Permit rII, CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2001 -00422
iv DEVELOPMENT SERVICES DATE ISSUED: 08/14/2001
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 16653 SW 88TH PL PARCEL: 2S114AD -02200
SUBDIVISION: WAVERLY ESTATES ZONING: R -12
BLOCK: LOT: 021 JURISDICTION: TIG
REMARKS: Single family remodel path 1
BUILDING
REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 12 FIRST: 204 sf BASEMENT: sf LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT: 7
VALUE: $ 63,000.00
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 204.00 sf REAR: 70
PLUMBING
SINKS: 2 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER:
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: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: 1 PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 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: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 1,204.27
This permit is subject to the regulations contained in the
PENNINGTON, MALCOLM B + HIGHLAND RIDGE DEVELOPMENT
Tigard Municipal Code, State of OR. Specialty Codes and
SHELLEY V P.O. BOX 6 all other applicable laws. All work will be done in
16653 SW 88TH PL BEAVER CREEK, OR 97004 accordance with approved plans. This permit will expire if
TIGARD, OR 97224 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 #: 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
Footing Insp Crawl Drain /Backwater Electrical Service Insulation Insp Final inspection
Foundation Insp Footing /Foundation Dn Electrical Rough In Rain drain Insp
Post/Beam Structural PLM /Underfloor Framing Insp Electrical Final
Post/Beam Mechanical Mechanical Insp Low Voltage Mechanical Final
Underfloor insulation Plumb Top Out Gas Line Insp Plumb Final
Issued B _ l .% Permittee Signature : --_
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
Building Permit Application
pate received: 7 /��D/ Permit no.: H /- eo
7 PT 7" ( I 6 I ee/‘
. . , 4"“ : '11' City of Tigard —
I/roject/appl. no.: Expire date:
CiryojTigard Address: 13125 SW Hall Blvd, Tigard, OR 9722 1
Phone: (503) 639 -4171 1 h (� Date issued: By: Receipt no.: '1
Fax: (503) 598-1960 ` / Case file no.: Payment type: —
Land use approval: ./ 1 &2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ New construction ❑ Demolition
X tion/alteration /replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address: . r 3 S . W. IS/ p L Bldg. no.: Suite no.:
Lot: ' 2 ( Block: ISubdivision:'uu a v`3 rS +a-1 p- I Tax map /tax lot/account no.: .9 / /1/4 - -,' 1p
Project name: - f
Description and location of work on remises /special conditions: PI Jc t A 1 0 1 4 "to 4- V eh B ti ei f 1° u U 4" e 1-t0 +" 4 y ------'—
Vt\ " & t m a> ' e•e P1 a..q 0
OWNER FOR SPE('IAL INFORMATION, USE CHECKLIST
Name: VevHN.ii,,q 4-0 v► (Floodplain, septic capacity, solar, etc.)
Mailing address: 6b 5
5 3 . Uv . $ 8'1- 'P L 1 & 2 family dwelling: /_ ,�/�
City: -''S't % ri v al • (State: b I ZIP: er 72 -t Valuation of work $ (.CJ r C � 't-�
Phone: Ilk_ 1,10i (Fax: IE -mail: No. of bedrooms/baths
Owner's representative: NA- Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.) c ../..G q
APPLICANT Garage /carport area (sq. ft.)
Name: 4-1 i )(1\ cr.,A '(Z la°3(o Ve o C C v , Covered porch area (sq. ft.)
Mailing address: P.O (3p f 4 14, Deck area (sq. ft.)
City: (3o•ex cv ee 1s I State: Ou • I ZIP: 'f700 Other structure area (sq. ft.)
Phone: (, 32- I.El56 Fax: (,32. wig E- mail:l.oNteI:vern0 1 m rciallindustriallmulti- family:
CONTRACTOR ' Valuation of work $
Existing bldg. area (sq. ft.)
