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13265 SW KINGSTON PLACE p i J6; (rJ N w N Cia U! O 3 d 0 i 3265 SW Kingston Place CITY OF TIGARD 13125 S.W. MALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE WOLCOTT PLUMBING CONTRACTORS PO BOX 2007 GRESHAM, OR 97030 Plumbing Signature Form Permit #: MST2002-00072 Date Issued: 3/6/03 Parcel: 2S104DA-?9700 Site Address: 13265 SW KINGSTON PL Sjbdivision: QUAIL H(-jLLOW - SOUTH Block: Lot- U23 Jurisdiction: TIG Zoning: R-4.5 Remarks: SF rowhouse,Unit #23, Bldg 3, BN plan with a deck Your company has been indica'�-d as the plumbing contrarJor 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 Division. No plumbing inspections will be authorized until this completed form is received OWNER PLUMBING CONTRACTOR: BROWNSTONE QUAIL FOLLOW LLC WOLCOTT PLUMBING CONTRACTOR; 12670 SW 68TH PKWY S-E 200 PO BOX 2007 PORTLAND, OR 97223 GRESHAM, OR 97030 Phone #: 503-598-7565 Phone #: 667-1781 Reg # LIC 23847 PLM 26-208P8 AN INK SIGNATURE IS REQUIRED ON THIS FORM X Sirl11;]tur' Of zed umber If you have any questions, please call 503.718.2433. CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORI. iNT PERMIT NOTICE DAVID JEROME. ELECTRIC PC GOA 751 HILLSBORO, OR 97123 Electrical Signature Form Permit #: MST2002-00072 Date Issued: 3/6/03 Parcel: 2S 104DA-19700 Site Address 13265 SW KINGSTON PI- Subdivision: QUAIL HOLLOW - SOUTH Block. Lot: 023 Jurisriiction: TIG Zoning. R-4.5 Remarks: SF rowhouse,Unit #23, Bldg 3, BN plan with a deck 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 electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Foran prior to the start of the work to the address above, ATTN Building Division. No electrics! inspections will be authorized until this completed form is received OWNER: ELECTRICAL. CONTRACTOR BROWNSTONE QUAIL. HOLLOW LLC DAVID JEROME ELECTRIC 12670 SW 68TH PKWY STE 200 PO BOX 751 PORTLAND, OR 97223 HILLSBORO, OR 97123 Phone #: 503-598-7565 Phone #: 648-5144 Req #: LIC M1051 Slip 28775 FjLE 34-11()(' AN INK SIGNATURE IS REQUIRED ON THIS FORM signature ofSupepol sing L>E'ctrician If you have any questions. please call 503.718.2433. ELECTRICAL PERMIT- CITY OF TI GAR D � RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2003-00168 13125 SW Hall Blvd., Tinard. OR 97223 (503) 610,4171 DATE ISSUED: 6/17/03 sn E ADDRESS: 13265 SW KINGSTON PL PARCEL: 2S104DA-19700 SUBDIVISION: QUAIL I IOLLOW- SOUTH ZONING: R-4.5 BLOCK: LOT: 023 JURISDICTION: TIG Proiect Description: All encompassing low voltage. A.RESIDENTIAL _^ B.COMMERCIAL -- AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: X BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: X G:.00K: MEDICAL: HVAC: X DATA/TELF COMM: NURSE CALLS: VACUUM SYSTEM: X FIRE ALARM: 0UTf 1OOR LANDSC LITE: OTHER: X HVAC. PIROTECTIVF SIGNAL: INSTRUTAE14TATION: OTHER: TOTAL#OF SYSTEMS: Owner: Contractor: BROWNSTONE QUAIL HOLLOW LLC AZIMUTH COMMUNICATIONS INC 12670 SN/ 6bTH PKWY STE 200 P.O. BOX 508 PORTLAND, OR 97223' WILSONVILLE, OR 97070 Phone: 501-599-7565 Phone: 503-619-0110 Reg#: I LI. 30-941F. 2312I.EA I W 145`z2X FEES Required Inspections !, Description Date Amount _ Low Voltage Inspection �I I I'It1I I I LLR Pci- iit 6/17/03 $75.00 Elect'I Final 1 state"fax 6/17/03 $6.00 Total $81.00 This Permit is issued subject to the regL'ations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 throuc Issued by — f,; _— 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 SUPR. E'.EC'N _ __— _ _ DATE: LICENSE NO- Call 639-4175 by 7:C0 P.M.for an inspection needed the next business day } Electrical Permit Application Date received: ;-12 c,3Permit City of Tigard Project/appi.no.: Expire date: City ofTigard Address: 13125 SW Hall lilvd.'I igerd,Oh 9/223 Duce issued: Hy (,' Rcccjpt Phone: (503) 639-4171 __ _.