13025 SW PRINCETON LANE 13025 SW Princeton Lane
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 pd
MST r 0 ��—
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Received _ --Date R este.d__ "�_ AM_ — PM_._ _ BUP
Location _ �� . J Suite._— ____- MEC _
Contact Person --___.____ __ —__ Ph(—) __^ PLM _—
Contractor_ _ _ —. —____ _ Ph SWR _—
BUILDING Tenant/Owner ELC �.—
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drai.i SIT
Slab Inspection Notes: — -- ---- - --
Post& Beam - ---- -- 4 ----- ---------
Shear Anchors
Ext Sheath/Shear --- --
Int Sheath/Shear
Framing —�-- _
Insulation —
Drywall Nailing --"--
Firewall
Fire Sprinkler
Fire Alarm a C.i
Susp'd Ceiling 1 r
Hoot _70-
Other: _-- -------�._ /
Final -G —
PASS_ _PART FAIL i
Post&Beam T —
Under Slab - ------ - —-
Rough-In
Water Service --- --- -
Sanitary Sewer
Rain Drains - --
Catch Basin/M ole
Storm Drai -- - - —— —
Shower P n
Other:
in
A r04<�W FAIL ------_
_ HANICAL —
Post& Beam
Rough-In
Cas Line
Smoke Dampers -- - -�--�- -
Final
PASS PART FAIL --------_---
ELEC_TRICAL —
Service
Rough-In --
UG/Slab
Low Voltage --
Fire Alarm
FinalReins tion fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL L� P�
SITE [ i Please call for reinspection RE:_—_—__ — E] Unable to Inspect-no access
Fire Supply Line /� 1 ,''►
ADA
A Date L Inspector
Approach/Sidewalk ''
PP
Other: ----- _- -
Final DO NOT REMOVE this Inspection recordi fro ::~i the Job site.
PASS PART FAIL
CITY OF TIGARD
13125 S.W. HALL BLVD,
TIGARD, OR 97223
IMPORTANT PERMIT NOT"_;E
DAVID JEROME ELECTRIC
PO BOX 751
HILL.SBORO, OR 97123
Electrical Signature Form
Permit#: MST2002-00091
Date Issued: 914/02
Parr el: 2S104DA-22900
Site Address: 13025 SW PRINCETON LN
Siffidivision- QUAIL HOLLOW - SOUTH
Block: Lot: OSS
Jurisdiction: TIG
7oning: R-4.5
Remarks: SF rowhouse, Unit$5, Bldg 12,13N plan with deck. STRUCTURAL FILL,
REQUIRES GEO-TECH INSPECTIONS AND REPORTS
Your company has been Indicated as the electrical contractor for xhe permit indicated above. In order for the
electrical permit to be valid,the signature of the supervising ek:ctrician is required. Please have the
appropriate Individual from your company sign belrjuv and return this Floctrical Signaturp Form priorto the
start of the work to the address above, / TTN: Building Urvision.
No electrical inspections will be authorized until this complebod form is received
OWNER. ELECTRICAL_ CONTRACT I UR
BROWNSTONE QUAIL HOLLOW LL.0 DAVID JEROME ELECTRIC
1:670 SW 68TH PKWY PO BOX 751
STE 200 HILLSBORO, OR 97123
PORTLAND, OR 97223
Phone#. 503-598-7565 hone#: 848-6144
Fteg # LII; 36051
SLIP 29775
FLE 34-119c
AN INK SIGNATURE I'S REQUIRED ON THIS FORM
Signature'of Supervising Electrician
If you have any questions, please call (;b03) 639-4171, Pxt. #,a fr
ro0z .Idrqa Drmq amv�1d. ,ao XITa Tloctape0g XVd 27:O1 ,1113. C0/7.0/TO
CITY OF TI +�V,�AR® MASTER PERMIT
PERMIT#: MST2002-00091
DEVELOPMENT SERVICES DATE ISSUED: 9/4102
1312.5 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 13025 SW PRINCETON LN PARCEL: 2S104DA-22900
SUBDIVISION QUAIL HOLLOW SOUTH ZONING: R-4.5
BLOCK: LOT: 055 JURISDICTION: TIG
REMARKS: SF rowhouse, Unit 55, Bldg 12,13N plan with deck. STRUCTURAL FILL, REQUIRES GEO-TECH
INSPECTIONS AND REPORTS
BUILDING
REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: FIRST: 172 of BASEMENT: of LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR LOAD: 50 SECOND: 733 of GARAGE: 547 at FRONT: PARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS: I FINBSMENT: 733 of RIGHT:
VALUE: $162,203.60
OCCUPANCY GRP: R3 BDRM: 2 BATH: 2 TOTAL: 1,636.00 of REAR:
PLUMBING
SINKS: 1 WATL'R CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN TRAPS:
LAVATORIES: 2 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB/SHOWERS. GARBAGE DISP: I WATER HEATERS: 1 WATER LINES: BCKFLW PREVNTR GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL _
FUEL TYPES FURN<100K: BOILICMP<3HP: VENT FANS: 3 CLOTHES DRYER: 1
I pG FURN>000K: UNIT HEATERS: HOODS: I OTHER UNITS:
MAX INP: hlu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: I
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp: 1 0 •200 amp: WISVC OR FDR: PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 3 201 400 amp: 201 400 amp: lot WIG SVCIFDR: SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL SR CIR: SIGNALIPANEL: IN PLANT:
MANU HMISVCIFDR: 601 1000 amp: 601+amp9•t000v: MINOR LABEL:
1000+amplvolt: PLAN REVIEW SECTION
Recnnnect only: >600 V NOMINAL: CLS ARF-AISPC OCC:
>=4 RES UNITS: 9VCIFOR>=225 A.:
ELECTRICAL-RESTRICTED ENERGY
_ A.SF RESIDENTIAL a.COMMERCIAL
AUDIO&STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMWAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTW BOILER: HVAC: LANDSCAPFARRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATAITELE COMM: NURSE CALLS: TOTAL M SYSTEMS:
TOTAL FEES: $ 5,500.08
Owner: Contractor: This permit is subject to the regUlations contained in the
BROWNSTONE QUAIL HOLLOW LLC BROWNSTONE HOMES,LLC Tigard Municipal Code, State of OR Specialty Codes and
12670 SW 68'1 H PKWY 12670 SW 68TH PKWY all other applicable laws. All work will be done in
STE 200 PORTLAND,OR 97223 accordance with approved plans. This permit will expired
PORTLAND,OR 97223 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 are set
Rog 0: LIC 124627 forth in OAR 952.001-0010 through 952-001-0080. You
may obtain copies of these rules r direct questions to
OUNC by calling(503)24E 1501
REQUIRED INSPECTIONS
Sewer Inspection Electrical Service Gas Line Insp Gyp Board Insp Plumb Final
Fooling 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 Inst Smoke Detector Final Inspection
Firewall Insp Elertrical Final
Plmlundslb Insp Framing Insp
Issued By : / r r' /r' Permittee Signature : .1
Call (503) 639-4175 by 7:00 p.rn. for an inspection needed the next business day
CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES
PERMIT#: SWR2002-00066
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 4171 DATE ISSUED: 9/4/02
PARCEL: 2S104DA-22900
SITE ADDRESS; 13025 SW PRINCETON LN
SUBDIVISION: QUAIL HOLLOW- SOUTH 'ZONING: R-4.5
BLOCK: LOT: 055 _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 9/4/02 $2,300.00 27200200000
PORTLAND,OR 97223 INSP CTR 9/4/02 $35.00 27200200000
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 ' r i'_ Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
RECEIVED
Building Permit Application ✓
Datereceived: /y /1A Permitno.:
City of Tigard C11•Y up '11UAKLI, Project/appl.no.: Expire date:
Ciryol 8d Ti anAddress: 13125 SW Hall 131"M>
Phone: (503) 639-4171 j Date issued: By: It) Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: —W-_ — 1&2 family:Simple Complex:
7UUI &2 family dwelling or accessory U Commercial/industrial U Multifamily U New construction U Demolition
Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other:
JOB t
Job address: / GAS <'w Y 'w c L!h. c, Bldg.no.: Suite no.:
Lot: Block: Subdivision:l!lH�G !111^1-krQ Ll Tax map/tax lot/account nu.:,-/ nr9 S5�
Project name: _
Description and location of work on premises/special conditions: __ ___ -- ------- ---
1 1 1
11
Name: r 0
Mailing address: ID-611i D.rax: 1&2 tinnily dwelling:
City: o '�' rti�. Stntc:b�INo.of
ZIP: _ Valuation
bedrooms/baths....................
