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13300 SW KINGSTON PLACE W W O n N G O N 7 'T7 C' C1 m tlJ a. 1 7 f 1 4 I A 13300 STI Kingston Place CITY OF TIGARD MASTER PERMIT DEVELOPMENT SERVICES DATE ISSUED:PERMIT 4/11/0302 00050 13125 SW Ball Blvd.,Tigard, OR 97223 (503)639.4171 SITE ADDRESS: 13300 SW KINGSTON PL PARCEL: 2S105DA-(-)HS06 SUBDIVISION: QUAIL HOLLOW -SOUTH ZONING-. R-4.5 BLOCK: LOT: 006 JURISDICTION: TIG REMARKS: SF rowhouse, unit 6, Bldg 5, CS 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 O'WORK: NEW HEIGHT: FIRST: 320 sf BASEf1ENT: sl LEFT: SMOKE DETECTORS: Y T rPE OF USE: SFA FLOOR LOAD: 50 SECOND: 744 sf GPRAGE: 412 st FRONT: PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS 1 TWO 732 at RIGHT: GCCUPANCYGRP: R3 BDRM: 3 BATH: 3 TOTAL: 1,795 at VALUE: 173,305 60 REAR: PLUMBING SINKS: I WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN- TRAPS: LAVATORIES: 3 DISHWASHERS: i FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUBISHOWERS: 2 GARRAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 9CKFLW PREVNTR: GREASE TRAPS: MECHANICAL OTHER FIXTURES: iFUEL TYPES _ FURN<100K: 1 BOIL/CMP<3HP: I VENT FANS: 4 CLOTHES DRYER: 1 GAS � FURN>=IOOK: UNIT HEATERS: HOODS I OTHER UNITS: I MAX INP btu FLOOR FURNANCES: VENTS: I WOODSTnVES: GAS OUTLETS: I ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS _MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: I 0 200 amp: WISVC OR FDR: PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 50nSF: 3 201 400 amp: 201 - 400 a,np: 1st WIO 6VC/FDR: SIGNIOUT LIN LT- PER HOUR: LIMITED ENERGY: 401 600 amp: 401 - 600 amp: EAADDL BR CIR SIGNAL/PANEL IN PLANT: MANU HM/SVCIFDR: 601 1000 an is 601+8mps-I Wow MINOR LABEL 1000+amplvolt Reconnect only: PLAN REVIEW SECTION -4 RES UNITS: SVCIFDR>=225 A.: >600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL•RESTRICTED ENERGY__ _ A,SF RESIDENTIAL _-_ B.COMMERCIAL AUDIO&81EREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM INTERCOM/PAGING: OUTDOOrt LNOSC LT: BURGLAR ALARM OTH: BOILER: HVAC: L 4NDSCAPEARRIG: PROTECTIVE SIONL: GARAGE OPENER: CLOCK: INSTRUMENTATION. MEDICAL: OTHR: HVAC: DA'rA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 5,599.33 BROWNSTONE c]I.IAIL HOLLOW L;C BROWNSTONE HOMES,LLC Th!s permit is subject to the regulations contained in the 12670 SW 68TH PKWY STE 200 12670 SW 68TH PKWY all Municipal Code,State OR. Specialty Codes and PORTLAND,OR 97223 PORTLAND,OR 97223 all othh er applicable laws. All work will be done i accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or if Lie work is suspended for more than 180 days. ATTENTION, Oregon law requires you to follow rules adopted by the Phone: 503-598-7565 1 hone: 503-598-7565 Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through 952-001-0080. You Rei wt [.1C 124627 may obtain copies of these rules or direct questions to OUNC b; calling(503)246-1987. REQUIRED INSPECTIONS Low Voltage Ftg Drain Bsm't Walls Mc,:hanlcal Insp Shear Wall Insp Water Line Insp Building Final Erosion Control Insp 8, Slab Insp Plumbing Top Out Exterior Sheathing Inst Smoke Detector Final inspection Sewer Inspection Plm/undslb Insp Framing Insp Firewall Insp Electrical Final Footing Insp Electrical Sery,e Gas Line Insp Gyp Board Insp Plumbfinal Foundasion.insp Electrical Rjugh-in Insulation Insp Rain Drain Insp M1 ani I Final Issuk By :� t �,� �l��tz,.ti_UJi � Permittee Signature Call (503) 639-4175 by 7:00 p.m.for an Inspection needed the next business day \JTY OF TIGARD SEWER CONNECTION PERMIT _ Dc:��ELOPMENT SERVICES PERMIT#: SWR2002-00029 13125 SW Hall F''vd., I ioard, OR 97223 (503) 639-4171 DATE ISSUED: 4/11/03 SITE ADDRESS; 13300 :;W KINGSTON PL PARCEL: 2S105DA-OHS06 SUBDIVISION: Qt All, 1;9LLOW BLOCK: LOT: JURISDICTION: IIci TENANT NAME: USA NO: FIX rURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: :3FA NO. OF BUILDINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF rowhouse. Owner: -- --- Ow -- __ FEES BROWNSTONE: QUAIL HOLLOW LLC Description Date Amount 12670 SW 68TH PKWY STE 200 PORTLAND, OR 97223 1SWUSA SwrC'onncct 4/11/03 $2,300.00 1SWUSA SwrC'onnect 4/11/03 $0.00 Phore: 503-598-7565 ISWINSI'l Swr Inspect 4/11/03 $35.00 JSWINSPI tip\r Insheo 4/111103 $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 wil! be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a"Tap and Side Sewer" Perm r i �j Issued by: tel. `� f,'``(! ,t( �, L• , Permittee Signatur � � 6 .�� Call (503) 639-4175 by 7:00 P.M. for an Inspection needed It next business day 9,oeP--eA15*%A� Building&randt Application Date received: " Permit no.: I-/SfgenA—eeo&) City of Tigard — Address: 13125 SW Hall Blvd, ED no.: — Ex sue date: (�irynjTigard �i Phone: (503) 639-4171 t"" � Date issued: y:I %/ Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type Land use approval: I°2 family:Simple Complex U I ec 2 family dwelling or accessory U Commercial/industrial U Multi-laindy U New consttucucm J Denwiltion G Acldition/alteration/replacetment U Tenant improvement U Fire sprinkler/alarm U Other: JOB SITE INFORMATION Job address: ,j S' ! Bldg.no.: Suite no.: Wt: Block: Subdivision: i SLC Gtti' SCLi//1 Tax map/tax lot/account no.: Project name: Description and location of work on premises/special conditions: '01MIATION, USE CHECKLIST M'NER FOR SPECIAL INI Name: C3J � nc.�c solar,(Floollplain,septic M �uj� n 1&2 family dwelling. City: P0 J.- State:C)R ZIP: Valuation of work....................................... Phone - Fax: p E-mail: No.of he.drooms/baths............................... Owner's representative: Total number of floors................................. Phone: 8 Fax:4.20— E-mail: New dwelling area(sq. ft.) Garage/carport area(sq.ft.)......................... Name: Q f Q tJi7 .S�i6t• c _�- �__1:1Ct.1.1LrC�_(([ Covered porch area(sq. ft.) ..........I.............. Mailing address: � j__T� Deck area(sq.ft.) ............... ....................... _ City: I- � State: Zlf. � Other structure area(sq. ft.).. ........ ............ ifi" - - Commercial/ludustriAUmultI-farttrt Phone Fax: Email: Y: 1 1 Valuation of work........................................ g Existing bldg.area(sq,ft.) .......................... _ Business name �. New bldg.area(sq.ft.) ............ Address: g ... ............ r _ ° Number of stories ....................................... Stately ZI Type of construction.......................... ......... Phone - Fax:42o Occupancy btoup(s): Fxisting: CCB no.: t�. - -_�--_� _ — City/metro lie.no.: Nc w: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name: t L��j provisions of ORS 701 and may be required to be licensed in the Address: 4��j I'//�.� ��, c � jurisdicdon where work is being performed.If the applicant is Cit : State ZII':? exempt from licensing.the following reason applies: Contact pcc;on__ Phone: _ X: E-mail: -- - - - — Name: —,„ , _Msa( L Contact person: f��i Fees due upon appixotion ..... ........ $ ............. Address: 't,V r c c<} Date received: City: r c"� tato: 7.IP: 3 Amount received ....................................... . $ Phone: � ' —ct 7 Q Fax: E-mail: Please refer to fee schedule.— I,hereby certify I have read and examined this application and the I N A all jurisdictions sotto credit card,,please call jurisdiction for rnrn IC!(1TM110` attached checklist.All provisions of laws and ordinances governing this U Visa U Mastercard work will be complied whr a ed berrin or not. Credit cud numrttr Authorized sl re: _ ca �Expires Print flame: _.—�_--- �` CardWd”si-girw—um s Amamt Notice:This pemttt application expires if a permit is not obtained within 180 days after it has been accepted m complete. N04613(sanrcoM) Plumbing Permit Application "Daterm=ceived: I'eamilno.:) City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Sewer permit no.: Building permit no.: City ojTigard Mone: (503)639A 171 Project/appl.no.: Expire date: Fax: (503)598-1960 trate issued: By: receipt no.: - Land use approval: -__ - Case file no, Payment type: 1 0 I &7.family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement U New constriction U Addition/alteration/mplaccment U Food service U Other. __- 1 ' 1 1SCIIIEDULE-Vor special Information use diecklitift) lot address: .C' $=W <. _ p�a c - Ueccriptinn (fit . Fee Total Bldg.no.: Swte no.: New 1-and 2-family dwellings only: Tax ma lax lot/account no.: (!Includes 100 ft.forearhutility c000e Hou) S:72 (I)bath Block: Subdivision: SfI�(2)batt, Project name: _ slTR(3)bath City/county: -_ -- ZIP: Each additional bath/kitchen Description and location of work on premises: - _ Site dElitles: Catch basin/area drain -- -� -" - Drywells/leach line/trench train Fst.date of complcUonlinspection _ _ 1 1 Footing gnus(no.!in. It.) Manufactured home utilities Woicon 1'Iunrhing Manholes T Rain drain connector PO Box 2007 Sanitary sewer(no.lin.f+.) -- Gresham OR 97030-0594 Storm sewer(no.lin..ft.) - - 503-667-1781 Water service(no. lin.ft.) - - CC'B:23847 I'l.M 0:26-208PB hlxture or Hem: Absorption valve Contractors representative signature: - - Back flow preventer Print name: -- -_- Date: Backwater valve -- - 1 Basinsflavato- Clothes washer Name: -- --- _-------- --- Dishwasher Address: Drinking fountain(s) -�- City: - --_- -�-- State:-- ZIP: Ejectors/sum Phone: Fax: E-mail: Expansion tank --- Fixtu sewer cap - - Name(print): Hoot drains/floor sinks/hub - — Mailing address: `-- -- -- Garbage disposal Hose bibb City: tate. ZIP: Ice maker 17ax E- Phone: mail: Interce or/ tra — —_ (honer installation/residentiol m6ritenance onlv: The actual installation Primers) will be trade by me or tfte maintenancx and ref air made by my rrgular Roof drain(commercial) employee on the propttty I own as per OhS Chapter 447. Sink(s),basin(s),lays(s) -- - - Ownet's signature: - _ Date: Sump YNINNIMM Tubs/shower/shower pan !Jnnal Name: _ Water closet Address: _ _ _ Water heater State: ZIi': Other. - -- --- -- email: --� Total -- Minimum fee................$ - Nd an}icidicdm tnat+l t�t+.'it urda,/iter'call rviid'itt3oo fel mate idue alas. Notice:Th:-permit application plan review(at -_ 96 $ , U%isa U MasterCard expires if a permit 4„ot obtained ) oteM card=t�. _— --_.._--_ State surcharge(8%)....S --- within 180 days offer h h><:been -- Name d eard*tda to alms=CM&card � aceeTted as complete. TOT.A L .......................$ E -- Canuotda� -- - _ Aaoral II0,1616(ti+00Kt71.t) MechanicW Permit Application n Date raxivnd: = �i Permit no.:n�/lap�p't-pC�1 City of Tigard Project/appl.no_: Expire date: MUM Circ of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Phone: (503) 639-4171 Date issued: y: F eipl no Fax: (503) 598-1960 Case Ii le no.: Payment t/pe: Land use approval: -- Building permit no.: "] 1 & 2 family dwelling or accessory U Commercial/industrial U Multi-family U Tcnant improvement l)New construction U Addition/alterauon/replacement U Othet: If SITE INFORMATION1 1SCIIEDULE Job address:( !"( w I Indicate cqMpment uantities in boxes below. Indic,ale the dollar BIdF. no. Surtc no. value of ell mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no.: profit.Value S _ Lo Block: �Su�,vision: 'See cl e:klist for important application information and Proiect name: jurisdict'.on's fee schedule for residential permit fee. City/county: -_ ZIP: -- ISCHEDULE Ucscription and location of work on premises: Est.date of omplction/insprA:tion: I>Icsrai Qt • Res.ouly Resod Tenant improvement or change or dse: C' Is existing space heater!or conditioned"U Yes U No Air conditi J unit _Cid) — rr wn iuonmg(sur p an requ�-- _ Is existing space insulated'Ll Yes �_]No Iteration of existing _A'system _ CONTRACTOR oiler/compressors '- State bailer permit no.: __ NP __Tons BTU/11 Four Seasons 1[tating A/C Service Inc Tir smo edampers/ uctsmokedetec•tors _ 110 Box 66409 eat pump(site plan required) Portland OR 97290-6409nsta Urcplacefurnace—�rner_� F 503-775.5919 Including ductwork/vent liner ❑Yes U No _ - CCB: 48283 nstalUrep ace/re ocateocaters-suspe- ndR, wall,or flair mounted _ Narnc(plea a print): ant ore Bance other t_Fian furnace Reffigeratim CONTACT PERSON. Absorpuonunits BTU/il Name: C7tillers HP Com ressors_r- Hl' bnmenUl exh>•ctsl rent too: City: -- State: ZIP: Applianceven! Phone: Fax: E-mail hyercx -r1i s,Type I/Illres iutcFenTh,umal hood fire suppression system Nance: Exhaust fan with single duct(bath fans) Mailing address: muss ss stem a an�re�m aeonR or�._C City: -- -_ State: 7_IP. Oe piping a distribution(up to outlets) Type: , 1110 NG Oil _ Phone: Fax. E-mail -uT i meiieh `-nover 4o-uTits �rocenpLAg (schematic requir d; Number of outlets Name: _ —•— --__-,_ tet app oreq-a rpme.-i— Address: DeLorativefireplsce City: -_ i State:� ZIP: nsert-type � Wood tov pe letctove Phone: Fax: Email - - cr: Applicant's signature: Date: — Name (print): - ----- —� NO" }iat.aMuan aeon,ae&i arM,pkabe call jiril&-60"Pr mere wamrum Permit fee ................ Notix This permit application Minimum feeee................$ Ll c O Masts :ant maexpires if a permit is not obUined r �t card"�' - - --LL- within ISO days after it has hoes Plan inview(at _-_ __ �� __ FxStair surcharge(846)....S amr of ur�n d ten,oe itrant _— = soCCpted as complete. _— TOTAL .......................f . Cwdbolda tlpnmm — !moaa 4 DA617 OMUDM) Electrical Permit Application Date received. it_— Permlit no.- i j A sa City of Tigard Project/appl.no.: Expire date: city ofngard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Dateissued: By: — Receipt no, Phone: (503) 639-1171 — -- Fax: (503) 598-1960 Case file no: Payment type. Land use approval: 1 rNew ily a.,^lhng or accessory U Commercial/industrial U Multi-family U Tenant improvement ruction U Addition/alter?tion/replacement U Other: _ U Partial 11 1 ' 1 Job address: "�-� 'V' Bldlet-Cg no.. :Suite no.: Tax map/tax lot/accouni no.: Block: Sub ivision` �- ----�-- Project name: Description and location of work on premise, _�— Estimatccl date of completinn/inspection: CONTRACIrOR APPLICATION, I 7 Job no: Fee Max lkscription cry. (ea.) Iota) no,fns i JEROME ELECTRIC rve�r.�dn.tdl :�+e«rr�w-rami,per — PO BOX 751 seriar,rla�a: HILLSBORO OR 97123 1000sq h or less X03-648-514^ Each additional 500 sq h or porion thereof _— — CCB: 36051 ELC: 34-119C SUP: 2877S Limited energy,residential _ _ 2 Umiredenergy,non residential 2 Fach manufactured home or modular dwelling — Signature of supervising electrician(required) Due Service and/or feeder__ SUP elect.name(print): License no. Services or feeders-installation, alteration or relocaiion: OWNERPROPERTY 200 amps or less 2 Name(print): 201 amps to 400 amps _ - 2- - -- — — 401 amps to 600 amps 2 — Mail;ng address: 601 amps to 1000 amps_ City: — _-State: ZIP. _ Over 1000 amps or volts -- -- 2 Phone: Fax: E-mail: Reconnect onlyi— Owner installation:The irstailation is being made on property I own Temporaryaerkillon feeder-il which is not imended for sale,lease,rent,or exchange according to 200arrips rlewsratlon,orrelocst/'""` ORS 447,4';5,479,670,701. 2W ampsnrkx -_--- — 2 201 amps to 400 amps 2 Owner's signature: _ Date: _ _ 401 to 600 a s -� - -- 2 Branch circuits-ne",alteration, Name: or externioa per panel: A. Fee for nranch circuits with purchase of Address: service or feeder fee,each branch circuit 2_ City: Siete: ZIP: B. Per for branch circuits without purchase --- of smice or feeder fee,first branch circuit: 2_ Phone: fax: E-mail- - -- Ijch additional hronch circuit 10LAN REIVIEW(Plearte 'check all that apply) Misc.(Service w feeder not included): U Service over 225 amps-comrrnrrial U Health-care facility Each pump or irrigation circle 2 U Service over 320 amps-rating rif 1&2 U Haurdous location Each signor outline lighting 2 family dwellings U Building over 10,100 square feel four a Signal circuir(s)or a limited energy panel, U System over 600 volts nominal mor*.residential units in one structure alteration,oresiension• 2 U Building over three stories U Feeders,400 amps or more •Description _ U()er-upanl load over 99 persons U Manufactured structures or RV park I FAr h additional Ins"Im over the allowable in any of tee above: U Egessnightingplan U Other -_—_— Per inspection Submit__sets of plans with any of the above. Finvesugationfee The above are not applicable to temporary construction serrice. I other ----T — Nd VI pMselru3ru aortia credit cards,please call jurisdiction fa irare information Notice:This permit application Permit fee.....................S ___-- O visa O MasterCard expires if a permit is not obtained Plan review(at _ %) $ __— Credit card number _... within 190 days after it has been State surcharge(8%)....$ Fspires accepted as complete. TOTAL S Name Iden u shown an credit ear, ; S Cardholder sisnaiure — Amount 4404615(6A7n TAO CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 R EG�y y J EED IMPORTANT PERMIT NOTICE AN ; , 2003 DAVID JEROME ELECTRIC CIT Y '.r �:'jAPD PO BOX 751 HILLSBORO, OR 97123 Electrical Signature Form Permit #: MST2002-00050 Date Issued: 4/11/03 Parcel: 2S105DA-QHS06 Site Address: 13300 SW KINGSTON PL Subdivision: QUAIL HOLLOW - SOUTH Block: Lot: 006 .lurisdiction: TIG Zoning: R-4.5 Remarks. SF rowhouse, unit 6, Bldg 5, CS plan with deck. STRUCTURAL FILL, REQUIRES GEO-TECH INSPECTION AND REPORT. 4/10/03, adding a/c & gas fireplace. Your company has been indicated as the r lectrical 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, A17N: Building Division. No electrical inspections will be authorized until this completed form is received OWNER: E=LECTRICAL CONTRACTOR. BROWNSTONE QUAIL HOLLOW LLC DAVID JEROME ELECTRIC 12670 SW 69TH PKWY STE 200 PO BOX 751 PORTLAND, OR 97223 HILLSBORO, OR 97123 Phone #: 503-598-7565 Phone #. 648-5144 Req #: I I( 30051 SUP 2x77~ FLL: .34-114)( AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Sup rvisin lectrician If you have any questions, please call 503.718.2433. CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 9722:1 IMPORTANT PERMIT NOTICE WOLCOTT PLUMBING CONTRACTORS PO BOX 2007 GRESHAM, OR 97030 Plumbing Signature Form Permit #: MST2002-00050 Date Issued: 4/11/03 Parcel: 2S105DA-QH1006 Site Address: 13300 SW KINGSTON PL Subdivision: QUAIL HOLLOW - SOUTH Block: Lot: 006 Jurisdiction: TIG Zoning: R-4.5 Remarks- SF rowhouse, unit 6, Bldg 5, CS plan with deck. STRUCTURAL FILL, REQUIRES GEO-TECH INSPECTION AND REPORT 4/10/03, adding a/c & gas fireplace. Your company has been indicated as the plumbing contractor for the permit indicated above. lin order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature r,urm prior to the start of the work to the adiress above, ATTN: Building Division. 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 STE 200 PO BOX 2007 PORTLAND, OR p7223 GRESHA^JI, OR 97030 Phone #: 503-598-7565 Phone #: 667-1781 Reg #: LIC 23847 PLM 26-208PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X —� Signatures Autl' zed Plumber If you have any questions, please call 503.718.2433. ELECTRICAL - CITY OF TIGARD RE.STRICTEDEN RIGY DEVELOPMENT SERVICES � PERMIT#: ELR2003-00242 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/6/03 SITE ADDRESS: 13300 SW KINGSTON PL PARCEL: 2S105DA-0HS06 SUBDIVISION: QI IAIL. HOLLOW - SOUTH ZONING: R-4.5 BLOCK: LOT: 006 JURISDICTION: TIG Proiect Description: Installation of limited energy for audio/stereo wiring. 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: HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: r_ TOTAL#OF SYSTEMS: Ower: Contractor: BROWNSTONE QUAIL HOLLOW LLC AZIMUTH COMMUNICATIONS INC 12670 SW 68TH PKWY ST E 200 P.O. BOX 508 PORTLAND, OR 97223 WILSONVILLE, OR 97070 Phone: 503-5?9-7565 Phone: 503-639-o I I U Reg #: ELE 36-94CLE SUP 2312LEA LIC 145929 FEES s Required Inspections Description Date_ Amount Low Voltage Inspection (ELPRM"I I I I.It 1'crmit 8/6/03 $75.00 Elect'I Final (TAXA k Staic'la\ 8/6/03 $6.00 Total $81.00 This Permit is issued subject to the regulations contained in the T igard Municipal Code, State of OR. Specialty Codes and all other aphlicaJe 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 R!otifica„on Center. Those rules are set forth in OAR 952-001-0010 throuc IssuQd Permittee Signature EY 'c OWNER INSTALLATION ONLY _Y The installation is being made on property I own which Is not intended for saie, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY :31GNATURE OF SUPR. ELEC'N DATE: _ICENSF NO: Call 639-4175 by 7:00 P.M. for an inspection needed the next business day Electrical Permit Application \ [)are received; (r �4> Permit no.:: 0�1 �,� 01 City of Tigard Project/appl.no.: -- Expire daft -- t_'irl of lig a rd Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Rect:ip,no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case file no.: _ Payment type: Land use approval: TYPE OF PERMIT U I &2 family dwelling or ac;essory Q Commercial/industrial Q Multi-family U Tenant improvement XNew construction J Addition/alteration/replacement J Other: - -_ - J Partial JOB S11E 1 Job address: ©U S l t S'7(J��' L Bldg. no.: Suite no.: Tax map/tax lot,'a.count no,: Lot: Block: Subdivision: A j A(LtH — Proj cl 4TI and location of work on premises: GQ'i1CL��f prv_ _ Estimated date of complrl n m/inspection: Cf)NTRACTOIkAPPLICATION1 Job not Feu Max _ Description Qty. (ea.) Total no.ins Business name: AZ etu-tivi,(C r I,L) Nonresidential-singleor multi-famliyper Address: l f: drsellingutdl.Includesattaclredgarage. City: lt_LE ff�' State ZIP: (� ) Serviaincludcd: rJ63(2 U(1 U IP7�� � 1000 sq ft of less 4 Phone: Fax: i t S F.-mall' Each additional 500s ft,or portion thereof CCB no.: 14 5,F2&- Elec.bus, tic.no: � Cj`E C Limited energy,residential 2 City/metra ic.no.: 00 S l Limited energy,non-residential 2 2 Each manufactured home or modular dwelling _ --- Signature o(su ervisin electr (re uired) ante _ Service and/or feeder License no Services rfeeders-Installation, Sup.elect.name(print) u 1 ahem m ur relocation: to 200 at. t or less 2 Name(print): x,,� Z)�,I C 2ot ant s to 400 amps 401 am s to 600 amps ' - Mailing address: 601 amps to I(100 amps 2 City; Slate: I ZIP: Over 1000 amps or volts 2 Phone: Fax: Email: Reconnect onlyl Owner installation.The installation is being made on property I own Tempor>aryservicesorfeeders- which is not intended for sale,lease,rent,or exchange according to installation,alteration,or relocation: 200 amps or less _ 2 ORS 447,455,479,670, 701. 201 amps to 400 amps Otuner's signature: Date: 401 to 600 amps -m lil M I Branch circulls-ner+..�ltcralion, or extension per pane[• Name: A Fee fx btanch circuli with purchase of Address: service or feeder fee,each branch circuit 2 City: 7.1 P: - B Fee for branch cuouts without purchase __ ---- - of service or feeder fc:.first branch circuit. 2 f'llonC: i':tx: L-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 circle '- U Service over 32U amps-rating of 1&2 U Hazardous location Each sign or outline lighting 2 family dwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel. •System over 6011 volts nominal mc,e residential units in one structure alteration,or extension* 2 U Building over three stories J Feeders,400 amps or more *Description _ U Occupant load.,ver 99 persons J Manufactured structures or RV park Each addltinnel inspection over the allowable In any of the above: U Egress/lightingplan U Other -- Perins ection r— Submit_—sets of plans with any of the above. Investigation fee — The above are not applicable to temporary construction service. Other Permit fee ..............„....$ Not all)uriWictions accept -elu cards,please call Jurisdiction for more information Notice. Phis permit application plan review(al _ _ %) $ U Visa U MasierCtud expires if a permit is not obtained -- Credit card number - _� within 180 days after it has been Slate surcharge(8%) ....$ u rhawn nn credit x, °' accepted as complete. 'TOTAL ....................... - ane of cu alder - Ex, s Cardholder sl,me1ure Amount 440-461%(60WOM r A y � J a � y a p y Q '1 y b � � o f y A n; i CITY OFTIGARD 24-Hour inspection Line: 503 6 75 BUILDING P ( ) MST INSPECTION DIVISION Business Line: (503) 7'I BUP Received _ ----_-- Date Requested_��U-- -1�M - - — pM - - - BUP Location __/ � �Is" n -- -- Shite MEC — Contact Person . �c�.n ✓5 -�-�v Ph(�"� >) ":Z y - --.y 7 ' PL.M Ph( -) --- ---- SW Contractor_ — - - - -- r Tenant/Owner _ ELG - o g -- ELC - Foundation Access:I ELR Ftg Drain _�_-^^ Crawl Drain SIT Slab Inspection Notes: Post&Beam Shear Anchors 1 Ext Sheath/Shear Int Sheath/Shear Framing _ Insulation _ Drywall Nailing Firewall — Fire Sprinkler Fire Alarm Susp'd Ceiling —"- — Roof rn PKISS11 PART FAIL BINGi -- Post&Beam Under Slab -- - ,-- - - Rough-In _ Watei Service -- f Sanitary Sewer _ Rain Drains -- — --- --- Catcl• Basin/Manhole -- Storrs Drain Shower Pan - — Other: Final PASS PART FAIL MECHANICAL Post&Beam— Rough-In - Gas Line Smoke Dampers Final PARS PART FAIL ELECTRICAL - Service — Rough-In —�_ - - - ------ -- - - _ - UG/Slab Low Voltage - -- --- -- - ---- Fire Alarm Final Reinspection fee of$ __J required before next inspection. Pay at Clty Hell, 13125 SW Hall Blvd. PASS PART FAIL SITE E] Please call for reinspection RE _ Unable to inspect-no access Fire Supply Line V //�" ADA Oate_ ,1 - Inspector _\/C.!` Approach/Sidewalk Other:. Final DO NOT REMOVE this Inspection ref-ord from the job site. PASS PART FAIL CITY OF TIGtARD 24-Hour BUILDING Inspection Line: (503)639-4175 ST 0 INSPECTION DIVISION Business Line: (503)639-4171 BUP --__ � received __— Date Req ested— _-.1 13 BUP L.,cation — a �✓' _� yL PL _—Suite MEC Contact Pers t ILD rl_—���'5 __� Ph(_�Q� ?,_- PLM Contractor __D1GIC>~_r Ph(---) SWR _ _ DI W Tenant/Owner _ —_ _ ELC oting undat' Access: ELC q Dra' .ter' -�y" T i�" ELF! --- yawl ain -- ab Inspection Notes: SIT st earn ea .chors; 1 eath.10-hear I t oath/Shear a ing -_-- atiun all Nailing ------ ----- F wall Sprinkler -- - ---- -- -- - -- .. ---- - - --------_.._.._.._- Alarm u 'd Ceiling — ---- --- -- --...._.-- --- ----_ ---- -- - - 0 th -- --- - -- - - - ---- - T.. - ----- ---- ---- - (Final PASS PART FAIL - K_UMBiN --- -- - - -- --- -- Post Under Slab Rough-In bvaiel Service - - -- -- ---_.----- ---------- Sanitary Sewer Rain Drains -- - -_ — - Catch Basin/Manhole Stora- Drain --- --- - -- -- -- Shower Pan it )PART FAIL -- --- R-WbRMNICAL Post& Beam Rough-In --- - --- -- ----- -- --- Gas Line Smoke Dampers — Final PASS PART FAIL - ELECTRICAL ---------- Service Rough-In UG/Slab -----------._..___-- ---- - ---- ------ — Low Voltage Fire Alarm Final �] Reinspection fee of$________�____ required before rent inspection. Pay at City[fall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE:.___- L� Unable to inspect-no access Fire Supply 1_ine ADA Approach/Sidewalk Date Inspector / - -- Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP — Received _----Date Requested—/D —� AM— PM. —_ BUP — Location —_.—.-_�. 8 - -1---' — Suite_- _ MEC — S7 _ Contact Person ___—__. — --- Ph(---) PLM f;ontractor_ _._-_._ - --------_ _ Ph{_——) —_ SWR _—_---- BUILDING Tenant/Owner ELC Footing ELC Foundation Access: ELR — Ftg Drain ---- Crawl Drain SIT _ Slab Inspection NoteF Post&beam ---- -- - -- ---- — - ----- _ Shear Anchors Ext Sheath/Shear L ---`— Int Sheath/Shear Framing Insulation Drywall Nailing --� --- -- -- -------------- Firewall Fire Sprinkler ----- ------- -----------_--- - Fire Alarm Susp'd Ceiling --- Roof - Other:----- - - - Final PASS PART FAIL _ -- PLUMBI_m— N_G __ -- — POS-&Bea —� _ Under Slab - -- - Rough-In Water Service Sanitary Sewer - -- ----�- -----�_�_ Rain Drains —_- Catch Basin/Manhole Storm Drain --- - __ - - Shower Pan Other: - -- Final - PASS PART FAIL - ME_CHANICAL Post& Beam Rough-In — Gas Line S Dampers _-_- ----------_---___------ (TIASS PART FAIL E_ RICAL - - -- -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 Unable to inspect-- no access _ SITE - Please call for reinspection RE: Fire Supply Line - -A ADADute Inspector � ` _ Ext Appioach/Sidewalk -- i Other: - - Final DO hOT REMOVE this inspection record from the Job site. PASS PART FAIL