�_ Pax: (503) 598-1960 Case file no: Payment type Land use approval; __ 11111111 am I Kill 11111110 jd�� U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family J Tenant improvement AtNew construction U Addition/alteration/replacement U Other: _ J Partial INFORMATIONJOB SITF Joh address: / 6 S.S, N iv PL - Bldg.no.: Suite no,: Tax map/tax I.1t/aCcutint nu : Lot: ,7 Block: Subdivision: ('r(jkvN i_ 5;,c Project mune: Gtky t_ Ucscnption and location of work on premises: t)4)ic-t` _1, A-c. Estimated date of coin Iction/inspection: CON I'I(A(-I OR APPLICATION FEE SCfIEDULE Job no; Fee Description Qt , (ea.) Ibnhl Ne"residential-single or malt-fandly per _ Address:' rj dwellingunit.IncludcwattachrdFnroge, Citk4State ) ZIP: C Service Included; Phone: 1 ax; r E-mail: 1000 sq it or less _ a Each additional 500111 it or p,,,rn7n thereof CCB nn.; �j 2• Glee.bus,lie.no: c' ('C PLion edener residential gY •' City/metro tic.no.: (I e.)A G,SA Cl [.ante;energy,non-residential /0 I U 3 Each manufactured home or modular dwelling Signature of supervising el ictan(required) Date Service and/or feeder S-ip.elect.name(print). ( L 4 License no 2 i 12 Lt7 Services or feeders-Installallot., altcralIon or relocation: 200 amps or less i_h ^-- 201 amps to 400 amps Name(print): 2llµjrv�IyL Meilin address: 401 amps to 600 amps 601 amps to 1000 anhps City: �tatc: "LIP: �- Over I0W amps or volts 2 Phone: Fax: G-Illail: Reconnectonl I ()tyner installation:The Installation Is being made on property I own Temporaryservices orfeedem- whlch is not intended for sale,lease,rent,or exchange according to Installatlon,alteration,orrelocation: (ws 447,455,479,670,701. 200 amps or less 2 201 amps to 400 amps Ots net'ti til �Italure: Date: 401 to 600 aro s Branch rlrcults-net+,alteration, or extension per panel: Name: A Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit P: It Fee for branch circuit,1k uhnut urchnse Oily: Stale: ZIi . P I _ "t+enue or 11reden fee•first branch circuit �1 Phone: Pax: [3-mail lia,h addinnnnl branch iucuit PLAN REVIEW(Please chec*all that apply) Mlsc.(Servlce or feeder tot Included): J Service over 225 amps commercial J health-care facility Each pump or irrigution cucle � U Service over 320 amps-rating of 1&2 -1 1lazarduus location Euch sign or outline lighting familvdwellings U Building over 10,000square feet fouror Signal circuil(s)or c limited energy panel, U System over 600 volts nominal more residential units in one structure alteration,or extension* lT U Building over three stories U Feeders,4(x)amp-or more 'Descri tion U Occupant load over 99 persons U Manufactured stn:tures or RV park FAch additional Inspection over the allowable hl any of the above: — U Egressllightingplan U Other Per Inspection Submit_.sets of plans with anv of the above. Investigation fee The above are not applicable to temportr,y construction service. Omer Not all jurisdictions accept credit cards,please,:all jurlslicrion for more I ifonnsticitf Notice:This permit application Permit Il'l'... ................. U visa 0 MasterCard expires if a permit is not obtained Plan rev tees fill — IT I R Cirdn cord numher �� within 180 days after it has been State surcharge(89w .... $ iXl Iles accepted as complete. TOTAL .....