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N M 00 CN C 7 f1 O 7 r d a 12958 SW Princeton Lane CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MSTraZ-�0�o� L BUP _ Received Date Requested _ — _ _- PAS BUP Location . �-�l Sy -- .- AM-S w �ri N C..P / -- - i MEC Contact Person Ph(—) 7f-5 —53 W)' PLM Contractor Ph SWR - --- - BUILDING Tenant/Owner ELC Footing -- Foundation ELC Ftg Drain ACC@SS: —_� Crawl Drain ELR Slab Inspection Notes: SIT Post&Beam - Shear Anchors — Ext Sheath/Shear Int Sheath/Shear Framing - Insulation - Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling - -- -- Roof Other: —------ Final --- *PAS PART FAIL st&Beam Linder Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Oth r: ASS_ PART FAIL MkC_"ANICAL Post& Beam — - Rough-In Gas Line -- --------- Smoke Dampers Final - _PASS PART FAIL ELECTRICAL - Service - - Rough-In UG/Slab Low Voltage Fire Alarm - -- - Final PART FAIL Reinspection fee of$i _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PA §1-T—E -- Please call for reinspection RE:---____ [] Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Ditto _ InspectorExt Other: -- - — Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TI(AARJ 24-Hour BUILDING Inspection Line: (503) 639-4175 INSPECTION DIVISION Business Line: (503) 639-4171 MST BLIP Received Date Requested V/ _. AM__- _ _ PM _ BLIP Location —_ 1 GI 5- t� �� ✓`� Suite___ _ _ MEC Contact Person Ph(--) ---- ----- -— PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Footing Foundation Access:Access: ELC Ftg Drain Crawl Drain ELF! Slab Inspection Notes: SIT - Post& Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing -- Firewall Fire Sprinkler -------_—_ _ Fire Alarm Susp'd Ceiling - ---- - Roof O Other: Final PASS PART FAIL -"-- PLUMBING Post&Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Other: Find PASS_ PART FAIL - - MECHANICAL Post&Beam Rough-In Gas line Smoke Darupw,, Final PASS PART FAIL ELECTRICAL Service — Rough-In UG/Slab - -- - -- - Low Voltage ire�1 arm PAPART FAIL Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. S - Please call for reinspection RE: — Unable to Inspect-no access Fire Supply Line ADA / Approach/Sidewalk Date Inspector Other: Final DO NOT REMOVE this Inspection record fro,n the job site. PASS PART FAIL ►AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA/r � � � O t1 ► � N ► cv ► rD PON. 05414 ! rD ,44 ► �1 ► i � ► 44 ► 44 IP. fD a � rr h Y y 7 C O s a 0 y O S � l O Q R ` J D Qe �'1 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 INSPECTION DIVISION MST Business Line: (503) 639-4171 BUP Received — Date Requested. AM BUP Location /,� j 5 ,4 ��1-�y>�� _Suite _ _ MEC - — --- -- - Contact Person - —. ph( ) PLM - - Contractor _ — - -_. - - h( ) — ------ - SWR BUILDING Tenant/Owner -- -- - - - Fooling - - Foundation Access: ELC Ftg Drain Crawl Drain ELR Slab Inspection Notes: SIT Post&Beam - - Shear Anchors -- - Ext Sheath/Shear -- — Int Sheath/Shear _ Framing — Insulation D - Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling - --- - Roof Other: - --- ---.-- S PART FAIL ' BING - Past& Beam -_ - Under Slab Rough-In - Water Service Sanitary Sewer - -- -- - Rain Drains Catch Basin/Manhole - Storm Drain Shower Pan Other: Final - - — PASS PART FAIL MECHANICAL Post&Beam — Rough-In Gas Line — -- Smoke Dampers TES PART FAIL _CTRIC_ AL - Service Rough-In UG/Slab - Low Voltage Fire Alarm -- Final Reinspection fee of$ required before next inspection. Pay at Ci ty Hall, 13125 SW Hall Blvd.PASS PART FAIL SITE Please call for reinspection RE:_--- Unable to inspect-no access Fire Supply Line ADA �/ , C� �\✓ ` Approach/Sidewalk Date 'L,.