....
. ....
$ --
Phone' y
Owner's representative: Total number of floors................................. _
Phone: F:tx: f mail: New dwelling area(sq. ft.) ..........................
Garage/carport area(sq. ft.)
Name: r , N t` Covered porch area(sq.ft.) .........................
Mailing address: S W _ Deck area(sq.ft.) ......................................•.
Cit State: ZI . R Other structure area(sq.ft.).........................
Commerclal/luduttrial/multi-family:
Phone: Fax: E-mail:
11 Valuation of work........................................ $ --
Existing bldg.area(sq.ft.) ..........................
Business name: r-Q W v.st} t New bldg.area(sq.ft.)
Address: g r Number of stories........................................
City: Swterp Zl Type of construction
Phone' Fax:62o --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
Name: provisions of ORS 701 tnd may be required to be licensed in the
Address. p jurisdicUon where work is being performed. If the applicant is
State ZIP: exempt from licensing,the following reason applies:
Cit s_ _
Contact person:A N Plan no.: —
Phone: x: E-mail: --- —
Name: ,w. ,� � Contact person: Fees due upon application ........................... $
Address: 69w r c c Date received:
City: 61— tate: 7.1P: 3 Amount received .........................I............... $---
Phone: I E-mail: Please refer to fee schedule.
1 hereby certify I have read and examined this application and the Na gat luds"otn wcW credit cants,please call iurisdicaon for mac information
attached checklist. All provisions of laws and ordinances governing Uiis O Vias U Mastercard
work will be complied ' ,whethe ed I in or not. `"rd°U°'�`r'---
Cspires
Authorized sign tum:- _ — -- Name R ZRMIder"u'own O°nedit
card
Pfint dame: L l L.Lf-- — der �nuure Amami
Notice:This permit application expires if a permit is not obtained within 190 days after it has been accepted as complete. 4404611~r>M,
Plumbing Permit-Application
i Date received. Permit no.:
City of Tigard Sewer permitno. Buildingpcnnitno:
72k f ML Address: 13125 SW Ball Blvd Tigard,OR 97223 --
City oJTigard Phone: (503)639-4171 Project/appl.no.; _ Expiredatc:
Fax: (503)598-1960 Li FY UP I IUA D nate issued: 13;-�eipt
Land use approval: ��LDMG�MgjQL_ case file no.: Payment type:
1
mom"U I &2 fancily dwellrgl or accessory U C(nnn1<.1ciauindnstriA U Multi-family U'Cenant improvement
O New construction U Addition/alteration/replacencent U Ircx1 service U 011ier:
{ 1 1
Job address:/, scri tion Qty- Fee(ea Total
`" t New 1-anily dwellings only:
Bldg.no.: Suite no.: (ltaeludes 10each utility c�rnnc
lion)
Tax map/tax lot/account no.: SFR(1)b
Lot; --.>- Block: Subdivision: SFR(2)bath _
Project name: -- - — SFR(3)b -- —
City/county: _�7.IP: Each addiath/kitchen
Description and location of wort:on prrniises:- - Slteutillti;7- m
Catch basidrain
Est date of rompletion/inspection: U wells/ ineltrench drainhooting drno.lin.ft.)Manufactome utilities _
Mantcoles
Wolcott Plumbing Rain drain connector —
PO Box 2007 Sanitary sewn(no.lin.ft,)
Gresham OR 97030-0594 Storm sewer(no.lin.ft.)
503-667-1781 Water service no.lin.ft.)
CCB:23847 PLM N:26-2081113 MtureorItem:
--
Absorption valve
Contractor's representative signature: — Back clow preventer —
Nint name: I BackwaU r valve
ONTAVF PETtgo—KBasins/lavatory
Clothes washer _
Name: ---------- Dishwasher _
Address: - Drinking fountain(s)
Cit ----— State: ZIP: _ E ectors/sum
Phone: Fax: E'-mail: Expansion tank
Fixture/sewer cap —
oor drains/floor sinks/hub
Name(print): Fl
Garbage disposal
Mailing address: Hose bibb
City: _ State: 7.1p: Ice maker
Phone: Fax: E-mail: Interceptor/grease
Owner installation/residential maintenance only: The actual installation Primer(s) _
will be made by me or clic 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: Date:_ Sum —
NO—1911. Tubs/shower/shower pan
Urinal
Name: _ --___ Water closet
Address: Watcr heater _
City: State: ZIP: Other.
Phone: — T1:ax:_ Mail: Total
c� O,for a— Minimum fee................$
Nd dl j�sird;aiau snon+t credit cards.*Mh�+�+ Notice:This permit application plan review(al _�) $
-
U vi.:s Q MasterCard expires if a permit is not obtained
Credit cord wfobwwithin 180 days after it bas been State surcharge(89'0)....$
1°
accepted as concplele. TOTAL ....................... _
Nude d ardtnl+ler u dioivo m tredl ean�--
$
— —` Crdhddct dtsutmc -- AO w 44DA16(ti00S7Caq
MechanicalPermit l'ca
received: Permit ao.:f���
City of Tigard Project/appl.no.: _ Expi.edate: _
CiryoJTigard Address: 13125 SW Ball Illvd,Tigard,OR 9223 Date issued: _ By: Receiptno.:
Phone: (503) 639A I71 -
Fax: (503) 598-1960 CITY UP IIUAK se filen.: Paymcottype:
r31 JILDING T3M9I Iding permit no.:
land use approval: _ - — ---�--
61 Mom III n 3 11
U 1 & 7family dweiling or accessory U Commercial/industrial U Multi-family UTenant imprmeinemU Ncw tion U Add ition/alteration/replacement U Other:- __----
/ , t I r
111
ffl
ess: O 2L S W r'vtiG v tr Indicate equipment quantities in boxes below.Indicate t11c dollar
Suite no.: value of all mechanical materials,equipment,labor,overhead,
.: - profit.Value$ _ -
map/tax lot/account no.:
Block: Subdivision: *See checklist for important application information and
�� jurisdiction's fee schedule for residential Ipermit tcc
name: _ I r
unty: ZIP: t r
tion ar►d location of work on premises:_�------ i;M(�) 1.�Descri tion Qty. Res.only Res.onl
e of completion inspection: �:improvement or change of use: Air handling unit CFM
Is existing space heated or conditioned?U Yes U No it conditioning(sue plan required)
is existing space insulated?U Yes U No A terauon o eusung system -
. . of er compressor:
State boiler permit no.:
1--out Seasons I lcating&A/C Service Inc HP Tons BTUM
110 Box 66409 'u r smo a am duct sma a etectors
Portland OR 97290-6409 eat pump(site p an requir ) _
503-775-5919 nsta l/rep acefuma umvi-.-_ T
Including ductwork/vent liner U Yes U No
CC13: 49293 lnsta Vrep a re Deere eaters--suspen
City/mctro tic.no.: --- —_ - - wall,or floor mounted
_ enter for a p ianct ier an furnace
Name(Please print): a era on:
1 Absorption units BTUM
(millers- lip
Name: -- Com ressrxs Hl,
Address: _ - n uamenta a tut an teo ton
City: State: ZIP: Appliancevent _
- hex: E-mail: Dryer ex Faust
Phone: -I� Type 1 res. is c iazmat
rffiWlDI hood fire suppression system - —
Exhaust fan with single duct(bath fans)
Name: _ _ - - hanst cystcm a from euun or C
Mailing addmess: _-�_ -- e p p trot on up to outlets
City: _Ste: IIP_ _ Type; --L3'G Na Oil
Phone: hex: Email: 'ue Lpi n each a ition over ou ets
rocess piping( temauc requ re 1
Numtper of outlets - 4
Name: -Sorerlisrt4 app ce or eq-pment: !