$ —-Name of cu hob r ass own on cre d car I - Ctudholder si`nsturr Amuum 11 ,,hill,)st CITY O� �� MASTER PERMIT PERMIT#: MST2002-00072 DEVELOPMENT SERVICES DATE ISSUED: 3/6/03 13125 SW Hall Blvd., Tigard, OR 97223 1503) 639-4171 SITE ADDRESS: 13265 SW KINGSTON PL PARCEL: 2S104DA-19700 SUBDIVISION: QUAIL HOLLOW- SOUTH ZONING: R-4.5 BLOCK: LOT: 02+ .JURISDICTION: "II(i REMARKS: SF rowhouse,Unit#23, Bldg 3, BN plan with a deck BUILDING REISSUE: STORIES: 3 _ FLOOR AREAS REQUIRED SETBACKS_ REQUIRED CLASS OF WORK: NEW HEIGHT: FIRST: 172 at BASEMENT: of LEFT: SMOKE DETECTORS: Y TYPE OF USE: 5F FLOOR LOAD: 50 SECOND: 733 of GARAGE: 547 of FRONT: PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS: I TRRU 733 of RIGHT: OCCUPANCY ORP: H3 BDRM: 2 BATH: 2 TOTAL: 1,636 of VALUE: 16:,203.60 REAR: PLUMBING SINKS: I WATER CLOSETS: 2 WASHING MACH: I LAUNDRY TRAYS, RAIN DRAIN: TRAPS: LAVATORIES: 2 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUSISHOWERS: GARBAGE DISP: I WO rER HEATERS: I WATER LINES: BCKFLW PREVNTR: GREASE TRAPS. OTHER FIXTURES: MECHANICAL _FUEL TYPES FURN<10OW BO LICMP<3HP: VFNT FANS: 3 CLOTHES DRYER: I LP(; FURN-100K, UNIT HEATERS: HOODS: I OTHER UNITS: MAX INP: blu 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 snip: WISVC OR FDR: PUMPIIP.RIGATION. PER INSPECTION: EA ADL'L 50(,SF: 3 201 400 amp: 201 400 amp: tat WIO SVCIFDR: SIGN/OUT LIN LT: PER HOUR. LIMITED ENERGY: 401 600 amu: 401 000 snip, EA ADDL SR CIR: SIGNALIPANEL: IN PLANT. MANU HMISVCIFDR: 601 1000 amp: 601-amps-1000v MINOR LABEL: 1000+am01voll PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS: 9VCIFDR>=225 A.: >BtlU V NOMINAL: CL3 AREAISPC OCC: ELECTRICAL•RESTRICTED ENERGY A.OF RESIDENTIAL B COMMERCIAL AUDIO 6 STEREO. VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: 1','ERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL. GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATAITELE COMM. NURSE CALLS: TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 5,531.33 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 68TH PKWY STE 2.00 12670 SW 68TH PKWY all other applicable laws All work will be done in PORTLAND,OR 97223 PORTLAND,OR 97223 accordance with approved plans This permit will expire if work is not started within 180 days of issuance,or if the work is suspended for more than 180 days ATTENTION Oregon law requires you to fallow rules adopted by the Phone: 503-598-7565 Phone 503-598-7565 Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through 952-001-0080 You Rea w: (.IC 124627 may obtain copses of these rules or direct questions to OUNC by calling(503)246-1987 REQUI7IEG INSPECTIONS Erosion Control Insp 8, Slab Insp Plumbing Top Out Exterior Sheathing Insl Smoke Detector Final inspection Sewer Inspection Plrn/undslb Insp Framing Insp Firewall Insp Electrical Final Footing Insp Electrical Service Gas Line Insp Gyp Board Insp Plumb Final Foundation Insp Electrical Rough-In Insulation Insp Rain Drain Insp Mechanical Final Pim/Underfloor Mechanical Insp Shear Wall Insp Water line Insp Building Final T- 2 Issued By : % ' _., Permittge Signature : ;'i' 1;'1,�. t.; Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day CITYOF TIGARD SEW'_R CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2002-00047 