10100 SW MOLLY COURT C?
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10100 SW MOLLY COURT
� I�lei�® - _ MASTER PERMIT
CITY OF
PERMIT#: MST2003-00266
DEVELOPMENT SERVICES DATE ISSUED: 6/20/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 10100 SW MOLLY CT PARCEL: 2S1021313-02600
SUBDIVISION: MOORE'S MEADOWS ZONING: R-a 5
BLOCK: LOT: nii JURISDICTION: III
REMARKS: Const. new SF detached residence.
BUILDING _
REISSUE: SUN63U05P STORIES FLOOR A14EAS REQUIRED SE TRACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: :'4 FIRST: 11,'w st BASEMENT: st LEt SMOKE DETECTORS.
TYPE OF USE, nF FLOOR LOAD 41,1 SECONDt 171 0 GARAGE: 600 sf FRONT: 20 PARKING SPACES
TYPE OF CONST: 5N DWELLING UNITS 1 T4RD sf RIGHT: `-
OCCUPANCY ORP: R7 BORM: 7 BATH: 'i TOTALsl VALUE: 242,346 00 REAR: 1`
PLUMBING
SINKS: WATER CLOSETS: 7 WASHING MACH. i LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: I FLOOR DRAINS SEWER LINE.^,: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUBISHOWERS: i GARBAGE DISP: I WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
rUEL TYPES FURN<TOOK BOILICMP,3HP: VENT FANS: 3 CLOTHES DRYER: I
FURN--,TOOK 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: i
MAX INP: btu Ft OGR FURNANCES: VENTS 1 WOODSTOVES: GAS OUTLETS: 4
ELECTRICAL
RESIDENTIAL UNIT _ SERVICE FEEDER TEMP SRVCIFEEDEPS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - 20o amp 0 - 200 amp: WISVC OR FOR PUMPIIRRIGATION: PER INSPECTION:
EA AnD'L 500SF: r, 201 400 amp' 201 - 400 amp: 1 st W10 SVCIF DR SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp 401 000 amp: F A ADDL BR CIR SIGNAL/PANEL: IN PLANT:
MANU HMISVCIFDR: 601 1000 amu: 601*amps-1o00v: MINOR LABEL:
10004 amplvolt
PLAN REVIEW SECTION
Reconnect only:
>•4 RES UNITS: SVGFDR>=225 A.: >600 V NOMINAL: CLS ARF.AISPC OCC.
_ ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL _— _ B COMMERCIAL
AUDI')6 STEREO: VACUUM SYSTEM. AUDIO&STEREO: FIRE ALARM INl-ERCOMIPAGING: OUTDOOP 1.4E S-:LT.
BURGLAR ALARM: OTH: BOILER- HVAC: LANDSCAPFfIRRIG: PROTECTIVE SIGNL
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TF.LE COMM: NURSE CALLS: TOTAL N SYSTEMS.
Owner: Contractor: TOTAL FEES: $ 7,433.10
INTERCOASTAL DEV GROUP LLC JLS CUSTOM HOMES This permit IS subject to the re gulatwns contained In the
Tigard Municipal Code,State of OR SpecialtyialtyCodes and
PO BOX 91185 17200 NW CORRIDOR CT #110 all other applicable laws. All work will be done In
PORTLAND,OR 97291 BEAVERTON,OR 97006 accordance with approved plans. This permit will expire if
work is not started within 180 days of issuance,or f the
work is suspended for more than 180 days ATTEI4TION
Oregon law requires you to follow rules adopted by the
Phone: 503-209-8940 Phone 503-533-4006 Oregon Utility Notification Center Those rules are set
forth in OAR 952-001.0010 through 952-001-0080 You
Reg"' LIC 139970 may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987
REOUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam MechanlGa Plumb Top Out Exterior Sheathing Insl Insulation Insp Appr/Sdwlk Insp
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Rain drain Insp Electrical Final
Footing Insp Crawl Drain/Backwater Electrical Rough In Fireplace Insp Roof Nailing Mechanical Final
Foundatlon Insp PLM/Underfloor Framing Insp Gas Line Insp Water Line Insp Plumb Final
Post/Beam Structural Mechanical Insp Shear Wall Insp Gas Fireplace Water Service p Building Final
Issued By : ---- Permittee Signature
Call (503) 639-4175 by 7:00 p.m. for an inspection neeued the next business day
CITYOF LTIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2003-00169
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-41Y1 DATE ISSUED: 6120/03
PARCEL: 2S 102 BB-02600
SITE ADDRESS; 10100 SW MOLLY CT
SUBDIVISION: M(N)RF'S MFADOWS ZONING: It-4.5
BLOCK.: LOT: 007 � ^_JURISDICTION: 11( ,
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NLVV DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF detached dwelling.