Address: _ bccorative fireplace
------ State: ZIP: Tnsert-type _
City: W tov pe let stove '
Phone: I'ax: E-mail:
Applicant's signature: Date o
Name (Print): - -
- Permit fee.....................$
ctedii earth,pws call 1�s"0"rex rtrxe�"'-"'a0A- Notice:This permit application Na d1)<,dsd,ctlap+� t aPP� Minimum fee................$ -
❑Visa O MasterCard expires if a permit is not obtained Plan review(at _ `!b) $ —_
aedii cad num J — ;- within I go days after it his been State surcharge(8%)....$ —�—
_� d�� u� - accepted as complete.
=00 it Card TOTAL .......................5 _
d«N(:atturc Amo"a' 44944%417( +
Cardl,ol
p
Electrical Permit Application
A� ie received Permit no.: rr •
L-.
City of Tigard HLU �� ojectlappl.no. _ Expire date:
City ofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639-4171
Case file no.: Payment type:
Fax: (503) 598-1960 CITY UP d AjA1U
Land use approval: TILDING=f TON
❑ I &2 family dwelling or accessory U Commercial/industrial U Multi-family ❑Tenant improvement
❑New construction U Add ition/altetation/rcplacenien1 O Other: ❑Partial
JOB SITE INFORMAtIQN
Joh address: l.S w 1 Itilti ( �•�- Bldg• no.: .`,uiie nu. Tax ma /tax lot/account no.:
Block: Subdivision:
Project name Description and location of work on premises:
Estimated date of completiorihnspection:
tM1ikD1ULE,,
ten alar
Job no:
Description '►Jry. (r,.) 'lural no.fro
Streamline Electric New residential-deKk or multi-family per
DBA LaValley Corporation dwelling unh.Inckodesatuctsrdgarae.
Serrkelinc-tded:
6025 Gast 18't'St IoW sq ft.or leu 4
Vancouver WA 98661 Each additional SW sq.ft.or portion thereof
360-993-5080 Limited energy,residential 2
CCB:116514 EI-C#: 34-432C SUP#: Limltedenergy,non-residential 2
Each manufactured home or modular dwelling
Signature of supe ising electrician(required) Date _ Service and/or feeder 2
License no: Services or feedera-Installation,
Sup.elect.name(prim) alteration or relocation:
1 1 I V1 0 1 200 amps or less 2
201 amps to 400 amps 2 _
Name(print): -_--- 4oI amps to 600 amps 2
Mailing address: am
___ 601 amps to 1000 ps
City: Stale: ZIP Over 1000 arrips or volts _ 2
Phone: Fax: E-mail: Reconnectonl
Owner installation:The installation is being made on property 1 own TQ10porary cervices or feeders-
which is not intended for sale,lease,rent or exchange according to hstallation,alteration,or relocation:2W amps or less � 2�_2
ORS 447,455,479,670,'101. 201 amps to 400 amps _ 2 Owner's signature: Date: .____ _ 401 to 600 ams
—, ;A [-ce
circuits-sew,alteration,
sion per peel:
Name: _ _ nr branch circuits with purchase of
Address. ce or feeder fee,each branch circuit(til Stale' ZIP: __ ur branch circuits wilhotn purchase
Y' rvice or feeder fee,first branch circuit: 2_
Phone: Fax: tttail Each aJdinonal branch circuit
Misc.(Geake or feeder not Included):
2
U Service over 225 amps-mrr
merc,al U Healthcare foc,i„ Each Pump or irrigation circle
) �—
U Service over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting —
familydwellings U Building over 10.000 square feet four or Signal circuit(s)or a limited energy panel,
U System over 600 volts norninal more residential units in one structure alteration,at extatsion' 2
U Building over three stories U Feeders,400 amps or more •Descrition
U Occupant load over 91 persons U Manufactured structures or RV park Each additional inspection over the alloviable in any of the above:
U Egressnightingplan 0 Other- - --- Per inspection
Submit_eels of plans with any of the above. Investigation fee
Thr above are not applicable to temporary cotidmd1oo aerAce. Other
-- .....................
Permit fee S
No art Jwiadkrios,rapt pedis cards,please tail Jurisdiction ft"trrart in(onttarks, Notice:This permit application -
U Visa 0 MauuCard r�f.ires if a permit is not obtained Plan review Oct �) $ --
C"i card oomber within ISO days after it has been State surcharge(8%)....S —
`�"` accepted as complete TOTAL $
Name Iden as shown on cutin card s
Cardholder siptuntc Amok 446.1!15((An"INi
CITY OF TIGA RD 24-Hour
BUILDING Line: (503) 639-4175 MST QGO i_
INSPECTION DIVISION Business Line: (503)639-4171
- ---
.- BLIP —
Received Daaje Requested .3 1 AM_.._ __-__ PM BLIP
Location o a _ — - —Suite.-_ MEC
Contact Person . Ph(— �)"� �Z 3 PLM - -
Contractor ----- - _---- --- ----- - Ph(—) — SWR
BUILDING TpnanVOwnef ._..__ -.___ __-_.__-_ ELC
Footing -- ELC
Foundation ACCP,SS:
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 N 1►�.
PASS PART FAIL ----- _.
PLLIME ING _— -
Post&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
Final
PASS PART FAIL --- - - -- — -... - - - -- —
ELECTRICAL
Service ----- —� ---- -- -
Rough-In
UG/Slab
Low Voltage
Fire Alarm
u Reinspection fee of$_. required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PAS_ PART FAIL.
SITE _ Please call for reinspection RE:T ____ _ ❑ Unable to inspect-no access
Fire Supply Line - I�JN ��
ADA fDAte_ 2-� -" O 7 Inspector ''-- -- Ext_
Anproach/Sidewalk
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
r
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STREET TREE CERTIFICATION ►
Owner/Agent for
! (PLEASE PR %T) (PEK.Urr HOLDER)
ril '►
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Do hereby certify that the following location
! ►
meets City of Tigard/Washington Count- loll.
land use and development standards for street tree installation.
