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12974 SW Princeton Lane
i� CITY OF TIGARD ELECTRICAL -
ENER
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2002-00137
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 7/29/02
SITE ADDRESS: 12974 SW PRINCETON LN
PARCEL: 2S104DA-21900
SUBDIVISION: QUAIL HOLLOW- SOUTH ZONING: R-4.5
BLOCK: LOT: 045 JURISDICTION: TIG
Proiect Description: 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: OTHER:
TOTAL# OF SYSTEMS:
Owner: Contractor:
BROWNSTONE QUAIL HOLLOW LLC AZIMUTH COMMUNICATIONS INC
12670 SW 68TF-I 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 2312JLE
UC 145828
FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT CTR 7/29/0 $75.00 2720020000 Elect'I Final
5PCT CTR 7/29/02 $6.00 2720020000
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans 1`liis permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952-001-0010 through OAR 952-001 .0080. You may obtain copies of these
, rulescf irect q_uestions to
OUNC at (503)
I87
Issuedby Permittee Signature K.tJ ` 1 ')�`/
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'N _ _ DATE _-_
LICENSE NO: "13 _I _..M - - - ---- _— --- — — -----
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
I'.lectrical Permit Application
- Datereceived: j C:�t- Permit no.: 7
City of Tigard Project/appl.4: Expire date.
City of Tigard Address: 13125 SW flail Blvd,Tigard,OR 9722. Date issued: By-6( I i(ecei7tno.:
Phone: (503) 639-4171 -- -
Fax: (503) 598-1960 �'_'t Case file no.: Paymen!iype:
Land use approval:
'I VIIF OF!PERMIT
U I & 2 family dwelling or accessory U Commercial/industrial ❑Multi-family J Tenant improvement
5&New construction C Addition/alteratioNreplace ment J Other: U Partial
JOB SITE INFORMATION
Job address: 199 74 s,0, G '- ,tJ W Bldg.no.: Suite no.: ITax snap/tax lot/account no.:
Lot: 415 Subdivision: t
Prujec(na"'CAI. AiL- Neil i Description and location of work on premises: r ji, cG
I_titinlattd(lilt 4 L(mipletiorihnsptction:
CONTRACTOR 1S('IIFDtJLE
Job no: Fee Max
Ikscription Qq. (ea.) Total no.insp
Business niune: Z rr1 C'L 4 n(.i " " r
- Nen re+hlerrtlwl-single or multi-fandll per
Address: ' r" "S 1, )fbjy H M dwelling will.Includes aftaclKA garage.
City: L 0 t-G State:(,�/C' ZIP: <�� ](� Service included:
Phon � pi, Fax5b3 12 j t)U E-mail 1000 sq ft.or less
Eachadditional500sq It orpotlonithereof
CCB no.: 45 .2 'ec.bus. lic.no: a ('LLimited energy,residential
City/metro IIC.no.: ovpl.irnited energy,non-residential
29�U Each manufactured home or modular dwelling
S_ignaturc of"supervisin a riciun(re uired) —� Date Service and/or feeder - —
Sup elect nante(pnnt) r'T (f�� Lt(ensenu�. l� Services or feeders-Installation,
alteration or relocation:
200 amps or less
Name(print): �� nt.i 201 amps to 400 amps — —
401 amps to 600 ams
Mailing address: 601 amps to 1000 amps _
City: Slate: ZIP Over 1000 amps or volts_ _
Phone: Fax: E-mail. Reconnectonl
Owner installation:The installation is being made on property I own Temporary services or feeders-
which is not intended for sale,lease,rent,or exchange according to installation,atteratioit,orrelocation:
ORS 447,455.4711), 670,701 20()amps or less - ----
2U1 amps to 4(X)amp, _
Owner's si gnalui, Date. 401 to 600 amps
Branch circuits-nen,alteration,
or extension per panel:
Name: _ A Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit
City; Stale: I ZIP: B. Fee for branch circuits without purchase
---- of service or feeder fee,first branch circuit
Phone; It E-mail: Each additional branch circuit
PLAN REVIEW(I'lles4e,check all that appl.i Mise.(Seri Ice or feeder not Included I:
U Service over 225 amps-comrnercia] U Hcahh-care facility Each pump or irrigation circle
U Service over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting -
familydwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel.
USystem over 600volts nominal more residential units in one structure alteration,or extension* _
U Building over three stories U Feeders,400 amps or more *Description.
U Occupant load over 99 persons U Manufactured structures or RV park Erich additional Inspection over the allowable In any of the alcove:
U F"gress/lightingplan U Other .- -- -- Per inspection
Submit—seta of plana with any of the above. Investj ,tion fee
The above are not applicable to temporary construction service. other
Not all juris ictiom accept credit cards,please call judstiction for more infonnation Notice:This permit application Permit fee.4...................$ _
j Visa U MasterCard expires if a permit is not obtained Plan review(at _ %)
Credo card number within 180 days after it has been State surcharge(8%) ....$
Expires accepted as complete TOT sL • •• •• $ -
Name of c of r as shown on credit cud
_ S
Cardholder signature Amount
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee...................................................... $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total Ch--k Type of Work Involved:
Resideltial-per unit
1000 sq It or less _ _ $145.15 R 4 ❑ Audio and Stereo Systems'
Each additional 500 sq ft.or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy _ $75.00
C ach Manuf'd Home or Modular
Dwelling Service or Feeder _ $9090 2 �] Garage Door Opener'
Services or Feeders ❑ Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less _ $8030 _ 2
201 amps to 400 amps $10685 _ 2 ❑ Vacuum Systems'
401 amps to 600 amps $16060 2
6u1 amps to 1000 amps $240,60 2 ❑ Other
Over 1000 amps or volts $45465 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Installation,alteration,or relocation Fee for each system................................................... . . $75.00
200 amps or less $66.85 2 (SEE OAR 918-260-260)
201 amps to 400 amps $10030 2
401 amps to 600 amps - $133 75 2 Check Type of Work Involved,
Over 600 amps to 1000 volts,
see"b"above. ❑ Audio and Stereo Systems
Branch Circuits
New,alteration or extension per panel ❑ Boiler Controls
a)T he fee for branch circuits
with purchase of service or Clock Systems
feeder fee.