Owner: FEES._
INTERCOASTAL DEV. GROUP LLC Description , Date Amount
PO BOX 91185 - --
PORTLAND, OR 97 291 [SWUSA]Swr Connect 6/20/03 $2,300.00
[SWUSA] Swr Connect 6/20/03 $0.00
Phone: 503-209-8940 [SWINSP]Swr Inspect 6/20/03 $35.00
ISWINSPI Swr Inspect 6/20/03 $0.00
Contractor: --` — -
-------- — Total $2,335.00
Phone:
Reg #:
Required Inspections
Jhis Applicant agrees to comply with all the rules and regulations of the Clean Water Services. 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 throu &R 952-001-0100
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-0699
Issued by:
Permittee Signature:
Call (503) 639-4175 by 7.00 P.M. for an insP eclion needed the next business day
r
_9 _03 �o5tvtev A/- `'
Building Permit Application
r,\ Date received: I'i Hill(no.,.
City of 'Figs t ] -
Addrrs', I +125 SW al `'f t1a.�jl y� Zl I'n IecUappl. no.: t:xpire date:
PityrtjTiRard Date issued: 0 Rc .
Photic t ( i) 639-0171 l Y� xeit no.
P
Fax: (503) 598.1960 MAS 1 II Case tile no. Payment type:
1
Land use approval'(ATY OF I i( te0 1&2 family: ~tropic c, l rex: _J
k
U I &2 family d%%clling or accessory U Conimercial/industrial -J Multi-family WNew construction U Demolition
U Addition/;lit:rui m/rrplarrntcnt J Icnant improvement J lire sprinkler/alarm U Other:
.JOB SITE INFORMAI
1011 address: lot ' -` 'fillLL) w-t. 1' �'.rs ► Bldg. no.: Suite no.:
I ot: Mock: Subdivision: �'v,1 0. �, _ � ��} I ax snap/tax lot/accounr no.:
III o.ject name:
Description and location of work on picnuscs/special conditions: ----__._.---------- -_—`_ - ,__-- —__---
Name �v� CUw:� ---\ - x/r , I_`_ .
Mailing address: ,��[ ! _ 1&1 family dwelling:
C—if t Stat . 7.11': Valuation of work ...............•......................... $ ��
I'hun�cdr 'J 11:aQ4 F-mail No.nl'bedrooms/baths . .... ... . .. .... .. ...._ _1 Z!
Owner's representative: - P,5 Total number of floors .... . . .. _ ........ �_
1'hunc Fax I mall. New dwelling arca tsil ft)
Garage/carport area(sq It.) .... _-- _
Nttme: - ��� Covered porch arra owl ft t ...._.. ...
�._
Mailing address: _ Deck area owl h.) .
C':.y: 'irate: >.11' — Other structure arra t\y It 1 . .. . .........
I'honr: li-mail: -- -- -- (ommerclallindustriallmulti family:
Vuiva(lon of work ................... ....... $ ----__-- -
liu,inc., n,urn:
--T-'--
Existing arca Ls t.)
� .....
New hidg arta(sq f.). ............ ..................
Addr.\�
City' Number of stories........ ...... . ....
t 1 Type of construction .. . ......... .......
I'hon t ) mail
C( I Occupancy group(s): Lusting:.
_-
�---- — -- - New:
t uy/metro lic.no..
Notice:All contractor%and subcontractors are required to he
licensed with the Oregon Construction Contractors hoard under
Name: l 110LAd provisions o1'ORS 701 and may he required to be licensed in the
Address: jurisdiction where work is being performed If the applicant is
City:" State: 7.111:2a
exempt from licensing.the following reason applies:
Contact per n flan no.:
Phone _r Fa •1' L-mail
Name: le,r y; ('ontact person. LA, Fes due upon application.............................$ _-_----�-.--
Address: �- ! - - 5 ( Date received:
('ity, t State ill'S : Z Amount received . ......... ...... ................
