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Permit s. A CITY OF T I G A R D MASTER PERMIT PERMIT #: MST2004 -00171 -^ i �IWj DEVELOPMENT I ' SERVICES 97223 639-4171 DATE ISSUED: 8/23/2004 SITE ADDRESS: 14150 SW 89TH AVE PARCEL: 2S111AA -08200 SUBDIVISION: GREENSWARD PARK NO. 3 ZONING: R - 4.5 BLOCK: LOT: 066 JURISDICTION: TIG REMARKS: New SF detached BUILDING REISSUE: PH2206E STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,608 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,066 sf GARAGE: 557 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: 0 sf RIGHT: 5 VALUE: 263,036.30 OCCUPANCY GRP: R3 80RM: 3 BATH: 3 TOTAL: 2,674 sf REAR: 15 PLUMBING SINKS: 2 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: r VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: / / HOODS: 1 / �/ �� ,yq,, /� OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: V W � � D -/ • `�'/f'�i^-GC�/ G � ��5: 4 ELECTRICAL 7 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: PUMPHRRIGATION: PER INSPECTION: EA ADD'L 500SF: 5 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: 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: ALL - ENCOMP BOILER: HVAC: LANDSCAPEHRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: TOTAL FEES: $ 7,683.15 Owner: Contractor: This permit is subject to the regulations contained in the FOUR D CONSTRUCTION CO FOUR D CONSTRUCTION Tigard Municipal Code, State of OR. Specialty Codes PO BOX 1577 PO BOX 1577 and all other applicable laws. All work will be done in BEAVERTON, OR 97075 BEAVERTON, OR 97075 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. Phone: 503 - 590 - 0805 Phone: 720 - 7445 MOBL ATTENTION: Oregon law requires you to follow rules 5qqQQ�0805 adopted by the Oregon Utility Notification Center. Those Reg #: I IC 71037 rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Ersn Cntrl 681 -4444 Post/Beam Mechanical Mechanical Insp Shear Wall Insp Insulation Insp Appr /Sdwlk lnsp Sewer Inspection Underfloor insulation Plumb Top Out Exterior Sheathing Insl Rain drain lnsp Electrical Final Footing Insp Crawl Drain /Backwater Electrical Service Low Voltage Storm drain Insp Mechanical Final Foundation lnsp Footing /Foundation Dr; Electrical Rough In Gas Line lnsp Water Line lnsp Plumb Final Post/Beam Structural PLM /Underfloor Framing Insp Gas Fireplace Water Service lnsp Building Final Issued By : i' . Per mittee Si nature '.L�y� /� Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the n- business : ay Building Permit t , V ED FOR OFFICE USE ONLY City of Tigard DDate/By: I-, P 56 T Permit No.: •5� . sip ....06 ! - 7 / 13125 SW Hall Blvd., Tigard, OR 97221M 3 200 4 Plan Review ^^ t Phone: 503.639.4171 Fax: 503.598.1 CI qW TY b Other Pernu 1 I'` DDate/By: (hy, y: / � - I - H � - i �+'t Inspection Line: 503.639.4175 of TIGAR ' I Date Ready/By: /7 / e ® See Attached Checklist for Internet: www.ci.tigard.or.us G j VIS10 J Notified/Method: � � Supplemental Information BUILDING - , , ;' , ,!ii t'e, , tg §' i 14 t 3 ' OF W ORD REQUIRED DATA. 1- AND 2- FAMILY DWELLING • til New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the work indicated on this application. '.w„ ( t' - . S: t g ,7' 7. R ' -, i+' 6 . �f , E W . , :6, a , as�4 at,, �: '... /, Valuation: $ g 1- and 2- family dwelling ❑ Commercial /industrial Number of bedrooms: ❑ Accessory building ❑ Multi - family ❑ Master builder 0 Other: Number of bathrooms: 2 //2— ,. - _ 4 ' Y �: JOB SITE INFORMATION AND LOCATION ti, Total number of floors: 2 Job site address: f / ,S' J J 5 0"."---, New dwelling area: c��,��474luare feet City/State/ZIP: / /9 /7/ Cpl A A/ Garage/carport area: �,. square feet Suite/bldg. /apt. no.: Project name: Covered porch area: / 4/3 square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet �(g, to REQUIRED COM MERCIAL -USE CHECKLIST Subdivision: 6-4,04„4-4:_,..4.44_ ?fir I Lot no.: - Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the A 4 �, �,� . � � ��; 1 �� 1,4 , � o : =i �, ,,�F � z `�, � work indicated on this application. < 4 � / , Valuation: $ ,(S v cC S'� Existing building area: square feet New building area: square feet I I Number of stories: __ ��ft - ' � t3 � ' � °" 1 ` �1 4.' ''� a�-� �$ i `�"�. kf �+ku. 9 ! u . its 9. az . ,. o - . ace, a ,, , 3�� u' ` t -4 :s ' '. Name: / /. '3 6�k S7 e,L G ?€. d A) Type of construction: Address: t. 2? j . -- z' 77 Occupancy groups: City/State/ZIP: ..uZcs -..." d 4 97 d 7 S Existing: Phone: (5b3) 6-9 - t cp ck s- Fax: Lt .S 9 0— / 2S New: g f r s x !mot . 4:l mi,,„,..tf,,t° Business name: „L ,42-1' 47A All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: under ORS 701 and maybe required to be licensed in the Address: jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons City/State/ZIP: apply: Phone: ( ) I Fax: : ( ) E -mail: T, _ +f ,, i 4 I5,1� . � A , a M. r g Witlt d.u.; Business name: .....9fr»te_ /Z. Apb6 (f ': „ s BUILDING PERMIT FEES* Address: Please refer to fee schedule. City/State/ZIP: Fees due upon application Phone: ( ) Fax: ( ) Amount received CCB lic.: 77 Date received: Authorized signature: // e �� �.� This permit application expires if a permit is not obtained �/ within 180 days after it has been accepted as complete. I Print name 4i , ' - -- / - s Date: �'" -� * Fee methodology set by Tri- County Building Industry pN l Service Board. 1 1:1 Building \Pertnits\BUP- PemutApp.doc 12/03 440- 4613T(11/02/COM/WEB) One- and Two - Family Dwelling Building Permit Application Checklist FOR OFFICE USE ONLY City of Tigard Date/Bed Permit No.: Y: 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: Phone: 503.639.4171 Fax: 503.598.1960 l 1 1 1 ' � ' ° � ❑ Electrical ❑ Plumbing ❑ Mechanical 24- Hour Inspection Line: 503.639.4175 ,. Internet: www.ci.tigard.or.us ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ 0 0 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. - 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings PIP and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and/or lateral analysis plans. Must indicate details and locations; for non ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. . 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore: on and shall be shown to be ap plicable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Five (5) site plans are required for Item 11 above. Site plans must be 8-1/2" x 11" or 11" x 17 ". . ❑ ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ 27 "Drawn. to scale" indicates standard architect or engineer scale. ❑ _ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include tree protection measures as required by conditions of approval. ❑ ❑ ❑ 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. i:\Building\Permits \One- Two- FamilyChecklist.doc 12/03 Building Fixtures � Plumbing Permit App C_�� Vn c 10 FOR OFFICE USE O' 1X City of Tigard j`\ v` • Received . Received Permit No.: ra �6 f 13125 SW Hall Blvd., Tigard, OR 97223 S' Plan Review l Phone: 503.639.4171 Fax: 503.598.1960 G ‘.0 �'" 4 � Other Permit No.: D ate/By : 24- Hour Inspection Line: 503.639.4175 0 •' Ju ns: Internet: www.ci.tigard.or.us dv - Date ed /Meto S See Pen 2 for gaT V Notified/Method: Supplemental Information . � ; � ; 7. 1'4 New construction ❑ Demolition For special information use checklist Description I Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1-2-family dwellings (includes 100 ft. for each utility connection) � v a „ ,.'? , ° ; Y . � . SFR (1) bath 249.20 X 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler (- sq. ft.) Page 2 ° t m �. .� a i ''T''''-:'' _ ., , �.. . . >_ 'lilt: r ' 3 s ... . 1. Site utilities Job site address: /4,//s---6 c d ° e� 9 y ...4_, Catch basin or area drain 16.60 City /State /Z1P: -7 //� � � G, '722 Drywell, leach line, or trench drain 16.60 /� 1 ! l Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: Project name: Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 e- Subdivision: /`-�`C'�S�S ��,?�- I Lot no.: Water service (no. linear ft.: _) Page 2 Fixture or item Tax map /parcel no.: „ Absorption valve 16.60 s i ; ��I .. q`c ° r '41 12 ' ., 4 ;. Backflow preventer Page 2 2 %/ Attu) ABC Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 . �x �� a ei Drinking fountain 16.60 t ' 1, .,' k Ejectors /sump 16.60 Name: 4- k ,c7" CCC7l e s e) - Expansion tank 16.60 Address: Vtl:). 2 a . /,c-,2 7 Fixture /sewer cap 16.60 City/State/ZlP:2 ._ � 7‘32,,s---- Floor drain/floor sink/hub 16.60 Phone: (Sze) _ • a Fax: 3c, / Garbage disposal 16.60 v t ,, Hose bib 16.60 Ice maker 16.60 Business name: �7 _ � 2 �` , �!' 1S ?, d p !lam Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City/State/ZIP: Roof drain (commercial) 16.60 Phone: ( ) ,Fax:: ( ) Sink/basin/lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 as a,� s 1 ,� i Water closet 16.60 Business name: �� 2 `pL, 4 Water heater 16.60 Address: 45 45 ' ,SL � / � Other: City/State/ZIP: /yip Sh /�., p» l / 2 Subtotal ' - T , Minimum permit fee: $72.50 Phone:, 3 ) 6 �d X23/ Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: /95. Plumbing Lic. no. 4`-4/0 ?Z Plan review (25% of permit fee) f Q State surcharge (8% of permit fee) Authorized signature: /7 L�c�t,C g/e TOTAL PERMIT FEE , , Print name:A w22 � Dater -2‘-t,i This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. is\ Building \Permits\PLMF- PermitApp.doc 12/03 440- 4616T(10 /02/COM/WEB) Plumbing Permit Application - City of Tigard • Page 2 - Supplemental Information Fee Schedule: Residential Fire Su I s ression S stems: S 4 te �I g -1i . i m ° alr 99 age Footing drain - 1' 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Storm & Rain Drain - 1st 100' 55.00 a ti Pe'llt $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each > ? additional $100.00 or fraction thereof, to and i., ��`, . �,�, � .t..� . �. °� $ ,,., � including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof, to specially requested inspections - per hour 72.50 and including $50,000.00. Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . <y; W f•` .fi B 1 °F 3 .4 , .: , , Comments regarding fixture work: Ba.tis /Font Bath - Tub /Shower -_ -- - Jacuzzi/Whirl .00l -_ -- Car Wash -Each Stall - - -- -Drive Thru - - -- Cu . idor/Water As.irator - - -- Dishwasher - Commercial - - -- - Domestic - - -- Drinkin: Fountain - - -- E e Wash - - -- Floor Drain/sink - 2" - - -- - 3" - - -- -4„ -_ -- Car Wash Drain - - -- Garbage - Domestic - - -- Disposal - Commercial *Note: If the fixture work under this permit results in an - Industrial increase of sewer EDUs, a sewer permit will be issued and Ice Mach. /Refri:. Drains - - -- Oil S Gas Station - - -- fees assessed for the sewer increase must be paid before the Rec. Vehicle Dum. Station - - -- plumbing permit can be issued. Shower -Gang - - -- -Stall _ - -- Sink - Bar/Lavatory _ - -- Quantity Total - Bradley Isometric or riser diagram is required if fixture quantity - Commercial - - -- - Service - - -- total is >9. Swimmin: Pool Filter - - -- Washer - Clothes - - -- Water Extractor - - -- Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal - - -- Other Fixtures: - - -- is \ Building \Pennits\PLM- PennitApp.doc 3/03 Mechanical Permit Ap E FOR OFFICE USE ONLY I Received City of Tigard Date/By: Permit No.: ) *Srao(rn L DO /7 / 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 JUN 3 2 L� rn \ Date/By: Other Permit Inspection Line: 503.639.4175 . � � ,pl y �1i � W Date Ready/By: luris: 0 See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIG - Notified/Method: Supplemental Information BUILDING DIVISION `°" . ')'?` r: arC -..'' ' S ' ;. , . ,� i s t . 'EE' SC ased n th — value o t f the i;KLIST J New construction ❑ Addition/alteration/replacement Mechanical p ermi fees* are based o n the value oe work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑Other: mechanical materials, equipment, labor, overhead, and profit. -. � '<sl la @ O A � rl i �� ✓ Value: $ NI 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building b N E q ui Mi� / SYSTEM FEES* ❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist. Description Qt y. Ea. Total " ' . ' b t�6 „.a a' + at ^ �� s Heating/cooling - I Air conditioning or heat pump Job site address: / # S ( / i U .ta_., (requires site plan showing placement) 14.00 City/State/ZIP: -- --7- - / r p , . 2- 2 Furnace 100,000 BTU (ducts/vents) 14.00 .. Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Q / - Flue /vent for any of above 10.00 Subdivision , !v i4 Li�/e� Lot no.: _ice b - Other: 10.00 Tax map /parcel no.: Other fuel appliances e, r ,-1 Water heater 10.00 � " ` " `� Gas fireplace 10.00 4 Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 Chimney /liner /flue /vent 10.00 � x . �. k . ..,. . ., 1 Other: 10.00 Name: • a Ali or, le _ _ , v Environmental exhaust and ventilation Address: — Range hood /other kitchen r ,I equipment 10.00 City/State/ZIP: L �� Clothes dryer exhaust 10.00 / 3 U — !