— _ In"pertcrr Ext —_ Other:_ Final OO NOT REMOVE this Inspection record from the job site. PASS PART FAIL ELECTRICAL - CITY OF TIGARD RESTRICTED ENRIGY DEVELOPMENT SERVICES PERMIT#: ELR2002-00139 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 7/29/02 SITE ADDRESS: 12958 SW PRINCETON LN PARCEL: 2S104DA-22100 SUBDIVISION: QUAIL HOLLOW - SOUTH ZONING: R-4.5 BLOCK: LOT: 047 JURISDICTION: TIG Proiect Description: Install 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 . is 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 97223 WILSONVILLE, OR 97070 Phone: 503-598-7565 Phone: 503-639-0110 Reg#: ELE 36-94CLE SUP 2312JLE LIC 145828 _ FEES _ Required Inspections Type By Date Amount Receipt _ Y Low Voltage Inspection PRMT CTR 7/29/02 $7500 2720020000 Elect'I Final 5PCT CTR 7/29/02 $600 272.0020000 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 Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules qr irect ques6o s to OUNC at (503) 246-1987 ) terIssued by Permittee Signature X� OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale. lease, or rent. OWNER'S SIGNATURE: CONTRACTOR-INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N DATE LICENSE NO: � '�1:� . ILL __------___^__ __-- Call 639-4175 by 7:00 P.M. for an inspection needed the next business day Electrical Per init Application `-- Date received7? ,y Permitno.�J -QV/ � City of Figard Project/appl.no.: Expire date: City(if Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no. Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no,: Payment type: I ,toil tint, approval: TYPE OF U I &2 family dwelling or accessory ❑Commercial/industrial U Multi-family U Tenant improvement ,New construction U A(ldition/altendtion/replacement U Other: J Partial Joh address: / rj` b' 5,191 lam'«7e•L LA bldg. nu.: JU I Suite no.: ITax map!tax lot/account no Lot: #7Block: Subdivision: Project name:SuAlL kbudj I Description and location of work on premises: �01( 7 ��k?'___-__,_ Estimated date of completion/ins ection: - CONTRACUOR A111111,11CA]ION FIX i Job fru: i ee Muv lk•scription . (ea) total no.ill,i Business name: 192aj,nu int 6LIA1 01uwc t*jr-t+4A C A New residential single or multi-fanJly per Address: �12� r G� dwellingunil.(nciu(kaatraclrrlRaraRe. City: /L I✓rl Stalc:Q/ ZIP: Q?Q Service included: Phune:S,,, L;,%y`ii/,i FaxZ5�3tN,, --mail: 1000sy ft orless_ — -- a (` Each additional 500 sq,ft.or portion thereof CCB nu.: Elcc.bus.tic.no: - L Limited energy,residential _ City/metro lic. no.: .10;,5717 Limited energy,non-residential 1 eW fach manufactured home or modular dwelling St,nature of su ervisin ale clan(re utied) Late Service and/or feeder Sup.elect.name(printl' C , t�LG License no23/ZJ1 Services or feeders-Installation, alteration or relocation: 200 amps or less 7N,anie(pnint): �� 201 amps to 4(X1 amps- --- 401 amps to 600 amps s: 601 amps to 1000 amps City: State: Z1 P: Over I(XXlamps orvolts Phone: I E-mail: Reconnect only Owner installation:The installation is being made on property 1 own Temporary services or feeders which is not intended for sale,lease,rent,or exchange according to Installation, Iteration,or relocation: ORS 447,455,479,670,701. 200 amps or less _ 201 amps to 400 amps TA _ Owner's signature: Dale: 401 to 6W amps 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 _ City: Stale: ZIP: It Fee for branch circuits without purchase of service or feeder fee,first branch circuit Phone: lax: E-mail Hachadditional branch circuit Misc.(Service or feeder not Included): U Service over 225 anips commercial U health-care fe 1111) Fach pump or irrigation circle 2 U Service over 320 amps rating of 1&2 U Hazardous iocauon Hach sign or outline lighting - 2 fanuiydwellings U Building over IO,(XX)square Iect four o Signal circuit(s)or a limited energy panel. U System over 600 volts nominal more residential units in one structure alteration,or extension* — U Building over three stories U Feeders,400 amps or more •lkscn tion _ U Occupant load over 99 persons D Manufactured structures or RV park Each additional Inspection over the allowable In any of the above: U F.gressAightingplmr J Other: -_ — Per inspection Submit____sets of ptanv with on,of the alcove. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards,please call Jurisdiction for more mfomution Notice This pennit application Permit fee... ................. U visa U MasterCard expires if a permit is not obtained Plan review(at __ °k) S Credit card number L l within 180 days after it has been State surcharge(8%) ....$ -_- --G'-C Expires accepted as complete TOTAL ...... _ '`_ r G'�•' None of cardholder u shown on credit card S Cwdhol r—signature Amount 11.,.0 v ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES: TYPE OF WORK INVOLVED - RESIDENTIAL Complete Fee Schedule Below: —� - P Restricted Energy Fee...................................................... 575,00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total Check.Type of Work Involved Residential•per unit 1000 sq ft or less $145 15 _ 4 ❑ Audio and Stereo Systems' Each additional 500 sq ft,or portion thereof _ $3340 _ 1 ❑ Burglar Alarm Limited Energy _�_ $7500 '10 LAI Each ManuPd Home or Modular ❑ Garage Door Opener' Dwelling Service or Feeder _ $90.90 _ 2 Services or Feeders ❑ Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $80 30 _ 2 F-1 �ac��r;,n,ystems' 201 amps to 400 amps $10685 2 401 amps to 600 amps $16060 2 601 amps to 1000 amps $240.60 _ 2 l_J Other Over 1000 amps or volts $454 65 _ M 2 Reconnect only $66 85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY Fee for each system.._................................... $75 00 Installation,alteration,or relocation 200 amps or less $66.85 2 (SEE OAR 918-260-260) 201 amps to 400 amps _ $10030 _ 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see"b"above. L] Audio and Stereo Systems Branch Circuits Boiler Controls New,alteration or extension per panel a)The fee for branch circuits with purchase of service or Clock Systems feeder fee. r� Each branch circuit _ $665 2 LAW Telecommunication Installation h)The fee for branch circuits wlthouf purchase of service ❑ Fire Alarm Installation or feeder fee. First branch circuit $46.85 HVAC Each additional branch circuit $6.65 t—J Miscellaneous ❑� Instrumentation (Service or feeder not Included) Each pump or Irrigation circle $53.40 C1 Intercom and Paging Systems Each sign or outline lighting $53.40 Signal circuits)or a limited energy panel,alteration or extension $75.00 ❑ Landscape irrigation Control' Minor Labels(10) $125.00 Medical Each additional Inspection over ❑ the allowable in any of the above Per inspection _ $6250 Nurse Cetls�� Per hour _ $6250 _ In Plant $73 75 ❑ Outdoor Landscape Lighting' Fees: ❑ Protective Signaling Enter total of above fees $ Other _-_ -- 8%State Surcharge $ _ Number of Systems 25%Plan Review Fee See"Plan Review"sor_tion on $ No licenses are required Licenses are required for all other installations front of application — Fees: Total Balance Due $ _ Enter total of above fees = ❑ Trust Account p_-_ _ _.- 8%State Surcharge s Total Balance Due : All New Commercial Buildings require 2 sets of plans. i ldsts\formsklc-fees.doc 08/30/01 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT F ERMIT NOTICE WOLCOTT PLUMBING CONTRACTORS PO BOX 2007 GRESHAM, OR 97030 Plumbing Signature Form Permit #: MST2002-00108 Date ISSued: 4!x!102 Parcel: 2S104DA-QHS47 Site Address: 12958 SW PRINCETON LN Subdivision: QUAIL HOLLOW - SOUTH Block: Lot: 047 Jurisdiction: TIG Zoning: R-4.5 Remarks: SF rowhouse, Unit 47, bldg 10, BS plan with a deck Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR. BROWNSTONE QUAIL HOLLOW LLC WOLCOTT PLUMBING CONTRACTOR! 12670 SW 68TH PKWY STE 200 PO BOX 2007 PORTLA^!n, OR 97221 G-RFcy,nM. OR 97010 Phone #: 503-598-7565 Phone #: 667-1781 Reg #: 1 1r. 23847 PI M 26-208PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X �� _ Signa ureutho .ember if you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 57223 IMPORTANT PERMIT NOTICE STREAMLINE ELECTRICAL DBA LAVALL.EY CORORATION 6025 EAST 18TH ST VANCOUVER, WA 98661 Electrical Signature Form Permit #: MST2002-00108 Date Issued: 4/4/02 Parcel: 2S104CA•QHS47 Site Address: 12958 SW PRINCETON LN Subdivision: QUAIL HOLLOW - SOUTH Block: Lot: 047 Jurisdiction: TIG Zoning: R-4.5 Remarks: SF rowhouse, Unit 47, bldg 10, BS plan with a deck '(our company has been indicated as the electrical contractor for the permit indicated above. In order for the r=lectrical permit to be valid, the signature of the supendsing 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 ONTRACTOR:BROWNSTONE QUAIL HOLLOW LLC STREAMLINE ELECTRICAL 12670 SW 68TH PKWY STE 200 DBA LAVALLEY CORORATION PORTLAND. OR 97223 6025 EAST 18TH ST P�VANCPUVER WA 98661 Phone #: 503-598-7565 Phone 360-03-5080 Reg #: LIC 118514 ELE 34-4320 SUP 4801S AN INK SIGNATURE IS REQUIRED ON THIS FORM X ��'• _ _ _ Signature of Supervising Electrician If you have any questions, please call (503) 639-4171, ext. # 310 � CITYOF TIGARD -- MASTER PERMIT PERMIT#: MST2002-00108 DEVELOPMENT SERVICES DATE ISSUED: 4/4/02 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 12958 SW PRINCETON LN PARCEL: 2S104DA-QHS47 SUBDIVISION: QUAIL HOLLOW - SOUTH ZONING: R-4.5 BLOCK: LOT: 047 JURISDICTION: TIG REMARKS: SF rowhouse, Unit 47, bldg 10, BS plan with a deck BUILDING REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS� REQUIRED _ CLASS OF WORK: NEW HEIGHT FIRST: 172 of BASEMENT. s1 LEFT: SMOKE DETECTORS. TYPE OF USE: SFA FLOOR LOAD. 5n SECOND: 735 al GARAGE. 547 of FRONT: PARKING SPACES. TYPE OF CONST: 5N DWELLING UNITS. I FINBSMENT: 735 sl RIGHT: VALUE, S 162.566 20 OCCUPANCY GRP: R3 BDRM: RATH TOTAL: 1,04200 al REAR PLUMBING SINKS: 1 WATER CLOSETS: 2 WASHING MACH. I LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 2 DISHWASHERS: 1 FLOOR DRAINS. SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB/SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<WOK: BOILICMP c 3HF VENT FANS 3 CLOTHES DRYER: 1 LPG FURN-100K: UNIT HEATERS: HOODS: I OTHER UNITS. MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES OAS OUTLETS. 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADDVINSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 1 0 200 an p: W/SVC OR FOR: PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 3 201 400 amp: 201 - 400 amp: 1st W/O SVCIFDR: SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL SR CIR: SIGNAUPANEL: IN PLANT: MANU HMISVCIFDR: 601 • 1000 smp: 601-amps•1000v: MINOR LABEL: 1000♦amp/volt: PLAN REVIEW SECTION Reconnect onlv: o-4 RFS UNITS: SVCIFDR>•225 A.. >600 V NOMINAL: CLS AREA/SPC OCL: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO B STEREO. VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH. BOILER: HVAC LANDSCAPEIIRRIG: PROTECTIVE SIGNL GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM. NURSE CALLS TOTAL s SYSTEMS: Owner: Contractor 'TOTAL FEES: $ 5,50008 BROWNSTONE QUAIL HOLLOW LLC BROWNSTONE HOMES,LLC This permit is subject to the regulations contained in the 12670 SW 68TH PKWY STE 200 12670 SW 68TH PKWY Tigard Municipal Code,State OR. Specialty Codes and PORTLAND,OR 97223 PORTLAND,OR 97223 all other applicable laws. All work will be done accordance with approved plans. This permit will expired work is not started within 180 days of Issuance,or if the work is suspended for more than 180 days. ATTENTION: Phone: Poona: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Rep N: 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 Sewer Inspection Plm/undslb Insp Framing Insp Firewall Insp Electrical Final Footing Insp Electrical Service Gas Line Insp Gyp Board Insp Plumb Final Foundation Insp Electrical Rough-in Insulation Insp Rain Drain Insp Mechanical Final Wtr Proofing Bsm't Will Mechanical Insp Shear Wall Insp Water Line Insp Building Final Slab Insp Plumbing Top Out Exterior Sheathing Inst Smoke Detector Final inspe Issued �- Permittee Signature Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day ' ' CITYOF TI GARD SEWER CONNECTION PERMIT PERMIT#: SWR2002 00083 DEVELOPMENT SERVICES DATE ISSUED: 4/4/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 25104DA-QHS47 SITE ADDRESS; 12958 SW PRINCETON LN SUBDIVISION: QUAIL HOLLOW- SOUTH ZONING: R-4.5 BLOCK: LOT: 047 _ JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNIT'S: 1 TYPE OF USE: SFA NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection Owner: — ! FEES _ BROWNSTONE QUAIL HOLLOW LLC Type By Date Amount Receipt 12670 SW 68TH PKWY STE 200 -- PORTLAND, OR 97223 PRM T CTR 4/4/02 $2,300.00 27200200000 IrJSP CTR 4/4102 $35.00 27200200000 Phone: 503-598-75F5 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" Perm Issued b(,\ L� � i Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Plumbing Permit Application — Dau received: � �"r Permit no.: City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall filvd,Tigard,(1R 97221 ProjecUappl.no.: Expire date: City ofTigard I'ltone: (503)639-4171 Fax: (503) .599-1960 Date issued; By: I Receipt no.: Land use approval: — — -_—_.__ Case file no.: -- Payment type: 1 7UNcw 2 Family dwelling or accessory U Commercial/industrial U Multi-(anuly U Tenant improvement construction U Addi(ion/alteratiott/repl.!ccmc•nt U Food service U Other: I { 1 1IP10i I I1111 ARETvInformation _ Uescri (ioa Qt . hee(ea.) Total Job address: �In � ��'" ��J ,[� t�-- L�w�. Nen F-and 2-fan►ily dwellings only: Bldg.n0.: Suite no.: - (includes 100 fl.foreachrrlilityconneclion) Tax map/tax lot/account no.: SFR(1)bads Lot: Block: Subdivision: SFR(2)bath F'rojcct name: — — S[R(3)bath -- City/county: C:ach additional bat}Jkitchcn Description and location of work on premises:. _ Sileutllities: Catch basin/area-drain = Drywells/Ieach linc/urnch drain Est.date of come]elion/inspection: Footing drain(no.lin.it.) _ PLUNIBING WNTRACTOR Manufactured home utilities Business name: Manholes _ Rain drain conncctr. Wolcott Plumbing Sanitary sewer(no.tin.ft.)� PO Box 2007 Storm sewer(no.lin.ft.) Gresham OR 97030-0594 Water service(no.lin.ft.) 503-667-1781 Elxture or Item: CCIt 2ZQ47 PLM /1:26-2O`I'IAbsorption valve p _ Back now pmventer Print name: 11t°' Backwater valve 1NTA(T P1711SON Basins/lavalot y — Cioillcs washer Name: -- Dishwasher — Address: _ - ------- - -- Drinking fountain(s) CitState: ZIP: y Ejcctors/sump Phone: - - I'�x- — f:-nrail: Expansion tank — 1 F•txture/scwer cap Floor drains/floor sinks/hnb Name(print): _ Garba a dis sal Mailing address: _ ---- Hose Bibb City: - State_ ZIP: - Ice maker Phone: J Fax: E-mail: Interceptor/grease trap Owner installation/residential maintenance only: The actual installation Primer(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 ORS Chapter 447. Sink(s),basin(s),lays(s) _ Owner's signature: -- t!atr: _ -- Sump — Tubs/shower/shower pan Urinal Name: — Water close( — Addr-as: Water heater City: --- ---- State: j-11': Other. — - TT 1 Phone: Fax: -�E- -mail -- Total -- Minimum fee................$ Na dl)utirdicUmt txtm credit urd'•V"w eau jmiedcdao fm am 1°famd°a Notice:Tbis permit application Plan review(a( —%) $ -- U Yw U MastuCard expires if a permit is not obtained 1-�-- within ISO days after it has been Slate surcharge(8�)....f --- _ scoeptal a-s complete. TOTAL .......................$ Now d d Iowa as caul std---- s Ctdhdd� Amount 4404616(6�0XIM) MechanicalPermit Application — Daleroceivod: � '�C/ Permilno.:41� IM City of Tigard Projectlappl.no.: Expiredate: City of Tigard Address: 13125 SW Ifall Blvd,Tigard,OR 91223 — Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: - Building permit no.: TVPE OF PERMIT ❑ I & 2.family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Addifion/alteratiotl/rcplacement U Other: 1 { SITE INFORNIATION1 ! DULE Job address: ��`, 5indicate equipment quantifies in boxes below. Indicate the dollar Bldg.no.: _ Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value$ lot-�� Block: Subdivision: "See checklist for important application information and Project name: jut sdiction's fee schedule for residential permit fec. City/county: T— ZIP: — I &2 FAMILl'.DWELLING PERMIT FEE SCIIEDULE Description and location of work on premises:— 1 1 1 1 ! Fcc(ea.) Total Est.date of completion/inspection: Dewili on_ Qty. Res.only Res.only Tenant improvement or change of use: l Air handling CPM Is existing space heated or conditioned?U Yes U No dling unit !�Is existin space insulated?U Yes ❑No Air conditioning,(site plan required) - -_ F P' Alteration of existing I AC system AIMIANICAL 1 1 Botta compressors "state boiler permit no.: HP Tons BTU/H Four Scasons Heating&AiC Service Inc f7u0smoke dampers/ductsmo a detectors — PO Box 66409 Heat pump(site P an requt ) - - Portland OR 97290-6409 InstaiVreplaorfurnac umcr_— T /1 -` - 503-775-5919 Including ductwork/vent liner U Yes U No - CCB: 48283 n�ll/1ePa e relocate a - terssuspendea— wall,or floor mounted Name(please print): Vent Tor liance er than furnace - -- cf Absorp!ionunits_- BTUM Name: (alillers__ HP - --- — -- Co ressors_ HP Address: — _ _ —.--_ n nmenta st t%hauan ventilation: City: Slate: ZIP: Appliancevent Phone: Fax E-mail: -uezFuusi— _ — 1s,Type lyres. tc a sellar hood fire suppression system Name: Exhaust fan with singe duct(bath fans) Mailing address: Tahaust systema art from heating or AC — City_ Y State: ?IP: _ FuelP PIM and�ct�r on(up to out]etc) _� Type: —__U`G __ NG Oil _ Phone: Fax: 1 Fuel pipingeach additional ovFr4out ets ng(schematic required) Name: Number of outlets _ __-- ----- _ --_ -- �t rerr1R—di aP_PP umce or cvtu pment: Address: Decorative fireplace City: I State: ZIP: insert-type --- Phone: T Fax-- L-mail: Woodstovelpellet stove — (XW.. Applicant's signature. Date: Name, (print): --= --__ — --- — — Na as)urid"oru•ve"credit cards,please call)uridictim rR urort tofarttsstiest Permit fee......... ...........$ O visa U Wster('ard Notice This permit application Minimum fee................$ expires t e permit is not obtained Plan review at % $ tit card number: ____ _-- ._—l___-1 ( __ ) -- F.xptm within 18v days after it has been ---�me d�,yer tl oo�cwd --- accepted as complete. State surcharge(f%).. $ _ Cadbow"lipanare — - -Among - 44134617(boWort) Electrical Permit Application Datereceived: a y/r7j Permilno.:ikj City of Tigard Projecdappl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: I Receipt no.: Phone: (503) 6394171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval TYPE OF PERMIT U I &2 family dwelling or accessory U Cornmercial/Industrial U Multi-family U Tenant improvement U New construction U Adclition/alleration/replacement U Other: U Partial 11 SITE INFORMATION lob address: ac-15F4 W v v.� 111r1)' n r titnlr nu.. Tax map/tax iot/accouni no.: Lot: / Block: Subdivision: Pmject name: a Description and location of work on pirmises: Estimated date of Com letion/ins tion. APPLICATION Job no: Feeetas --- '—-- Description QIy. (ea.) Total q no.fns r Sti-canlline Llectric New residential-*wkor or Asunity per DBA LaValley Corporation dwellmunih.lncludesartact"prvw 6025 Last 18"'St seliCe�cla" Vancouver WA 98661 locaq ft olesa -- Eachhadditional SW sq h.or portion the 360-993-5080 Urnited energy,residential 2 CCB:116514 E1,01: 34-432C SUPP: Limited energy,non-residential � _ 2 Each manufactured tome or modular dwelling Service and/or feeder _? Signature of supervising electrician(required) pate _ License Services orkn ede —InstallaNtrrt, Sup elect name(print) alteration or relocation: PROPERTYOWNER 200 amps ar less 2 201 amps to 400 amps _ 2 Name(print): _ - _ 401 amps to 600 amps 2 Mailing address: — _ 601 amps to 1000 amps 2 City: state: — 111. Over IOW am nor vola J 2 Phone: Pax: E-mail: Reconnect only Owner installation:The installation is being made on property I awn Temporary services or feederhWallatlon,altentian,orrclocatlon: which is not intended for sale,lease,rent,or exchange according to 200 amps or leas _ 2 ORS 447,455,479,670,701. 201 arnps to 400 amps 2 _ Owner's signature: Date: — 4()l to 600 amps 2 Bran h circuits•new,alteration, or extension per panel: Name: _ A Fee for branch nrcuits with purchase,,I Address: _ service or feeder fee,each branch circuit 2 P: B Fix for branch circuits without purchase City: Slate: ZI _ of service or feeder fee,first branch circuit. — 2 Plums Fax: L-mail' Fachadditional branch circuit Mtsc.(senke or feeder not Each pumor iriation circle 2 Inc luded)- U Service over 225 amps umurMrctal U Health-care facility 2 U Service over 320 amps-rating of 1&2 U Huardous location Each sign or outline lighting _ farruly dwellings U Building over 10,17100 square feet four or Signal crrcuit(s)or a limited energy panel. U System over 600 volts nominal more residential units in arc structure alteration,or extension• _2 U Building over three stories U Feeders,400 amps or more •pescn tion U Occupant load over 99 persons U Manufactured structures or R V park tach additional Yspectiorr over the allowable in any of the above: U Egress/l ighting plan U Other -- --- Per inspection submit_bets of plans with any of the above. Investigation fee_ 1Le above are not applicable to temporary cotulructioa service. Other -- Permit fee.....................$ Na all junsdicuoru accept credit tarda,piease call junsdicuon for mare irtfmrtrim Notice Pus permit application U visa O MasterCard expires if a permit is not obtained Plan review(at _%) S _. Credit card number _ _—L 1 within Igo days after it has been State surcharge(8%)....$ _— Espims accepted as complete TOTAL .......................$ Named cardholder as Mown W ceMdit card = — Crdbolder siaoantae %.'riotart 4404615(~-OM) CITY OF TIGARC` 24-Hour BUILDING Inspection Line: (503) 639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST BUP Received _ __ _ Date Requested.___ AM---__-_ PM BUIj - ---— Location ---- �' p . �Ll�1cL�- - -Suite MEC Contact Person _ Ph( -) .-_ PLM 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 Sheath/Shear Int Sheath/Shear Framing - ---- - Insulation Drywall Nailing —-- --_----- -- _ - Firewall Fire Sprinkler ---- Fire Alarm Susp'd Ceiling --- -- ------- -----— Roof Other: ------- --- - --- -- - - Final ---------- PASS PART FAIL - -- -- ---- ------ PLUMBING_ Post 8 Beam _ - --- --v--- ---- _.-- - _ Under Slab —�--. Rough-In Water Service Sanitary Sewer Rain Drairs -- - — --------- - Catch Basin/Manhole Storm Drain - -- --- --- -- Shower Pan •� L_1�� Q D ��, Other: Final --- --- PASS PART FAIL _-- - - -- - MECHANICAL Post& Beam — Rough-In - ---------- Gas Line Smoke Dampers --- - -- -- - -- ------ - Final PASS PART FAIL - - ELECTRICAL Service - - - - - - - - Rough-In -_ — ALow volt Fire Alarm Final n Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd, PASS PART FAIL SITE E] Please call for reinspection RE: Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Did* -r - _ Ext -- Other Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL