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13330 SW KINGSTON PLACE w V.1 ro i t 0 0. 13330 SW Kingswn Place CITY OF TIGARD 24-Hour BUILDING Inspection Line: (50::) 639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BUP Received _—.--[)ate Reeq�uest'ed. BUP Location --. L ��_-1�� _�---.. Suite---- - -- MEC Contact Person _ PhPLM — Contractor --_._.._— _ -- Ph l ---) ------ SWR BUILDING f Tenant/Owner ELC _ ELC Foundation Access: Fig Drain ELR Crawl Drain ---- '- — Slab Inspection (votes: SIT Post& Beam - Shear Anchors Ext Sheath/Shear --" -- - Int Sheath/Shear Fremi!lg ----- - --- - Insulation Drywall Nailing - - --- -_- - Firewall Fire Sprinkler - --- Fire Alam Susp'd Ceiling — Roof - Other. ----- Final - PASS PART--FAIL— PLUMBING ART FAIL PLUMBING -- Post 8 Boam _ Under Slab -- Rough-In Water Service - -- --Sanitary Sewer Sewer _--- Rain Drains - -- Catch Basin Manhole Storm Drain ---------_.--------- Shower Pan 'her: ,nal PASS_PART FAIL _MECHANICAL --- Post&Beam Hough-In --- Gas Line - Smoke Campers Final PASS PART FAIL - -- — - -- - _ E_LE_C_TRICAL -_____. - -- - Service `- -- ^--- --- Rough-In -- — UP'Sta_b `1 pl�� , ry n Low Voltap - Fire AT�rm' U Reinspection fee of$---- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SITE C� Please call tor /inspecti RE:�_ - �� Unable to inspect--no u.;:ess Fire Supply Line ADA Date Inspector —�/ Ext _. Approach/Sidewalk - Other Final -� DO NOT REMOVE this Inspection rocord from the Job site. PASS PART FAIL CITY OF TICARC 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 — 7 BLIP Received Date '-requested �[ AM__________ PM- BUP i_ucaiiun 13 „�3 C-- ----Suite ---- MEC _ Contact Person — �' Ph( ) _ _- PLM Contractor._ - __- _ - _ Ph(- ) _-- _ SWR BUILDING Tenant/Owner ELC Footing ------- --- – Foundation Access: ELC - -------_-� .__ Fig Drain ELH Crawl Drain Slab Inspection Notes: :,IT -- Post& Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear __-- Framing Insulation Drywall Nailing --- --- Firewall T Fire Sprinkler _ ---- - - -- --------- - Fire Alarm Susp'd Ceiling _ _---- -- - Roof Other: ----- - - -- �— --- Final _PASS PART _FAIL PLUMBING Post& Beam Under Slab Water Service -- --- -- --- - —.-- —_ --- ---- - ----- Sanitary Sewer Rain Drair s _-_-- Catch B,sin/Manhole Storm Drain Shower Pan Other: -- ,f AS PART_ FAIL M -C_HANICAL --___- Pc-it& Beam --- Hough-In Ga,Line Smoke Dampers --- - - - - _._.— - -- ---- - _— ---------- Final PASS PART FAIL --- -ELECTRICAL Service Rough-In UG/Slab -- ______------ _ ---__--------- -------- ----- Low Voltage Fire Alarm ___—_-- Final I 1 Reinspection fee of$--__ required bbiore next inspection Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE — �� please call for reinspection RE:----- _-- j- Unable to inspect --no access Fire Supply Line r ADA Inspector Date Ins Approach/Sidewalk Da - P - - - - - - - -- Ext -- Other. _ _ Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY 4F TIGAeRC 24-Hour BUILDING Inspection Line: (503) 639-4175 PAST 2 - INSPECTION DIVISION Business Line: (503)639-4171 BUP - Received ---- Date Requested ! —- AM -• PM --- _ BUP _ Location —__— �J,3 - = — L' - -- Suite MEC _ Contact Person Ph( ) �� - _-=- PLM Contractor ..----- — - - — Ph( ) . — SWR --- - - __ BUILDING Tenar.t/Owner ELC Foo --- __tin�gg_ I � ELC _-�---- Foundation Access: ELR —_ Fig Drain Crawl Drain -- SIT Slab Inspection Notes: Post&Beam -- - ---- Sheal ., 'cors Ext S -1- Shear Int Shi 1' ,hear _ Framing ---- Insulation � Drywall Nailing Firewall y ---- Fire Sprinkler Fire Alarm — Susp'd Ceiling 4 Rout - - Oiher. .-_� - Fln SS PART FAIL -,C1_�- - tIMBING — - Post&Beam _ ender Slab .--------- Rough-In Water Service - Ranitary Sewer - FiFin Drains --- - - Catch 3asin/Manhole Storm Drai i - -- Shower Pan - ----- —_ - Other: Final PASS PART rpi' MLCHA_NICAL Post& Beam - - - Rough-In - --- Gas Line Smoke Dampers - - - ASS ) PART' FAIL - RICAL_ Service Rough-In UG/Slab Low Voltage - Fire Alarm Final Reinspertion fee of$__ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE F Please call for reinspection RE__---_ _____ __.T_—___ � Unable to inspect-no access SITE - Fire Supply Line _7 C Ins ADA Date -_ - -5 � -- P eetor --- _----_ — - Approach/Sldewalk Other:_-- -- Final DO NOT REMOVE this Inspection record from the fob site, PASS PART FAIL i ► j ! Poo d k ► I " U ► ! CL- �- ► ► Z r Q O ► �. � IG.. pool4f 70 ► �r; ° ► Poo- `. ! 1 a 4 ! ..,� — ► Cbr s rl ► ! ► 44 '4 �` ► ! , I i ► aL__ -- -- - - _ ► N � IL � n O v, C `O 4 � O o o � 0 0 0 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE WOLCOTT PLUMBING CONTRACTORS PO BOX 2007 GREUSHAM, OR 97030 Plumbing Signature Form Permit #: MST2002-00053 Date Issued: 1/13/03 Parcel: 2S104DA-18300 Site Address: 13330 SW KINGSTON PL Subdivision: QUAIL HOLLOW - SOUTH Block: Lot. 009 Jurisdiction: TIG Zoning: R-4.5 Remarks: SF rowhouse,Unit 9, Bldg 4, 5S plan with a deck. STRUCTURAL FILL, REQUIRES GEO-TECH INSPECTION AND REPORT 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 received OWNER: PLUMBING CONTRACTOR: BROWNSTONE QUAIL HOLLOW LLC WOLCOTT PLUMBING CONTRACTOR; 12670 SW 68'rH PKWY STE 200 PO BOX 2007 PORTLAND, OR 97223 GRESHAM, OR 97030 Phone # 503-598-7565 Phone #: 667-1781 Reg #: LIC 21847 PLM 26-208PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X Signature utho zed Plumber If you have any questions, please call (503) 639-41'1, ext. # 310 CITY OF TIGARD 1312S S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE_ DAVID JEROME ELECTRIC PO BOX 751 HILLSBORO, OR 97123 Electrical Signature Form Permit#: MST2002-00053 Date I9sued: 1/13/03 Parcel: 2S104DA-19300 Site Address: 13330 SW KINGSTON PL Subdivision: QUAIL HOLLOW - SOUTH Block: Lot: 009 Jurisdiction- TIG 7,jning: R-4.5 Remarks SF rowhousm,Unit 9, Bldg 4, BS plan with a deck. STRUCTURAL FILL, REQUIRES GEO-TECH INSPECTION AND REPORT Your company has been indicH[T-d as the electrical contractor for the permit indicated above. In order for the electrical pPrmit to be valid, the signature of the cupeivisinq electrician is required. Plemt% have the appropriate individual fmm your company sign below and rnturn this Electrical Signature Form prior to the start of the work to the address above,ATM Building Division. No electrical inspectlonfi will be authorized until this completed form is received OWNER: ELFCTRICAL CONTRACTOR BROWNSTONE QUAIL HOLLOW LLC DAVID JEROME ELECTRIC 12670 SW 68TH PKWY STE 200 PO ROX 751 PORTLAND, OR 97223 HILLSBORO, OR 97123 Phone#: 503.698-7566 hone#: 548-5144 Re # LIC 360SI SUP 2977~ ELF .44-1.19(. AN INK SIGNATURE IS REOUIRED ON THIS FORM a signature--of Supe n ncfan If you have any questions, piPase cell 503 718.2433. coal j JAM 9Q'TS aNV9I1L An AID T99M0009 TVA t9:21 JH.L COi07,/e0 �\ CITY OF TI GAS R D ELECTRICAL - RESTRICTED ENER ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2.003-00098 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639-4171 DATE ISSUED: 3/31/03 SITE ADDRESS: 13330 SW KINGSTON PL PARCEL: 2S104DA-18300 SUBDIVISION: OUAIL HOLLOW - SOUTH ZONING: R-4 5 BLOCK: LOT 009 JURISDICTION: TIG Proiect Descrintion: All encompassing low voltage. A.RESIDENTIAL B.COMMERCIAL AUDIO & STEREO: _ AUDIO & STEREO: INTERCOM & PAGING,: BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE: OTHER: ALL ENCOMP . x HVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTI-IFR: TOTAL# OF SYSTEMS: Owner: Contractor: BROWNSTONE QUAIL HOLLOW LLC AZIMUTH COMMUNICATIONS INC 1267U SW 68TH PKWY STE 200 P.O. BOX 508 PORTLAND, OR 97223 WILSONVILLE, OR 97070 Phone: 503-598-7565 Phone: ,03-631-0110 Reg #: ! LF. 36 94CLE Still 2312LEA l.i(' 145828 _ FEES �! i<equired Inspections _ Description Date _ Amount Low Voltage Inspection 1I1LPRIVIT] I LR Pcrmil 3/31/03 $75.00 Elect'I Final ('l A X 1 W4,State Tax 3/31/03 $6.00 Total $81.00 --- L This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 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. T!iose rules are set forth in OAR 952-001-0010 throuc r\ Issue ny f�_... �((( Permittee Sigmiture OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIG14ATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC;'N DATE: LICENSE NO: Call 639-4175 by 7:00 P.M. for an inspection needed the next business day Electrical Permit Application - Date received /si/ L Permit no.: City of Tigard Projectlappl.no.: Expire date: Address: 13125 SW Hall Blvd,Tigard,OR 97221 Date issued: By: Receipt no.: Phone: (503) 639-4171 — - Pax: (503) 598.1960 Case file no.: Payment type: Land use approval: i TYPE OF PERMIT U 1 &2 family dwelling or accessory U Commercial/industrial J Multi-family U Tenant improvement New construction J Ad(Inion/alteration/rcplacenu�nt J Other: _ L)Partial JOB SITE INFORMATION Job address: dik),S�p,), l r.%. V LN 131dg. no,:A Suite no.: Tal:map/tax lot/accoum no.: Lot: C7 113lock: Subdivision: oUf�l L- S0 Ll'[H Project name: (.'&L(�( L C et L-t-p Description and location of work on prem;ses: F,stimated date of contpicticm/inspection. APPLICATION1 Job no: _ _ I ee Ma% Business name: t2n� i ( Qly. (ea.) Tolal no.insp rrsidential single or multi fandly per Address: / dwellingunit.Inc ludesallaclserlgaragr' City: L ; LL State: , ZIP: c Cl SrrvlceIncluded: Phone: e11 Fax: ,'�.'c E-mail: 1000 s ft.or less 4 CCB no.: Elec.bus. lie.no: (' Each additional 500 sq.ft.or portion thereof Limited energy,residential City/metro lic.no.: j 4 5 q Limitedenergy,non-residential ? Each manufactured home or modular dwelling Signa re of su rvisin elect[ (required, Date Sul, t name - f [, Licenacao: ' L :_ Services or feeders-Installation, alteration or relocation: OWNERa 200 amps or less Name(print): _711112ALS` l 201 amps to 400 amps Mailing address: 401 amps to600AMPS 2 601 amps to 1000 amps 2 City: State: LIP: Over 1000 amps(it volis _ 2 Phone: Fax: E-mail: Reconnectonly l Owner install-ttion:The installation is being made on property I ops n Temporary sers Ices or feeder.- which is not intended for sale,lease,rent,or exchange according to Installation,allerallon,orrelocation: ORS 447,455,479,670,701, 200 amp.ur less _� _ 2 201 amps to 400 amps 2 Owner's si mature: _ _ Date 401 to 600 ams -- f--- —7 — Branch circult5-tric",alteration, Name: or extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder .c,each branch circuit 2 (qty. _ -__.-�-._ State_..___- Ills B. Fee for branch circu'ts without purchase -- - - -- -- Phone: of service or feeder fee,first branch circuit: 2 I ax: F,-[nail: Each additional branch circuit MISC.(Service or feeder not Included): O Service over 225 amps-commercial U HeaUh care facility Each um o:irrigation circle _- 2 U Service ov:r 920 amps rating of 1&2 'J Hazardous location Each sign or outline lighting 2 S milydwellings ❑Building over 10,000 squ;uc Icer(our''r Signal circuit(%)or a limned energy panel. U System over 600 volts nnminai more residential units In one structure alteration,or extension' ? U Building over three stones to Feeders,400 amps or more *Description. U Occupant loan over 99 persons U Manufactured structures or RV park FAch additional Inspection over the allowable In any of file above: U Egress/lightingplan U Other _- Perinspecuon -�� Submit-__ vets of plant with any of the 01)(11 P. Investigation fee '11he above are not applicable to temporal-%construction service. Other Not all junsdreuom accept nrdn card,,rlease call jurisdiction Im more information Notice:This permit application Permit fee.....................$ U Vt,a U MasterCard expires il'n permit is not obtained Plan review(at — %) $ _ — Cre1ir:aid number I / within 180 days after it has been State surcharge(8%) ....$ — Expfrcs accepted as complete. TOTAL ..........$ Name of card,.o r u shown on credit card S Cardholder elpinute Amount 444.615(NWCOMI April 29, 2003 CI7Y OF TIGMD OREGON Ron Estey 2670 SW 68"' Parkway, Suite 200 Tigard, OR 97223 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 #4, 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 thai area to cl ck for adequate bearing for this load at lots 7, 9, 59, 60, 61, 62, and 63. Or, you might contact your engineer to address the footing pad issue. Lot 24 was approved and lots 2, 3, 4, and 5 have not 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 insL'.e 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 bee- flagged "no further insptr.tions" until the testing or design is complete for bearing pads and/or shear walls. If you have questions, please call me at 503-718-2.440. Sincerely, 1 Darrel "Nap" WatHns Inspection Supervisor 1312.5.3W Hall Blvd., Tigard, OR 97223(503)639-4171 TDD(503)684-2772 -------- ---- - C YYO F 1 G/ �® MASTER PERMIT PERMIT#: MST2002-00053 DEVELOPMENT SER-,, XES DATE ISSUED: 1/13/03 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 63914171 SITE ADDRESS: 13330 SW KINGSTON I'I. PARCEL: 2S104DA-18300 SUBDIVISION: QUAIL HOLLOW - SOUTH ZONING: R-4.1, BLOCK: LOT: 009 JURISDICTION: I IG REMARKS: SF rowhouse,Unit 9. Bldg 4, BS(Option 3) plan with a deck. STRUCTURAL FILL, REQUIRES GEO-TECH INSPECTION AND REPORT- Revised to convert 304 sq ft of garage to living space. BUILDING REISSUE. STORIES: FLOOR AREAS REQUIRED SETEA:KS REQUIRFD CLASS OF WORK: NEW HEIGHT: FIRST: 17, sf BASEMI NT sf LEFT: SMOKE DETECTORS: TYPE OF USE: SFA FLOOR LO..v: SECOND: 735 sf GARA3E: 547 at FR)N1 PARKING SPACES TYPE OF CONST: 5N DWELLING UNI7S: 1 THIRD 735 of RIGHT. OCCUPANCY GRP: R3 BDRM: 3VALUE: 162,566.20 ATH� _ TOTAL: 1,642 of REAR PLUMBING _— SINKS: 1 WATER CLOSETS WASHING MACH: I LAUNDRY TRAYS. RAIN CRAIN: TRAPS: LAVATORIES. a CISHWASHERS. 1 FLOOR DRAINS, SEWER I INES SF RAIN DRAINS: CATCH BASINS: TUBISHOWERS. GARBAGE DISP: WATER HEATERS: 1 WATER LIN[S: BCKFLW PREVNrR: GREASE 'RAPS: OTHER:IXTURES MECHANICAL FUEL TYPES FURN a 100K: BOIL/CMP<3HP. VENT FANS: 3 CLOTHES DRYER: 1 GAS FURN>•100K: UNIT HEATERS: HOODS: OTHER UNITS MAX INP. btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES. GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS ORANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 •200 amp: 1 0 -200 amp: WISVC OR FDR: PUMPIIRRIGATIOW PER INSPECTION: EA ADD'L 500SF. 1 201 400 amp: 201 - 400 amp: tat W10 SVCIFDR: SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY 401 •$00 amp: 401 - 600 amp: EAADDL OR CIR: SIGNAUPANEL: IN PLANT: MANU HMISVCIFDR: 1101 - 1000 amp: 601+amps-1000v: MINOR LABEL. 1000+aMPIVolt PLAN REVIEW SECTION :onned only: -4 RES UNITS: SVCIFDR>=226 A.: >600 V NOMINAL: CLS AREIVSPC OCC _ ELECTRICAL•RESTRICTED ENERGY A.SF_RF-SIDENTIALB.COMMERCIAL AUDI(�6 STEIEO: VACUUM SYSTEM. r AUDIO 8 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT HURGL 1R ALARM: OTH: BOILER, HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPFNER: CLOCK. INSTRUMENTATION: MEDICAL: OTHR: HVAC DATAITELE COMM, NURSE CALLS: TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 5,879.99 BROWNSTONE QUAIL HOLLOW LLC BROWNSTONE HOMES,LI.0 This permit is subject to the regulations contained in the 12670 SW 68TH PKWY STE 200 12610 SW 68TH PKWY Tigard r applicable Codea law,State o OR. Specially(;rxfes and PORTLAND,OR 97223 PORTLAND,OR 97223 all other applicable laws. All work will be done accordance wfth approved plans. This permit will expire:.f work Is not started within 180 days of Issuance,or If the work is suspended for more than 180 days. ATTENTIO V: Oregon law requires you to follow 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. `!cu Rep k: I iC' 124627 may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. .iEQUIRED INSPECTIONS Plumb Top Out Foundatlon Insp Plm/undslb Insp Mechanical Insp Framing Insp Fireplace Insp Sewer In^pectlon Slab Insp Electrical Service Mechanical Insp Framing Insp Gas Line Insp Sewer Inspection Slab Insp Electrical Rough-In Mechanical Insp Framing Insp Insulation Insp Footing Insp Slab Insp Mechanical Insp Plumbing Top Out Framing Insp Insulation Insp Footing Insp Slab Insp Mechanical Insp Plumbing Top Out Framing Insp Insulation Insp Issued B . _f�._.1 �L.1 Permittee Signature [)( � Call (503) 639-4175 by 7:00 p.rn. for an inspection needed the next business day CITYOF TIGARD CEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2002-00032 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/13/03 SITE ADDRESS; 13330 SW KINGSTON PL PARCEL: 2S104DA-18300 SUBDIVISION: QUAIL HOL.I.()\k - tiOIJTH ZONING: It-4.5 61-OCK: LOT: 009 _ JURISDICTION: IIc; _ TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SFA NO. OF 9UIL DINGS: INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Sewer connection for new SF rowhouse. Owner: _-- FEES BROWNSTONE QUAIL HOLLOW LL.0 -- — — 12670 SW 68TH PKWY STE 200 Description Date Amount PORTLAND, OR 972.23 [SWUSA]Swr Connect 1/10/03 $0.00 [SWUSA]Swr Connect 1/10/03 $2,300.00 Phone: 503-598-7565 [SWINSP]Swr Inspect 1/10/03 $0.00 Contractor: [SWINSPI Swr Inspect 1/10/03 $35.00 — _ --- —v 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" Perm Issuecby: 7 K kr 141 Permittee Signature: �t Call (503) 639•4175 by 7:00 P.M. for an inspection. needed the next business day U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition U Addition/alteratiun/replacen:ent U'I'enant improvement U Fire spnnklertalarm U Other: _- -- — JOB SITE INFORIVIXTION I — _��;,� Ce Bldg. no.: Suite no.: Job address: C a-% 7` � ` YT) -4 l,oc Blcxk_- Subdivision: r!/� i 'C�r'h -tc'<<'�� l t�tap/tax lot/accoun no.: " , - - -- Project name: Description and location of work on pre mises/special conditions: f - oil Name: Mailing address: I &2 family dwelling: Statc:(It)R "LIP: Valuation of work................................ - - -- ('ifv• C�� Phone. -- -�5 Fax: o E mail: No.of bedrooms/baths................................. —__-- a 'Total number of Boors................................. --- Owner's representative: -- E; mail: New dwelling area(sq. ft.) .......................... Phone: Fax: - Garage/carport arca(sq. ft.)......................... Covered porch arca(sq. ft.) ......................... Name: a f CLW_In :��t`� l -1-sai"tir_ Deck area(sq.ft.) ...... Mailing address: .SL's_ �' `'' Other swat+re arca(s . ............. ......•...... .ft . -- City: c- -- Stater zIP. 4 -- - Fax: E-mail: (;ommcrclaUlndustrial/mulfi-fandly: 1'holl1 Valuation of work $ 1 Existing hidg.arca(sq. ft.) .......................... _-- Business name.-��cam! v. _ -�? _ New bldg.area(sq.ft.)................................ _ Addrrss: {� g __ { Number stories........................................ .�— d r .— 4 Shwa City' 71 T•ype o(co1 .wetion.................................... --- PhFax:b mail --- occupancy groul)(s): Existing: CCB no.: .�i<t ----- blew: City/metro lic.no: Notice:All contractors and subcontractors arc required to be licensed with the Oregon Construction Contractors Board under �� LD - -_- _-_..- provisions of ORS 701 and may be required to be licensed in the Name: urisdiction where work is being performed. If U.e applicant is Address: (�- f _ V C..tate exempt from licensing,the following reason applies: City•��t t_ Stale z1P: --- v _ Contact derson: v, Plan no.:Phone: x: F mail: Contact person Al Fees due upon application ........................... $ - Dale received: -- Address: 9- ` It! c V cc ^—_J Amount received ....................................... -J City r - c� tart: T_IP: 3 ..Please refer to fee scWul!. Phone: Q Fax: E-mail: Nd VI juriseicUau�ccerN atdll catdt,pleau call juriidictlan fcx nxxe Infatuation hereby certify I have read and examined this application and the ❑viae ❑P4uterCud attached checklist. 411 provisions of lbws and ordinances governing this U it cud somber_ — -- work will be c��mplicd whether ed herein or not. v res Authorized sit rta,,urr.: --_—--- N.me ar wdralder u rbo+m oa Il ere--— S \� —Crdholder�Ipulwe Amount Print name: '. Y Notice:711js permit application expires if a permit is not obtained within ISO days atter it hes been accepted m completc. 4144613(yGNC'OM) O New construction 0 Addition/alteration/replacement ❑Food service 0 Other: JOB SITE tNFAORNIATION ' Information use checklist) Job _, Description Qt . IFeclea. Tota address: l 3.1 C S_W Ic �e�__-P a<<_ New I-and 2-1,rmily dwellings only: Bldg.no.: _ - Surte no.: � — ( udes1000.for each utilityasonectioo) R Tax map/tax lot/account no.: _ _ SF (1)bath -Loc-7 j — i3-lock ---I Subdivision: SFR(2)bath — Project name: _ --`— SFR(3)bath City/county: ZIP: -- Each additional bat}t/kitchen Description and location of work on premises: SiteutWtles: Catch basirdarea drain Est,date of completion/inspection: prywells/leach line/trench dein — —_ Footing drain(no. lin.ft.) Manufactured home utilities o...s_ . Manholes — Wolcott Plumbing Rain drain connector PO Box 2007 Sanitary sewer(no. lin.ft)-- Gresham OR 97030-0594 Storm sewer(no.lin. ft.) _- 503-667-1781 Water service(no lin.ft.) CC[3-23847 PIAL#:26-208PB Fixture or New: Absorixion valve Contractors represent:.ive signature: Rack flow Preventer _ --` Print nanre: pate: Backwater valve r Basins/lavatory ('lott>cs washer Name: „_ ----- _ Dishwasher Address: prinking fountains) City: _— — State: FEE- F,jectors/sump -- Phone Fax: E-mail: Expansiontank Fixturr/sewer cap NFloor drains/floor sinks huh Name(print): `_ -- Garttage disposal - — — Mailing address: -- —__ _ — Hose bibb — city: ��State: ZIP: Phone: Fax —TE-mail: — — Inte.rreptoe/grease trap — Owner installation/residential maintenance only: The actual installation Primer(s) _ will be made by me or the maintenance and repair-wade by my regular Roof drain(commercial) errspiuyx on the property I own as I+!r ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's signature:— pate: — Sump — Tubs/shower/shower Pan — Urinal _ Name: --- ---- -- —__— —_. __Wates closet ---— -- —— Address: _— Water heater City:--_ — State: ZIP_ —_ Other. — Pirone: — ——__ mail: _ _ _ Total Na su�Ct.�cuom soar.oee�I cam,t�call M+� f«am,,ii Notice:This r>-rmit application Minimum fee................S ---- O Visa 13 MasterCard a cplres if a pe+mit is not obtained Plan review(at — �) S -- l]edsu --E---_ within 180 days after it has been State stltrltarge(845) ....$ --- aitii '-- E.�' accepted as complete. TOTAL .......................$ Nam at ewdb A n w**V.6 M can! —_---_— S 44GA61616000RTA11i U New construction U Additiun/alteration/replacement U Other: If SITE 11FORMATION1 1SCHEDULE Job address:13 ;C _��t {�Lw Indicate equipment quantities in boxes below.Indicate die dollar Bldg.no.: Suite no.: value,of ail mechanical materials,equipment,labor,overhead, Tax map/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: _I ZIP:----- 1--- Dewnption and location of work on pirmises: t 1 t P 11=i Fee(ea.) Total Get.date of complctiorJinspcction: — - Qtv. Rmoal Resod Ge Tenant impr,ovement or change of use: Air handling unit CFM Is existing space heaved or conditioned?U Yes U No Air con itioning(site pilin required) Is existing spat,, ir.ulated?U Yes U NoATtcration of exist n�_1VA('MECHANICAL system CONTRACTOR -Boiler/compressors State,tx)ilet permit no. Four Seasons Heating&A/C Service Inc _ HP ---Tons—_ BTU/ll I -_ 6 �rjs_mr ke3ampers/ ircismokeclet'tors _ PO Box 66409 iieat pump(sits-plan required) Portland OR 97290-6409 -Tnsta(UrepT--ace turns-cwt Fn-e -�J%I; — 503-775-5919 Including ductwork/vent liner U Yes U No CCB: 48283 nstalVrepfacVrel tate eaters-aus�ed wall,or floor mounted _ Name(please print): en;to a—fiance o u an urnace eCONTACT PEASON eta Absorption units__ n Uit1 _ Name: tltillas—.—_,_—�--_ 14P - — Addtcss: — --- Compressors_ HP — — it omenta ext awl and vent t0oa: City: — State: ZIP: _ Appliancevent_- Phone: Fax: E-mail: Try rextaus[ _ 111110 Ji TUres.Wt�cTieaharmat hood fire suppression system _ Name: Exhaust fan with single duct(bath fans) Mailing address: p aust c stem art rom eaun or City: State: ZIP:: p oto up to ou ds) Type: --LPG —_ NG __ Oil Phone: Fax: E-mail: ue Il o enc ITnalover oudcts em p (schematic requ ) Number of outlets Name: — [Ter lI�applGnce or" pment. - -- Address: - _- _—_ Decorative fireplace City: State. ZIP: nsert-type -— _--- - Phone: Fax: E-mail: W�o�pe-fTustove _ — er. Applicant's signature: _-_— �- Name (print): - ----- Permit fee..................... Not as}urir4K%m[[toga arat cw&.plwe an jurisdiction fa[mare Warmrim Notice:This permit application Minimum fee................