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12995 SW PRINCETON LANE cc CA n 0.4 12495 SW Princeton Lane MASTER PERMIT _ CITYOF TIGARD PERMIT#: MST2002-00113 iJEVELOPPJIEN'f SERVICES DATE IS'LIED: 6/6/02 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 12995 SW PRINCETON LN PARCEL: 2S104DA-QHS52 SUBDIVISION: QUAIL HOLLOW-SOUTH ZONING: R-4.5 BLOCK: LOT:052 JURISDICTION: TIG REMARKS: SF rowhouse,Unit 52,Bldg 11,BS plan with deck.STRUCTURAL FILL.. REQUIRES GEO-TECH INSPECTIONS AND REPORTS BUILDING REISSUE STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED C1ASS OF WORK: NEW HEIGHT: FIRST: 172 of BASEMENT: of LEFT: SMOKE DETECTORS' Y TYPE OF USE: SFA FLOOR LOAD: 50 SECOND: 735 If GARAGE: 547 of FRONT: PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: 1 FINSSMENT: 735 If RIGHT: VALUE: S 1,,2.5882G OCCUPANCY GRP: R3 BDRW 2 BATH: 2 TOTAL: 1.64200 at REAR: PLUMBING SINKS: 1 WATER CLOSETS: 2 WASHING MACH 1 LAUNDRY TRAYS: RAIN GRAIN: TRAPS: LAVATORIES: 2 DISHWASHERS: I FLOOR DRAINS: SENEP.LINES: SF RAIN DRAINS: CATCH BASINS: TUBISHOWERS: 2 GARBAGE DISP: I WATER HEATERS: I WA TER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<t00K: BOIUCMP c 3HP: VENT FANS: 3 CLOTHES DRYER: I LPG FURN>-100K: UNIT HEATERS: HOODS: I OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: `NOODSTOVES: GAS OUTLETS: I ELE!'TNICP L RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS _ BRANCH Clk^I"TZ MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 1 0 200 anio: WISVC OR FDR: r"IMPIIRRIGATION: PER INSPECTION: EA ADD'L 5003F: 3 201 •400 amp: 201 400 amp: Lt WIG SVCIFDR: 313NIOUT LIN LT: PER HOUR: LIMITED ENERGY: 101 800 omp: 101 800 amp: EA ADOL BR CIR: :IGNAUPANEL IN PLANT: MANU HMISVCIFDR: 601 • 1000 amp: 601+ampl•1000v: MINOR LABEI: 10004 Imolvolt: PLAN REVIEW SECTION —_ Reconnect only: RE9 UNITS: SVCIFDR>•228 A.�. >600 V NOMINAL: CLS AREAISPC OCC: »4 ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL FIRE ALARM: INTERCOM PALING: OUTDOOR LNDSC LT' AUDIO 6 STEREO: VACUUM QYSTEM: AUDIO 8 STEREO: . BURGLAR ALARM: OTH: BO;IER: HVAC: LANDSCAPE/BRIG: PROTECTIVE 51GNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MF 3ICAL: OTHR: HVAC- DATA TELE COMM NURSF CALLS: TOTAL N SYSTEMS: TOTAL FF.ES: $ 5,500.08 Owner: Contractor: This permit is subjec to the regulations contained in the BROWNSTONE QUAIL HOLLOW LLC BROWNSTONE HOMES,LLC Tigard Municipal Cr.ie,State of OR Specialty Codes and 12670 SW 68TH PKWY 12670 SW 68TH PKWY all other applicable sews. All work will be done in STE 200 PORTLAND,OR 97223 accordance with F�proved plans. This permit will expire if PORTLAND,OR 97223 work is not starts!within 180 days of Issuance,or if the work is suspenr ad for more than 180 days ATTENTION Phone: Phone: Oregon law rer uires you to follow rules adopted by the Oregon Utility,4otification Center. Those rules are set Reg N: LIC 124627 forth in OAR 452.001-0010 through 952-001-0080. You may obtain .opies of these rules or direct questions to OUNC by ailing(503)246-1987. REQUIRED INSPECTIONS Sewer Inspection Electrical Service Gas Line Insp Gyp Board Insp Plumb Final Footing Insp Electrical Rough-in Insulation Insp Rain Drain Insp Mechanical Final Foundation Insp Mechanical Insp Shear Wall Insp Water Line Insp Building Final Slab Insp Plumbing Top Out Exterior Sheathing Insl Smoke Detecto Final inspection LPlm/undslb Insp Framing Insp Firewall Insp Electrical Fina' Issued B ;� f �) _ Permittee Sic,iature Y Call (503) 639-4175 by 7:00 p.m. for an inspectior needed the ext business da CITYOF TIGARD __ SEWER CONNECTION PERMIT DEVELOPMENT SERVICES -RMIT#: SWR2002-00088 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 - ISSUED: 6/6/02 SITE ADDRESS; 12995 S`JV PRINCFTON LN PARCEL: 2S104DA-QHS52 SUBDIVISION: QUAIL HOLLOW- SOUTH 1 ONING: R-4.5 BLOCK: LOT: 052 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SFA NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for SF rowhouse. Owner: _FEES BROWNSTONE QUAIL HOLLOW LLC Type By Date Amount Receipt 12670 SW 68TH PKWY STE 200 PRMT CTR 6/6/02 $2,300.00 27200200000 PORTLAND, OR 97223 INSP CTR 6/6/02 $35.00 27200200000 Phone: 503-598-7565 Total $2,335.00 Contractor: Phone: Rey#: Required Inspections i 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 (SSUed by �;''�rl :%��'� f t! Permittee Signature: s ay �-- Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next busines ^ building Pcrm�t� fitfibri "MNNR46W&"/ ; City of Tigard Date received: ,21Y odt Permitno.;�Av 2-&//3_ Address: 13125 SW Hall Blvd,wit Qi>'F'ctProJecUappl.no.: Expire -- Phone: (503) 6394171 MU)IM4 D )ate issued: By: , ) Receipt no,: Fax: (503) 598-1960 �'^ I Case file no.: Payment type: Land use approval: I I&2 family:Simple Complex: r U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family O New construction U Demolition U Addition/alteration/replacemenl U Tenant improvement U Fire sprinkler/alarm U Other: O; SI1TJE INFORMAIriON Job address: �� 1 C Bldg.no.: // Suite no.: Lot: I Block: Subdivision: ' __ r Tax map/tax IoUaccount no.t. �' -L2//- 5 Project name: Description and location of work on premises/special conditions: r 1F.1 a III N] t ____--- 711111 IM Name: �( �LQ� 1ti91- t Jnr,: rwil 1111,111 Fit IN ill DIVA Mailing address: I� � u ,�c� - 1 &2 family dwelling: City: o r'� Statc:t±.�� ZIP: Valuation of work............. Phone - - Fax: E-mail: No.of bedrooms/baths................................. --- Owner's represcrrtauvc: ' Total number of floors................................. Phone: Fax: _? E-rnail: New dwelling area(sq.ft.) ......................... Garage/carport area(sq.ft.)......................... Name: Covered porch area(sq. ft.) ...................... � ��_ _ Mailing address: W U- -.S' Z Deck area(sq. ft.) ............. - .................. _ City: ,- _ State: 7.II Other structure area(sq. ft.) .. -............ . i one: Fax: E-mail Commercial/industriaUmulti-family: " UU&;f,,1WK1I1 Valuation of work........................................ $ Business name: r' w , Existing oldg.area(sq. R.) .......................... ,s4cvc- LAO t New bldg.area(sq.ft,) Address: g r ............................... = - Number of stories........................................ City: r c Statcxn Zl T --- - - ype of construction.................................... Phone _ - Fax:ba,p-• -mail: -------- - hono.: Occupancy group(s): Existing:CCB -- --. -- ---- — New: - City/metro tic.no.: Notice:All contractors and subcontractors are required to be — licensed with the Oregon Construction Contractors Board under Name:—�6 LQ provisions of URS 701 and may be required to be licensed in the Address O v L -5 c, �e �— — jurisdiction where work is being performed.If the applicant is Cit : StateZIP: exempt from licensing,the following reason applies: Contact person: H Plan no.: ---- - — -- Phonc:- - x: E-mail: - Name: ,, ,, Contact person: Q Fees due upon application ........................... $ Address: 6 4 69 _U-) 4,,.If c4 Date received: _ City: �. 14 .late: L1P: Amount received $ - Phone: Fax: E-mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Nd ur iurixdkdan xcap Credit arch,rAmw as)urisdkUon r«more tnrortrugrtao. attached checklist. All provisions of laws and ordinances governing this U via. U MasterCard work will be complied ,wheth. nrd herein or not. creat ewd number— -exp1m Authorized si re: Arne or o dxnm on credit card Print name: '-Q ^ --.--- 1 t-.rdnotser a tnat� _ Amomt Notice:This permit application expires if a permit is not obtained within ISO days eller it has been acoepted as complete. 440-4613(WOVOM) Plumbing!"er �tel@ City of 'ItigA><'d . Datereceived: Pernutno.