ADDRESS: ►v
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A Lar:a : � SUBDIVISION: L �� C � ►
1
: BY: DATE: Z
! h CEIVED BY: .�� DATE: >�Z�/�`� i►
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CITY Of T{G"D
Residential Certificate of Occupancy
Permit No.: ��� U 5 ( Address. �� 1 �2-�
Owner/Contractor:
Date of Final Inspection: V Inspector:
One& Two Famih•Dm etling
This structure has been found to be in substantial compliance with the provisions of the State of Oregon `
Specialtn Code and is hereby approved for occupancy.
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175 Ono
INSPECTION DIVISION Business Line: (503) 639-4171
BLIP -
Received ___- —Date Requested_—L _AM PM -__ -__ BUP
Location ----.-_I -_ Suite MEC _
Contact Person _ Ph(—) 7�3�S3 S PLM _
Contractor _- - Ph( ) __ _ SWR _ -__—
BUILDING _ Tenant/Owner ELC - --
Footing - ELC
Foundatior 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: -- - -� - - -- -
FI" )
ASS PART FAIL --- -_._.._ - ---- -- - -- --
ow
Post&Beam
Under Slab -------- -. -- -
Rough-In
Water Service ------------------- - -- - - -
Sanitary Sewer
Rain Drains --
Catch Basin/Manhole
Storm Drain -- J-- - -` - -
Shower Pan -
Other: -- ---- --
Final
PASS PART FAIL - - - -
MECHA_NICAL ----
Post&Beam
Rough-In _--_ -------- --------- --
Gas Line
Smoke Dampers --.... ---- - -- ----- _- --
Fin�l,�,
I� P<.-T FAIL -- ---- --- --- ----- --- - ------
ELECTRICAL --
Service
Rough-In ---- --.- _--_ - -.--- -
UG/Slab
Low Voltage --� _-- _-_ -. ---------- -
Fire Alarm
Final t-I 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 ��f�
ADA inspector \ � `< ��-�'" - Ext
Approach/Sidewalk
Other:
Final ISO NOT REMOVE this Inspection recoirdl flrom the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 75
INSPECTION DIVISION Business Line: (503) MST -.
Received Date Requested
BLIP -- -- -- -- -
Alvl PM .� BLIP
Location l 716 Z `� 4, J
w�cam._— Suite
Contact Person _. _- __— — Ph(—) _ _ PLM -
Contractor _-- _ P ( ) SWR -
BUILDING Tenant/Owner ELC
Footing - -- —----
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: �— ------ SIT
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing -
Insulation
Drywall Nailing -- _
Firewall J
Fire Sprinkler
Fire Alarm
Susp'd Ceiling - . - - - --�—JU
-
Roof
s
Other:
Final
PASS PART FAIL - --— —
PLUMBING�----
Post&Beam — --- - - -- - - __ 10 - f-----—
Under Slab -
Rough-In
Water Service - -
Sanitary Sewer
Rain Drains - - - --
Catch Basin/Manhole
Storm Drain
Shower Pan
Other: _-------- --- - ----- -
Final
PASST FAIL
AN L
e
Pos -
am ---- - ---- — --------
Rough-In `�' -- ----- —�
Gas Line
2S ke Dampers
ASS PART FAIL --� -
_RICAL
Service -- -— �—__ -- --
Rough-In
UC/Slab - - - —
Low Voltage
Fire Alarm -- -
Final I Reins
PASS PART FAIL. pectlon fee of$— required before next inspection. Pay at City Hell, 13125 SW Hall Blvd.
SITE A Please call for reinspection RE: Unable to inspect-no access
Fire Supply Line
ADA d
Approach/Sidewalk Date Z 4/ - Inspector
Other:
Final - _—I DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503j 75
INSPECTION DIVISION Business Line: (5067MST
_ Bl1P
ReceivedDate Requested - /� 7_ AM _ PM _ BUP
Location bW�c.. — --_-Suite EC Qv �-"
Contact Person Ph(_-_- ) _ --_-__- PLM
Contractor__ _ __.. Ph �._
-� SWR -----------
BUILDING Tenant/Owner — ELC
Footing
Foundation Access: ELC -_-- _
Ftg Drain ELR
Crawl Drain _
Slab Inspection Notes: SIT
Post& Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing ---- -- ---
Firewall
Fire Sprinkler _
Fire Alarm •
Susp'd Ceiling
Roof
Other:.----
Final
PASS PART FAIL - —
PLUMBING
Post&Beam
Under Slab
Rough-In
Water Service _
Sanitary Sewer
Rain Drains -
Catch Basin/Manhole
Storm Drain
Shower Pan
Other:_
Final
PAS T FAIL
ME --- ----
Post&Beam
Rough-in { ��
Gas Line
Smoke Dampers
-ina
P PART FAIL
E CTRICAL
Service
Rough-In
UG/Slab
Low Voltage
Fire Alarm —
Final Reinspection fee of$ 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 '
Approach/Sidewalk D�— Z.� d Inspector v 1..�
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITYOF TIGAR® MECHANICAL PERMIT
DEVELOPMENT SERVICES DATE ISSUEDDPERMIT :: 4 4/1/03 3-00162
/1/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S104DA-22900
SITE ADDRESS: 13025 SW PRINCETON LN
SUBDIVISION: QUAIL HOLLOW - SOUTH ZONING: R-4.5
BLOCK: LOT: 055 JURISDICTION: TIG
CLASS OF WORK: NEW �! FLOOR FURN EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS _ HOODS:
FUEL TYPES 0 3 HP: DOMES. INCIN:
Pc; 3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITSOTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Installation of'gas Furnace.
Owner: �__— FEES
BROWNSTONE QUAIL HOLLOW LLC Description _ Date _ Amount
12670 SW 681-H PKWY JMtiC'I{] permit Fee 4/1/03 $72.50
PORTLAND, OR 97223
STE 200 [TAX] 8%,StateTax 4/1/03 $5.80
-- �
Total E78.30
Phone: 503-598-7565 ----
Contractor:
THERMOTECH
26716 S. BOLLAND RD.
CANBY,OR 97013 _ REQUIRED INSPECTIONS
Mechanical Insp
Phone: S01-263-8000 Final Inspection
Reg #: L IC 118695
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will he 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 in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00
Issued By:• Permittee Signature: —
Call (503)639-4175 by 7:00 P.M. for inspections needed th� ne t business day
gEQEIV�p . OFFICEUSE
Mechanical Permit ASU icatmi Received 4 Mcchamcal�
Date/BY
l / Q� C'2tNo./y
Planning A pr al Building
City of Tigard Ul(Y OF 1 IGAHU Datcmy: Permit No
13125 SW Hall Blvd. lgl)II_f�lt`1G nIVIS10f Plan Review other
Tigard,Oregon 97223 Date/B � Permit NoPost-Re .'.
Phone: 503-639-4171 Fax: 503-598-1960 Date/By:
yCand Use
Case No.:
Internet: www.ci.tigard.or.us Contact See Pape 2 for
24-hour inspection Request: 503-639-4175 Narnc/Method _ Su lemenral Information.
TYPE OF WORK _ "COMMERCIAL FEE*SCHEDULE-USE CHECKLIST
New construction _ Demolition _ Mechanical permit fees'are based on the total value of the work
Addition/alteration/ lacetnent Other: performed. Indicate the value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead and profit.
CATEGORY OF CONSTRUC'T'ION
1 &2-Famidwelling. Commercial/Industrial Value: S See Page 2 for Fee Schedule
l
Multi-Family RESID.KNI-141 EQUIPMENT/SYSTEMS FEE*
_Acccsso Buildin
_ Description ____L t Fec ea• Total
Master Builder Other: _ Heatin I ""-ling
— JOB SITE INFORMATION and LOCAT N_ Furna -add-on air conditioning----- 14.00
Job site address: i X011 m a- — sus heat pump 14.00
Suite#: Bld /A t.#: Duct work 14.00
—gam ---- H dronic hot waters stem 14.00
Project Name: Residential boiler
Cross street/Directions to job site: for radiator or h dronic system) 14.00
Unit heaters(fuel,not electric)
in wall in-duct,suspended,etc.) _ 14.00
Flue/vent(for any of above) 10.00
Repair units 12.15
Subdivision: Lot#: S _Other Fuel Ap illances _
Tax ma / areal #: Water heater — 10.00
DESCRIPTION OF WORK Gas fireplace 10-00
Flue vent water heater/gas fireplace) 10.00
�
Log lighter as 10.00
Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner/flue/vent_ 10.0_0 _
[�PROi'ERT OWNER I'- 1�T-- Other: 10.00
Environmental Exhaust&Ventilation
N'a1rie:- _ - 11' --- Range hood/other kitchen equipment 1000
Address: l u' . 4'� Clothes dryer exhaust 10.00
City/State/ZipsPbA,4t 'r ) Dom' -el Single duct exhaust
Pholle: -211t Fax: _ (bathrooms,toilet compartments,
APPLICANT_ �_ CUNTAC'f 1'ERSO titilit rooms) 6.80
Attic/crawl space fans 10.00
Na111C:-� -— -- -__--- -- Other: 10.00
Address: J` Fuel PI hi
Cit /State/7i _ **(55.40 for first 4,St. each additions
-- Furnace etc.
Phone: Fax: _ ___ Gas heat pump _ ••
E-mail: Wall/sus nded/unitheater
_
Cc-ACTOR Water heater
-" --
Fireplace
Business Name: -_ Range ..
Address: ,- r ' >_r , _�. fss' I ,f1 -— BB _ .. --
Cit /State/Zi e L t_ 11" CP" 07711 t _ Clothes dryer 2m __
Phone: 7 r. ; _ '),-v Fax: _ other - •`
_ Total:
CCB Lic. # /t .� _- Mechanical Permit fees*
Authorized t��, _ Subtotal: S _
Signature: I Date:-- - Minimum Permit Fee S72.50 $
5
Review Fee2( 5°40 of Permit Fcc) S _
-- (Please print name) ---�- State Surcharge 8%of Permit Fee) $ S: d
TOTAL PERMIT FEE S ^
Notice: I Ili%pet mit application expires if a permit Is not obtained within --;-Fee methodoiopy set by Tri-County Btilidinit Industry Service Board.
IAO days after it hai been accepted as complete.
i\Usts\Pemiit Foms\MecPcrtnitApp,d<K 01%111
Mechanical Permit Application - city of'Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:___
Total Valuation: Permit Fee:
51.00 to$5,000.00 Minimum_fec_$72.50
$5,001.00 to S10,0W.W $72.50 for the first S5,(W.00 and V 52
for each additional$100.00 or fraction
_ thereof,to and including S10,M)00.
510,001.00 to$25,000.00 $148.50 for the first$10,000.00 and
$1.54 for each additional$100.00 or
fraction thereof,to and including
$25 000.00.
$25,001.00 to$50,000.00 $379.50 for the first$25,O1N).(N)end
$1.45 foreach additional$IW.Wor
fraction thereof,to and including
_ $50,000.00.
550,001.00 and up $742.00 for the first$50,000.00 and
51.20 for each additional$I(Y)W or
fraction thereof.
Assumed Valuations Per Appliance:
Value Total
J>Ss-c QtY (Fa) Amount
Furnace to 100,000 B1'U,including 955
ducts&vents
Furnace>100,000 BTU including ducts 11170
&vctlLc_ _
Floor furnace including vent _ 955
Suspended heater,wall heater or floor 955
mounted heater _
Vent not included in appliance permit 445
Repair units _ 805
<3 hp;absorb unit, 955
to I Wk B'I'U
3-15 hp;absorb.unit, 1,7W
101k to 5Wk B1'U
15-30 hp;absorb.unit,501 k to 1 mil 2,310
BTU __
30-50 hp;absorb.unit, 3,4W
1-1.75 mil.BTU _
>50 hp;absorb.unit, 5,725
>1.75 mil B-111
Air handling unit to 10,(M cfm 656
Air handling unit>10,000 cfm 1,170
Non• ortable evaporate cooler _ 656
Vent fen connected to a stele duct 446
Vent system not included in appliance 656
permit
Hood serve ay mechanical exhaust 656
Domestic incinerator 1,170
Commercial or industrial incinerator 4,590 _^
Other unit,including wood stoves, 656
inserts etc.
Gas piping 14 outlets 300
Each additional outlet 63 _
TOTAL COMMERCIAL $
VALUATION:
iADsts\Permit Fonns\MecPermitAppl'g2.doc 01103
CITY OF `rIGARD 24-Hour
BUILDING
Inspection Line: (503)6 5
INSPECTION DIVISION Business Line: (503)631
SUP —
Received —Date Requested ��� AM_ PM — BLIP -_
Location —__ ..__...� 0 Com' suite Suite---- - _ �7, "
Contact Person ---- --- Ph
Contractor r -- ----------- -- Ph(--.) SWR
UILDING7Tenant/Owner - - _ — -- -- ELC
F otina ELC
F undation / Access:
Ft Drain ELR
Cr I Drain
Sla , Inspection Notes SIT _—
Pos R Bea - - - - -
She r Anc ors
I-xl hea /Shear
Int S eat /Shear
Frami g -
Insula n
Drywa Nailina -
Firew
Fire S r kler __+---
Fire ar
Sus Ce rrnl - - -
Roo
Ot r:
ASS PART_FAIL
—
PLUMBING —. -- -- - -- - ----
Post& 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
Hough-In -------
Gas Line
Smoke Dampers -
-m
PART_FAIL - -----�-- --J--
ELECTRICAL —
Service
Rough-In --
UG/Slab
Low Voltage -
Fire Alarm
Final Reinspection tee of required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
_PASS PART FAIL
SITE _-� [� Please call for reinspection RE: — — F� Unable to inspect-no access
Fire Supply Line �j
ADA /t711d �✓ '-`_'_�
Approach/Sidewalk Dab_ -- - 111ap�tof - _-_-- _- Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITYOF TIGARD MECHANICAL PERMIT__
DEVELOPMENT SERVICES PERMIT#: MEC2003-00152
13125 SW Hall Blvd., Tigard, OR 97223 503) 639-4171 DATE ISSUED: 3/28/03
g ( PARCEL: 2S 104DA-22900
SITE ADDRESS: 13025 SW PRINCETON LN
SUBDIVISION: QUAIL HOLLOW SOUTH ZONING: R-4.5
BLOCK: LOT: OSS JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS.
