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12988 SW PRINCETON LANE N �O QO OD UC G n <D O 7 O1 7 fD 12988 SW Princeton Lane CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 630- 175 MST INSPECTION DIVISION Business Line: (503) 639-4117 B U P Received __ __ c� GDat Requested_ / AM--_ ____ PM -- BUP 7,.tA _�Q Location I ;L / a ��' L' Suite _ _.__ - MEC Contact Person n7t22 Ph( ) 7 PLM Contractor_ � 1 * Ph( } L 0 5WR BUILDING Tenant/Owner — -_ —. ELC - -_ Footing ELC _ Foundation Access: Ftg Drain ELR �24X --<.h Q Crawl Drain Slab Inspection Notes: SIT Al, / tn4ol1(, 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 - 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&Beam — — ---- ------------- - ------------- __ — Rough-In -- Gas Line — Smoke Dampers ---- _-- -__ ------ - ----- _-.-_. Final PASS PART FAIL ELECTRICAL Service Service -- -------------- ---- - Rough-In ---- -- ----_— -__- UG/Slab Low Voltage --- -- -._-__ �--- ---_--_- F'r Alarm _;Q4ART [J Reinspection fee of$_- -required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SIM -- - F] Please call for reinspection RE:_ - [� Unable to Inspect-no access Fire Supply Line ADA Approach/Sidewalk Date _Ext Other: Final DO NOT REMOVE this Inspection .ocord from the jo site. PASS PART FAIL CITY OF TIGARD 24-Hour Q BUILDING Inspecfios. _;ne: (503) 639-4175 MST Z' C7" -- INSPECTION DIVISION Business Line: (503)639-4171 BUP Received — Pate Requested— D AM------ PM - BLIP — Location — - �� ;►,, -� _Suite — - MEC - - Contact Person -- --- Ph( ) — PLM ---- - - ---- Contractor .__ �h( ) SWR - BUILDING Tenant/Owner ELC Footing ELC Foundation Access: ELR Ftg Drain Crawl Drain - - -` SIT Slab Inspection Notes: - Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Fhear Framing - ---- Insulation Drywall Nailing - Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof ____- .- � C Other: Final PASS PART FAIL PLUMBING- --- Post&Beam Under Slab Rough-In Watar Service --- --- Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Oth ----- -- ...-- --- P_A PART FAIL HANICAL - Post& Beam Rough-In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL _-_ .. Service T Rough-In - -- - UG/Slab Low Voltage -----._-_-. - -.-- - Fire Alarm Final U Reinspection fee of$-__ 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 _re Fire Supply Line � -� ADA Dat Inspector Ext_ Approach/Sidewalk -" Other: - Final DO NOT REMOVE "this I;:tiepectlon record from the 1013 Site. PASS PART FAIL lq\AAAAAAAAAAAAA 1AAAAAAAAAAAAAA,& .AAAAAAAAAAAA/Y,, '4 D 9 loo. . ► 4 Qn �; C ► 4 CL rb rDli r ► C� rb0Z ► t �y i % ~ o ► 440 Poo wrDa ► cro Moo�05 0 Poo- Ob, O ► ► oil- "� ► m � � ° n zR CL con "It O OFQ It CITY OF TIGARD 24-Hour DUILDING Inspection Line: (503) 639-4175 MST "a `OeDc�) INSPECTION DIVISION Business Line (503) 639-4171 BUP Received Date Requested ( — — AM--- PM BLIP Location _ �dK-1 Suite—- MEC ------- Contact Person _ _ Ph( ) _ PLM _— Contractor___.__.. - __ Ph( ) SWR BUILDING TenanYOwner _ �_ ___ _ __ ____._ ELC _ Footing ELC Foundation Ftg Drain ELR Crawl Drain --- Slab Inspection Notes: SIT Post&Beam - --- - - - Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing i— Insulation / .�j/'� .��,r � e Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling i Roof OUL PASS PARTFAI ' PLUMBING — Post&Beam Under Slab - Rough-In V— Water Service - -- -- — Sanitary Sewer Rain Drains ---- -- — --- Catch Basin/Manhole _ Storm Drain - ---—--- Shower Pan Other: ---- - -- —— — Final -------- — __ PASS PART FAIL -- MECHANICAL Post&Beam — Rough-In -r- — Gas Line d4/// Smoke Dampers —— PART FAIL -- — --- -- -- -- - ELECTRICAL Service ------i - _-- _ Rough-In -------- ---- --- - — UG/Slab Low Voltage _-------_-_� ----_.--,_ —.----- Fire Alarm Final L Reinspection fee of$____.— --required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS_ PART FAIL SITE Please call for reinspection RE:— —_ — Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date — � InExt spector Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST — -- INSPECTION DIVISION Business Line: (503)639-4171 BUP Received 1,212 Date Requested 02, P AM____ PM — BUIR Location _ �� ✓%��� '-mss Suite_ MEC Contact Person _—_ ph( ) PLM —.--- Contractor Q aaPh( ) ' SWR -- BUILDING Tenant/Owner — _ ELC _ Footing ELC - — Foundation Access: Ftg Drain Crawl Drain Slab Inspection Notes: Sr' — --- Post&Beam - _- Shear Anchors _56���J lr Ext Sheath/Shear - Int Sheath/Shear Framing - ------ - - - Insulation Drywall Nailing - Firewall Fire Sprinkler ---� - Fire Alarm Susp'd Ceiling - Roof Other:----- - -- ----- - Final PASS_ PART FAIL �— Post&Beam Under Slab - Rough-In Water Service - ------------- -— Sanitary sewer Rain Drains ----- -- -- Catch Basin/Manhole Storm Drain ---- - - -- Shower Pan Other:---- ----- - Final PASS PART FAIL MECHANICAL ___ - - ---- Post& Beam - Rough-In ----- Gas Line Smoke Dampers -- -- - _ — - Final PASS PART FAIL -'--- -- -- _ --� - ELECTRICAL Service Rough-In - _ -------- ------- - UG/Slab Fire Alarm Final Reinspection fee of$__ -required before next inspr^tion. Pay at City Hall, 13125 SW Hall Blvd PART FAIL S .-__----_-_ Please call for reinspection RE: Unable to inspect -no access Fire Supply Line ADA Date _ 1C'� InspAr•toR _-�1M ` / 7 Ext _ Approach/Sidewalk � � Other: ----------- - Final DO NOT REMOVE this InRpoction record from tiie job site, PASS PART FAIL CITY A F TI GAR® –��' ELECTRICAL PERMIT - (V) RESTRICTED ENERGY J DEVELOPMENT SERVICES PERMIT #: ELR2002-00217 # 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 10/15/02 PARCEL: 2S104DA-21200 SITE ADDRESS: 12988 SW PRINCETON LN SUBDIVISION:QUAIL HOLLOW- SOUTH ZONING: R-4.5 BLOCK: LOT: 038 JURISDICTION: TIG Proiect Description: Low voltage for voice/video. 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: 1 INSTRUMENTATION: OTHER: – —� TOTAL# OF SYSTEMS: Owner: Contractor: BROWNSTONE QUAIL HOLLOW LLC AZIMUTH COMMUNICATIONS INC 12670 :SW 68TH PKWY STE 200 P.O. BOX 508 PORTLAND, OR 97223 WILSONVILLE, OR 97070 Phone: 503.5914-75(15 Phone: 50-639-011() 503-039-0110 Reg#: I:I I 36-94CL1-: Still 2312.11.1•:1 LIC 195828 _ FEES Required Inspections_ _Description Date Amount Low Voltage Inspection I I 1'1t N1 1 I:1.R Pcrnut 10/15/02 $75.00 Elect'I Final f I \I xi', State Tax 10/15/02 $6.00 Total $81.00 J 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 nines adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 962-001-0010 throuc Issued by Permittee Signature �0 L 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: CON f RACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N i 1 DATE: LICENSE NO: - Call 639-4175 by 7:00 P.M fur an inspection needed the next business day Electrical Permit-Application --- — Date received: v- I<,-Co Permitno,:EL/ ,. �r City of Tigard Projecdappl.no.: Expire date: CayolTigard 'Address: 13125 SW Ilall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (503) 639-4171 Fax: (503) 598-1960 Case fileno.: Pny enttype: Land use approval: Ir? TYPE OPPIERMIT U I &2 family dwelling or accessory U Commercial/industrial 0 Multi-fatnily ❑Tenant improvement New construction ❑Addition/alteration/replacemenl U Other: U Partial JOBSITE INFORMATION Joh address: - �� v („N Bldg.no.: Suite no.: Tax map/tax lot/account no.: Lot: 3 1 Block: Subdivision: 11rF(C Sou Project name: t/_ _cjW'i?r Description and location of work on premises; Estimated date of completion/inspection: CONTRAUOR APPUCAtION. d Job no: FeeMax - Description Qty. (ea.) Total no.lnsp Business name: Zlm"Lti ec"s, �f C t` New residential-singleormultl-famllyper Address: n j,4d, ljL'/;t7�i -✓� dwelling unit.Includes attached garage. City: , fr_L� State:p1_ Z1 P: C'JL'?U Service Included; 10(X)sq.fl.or less phone; ) jYJ Fax E-mail: Each additional 500 sq.ft.or portion thereof CCB no.: Elec.bus.lie.no: q ceo Limited energy,residential 2 City/gletro lic.no.: U v&ft, ' Limited energy,non-residential Each manufactured home or modular dwelling Signature of supervvisin€el iclan(re uired) DateService and/or feeder 7 Servlccsurfeeders—Installallon, Sup,elect.anon (print). 'a�GT �( License no: L l_( alteration or relocat Ion: 1 200 amps or less 201 amps to 400 amps 2 — Name(print): ,4k),'Ivsnwv 401 maps to 600 amps 2 Mailing address: — 601 amps to 1000 amps City: State: ZIP:_— Over 1000 amps or volts 2 Phone: Fax: E-mail: Reconnectonl l ti�tner installation:nic installation is being made on property I own Temporaryservicesorfeeders- installation,alteration,or relocation: ,III ith i l not intended for sale,lease,rent,or exchange according to 200 amps or less 2 — ORS 447,455,479,670,701. 201 amps to4DOamps 2 ()tuner's signature: hale: 401 to 600 ams ---� - 2 111`1191 itsBranch clrcults-new,alteration, or exterolon per panel: Ntune: __ A. Fee for branch circuits with purchase of Address: _ service or feeder fee,each branch circuit 2 �State: ZIP: B. Fee force or f circuitswithout purchase Ctty: — of Feservice n feeder fee,first branch circuitPhone: T_ il Each additional branch circuit — "` S11sc.(Service or feeder not Included): Each pump of irrigation cucle 2 U Service over 225 mnps•conunercial U Health-care focihn — — 2 U Service over 32U amps-rating of 18 Z U Hazardous locmmii Each sign or outline lighting fmnilydwellings U Building over 10,000 squat feet four or Signal circuit(&)or a limited energy panel, U System over 600 volts nominal more residential units in one structure alteration,or extension• 2 U Building over three stories U Feeders,400 amps or more •Ckscri tion: — U Occupant load ever 99 person i U Manufactured structures or RV park Fach additional inspection over the alloNable In any of the above: U L•gress/)ightingplan U Other: — — Per7nspection — E_ submit__--_sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. other Notice:This permit application Permit fee..................... Not acc ll jurisdiction%aept credit cards,please call Jurisdiction for more infortnanon Plan review(at %) $ O visa U MasterCard expires if a permit is not obtained — Credit card number: .�_ within ISO days ofler it has been State surcharge(9%) ....$ t,%pires accepted as complete. TOTAL ....................... — - Nuts o cerdholderis ihown nn crewi c� _ de;—.it—.,U, 440-4611 t�XK +t CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE WOLCOTT PLUMBING CONTRACTORS PO BOX 2007 GRESHAM, OR 97030 Plumbing Signature Form Permit #: MST2CO2-00080 Date Issued: 7116/02 Parcel- 2S 104DA-21200 Site Address: 12988 SW PRINCETON LN Subdivision: QUAIL HOLLOW - SOUTH Block: Lot. 038 Jurisdiction: TIG Zoning: R-4.5 Remarks: SF rowhouse,Unit # 38,Bldg 8,CSB plan. STRUCTURAL FILL, REQUIRES GEO-TECH INSPECTION AND REPORTS 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 PKWY STE 200 PO COX 2007 PORTLAND, OR 97223 GRESHAM, OR 97030 Phone #: 503-598-7565 Phone #: 667-1781 Reg #: 1 Ir 23847 P1 M 26-208PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X _�-- Signature bfWuthorrz4d Plumber If %,ou have any questions, please call (503) 639-4171, ext. # 310 CITY OF 'rIGARD 13125 S.W. HALL. BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE STREAMLINE ELECTRICAL DBA DIBA LAVALLEY CORONATION 60 25 EAST 18T H ST VANCOUVER, WA 98661 Electrical Sigr.atLira Form Permit l+: iti1ST2002-0uuSS Date Issued: 7116102 Parcel: 2S 104DA-21200 Site Address: 12988 SW PRINCETON LN Subdivision: QUAIL HOLLOW - SOUTH Block: Lot: 038 .Jurisdiction: TIG Zoning: P,-4.5 Remarks: SF rowhouse.Urrit # 38,Bldg 8,CSB plan. STRUCTURAL FILL, REQUIRES GEO-TECH INSPECT ION AND REPORTS Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permi', to be valid, the signature of the supervising electrician is requirea Please have the appropria,- individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATT'N: Building Dept. No electrical inspections will be authorized until ti•ris completed form is received OWNER ELECTRICAL CONTRACTOR: BROWNSTONE QUAIL HOLLOW LLC STREAMLINE ELECTRICAL 12670 SW 68TH PKWY STE 200 DBA LAVALLEY CORORATION PORTLAND, OR 97223 6025 EAST 18TH ST VANCOUVER W 98661 Phone #- 503-598-7565 Phone #: 360-03-5080 Req #: LIC 116514 ELE 34-432C SUP 4601S AN INK SIGNATURE IS REQUIRED ON THIS FORM X -- =— Signature of Supdrvising Electrician If you have any questions, please call (503) 639-4171, ext. It 310 /� MASTER PERMIT _ CITYOF TiGARD PERMIT#: AST2002-00088 DEVELOPMENT SERVICES DATE ISSUED: 7/16!U2 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S104DA-21200 SITE ADDRESS: 12988 SW PRINCETON LN ZONING: R-4.5 SUBDIVISION: QUAIL HOLLOW - SOUTH JURISDICTION: TIG BLOCK: LOT: 038 REMARKS: SF rowhouse,Unit tt 38,BIdg B,CSB plan. STRUCTURAL FILL, REQUIRES GEO TECH INSPECTION AND REPORTS BUILDING `--- ""—" FLOOR AREAS REQUIRED SETBACKS REQUIRED REISSUE: STORIES: CLASS OF WORK: NEW HEIGHT: FIRST: 320 of BASEMENT: if LEFT: SMOKE DETECTORS: Y TYPE OF USE: SFA FLOOR LOAD: ,:,o SECOND: 744 of GARAGE: 412 of FRONT: PARKING SPACES: RIGHT: TYPE OF CONST: 5N DWELLING UNITS 1 FINBSMENT: 732 of VALUE: $173.3n5 60 OCCUPANCY GRP: R3 BDRM. r BATH. 3 TOTAL: 1.79600 rf REAR: PLUMBING LAUNDRY TRAYS: RAIN DRAIN: TRAPS SINKS: t WATFR CLOSETS: 3 WASHING MACH: 1 : LAVATORIES: 3 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 5F RAIN GRAINS. CATCH BASINS: TUBISHOWERS: 2 GARBAGE DISP: I WATER HEATERS: I WATER LINES: BCe(F'_W PREVNT GREASE TRAPS: OTHER FIXTIIRE9: MECHANICAL FURN<1100K: 1 BOIUCMP<3HP: VENT FANS. 4 CLOTHES DRYER: 1 FUEL TYPES FURN>=100K UNIT HEATERS: HOODS: 1 OTHER UNITS: LPG GAS OUTLETS: I MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: ELECTRICAL _RESIDENTI_A_L UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS AOD MISCELLANEOUS 'L INSPECTIONS 0 200 amu: t 0 200 amp: WISVC OR FDR: PUMPIIRRIGATION: PER INSPECTION: 1000 SF OR LESS: 1 PER HOUR: EA ADD'L 5009F: 1 201 400 emp: 201 400 amp: Hl WIO 9VCIFDR: 91GNIOUT LIN LT: EA ADDL BR CIR: SIGNALPANEL: IN PLANT: LIMITED ENERGY: 401 600 amp: 401 600 amp: MINOR LABEL: MANU 14MI9VCIFDR; 601 1000 amp: 6011.empo-1000v: 1000+amplvolt: PLAN REVIEW SECTION Reconnect only: >.4 RES UNITS: SVCIFDR>*226 A.: >600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL•RESTRICTED ENERGY B.COMMERCIAL A.SF RESIDENTIAL —•— AlID10 6 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING� OUTDOOR LND9C LT` BOILER: HVAC LANDSCAPFARRIG: PROTECTIVE SIGNL•. BURGLAR ALARM: OTH: MEDICAL: OTHR: CLOCK: INSTRUMENTATION: GARAGE OPENER. DATARELE COMM: NURSE CALLS: TOTAL N SYSTEMS HVAC: TOTAL FEES: $ 6,099.33 Owner: Contractor: This permit is subject to the regulations contained'n 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 N work is not started within 180 days of issuance,or if the work is suspended for more than 180 days ATTENTION Phone Oregon law requires you to follow rules adopted by the Phone: Oregon Utility Notification Center Those rules are set Rog N: LIC 1246;, 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/undslab Insp Shear Wall Insp Gyp Board Insp Mechanical Final Exterior Sheathing Insl Firewall Insp Plumb Final Footing Insp Mechanical Insp / Foundation Insp Plumb Top Out Special Insp.required Rain drain Insp Final inspection Gas Line Insp Water Line Insp Building Final Slab Insp Electrical Rough In Electrical Final WIT Proofing Bsm't We Framing Insp Insulation Insp _ Issued By : t_ Permittee Signature : Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next bus Mess da� CITYOF TI G RD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: s 16/02 •000s3 DATE ISSUED: 7/16/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S 104DA-21200 SITE ADDRESS; 12988 SW PRINCETON LN SUBDIVISION: QUAIL.HOLLOW•SOUTH ZONING: BLOCK: LOT: 038 JURISDICTION: TIG IG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF US( : SFA NO- OF BUILDINGS: INSTALL TYPE: LTPSWR iMPERV SURFACE: Remarks: Sewer connection Owner: - FEES _ BROWNSTONE QUAIL HOLLOA' LLCType By Date Amount Receipt 12670 SW 68TH PKWY STE 200 — PRMT CTR 7/16/02 $2,300.00 27200200000 PORTLAND, OR 97223 INSP CTR 7116/02 $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: Permittee Signature: Call (503) 639-4175 by 7:00 P.M.for an inspection needed the next business day O I &2 family dwelling or accessory U Commercial/industrial U Mule-family U Tenant improvement U New construction U Add ition/alteration/rcplacement U Fcood service U Other -T 1 { SITE INFORMATION1Information use dieck 151) Job address: .�� U� r refc. L. Mbscri tion _ O' •. Fee(ea.) Total Bldg.no: Suitc no.: New ll-and 2-family dwellings only: Tax ma tax loUaccount no.: (Includes 100fl.foreachutllltyconner-tion) fU SFR(1)bath Lot: ck:BloSubdivision: 3. � Silt(2)bath _ Project name: SFR(3)bath City/county:_ ZIP: Each additional badAitchen Description and location of work on premises: SiteutWties: _ Catch basin/area drain _ Est.date of con.pletion/inspection: Drywelis/leach linc/trench drain— — Footing drain(no.tin. it.) { 1 1 Manufactured home utilities _Manholes Wolcott 1'lunihu1 - Rain drain connector PO Box 200? Sanitary sewer(ho. Hn. fi.)--' —Gresham OR Storm sewer(no.lin.ft.) 503-667-1791 Water service(no.lin.ft.) CC[3:?3947 11I.M 11:26-2091'13 Ilxture or item: --- -- Absorption valve Vrint.mnw tractor's,representative signature: pack flow reventer _ [)arc: Backwater valve — 1N]MT PERSON Basinsliavatory Name: Clothes washer Address: — -- Dishwasher — City: ---—�_ State: ZIP: Drinking fountain(s) _ `Z — r __ Ejectors/sump — Phone: Fax: E-mail: F3xpansion tank Fixture/sewer cap _Name(print): Floor drains/floor sinks/hub _ Mailing address: — — Garbage disposal -- _- _------- Hose bibb _ City: _ State: 71P: Ice maker Phone: _�Fax J Email: __ InttrLor—g_rcase trap — _ — Owner installation./residential maintenance only. The actual installation Primer(s) will be made by me or the mainteruwcx and repair made by my regular Roof drain(commercial) _ employee on the pniperty I own is per ORS Chafwer 447. Sink(s),basin(s),lays(s) Owner's signature:___ Date: Sump — — Tubs/shower/shower pan _`— Urinal 7===Fax: Water closet Water heater ste: Other.E mail: -- Total Nffw ctl m rxro mxbt c &,pkre uu jairdicdm m for alataoram Notice:This permit application Minimum fee................$ Not dl i �— a Yw U MutprCOMexpires if a permit is not abtaincd Plan review(at ) $GmM _-- amara --. --_-- ---1 — within 190 days after it has been State surcharge(.396)....TOTAL .......................$ N.me ar aarcLolecr a iha+ro ora card — accepted as uomplett. _ s _ - dsaram _�am�:ee 4144616(600btaa14) O New construction U Add ition/alteratio rel,acemcn - 1 { 1 1 1 , lob address: $U.� t`6^4 v indicate equipment quantities in boxes below.Indicate the dollar Suite no.: value of all mechanical materials,equipment,labor,overhead, Bldg.no.: profit.Value$ - Tax I.,aphsix lot/account no.: 'See checklist for important application information aril Lot: e �Qiock: Subdivision: puri•diction's fee schedule for residential permit fec. Project name: 1SCHEDULE City/county. —�-ZIP _ ' 1 ! 1 1 Description and location of work on premises: - Hec(ea) I dal _ 1Dctcri 'on - Qty. Res.only Res.only Fst.date of comPletion/inspection: _ Cc Tenant improvement or change of use: Air handling unit CFM Is existing space heated or conditioned?U Yes U No —Arm, itionmg(arc pian requir«--T-- Is existillp space insulated?U Yes U No -ATtcrationo exis g IVAC systcrn oiler com(nessors State boiler permit no.: NP Tons I3TUM Four Seasons Heating&A/C Service inc --- -Mire smo e ani�duct sm eat pump(site p an requug o a electors PO Box 66409 nsta rep ace urea• ,urner__Wlt Portland OR 97290-6409 Including ductworfr/vent liner U Yes U No 503-775-5919nstallhrTacdrelocate eaters---suspennec-f, CCB: 48283 wall,or floor mounted - -- - -went for a Wince other than furnace Name(please tint): r era oa 11 Absorptionunits.__-______ BTU/11 Name: __— Com trssors _-- lip - Address: isi omen tett atn yen i on: City: State ZIP: - `_ Appliancevent ---- �- - Ut er ex gust PF,one. Fax: Entail: Y s, 1'ypr res. eche sinal 1 DI hood fire suppression system Exhaust fan with single duct(bath fans) _ Name: —.__- ___ ---- .xVaust s stem apart from catin or AC Mailing address: _—_-__ e p p ng*Q on up to ou els City: "� ----- .SType: t3'U tate: - ZIP: _ Oil _ - _ .- __` N(; _ --- Phone: 1'ax E-mail: •vel t tng eac additional over 4 outlets 'rocest piping(schematic required) Numaxr of outlets - Name: _-.-- - O(We-r T�eia�cI or eyulpm�ret: Address: `---' Decorative fireplace -- - --- r State: ZIP: --- nsert-type City:_ -_ - tovc pc Ietatove [Mone: I�ax: E-mail: (hhcr. Applicant's signature. bate: — �' --- Name S Permit fee..... --- Na an on%WMA CM&cords,*W call)arifi&c6an rm nae ida amilin Notice:This permit aPPlication Minimum fee................$ ____e_----- U Visa U MasterCard expires if a permit is not obtained Plan review(at —%) $ - 1- 1 within 180 days aver it has bow o,&t card oumtxr.— -__._ --- t:�,;,n State surcharge(896) $ _ u sent — accepted as complete. TOTAI, .....$ - -- see d s .................. --- Casdlsokla dgoadae ---- A 4/04617(60MC , ❑New construction itio a era to rep acemen JOB SHEINVORMATION Job address: (igle s w I Bldg.no.: 1 Suite no.: Tax map/tax lot/account no.: Lot: f' Block: Subdivision: - _____ _ Ptvject name: Description and location of work on premises: Estimated date of completion/inspection: 1 1SCHEDULE; Job no: l ec Ma► Total nn.Ins Streamline Electric Newresk"fial-dWkortmufti-famlly per DBA LaValley Corporation dwraangunh.lnclwksanaclydgaraRa 6025 Last 18"'St 1000 69 ft.or less 4 Vancouver WA 98661 Each additional 500 sq,ft.or portion thereof 360-993-5080 Limited energy,residential 2 CUB:116514 ELCII: 34-432C SUPi1; Umitedenergy,non-residential 2 ~ Each manufactured home or modular dwelling Signature of supervising electrician(required) Due Service and/or feeds _ 2 License %ervicaorfeeders-Installation. Sup.elect.name(print) alteration or relocation: VROPERTY tl 200 amps or less — 2 Name(print): 2011 amps to 400 amps,_—__- - --- 2 --- 401 amps to 600 amps _ 2 - Mailing address: _ _ 601 amps to loon amps 2 City: State: ZIP: Over loon amps or volts _ 2 Phone: Fax: I E-mail: Reconnect only I Owner installation:The installation is being made on property 1 own Temporary wrvkes w feeders- which is not intended for sale,lease,rent,or exchange according to Installation,alteration,orrrlocation: 200 amps or less 2 ORS 447,455,479,670,701. 201 amps to 400 amps - _ - 2 Owner's signature: Date: 401 to 600 amps --— _ 2 Branch clrcult,-new,alteration, or eslenslon per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2- Slate:Slate ZIP: B. Fee for branch circuits without purchase of service or feeder fee,first branch circuit: 2 f'honC' - - Fax: E-mail: Each additional branch circuit -- Misc.(Service or feeder not included) U Service over 225 amps-commercial U Health-care facility Each pum or irrigation circle — 2 •Service over 320 amps-rating of 1&2 U Hazardous location Each sign or outline fighting _ 2 familydwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel. U System over 6W volts nominal more residential units in one stricture alteration.or extension• w _ _ 2 U Building over three stories U Feelers,400 amps ormorr *Description _ _ _--_- U(k-cupam load over')9 persons U Manufactured structures of R V park Each additional fnsperlIon over the anon able in any of the above: •fgressnightingplan U(Rhes -- -_-- Per inspection Submit_sells of phun with any of the above. Investigation fee Title above are not applicable to temporary consttrudloo service. Other Not all Jwiaeietiom accept credit cads.pkase call Jurisdiction rot nxwr mfa too m Notice:This permit application Permit fee.................... - U Visa 0 MoterCard expires if a permit is not obtained Plan review(at ___ %) $ _— credit cad somber: within 180 days after it has been State surcharge(8%)_.$ _ R` accepted as complete TOTAL ....................... ��ame of ear�fir der a, as t err S Cardboldet atyutae -- Areouww - 440.4615(6M"WI)