- Sewer permit no.: I3uildinspermilno.:1C fCjG710/�,�_ Address: 13125 SW Hall Blvd,T19k OR 97223 - CityojT•igard Phone: (503)6394171 CYFY UP I IUAKLt t'rojecl/appl.no.: Expire date: Fax: (503)598-1960 WILDING DTVM( � Date issued: [iy: Rccciptno.: -- Land use approval: Case file no.: Payment type: ❑ 1 &2 family dwelling or accessory ❑C'.ommerciaUindusuial Cl Multi-family LI Tenant impmvement ❑New construction ❑Addition/alteration/replacement U Food service U Other. II 1 t I Job address: Description Qt . hcr(ea. Total � 1,S - .�'W t in r e-�o�, er. a. - . Bldg.no.: Suite nu.: New 1-and 2-family dwellings only: -- (lncludes100 fl.fureachutility cotrnectiou) Tax snap/tax lot/account no.: _ SFR(1)bash Lot: - Blcr k: Subdivision: _ SFR(2)bath Project name: SFR(3)bath ~— City/county: ZIP: Each additional batlMtchcn Description and localiun of work on premises: SiteulWties: Catch basin/area drain t st.date of complel i, winspection: D wel's/leach line/trench drain PiUSI III NG'CONVIACTOR Footir Irmo(no.lin.ft.) Mane .cturrd home utilities _ Rnein�ee nnrr�r 7i" n. Iles Wolcott Plumbing n drain connector PO Box 2007 ni sewer(no.lin.ft.) Gresham OR 97030-0594 Storni sewer(no.lin.ft.) 503-667-1781 Water service(no :n.ft. ("CI3:23847 PI h1 11:26-208PB lixture or Rem: Contractor's tepteacntauve srgruwte: Absorption valve Print name: hate: Back flow preventer Backwater valve u Basins/lavatory Name: Clothes washer Address: Dishwasher - _ Drinking fountain(s) City: State: ZIP Phone: - 9 a>r: 1', mail: Ejectors/sump Expansion tank ixturelsewer cap Name(print): Floor drairts/floor sinks/hub Mailing address: -- Garbage disposal ��, liose bibb _ City: , - State: Ice maker Phone: Fax: E-mail: Interceptor/grease trap _ Owner installation/residcntial maintenance only: 7W actual installation Primet(s) will be made by me or the tuaintenancc and repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Chaplet 447. Sink(s),basin(s),lays(s) Owner's signature: Date: Sump Tubs/shower/shower pan Name: Urinal - ----- - -- - - --- Water closet Address: Water heater _ City: `--- State: Z[P:_ J Other. Phone: Fax: E-mail Y Total Na W i �aasrt c+odit comb.r4eue all j�cicdictioo fa male Idorfubm Minimum fee................$ Notice:71is permit application O Vi" o tfast•�Card Plan review(al _%) $ expires if a permit is not obtained --- Qt&t crd mmba:_ _. _ _ ._ within 180 days after it has been State surcharge(8%)....$ --_— — Nude d ard6okter u td�orvo as emda cant accepted as complete. TOTAL .......................$ Csxnx a dy,se Aanao� - 4104616(MME)ME) Mechanical• H� P&Kion .N&0 Date nmelved: Permit no.: City of Tigard Pmjecdappl.,M.: Expim date: -- City ojTigard Address: 13125 SW Hall Blvd,Tigard,OR'97223 -- Phone: (503)639-4171 Date issued: By: Rmciptno.: Fax: (503) 598-1960 L11'Y OF I AjAFJJ Case file no.: Payment type: BLLDINd D�V1' ION [Building permit no.: Land use approval: c U 1 &2 family dwelling or accessory U Commercial/industrial U Mniti-family U Tenar. ::provement U New construction U Addition/alteration/replacement U(Wier._ Job address:= SW i'� 1,1-4-,-_" La V:` Indicate equipment quantities in boxes below.Indicate the dollar Bldg.no.: I Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lottaccount no.: profit.Value$ _ - C,ot: Block: Subdivision: *See checklist for important application information and Project name: _ Junsdic lion's fee schedule for residential permit fee City/county ZIP: _ t « t Description and location of work on premises: s t 1 t l m(ea.) Total Est.date of completion/inspecdon: _-- Urscri iar Qty Res.only Res.only h Tenant improvement or change of use: i an Air handling unit ('fTvl _ Is existing space heated or conditioned?0 Yes U No Air con iuoning(site plan requ ) _ Is existing space insulated'U Yes U No Afterationo eausun system of er compressors State boiler pemrit no.: HP Tons BTU/11 Dour Seasons Heating&:A/C Service Inc •irestmke difiriptvViluct smoo ccdetectors PO Box 66409 eat pump(s to p an regw ) _ Portland OR 97290-6409 Installfreplace? urner �fTT1i 503-7/5-5919 Including ductwork/vent liner O Yes U No CCU 48283 nsta11/replacelrelocate heaters-suspended, wall,or floor mounted _ (please Vent orappliance er an furnace. se Absorption units BTU/11 Name. Chillers____ _- HP -- ------ -- - -- Cam ssors----- Hp Address: _ amen ust and res ton: City: State: ZIP: Appliancevent Phone- Fax: Dryerexhaust Hoods,Typelfil/res. tc a lazmal hood fire suppression system Name: Exhaust fan with single duel(bath fans) Mailing address: aust systems art from caUn,ori C City: -- -- — State: ZLP v lte pp p Irat on(up to 4 outlets Type: M NO Oil Phone: Fax f i-mail: 7-ucl pipiripeachaddifional over out.ets t 'rocas.piping(. etnatic required) _ Number of outlets Name: _ ter app ce or equ pment: -- Address: _ _ Decorativefuoplace _City: _ State: ZIP nsert-type Phone: Faz: E-mail. Woodstov pe.:et stove rev Applicant's signature: Date: U er, _ Name(print): _—1 _ - Nd till Jeaiadieeionsaeoetw credit anis,t4r2u edl furiadictlan fa mace faferntaaon Permit fee.....................$ Notice:This permit application Minimum fee................$ ❑Visa t]MasterCard expires if a permit is not obtained Credit card numb — -- within 180 days after it hes barn Plan review(at _%) s t accepted as complete. tate surcharge(8 A)»..t iartr a c u oo aed;t eerier s �p TOTAL ................ S _— (:ardbotder gitutun Amwm 4144617(690MW) Electrical Pen EOe� Datereceived: Perm itno.:/y ;r-7, City of Tigard Project/appl.no. Expiredate: City of Tigard Address- 13125 SW Hall Blvd,Tigard,CO 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 L11-Y Up 11lsARl� -- Fax: (503)598-1960 ji[j�, wa r ��file no.: Payment type: Land use approval: _ 1 ❑ 1 &2 family dwelling or accessory ❑Commercial/indusuial U Multi-family U Tenant impr( -,rnent ❑New construction U Addition/alteration/replaccnisnt U Other: U Partial 11 SITE INFORMATION Job address: ��w , ,��` �, ,,� Bldg. no.: Suite no.: ` Tax map/tax lot/account- Lot: Block: Subdivision: _Project name: _ _ -- Description and location of work on premises: estimated date of completion/inspection CONTkA(-I'OR OPLICATIODULE .106 n0: Fee Mai ---- - - - - - - lleaeription Qty. (ea) Total no.I2ilL- Streamline Electric Newresidmiial-erargleofmulti lamih per DBA LaValley Corporation dwelling unh Includessdtachedgarage. 6025 fast 18111 St Serviceltrcluded: Vancouver WA 98661 1000 sq ft or lea' _- _4 Each additional 500 .ft.or portion thereof 360-993-5080 Limited energy,residential 2 CCB:116514 FLCIt: 34-4320 SUPtf: Umitedenergy,non-residential -- -2 Each manufactured lame or modular dwelling Signature of supervising eloc cion(required) pate Service and/or feeder _ 2 Sup elect.name(print) IJoann no: Sirnicesorfeedera•-installation, 1 1 alteration or relocation: 200 amps or leas 2 Name(print): 201 amps to 400 amps -- 2 Mailing address: -"— 401 amps to tiro amps 2 601 amps to 1000 amps _ 2 Over 1000 amps or units 2 City: Slate: ZIP: Phone: Fax: I E-mail: Reconnect onix - Owner installation:The installation is being made on property I own Temporary Wit V d or feeders- which is not intended for sale,lease,rent,or exchange according to h:tailatiomalteration,orrelocation: ORS 447,455,479,670,701. 200 amps or less 2 201 amps to 400 strips 2 Owner's signature: Date: 401 to 600 ams 2 Branch circuits-new,alteration, Name: or extension per Fuel: A Fee for branch circuits with purchase of Address: service or feeder fee,each branch circum 2 Cil ^- ---- Stale: rZIP: B Fee for branch circuits without purchasr- -- Phone: I ,t� E-mail: of service or feeder fee,first branch circus 2 Each additionrl branch circuit Mbc.(Service or feeder nor Inclyded): O Service over 225 amps commercial U Health-care facility Each pump or irrigation circle 2 O Service over 320 amps-rating of I SO2 U Hazardous location Each sign or outline lighting family dwellings U Building over 10,000square feet four or Signal circuit(s)or a limited energy panel, O System over 600 volts nominal more residentiel units in one structure alteration,or extension* 2 O Building over three stories U Feeders.400 amp or more •Descrition ❑Occupant load over 99 per-ions U Manufactured structures or RV park Each additional toapMion over the allowable In any of the above: O FgrexsAightingplan U Other Perinspection -- Submit —sets of plans with any of the above. Investigation fee The above are not applicable to temporary constnMioo aeawice. Other --- - --- --- Na all)unsdicuons rrclw ctedii cards,please call jurisdiction for arae htfornwlm Notice:This permit application Permit fee.....................S U Visa U MasitrCard expires if a permit is not obtained Plan review(at %) $ -_ credit card number _ 1_L within ISO days after it has been State surcharge(8%)....$ Expires accepted as complete TOTAL . S Naar of cardholder as shown on credit ciA S _ Cardholder sigtusure Amount �__ 440-4615(601K'C►M) CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 972.23 IMPORTANT PERMIT NOTICE WCLCOTT PLUMBING CONTRACTORS PO BOX 2007 GRESHAM, OR 97030 Plumbing Signature Form Permit #: MST2002-00113 Date Issued: 6/6102 Parcel: 2S104DA-QHS52 Site Address: 12995 SW PRINCETON LN Subdivision: QUAIL HOLLOW - SOUTH Block: Lot: 052 ,Jurisdiction: TIG Zoning: R-4.5 Remarks: SF rowhouse,Unit 52,Bldg 11,BS plan vJth deck.STRUCTURAt_ FILL, REQUIRES GE13-TECH INSPECTIONS AND REPORTS 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 PO BOX 2007 STE 200 GRESHA.M, 0-0 97030 PORTLAND OR 97223 Phone #: 50�-598-7565 Phone #: 667-1781 Reg #: 11C 23847 PI M 26-208PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X AA.11 Sign tau ni: uthori Plumber If you have any questions, please call (503) 639-4171, ext. # 310 ELECTRICAL PERMIT- CITY ERMIT•CITY OF TIGARD RESTRICTED ENERGY _^ DEVELOPMENT SERVICES PERMIT#: ELR2002-00170 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 8/ 28/02PARC22600 SITE ADDRESS: 12995 SW PRINCETON LN Zi IING: R-4 5 SUBDIVISION: QUAIL HOLLOW - SOUTH JURISDICTION: TIG BLOCK: LOT: 052 Project Description: Limited energy for audio/stereo. A.RESIDENTIAL — B.COMMERCIAL_ __--------- -AUDIO 8. STEREO: X AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER: LAN DSCAF ARRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DA'I-A/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL#O SYSTEM : Owner f Contractor: BROWNSTONE QUAIL..HOLLOW LLC P.O. COMMUNICATIONS INC 08 12670 SW 68TI-1 PKWY P.O. BOX STE 200 V�ILSONVILLLLE, OR 97070 PORTLAND, OR 97223 Phone: 503-639-0110 Phone: 503-598-7565 Reg #: ELE 36-94CLE SUP 2312JLE LIC 145828 _ FEES Required Inspections _Type By Date Amount Receipt Low Voltage Inspection PRMT CTR 8/28/02 $75.00 2720020000 Elect'I Final 5PCT CTR 8/28/02 $6.00 2720020000 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 thf regon Utility Notification Center. Those rules are set forth in OAR 952-901-0010 through OAR 952-001 008U. You may obtain copies of these rules orirect questions to OUNC at (503) 24 1987. Issed by ` cr T C �,'_'__ Permittee Signature c OWNER INSTALLATION ONLY The installation Is being made on property I own which is not intended for sale lease, or rent. OWNER'S SIGNATURE: DATE: ---- — CONTRACTOR INSTALLATION _- - SIGNATURE OF SUPRDATE:- ELEC'N —_ --- - LICENSE NO: - Cali 639-4175 by 7:00 P.M. for an inspection needed the next business day j Electrical Permit Application "Datercceived: ��'g O) Permit no.:��k�� v City Of Tigard 1'rojecl/appl.no.: Expire date: City ujTigard Address: 13125 SW Ilall Biv;,'Tigard,OR 97223 Date issued: yk,_-,I Receiptno.: Phone: (503) 639.4171 Fax: (503) 598-1960 j;w_ rase file no.: Payment type: Land use approval: 1 U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement New construction U Addition/alteration/re place men U Other:_ U Partial .1011 SITE INFORMATION Job address: - LAiBldg.no.: Suite no.: ITax map/tax lot/account no.: Lot: �` Block: Subdivision: M(L LLOP_i _ Project name: t gdLj ) I Description and location of work on premises: r c-t 01 dcr, Estimated date of completion/inspection: CONTRACTOR Job no: 1 cc DUn Business name: int iif 'A r-1 L,Al S Dc,cril,lion Qtv. (ca.) 'total no.lisp New rrsldential sinr;le nr multi-L•uoil�IK•r - Address: �'S Sea J dwelling rill.Includes attached garage. City: 1L "4,C State: ZIP:C] t' , Service included: Phone: /3 <) 0;jL 11711X:5�3 OV[.,fi E-mai l: 1000 sq.n.or less 4 CCB no.: Elec.bus,lie.no: Each additional 5(K)sq.ft.or portion thereof L — �'` -- Limited energy,residential 2 City/metro lie.no.: `XJL)�(oSfLimited energy,non-residential _ 2 f 4 Each manufactured home or modular dwelling Sii�of su rvisin els an(required) Date Service andlor feeder 2 T-i Services or keders-Installation, Sup.elect.name(pnnU: L. _61 ' '1 ! r Li.enxc no:L•` /��C[ alteration or relocation: 1WNER 200 amps or less 2 Name(print): /r/�ew S d•L L 2(11 amps l0 4(N)amps 2 Mailing address: _ 401 amps to 600 amps 2 601 amps to 1000 amps 2 Cily: _ SlalC: ZIP_ Over IOW amps or volts 2 Phone: Fax: E-mail: Reconnect only I Owner installation:The installation is being made on property I own Temporaryservicesorfeedem- which is not intended for sale.Irau•, rrni,nr rvchange according to Installation,alteration,or relocation: ORS 447,455,479,670,701 200 amps or less _ _ 2 201 amps to 41N1 amps 2 owners Signature: 1111t' ft)Iyii`iWamps— -_--- 2 Branch circuits-new,alteration, ur extension per panel: Name— _ A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: i Stale: ZIP: B. Fee for branch circuits without purchase -- of service or feeder fee,first branch circuit 2 Photic: Fax: E-mail: Each additional branch circuit- PLAN RIEVIEW'(Please check all flint apply) -- Misr.(Service or feeder not Included): U Service over 225 amps-commercial U iicalrh-care facility Each pump or ittiganon circle - 2 UService over 320amps-toting oft&2 U Hazardous location Fach sign or oulline lightiog _ 2 family dwellings U Building over 100)(1 square feet frturor Sigoal LIN Uit(s)or a limited energy panel. U Systemnver600 volts nominal more residential units in one structure alteration,or extension" i— _ 2 U Building over three stones U Feeders,400 amps or more *Description _ _ U(h cupant load over 99 persons U Manufactured structures or RV park arch additional inspection over the allowable In any of the above: U F.gress/lighlirlpplan U Other __-— Perinspection Submit_—sets of plans with any of the above. Investigation fee _ Vie above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards,please call jurisdiction for more information.' Notice:This permit application Permit fee.................. ..$ 75 - U visa U MasterCard expires if a permit is not obtained Plan review(at , %) $ Credit card nun0er. L __ within 180 days after it has been State surcharge(8%) ....$ Miresaccepted as complete. TOTAL. .... $ I/ Name of cordholder as shown on credit cord S Cardholder si(insiure --- -- — — Amount 440-4615(WOWOM) CITY OF TIGARD 24-Flour BUILDING Inspection Line: (503) 639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 BUP ---- ---- -- - - Received _- Date Requested ! —D -0_2_ AM -___. PM __ BUP Location v� � 5(,e) alr,ce&n at,e _Suite MEL' Contact Person Ph(_ ) __ PLM -_ Contractor 2-1 my-11, an ,v„rti,'cy,6 nr h( )GC C� /�1.'S SS SWR r ILDl_NG Tenant/Owner _ -___--__ ELCtingndation ELC _. Access: �=tg Drain ELF! . Crawl Drain _+ Slab Inspection Notes: SIT _ Post&Bean Zia,- __ Shear Anchois - 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&Beam -- - __-- --_<< - Under Slab - 6 ��--T •_r Rough-In Water Service ------ --- �� Sanitary Sewer Rain Drains -- _ —-- - ----- - --- --- .__._. Catch Basin/Manhole Storm Drain - - - Shower Pan �- Other: Final _ PASS PART FAIL MECHANICAL Post 8 Beam --- -- - - Rough-In - --- - -- - Gas Line Smoke Dampers Final PASS PART FAIL --------- -- ---- - -- --- -- v._ -- --- ELECTRICAL— _ Servico Rough-in UG/Slab Fire Alarm M-00 PART FAIL F-1 Reinspection fee of$ _---_required before next Inspection. Pay at City Hall. 13125 SW Hall Blvd PART --- SITE ❑ Please call for reinspection RE: ___ r Unable to inspect no access Fire Supply Line ADA Approach/Sidewalk DM#e In•pect or � Ex# Other. Final DO NOT REMOVE this inspection record from the job site, PASS PART FAIL CITY OFTIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE STREAMLINE ELECTRICAL DBA LAVALLEY CORORATION 6025 EAST 18TH ST VANCOUVER, WA 98661 Electrical Signature Form Permit #: NIST2002-00113 Date Issued: 6/6/02 Parcel: 2S104DA-QHS52 Site Address: 12995 SW PRINCETON LN Subdr.,ision' QUAIL HOLLOW - SOUTH Block: Lot: 052 Jurisdiction: TIG Zoning: R-4.5 Remarks: SF' rowhouse,Unit 52,Bldg 11,131c plan with deck.STRUCTURAL FILL, REQUIRES GEO-TECH INSPECTIONS AND REPORTS 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 electricin 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 i5 received 0VVNIR. ELECTRICAL CONTRACTOR: BROWNSTONE QUAIL HOLLOW LLC STREAMLINE ELECTRICAL 12670 S7V 68TH PKWY DBA LAVALLEY CORORATION STE 200 6025 EAST 18TH ST ORTL,�ND pR 97223 YANCOUVER WA 98661 'hone t# 503-598-7565 t' lone #. 360-03-5080 Req #: LIC 116514 ELE 34-1,32C 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 CITY OF TIGARD BUII DING INSPECTION DIVISION 24-Hour Inspection Line: 639- 15 Business Line: 639-41. BUP — -- —� Date Requeste I3/ O _AM PM _ QLD n / Suite LocatioMEC -s+�l --" Ph � �1"�� PLM Contact Person - — P h — SWR �- Contractor ---- �� Tenant/Owner ELC UILDING - ------ ------- ELR e g Wall Footing Access: FPS Foundation Ftg Drain --- SGN Crawl Drain Inspection �,otes: _ SIT _ Slab __ -- -_.. -- Post&Beam Ext Sheath/Shear O J-P) Int Sheath/Shear i Framing S `- "— Insulation Drywall Nailing Firewall -- Fire Sprinkler -- / Fire Alarm Susp'd Ceiling r, Roof ` J Misc. '-- i;iin�a`--- - t1 4) r _ --�- r r SS PART FAI / -- -/-- PLUMgINO Post&Beam y� -_ '� �.(S Under Slab -- - Top Out Water Service -- — Sanitary Sewer Rain Drains Final C PAS T FAIL _, - - -`---- CHANIC earn - Rou h In - Gas Line �- S e Dampers - --- inal ff AS PART FAIL _ _ECTRICAL Service Rough In � S — UG/Slab , -- -� Low Voltage Fire Alarm _ / • -- - Final Cj r 1 _._ ! 1�3� PASS PART FAIL -- O J SITE !, Backfill/Grading Sanitary Sewer required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Storm Drain [ J Reinspection fee of$ 4 Catch Basin �_ - [ ]Unable to Inspect no access Fire Supply Line [ ]Please call for reinspection RE: ADA �\ 1 Approach/Sidewalk Z. Inspector ___v_�.�' Ext _ Other Date - -- � �----- -_.._ - - Final PASS PART FAIL I DO NOT REMOVE this inspection record from the job site. 9 ' ►eAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA � t o ► 4 � No.a ��' 0. 4 4 pill. .1 ON. CL C y ► a.Un r rD CD ► rD ► CD rD ► 4 M . o • C� CrQ ! CN rt, ► Pool 1 0 ► 44 � o 44 �' A i 4 4 ► A _ CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 BUIP Received __ - Date Requested__ t -_ __- AM--- - PM—__�. BUP - --- Location -_---_1��_9. �__-_�� - �"=__ Suite T-__ c_- � MEC Contact Person - - --- - Ph(---- ---) -�� 3-�� PLM Contractor-- - Ph SWR - — BUILDING Tenant/Owner ELG Footing --�-_.- ELC Foundation I tg Drain Access: ELR 0 tol _ Grawl Drain Slab Inspection Notes: Post&Beam --_ --_-- - - Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing ------- - — _ -- Insulation Drywall Nailing - - - Firewall Fire Sprinkler - -- - _ - Fire Alarm Susp'd CeilingRoof Other: �n Other:-------__.. . , Final PASS PART FAIT. PLUMBING - -- ---- — — — Post& Beam Under Slab -- — Rough-In Water Service Sanitary Sewer Rain Drains -- Catch Basin/Manholo Storm Drain Shower Pan Other:-- ------ -. Final d PASS PART FAIL MECHANICAL --- ---- Post&BeamW� T Rough-In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough-In I_JG/Slab IowVoltage ----�.