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Permit CITY OF TIGARD MASTER PERMIT Alk PERMIT #: MST2003 -00472 -41I-;/.11 DEVELOPMENT SERVICES DATE ISSUED: 9/17/2003 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 14385 SW 80TH PL PARCEL: 2S112BA -05100 SUBDIVISION: WAVERLY MEADOWS ZONING: R - , BLOCK: LOT: 005 JURISDICTION: TIG REMARKS: Residential remodel of master bath, bedroom and kitchen, alteration of (4) windows and (2) skylights. 10/2/03, add an additional (5) branch circuits. 2/7/05, PERMIT REINSTATED FOR 30 BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THRO: sf RIGHT: VALUE: 2,000.00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR: PLUMBING SINKS: 1 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL /CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 1 0 - 200 amp: 0 W /SVC OR FDR: 00 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: 00 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 • 600 amp: EA ADDL BR CIR: 0.00 SIGNAL /PANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 448.43 This permit is subject to the regulations contained in the MICHAEL, RANDOLPH + PHYLLIS J METRO SERV INC Tigard Municipal Code, State of OR. Specialty Codes 14385 SW 80TH PL 7007 SW PINE ST and all other applicable laws. All work will be done in TIGARD, OR 97223 TIGARD, OR 97223 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. Phone: Phone: 245 - 4877 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: LIC 118407 rules are set 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 Plumb Top Out Framing Insp Electrical Service Electrical Final Electrical Service Plumb Final Electrical Rough In Final inspection Electric. - •ug n I , l Issu-d By : _ / .,.4:.,„:„. Permittee Signature ��C11 , /�, ! ���Sr �' Call (503) 639 -4175 by 7:00 p.m. for an inspection neede• e next • • -ss day /e) A-4 - CI Y OF GARD Q4,7 MASTER PERMIT • PERMIT #: MST2003 -00472 kosto �,L �.� DEVELOPMENT SERVICES DATE ISSUED: 9/17/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 14385 SW 80TH PL PARCEL: 2S112BA - 05100 SUBDIVISION: WAVERLY MEADOWS - ZONING: R -7 BLOCK: LOT: 005 JURISDICTION: TIG REMARKS: Residential remodel of master bath, bedroom and kitchen, alteration of (4) windows and (2) skylights. 10/2/03, add an additional (5) branch circuits. BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: VALUE: 2,000.00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR: PLUMBING SINKS: 1 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 1 0 - 200 amp: 0 W /SVC OR FDR: / Q PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: 00 is'tL, SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EAADDL BR CIR: 0. SIGNAL /PANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 323.43 This permit is subject to the regulations contained in the MICHAEL, RANDOLPH + PHYLLIS J METRO SERV INC Tigard Municipal Code, State of OR. Specialty Codes and 14385 SW 80TH PL 7007 SW PINE ST all other applicable laws. All work will be done in TIGARD, OR 97223 TIGARD, OR 97223 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: Phone: 245 -4877 Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You Re g # LIC 118407 may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Electrical Service Final inspection Electrical Rough In Framing Insp Plu b ainal Plum, b Flnal Iss d By : _, -- 1 �� —�:_ Permittee Signature : _,,�1 "1-- if ,/— Abb./ _,_ -1111& /" Call (503) 639 -4175 by 7:00 p.m. for an inspection needed t e next business day \ MASTER PERMIT CITY TIGARD PERMIT #: MST2003 -00472 �,�i�� DEVELOPMENT SERVICES DATE ISSUED: 9/17/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 14385 SW 