-- __
Phone• -SUS 1 ax: I I';-mail Please refer to fee schedule.
hereby certil'y I have read and examined this application and the N,,t all tmr•dtctuom mrrpt ardn cards please call ryn,dtctun fa rroxr 0,tmawm
attached checklisi All provision. aws and ordinances governing this J visa J SimsterCard
.' t lydtt card numhet �.. .
work will he c,mtplird wl •ll'ted heron or not.
__ _ .
Authorized signator '._ _ )arc: _- _' .�rr_r�_,I ar ih sldrr._a.sh awn_-m rrdn c--ard-
Print name: _5
t'ardluAdet +tpnaturr Amount
Nottcr fhts permit application expires if perms (:..not obtained within 180 days after it has been accepted as complete 44114611 6411 iW
Electrical Permit Application
_ Date received: Permit no.:
City of Tigard lsrojeci/appl. no., Expire date:
('ilyofTigard Address: I?125 SW Hall Blvd. Iigard,OR 97223 Date issued: _ BY: Receipt no,.
Phone: (503) 639-4171 -
Pax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
'111 a 61TM IM
U I & 2 family dwelling or accessory UCommerciaihnd ,ti ial UMulli-farnily U Tenant imprt %idiot
New construction U Addition/alteration/replacement U Other: U Partial
MIN111 to
Joh address:II) - Bldg. no.V� Suite no.: Tax map/tax lot/account no
Lot: Block: SubdivNiol
Project name: Description and location of work on premises:
Estimated date of completion/inspection:
Job no: rt.. Mox
Business name: e e Dewri pj ion () ksl•i total no.lns
Address: Ness residential-stnrleormuld-family per
C �.�. dNPlBIrg IIIIIf.tIKI1NIP5 gItAcI1/VI QArij,e.
City: JStatetX 1ZIP: Ser,IcehvchN(ed:
Phone' 2,- I'*ax: _ I_-mail: -- IM0 V4 it.or less 4
CCB no.: Elec. bus, lic. no: Bach additional 5(10 sq.ft.or portion thereof
Limited energy. residential 2
Oily/mel ,lit:.no.: _ _ Limited energy, non-res,dennal 2
s. 3 hash manufactured hour or mtshilar dwelling
�' 1 -� — tics ice and/or feeder 2
Si nature of sit rvisin electrician (required) _ I) to
Sill) elect.name(print). — — Y license no Servlcesorfeeders-Instal lotion.
■lleratlonor relocatlon:
2fxi amps or less _ 2
Name rPri^ " s - ` 2 11
t)' ams u:400 a it s
\ 4o1 ,un . to 600 ams 2
Mailing addrdss: s e - 601 am . to loco ams 2
Cly: Stat 1,11 . Over IOW amps or volts 2 —
I'bon I a -I I L Cil E-mail: Reconnect viol I
Owner installation: The installation s being made on property I own Tempoaryservices orfeeden-
which is not intended for
side, rent,or exchange according to Insmllation,alteadon.orreloation: /
OILS 447,455,479, 711x7 21.x)am s or less 2
2x11 Amp.to 41st am,s 2
Owner's si nature::- bate: an; r- - - — 2 '-
Bruwh(ircuits ne",olteratlon,
or P;terrslon prr 1Nrnel:
NaInc. A U A Lee for brach circuits with purchase of
Address: - p :\, ,v r service or feeder fee,each branch circuit 2
City: State."' Fee for branch ciioiw. Aitfvxn purchase
— -- -7— 1 _of service or feeder fee,first Manch circuit:
Phone:!' 1 f"' I a�m i n.ul: — -
P:ach additional branch circuit.