—_._--_-J-__- F it larm Final Reinspection fee of$-__. required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL S �_� Please call for reinspection RE: __ _— ❑ Unable to inspect-no access Fire Supply Line ADA linsplctOr t/ - Approach/Sidewalk ___ tY__._.__�l_ -- Other: Final DO NOT REMOVE this Inspection record from the job site. PASS rART FAIL CITY OF TIGARD 24-Hour Inspection Line: (503) 639-4175 BUILDING MST J' INSPECTION DIVISION lousiness Line: (503) 639-4171 l BUP - - - - -- -- laeceived _ Date Requested_ / AM—_ -_ - PM -- -- BUP Location -- l , C C .5 L��7�Gly suite— MEC -- - y� - --- - - Cnntact Person —— Ph( _—) PLM Contractor __ — Ph( ) _- __-- SWR BUILDING Tenant/Owner __ ELC Footing — ELC Foundation Access: Ftg Drain ELR - -- - Crawl Drain -- ---- - SIT Slab Inspection Notes: Post&Beam ---- — _ Shear Ancho Ext Sheath/Shear Int Sheath/Shoar Framing - - Insulelion za Drywall Nailing --- -- Firevrall -- Fire Sprinkler �—f- Fire Alarm ,` a�►'�_�. t� �i'�Zh� - Susp'd Ceiling — - Roof ---- Other: Final PASS_ PART FAIL -- Post& Beam ---- Under Slab - ----- -- Rough-In Water Service — ---- Sanitary Sewer Rain Drains -- Catch Basin/Manhole Storm Drain — — Shower Pai Omar.-- - --- -- ` elf -in -- -- ------ ---- - - _ PASS PART FAIL MECHANICAL -- Post& Beam Rough-In -_---- - __. Gas Line Smoke Dampers ----— - _ -- Final PASS PART FAIL ------ --- - ELECTRICAL Service -- -- ._ Rough-In - ----- ----- - -- UG/Slab Low Voltage -- ---- --- �t-- - ----- - �_— Fire Alarm Final ,reinspection fee of$_(4�;_ -required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART_ FAIL f SITE Please call for reinspection RE:_ ��✓�- � Unable to inspect-no access Fire Supply Line ADA1f ^ 1,- Approach/Sidewalk Dab— K} -LJ r-- Inspector -- Other:_ Final OT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503) 639-4171 MST BLIP _ Received ______ Date Requested_ AM- PM BLIP _— Location _� _ y. ��-Cil�6C�U�-Q9 r —Suite— MEC Contact Person Ph ( } -7 PLM Contractor - Ph ( } - _ — SWR - BUILDING Tenant/Owner - -- ---- ELC -- _- - - --- Footing ELC Foundation ACCess: Ftg Drainq ELR CCrawl Drain Slab Inspection Notes: SIT _ Post R 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 i3 Beam - ----- -- - -------- Under Slab — --- -- ----- Rough-In Water Service -- - ------ -- - - - - -- Sanitary Sewer Rain Drains -- ------ --- --- Catch Basin/Manhole Storm Drain - --- - — — ----- --- - Shower Pan Other: ------- — — —.-- — --- -- in _. /TA_5VS PART FAIL --_-- - -- --- -- -- -- - _CHANICAL -- - --- — -`--- _ Post& Beam Rough In _-_-- Gcrs Line smoke Uamhers -- ---- - F incl PASS PART FAIL - - - - -- — ELECTRICAL Service --- -- - ----- Ruugh-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:- -._ Unable to inspect-no access Fire Supply Lina ADA Approach/Sidewalk Bats I C_ Inspector_ Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 BUP Received __------Date Requ ted _LL1— - -. AM------ PM -- -- BUP Location _ �� 5 � '1%'-�� x 1 Suite MEC Contact Person Ph(--) —��—5 PL!11 — Contractor — Ph(—) --- - _. SWR _ =t3[11LDIN TenanUOwner -__ ELC _ - 00 g - ELC - — Foundation Access: Ftg Drain ELH _- — -- 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: AS _PART FAIL MBING—_--�- Post&Beam Under Slab Rough-In Water Service -- Sanitary Sewer Rain Drains -- -- Catch Basin/Manhole Storm Drain —- ----- Shower Pan — ----- —-- --- -- Other: _— -- — Fnal — _ --_ - ------- --- -- ----- _PASS PART FAIL _MELHANICAL—____ _ -- .---- ----- -- - --- — -- Post&ream Rough-In — ---- ----- — — — Gas Line _— Smoke Dampsrs ---� -- — ----— — Final PASS PART FAIL — ELECTRICAL --- 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: Unable to inspect-no access Fire Supply Line ADA (Date� Inspecto Approach/Sidewalk Other: Find IDD NOT REMOVE this Inspection record from the Job site. PASS PART FAIL n � O c C. rr 2 a 0 � rr-r EL �. Ci n ra a O o ^ a 3 IS 3'