1312.5 SW Fall Blvd., Tigard, OR 9722.3 (503) 639-4171 DATE ISSUED: 3/6/03 SITE ADDFF_SS; 13265 SW KINGSTON PL PARCEL: 2S104DA-19700 SUBDIVISION: Q1'All, IIOLLOW -SOUTH ZONING: It-4.5 BLOCK: LOT: t ' JURISDICTION: 116 TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEIN DWELLING UNITS: 1 TYPE OF USE: SFA NO, OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF towhouse. Owner: - - _ FEES BROWNSTONE QUAIL-HOLLOW LLC Description _ Date Amount 12670 SW 68TH PKWY STE 200 _ PORTLAND, OR 97223 SWI!SA Swr Connect 3/5/03 $2,300.00 (SW('SAjSN%rC'unttcct 3/5/03 $0.00 Phone: 5111-598-7565 1SWINS111 S\\r Inspect 315/03 $35.00 SWINS111 Stir Inspert 3/5/03 $0.00 Contractor: -- -- -- Total $2,335.00 Phone: Reg #: Required Inspections This 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 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-6699. Issued by: _ J� Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day ' Building Permit Application City of Tigard Date eceived:� �i Permit no.: Address: 13125 SW hall Blvd,9i EQFjV ED Project/appl.no.: xpi ate: Ciry ofTigard Date issued: B Recei t nu,: Phone: (503) 639-4171 Y� P Fax: (503) 598-1960 Case file no _ Payment type: Land use approval: �i.11 , �"� f IUAE1:1 , I&2 family:Simplex Complex • 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U New constriction U Demolit+on •Addition/alteration/replaccment U Tenant improvement U fire sprinkler/alarm U Other: .1011 SITE INFORMATION Job address: �,_�� '� <c �. . -{ etc c Bldg.no.: Suite no.: l.ot: Blcxk: Subdivision: lar4. /��Gcc't� S''it %7> Tax map/tax lot/account no.:�r�/pc t>R- I,,� Project name: Description and location of work on premises/special conditions: (Hoodplain,septic capaciff,solar,etc 011'NER 1:011 SPECIAL]INFORMATION, USE U111E Mailing address: L` I &2 family dwelling: City: ta'J.- C's. State:b)Q JZIR JID Valuation of work........................................ $_ _- Phone• - - Fax: E-mail: No.of bedrooms/baths................................. Owner's representative: Ro Total number of floors................................. _ Phone: e Fax* E-mail: New dwelling area(sq. ft.) Garage/carport area(sq. ft.)......................... _ Name: - ��,ec� Covered porch area(sq. ft ......................... -- Mailing address: (,v >� Deck area(sq.ft.) .............. ......................... -- City: ; State: 7,I . 4 - Other structure area(sq. ft.).........................PID _ Phone: 6;S" Fax• F-mail• (ommerclaUlndustrlal/multl-family: Valuation of work........................................ $ Business name: Existing bldg.area(sq.ft.) .......................... r �'� t New bldg.area(sq.ft.) Address: -�g ..... ........................ r ° tType Number of stories........................................ _ City: StatezDF ZI Mtonc• - "' _ Fax:bzo- �-mail: otconsttucdon................................... _ Occupancy group(s): Existing,: CCB no.: 16 _ _ Ne N: City/metro lic.no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon Constructior Contractors Board under Name: L'o provisions of ORS 701 and may be r,quired to be licensed in the Address: r `�` _ 1_ jurisdiction where work is being pe formed.If the applicant is Cit t Slate 7.IP: exempt from licensing,the follow.ng reason applies: Contact person. r" Plan no.: — Phone: x: E-mail: - x 14 WoO Name: r,,. a L u L Contact person: Fees due upon application .......................... $ Address: LL) <C1 144 r<cam} Date