(Service or feeder not Included):
i uh or ori awn ctrdv 2
J ticrvae over 25 ;dnpsconmrrcial J Ileilih care Luilus t,;�� B
J Service over 320 amps-rating of I&2 J ilaxwdous location i ech sign or outhne fighting —2
farnily dwellings J Building over 10,001)square feet four or Signal circuit(s)or a flouted energy panel,
J Symem over 101 volts nonural more residential units in.xle structure Alcratuxt, or extension'
J Building over three stoics J Feeders,4(X)amps of more `Mscri n tin
J Oralpant load over 99 persons J Manufactured structures or RV park Fach additional Inspection over the allorvabte In any of the above:
J 1-.gres%Aighting plan J Other ..._-
----- ------- I'cr :mpc'cuun
Submit—sets of plans with ani or the shove. Imcsuganon fee -- -- ---— -
The above are not applicable to temporary construction service. Other
Nie all unsdimLms accr rr,hi cud. rs%e call unsdtcrum fit nnrr mt,vmm�nn Pl'fmll tee ... -............. ..
i r«� r+ I Notice: This perms application
J Visa J Masten ud expires if a permit is not obtained flan Iv%few(at ,_ %
Credit card number _________- . within 180 ciays after it Iles been State surcharge(8%1 .. S —_
Pitts accepted as complete TOTAL ...... . .......... S
-'- N'amr of oder a.shownin cn:dit pard '� —�
S _
Armmm lit;M1 s tN XWOM,
Mechanical Permit Application
' — -- — Date received: Permit no
City of Tigard Pruject/appl. no.: Expire data — -- --
CitYy q('figard Addic,,s ! ;125 SW hall Blvd,Tigard.OR 9722
)>1);I 639-4171 Date issued: By: - Receiptipt no.
Phone .
Fax: (503) 599-1960 Case file no.: Payment type:
Land use approval: Building permit no
;�Rldg.
I & 2 family dwelling (n ILVOYWIn JComrnercial/industrial J Mulli4dilliIi U Tenant improvement
New construction J Addition/alteration/replacement J Other.
Jobaddress: Indicate equipment yuanuUcs In huxcs below, Indicate the dollar
no,; uile nu.. value of all mechanical materials,equipment,labor,overhead.
Tax map/tax lot/account no.: profit. Value$
Lot: I Block: Suhdivision:%o6j-rt, 'See checklist for important application information and
Project name; - mrisdiction's fee schedule for residential permit fee
City/county;Lk)nLk, %11.
Description and location o work on premises: -
Fee(ea.) Total
Est.date of completion/inspection: i G,' Description Qtv. Res.only Res.on1
Tenant improvement or change of use: Air handling unit
Is existing space heated or conditioned?U Yes U No Air conditioning(site Ian reywred) _
Is existing space insuiated?U Yes U No Alteration of existing H VALsystem
B(if ler/ctvnptessors
State huller peoutr nil
Business mime:
Address: � Dire/smoke danipcis/duct smoke detectors
City: SlahL, %II': oat ptunp(s to p an reywre 1 _
Thune l ' I'u94411 1 -mail: nst top ice lurnac• +urner
^ — — Including ductwork/vent hoer J Yes J No
TIC 111 no.: c� C1 _ nsta rep ac re ucate heaters - %wgvnt e .
City/metro lic.no.: wall,or Baur mounted
Name ( lease tint): Y ( Vent for a ,Rance other than furnace
Kell"',
r kcrahon:
m."llpuon units _ __-_- It 11'/B
�^ 1 Chillers FII'
Name: l_ J �i3`sT[+u, ` ( „thil,, ,, •,r, nI
Address: Environmental RTtaust ani-emu at on:
C it VAA
J Stat a Appliance vent
Phone. Fa -q&()u Imail: 1)r er exhaust /
Hoods,Type I/II/rtes. kucheNhaimat
1 hood fire suppression system
Name. ' �e��` �__ trsj-o , Exhaust fan with single duct (h;ih fans)
Mailing addreEs; 1 Fx haust system apart bion iw,tnn or AC
lie p an sir notion Iup to outlets)
Clfy: i Stat . ��F-- -- IYtx t 1.11(iNO Oil
Phan l a . t/ Email lir piping each ad ninth liver outlets
rocexs p1pring(whemanc required)
Nuud,ei ul outlets
Name: ter ste appliance or eq ptnen:
Address: I Iccurative tireplac-�_ _
Cit q'�� late. ( '1.IP Insert type-----
-�rd-
Thum: < - F,tx: L-mail: Ut rcr _---------.- _—
Applicant's signature. Datc:
Name(printl
Permit Ice ....... . S
Mit all)umllio ma acorn credit Lard- (+Iraae call iu dtcnon hn MR tnr"mt+an'm Notice: Thislication
J vls;t J Masicti'anl �rmit application Minimum fee......._.... . $
expires if a permit is not obtained Plan review,(at __ •%I S
eu card nutnhet -__ - ___._._— - ._._t_.__�_-_ within IRO days alter it has peen
_.__
r.,rtrr. State surcharge(914 1 S
Namr++r—cird�inlder aL Lhuwn++n c yard accepted as complete.
('ardhddet ttgnaturc Am-+unt iW-�r+17 irnxltt'rrMi
Plumbing Permit Application
Date received Permit no.:
City of Tigard Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd.Tigard.OR 97223 — `—�
Cin'of Tigard phone: (503) 639-4171 I'rojtxt/appl. no.: Expire date:
Fax: (503) 598-1960 Date issued By: Receipt no
Land use approval: Case file no. Payment type:
U I & 2 family dwelling or accessory UCommercial/industrial U Multi-family J Tenant improvement
A New construction U Add ition/al teration/replacem(+nt 1 ood service J Other-
.10111
Job address: CCT Description -_ Fec(ca.) total
Bldg. no.: Suite n(.. New I-es and 2-family dwellings onit:
/tax lot/account no.: (Includ100 ft.for each utility connection)
Tax ma
p i SI.R(1)bath
Lot; Block: I Subdivision:VWcx,2SOtt Slit (2)bath
Project name: SFR(3)bath _
City/county: Each additional bath/kitchen
Description and location of work on premises: �_— Site utilities:
_ C+itch basin/area drain
I?st.date of completion/inspection: Drywells/leach line/trench drain^,
Footing drain(no.lin.ft.) _
Manufactured home utilities
Business name:'E ,4 _ Manholes—
Address: Rain drain connector 410
City: bC O State g_ '/.II'C�}12 Sanitary sewer(no. lin.ft.) �—
I'hone 1 e E-mail: Sttrcm sewer rnu, lin. ft.) iJ
Water service(no.lin.1't.)
CCB no.: ?.Z.(„ Plumb.bus.reg. no y(�. ��� 'Y>
City/metro lie.no.: ;,F I - U Elxture or Item:
Contractor's representative signature: _ Absor low valve
Hack flow presenter
Print name: J0401 I tLA- Hack water valve
�1 Basins/lavatory
Name. �..,�a CU'ulbeV_ Clothe, wesi;^r
I)ishw.tsher
Address:
r� Drinking fountain(s)
Cil _ '
' 3--F,� Stat� 'LII. i:jectors,'swnp
Phon -t (vFa , 3 E-mail: I'A ansion tank
Fixture/sewer ca
Name(print):_'VJVe-jr-COta-S rA7D)rQ-7EDO Floordrains/floorsinks/hub
Mailing address: Uarba to disposal
Hose bibb
City: Stat '/.II'. 2-cf Ice maker _ _--
Phone: %ct I jq-jjqqjF-mail: Interceptor/grease trap
Owner instal lation/residential maintenance only: The actual installation Primer(s)
will he made by me or the ni ann•end repair made by my regular Roof drai tcommercial) _
employee on the pr +cr r()RS Chapter 447. Sink(s),hasin(s),lays(s)
Owner's signature mature _ ��__ Date: 51,103 Sump _
Tubs/shower/shower pan
Urinal
Name:
4 _ ---- Watcrcloset
'dress: < ( Water heater
./�1,a��_1� -J��....State•
L — Other.
5 I'ax: I:-mail: Intel
Ns,t d,junsdictums accept credit cards.Mease tali jurisdiction fist nitre in(onnaiwnMininwm fee...._....,,.... g
Nonce: This permit application plan review lar __ %) 5
J Visa J MasterCard expires if a permit is not obtained
Credit cud number within 180 days after it has been State surcharge(9%).... S
liitpke+
— ---- --- --- accepted ac complete TOTAL .... ......... ........
Manx of cardholdet as shown on crcd____J
S __
-e-� Cardnolderngnauure-T---- Amount d10MtIf,tesrtxYCOM)
10' S.S.E.
A
26.00 ,bb105Dr Ga `,tlF�ns�
E1�nn S�IFansa
(Tract A)
�an1,d
Nq Private ST
,th 76.26P U.F.
Street Tree
Concrete
Dft"and. 7
„ and
�.rppraach
aU ,r,�
L 13 011
tory Lk*
. . . ebb
i
1
109.23
l
ti
Scale l " = 201 Applicant:
Lot 7 Moore's Meadows Subdivision Intercoastal Development Group LLC
13605 NW Bethany Ct Ste 101
10100 s N V Molly C t. Beaverton, Or 9 7006
O TI(sARD- 'ill! PLA N REN'tF
}it'll.!►ri.� i�!I.. 01 t
4'i��i "� 1"Ic artut�:e' ��11rlPr���"t �,j ,•� �
i�tli�iitiurlt I�u►I<<�r�:� }I:� ',r ti� ('��,•1
� 11 •G �iG'I'�`ill' h1�,1�'P�f�tt i '."IiCt l�k'1�11jrCc� �i �� �'' � �
•\�itull tih�rll"�' '�i,� C.T�A}r}11"4►YCti �.� !�i�l .��r�?f1��'�' j
11� I'lar �Approved N�"rt
2 .03
-- ELECTRICAL PERMIT-
CITY OF TIGARD —
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2003-00249
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 8/12/03
PARCEL: 2S102BB 02600
SITE ADDRESS: 10100 SW MOLLY CT
SUBDIVISION: MOORE'S MEADOWS ZONING: R-4.5
BLOCK: LOT: 007 JURISDICTION: TIG
Proiect Description: AUDIO/STEREO
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 HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL_# OF SYSTEMS_
Owner: Contractor:
INTERCOASTAL DEV. GROUP LLC QUADRANT SYSTEMS
PO BOX 91 185 PO BOX 14833
PO RTI-AND, OR 97291 PORTLAND, OR 97293
Phone. 5(0-709-9940 Phone: 503-209-8940
Reg #: M331-55560002466
SUP 121IJLF
LIC 96806
FEES -- — ELI 96cfligl6h Inspections
_Description Date _ Amount Ceiling Cover
�11.11100 11 FL R Permit 8/12103 $75.00 Wall Cover
Elect'I Final
I AXI 81!S,State Tac 8/12/03 $6.00
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 18. 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 throuc
Issued by �.~ _ Permittee Signature, j_�t-3
OWNER INSTALLATION ONLY
The installation is being imide on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: __ _ DATE:��__
CONTRACTOR INSTALLATION ONLY.___
SIGNATURE OF SUPR. ELEC'N __—_ i— __— DATE:----,------
LICENSE NO: — _ -T-----
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
08/11/2003 13:3H 5032362322 QUADRANT SYSTEt!' PAGE_ 02
Electrical Permit Application I Tate/BX- GI�D 3 � Permit No.64644V3-07D -�
City of Tigard Planning Approval Sigh
payJBy _ Permit No.
13125 SW Hadi Blvd. Pian Review Other
Tigard,Oregon 97223 paterH __ Permit No.:
Phone; 503-639.4171 Fax. 503 596-1960 Post•Revicw Land use
Dates Cisc N2.1
Internet: www,ci,tigard or.us Contact JuMa,: Sec Page 2 for
24-hour Inspection Rcquest: 503.639-4175 NamrJMetltnd Su Iemental inforsnatintl.
11777.
.... .,Qct.
New co_n truction Demolition -Setvtec over 225 amps• Health-care facility
commercial Ll Hazardous location
Addition/alteration/re tlaccment Cpher: []Service over 320 amps-rating of [3 Building over 10,OW square feet,
�"I.I I^ ' s?ra' '�� � rc�:'!: i&2 family dwellings four or more residential units in
A. 1 &2-Family dwcllin, ❑Commercial/Industnal System over 600 vola nominal one structure
- -- ❑Building over three stories ❑Feeders,400 amps or more
Accesso Building Multi-Family []Occupant load over 99 perrnorts []Manufactured structures or RV park
Master Builder Other, ❑Egresslighting plan
•r
Submit-_ sets of plan4 with any of the above.
"' m The above are rine■ rlicable to teprary construction ser•ace.
„Job site address: I C) 1r�o m,I t 1 i °-'-k- mm "�
—_
Suite#: Bids�APt.I: Number of ins ectinas_per_permit allowed
Project Name: - Oestri Ilan -- Qty Fec(ea.) rota)
-- -- New residential-Onale or mulls-fatally per
Cross strccMrech0115 t0 Jab site: dwtillnl{colt.Includes attached garage.
9ervlceincluded:
100(1 sq,it Of lens 145.15 4
ach addidand 5O0 sett ar portion thereof _ 33.40 1
Subdivision: - �1 t�. Qom*- Lot A�: Li Iced energy,residential I_ 75.00 1�0 2
_ Limited trier non reai�ntial 75.00 Z
'rax arccl#: Foch manufactured home or modular dwelling
j Service and/or feeder 90 90 2
t Servlctn or feeders-InOollatlnn,
fJ( •�'�� /u�u�y alteration or relocation:
J ' 200 amps tar Ices $030 2
201 amps o 400 xmns_ . --_--- 106. 2
401 amps to Guo amm rs 160,60 2
I amps In I�_.� 240.00 2
IN Over No sm�a m volts 454.65 2
5
Name: _I L�, �,,,-I {-- rt1:; - aeconnectonly 2
Address: Temporary services or feeders-installation,
- -- —--� alteration,or relotatlom
Cit — _ 2•w amsorlc�a G6 as: I
3. cl r1 t ' F11X: 201 acmes to 400 amps
Phones 3 (00,30 l
_ M ('l 401 to 600 amps _ _ - - 133 75 2
9rench circuits-new,alteration or
N arne: ascension per panel:
-_ — -— A.Fee for branch circuits with purchase of
Address: —_ service or reed"fee:,cath branch circuit _ 6.65 1 2
�'I�t�/St3� to/ZIp. -- - - --- 9.Fee for"rich circuits without purchete of
service or reeiler fee,first branch circuit 46,85Z
Phone: j -a x
� >:+ch■ itional bench circuit -- It65 2
ly-ttlall' Mlsc.Mm'ce or feeder not hlcluded):
Each m or irrigation tittle - 53.40 __� 2
Each a or outline lighting -5).40 2
Job NO: 3 l I Signal circuit(s)or a limited energY IAMI,
2
aIle,ation ort nsMon
Business Name: v..A•.d-r.r4:�, s-h'w� _ DF fe;tptinn. "
Address: _City/state/Zip:l %�"i t or �2 � Each additional Inspection over the aliowabte In an of the above:
_ Pei ctitm pa hour train- I tour) .301
Phone: � -d4- S dr Fax: b 'a1 tnv n tionfeefeel _
CCB Lic.#: 9 t.P6L Lie. #: 12. 11 !=ZA _
Supervising electriciat /- •- _ Subtotal I S ,No
si antra re�uiiCd; [�e� - Plan Review(25%of Permit Fee) I $
PrintName: 1�kjtl :lIE4! Lic.#: _2.f( (t_— State SrgA,0
urchae i of Pcnwt Fee S
-- TOTAL PERMIT F)Ellr S e q4
Authorized C` ' l Notice: "it permit application espiret fro permit Is not obtained within
`ku...t _ _ bate t t -r 1R0 de-after It has been accepted a complete.
$lgnatUlC. _ -` •Fre methedolon set by Tri-County Building!Industry 5emiee Aoard.
(Please print name)
i:,.nsts\Petmit Fr_, Nelcl,crm+itApp.doe 01/03
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175 zz
MST J �-Oc'J1U�o
INSPECTION DIVISION Business Line: (503)639-4171
9 U P - ----- -- - -
Received __ Date Requested d=_1L— AM RM _ BUIP
-ocation _ r dV -_ _ L- w _Suite__ MEC;
Contact Persun Ph( -1 � - f PLM
Contractor_._ ----_-- _ ___-_.___---------------.- -- Pit( ___) .___..._ _ SWR
BUILDING Tenant/Owner - - _ _ _ - - ELC -
Footing ELC
Foundation Access:
Fog Drain ELR
Crawl Drain -
Slab Inspection Notes: SIT
Post& Beam
Shear An;hors --
Ext Sheath/Shear
Int Sheath/Shear
Framing - -- - -
Insulation
Drywall Nailing -- - - -
Firewall
Fire Sprinkler
Fire Alarm
S,jsp'd Ceiling - --- - -
Hoof
Other. - - --- -
=Fi1'� _
SS PART FAIL - --- - -
MBING _
Post& Beam _
Under Slab -- _�-
Water Service
Sanitary Sewer
Rain Drains - ---- -- -
Catch Basin/Manhole
Storm Drain - - --- -� ----
Shower Pan
Other _ --
Final
PASS PART FAIL - - -- ------
MECHANICAL
Post& Beam
Hough-In - -_
Gas Line
Smoke Dampers - - - - - - - -- -- - -
i ,: o
ASS PART FAIL - --- --- - --- -
ICAL -
____ __-----------_-
Service
Rough-In
Low Voltage
Fire Alarm
Final Reinspection fee of$_-_ re ins at Ci Hall, 13125 SW Hall Blvd.
PASS PART FAIL 1 -1 � - required before next inspection. Pay
City
__-. ---
_SITE___ ! Please call for reinspection RE: -_ Unable to inspect-no access
Fire Supply Line
ADA /�t,IAI
Approach/Sidewalk
pate _._It � .�_ Inspector .
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: X503) 639-4175 2 �l
INSPECTION DIVISION Business Line: (503)639-4 i 11 MST
BLIP —
Received —_- ___–Date Requ stAM_ PM __ BUP
Location ._� �� v _s __--_Suite___ MEC
Contact Person V`t C'y' / n� Ph(0�9_) (a PLM —
Contractor _ _ _ Ph SWR
BUILDING Tenant/Owner ELC
Footing e
Foundation Access: ELC
Ftg Drain ELR _
Crawl Dain
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors I
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fire call
Fire 33pritWer 1--_%L! __-..--_-
Fire Aiarm
Susp'd Ceiling - ——
Roof
Other: _—.—_ — --- _-
Final -
—f=
PASS PART FAIL --`l- ` --
Pt�_ IABI N �
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain --- -----
Shower Pan
PARTFAIL __..
HANICAL
Post& Beam
Rough-In --
Gas Line
Smoke Dampers - -- -- --
Final
_PASS PART FAIL - -- ---
ELECTRICAL _
Service
Rough-In —
UG/Slab
Low Voltage -- - ---__--- _--_— —_
Fire Alarm
Final U Reinspectlon fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hail Blvd.
PASS PART FAIL
SITE Please call for reinspection RE. _.__ Unable to Inspect-no access
Fire Supply Line �•) `-
ADA 6 i �
Approach/Sidewalk Date Inspector l ___ �' Erect
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 G� Q
INSPECTION DIVISION Business Line: (503)639-4171 MST -
BUP
Received Date Requested AM____.. PM_ __ BUP
Location Q 66 r LA-4-bLI Suite MEC
J
Contact Person Ph( ) �- �t�`__ SO v PLM
Contractor Ph( ) _ _ _—_ SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC --_-_------- -__---
Ftg Drain Access: ELR �'o4 t-1
CrawlDrain —
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors
Ext Shoath/Shear
Int Sheath/Shear
Framing ------ — --- - - - - ------ -
Insulation
Drywall Nailing ------- ---- - -- - --
Firewall
Fire Sprinkler -- -- - - -- --- - -- --
Fire Alarm
Susp'd Ceiling _- ----- - --- - -
Roof
Other:
Final
_ PASS PART FAIL - --- --- - - ---- - ----- - --
FAIL
PLUMBING
Post& Beam
Under Slab - - --- - -
Rough-In i
Water Service - - - --- --- --— - - --
Sanitary Sewer
Rain Drains -- -
Catch Pasin/Manhole J ?i
Storm Drain --
Shower Pan
Other:
Final
PASS PARI( FAIL 74
MECHANICAL
Post&Beam -—
r1ough-In _ --
Gas line
Smoke Dampers — --— ---
Final
P T FAIL
ELECTR _ L A
_S, ice
LX
GV
oM arm
Final Reins required before next ection fee of$_ re inspection. Pa at Cit Hall, 13125 SW Hall Blvd.
yA 88 PART FAIL [�-_� p q y y
•-------
Please call for reinspection RE: Unable to inspect-no access
Fire Supply Line
Ann d'" 1 C'f _ Inalpeeer ��"`�'' Ext - ----
Approach/Sidewalk Date. `_ ....Z� --__ -_---
Other:
Final DO NOT REMOVE this Inspection reco from th-job site.
PASS PART FAIL
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