13200 SW RAPTOR PLACE 1
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13200 SW Raptor Placa
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171 _s
BUP
Received _ Date Requested C °Z 3 AM—.-- PM_—__— BUP
Location l 3 �� D u �"� -r- Pte. _Suite MEPC -
Contact Person Ph( ) 2 7 S-- `l 1 rj PLM
Contractor--_. _ Ph SWR
BUILDING TenanUR!ilp __ ELC _
Footing '`5 ,:�, 7 3I-3 ELC
Foundation Access: _
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors -
Ext Sheath/Shear
Int Sheath/Shear /
Framing
Insulation 6 S'I
Drywall Nailing — C� "'' T �'�" Z1 -E2-
—
Firewall
Fire Sprinkler _ -
I Fire Alarm —
Susp'd Ceiling
Root
Other: -----
Final
PASS PARTFAIL T
PLUMBING
Post&Beam
Under Sleb —_—
Rough-in
Water Service
Sanitary Sewer
Rain Drains -- --_.-..__-----------_—__ �_� _ _—_—
Catch Basin/Manhole
Storm Drain
Shower Pan
Other:
Final _------_--.-____�_
PASSPART FAIL — _�------__._.____-- -------- —_-- --
—__
MECH_ANI_CAL
Post&Beam
Rough-In ------------ — _ __ —---- — —-- ---- --
Gas Line
Smoke Dampers --- ---- ------- -— --- —----- --
C,a'
PAS � PART FAIL
_ TRICAL v—
Service
Rough-In -.---
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of$____— required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
_PASS PART FAIL
SITE _ Please call for reinspection RE: _—d _ Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Dili Inspeter Ext
Other:
Final �— DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF Tl ARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 NIST
FtUp _-
Received _Date Requested _AM —PM_ RUP
Location .-- —��
Suite MEC
Contact Person ph I(—) � ' `�.S ' 3 PLM
Contractor`_ — — Ph( •—) _. —,_ SWR
BUILDING Tenant/Owner - -_ ELC
Footing - -
Foundation ELC
Ftg Drain Access: --
Crawl Drain ELR
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors
Anchors
Ext Sheath/Shear - —
Int Sheath/Shear -----�-___
Framing --- .. ------ -
Insulation
Drywall Nailing ---
FirewallFire Sprinkler
Sprinkler
Fire Alarm ---�- —
Susp'd Ceiling — -- -- --
Roof -
Other. --- -- ---
Final ---.- --
PASS PART_ FAIL -.`- ----- -- - - --- - _ _
Post&Beam - - - - -_
Under Slab
Rough-In ---__—
Water Service
'sanitary Sewer -- - ----
Rain Drains �C
Catch Basin/Manhole --
Storm Drain
Shower Pan T -"
Other: -----
__ -----
�nal
SS P/�RT FAIL i--"-- -- _-_
#Po
H. ICAL A Beam ----- -- - - ---
Rough-In
Gas Line -
Smoke Dampers _ _-
�PRT
Service-- -�-- —- —
Rough-In _
UG/Slab - -- --_
Low Voltage _
Fire Alarm -- - - -
--nF1Reinspection fee of required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
_ 40M'l PART FAIL_
_-- �— ❑ Please call for reinspection RE: __ ❑ Unable to inspect-no access
Fire Supply Line
ADA 2.
Approach/Sidewalk Date- � inspector
-7
Other: _
Fina! — ---�-- DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAR
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)6.,9-4175 MST
INSPECTION DIVISION Business Line: (503)639-4171
3� BUP
Received �__ _Date Reque ted__— ��. AM%!-'r M BUP
Location — CSU _ —.� __ _Suite__ MEC
Contact Person lrG .r ! , _— ph
Contractor Ph( ) SWR
BUILDING Tenant/Owner __ _ ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain -------------__
Slab Inspection Notes: SIT
Post& Beam
Shear Anchors — ---- �—— v---- - ---_— _ _ _
Ext Sheath/Shear
Int Sheath/Shear
Framing --
Insulation --
Drywall Nailing 0
Firewall �� 1 ► _ -
Fire Sprinkler -- --- — � �`--� -�
Fire Alarm
Susp'd Ceiling —
Roof
Other:.----— _ — - -- --- ---_ — --
i
PART FAIL -----_.__—.-- -- ---
PLUMBING -
Post& Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drainsr�___ —
Catch Basin/Manhole
Storm Drain --- - - —
Shower Pan
Other: --.-_�._--- -- ----- -- —
Final
!'ASS PART FAIL---1
--
M,ECH_ANICAL
Post&Beam ---
Rough-In ---- -- - --------_ _.—
Qas Line T. --
Smoke Dampers -------•----- _—____-.----_--_�___-— ___-__. �T--
Final
PASS PART FAIL _-..._.-_ ---_ __-------- ------._-------.._.� -- __--
ELECTRICAL
Service —
Rough-In
UQ/Slab --------------- -----_._.._._—___—_____—� .----_.