Business name: tg 0 ,4 Rtage PPv Coup
New bldg. area (sq. ft.)
Address: ?• U (3 o Y 4`' 4 Number of stories
City: (3aoe✓LA, o e 1 'C I State:C. sr. I ZIP: c 1 700 4 of construction
Phone: (, 32 -ugr� i, I Fax:(, 32 -'4 % ?5 1E-mail: " L" c ow, Occupancy group(s): Existing:
S CCB no.: 3 2 S `l New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
AR(7IITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: �� au )e I' t.C. 1- e c provisions of ORS 701 and may be required to be licensed in the
Address: 1 S 2 S i' S t c. i Z�-0 y' . jurisdiction where work is being performed. If the applicant is
City: C u c..\- a ..wa 5 State: c, V ZIP: c( o t exempt from licensing, the following reason applies:
Contact person: 'S pe, kw (4, y e Plan no.:
Phone: 503 - /, S X19 Fax: 0 Z q E -mail:
Name: Contact person: Fees due upon application $
Address:
..... Q- e Gad d 0 V e Date received:
City: (State: IZIP: Amount received $
Phone: I Fax: 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 ❑ Visa ❑ MasterCard
work will be complie t 11,,,.....,,l_ t 1 , whe s 1 • ci ied h ein or not. Credit card number: / /
Authorized si ature: • � � •' ae: 7 -2 3 - O' Name of cardholder as shown on credit card Expires
Print name: ON+a c) r_. b..-1 1 tN Cardholder signature $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6/00 /COM)
One- and Two - Family Dwelling #.
s w� . � Building Permit Application Checklist Reference no.:
t�l II g PP Associated permits:
City of Tigard City of Tigard Y g ❑ Electrical CI Plumbing ❑Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 ❑ Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews.
2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc.
3 Verification of approved plat/lot.
4 Fire district approval required.
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 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 Oregon and shall be shown to be applicable to the project 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 1 1 " x 17 ".
24 Two (2) sets each are required for Items 16, 19, 20 & 22 above.
25 Building plans shall not contain red lines or tape -ons.
26 No rolled, reversed or mirrored building plans will be accepted.
27
28
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 440 -4614 (6ro0/COM)
Mechanical Permit Application
A
Date received: 7 i ,,'(� j Permit no.: )1 -c 9/0
si"+r•' '_' 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: Building permit no.:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction %Addition /alteration/replacement ❑ Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: 6 . G3 S .tar $ F L 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.: V profit. Value $ .
Lot: a I [Block: I Subdivision: W av I es Tu-tn *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: °r t g et t a I ZIP: 1' 7 2_2_ 61 1& 2 FAMILY DWELLING PERMIT FEE SCIEDULE
Description and location of work on premises: AND COMMERICAL /INDUSTRIAL EQUIPMENTSCIIEDULE
Fee(ea.) Total
Est. date of completion/inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned ?'.Yes ❑ No Air handling unit CFM
Air conditioning (site plan required)
Is existing space insulated? ►: Yes ❑ No Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
State boiler permit no.:
Business name: 1 t 1►N u. Ridge c.� g e p e V•
/ HP Tons BTU /H
Address: F.0 t jc u . Fire/smoke dampers/duct smoke detectors
City: N3 e u u e ti C v ee IT I State° V. I ZIP: 5 0 Li Heat pump (site plan required)
Phone: - 7 Q q - 6 0 0 5' I Fax:1112 -1. E -mail: t i i 's a pew el/ Install/replace furnace/burner BTU /H
CCB no.: 5s - 3 2q 7 cr,..A0 1 . e 0,,, Including ductwork vent liner CI Yes ❑ No
I nstall/replace/relocate heaters - suspended,
City/metro lic. no.: p wall, or floor mounted
Name (please print): A d v, 01 ty • .. 1 1‘;1/4 Vent for appliance other than furnace
('ONTACT PERSON Refrigeration:
Absorption units BTU /H
Name e• / U p 05 C A O V Chillers HP
Address: e) C Comyressors HP
Environmental exhaust and ventilation:
City: I State: . ZIP: Appliance vent .