received: City: r c�. talc: ZII': ja3 Amount received ........... ............................. $ _ t Phone: ;� p Faz: E-mail: Pleas: refer to fee schedule. I hereby certify I have read and examined this application and die Not all jariMcdom scept a At ate,Pkw ati jurisdiction for more iftfa��. attached checklist.All provisions of laws and ordinances governing this O Vin ❑MuterCsr l work will be compliedyM4,whetha ed herein or not. CmWi card numbs -- —1--/ Upims Authorized sign ture: _ Nann ;MR:r u shown on credit are Print name: '. Cwdb Ida sipsture s Amotmt Notice:This permit application expires f a permit is not obtained within 190 days after it has been scceptc i as complete 440,4617 ttr WUMt Plumbing Permit Application City of Tigard °ate"ectived: -- Pem(no. Address: 131.25 SW Hall Blvd,Tigard,OR 97223 -Sewer permit no.: Building permit no- -- City ojTigard ;Mone: (503) 539-4171 I'roject/appl.no,:� Expiredatc: Fax: (5U:1)598-19W Date issued By: Receipt no.: Land use approval: — Case file no Payment type. TVPEqFP U I &2 family dwelling or accessory ''Commerciallindustrial U MultifamilyU Tenant improvement U New construction U Addition/alteration/replacement U Food service U Other: A ; SITIE INWRIIHATION Job address: j?(:a rSW �,� A� a.cc �_� Description "y. tec(ca.) Total Bldg.no.: _ Surtc no.: New I-and 1-family dwellhrgs only: Tax map/tax lot/account no.: --- (includes 100 ft.for each utility connection) SM(1)bath Lot: J Block_i Subdivision: _S17t(2)bath--- �� — Project name: SFR(3)bath -City/county: 211': Each additional batlt/kitchcn Description and location of work on premises: Siteatultles: _ Catch basin/area drain Eat.date of completion/inspwdon: v Drywells/Irach line/irench drain PLUMBING CONTRAC70it Footing drai,i(no. lin.ft.) — Manufactumd home utilities Manholes Wolcott Plumbing Rain drain connector -- PO Box 2007 Sanitary sewer(no. lin. ft.) - Gresham OR 97030-0594 Storm sewer(no.lin. ft.) 503-567-1781 Water service.(no.lin. ft.) CCIi:23x.17 PI.M t1:26-208PB IlxtureorItem: Contractor's representative signature_: Absorption valve Print name: i — T Date Back flow prrventer Backwater valve 1 1 Basins/lavatory Name: Clothes washer Address" --- Dishwasher Urinkin fountain's) City: State: LII': er_tors/sump - -- Phone: Fax: I mail: Expansion tank — Fixturelsewer Lap Name(print): flour drains/floor sinks/hub - -- Mailing address: - --- - �- -- - — Garbage disposal -- -- - Hose hibb City: _ State: 7�P: let maker _ Phone:— Fax: F;-mail: -v v Interct or/grUase tra _ -- Owner installatior/residential maintenance only: The actual installation Primcr(s) will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on tic properly I own as per ORS Chapter 447. Sink(s),basin(s),lays(s)_ OHmer's signaturc:—_� Date: Sump _ Tubs/shower/shower pan - Name: Urinal Wrter closet Address: --�..--- �— --_'-- Water htsater --� City- -�----tate. ZIP: — __ Other. -� Phone: w Fax: _ ,Mail: —� A 7bW _ --� Not W juridictlant axxpt utcht rrd4/ieatK do ratzdictiaa for mart NamMim Notice Thit prnnil application Minimum fee................$ U Yw O MuterCard expires i a permit is not obtained Plan review (at _.- %) $ aedtt cad rmber, --1 �-- within I FO days aRa it has been State surcharge(8%) ....S -- "' TOTAL ...................... Name d eadbotd7 u a�o.a r aedit card - ecrtplrxl as axnplcte. s - _ Canlbalda,tt� � AeOw 4404616(SR1aC10M) �• Mechanical Permit Application Date received: Pern►it no.: City of Tigard Projecl/appl.no.: — Expire date: City of7igard Address: 13125 SW Hall Blvd,ll)•ard,OR 97223 Date issued: By. — Phone: (503) 639-4171 _- Receipt no. Fax: (503) 598-1960 Case file no_: Payment type: Land use approval: _ _ Building permit no. 71'PE 10.1'PERMIT U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Addition/al teration/replace mt.r•l U Other._. INFOMIATION CONINIERCIAL1SCHEDULE Job address: 3at;!5 L13 r Indicate eytlipment quantities in txtxes below.Indicate the dollaf Bldg.no.: Swte na: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: —_ profit. V lue$ Lot: -23 Block: Subdivision: •Sec cklist for important application information and Project name: jurisuction's fee schedule for residential permit fee. City/coun(y: 'LIP: Description and location of work on premises: FF Ier(M) Total Est.date of completion/inspection: ilition Qty Res.only Res.only Tenant improvement or change of use: Airhandlingunh CFM_ __ Is existing apace heated or condrtioncd7 U Yes U No ircon itionmg(site Ianrequired) _ Is existing space insulated?U Yc,, U No A teration o existing system CONTRACTOR i705ffpfressiurs State boiler permit no.: HP Tons $TUM JEROMt LLEcrR1C' -Fire/srnoke dampers/duct smoke detectors - PO BOX 751 r eat pump(site plan required) _ n HILLSBORO OR 97123 rep ace uma urner Including ductwork/vent liner U Yes O No 503-648-5144 InstalUreplacelrelocate beaten-suspended, CCR: 36051 FLU: 34-119( til 1 . 28775 V,all,or floor mounted -- - tvaruc t}piuuc Niru(). Vent(ora liana o ertTian umace e era CONTACT Absorption units BTU/Ii Name: Chillers Hp — — - ---- - -- Com pressois IIP Address: nmeo a a/1 gent ton: City: ---^---- State: ZIP: Appliance vent Phonc: Fax: Email: hyerci6aost Tia�i s'1 ype J res_V tcFe aunat hood fire suppression system Name: Exhaust fan with single duct(bath fans) _Mailing addc�ss Exhausti Siem i an from ica n+or AT City: State: ZIP: Fuelpiping on(up to ou else � Type t1'(.i __ NG _ Oil Fax E-mail: 'uurl'i inRca—fc—ed(liiicnT�v—cr dout.cts 'coerces piping(schematic required) Number of outlets Name: -� T_ �t6evT�tppt at-ncc o�eqt-Tpmeai: - - Address: _ _ Decorative fireplace City: State: Zfp: it sen-type --� tov pe lel stove Phone Fax: G-mail: - - ( ter. Applicant's signature: Date: Otber� Name (print): Not all jurisdictions tet"creat cads.pkar call kiriiactlan tat mtxe irtronaaatn Permit fee.....................$ -- U Visa ❑Mast,-K:ard Notice:This permit application Minimum fee........ .......$ _ expires if a permit is not obtained Plan review(at __ %,) $ r .tit cad number ---.�— — Ettpira within ISO days hfler it has been d ratted as Dora rte. Slane stucFta.�c(9%)....S �_- Namr uldrr u&_w as crtdn card'-- s accepted f' TOTAL .......................S -- __—_(adbcldu utnatttrt Amomt 416;617(05MU putt a Electrical Permit Application Date received: permit no.: City Of Tigard Project/appl.no.: Expire date: City rfTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 bate issued: By: Receipt no.: Phone: (503) 639-4171 - — _ Fax: (503) 598-1960 Case file no,: Payment type: Land use approval: J I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New construction U Addition/alteration/replacement IJ( 1bet _ U Partial 1 INFORMATION Job address: ;1 Bldg. no: Suitr. nn.: Tax map/tax lot/account no.. Lot:_Z Block: Su ivision: _ Project name: Description and location of work on premises: Estimated date of completion/inspection: CONTRWFOR APIIIACAYION FIFE SCIIEDVLE Job no: Max Rneinoce nor"P. n4scriplfon _ Qty. (ea) Tbtal no.insp JEROME ELECTRIC Newaldesntal singirorinuhifamil'vlrr d"eftWill.In<iurim attactied Qarw PO BOX 751 senloeiaelrhd: 111LLSBORO OR 97123 1000 sq ft or less _ 4 503-648-5144 Each ariditional 500 sq.ft.or portion thereof Limited energy,residential 2 CCB: 26051 E:LC: 34-119C" SUP: 2877S Limited energy,non-residential _- 2 F'vch manufactured home or modular dwelling Signature of supervising electrician(requited) pate Service and/or feeder 2 Sup.elect.name(print): I License no Services or feeders-indallation, alteration or relocation: OWNERPROPEFY 1 200 amps or less 2 NRme(print): 201 amps o 400 amps--__ 2 Mailing address: 401 amps to 600&nips —2 601 amps to 1000 amps 2— City: S(alC: ZIP: over 1000 amps or volts 2 — Phone: Fax: E•-mail: Reconnectonly - I Owner installation:The installation is being made on property 1 own Temporary wrvicasorfeeder•-� which is not intended for sale,lease,rent,or exchange according to Yutallatlon,aherstion,orrelocation: ORS 447,455,479,670,701. 200 amps or less 2 [�220�1amps to 400 amps 2 Owner's signature: Date: 01 to(><10 amps - — 2 Branch circuits-new,alteration, or extension per panel: Name' —� A Fee for branch artvits with purchase of Address: service or feeder fee,each branch circuit 2 City: _ --Est : ZIP: B. Fee for branch circuits without purchase - hone: Fnx: E-mail: of service or feeder fee,first branch circuit: _ 2 Each additional b,.rich circuit I'LAN REVIEW(I"Imse check all flint apply) Mkc.(Serrke v 1"der not included): U Service over 225 Mps•commercial U Health-care facility Each ump a imgatian circle 2 O Service over 320 amps-rating of 1&2 U 1 rardous location Foch sign or outline lighti^g 2 family dwellings ❑Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel. ❑System over 600 volts nominal more residential units in one structure alteration,or extension• 2 U Building over three stories U Feeders.400 amps or more *Description _ -- U occupant load over 99 persons U Manufactured structures or RV park Each additlmal Impeetlon over the allowable M my of tie above: U EgressAightingplan U Other — Per inspection ( T"—'— Submit_rets)f plam with auy of the above. Invesugstion fee The above are not applicable to temporary construction service. -- Na all jundictions accep credit cards,please call junsdiction rat mare infmnauon Notice:This;m mit application Permit fee.....................$ ❑Visa U MasterCard expires if a permit is tot obtained Plan review(at _ %) $ Cmdi card oamber —_�1� within 190 days after it has been State surcharge(8%)....$ Expire` accepted as complete. TOTAL . $ Name of cardholder u tbown as credit card Cardholder signature Amount 140. 615(6�UOK'OM) r I ► 41 cp �; -+- - s 44r ► :l �. p• �: •I � :d h ► •( - F > 'may � � w, ,� "J�,,: � i► pop W r I `.� r r► �®��r� rri♦� ��/ � '�♦ • ♦♦ ♦ �♦♦!'♦�1'♦7♦ � I� Tr'I�'''I'��►r'1'-'1'� 'OA► � O O "ti � � c� � � � � s' � ° �. � � � 0 0 n. y D n H r-. H 0 � `.7 � O� C. J c 7 a � w 0 "o �€ � � r N �. � � �� ti� O R � N G � 5 � �. r, V a �� r0 ro � .� n �' � ^"' � civ n � o � s: �`' � � 5 1 ro o M '� O � � Q O `. J Yin o �� ° �� s `�C ,. 0 �� 01TY OF TIGARD 24-Hotly BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 �- BUP Received -------------Date_Requested-_ �_24r AM_—_____._ PM __a______.a BUP — Location _._� 3 -�o.S- �—_--Suite -- _-_ MEC ---------_.