$ U Yin O MssterCanf expires if a permit is not obtained Plan review(at _ %) $ rlydlt`a`d'O°" ---------- --- =� within 190 days after it has been — New 9;;,,,�-' accepted as complete. OStatsuet large(8%)._$ = TOTAL .......................$ Cadbotder dptatum - __ - AnKmi 440-4617(6' ) family dwelling or accessory W Comr.iercial/itidustrialu t- amt y Li I Cnant improvement U New construction U Add:!ion/alteration/replacemenl U Other: _- U Partial JOB SITE INFORMATION Job address ," (�� _ A Bldg. no.: Suite no.: Tax map/tax lot/account no.: Lot_ Block: u[A ivision: Project name: -Description and location of work on premises: Estimated date of completion/inspectjon: CON-11RACI OR All"I'LICA]ION 111"I" SUIII D[ I'll ,lob rAo: Fee Max Description Qty. (ea,) Total no.Ins Streamlire Ideclric Nenresidenu.l-dagteormuldd-famllyper i DBA ! Valley Corporation dwelliogtoM.laclode.mac1"pnrge. 6025 f +Sl 1$�I St Servicelntie": I D()0 sq ft or less 4 Vancouver WA 98661 Fach additional 500 sq_ft or portion thereof 360-993-50130 Limited energy,residential 2 CCI3:116514 ILC#: 34-4320 SUPN: Limited energy,non-residential 2 Each manufactured home or mcxdular dwelling Signature of supervising electrician(required) Date — Service and/or feeder --- 2 - Sup.elect.name(print) License no SwrHtYsorfeeders-lasiallnlfon, alleration or relocation: 200 amps or less 1 Nance(print): 201 amps to 400 amps_ 2 — -- 401 amps to 600 amps 2 Mailing address 601 amps to 1000 amps 7 (City, _— —--" _ State: ZIP: -- Over 1000 amps or volts 2- -Phone: Fax: E mail: Reconnect only i Owner installation:The installation is being made on property I own Teerporaryaervicesorfeeders- which is not intended for sale,lease,rent,or exchange according to installation,aheratioo,orrekwittion: ORS 447,455,479,670,701. 200 amps or Ieas _- - 2 201 amps to 400 amps 2 Owner's signature: Date. 401 to 600 amps 2 MMBranch circahs-twit,alteration, a extension per pool: Name: _ — A Fee for branch circuits with purchase of Address: ser,ice or fader fee,each branch circuit 2 City: State; ZIP: d Fee for branch circuits without purchase of service of feeder fee,first branch circu-t: 2 Phone: Fax: E-mail: - —- Fich additional branch circuit Misc.(Servke or feeder nol in-!ceded): U Service over 225ampscommetcial U Healthcare facility Eachpump orirrigationcircle 2 rJ Servioe over-120 amps-sting of 1&2 U Hazardous location Fach signor outline lighting _ 2 family dwellings U Building over 10,(1(x)square feet four or Signal circuits)or s limitrd energy panel, U System over 600 volts nominal more residential units in one structure alteration,or extension* — _ 2.__ Building,over three stories U Feeders,40(1 snips or more 'Description U Okcupant load over 99 persons U Manufactured structures of R V park Fach additloml lin"ion over the allowable In my of Or above: U FgrrssIlightingplan U Other —_�-� _—_ per inspection Submit, lets of pbsas with any of the above. Investigation fre The above are not applicable to temporary construction service. other -- -- Not ala iwisdictions acctpr credit cards,pleat call jurisdiction fa mw inftxnwion Notice:This permit application Permit fee.....................$ U visa U MasterCard expires if a permit is col trbtained Plan review(at ___ %) $ trots card number .._L__ within 180 days after it has been State surcharge(8%)....$ accepted as complete. TOTA1, . $ Name d candholde+as shown on credit card cardholder sigwlure _ Amount 44M615 160"NO