'TYPE OF USE: SFA UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
_FUEL TYPES _ 0 - 3 HP: 1 DOMES. INCIN:
(;AS 3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE. 50 + HP: CLO DRYERS:
FURN < 100K BTU: _ AIR HANDLING UNITS OTHER UNITS:
FURN >=100K BTU: <= 10000cim: GAS OUTLETS-
> 10000 cfm:
Remarks: Installation of exterior n('unit. Cannot he placed in the required setbacks.
Owner: FEES
BROWNSTONE QUAIL HOLLOW LLC Description Date Amount
12670 SW 68TH PKWY 3/"28/03 $72..50
STE 200 [MLC.'tl) I crmit Pec
PORTLAND, OR 97223 [TAX] 8 Statcl'a\ i 3!28103 $5.80
Phone: 503-598-7565 Total $78.30
Contractor:
THERMOTECH
26716 S. BOLLAND RD.
CANBY, OR 97013 REQUIRED INSPECTIONS
Phone: 503-263-8900 Cooling Unt Insp
Final Inspection
Reg#: LIC 118695
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00
Issued By: Liz I, Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next bushiess day
FOR OFFICE USE ONLY
Mechanical Permit Application
ReceivMechanical
DatPermit No.i,
Planning Approval Building
City of Tigard Date/By- Permit No _
13125 SW Hall Blvd. Plan Review Other
Tigard,Oregon 97223 Date/By: Permit No.. _—
Phone: 503-639-4171 lax: 503-598-1960Post-Review Land Use
L" Datc/By: Case No.:
Internet: www.ci.tigard.or.us Contact Juns.: IsScc Parc 2 for
24-hour Inspection Request: 503-639-4175 Name/Method Su Icmental Information.__
_ TYPE OF WORK COMMERCIAL FEE*SCHEDULE-USE CHECKLIST
_ New construction _ Demolition Mechanical periiit fees"are based on the total value of the work
Addition/alteration/re�lacement ❑ Other: performed. Indicate the value(rounded to the nearest dollar)of all
CATEGORY OF CON TRUCTION mechanical materials,equipment,labor,overhead and profit.
1 &2-Family dwellin Commercial/Industrial Value: $- See Page 2 for Fee Schedule
Accessory Building Multi-Famil RESIDENTIAL EQUIPMENT/5YSTEMS iiNe SCHEDULE
Description rFee(ea.) Total
_Master Builder LJ Other: — Heating/Coolinst
_ _JOB SITE INFORMATION and LWATION Furnace-add-on air conditioning' 14.00
Job site address: /30-� i� c Gas heat um 14.00
Suite#: Bldg./Apt.#: Duct work 14.00
II dronic hot waters stem 14.00
Project Name: Residential boiler
Cross street/Directions to job site: for radiator or_ydronic system) 14.00
Unit heaters(fuel,not electric)
in wall in-duct suspended,etc. 14.00 _
Flue/vent for any of above 10.00 —_
_— -- -
Repair units 12.15
Subdivision: _ Lot#: Other Fuel A uaneea
Tax ma / arcel #: V Water heater 10.00
DESCRI_P_Tl N OF WORK Gas fireplace _ — 10.00 _
r
/I �� Flue vent(water heater/gas lire lace 10.00
-tA— Log lighter as 10.00
_ Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chintne /liner/flue/vent 10.00
PERTY OWNER �NANT Other: 10.00
Environmental Exhaust&Ventilation
Name: tL:��S-�pg�_ �ti Range hood/other kitchen equipment 10.00
Address: _ Clothes dryer exhaust 10.00
Citi/State/Zip: _ _ _.._ Single duct exhaust
Phone: Fax: (bathrooms,toilet compartments,
APPLICANT CONTACT PERSON utilityrooms 6.8U
Name: Attic/crawl space fans 10.00
--- — -- _.__ Other: 10,00
Address: Fuel Piping _
City/State/Zip: **($5.40 for first 4,S1.00 each additional
Furnace,etc.
Phone: I'aX_ Gas heatpump "
E-mail: _ Wail/sus ended/unit heater _ •'
__ CONTRACTOR Water heater —
Fireplace
_Business Name �� ..,,�,.� �� ., —
Address: Rangy
LB
-- — _ '•
City/State/Zip: Clothes dtyer asl •�
FaX; •'
Phone' �---�— Other: — Total:
CCB Lic. #: Mechanical Permit Fees'
Authorized '"" ? _ Subtotal: $
Signature: Date: T Minimum Permit Fee$72.50 S
Plan Review Fee(25%of Permit Fee) $
State Surcharge(8%of Permit Fee $
(Please print name) —'� TOTAI:PERMIT FEE $
Notice: 'I his permit application expires If a permit Is not obtained hithin Fmethodology
h dol requlcered fqvt or xte for AIC Building Industry Service Board.
IAO dans after It has been accep ' ella
ted as complete. Pt
I\Dsts\Permit Norms\MccPennuApp.duc 01/03
Mechanical Permit Application - City of'I'igard
Page 2 - Supplemental Information
Commercial Fee Schedule:
'Total Valuation: �M Permlt fee:
SI.00 to$5,000.00 Minimum fee$72.50
55,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52
for each additional$100.00 or fraction
thereof,to and including 510,000.00.
$10,001.00 to$25,000.00 5148.50 for the first 510,000.00 and
S1.54 for each additional 5100.00 or
fraction thereof,to and including
_ 525,000.00.
$25.001.0(Tto$50,000.00 $379.50 for the first S2`-�rx1.00 and
$1.45 for each additional W W.00 or
fraction thereof',to and including
550,000.(x).
$50,001.00 and up 5742.00 for the first 550,000.00 and
$1.20 for each additional$100,00 or
fraction thereof'.
Assumed Valuations Per A llance:
-- �� Value Total
Description: t 1[a Amount
Furnace to 100,000 BTU,including 955
ducts&vents _
Furnace>100,000 BTU including ducts 1,170
&vents
Floor fumace including vent_ 955 1 _.
Suspended heater.wall heater or floor 955
mounted heater
Ventnot included in appliance permit 445
Ite Bair units _ $05
<3 hp;absorb.unit, 955
to I 00 BTU
3-15 hp;absorb.unit, 1+700
101k to 500k B'ru
15-30 hp;absorb.unit,501 k to I mil. 2,310
BTU
30-50 hp;absorb.unit. 3,400
1-1.75 mil.BTU
>50 hp;absorb.unit, 5,725
>1.75 mil.BTU _ 0000
Air handling unit to 10,000 cfm, 656
Air handling unit>10,000 cfm 1,170
Non-portable evaporate cooler 656 _
Vent fen connected to a single duct 446
Vent system not included in appliance 656
rmit ---
flood served b mechanical epthwisl 656 _
Domestic incinerator 1+170
Commercial or industrial incinerator 4,590
Other unit,including wood stoves, 656
inserts,etc.
(las piping 14 outlelg _ 360
Each additional outlet 63
TOTAL COMMERCIAL $
VALUATION:
is\Osis\Penni(romps\MecPermitAppPg2.doc 01103
Mar 28 03 10: 03a BROWNSTONE HOMES 503-620-9965 p . ?
1�NIT G
��I UNIT
q;,F,i UNIT �. B N I 6
tNIT I' LNIT B-° wwl � �oQP.unro
C4,1 1 D 5 j B-5 I rs�uncal , (opP.
DO*
r--- I
''LAN; LEVEL ------
_�--~
i
- --- -----•, � jib �-', �.�.�- `'� �
,, _
II laa+.l v NIT
I 6 I$ UNIT ori °
- 1F3..5 I
LEVEL
ELECTRICAL PERMIT
CITY OF TIGARD •
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2002-00295
13125 SW Hall Blvd., Tigard. OR 97223 (5031639-4171 DATE ISSUED: 12!16/02
PARCEL: 2S 104DA-22900
SITE ADDRESS: 13025 SW PRINCETON LN
SUBDIVISION: QUAIL HOLLOW - SOUTH ZONING: R-4.5
BLOCK: LOT: 055 JURISDICTION: TIG
Protect Description: All encompassing low voltage.
A.RESIDENTIAL _ B.COMMERCIAL_
AUDIO & STEREO: X. 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 : X HVAr PROTECTIVE SIGNAL:
INSTRUMENTATIt- OTHER:
_ TOTAL#OF SYSTEMS___—
Owner: — Contractor:
BROWNSTONE QUAIL HOLLOW LI-C AZIMUTH COMMUNICATIONS INC
12670 SW 6bTH PKWY P.O. BOX 508
STE 200 WILSONVILLE, OR 97070
PORTLAND, OR 97223
Phone: 503-598-7565 Phone: 503-639-1)111,
Reg#: ELE 36-94('LE
SUP 2312LEA
LIC 145828
_ FEES Required Inspections _
Description Date --_ —Amount Low Voltage Inspection
(E.LI'RNI I I 1 i.lt Pcnnit 12116/02 $75.00
Elect'/ Final
ITA\ 8"/o State I'm 12/16/02 $6.00
Total $81.00
This Pen-nit 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 worts 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 lhrouc
Issued X [�-�tiy\/0._ �.____ Permittee Signature _—
_ 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 ONLY _
SIGNATURE OF SIJPR. ELEC'N
LICENSE NO: .._— ---------�^.-- -------- -- ----
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
Electrical Permit Application
_ Datereceived: /A /� 0� Permitno.:
City of Tigard RECEIVE Project/appl.no.: h ire date:
City(!f Tilard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: y J I Receipt no.:
Phone: (503) 639-4171 13 200[.
Fax: (503) 598.1960 DEC Case file no.: Payment type;
Land use approval: CITY OF TIGARD
U 1 &2;familywelling or accessory U Commercial/industrial U Multi-farnily U Tenant improvement
New ion ❑Add idon/alteration/replac:ement l]Other: U Partial
Job addrebdLS Sit . 't,v�t Id.. LA Bldg. no.: /a Suite no.: Tax map/tax lot/account no.:
Lot; Tc; Block: Subdivision: 014194L 5,W
Proiect name: CIO-, i` Saes rr+ Description and location of work on premises: Y01C01,10,F0
Estimated date of completion/inspection:
CONTRAV11*0111 A111111,11CATION FEE, SCHEDULE
Job no: F'ee t+1nx
Business name: Az4m"TA C1DMr�1 u�I C'ATldnJ l --"- - Description Qty. (res.) Total no,Insp
New reAdential-single or multi-family per
Address,'�30) 5- ). Mpg dwelling wdt.Includes attached garafr-
City: Uj fL-,C 4411 LL&:- State:0,(2- 1 ZIP: 97706 Service Included:
Phone: G Fax G3 o/r E-(nail: 1000 sq.It.or less 4
FAch additional 500 sq.ft.or portion thereof _
CCB no.: 1µ5 Elec.bus.lic.no: ,66-y Limited energy,residential 2
City/metro lic.no.: aW U52`) Limited energy,non-residential 2_
`z /Z�/-��Q Z Each manufactured home or modular dwelling
Signe ore of supervising elect iv an(required) Date Service and/or feeder
11
Sup.elect.name(print): y License no:.Z,3/2 e.Eq Services or feeders-Installallon,
alteration or relocation:
200 amps or less 2
7(print): A)PTyA)E _ _ 201 amps to 400 snips 2
401 amps to 600 amps 2
_ 1401 amps to 1000 amps 2
Cit Stale: ZIP: Over 1000 un s or volts 2
Phone: Fax: E-mail: Reconneuonl I
Owner installation:The installation is being made on property I own Temporary services or feeders-
which is not intended fir sale,lease,rent,or exchange according to Instalint ion,sdteratIon,orretocation:
ORS 447,455,479,670,7(j;. 01
i. 2amps or less 2
2 _
01 amps l0 400 amps _ _ 2
Owner's si nature: Date: _ 401 to 600 ams — 2
�01 11101.1i 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: State: ZIP: B. Fee for branch circuits without purchase
- -
-----------
-- of service or feeder fee,first branch circuit 2'
I'hnne; I'ax: F,-mail: ----- -- --
Each additional branch circuit:
Misc.(Service or feeder not Included):
U service over 225 amps-commercial U Health-care facility Each pump or irrigation citcle '-
U Service over 320 amps-rating of 1&2 U Hazardous loeation Each signor outline lighting 2
family dwellings U Building over 10,w)square fen four or Signal circuit(s)or a limited energy panel,
USystem over 600volts nominal more rcsidendalunits inone structure alteration,orextrmoon• 1
U Building over three stories C: Feeders,4(x)amps or more •Descri pion
U occupant load over 99 person U Manufactured structures or RV park each additional Inspection over the allowable In any of the alcove:
U Egress/lightingplan U Other" - —_ Pet inspection
Submit—sets of plans with any of the above. Investigation tee_—__—__
The above are not applicable to temporary conslniction service. Other _-
- Permit fee.....................$
Not alictitxu accept credit cards,please call jurisdiction fa nose Infxrnatlon Notice:This permit application --
r U MasterCard expires if a permit is not obtained Plan review(at — %) $
„card number: _-- --" --_ I within 180 days after it has been State surcharge(8%) ....$ _—_�—
t_rpirrs accepted as complete TOTAL . ......$
Naar.d cardholder u shown on credit cum ,--
Cardholder signature Atnonot 440.4615(firWrCOM)
CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2002-00570
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 15104 2
PARCEL: 2S10402
SITE ,ADDRESS: 13025 SW PRINCETON LN
oUBDIVISION: QUAIL HOLLOW- SOUTH ZONING: R-4.5
BLOCK: LOT: 055 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SFA UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS_/COMPRESSORS HOODS:
FUEL TYPES_ 0 - 3 HP: DOMES. INCIN:
LPC; �Y 3 15 HP: COMML INCIN:
MAX INPUT: BTU 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS _ OTHER UNITS: 1
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 Cf m:
Remarks: Installation of gas fireplace and gas piping.
Owner: FEES
BROWNSTONE QUAIL HOLLOW LI-C DescriptionDate Amount
12670 SW 68TH PKWY Ihtla'111 1'ermit I er 12/12102 $72.50
STE 200 I'AX) R"s,Sw(e fay 12/12/02 $5.80
PORTLAND, OR 97223
Phone: 503-594-7505 Total $78.30
—
Contractor:
FOUR SEASONS HEATING & A/C
PO BOX 66409
PORTLAND, OR 97290 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 503-775-591() Mechanical Insp
Reg#: LIC 48283 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Centei. Those rules are set forth in OAR 952-001-00
Issued 4Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for lospections needed the next bus;nPss day
Mechanical Permit Application
Date received: / p� Permit no.:N� 5 70
City of Tigard ProjccUappl.no.: Effpim date:
C'iry(if Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: B Receiptno.:
Phone: (503) 639-4171
(.
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: Building permit no.: Rf5j_,14CG } -
TYPE OF PERMIT
&2 family dwelling or accessory U Commercial/industrial U Multifamily U Tenant improvement
New construction U Ad(Iitiort/alteration/replacement U Other: _-
11 SITE IN FORIMATIONCOMMERCIAL 1SCHEDULL
Job address: �C ; '-)(L, 116"1 1C y� (( Indicate equipment quantities in boxes below.Indicate the dollar
Bldg.no.:U Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax ot/ticcount no.: profit. Value$
l ot: Block: S tbdivision: t *See checklist for important application information and
Projec e: t juris,iiction's fee schedule. for residential prnttit Ice
City/county: y ZIP: - MMMMUM go AL 1111111111
Description and I t on of work o remissgs: 7A,rr
1 1 r
t1 I� l V" J r — I cc(rr.► !ural
Est.dale of completion/inspection: Ihnwriplion Qcy. Res.only Rm.only
Tenant improvement or change of use: ng unit __CFM
Is existing space healed or conditioned?U Yes U No Air conditioning(site plan required)
Is existing space insulated?U Yes U No _JL Alteration ofcxistingliVACsystcm
MECHANICAL CONTRACTOR o er compressors
Business ame: Uwr State boiler permit no.:
— -- --
Addie. NP _Tons BTU/N
-
atnpersn uct smoke detectors
City: V c/Y-tStale ZIP: qT0 Bear pump(site plan reyutrec)
Phone:,5i3 5-39-9141 Fax: E-mail: ":i I/rep ace urnace urner MUM
Including ductwork/vent liner U Yes U No
CCB no.: I _— nstall/replace re ocate heaters-suspcn e ,
City/metro lic.no.: wall,or Floor mounted
Nance(please print): — Vent for appliance other t :,, f-mace
1 1 of gest on:
Absorption units__ Iil'lflll
Name:r L v' - ( Chillers
Address. j Compressors HP
Environmental exhaust and ventrlal Frr.
City:/ �." (l(.( � f Stat I APPlianccvrnI
Phone: Q Fax: E-mail: �ryerex roust _
or s,Type res.kite cr azmat
hood fire suppression system
N.
Exhaust fan with single duct(hath fans)
Mailing address: �— 'x roust s�stcm a art from heatingor AC
City: - state: ZIP: •ue piping an rclr ul on(up to outlets)
Type. ___LNj _ NG Oil
ucl IiPhone: Fax: E-mail: over 4 outlets
roces!piping(schematic require(r)
Name: Numt,cr of outlets
_ 1-.ler listed oppillance or equ patent:
Address: _ _ Decorativefireplacc
City: State: ZIP:_— T nseri type
Phone: Fax: E-mail: stov ped et stove
_LaCE
Applicant's signature: Date: other:
Name (print): --
Na all jurisdictions accept credit cads,please call jurisdiction for note inftttnation I'ei reit fee.....................$ _� �0
U Visa U MasterCard Notice:This permit application Minimum fee................$ _ ,
expires if a permit is not obtained Plan review(at — 96 $
Credit cad number _-__-_ — F i / within ISO days after it has been ) ---1�
p State surcharge(8%) ....$ J5 _
-- — -re accepted as complete.
Nana d cardholder a that i t � credit cad acce
s TOTAL .......................
Cardholder signature -- Amount
—^-- ---- 440I617(6Ag4'OM)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: PERMIT FEE: Description: Price Total
$1,00 to$5,000.00 _ _ Minimum fee$72.50 Table 1A Mechanical Code oty (Ea) I 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$16,000.00 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 healer 14.00
$25,001.00 t $$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_,0_01.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boller Heat Air
$1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond
I fraction thereof, footnotes below. Comp
Minimum Permit Fee$72.50 SUBTOTAL: $ 7)<3HP;absorb unit
to 100K BTU _ _ W52.20 .
B°/.State Surcharge $ 8)3-15 HP;absorb unit 100k to 500k BTU25%Plan Review Fee(of subtotal) 9)15-30 HP;absorbRequired for ALL commercial permits oni $ unit.5-1 mil BTU 10)30-50 HP;absorb
TOTAL COMMERCIAL PERMIT FEE: $ unit 1-1.75 mil BTU
11)>50HP;absorb
unit>1.75 mil BTU 87.20
ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM 1000
-- Value Total 13)Air handling unit 10,000 CFM+
Descriptions CiEa Amount 17.20
Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler
ducts&vents _ 10.00
Furnace>100,000 BTU including 1,170 15)Vent fan connected to a single duct
ducts&vents 6.80
Floor furnace Including vent 955 16)Ventilation system not Included in
Suspended healer,wall healer or 955 appliance permit 10.00
floor mounted heater 17)Hood served by mechanical exhaust
Vent not Included in appliance 445 10.00
permit - 18)Domestic Incinerators
Repair units 805 17.40
<3 hp;absorb.unit, 955 19)Commercial or Industrial type Incinerator
to 100k BTU 69.95
3-15 hp;absorb.unit, 1,700L 20)Other units,Including wood stoves
101k to 500k BTU 10.00
15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets
mll.BTU _ 5.40
30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each)
1-1,75 mil.BTU 1.00
>50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $
>1.75 mil.BTU
Air handling unit to 110,000 cfm 656 - -8%State Surcharge $
Alr handling unit>10,000 chn _ 1,170
Non- rtable evaporate cooler 656
Vent fan connected to a single duct 446 TOTAL RESIDENTIAL PERMIT FEE: $
Vent system not Included In 656 _ _appliance permit _
Hood served b mechanical exhaust 656 Other Insect Ions and Foes:
1 Inspections outside of normal business hours(minimum charge-two hours)
Domestic incinerator 1,170 $62 50 per hour.
Commercial or Industrial Incinerator 4,590 2 Inspections for which no fee is specifically indicated (minimum charge-half hour;
Other unit,Including wood stoves, 656 $62 50 per hour
Inserts,etc. _ 3 Additional plan review required by changes,additions or revisions to plans(minima 1
Gas I in
e 1-4 outlets - _360 charge-one-half hour)$62.50 per hour
Each additional outlet 63 'State Contractor Boller Certification required for units>200k BTU.
TOTAL COMMERCIAL $ `Residential AIC requires site plan showing placement of unit
VALUATION: All New Commercial Buildings require 2 sets of plans.
I:Wstslforms\mech-fees.doc 02/11/02
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
WOLCOTT PLUMBING CONTRACTORS
PO BOX 2007
GRESHAM, OR 97030
Plumbing Signature Form
Permit #: MST2002-00091
Date Issued: 9/4/02
Parcel. 2S104DA-22900
Site Address: 13025 SW PRINCETON LN
Subdivision: QUAIL HOLLOW - SOUTH
Block: Lot: 055
Jurisdiction: TIG
Zoning: R-4.5
Remarks: SF rowhouse, Unit 55, Bldg 12,BN plan with deck. STRUCTURAL FILL,
REQUIRES GEO-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 GRESHAM, OR 97030
PORTLAND OR 97223
Phone #: 50'3-598-7565 Phone #. 667-1781
Reg # I Ir 23847
PI M 26-208PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature o uth nz_ed Plumber
It you have any questions, please call (503) 639-4171, ext. # 310