Phone: Fax: E -mail: Dryer exhaust
OWNER Hoods, Type 1/ II/res. kitchen/hazmat
hood fire suppression system
Name: . e \nu in -4 ki1 Exhaust fan with single duct (bath fans)
Mailing address: 11 5 ? . 7. U„ . SS' p L Exhaust system apart from heating or AC
Cit ej I State: v NCI Z IP: ' 7 2 21,' Fuel piping and G distribution (up to 4 out
Y �t car Type: il
Phone: 24 - II 06 Fax: E -mail: Fuel piping each additional over 4 outlets
Process piping (schematic required)
Number of outlets
Name: K V a 431a es∎c\n' k P e Jr PC Other listed appliance or equipment:
Address: I, SZ s9 5.F 7 �J D Decorative fireplace
City: c VC[towa> State:6 vzi ZIP:(1 7(, 1 S Insert - type
Phone: $p3 - (t. u Fax:So3 - �� - mall: Woodstove/pelletstove
' Other:
Applicant's signature: F ) Date: 7 -23 - 0/ Other.
Name (print): ID eMa 1 d 5. 44. uw t t "1
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $
❑ Visa ❑ MasterCard Notice: This permit application Minimum fee $
expires if a permit is not obtained Plan review (at — %) $
Credit card number: / / w ithin 180 days after it has been
Expires y State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete.
$ TOTAL $
Cardholder signature Amount 440-4617 (6/00/COM)
MECHANICAL PERMIT FEES .
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: FEE: Description: Price Total
$1.00 to $5,000.00 Minimum fee $72.50 Table 1A Mechanical Code Qty (Ea) Amt
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and 1) Furnace to 100,000 BTU
$1.52 for each additional $100.00 or including ducts & vents 14.00
fraction thereof, to and including 2) Furnace 100,000 BTU+
$10,000.00. including ducts & vents 17.40
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and 3) Floor Furnace
$1.54 for each additional $100.00 or including vent 14.00
fraction thereof, to and including 4) Suspended heater, wall heater
$25,000.00. or floor mounted heater 14.00
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and 5) Vent not included in appliance permit
$1.45 for each additional $100.00 or 6.80
fraction thereof, to and including 6) Repair units
$50,000.00. 12.15
$50,001.00 and up $742.00 for the first $50,000.00 and Check all that apply: Boiler Heat Air
$1.20 for each additional $100.00 or For items 7 -11, see or Pump Cond
fraction thereof. footnotes below. Comp **
7) <3HP;absorb unit
ASSUMED VALUATIONS PER APPLIANCE: to 100K BTU 14.00
8) 3 -15 HP; absorb
Value Total unit 100k to 500k BTU 25.60
Description: Qty (Ea) Amount 9) 15 -30 HP; absorb
Furnace to 100,000 BTU, including 955 unit .5 -1 mil BTU 35.00
ducts & vents 10) 30 -50 HP; absorb
Furnace > 100,000 BTU including 1,170 unit 1 -1.75 mil BTU 52.20
ducts & vents 11) >50HP: absorb
Floor fumace including vent 955 unit >1.75 mil BTU 87.20
Suspended heater, wall heater or 955 12) Air handling unit to 10,000 CFM
floor mounted heater 10.00
Vent not included in applicance 445 13) Air handling unit 10,000 CFM+
permit 17.20
Repair units 805 14) Non - portable evaporate cooler
< 3 hp; absorb. unit, 955 10.00
to 100k BTU 15) Vent fan connected to a single duct
3 -15 hp; absorb. unit, 1,700 6.80
101k to 500k BTU 16) Ventilation system not included in
15 -30 hp; absorb. unit, 501k to 1 2,310 appliance permit 10.00
mil. BTU 17) Hood served by mechanical exhaust
30 -50 hp; absorb. unit, 3,400 10.00
1 -1.75 mil. BTU 18) Domestic incinerators
>50 hp; absorb. unit, 5,725 17.40
>1.75 mil. BTU 19) Commercial or industrial type incinerator
Air handling unit to 10,000 cfm 656 69.95
Air handling unit >10,000 cfm 1,170 20) Other units, including wood stoves
Non - portable evaporate cooler 656 10.00
Vent fan connected to a single duct 446 21) Gas piping one to four outlets
Vent system not included in 656 5.40
appliance permit 22) More than 4 -per outlet (each)
Hood served by mechanical exhaust 656 1.00
Domestic incinerator 1,170 Minimum Permit Fee $72.50 SUBTOTAL: $
Commercial or industrial incinerator 4,590
Other unit, including wood stoves, 656 8% State Surcharge $
inserts, etc.