Each branch circuit $6.65 `-- 2
Data Telecommunication Installation
h)The fee for branch circuits
without purchase of service ❑
or feeder fee. Fire Alarm Installation
First branch circuit $46.85
Each additional branch circuit $6.65 HVAC
Miscellaneous
(Service or feeder not included) Instrumentation
Each pump or Irrigation circle $53.40 _
Each sign or outline lighting $53.40 ❑ Intercom and Paging Systerns
Signal circult(s)or a limited energy
panel,alteration or extension — $75.00 ❑ Landscape Irrigation Control'
Minor Labels(10) $125.00
Each additional Inspection os or CJ Medical
the allowable in any of the above
Per inspection _ $6250 ❑ Nurse Calls
Per hour _ $62.50
In Plant $73.75_ — �❑ Outdoor Landscape Lighting'
Fees: �❑ Protective Signaling
Enter total of above fees
------ Other—_
811.State Surcharge $
------ _ —Number of Systems
15%Plan Review Fee
See"Plan Review"section on $ ' No licensee are required Licenses are required for all other installations
front of application
---- Fees:
Total Balance Due $
--�� Enter total of above fees
II ❑ Trust Account# 8%State Surcharge $
All New Commercial Buildings require 2 sets of plans. Total Balance Due
c Wsts\forms\etc-fees doc 09/30101
CITY OF TIGARD MASTER PERMIT ^_
PERMIT M MST2002-00105
111116110 DEVELOPMENT SERVICES DATE ISSUED: 4/4/02
13125 SW Hall Blvd., Tigard, OR 972,2/3 (503) 639-4171
SITE ADDRESS: 13086-SW YAt€Pi- �'� 97 T S w�' � 1�� ���'� PARCEL: 2S104DA-QHS4
SUBDIVISION: QUAIL HOLLOW SOUTH ZONING: R-4.5
BLOCK: LOT:045 JURISDICTION: TIG
REMARKS: SF rowhouse,Unit#45,Bldg 10,DS plan with deck
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: FIRST: 303 of BASEMENT: of LEFT SMOKE DETECTORS
TYPE OF USE: SFA FLOOR LOAD: 50 SECOND: 744 of GARAGE: 370 of FRONT PARKING SPACES
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: 732 of RIGHT
VALUE: S 178,581.80
OCCUPANCY GRP: R3 BORM 3 BATH. l TOTAL: 1,83900 of REAR.
PLUMBING
SINKS: 1 WATER CLOSETS: 7 WASHING MACH: + LAUNDRY TRAYS. RAIN DRAIN TRAPS:
LAVATORIES: 3 DISHWASHERS + FLOOR DRAINS SEWER LINES. SF RAIN DRAINS: CATCH BASINS:
TUB/SHOWERS '1 GARBAGE DISP. 1 WATER HEATERS + WATER LINES: BCKFI.W PREVNTR. GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN<TOOK: I BOILICMP c 3HP. VENT FANS: 4 CLOTHES DRYER: 1
FURN>-11001(: UNIT HEATERS: HOODS: I OTHER UNITS:
MAX INP btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT SFRVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp. 1 0 200 amp: WISVC OR FDR: PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 50OBF: 3 201 400 amp: 201 400 amp: tat WIO SVCIFDR: SIGN/OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 800 amp: 401 800 amp: EA ADDL OR CIR SIGNALIPANEL: IN PLANT:
MANU HMISVCIFDR: 801 • 1000 amp: 8014ampo•1000V: MINOR LABEL:
1000•amplvoll
PLAN REVIEW SECTION
Reconnectonh:
>•4 RES UNITS: 9VCIFDR>•225 A.: >800 V NOMINAL: CLS AREAISPC GCC'.
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO S STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM: INTERCOMIPAGING. OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG- PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION. MEDICAL OTHR:
HVAC: DATArTELE COMM: NURSE CALLS TOTAL N SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 6,040.96
This permit is subject to the regulations contained In the
BROWNSTONE QUAIL HOLLOW LLC BROWNSTONE HOMES,LLC Tigard Municipal Code,State of OR. Specialty Codes and
12670 SW 68TH PKWY STE 200 12670 SW 68TH PKWY all other applicable laws All work will be done in
PORTLAND,OR 97223 PORTLAND,OR 97223 accordance with approved plans. This permit will expire If
work is not started within 180 days of issuance,or if the
work is suspended for more than 180 days. ATTENTION
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Reg N: LIC 124152/ forth in OAR 952-001-0010 through 952-001-0080. You
may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Sewer Inspection Plm/undslb Insp Framing Insp Firewall Insp Plumb Final
Fooling Insp Electrical Service Gas Line Insp Gyp Board Insp Mechanical Final
Foundation Insp Electrical Rough-in Insulation Insp Rain Drain Insp Building Final
Wtr Proofing Bsm't Wa Mechanical Insp Shear Wall Insp Smoke Detector Final Inspection
Slab Mip Plumbing Top Out Exterior Sheathing Inst Electrical Final
Issued By : -A-� � I Permittee Signature
Call (503) 634-4175 by 7:00 p.m. for an inspection needed the next business day
CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2002-00080
13125 SW Hall Blvd., Tigard, OR 97223 (5033) 639-4171 DATE ISSUED: 4/4/02
SITE ADDRESS; .13GOf-3N-YAt� r = �7 7� /� PARCEL: 2S104DA OhiS45
SUBDIVISION: QUAIL HOLLOW - SOUTH ZONING: R-4.5
BLOCK: LOT: 045 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SFA NO. OF BUILDINGS:
INSTALL.i YPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection
Owner: FEES_ _
BROWNSTONE QUAIL HOLLOW LLC Type By Date Amount Receipt
12670 SW 68TH PKWY STE 200
PORTLAND, OR 97223 PRMT CTR 4/4/02 $2,300.00 27200200000
INSP C7 R 4/4/02 $35.00 27200200000
Phone: 503-598.7565 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. 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
Issued by: /t Permittee Signature: ,
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day l�
Building Permit Application
"Dlv,d /41Permit no.:l x, ;. W,
AddreCityss;
ti►3 25SWHTigard �/C D Pro est/. I.no.:
City of Tigard
Address: 13125 SW Hull Blvd, V G � pp pirodate:
Home: (503) 639-4171 Date issued: Byl AA Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: _ r 1&2 family:Simple Complex:
❑ 1 &2 family dwelling or accessory 0 Commercial/industrial ❑Multi-family ❑New construction ❑Demolition
❑Addilion/altcration/replacement ❑Tenant improvement ❑Fire sprinkler/alarm ❑Other:
Job address: Bldg.no.: /O Suite no,-.Block: Subdivision: - Tax map/tax IoUaccount no.:
Project name:
Description and location of work on premises/special conditions:
OWNER FOR SPECIAL INFORMATION, USE CIII-CKLIST
Name: f-0 , Vg (I loodplaill,%4-111 ic capach 1,Solar,Cie.)
Mailing address: n _ c I&2 family dwelling:
City: C,y -� rx _ State:i! ?_IP: Valuation of work $
Phone zJ, y Fax p F-mail: No.of bedrooms/baths................................. —
Owner's representative: ' Total number of floors.................................
Phone: �LC' Fax: _ B-rnail: New dwelling area(sq.ft.)unto Garage/carport area(sq.ft.).........................Name � ct5 �� Covered porch area(sq, ft.) •........................
Mailing address: Deck area(sq.ft.) ........................................
f
City: ; State: ZI . 4 Other structure arca(sq.q t.).........................
a
Fax: E-mail: Commercial/industrial/multi-family:
" -W C I Valuation of work........................................ S
Business name 1 (j2 " C L,,,� ` �_� xis ng bldg.area(sq.ft.) .......................... --
Address: �` r New bldg.area(sq.ft.) ................................
tfo _ ` Number of stories
.......................•.•.......
City: State>JpLI
Type of construction
.................................... —
Phone Fax:6ao •c -mail: Occupancy group(s): Existing:
CCB no.:
- New:
City/metro lie.no.: Notice:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name (,Q provisions of ORS 701 and may be required to be licensed in the
Address: r AVL –Sc�. Ec n jurisdiction where work is being performed. If the applicant is
City: State Till: -- exempt from licensing,the following reason applies:
� � ��(�
Contact person: H Plan no.: — — --
Phone: x: E-mail: -- —
Name: ,t,,, j:yp,2L. L Contact person: DtA Fees due upon application ........................... $—
Address: 'W <' "cam}- Date received:
City: �•� tate: ZIP: 3 Amount received ......................................... S
Phone: , ' _ - p Fax: I E-mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Na all Jur ubeflons swe(M c«e6t cards,ptew um Jurisdiction rat mare mfo muaon
attached checklist. All provisions of laws and ordinances governing this U visa U MasterCard
work will be complied wheth r e ' ed herein or not. mit ow numb"
EXPil t
Authorized sign ure: Name of card olda as dKwa oa emM card
S
Print name: Eia0d=sigwum — Amount
Notice:This permit application expires if a permit is not obtained within 180 days after it has been acoeoted as complete. 440-4613(ICOM)
Plumbing Permit Application �, 1
r T
"Dater"�e=ceivemd: / n"ImIt no.�"l,Ow, Poky)
City of Tigard Sewer permit no.: _ Building permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223 Project/appl.no.: Expire date:
Ci{yci/7i�nnl Phone: (503) 639-4171 --
Fax: (503) 598-1960 Date issued By, Receipt no
Land use approval: Case file no Payment type
:
OF PERMIT
U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction U Addition/alteration/replacement U F(xx)service U Other.
1 I ► 1 i
Description Fee(ea. Total
Job address - -- — New I-and 2-family dwellings only:
Bldg.no.: Suite no.:,_____ (includes 100 ft.for each utility connection)
Tax map/tax lot/account no.: SER(1)bath_______
Lot: I//5 Block: Subdivision: SFI2 (2)bath
Projects name: SF-'R(3)bath
City/county: Each additional ba0t/kitchen
SitDescription and location of work on Cat utilities:
premises: —
Catch basin arca drain _
— Urywells/leach line/tmnch drain
Est.date of completion inspection: _Fooung drain(no.lin. ft—
I'LUNIIIIIING CONTRACTOR
Manufactured home til.......
Rncinrec nTrne Manholes
Wolcott I'lun)Ini,� Rain drain connector _ _
PU[lox 21107 Sanitary sewer(no. lin.ft.)
Storm sewer(no.lin.ft.)
Gresham OR 97030-0594 Water service(no.lin.ft.)
503-667-1781 1 Fixture or Mem:
C'C13:23847 I'I.M 0:26-2051'1i Absorption valve
t onttaetor s representative signature: _ Back now preventer
Print name: - - Date: Backwater valve —
[3asins/lavator��— v_ _
Clothes washer
Name: -- Dishwasher _
Address: Drinking fountains) _
City: State: ZIP - _Ejectom/sump --
Phone: -- Fax: E-mail: Expansion tank -- -• --
1 F ixturelsewer cap
Floor drains/floor sinks/hub
Name(print): -- Giuffre disposal____ —
Mailing address: Hose bibb
City: State:_ ZIP Ice maker —
Ffione: -mail: Interce'tor/grease trap
Owner installation/residential maintenance only- The actual installation i himer(s)
will he made by me or the maintenance and repair made by my regular Roof drain(commercial) _
employee on the property I own at per ORS('hapter 447. Sin ( -bafin(s), ays(s)
Owner's signature: __ Date: Sum
Tubs/shower/ahower pan -
Urinal _ --
Name: -- Water closet _—
Address: _— __ Water heater
City: �- State: ZIP: - Other.
Phone: _ - IF -mail: T
_ Minimum fee................$
Na
OU Widi(tiWA k*xgr ov&t conk,r'r"cal1)wt,dkfim I'm m0or idamrkn Notice:This permit replication
Plan review(at __ 96) $
O visa O Mastercard expires if a permit is cot obtained State surcharge(8%) ....$ — -
;� within 180 days after it hm been
F.>ep
_ acxepted as axnplete TOTAL ....................... _
Nape
Of cadioldrr un m ctedh cad —_
440-4616�616(NnOOOM)
AwwW
i
Mechanical Per mit Application
rDateeived: g ?% Permit ao.: G{7;1 (' D
City of Tigard Project/appl.no.: Expire date:
CiryofTigard Address: 13125 SW Ifall Blvd,Tigard,OR 97223 Date issued: 13y: Reccipino.:
Phone: (503) 639 4171
Pax: (503) 598-1960 Case file no.: Payment type:
Land use approval: Building permit no.:
U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family LI Tenant improvernew
U New construction U Addition/alteration/replacement U Other.
1 ! SITE'INFORMATION COMMERCIAL VALUATION
_Job address _ Indicate equipment quantities in boxes below.Indv:atf!die dollar
Bldg.no.: Suite,no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$ _
I.ot: y_j Block: Subdivision: "Sec checklist for important application inforination and
Project name: jurisdiction's fee schedulr for residential permit fee.
City/county: ZIP: _ r I
Description and location of work on premises:
Ftr(m) Total
Est.date of completion/inspection: Description t(y. Rm.ordy Rci.only
Tenant improvement or change of use:
Is existing space heated or conditioned?U Yes U No Air handling unit C d) -
Au conditioning(sere plan required)
Is existing space insulated?U Yes U No A terationofextstng Csystem _
CONTRACT011.1oiler cornpressors
State boiler permit no.:
lip Tons BTU/H
I-'our Seasons Heating&A/C Service IncI"ire/smo- keedampen/ductsmo a etectors
PO Box 66409 Teat pump(site plan requir )
Portland OR 97290-6409 1nstalUreplacefurnacc/burrher T
503-775-5919rep Including duc(wort/vent liner O Yes U No
CCB: 48283 nsta Uark rc o ateheaters-suspen ,
wall,or floor mounted _
N181me Iettffe titlt): ent forappliance other than furnace
e eta
Absorption units Bl'U/1l
Name: Chillers HP _-
Address: - 0) i ressors_ III'
- __— --- - virotmitnital exhatul mad teat toe:
(lily: -- —^F �— Slatc: 'LIP: Ap liancevent
ihonc Fax: E-mail: )rycrex haust -- -- —
I A ood s,fylTc`liUres7utch_c_ iarmal
hood fire suppression system _
"Name: Exhaust fair with single duct(bath fans)
angtrcss: -
Exhaust system apart froml eating or A(_'
f City: — -�— -- State LIP: ue p p g anddWr wflon(up to 4 outlets)
-- --- ---— �- - EYpe ----1.PCi _._._.._ NG _ 0il _
Photic: hax: F trail: Inclrin,eac—ha di ional over 4outlels
Process piping(srlhemat icreq uired)
Number of outlets
Name: t tUTer-FSR cep—pl ance or equlnrocm:- - --
Address: Decorative fireplace
City: Stale: l l Insert-type
Phone: Fax: li-mail: o tov pe let stove
Applicant's signature__ Date: p et.
Name (print):
Not all jurisdictions accept credit cants.peau call Jmisdrction I'm more Informadaa Permit fee.....................$
Notice:This permit application -___-__---
U visa U MasterCard Minimum fee................Is —-----_-_---
r"dit card oumlxr. expires if a permit is not obtained Plan review(at — %) $ _
Nigro within ISO days after it has been State surcharge(8%)....$ _
Namc at emfwlda as shown ao credit caul s accepted as complete TOTAI.
Catdhddet alpahae — Ar omr 4464617(6050k_ j
Electrical Permit Application
Date received. .1 11 Q Permit no.: h 1 Ol7 -pp p
lk City of Tigard Project/appl.no.: Expiredate:
Cityr/ffil, Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receiptno.:
Phone: (503) 639-4171 —
Fax: (503) 598-1960 Case file no.: Payment type:
Lanz) use :thrrovnl:
OF PERMIT
U I &2 family dwelling or accessory U Commercial/industriai U Multi-family U Tenant improvement
U New construction U Addition/alteration/replacement U Other: _ U Partial
li
Joh adt'ress: _ Bldp. no.: Suite no: Tax map/tax lot/account no.:
Lot: Block: tiultdivision: -
Project name: bcscription and location of work on premises:
Eistimmed date of aunplcuun/uttihr u(no --
CON-11 RACI OR APPLICATION FFE 1
Job no: Fee '11as
Streamline 1.ICCU'Ic Dewription (jt>• (ea.) Iolal no.iollp
Nen residnnial-single or mulli-famay per
DBA LaValle Corporation y � dncllhtkunit.Includes Wtaclied garage.
6025 East 18t1i St Seniceincluded:
Vancouver WA 98661 111111 sq It or Iv!., 4
360-993-5080 latch uddition,d 5(x1 s .Il.or portion thereof
CCB:116514 ELC#: 34-432C SUP#: Limited energy,residential 2
Limited energy.non-residential 2
Bach manufactured home or modulardwelling
Signature of supervising electrician(requited) Date Service and/or feeder 2
Sup.elect munr(pontI. License no: Services or feeders-installation,
741
lteration or relocation:
11)amps or less 2
Name(print): 01 amps to 4W amps - ,_ — 2
1 amps to 6(11 amps 2
Mailing address:— 01 antp to 1(x)(1 amps _ 2
City: Stale: ZIP: 7ver Relit amps or volts 2
Phone: I ax: E nuul; econnectonl —! I
Owner installation:The installation is being made on property I own Temporary sers'um nr reedem-
which is no(intended for sale,lease,rent,or exchange according tU Installatlon.aherallon.orrelocation:
2ikess
URS 447.455,479,670,701. 01 amps to W 2
_III amps l0 4U0 arnp� -- -- 2
Ow'ner's Signature Date: 401 to 6(1)ams 2
Branch circuits-nen,alteration,
or extension per pan-1:
Natne: — A. Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circun ,
City: — Stale: ZIP: y. Fee for branch circuits without purchase
-- —
Phone: of service or feeder fee,first branch circuit
I .t I nuril
1•nch additional hruuh circuit
Mtsc.(Service or feeder not Included):
7f.nuldwellings
amps-commercial J Health-care facituy Fach pump or irrigation circle
mnps-rating oft&2 UHazardouslocation Fach sign tit outline lighting — ?
U Building over 10,000 square feet foot or Signal circums)or a limited energy panel,
yvolts nominal more residential units in one structure alteration,or extension* --
U Building over three stories U Feeders,4W amps or more *►kscrition _
U Occupant load over 91)persons U Manufacturml structures or RV park Each additional Inspection over the allowable In any of the above:
U Film ss/lightingplair J other Per inspect ron _
Submit--sets of plane with an}of the above. Investigation fee
The above are not applicable to temporary construction service. other
-- $
Nor all jurisdictidxts accept ccreditcreditcords.pleau rollµuiaU.uon lin nvnr inlrorttatirNt Notice:This permit application Permit fee.....................
U Visa U MasterCard crpires if a permit is not obtained Plan review(at _ %) $
Credit card number L __/ within 190 days after it has been State surcharge(8%) ....$
t`r accepted as complete. TOTAL .......................$
Now of cardholder as shown on credit card
S
Cardholder ei(tnauun Amoum 440-4615 1&MCOM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee................ ........ ............... $75.00
Number of Ins e:tions per Permit allowed) (FOR ALL SYSTEMS)
Service included: Items Cost Total Check Type of Work Involved:
Residential-per unit
1000 sq it or less $145 15 q Audio and Stereo Systems'
Fach additional 500 sq ft or
portion thereof $33.40 _ 1 Burglar Alarm
Limited Energy $7500
Each Manufd Home or Modular Garage Door opener'
Dwelling Service or Feeder $90 90 g
Services or Feeders l J Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less $80.30 _ 2 ❑
201 amps to 400 amps $106.85 _ 2 Vacuum Systems'
401 amps to 600 amps __ $160 60 2
601 amps to 1000 amps _ $240.60 2 other
Over 1000 amps or volts _- $454.65 2
Reconnect only $66.85 2
TYPE OF WORK INVOLVED COMMERCIAL ONLY
Temporary Services or Feeders
Installation,alteration,or relocation Fee for each system.......................... ............................... $75.00
200 amps or less $88.85 2 (SEE OAR 918.260-260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.7'i 2 Check Type of Work Involved:
Over 600 amps to 1000 volts, ❑
see"b"above. Audio and Stereo Systems
Brarrch Circuits ❑ Boiler Controls
New,alteration or extension per panel
a)The fee for branch circuits
with purchase of service or ❑ Clock Systems
feeder lee.
Each branch circuit $6.65_._ _ _ C� Data Telecommunication Installation
h)the fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch circuit $46.85
Each additional branuh circuit $6.65_ HVAC
Miscellaneous ❑ Instrumentation
(Service or feeder not Included)
Each pump or irrigation circle $53.40 - ❑ Intercom and Paging Systems
Each sign or outline lighting $5340
Signal circuits or a limited energy
panel,alteration or extension $7500 —_ ❑ Landscape Irrigation Control'
Minor Labels(10) $125,00 _
Medical
Each additional inspection over ❑
the allowable In any of the above ❑ Nurse Calls
I'er inspection $62.50
Per hour $62.50
In Plant $73.79 _ ❑ Outdoor Landscape lighting'
Fees: ❑ Protective Signaling
Enter total of above fees $ ❑ Other
8%State Surcharge $ - -_ Number of Systems
25%Plan Review Fee ' No licenses ere required Licenses are required for all other Installations
See'Plan Review"section on $
front of application. ----- -- -- — --
Fees:
Total Balance Due $
—�-- Enter total of above fees $
Trust Account# 8%Stale Surcharge $
Total Balance Due $
All New Commercial Buildings require 2 sets of plans.
i'Asts\firms\eIc-fees.doc 08/30/01
SEE 35MM
ROL..L #2 0
FOR
OVERSIZED
DOCUMENT
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
STREAMLINE ELECTRICAL
DBA LAVAL.LEY CORORATION
6025 EAST 18TH ST
VANCOUVER, WA 98661
Electrical Signature Form
Permit #: MST2002-00105
Date Issued: 414102
Parc-!: 2U104r)A-Q1-1S45
Site Address: 13088 SW YALE PL
Subdivision: QUAIL HOLLOW - SOUTH
Block: Lot: 045
Jurisdiction: TIG
Zoning: R-4.5
Remarks: SF rowhotise,Unit #45,Bldg 10,DS plan with deck
Your company f as been indicated as the electrical contractor for the permit indicated above. In order for the
electrical permit to be valid. the signature o`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: Building Dept.
No electrical inspections will be authorized until this completed form is received
OWNE=R ELECTRICAL CONTRACTOR
BROWNSTONE QUAIL HOLLOW LLC STREAMLINE ELECTRICAL
12670 SW 68TH PKWY STE 200 DBA LAVALLEY CORORATION
PORTLAND, OR 97223 6025 F^cT 18TH: ST
�/ANCPUVER WA 98661
Phone tl: 503-598-7565 P gone 360 3-5080
Req #: LIC 116514
ELE 34432C
SUP 4801S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
1
r
Signature of Supervising Electrician
If yo- have any questions, please call (503) 639-4171, ext. # 310
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERM,r NOTICE
WOLCOTT PLUMBING CONTRACTORS
PO BOX 2007
GRESHAM, OR 97030
Plumbing Signature Form
Permit #: MST2002-00105
Date Issued 4!1!02
Parcel: 2.q104DA-QHS4510
Site Address: 1:3086 SW YALE PL ' l--7Y
Subdivisior, OUAIL HOLLOW - SOUTH
Block: Lot: 045
Jurisdiction: Ti G
Zoning: R-4.5
Remarks: SF rowhouse,Unit #45,Bldg 10,13S plan with deck
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 Dept.
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 PKWN' STE 200 PO BOX 2007
r,o R"TL A 1-4 D, OR x'22? CRESHANI, CR 97030
Phone ##: 503-598-7565 Phone #: 667-1781
Reg # I Ir. 23847
PI M 26-208PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X
Signatur o ori:_. Plumber
li you have any questions, please ca!! (503) 639-4171, ext. # 310
CITYO F T I GA R D - MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2003-00184
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/11/03
PARCEL: 2S 104DA-21900
SITE ADDRESS: 12974 SW PRINCETON LN
SUBDIVISION: (QUAIL HOLLOW - SOUTH ZONING: R-4.5
BLOCK: LOT: 045 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTE"3:
STORIES: _ BOILERS/COMPRESSORS HOO S:
FUEL TYPES _ 0 3 HP: 1 DOMES. IN(,IN:
3 15 HP- COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE. 50 + HP: CLO DRYERS:
FURN < 100K BTU: _ AIR HANDLING UNITS _
FURN —100K BTU: — 10000 cfm: OTHER UNITS:
> GAS OUTLETS:
10000 cfm:
Remarks: Installation of A/C unit. Unit cannot be placed within required setbacks.
Owner: FEES _
BROWNSTONE QUAIL HOLLOW LLC Description Date Amount
12670 SW 68TH PKWY STE 200
PORI-LAND,OR 97223 (h11.1 11I I'crmit Fee 4/11!03 $72.50
(TAX)8°/,StatcTax 4/11/03 $5,80
Phone: 503-598-7565 Total $78.30
Contractor:
THERMAL FLO
14865 SW 74TH AVE.#190
TIGARD, OR 972.24 REQUIRED INSPECTIONS
Phone: 503-670-8383 Mechanical Insp
Final Inspection
Reg #: 1.IC 151847
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00
f Permittee Signature,
Issued By: . g
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application
Daterecerved: '/// Permit no.11E"CZp0J 4041`
City of Tigard t r~ Project/appl.no.: Expire date:
CltynfTignrd Address: 13125 SW Hall Blvd.Tigard,OR 97223"'l- Date issued:
I lay R cetptno.:
Phone: (503) 639-4171 / )
Fax: (503) 598-1960 / Case file no.: Payment type:
Building permit no.:
Land use approval:
I I PE OF PERMIT
I &2 family dwelling or acces!:ory J('onuttercuil/inclu:,lrial U Multi-family U Tenant improvement
U New construction U Ad( ition/al teration/rehlacemeIII _)(Wiry
11 � 1 1 1
Job address: __ Indicate cguipnn•nl quantilics in hntr,hcluH. Indicate the dollar
— value of all mechanical materials,equipment,labor.overhead,
Bldg.no.: Suite no.:
profit. Value$
Tax map/tax lot/account no.:
Lot: Block: Subdivision: *See checklist for important application information and
Project name: - iurisdiction's fee schedule for reside Tial hermit fee.
I 6l�iau Flo c.ovJ 0�` --
t
City/county:"'Ts,�, W Ai I ZIP: 72-L3 1 t
Description and location of work on premises:, f4
t t
Icc(ca.) Iota[
Description Hm.only Res.otm
Est.date of completion inspection: IIVAC-
41>.
Tenant improvement or change of use: Air handling unit f'FM
Is existing space heated or conditioned?U Yes U No Air con itioning(site p an require )
Is existing space insulated?U Yes U No A teration o existinglTVA -systemMECHANICAL CONTRWYOR _
of er/compressors
State boiler permit no.:
Business name: �,(� ��� S1.�C HP Tons BTU/H —_
Address: l 86 W it smo c ampers/ uct smoke detectors
City: - State:QGl ZIP:g72Zy cat pump(silo p an required)
mita rep ace urn ace/ urner
Phone: 4,10-g �} Fax: (0�p- E-mail: Ln� .Tft Including ductwork/vent liner U Yes U Na
CCB no.: 115J -7 MA&I'-_w M V 10 Q I Install/replace/relocnte caters suspended,
City/meirolic.no.: '7's?-7 f`1k. wall,or floor mounted _
Vent for appliance other than furnace
Name(rlease print): (x,T.., '��c-N� efr gest on:
Absorption units - BTI 1/11
Chillers _ fill
Name: N Com ressors Ill'
Address: _ $Ar+NE nv ronmenfiklexhausit and ventilation:
City: Stale: ZIP: Appliancevenl
Phone: rax: E-mail: )ryerexhaust
oo s, ype res. itc ten/hazmat
hood fire suppression system
Name: Ap 7A ACaE T C Exhaust fan with single duct(bath fans)
:x
system apart front heating or AC
Mailing address: 2,c3 ' .ue p p ng and distributlin-_(up to 4 out els)
City: Ui ffc Statc:pk ZIP: 12L -H -- o3 _
�_ _ 'Iylx: NGil
Phone:15 U- 'LZc,. Fax:S o 52trI E-mail: I uel Piping each additional over 4 outlets
process piping(wheittatic required)
Number of outlets
Name; a-ppffance o--r exp iie :
Address --- _ Uecorativefireplace
City: — State: ZIP: nsert-type
C c stove/pe et stove
__
Phone: I E-mail: Other: —
Applicant's signature: -^ i Date: Ot er:
Name (print): -- -
-. Permit fee.....................$
Not all Janis, ctiom a.ceje cmlit earls,please call jurisdiction fa nae infa.nntion. Notice:This permit application '
Pe PP Minimum fee................$
U Visa U Master(and expires if a permit is not obtained Plan review(at _ %) $ _
Credii card number._ — -- Expim within 180 days alter it has l
e>,pirer y Slate surcharge(89Ei)....$ 5 +O
Name of c of r esihown on credit c accepted as complete. TOTAL . $
s
Cardholder niptature A., 410-4617(WICOM)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: PERMIT FEE: Dascription: Price Total
$1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code Oly (Ea) Amt
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU
$1.52 for each additional$100.00 or including ducts&vents 14.00
fraction thereof,to and Including 2) Furnace 100,000 BTU+
_ $10,000.00. Including ducts&vents 17.40
$10,001.00 to$25,000.00 $148.50 for the first 510,000.00 and 3) Floor Furnace
$1.54 for each additional$100.00 or including vent 14.00
fraction thereof,to and including 4) Suspended heater,wall heater
$25,000.00. or floor mounted heater 14.00
$25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not Included in appliance permit
$1.45 for each additional$100.00 or _ 6.80
fraction thereof,to and Including 6) Repair units
_ $50,000.00. 1215 _
$50,001.00 and up $742,00 for the first$50,000.00 and Check all that apply: Boller Heat Air
$1.20 for each additional$100.00 or For Items 7.11,see or Pump Cond
fraction thereof. footnotes below. Comp ••
Minimum Permit Fee$72.50 SUBTOTAL: 7)<3HP;absorb unit
$ to 100K BTU 14 00
8'/.Slate Surcharge a 8)3-15 HP;absorb
unit 100k to 500k BTU 25.60
- -
25%Plan Review Fee(of subtotal) $ 9)15-30 HP;absorb
unit 5-1 mil BTU 35.00
Required for ALL commercial permits only . -
TOTAL COMMERCIAL PERMIT FEE: $ 10)30-50 HP;absorb
unit 1-1.75 mil BTU 52.20
11)>50HP;absorb
unit>1,75 mil BTU 87.20
ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM
_ 10.00
Value Total 13)Air handling unit 10,000 CFM+
Description: Qt Ea Amount 17.20
Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler
ducts&vents 1000
Furnace>100,000 BTU including 1,170 15)Vent fan connected to a single duct
ducts&vents _ _ 6.80 _
Floor furnace Including vent 955 16)Ventilation system not Included In
Suspended heater,wall heater or 955 appliance permit 10.00
Floor mounted heater 17)Hood served by mechanical exhaust
Vent not Included in appliance 445 10.00
ermit 18)Domestic Incinerators
Repair units _ 805 17.40
<3 hp;absorb.unit, 955
to 100k BTU 19)Commercial or Industrial type incinerator
3-15 hp;absorb.unit, 1,700 69.95
101k to 500k BTU 20)Other units,Including wood stoves
15-30 hp;absorb.unit,501k to 1 2,310 10 00
mil.BTU 21)Gas piping one to tour outlets
30-50 hp;absorb.unit, 3,400 5.40
1.1.75 mil.BTU 22)More than 4-per outlet(each)
--- 1.00 _
>50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $
>1.75 mil.BTU _
Air handling unit to 10,000 cfm 656
Air handling unit>10.000 c 1,170 eX State Surcharge $
Non-portable evaporate cooler 656 _ TOTAL RESIDENTIAL PERMIT FEE: $
Vbrtt fan connected to a single duct 446
Vent system not included in 656
Hood Served by exhaust 656 Other Inspections and Fees:
Domestic wine mechanical
1,176 1 Inspections outside of normal business hours(minimum charge-two hours)
$62 50 per hour.
Commercial or industrial Incinerator 4,590 _ 2 Inspections for which no fee is specifically indicated (minimum charge-hall hour)
Other unit,including wood stoves, 656 $62 50 per hour
Inserts,etc. 3 Additional plan review required by changes,additions or revisions to plans(minimum
Gas piping 1-4 Outlets _ 360 charge-one-half hour)$62 50 per hour
Each additional Outlet 63 _ "State Contractor Boller Certification required for units>200k BTU.
- --- ""Residential A/C requires site plan showing placement of unit.
TOTAL COMMERCIAL $
VALUATION: All New Commercial Buildings require 2 sets of plans.
I:\dstsVorms4nech-fees.doc 02/11/02
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
. MST -_-
INSPECTION DIVISION Business Line: (56)639-4171 --
c BUP —
Received D to Requested AMPM BUP
Location ..___ Suite MEC 3
Contact Porson _ Ph( ) •s�aZ . ��(�`� PLM
Contractor _------- - - — Ph( ) -- SWR -
BUILDING Tenant/Owner - � ELC
Footing 5 7 ELC
Foundation Access:
Fig Drain ELR —
Crawl Drain
Slat, Inspection Notes: SIT
Post&Beam
Shear Anchors G--
Ext Sheath/Shear
Int Sheath/Shear
Framing �O - --
Insulation (�
Drywall Nailing — - -
Firewall
Fire Sprinkler
Fire Alarm �l Z� •-L.�
Susp'd Ceiling
Root _
Other:_
Final
PASS PART FAIL - - - - - - --
PLUMBING _
Post& Beam
Under Slab — - �
Rough-in
Water Service -- --- ------
---- ----
Sanitary Sewer
Rain Drains -
Catch Basin/Manhole
Storm Drain
Shower Pan
Other: - -
Final
_PASS PART FAIL
MECHANICAL,_' -
Post&Bea
Rough-In �(• C -
Gas Line
Smoke Damp
A PART_ FAIL
ELECTRICAL
Service -
Rough-In
UG/Slab
Low Voltage _
Fire Alarm
Final Reinspcctior,fee of$.____._ .--- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE _ Please call for reinspection RE: __.�^_ __ —_________.__- linable to inspect-no access
Fire Supply Line
ADA lj /C' �--I -
Approach/Sidewrilk Data rsapsctor Ext
_ _ `"' t' -_
Other.
