Permit . ,•
CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2001 -00034
- 'ill DEVELOPMENT SERVICES DATE ISSUED: 2/28/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15589 SW 88TH AVE PARCEL: 2S111DA -13300
SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R -7
BLOCK: LOT: 126 JURISDICTION: TIG
REMARKS: S/F Path 1
BUILDING
REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 16 FIRST: 1,608 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: 435 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: sf RIGHT: 5
VALUE: $ 150,350.00
OCCUPANCY GRP: R3 BDRM: 3 BATH: 2 TOTAL: 1,608.00 sf REAR: 27
PLUMBING
SINKS: 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 3 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 BOIL/CMP < 3HP: VENT FANS: 4 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: 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: $ 3,572.39
LEGEND HOMES LEGEND HOMES CORP This permit is subject to the regulations contained in the
12755 SW 69TH AVE #100 12755 SW 69TH AVE #100 Tigard Municipal Code, State of OR. Specialty Codes and
PORTLAND, OR 97224 TIGARD, OR 97223 all other applicable laws. All work will by done i
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 60563 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 Mechanical Mechanical lnsp Gas Line lnsp Appr /Sdwlk lnsp Building Final
Sewer Inspection Underfloor insulation Plumb Top Out Gas Fireplace Electrical Final
Footing lnsp Crawl Drain /Backwater Electrical Rough In Insulation lnsp Mechanical Final
Foundation Insp Footing /Foundation Dr Shear Wall lnsp Rain drain lnsp Plumb Final
Post/Beam Structural PLM /Underfloor Low Voltage Water Line lnsp Final inspection
Issued B : -e--� Permittee Si e nat : �-ti ► / - - �
By -7 �.liyyt� g ��
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITY OF TIGARD
13125 S.W. HALL BLVD.
1 TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
GARNER ELECTRIC
21785 SW TUALATIN VLY HWY #C
ALOHA, OR 97006 -1249
Electrical Signature Form
Permit #: MST2001 -00034
Date Issued: 2/28/01
Parcel: 2S111 DA -13300
Site Address: 15589 SW 88TH AVE
Subdivision: APPLEWOOD PARK NO. 3
Block: Lot: 126
Jurisdiction: TIG
Zoning: R -
Remarks: S/F Path 1
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
LEGEND HOMES GARNER ELECTRIC
12755 SW 69TH AVE #100 21785 SW TUALATIN VLY HWY #C
PORTLAND. OR 97224 ALOHA, OR 97006 -1249
Phone #: Phone #: 503 - 648 - 4552
Reg #: u C 121159
SUP 37075
ELE 34 -305C
AN INK SIGNATURE IS REQUIRED 0 THIS F RM
X
Signat of Supervising Electrician
If you have any questions, please call (503) 639 -4171, ext. # 310
' e r S uJP, a-oa> - 00 a'- -3
Building Permit Application
Date received: 70 p 1 Petn(i t / —0aeo
1` ;:i � City of Tigard ( `�
Project/appl.no.: Expire date:
Address: 13125 SW Hall Blvd, Tigard, OR 97223
City of Tigard Phone: (503) 639 - 4171 Date issued: By: I Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1&2 family: Simple Complex: -
TYPE OF PERMIT
I>erf & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family 'New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinidedalarm ❑ Other.
JOB SITE INFORMATION
Job address: ,'3T i ` ‘, , . ., ,,, _ .��� 4 ,7 F i Bldg. no.: Suite no.:
Lot: /) Cv Block: Subdivision: P 1,) vv D PA LV. , Tax map /tax lot/account no.:
Project name: J T 3 0- K :. G, , 3 L . 51 / 3 2
Description and location of work on premises/special conditions:
O11'NER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: 4 (04 a 0d /O/Y1rPS ( Iloodplain ,septiccapacity,solar,etc.)
Mailing add Ass: / a7,s 7_5 ,.iIzJ 1p q .4 - 1 & 2 family dwelling:
City: ?G &/,. IState:04 IZIP: 97 � Valuation of work .......50 - > $ - :=2.--7,4 - ,11. - .7 -
Phone: -G,ZQ , P o w I FaxS -f I E -mail: No. of bedrooms/baths _'
Owner's representative: PE & �1 DL C)NL-'1 Total number of floors
• Phone: 0 - `b(. ) Fax: S'` t -& - 100 E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.) I/
Name: /, ,p��JJ'',Q ry .4/ //0� , p S . Covered porch area (sq. ft.)
Mailing address: / ,1.. xj S l ,) 1p 77.11- Deck area (sq. ft.)
City: rJ-ijCHry,n of I Staley/ . 1 zi• q ]A,22 Other structure area (sq. ft.)
Phone (' O Fax> ' di v e d E-mail: Commercial/industrial/multi-family:
•
CON TRACTOR Valuation of work $
Existing bldg. area (sq. ft.)
Business name: Z 007 a��/ rl�'} j �'
New bldg. area (sq. ft.)
Address:1 j 9 .i,-e_i Number of stories
City: POO( / I state:) k I ZIP: 1 70-, 2- 3 Type of construction
Phone: j a0 C 1 Fax:S - 7 ( 1 9 E -mail: .
Occupancy group(s): Existing:
CCB no.: ( 6 p 3 -), New:
City/metro lic. no.: 7 - Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: L P yytd 11 49 /AO i provisions of ORS 701 and may be required to be licensed in the
jurisdiction where work is being performed. If the applicant is
Address: / ..7.5--j- w t 9 11 ,1-„,..e-- exempt from licensing, the following reason applies:
City: ids {-I 'Id Stateto4 I ZIP: •92,2
Contact person: Q' • B ,- $deq Plan no.:
Phone:4 .; O(9 Fax,'-#r ;i E -mail:
ENGINEER
Name: rf ,,e f, A. Contact person: Fees due upon application $
Address: ' - , • / OA Date received:
City: -7 a , - o / Stater ZIP: q 7a�3 Amount received $
Phone: GJ - 7das1Fax: I E -mail: • Please refer to fee schedule.
I hereby certify I have read and examined this application and the ( Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this I ❑ visa ❑ Mast«Card
work will be complied with, whether s • ified he in or not. credit card number: Expires
i /
Authorized ' Agnature• • -- �i /- ,„ ,,�.,Ii a ate: / 0 J Name of cardholder u shown on credit card
Print name:/ J Px / Cardholder signature $ Amount
Notice: This permit applicatt >pires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6A0/COM)
•
Electrical Permit Application
Date received: Permit no.:
- r ' ' 7.1 .. City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
rd 1 & 2 family dwelling or accessory 0 Commercial/industrial O Multi - family ❑ Tenant improvement
X New construction ❑ Addition/alteration/replacement 0 Other. ❑ Partial
JOB SITE INFORMATION
Job address: /s S' '9cS '„ o ,„ r,5k, _ Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot: / _,j /Q I Block: Subdivision: . p .'/ Q._ iC • '
Project name: I Description and location of work on premises: •
Estimated date of completion/inspection: •
CONTRACTOR APPLI('ATION FEE SCHEDULE
Job no: ., -�>) / , 4, Fee Max
Business name: 6 p/n &1 Description Qty. (ea) Total no. Insp
New residential - o multi-family per
Address: ..21 ? rl ' S AV rU dweWng unit. Includes attachedgarage.
City: I State I ZIP: 9 ( Servicebtcluded:
Phone /-/ .2 jJ I Fax: 6W -- 7 j,1j -m 1000 sq. ft. or less • 4
Each additional 500 sq. ft. or portion thereof
C : 10.: / S q I Elec. bus. lic. no: aye c mitedy residential / 2
ity . • I 3 7 ! 7 $ Limited energy, non- residential 2
• I v Each manufactured home or modular dwelling
gn ture f g el - • 'clan (required) Date Service and/or feeder 2
.elect name (print): 37 o S Services or feeders— installation,
Sup. (P ) Cr / L S d , A t .,e. License no: alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): L 441244 5 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 7 7 - ,s w G9 il-,-¢ .a- 601 amps to 1000 amps 2
City: "R,� d4 I State64 I'ZIP: 7� Over 1000 amps or volts 2
Phone: GaG / Otr(j I Fax:s-9F tit 1E-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 adOO,'d on, or relocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
/� 201 amps to 400 amps 2
Owner's signature: V 0 Oti 401 to 600 s 2
Branch circuits - new, alteration,
or extension per panel:
Name: r rrc ti t ,) oy, . A. Fee for branch circuits with purchase of
Address :474, 7 ! p!) i/ j 7 n TA service or feeder fee, each branch circuit 2
City: c' ,.. �Q. tatep� I ZIPcf 7 B. Fee for branch circuits without purchase
Phone: .6, , - pv Fax: E - mail:
of service or feeder fee, first branch circuit: 2
Each additional branch circuit:
PLAN REVIEW (Please check all that appl ■) Misc. (Service or feeder not included):
O Service over 225 amps - commercial Cl Health -care facility Each pump or irrigation circle 2
O Service over 320 amps- rating of l &2 0 Hazardous location Each sign or outline lighting 2
family dwellings Cl 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 then stories 0 Feeders, 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or RV parr
Each additional Inspection over the allowable in any of the above:
O Egress/lightingplan 0 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 $
O Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card numbs: / / within 180 days after it has been State surcharge (8%) .... $
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440 -4615 (6A0KCOM)
r
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
4. Complete Fee Schedule Below: .
Number of Inspections per permit allowed Restricted Energy Fee $75.00
Service included: Items Cost Total (FOR ALL SYSTEMS)
4a. Residential - per unit Check Type of Work Involved:
1000 sq. ft. or less $147.15 4
Each additional 500 sq. ft. or El Audio and Stereo Systems
portion thereof $33.40 1
Limited Energy $75.00 0 Burglar Alarm
Each Manufd Home or Modular
Dwelling Service or Feeder $90.90 2
• 0 Garage Door Opener*
4b. Services or Feeders
Installation, alteration, or relocation 0 Heating, Ventilation and Air Conditioning System'
200 amps or less $80.30
•
2
201 amps to 400 amps $106.85 2 0 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 TYPE OF WORK INVOLVED - COMMERCIAL ONLY
4c. Temporary Services or Feeders .
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 . Check Type of Work Involved:
Over 600 amps to 1000 volts, .
see "b" above. El Audio and Stereo Systems
4d. Branch Circuits
New, alteration or extension per panel ❑ Boller Controls
a) The fee for branch circuits
with purchase of service or ❑ Clock Systems
feeder fee.
Each branch circuit $6.65 2 ❑
b) The fee for branch circuits Data Telecommunication Installation .
without purchase of service
or feeder fee. ❑ Fire Alarm Installation
First branch circuit $46.85
Each additional branch circuit $6.65 n HVAC
4e. Miscellaneous El (Service or feeder not included) Instrumentation •
•
Each pump or Irrigation circle $53.40
Each sign or outline lighting $53.40 n Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 ❑ Landscape Irrigation Control*
Minor Labels (10) $125.OG
4f. Each additional inspection over ❑ Medical
the allowable in any of the above ❑
•
Per inspection $62.50 Nurse Calls
Per hour $62.50
In Plant $73.75 ED Outdoor Landscape Lighting*
5. Fees: n Protective Signaling
La. Enter total of above fees $
8% Surcharge (.08 X total fees) $ ❑ Other
Subtotal $
1 Lb. Enter 25% of line 5a for Number of Systems
I Plan Review if required (Sec. 3) $
Subtotal $ • No licenses are required. Licenses are required for all other installations
❑ Trust Account # FEES:
Total balance Due $ ENTER FEES $
8% SURCHARGE (.08 X TOTAL ABOVE) $
TOTAL . $
Plumbing Permit Application
Date received: Permit no.:
. �, ,�l�y, IL City of Tiga
. . :_ 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 Receiptno.:
Land use approval: Case tile no.: Payment type:
TYPE OF PERMIT
1 & 2 family dwelling or accessory ❑ Commercial/industrial l] Multi- family ❑ Tenant improvement
slew construction ❑ Addition/alteration/replacement 0 Food service 0 Other.
JOB SITE INFORMATION FEE SCIIF.DULE (for special inform ation use checklist)
Job address: /. (� 9' „[� ,�Z �' `4"..1K-""1 v Descri don Qty. Fee(ea.) Total
Bldg. no.: S uite no.: New 1 -and 2- family dwellings only:
- (indudes 100 ft. for each utility connection)
Tax map/tax lot/account no.: SFR (1) bath
Lot: /12 (p IBlock: I Subdivision: SFR (2) bath
Project name L •� C "DQ e , � SFR (3) bath
City/county: / t cmyYil I ZIP: 71 2,2.4 Each additional bath/kitchen
Description and location of work on premises: Site utilities:.
Catch basin/area drain
•
Est. date of completion/inspection: Drywells/leach line/trench drain
Footing drain (no. lin. ft.)
PLUMBING CONTRACTOR Manufactured home utilities
Business name: (,JOl rd P/1/17.. ./7/ Manholes
Address: p 0 z3 , y a D0 Rain drain connector '
City:6 T45110/4)1 1 State:0A I ZIP: 9 703 Sanitary sewer (no. lin. ft.)
Phone: &6 7_, / I Fax: G 7..q f I E -mail: Storm sewer (no. lin. ft.) .
CCB no.: Plumb. bus. re g. no: Water service (no. lin. ft.)
°� y 1 g °������� Fixture or item:
City/metro lic. no.: Absorption valve
. Contractor's representative signature: p I " 07t"i Back flow preventer
Print name: Q - 42 de d// JJ Date: Backwater valve
CONTACT PERSON Basins/lavatory
Name: 6 for ,` cc- Clothes washer
Dishwasher
Address: pc, R el• - 7 Drinking fountain(s) .
City: or n f h o yfi I Staten: I ZIP: 9. 7D,35 Ejectors/sump
Phone: „ - 0 ' Fax: E-mail: Expansion tank -
OWNER Fixture/sewer cap
Name (print): Z,.p Q lie 74 67_5 Floor drains/floor sinks/hub
Garbage disposal
Mailing addres / 7,3 �ZV G ) Hose bibb •
City: Poe- cr 4,4 State: a &. I ZIP: '77� Ice maker
Phone: 4_10 n ab I Fax: dc? „” I 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 per ORS Chapter 447. Sink(s), basin(s), lays(s)
Owners signature: ? 4 G / 2a -0 /. Sump
Tubs/shower /shower pan
Name: . . A Urinal
r rr Water closet
Address: 4 cf .9 j_ #- J1-0,e) Water heater
City: -7-'} 4I,,/ I State:0, I ZIP:1 Other. • •
Phone: 4 y -)4d�j Fax: I E -mail: Total
Not all jurisdictions accept credit cards, please call jurisdiction for more information- Notice: This permit application Minimum fee $
❑visa D Mastercard Plan review (at %) $
Credit card number. / / within 180 if a permit is not r it has been obtained
n State surcharge (8%) .... $
Expire within days after been
accepted as com lete. TOTAL $
Name of cardholder u shown on credit card P P
S
Cardholder signature Amount
440 -4616 (6I00/COM)
PLEASE COMPLETE:
FIXTURES • (individual) }Qty .pn� ce,• ;
- Fixture Type Quantity by Work Performed
Sink 16.60 New Moved Replaced Removed /Capper
Lavatory 16.60 Sink
Lavatory
Tub or Tub /Shower Comb. 16.60 -
Tub or Tub/Shower Combination
Shower Only • 16.60 Shower Only
Water Closet 16.60 Water Closet
Urinal
Urinal 16.60 Dishwasher
Dishwasher 16.60 Garbage Disposal
Laundry Room Tray
Garbage Disposal 16.60 Washing Machine
Laundry Tray 16.60 Floor Drain/Floor Sink 2'
'
Washing Machine 16.60 4 3 "
Floor Drain/Floor Sink 2" 16.60 Water Heater
3" 16.60 Other Fixtures (Specify)
4" 16.60
Water Heater 0 conversion 0 like kind 16.60
Gas piping requires a separate mechanical permit.
MFG Home New Water Service 46.40
MFG Home New San/Storm Sewer • 46.40
• COMMENTS REGARDING ABOVE:
Hose Bibs 16.60
Roof Drains 16.60
Drinking Fountain 16.60
Other Fixtures (Specify) 21.75
IP
Sewer - 1st 100' • 55.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00
Water Service - each additional 200' 46.40
Storm & Rain Drain - 1st 100' 55.00
Storm & Rain Drain - each additional 100' 46.40
Commercial Back Flow Prevention Device 46.40
Residential Backflow Prevention Device' 27.55
Catch Basin 16.60
Insp. of Existing Plumbing or Specially Requested 72.50 •
Inspedions per/hr
Rain Drain, single family dwelling 65.25
Grease Traps 16.60
QUANTITY TOTAL
Isometric or riser diagram Is required if Quantity Total Is > 9
"SUBTOTAL
8% SURCHARGE
■ "'PLAN REVIEW 25% OF SUBTOTAL e~ m.
Required only K fudure qty. total Is > 9 s � k
TOTAL
'Minimum permit fee is $72.50 + 8% surcharge, except Residential Backflow Prevention
Device, which is $3625 + 8% surcharge.
""Alt New Commercial Buildings require plans with Isometric or riser diagram and plan review.
•
•
Mechanical Permit Application
Date received: Permit no.:
'' City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
.C� & 2 family dwelling or accessory ❑ Commercial/industrial 0 Multi - family 0 Tenant improvement
VII construction 0 Addition/alteration/replacement 0 Other.
Job address: 13 ;. '7 f l fi 4 ,, 6 r,-g-,,. 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.: profit. Value $ • •
Lot: r (t, (Block: I Subdivision - 4) � See checklist for important application information and
Project name: ^ > � c.NC • jurisdiction's fee schedule for residential permit fee.
City /county: — ,, 4 ZIP: .2.2/ • I & 2 F D11'ELLING PERMIT 111: Mill In II
Description and 1. ation of work on premises: AM) €011111 :RICALIINDUSTRIAL EQUIPIIENTS('IIFDULE
Fee (ea.) Total
Est. date of completion/inspection: Description Qty. Res. only Res.only
Tenant improveme sr change of use: IIVAC:
Air handling unit CFM
Is existi t : space heated or conditioned? 0 Yes 0 No '
Air conditioning (site plan required)
Is e • • g space insulated? 0 Yes 0 No Alt of existing HVAC system
I I IA. 'ILINICAL CON] It.1([Olt Boiler /compressors
State boiler permit no.:
Business name: ,� ,., /eu> H P Tons BTU/H
Address: fit! , / k5 Fire/smoke dampers/duct smoke detectors
Ci q ` i Stat imp: 970? f 4, Heat pump (site plan required)
tY ! !yr I .3
Fax: ��L93I E -mail: Install/replace furnace /burner BTU /H
Phone: 0 Z5 - 3 - 7) Including ductwork/vent liner 13 Yes O No
CCB no.: k? / 31 Install/replace/relocate heaters- suspended,
City/metro lic. no.: / 0 2 7 Le. wall, or floor mounted
Name (please print): 1)o/3i) 0.. Vent for appliance other than furnace
CONTACT PERSON Refit
n.
Absorption u units BTU/H
Name: p , GL Chillers HP
Compressors HP
Address: g hi.? di c J'f, Favironmental exhaust and ventilation:
City: Pc.,, 6-_-_/c.,71 LState :0/t I ZIP: y71 Appliance vent _
Phone;, -77,r Fax 7L 3 E -mail: Dryer exhaust
OWNER Hoods, Type 11 II/res. kitchen/hazmat
hood fire suppression system
Name: if, ..e ,,7- 0/ //Dl77 o S Exhaust fan with single duct (bath fans) -
Mailing address: / - , - ;_y' -- , - ft- ,4- 4>-0-- Exhaust system apart from heating or AC
Fu p ping and distribution up to 4 ou ets
City: A ZENCIPINIMINI Statep ' Z : 97d,t3 T LPG NG Oil
Phone: ,...s. „ MI ie E-mail: Fuel .i . in : each additional over 4 outlets -. ENGINEER . essp1. .: scu ematicrequired)
, Number of outlets
•
. Name: / rt G h • Other listed appliance or equipment:
Address: 4 z9 ` p��y� acvi Decorative fireplace
City: '� •`�'efr7 I State: I ZIP: Insert - type
Phone: /o..2 l/- 24, } (Fax: oodstovelpelletstove E-mail: E mail: Other:
Applicant's signature: p�f l 4 at : /-2° 1=1/ - baler:
Name (print): { /�10 %) �
Not an jutisdicuons accept � •t cards, PI ca n jurisdiction for moil on.
irdweetiN Permit fee $
Notice: This permit application Minimum fee $
O Visa 0 MasterCard expires if a permit is not obtained
Credit card number. / / 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 440-4617 (6/00/COM)
Commercial Schedule
• 1 &2 Family Dwelling Schedule
ASSUMED VALUATIONS PER APPLIANCE
Description -
Furnace to 100,000 BTU Table 1A Mechanical Code • Qty Price Total
inducing ducts & vents 955 1) Furnace to 100,000 BTU
including duds & vents 14.00
Furnace > 100,000 BTU 2) Furnace 100,000 BTU+
including ducts & vents 17.40
induding ducts & vents 1,170 3) Floor Furnace
floor furnace Including vent - 14.00
4) Suspended heater, wall heater
including vent 955 or floor mounted heater 14.00
suspended heater, wall heater 5) Vent not Included in appliance permit 6.80
or floor mounted heater 955 6) Repair units 12.15
Vent not included in appliance permit 445
Check all that apply. *Boiler Heat Air
PP P For Items 7 -10, see or Pump Cond Qty Price Total
Repair units 805 footnotes 1,2 Comp - _
7) <3HP; absorb unit to
< 3 hp; absorb.unit 100K BTU 14.00
8) 3-15 HP; absorb unit
to 100k BTU 955 100k to 500k BTU 25.60
3-15 hp; absorb.unit 9) 15 -30 HP; absorb
unit .5-1 mil BTU 35.00
101k to 500k BTU 1700 10) 30-50 HP; absorb
unit 1 -1.75 mi BTU 52.20
15-30 hp; absorb.unit 11) >50HP; absorb unit >1.75 mil BTU
501k to 1 mil. BTU 2310 87.20
12) Air handling unit to 10,000 CFM
30-50 hp; absorb.unit 10.00
1 -1.75 mil. BTU 3400 13) Air handling unit 10.000 CFM+ 1720
• 14) Non-pottable evaporate cooler
> 50 hp; absorb.unit 10.00
> 1.75 mil. BTU 5725 15) Vent fan connected to a single duct
6.80
Air handling unit to 10,000 cfm 656 16) Ventilation system not Included in
appliance permit 10.00
Air handling unit > 10,000 dm 1170 17) Hood served by mechanical exhaust
Non - portable evaporate coller 656 1000
18) Domestic incinerators
vent fan connected to a single duct 446 17.40
19) Commercial or industrial type incinerator
Vent syst not included In appliance permit 656 69.95
Hood served by mechanical exhaust 656 2.0)
Other units, includin wood stoves 10.00
Domestic indnerator 1170 - 21) Gas piping one to four outlets
5.40
Commercial or industral Incinerator 4590 22) More than 4-per outlet (each)
1.00
Other unit, including wood stoves, inserts, etc. 656 Minimum Permit Fee $72.50 SUBTOTAL gag
Gas piping 1-4 outlets 360 • 8% SURCHARGE
Each additional outlet 63 PLAN REVIEW 25% OF SUBTOTAL
Required for ALL commercial permits only
TOTAL Megaili
Other Inspections and Fees:
1. Inspections outside of normal business hours (minimum charge -two hours)
$72.50 per hour
2. Inspections for which no lee is specifically indicated (minimum charge-half hour)
$7250 per her
Total Valuation Fee 3. Additional plan review required by charges, additions or revisions to plans (minimum
charge-one-Nth hour) $72.50 per hour
'Stale Contractor Baler Certification required
$ 1.00 to $ 5,000.00 Minimum $72.50 ^Residenaat NC requires site plan showing placement of unit
$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 including $10,000.00
S10,001.00 to $25,000.00 S148.50 for the first $10,000.00 and $1.54
for each additional $100.00 or fraction
•
thereof, to and including $25,000.00
•
$25,001.00 to $50,000.00' $379.50 for the first $25,000.00 and $1.45
for each additional $100.00 or fraction
thereof to and including $50,000.00
$50,000.00 and up 4 $742.00 for the first $50,000.00 and $1.20
for each additional $100.00 or fraction
thereof
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MsTzfr' / 'U3
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 � -
BUP
Date Requested ' J AM PM BLD
Location / y -- e ( g 3 ( g AO Suite MEC
Contact Person Ph 5-Gard 9 � _ PLM
Contractor Y )1 r Ele J ' Ph SWR
BUILDING Tenant/Owner *A-wm D Q/ - 4 ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
: Gf 4 „s--.
Misc: � /
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
LE 41
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Other oach /Sidewalk � J - / Inspector M � Ext
Date
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST - Zr- - Ce , C ( 1
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ,
/ BUP
Cc�/ P Date F quested I% /( AM PM BLD
Location ceR. Ailfr Suite MEC
Contact Person Ph 2 571 Ogo2 3 PLM
Contractor Ph SWR
UIL Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
SASS PART
PLUMBING s1��
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PAS T FAIL
L
Post & Beam
Rough In
Gas Line
Smoke Dampers
SS in I
PART FAIL
RICAL
Service
Rough In
UG /Slab
Low Voltage m '
Fire Alarm / `,
Final • 4
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk t
I
Date Inspector
Other E x t
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
C OF TIGARD BUILDING INSPECTION DIVISION
3
1 _
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
�c Date Requested 6// AM PM BLD
Location l S ( eta Suite MEC
Contact Person Ph IAA 3-3 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain (-e u),(%rX SGN
Crawl Drain Ins fiction Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
'ART FAIL
G
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sew
f lip Drains
`F
40 PART FAIL
'ICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date ) !/ / 3 sp ec
/o / Int // 1 J , 2 Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site
/ - t
CITY OFTIARD BUILDING INSPECTION DIVISION
• MST .7 G
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
• BLIP
Date Requested - (( AM PM BLD
Location (,5 69 S g✓ 9 Ata( Suite MEC
Contact Person Ph Vf a 92 ) PLM
Contractor Ph SWR
B�U LC11N' Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing 0211 e - Lc 1.1 'TO G ci
Insulation , /'
Drywall Nailing ,
Firewall
Sprinkler 0_4_4 c� far 1 ' 2,1 , c= - 5.
Fire Alarm
Susp'd Ceiling �� /�`-� c L.-
Roof
Misc:
Final
SS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
C E cba
Post eam
Rough In
Gas Line
Smoke Dampers �F
ASS PART
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Dat 6 �� Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
- CITY OFTIGARD BUILDING INSPECTION DIVISION '
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
MST r J -4.6G 3
BUP
Date Requested 6' AM PM BLD
Location /r g 5 w gr e a , 1 Suite MEC
Contact Person Ph5 a 9 i PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation ,, QQ FPS
Ftg Drain / 7. � 300.a w. SGN
Crawl Drain Inspection o es:
Slab SIT
Post & Beam
Ext Sheath /Shear eip Int Sheath /Shear - /
Framing / Y`e? / — --/ i S � , yt a I � yr �l / o C )-cc+� p cam// �r/ Insulation ,�(
Drywall Nailing "/O W
Firewall y 4 /' e i ,,t
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PART FAIL
flLUMBl�
& Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
(ring)
PASS olgrOP FAIL
MECHA
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA G /
Approach /Sidewalk Date - 0 ' 0 / Inspector ' e ! 1 L e ( { - Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
G. 31 --
Crfy or TIGARD BUILDING INSPECTION DIVISION MST
24•Hour Inspection Line: 639 -4175 Business Line: 639 -4171
• BUP
Date Requested aa' Z- AM PM BLD
Location /) 5 F 9 54.,IY Suite MEC
Contact Person Ph atar -f71 - Z- PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING O k T 7o
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA �,�A
O eroach /Sidewal7 Date L(72- ,A/ 3 0/ Inspector i4 f Ext f/P
F
PART FAIL DO NOT REMOVE this inspection record from the job site.
Gain "ea-6663c( .
- CITY OI TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
• BUP
Date Requested ' — /- 3 AM PM BLD
Location ( S iS Sw gg.6r Aar Suite MEC
Contact Person Ph S f k" o fZ3 PLM
Contractor Ph SWR
Tenant/Owner ELC
Re ainmg Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
F
PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
Final
PASS PART FAIL
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date / / — !� / Inspector / E
Final
_ PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
- • 'jITY OF TIGARD BUILDING INSPECTION DIVISION s
24- Hour Line: 639 -4175 Business Line: 639 -4171 MST 2e-/
•
/ BUP
Date Requested / / AM v PM BLD
Location /S J ? y Sw eir A ✓P Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
jl Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear -
1;1 S Lit /r. e A �■ 5
n s cation
Drywall Nailing (74 S r a g S. r t'o iL /5 /HI / c
Firewall
Fire Sprinkler } $ ,) 4-1 7q 23
Fire Alarm
Susp'd Ceiling
Roof
Misc:
F PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
CH A
Post & Beam
Smoke Dampers
Fi
PAS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date «--1 / dl Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
gUP _
• Date Requested 1 -- /v AM v PM BLD
•
Location }�3 $9 ,Sw � 70404_ Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
e �svw
Rough In
UG /Slab
Low Voltage
Fire Alarm
F'
PA ART FAIL
SI
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ nable to inspect - no access
ADA
Approach /Sidewalk
Other Date q- Inspector !_ _ _ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
•C TY'OF TIGARD BUILDING INSPECTION DIVISION MST zY— j ' ` I
. 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
•
BUP
Date Requested 4' —/ AM PM BLD
Location / S J .51 g 8 ' e Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
�tl lift Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int
Insulation
Drywall Nailing S ✓✓L;. A_Je 1AT S4 S 71.7, --e 5
Firewall
Fire Sprinkler "r2-.. ) ,
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART (FA;
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
NI 4.
- -am
- ou•s
�pe
moke Dampe
Final
PASS PART FAI
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk D ate Y ��( Inspector Other P Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
• • CITY OF TIGARD BUILDING INSPECTION DIVISION MST ••• a ta .3
. 24-1-lour Inspection Line: 639 -4175 Business Line: 639 -4171
•
_ OUP
Date Requested C.,� — s AM PM BLD
Location / 575 sw 1I Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
Post & Beam
Under Slab
Water Service
Sanitary Sewer
Rain Drains
�.% 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
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA //►►
Inspector E
Approach /Sidewalk Date 5/1is It
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
• • CITY OP TIGARD BUILDING INSPECTION DIVISION Ms 2 o '/1-D a
24=Hd"Ur Inspection Line: 639 -4175 Business Line: 639 -4171 ,
•
. BUP
. Date Requested 3 7• 51 AM PM BLD ,.
Location / cg 23 9 j Suite MEC 11111Well/
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post ' - -
�•� su ��,.-rli
r. •
Insulation /
Drywall Nailing gt Ar
Firewa ,� / / •/ uZ)
Fire Sprinkler
�y (L
Fire Alarm
Susp'd Ceiling
Roof
Misc:
• PART FAIL
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach/Sidewalk
Other Date 3) ' 2 7/ c � Inspector -- Th if‘n
Final
PASS PART FAIL • DO NOT REMOVE this inspection record from the job site.
• ;91Df O1 TIGARD BUILDING INSPECTION DIVISION G v3
24 Inspection Line: 639 -4175 Business Line: 639 -4171 MST Y
'SUP
Date Requested Z 7 AM 1 .-PM BLD
Location / 6' S Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
but n�tin Z Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Bea
Ext Shea /Shear ( 5'
Int Sheath /Shear r
Framing // /4i 00 fl// S Ste- ✓7 (' �`c 14)2. �Ji'�LC . Ci,g7 /2
insulation
Drywall Nailing ,4 c o c. 577 C T ii
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART AIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
I Approach /Sidewalk 3 _ 2 7 _ Ul
Other Date Inspector E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
• - .;CI ll;0I TIGARD BUILDING INSPECTION DIVISION , -
MST tpl —Uv
'24 Inspection Line: 639 -4175 Business Line: 639 -4171
•
• BUP •
Date Requested 3- i3 AM 1.-----' PM BLD •
Location 1 ..5 - 5 - 60 51 g g r e 4 vim Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
CIBADUIK. Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
ost & Bea
eath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Fi
AS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
<11 CHANIC
- os : =:+;;_
• oug n
Gas Line
Smoke Dampers
F PAS5) PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk D 3 - 13- 0 l Inspector t
Other Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
LA,
• • c JJ' *'Y • OF TIGARD BUILDING INSPECTION DIVISION
MST Ze - -,
4 =Hour Inspection Line: 639 -4175 Business Line: 639 -4171
a RUP / =
. Date Requested 3- ! L AM PM BLD ,k _
Location / S 5111 S ‘4../
Suite MEC
Contact Person Ph 7 / 7 �/ PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
os
Under Slab
1 Top Out
Water Service
Sanitary Sewer
Rain Drains
F.
43 4 RT FAIL
ICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Otheoach /Sidewalk 3/2/n I n spector / Ext
Date �7
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
f S
• ; ; CITY TIGARD BUILDING INSPECTION DIVISION
MST /' 64) 63 Y
24 - Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
• Date Requested AM PM BLD 14P
Location 1 SC b' 9 S MEC 11/
Contact Person Ph 9 $' ,9— e/' Z/ PLM
Contractor Ph SWR
!., Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Jain SGN
Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Fi
- ASS PART FAIL
Post & Beam
Under Slab
Top Out
ice
Fin
PART FAIL
ANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA y /t Approach /Sidewalk Date 1 / Inspector
Other E x t
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
Y ' 7,.o .• •' • t •
• CITY OF TIGARD BUILDING INSPECTION DIVISION
. MST Z'id "G C3 �
�
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171. •
BUP
• Date Requested ) AM v PM BLD •
Location / 5 5 $ 5 - go ..}4,,e Suite MEC
Contact Person Ph nr u J Z 7 ( PLM
Contractor Ph SWR
G�J.t1tA1 Tenant/Owner /j, ELC
Retaining Wall ELR
Footing 4 � Access: FPS
g Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc
Final
PART FAIL
UMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date 3 - 5 - = O/ Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
• - . : -1 OF TIGARD BUILDING INSPECTION DIVISION
'24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
/ BUP
• Date Requested 3 AM PM BLD
•
Location / 5 — .SA C ? 5 6B Suite MEC
Contact Person Ph 5 'V107 PLM
Contractor Ph SWR
/�
Tenant/Owner f buy ELC
Retaining Wall ELR
Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk � �
Other Date /� / Inspector E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
MST — Master Permit
4 Inspection Description Date Passed By Notes •
Grading
Footing /Setback 3 — _ 0/
Foundation walls 2
Slab
Footing drain
Waterproof basement walls
Plumbing underslab
Crawl drain 3/ '/b /
Post/beam plumbing 3//,2/,),i 30
Post/beam mechanical 3 - 13-- o ,
Underfloor insulation '' JJ��
Post/beam structural 3 - I - c / `
Shear walls /anchors f 2 7/U ( Fs
Exterior sheathing 17-1/0 (,
Plumbing top -out 1 57II / iv
Gas line & test - t l -- o f V
Mechanical rough -in 1--it- e t (�d
Electrical rough -in
Electrical service 4 is o
Low voltage
Sprinkler rough -in
Backflow preventer
Roof nailing
Firewall
Framing
MFG -Home set -up
Insulation 4- t s- o t KR
Drywall nailing
Masonry /Reinforcement
Rain drain '3 / & / b /
Sanitary sewer 3 /to / G r T/9
Water service 6,
3 /
Pump /fill septic tank
Approach /sidewalk
Grading final
Mechanical final Co gip / (4
Plumbing final &p-/ 3 -a /
Electrical final (y (!b//O
Final inspection , f 13) 0 ( p
Special Reports
SWR - Sewer Permit
Inspection Description Date Passed By Notes
Sanitary sewer
Final inspection
INSPECTION RECORD — MST (MASTER) PERMITS