Business Line: 639-4171 MS'f /C�
Date Requested -w'-� - AM pM BUP
BILD
Location_ . .n- Suite _
— MEC
Contact Person _ _ (,`-Ci✓�
F' J �j 7� .5 J7C PLM _
Contractor - Ph _ SWR
BUILDING —� Tenant/Owner ELC -`-
Retaining Wall
Footing Access: +� ELR
Foundation
Fig Drain FPS
Crawl Drain Inspection Notes SGN
Slab
_—____ -_. .___—..----___ - SIT
Post 8 Beam - -- ---
-- ---------------
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation -
Drywall hailing - -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling —`
Roof
Misc:
S ~ PARI FAIL
ING - -
Post RBeam
__-
Under Slab
Top Out - .-----
Water Service
Sanitary Sewer - ----
Rain Drains
Final -PASS PART FAIL.
MECHANICAL ---
Bost& Beam
Rough In _-_—
Gas Lire _
Smoke Dampers
Pt( S' PART FA''.
E TRICAL - -
Service -
Rough In ----- _
UG/Slab —
Low Voltage ------.- ___- .._---._-
Fire Alarm
Final
PASS PART FAIL.
SITE
Backfill/Grading - ---- —_ -
Sanitary Sewer
Storm Drain I I R(-inspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line I I Please call for reinspection RE:—_ ( J Unable to inspect-no access
ADA
Approach/Sidewalk Date
Other Inspector-_ � � Ext
Final
PASS PART _FAIL DO NOT REMOVE this Inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 business, Line: 639-4171 MST -2-6r, t �22 1
BLIP
Requested AM _PM -- BLD
Suite MEC
Locatrin 31
Conta(.t Person Ph PI-M
Contractor Ph SWR
ELL
[BUILDING Tenant/Owner
BUILDING ELR
lRetaining Wall
Footing Access: FPS
Foundation
Ftg Drain SGN
Crawl Drain Inspection Notes: SIT
Slab
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
r%eS710*RT FAIL.
[lost& Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Drains -----
in
a
S
P
A
RT
FAIL
HANICAL _
Post& Bean,
-
Rough In
—
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECT RICAL
Service
Rough In
UG/Slab
Low VLItage
Fire Alarm
Final
PASS PART FAIL
51TE
Backfill/Grading
Sanitary SewerPay at City Hall, 13125 SW Hall Blvd
Storm Drain I ]Reinspection tee of$___ ---. required before next inspectil)"
Catch Pasin i Please call for reinspection Unable to inspect- no access
Fire Supply Line
ADA 7 Ext
Approach/Sidewalk Date Inspector_
Other
Final
PASSPARTFAIL DO NOT REMOVE this inspection recorA from the job site.
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CITY
OF TIGARD _ MASTER PERMIT
(C'
\\ PERMIT#: MST2001-00185
DEVELOPMENT SERVICES DATE ISSUED: 8/6/01
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 13189 SW RAPTOR PL PARCEL: 2S104DA-09200
SUBDIVISION: QUAIL HOLLOW -WEST ZONING: R-4.5
BLOCK: LOT: 078 JURISDICTION: TIG
REMARKS: New SF detached rowhouse in Buiiving#3.Setbacks as per sheet A10.1 C
Plan B-N
BUILDING _
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS_ REQUIRED
CLASS OF WORK: NEW HEIGHT: 31 FIRST: 173 of BASEMENT: it LEcT: SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 705 of GARAGE: 519 of FRONT: PARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS: I FINSSMENT: 580 01 RIGHT:
VALUE: S 136,193.00
OCCUPANCY GRP: R3 BDRM: 3 BATH: 2 TOTAL: 1,459.00 at REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN:.002 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: CATCH BASINS:
TUBISHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES: I
MECHANICAL
FUEL TYPES _ FIIRN<100K: I BOIUCMP c AHP: VENT FANS: 3 CLOTHES DRYER: 1
GAS FURN> 100K: UNIT HEATERS: HOODS: OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 11
ELECTRICAL _
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 0 200 amp: WISVC OR FOR PUMPARRIGATION: PER INSPECTION.
EA ADD'L 500SF: 3 201 - 400 amp: 201 •400 amp: 101 W/O SVC/FDR: 2• SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL BR CIR: I SIGNALIPANEL: IN PLANT:
MANU HMISVCIFDR: 601 - 1000 amp: 601+6mpa•1000v: MINOR LABEL:
1000+amplvolt
PLAN REVIEW SECTION
Reconnect only: >.4 RES UNITS: SVClFDR>-226 A.: >600 V NOMINAL: CLS AREAISPC OCC:
ELECTRICAL•RESTRICTED ENEROY
A.SF RESIDENTIAL � B.COMMERCIAL
AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNOSC LT:
BURGLAR ALARM: 0TH: ALL ENCOMB BIALER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL•
GARAGE OPENER: CLOCK: INSTRUMENTATION MEDICAL: OTHR:
HVAC: DATAITELE COMM: NURSE CALLS TOTAL N SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 5,683.49
This permit is subject to the regulations contained In the
BROWNsrONE HOMES BROWNSTONE HOMES,LLC Tigard Municipal Code,State of OR Specialty Codes and
12670 SW 68TH PKWY#200 12670 SW 68TH PKWY all other applicable laws. All work will be done in
F)RTLAND,OR 97223 PORTLAND,OR 97223 accordance with approved plans This permit will expire H
work is 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 am set
Reg N: LIC 124027 forth in OAR 952-001-0010 through 952-001.0080 You
may obtain copies of these rules or direct questions to
CLINIC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Underfloor Insulation Electrical Service Gas Fireplace Ponding before tear-ofl Mechanical Final
Sewer Inspection Plm/undslab Insp Electrical Rough In Insulation Insp Water Line Insp Plumb Final
Footing Insp PLM/Underfloor Framing Insp Gyp Board Insp Water Service Insp Final Inspection
Foundation Insp Mechanical Insp Low Voltage Firewall Insp Appr/Sdwlk Insp
Slab Insp Plumb Top Out Gas Line Insp Rain drain Insp Electrical Final
Issued By :
taeos-1)
+-L.t-- Permittee Signature Q==
---
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITYOF TIGARD SEWER CONNECTION PERMIT
SWPDEVELOPMENT SERVICE PERMIT
ISSUED: 8/6/01 PERMIT#: 8/6/01 1-00127
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
PARCEL: 2S 104DA-09200
SITE ADC .ESS; 13189 SW RAP'rOR PL
SUBDIVISION: QUAIL HOLLOW -WEST ZONING: R 4,5
BLOCK: LOT: 078 JURISDICTION: TIG
TENANT NAME:
USA NO: FIX'f URE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IM-ERV SURFACE:
Remarks: Sewer connection for new SFdetached rowhouse.
Owner: _ _FEES
BROWNSTONE HOME.`5 Type By Date _ Amount Receipt
12670 SW 68TH PKWY #200
PORTLAND, OR 97223 PRMT CTR 8/6/01 $2,300.00 27200100000
INSP CTR 8/6/01 $3500 27200100000
Phone: 503-598-7565 Total $2,335.00 _
Contractor:
Phone:
Reg #:
Required Inspections
I
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agenr I. The permit expires
180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not
guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given,the installer
shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and
Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080
You may obtain copies of these rules or direct questions to OUNC by calling(503) 246-1987.
Issued by: � _ — _ Permittee Sianature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
00/ a0/2 7
Building Permit Application
Date received: Permitno.:/�fT'
City of Tigard Project/appl.no.: Expire date:
City nJ*Tigad ad nAddress: 13125 SW Hall Blvd,Tigard,OR 97223
8 Phone: (503) 6394171 Date issued: By e.. Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval' _ 1&2 family:Simple Complex:
L'fl &2 family dwelling or accessory U Commercial/industrial U Multi-family U7 New construction U Demolition
0 Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other:
JORSUI FINFORNIA]ION
Job address: ) /�II r u /._ ,��. Bldg.no.: Suite no.:
Lot: Block: Subdivision: ,.t L as T, T'ax map/tax lot/account no.:
Project name: Q L W,I Ic W —
Description and location of work on premises/special conditions: 0M.0 -- ----- -
Elio
Name: _ 1p*jt- iii M t=s
Mailing address: 1'Ua'70_Ste' !o$�`�le _?ZO 1 do 2 hmUy dwelUng:
City' f pp,.-t)A K30 I State:oi- ZIP: 722-3 Valuation of work..... .............. .............. $
Phone: Fax:fl iS got 1 I E-mail: No.of bedrooms/baths............ .......I......
Owner's representative: IM bAtA�`5 Total number of floors..............3..............
5 Fax:5 711919'L Email: New dwelling areas ft. �..`F?.Q�r?
Phone: ( q. ) ..... _
Garage/carport area(sq.ft.)........................
f`lnme: � mac, g80�G • Covered porch area(sq.ft,) ..4U�..F.�.....