80TH PL PARCEL: 2S112BA -05100 SUBDIVISION: WAVERLY MEADOWS ZONING: R -7 BLOCK: LOT: 005 JURISDICTION: TIG REMARKS: Residential remodel of master bath, bedroom and kitchen, alteration of (4) windows and (2) skylights. BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD. sf RIGHT: VALUE: 2,000.00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR: PLUMBING SINKS: 1 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: 1 W /SVC OR FD R: 00 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: 00 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EAADDL BR CIR: 0.00 SIGNAL /PANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 287.52 This permit is subject to the regulations contained in the MICHAEL, RANDOLPH + PHYLLIS J METRO SERV INC Tigard Municipal Code, State of OR. Specialty Codes and 14385 SW 80TH PL 7007 SW PINE ST all other applicable laws. All work will be done in TIGARD, OR 97223 TIGARD, OR 97223 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: Phone: 245 -4877 Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You Reg #: LIC 118407 may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Electrical Service Final inspection Electrical Rough In Framing Insp Electrical Final PlCr al \ Issu B Ku `-�tX , S ' Permittee Signature : A �� � 111. Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day i Building Permit Application . FOR OFFICE USE ONLY Received G Building , j � �® Date/By: / / 7 0 3 Permit No.: I'r ,3 7 / / 7y 1 Tigard E! Planning Approval Other C ty of ��V Date/By: PermitNo.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 SEP 1 7 2003 Date/By: Permit No.: Phone: 503- 639 -4171 Fax: 503 -598 -1960 G � 1 u G�iy� �y� ( Post- Review Land Use Internet: www.ci.tigard.or.us 'I Date/By: Case No. 24 -hour Inspection Request: Contact ®See Page 2 for p q U MDV1SlON Name/Method: f/ Supplemental Information c�r x � ti .. �.,, j .. � � ,,���� r ��� aw i 3g „, � � '�s ' n '' z��t 'f� �''E��T �� , { � y �_. � ?. a . 3 NI P, LOY W`�?,R� S. TRIM ', I'l -1, r ; .. Q1 R +ED D . 4 t "spy ❑ New construction El Demolition ° _ 1= 2'� aril;ft; / LL1N Addition/alteration/replacement El Other: .- ,..:, .:.- -- - . Eid r, M , i ._,, . , ., , ,y-,-,t ' ." (A EG®RY O GO NAt'(JO.RO ! 7: Vfintt Note: Permit fees* are based on the total value of the work performed. Indicate El 1 & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead and profit for the work indicated on this application. 2s e op ❑ Accessory Building ❑ Multi- Family _ ❑ Master Builder ❑ Other: Valuation $ ' or N n Ji9B -SIT sIN QR] 'I%TQN i d 0.00 o " .A.N. No of bedrooms: No of baths: Job site address: / 43 $ 5 --- '5 64 S30 Pi • Total number of floors New dwelling area (sq. ft.) Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft.) Project Name: M te..A q..g � � (240A0 o de I Covered porch area (sq. ft.) Cross street/Directions to job site: 4 j . ti O u J`0 Deck area (sq. ft.) Other structure area (sq. ft ) tO n, ., C�0.+) 4 o �o rw Cr(. 12_64 ( 06211W) +o - w t b1§ 44^ rt Ace, CW e-S -0 ;�� `�� ' g6 at En Il ' �� F 1r a r t ja Subdivision: Lot #: Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate ` xamat ` StDESCRIl'i I'ovapai old- :. ,, the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead and profit for the work indicated on this application. Rice, Lou ("v)d &II darle... re /OLai W mot 060 5, d o d e / J .1 Z Valuation $ � ' /' Existing building area (sq. ft.) t dl f19� / New building area (sq. ft.) Number of stories ° I P,ROPiRTI',OWNER ' Cols 4 FlintYMTV ; „ Type of construction Name: erAne /it-(,h a ei Occupancy group(s): Existing: 9%tn /O/ New: Address: / ¢3 $.� .�w 0p City /State /Zip: ✓ cod 02, Phone: £b (q, 3 `7 0 Fax: NOTICE: All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under ( 741* TC'AN ?? ",£1 _ r-"*A + t '' provisions of ORS 701 and maybe required to be licensed in the Business Name: jurisdiction where work is being performed. If the applicant is exempt Contact Name: from licensing, the following reason applies: Address: City /State /Zip: Phone: I Fax: �fi, E-mail: B>�7 � >t�s � kk Please r e r t'o``ttee. "sc e i �T e 3 + ° " �, k� ... s � ... g G®NT AC {I DI2 °-44f e� = x 7 . . z fe C% f 3 :"aY`"'", ,» i ,, °. fbV : ; � i a • Business Name: / � oQ'e?/ I'1" Fees due upon application $ Address: /? $l v,` iuhre Cs . City /State /Zip: 7t tr ti v /Z 9 .7e6e3 Amount received $ Phone: � ( Fax: ' b 50 s Date received: CCB Lic. #: %. , / Authorized % /�J Notice: This permit application expires if a permit is not obtained within Signature:. , Date: � /' 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. (Please print name) i:\Dsts\Permit Forms \BldgPermitApp.doc 01/03 f � Aft„ One- and Two - Family Dwelling - 1,1 Building Permit Application Checklist Reference no.: Associated permits: City ofTigard City f Tigard Y g ❑ Electrical ❑ Plumbing ❑ Mechanical Address: 13125 SW Hall Blvd, Tigard, OR 97223 ❑ Other: Phone: (503) 639 -4171 Fax: (503) 598 -1960 THE 'FOLLOWING ITEMS ARE REQUI ' D FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. • 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. 3 Verification of approved plat/lot. 4 Fire district approval required. 5 Septic system permit or authorization for remodel. Existing system capacity 6 Sewer permit. 7 Water Ootrict approval. 8 Soils report. Must carry original applicable stamp and signature on file or with application. 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch -basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if there is more than a 4-ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells/septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub -floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non - prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists over 10 feet long and/or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or architect licensed in Oregon and shall be shown to be applicable to the project under review. JURISDICTIONAL SPECIFICS 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". 24 Two (2) sets each are required for Items 16, 19, 20 & 22 above. 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will be not accepted. 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. 27 "Drawn to scale" indicates standard architect or engineer scale. 28 Site plan to include tree size, type & location per approved project street tree plan (if applicable), and COT Street Tree List. Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 440 -4614 (6 /00 /COM) Building Fixtures • Plumbing Permit iOn FOR OFFICE USE ONLY . U E W E D Received Date/By: Plumbing )7 / Permit No.: OD, j- e lf) 7- of Tigard Planning Approval Sewer J g Date/By: Permit No.: 13125 SW Hall Blvd. SEP 1 7 Plan Review Other Tigard, Oregon 97223 Date/By: Permit No.: Post - Review Land Use Phone: 503- 639 -4171 Fax: 503-59&11190)F TI 4.h;�dNll(I,I `,\ Date/By: Case No.: Internet: www.ci.tigard.or.us BUILDING , u y I I Contact Juris.: ® See Page 2 for 24 -hour Inspection Request: 503- 639 -4175 ` '�" Name/Method: Supplemental Information. El s4Aifik' 3a� '�� x � � "i""3i �. n ��' . a.us+�9 tF x o 7 # ; IVRA ... Y* .E QF NVISO :�, E . ":. MIM SCHOAi}LEdigspecial it rmairaV ,cite laRM2 ❑ New construction ❑ Demolition Description I Qty. I Fee(ea.) I Total ❑ Addition/alteration/replacement ❑ Other: w1familyd yell g X `" �'. C"G(aTtYQCO5eRU IO 1 (includ 100 lfifor ea uiar conneetJon 'rte , 111 1 & 2- Family dwelling El Commercial/Industrial SFR ( bath 350.00 SFR (2) bath 350.00 Accessor Building ❑ Multi Family SFR (3) bath 399.00 ❑ Master Builder ❑ Other: Each additional bath/kitchen 45.00 gilen ,' ' aI1SLMOTOR1yIt1"TI,O ; an TOCA ITO J = . Fire s render - s ft.: .Page 2 Job site address: / yz3 3 S $�✓ 10 Pk/0• 10 A Site ,Ut►l tiesVI -., ; I I Suite #: Bldg. /Apt. #: Catch basin/area drain 16.60 Project Name: Drywell/leach line /trench drain 16.60 Footing drain (no. linear ft.) Page 2 Cross street/Directions to job site: Manufactured home utilities 110.00 Manholes 16.60 Rain drain connector 16.60 • Sanitary sewer (no. linear ft.) Page 2 Subdivision: Lot #: Storm sewer (no. linear ft.) Page 2 Tax map/parcel # `� o ft a" 3 f< w�� DES RLP ° N . e service (no. _.. . M Tizfure or,; Ite ' „v Page 2 ,"'LL. ME Water to Absorption valve 16:60 Backflow preventer Page 2 Backwater valve 16.60 Clothes washer 16.60 • Dishwasher 16.60 Drinking fountain 16.60 • IP OP 'RTiiY UVG I w ma E ANTt',, ; .,,,., , ± . •.� ;. Ejectors /sump 16.60 Name: /2a vt o f Mt J i t� Expansion tank 16.60 Address: /4 3 pf 5 �,�/ B p/Q G� Fixture /sewer cap 16.60 City /State /Zip: 771 4 WI Floor drain/floor sink/hub 16.60 Garbage disposal 16.60 Phone: -4 50 3 Z/3 7Fax Hose bib 16.60 falatairONSTMLICiNkiii & El CONtTfA"MER'SOIv ? Ice maker • 16.60 Name: Interceptor /grease trap 16.60 Address: Medical gas - value: $ Page 2 City /State /Zip: Primer 16.60 f drain • 1) 16.60 Phone: Fax: . avato ' ry / 2, 16.60 E -mail: Tu. /sho ./sholfe 16.60 . `% ,. . ' I `J ,CQN 2 ORO a,H v + $11031,7:-%! Urinal 16.60 Business Name: (,Je_,' j2 ph) r4 blr/5 Water closet 16.60 Water heater 16.60 Address: Other: City /State /Zip: • Other: Phone: Fax: ?aa- . , ;1P1i44 ng P -e i tie , ° 'T . _ W.' i' CCB Lic. #: Plumb. Lic. #: Subtotal $ Minimum Permit Fee $72.50 $ SD Authorized Residential Backflow Minimum Fee $36.25 7 / - Signature: Date: Plan Review (25% of Permit Fee) $ State Surcharge (8% of Permit Fee) $ C. Fc O (Please print name) TOTAL PERMIT FEE $ 'f cs' , '1 Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans with isometric or • 180 days after it has been accepted as complete. riser diagram for plan review. *Fee methodology set by Tri -County Building Industry Service Board. i:\Dsts\Permit Forms\PlmPermitApp.doc 01/03 • Plumbing Permit Application - City of Tigard • Page 2 - Supplemental Information Fee Schedule: _ Residential Fire Suppression Systems: , -tt Utllttles :D= 7. n - 4 ' WF ea 't" ae *• -a et + ,;: -z ' n... '9"�:,'z 4 ' ,_,.s�, K .. , . P 4 T ota S,uarFotge Pe riru v t F,ee xa. ^F 3�P:d +ASpc � . ,vAm zi A ., - �� L "A, = � - it.f.F:vt°.ti$a'F "x Footing drain - 1 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: • Water Service -each additional 100' 46.40 . �valua*1!1 k «, Pernut Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each additional $100.00 or fraction thereof, to and c XtUrC,,01 CtIll` Q eY 4 btd� 4 ,. �., .. ..m- including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $37950 for the first $25,000.00 and $1.45 for each additional $100.00 or fraction thereof, to Inspection of existing plumbing or and including $50,000.00. specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for Subtotal: each additional $100.00 or fraction thereof. • Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees *. �� 'bO � z, � � ,�Quan"hty��y-3(>`�xt�rej Wor�k�Performe.�. � Comments regarding fixture work: iKx Ftxture'Type 1 w " ia " Eepla2 • t am • N 'iv Baptistry/Font Bath - Tub /Shower - Jacuzzi/Whirlpool Car Wash -Each Stall -Drive Thru Cuspidor/Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash Floor Drain/sink - 2" • -3" 4 „ Car Wash Drain *Note: If the fixture work under this ermit results in an Garbage - Domestic p Disposal Couuuercial increase of sewer EDUs, a sewer permit will be issued and - Industrial fees assessed for the sewer increase must be paid before the Ice Mach. /Refrig. Drains plumbing permit can be issued. Oil Separator (Gas Station) Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar /Lavatory - Bradley - Commercial - Service Swimming Pool Filter Washer - Clothes Water Extractor • Water Closet - Toilet Urinal Other Fixtures: is \Dsts\Permit Forms\PlmPermitAppPg2.doc 01/03 Electrical Pern0 Ig • in FOR OFFICE USE ONLY . • f , - 1 Received Date/By: . Electrical Permit No.: City • of Tigard Planning Approval Sign 13125 SW Hall Blvd. SEP 1 7 2003 Date/By: Permit No.: Plan Review . Other Tigard, Oregon 97223 Date/By: Permit No.: Phone: 503-639-4171 Fax: CR03R-TEGARD tovilawili Post-Review Land Use Internet: www.ci.tigard.or.uPU1LDING DIVISION . Wrii I Date/By• Case No.: Contact Juris.: El See Page 2 for 24-hour Inspection Request: 503-639-4175 ''''" ' Name/Method: Supplemental Information. tigfiEffntk,'74 OMETATMVOMOMWOMMAMINITAITARWMICOM El New construction [ 0 Demolition .0 Service over 225 amps- 0 Health-care facility commercial 0 Hazardous location 0 Addition/alteration/replacement 0 Other: 0 Service over 320 amps-rating of 0 Building over 10,000 square feet, bfiPatrggaltWAVEW.WV 1 & 2 family dwellings four or more residential units in [11 1 & 2-Family dwelling 0 Commercial/Industrial 0 System over 600 volts nominal one structure 0 Building over three stories 0 Feeders, 400 amps or more 0 Accessory Building 0 Multi-Family 0 Occupant load over 99 persons 0 Manufactured structures or RV park 0 Master Builder 0 Other: 0 Egress/lighting plan 0 Other: aWileataM4E:041 ffieL:=411 Submit sets of plans with any of the above. The above are not applicable to temporary construction service._ Job site address: /4-3 OS k) 6 Y.- 1)/4,, 2„:„.„,„,„.., Suite #: Bldg./Apt.#: Number of inspections per permit allowed Project Name: Description Qty Fee (ea.) Total New residential-single or multi-family per . Cross street/Directions to job site: dwelling unit. Includes attached garage. Service included: 1000 sq. ft. or less 145.15 4 Each additional 500 sq. ft. or portion thereof 33.40 1 Limited energy, residential 75.00 2 Subdivision: Lot #: Limited energy, non residential 75.00 2 Tax map/parcel #: Each manufactured home or modular dwelling cimmmr;54 service and/or feeder 90.90 2 Services or feeders - installation, . alteration or relocation: • 200 amps or less 80.30 2 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 N . „,:; r o tom m i tosvotkm: .,,,, migo:2 wINR,T 601 amps to 1000 amps 240.60 2 Over 1000 amps or volts 454.65 2 Narne: t e_,E4 4 - Le ,t 144 qe1 Reconnect only 66.85 2 Address: /4316 5 A.) s 094 p i Temporary services or feeders - installation, alteration, or relocation: City/State/Zip: 7q 200 amps or less 66.85 • I Phone: .'"':' : ,51) 3 & 2,0 -- 4 7 3-7 201 amps to 400 amps 100.30 2 '''' 4 401 to 600 amps 133.75 2 6 1 ' r.S.WEIGAN fri rdONVAVT;VtitgbNs:' . la -' -.L"-4--L-''..'-'-'' .-•-''''''''''''' ' ' 4 "r ' ' -=-=-- ' ' ------.'-'--'''-:.--- .----'-----'-'" ''''' . '` - - Branch circuits - new, alteration, or Narne: extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 6.65 2 City/State/Zip: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit 46.85 2 Phone: Fax: Each additional branch circuit 6.65 2 E-mail: Misc.(Service or feeder not included): ,- .-,,.: i,,,,. . Each pump or irrigation circle NSCrdrtAZTM:MfEOWCIVKM.ktltViiiiitA2V.,i;;n..:.:,:-:l., Each si 53.40 2 gn or outline lighting 53.40 2 Job No: Signal circuit(s) or a limited energy panel, • " alteration, or extension Page 2 2 Business Name: /11— Er pole, (le-.- c. Description: Address: Each additional inspection over the allowable in any the above: City/State/Zip: Per inspection per hour (min. 1 hour) 62.50 Phone: ( 0 9) Fax: Investigation fee: Other: CCB Lic. #: Lic. #: cazzl7 samoratmovoinr,L74::::z:as', Supervising electrician Subtotal $ signature required: Plan Review (25% of Permit Fee) $ Print Name: rA a t/le...> -a"-rws Lic. #: State Surcharge (8% of Permit Fee) $ • . TOTAL PERMIT FEE $ Authorized Notice: This permit application expires if a permit is not obtained within Signature: Date: 180 days after it has been accepted as complete. *Fee methodology set,by Tri-County Building Industry Service Board. (Please print name) i: \Dsts \Permit Forms \E1cPermitApp.doc 01/03 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all systems $75.00 Check Type of Work Involved: n Audio and Stereo Systems n Burglar Alarm ❑ Garage Door Opener n Heating, Ventilation and Air Conditioning System n Vacuum Systems n Other COMMERCIAL WORK ONLY: Fee for each system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: n Audio and Stereo Systems n Boiler Controls Clock Systems n Data Telecommunication Installation n Fire Alarm Installation n HVAC n Instrumentation 0 Intercom and Paging Systems n Landscape Irrigation Control El Medical El Nurse Calls Outdoor Landscape Lighting n Protective Signaling n Other Number of Systems * No licenses are required. Licenses are required for all other installations i:\Dsts\Permit Forms \ElcPermitAppPg2.doc 01/03 From: Brian Perkins To: Fax#5035981960 Date: 09/25/2003 Time: 3:43:04 PM Page 1 of 1 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 ' r, ' MPORTANT PERMIT NOTICE •t1'� 1 - OX 128 ELECTRIC RECEIVED • OREGON CITY, OR 97045 -1808 V SEP 2 2003 CITY OF TIGARD Electrical Signature Form BUILDING DIVISION Permit #: MST2003 -00472 Date Issued: 9/17/03 Parcel: 2S112BA -05100 Site Address: 14385 SW 80TH PL Subdivision: WAVERLY MEADOWS Block: Lot: 005 Jurisdiction: TIG Zoning: R -7 Remarks: Residential remodel of master bath, bedroom and kitchen, alteration of (4) windows and (2) skylights. our company has been indicated as the electrical contractor for the permit indicated above. In order for the Iectrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and retum this Electrical Signature Form prior to the ;tart of the work to the address above, ATTN: Building Division. ■0 electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: MICHAEL, RANDOLPH + PHYLLIS J M -ERWIN ELECTRIC 14385 SW 80TH PL PO BOX 1282 TIGARD, OR 97223 OREGON CITY, OR 97045 -1808 Phone #: Phone #: 503 -655 -1808 Reg #: ELE 3-431C LIC 150756 SUP 2703S AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Supervising Electrician f you have any questions, please call 503.718.2433. c La - r2: 3 - 5r8 / � i CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MS 0LL - - 4Q 41, INSPECTION DIVISION x Business Line: (503) 639 -4171 d BUP Received Date Requested — / I AM _PM BUP Location / Lf3 0 [,0 Y- " (I Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( . ) • SWR �U ILDI Tenant/up gO 0 J (37 ELC Footing Foundation ELC Access: Ftg Drain • EL c_ - az) - PL ill ELR Crawl Drain Slab Inspection Notes: /�� - , SIT Post & Beam Ali a -/� �i� Shear Anchors Ext Sheath/Shear Int Sheath/Shear '� :` Framing " IC ° :�i .,. Insulation J Drywall Nailing , ikA j � `, .rid, 4 Z-" �- Firewall � � � ` 1 ' vG '�-' ' � i Fire Sprinkler , (� ^ � e � ._ � Fire Alarm � � ■(.�� cQ__"_ Susp'd Ceiling Roof 4- Lu (v� S Z — S - J / "� 5 . Othe • anal PART FAIL UMBIN • o : : eam \�� <-- 1 -•\ Under Slab E (��'� ` \--A.-"--4" [ � V� �✓� Rough -In `!:U\ -r ek Water Service Sanitary Sewer Rain Drains ` 0 Catch Basin / Manhole r i 14 - � `D Storm Drain ' �; '� S je hower Pan KI i+1 CL D n ‘A �►L _\/\ C'S 0 iNt ' IN\ 0 4); W\N\ PART FAIL ry �, A r MECHANICAL �J ' �V \ \ x - Post & Beam Rough -In Gas Line Smoke Dampers -� n �' Final P G p ' \ 1 � c71'1�'iC `ZAI .) 01\1 PASS - � RT FAIL ECTR 'L .• .. - n UG/Slab V� i t Low Voltage Fire Alarm (till El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line P(---°s9 / / ADA Date "o , — Inspector ILL,. .A../ +r.'' Ext Approach/Sidewalk Other: Final DO NOT REMOVE this inspection record from the ' ' b site. PASS PART FAIL CITY OF TIGARD , -..: 24 Hour; . 1 �. - • BUILDING - _ _ � ;Inspection Line (503) 639 -4175 MST�60 - 66 7 INSPECTION DIVISION -� -- Business x,(503 639 -4171 _ - BUP • Received Date Requested r 1- • r AM PM BUP Location aI F f 3 q c -- Suite ~' MEC Contact Person Ph ( ) PLM ,, Contractor ----, y Ph ( ) SWR BUILDING - Tenant/ - u l P0,ki. /I (' R d — ' 3 7 - ELC Footing Q ELC Foundation Access. ' 7-� Ftg Drain t ' EL. -- f2 L0 PL_ tri ELR Crawl Drain Slab Inspection Notes: /� /]' /' a G �� SIT Post & Beam / (� �L.�� 1 Shear Anchors 0 - Ext Sheath /Shear �' ,/j Int Sheath /Shear C JC // 9 ® / 0 /9- ' 7) Framing n -- , Insulation - Drywall Nailing 1 n t .. Firewall V it a A4._32. `l f Y . sT•z c -- l �' 2 ',AA_ -Fire Sprinkler 2 ' I -.. ` Fire Alarm t ..€ �!(..ti .....I /\ �, ,,c C p '1 Q•�_ — Susprd Ceiling — �/�L { _ l Roof �T— �lMp S 2"- c` 4 - . 1 Other: Final k / , � x ASS' -P ART ,/ FAIL �--' " ' "`... --./ A PL`UMBINet Post' &'Beam Y ' �' Under Slab 1 �+ 6 - - - ( • - _ ` - 1. + .4�j 1..,�,1x _ - ^ :% . + 1 - Rough-In Water Service Sanitary Sewer - c j Rain Drains. v , ! Catch Basin / Manhole t 1 k C l l n� V� ) , ) ,� n.. Storm Drain ` IN v \ - /i ce Shower Pan -- ‘c \O N c\ ` `7 S S - ) PART FAIL ‘,. MECHANICAL \IY( \\/ _ Post & Beam Rough -In _ Gas Line Smoke Dampers ' �- ` ` ,,� `. Final P/t,RT FAIL i J •- � W 1� \'1 C7 Nir C.,e7 1s 1 11 n h1 ` • /ELECTRICAL ' - ro h -In - . UG /Slab \ Low Voltage V4 Fire Alarm mal Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS1 PART FAIL P q P Y tY SITE ❑ Please call for reinspection RE: D Unable to inspect - no access Fire Supply Line RC— l 7 ADA Date �-= d 4 Inspector A L'�4 `2 ' 1/ , --� -' # 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;._(503);639 -4175 MST 3 -06 "--_- INSPECTION DyVISIdN ' Business Line: (503) 639 -4171 BUP Received Date Requested 1 0 — 9 AM PM � BUP Location / 1 13 5S FO S`'`` fL Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear �� I Framing �! :1<IJ► • I • L' v L j Insulation Drywall Nailing 1, Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL U Post & Beam Under Slab R ugh-In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: • F , PART FAIL HANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final , ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART— FAIL SITE ❑ Please' all for reinspection RE: El Unable to inspect — no access Fire Supply 'ne A a Da Side t t ©/ C\ / b5 " - Ext Inspector PP , Other: Final = • ° DO NOT REMOVE this inspection record from the job site. SS PART FAIL ri CITY OF TIGARD - 24 -Hour BUILDING Inspection Lines (503).,639 -4175 MST 1 d 0 1--1 INSPECTION DIVISIQN Business Line: (503) 639 -4171 BUP Received Date RegNested ) \,? AM PM BUP Location ) CaD Suite J � MEC Contact Person L Vti Ph (5 0) 1�' (�J q � PLM (� Y P Q'3 J — . SWR Contractor � � �,� ) � c� �-4-'� I BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain I ELR Crawl Drain er )• Slab Inspection Notes: S IT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear • Framing Insulation I i W kill p C e, Drywall Nailing • — Firewall , 0 N9 D0 Fire Sprinkler Fire Alarm Susp'd Ceiling r- � N ) ,A, Ari) Roof r " J 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 LE ThICg� e rviceJ UG /Slab Low Voltage Fire Alarm Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE El Please call for einspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Date ��' Inspector 0 f Ext Approach /Sidewalk Other: Final DO NOT REMOVE this inspection record fro the job site. PASS PART FAIL CITY OF TIGARD '24-Hour ' BUILDING Inspection Line:-= 3— 60 V 7 Z__ INSPECTION Dfl ISION Business Line: (503) 639 -4171 ( �^ Z / 3f 1 BUP Recei / 0 1' '' Date Requested AM PM BUP Location > g--3 - 'IA- c---e- Suite MEC Contact Person " �''i 4 - ." - p C (/ ) 5 ` 74 . 0. / PLM `' Contractor C� �,CJ T C3 L S "( D3 Pitt ( ::;( 3 ) q 3 ift 1 Z I SWR BUILDING Tenant/Owner D N 9 2-k ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain L Slab Inspection Notes: 74 U SIT Post & Beam Shear Anchors Ext Sheath/Shear s O �' / /�N'„ Int Sheath/Shear Framing • Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm (() / (l , 3 U „,d__ „oats ,,,, 6 e Susp'd Ceiling / //� Roof Q.-- iP G 4 1--0 h e'. fo VY ‘G Other: Final PART FAIL / kt 0 CC/ PASS PLUMBING 0 'rt./ c° C'i o� -c0 to / u c .1 rk.r 4 Q 1( /- of y � G'P_cL Post & Beam ` `O I /_ Under Slab 7'�_ `2�.�1 U` !4 d- 6 t�.S' Cr i Rough -In Water Service Sanitary Sewer e S1 ---- /e0 do es- kJ o V- i v E Rain Drains / Catch Basin / Manhole p1-e,� 144 L4 H'I e e � L�� , f ( 1 Storm Drain > �j� Shower Pan � Irt �� a. b 0 Q _ 44/ E��l Z �� "/ Other: / Final PASS PART FAIL ( l r P MECHANICAL © V - +1 •Q 7” r vl 04, b� ac 6 'i- �,Q -tLf- Post & Beam Rough -In 10 Q- 0 vl Z n 'e';--7`Q- v (�4 Gas Line Smoke Dampers Final 0, t/ 0 k e aelp -T / / 11 /14 6 C� . ART FAIL AL cough ilk, k �� l ` Low Voltage _ do Ci.__A Fire Alarm Final El fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS dr / /e' SITE `� ❑ Please call for reinspection RE: 0 Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk Date `0 Z' 4 Inspector Ext 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 - - — o o INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested / ° _/ AM PM BUP Location l L43'5 0 pi • Suite MEC Contact Person Y a.r Ph ( ) 4 421 — L ie17 / PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors . Ext Sheath/Shear Int Sheath /Shear Framing ' 1A s'Se/ d --r 4 J.:5 Sr waS �e ,�� ✓wG.�S' v�c�/� Insulation Drywall Nailing N � vtA `' ' ` ` 0,/1, L ( 4),4,‘z c E 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 Pos • 4: eam �` ough - In ne Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: Q Unable to inspect — no access Fire Supply Line ADA Date A -9 —0 3 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 Linef- (503 ),639 -4175 - 0 04 7 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested 1,0 / AM PM BUP Location / 3T55 R pig ca— Suite MEC Contact Person .' ► an Ph ( ) 4-/a/ - `da.7/ PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain �N 1 ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear heath/Shear Framin In�ation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: '1�) PART FAIL P . ' BING 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 ELEC RICAL t 4J1UW f lse • re Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line 7 ADA Date /0/ 3 Inspector \/ - 1 Ext Approach /Sidewalk p Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL