Permit � MASTER PERMIT .
PERMIT #: MST2002 -00187
I� DEVELOPMENT SERVICES DATE ISSUED: 4/15/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11234 SW 84TH AVE PARCEL: 1S136CB-10200 .
SUBDIVISION: A SH C REEK MEADOWS ZONING: R -7
BLOCK: LOT: 006 JURISDICTION: TIG
REMARKS: Construction new SF detached residence. Path 1
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 835 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,113 sf GARAGE: 460 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: sf RIGHT: 5
• - VALUE: S 187,436.80
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 1,948.00 sf REAR: 48
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 . TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 ' CATCH BASINS:
TUB /SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: , 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES • FURN < 100K: 1 BOIUCMP < 3HP: ' VENT FANS: 5 CLOTHES DRYER: 1
GAS , FURN > =100K: UNIT HEATERS: , HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 • WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL .
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 • 200 amp: - ' 0 - 200 amp: W /SVC OR FDR: 1 PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 3 201 400 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: SIGNAL/PANEL: IN PLANT:
MANU HM/SVC /FDR: 801 - - 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 8 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: . INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: • TOTAL FEES: $ 6,759
This permit is subject to the regulations contained in the .
ESLINGER BUILDERS INC ES LINGER BUILD INC Tigard Municipal Code, State of OR. Specialty Codes and
11575 SW PACIFIC HWY. 11575 SW PACIFIC HWY all other applicable laws. All work will be done in
PMB160 TIGARD, OR 97223 accordance with approved plans. This permit will expire if
TIGARD, OR 97223 • work is not started within'180 days of issuance, or if the
work is suspended for morethan 180 days: ATTENTION:
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Reg #: LAC 62363 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
Erosion Control Insp 84 Post/Beam Mechanical Mechanical Insp Shear Wall lnsp Insulation Insp Mechanical Final
Sewer Inspection Underfloor insulation Plumb Top Out Exterior'Sheathing Insi Rain drain Insp • Plumb Final
Footing Insp Crawl Drain /Backwater Electrical Service Low Voltage Water Line lnsp Final inspection
Foundation Irisp Footing /Foundation Dr; 'Electrical Rough In Gas Line Insp Appr /Sdwlk Insp
Post/Beam Structural PLM /Underfloor Framing Insp Gas Fireplace Electrical Final
,( .. Permittee Signature : "'v
Issued By : 4.., g
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business ay / -
•
7DLsT 3 ) q�6 Z J3a 7' S lv , Obi .f. 3 , .
B uillding Permit Application
Date recei ved: , Pc
j > 7 0 ,
Y l M Perini( no.: fil7�� ..00 Fs1
��,.,.��� City of Tig�I -� , y
Address: 1 3125 SW Hall Blv i
cr R 7 " Project/appl. no.: Expire elate:
City o Tigard , 9 .. ' �.
Phone: (503) 639 t Date issued: Receipt no.:
• . Fax: (503) 598 -1960 F,
,- �.' `/ Case file no.: Payment type:
Land use approval: CA Y a .`; 1__;r- I &2 family: Simple IZEM
. •.. . TYi'lE OF PwiLMIT : -..
U I & 2 family dwelling or accessory U Commercial /industrial U Multi-family XNew construction U Demolition
U Addition /alteration /replacement U Tenant improvement LI Fire sprinkler /alarm U Other:
: . . .JOR SI FF INFORMATION 1.. ::..
Job address: to MR Bldg. no.: Suite no.:
Lot: , Block: Subdivision: A;5k , ec - /6. Lea, loins Tax map /tax 10/account no.: /5 1 36, C$ art,
Project name: d ., 1. 'Xe (`� , 102_O0
Description and location of work on premises/special conditions: .ii) ( ✓11l� F T
M i
_ �° L [,7 HD)rn
. . OWNER . . • . : FOR SPECIAL INFORMATION, USE CHECKLIST .
Name: E5 tige` P c/' &_.I jo P_..1(' > Tyi.C_.• ( Floodplaln ;septiscapacity,solar,cue,)
Mailing address: //„ U7ti' <&j Tao 1J-(c. 43 I6() 1 & 2 f amily dwelling:
/ U
City: T o (�•(t State: p ZIP: 97 :99.3 Valuation of work .... 8.4..UtU4,
ot $
Phone: 69b -. Qc /S"IFax:6�2'J . f7 . -mai No. of bedrooms/baths 2
0I
Owner's representative: 0 �tvl - -�I ylq t~ 'Total number of floors .2-
Phone:•%S 1 .. ,e_, Fax: yt E -mail: U New dwelling area (sq. ft.) Iqc(Z
....:
• . ....., „ • • . • APPLICANT : • ' „ . .; .:.. ::.:::. Garage/carport arcs (sq. ft.) L i (9
Name: E-6 /d el e IV' B u 110 c a. , — i�IC.. Covered porch area (sq. fl.) - > <A —
Mailing address: a . hue ) 0 ,7 Deck area (sq. It.) �
City: State: ZIP: Other structure area (sq. fl.) _NI, —
Phone: Fax: E -mail: Cr trial /u family:
-• . :. ::.. • CONTRACTOR Valuation of work $
•
Business name: 'S '4.�n RI, et: Existing bldg. area (sq. )
I C ` ' New bldg. area (sq. ft.)
Address: ��Q l'I _ el—) D!)<
Number of stories
City: State: rZll': ..
Phone: I Fax: I E -mail:
Type of construction ....
Occupancy group(s): E ' ling:
no.: 6 236 ;
•w:
I City/ ietro lie. no.: _ w 6
• Notice: All contractors and subcontractor' arc required to be
. ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: F I t r-c .05 wee izi, .5,nc... . provisions of ORS 701 and may be required to be licensed in the
Address: 712. S( p v� Stfi - r0
City: 71�L1<.'� Y"Gtt jurisdiction where work is being performed. If the applicant is
Cit c. exempt from licensing, the following reason applies:
I i�r ZIP: �.2��
Contact perS B 6 1 6, of , of Plan no.:
Phone:6,2l/ - c4 I Fax: E -mail:
Name: polls rf• 1 Yrl ear' Contact Person: ij r'r. Fees due upon application
Address: -I 04 t? Doe _ Date received:
City: State: IZII': Antonia received '1' .----------____ -
Phone: (Fax: I E -mail: _ Please relcr to lee schedule.
-
1 hereby certify I have read and examined this application and the Nut all jmisdictioas accept crulit cants, please call jutisdic • fur naae iafonuation.
attached checklist. All provisions of laws and ordinances governing this U Visa U Mastercard
work will be complied % it ,i h t ; }4 specified herein or no). i Credit card number: _ /___/—
Expires Authorized signature: '•/ 1► D 1 1 e: �'' (0 credit �/ \ � � Name of cardholder as shown on edit card
Print name: / Q 1 ' 11 ( V� ,% - I /' i i r-- Cardholder signature $
Amount
Notice: This permit application expires if a perm tr-i not obtained within 180 days alter it has been accepted as complete. 4- 10 -4bDJ (Orot)COM)
1
Plumbing Permit Application
C >< of T l s`irU Date received: . P no.:j1 �Z
, �� g Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd, Tigard, OR 97223
City ojTigard Phone: (503) 639 -4171 Project/appl.no.: Expire date:
Fax: (503) 598 -1960 Date issued: By: I Receipt no.:
Land use approval: Case rile no.: Payment type:
TYPE OF PUR11117'
❑ 1 & 2 family dwelling or accessory U Commercial/industrial O Multi- family U Tenant improvement
.New construction ❑ Addition/alteration/replacement O Food service O Other:
'( JOB SITE INFORMATION FEE SCHEDULE (for special lnforivatlott use checklist)
Job address: 11 13'4 SW 8H Ave_ fi 4 1 0r- c(-112 Description Qty. Fee(ea.) Total
Bldg. no.: Suite no.: New 1- and 2- family dwellings only:
Tax map /tax lot/account no.: S
(Includes 10011 .foreaclt utility connection)
SFR (1) bath
Lot: (, IBlock: I Subdivision: A (f 4k ht totdaw1 SFR (2) bath
Projcc: name: Ail., C (e -c k I 1. c>I n ter 5 SFR (3) bath
City /county: Ti gqQrj , )„n/A I ZIP: `1722:5 Each additional bath/kitchen
Description and Ideation of work on premises: Site utilities:
New 5 L r. , g I c Fq , i I 1 a . Catch basin/area drain
Est- date ofcompletion/inspection: ;�:. -;, I- 3a —0. Drywells/leacltlineltrenchdrain
PLUMBING CONTRACTOR Footing drain (no. tin. ft.)
Manufactured home utilities
Business name: 9 C.)a)✓ IL-k-111-}20-- (/VL(. Manholes
Address: 11 Z' 3(,,-) Eck t� (2d D Rain drain connector
City: 5h — ci
fro A • I State: C( I ZIP:Cl - 11 4 10 Sanitary sewer (no. lin. ft.)
Phone: Ioe • 14S2 I Fax: 6 /5; • it v=31 1E-mail: Storm sewer (no. lin. ft.)
CCB no.: C1 ( 4 ( I Plumb. bus. reg. no: 1 - � � D"5 Water service (no. lin. ft.)
City /metro lic. no.: 0000'3 � ' _ Fixture or fle et:'
Contractors representative signature: i�Pr� Absorption valve
Back flow preventer
Print name: OMB. Date: (0 •Z3 0% Backwater valve
CONTACT PERSON Basins/lavatory
Name: R i r h p
�ty y„ c Clothes washer
a t ishwasher -
Address: S1« Al A A lao v t Drinking fountain(s)
City: I State: I ZIP: Ejectors/sump
Phone: Fax: E-mail: Expansion lank
OWNER Fixture/sewer cap
Name (print): E S i �, e f v . Floor drains/floor sinks/hub
99 � d e r s Imo' Garbage disposal
Mailing address: 1,157k 5 J Pctc P(1I) 1('C' g
H `� Hose Bibb
City: Tinard I State:o ZIP: 5 72.13 Ice maker
Phone: c 20 -9s IN I Fax: c, 10-111751 E -mail: Interceptor /grease trap
Owner installation/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain (commercial)
employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s)
Owner's signature: Date: Sump
ENGINEER Tubs/shower /shower pan
Name: Urinal
N Water closet
Address:
Water heater
City: I State: I ZIP: Other:
Phone: I Fax: I E -mail: Total -
Not all Jurisdictions accept credit carts, please call Jurisdiction for mom information. Minimum fee $
CI Visa CI MasterCard Notice: This permit application
Plan review (at %) $
Credit card number: ! i expires if a permit is not obtained Slate surcharge (8%) .... $
Expires within 180 days after it has been
accepted as complete. TOTAL $
acce
Name of cardholder as shown on credit card P P
S
Cardholder signature Amount - 440 -4616 (600+COM)
.. 1Vfechanical Permit Application
Date received: Permit no.:P25/;25941- -Can
at.` 1 i City of Tigard
"� �� . y Projcct/appl. no.: Expire dale:
City n / Tigard Address: 13125 SW Nall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Dale issued: By: Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land Use approval:
permit no.:
, ,TYPE'.OT, •PERINII •:;_
U I & 2 family dwelling or accessory U Commercial /industrial U Multi- family U Tenant improvement
I. New construction U Addition /alteration /replacement U Other:
• JOB SITE. INFORMATION :. •• COMMERCIAL VALUATION; SCHEDULE
Job address: I I Z?,i-I 5U) : ' ' r . . ,f O q ZZ 3 Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suite no,' value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: / I3K�GZ profit. Value $
Lot: (p Block: Subdivisioirf j1 area i -o 1 t *Sec checklist for important application information and
Project name: Mx a jurisdiction's lee schedule for residential permit fee.
City /county: • C' 'rc ZIP:
f j� g. : 1• & 2 FAMILY, DWELLING PERMIT FEE SCHEDULE`,••".
Descri lion and Iocalion (I work on prcmjscs: AND COMMERICALIINDUSTRIAL EQUIPMENTSCHEDULE
pew 145 le libl to TTo /1 �.._ .- Fce(ea.) Total
Est. date of complclion inspection: inteemegeo. 7-30 — Description Qty. Res. only Res. only
Tenant improvement or change of use: IIVAC:
Is existing space heated or conditioned? U Yes U No Air handling unit CI M
Air conditioning (site plan required)
Is existing space insulated? U Yes U No Alteration of existing IIVAC system
• '" MECHANICAL' CONTRACTOR;:':' "` : :;;.: < ; `. Boiler/compressors
Business name: • E A lei me - % V( � State boiler permit no.:
` IIP Tons BTU /II
Address :'? > c--- Fire /smoke dampers /(luctsmoke detectors
City: ("1? yi ) 0 I State I ZIP: 70/3 Beat pump (site plan required)
Plione:aW l9 C) I Fax: I E -mail: Install /replace furnace/burner B'f U/lI
CCB no.: C�,Q� Including ductwork /vent liner U Yes U No
1 Instal l/replace/relocate healers - suspended,
City /metro lie. no.: i I - wall, or floor mounted
Name (please print): C 0 C - • LC- C p Vent for appliance other than furnace
•.... CONTACT PERSON'
• Refrigeration:
rot•
Absorption units BTU/I-1
Name: do c1 G ( lee i) ,�-- Chillers 1•11) Address: 1 ( lab v � Com lressors 1113 `� ' Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
• :. '. :..: Floods, Type V chen/hazmal
ooc II /res k11
hood fire suppression system
Name: 'S is vlr p 1( Butt r2A/".5 ! 'D" &. , Exhaust fan with single duct (bath fans)
Mailing addressa ' .c" 60) RI (ti rt - 1(=. 1I•LUU PMg (ipe) Exhaust system apart from or AC
City: di r e State: r * SIP: Fuel piping and distribution (up l0 4 outlets) ■--
Type: LPG NG Oil
Phone: ) ax• ' -
�� F 6�� '' _ ,� Fuel piping each additional over 4 outlets III
ENGINEER . :. • Process piping (schematic required)
Number of outlets
Name: N / A-., Other fisted appliance or equipment:
Address: Decorative fireplace
City: 'State: I ZIP: Inert - type
Phone: Fax: Il mail: Wnodstove/ {)el{elstove • Oilier:
Applicant's signature: ' i' I Date: 3462 Z Other:
Name (print): lVCi_ cJ 1vvt fail /y1I P• •
Nol all jwisdiclions accept credit cards, please call jmisdiclion for more information Permit fcc
0 Visa 0 MaslciCard Notice: This permit a Minimum fee $
expires if a permit is not obtained
Coedit card number: I wi 180 days it has been Plan review (at %)) $
tsp y State surcharge (8%) .... $
Name of cardholder as shown on credit card accepted as complete. TOTAL
$ —
Cardholder signature Anmmd 4.1(1 -4(17 ((u0(1lCOA)
• 1 /
•
• • . . 3 • Electrical Permit Application
j ik Date received: Permit no.aPr - �p0 /g7
:all City of Tigard Projeci/appl.no.: Expire date:
Cifyn�/ignrd Address 13125 SW 1 - tall Blvd, Tigard. OR 9722 Date issued: fly: I Receipt Ito.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
❑ I & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi- family ❑ Tenant improvement
New construction ❑ Addition/alteration /replacement ❑ Other: ❑ Partial
. • . JOJ3 SITE INFORMATION
Job address: ii sup 514 - ' L� ,-J o.. - n'z3 Bldg. no.: Suite no.: Tax map /tax lot /account no.:
Lot: ( 'Block: 'Subdivision: Aim cr•e -eK rl cactow . )
Project name: A Ti, (r< •eK ' Description and location of work on premises: New S 1,. k Fay, i 1
— �,
Estimated date of completion /inspection: .r:,. -10 J
(• '"' - - .•-° -. CONTRACTOR
.:.... ,. ,.,....,_. ..... ..... •••• FEE-SCHEDULE-------------,-----
Job no:
Fee Max
Business name: D.A. Jerome Electric
Description Qty. (ca.) Total no. irtsp
New residential -aingk or n family per
Address: PO Box 751
dwelling unit. Includes attached garage.
City: Hillsboro I State° R I ZIP: 97123 Service included:
Phone: 6 4 8- 514 4 I Fax: 6 4 8- 9 7 2 ' -mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof
3 6 0 51
CCB no.: I Elec. bus. lie. no: 34 -119 ( Limited encrgy. residential 2
City /metro lie. no.: 1063 Limited cncrgy, non - residential 2
__' Each manufactured home or modular dwelling
Signature of supervising c eclrician (requited) Date Service and/or feeder 2
Su elect. (print): It . License i Services or feeders- installation,
Sup. (p ): D av i e alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): Estill-tr. build-erS _t. -1, 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: li5 SW tact tt• 41t., P'113 I
�o� 601 amps to 1000 amps 2
City: T ; y c , r d I statC:G I ZIP :9 72.2.1 Over 1000 amps or volts 2
Phone: ( 7 0_95 1 S I Fax: re 2 U -9`151 E -mail: Reconnect only 1
Owner installation: The installation is being made on properly I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to hrstallalion , alteration, orrelocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
Name: /�
or extension per panel:
,' -� A. Fee for branch circuits with purchase of •
Address: service or feeder fee, each branch circuit 2
City: ] State: • I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail: .
Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not lncluded):
❑ Service over 225 amps - commercial ❑ Ilealthh -care facility Each pump or irrigation circle 2
U Service over 320 amps - rating of 1&2 0 I lazardous location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 square feel four or Signal circuit(s) or a limited energy panel,
U System over 6(X) volts nominal more residential units in one structure alteration, or extension* 2
U Building over three mimics U Feeders, 400 amps or more *Description:
U Occupant load over 99 persons U Manufactured structures or RV park Each additional Inspection over the allowable in any of Ilse above:
❑ Egress/lightingplat U Oilier.
Per inspection I I I I
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other .
credit cards, please call j urisdiction for m ore information. Permit fee $
Not all j urisdictions accept p Notice: This permit application
U Visa U MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days abler it has been State surcharge (8 %) .... $
Expires TOTAL •
accepted as complete. $
Name of camJholdcr as shown on credit card
$
Cardholder signature Amount 4.10 -4613 (lJlx)/('OM)
CITY OF TIGARD 24 -Hour'
BUILDING"' Inspection Line: (503) 639 -4175 MST ' � ( g 7
INSPECTION,DIVISION Business Line: (503) 639 -4171
/-i BUP
Received Date Requested AM PM BUP
Location I f ?- 3 Suite MEC
Contact Person Ph ( ) F 4 19- PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain L &DX C (3 ELR
Crawl Drain
Slab Inspection Notes: �, � t SIT
Post & Beam
Ext Shear ea t h / ear / _e 2-Y1 � �
Ext. Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
' . PART FAIL -
PL I = ING
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 -
•
,PpV 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 call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line /iK
ADA Date Od 2 Inspector
Approach/Sidewalk 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 MST — 00 ( 7
INSPECTION DIVISION Business Line: (503) 639 -4171 -
BUP
®
Received Date Requested o O AM PM BUP
Location l i - 11_4 B `"I ite / MEC
Contact Person .4 Ph ( ) �`[ c l q �� PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation //�� ELC
Ftg Drain Access: 2— a `_ (� 13 ELR
Crawl Drain G
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing •
Firewall
Fire Sprinkler
/ , / /A - .- i -� t� ,
Fire Alarm
Susp'd Ceiling
Roof , Ir1�� yf !�— /� ArIPIPIV `/
Other: / /�� Final /1/ �r� —� i� / � 1 �/1/
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
/• • PART FAIL
L ' ANICAL
Post & Beam •
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm -
Final LI Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE LI Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA 51/
Approach /Sidewalk Date Inspector Ext
Other: �t��
Final DO NOT REMOVE this inspectio cord from the job site.
PASS PART FAIL
•
CITY OF TIGAR 24 -Hour — •
BUILDING Inspection Line: (503)'639 -4175 d v / g -7
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested " AM PM BUP
Location / I - 31-f 4 A Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) r2 l — S'5 / SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain L..; e ! ' ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall CN* (1 � Fire Sprinkler \y l
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post& Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
P- Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call fir reins•ection RE: El Unable to inspect — no access
Fire Supply Line
ADA Date S7 ' 22- Inspector # Ext
Other:
Final DO NOT REMOVE this inspection record fr t e job site.
PASS PART FAIL -
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STREET TREE CERTIFICATION
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( I, ' ' �d ► % S , Owner /Agent fors �� • (PLEASE a INT v (PERMIT H ►
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• Do hereby certify that the following location ■
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A meets,Ci-ty of Tigard /Washingt Count •
• l and use and development standards for street tree installation. •
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• ADDRESS: t h �.I �Sln7 S`� a /`�I S I ZGY�Z- (�1 6 • •
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• LOT: (p SUBDIVISION: C v , cii— 3 ., ■
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i BY: DATE: 1 '! L' o Z ► •
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• RECEIVED BY: DATE: • •
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