Gas piping 1-4 outlets 360 25% Plan Review Fee (of subtotal) $
Each additional outlet 63 Required for ALL commercial permits only
TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE: $
VALUATION:
Other Inspections and Fees:
1. Inspections outside of normal business hours (minimum charge -two hours)
$72.50 per hour.
2. Inspections for which no fee is specifically indicated (minimum charge -half hour)
$72.50 per hour
3. Additional plan review required by changes, additions or revisions to plans (minimum
charge-one-half hour) $72.50 per hour
* State Contractor Boller Certification required for units >200k BTU.
** Residential A/C requires site plan showing placement of unit.
i:\dsts \forms\mech- fees.doc 10/11/00
- A Plumbing Permit Application
Date received: 7 0 9'.,7, ci Permit no.: kb ace/- /- X '49-2-
, ,�`,, City of Tigard
g 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: Receipt no.:
Land use approval: Case file no.: Payment type:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory ❑ Commercial/industrial 0 Multi- family 0 Tenant improvement
0 New construction 0-,Addition/alteration/replacement ❑ Food service ❑ Other:
JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist)
Job address: ( (c 5 3 Cj J() esk, D Description Qty. Fee (ea.) Total
Bldg. no.: Suite no.: New 1- and 2- family dwellings only:
(includes 100 ft. for each utility connection)
Tax map /tax lot/account no.: 2Z0 + SFR (1) bath
Lot: Z t I Block: I Subdivision: l a yeI-1 T G S SFR (2) bath
1
Project name: SFR (3) bath
City /county: l ax , I ZIP: G'l 7_2,4(.. Each additional bath/kitchen
Description and r ation of work on premises: r -Vno GUM Site utilities:
1
}Li ektiAA. Catch basin/area drain
Est. date of completion/inspection: Drywells/leach line /trench drain
PLUMBING CONTRACTOR Footing drain (no. lin. ft.)
Manufactured home utilities _
Business name: 0 Wi 4 Manholes =
Address: 1(p((53 sq.() g''+- P/ Rain drain connector
City: I State:0 ZIP: C'/ e., ti Sanitary sewer (no. lin. ft.)
1
Phone:5p - i0 b I Fax: I E- mail:pennin aion -m , Storm sewer (no. lin. ft.)
1-1 " l 1 ` Co Water service (no. lin. ft.)
CCB no.: I Plumb. bus. reg. no:
City /metro lic. no.: Fixture or item:
Absorption
Contractor's representative signature: Back flow flow valve
Back preventer
Print name: Date: - Z3 - 1 Backwater valve
CONTACT PERSON Basins/lavatory ■ -
Name: :Like- l let. e rY)v� r h_vt.t C L
t'�.
Clothes washer
Address: 1 (p 106 �(,(.} Q, p i Dishwasher
Drinking fountain(s) =
City: - Tiorkek jak ] State: 00 ZIP: c7 2_24 Ejectors/sump MI Phone: t - 0 e. Fax: E -mail: Expansion tank =
OWNER Fixture/sewer oo r drains/floor cap =
Name (print): /"1 � Sl� , ,,f rQ•v\_� Floor d i is sinks/hub
g Ip to 5 3 � R g} �� Q ` " Garbage disposal
Mailing address: ) 4.--(.A � Hose bibb ME =
Cit : I State:D E I ZIP: 9 7 2 � 4 Ice maker MI
Phone: 3 -(071 -1 10 b I Fax: 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 r • r ORS Chapter 447. Sink(s), basin(s), Iays(s) t i)
Owner's sign. / 0 ' . ' !il'i Date: 7 z3 O Sump ■--
VNGINEER Tubs/shower /shower pan
Urinal N
Name: j , 6 K I(' (t,(,t,r,�Q, Water closet
Address: 1 51-EA 5 6 e \ C- Lj 2.02., Water heater
City: ( a C Q r c t S I State:O f .I ZIP: o 7 015 Other:
Phone:503 I I I Fax4,05& - (P2-q1 1E-mail: Total
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Minimum fee $
Notice: This permit application Plan review (at %) $
❑ Visa ❑ MasterCard expires if a permit is not obtained
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $
Expires TOTAL $
Name of cardholder as shown on credit card accepted as complete.
$
Cardholder signature Amount 440 -4616 (6/00 /COM)
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2- family dwellings only:
FIXTURES (individual) QTY (ea) AMOUNT (includes all plumbing fixtures in PRICE TOTAL
Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT
Lavatory 16.60 for each utility connection)
One (1) bath $249.20
Tub or Tub /Shower Comb. 16.60 Two (2) bath $350.00
Shower Only 16.60 Three (3) bath $399.00
Water Closet 16.60 SUBTOTAL
Urinal 16.60 8% STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25% OF SUBTOTAL
Garbage Disposal 16.60 TOTAL
Laundry Tray 16.60
Washing Machine 16.60
Floor Drain /Floor Sink 2" 16.60 PLEASE COMPLETE:
3" 16.60
4" 16.60
Water Heater 0 conversion 0 like kind 16.60 Quantity by Work Performed
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
permit. Capped
MFG Home New Water Service 46.40 Sink
MFG Home New San /Storm Sewer 46.40 Lavatory
Tub or Tub /Shower
Hose Bibs 16.60 Combination
Roof Drains 16.60 Shower Only
Drinking Fountain 16.60 Water Closet
Urinal
Other Fixtures (Specify) 16.60 Dishwasher
Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain /Sink: 2"
Sewer - 1st 100' 55.00 3 „
Sewer - each additional 100' 46.40 4"
Water Service - 1st 100' 55.00 Water Heater
Water Service - each additional 200' 46.40 Other Fixtures
(Specify)
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
Inspection of Existing Plumbing or Specially 72.50
Requested Inspections per/hr COMMENTS REGARDING ABOVE:
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% STATE SURCHARGE
* *PLAN REVIEW 25% OF SUBTOTAL
Required only if fixture qty. total is > 9
TOTAL $
* Minimum permit fee is $72.50 + 8% state surcharge, except Residential Backflow
Prevention Device, which is $36.25 + 8% state surcharge.
* * All New Commercial Buildings require plans with isometric or riser diagram and
plan review.
is \dsts \forms \plm- fees.doc 10/10/00
A Electrical Permit Application
Datereceived: 7 3 O Permit no.: t4 via a -
, f. “.' I`� City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receiptno.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction )4 Addition/alteration /replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION
Job address: /' / S y S Le/ K'$ 1 7 Bldg. no.: Suite no.: Tax map /tax lot/account no.: Z '
Lot: ) ' f (Block: (Subdivision: (,(f c , t - , ly 6” s ,4,
Project name: I Description mid location of work on premises: K.,, l l r ,,,, g r “..-1 c � .{ 1
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE S('IIEDEI E
Job no: oko 5 3 / a
Fee Max
Business name: Cj (, ) 2'i. ft SLe6- ? ` , , -r Z Description Qty. (ea.) Total no. insp
/ New residential - single or multifamily per
Address: l 6 (,' S 3 s q - '4_ dwelling unit. Includes attached garage.
City: `--, 5 `,r j I State: Q I ZIP: 57 y.. Serviceincluded:
Phone: 6 0L/- //Q 6 I Fax: I E -mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof
CCB no.: 'Elec. bus. lic. no: Limited energy, residential 2
City/metro lic. no.: , Limited energy, non - residential 2
''�`= �_ - " N _ q g _ Each manufactured home or modular dwel ling
Signature . i . n _ e1.' ician (required) D Service and/or feeder 2
Sup. elect. name (print): License no: Services or feeders - installation,
alteration or relocation:
200 amps or less 2
Name (print): ( - , , , „ , / e ) / 7 7 1 . S I & I I ,e r ti ?r o .. r j 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: / (, � Su gg"7 - '? / Ck c -0 601 amps to 1000 amps 2
City: T c. „,,.-- ii- c ' (7E_ I State: ZIP: 9 7Z? Over 1000 amps or volts 2
Phone: G z1 - ( — /a IFax: (E-mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation:
201 amps or less 2
ORS 447, 455, 479, 670, 701.
_ 201 amps to 400 amps 2
Owner's signature: _ _ Date :7 - �/ 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
or extension per panel:
Name: • i Z q c, > E A. Fee for branch circuits with purchase of
Address: / 52 5 - 9: s e 'Z service or feeder fee, each branch circuit 2
City: , ( , f �C cr . c. s 'State: 6 - - ' z I ZIP: Cf 7 , - B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: 6 s ,_ ) Fax: 6 S _ „ ,k ' A E -mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
❑ Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps- rating of 1&2 ❑ Hazardous location Each sign or outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2
❑ Building over three stories ❑ Feeders, 400 amps or more *Description:
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lightingplan ❑ Other. Per inspection 1 1 1 (
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 $
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at %) $
Credit card number: / / 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 (6/00/COM)
•
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
/� Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total `I' Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular
Dwelling Service or Feeder $90.90 2 ❑ Garage Door Opener
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System*
Installation, alteration, or relocation
200 amps or less $80.30 2 ❑
201 amps to 400 amps $106.85 2 Vacuum Systems
401 amps to 600 amps $160.60 2 I �
601 amps to 1000 amps $240.60 2 I I Other
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
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 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see "b" above. ❑ Audio and Stereo Systems
Branch Circuits I �
New, alteration or extension per panel I I Boiler Controls
a) The fee for branch circuits I -- I
with purchase of service or I I Clock Systems
feeder fee.
Each branch circuit $6.65 2 ❑ Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service ❑
or feeder fee. Fire Alarm Installation
First branch circuit 1 $46.85 (1 (, � � f �
Each additional branch circuit $6.65 I I HVAC
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 ❑
Each sign or outline lighting $53.40 Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 ❑ Landscape Irrigation Control
Minor Labels (10) $125.00
Each additional inspection over n Medical
the allowable in any of the above I � I
Per inspection $62.50 1 1 Nurse Calls
Per hour $62.50
In Plant $73.75 ❑ Outdoor Landscape Lighting
Fees: n Protective Signaling
Enter total of above fees $ I I Other
8% State Surcharge $
Number of Systems
25% Plan Review Fee
See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations
front of application.
Fees:
Total Balance Due $
Enter total of above fees $
❑ Trust Account # 8% State Surcharge $
Total Balance Due $
i:\dsts\forms\elc-fees.doc 06 /07/01
RECEIVFr
■
►�
.
AUG 2 � IOC � Permit #: N'pT � / -co L} � a--
'% 110106 s\nl 8' .
v � m�!s'; . COMMUNITY u Address:
N etrra Z
\' "" `T Issued by: Date: ' t 4 -01
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B:
�( 1. I own, reside in, or will reside in the completed structure.
13R
CT IS 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
x 3A. My general contractor is 19h lAvvvi 4ZcI 8 3 2 $ 9
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
n 3B. I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above information is correct and that I have read and do understand the Information
Notice to Property Owners ab • ut Construction Responsibilities on the reverse side of this form.
A // � %._. 5 '-- /G — ,20 0 /
ign. ture of permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST �oo/ Do eiZz
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 -
BUP
Date Requested / – S AM PM BLD
Location / j, G j , C - 3 8 R- PL_. Suite MEC
Contact Person Ph n J - 7 -3 R'77. PLM
Contractor Ph 5 g- 6,3 83 SWR
Ut DI Tenant/Owner ELC
Retainin all ELR
Footing 1. 1_,4 v � .---7,-7---,.-
c! -` r f
Foundation - ,?ii FPS
Ftg'Drain SGN
Crawl Drain Inspection Note •
Slab ,-�Y1__ / -�—/t l ` P SIT
Post : eam
' y ear r _ /_/ J/ ' .7 4 , ^
'1 -a hear 1
l i s -
nsu ation
Drywall Nailing
Firewall
Fire Sprinkler - --, )
Fire Alarm 5 f2 _ GI /C�.e /V--- L CGS
Susp'd Ceiling C'
Roof V D / / / I--/ PQ rr/e A Misc: �
PART FAIL _
PLUMBING
Post & Beam
Under Slab
Top Out /
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
M ,J1!1
AL ."
P
7
ost & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
CTRICAL
�. .1
UG /Slab
Low Voltage
Fire Alarm
Fi
ASS 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
Approach/Sidewalk Date ( J y
Other Inspector Ext
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST o O 60 2-1-
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested l AM PM BUP
Location / S 3 ,PL- Suite MEC
Contact Person Ph ( ) ?le) 3 0 7 PLM
Contractor Ph ( ) SWR
ILDI
- Tenant/Owner ELC
ng ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation z -i i Q s
Drywall Nailing / �
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
■Itk •ART FAIL
(///////
PLUMBING
—Post & Beerri -
- 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 0 Please call for reinspection RE: 0 Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date /0 /V /j
Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD BUILDING INSPECTION DIVISION MST Od /..-G y L z�
24 -Hour Inspection tins _ ,39 -4175 Business Line: t. 4171
BUP
Date Requested ( AM PM BLD
Location ��2 S3 S`v 9 c Suite MEC
Contact Person (� � Ph ? 7U ' 3 F77 PLM
Contractor /✓ 1 Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing
Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof �, Fi Final C c th
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
ELE
Service
Rough In
UG /Slab
Low Voltage
•eA -
F'
PAR 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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date // — 0 2 / ""(2/ Inspector /Lcy Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUS' OINQ INSPECTION DIVISION MST
24 -Hour Inspection Line: 63:. 475 Business Line: 639 -4,
BUP
Date Requested AM PM BLD
Location f'° ,ft' Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall G.a+r. - f Z r� - W sv t pr ELR
Footing rY'` cp 1 `
• Foundation �r f � �,� -�.� p �� �. ^ `. ,A- > w,' FPS
Ftg Drain -1 SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear •
Framing
Insulation LC � .,._.
Drywall Nailing
Firewall '
d�
Fire Sprinkler ' - ---�
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PW MBtNG
Post Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
1`i
40 1110 ART FAIL
- . LAICAL
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 Z - ' . Q
Other
Date 1/" 0 / Inspector /c>•1.' Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BI INSPECTION DIVISION MST e Z OO
24 -Hour Inspection Line: 63 75 Business Line: 639-4
// BUP
`C
Date Requested _ Z AM PM BLD
Location [ (o 1p .S 3 �� � �� Suite MEC
Contact Person Ph 5f-8 70 3 ? PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ) ELR
Footing Access:
Foundation f L _ t ` FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
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 1
P ASS PART FAIL
PLUMBING
Post & Beam
Under Slab
itia jlab
Water Service
Sanitary Sewer
Rain Drains
-
i ART 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: [ 1 Unable to inspect - no access
ADA
Approach /Sidewalk Date /6 U / Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISIO►'' MsT bo l --do �2Z
24 -Hour Inspection.Line: 6;. A75 Business Line: 639-4 _ . 1
BUP
Date Requested 9- / ( AM PM BLD
Location I Jfo S3 g Suite MEC
Contact Person Ph 6 -- 8'76.3 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation p ` .14. FPS
Ftg Drain ar 4 / '^' G t a Or t SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Framing ath /Shear /�) 7/VV / ' ✓ ` r „,
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
t'& Beaj
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
PASS ART FAIL
ANICAL
Post & Beam
Rough In
Gas Line r
Smoke Dampers �/ f-es % Cr44J l ? 4 / C.� Jam/ / 7 /CGS .1 p/ `rt s�
Final c
PASS PART FAIL /C d cc>, / f e ) f ( 71--/c ,
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 /€,4 Approach /Sidewalk / �° other Date J Inspector � Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BU" .DING INSPECTION DIVISIO►' MST � . CO q Z
- G��
24 -Hour Inspection. Line: 6s_ i175 Business Line: 639 -4..1
BUP
Date Requested pr /G AM PM BLD
Location 1 (o &..c3 l� g PL Suite MEC
Contact Person (/f 1 /Lc,o Ph 977 3g 77 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
dCsulon
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
t ART 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 /D- y --c Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BI !II .DING INSPECTION DIVISION
MST ,2--4 yZZ_
24 -Hour Inspection, Line: (j 175 ' Business Line: 639-4
d e � Date Requested �/3 AM PM BUP
_����� BLD
Location 1 �o(o S3 F "' L - Suite MEC
Contact Person (�/L/,a Ph 9 762 3 F77 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: )171_,
lam- SIT
Post & Beam
/Shear
In S eathlShear /�
Insulation '�)
Drywall Nailing fre Firewall
Fire Sprinkler
6
Fire Alarm
Susp'd Ceiling
Roof
Misc:
" PART FAIL
= ING
Post & Beam
Under Slab
Top Out
Water Service t
S_ er
am
•
"� PART FAIL
=a L
•os .
Gas Line
Smoke Dampers
F'
ART FAIL
t CTRICAL
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 reinspecti•n RE: [ ] Unable to inspect - no access
ADA Approach /Sidewalk Date 1 Inspector /, Ext Other
Final
PASS PART FAIL DO OT REMOVE this inspection record from the job site.
CITY OF TIGARD BU" ')ING INSPECTION DIVISION MST .2-6e)-DD
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4,
BUP
Date Requested 9 / t AM PM
// BLD
Location , 4 P ( 5 3R` Suite MEC
Contact Person Ph c f ~ 7 v 3 '77 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab _ SIT
Ext Sheath /Shear
Int Sheath /Shear
Framing EK'T�� a
Insulation
Drywall Nailing
Firewall /
Fire Sprinkler ( s2/ /�r� SrL S S��t
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PAR 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 Date - ,7 DV Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BIIILI4ING INSPECTION DIVISION
MST ��/ e.50
24 -Hour Inspection Line: 6. 4175 Business Line: 639• /1
BUP
Date Requested AM / 0 PM BLD
Location le ,S 3 nn 2 Suite MEC
Contact Person l " Ph x10 9-7 Ts- 3 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
.,,. FPS
Ftg 'rain SGN
Crawl Drain Inspection Notes:
Slab 1/ 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
P L 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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk
Date
Other R 2 7 0 / Inspector /4 Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.