� �9 / ( c Singt duct exhaust (bathrooms, Fax: Phone: ) � d � toilet compartments, utility lity rooms) 6.80 Attic /crawlspace fans 10.00 a., Other: 10.00 Business name: i ,,/ ,, ) M Fuel t in P�P� t; Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City/State /ZIP: Wall/suspended/unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace E -mail: Range i apw w . ,. a ,,,,c1: ; Barbecue Clothes dryer (gas) s / ✓ . '/. Other: - Address . D 4 0 _k ,- 5 , S a a e� 9 ds a tl 7 City/State /ZIP: /Ze A , A - C . Subtotal Minimum permit fee ($72.50) Phone: ( • ) 42 O — 3 Fax: ( ) Plan review (25% of permit fee) State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: &/l nest.. �yJie This p ermit application expires if a permit is not obtained within 180 I . ( days after it has been accepted as complete. Print name: /j� ,e7,,/G ! � D ate: � � _„,/, * Fee methodology set by Tri- County Building Industry Service Board i:\ Building \Permits \MEC- PennitApp.doc 12/03 440 46I7T(11/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. i:\Building\Permits\MEC- PermitApp.doc 12/03 2 Electrical Permit Application A FOR OFFICE USE ONLY City of Tigard g R E C E I V r . !Eiew Permit No.: OR 97223 rr „, -00 l7 Phone: 503.639.4171 Fax: 503.598.1960 / "ip, r � „\ Other Permit: � � Inspection Line: 503.639.4175 - R 'IL, I ` Date/B Date Ready/By: Jugs Ea See Page 2 for Internet: www.ci.tigard.or.us JUN 1 i • Notified/Method: Supplemental Information er; 4kr ' ., -, 4, kl* i4 .' 0 , :, . e if , ` ' � _ . ALAN R,EV E':4?V [ New construction ❑ Additi f jCre0iN Please check all that apply: ❑ Demolition ❑Other ❑Service over 225 amps, comm'l ❑Hazardous location ❑ Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., ii d : IY of l- and 2-family dwellings 4 or more new residential g 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building 0 System over 600 volts nominal units in one structure ❑ Multi family ❑ Master builder ❑Other: ['Building over three stories ❑Feeders, 400 amps or more P ❑Occupant load over 99 persons ['Manufactured structures or 3 r,, °� ., g k ? ° / 1 . y ❑E ess/li tin lan RV park Job no.: Job site address: /41j 1j S LU cP97-ttiOc?__ ❑Health -care facility ❑Other: Submit 2 sets of plans with any of the above. City /State /ZIP: , 47' , 4 1 2 79-2-v The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: f Project name: , .. ' ” ° DU `E` , Description I Qty. I Fee. Total Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 6 4, 1,000 sq. ft. or less 145.15 4 Subdivision: f , f 5?...../i9 I cp,d)Q4. f Lot no. Ea. add'1 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential / 75.00 2 Limited energy, non - residential 75.00 2 4 ' 7 t - . t " g ` i " _ '' - Ea manu or mo dul ar ,JA AA rr -- � dwelling, service and /or feeder 90.90 2 0 / / � - 2 o L J 4 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 ' 1, : , ate 201 amps to 400 amps 106.85 2 `., a �' 's °t ' " g ' ,, - �' " 401 amps to 600 amps 160.60 2 u A Z Name: f� S�� L ? � 6 it) 0_,_ 601 amps to 1,000 amps 240.60 2 Address: ,O. & Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City/State /ZIP: 2 ` 3.1- 7? 6-7 Temporary services or feeders installation, alteration, and/or Phone: Fax: _ relocation � ^���` ©d �05 f ,_s---,,O,_/ 7�S t' 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch circuits — new, alteration, or extension, per panel '- '.,> ; 7 , r h o s A. Fee for branch circuits with '" 4' ''' service or feeder fee, each Business name: c%) -7"� O ,,,, „ S J A U� branch circuit 6.65 2 r' B. Fee for branch circuits Contact name: without service or feeder fee, each branch circuit 46.85 2 Address: Each add'I branch circuit 6.65 2 City/State /ZIP: Miscellaneous (service or feeder not included) Phone: ( ) f Fax:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - .1 ' , ' ' :a a "'° ; :7 s 5 energy panel, alteration, or Yname. extension. Describe: Page 2 2 Business To k.G�SLec%A ∎C Address: -7 S� s: i i / .gj metre Each additional inspection over allowable in any of the above mot- !' 9- re Per inspection 62.50 City/State /ZIP: ) 6 1 7 - 4,0i u / b. "7-9 2/ Investigation per hour (1 hr min) 62.50 Phone: (5 2e/0'�,'7 7 . Fax: ( / ) Industrial plant per hour 73.75 CCB Lic.: ,"�dr->dl Electrical Lic. 23 C p 3A (� Suprv. Lic.: p' S Subtotal �/ Suprv. Electrician signature, required: y .4. 1 . , i r m (s -eC_ .e� // � Plan review (25% of permit fee) Print name: 06 4(7 /�? >c. 6)61 �1 Da te: 2 4 - State surcharge (8% of permit fee) a y / TOTAL PERMIT FEE Authorized signature: ` �/ i This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name j , . Date: 1/43 ----9 e _,,, e * Fee methodology set by Tri- County Building Industry Service Board ** Number of inspections per permit allowed. i:\ Building \Permits\ELC- PermitApp.doc 12/03 440.4615T(10/02/COM/WEB Electrical Permit Application - City of Tigard • Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations is\ Building \Permits\ELC- PermitApp.doc 04/03 CITY OF YIGARD BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: ' PHONE #: Inspection Request Scheduled For: Date: , , - Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections/Comments/Instructions: A IL 211111111iIIIWYM4Wilffribi., i f z f )14/ (1# cptiS;p9 /A6, c//d (, t, LI PASS IN 'PARTIAL APPROVAL El CANCEL II NO ACCESS 0 FAIL fl CALL FOR INSPECTION LI ADDITIONAL FEES ASSESSED Inspector: Date: ,, ", Phone #: (503) 718- CITY OF•TIGARD • w BUILDING DIVISION PERMIT #: MST2004 00171 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 8/23/2004 Phone: (503) 639 -4171 / �b���� i °iFiv,k Inspection Requests (24 Hrs.): (503) 639 -4175 - INSPECTION WORKSHEET FOR DATE: 4/7/2005 TIME: 7 :14AM PAGE: 38 SITE ADDRESS: 14150 SW 89TH AVE CLASS OF WORK: SUBDIVISION: GREENSWARD PARK NO. 3 LOT #: 066 TYPE OF USE: PROJECT NAME: GREENSWARD PARK NO. 3 DESCRIPTION: New SF detached OWNER: "BUR D CONSTRUCTION CO, PHONE #: 603590 -0805 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 5940805 Inspection Request Scheduled For: Date: 4/7/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 003990.02 503. 720.7445 Y Corrections /Comments /Instructions: I < / < i . i, /if / i Arare./7 1., , r -- 9 _ 1, mg: / . A 1 . .111 i . / Ill . A ' ' G A l i JL _ / % / J / ,L • e�' ( 10 41 41- 1 1 1 414 / ND D gei 'fe-,‘(,0 I PASS ❑ PARTIAL APPROVAL El CANCEL ❑ NO ACCESS X FAIL ❑ CALL F R INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: . 7 �V Phone #: (503) 718- CITY OFTIGARD , r "" - BUILDING DIVISION PERMIT #: MST2004-00171 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/23/2004 Phone: (503) 639 -4171 �r " A„„\ Nime i Inspection Requests (24 Hrs.): (503) 639 -4175 W INSPECTION WORKSHEET FOR DATE: 4/11/2005 TIME: 7:10AM PAGE: 13 SITE ADDRESS: 14150 SW 89TH AVE CLASS OF WORK: SUBDIVISION: GREENSWARD PARK NO. 3 LOT #: 065 TYPE OF USE: PROJECT NAME: GREENSWARD PARK NO. 3 DESCRIPTION: New SF detached OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503-590.0805 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 590-0805 Inspection Request Scheduled For: Date: 4/11/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 004216-01 503-720.7445 Y Corrections /Comments /Instr ctions: KE:Pe (C L PT ° sr - C -4- S-Sd 4 (_,) Co" ' L-T A - 4 , /0 --1-- _4_ iv IT-1-4_,(-___c____-- ./ .10 ;'"ASS MI PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS 1I FAIL N CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED S --- Inspector: I_ AMP Date: L � // 0 Phone #: (503) 718 - CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST Z.4 7 ! INSPECTION DIVISION Business Line: (503) 639 -4171 / BUP Received Date Requested /� ! °z , -- AM PM BUP Location / LI I b x! c� 1- k lit - ---Q Suite MEC Contact Person Ph ( ) gq.C PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall �( W \� t1D� OU�t tk � b 4tw + `' ` A L_ Fire Sprinkle ) Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Water Service 2 : 1 7 y, / Water Se 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 U tAw Voltage Fire Alarm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL SITE Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Date J r d �� Inspector Approach/Sidewalk p E7ct Other: Final DO NOT REMOVE this inspection recor from t job site. PASS PART FAIL CITY OFTIGARD J ' BUILDING DIVISION PERMIT #: MST7004- UI7171 I 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 8/23/2004 � Phone: (503) 639 -4171 , , ii ,, Iy�oiP�i�� l i'I' Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/12/2005 TIME: 7:09AM PAGE: 6 SITE ADDRESS: 14160 SW 89TH AVE CLASS OF WORK: SUBDIVISION: GREENSWARD PARK NO. 3 LOT #: 066 TYPE OF USE: PROJECT NAME: GREENSWARD PARK NO. 3 DESCRIPTION: New SF detached. 4/11/05: ADDED NC. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503 - 5940805 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 590 -0805 Inspection Request Scheduled For: Date: 4/12/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 004322 -01 503 - 7247445 Y Corrections /Comments /Instructions: ID iv6E1 eC CA L CFI ,.,, ,/k.,LA ❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: -4 ®J Phone #: (503) 718- CITY OF TIGARD - . - • - BUILDING DIVISION PERMIT #: MST2004- 00171 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/23/2004 Phone: (503) 639 -4171 " Ili;; � �`' Inspection Requests (24 Hrs.): (503) 639 -4175 __.. INSPECTION WORKSHEET FOR DATE: 4/12/2005 TIME: 7:09AM PAGE: 5 SITE ADDRESS: 14150 SW 89TH AVE CLASS OF WORK: SUBDIVISION: GREENSWARD PARK NO. 3 LOT #: 066 TYPE OF USE: PROJECT NAME: GREENSWARD PARK NO. 3 DESCRIPTION: New SF detached. 4/11/05: ADDED NC. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 603. 590-0606 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 590 -0805 Inspection Request Scheduled For: Date: 4/12/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 004322 -02 503. 720.7445 N Corrections /Comments/ Instructions: /� aV , r9� Ar`t2��A. C..�lcr LL ---tom --Q.CE (--- c t- C -' c)6 li PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED /�' ` `Z-- Inspector: Date: �-! Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2004 -00171 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/23/2004 Phone: (503) 639 -4171 /, „,,, , �q 1 i ° N�'il 1i Inspection Requests (24 Hrs.): (503) 639 -4175 __.. INSPECTION WORKSHEET FOR DATE: 4/11/2005 TIME: 7:10AM PAGE: 12 SITE ADDRESS: 14150 SW 89TH AVE CLASS OF WORK: SUBDIVISION: GREENSWARD PARK NO. 3 LOT #: 066 TYPE OF USE: PROJECT NAME: GREENSWARD PARK NO. 3 DESCRIPTION: New SF detached OWNER: FOUR D CONSTRUCTION CO, PHONE #: 601590.0806 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 590.0806 Inspection Request Scheduled For: Date: 4/11/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 00421642 501720 -7446 Y Corrections/Comments/Instructions: USA L lZ ©,s,c,A S c= r yl2 t C c= r L� ” .-� ( S u t - .-4 7 C c.-- l , i ce/ /4:7_Z- v Al r /•!o 2 s pi- c c-s1" ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS (FAIL MI CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: _ Date: J Phone #: (503) 718- % CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2004 -00171 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/23/2004 din,,, Phone: (503) 639 -4171 , i1I',INili, I _I' Inspection Requests (24 Hrs.): (503) 639 -4175 ,...,_hl �'I .. INSPECTION WORKSHEET FOR DATE: 4/11/2005 TIME: 7 :10AM PAGE: 11 SITE ADDRESS: 14160 SW 89TH AVE CLASS OF WORK: SUBDIVISION: GREENSWARD PARK NO. 3 LOT #: 066 TYPE OF USE: PROJECT NAME: GREENSWARD PARK NO. 3 DESCRIPTION: New SF detached OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503.0 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 590.0806 Inspection Request Scheduled For: Date: 4!11/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 004216-03 603. 720-7446 N Correction /Comments /Instructions: " L t/ i\/ .1- I 1•/ o :172V 3 c .ASS MI PARTIAL APPROVAL El CANCEL El NO ACCESS FAIL • CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED / Inspector: `� L Date: / °C— Phone #: (503) 718- / CITY OF TIGARD - BUILDING DIVISION PERMIT #: MST2004-00171 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/23/2004 Phone: (503) 639 -4171 ' NI °Nilk i � Inspection Requests (24 Hrs.): (503) 639 -4175 �� " "" INSPECTION WORKSHEET FOR DATE: 4/7/2005 TIME: 7:14AM PAGE: 37 SITE ADDRESS: 14150 SW 89TH AVE CLASS OF WORK: SUBDIVISION: GREENSWARD PARK NO. 3 LOT #: 066 TYPE OF USE: PROJECT NAME: GREENSWARD PARK NO. 3 DESCRIPTION: New SF detached OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503- 590 -0805 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 590-0805 Inspection Request Scheduled For: Date: 4/7/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message FX1- 399 Plumbing final 003990 -03 503.720.7445 Y Corrections /Comments /Instructions: o H W6c.>-e-._ To," c \ 0 c . R- N D-' fl 4vz____ Ar ,6-t--9 .. Ow O m PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED V2_ Inspector: �� Date: ( V7 A Phone #: (503) 718- CITY OF TIGARD 24 -Hour • u BUILDING Inspection Line: '(503) 639 -4175 MST �� / d v / INSPECTION DIVISION Business Line: (503) 639 - 4171 p � BUP Received �` Date Requested / 2- — Z 6 AM PM BUP Location / / .5 6 lS `� 'I14 / -_-U` -' -- Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Unde Slab ( M vice Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Fi 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 LI 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 P(21/ ADA L Approach/Sidewalk Date Inspector 1 Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL F TIGA BUILDING o'y �7� Cif OF OR �` � - �' Allik - 13125 SW 11 Blv Tigar 539 't 5 _ H ■ a ,oast Lane (503) N amour inspection Request ., 82BS't j Z' ;� E 3c�n Division FAX t3 NV C� T1GdRa 1 lns - L - - — f a fit, �i 15 � � � .P_. � � , w " Watkins, inspection Supervisor �: Darrel `hap - 4 �os P� ° � e 1 - i J - cn ROM: y, � . y ,..� � a�ite Company dam Office Contact Phone:. Contact Person's Name Mei W al �� Type ofi ; ass • econ Permit omit SW) a g AM Job Site Adclr..ss ( �� , J rt ;► _ �. b' cs \ \ Needed j PM (incl. 3 letter -raft) a i t 9 �yy 11 +14-040 — j " • _ a -a,, . • _i 14.--Z Z ..,- , d _. \ _ ...d ;Lai , , , . l_....a ,, . ` � J D ..IIIMIUIIIIIII"l11111.11111 -o for the following business day. , m scheduled f Kmmao,�ie°"'°'g° isa a OO Pit' will be sc� �� as needed received prior to 7' include adds Information f� tr,saeo� ion r$gnests �,_..._t,. „eP {his !crrn A CITY OF TIGARD. 24 -Hour • / BUILDING Inspection Line: (503) 639 -4175 MST Da 17` - "d d 17 / INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested I - — ZZ AM PM BUP Location s _ 7� � L .�I-&_ Suite MEC Contact Person L- 1 1) 1^ _ J Z Ph ( ) Gi 9 —c2-3 // PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof 1/7■ Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab ater Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ds / 6 ADA Approach/Sidewalk Date ( ' 2/ ` Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD. 24 -Hour BUILDING • Inspection Line: (503) 639 -4175 MSTO - hO 1 7 , INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Re ested G l — / T AM PM BUP Location / 7 ek./.4."_' Suite MEC Contact Person J Ph ( ) to 140 a 311 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING eam — �� `✓ Rough -In � �� r Service � Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final S PART FAIL CHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA D � I / c 1 6 l Inspector Ext Approach/Sidewalk l Other: Final DO NOT REMOVE this Inspect n record from the Job site. PASS PART FAIL CITY OF TIGARD. 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST -60 1 l INSPECTION DIVISION Business Line: (503) 639 - 4171 BUP Received Date Requested q -PM BUP Location / '7 / .c& g �1 `� Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) 96 -4 --/6 3/ SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanita Sewer Catch Basin / Manhole Storm Drain Shower Pan Other: FiI - 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 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 ADA Approach/Sidewalk Date 9 ) D ` Inspector CI , I `''z 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 o100 6 /71 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested l / AM PM s� BUP \ Location / / 5 g Suite MEC Contact Person Ph ( ) 6 - 3/ PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Se rvice a ar Rain Drains Catch Basin / Manhole Shower Pan Other: Fi PAS 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 ❑ 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 Approach/Sidewalk Date G i Jo 4 Inspector � '"�^� � \ t Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL A CITY OF TIGARD 24 -Hour BUILDING • Inspection Line: (503) 639 -4175 MST aU 4 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested / AM PM BUP Location . I ( / S7) wq - &-o-e-- Suite MEC Contact Person Ph ( ) - 7d, c) -74/4/-s" PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear fFramin. rrutr Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final SS PART FAIL LUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PAS FAIL CRANK Post & Beam Rough -In, Gas Line Smoke Dampers Fin AS 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 ADA Date - ' . 24 - Approach/Sidewalk Inspector Ext PP Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour - - BUILDING Inspection Line: (50 639 -4175 MST _6O/ INSPECTION DIVISION Business Line: (5 ) 639 -4171 _ BUP Received Date Requested ' 3 AM PM BUP Location Suite MEC Contact Person ,' CZcIe -_ Ph ) 7r D - 7 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain Safi / i0; ' - :' sa rp etLa�,. ;7! /' �r1w.' � � - 'r✓�/ ELR Crawl Drain � � Slab Inspection Notes: ' SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear I Po 732ij Insulation v. r� c / L- i P F' i- Y7) `j Drywall Nailing Fire Sprinkler a) pr��"� ( vt4) r-es �/. f.} - / L Fire Alarm Susp'd Ceiling Roof Other: .3') Ft g Final PASS PART 77-1 �! I�l !: 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 a s Line Smoke Dampers Final PASS PART 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: El Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (50 ) 639 -4175 • MST —GU l 7( INSPECTION DIVISION Business Line: (5 ) 639 -4171 BUP Received - 3r 1 Requested AM °� _ AM PM BUP • Location / '/ /.� <g / '� Suite MEC Contact Person 'Dauer— Ph ) 019 _ 74'4' PLM Contractor P ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear �= . VC 5 tS i 40 IP Framing x=/41 J Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Smoke Dampers F'� PART FAIL TRICAL 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: Li Unable to inspect — no access Fire Supply Line ADA (/ • Approach/Sidewalk Date ! - �— " Inspector . Ilk 4111111111110.--- Ext Other: Final DO NOT REMOVE this inspection recor' om the job site. PASS PART FAIL CITY OF TIGARD. 24 -Hour BUILDING Inspection Line: (503) 639 -4175 . MSTc UST �6/ 7 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested I -3 AM PM BUP Location ) Y / 57) o \` 6 1-0-0-- Suite MEC Contact Person C.VlJ%--e Ph ( ) dal) - 7 (-/-Q.< PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Sheath/Stya Sheath/S e Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final gr iPART FAIL 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 Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: n Unable to inspect — no access Fire Supply Line ADA Date / 2 - °- � U 4 Inspector Ext Approach/Sidewalk P Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 - Hour . BUILDING Inspection Line: 639 - 4175 MST �d d y oa l 7 t INSPECTION DIVISION Business Lin (503) 639 -4171 BUP Received Date Requested AM PM BUP Location Li (S Suite MEC Contact Person Ph ( ) 7 7 4 / 4 '3 -- PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT -.st : Be Shear Anchors Ext Sheath/Shear Int Framing Sheath/Shear l C�� v,4--rO Insulation Z Q lit— Drywall Nailing Firewall Fire Sprinkler � Fire Alarm Susp'd Ceiling Roof , � Other ` , `.: Fi PASS PART FAIL BING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains • Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL <P60 Bea Rough -In Gas Line Smoke Dampers PA SS ART FAIL 'ECEL 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 ADA ay /%1/2 Approach /Sidewalk Date ! ' °'' Inspector Ext Other: Final DO NOT REMOVE this inspection re rd from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 • G v + INSPECTION DIVISION Business Line: (503) 639 -4171 MST y G 7 BUP Received Date Requested 3'36 AM PM BUP Location 1 `./ / U 9 - / — v`"e-- Suite MEC Contact Person Ph ( ) '7 6 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing � ELC Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: ) D D p SIT Post & Beam f24-c� -Gf� Shear Anchors V Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing ■ a' (- . - •• Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final AS PART FAIL • = 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 Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE El Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA I Approach /Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL a/157 ' , STREET T REE CERTIFICATION 1 JA ri‘ / 0> I, Tppy ITS be 7 PP0 - — , C wner ent for g F6u12 Ce,Nsr gut cfi ox/ (PLEASE PRINT) , HOLDER) { 44 / L 6 p a,,. Imp Do hereb i . , , x wing location If> meets '" i . x f Ti 6 ard / hiliston County ® l and use and development standards for street tree installation. 0 /7 SC ADDRESS: `� S. Li 9 1 LOT: SUBDIVISION: C� G BY: , `�� DATE: '/J 1 —v S RECEIVED BY: C, u � DATE: y ,)j -9. L AA AAAAAA G:. AAAA A® A � AA A AA A ® V ` A O- • A Is STREET R R T EE CE T IFICATION .. 1 Is A is 444 O- 1 I, D v ID D i' -PI�o 9-T , 0 caner gent for FF u YZ C /vSt gt,i ctI © ./ Os- (PLEASE PRINT) (PERMIT HOLDER) . 1 xxf, ® . ® Do hereb V � , t �r, me' f qta v . img location to- ® meets it. Ka f . ® r d a- on ounty 0- ® land use and development standards for street tree installation. ADDRESS: lLi1 S: LU, `2)9 i-1k A Oil- LOT: SUBDIVISION: (Rc. X10;2fit ' A�-K __ BY: , ,, ` e'vr � DATE: '/'1 I -- S I Os- ® RECEIVED BY: , ;, DATE: 1,) - .) gym;: 0. A V' VVVVVVVVVVVVVVVVVVVVVVVVVFVVVFVVVVVVVVVVVVVVVVVVVVVVVVVVVVN