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Permit 1 .. ,a CITY OF TIGARD MASTER PERMIT PERMIT #: MST2004 -00159 �I DEVELOPMENT SERVICES DATE ISSUED: 6/30/2004 .....,,,,. 67 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 15080 SW 93RD AVE PARCEL: 2S111 DB -KE003 SUBDIVISION: KESSLER ESTATES ZONING: R -4.5 BLOCK: LOT: 003 JURISDICTION: TIG REMARKS: New SF detached BUILDING REISSUE: BVH3684 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 22 FIRST: 1,652 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 2,032 sf GARAGE: 782 sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: I THRD: sf RIGHT: 5 VALUE: 361, 595.40 OCCUPANCY GRP: R3 BDRM: 5 BATH: 3 TOTAL: 3,684 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: 1 VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 2 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 6 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: PUMP /IRRIGATION: PER INSPECTION: EAADD'L 500SF: 7 201 - 400 amp: 201 - 400 amp: 1st W /OSVC/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: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 8,038.46 This permit is subject to the regulations contained in the BUENA VISTA CUSTOM HOMES BUENA VISTA HOMES Tigard Municipal Code, State of OR. Specialty Codes 6932 SW MACADAM AVE STE C 6932 SW MACADAM SUITE C and all other applicable laws. All work will be done in PORTLAND, OR 97219PR PORTLAND, OR 97219 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: 503 443 - 6033 Phone: 503 443 - 6033 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: LIC 152235 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 Plumb Top Out Exterior Sheathing Ins Rain drain Insp Electrical Final Sewer Inspection Underfloor insulation Electrical Service Low Voltage Storm drain Insp Mechanical Final Footing Insp Crawl Drain /Backwater Electrical Rough In ' Gas Line Insp Water Line Insp Plumb Final Foundation Insp PLM /Underfloor Framing Insp Gas Fireplace Water Service Insp Building Final Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Appr /Sd Ik Insp c Issued By : 13 " Permittee Signature : t-" C Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the ne busines day i / / ,. Building Permit Received FOR OFFICE USE ONLY / Building Permit No.: a/ � // - 72, City of Tigard J' JUN Planning App oval other c f -ass 13125 SW Hall Blvd. UN 1 200I Date/By: Permit No.: Plan Review Other Tigard, Oregon 97223 Date/By: /'1 A V 6 - as - °4 Permit No.: Phone: 503 -639 -4171 Fax: 50(£•IT9tSlJ'1I9IRGA "''''';', li '' Post - Review Land Use l Internet: www.ci.tigard.or.us BUILDING DIVI'a1r ''' �• I ' Date/13 : Case No. Contact Juris.: 0 See Page 2 for 24 -hour Inspection Request: 503- 639 -4175 Name/Ntethod: / , Supplemental Information . TYPE OF WORK REQUIRED • _. . REQ D DATA :. :. :.,<x, _., © New construction El Demolition i & 2 FAMILY DWELLING . (1 Addition/alteration /replacement ❑ Other: CATEGORY OF CONSTRUCTION Note: Permit fees" are based on the total value of the work performed. Indicate © 1 & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead and profit for the work indicated on this application. ❑ Accessory Building ❑ Multi- Family ❑ Master Builder ❑ Other: Valuation s e /, 595 '° JOB SITE INFORMATION and LOCATION - . No. of bedrooms: 14 o baths: Job site address:/5060 •(� y AhJti Total number of floors ,. New dwelling area (sq. ft.) Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft.) Project Name: Covered porch area (sq. ft.) Cross street/Directions to job site: Deck area (sq. ft.) Other structure area (sq. ft.) :REQUIRED DATA: ;. COMMERCIAL - USE CHECKLIST , ECKLIST ._ , Subdivision: � . .5k SIct- 1 Lot #: Tax map /parcel #: Note: Permit fees' are based on the total value of the work performed. Indicate • DESCRIPTION OF WORK • the value (rounded to the nearest dollar) of all equipment, materials, labor, NEW CONSTRUCTION — SINGLE FAMILY RES , overhead and profit for the work indicated on this application. DEATACHED RESIDENCE Valuation S Existing building area (sq. ft.) New building area (sq. ft.) Number of stories ® PROPERTY OWNER I .❑ TENANT ...: -• •• .. : • . •Type of construction Name: Buena Vista Custom Homes Occupancygroup(s): Existing: Address: 6932 SW Macadam Ave. Ste C New City /State /Zip: Portland, OR 97219 Phone: 503 - 443 - 6033 Fax:503 443 - 2443 NOTICE: All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under A PPLICANT ❑ CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the Business Name: SAME AS ABOVE jurisdiction where work is being performed. If the applicant is exempt Contact Name: El iabeth Moore from licensing, the following reason applies: Address: City /State /Zip: Phone: Fax: • E - mail: 'BUILDING PERMIT FEES* - . ' - •....: . :..:.• Please refer to_fee schedule. :: CONTRACTOR ' . • .. ... -- • Business Name: Buena VIsta Custom Homes Fees due upon application S Address: 6932 SW Macadam Ave. Ste C City /State /Zip: Portland, OR 97219 Amount received S Phone: 503 - 443 - 6033 Fax:503- 443 -2443 Date received: CCB Lic. #: 152235 Authorized _ Signature: t /n� a . f Date: Notice: 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. (Please print name) i:\Dsts\Permit Fortes \BldgPermitApp.doc 01/03 • , 03/0 /2004 16:21 FAX 5036284633 THE MULLEN COMPANY 4 HENNA VISTA 0002/003 Plumbing Permit 4. 1 • : t,,4 U Plumbing Detc/BY: Permit Na.: N7� � City of Tigard 1 ' ' Received Planning Approval Sewer 13125 SW Hall Blvd. JU� 2°� Plan 3y: Permit No.; Plan Review other Tigard, Oregon 97223 Date/13y: Permit No.: Phone: 503- 639 -4171 Fax: 503 -g ,t11OTI a Posu2uview land Ute Internet: www.ci.tigard.or.us R111LDING DIV .7.1.4:'-'.-.i 1 .'' I . i .. Contact rase No.: ® 6633 Contact Juris.: See Page 2 tor 24 -hour Inspection Request: 503-'63'94175 - Name /Method: Supplemental Inrormatloo. . _'IY O W , '1.-.. .' •; , r' _ .. • k$8* SCEU.D.>JL$ foe info tIbVidee New construction Demolition Description 1 Qtr. I Reo(ea.) ( Totxl �'�'' � A'�. ✓•!. 1. Additive /i�lte7ation/reptacetne�•t ,_,{, Other, "• : ,� s �. �D�,'`' ;er fit• SFR (1) bath 249.20 Z & 2 - Famil dwellin: 0 Commercial/Isldustrial SFR (2) bath 350.00 ■ Accesso Buildin_ Multi - Famll SFR (3) bath 399.00 IN Master Builder Other: Each additional bath/kitchen _ 41.00 JOB SITE O194ATIQI andLOCAt OK • ' . Fire sprinkler - aq, ft.: _ Pa e 2 Job site address: / .5 8 D Y3 ' •. .. .. - Site. Utilities . : k:. r: y�� . _ _ .. -. Suite #: 1 Bldg. /Apt, #: Catch basin/arca drain 16.60 Project Name: - Drywcll,lruh line/trench drain 16.60 Footinkdrain (no. linear ft.) Pa • e 2 Cross stl"eeVDirections to job site: Manufactured home utilities 110.00 - Manholes 16.60' _ Rain drain connector 16.60 _ Sanitary sewer (pa. linear ft.) Page 2 Subdivision: I Lot #: �J Storm sewer (no. linear ft.) P 2 Water service (no, linear ft) Page 2 Tax map /parcel #. • • ',' 1 • Fixture or Item . 'A .. . - DESCRIPTION OF WORK Absorption valve 16.60. NF, - SINGLE FAMILY Backilowprevcntcr Paget FAMILY DETACHED RESIDENCE Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 .01 PROPERZY'ovirNFi ',: r•. '•'FE1�fATIT Drinking fountain 16.60 Ejectors/Jump _ 16.60 Name: Buena Vista Custom Homes Expansion tank 16.60 I Address: 6 9 3 2 SW r(acOam _ Ave _ s t P c Fixture/Sewer ca- 16.60 City /State/Zip: Portland OR 9721 9 Floor drainJtloorsink /hub 16.60 rfax: Garbage disposal 16.60 Phone: 503 -- 443 - 6033 503.'443 -2443 _ Hose bib r� - 16.60 APPLICANT • • ° 1CO> Tai�,'ir ERSON . Ice maker 16.60 Name: Ray Mullen interceptor /Breasetrap 16.60 Address: Medical Ras • value: S Page 2 Primer 16.60 Cl /State/Zit: Roof drain (commercial) 16.60 Phone: Fax: Sink/basin/lavatory 16.60 E -mail: Tub /shower /shower pan 16.60 • . CONTRACTOR : • • • , Urinal 16.60 _ Business Name: ED Million Plumbing Water Urinal 16.60 ., Address : 24470 SW Rainbow Lane Ot atreatcr 16.60 her: City /State /Zip: FIi ]bars) . qR 9 71 7 a other. , :Pluwblasl:'Patmlt:: i•..' ....• Phone: 5 01 629 -1 2 Fax :�3 -h28 b.. .1 _ Subtotal S CCB Lic. #: t . • Plumb. Lic. #: - _ • 0.. - • Minimum Permit Fee S72_50 S Authorized - � � ' Residential Backflow Minimum Fee $35.25 Signature: � ,_ a c: Plan Review LS56 of Permit Fee) S Ray ul en State Surch • e 8% of Permit Fee S (Please print name) TOTAL PERMIT BEE S Notice' Tbiri permit application expires Ira permit is not obtained within • All new commercial buildings require 2 lets of plans with isometric or 180 days after ti has beta accepted as complete. riser diagram for plan review. - Fee methodology set by Tri County Boitding Industry Service Board. iADtts \Permit ForntalmPermltApo.doc 01/03 0gd04/2004 16:26 5032537693 SUN GLOW INC PAGE 02 y Mechanical Permit A A. ' c a t i o n FOR CIFFI .I. I ' F (' t.' t Received Mechanical oata : Permit No.: y r- 0 . 270 9 �� °'�4C��—, ° B Planning Approval Building City of Tigard p :: Permit No.: 13125 SW Halt Blvd. AUN 1 2004 Plan Review other Tigard, Oregon 97223 faaWBr Permit No.: Phone: 503 -639 -4171 Fax: 503-598-1960 Dateit Land Use Internet: www,ci-tigard.or.us CITY O p T IGA I RD ,. i, : � Cue No. �?�5,� , � � Contact Juris.: _o s page 2 for 24 -hour Inspection Request; l•1639NAF VIS catnc/Hethod: S9plemental Inrortttadoo. • — • .:e' , TIME OF WORK 5>3i'°•'. c ,.....• ".: . , '''S.CO)VDNE C1iA>4 Zt = USItcREC1 :' • a lE New construction • Demolition Mechanioai permit fees* are based on the total value of the work IN Addition/alteration/re placement • Other: performed. Indicate the value (rounded to the nearest dollar) of all :.GATEGE1It ; OF:GO1 L, � ; ,,.-' r mechanical materials, equipment, labor. overhead and profit. _ .., •r . -.: ";: L 1 & 2 -Famil dwellint ■ Con mercial/Indust ial Value. S See Page for Fee Schedule ■ Access() Buildit% IMEMEMIMINIIIIIIII , : Rgsmism i,;8 • r A 5FEBI:ScECEDULI , Deecr'.don * Fe ea. 'Fetal ta Master Builder ■ Other: ,JO : S I T E II 'ORMATION L O C A T I O N • - •::: t • Job site address: p . • _ •x5Z t Bld _ . /A. • t. #: Duct world MINI 14.00 Pro'ect Name: H dronic hot waters tem 14.00 Residential boiler Cross street/Directions to job site: fbr radiator or h • ronic sv,tem 14.00 Unit heaters (fuel, not electric) in wall, in.due su • . nded etc.) 111 14.00 Fiue/vent for an of above i 0.00 Subdivision: Lot #: 1111 Repair units 12.15 Other Fuel A • • Ibtates Tax map/parcel #: t t t ' '• DES •t s• [ON • F WORK , ' : • ' t t t NEW CONSTRU TION —SI GL' P' I' _ 10 - 00 MEM DETACHEtn RESIDENCE _ Lo. h. ter 10.00 — ... 0.00 IIM . weed . —lace/insert 10.00 Chitral /liner/flue/vent MIN 10.00 IMMO .ET.• TROPF '>l'SC' O & 7. • , tt'CITI TAFQT'1t"4:w'c : : :: .. Other NM i0.00 Vesellekota Name: s vas . hood/other Address: 6932 SW Maca. - .tt •v- B . C Clothes I: Ci /State/Zia : Portland OR 97219 Single duct exhaust Phone , _ • _ . e Fax: ► _ .. _ • • (bathrooms, toilet cerstpattrzcnts, IN APPLICANT - . • . 3C1 'CONF PERSON . " urili rooms • 6.80 Name: David Goloba • •t ME Other 10.00 Address: :3= irmazet •• Ag f umt 4, 3140 tub additional Furnace etc. lo 1. Phone: Fax: E-mail: — 9Jalvsuspeaded/unithcater °" CONTRACTOR Water heater '. Business Name: Fi • • ► a ce '., S�ut} GLow Inc- MO .. Address:2428 SE 105th Ave. 0SQ BM= Ci /State/Zi• :Portland , OR 97216 Clothes. er :as Phone: 503 253 - 7789 Fax:503 -25 b ".5 Other: Total: � . •CCB Lic. #: 81 31 Mee Permit Fees' _ - Authorized , Subtotal: S Signature: Datc: isyp-1 Minitiallintatmi David Golob y ul (Please print name) State Sure a TOTAL PE entut FEE S Notice: This permit application expires If a permit is not obtained within *Fee methodology f or Tr es arC�NC Building . Industry Service Board. 580 dale after it boa been accepted as complete. i:\Asts\PcrmitFccinsW PermitApp.doe 0UO3 • 23 104/2004 15:11 5036425815 ROSS ELECTRIC INC PAGE 02 qsvq Electrical Per' 'ppl' tion Received .OA 1 P t N • o , j J ] /OrD 00/ ` DawB Permit N'' � S City of Tigard Planning Approval Si 13125 SW Hall Blvd. GvN OF �1 VAS Plan Review Ot t Na.: Tigard, Oregon 97223 p11.1G u Date/By Permit No.: Phone: 503- 639 -4171 Fax : =598 -1960 Post-Revicw Land Use Internet: www.ci.tigard.or.us Contact Case No,: 24 -hour Inspection Request: 503-639-4175 Contact Juris.: Su See Page 2 for Name/Method: _ Supplemental Information. 1 -- .. -`.TYPE: OF WOIif . • gli • . ,. .... P,1<..AKREV'IEW :( Please' eht 'icTci►1C;tiiat :aplti>y); : ' . - . .. New construction Demolition ❑ Service over 225 amps - 0 Healthcare facility ❑ Addition/alteration/replacement Other: commerc ❑ Hazardous location ❑ Service over 320 amps - rating of ❑ Building over 10.000 square feet. . CATEGORYOF'COIV'$ •.RBCTION. 1 & 2 family dwellings four or more residential units in .e ,/ & 2- Family dwelling �Cotllrflel cialflndustt tai El System over 600 volts nominal one structure Accessory $uildin ]Multi - Family ❑ Building over three stories ❑ Feeders, 400 amps or more Master Builder ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park O ther: ❑ Egress/lighting plan ❑ Other: '. '. :Toe SCCE INFORMATION•alfti I: a . . oil • Submit _ sets of plans with any of the above. / The above are not applicable to temporary construction service. Job site address: n� ��I' Suite #: Bldg./Apt.#: � � 'FEIE'*sC���.,;. : :° c ° : � , •; F;; :�-• :;_ : . -•,„; _. Number of inspections per permit allowed Project Name: Description Qty Fee (ea.) Total Cross street/Directions to job site: New residential-single or maid-family per dwelling atilt Includes attached garage. Service Included: 1000 sq. ft. or less 145.15 4 Each additional 500 sq. It. or portion thereof 3140 1 Subdivision: S Lot #: Limited energy, residential 75.00 2 Limited energy, non residential 75,00 2 Tax map /parcel #: Each manufactured home or modular dwelling DE f' ON OF`WORIC : : :. service and/or feeder 90.90 2 F l.' Con 5 S Services or feeders - InstaIIatiati, ./4 ' C w in f // alteration or retocatbn: g'`- (, . d -2 200 amps or less 80.30 2 201 amps to 400 amps 106.95 2 l 401 amps to 600 amps 160.60 2 j'IeROEtERTY• OWNER FElSP . - 601 amP1 to 1000 amps 240.60 2 Name: 1 en a- Y S (..:ti _ Over 1000 amps or volts 454.65 2 Reconnect only 66.85 2 Address: CP ci 'S g.. 51t/ do71 ,fr 5-1-, ,L Temporary services or feelers - installation. - Clty /State / : Per 0 or relocation: n: ` 7, -/q 200 amps or leas 66.85 I Phone t) 2/43 - (0c05 FaX ' f 4 z/ 5 201 amps to 400 amps 100.30 2 C . i !jN 4111 to 600 amps 13 7.75 - 2 1�I [ Branch circuits • new, alteration, or Name: V Q.. g-0.5 5 extension per panel: Address: A. For: for branch circuits with purchase of service or feeder fee, each branch circuit 6.65 2 City /State /Zip: B. Fee for branch circuits without purchase of Phone: service or feeder fee, first branch circuit 46.85 2 Fax: Each additional branch circuit 6.65 2 E -mail: Misc.(Scrvice or feeder not included): Eachpump or irrigation circle ::::.:;,.,; : CON.'�A4TE)R :. s3.4o_ 2 Job No: Each sign or outline lighting 53.40 2 Signal circuits) or a limited energy panel, Business Name: �Z alteration, or extension _ Page 2 2 Add ress: 87p 5 k) Description: � City /State/Zip: }i-1 it S i Ci hb , DR '77193 Each additional inspection over the allowable In any of the above: Per inspection per hour (min. 1 hour) 62.50 _ _ Phone :50,3 (' f 2 Z300 Fax: &) (Q Z 619S investi .: non fee: CCB Lic. #: 1$7dq / Lie. #: 3 34.e.. Other: Supervising electricci '"— : : : ? :: ;•.,.-••.:•!• Ele rtalPe7ciaT t ?r.. .....`,.'.;i'[;: X si required- Subtotal - 5 Plan Review 25% of Permit Fee $ v' Print Name: .s+ ,Q CROSS Lic. #: V23a,S State Surcharge (8% of Permit Fee_LS Authorized TOTAL PERMIT FEE S Notice: This permit application expires If a permit is not obtained within Signature: Date: 180 days after it has been aeeaptcd is complete. "Fee methodology set by Tri - County Buildioa industry Service Board. (Please print name) - i:\Dsts \Permit Forrm'ElcPcrmitApp.doc 01/03 CITY OF TIGARD 24 -Hour BUILDING 410 Inspection Line: (503) 639 -4175 ( MST .2.6° lS? INSIStCTION DIVISION Business Line: (503) 639 -41 1 BUP Received ) Date Requested AM PM � BUP Location / 5 g U 1 e S ' MEC Contact Person j Ph ( 7ld g qls 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 -11.411° — � f/ 6 / ' z g � 9 z o . O 4 / Framing � F Insulation e- FM) Drywall Nailing Firewall Fire Sprinkler Fire Alarm ASc-- - Susp'd Ceiling - Roof Other: M / � (0115 PART FAIL PLUMBING - - Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan 1/ Other: Final PASS PART FAIL MECHANICAL _ Post & Beam Rough -In Gas Line Smoke Dampers 4E ) 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 - 0 Approach/Sidewalk Date ' (' Inspector Ext Other: Final DO NOT REMOVE this inspection recor rom the Job site. • PASS PART FAIL CITY OF TIGARD , 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST' 4' INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date g Requested �/ 9��` `�`" AM PM BUP Location /5 $ / 3 -LT Suite MEC Contact Person Ph ( ) '7f U PLM Contractor Ph ( ) SWR BUILDING _ Tenant/Owner ELC Footing ELC Foundation . /���� Ftg Drain Access: /. "� 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 "CUMBjG % / k Par Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole - / , L.-- Storm Drain /p15: Shower Pan / ' „ Y / (V i 0 0 PASS PART ;g � MECHANICAL ■ /7 • l Post& Beam Rough -In Gas Line J` r' -2_��- Smoke Dampers C Final P FAIL CTRICAL rvir.P Rough -In UG /Slab Low Voltage • Fir- Alarm Reinspection fee of $ required before inspection City Hall, 13125 Hall Blvd. PART FAIL Please call f• ' reinsp,• ction RE: / #1�� ❑ Unable to inspect - o ac ess Fire Supply Line` ADA Approach/Sidewalk Date Inspe • r I /� /I =_ Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL 0-A STREET TREE C .. .. ,, F;- - I, � / � l. ; /764-, , Owner /Agent for . 6 L teh a �ho�( 6t C ' .4t/on, ); 3 ox,. (PLEASE PRINT) (PERMIT HOLDER) / _ x " 1 Do eerty t f ollowing location meets ; Ct fT�-i o and /Washington County �.�.x,Yr�� �a.ti:,oAM,��x_ :�:, :��� land use and development standards for street tree installation. ADDRESS: / 5 D -SW ?3f!#�L 0. 0. LOT: 3 SUBDIVISION: 0 . 1 B Y: DATE: 2 7/ y 0„. .. 4 RECEIVED BY: _ ��, DATE: d ^ 07/ 0- ® , V '= r