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TICARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 MST
BLIP
Received Date Requested 0 - AM PM BLIP
Location -�- 7 � 2f� -Suite___ MEC
Contact Person Ph(_ -__) '�3 ,� PLM
Contractor Ph( ) _ SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: --------
Crawl Drain E L R
Slab Inspection Notes: SIT
Post& Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear -
Framing
Insulation -- -
Drywall Nailing
Firewall --
Fire Sprinkler
Fire Alarm S
Susp'd CPilif g
Roof
1
Other:
Final -- --
PASS PAR_ T FAIL - --
PLUMBINu
Post& Beam — ------
Under Slab
Rough-In
Water Service
Sanitary Sewer —
Rain Drains
Catch Basin/Manhole
Storm Drain
Shower Pan - - - -
Other:
Final
PASS PART FAIL
MECHANICAL - �l)r�- 60 I
Post&Beam
Rough-In -_
--
as Line
Smoke Dampers -
Final -"
PASS PART FAIL
ELECTRICAL LL
------ -------
Service - ---...
Rough-In
UG/Slap - - - -
Ita
Fire Alarm
Final
PASS PART FAIL Reinspection fee of$- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE vPlease call for reinspection RE: _- C� Unable to inspect-no access
Fire Supply Llne ,
ADA
Approach/Sidewalk Dab-- n� Inspector
-
Other: Ext- �
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
BLIP
C, q/
Received _ _Date Requested j_/ -� — AM PM BLIP
Location L Z 17 y 5 111«is - Suite _ MEC
Contact Person _- -- Ph( ) __7 3?-3 '.5 PLM _-_--_---.---____--
Contractor -- —- --- Ph(-- - - ) - SWR —
BUILDING Tenant/Owner -__-_- ELC - ._....-.---
Footing ELC
Foundation Access:
Ftg Drain ELR ---_-----____--
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing --
Insulation
Drywall Nailing - - - - -----
Firewall
Fire Sprinkler
Fire Alarm _
Susp'd Ceiling
Roof
Other.
Final
PASS PART FAIL
Post&Beam
Under Slab --
Rough-In
Water Service --_
Sanitary Sewer
Rain Drains ---
Catch Basin/Manhole
Storm Drain
Shower Pan
Other:
TAOS PA_Rl" _FAIL
4KeCHANICAL
Post&Beam
Rough-In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough-In -- -
UG/Slab
Low Voltaae -_ —� -- —
Fire Alarm
Final 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 Daft IesPOCtOr
Approach/Sidewalk _ ----
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 2 MST ez)
- ----
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Received ---..-.------Date Requested_-
AM `''/ PM BLIP
Location _ i �? / I ���~� _Suite_ �- _ MEC
Contact Person � Ph(__ _) _`� _ l�� PLM
Contractor -_-- -- - - Ph( ) SWR - --
BUILDING Tenant/Owner ELC
Footing E L C
Foundation
Ftg Drain Access: �M �, ELF!
Crawl Drain --
Slab Inspection Notes: SIT
Post& Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywaii Nailing _
Firewall
Fire Sprinkler ---- - - -- _ ---
Fire Alarm
Susp'd Ceiling --
Root
Other: )\rt p L-1. 69o ,
-
Final
PASS PART FAIL -
PLUMBING _ —
Post&Beam -
Under Slab 1�+
Rough-In N G 6 F-� K ) FL_ I W rl\
Water Service
Sanitary Sewer 14n W c-,7-
Rain Drains
Catch Basin/Manholes, G
Storm Drain -- /
Shower Pen All)1
Other:
Final
PASS PART FAIL
MECHANICAL -
Post& Beam
Rough-In - -----
Gas Line
Smoke Dampers - -- - --- ---
Final
PASS PART FAIL
ELECTRICAL
Service
Rough-In
UG/Slab
Low Voltage ------- - ---- --_ -
Fire Alarm
MReinspection fee of$_ _-_.-�__requi,ed before next inspection. Pay at City Hall. 13125 SW Hall Blvd.
ASS PART FAIL Unable to inspect-no access
SITE--' C� Please call for reinspection RE: p
Fire Supply Line
ADA 9
Daft �' � - - - Inspector' //_ SZ��"� Ext—_--
Other:
- DO NOT REMOVE this Inspection record from the(job site.
PASS PART FAIL
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CITY OF TIGARD 24-Flour
BUILDING Inspection Line: (503)639-4175 �y --
MST
INSPECTION DIVISION
Business Line: (503)639-4171 y� �Cf�_-J! _
BLIP
Received -/
__.____,_Date Requested— AM_ PM
1 --_-,�—� T.-.._� BLIP f�_�7 c/ i�/1„! -c.tg�_ Suite MEC
Contact Person �_C� _ ph � 3—5-3 PLM
Contractor Ph(_ ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access' ELC
F'a Drain ELR
Crawl Drain __
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear -
Framing
Insulation -
Drywall Nailing
Firewall - --
Fire Sprinkler
Fire Alarm i
Susp'd Ceiling -
Roof
Other: - --
SS PART FAIL - -
Po —
_
st 8 Beam --
Under Slab
Rough-In
Water Service
Sanitary Sewer --
Rain Drains
Catch Basin/Manhole
Storm Drain ---__---------ShowerPan
Other.
Final
PASS PART FAIL ---
MECHANICAL
Post& Beam - --
Rough-In
Gas Line
Smoke Dampers
SS PART _ FAIL_
_T_RICAL _
Service —�
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final t_J Reinspection fee of$�� -._____ required before next inspection Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
-SITIE D Please call for reinspection RE: -.. _ ❑ Unable to inspect-no access
Fire Supply line
ADA
Approach/Sidewalk Date �/ _ Inspector _ - _
Other: EX!
Final DO NOT REMOVE this Inspection record from the jab site.
PASS PART FAIL