Mailing address:
Deck area(sq.fl.) ................................... ....
City: State: 'LIP: Other structure..area(so.ft.)........."... ..........
Phone: Fax; E-mail; C.ommercial/industrial/multi-family:
Valuation of work........................ ............. $
Existing bldg.area(sq.ft.) ..........................
Business name: 58ft. New bldg.area(sq.ft.).
...........
Address: Number of stories
City: State: ZIP: Type of construction....................................
Phone: Fax: E-mail: Occupancy gmup(s): Existing:
CCB no.: New:
City/metro lie.no.: Notice:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: �ql G'1 ,� d provisions of ORS 701 and may be required to be licensed in the
Address: \`q �*CONDt 3i !o$� jurisdiction where work is being performed.If the applicant is
exempt from licensing,the following reason applies:
City: State:W ZIP: (0101 - _
Contact person: Plan no.: _ -
Pltone:766- 40 -tFax:'u 47- E-mail: --
Name:WQ Contact person:r 67Q Wi11, Fees due upon application ........................... $
Address: 'Std-' i 0tt9a_5 , Date received:
—city:: StatiZ�- ZIP: Amount received ......................................... $
Please refer to fee schedule.
Phone:,ft��It) 3 Fax: E-mail: _
1 hereby certify I have read and examined this application and the Not wl iu iadictlona accept crtai cards,plena can Jurisdiction for irk. lnromwion.
attached checklist.All provisions of la s and ordinances governing this U Visa U MasterCard
work will be compli ,whe ifled herein or not. cteeit cad number r_ = __._L—L
Expires
Authorized signaatuhhre: Da•e: � Name d cardholder a ahown on credit card
Print name: M V Amount
Notice:This permit application expires if a permit is not obtained within 190 days after it has been accepted as complete. +.34613(&WcoM)
1\ Mechanical Permit Application
"Daterewreived: Permitno.:;
-
City of Tigard {lrojecUappl no.: Expire.date.:
CitvofTigard Address: 13125 SW Hall Blvd,Tigard,OR 91223 Date issued: By: Receiptno.:
Phone: (503) 6394171
Fax: (503) 598-1960 Case file no.: -_ Pay ment type.:
Land use approval: _ Building permit no.:
!
4LJ &2 family dwelling or accessory U CommerciaUindustrial U Multi-family U Tenant improvement
Qj New construction U Addition/alteration/replacement I Other:
1 !
Job address: L K i. _ indicate equipment quantities in boxes below Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical ma s,equipment,lahor,overhead,
------
Tax m lot/account no.: profit.Value$ _5k=
Lot: Block: Subdivision:Q0 A,I ow 'See checklist for important application information and
Project name: 1-61 Into TflkK
,t�' jurisdiction's fec schedule for residential permit fee.
City/county: 1C-,AYE ,vi.)Ak4 ZIP: 2-2'�'
Description and location n work on premises: A 0 l ! J Is,F1 Wr i
Fec(ra.) Total
Est.date of completion/inspection: _ — ItMscriplitm — r_, l
y. lte+.onl RGc.o„hTenant improvement or change of use: Air handling unit CFM j
Is existing space heated or conditioned"U Yes U No it con rtion ng(site p an regw ) ___ j
Is existing space insulated?U Yes U Nr A tcrationMECHANICAL o exhsung system _ 1
! ! of er compressors
` _ State boiler permit no.:
Business name: UU � ` `'t
E" A }CO�I nd __ HP __Tons BTU/H
Address: (v _ it smo a damper uct shoo a detectors _
City: c�(L"1�_ State%N-rr ZIP:97 290 ent pump site plan at require —
Fax: nsta rep ace urnac timer
Phone: �_7-5 775 114) Email: -- Including ductwork/vent liner U Yes U No
CCB no.: Q G Z.Q nsial Urep I ac re locate heaters-suspen
City/metro lic.no.: Do DO 1 02S wall,or floor mounted
Name(please print): I h IV M)l}(►yt, Vent fora iana 1) er than furnace
(VNTACT PERSON Refifteratim
Absorption units
Name. -Z I l Chillers___ HP
ECom pressors HP
Address: t• m
ronenta exhaust and Tent on'
City: State: ZIP: Appliance vent ( _
Phone: Fax: E-mail: erex gust ► _
7s,Type res. itc a azmat
hood fire suppression system _
Name: �(1�G Exhaust fan with single duct(bath fans)
Mailing address: �— .x ausrt_s system allart From eatin o�
City: --- State.: 7.1P: 7Type:piping m W u""'but on;p to outlets
Ype: — _til
Phone: I ,r'• E ,Mail: uT i in each additional over outlets
Process piping(se. ematic requ )
Number of outlets _
Name: I„r-k"�l vl� �,°- A ter stedipp ante or equippme�tl:—
Address: — Decorative fireplace
City: State: ZIP: nT sett-type
_
Fax: E-mail: Woodstov pe etstove
Phone: er:
Applicant's signature:
Name(print): -
Permit fee....... .............$
Na all imidichim ecoept cndih ewdA.place CAR hnidktim r«nWM InfermOtion. Notice:This permit application Minimum fee................$ _
U v9sa U MasterCnd expires if a permit is not obtained Plan review(at _ %) $ , 4
C rMi cmd numha: --1— within 180 days after it has been 7 "i
.xpire� y State surcharge(896)....$
N. C �:�uv a, h crd s accepted as complete. TOTAL E -�
Uwdholder Sipultre - Ahaomr 4404617(60UK.Y)M)
r
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE. 1 & 2 FAMILY DWELLING FFE SCHEDULE:
TOTAL VALUATION: FEE: Description: �-�- PriceTotal
$1.00 to$5,000.00 Minimum fee$72.50 table 1A Mechanical Code _ Ch (Ea) Amt
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU `-
$1.52 for each additional$100.00 or including ducts&vents _ 14.00
fraction thereof,to and Including 2) Furnace 100,000 BTU+ -
_ $10,000.00. Including ducts&vents 17.40
$10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace -
$1.54 for each additional$100.00 or including vent 14.00
fraction thereof,to and Including 4) Suspended heater,wall heater
$25.000.00. or Floor mounted heater _ 1400
$25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not Included in appliance permit
$1.45 for each additional$100.00 or 6.80
fraction thereof,to and Including 6) Repair units ---
$50 000.00. ___ 12.15
$50,001.00 and up $747..00 for the first$50,000.00 and Check all that apply: Boiler Haat Air
$1.20 for each additional$100.00 or For Items 7.11,see or Pump Gond
_ fraction thereof. footnotes below. Com
7)<3HP;absorb unit -
ASSUMED VALUATIONS PER APPLIANCE: to 100K BTU 14.00
Value Total 8)3-15 HP;absorb -
Description: Q L Amount unit 100k to 500k BTU __ 25 60
Furnace to 100,000 BTU,Including 955 -- 9)15-30 HP;absorb
ducts&vents unit.5-1 mil BTU _ 35.00
Furnace> 100,000 BTU including 1,170 10)30.50 HP;absorb
ducts&vents unit 1-1.75 mil BTU 52.20
Floor furnace including vent 955 11)>50HP:absorb
Suspended healer,wall heater or 955 unit>1.75 mil BTU 1 87.20
fluor mounted heater 12)Air handling unit to 10,000 CFM ( - -
Vent not Included In applicance' 445 10.00
'pemllt� 13)Air handling unit 10,000 CFM+
Repalr units 805 17.20
<3 hp;absorb.unit, 955 14)Non-portable evaporate cooler
to 100k BTU 10.00
3-15 hp;absorb.unit, 1,700 15)Vent fan connected to a single duct
101k to 500k BTU 6.80
15-30 hp;absorb.unit,501k to 1 2,310 16)Ventilation system not Included In
mil.BTU a,apilance permit 10.00
30-50 hp;absorb.unit, 3,400 - 17)Hood served by mechanical exhaust
1-1.75 mil.BTU _ 10.00
>50 hp;absorb.unit, 5,725 18)Domestic incinerators
>1.75 mil.BTU 17.40
Air handling unit to 10,000 ctm 856 19)Commercial or Industrial type Incinerator
Air handling unit>10,000 cfm 1,170
Non-portable evaporate cooler 856 20)Other units,including wood stoves
Vent fan connected to a single duct 446 - 10.00
Vent system not Included in 856 21)Gas piping one to four outlets
appliance permit _ 5.40
Hood served by mechanical exhaust 656
22)More than 4-per outlet(oath)
Domestic Incinerator 1,170 1.00
Commercial or Industrial Incinerator 4,59q_ _-I Minimum Permit Fee$72.50 SUBTO AL: ;72
Other et Including wood stoves, 858 -c. 8%State Surcharge $ _ (
Gas piping 1-4 outlets �3W 25Y.Plen Review Fee of subtotal
Each additional outlet � 83 � ( ) �(
--- Required for ALL commercial permits only
TOTAL Comm RCIAI.
$ TOTAL RESIDENTIAL PERMIT FEE: $
VALUATION:
.tier In i�Ftlona ar�Flse:
1 inspections outside of normal business hours(rninimurn charge-two tx)(us)
$72.50 per hour
2 Inspections for which no fee is spfr�irncally indicated (minimum chargo-half hnur)
$72,50 per hour
3 Additional plan review required by changes,additions or rev;slons to plans(minimum
charge-one-hall hour)$72 50 per hour
State Contractor Boller Certification required for units v200k B TU.
"Residential AIC requires sRn plan showing placement of unit
1:klsts\fomu\mech-fees.doc 10/11/00
El(ectrieW Permit Application
�oltno.:P��
City of 'Tigard
Ai
jl eap"date:
c„y,rrk0,W Address: 1312b SW HaII Blvd TIW, OR 97223
Per xat (5n3)(09-4171 Das issaaae ay:
Paz (Sf)3)59d 1960 Cast file
Land use approval:
2 family dwelllaa of aoccommy 0 ComrtasreialAradustnai O Muld•fWvdiy U Tenam improvement
ji"New cora msetion U AdditkWaltersuoWrtplacfarmm O Otter:._ U Partial
Job ad&$”: ! Blda.eo:..._ Suitefro.. 7-1!!m t kxlaccount no.:
Let: 1 Itk�ck T- ummalaa �1v�a t Ho Ilrva war
Noe"nar to _ _1—"`h Con end la-at, n o(wm t oa pmmieea: N fw —fm—?VW r1mo
Iatimwed date of emp etion/Ins �tion:
Job not
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awIMMMUIVILM! c t r.ea ml ins_.E1, rWW ftkg
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PVWW, 9 9 3- u' trsail: loonue,-t m I S
M tw,:1 6 1 F%sc bas.Ik.ne: 34-432C watlldrya.l 5Wn,or kd�
Llaerane r,erd'nd 9SXT
_.
cl Menem ile fwd
_ �,�. Llfana:ea.r�rr M�x�.rc. 110MW1
Mnh muwfrauredFiofrN a rwduIw drwelllq
of rga w, n4U W t �^ SNvks Crit*6re0v t
r..+...��e9 bNa , �_ -
eMrreaaa or ro1M�.tter: �
Namc(pM y G,
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hW address: _ 1` �dT"r�qr io s
µ�/a� 1. m
T !up Slate t:)- ZIP -M 1009
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phow, >„y{ 6 Fi-tllAil; RarwModnd ��
(Aww Inawletim.116 arutallati011 is imp madecan prt�own 1IWpWWWV r AM&M
which Is not Itnelriaf fo!sale I nr eachan/s raocordinp tv b npoew abMfok%orea4onM Baa
O(tS 417,d11,179, ,tU I enMn fie are. -----
r/ 'm, iMT3t3.r,w 2
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t7 Iytwr o.w fi00 earn an.wml near reoft"al rfwta.e Cast aeaw,n etwr�ron.or n reeatmra j
U hold"erW we aerra U%mkn 41 amps w more
to ofalpeN h>N Wer VO perrune U MattActemd V W"w N V peWtrr
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taartifNlt___naq K I�n}I�sat?�Mo ab.sr. � Lmaed�tlOa�o �_.���� y 1�T-^�w.
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*unto 110 days a(Iw it hes bow, State sumharpe(8%),., S
ear w��" ' aeo°pMd M ttaraplMa. 7 OTAL ...._.... .......,S
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Mar-06-01 03:06P Wolcott Pluntb irsci 503 667 9891 P _ t)1
01.100/01 TUR 14-41 VAX 503 %Ors 1960 CI FY tilt TICARr) �J(02
Plumbing Permit Application
City Of Tigard - -- Datereccivb: Parnutno. �
Aftena: 13123 SW Hall Blvd,Tiger 1,OR 97221 Sown Parfait no.: Dudeing permit no.,
00 of Tigard Phone: (,11t(19)630.4171 hojecl/appl.no.: Bxpytadnte.
Fix: 15!).1) 59&1960 Datelaqued' _ By: Rtce;puK
Lwid -iso approval.- �— Cgss: no. PaymenLtype:
U I &1.family dw0ling ur accereory O Comrm,rciallsndytnW 3 Multi-family U Tennmt imprnvemcni
C7 New cuostrucuou 0 Additl(n/jlterat+tra/rr:piacerrent U Fund wrvice Q Other
111111M UM 11 MELIKIRMUM Ila 11 TUT13311=
C Dearriptlou ljf7. Fcerea. Total
)qui adtlltes: .� J i (�. _.—.�
81d .nu: Suiae no,; New I.as tartaliy d"CM,gi OWy7
Bldg npJtaxlot/aecouotno.: — 0whidnIfmit.for er.chuut)ryroan#Cdo 1, 1
TRA SFR(l)bath
L-)t. V I Block Subdivision:
Piro act n11mc: SFR(, both
city/county: ZIP: - Ea cdhi a I i o is aT b itc n
Description and location of work on prcm)aes: Slie utiblisa:
Catch b,uievarea drain
Est date of cm letiowlaspection' ywclrleac line ccffiaFn
Ftsodn rain no. n,
.
' \ &nuractwre tine utthtles
Iti3vicss uarne: tr�0 C.O ti M_._ tN
rAddrti.sR:�(N O k 7.00? i n nun conn crew -
city. Slow :,IP• T. —
P11oae So;-44�-I'!( Ca+ Gil-9tl 1 I E moll: y��psi-orrYStorm sewer(Do.VA. --
CCB no 1, 1 Plumb,bus.reg.—24-Z o d Pp water service no.Un. t'
rCityrmew lic no.: F1)ttutre or tteet;
Contractor's mptcseMadvc at 0 ttuc:
Ab don valve
— D -- ac ow prsveotcr
Yrininatne a� L-'. et h water valve --
ai1nV oval �—
Olt Ct WV __
Nance
t.qwns er
Addteur
City, SWIe'. Up: n nlrAltltrtn(t)
�1bf Nmp —
Phone: Fax EAMIJ011 Unk
FixtureiFtevor, ;♦ `—
Name(print): Flasr ,troy in u
- — ----- Mbize oil'a1
Maw address: _ Hose bobb _
City. — -- 9tUc tipice Illiker
Pttune. — Fox: Email _ :tierce for grcaae trap
Qwnc; tnetallshuNrestdtnusl mmmensrwe only: no actual inslalladon 1'r.merla
wall be nwtie t•y one,at the maintenance aura repair Mi de by my regular Roof dr.u& commercial
employee on the pmpeny I uwo a.1 per URS Chapter 147 �t (s,blutrW,lava(q
Owner'>t sl nature: D Ke' _ urn - ---
u ars rswet ower pan
Nutte: _ _.ter. ater c aet
AJdrcsa. T rater heater
Ctly — T SWe: LIP. _ -r,
Phone: _— rax: E•ntaii��--- _ ota
Mimmvnl fee... : i 274—LAT.-
w.ts)*VscuMtKear .rt+°rriliurirue" w:rorewe a ItA No!ix nil Permit applirabon Plan review(at
U Ass O M81Wcard exptrcs if a rt:rtslt is out obtained -
qRy,ad rowan -Iry,.L_ within 181 days otter it has been State swchugv 1896) f
fi TOTAI, .
-' .�cy i�cccv:cdas:ornobca
' 1 it rM�+air gf.1N aM s
_ -�•..—.*•inrb Jntfnlsun _ Am WiM U`�/ {MW:atANn'C CMS!
t-
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��j
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#: MST2001-00185
Date Issued: 816101
Parcel: 2S104DA-09200
Site Address: 13189 SW RAPTOR PL
Subdivision: QUAIL HOLLOW -WEST
Block: Lot: 078
Jurisdiction: TIG
Zoning: R-4.5
Remarks: New SF detached rowhouse in Building #3.Setbacks as per sheet A10.10
Plan B-N
Yoircompany has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical permit to be valid, the signaturE o-the supervising electrician is required Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
slant of the work to the address above, AT-TN: Building Dept
No electrical inspections will be authorized until this completed form ;s received
OWNER: ELECTRICAL CONTRACTOR:
BROWNSTONE HOMES STREAMLINE ELECTRICAL
6025 EAST 18TH STREET
12670 SW 68TH PKWY ' "90 VANCOUVER, WA 98661
PORTLAND, OR 97223
Phone #: 360-993-5080
Phone #: 503-598-7565 L;C 116514
Rea ' ELE 34A32C
SUP 4981S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X
Sictnature of Sup rvising Electrician
It you have any questions, please call (503) 639-1171, ext. # 310