Low Voltage
Fire Alarm -----_-__---------a___..__
Fina, Reinspection fee of$- required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
.-PASS PART FAIL
Please tail for reinspection RE: _ Unable to Inspect-no access
Fire Supply Line
ADA - /Q
Date. � 1
Approach/Sidewalk - Inspector—.__ "�-�• —
Other:
Final -�� DO NOT REMOVE this Inspection record from the fob she.
PASS PART PAIL
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MASTER PERMIT
CITYOF TIGARD PERMIT#: MST2001-00162
DEVELOPMENT SERVICES DATE ISSUED: 10/30/01
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 13200 SW RAPTOR PI- PARCEL: 2S104DA-05700
SUBDIVISION: QUAIL HOLLOW -WEST ZONING: R-4.5
BLOCK: LOT:043 JURISDICTION: TIG
REMARKS: New SF detached rowhouse in Building#2. Setbacks as per sheet A10.10
Plan D-SB
BUILDING
REISSUE:
STORIES: i FLOOR AREAS REQUIRED SETBACKS REQUIRED
—
CLASS OF WORK: NEW HEIGHT: 31 FIRST: 173 of BASEMENT: at LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 735 at GARAGE: 547 at FRONT: PARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: 507 of VALUEb 140.709 00 RIGH r:
OCCUPANCY GRP: R3 BDRM: 3 BATH: 2 TOTAL: 1,475.00 of
REAR:
PLUMBING
31NKS'. 1 WATER CLOSETS: 2 WASHING MACH: t LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS-
LAVAIORIFS: -1 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN JRAI
TWNS: 2 CATCH BASINS:GREASE TRAPS:
TUB/SHOWERS GARb:LGE DISP. 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR:
OT++ER FIXTURES: 1
MECHANICAL. -
FUEL,TYPES
FURN<10OK: 1 BOIUCMP<]HP: VENT FANS: 3 CLOTHES DRYER, 1
GAS
FURN>*100K: UNIT HEATERS: HOODS: OTHER UNITS: 1
MAX IMI>: blu FLOOR FURNANCE3:
VENTS: 1 WOODSTOVES: GAS OUTLETS: I
ELECTRICAL - -
RE_!IIDENTIAL UNIT SERVICE FEEDER _TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp: 0 200 amp: WISVC OR FDR: 2 PUMPIIRRIGATION: PER INSPECTION:
EA ADO'L 5003F: 3 201 •400 amp; 201 •400 amp: 101 WIO SVCIFDR: 00 SIGNIOUT LIN LT:
PER HOUR:
LIMITED ENERGY: 401 000 amp: 401 000 amp: EA ADDL BR CIR: 1 SIGNAUPANEL: IN PLANT:
MANU HMISVCIFDR:
801 • 1000 amp: 001+ampa11000v: MINOR LABEL:
1000+omplvoll: PLAN REVIEW SECTION
Reconnect only: ,e4 RE9 UNITS: SVCWDR>-225 A.: >000 V NOMINAL: CLS AREAISPC OCC:
ELECTRICAL•RESTRICTED ENERGY
B.COMMERCIAL
A.SF RESIDENTIAL _
AUDIOS STEREO: VACUUM SYSTEM: AUDIO d STEREO:
FIRE ALARM: INTERCOMIPAGiNG: OUTDOOR LN03C LT:
RRIO: PROTECTIVE 91GNL:
BURGLAR ALARM: O1H ALL FNCOMB BOILER: HVAC: LANDSCAPEA
GARAGE OPENER:
CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC:
DATAITELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS:
TOTAL FEES: $ 5,691.92
Owner: Contractor: This permit is subject to the regulations contained in the
BROWNSTONE HOMES 9 p
BROWNSTONE HOMES, LLC Tigard Municipal Code.State of OR Specialty Codes and
8TH PKWY
12870 SW 88TH PKWY 0200 12670 SW 6all other applicable laws. All Work will be done in
PORTLAND,OR 97223 PORTLAND,OR 97223 accordance with approved plans This permit will expire B
work is not started within 180 days of issuance or if the
work is suspended for more than 180 days ATTENTION
Phone: Oregon law requires you to follow rules adopted by the
Phone: Oregon Utility Notification Center Those rules are set
