Permit CITY OF TIGARD `y ELECTRICAL PERMIT
PERMIT #: ELC2003 -00386
l i d ' DEVELOPMENT SERVICES DATE ISSUED: 7/18/03
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171 PARCEL: 2S112AA - 00900
SITE ADDRESS: 14140 SW 72ND AVE 130
SUBDIVISION: NELSON BUSINESS CENTER ZONING. 1 -H
BLOCK: LOT : JURISDICTION: TIG
Project Description: Tenant improvement, installation of (2) 175 amp & (1) 200 amp feeders, (2) 400 amp feeders and (28)
branch circuits. Job No. 61 -35894
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: 0
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 5 W /SERVICE OR FEEDER: 29 PER INSPECTION:
201 - 400 amp: 2 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: 1 > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
SPIEKER PROPERTIES LP CHRISTENSON ELECTRIC
4380 SW MACADAM AVE STE 100 DBA INTEGRATED ELECTRONIC SYS
PORTLAND, OR 97201 P.O. BOX 708
EUGENE, OR 97440
Phone: Phone: 541 - 486 - 4456
Reg #: LIC 458
ELE 26 -34C
FEES SUP 873S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 6/25/03 $1,095.45
[TAX] 8% State Tax 6/25/03 $87.64 Elect'1 Service
[ELPLCK] ELC Pln Rev 6/25/03 $273.86 Elect'I Final
(additional fees not listed here)
Total $1,670.55
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 at (503) 246-6699 or
1- 800 - 332 -2344.
Issued By: Per t Signature:
OWNER INSTALLATION ONLY 7 /P- ` l 3
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:
Call 639 -4175 by 7:OOpm for an inspection the next business day
V.
Electrical Permit Appli
Date received: Permitno.: FT,F.r2nn3 —n)386
s hl '
J � , g ew J pP P Cl of Ti and 6R Pro'ect/a 1 no.: Expire date:
r
Address: 13125 SW Hall Blvd 722
City of Tigard Date issued: By: I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Jklk- 2.5 2*1 Case file no.: Payment type:
Land use approval: CITY OF 0
SIGARO N
Wt S1
0 1 & 2 family dwelling or accessory 031) Commercial/industrial O Multi- family O Tenant improvement
O New construction O Addition/alteration/replacement 0 Other. O Partial
Job address: 14140 SW 7 2ND Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot: ( Block: (Subdivision:
Project name: POLY (AST (Description and location of work on premises: ADD FEEDERS PER INSPECTOR
Estimated date of completion /inspection: QUESTIONS ?CONTACT JOHN EKMAN (503) 706 -4916
.. - - _ -- (:oNil (:l4)R-APPLICATION .1 1•:1•: M-'11E1MILE
Job no: 61 -35894 Co 0 3 Fee - Max
• Business name: CHRISTENSON ELECTRIC, INC. Description Qt'. (ea.) Total no.insp
New reaiden hl -single ormulti- fandly per
Address: 1631 NW THURMAN ST 2ND FL dwelling unit. Includes attached garage.
City: PORTLAND ( State: OR ( ZIP 97209 -25 Senicebsduded
Phone503 419 3600(Fax:419 36361E -mail: moo sq. ft. orless 4
Each additional 500 sq. ft. or portion thereof
CCB no.: 00458 ec. bus. lic. no: 26 -34C Limited energy, residential 2
City /met r•. no.: 5 ' ' Limited energy, non- residential 2
-- i - Each manufactured home or modular dwelling
Sign . re of supervisi . e ec . (rcqui Date 7/24/03 Service and/or feeder 2
Sup. elect. name (priniR IAN CHRISTOPHER License no: 87 3 S Services or feeders — Installation,
alteration or relocation:
200 amps or less 2 80. : 0 16 ( . 6z)
201 amps to 400 amps 2
Name (print): 401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: (State: ( ZIP: Over 1000 amps or volts 2
- Phone: Fax: 1 E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary senlca or feeders - -
which is not intended for sale, lease, rent, or exchange according to bavtaI1ation, alteration, orrelocation:
200 amps or less 2
ORS 447, 455, 479, 670, 701.
201 amps to 400 amps 2 •
Owner's signature: Date: 401 to 600 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 6. 6 5 2
City: 'State: • ( ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: ; 6 • 2
Phone: ■ Fax: E -mail: Each additional branch circuit: 5. b S
PIN Itl•:Vll•:W1 (Please check all that apply) Misc. (Service or feeder not included):
O Service over 225 amps - commercial 0 Health-care facility Each pump or irrigation circle 2
0 Service over 320 amps- rating of 1 &2 0 Hazardous location Each sign or outline lighting 2
family dwellings 0 Building ova 10,000 square feet four or Signal circuit(s) or a limited energy panel,
75
O System over 600 volts nominal more residential units in one structure alteration, or extension' _ 2
0 Building over three stories 0 Feeders, 400 amps or more *Description: .
0 Occupant Toad over 99 persons 0 Manufactured structures or RV park Each additional Inspection over the allowable in any of the above:
O Egress/lightingplan O Other. Per inspection
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ )Fin _ 6n
O Visa 0 MasterCard expires if a permit is not obtained Plan review (at 2.5_ %) $ _____4a4.5__.
Credit card number: 1 / within 180 days after it has been State surcharge (8%) $ 12 8 S /
Expires accepted as complete. TOTAL $ 213.60 .
Name of cardholder as shown cm credit card
$
Cardholder ,ignature Amount 44114615 (6I00/COM)
OCTOBER 2000 +FEE ON BACK OF FORM
v
Electrical Permit Fees: - Limited Energy Fees:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
COm `
P Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total 4, Check Type of Work Involved:
Residential - per unit I !
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
- . portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy _ $75.00 = .
Each Manuf'd Home or Modular ❑ Garage Door Opener'
Dwelling Service or Feeder $90.90 2
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
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
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 $100.30 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 ❑ Boiler Controls
New, alteration or extension per panel
a) The fee for branch circuits
with purchase of service or ❑ Clock Systems
feeder fee.
Each branch circuit $6.65 - 2 ❑ Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch circuit $46.85
Each additional branch circuit $6.65
Miscellaneous ❑ 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 circuit(s)) or a limited energy
panel. alteration or extension $75.00 ❑ Landscape Irrigation Control
Minor Labels (10) $125.00
Each additional Inspection over ❑ Medical_
the allowable in any of the above
Per inspection $62.50 El Nurse Calls • Per hour $62.50 _ _
In Plant ~ -- $73.75 �_^ El oo
Outdoor Landscape Lighting'
Fees: ❑ Protective Signaling
Enter total of above fees $ n Other
8% State Surcharge $ Number of Systems
25% Plan Review Fee
See Tian Review" section on $ * No licenses are required. Licenses are required for all other installations
front of application.
Fees:
Total Balance Due $
Enter total of above fees $
❑ Trust Account # 8% State Surcharge $
Total Balance Due $
iAdsts\forms\elc- fees.doc 10/09/00 OVER FOR APPLICATION
M CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00386
�s ' -' DEVELOPMENT SERVICES DATE ISSUED: 7/18/03
_44 �' �� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 2S112AA-00900
SITE ADDRESS: 14140 SW 72ND AVE 130 ZONING: I -H
SUBDIVISION: NELSON BUSINESS CENTER
BLOCK: LOT : JURISDICTION: TIG
Project Description: Tenant improvement, installation of (2) 175 amp & (1) 200 amp feeders, (2) 400 amp feeders and (28)
branch circuits. Job No. 61 -35894
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: 0
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 3 W /SERVICE OR FEEDER: 28 PER INSPECTION:
201 - 400 amp: 2 1st W/O SRVC OR FDR: 0 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 0 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: 1 > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
SPIEKER PROPERTIES LP CHRISTENSON ELECTRIC
4380 SW MACADAM AVE STE 100 DBA INTEGRATED ELECTRONIC SYS
PORTLAND, OR 97201 P.O. BOX 708
EUGENE, OR 97440
Phone: Phone: 541 - 486 - 4456
Reg #: LIC 458
ELE 26 -34C
FEES SUP 873S
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 6/25/03 $1,095.45 Elect'I Service
[TAX] 8% State Tax 6/25/03 $87.64 Elea! Final
[ELPLCK] ELC Pin Rev 6/25/03 $273.86
Total $1,456.95
This Permit is issued subjed 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 at (503) 246 -6699 or
1- 800 - 332 -2344.
Issued By: Si 4_, / �� -r .l ' Permit Signature
OWNER INSTALLATION ONL
The installation is being made on property I own which is not intended for sale, I - - • r rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO: g'l �� C
-
Call 639 -4175 by 7:OOpm for an inspection the next business day
R .. Electrical Permit App
Date received' -d -dam Permitno.: ,ti - 003 , •
1 j `'.'� 1 i: City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: MI Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: `
7 1 PE Of PERMIT
0 1 & 2 family dwelling or accessory a Comme 0 Multi - family 0 Tenant improvement
0 New construction 0 Addition/alteration/replacement 0 Other. 0 Partial �.I
ON
Job address: 14140 SW 72ND Bldg. no. : Suite no. /•0 Tax map/tax lot/account no.: 0
Lot: I Block: I Subdivision:
Project name:POLY CAST I Description and location of work on premises: 1 200A SVC, FEEDERS, CIRCUITS
Estimated date of com letion/ins tion: UESTIONS ?CONTACT JOHN EKMAN 503 706 -4916
Job no: - CO Fee - Max
• Business name: CHRISTENSON ELECTRIC, INC. Description Qty. (ea.) Total no.lnsp
1631 NW THURMAN ST 2ND FL New residetdial - or
nadti-fandly I er
Address: dwelling unit. Inclades attached garage.
City: PORTLAND I Ste: OR I ZIP: 97209 -2518 Service include
Phone503 419 36001 Fax: 419 36361 E -mail: 1000sq. ft. or less 4
CCB no.: 00458 • - . bus. lic. no: 26-34C Each additional 500 sq. ft or portion thereof
- Limited energy, residential 2
City /me l ov no.: Limited energy. non- residential 2
T f�9/15,511r Each manufactured home or modular dwelling
Signet of supervisin: lectrici (required) Date 6/24/03 Service and/or feeder 2
Sup. elect. name(prinbRIAN CHRISTOPHER License no: 873S Services or feeders — installation' ?..40..c.01
alteration or
200 amps or1 A 1) 200A 3 80.20 2
Name (print):
201 amps to 400 amps 2 106.35 2; 3.
401 amps to 600 amps 2
Mailing address: - 601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 12 00A 1 +54.65 2/
Phone: 1 Fax: 1 E -mail: Reconnect only 1
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 a O° '� ' H0O ' Or � OCadO°`
ORS 44 455, 479, 670, 701. 200 amps or lest; 2 • 201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 s 2
Branch circuits - new, alteration,
or extension per pane[•
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 28 6.65 186.202
City: I State: • 1 ZIP: B. Fee for branch circuits without purchase #�
Phone Fax: E-mail: service or feeder fee, first branch circuit: 2
Each additional branch circuit: .
1'1.:1 \'' ItI•:\'I (Please check all ilia( ap)l)) Miu . (Service or feeder not included):
O Service over225 amps- oonunercial 0 Health -care facility Each pump or irrigation circle 2
O Service ova 320 amps- rating of 1&2 0 Hazardous location Each sign or outline lighting 2
family dwellings O Building over 10,000 square feet four or Signal circuit(s) or a limited energy /VT?
O System over 600 volts nominal more residential units in one structure alteration, or extension* _ 2
O Building over three stories 0 Feeders, 400 amps or more , Description: .
O Occupant Toad over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
0 Egress/lightingplan O Other: Per inspection 1 I 1 1
Submit — sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Na all jurisdictions accept credit cards. please call jurisdiction for more information. Notice: This permit application Permit fee $ 1095.45
O Visa 0 MasterCard expires if a permit is not obtained Plan review (at 2 5 %) $ 2 7 3 0 8 6
Credit card manner: / / within 180 days after it has been State surcharge (8%) $ _ 87.64
Expires accepted as complete. TOTAL $ 1.456 9 5
Name of cardholder as shown on credit card
S
Cardholder signature Amount 440-4615 (6/00/COM)
OCTOBER 2000 J 6 A" Et-c N +FEE ON BACK OF FORM
1 O P1Ib
Electrical Permit Fees: Limited Energy Fees: '
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total 4, Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
• portion thereof $33.40 ❑ Burglar Alarm
Limited Energy $75.00
Each Manned Home or Modular a Garage Door Opener'
Dwelling Service or Feeder $90.90 2
Services or Fps ❑ Heating. Ventilation and Air Conditioning System'
Installation, alteration, or relocation
200 amps or less $80.30 2 El 201 amps to 400'emps $106.85 2 Vacuum Systems*
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 El Other
Over 1000 amps or volts $454.65 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 $100.30 2 Check Type of Work Involved:
401 amps to 600 amps $133.75 2 y�
Over 600 amps to 1000 volts, ❑
see "b" above. Audio and Stereo Systems
Branch Circuits ❑ Boiler Controls
New, alteration or extension per panel
a) The fee for branch circuits ❑
with purchase of service or Clock Systems
feeder fee.
Each branch circuit $6.65 2 ❑ Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder flee.
First branch circuit $46.85
Each additional branch circuit $6.65 ❑ HVAC
Miscellaneous ED Instrumentation
(Service or feeder riot 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 Landscape Irrigation Control*
panel, alteration or extension $75.00 El
Minor Labels (10) $125.00 ❑
Medical
Each additional inspection over
the allowable In any of the above
Per inspection $62.50 • ❑ Nurse Calls • Per hour $ 62 . 50
In Plant $73.75 ❑ Outdoor Landscape Lighting'
Fees: ❑ Protective Signaling
Enter total of above fees $ ❑ Other
8% State Surcharge $ Number of Systems
25% Plan Review Fee
See - plan Revievf section on $ * No licenses are required. Licenses are required for all other installations
front of application.
Fees:
Total Balance Due $
Enter total of above fees $
❑ Trust Account # 8% State Surcharge $
Total Balance Due $
i:Wsts\formss\elc- fees.doc 10/09/00 OVER FOR APPLICATION
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (303) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested /0 — AM PM BUP
Location /4/ 71 ^a A-ve • Suite 1.30 MEC
Contact Person Ph ( ) 706 4q/(0) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 4 a - 003842
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam _ Anchrs
Ext Sr Sh ea t h / ear /1 Ext eah/h �C_S�-
Int Sheath/Shear
Framing
O^ t
Insulation
Drywall Nailing ",�����j \1 Q CI �1 laV1 r tlft V
Firewall �M
Fire Sprinkler '
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
/44 -
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
Low Voltage
F - _ larm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
• • -- PART FAIL
S E ❑ Please call for reinsp= tion ' E. ❑ Unable to inspect - no access
Fire Supply Line /
Approach/Sidewalk Date 2 Inspect - �.� Ext
Other:
Final D ' NOT REMOVE this Inspection record from the ob site.
PASS PART FAIL
CITY OF TIGARD 24-Hour. •
BUILDING Inspection Line: (603) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested AM > PM BUP
Location /q/(40 - a i n / / Suite 3 0 MEC
Contact Person ,,� Ph ( ) '7 O & — q q (6o PLM
Contractor t/1 ( ) SWR
BUILDING Tenant/Owner ELC 3 /
- D 6 3g4
��
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 / e k Q � �, ` _ / ( 2-
PLUMBING � 1 S 2 C n
cr 2 �-crI - v 4
Post & Beam
Under Slab
Rough -In
((;), OLc 06 ( c c/- 4 4 c / �a? y oo h E_ We - Water Service P �
Sanitary Sewer
Rain Drains e cy l
Qom
a t‘ � "
'"
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
Low Voltage
Fire Alarm
<Ala 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
*ASS al) FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line `
ADA Date - 2 r _03 Inspector Ext
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: (603) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP •
Received Date Requested . °Zg AM PM BUP
Location / (Lf D 7� ✓>t Suite l3 MEC
Contact Person Ph ( ) '7a C 49'1 (Q PLM
Contractor D Ph ( ) SWR c�
BUILDING Tenant/Owner / ��Zr -a%� ELC 3 —60 3n
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 r '1 • 1 " K/ R.40 �]� �' D Drywall Nailing / ► :'�(. J
Firewall
Fire Sprinkler _ 1��
Fire Alarm 7 (J "'� \ L� c \ i \^(\6(
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
‘l
Post & Beam
Under Slab , r l! . U W , • / VDV ,■
Rough -In \\K
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
C�ervic�
1Rt gh -In
UG/Slab
Low Voltage
Fire Alarm
Fin Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
447 PART FAIL
SIT 0 Please call for reinspection RE: ❑ Unable to inspect – no access
Fire Supply Line - J / '
ADA Date / '� 03 Inspect + Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this inspection record rom the j alts.
PASS PART FAIL