The URL can be used to link to this page

13015 SW PRINCETON LANE 13015 SW Princeton Laine CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 MST - -----L------ INSPECTION DIVISION Business Line: (503) 639-4171 BLIP Received __ _Date Re uested 3 .-;'--1 AM PM -__ BLIP Location _3_01s5-- Suite_ MEC4 2, Contact Person _ - Ph( ) � _=-�-3 - PLht Contractor Ph SWR __-- BUILDING Tenant/Owner ELC __- _ - - ------ Footing ELC Foundation Access: Ftg Drain ELR Crawl Dain — Slab Inspection Notes: SIT - Post&Beam -- -----.... ------ --- Shear Anchors Ext Sheath/Shear Int Sheath/Shear FramingDrywall ryInsulation v f/ ) DryS 1 wall Nailing Firewall 1 - Fire Sprinkler Fire Alarm Susp'd Ceiling -�- Root Other:_ - ------------ _- Final _ PASS-- PART FAIL PLUMING Post&Beam Under Slab - - ---- -- Rough-In Water Service --- - - - - -- - - _ - Sanitary Sewer _ Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Other: .-------- S _PART FAIL CHANICAL Post&Beam Rough-In --------- — --------- Gas Line Smoke Dampers ----- --- ---- -- Final --- - - ------ PASS PART FAIL ELECTRICAL Service Rough-In --- --— - UG/Slab Low Voltage ----- - -- - -----. — Fire Alarm Final Ll Reinspection fee of$ -_—_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PARI F.AiL SITE _ Please call for reinspection RE: _ _ _— Unable to inspect-no access Fire Supply Line ADA Dsts I Inspector ff / --- -. Ext __.. Approach/Sidewalk -T-- -- ^+her._.- Final DO OT REMOVE this inspection record from the job .,te. PASS PART FAIL CITY OF TIGA.RD 24-1iour BUILDING Inspection Line: (503)635-4175 INSPECTION DIVISION Business Line: (503)639-4i71 MST BLIP _ 2 Received / �� Date 7t ested AM_---._ PM - BLIP Location _Suite _—__— MEC Contact Person _ _ - __ -.___ 77ylVl Ph( )��,� S PLM Contractor _ _ ___ _ Ph( ) -- S W R BUILDING Tenant/Owner —_ ELC - Footing ELC Foundation Access: Ftg Drain ELF! Crawl Drain Slab Inspection Notes: SIT - - - Post&Beam Shear Anchors - - Ext Sheath/Shear Int Sheath/Shear Framing -- - Insulation Drywall Nailing — - - -- - - - -- Firewall Fire Sprinkler - - - --- ----- . —---- - — F'-e Alarm Susp'd Ceiling - Roof Other: --- - — Final — PASS PART FAIL -- PLUMBING Post&Beam Under Slab -- -- -- Rough-In Water Sorvice --- -- -- - - - --- - - - Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain --- Shower Pan Other: - Final — PASS PART_FAIL MECHANICAL Post&Beam Ruugh-In - - - Gas Line Smoke Dampers Final PASS PART FAIL _ --- --- ELECTRICAL Service Rough-In UG/Slab Low Voltage Fire Alarm AS PART FAIL F] Reinspeclion fee of$_ required before nex'inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE —!A ❑ Please call for reinspection RE:`.._.___.__._______ _ Unable to Inspect-no access Fire Supply Line _. Approach/sidewalk Daft_--2� Inspeator ____ - - _ Ext_. Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 34-Hour BUILDING Inspection Line: (503) +639-4175 MST INSPECTION DIVISION Business Line: (503) 639-4171 BUP ------ --- --- Received Date Requested AM - PM _ _ BLIP Location --- _ Suite__ MEC Contact Person 6-111,__-_ Ph( ) 2q3 53Y PLM - Contractor_ __..____ - PhSWR BUILDING Tenant/Owner ELC Footing ELC Foundation -- r ccass: Ftg Drain ELR - Crawl Drain _ Slab Inspection Notes:P � a SIT Post&Beam Shear Anchors - Ext Sheath/Shear Int Sheath/Shear Framing ------ --- --- - Insulation Drywall Nailing I� - Firewall Fire Sprinkler -- - Fire Alarm Susp'd Ceiling - Roof Other. - Final PASS PART FAIL -- - ----�—�_-- -- -� PLUMBING Post&Beam Under Slab Rough-In Water Service ------ -- ----- -- -.—. __ Sanitary Sewer Rain Drains --- ----- ------ ------ --- -.- ---------. Catch Basin/Manhole Storm Drain - ---- -- --___- --_— _ Shower Pan Other: ______ --_---- ----_. .-_—.-- ------------..- -- Final _PASS PART FAIL MECHANICAL ------- Post&Beam - Rough-In ------ - - ----- - _ — Gas Line Smoke Dampers ---- ----- - -- -- ---- -- Final PASS PART FAIL730-V L -O — — — --- EC RICA Service Rough-In L . _ �Z�D �.' V_�_ — UG/Slab _-- Low Voltage O% ?� Cr.N � _ Fire Alarm [� Reinspection fee of$__ -__required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASPART FAIL SiTr Please call for reins ection RE:_-- -- ---"--_, Unable to inspect--no access Fire Supply Line ADAr-, Approach/Sidewalk Dat✓' -__.r. Inspector Other: Final DO NOT REMOVE this Inspection record fUom the Jobe slte. PASS PART FAIL 341 i► I► STREET FREE CERTIFICATION L , Owner/Agent fors / 'vi/ U (PLEASE PRINT) (PERMIT HOLDER) .� i 4 I► 7 Do hereby certify that the Collo-wing location I► 4 meets City of Tigard/Washington County I No. .4 No. Iland use and development standards for street tree installation. ADDRESS: l SUBDIVISION: 1J - �� (► �f LOT: � ► L 2�' BY: DATE: v ,li i i RECEIVED BY: DATE: _ ► kAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA 30. a 'r STREET TREE CERTIFICATIOT.N. E I, cl- 'USiuV£ Ic , Owner/Agent for �► —T (PLEASE PREM PEA..�ffT H<)i DtR1 �► Do h-e-reby-twffy thax the following location meets City of Tigard/Washington Count- � �( land use and development standards for street tree installation. l► �t s t ADDRESS: — �� 5� ��1i�UGy-7x� (,!J \ �� _ ► iI �► I LCT: SL3BDTVISIC7N: _ jLuaL -�Gcc.t Sv�;►a- BY: �� c2 v �,�,:� s DATE: "`-2� -6 1' R-E.CEIVED BY --- - - - DAfE: "7 -- - - ► /TTTT1'TTvTivvvyTTTT®TVVTTTVTTiPTTTTTVTTTTTTTTvvvvvvvvv vvvv\ CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE. DAVID JEROME ELECTRIC PQ RAX 751 HILLSBORO, OR 97123 Electrical Signature Form Permit#: MST2007-00090 Date Issued. 914102 Parcel 2S104DA-22800 Site Address 13015 SW PRINCETON LN Subdlvision: QUAIL_ HOLLOW -� SOUTH Block:: Lot: 054 Jurisdiction_ TIG Zoning: R-4.5 Remarks: SF rowhou%e,Unit 54,Bldg 12,C5 play, with deck. STRUCTURAL. rll.L, REQUIRES GEO-TECH INSPECTIONS AND REPORTS Your corTrpanv has been indicated as the electric8l contractor for the permit indicated above. In order for the electrical pen-nit to be valid, the Rignature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Ll- . cAI Signature Form prior to the dart of the work in the address above,A,TTN: Building Division Nu electrical insppetion*will by authorized until this completed form in rwceivedi OVvT4FR ELEC I RICAi CONTRACTOR: BROWNSTONE O.UAIL HOLLUW Li-C DAVPO ID J 751 sT'E 2a0 ME ELECTRIC 12670 66TH PKWYHILLSBORO, OR 97123 PORTLAND, OR 97223 Phone 1t. 50398-7566 hone #. 64$ 5144 Req # 1.1C. 3651 SUP MIS FLE 34-1190 AN MNK SIGNATURE, IS Rr-QUIRED ON THIS FORM ` Sipn,ature o upervisIng Electrician If you have any questiors, please call (503) 639-4171, ext ,3fi6 I{? _-. ZoorA SAM t)TIO awni't 3o uo 199rtMOS TVA 98:0T MU co!ZO/To CITY OF TIGARD ELECTRICALRESTRICTED ENERGY- f V RESTRICTED ENERGY DEVELOPMENT SERVICES PERMIT#: ELR2002-00294 3125 SW Hall Blvd.. Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/16/02 SITE :ADDRESS: 13015 SW PRINCETON LN PARCEL: 2S104DA-22800 SUBDIVISION: QUAIL HOLLOW-SOUTH ZONING: R-4.5 BLOCK: LOT: 054 JURISDIC'1-ION: TIG Proiect Description: All encompassing low voltage. A. RESIDENTIAL B.COMMERCIAL_ AUDIO & STEREO: X AUDIO & STEREO: INTERCOM & PAGING: BURGLAR ALARM: BOILER. LANDSCAPE/IRRIGAT: GARAGE OPENER: CLOCK: MEDICAL: HVAC: DATA/TELE COMM: NURSE CALLS: VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE. OTHER: ALI. ENCOMP X MVAC: PROTECTIVE SIGNAL: INSTRUMENTATION: OTHER: TOTAL#OF SYSTEMS: _ Owner: T Contractor: BROWNSTONE QUAIL HOLLOW LLC AZIMUTH COMMUNICATIONS INC 12670 SW 68TH PKWY P.O. BOX 508 STE 200 WILSONVILLE, OR 97070 PORTLAND, OR 97223 Phone: 503-598-7515 Phone: 639-01 10 Reg #: III 36-94C'LE til I' 2312LEA _ 1I( 145828 FEES Required Inspections Description Date _ Amount Low Voltage Inspection �I I I,Iz\1 C) 1.1R Permit 12/16/02 $75.00 Elect'I Final �TA N 18" State Tux 12/16/02 $6.00 Total $81.00 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or if work is suspended for more than 180 days. ATTENTION: Oregon law requires You to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 throuc Issued I�, IQL/Nt��J�J►�a Permittee Signature OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease. or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ON'-Y SIGNATURE OF SUPR. EI_EC'N CRATE: LICENSE NO: Call 639-4175 by 7:00 P.M. for an inspection needed tn: next busiress day Electrical Per trait Application Datereceived:/,AR y. Permit no.: City of Tigar� �j V Project/appl.no.: filtiske date: City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: ceiptno.: Phone: (503) 639-41713 2GG2 - Fax: (503) 598-1960 DEC Case file no.: Payment type: Land use approval: CITY OF TIGARD at III QlN(j 1 U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement Pew construction U Addifi(n/altcrnlinn/replacenx•nt U Other' � U Partial 1 FORMATION Job address: 30i 5—s U, .I 1U4 7T4; t �L Ifldy inn : /„( Suite no.: ITax map/tax lot/account no.: Lot: _ Block: Subdivision: QUAIL 5cV Tarr _ Project name: 4'a IDescription and location of work on premises: Vat 1 SFr L IOFy __ Estimated date ol'completion/inspection: APPLICATIONCONTRACUOR 1 Job no: _ I ec Max Business name: ZI&I LC774 ti (,t t( ;1,)") C Description ply. (ea.) Total no,ins r New msidential-single or mul0-ramih per AddrC59: t./. y{ dwellinguuil.Inciutk-,atlaclrcdgarage. City: LLI(i.$ .t)4rl L I.L State:Qi',1ZIP: c'7UJG Service included: Phone: FaxSope, 'ai - E-mail: I(Nxlsq.It.orlest, 4 r finch Additional 5(xr sq.ft.or portion thereof CCB no.: /M a Elea bus.tic.no: >� CE - — Limited energy,residential 2 City/metrolic.no.: (M)(,S'/? Limited energy,non-residential 2 Each manufactured home or modular dwelling ZL_4� __ __ / /2IaL _ e Signature of supervisinj elect Ian(required) Date Service And/or feeder Sup,elect.name(print): 7J ( � �r Litxnse nu. ?3i1 a Services orreeden-Installation, alteration or relocation: 1 OWNER 200 nnips or less 2 01 amps to 400 amps 2 2 Name(print): t1l4 U)A,1E_ __— ------ _.-__� 201 amps to 600 amps 2 Mailing address: 601 amps to 1000 amps 2 City: State: ZIP; Over I((X)amps or volts 2 Phone: hax: E mall Reconnect onl I Owner installation:The installation is being made on property I (mit Temporary services orfecders- which is not intended for sale,lease,rent,or exchange according to installation,alteration,or relocation: ORS 447,455,479,670,701. 200 amps or less _ 2 2(I I amps n.41111 Amps 2 O\Vlll'r S SI�nalufC: UA(C: 401 to 6811 atu+s 2 Branch circuits-new,alteration, or extension per panel: Name: - -- A Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: Stale: ZIP: H. Fee for branch circuits without purchase —--- — -`-- of service or feeder fee,first branch circuit. 2 11110Ire: Fnx: Email I uchadditionnlbranchcircuit: - --- Misc.(Service or feeder not Included): U Service over 225 amps-commercial U Health-carr faciht} Each pump or irrigatian cute U Service over 120 amps-rating of 1 Net U Hazardous location Bach signor outline lighting 2 family dwellings U Building over 10,M)square feet four or Signal circuk(s)or a limited energy panel, U System over 6W volts nominal more residential units in one structure alteration,or extension• _ 2 J Building over three stories U Feeders.400 amps or more •lkscn tion: U Occupant load over 99 persons U Manufactured structures or RV park fuch additional Inspection over the allowable in any of the above: U f:gmistlighdngplan U odter: -- Per inspection _ F—T -- Submit_ - sets of plans with any of the alcove. Investigation fee '11ne above are not applicable to temporary construction service. Other Not nil Jurisdictions accera credit audit,please call jurisdiction for more InformationNoticc. [his permit application Permit fee.....................$ U Visa U MasterCard expires it's permit is not obtained Plan review(at — %) $ Credit cud number: _ _L�— within 180 days ager it has been Slate surcharge(8%) ....$ Expires accepted as complete. TOTAL ......, ...5 _ Name of cardholder as shown on credit card Cardttol r siRrtaturc Amotir 440-461.5(fiffWoM) ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES- —-- — -�"� TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Complete Fee Schedule ,Beim: Rest acted Energy Fee...................................................... $75.00 Number of Inspections 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 __ _ Audio and Stereo Systems' Each additional 500 sq it or portion thereof _ $33.40 J_ 1 El Burglar Alarm Limited Energy $75.00 _ Each Manufd Home or Modular El Garage Door Opener' Dwelling Service or Feeder $90.90 Services or Feeders Heating,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $80.30 2 Vacuum Systems` 201 amps to 400 amps $106.85 2 El 401 amps to 600 amps _ $160.60 _ 2 E] Other 601 amps to 1000 amps $240.60 __ _� 2 Over 1000 amps or volts $454.65 2 Reconnect only $68.85_ _ 2 Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY allorice or relocation Fee for each system.......................................................... $75 00 Installation, 200 amps or less $66.85 (SEE OAR 918-280-260) 201 amps to 400 amps $100.30_ 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, ❑ Audio and Stereo Systems see"b"above. Branch Circuits Boiler Controls New,alteration or extension per panel a)The fee for branch circuits Clock Systems with purchase of service or feeder fee. Each branch circuit $6.65 F-� Data Telecommunication Installation b)The fee for branch circuits without purchase of service Fire Alarm Installation or feeder fee. First branch circuit $46.85 HVAC Each additional branch circuit _ $6.65___.._ ❑ Miscellaneous F-1 Instrumentation (Service or feeder not Included) Each pump or Irrigation circle $53.40 ❑ Intercom and Paging Systems Each sign or outline lighting $53.40 Signal circuits)or a limited energy $75.00 ❑ Landscape Irrigation Control' panel,alteration or extension — Minor Labels(10) $125.00 _ r, Medical Each additional Inspection over LJ the allowable In any of the above Nurse Calls Per inspection $62.50 Per hour $62.50 _ In Plant $73.75 LJ Outdoor Landscape Lighting` Fees: Protective Signaling Enter total of above fees $ Other_ _ _ ----------- 8%State Surcharge $ _ Number of Systems 25%Plan Review Fee ' No licenses are required Licenses are required for all other installations See"Plan Review"section on $ — front of application. Fees: Total Balance Due $ Enter fetal of above fees s -- ❑ Trust Account# ___- _ __ 81,a State Surcharge = Total Balance Due s All New Cotmmercial Buildings require 2 sets of plans. i:\dsts\fomu\etc-fees.doc 08/30/01 CITY OF T I G A R D _ MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2002-00569 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6'39-4171 DATE ISSUED. 12/13/02 PARCEL: 2S 104DA-22800 SITE ADDRESS: 13015 SW PRINCETON LN SUBDIVISION: QUAIL HOLLOW - SOUTH ZONING: R-4.5 BLOCK: LOT:054 JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: SFA UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS FOODS: _ FUEL TYPES 0 - 3 HP: DOMES. INCIN: I-PG 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMF'ERS7: 30 - 50 HP. WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: 1 FURN >-100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: 1 Remarks: Installation of gas furnace and gas piping. Owner: FEES BROWNSTONE QUAIL HOLLOW LLC Description Date Amount 12670 SW 68TH PKWY %1l c'I I I I'ermit Fee 12/12/02 $72.50 STE 200 I \I StMCTax 12/12/02 $5.80 PORTLAND, OR 97223 Phone: 503-598-7565 Total $78.30 Contractor: FOUR SEASONS HEATING & A/C PO BOX 66409 PORTLAND, OR 97290 REQUIRED INSPECTIONS Phone: 503-775-5919 Gas Line Insp Mechanical Insp Reg#: LIC 48283 Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00 Issued B / .,�.I _ ff- f:� "1 l dG --- Permittee Signature: �- Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day Mechanical Pernut Application Date received: / / p;- Permttno.:h"o 10 City of Tigard Projecl/appl.no.: lel ate: CiryajTigard Address: 13125 SW Hall Blvd,Tigard,OR 9772 Date issued: By: Receipt no.: Phone: (503) 639.4171 Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: Building permit no.: f-15r1,033 TYPE OF PERMIT &2 family dwelling or accessory U Commercial/industrial J Nlulli I;mok U Tenant improvement New construction U Addition/alteration/replacement _1()III(.[ 6111 SITE,INFOlItMATIONO' Job address: ncete1'! _Q, Indicate equipment quantities in boxes below. Indicate the dollar Bldg,no.: Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax mrit*4 t/account no.: profit.Value$ _ Lot: � Block: Subdivision: •See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit Ice. City/county.-T y" ZIP: ► t Description andtt on of work o remissccs: t t t t �Q (, n l ` I er(m) Total Est.date of completion/inspection: Ikscri lion Qty. Res.only Res.only Tenant improvement or change of use: IIVAa"' Air handling unit --CFM— Is CFMIs existing space heated or conditioned?U Yes U No it conditioning(site plan required) _ Is existing space insulated')U Yes U No Alterationofexisting HVAC system or cr compressors State toiler permit no,: Business ame: Lt.y =_C�`�GY HP Tons FITU/H Addie 16 it smo a dampers/duct smo a etectors City: State 0 K 171 P: eat pump(site plan require ) Phone:,50 537-9141 1'ax: E-mail: Insta repace urnac urner j I U7[T Including ductwork/vent liner Ll Yes U No CCB no.: _ nstalureplace re ocale heaters-suspen , City/metro lic.no.: wall,or floor mounted Name(please print): ent or allTiance other than furnace e emt on: 1 1 Absorption units__.__ _ BTU/11 Name:-T->CLYA O,t �U,f W- Chillers —_ --- HP — Compressors---- HP Add"'` Wle Lj Environmental ex taunt an'rent al on: City: i ( ( _ Slat J 7 Appliance vent Fax: Email: )ryercx gust _ 1 [foods,Type res. ttc a iazmat hood fire suppression system Name: _ Exhaust fan with single duct(hath fans) Mailing address: Y x)aunts stem a art nnn lcatin or AC Ue piping an sl ul on(up to 4 outlets) City: _ SUuc: ZIP: Tyle: LPA NG Oil Phone: Fuel pipingeac aitional over 4outlelss IN roeesspiping(schematicrequiret) _ Number of outlets Name: Other fided appliance or equipment: , c'O Address: 1 corative fireplace City: te: ZIP: _ Insert-type Phone: x: E-mail: c stov pe et stove Ch er: Applicant's sigZatu bate: 1 r: Name(print): ,^ jutimuction rtx NM all jutisdicn(un accept r,11,cud%,pleue call "W"infommion Permit .......... .....$ _ Uviss ❑MasrclC'erd Notice:'lhispermit application Minimum fee................$ expires if a permit is not obtained Plan review(at 7(,) $ Credit card numtter __�.�__�_.^ --- I /— within IBB t' seller it has been --' — [iapircs State surcharge(896) ...,$ Name nt ce older ate,own on—l- c�-- s accepted as complete. TOTAL $ --Cardholder si`na0ur Amount W4617 t6WWOM) i MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDU E: TOTAL VALUATION: PERMIT FEE: Description: � Price Total Table 1A Mechanical Code Qty (Ea) - Amt $1.00 to$5,000,00 Minimum fee$72.50 1) Furnace to 100,000 BTU $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and IncludIno ducts&vents 1400 $1.52 for each additional$100,00 or 2) Furnace 100,000 BTU+ fraction thereof,to and Including includin ducts&vents 17.40 $10000.00. Floor Furnace $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) including vent 1400 $1.54 for each additional$100.00 or - frartion thereof,to and including 4) Suspended heater,wall heater 14 00 $25 000.00. or floor mounted heater _ $25,001.0to 0 $50,000.00 $379.50 for the first$25,000.00 and 5) Vent not included in appliance permit 6.80 $1.45 for each additional$100.00 or fraction thereof,to and including 6) Repair units 12.115 $50000-00, _ --- $50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boller heat A(r $1.20 for each additional$100.00 or For Items 7.11,see or Pump Cond fraction thereof. footnotes below. Comp •` _ 7)<3HP;absorb unit Minimum Permit Fee$72.50 SUBTOTAL: $ to 100K BTU 14'00 8%State Surcharge8)3-15 HP;absorb 25.60 $ unit 10%to 500k BTU EtIE 250 Plan Review Fee(of subtotal) � 9)unit.5-1 t.5-1 mil BTU HP;absorb 35.00 Required for ALL commercial ermits onl 10)30-50 HP;absorb TOTAL COMMERCIAL PERMIT FEE: �� unit 1-1.75 mil BTU 52.20 _. 11)>50HP;absorb 87.20 unit>i.75 mil BTU ASSUMED VALUATIONS PER APPLIA_NCEt _ 12FKir handling unit to 10,000 CFM 10.00 Value Total 13)Air handling unit 10,000 CFM+ Description; Q Ea Amount 17.20 Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler ducts&vents 10.00 Furnace-;;-I 00,000 BTU Including 1,170 15)Vent fan connected to a single duct ducts&vents 6'80 Floor furnace Includin 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 805 Repair units 17.40 <3 hp;absorb.unit, 955 19)Commercial or Industria!!;pe incinerator to 100k BTU 69.95 ` 3-15 hp;absorb.unit, 1,700 20)Other units,Including wood stoves 101k to 5t10k BTU -r- _-- 10.00 15-30 hp;absorb,unit,501k to 1 2,310 21)Gas piping one to four outlets frill,BTU 5.40 30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each) 1.1.75 mil.BTU Y 1.00 >50 hp;absorb.unit, 5,725 Minimum Permit Fee 572.50 SUBTOTAL: $ >1.75 mil.BTU Air handlln unit to 10 000 cl,a 656 _ a%State Surcharge $ Air handling unit>10,000 cfm _ 11,170 Non-portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to a single duel 446 Vent system not Included In 656 a !lance emit tether P__ _- Ins ectiona and of n Hood served by_mechanic_al exhaust 658 t Inspections outside or normal business hours(minimum charge-two hours) Domestic incinerator 1,170 _ $82 50 per hour Commercial or industrial Incinerator 4,590 2 Inspections for which no fee is specifically indicated (minimum charge-half hour) Other unit,Including wood stoves, 656 $82 50 per hour Inserts etc. - 3 Additional plan review required by changes,additions or revisions to plans(minimum Gee i I 1 4 outlets 860 y charge-onP-half hour)$62 50 per hour Each additional outlet 63 `3tate Contractor Boller Certification required for units>200k BTU. Residential A/C requires site plan showing pincement of unit. TOTAL COMMERCIAL VALUATION: All New Commercial Buildings require sets of plans t:ldstsiformslrnech-fees.doc 02/11/02 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE WOLCOTT PLUMBING CONTRACTORS PO BOX 2007 GRESHAM, OR 97 030 Plumbing Signature Form PerrrA #: MST2002-00090 Date Issued: 9/4/02 Parcel: 2S 104DA-22800 Site Address: 13015 SW PRINCETON LN Subdivision: QUAIL HOLLOW - SOUTH Block: Lot: 054 Jurisdiction: TIG Zoning: R-4.5 Remarks: SF rowhouse,Unit 54,Bldg 12,CS plan with deck.. STRUCTURAL FILL, REQUIRES GEO-TECH INSPECTIONS AND REPORTS Your company has been indicated as the plumbing contractor for the penr,it 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 QUAII HOLLOW LLC WOLCOTT PLUMBING CONTRACTOR' 12670 SW 68TH PKW PO BOX 2007 STE 200 GRESHAM. OR 97030 PORTLAND OR 97223 Phone # 503-598-7565 Phone #: 667.1781 Reg #: I Ir 23847 PI M 26-208PR AN INK SIGNATURE IS REQUIRED ON THIS FORM Signatu`r"'d Autt razed P!umber If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD BUILDING INSPECTION DIVISION 4js ) 24-Hour Inspection Line: 63; 175 Business Lime, 639-4 C1^ BUIR Date Requested_ —AM PM BLD Loca �_ 1�t' I `� .�.-� �- -.�� — Suite �_. EL, -11 �i Contact Person _— _ Ph _— _ PLM _ 'fid+ �-e Contr Ph ------- SWR Tenant/Owner _ --� —__ ELC — ,Nall ELR Footing Access. Foundation FPS ----- - -._-- Ftg Drain SGN Crawl Drain Inspection Nates Slab --- ------ -_-- - ---- -- -- - --- - - __ SIT Post 8 Beam --ii�—A- Ext Sheath/Shear Int Sheath/Shear \ _ Z d /l /L- Framing t� � Insulation `fin �( L Drywall Nailing � �� = Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Mise --- — �_ i F SS PART FAIL ----- _ - — — - ----- - - -- L ING Post&Beam ,Under Slab Top Out Water Service Sanitary Sewer Rain Drains — Final ti i i P RT FAIL -_ —.__ - rEA � - i Rough In Gas'.ine -- --- -- S e DampP s, 11l 0CS • PART FAIL TRI CAL - -- - - - -----�--f---- Service Rough In UG/Slab - - ---- Low Voltage Fire Alarm - --- - - --- - - - Final PASS PART FAIL SITE _ Backfill/Grading -- -- ` -- Sanitary Sewer Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ J Please call for reinspection RE. [ ]Unable to inspect-no access Fire Supply Line _-� ADA Approach/Sidewalk VzVon Other Date Inspector '- Final PASS PART FAIL 00 NOT REMOVE this inspection record from the job site. CITY OF TIGARD I Residential Certificate of Ocrir pcjjjc rmit ^OT �Pe Owner/Contractor: Date of Final Inspection: I j �ctiy D Inspector•. _ This structure has been found to be in substantial compliance with the provisions of the State of Oregon One& Two Fam' S rialto Code and is herebya ved for Deco rh Dwelling uJ�g9�6. 03 ',1111'�i1'::3 FAI 501 ft7n VII r{RLSQN TESTV uu: Car. son Ceotec,mica . Malo011ie"(mien Mc. GU. 9ux.VV 14 400 Ht,dBonAvgrs,HE PQ 6!,r 7¢111 A 0;,-i%kr,M(:�AYC„ 1bt1U,1. Im f,Qare,0'600�07211 Sslrn,ON 9-n0+ Send,on VTM5 Gna+ennnbil cor*V111119 ►+,vr1e(W.1)04-3460 Ph.Y1e 1903)6119.1252 Phone;5411)330.9155 (,3M♦)drflDn h,�p�axln ir0 PIo��1�d tnvH FAY(503i 117 .0 a; rAr(909)389.1309 PAX 1541)330 WW March 7', '1003c �') R . loll Kelly I �0 ' 16 ilk to Aff,wnStpw 1 '10R1f3y 1261'u SW bbl' Parkway#2110 Iioard, Oregon 81223 Re. Final Letter of Gooteehnical Observations Ouail hollow Building 12 M h Worcheuter and Princeton Ir 1 Tigard,Oregon CGT Pro(e1.t G0302M the purpose of this hatter in pr:)vlde yet. w1'• rlormallor ; the foulr,latron .ubgrade eor huild r1�j '2 of thea Uua I NcIlow 9ubd1\.•1sio,1 1r f igarc C~�!,,un At your rvr.m—'l We Oh9f!►Ve(t 10011'19 sul+„rAde conclrtiens after th,i oulldmy had been corslruct@�, cy untholtng down nt-yl %)the fr.undaton zind probing widerneath the footing with a ”: inch tliamelel fuundatior. od Suhgwe crnndltlons consisted of rro drum dense poll in the po'.huled local,or►s. with one excep!lon r+t the nr,Ih\vesl corner ;1t the building 12 50(jrade t'ond+ons :d lhlti Ivivat1ol coll'iA e!I of c.011 5011 CGT obsrrvr)d that the soft sotl wn-� romuvrd from the• hase 1)f t!IA fnnting Anet replaced Wit rn,ittolled density fill m) recomme,tide d on 3118;03 9asod on our obsurvatlrnsthn fr3Cting s, hq-nie ob%or,eq for tudtJng 1, hrl; !.een preparers 0 accordance with our roc:ommendauuns Phase Can!acl I1tS if you have anv qut'stiul,s 1�CSpE r.t1U i/ ,uhm,tted, CARLSON GEOTECHNICAL ! /c?<LII� J �' l �at11 till/, Jared kle shell pdS64Af Q Gen;erhtlinA Staff sr,nk J nq M Ni mgr .F Pr opal(;A 1,chr,1_ral rFxPlHtes(� �+ �• _1 /?E_100AIA17E2� 70 /1`5/1 /03 aA117-_ ` CITY ®F T i A R 0 MASTER PERMITPERMIT#: MST2002-00090 DEVELOPMENT SERVICES DATE ISSUED: 9/4/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4,171 SITE ADDRESS: 13015 SW PRINCETON LN PARCEL: 2S104DA-22800 SUBDIVISION: QUAIL HOLLOW - SOUTH ZONING: R-4.�, BLOCK: LOT: 054 JURISDICTION: 'I Ili REMARKS: SF rowhouse,Unit 94,Bldg 12,CS plan with deck STRUCTURAL FILL, REQUIRES GEO-TECH INSPECTIONS AND REPORTS. 5/29/03 Add A/C unit BUILDING REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBI.CKS REQUIRED CLASS OF WORK: NEW HEIGHT FIRST: 320 st BASEMENT sl LEFT: SMOKE DETECTORS: Y TYPE OF USE: SFA FI OOR LOAD 50 SECOND 144 cf GARAGE 4I of FRONT: PARKING SPACES TYPE OF CONST: 5N DWELLING'1NITS I 14RD 131 sl RIGHT: . OCCUPANCY GRP: RJ BGRM. BATH. � TOTAL. 1795 VALUEt 17 3U5 50 sf REAR: PLUMBING SINKS. I WATER CLOSETS WASHING MACH. LAUNDRY'FRAYS: RAIN DRAIN. TRAPS: LAVAIORIES. I DISHWASHERS I FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUBISHOWERS GARBAGE DISP. I WATER HEATERS: 1 WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICA FUEL TYPES FURN<T00K. BOILICMP-3H t VENT FANS. 4 CLOTHES DRYER: t I PG FURN100K. UNIT HEATERS. HOODS: I OTHER UNITS: MAX INP: blu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: I ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS_ BRANCH CIRCUITS MISCELLANEOUS AWL INSPECTIONS 1000 SF OR LESS: 1 0 200 amp I 0 200 amp WISVC OR FDR: PUMPARRIGATION: PER INSPECTION EA ADD'L 500SF: 3 201 400 amp: 201 400 amp: 1st W/O SVCIFDR: SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 600 amp. E AADDL SR CIR: SIGNAUPANEL: IN PLANT: MANU HM/SVC/FDR: 601 1000 amp: 601+amps•1000v: MINOR LABEL: 1000+amolvolt: PLAN REVIEW SECTION Reconnect only: +-4 RES UNITS: SVCIFDR>-224 A.: a 600 V NOMINAL: CLS AREA/SPC UCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO&STEREO: VACUUM SYSTEM: AUDIO 6 STEREO FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER HVAC: LANDSCAPEIIRRli PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATAITELE COMM: NURSE CALLS: TOTAL 6 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 5,645.70 BROWNSTONE QUAIL HOLLOW LLC BROWNSTONE HOMES,LLC This permit is subject to the regulations contained in the Tigard Municipal Code,State of OR. Specialty Codes and 12670 SW 68TH PKWY 12670 SW 68TH PKWY all other applicable laws. All work will be done in STE 200 PORTLAND,OR 97223 accordance with approved plans. This permit will expire if PORTLAND,OR 97223 work is not started within 180 days of issuance,or if the work is suspended for more than 180 days. ATTENTION. Oregon law requires you to follow rules adopted by the Phone: 503-598-7$65 Phone: 503-598-7565 Oregon Utility Notification Center. Those rules are set forth In OAR 952-U01-0010 through 952-001-0080. You Ren N: LIC 1246?' may obtain copies of these rules or direct questions to CLINIC by calling(503)246-1987. REQUIRED INSPECTIONS Sewer Inspection Mechanical Insp Electrical Service Shear Wall Insp Insulation Insp Firewall Insp Footing Insp Mechanical Insp Electrical Rough In Exterior Sheathing Inst Insulation Insp Rain drain Insp Foundatlon Insp Mechanical Insp Framing Insp Exterior Sheathing Inst ,JnsWation Insp Water L Insp Slab Insp Plumb Top Out Framing Insp Special Insp.required Gyp Board Insp ElectHcal final Plm/undslah Insp Plumb Top Out Framing Insp Gas Line Insp Firewall Insp Mebhani I Final Issued By ,f Permittee Signat re �' Call('503)639-4175 by 7:00 p.m. for an inspection neede next business day CITYOF TIGARD _ SEWER CONNECTION PERMIT PERMIT#: SWR2002 00064 DEVELOPMENT SERVICES 13125 SW Hall Blvd., Tigard, OR 9722.3 (503) 639-4171 DATE ISSUED: 9/4/02 PARCEL: 2S104DA-22800 SITE ADDRESS; 13015 SW PRINCETON LN SUBDIVISION: QUAIL HOLLOW - SOUTH ZONING: R-4.5 BLOCK: LOT: 054 JURISDICTION: TIG _ TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SFA NO. OF BUILDINGS: INSTALL TYPE: L.TPSWR IMPERV SURFACE: Remarks: Sewer conrection for SF rowhouse Owner: ------- -- _ FEES — BROWNSTONE QUAIL HOLLOW LLC 'Type By Date ^ Amount Receipt 12670 SW 68TH PKWY — -- — --- STE. 200 PRMT CTR 9/4/02 $2,300.00 27200200000 PORTLAND, OR 97223 INSP CTR 0/4,02 $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 frorn 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" Permit and the Agency will install a lateral. ATTENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952--001-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling (503) 246.198 Issued by: /_ Permittee Signature: Call (5021639-4175 by 7:00 P.M. for an inspection needed the next business day RECEIVED Building Permit Application — Date received: % y 0 v Permit no.:I S74002- �Q City of Tigard Cut uF 11,uARL► Address: 13125 SW Hall ISUMMOICIMEMP Project/appl.no.: Expire date: City nj77gard Phone: (503) 639-4171 Date issued: By;J,P, I Receipt no.: Fax: (503) 598-1960 i Case file no.: Payment type: Land use approval: 1&2 family:Simple Complex: TYPE OF PERMIT U I �� 2 family dwelling or accessory U Commercial/industrial U Multi-family 0 New construction U Demolition U Additi„tJaltcratiol>/replacement U Tenant improvement J Fin•sprinMerlalarm U Other: JOB SITE INJ;6RMATION Job address: 'LOr,kc'L c `KL Bldg.no.: ” Suite no.: Lot: S' - B`loc Suhdivision: qy��/�d� ;:. _�L' ly Tax.nap/tax lot/account no.: ''Iey/ Project name: Description and location of work on premises/special conditions: 1 INFORMATION, (Floodplain,seplic capacity,so far,etc.) Name: f Mailing address: IN -�' 1 &2 family dwelling: City: p r-4". tc Statc:e)R ZIP: -jq)2:,.Q Valuation of work......................... ............. $ _ Phone - Fax: p Ii-mail: No.of bedrooms/baths................................. Owner's representative: RoxTotal number of floors................................. Phone: _r. ` F' I'ax:(, I: mail: New dwelling area sq.ft. APPLICANT Garage/carport arca(sq.ft.).............I........... Name: f „� Covered porch arca(sq.ft.) ......................... Melling address: _SW ->� _ Deck area(sq.ft.)........................................ City: t .�c State: ZIP. 4 Other structure area(s . ......................... — Phonc: hex: I •mail: Commercial industrial/multi-family: 1 Valuation of work........................................ $ Existing bldg.area(sq. ft.) .......................... Business name: C , --� t New bldg.area(sq.ft.) ................................ Address: r5' cltk Number of stories ................. Statco ZI . .... Phone - Fax:62c^ •r --mail: TYIx of construction........................ ......... --- (h:cupancy group(s): Existing: CCB no.: 1 Z 4 6 ,2� _ New: City/metro lic.no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under _Narne: (a ( [: provisions of ORS 701 and may be requited to be licensed in titc Address: 4 L S:. ."le U jurisdiction where work is being performed.If the applicant is City; s State ZIP: exempt from licensing,the following reason applies: Contact person: He Plan no.: -- —- Phone: _ x: 1 E-mail: - Name:i w. Pon¢ Contact person: Fees due upon application ........................... $_ Address: SLC �J c f-4 Date received: City: t cti.r Nite:Lnk JZIP77�J.)_3 Amount received ......................................... $ p 1 Fax: E-mail: Please refer to fee schedule. 1 hereby certify 1 have read and examined this application and the Not all prrisdictiom acre"credit cards.please call jurisdiction for mrxe information attached checklist.All provisions of laws and ordinances governing this U Visa U Mastercard work will be complied whetite red herein or not. credit care manner J —_`--- — I-1rc1—_ krlAuthorized Sign tire: . : — Named cardmider n shown on credit card $ Print name:- w r __. Crdtalder signature —� Arnmt Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 1444613(60WOM) Plumbing-Penni�� ,� Date r ceived: Pertthit no.:HS1' City OAr Tigard Sewer permit no.: Building permitno.: Address: 13125 SW I fall Blvd,Tigard,OK 97223 — CityoJ7-igard I'ttone: (503)639-4171 Project/appl.no.: Expire date: Fax: (503)598-1960 �,,j j y 0 PI IUAKL' I Date issued: Hy: Receipt no.: ILgL.DING DIV19, 10Casc file no.: Payment type: Land use approval: -- -_--- TYPE OF PERMIT U I &2 family dwelling or accessory U Commerc:iallindustriai U Multi-family U Tenant improvement U New constntction U Addition/aheration/replacement U Food service U Otter:_ 368 SITE INrdRr*iATION1 (for special Information use checklio) Job address: �h W a v a Ucscription _ fN . Fee(ca.) Total Bldg.no.: Suite no.: New 1-and 2•famlly dw-cllings only: (includes 100 fi.for each uritft y connection) Tax map/tax lot/account no.: -_ SFR(1)batt Lot: 4 Block_ Subdivision: SFR(2)bath -- - — -- Project name: _ — ---- SFR(3)bath - -- City/county: T7,1P: -- Each additional batlulitchen Description and location of wort on premises: _ Site utilities: Catch basin/area drain Fst date of completion/insptxtion PLUM. — f hrywells/leach lineltrench drain - RING 1 1111 Footing drain(no.lin.ft.) _— Manufactured home utilities _ Manholes Wolcott Plumbing Rain drain connector _ PO Box 2007 Sanitary sewer(no.lin.ft.) Gi-eshatn OR 97030-0594 Storm sewer(no.lin.ft.) 503-667-1781 Water service(no.lin.ft.) CCB:23847 111.M #:26-2081'1 Fixture or Item: Absorption valve Ghatractor's representative siRrtautle: Back flow preventer Print name: Dari': ,Backwater valve 1 1 Basinstlavatory Name: Clothes washer ---- ---- --— — Dishwasher Address: _ _ Drinking fountain(s) --- -- Cit . State: �.II': —.--- — _y — ----,------- Gjectorslsump I'fhonc; Fax: B mail Expansion tank _� - — rxture/scwer cap _ Name(print): -- Floor drainstfloor sinks/liub - Garbage disposal Mailing address: _ _ — - - - Hose bibb City: State: ZIP: erIce mak ---- --- Phone: _ JPax: E-mail: Interceptor/gmase trap Owner installation/residential maintcmuice only: The actual installation Primer(s) will be made by me or the maintenance and repair tnade by my rrgular Roof drain(commercial) _— employee on the property I own as per ORS Chapter 447 Sink(s),basin(s),lays(s) _ Owner's signature: Sump Tubs/shower/shower pan Urinal Name: - Water closet _ Address: _ Water heater City: �- — State: ZIP: Other. Phone: _ - - - Fax: J Iii-mail: - -- - Total Na W knir"au wcro«edit card,please eaa rutcdkdoa rot mar idawrtan Notice:This permit application Minimum fee................$ _. U Vus U MastaCwd expires if a permit is not obtained Plan review(at — %) $ «matt cmd aimber.__— -- - within 180 days after it has been State surcharge(8%)....$ Name of atelharda to siowo m,7031 eltd s accepted as complete. TOTAL .......................$ 4"16 01Ot1COW Mechanical l'erm' . 4 a bm 1W�W W 0—date reeeivod: Phnit no.:f t,ity of Tigard ProjecUanpl.�.: —_ FxpiredatccCity of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 1*7223 , pate issued: By: Receipt no.: Phone: (503) 639AI71 afy OF DAJ —� Fax: (503) 598-1960 file Payment type: ---_----____ 8�� g Building permitno.: Land use approval: -- —- – TVPIE 1 U 1 &2 family dwelling or accessory U Commercial1industrial U Multifamily U'I chant inyxovcntcot U New constnlction U Additiolgalteratior/replacement U 06ter:_ — — 1 { 001-1 t a 1 1 1 Job address:I Indicate equipment quantities in boxes below.Indicate the dollar Bldg.no.: Suite no e --_ value of all mechanical materials,equipment,labor,overlid, profit.Value$ Tax map/tax lot/account no. — Lot: Block:__ Subdivision: —__ •Sec checklist for important application information and jurisdiction's lee schedule for residential permit fee. EDes,ctiption:and name: _T - ------ 1 unty: --_--_-- t l r 1 t ow location of work on promises:— —_-- -- hce(eA) 7,Q(Y. Res.only Res.only e ocompletion/inspection: Tenant improvement or change of use: Air handling unit CF-M Is existing space heated or conditioned?U Yes U No Air con i6oning(site p an requ )Is existing space insulated?U Yes U No A terauon of exisu—ng IAC system 1 1 taller/compressors State boiler permit no.: ilP --Tons—BTU/11 Four Seasons heating&AIC Service Inc Fr srm edam ductsmokc etectors - PO Box 66409 eat PUMP-site P an royuirc3)- Portland OR 97290-6409 nst�reTacefurnacd urner_- 503-775-5919 Includit.g ductwarlUvent liner O Yes U No _ nsta repacrlmlicatchcatcrs-suspcn CCI3: 48283 wall,or floor mounted �ent�or as liarxx otter than fns nacc Name(please print) c era CONTACT1 Absorptionunits___._ Grillers � —___ Ill' -- Name: — -C ---------�--—__-_ - Co ressors-l ItII�'o n:Addfa- Wrmenix a State: ZIP: Applianccvent ity: _- Phone: -_--- Fax: Lmail: rycrezFaust — �iods, ype res. it K ta7mct- 1 hood fire suppression system -- Name: _ Exhaust fan with single duct(bath tars) - -- - x aust system apt from ,eaung or AC Mailing address: - - ,uc p plTug�-d'dribu7on(up to 4 ou cis City: _ - Stale: Z1P: —--_ Type. IFG _._ NG Oil _ Fax: Email: uc t m w i6orul'over outlets Phone: Croce, P P g(sc maticrequrr ) — -- Number of outlets Name: _ _ --------- ter c3ipiVu- e a ueq Pment: Address: ___ Decorativefireplacx ---_ --- State: nsert-iype -- City: __ _-- -- — �Ttov pe Id stove — __-- Phone Fax: E-mail: (x t--� — Applicant's signature: Date: Name (print): ---- ----- - Permit fee.....................S Not all jw{w"Offs WXer ciedif earth.vk+�cvt jwisd tion fa mor`id—dw Notice:This permit application Minimum fee............... _ -- O Visa U MasterCard expires if a permit is not ohtained plan review(at —_%) $ Ciedir card number: — �i -- within 180 days after it has leen - State surcharge(896) ...$ --- accepted as complete. .me at�as aedu c«d s TO'fAl. .......................$ -- - t'ard6older tlRntture -_ Aaoad-.._ 4104617(60WWL