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Permit A ' CITY OF TIGARD MASTER PERMIT PERMIT #: MST2002 -00008 DEVELOPMENT SERVICES DATE ISSUED: 1/25/02 �� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 11258 SW 84TH AVE PARCEL: 1S136CB -10000 SUBDIVISION: ASH CREEK MEADOWS ZONING: R -7 BLOCK: LOT: 004 JURISDICTION: TIG REMARKS: Construction of new single family detached residence. Path 1 BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 709 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 892 sf GARAGE: 413 sf FRONT: 24 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: sf RIGHT: 8 VALUE: $ 154,880.00 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 1,601.00 sf REAR: 52 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 0 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: 4 CLOTHES DRYER: 1 GAS FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 0 MAX INP: btu FLOOR FURNANCES: VENTS: 1 W0ODSTOVES: 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: SIGNAUPANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ ampNolt : PLAN REVIEW SECTION • Reconnect only: >=4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS ARENSPC 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: $ 6,518.49 ESLINGER BUILDERS INC ESLINGER BUILDERS INC This permit is subject to the regulations contained in the 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 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: Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Reg #: LIC 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 8 Post/Beam Structural Plumb Top Out Exterior Sheathing Insr Water Line Insp Sewer Inspection Post/Beam Mechanical Electrical Service Gas Line Insp Electrical Final Footing Insp Underfloor insulation Electrical Rough In Insulation Insp Mechanical Final Foundation lnsp PLM /Underfloor Framing Insp Gyp Board lnsp Plumb Final Foundation Mechanical Insp Shear Wall Insp Rain drain Insp Final inspection Issue By : �� eniu0 f f • �I ' G��' "° Permittee Signature : ..6 , 1 Call (503 ; 9-4175 by 7:00 p.m. for an inspection needed the next busine - day 7csr / -1ro -d ,L ,l3 r . .•. Building Permit Application A I, ��1" Clty Of T�gard Date received: Permit no.: �yT�ry07 -00�1g ' " Project/appl. no.: Expire date: CityofTignrtl Address: 13125 SW Hall Blvd, Tigard, OR 97223 Phone: (503) 639 -4171 Date issued: By: Receipt no.: Fax: (503) 598 -1960 ' . Case tale no.: Payment type: Land use approval: I &2 family: Simple Complex: . . . , .TYPE OF PERMIT . . • . • . . . ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family XNew construction ❑ Demolition ❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other: _ ...... • JOB SITE INFORMATION • : _ Job address: 1125/S 5 W /5 A vt . I l t 4 d t () P / 7121) Bldg. no.: Suite no.: /1-C../Ye) Lot: I Block: Subdivision: i t5f ('Xe I'lkaciow Tax map /tax lot /account no.: /5 L . -B Project name: .� k O.r�°eo.L. /a -7 Description and location of work on premises/special conditions: ► . " _ t ` 4 (• .' 1 DM e...- a • OWNER • . • FOR SPECIAL INFORMATION, USE CHECKLIST Name: • _ t p . j , (Floodpialll, septic capacity, solar, c>tc,) ,MINSIV Mailing address: // .7i.' I }x4 k (1 U L) 431 16t 1 & 2 family dwelling: City: )elf? 1�• State: �,1j ZIP: 97Q..). - Valuation of work /sy 8.8 $ Phone: 6 ; k j- .CQ,c/5" I Fax:499 -/4y , - -mail: No. of bedrooms/baths VI.Fi Owner's representative: ; (eel lwl -- - I/ r1dQ." Total number of floors 2. Phone:' Fax: i A e E-mail: Ne w d welling area (sq. ft.) .„. 2 ( - . .. . APPLICANT..;..... . . . .:.:.:,.:..:.:.. Garage /carport area (sq. ft.) y 13 Name: E. P � B IA 110 g ! .y�,C_ , Covered porch area (sq. ft.) k/f A Mailing address: yyt6 S , Q 0 tJ@ Deck area (sq. ft.) hi ;r,� City: . [State: ZIP: Other structure area (sq. ft.) Ni /A Phone: Fax: E - mail: • Cwnincrcial/industrial/tmulti- family: . ` ` . CONTRACTOR • . • ; Valuation of wo \ $ Business name: .---..S ja (' €.t `0 f Existing bldg. area (sq. ft.) \• I "�l New bldg. area (sq. ft.) Address: 7.5.,6? Vl1t°rJ f ���° Number of stories City: I State: I ZIP: Phone: I Fax: I E-mail: Type of construction C no.: I � 3 Occupancy group(s): Existing: New: City /t etro lic. no.: w 6 Notice: All contractors and subcontractors are required to be . . , ARCHITECT /DESIGNER . licensed with the Oregon Construction Contractors Board tinder Name: iD, 1 a re 11 .05 wee ti. 5 _ , provisions of ORS 701 and may be required to be licensed in the Address: 71 18 .( t o r , 0 , 1 f" 2,©b jurisdiction where work is being performed. if the applicant is City: T ;c,ra ,-- � Cit e. exempt from licensing, the following reason applies: 11rr i3 St4i �2 l ZIP: 41.2 3 Contact perion:Britnj tttCYrat'Ivi (7.f Plan no.: mot Phone:6,9 4 - '-7 5 1 Fax: E -mail: Name: fb1 h re f k yj.5 yn e v" Contact person: Fees ■ due upon application $ Address: -S vy , e , 5 R. [, p_— Date received: City: State: IZ11': Amount received $ . -__— —_ - -.- Phone: I i ax: I l mail: _ Please refer to Ice schedule. I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cads. please call junisrliction for mole infornuuiun. attached checklist. All provisions of laws and ordinances governing this ❑ Visa ❑ MasterCard work will be complied ' i, hell r specified herein or no Crc tlit ca rd number: / / / / Expires Authorized signature: ` . Date: t `l Name of cardholtkr as shown on credit card Print name: Q-, It .1" ( Vte1 Ta Bt) I f •11-- Cardholder signature $ Amount Notice: This permit application expires if a penniA not obtained within 180 days after it has been accepted as complete. 440 -4613 (6/00/COMM) /I • A . Plumbing Permit Application Date received: / /`f 4 Pennitno.:�51AaaA -ear$ „t , ►rt�y ; ' City o f T igar d 14, , . Sewer permit no.: • Building permit no.: - Address: 13125 SW Hall Blvd, Tigard, OR 97223 City of Tigard Phone: (503) 639 -4171 Project/appl.no.: Expire date: Fax: (503) 598 -1960 Date issued: By: I Receipt no.: Land use approval: Case file no.: Payment type: • TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement New construction ❑ Addition/alteration/replacement ❑ Food service ❑ Other. JOB SITE INFORMATION FEE SCIIEDULE (for special information use checklist) Job address: 1115% 5 W 8ti t5 /4ve iii'a fd t oll `17 Z23 Description Qty. Fee(ea.) Total Bldg. no.: Suite no.: New 1- and 2- family dwellings only: Tax ma /tax lot/account no.: CJ (includes 100 R. for each utility connection) P IS 3G C IA O SFR(1)bath Lot: 9 (Block: I Subdivision: AS� Cft4k eadaws SFR(2)bath . Projcc name: Ai t, C el. ciows SFR(3)bate City /county: Ti ovarcl 1 WA 1 ZIP: 17 z15 Each additional bath/kitchen Description and Ideation of work on premises: Site utilities: . New 51_114 Fct -‘•. i I lie,,., e - Catch basin/area drain Est. date of completion/inspection: - _02_ - Drywells/leach line/trench drain PLUMBING CONTRACTOR Footing drain (no. tin. ft.) Manufactured home utilities Business name: ILA- 0\1214-, 1/t'lC Manholes Address: II Z' 1 ¶ E4 i.. (2c a Rain drain connector City: e.i occ\ J I State:C ZIP:C1 1140 Sanitary sewer (no. lin. ft.) Phone: t2"1_,- (4SZ I Fax: (,Z6 146Z I E -mail: Storm sewer (no. lin. ft.) CCB no.: ci (.' (o I Plumb. bus. reg. no: ? 2./ pfzj Water service (no. lin. ft.) City/metro lic. no.: 0000 I ' Fixture or item:' Contractor's representative signature: / Absorption valve Back flow preventer Print name: _ Ali O M1L Date: (() -Z3 0% Backwater valve CONTACT PERSON Basins/lavatory Name: K\ C h Rh Irv, c Clothes washer Address: 5e,1„tt Al Abov -e Di Drinking f unlain(s) • City: I State: I ZIP: Ejectors/sump Phone: Fax: E -mail: Expansion tank OWNER Fixture/sewer cap tint): Floor drains/floor sinks/hub Name (p E s I i �, .e f 15 v. � d e r 5 I , , r Garbage disposal Mailing address: 1157* 54/ Pat if ;c N,./, P 0 II) 16,n Hose bibb City: T io►rd 1 State:0K ZIP: gizz3 Ice maker • Phone: G 20 -cis II I Fax: c,, Z0-91175 I E -mail: Interceptor /grease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the mainten ce and repair made by my regular Roof drain (commercial) employee on the pro=n a F ORS Chapter 447. �/ Sink(s), basin(s), lays(s) Owner's signature: Date: `'L Sump Tubs/shower /shower pan Name: Urinal Water closet Address: Water heater City: I State: I ZIP: Other: Phone: - ( Fax: 1 E -mail: Total - Not all Jurisdictions accept credit cards, please call Jurisdiction for more information. Notice: This permit application Minimum fee $ ❑ Visa ❑ MasterCard Plan review (at _ %) $ Credit card number: / / within 180 180 days after permit is not r it has Mend State surcharge (8 %) .... $ Expires ithi been TOTAL $ Name of cardholder as shown on credit card accepted as complete. $ Cardholder signature Amount 440 -4616 (6r04/COM) • Mechanical Permit Application .;' Date received: //,‘ da. Permit no.:mr,1 - eoce87 1; "�yi ":. City of Tigard .�t+�1� ^:_. .,:. y b ProjccUappl.no.: Expire date: Ciryoj'ligrrrd Address: 13125 SW Hall Blvd, Tigard OR 97223 Phone: (503) 639 -4171 Date issued: By: Receipt no.: Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: Building permit no.: . , `TYPE'OF. PERIYIIT ❑ I & 2 family dwelling or accessory 0 Commercial /industrial ❑ Multi- family ❑ Tenant improvement b. New construction ❑ Addition /alteration/replacement 0 Other: JOB SITE INFORMATION . 1 COMMERCIAL :VALUATION 'SCHEDULE , Job address: I 12_5 A 5%4 1'1 A V4 . I Tir rd ti aR M22.21 Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot /account no.: i 13(,G-E o tc.o profit. Value $ . Lot. 1.1 Block: 1 Subdivision4l d ree lL I�ELaCIfw5 *See checklist for important application information and Project name: --,14 ix_ . e jurisdiction's fee schedule for residential permit fcc. City /county: •c° re EI ZIP: 0 043 � ; & .2 FAMILY, DWELLING `PERMIT FI>E'SCHEDULE'.' ''. Descrigtion and luc?ttion I work on premises: , ` AND COMMERICAL/INDUSTRIAL r EQUIPMENTSCNEDULE IVI s /rte ? e , --Fam rt Gt) fin( Fee (ea.) Toll Est. date of complcliou inspection: 1 g -pZ Description Qty. Res. only Res. only Tenant improvement or change of use: ' IIVAC: Is existing space heated or conditioned? 0 Yes ❑ No Air handling unit CFM Is existing space insulated? CI Yes ❑ No Air conditioning (site plan required) Alteration of existing HVAC system ': MECHANICAL CONTRACTOR:':`: Boiler /compressors Business name: =lied State boiler permit no.: Ex), ■ l ed 'It1c` ✓le HP Tons BTU /H Address: T.D. Tp.ox 12, a ` 4 Fire/smoke dampers/duct smoke detectors City: Pip yh f , I State:Ok I ZIP: 9 76)/3 Heat pump (site plan required) Phone:,,Vad,_ Z7 _ /,1 9 I Fax: I E -mail: Install /replace furnace/burner BTU /1 -1 CCII no.: !� p0 Including ductwork/vent liner U Yes U No Install/replace/relocate healers- suspended, City /metro lic. no.: 1 13 2. wall, or floor mounted Name (please print): 0 J! x( - 67 e Q-`' Vent for appliance other than furnace CONTACT PERSON' Refrigeration: Absorption units BTU /l1 Y1 A Name: eV N , r e q 6 ("' Chillers 1IP Address: ! t, e __, a,, 5 l , I,, D U e � Compressors I IP u la Environmental exhaust and ventilation: City: I Slate: I ZIP: Appliance vent Phone: Fax: E -mail: Dryer exhaust OWNER Hoods, ' Type I II /res. kltchett/hazmal hood fire suppression system . Name: ' S (j, -. e.t 1 S t ) ( 4 2 4 ,`S 1 ' e_. . Exhaust fan with single duct (bath fans) Mailing address1l y 6(,O /p �.. U�V pA.(e? !be) Exhaust system apart from heating or AC Fuel piping and distribution (up to 4 outlets) Cit y: 'T7 a I State: � I Zr1P: 9 / 0. T LPG NG Oil Y(�� Phone: ,,,,..I - Fax6 O - ! ..1 -mail: Fuel piping each additional over 4 outlets ENGINEER Process piping (schematic required) Name: N / - r Number of outlets Other listed appliance or equipment: Address: Decorative fireplace City: I State: I ZIP: Insert - type Phone: Fax: E-mail: Woodstovc/pclletstove Other: Applicant's signature: • I Date: Other: Name (print): ) OIyyt ' d fr1lP._. 'Not all jntisdiclions accept credit cards. please call jurisdiction for more informations Permit fee $ 0 Visa O MasterCard Notice: This permit application Minimum fee $ Credit card nurnt,er: / / expires if a permit is not obtained Plan review (at %) $ Expires within 180 days after it has been State surcharge (8 %) .... $ Name of cardholder as shown on credit card accepted as complete. $ TOTAL $ ` Cardholder signature Amount 440 -0617 (6/0O /COM) , A Electrical Permit Application Date received: / / r� /11a. Permit no.:tbrAepg - +I, City of Tigard Project/appl.no.: Expire date: Cityof'/igard Address: 13125 SW Hall Blvd, Tigard, OR 9722 Dale issued: By: l Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT 0 1 & 2 family dwelling or accessory 0 Commercial /industrial 0 Multi- family 0 Tenant improvement $New construction 0 Addition/alteration/replacement 0 Other: O Partial JOB SITE INFORMATION Job address: 02.st 5 W $`I 1.4 A v.( . IV3o.rol L oft Ana Bldg. no.: Suite no.: Tax map /tax lot/account no.: 15130, c 5 lOQo Lot: L) IBlock: (Subdivision: Am Cre.eK ticq t°bp) Project name: Ail cll. ,41( I Description and location of work on premises: New S t,.q f Fc, . i I t Estimated date of completion/inspection: 7 - - . J ttttsl► - . -CONY( ACTOR PPL-IeAT10 ..,. _......,.._..,. _._...__.. --- ...., ... : .. .........._.... :. FEE•- SEIICDULE-• -: ...- ...e:, ---- :.:_.- ::..._..._-. Job no: Foe Max Business name: D . A. Jerome Electric Qty. (ea.) Total no. insp Newresidential- single or multi-family per Address: PO BOX 751 dwellingunil . Includes attached garage. City: Hillsboro I States) R I ZIP: 97123 Service Included: Phone: 648-5144 I Fax: 64 8— 9 721 §-mail: woo sq. ft. or less 4 CCB no.: 36051 I Elec. bus. lic. no: 34_119 f: Each additional 500 sq. ft. or portion thereof Limited energy, residential 2 City /metro lie. no.: 1063 Limited energy, non - residential 2 Each manufactured home or modular dwelling Signature of supervising a ectr� ician (required) Date Service and/or feeder 2 Sup. elect. name (print): David i • a II - License no: I Services or feeders — Installation, alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name (print): E t 0,1 f (5uiid -ern Iti,C_ 201 amps to 400 amps 2 Mailing address: p 401 amps to 600 amps 2 T , `15 7 S W Pact tt^ � I 4.4 � f U IC O 601 amps to 1000 amps 2 City: t i c„ rd State:U ZIP:9 7 2 23 Over 1000 amps or volts 2 Phone: ( ' 0 7 Q _46 1 c I Fax: Cn 2 0 .91751 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, lea , rent, or exchange according to btslallatlon , alteration, orrelocation: ORS 447, 455, 479, 67 , 7 1. 200 amps or less 2 • 201 amps to 400 amps 2 Owner's signature: Date: / 8. 401 to 600 amps 2 Branch circuits - new, alteration, Name: or extension per panel: N A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 Cit I State: • I ZIP: B. Fee for branch circuits without purchase Phone: Fax: E -mail: of service or feeder fee, first branch circuit: 2 Each additional branch circuit: Misc. (Service or feeder not included): 0 Service over 225 amps- commercial 0 Health -care facility Each pump or irrigation circle 2 O Service over 320 amps - rating of 1&2 0 Hazardous location Each signor outline lighting 2 family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, O System over 600 volts nominal more residential units in one structure alteration, or extension* 2 O Building over duce stories 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 the above: O Egress/lighting plan U Other. 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 Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ 0 Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number: I I within 180 days after it has been State surcharge (8%) .... $ Expires accepted as complete. TOTAL $ Nacre of cardholder as shown on credit card $ . Cardholder signature Amount 440 -4615 (6r00/COM) CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST --0-e) INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested AM PM BUP Location /7 Fc( WL Suite MEC Contact Person Ph ( ) cksy PLM Contractor Ph ( ) SWR BUILDING -- Tenant/Owner ELC Footing Foundation ELC ccess. Ftg Drain `oX = Crawl Drain E ELR J - - Slab Inspection Notes: SIT - Post & Beam tiv# Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Aor� r .i / Drywall Nailing - — -� - Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Final PASS PART FAIL PC9r/e,d-71a-ir•-- PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Os • PART FAIL HANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In c� 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: Unable to inspect — no access Fire Supply Line ADA Date b Inspector Ext Approach/Sidewalk Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF. TIGARD - 24 -Hour - BllIEDINa Inspection Line: (503) 639 -4175 MsTa40a- G 070 _ INSPECTION DIVISION Business Line: (503) 639 -4171 �(� BUP Received Date Requested � AM PM BUP Location ) \\ Suite MEC Contact Person Ph ( ) 618'S PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR 1, Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing • Firewall C 6 Fire Sprinkler ^►' �J Fire Alarm Susp'd Ceiling Roof y T M ra 't 1. A c 54 o Erl r V( Final )14 j PART FAIL �`! O.� �1'� L� Cf7 n I b �����G' b1I(li �`)r PLUMBING AIL V1� Lam, PD VI CI ' r � " i P 1}J �� V ,l � 5 M f 4 .- W Post & Beam Under Slab ) 1, 011/1 C71 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 �Fina Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL Z Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ) ' Approach/Sidewalk . Data_ inspector Ext Other: Final DO NOT REMOVE this inspection record from -th ob site. PASS PART FAIL CITY OF TIGARD 24 -Hour - - = A ' BUILDING Inspection Line: (503) 639 -4175 MST o� O d U p INSPECTION DIVISION Business Line: (503) 639 - 4171 BUP Received - Date Requested /7 AM PM BUP Location / I a,_5 y - )Q— ' Suite ! MEC Contact Person Ph ( ) � [7 t - 4' g PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC • Ftg Drain CCe L 4 6 , Ox _:____,_ Crawl Drain EB L ELR 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: a ril S 4 PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final P RT FAIL MECHANICAL Post &eam - Rough -In Gas Line S e Dampers inal ASS PART FAIL RICAL 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 V ❑ Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Date e-, Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL ® AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA A A ►.. .1 TIFI ATION T EE C E C R R STREET A ■ ® ► -4 lob ® ► ® ® I, • d l A li , Owner /A gent f or (� ?u4IL�Q, 11.- A (PLE PRINT) �(J (PERMIT HOLDER) A ■ •1 ► A ► A ► A Is . ® ► A Do hereby certify that the following location t A meets City of Tigard /Washington County I. A ► A land use and development standards for street tree installation. A ■ A ► — �- 110. ® ADDRESS: �t 2 S t., .) a � , 1i � o (L c " ( . ZZ3 M5 ! 2a72 -ao r 10. ® V O- il • A • LOT: `{ SUBDIVISION: l& CKk lei AtiadOLA ® • BY: DATE: 61 4z, • A ► A ► ® 6.- 7 -O ® RECEIVED BY: �,� �� DATE: lk