Rao a: LIC 124627 forth in 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 8, Underfloor Insulation Electrical Rough In Gas Fireplace Roof Nailing Mechanical Final
Sewer Inspection Pimlundslab Insp Framing Insp Insulation Insp Water Line Insp Plumb Final
Footing Insp PLM/UnderfloorLMlUnderfloor
Shear Wall Insp Gyp Board Insp Water Service Insp Final inspection Foundation Insp Mechanical Insp Extericr Sheathing InAr/Sdwik trial Firewall Insp pp Insp
Slab Insp Electrical Service Gas Line Insp Rain drain Insp Electrical Final
� a
Issued By : Permittee Signature
usiness day
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next b
CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SVVR2001-00104
1312.5 SW Hall Blvd.,Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 10/30/01
SITE ADDRESS; 13200 SW RAPTOR PL
PARCEL: 2S104DA-05700
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R-4.5
BLOCK: LOT: 043 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: 'sewer connection for new SF detached rowhouse.
Owner: _----
-- _ FEES
BROWNSTONE HOMES - '�---- ��
12670 SW 68TH PKvVY #200 Type By Date _ Amount Receipt
PORTLAND, OR 97223 PRMT CTR 10/30/01 $2,300.00 27200100000
INSP CTR 10/30/01 $35.00 27200100000
Phone: 503-598-7565 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
This Applicant 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 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 Signature:
Cali (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
y
Building Permit Application
Date received:_ V o Permit no,�+�%'
City of Tigard ProjecUappl.no.: Expire date:
Cit Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223
City o f 8 Phone: (503) 639-4171 Date issued: BYL/4f I Receipt no.:
Fax: (503)598-1960 Case file no.: Payment type:
Land use approval: _ I&2 family:Simple Complex:
TYPE OPPERMIT
iZ!'1 &2 family dwelling or accessory U Commercial/industrial U Multi-family 0 New construction U Demolition
U Addition/alteration/replacement U'fenant improvement U Fire sprinkler/alarm U Other:
JOB SITE INFORMATION
Job address: ,3,j �� 5 /L ICr Bldg.no.: ,:Z Suite no.:
Lot: Block: Subdivision: O.,L ow L),�T. Tax map/tax lot/account no.:
Project name: C� A L !. J_
Description and location of work on premises/speAal conditions: _ )� 4 ? -------
_ FOR.SPECIAL INFORMATI[ON,
Name: M Q_b
Mailing address: 1'ZX&70 e,w (o6th QWAI' 200 — 1 do 2 family dwelling:
City: -r qState:rN- Z1P: 70-3 Valuation of work...................... ................. $ ,
- -
Phone: Fax: f3 908 ITE-mail: No.of bedrooms/baths........................I........915(25
_ ---
Owner's representative: /tr1 I? t ADt"�� 'total number of floors.................3-- ......... _ __
I ax:571�1q'L mail: LotZrstructure
ng areas ft, �.. .
Phone: X75 ( q. ) ..... -
ort area(sq. ft.).......�.......:.........
Name: �F q - rch area(sq.ft.) ........-:.............
- s ft. 4C..saa T--1
Mailing address: q. ) ..................................... .. ---- ----
City: State: 'LIP: area(sq.ft.)......I.. ............... --
Phone: Fax: E-mail: ('ommerciallindustrialimulti-family:
1 Valuation of work..................I..................... $
NTRWIFOR
1111110 Existing bldg.area(sq.ft.) .......................... ---
Business name: fes;, R � New bldg.area(sq.ft.)
................................
.....•..
Address: Number of stories........................................
Type of construction.
City: - State: ZIP: ................................... _.
Phone: Fax - E-mail: Occupancy group(s): Existing: -
CCB no.: New:
City/metro lic.no.: Notice:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
"Namme1Q, '1 d _ provisions of ORS 701 and may he required to be licensed in the
Address: ��q� i Ct�1f5 t tL 1oS� jurisdiction where work is being performed.If the applicant is
exempt from licensing,the following reason applies:
City: State:W VZIP:j(0101 -
Contact person: Plan no.:
F'hone:'jbb- 4(0Fax:W.,47- E-mail:
Name:WQA�,- Contactperson: FN IhI 11, Fees due upon application ........................... $
Address: 'S�� �i M t4d Date received: _
City: State:; ZIP: Z3 Amount received .........................................
_Phone:,{prpg -q b 33 Fax: '-- E-mail:
Please refer to fee schedule.
I hereby certify 1 have read and examined this application and the Not all}uridknom weep crtda Cards,prove all Judidictian fa mort mfarrnstian
attach(A checklist. All provisions of la s and ordinances governing this U Visa a MasterCard
work will be complie�t 1,whe ifled herein or not. 0"at cud number
• pira
Authorized signature: ��_ Date: Uti�,— Name of caidwIder as ahown on credit card
Print name:_ !~�� Q' L Apt'-, lwl
- Cudder aipaturt — = Amormt
Notice:This fKrmit application expires if a permit is not obtained within I gn days after it has been accepted as complete. 44o-4613(6WCOM)
Mechanical Permit Application
IDatereceived: Permit no.:rJt;r'0 -CJS/(�_7_
City of Tigard Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd,'rigard,OR 97223 Date issued: By: I Receipt no.:
Phone: (503) 6394171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval' L Building permit no.:
t
1:7'New
2 family dwelling or accessory U Cornmer,i,ii/indu;tn:1l U Multi-family U Tenant improvement
construction U Addiiiim/alteration/teplacement U Other. —._—__....__—_—_
i 7 t r
Job address: Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical matt Ws,equipment,labor,overhead,
profit.Value$ 3��
Tax map/tax lot/account no.: " .
Block: Subdivision:r.1 A,I �, •See checklist for important application information and
r--- jurisdiction's fee schedule for residential permit fee
Project name: ( \ Ejb 0 1(9K1\30C*Ak✓.
City/county: IC�AY D {>�}-1 ZIP: 'j2� t t
Description and location o work on premise _ ;i v t t t r
Fee(ea.) Total
Est.date of completiorl/inspection: B+t�cri oo Qt . Res.onl Res.onl
Tenant improvement or change of use: Air handling unit CFMp
Is existing space heated or conditioned?U Yes U No Air con iuoning(pile p an requir )
Is existing space insulated?U Yes U Noterauon of existing HVAC system
Won 11011111 of er compressors
State boiler permit no.:
Business name: -pU �j A 1U�1 }C ln� HP Tons BTU/H _
Address. O to(o , •ire/smo a amper uct smoke detectors _
City: c�(L S F� Statevr-C ZIP:c�7 ZqU cut pump(site p anrequir —
_Phone: �j-S Fax:-17, I l41 Email: nsta rep ace urnac umer
Including ductwork/vent liner U Yes U No
CCD no.: 2155 nsta rep ac reovate eaters-suspen ,
City/metro lir..no.: OD DO 110?-S wall,or floor mounted
Name(please print): Vt M11��rt3ai
Vent of as lance otTicr diann furnace
e erst on:
Absorption i mils_ BTU/H _
Chillers HP _
Name: -�I LA Cbm mssors J_ HP
Address: ;_ n ronnienta exhaust and ventilation:
City: State: ZIP: Appliance vent ( __
Phone: Fax: E-mail: ryerex Rust I
oods,Type It I Ures.k tc a azmat
hood fire suppression system
Name: Exhaust fan with single duct(bath fans) _
Melling address: _ "x Rusts stem a art rom eaun or
State: ZIP: ire piping anil distribution up to outlets)
City: — Type: LPO __ NO X_ Oil
Phone: Fax: I Fueli m -each additional over ou cts
p
rocesap (schematic requi )
Number of outlets
Name: �a 1q IVl1� a�. /��C�a ter I Wed appor equ pwmt
Address: _r Decorative fireplace
City: State: ZIP: nsen t pe
Phone:
Fax: E-mail: lov Pe eistove
^�
Other:
Applicant's signature: Date: _
EE
Name(print):
Permit fee................... .
