Permit (30) CITY OF TIGARD SITE WORK PERMIT
440 r DEVELOPMENT SERVICES PERMIT # : SIT2006 -00006
{ j.'.��� �� ,. 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED : 8/25/2006
PARCEL : 1 S136DD -04100
SITE ADDRESS: 11850 SW 67TH AVE ZONING : MUE
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT: 007 JURISDICTION : TIG
Project Description: Site work (building 1 & parking garage site)
CLASS OF WORK: NEW PAVING ?: Y RESO. NO:
TYPE OF USE: COM GRADING ?: Y VALUE: 250,000.00
EXCV VOLUME: 1,500 cy LANDSCAPING ?: Y
FILL VOLUME: 5,000 cy SITE PREP ?: Y
ENG FILL ?: Y STORM DRAINS ?: Y
SOILS RPT REQD ?: Y IMPERV SURFACE: 71,667 sf
Owner: FEES
PACIFIC NW PROPERTIES Description Date Amount
ATTN: PAUL GRAM [BUPPLN] Pln Rv -Valu 6/2/2006 $864.05
P.O. BOX 2206 [FLS] FLS Pln Rv 6/2/2006 $531.72
BEAVERTON, OR 97075 [ BUPPLN] Addl Pln Rv 8/25/2006 $400.00
Phone: 503 - 626 -3500 [BUILD] Prmt Fee -Valu 8/25/2006 $1,329.30
[TAX] Valu 8% State Surcha 8/25/2006 $106.34
Contractor: [ERPLN] Erosn Pln Rv CWS 8/25/2006 $32.50
[EROSN] Erosn Pln Rv COT 8/25/2006 $32.50
P + C CONSTRUCTION CO. [ERPRMT] Erosion Control 8/25/2006 $100.00
PO BOX 410
GRESHAM, OR 97030 Total . $3,396.41
Contact #: FAX 503 - 667 -2565
PRI 503 - 665 -0165 REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 -4444
Reg #: LIC 38619 Structural masonry
Engineered soils
Special inspection (see plans)
Final observation & acceptance
Structural observation
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 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: adeAn . Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Site Work //id S 66 6 W ------
BuildinE Permit Ap :I ( j J V I t F OR OFFICE USE o�'1 :�
City of Tigard 1 • Received
V Date/B . , / ,/ I Permit No.S i � # eya
13125 S Hall Blvd Tigard, OR 97223 II � Plan Revi - Jill
Phone: 500 3.639.4171 1 Fax: 503.598.1919 60) J R 2 U // '.,c : I Date/B . ! Other Permit.
Inspection Line: 503.639.4175 tt �,; � ''a Date Re.. By: El See Page 2 for
U
Internet: www.ci.tigard.or.us TY OF 1!VC1 ` Notified/Method: IMI Supplemental Information
3tm..nm'r. rITJQ
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
Z New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
• CATEGORY OF CONSSTRUCTION work indicated on this application.
❑ 1- and 2- family dwelling I " ommercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: jl Zf 5-D �J 67 New dwelling area: square feet
City /State/ZIP: �,�R7 ( r ') t c e- 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name:
et3tt_Dtn►el Q t (4 13.11-/N�1 Covered porch area: square feet
Cross street /directions to job site: STCL.) Deck area: square feet
,J 6- 1-tkrriDi, 5 Co g -14 Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $ 2S Cx7C--)
1,10.x. Oi rle.-- 13 , t i-i 5 7- rate_ v u S - a-oi l
1 I 1 Existing building area: •-- square feet
—/ New building area: 4-3 (,f 7 i square feet
E PROPERTY OWNER I ❑ TENANT Number of stories: I. 1 `�R 1419
Name: 'PHU t%rL N 2TIkl.I 'P� . Type of construction: _ F, i i' g
Address: 6 oa i /06 -r iti, l Sucr - /7S Occupancy groups:
City / State/ZIP: e)2 9 7nr� 5 Existing:
I
Phone: (5O-j) 6 2 ' - z Fax: ( &3 6 7 i - oz f 1 New: '8 - 3 Z
❑ APPLICANT ❑ CONTACT PERSON NOTICE
Business name: M t to i 1:1....? t 1io ei rtez JP j 1 All contractors and subcontractors are required to be
Contact name: I licensed with the Oregon Construction Contractors Board
�N VA--5--.4_.—Z.— under ORS 701 and may be required to be licensed in the
Address: 7 6 5 ) D ST , S u ,.rte IZo jurisdiction in which work is being performed. If the
applicant is exempt from licensing, the following reasons
City /State/ZIP: 1c. n r e, dL_. '9i 2:Z.5 apply:
Phone: ( S3) Z 4 4-- 0 5 - sz. I Fax:: (5 ) 24 4 -o4 1 kik/ . gbe -l.O
E-mail: it)tih @_ ,,,,,,c),, e c , 4' m M f f�S 53i. 7 3
CONTRACTOR
Business name.
r
\ 1 (� . �h '
7U r " B UILDING PERMIT FEES
Address:
d � Q Please refer to fee scheduler 2 103v - f9'�. 7
Phone: (0 h .� , �> I Fax ) /
9 Fees due upon application
/
1 ) q Amount received
Authorized signature:
Date received. Q,5 This permit appl i n/
cat n e pires if a permit t not ob ained
/ within 180 days aft r it has been accepted as complete.
Print name: ,,,,j �
.1 V Date: t r ` /c ( 3, • Fee methodology set by Tri- County Building Industry
Service Board.
is \Building \ Permits \SI•I•- PermitApp.doc 12/03 440- 4613T(I I /02/COM/WEB)
r
City of Tigard: Site Work Permit Checklist
Page 2 - Supplemental Information
Commercial, Multi - Family and One- and Two - Family Dwellings:
No permit is required if fill is less than 50 yards (5 dump truck loads), or less than 3 feet deep and will
not be supporting a structure. If a building will be constructed on the fill, it must be engineered fill. If
fill is in a flood plain, drainage way, or wetland, the applicant must apply for a sensitive lands review
(SLR).
Please complete all items below, unless otherwise noted.
Excavation Volume: 1, saw cu. yds.
Grading Volume:
(Soils report required for >5,000 cu. yds.) S o cu. yds.
Fill Volume:
(Fill exceeding 12" in depth shall be
compacted to 90% of maximum density) � gao cu. yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU
❑ Concrete
Other: Te,a
*Total new impervious area including all
buildings, sidewalks, and paving: 7 / 66,7 sq. ft.
Site Utilities Plumbing Work:
Complete the Plumbing Permit Application for site utilities plumbing work.
Plans Required: See "Site Work Permit Application - Plan Submittal Requirements"
attached. The following must accompany this application:
❑ Site Plan with Vicinity Map showing ❑ *Parking (including ADA) and
ADA compliance Lighting Plan
❑ Grading Plan and details ❑ *Landscaping Plan
❑ Erosion Control Plan and details ❑ Soils Report (if required)
❑ Retaining Structures
*Does not apply to One- and Two - family dwellings.
# of Plans
TYPE OF SUBMITTAL Required at
(Includes New, Additions or Alterations) Submittal
Commercial 2
Multi- Family R -1 Occupancy 2
One- & Two - Family Dwelling 2
i:\BuildingWorms \SIT- PermitApp.doc 1/13/04 2
CITY OF TIGARD .
BUILDING DIVISION . PERMIT #: SIT2006.00006
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 812612006
Phone: (503) 639 -4171 4 +
Inspection Requests (24 Hrs.): (503) 639 7 4175 . ' °'I I�
INSPECTION WORKSHEET FOR DATE: 9/22/2006 TIME: 7:02AM PAGE: 45
SITE ADDRESS: 11850 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Building 1 and 2 site work.
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503 626
CONTRACTOR: p + C CONSTRUCTION CO. PHONE #: 503 - 665.0165 •
Inspection Request Scheduled For: Date: 9!2212006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
420 Sprinkler supply lines 037021 -01 503- 572 -7305 N
Corrections /Comments /Instructions:
.1•■ . AA 1
❑ PASS T PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
i
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDIT NAL FEES ASSESSED
Inspector: Ant Date: ea Phone #: (503) 718 -4'
p r
CITTOF TIGARD •
- •
BUILDING DIVISION . •
PERMIT #: W2006-00006 •
13125 SW Hall Blvd., Tigard, OR 97223 ffl DATE ISSUED: 8/25/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 10/11/2006 TIME: 7:02AM PAGE: 48
SITE ADDRESS: 11850 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Building 1 and 2 site work. .`
OWNER: PACIFIC NW PROPERTIES, . PHONE #: 503-626.3500
CONTRACTOR: p + C CONSTRUCTION CO. PHONE #: 503
Inspection Request Scheduled For: Date: 10/11/2006 Pour Time 2:00
Code # Inspection Description Confirm # Contact # Message
205 Footing 038006.01 503-969-8240
Corrections/Comments/I Instructions:
• 5;v5f 6 \‘? .0
D g -- 2A - 6 oo ) /
C S
* 6" a, C.
fl PASS , t7(.QRTIAL APPROVAL CANCEL • NO ACCESS
[ FAIL n CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED
Inspector: Date: /6 Phone #: (503) 718- 2.—
CI ■ ■',OFTIGA D .
BUILDING DIVISION PERMIT #: SIT2006- 00006
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8f25/2006
Phone: (503) 639 -4171 , \
Inspection Requests (24 Hrs.): (503) 639 -4175 ` �.1 + �- __ I ,
- INSPECTION WORKSHEET FOR DATE: 10/19/2006 TIME: 7 :02AM PAGE: 58
SITE ADDRESS: 11850 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Building 1 and 2 site work.
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503626.3500
CONTRACTOR: P + C CONSTRUCTION CO. PHONE #: 503 -665 -0165
Inspection Request Scheduled For: Date: 10/19/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
420 Sprinkler supply lines 038485 -01 503 - 730.8325 Y
Corrections /Comments /Instructions_: ;p s t '
LATE1
�% �� ' '� i t TO lam"
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❑ PASS ❑PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ' ALL FOR INSPrCTION ❑ ADDIT NAEES ASSESSED
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Inspector: id � ,� Date: U Phone #: (503) 718- �3
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1 CITYZok
BUILDING DIVISION ,
PERMIT #: SIT2006-00006
i 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/2512006
Phone: (503) 639-4171 ,74.1116\•\ilill'
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 10/24/2006 TIME: 7:02AM PAGE: 63
SITE ADDRESS: 11860 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Building 1 and 2 site work.
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503-626-3500
CONTRACTOR: P + C CONSTRUCTION CO. PHONE #: 503-665-0165
Inspection Request Scheduled For: Date: 10/24/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
420 S'prinIder supply lines 038715-01 503-969-0240 Y
Corrections/Comments/ Instructions:
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1 I PASS • IZAL APPROVAL D CANCEL E I NO ACCESS
1 1 FAIL I CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
16 ' V A
Inspector: 411.r .
Date: t6 --.- ' °P Phone #: (503) 718
A:z.
. . .
CITY OF TIGARD ,
BUILDING DIVISION . A PERMIT #: SIT-2006-00006 13125 SW Hall Blvd:, Tigard, OR 97223' DATE ISSUED: 8/26/2006
Phone: (503) 639 -4171 4..11^,..il iiil
Inspection Requests (24 Hrs.): (503) 639 -4175 „Jig- 11.
INSPECTION WORKSHEET FOR DATE: 4/2/2007 TIME: 7:02AM PAGE: 41
SITE ADDRESS: 11850 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Building 1 and 2 site work.
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503 -626 -3500
CONTRACTOR: P + C CONSTRUCTION CO. PHONE #: 503 - 665.0165
Inspection Request Scheduled For: Date: 4/212007 Pour ' -
Code # Inspection Description Confirm # Contact # Message
205 Footing 045826 -01 503- 572 -7305 N
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Correcti s /Comments /Instructions: .
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L. r iate• .� .:I_ .ate• ) i1
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❑ PASS 1 ,Z . AIRTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL 2 . L FOR INSPECTION ❑ ADDITIO AL FE S ASSESSED
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Inspector: — Date: b Phone #: (503) 718 -
i
CITY OF TIGARD
r
BUILDING DIVISION PERMIT #': SIT2006.00006
13125 SW Hall Blvd., Tigard, OR 97223 - DATE ISSUED:` 8/25/2006- - --
Phone: (503) 639 -4171 l'i
Inspection Requests (24 Hrs.): (503) 639 -4175 .. " ,.'IIII
INSPECTION WORKSHEET FOR DATE: 5/4/2007 TIME: 7:OOAM PAGE: 44
SITE ADDRESS: 11860 SW 6TTH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Building . 1 and 2 site work.
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503.626 -3500
CONTRACTOR: P + C CONSTRUCTION CO. PHONE #: 503 - 65.0165
Inspection Request Scheduled For: Date: 5/4 /2007 Pour Time: 11:00
Code # Inspection Description Confirm # . Contact # Message
210 Foundation walls 047644 -01 503.969 -8240 N
Corrections /Comments/ Instructions:
S @--- t 4 96- v &(ZS
4;0-( (117, Z ( ' ike-5-
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PASS NRTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
' J� A
Inspector. Date: 7 1/0 Phone #: (503) 718 - 7
CITY OF TIGARD --
BUILDING DIVISION PERMIT #: SIT2006.00006
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/25/2006
Phone: (503) 639 -4171 ' �; F'' �� �i��'.
Inspection Requests (24 Hrs.): (503) 639 -4175 _:�
INSPECTION WORKSHEET FOR DATE: 5/23/2007 TIME: 7:OOAM PAGE: 77
SITE ADDRESS: 11850 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Building 1 and 2 site work
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503- 626 - 3500
CONTRACTOR: P + C CONSTRUCTION CO. PHONE #: 503 - 665-0165
Inspection Request Scheduled For: Date: 5/23/2007 Pour Time: 11:00 •
Code # Inspection Description Confirm # Contact # Message
210 Foundation walls 048832 -01 503- 572 -3238 N
Corrections /Comments/ Instructions:
-v- L--/iv g6 7 Z twovl� f
1 K
o n
❑ PASS ❑ PARTIAL APPROVAL CANCEL pi NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
CI ■ Y OF ■ IGARD .,. f .
BUILDING DIVISION PERMIT #: SIT2006.00006
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/26/2006
Phone: (503) 639 -4171 4 q P tl*
Inspection Requests (24 Hrs.): (503) 639 -4175 '
INSPECTION WORKSHEET FOR DATE: 6/6/2007 TIME: 7:01 AM PAGE: 46
•
SITE ADDRESS: 11858 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
.-` DESCRIPTION: Building 1 and 2 site work. .
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503 - 626.3500
CONTRACTOR: P + C CONSTRUCTION CO. PHONE #: 503. 665.0165
Inspection Request Scheduled For Date: 6/6/2007 Pour Tim . 9:00 '
Code # Inspection Description Confirm # Contact # Message
210 Foundation walls 049687 -01 503-572 -3239 N
Corrections /C mments /Instructions:
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n PASS ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ' \./ 6 ; _ Date: (0 6 /en Phone #: (503) 718- ZYZy
4
CITY OF TIGARD
BUILDING DIVISION PERMIT #: SIT2006.00006
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/25/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 . '_ `�' �....
INSPECTION WORKSHEET FOR DATE: 5124/2007 TIME: 7:00AM PAGE: 57
SITE ADDRESS: 11850 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Building 1 and 2 site work
OWNER: PACIFIC NW PROPERTIES,. PHONE #: 503 - 626 -3500
CONTRACTOR: P 4- C CONSTRUCTION CO.. PHONE #: 503-665-0165
Inspection Request Scheduled For: Date: 5/24/2007 Pour Time: 9 :00
Code # Inspection Description Confirm # Contact # Message
205 Footing 048925 -01 503- 572 -3233 N
Corrections /Comments /Instructions:
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PASS P4 PARTIAL APPROVAL _ CANCEL ❑ NO ACCESS
n FAIL a PALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: _�� Date: ' Phone #: (503) 718- `� � �,
. 4
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: SIT200&.00008
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/2&2006
Phone: (503) 639 -4171 44 " 1
Inspection Requests (24 Hrs.): (503) 639 -4175 r� 1! .
INSPECTION WORKSHEET FOR DATE: 9/13/2007 TIME: 7:01AM PAGE: 33
SITE ADDRESS: 11860 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Building 1 and 2 site work.
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503 - 626.3500
CONTRACTOR: P + C CONSTRUCTION CO. PHONE #: 503-665-0165
•
Inspection Request Scheduled For: Date: 911312007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
499 Final inspection 055648 -04 503 - 572 - 7305 N
Corrections /Comments /Instructions:
•
; FA PASS PARTIAL APPROVAL . ❑ CANCEL ❑ NO ACCESS
II FAIL eii CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: - Date: 0 Phone #: (503) 718 - 2.-v7
CITY OF TIGARD
BUILDING DIVISION PERMIT #: SIT2006 -00006 •
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/25/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 � &.. • F:_..
INSPECTION WORKSHEET FOR DATE: 6/15/2007 TIME: 7:02AM PAGE: 81
SITE ADDRESS: 11850 SW 67TH AVE CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE COMMONS LOT #: 007 TYPE OF USE:
PROJECT NAME: TIGARD TRIANGLE COMMONS
DESCRIPTION: Building 1 and 2 site work.
OWNER: PACIFIC NW PROPERTIES, PHONE #: 503 -626 -3500
CONTRACTOR: P + C CONSTRUCTION CO. PHONE #: 503-665 -0165
Inspection Request Scheduled For: Date: 6/16/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Me - se
420 Sprinkler supply lines 050273 -01 503 -572 -7305 • ' /'
At
Corrections /Comm is /Instructions: —
,
•
❑ PASS P ' PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
y i G_ iy � Inspector: _ Date: +� ' O b Phone #: (503) 718 - 2""