--_-_�_ Contact Person . _ Ph � PLM --- r7 Contractor��a A• 6ej:;ir_k Ph(-------) r22-L- 5-- SWR _._----- ------ BUILDING Tenant/Owner __ ELC Footing — Foundation ELC Access: Ftg Drain ELR s�6t)3'C016_ Crawl Drain _ Slab Inspection Notes: SIT Post& Beam Shear Anchors -- Ext Sheath/Shear — Int Sheath/Shear - Framing ---- - -- - --- -------_ -�� Insulation Drywall Nailing '— — Firewall / Fire Sprinkler Uri l ---- - -- Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING �- Post& Beam lhrcter Slab - - - - -- - - -- Rough-In Water Servict ---- - - Sanitary Sewer Rain Drains ---- -------- Catch Basin/Manhole ,torm Diain - - - -- Shower Pan Other: - Final PASS PART FAIT. MECHANICAL Post&Beam Rough-In -- - - - - - - - Gas Line Smoke Dampers - - -- - - - - - - - - Final PASS PART_ FAIL - - ELECTRICAL Service - - - - Rough-,n UG/Slab _ ----- -- -- - ----- _. — Low Voltage Fire Alarm _ _ - - ---------- -------- Flha LA Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ` CEM> PART FAIL SITE L Please call for reinspection RE:_ _--_ Unwe to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date 1441 - _KnnLa Inspector -- Et -- Other: Final -� DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)4}�175 - MST INSPECTION DIVISION Business Line: (503) BUP ---- -- -____-- Received _...--_�,��-- Date Requested AM -_ PM __ BUP ___-_-- L.ocation Suite - ---__ __ _ ___ MEC Contact Person _—__-.- __------__-- _ Ph PLM --- ------___.__ Contractor . . _ Ph(—— ) ----- SWR -- - - — - - --- BUILDING TenantJOwner — _—__-__- _ __ __ ELC Footing ELC Foundation Access: Fig Drain ELR Crawl Drain -- - Slab Inspection Notes: SIT Post& Beam -------- Shear Anchors --- - Ext Sheath/Sheat Int Sheath/Sh, at Framing -- -- ---- -- Insulation Drywall Nailing - -- Firewall Firo Sprinkler Fire Alarm Susp'd Ceiling --- Raof Other: Final PASS PART FAIL PLUMBING - Post&B-ea n i Under Slab - Rough-In Mater Service - -- S& itary Sewer Rain'trains - — Catch uasin/Manhole Storm Drain - - - ----- Shower Pan r: _ PART FAIL — MECHANICAL Post&Be-im Rough-In Gas Line Smoke Dampers --- Final _PASS PART _FAIL - ELECTRICAL Service IRough-In UG/Slab Low Voltage Fire Alarm Final [� Reinspection fee of srequired before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART _FAIL_ SITE LL Please call for reinspection RE:_-_— Unable to inspect-no access Fire Supply Line ADA �71' Approach/Sidewalk Date _�1 '�h_ �__. Iia�pectoQ �. ^' ��^'�- Ext Other: Final _ DO NOT 19EMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-41MST 70 Z -0:�)O 7 �---' - INSPECTION DIVISION Business L!ne- (503)639-41'!1 BUP — y 9; Received _ _ Date Requested___ _? AM_— PM BUP Location _� �� -----� r1� MEC Suite _ Contact Person _ Ph( PLM — Contractor ____— - Ph(-.—) SWR _ ---.------_.--- ---- BUILDING -renant/Owner _-- -- ---_-- ELC _-__.------- -----_--- Footing -- ELC Foundation Access: ELR Ftg Drain - Crawl Drain -- Slab Inspertion 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:F ASS PART FAIL GING - - - Post& Beam Under Slab Rough-In Water Service -` -- - Sanitary Sewer Rain Drains - - Catch Basin/Manhole Storm Drain - Shower Pan Other: - - Final PASS PART FAIL Post&Beam - Rough-In Gas Line Smoke Dampers _- J A PART FML ELECTRICAL -- - -- Service Rough-In -- -- -- - --- ----- UG/Slab Low Voltage Fire Alarm Final Fj 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 / Q ADA U 6 Inspector Ext Approach/Sidewalk Date _.-- Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL