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13290 SW Kingston Place
ITY OF 'TIGARD MASTER PERMIT
PERMIT#: MST2002.-00049
DEVELOPMENT SERVICES DATE ISSUED: 4/11/03
13125 SW Hall Blvd.,Tigard, OR 97223 (503)039.4171
SITE ADDRESS: 13290 SW KINGSTON PL PARCEL: 2S104DA-17900
SUBDIVISION: QUAIL HOLLOW - SOUTH ZONING: R-4.5
BLOCK: LOT: 005 JURISDICTION: TIC;
REMARKS: 5F rowhouse,unit 5,bldg 5,BS plan with deck. STRUCTURAL FILL, REQUIRES GEO-TECH
INSPECTION AND REPORT. 4/10/03, adding a/c& gas fireplace.
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: FIF.ST: 172 at BASEMENT: of LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR.LOAD: 50 SECOND: 735 at GARAGE: 547 at FRONT: PARKING SPACES:
TYPE OF CONST: 5N DWELLING UNITS: 1 1HRO 735 of RIGHT:
OCCUPANCY GRP: R3 BDRM: c" BATH: 2 TOTAL: 'S4; gVALUE: 162,566 20
} REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: 2 WASHING MACH: I LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
L.AVATORIES 2 DISHWASHERS. I FLOCK DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUBISHOWER'r GARBAGE DISP: I WATER HEATERS: 1 WATER�.INES: BCKFLW PREVNTR- GREASE TRAPS.
OTHER FIXTURES:
_ MECHANICAL
FUEL TYPES FURN<100K: BOILJCMP c 3HP: 1 VENT FANS: 3 CLOTHES DRYER: 1
GAS FURN>-TOOK: UNIT HEATERS. HOODS: t OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEh'P SRVC/FEEDERS BRANCH 17IRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 -200 amp: 1 0 200 amp. W/SVC OR FDR: PUMP/IRRIGATION PER INSPECTION:
EA ADD'L 600SF: 3 201 400 amp; 201 - 400 amp: 1 at WIO SVCB°OR: SIGN/OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 000 amp. EAADDL BR CIR: SIGNAL(PANEL. IN PLANT.
MANU HM/SVCIFDR: 601 - 1000 amn: 601+emps•1000v: MINOR LABEL.
1000+Implvolt:
PLAN REVIEW SECTION
Reconnect oniv:
>-4 RES UNITS: SVC/1 DR>=229 A.: >600 V NOMINAL. CLS AREA/SPC OCC:
ELECTRICAL•RESTRICTED ENERGY
A.SF 4ESIDENTIAL - B.COMMERCIAL _
AIIDIO&STEREO. VACUUM SYSTEM AUDIO&STEREO: FIRE ALARM: 114TERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: 0TH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION. MEDICAL. OTHR:
HVAC: DATA/TEI E COMM•, NURSE CALLS: TOTAL 0 SYSTEMS:
Owner: Contractor: TO7 AL FEES: $ 5,879.99
BROWNSTONE QUAIL HOLLOW LLC BROWNSTONE HOMES,LLC This permit is s Iblect to the'egulations contained in the
12670 SW 68TH PKWY STE 200 12670 SW 68TH PKWY Tigard Municipal Code,State OR. Specialty in des and
PC RTLAND,OR 97223 PORTLAND,OR 97223 all other applicable laws. All work will be done it
( accordance with approved pans. This permit will expire If
work is not started with n 180 days of issuance,or if the
work is suspended for more than 180 days. ATTENTION:
Oregon law requires you to follow rules adopted by the
Phcno. 50;-59$-7565 Phone: 503-598-7565 Oregon Utility Notification Center. Those rules are set
forth in OAR 952-001-0010 through 952-001-0080. YJII
LIC 124627 may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8. Plm/undslb Insp Framing Insp Firewall Insp Electrical Final
Sewer Inspection Electrical Service Gas Line lisp Gyp Board Insp Plumb Final
Footing Insp Electrical Rough-in Insulation Ir,sp Rain Drain Insp Mechanical Final
Foundation Insp Mechanical Insp Shear Wall In,p Water Line Insp Building Final
Stab Insp Plumbing Top Out Exterior Sheathing Ins[ Smoke Detector Final Inspection
ISSLed 134- y� �y permittee Signature : ) —
Call (503) 639-4175 by 7:00 p.m. for an Inspection needed the next business day
CITYOF TIGARD _ sLIAVER CONNECTION PERMI" _-
DEVELOPMENT SERVICES PERMIT#: SWR2002-00028
13125 5W Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 4/11/03
SITE ADDRESS; 1329L .W KINGSTON PL PARCEL: 2S104DA-17900
SUBDIVISION: QUAIL HOLLOW-SOUTH ZONING: R-4.5
BLOCK: LOT: 005 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 new SF rowhouse.
FEES
BROWNSTONE QUAIL HOLLOW IA.0 Description Date Amount
12670 SW 68TH PKWY S FE 200
PORTLAND, OR 97223 [SWUSA]Swr Connect 4/11/03 $2,300.00
[SWUSA]Swr Connect 4/11103 $0.00
Phone: 503-598-7565 [SWINSP]Swr Inspect 4/11/03 $35.00
[SWINSP]Swr Inspect 4111/03 $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 Serktices. 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
,hall 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 952-001.00 through OAR. 2-001-0100.
You may obtain copies of these rules or direct questions to OUNC by calling (5031 246 699.
Issued by: _ �LL " _�� ?�� 2_ Permittee Sig.tatre Ll�
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Build.i ag.Permit Applicationiv
City of Tigard Datereceived:: av't Permit n,,:l/-,;r n;-ab F
" Lno.:
''irynfTigard Address: 13125 SW Hall Blvd, ' 2 3 D Pro1xde pp Ex iredate:
Phone: (503) 639-4171 Date issued: 65.4 J�Q Receipt no.:
Fax: (503) 5YR-1960
Case file no.: Payment typ-
Land use approval: AAU 1&2 family:Simple Complex:
MFU
U I &2 family dwelling or accessory U Commercial industrial U Multi-family U New construction U Demolition
U Addition/alterat-:on/replacement U Tenant improvement U Fire sprinkler/alarm U Other:
.1011 SITE 1
Job address: F3 :Z 76) S'[c1 � Bldg, no.:
Lot: C�—___ 6 Suite no.:
Block: Subdivision: _wt r, NC t. t L'e C t � Tax ma tax lot/account no.: A6/a LA-
Project name:
r.
Description and location of work on premises/special conditions:
( "i tiling address r n
ic 1 .1'r 2 family dwelling:
ity: 0 r�C��.� State:blQ 'Lf P: � Valuation of work.............. ..
S Fax:&20 E-mail: No.of bedrooms/baths................................
Owner's representative: ---- _
Total number of floors......................
Phone: Fax: F-mail: --
New dwelling arca(sq. ft.) ..........................
Garage/carport area(sq. ft,)........................ _
Name: 5. `,L Lf Covered porch area(sq.ft.) ......................... _
Mailing address: 1:„6,_s•t.e) Et, �h • Deck area(sq.ft) ..............
City: ,- State: Z[ ' Other structure.area(sq. ft.
Phone: FaxF.-mail: Cummercial/industrlahmultl-family:
(bNTRA1 Valuation of worl�........................................
Business name.: r.0 . t Existing bldg.area(sq. ft.) .......................... —
Addirlss:-_ —'� New bldg.area(sq.ft.)
City: Statc�� ZI Number of stories........................................
Phone* Fax:6 zo •-mail:— Type of cons:nrction................................ .
CCB no.: ��-- Occupancy group(s): Existing:
City/metro lic.no.:
New:
Notice:AI!contractors and subcontractors arc required to be
licensed with the Oregon Construction Contractors Board under
Name: �6_L,O _ provisions of ORS 701 and may be required to be licensed in the
Address: — - --- jurisdiction where work A being performed.If the applicant is
_.w3._Q_ r'� V(_ -Sw�.� O g Pe
City: '_ State ZIL-2jEty exempt from licensing,the following reason applies:
Contact person: N� Plan no.:
Phone: Zr x _TF-mail: — _--
Name:g'l -
a Contauc person: Fees due upon application- pp $
Addresw ��6hP
c-}- D!uereceived:City: 3tate: Amount received
.................................:......
Phone: a Fax: E-trail: - Please refer to fee schedule.
I hereby certs,'y I have read and examined this application and the Not all for nxrr In7nnutian iurisd cr;ory rcepr �rude,pleasr call Jw1rd cti n
attached checklist.AU provisions of laws and arrtinances governing this U vise U ntdtr«c'arc1
work will be complied wheelie ed herein or not. c r6t c.rd ouroxv _T —_ _
Authorized Sig re: _..__ Uprres
Nurse d cudho u ur,wn on ai�lt::ard
Print acme: $
Notioe:This pLrmit applicadon expires if a permit is riot obtained within 180 days after it has heen accepted as complete 440 461j 60WMW4)
Plumbing Permit Application
rp"ojectlappl.