Nd all paisdicuom Recut emill CW&.t10—eau)adWktlm rot more ttdorttt dmi Notice:111is permit application Minimum fee................$
u Vua U MasterCard expires if a permit is not obtained
Cmdttcrd samba: Flan review(at _ 9h) $ _
ms within Igo days after it has beenState surcharge(8%).....$
�T_ t0l o W! turd accepted as complete. TOTAL $ .......
C da danatut �— 440.4617(6MCOM)
Electrical]Permit Application
au neoew.�a: r�rr,pt,,,n.:
City of Tigard Expfte,te:
riry„rTt„�.�r Addle],: 1312,a S W Hall 81vd,1'1ptd,OR 97M (late ltra .. - � -
Phmw: 001)619-4171 ay, tiaaNpteo.
Pat: (X!1)39&1m Case rd.no.;
'.and use approval:
W_Y A 2 family dwelling ce awessary U rom"wmiaorwuttrw �2 M00-family U Tenant tmptovmww
Id t`tew cdtattv�iiat J AdditiWalterawwwrplacamcnt O Otlfet: U Puhai
01511011111 OMMINIA19
JC41 a,idtyae: Bid .nn. Suits na, _[TOA n, lal��µ
--..E _-....
l tx: i3kxk uhQivul ulht L hie Ilur►a we%r _
1'rcrjcct name: �'� Fly I I oto) � Deirrlplton and la�tmn of wtt+lc oA premises h;�J fp,l�!�♦�Ylpa
EaUmatcd dla Vf crxtl eb Im on: -
Jew na 2'a nta
Bwlrues Haste �q t r.eam 1 1ne .P.�t l i r•
r 2Mr
n+h M
�wetaett.rf rwlder�ea�lelr,r+a
UnCouvU IState W A ZIP: 98661 %-Vk eM om"
Mom; 993- 3.. CIL mail: Iwu«i n MIMe 17 14S
CCFI no.:1 6 5 14 1 Ewc.but.tic.no! 3 4-4 3 2 anaWtlalW wo_�n.a t�
CI Mmtm Ik.no.: L,wnec r ant nrw,rt,wenual _
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K a�rfyUm-��plai�a�V tMle — UM M&KVnr
M sinn.Mf4 !: t twn,r to e,.►fw�.rr-�iutr bl M
Nwnwlaa or relerok": O}
100 aln�+.r»tan _ 2
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crvfrer Inauallerion _ rtut�Jlati0tl ins made at p"'petty ��
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which 1e Pa lr vended for Vele.1 nr aachans bocordlns to bola mewJ6ba"VO Krd�aMkoc
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fermi,dvv*IL%/t 0 NO"ovw) 00D wr•�e Aw few n atttwufi)nl s maw rnrcly t�
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I0/TO 39Vd :II8103_13 34IIWV38-S 6, Z T 1007.,'�0.'��1
Mat",-06-01 03:05P Walcott Plumb`,n47
503 667 9891 P .01
UVOU/01 TV' 1.11 41 WAX 50:1 SOH 1960 CITY (F TICAM) Vio01
Plumbing Permit Appiicatiun
1:>om rcu read: Pernut no.:/J(ry' / -✓
City �of )t i and
9ewtiparrnit�o.. Dudein�pemitno.:
nddrene: 13123 SW N.111 1.1-1, 1Isa,1,r)F , 2z°
Cdryoj77rard Mone: (!5(1'4)639-4111 Protecvaptl no: - Hxputatte:
pout: 1,503) 591111-1960 Dateisvurd 8y: ReceiprlK,
L W uses approval: <<krlle PaymcnlType
U 16112 family dweiling ur ace—M U Cowin r6,-J/IMu+tnrl U Mu:n-farnity Cl Tenant tmprovemcmt
Q New CWtttrucUdn CJ A.Jdttl Nrltrnntto/repl*cemenl U Food tc:rvice q Ot}xr
Job addceas: 3,�(�() 1-- 1 Ueac riptiou Qc.. Fee I e>,.) Tot*] I
�: > f (... No"1-and tietetI aNetFJnge auily. -
Bld
8 � r- (t�t:Ndea 100 Q.for trach tAilit�tunpec tloa)
Tax mapAax Iovoccouut no. SFR 1 I)bath
I,ut. BlochSubdivision: — O a
Project namc; _ _ ( ) a -
Cityimun : �'LIk': E•aac+oJ�tona wh&schen
Desctlptton and location of wuck nn prcmiaes: _ blte ulWthar
Catch basin/area dmtn
Est.date of ccxn letioNrua lien^~ tywci lane sae7venc s c run
om-ow nj drAW nn Iln.
Maltutectyre4 horne unitbes
P�ddtew.
.a• 6 opt 'Z o O _ MR,�nln connectrx
Gty: O C!A,Gr+ I stateQ :li' a t sewe`-`�1j(tlo io
Pirour So3-d4'r-l� 1 (av bt:7-9tl 1► E.moll: y► -°'s'vStorm sewer no.lin.n.) --
Fiumb.bus.is oo: Z o Pp Water service no. 'n.
CCB no.- 2 j�`g] -_ R �t�ttyte or Neotr
Cityitnetru lie no.: Ab dos valve
Cuotticwr'a reprcaemadvc a�yoaturc:+' aJJ�Ad '� ack ow pteveotet
Yriat nalnr 1 a. L.'. '' e�I D13KCkwxter vn ve
t asln lavato
adws wwhcl-
Now DiAwnsRr —
Addrevawiit►13n�totrntad'(1)
City. r_ —�5t.a :iF; �t C Crump - --
Phone: Fax E Orai1 En emion Lank _ _ ---
isttu sewer cap
Flas'-li oor sinTts u _ �.__.
Nume(ptint): _1 ___ ___� -. er
ose bt b_ --
Stare' '1P_ Ce In Ter
Ptrune� Inn; Email :ticrte tor/ nave trap
nwnrl Initalienurt�rellydenttni maintenance in," Thtactwxl instai ladun I't:m-er(.
wtll be mute try Ing or the maintenance and tepair ttu da fly Itty n ktUlat 96011' rut; clNtrmetcial
employer on the p:ttperty I awn at M QRS Chapter 147 t (s),batm(y.Ltvv t
ownrr's signature: --- - - 1,or sump
.. _ ---
u
UnnaT-� _
atec c Fiat - —
AJJrcrr� attrheater—
ZIP. Total
Lt Lw n e
----- Minimum fee,.. f 71 d- -
wrrjt VACTIoas+es+Mtr+dllu�dt prn++talliutiwUtwlamatt t+fMu�n !ktt(7e 1w.pennitapplication
MianraVlCw(tl
U All O M+statC+ta � , expires if a permit is our obtain-d State%utcharr(8%), 3
C:Jll+std wtttte _�- - i - wlthl,,ISO days*lies it has bean
ttlnru TOTAL .. ...
.
........... .
_ rcw.pted as compbla '
� �el cy�e�ai�Mrr en ntJN�
-�W Tvdedat :TFTtlrrs Aatwtli t)(�3
�t:u01q tbAO'C tM+)
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Mar-06-01 03 :05P Wa lc_ot t. P 1 umb i nq 503 667 9891 P _ 0;,
01`06/01 TUL 14 4. 1'.1.5 Sol 599 1963 C1Tl OF 003
PLUMBING PERMIT FEES:
1.'TOTAL New 5 and 241kmHy dWIflnp•e0y:
1 Fly-( [ IedlvWuar�) _ do" •A 1 AMO�IJJjj�d}T• (HchaJos all plumb!no Jlwturet in PIKE ` TOTAL
r. d
6 61 the wellt g and the flrst100 ft QTY (yelp AMOUNT
swit - - IY to e1 for filch u! 4,0n11ec42n
1 Onei!bdth S24e 20
Tub "uWShuNer tomb wo 2 bam _• u350.00
Show-or Only 16.81 Three l3)Ven- _ — $.-
'atir Cleve► 1 —���� -VUDTOTAL
tlr) aI 8• a%9-�R1!$URCIIARGF. „�
curtwayhfr 168JPLAN REVIEW 45%OF SUBTOTAL
^�
C3arbey GMpaeal 1
Laundry roy IELfO
ath rtq Mach na� — I t
n F-
F10—0ru I.,�IIV7 OUr lIk r Is to PLEASE COMPLETE'.
J'
4• 16.E 0 _
ov.lei n•aur O wnwro on o uk•rk,d 16 t Guant-- ti--�Nar P•r�orintd_
Gal piping requires a teparllta mr►chartcal ' 100
Fllttwe Type: New Movsa. Rep. cot R•movow
c•rn>t— G d
MFG Homo Now Naw Service 46.0 Sink
MPQ Ftorne New 5aN5tOrm ewer 48 r G lava!
u or bblSh0wer 1
IiOlga ba - 10 I'D CombinaUon
Roof Dame 18.140 Ahowor 61l —_�—
17nnk'np Fountain 161 0 Wolof Closet
8110
Unroll
1
Olhw Fix ores(G city) _ Dllhwafher_
Garbage Cls"Pal
Laundry Room r
--- — Washin M• ins
„� loor r•inl iNc
Sewer•1st— 10J _48 i0 I' 3"
Sower•sae addltiui•t tow A8 10 4'
ary —
w•terseo•1e1
_ Other raturas
Nra er e17ce•each at d tion:;1413 46 10
,arm 8 Raln Olein• 'It 100' 55, _
dorm--SRail1�G•ucn ad— OhTonil 100' 46.10 -----
Comm--- Bar-FIeW r•w.�>i►on Ow • 46 10 - --
Reab•nLy1 E4Vxflcw P1ePle;enllon •vice• 27 55
Gotch 3atrn f 1880
InapWiun at E.11111-n-OW-MR hp or peC ety Y
Ra uelt•d tnbPactlall COMMENTS AEGA IDINt3 ABOVE!
May,Ul :lnyl•rarrAy dwell q—�
Grease T1 Ps 16 00
QUANTITY OTAI i —
Uortrtnc er sur el•ar•m rl•etived If
Syr STATE SURCHARGE -- — --
1 •'PLAN REVIEW 15'+6 QP��BTOTAL
•Minlrharn pnmNlae Ir er:w•ex Hiro•,•'Forge.uoat»RIP,A 411/1 e•o•IC•e
F4vM9.�n Oev¢e,
*h L11 6»e 13 110ro Wrtharpe
�•a1 Maw Cs#"_*rclal a�IlalnQa rrMe�e IFIa'la wkh laowut•M Y'ti v l4eron„�
Nan•v Aaw.
11dabVorrnalpint•keedoc �Cr101J0
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTART PERMIT NOTICE
STREAMLINE ELECTRICAL.
6025 EAST 18TH STREET
VANCOUVER, WA 98661
Electrical Signature Form
Permit#: MST2001-00162
DMe Issued: 10130101
Parcel: 2S104DA-05700
Site Address: 13200 SW RAP'1OR PL
Subdivis'on: QUAIL HOLLOW -WEST
Block: Lot: 043
Jurisdiction: TIG
Zoning: R4.5
Remarks: New SF detached rowhousce in Building #2. Setbacks as per sheet A10.10
Plan D-SB
Your company has been indicated a,, the electrical contractor for the permit indicated above In order for the
electrical permit to be valid, the signat.ire of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
BROWNSTONE HOMES STREAMLINE ELECTRICAL
12670 SW 60TH PK ' #200 6025 EAST 18TH STREET
Phone #: 503-598-7565 Phone #: 360-993-5080
Req #: LIC 116514
ELE. 34-432C
Jul' 40015
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Jj
X ��.
Signature of Supervising Electrician
If you have any questions, please call (503) 639-4171, ext. # 310