received: :' Permit no.:City of Tigard wn permit no. Building per,ru:no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223CityojTigard phone: (503) 639-4171 no.: Expire date:
Fax: (503)598-1960 Date issued: By: Receipt no.:
Land use approval: —_— Case file no.: Payment type:
U I &2 family dwelhr,g or accessory U Commercial./industrial U Multi-family U Tenant improvement 1
U New construction U Addition/alteration/mplace,vent U Food service U Other:
401111 SITE lNirORNIATION ' 7
Job address:j a�i r[ Description Qty. I es(ca. total
—� New 1-and 2-famil} dwelling: only:
Bldg_no.: Swte no.: — _ (includes 100 ft.for each utilNy comiection)
Tax map/tax lot/account no.: _ SFR(1)bath
l ot: Block: T.SuSFR(2)bath -- -- _
Project name: SFR(3)bath -
City/county: ZIP: _— Each additional baUA.itchen
Description and location of work on premises:— Sitelutllities:
_ Catch basirdaica drain _
Est.date of compleuortiinspection: Drywells/leach line/trench drain
Footing drain(no.lin. ft.)
Manufactured home utilities
Manholes
Wolcott I'lumbing Rain drain connector —�— --- —
PO Box 2007 Sanitary sewer(no.lin.ft.)
Gresham OR 97030-0594 Storm sewer(no.lin.ft.)
503-667-1 IQ 1 Water service(no.tin. ft.)
CCB:23847 PLM #:26-208PB F1%lure or Item:
-- Absorption valve _
Contractors representative signature:_ Back now preventer —
Print name: Date: Backw-'--valve_
Basins/lavatory
Name: Clothes washer —�
Dishwasher
Address: Drinking fowitxin(s) - _- —
City: �------------ State: 7.1P: __. Ejcctors/sun�— _
Phone: Fax: Email: Expansion tank _
Fixture/sewer cap
Name(print): — Floor drains/floor sinks/hub
Garbage dispos d _
Mailing address:v e bt1— — — Hos
City: State: ZIP:_ lee maker -
Phone: - — Fax: —IF%-mail: tctce or/grease nap ----
Owner imstallation/residentW maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain(commercial)___--__
employee on the property I own as per ORS Chapter x'47. aink( s),bp"In(s)_,lays(s)
Owner's signature: —_ Date: — 5i --- —Tubs/shower/shower pan
-UrinalName: J_ _ Water closet _ —
( Address: __ Water heatci
City: State: ZF1': Other. _
Phone: j'�-
Nat all}wit&cdom wmV cvn&csrcads- plow till lurisd"nn r�(w ayw WwnwimNoUoe:This per flit application
Minimum fee................$ — _--
U VI" U MasterCard expin-s if a permi'is no.obtained Plan review(at _%) $
-.L-L— wiUrin 180 days f.fter cha
it hm been State surcharge(8%)....$
r• pr., TOTAL .......................$ —
-- Nam d ardtnlder u drown�aedir yard --- acoepled aA Door::late
S
_ _-- C.dbolder da we.e-- _ --n.ar 4404615(&KKVCr W
Mechanical'PermitApplication _
Permit no.: rkw?-G'X*
City of Tigard hgiect/appl.no.: Expiredate:
t iryr�('rigarA Address: 13125 SW Nall Blvd,Tigard,OR 97223 `--
Phone: (503) 639-4171 Date issued: By: Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: Building permitno.:
❑ 1 &2 family dwelling or accrscory U Commercial/industrial U Multi-family G Tenant improv;ment
O New construction U Addition/alleration/replacement U Other: _
II SITUNFORMATION COMMERCIAL VALUATIONSCHEDULE
LQ \' ;uLn<< — Indicate equipment quantities in boxes below. Indicate the dollar
Bldh.no.: Smtc r u.: value of all mechanical materials,equipment,lab.u,overhead,
Tax haat;tax lot/account no.: profit. Value$
Lot: Block: Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: - ZIP:_ 0 1 Hil It
Description ani location of work on premises _ 1 h /
Est.date of c:omplr6on/inspection: Dir-aMptiaopy. Frv( 1 Res Total
Tenant improvement or change of uKe: - Al
nWI
Is existing,space heated or conditioned?U Yes LJNo Alr handling unitAir con3itioning(site plan required)
Is existing space insulated?U Yes U NoA ter-T aeon of existing HVAC system
MECHANICAL CON"AtUllt Boilerfrompressors -- _
- Stet:boiler permit no.:
I our Seasons Ileating& AJC Sort ice Int. HP Tons BTU/
MiOsuioke dam o a effectors
10 flux 66409 -Tfeat pump(site plan required)
Portland OR 97290-6409 InstalUmplacefuma -
503-775-5919 Including ductwork/vent liner U Yes U No
CCD: 48283 Instal Vrep ace/reocate eaters—susp'nderi,
wall,or floor mounted _
Name(please tint): end-t Torii liarother-thanTrnace -- -- -
Ai r;rption�lnits---�_-_ __ BTWI I
Name: Chillers__-...-----_�-_ _ lip - -- -
Addtrss. -_--- compressors_--_ _ _ lip
City: ronmenta oet asst
State: a rcradla�on-
_
-- � ZIp:---"-"----- AFPiianccvcnt
Phone: Fax: Dryerexhaust -
11- S, 'yps,I/I Ure s.Tc i"'fiett�iaunat ---
hood fire suppres.inn s;stem _
Name: �- Exhaust fan with single dict(hath fans)
Mailing address: •x austsstern apart from heath.rg or AC -
_City: State: 'LII': Oe P p1nr siad d4tribution up to 4 outlets)
--- --- Ti pr - _LPG _ NO t"hi
Phone:
Fax: E-mail: fuck�i+n�eaacchi adaiucnal overt u
Proccping,-lite( erratic required)
Name: NumtNt of outlets
- -- ----- - - i IIsia-r pcd�aior eq ptmeal:
Address: Uecorativtfireplace
City: - T - State: ZIP: - —_ nsert-type
Rhone: Fax _: i mail: Woodstovi7peFIR stove -
Applicant's signature: Date:
er
Name (print):
N+z dl)r�brm WXW t?rA,card,,r{ew call juridicaoo for mae irdo--� Permit fee—..................$
O Vera O MasterCard Notice:This permit application Minimum fee................$ -
ttr cad anmbe J explrrs-'f a permit is not obtained
p� within 180 Rays after it bees been State
review(at
at — %) $
— Naar d'caft�,otde�,uTio+ve`on a'eee c:d ��_ accepted a5 complete. Stats surcharge(8%).. $
TOTAL .......................
443Ac 17(605MM)
Electrical Permit Application
— Datertxeived:J r/,r'l Permitno., �jfetCt� -C.1� 9
City of Tigard Project/appl.no.: Expire date:
Ciq•oJTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: I Receipt no.:
Phone: (503) 6394171
Fax: (50:) 598-1960 Case file no.: Payment type v
Land use approval:
71 & mily dwelli ip or accessory U Commercial/industrial U Multi-family U Tenant improvement
nstruction U Addition/alteralion/replacr- sent U Other: _ U Partial
JOB SITE INFORMA11ON
Joh ad_ dress V1r S � f31dg. no.: Suite no.: Tax map/tax lot/account no.:
-
lh yi—rye. i
Lot: _� Block: SU ivision:
Project name: Ik;rnption and location of work on promises:
Estimated date of cornpletion/inspection:
rAPPLICATION
�-JLROME
ob no: Fre M"
— --- — Isescrl tion Oty. (ea) Total no,tris
ELECTRIC New redderst,l aig(te or math family per
PO BOX 751 drrellLrRsdt.lncludeafhctirdprage.
service larluded:
HILLSBORO OR 97123 1000%q ft otlaa
503-648-5144 Each additional 500 sq.A.or portion thereof -
CCB: 36051 F,LC: 34-1190 SUP: 2877S Limited energy,nonres-elide z
Limited energy,non-residential 2_
- Each manufactured home or modular dwelling
Signature of stir;vmsmg elecincian(required) Date Service and/or feeder _ 2
Sun elect name(pnru i Liceme no Services orfeedert-Matallstion.
alierstim or relocation:
1 200 amps or las _ 2
Name(glint): 201 amps to 400 amps _ _ 2
-- — ---- — 401 amps to 600 amps 2
Mailing address: 601 amps to IO(I(I amp! 2
City: '_ State: P. — Over 1000 amps or volts 2
Phone: ._._ Fax: E-mail: Reronr,ectonly �_ 1
Owner installation:The installation is being made on property I own Iemporaryserwk—orfeeders-
which is not intended for sale,lease,rent,or exchange according to r20
llation,aNehtlon,orrelocation:
URS 447,455,479,670,701. amps or less 2
apps to 400 amps 2
Owner's signature: Date: to 6(M)am)! 2
y. y Branch cirratts-new,attention,
or extendoe per pawl:
Name: A Fee for blanch circuits with purchase of
Address: service or feeder fix,each brunch circuit 2_
City: Stale: ZIP: — B. Fee for branch circuits without purchase
------ of service or feeder fee,first brach circuit: 2
Phone.: fax: E-mail: FAchadditionalbrenchciri:Ot:
Misc.(Service or feeder not Inc laded):
U Service over 225 anps-commehriat U Health-care facility Each pump or irrigation circle z
U Service over 320 amps-rating of 1 dr2 U Hazardous location Each sign or outline lighting 2 _
family dwellings U Building over 10,000 square teat 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 rJ Feeders,400 amps or more "Dmri tion _
U occupant load over 99 persons U Manufactured structures or RV park Usch additlowd Inspection over the allowable in m2 of&above-
❑EgressAighting plan U Cither Pet inspection rr��
Submit_--sets of plans with env of the abate. Investigationfee Y
The above are not applicable to temporary construction service. other
Not all)unsdicuoa accep credit card%,please call jurisdiction fa mac infamauon Notice:This permit application Permit fee.....................
U Visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $ _--._---
Credit card number � _—�. __,. within 180 days after it has been State surcharge(11%)....$ _ _._---
E.hires accepted as complete. TOTA1. . ............_.......I _
-----
Nam d eartrholdu u shown on c tt�i cry- _ _ .
f
Cardholder Opium 4404615(&OfYC OW
CITY OF TIGARD
13125 S.W,
TIGARD, ORHALL 9722BLVD. RECEIVED
IMPORTANT PERMIT NOTICE APR 15 2003
CITY OF I IuARD
DAVID JEROMF ELECTRIC BUILDING DIVISION
PO BOX 751
HILLSBORO, OR 97123
Electrical Signature Form
Permit #: MST2002-00049
Date Issued: 4/11103
Parcel: 2S104DA-17900
Site Address: 13290 SW KINGSTON PL
Subdivision: QUAIL HOLLOW - SOUTH
Block: Lot: 005
Jurisdiction: TIG
Zoning: R-4.5
Remarks: SF rowhouse,unit 5,bldg 5,13S plan with deck. STRUCTURAL FILL, REQUIRES
GEO-TECH INSPEECTION AND REPORT. 4/10/03, adding a/c & gas fireplace.
l'our 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 Form prior to the
start of the work to the address above, ATTN BLli!ding Division
No electrical inspections will be authorized until this completed form is received
OWNFR: ELFCTRICAL CONTRACTOR:
BROWNSTONE QUAIL HOLLOW I I C 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 #: I.u; 26051
SUP X8775
ELE 34-119('
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X �
;signature of Supervising Electrician
If you have any questions, please call 503.718.2433.
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 #: MST2002-00049
Date Issued. 4l-i 1103
Parcel: 2S104DA-17900
Site Address: 13290 SW KINGSTON PL
Subdivision: QUAIL HOLLOW - SOUTH
Block: Lot: 005
Jurisdiction: TIG
Zoning: R-4.5
Remarks: SF rowhouse,unit 5,bldg 5,13S plan with deck. STRUCTURAL FILL, REQUIRES
GEO-TECH INSPECTION AND REPORT. 4110/03, adding a/c & gas fireplace.
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 Division.
No plumbing inspections will be authorized until this completed form is receiver!
OWNER: PLUMBING CONTRACTOR:
BROWNSTONE QUAIL HOLLOW LLC WOLCOTT PLUMBING CONTRACTOR!
12670 SW 69TH PKWI' SITE 200 PO BOX 2007
PORTLAND, OR 972.23 GRESHAPA, OR 97030
Phone #: 503-598-1565 Phone #: 667-1781
Reg #: LIC 23847
PLM 26-208PB
AN INK SIGNAYN URE iS REQUIRED ON THIS FORM
Signature f Au orzed Plumber
It you have any questions, please call 503.718.2433.
April 29, 2003 C!TY OREGON
12670
TREGON'� �
Ron Estey
12670 SW 68'x' Parkway, Suite 200 �
Tigard, OR 972.23 ---
RE- Plan review of conversions and additions.
Dear Ron,
I have completed the plan review of the 15 units that have been or are to be
converted to additional space options or have been altered for increased living
space.
I personally reviewed the pictures provided by your site superintendent for
building 44, and found that the 24" X 24" X 12" pad under the point load
transferred down through the inside bathroom wall was not installed.
You will have to arrange for a 2" core drill at tha', area to check for adequate
bearing for this load at lots 7, 9, 59, 60, 61, 62, and 63. Dr, you might contact
your engineer to address the footing pad issue.
Lot 24 was approved and lots 2, 3, 4, and 5 have riot been poured.
Lot 19 has been revised to reflect storage space in lieu of the original bedroom.
The bay was also credited and the added "niche" was recorded. Do insure that
there are no headers or jambs at the "niche" so in no way can it appear to be a
closet.
Lots 7, 9, 59, 60, 61, 62, and 63 have been flagged "no further inspections" until
the testing or design is complete for bearing pads and/or sl.-,ar walls.
If you have questions, please call me at 503-718-2440.
Sincerely,
Darrel "Hap" Watkins
Inspection Supervisor
1312.5 SW'Hall Blvd- Tigard, OR 9722.3(593)639-4171 TDD(563)6PA-2772 — _ _
CITY OF T. ENER GARD ELECTRICAL -
RESTRICTED ENERGY
DEVELOPMENT SERVICES — PERMIT#: ELR2003-00241
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 8/6/03
SITE ADDRESS: 13290 SW KINGSTON FL
PARCEL: 2S 104DA-17900
SUBDIVISION: QUAIL HOLLOW- SOUTH ZONING: R-4.5
BLOCK: LOT: 005 JURISDICTION: TIG
Proiect Description: Instaliation of limited energy for audio/stereo wiring.
A.RESIDENTIAL _ B.COMM=RCIAL
AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/iRRIGAT:
GARAGE OFENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LA.NDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAk'. :
INSTRUMENTATION: OTHER:
TOTAL# OF SYSTEMS_ :
Owner: Contractor:
BROWNSTONE QUAIL HOLLOW I._L.0 AZIMUTH COMMUNICATIONS INC
12670 SW 68TH PKWY STE 200 P.O. BOX 508
PORTLAND, OR 97223 WILSONVILLE, OR 97070
Phone: 503-598-7565 Phone: 503-639-0110
Reg #: ELE 36-94CLE
SUP 2312LEA
LIC 145829
FEES _ Required Inspe,aions
Description Date Amount7EIectyl
oltage Inspection
[EL,PRMT] ELR Permit 8/6/03 $15.00 Fina!
[TAX] 8%State Tax 8/6/03 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OP. 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 follllow-rohe's-adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 throuC
I
Issued t y Permittee Signature �� � 14�
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. ELEC'trDATE:
—_-
LICENSE NO:
— --
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
Electrical Permit Application
rDatereceived: </ 6o p5 Permit no.: 1,1Z;L-V
City of Tigard Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd,Tig,~ OR 97223 Date issued: By: Receipt no.
Phone: (503) 639-4171
Fax: (503) 598.1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERmiy 0
U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
$(New construction U Addition/alteration/replacement U Other:__ _ ❑Partial
Job address: / (/ 1. ,t j-01 �� Bldg•na:�_ Suite no.: Tax map/tax lot/account no,:
Lot: Block: �inhdi�ision: �(� �Z1cl7N
Protect name: ` `' _ —description and location of work on premises: UDf CCQ _
Estimated date of completion/irts vection:
F FSCHEDULE
Job no: � ret Max �
- I Description Qty. ea.) Total no.hes
Business name: i, u 1 lC i L- Newresl tial-single ormulN•famllyIKr
Address: - l /, b f dwelling..nii.includeaaltachedgarage,
City: .t,` c1r�)JILLE State ZIP: C Service Included:
Phone:r (�,3q U((u Fax: ,/ 011 S E-mail: 1000 aq.n nr les, _ 4
Each additior al 5UU sq ft.or ponion thereof
CCB no.: 14 5,Y,-2)� Elec.bus,lic.no: 1� �j`F Cc Limited energy,residential 2
City/metro li no.: (� S I Limited energy,n(in•residential
12V I& Each manufactured home or modular dwelling
Signature of supervising electricia uired) Date Service and/or feeder
I,icensenn SerrI orfeeders-Installation,
Sup.elect.name(pnni). U. EaeL. alteration or relocation:
200 amps or less _ -'
201 amps to 400 amps 2
Name(print): 9LX,d Pl j Z)4.1 C_- 401 amps to 600 amps '-
Mailing address: 601 amps to 1000 amps _ 2
City: State: Z111: Over 1000 amps or volts 2
Phone: Fax: I E-mail: Reconnectonly I
Owner installation:The installation is being made nn property I own Temporary services orfeeders-
4hich is not intended for sale, lease,rent,or exchange according to lnstallotion,alteratlon,orreiocation-
ORS 447,455,479,670,701. 200 amps or less
201 nntp�,to 400 amps
)weer's signature: Date: 401 to 600 ams 2
Branch circuits-new,alteration,
or exismlon per panel:
NamC: A. Fee for branch circuits with purchase of
Address: service or feeder ice,each branch circuit 2
City: Stele ZIP: H. Fee for branch circuits without purchase
--
of service or feeder fee,first branch circuit 2
Phone, I I ni,nl
Each additional branch circuit.
PLAN REVIEW(Plene check all Am apply) liac.(Service or feeder not Included):
O Service over 225 amps-cnmmercial J Health ewe tuciltly ACh pump Or irrigation CIfCIC 2
•Service over 320 amps-rating of I&2 U Hazardous location Each sign or outline fighting 2
familydwellings I Building over 10,000 square F!et four or Signal circuit(s)or a limited energy panel,
❑System over 600 volts nominal more residential units in one structure alteration,or extension* L
U Building over three stories U Feeders,400 amps or more *Description
U occupant load over 99 persona O Manufactured structures or RV pork FAch additional Inspection oVcr tet•allowable In any of the above:
U Egress/Iighringplan U Other- _ Pennspection [—r-1—
Submit_sets of plans wile any of iirr?above. Investigation fee
The above are not applicable to temporary construction service. other
Not all jurisdictions accept credit cards,please call jurisdiction for more informatlott Notice:This permit application Permit fee.......... ..........
❑visa O MasterCard expires if a permit is not obtained Plan review(at — %) $ —
Credit cud number _.�_.�^ __L�-_ within 180 days after it has been State surcharge (896) ....$ _
Expires accepted as complete. TOTAL $
Name of cu of r u shown on c- reale card
S
—� Cardholder Ugnaw �� Amount 4w-4AIs tN00cc)Mi
i
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 CMS:�)
INSPECTION DIVISION Business Line: 1503)639-4171 BUP
Received Date Reque ted_1 D - q AM _-_ _— PM — SUP
Location _ 1 uite-----__ - - --- MEC --�---- ---
ContactPersonLfk����`���_ ►( -) _.--.---------- -- PLM --- —
ContractorPh(-// -) ---- --- - -- _� SWR
BUILDING TonantlOwner _ �1— — _.___.__ ELG
Footing ELC __—
Foundation Access:
Ftg Drai;i ELR
Crawl Drain
Slab Inspection Notes: T—� SIT _
Post it Beam -
Shear Anchors —-
Ext Sheath/Shear
Int Sheath/Shear
Framing - - - - - -- --
Insulation
Drywall Nailing
Firewall
Fire Sprinkler - -- -t—
Fire Alarm \ __
Susp'd Ceiling - - '—
Roof _
Other: —
Final
PASS PART FAIL --- - - -- -- --
PLUMBING_
Post& Beam
Under Slab -
Rough-In
Water Service -- - -- - — — -- —
Sanitary Sewer
Rain Urainc ---- ----- — — -
Catch Basin r Manhole
Stone Drain — ---—� —
Shower Pan
Other: —
Final
PASS PART FAIL
MECHANICAL
Post&Beam
Rough-In --
Gas Line
Smoke Dampers - -- ------ - -
Final
PASS PART FAIL ----
LECTRICA
Service
Rough-In J
UG/Slab
Low Voltage —b�►�� _ ..r�JG /i- I !'. �
m
c_
Final PART FAIL Relnspectlon fee of$——.required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE —� - [� Please call for reinspection RE:—_ Unable to inspect-no access
Fire Supply Line
ADA Fiat .. llnspectpr -_ a �'`-`-"� _Ext _
Approach/Sidewalk
Other:
Final DO NOT REMOVE this Inspect"sin re+:ord from the ob site.
PASS PART FAIL
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CITY OF TIGARD 2a-Hou-
BUILDING Inspection Line: (503 175 '..
INSPECTION DIVISION Business Line: (50 71
BLIP
-
I
Received _����— Date Requested b t ___ AM__—___ PM ___._ __.._ SUP
Location -'_L—Ifi � 1� -✓� Suite-------_---__--- MEC ------.�. ----
Contact Person Ph(-__._.. ._1 - _- —_ PLM _ -
Contraci-- — Ph( ___) _ SWR —_
BU _ IN Tenant/Owner —_� _- \�_ ELC
Foo -' �. ELC _
Foundation Access--
Fog Drain ELR ------_---
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam -
Shear Anchors '-'----
Ext Sheath/Shear _
Int Sheath/Shear --' -� ----�4 �
Framing - -
Insulation
Drywall Nailing - � -- •' -------
Firewall
Fire Sprinkler _ —�_ _ - ---- ---_--.._ .--_ _-__ --------_—_--
Fire Alarm
Susp'd Ce,ling ---- — - —
Roof
Ot e : --- - _ _—- ---
WSS, PART FAIL -------_ ��— — ---- -- -- ___- --
PEIMING _
Post& Beam
Under Slab A --.
Rough-Ir
Water Service
Sanita,y Sewer
Rain Drains — - - -- - --- --
Catch Basin/Manhole
Storm Drain
Shower Pan
Otner. — -- �---
-------
Final
PASS PART FAIL - - ---- ---- — —
MECHANICAL
Post&Beam
Rough-In - -- ------ — - ----------- _..
Gas Line
Smoke Dampers - - - -
Final
PASS PART_ FAIL -- ----.- -- — --- - -
E%.ECTRICAL
Service ---- - --- ---_---__-- — -
Rough-In -- - ----------_-__--_ - --�w_—___^ __
UG/Slab
Low Voltage - - --- __-� ---- -- -------- -
Fire Alarm
Final ❑ Reinspectiun fee of$._ required before next inspection. Pay et City Hall, 1595 Hall Blvd.
PASS PART FAIL
SiTE Please call for reinspection RE: _ Unable to inspect-no arcess
Fire Suoply Line
ADA Cate 1 �_ Ins actor _-_1`-�'_-�-•-
Approach/Sidewalk - - ��- p Ext
Other:
Final ISO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST ':::>ZCC)
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Received Date Requested- _— AM PM __ BUP
a � ,
Location _ _— K-�N�— ._I�� _SuiteME--
Contact
ECContact Person _ _—_ _. _ Ph PLM —
Contractor - Ph (----) SWR — __--
BUILDING _ _ Tenant/Owner _ ELC
opting
Foundation ELC
Ftg Drain Access.
ELR _ -_-
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors -
Ex'Sheath/Shear
Int Sheath/Shear
Frrming
Insulation
Drywall Nailing -- --- - ---- - --- ---- ------- - - _._. _. - ----------
Firewall
Fire S iiKler --
Fire Alarm
Si,sp'd Ceiling - -- - - -- --- -
Roof
Other: _. ------ - - __
Fir
P^.S3 PART FAIL
PLUMb1NG
Post& Beam
Under Slab
Rough-In
Water Service -- _--- -
Sanitary Sewer
Rain Drains -- ----- ---
Catch Basin/Manhole
Storm Drain --------- --
Shower Pan
i
ASS PAP'r FAIL ------- -- ------ -___.-__._____ _ — - --
ANICNL
Post&Beam _-^--
Rough-In --- ------- — —— _� - -- --—
Gas Line
Smoke Dampers
Final
PASS PART FAIT_ - ---- --- - ------ - --- --
ELECTRICAL Service
-__-- -
---------------------
Rough-In
UG/Slab ------ _ - --------
Low Voltage
Fire Alarnr -_�__---
Final l Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL.
SITE - Please call for reinspection RE:--_-__ -__-__-- �� Unable to inspect-no access
-- -----------
Fire Supply Line
ADA
Approach/Sidewalk Date _ v Insp•der - , J ,- Ext
Other:
Final 00 NOT REMOVE this Inspection record from the job site.
PASS_ PART FAIL
CITY OF TIGARD 24,
BUILDING Inspectioa Line: (503)639-4175 Dm�T
INSPECTION DIVISION Business Line: lZ03 639-4171
)
BUP
Received —__ —_Date ReOUested____�_�_ -- AM__ P! BLIP
Location _ ����'u-�_� S` 1 l —suite —_ MEC
Contact Person —_ jtZ1cL. Ec 4:rn S _ Ph (_ �.�) 7 - _ dry PLM
Contractor Ph (_ _) . SWR
UICDING Tenant/Owner __ _ --_— ELC
Footing ELC
Foundation Access: �-_.--
Fog Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors - ---- --- -
Ext Sheath/Shear
Int Sheath/Shear
Framing - - ---__ - - - - --- - --
Insulation o
Drywall Nailing
Firewall
Fire Sprinkler -- - -- [ -- —
Fire Alarm �- QTY (� !
Susp'd Ceiling ----
Roof
Filial - L�l3ZJ/�Q✓-�
PASS PART FAIL --- �_-— -----
PLUMBING
Post 8 Beam —
Under Slab
Rough In
Water Service ----- - -- - ---------.__—�_-
Sanitary Sewer
Rain Drains ----- - --
Catch Basin/Manhole
Storm Drain --- - - — —
Shower Pan
Other. - - --- — -------- --
Final
3=_ T FAIL -- - -------- - - --�_�
MECHANICAL
Post eam
Rough-In --- —
Gas Line
5ng4a Dampers - - ---- -
Final
f!Fkl PART FAIL -------- ____- -___.___.- ---------- ------_____-
TRICAL
--------------
Service
Rough-In
Low Voltage -------_-_---
Fire Alarm
Final Reinspection fee of$_—_-_�_ required before next inspection. Pay at City Hali, 13125 SW Hall Blvd.
PASS PART FAIL
--- __
SITE Please call for reinspection RE:_._.—__-- -___-_- �,� Unable to inspect-no access
Fire Supply Line /
ADA .- � �j V
ApproachiSidewalk }date L� Inspector -. - _-__---_-__-- --- -- ---Ext _
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
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