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Permit
61;1 / • / 4 tA tjj CITY OF TIGARD MASTER PERMIT PERMIT #: MST2004 -00134 .� D EVELOPMENT SERVICES DATE ISSUED: 5/26/2004 %.-- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 16240 SW 108TH AVE PARCEL: 2S115AA -SP002 SUBDIVISION: SWARTWOOD PARTITION ZONING: R -25 BLOCK: LOT: 002 JURISDICTION: TIG REMARKS: New SF BUILDING REISSUE: M2170 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,209 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,071 sf GARAGE: 667 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5 VALUE: 227 OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2,280 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 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: VENT FANS: 4 CLOTHES DRYER: 1 ELE FURN > =100K: 0 UNIT HEATERS: HOODS: 1 OTHER UNITS: 0 MAX INP: btu FLOOR'FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 0 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: • EA ADD'L 500SF: 4 201 - 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: $ 8,048.17 RTWOOD OWNER This permit is subject to the regulations contained in the SWA SWA SW 108TH Tigard Municipal Code, State of OR. Specialty Codes 16260 TIGARD, OR 97224 and all other applicable laws. All work will be done in 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: 503 639 - 9203 Phone: ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: 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 Insl Water Line Insp Plumb Final Sewer Inspection Underfloor insulation Electrical Service Low Voltage Water Service Insp Building Final Footing Insp Crawl Drain /Backwater Electrical Rough In Insulation Insp Appr /Sdwlk lnsp Foundation Insp PLM /Underfloor Framing Insp Rain drain Insp Electrical Final Post/Beam Str ntural Mechanical Insp Shear Wall Insp Storm drain lnsp Mechanical Final Iss ed By : 1 i _ .; ' ..di1 of ., _ Permittee Signature : , fi b -' !t , / , • , Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day C1T 1 OF TIGARD MASTER PERMIT PERMIT #: MST2004 -00134 so, DEVELOPMENT SERVICES DATE ISSUED: 5/26/2004 • ' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 SITE ADDRESS: 16240 SW 108TH AVE PARCEL: 2S115AA -SP002 SUBDIVISION: SWARTWOOD PARTITION ZONING: R -25 BLOCK: LOT: 002 JURISDICTION: TIG REMARKS: New SF • BUILDING REISSUE: M2170 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1.209 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,071 sf GARAGE: 667 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5 VALUE: 227,544.10 OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2,280 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 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: BOIUCMP < 3I-IP: VENT FANS: 4 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4 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 FOR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 4 201 - 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: SIGNAUPANEL: 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: $ 8,048.17 SWARTWOOD OWNER This permit is subject to the regulations contained in the 60 SW 108TH Tigard Municipal Code, State of OR. Specialty Codes 162 and all other applicable laws. All work will be done in TIG S 1 T1-I accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. Phone: 503 639 - 9203 Phone: ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: 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 Insf Rain drain Insp Electrical Final Sewer Inspection Underfloor insulation Electrical Service Low Voltage Storm drain lnsp Mechanical Final Footing lnsp 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 lnsp Shear Wall lnsp Insulation Insp Appr /Sdwlk Insp Issued By : /,1AL./fL , Permittee Signature :/r 1z__ E,4, urotrrN Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day V ® 5 �• -_oI" 00 Building Permit . Aio,'1, ■'+ . FOR OFFICE: -USE ONLY , City g Of Tigard R c 1QO Received t Date/By: ( 3D/di/ hl/ L.8 Permit No[ j a004 ^Q0 t 3M 13125 SW Hall Blvd., Tigard, OR 97223 ? Plan Revie �� / �. 1 /1 Ft� t I Other Pemutth (_,a,., � 3 Phone: 503.639.4171 Fax: 503.598.19 0 ••{ G t; �GP�pl'�I Date /By: r1 AJ S 2� D / Inspection Line: 503.639.4175 G, `'( O ` HI SS, sJ P' I Date Ready /By: // C Juris: ® See Attached Checklist for w , 2 ^J� �Y J Internet: www.ci.tigard,or.us u1�Q�,VG Notified/Melhod: Supplemental Information 0 C/22fkl B _ , r�: rh• P'•' ki, �$.i W *i: ' ,i��r[ , >s , .�v „g ;;i;r; 1� _ rvs +rasa..: n t �w .:a4 J). [gy:.yr G'r� ': '" f.J Y � - ••tip .. t , ; : A •F:. �.tCy 1.:.,1' =' "4[Vf „ -L�� 'r4•'�k'o-. � i;•a:w i ':'G .::� r �.t "i' _ ''` D DATA: ;. 2 ,6%ii 'Y DWELLING J'"l ;'9 ..,�„ ) ,,. �' e. ',1;; ::r' RE' UIRE ';,�„ w� <<'�":,,• - >;i'"'ixs llr;' := �TYEE..OF'iW.QRIC s.:..''_+1�- �L . � � Q . , r , . u «;�"�rt+ a> e'::'' �� `�;a�' ^ �`�lrY'�����i , 'tr'� " r. ....v,.E.: {u,�'." � qn..• .. - r- ^��i+•y�,:l.!, .., . , . , .. ��;:S.t �� -. . ..- . „ Q New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the „t,:.y,;s..a', ,, ., ^1c• =$.sf ., .- d iiiwe:, a4u., :..i,:., i tj' .r =e; " „- (`�•aE t,:w work indicated on this application. ,. •� .fir.+= .1 i� w�l g;44 15 tCA'PEGORYa OF,'.GOIVSTRi7.0 GION : I..f= :.f: : , .. , -, k ?::Nt;� »t.: „jam;$” uXi? f' 3sti:., -.:-�.;c;;+,xr,.so's•-z«rta „ :; ari.:_ > ^rert�.f�rs 9 ;.`G. 5';` �„ ta.��t':r::,'�:lt. �,ra:: r,u ,� '��' Valuation: $ rif � - and 2- family dwelling ❑ Commercial /industrial Number of bedrooms: ❑ Accessory building ❑ Multi - family ❑ Master builder Number of bathrooms: , � ❑ Other: rF• r¢ _• ., :, z .,: ,; � ;H: _ µ: ;r ;r. ri: ._, s,4:. sH•r ' „. ,..: ;:f3n: ';p {;: Total number of floors: s -R - s�1 : -I PA , �� JOB S I TE,j IN'FOR NIAT IA L AND, LOCATIO ) r. r : _ Z- :,,k;. ,d9gk: +sl?� idttt , g,.-Zt..: Cr._t'd4.ha.g.i... > , , ,,+hn.' e, -f h a Tkw.9 ,. ,,.,k,,,,,` . ,,4 ..../.. . I.. ,F= 1 Job site address: / 6, , go so. /03 /9 lie, , New dwelling area: 2 8. square feet City/State/ZIP: l, 9 a rot OK 9 2 1( Garage/carport area: ,, 6 7 square feet Suite/bldg. /apt. no.: Project name: Covered porch area: If square feet Cross street/directions to job site: jk r A m Ro(. .- / o 'J 9t e. . Deck areap h) - -? 6, O square feet Other structure area: _. N. square feet '; DAT C • ' - +: RC I AI 1 C : -ri Subdivision: 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.: a 5 II 5/3 R - 0 0 L 1 0 0 equipment, materials, labor, overhead, and the profit for the ry ^, .,^.,�s;.�z '�:;, ;�:;_a> >. =fi=x' ,.r.•;y5 ,��- • f'�,: }�? .1iN �,; �:.7° °'. .ft ' , E i._ ;t`�;' 4; :k :.:3.; :mot?; '4.' .: work indicated on this application. ' = i r.'"sd: �;+tc : ':;': r �,p�y ,a, :.Sri::s., ;DESCRIPTI4• OF,4FrWQItI{ "w •„ O. : i :.., ;.;; 1 g PP ” arti6it” u�r�:' �i' �;; �Y�,' �' 1;,, 4' �,. �aa��. �. f�, � 1 , ��`, rlxrr�.:irn';; "�'r;9w�s ^.�.,., it sraa,:s;4�,�ra#a.'u�:;,...:na. �',�•::;,,,. ", a��. au i':'= �, „.;:s4;.r,�::�:�01��,-'.iii `�':? =. .. ,.n.,., n6., .,, Valuation: $ -Ft m :Jy d.nl II,nq Existing building area: square feet New building area: square feet .x rfr s[4ROE PRTY OWNER ; Fr. ; ,I ” ®TENANT " t " "� Number of stories: ,,... -.�Z�i �3N4. a€ r. .*, „�bs+ xw.+.. 3..,,,< ,.,a�.w.?,,: _ ..'.i.= .�,�.8P4 "t' Asa" x'.` � s.;',` ..,.” .u u. ,,.. . ,t.;R „ � , _ Name: 562 CAC `4 - 0rAc - .3 - 4 - 60 ring( Type of construction: Address: / 6 Z G o .. K) /a q tre , Occupancy groups: City/State /ZIP: 17 a r. 4 ()K r 7 a2- - '74 Existing: Phone: (5 6 3 9- 9 2. 0 3 Fax: (563) 6 3 9. 9 Z O 3 New: .... .,. ,.,.. ., .., a�-, .... .e.+,...0 ",.,;. .:.a �, ....: :'.a °:"+„v"`,.�i.t 3� • .3 5 :Yam ii'.+ �i. ._ s N . a a. ,' , h ,. =�. . _ ,Y ;';•�' ,>F?;xr.' .,Ig+� +, ,�. y „ ,,. +: s +,. , . r' "5t; c ;14 - � N -k , airs,., . ' = , ;;1 c. _ &<' r ��_'; �er .tiz•� ^ ^.:.� { ®�'CONT 3. : �r ;rr� ^ �'� : u °, .a7 �• ;i '24'4;0-; +''44� ,: r , t :�:_' •�APLICNT. ati� � , ar,,,t, w.. r:.a:,> �_:�• -. NOTICE g} . ,�: • r` iti ®'. , .,r<`K a'' t'i;;" -;r' ,.. ,,, �tl••. ., ,. :M V;, w ,y . '., = ., �as,x,. ".viGi ^a1nr, "� c1,.,t4�t�L,.. ,..a , Cy �` _ :: @ - -' r : '. .E i.: 2 .z :nl,r +lt���;::t6.;aardt;, =„c. :,,aa +4�na�'m�� .o .rt>s�.. " {;�_:fr 6. ;.; i.}: „. . � a.��'C`':•S�c;y,•_+1?r., � -'._ Business name: All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: under ORS 701 and may be 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: ( ) Fax: : ( ) owner � L 7.t r /ll P r E -mail: • '. •.,xM ^sz°, r�: r ”. = . ;R,p ".?;sB»+rr: T +'.!:f ;,.;�r ;a;u.»��v,' c?y <p 8I, ^'F` s,.'3"�,`.'y'F1LS `, "a^ },;,';�.i c''^'ti i`+ ;:ice h:l ,wr7;„ #ei #::,'�.5:.BE?..;u. ; +'.t'; :r" ; m �,t :,� :, Y + « ":,` ;s;e >,,.:.'i` -� ;�, r; " x a, z �» 'A,6 t A. "•VCONTRACTORti: +I • . k -- r - .. S 6 lr y ,,,;_.c`l+�w 1 t�'`i ?�t�',,..i�r P,h� . -.M ...'P4, ,5u ,:;; :;:i���'i °I p. u5;b�a„ �� 4� "a' =- 11��`';.j: o�'RT4 g i?,,�rz Business name: Q 1,0 n e f puts I ti e r "r�• 5'Ir9 1(ts Biiiiv 6,4,- RMIT''rFEES* Address: Please refer to fee schedule. City/ State/ZIP: Fees due upon application Phone: ( ) Fax: ( ) Amount received CCB lie.: (� v /�1 Date received: Authorized signature: ( : & . < 1 . . , - "" " - This permit application expires if a permit is not obtained �' within 180 days after it has been accepted as complete. Print name: GY' e-2 5,/...X.I --a- w0 o ot Date: q /30/ 0 y * Fee methodology set by Tri- County Building Industry / Service Board. i:\Building \Permits \BtJP- PemutApp.doc 12/03 440- 4613T(11/02/COM /WEB) • One- and Two - Family Dwelling ' Building Permit Application Checklist F OR OFFICE USE ONLY City of Tigard oa;eiV a Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: Phone: 503.639.4171 Fax: 503.598.1960 / ��p4 k 24- Hour Inspection Line: 503.639.4175 • ∎' i ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.ci.tigard.or.us CI Other: . THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ El ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ - CI 3 Verification of approved plat /lot. ❑ ❑ - ❑ 4 Fire district approval required. Name of district: ❑ ❑ _ CI 5 Septic system permit or authorization for remodel. Existing system capacity . ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ - CI 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- ❑ ❑ ❑ :.,'n protection, etc. f 10 3 , omplete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ I, • a ing codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size 1 sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyrig' iolations exist. 11 Si /plot p +n drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ ' t re ' . ore than a 4 -fl. 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; ; pc ; impervious area; ; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size El ❑ ❑ and location. 13 Floor p lans. Show all dimensions, room identification, window size, location of smoke:detectors, water heater, CI CI CI 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 El ❑ ❑ 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 applicable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 3 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\Petmits \One - Two- FamilyChecklist.doc 12/03 ' , Building Fixtures RECEIVED Plumbing Permit Application FOR OFFICE.,USE O NLY APR 3 A l i Received City of Tigard �'I "IU�(� Date/By: Permit Na 11 - f a I/ 13125 SW Hall Blvd., Tigard, OR 97223 >� Plan Review \�J'(�/ yl 7 c Phone: 503.639.4171 Fax: 503.598.1960 C ITY 0 lym!'.�1 +I "� Date/By: Other permit No.• 24- Hour Inspection Line: 503.639.4175 BUILDI !!y r' `� Date Ready /By: Juris: [r] See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information 4 x: " - r T PE 08, „WORK a $ � z ' m, BEE SCHEDUL � �d Via.. �v�� �.� � - �° g - _°• „��.�_��:..- � �s' ,.t o ' x� ' .✓,�ix^r � s� sa k. ...�.. -.. ,.��.....ro � • -�r� ,.��.z „ �. New construction ❑Demolition For special information use checklist. Description Qty. Ea. Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) aa' s . v 4 - x a _ " • �sz it x N '"fix 7 5 ' „ W' ' + .! '3 . , • 4 , CATF RY OF CD> S 4 1 6 1. ^ w, SFR (1) bath 249.20 10 - 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 il �_1 .�' �a :N. y JOB Q N i O r1�TIOFi s y a r , ,. Site utilities Job site address: / 6 Z Li o Ss / 0 ( Are---- Catch basin or area drain 16.60 City/State /ZIP: T; A r A Or, q 7 ZZ q Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: Footing drain (no. linear ft.: ) Page 2 Cross street/directions to job site: -H1 4 L g _4 Manufactured home utilities 1 10.00 / k r vl Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: lLot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: - : ".,^. x-- , Absorption valve 16.60 . �� x° 4 :4 �` Backflow preventer Page 2 p , " ° l 'i . sro '?`�� . DESCRIPTId,, OF WORD 1 �,aSl.... ;.� _ 9t:_i.k: r ',m�,... _.,.". ' d,.^m•. .;- - €'"��, C+-- ^`^. -r.. -3o�° ..w ;�i..,. Ain _, ".. �.. „`��. �. Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 �,,s�- -. s a'a mar, Dr inking fountain 16.60 g ti -YROPE .;,,, WNE i � I ' " x ' Ejectors /sump 16.60 Name: 770. C-. K 4- G- race_ C2 Stio k r C o k Expansion tank 16.60 Address: / ( Z (O h 31 / 0 6" Aire- Fixture /sewer cap 16.60 City/State /ZIP: T a r- O 7 z-2--1-1 Floor drain/floor sink/hub 16.60 Phone: ( b 3) 3 - 9a 0 3 Fax: (50 ) 63 1 O _. q.2 of _ Garbage disposal 16.60 ;? `❑ APELIGA1YT Hose bib 16.60 t f ',,. ..`t - ... . .. K .. ._ .'.. v r.:' O b . ' a ON T Z�O PFt,12r5Q k, Ice maker 16.60 Business name: 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 - v' t1 �. '`;tom P Pt ` N .. ,.r W ,� r '�'� W,�.. ��" GOI'I'RAG�®'R;. '�s . ,,�, �,��s; "�z',�,: Water closet 16.60 Business name: a V, 4 i . b IAA I f r/1 r 4. - Water heater 16.60 Address: ' / Other: City/State /ZIP: Subtotal Minimum permit fee: $72.50 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: Plumbing Lic. no.: Plan review (25% of permit fee) Q� / State surcharge (8% of permit fee) Authorized signature: /�C/ o TOTAL PERMIT FEE Print name: G rq ce �ul Qt-4 co d Dater 6o / if 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. i:\ Building \Permits\PLMF- PemtitApp.doc 12/03 440 461OT(10 /02 /COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: �_ Qtye' ;lee'(e " To tai °Su Fo erm><t Fee ><te trkt><es -� �,M.. Arw Footing drain - l g 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 - Ist 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 riTO,';i' . .; r nri„ � -' , <;_ . < : � : '. , ' a amma l , Permit ree Storm & Rain Drain - 1st 100' 55.00 $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 Qt Fee '4Citirg additional $100.00 or fraction thereof, to and 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 and including 0.00. specially requested inspections - per hour 72.50 Subtotal: $50,001.00 and up $742.00 for the e 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 * . t 4 an ity by (Fixture) Worl erf S- med� =. 'FtxtuceType NIX �Replaoe, �A�' S Extsttu Ica ea Comments regarding fixture work: Baptistry/Font Bath - Tub /Shower - Jacuzzi/Whirlpool Car Wash -Each Stall • -Drive Thru Cuspidor /Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye 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. /Refrig. Drains Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the Rec. Vehicle Dump Station plumbing permit can be issued. Shower -Gang -Stall Sink - Bar /Lavatory ' ' Bradley Quantity Total - Commercial Isometric or riser diagram is required if fixture quantity Service total is >9. Swimming Pool Filter Washer - Clothes Water Extractor Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal Other Fixtures: i.\ Building \Permits\PLM- PemutApp.doc 3/03 • Mechanical Perm t . ,,I * . l ® FO OF>FICE.USE ON City of Tigard - R 3 O 20 Plan R a Permit No./ ,,� . 0X)1 °i 13125 SW Hall Blvd., Tigard, OR 97 Plan Review I Phone: 503.639.4171 Fax: 503.598.1960mnrNl� Date/By: Other Permit: Inspection Line: 503.639.4175 . �� Internet: www.ci.ti ard.or.us CITY OF TIGARD _ Date Notified/Method: /Me Notified/Method: S No Tuns' See Page 2 for Supplemental upplemental Information BUILDING DIVISION '.NEa ' " "-•_ .f * 'J - - ' _ ' . 1 a> }... e.. C; ;s "s: :,"5'.x, i' "• .i,.sx�.,. -.,� -; a«Y3.. is - i :� s. 'fi t ' , t [fi34. ':Yi° `. . it m _.➢ . #. ,; 3 ti":.,��: � ,tTYPE,,OF" WORK . _« .� ':. xa.. , ��;'; �C 'ERCTAL�:FEE:;.,S TJ ECKI:IST ew construction ❑ Addition/alteration/replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. °� .. V,- 4 ' ,' ,� � , . ,. 4 ' ' r Value $ � CATEGORY` O GO NS T R CTION , . ��._�,t „ �m I r 4- Si - � - and 2-family dwelling C ommercial /industrial l RESIp,,Fj I SY y g ❑ ❑ A ccessory building "`" " `'" " - For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total �. .��?' �,.; r �.;, «:��:�a::.:a =��" - > =s��w ;a� ; �.�: �s:, - �x.� xxne >4c - � ' .� . ,. . ;Y x., R y ,.;, -,�- i .' ° .:' ,,.r. icili.SiT, INFO AN EA L X' A` :i Heating/cooling Job site address: / lg / n �Cffi' Air conditioning or heat pump Z )� D S ) , -p (requires site plan showing placement) 14.00 City/State /ZIP: 1 ' Q 0 972-2-'1 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: / O /1. _ - d T7t� c �t.t r �G Q . 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 Subdivision: Lot no.: Flue /vent for any of above 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances Water heater 10.00 5 ° i - ,. 3 „ '' � ESG e IO 1 OFrDWRK A , `<' � .;',„ a Q : , .x s,,,,.,, . �.ft :loge � fl. Gas fireplace 10.00 Flue vent for water heater or gas fireplace 1.0.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 Chimney/liner/flue/vent 10.00 ri* -s €PRUP RTY OWNER a a t ,, ®TENANT NF s ' 1 y �_,. a.F. �. Other: 10.00 Name: 3 4 G {, (Lc S Q r -h A D O J Environmental exhaust and ventilation FA Range hood /other kitchen Address: �j / �n Z (o Q , I/� ) 0 O A � equipment 10.00 City/State /ZIP: 1 ` a. rL Q � 91 g Clothes dryer exhaust 10.00 • 1 ` J LI Single -duct exhaust (bathrooms, Phone: -b3) (, .q 2. o 3 Fax: ( ) toilet compartments, utility rooms) 6.80 : '-- ,- APPLICANT ,, ° 1 M ` "' ' ' IACO TACT` b ' Attic /crawlspace fans 10.00 Other: 10.00 Business name: Fuel piping 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 . , s 3. :: r u. , ' =� . zr 5 5 neu vuSuu " se , , '.. . I` ; ° iN �.,s' � _ U; a , ^ C � �� Mr k g ss ' . , r*ta: e k. Barbecue r . � �4 � ;� �.� �' `�' � � .:Taw Clothes dryer (gas) Business name: Q (�) y1.e r -e OW Other: Add ress: .�,�;,� ?5„4. _m =, �. =,a; aaa. =e�z,...__. _, . 1 �, ; �i t „ X111 `NI�ECHAN3.4,„ :PERiVIIT;'E:0i : City/State/ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lic.: State surcharge (8% of permit fee) TOTAL PERM FEE Authorized signature This permit application expires if a permit t is is n not obtained within 180 Q d after it has been accepted as complete. Print name: Gra Q. .k S v..)Q f 1.4.1 o ad( Date: 1 1 (3 a to q * Fee methodology set by Tri- County Building Industry Service Board is\Building\Permts \ MEC- PermitApp doc 12/03 440 -4617T (I1 /02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: total; Valuat><on . . Rermif fee ; e ; �.. F $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 fast $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 - . - ., FOR OFFItE USE ONLY City of Tigard RECEIV AA Received Date/By: Permit No.iiir,, .... / 9 1 9 /t( 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 ,AWITir Date/13 : Other Permit: Inspection Line: 503.639.4175 APR 3 0 r„, ,-,, II Date Ready/By: Ions 121 See Page 2 for Internet: www.ci.tigard.or.us — Notified/Method: Supplemental Information Tri.ONAWW,Ate"-PfAitleiViV,,a0a6a <fliMARRAWnenkitie„A taiRI:=7;MTOPMIEASWITACtee :''7- .:: .-' :. : ' ' : 'k'A 73 r ittl.:61,,t-,,iin. , .1,E..,a.M.' P4 A ,,,,,,,,,,,, - , a , '- ,,,,,,, " ,,,,,,,,,, '',, ,,,.- -,, ..,,,,, ', ., ' = " ''. • - • - - rJew construction Ej AdditiAlikRiWreplacement Please check all that apply: 0Service over 225 amps, cornm'l 0 Hazardous location 0 Demolition 0 Other: Maypigt ,i S„ 1=1 ervice over 320 amps — rating EBuildng over 10,000 sq. ft., 4.Wiranaletaggiiiinto M; . ' , :..,..:l;':Wli of 1- and 2-family dwellings 4 or more new residential Xl and 2 dwelling 0 Commercial/industrial 0 Accessory building EI System over 600 volts nominal units in one structure DBuilding over three stories 0Feeders, 400 amps or more 0 Multi 0 Master builder 0 Other: ['Occupant load over 99 persons 0Manufactured structures or ‘ " 0 Egress/lighting plan RV park Job no.: 0Health facility 00ther: Job site address: / 6 2_ L/ ) / Sk Og ncrQ Submit 2 sets of plans with any of the above. City/State/ZIP: --r-T 7 , rk '01 9 - 7 2- (1 The above are not applicable to temporary construction service. '' . '- j ;i . r -,444.',4j:-RIMORi Sqtinq Suite/bldg./apt. no.: Project name: na Itr Description Qty. I Fee. Total ** Cross street/directions to job site: i oyi j (),,,,, q - T)., , rk tog-7 I New residential single- or multi-family dwelling unit. I . Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map/parcel no.: . . Limited energy, non-residential 75.00 - 2 044,:v.,,,,v*veriiw-ekiffio,Wi ke lkyol"'INAt'S.4:WAII-4.M 4 titaWA''I'AVIIkikIi , 'E-1-5‘. ,IP fle:II*AIN,A 4, Each manufactured or modular dwelling, service and/or feeder 90.90 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 T-61,4fialf15,igwvin T a Nfi ...w.t : Ir i t i o. 201 amps to 400 amps 106.85 2 _ . „.a,,,:., .. = Wi=4-1IAIIIIIeIWAAII 401 amps to 600 amps 160.60 2 Name: ( j et 0,k 4... (--,.%- ra 0.-Q.. •S \/..)6k r o I.) (A 601 amps 10 1,000 amps 240.60 2 Address: ) , 2. 6, ( - - (A) / 0 k A A-- Over 1,000 amps or volts 454.65 2 , Reconnect only _ 66.85 2 City/State/ZIP: - a „4 0 q72--- Li Temporary services or feeders installation, alteration, and/or relocation Phone: 5 3) 1, 3 Fax: ( ) 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, „,- Pt, or exchan: according to ORS 447, 449, 670 and 711. G V 401 amps to 600 amps 133.75 2 Owner signature: dk.eir,1 ._ ■•.f..//:_,...—..L Date: I / Branch circuits - new, alteration, or extension, per panel kl.: ye owl torwevwfvfigrizouatef A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 each branch circuit 2 Address: Each addl branch circuit 6.65 2 City/State/ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) Fax: : ( ) Sign or outline lighting 53.40 2 E Signal circuit(s) or limited- -R energy . panel, alteration, or extension Describe: Page 2 2 Business name: OWill'e r b ,A : I I€ r Address: Each additional inspection over allowable in any of the above Per inspection 62.50 City/State/Z1P: Investigation per hour (1 hr min) 62.50 Phone: ( ) Fax ( ) Industrial plant per hour 73.75 . 4441;t:fa.W.CM:gtc7AiTIWC,10-;5‘. Mtli CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal Suprv. Electrician signature, required: Plan review (25% of permit fee) State surcharge (8% of permit fee) Print name: Date: TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: * Fee methodology set by Tri-County Building Industry Service Board ** Number of inspections per permit allowed. il\Building\Permits\ELC-PertnitApp.doc 12/03 440-4615T(10/02/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMI FEES: : S 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 n 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 i:\ Building \Perrnits\ELC- PeimitApp.doc 04/03 Permit #: 1` 4-,), 02� Address: l (D 0 / Issued by: se Dat j b 9 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. 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3A. My general contractor is (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 • ,".., 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 about Construction Responsibilities on the reverse side of-this form. ��,,,�r"a►� -a� .5 /d y (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) _ ' information Notice to Property Owners About Construction Responsibilities Note: This information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 70.V55(5). lfyou are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYER RESPONSIBILITIES: If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvement of a residential structure, you will, in most instances, be ruled to be an employer and the people you hire will be employees. As the employer. YOU must comply with thefol lowing: Oregon's withholding tax law: As an employer, you mustwithhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Oregon Dept. of Revenue at 945-8091. Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Department at 378-3524. Workers' compensation iusurance: As an employer, you are•subject to the Oregon Workers' Compensation Law, and must obtain workers compensation insurance for your employees. ifybu fail to obtain workers' compensation insurance, you may be subject to penalties and will be liable for all claim costs ifone ofyour employees is injured uothe job. For more information, call the Workers' Compensation Div ision at the Department of Consumer and Business Services at 945-7888. 0'S.JntermmlRevwmmoServiuc:Asuucmp|oyer,you/ouslwithho|d[ederu/iucomctuxfrom employees' wages. You will be liable for the tax payment even ifvou ddn't actually withhold the tax. For more information, call the internal Revenue Service at 1-800-829-1040, nTHPR RFQPONsIBII I AND ARFAA nF cnNcFRN: Code compliance: Aa1he perm i\ holder for this project, youur responsible for resolving any failure tomeet code requirements that may be brought to your attention through inspections. Lim4ilityuod property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint oversprav, water damage from pipe punctun:o, fire, or work that must be re-done. Time to supervise employees: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the expertise to act as yourown general contractor, to coord inate the work ofrough-in and finish trades, and to notify building officials at the appropriate times so they can perform the required inspections. If you have additional questions. write or call the Construction Contractors Board (PO Box !4l40, Salem, [\R97]UA-505Z 503/378'462l). The Board is located at 700 Summer St. NE Suite 300, in Salem. p,op'mvo.nm+ • CITY OF TIGARD BUILDING DIVISION PERMIT #: iVISI2Ot31 00134 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5}2 € /2t 0.ii Phone: (503) 639 -4171 a " �u'�Rlmllikill i In Requests (24 Hrs.): (503) 639 -4175 `:_.• INSPECTION WORKSHEET FOR DATE: 5119/2006 TIME: 7 :01AM PAGE: 9 SITE ADDRESS: 16240 SW 1,08TH AVE CLASS OF WORK: SUBDIVISION: S ARTWOOD PARTITION LOT #: .002 TYPE OF USE: PROJECT NAME: 'WAIR1'WOOD PARTITION DESCRIPTION: Now SF OWNER: SWARTWOOD, PHONE #: aI3 639.9203 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: '19/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 030225-01 603-6M203 03 N I Corrections /Comments /Instructions: " t./ZC : / -odieek eirnz, ei/ --Q�s C_ w�n.� . CZ X eP hi-, 2 ?ye/ ,,fin Mil- 6� - 7 5 p /" ' R 3tdcj 6 • n PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS IX FAIL M CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: 9�ir'[ Date: 61- Phone #: (503) 718- e._-‹ CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2004- 001314 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/26/2004 Phone: (503) 639 -4171 /n�lp�pi'�Itl Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/6/2005 TIME: 7:02AM PAGE: 38 Dv -2�'�- SITE ADDRESS: 16240 SW 108TH AVE CLASS OF WORK: SUBDIVISION: SWARTWOOD PARTITION LOT #: 002 . TYPE OF USE: PROJECT NAME: SWARTWOOD PARTITION DESCRIPTION: New SF OWNER: SWARTWOOD, PHONE #: 503.639.9203 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10/6/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mecnanical final 017637 -01 503-639-9203 N Corrections /Comments /Instructions: �o 7- 0 a-ri.7°G %f • FA PASS A4TITIAL APPROVAL f CANCEL ❑ NO ACCESS • n FAIL f �Lt FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED S Inspector: Date: Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2664 -6611 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/26/2004 Phone: (503) 639- 4171nM�� I � Inspection Requests (24 Hrs.): (503) 639 -4175 J' � L. INSPECTION WORKSHEET FOR DATE: 10/6/20066 TIME: 7:02AM PAGE: 37 SITE ADDRESS: 16240 SW 108TH AVE CLASS OF WORK: SUBDIVISION: SWARTWOOD PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: SWARTWOOD PARTITION DESCRIPTION: New SF OWNER: SWARTWOOD, PHONE #: 503 - 636-3203 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10/6/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 017637 -02 503639-9203 N Corrections /Comments /Instructions: ' ■ � _ �f . i 0114W/AWAIMAIRP _/Irgdr■ * Ae...s --- AllPlftEdd ' 511 Ao_t I I PASS 1j PARTIAL APPROVAL ❑ CANCEL NO ACCESS I I FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector Date: 0 i Phone #: (503) 718- .._.CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2OO11 -OOHS 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/26/2004! Phone: (503) 639 -4171 �immi iii • Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/20/2006 TIME: 7 :08AM PAGE: 37 SITE ADDRESS: 16240 SW 108TH AVE CLASS OF WORK: SUBDIVISION: SWARTWOOD PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: SWARTWOOD PARTITION DESCRIPTION: New SF OWNER: SWARTWOOD, PHONE #: 603- 639 -9203 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/28/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 012323 -02 603- 639 -9203 N Corrections /Comments/ Instructions: e l - Ah.ea-&5 d ie.c./g 61 1 I.LA.-,A1 — ❑ PASS n PARTIAL APPROVAL 21. CANCEL n NO ACCESS ❑ FAIL ❑ ' "` L F.' v-= : ❑ ADDITIO ' L FE - ASSESSED �. Inspector: D ate Phone #: (503) 718 - CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST ',76,0 4 1 —DO / 3 5 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested l — 7 AM PM BUP Location Suite MEC Contact Person ,-4:41.-- Ph ( ) (, �' "�a`�� 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 Under Slab Water Service Sanitary Sewer _ Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: �[�►85 PART FAIL M 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: 0 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: (503) 639 -4175 MSTaOO / — /3 l INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested /? —/ 3 AM PM BUP Location / h -- gb / n " , Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner (o ,3 -9 c?- a-- 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 o- ../ Firewall 4010.". Fire Sprinkler �� - r- Fire Alarm Susp'd Ceiling � Roof Other: Other: Final PASS PART FAIL PLUMBING �'. ,. Post & Beam Under Slab _ _ Rough -In _O . Water Service - v " ( � I Sanitary Sewer Rain Drains Catch Basin / Manhole *MU tgrii,/l , ., _' 7' Storm Drain Shower Pan _ -- / i - Other: �� s f Final ga 4 , PASS AMU:. MECHANICAL , " { ` Post & Beam r , Rough -In Gas Line daii i i pppr- _, Smoke Dampers - • ��. Final PASS PART FAIL E / LECTRICAL , W Service - Rough -In UG/Slab Low Voltage _ i _�I Fire Alarm Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall; 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: 0 Unable to inspect – no access Fire Supply Line ADA Approach /Sidewalk Date / '77,__3 i 6 P( ' Inspector ')' Ext Other: l Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD '' ` • BUILDING DIVISION s ` ' PERMIT #: MST2004 -00134 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/26/2004 /� Phone: (503) 639 -4171 Nfljiueliti' Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/28/2006 TIME: 7:08AM PAGE: 38 SITE ADDRESS: 16240 SW 108TH AVE CLASS OF WORK: SUBDIVISION: SWARTWOOD PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: StW/AR1WOOD PARTITION DESCRIPTION: New SF OWNER: SWARTWOOD, PHONE #: 503 -639 -9203 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/28/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 012323 -01 603 -639 -9203 N Corrections /Comments /Instructions: e %-e C Z® 5 C e '.G - , / = o _ / Jai r , s _ • n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS lffFZIE n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 7 ——g_-_,,___ Phone #: (503) 718- ' - CITY OF TIGARD ,. , BUILDING DIVISION _ d. PERMIT #: MST2004 -00134 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/26/2004 Phone: (503) 639 -4171 : Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/1/2005 TIME: 7:14AM PAGE: 70 ' SITE ADDRESS: 16240 SW 108TH AVE U u FLASS OF WORK: SUBDIVISION: SWARTWOOD PARTITION \ LOT #: 002 TYPE OF USE: PROJECT NAME: SWARTWOOD PARTITION DESCRIPTION: New SF OWNER: SWARTWO OD, • PHONE #: 503.639 -9203 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/1/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 010610.01 503-639 -9203 N Corrections /Comments /Instructions: • • 17A PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: & • Y v Date: 1 I i 03 . Phone #: (503) 718- CITY OF TIGARD d. BUILDING DIVISION PERMIT #: MST2004- 0013.4 13125 SW' Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/26/2004 Phone: (503) 639 -4171 � °ijj�ljlhl� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 29 SITE ADDRESS: 16240 SW 108TH AVE CLASS OF WORK: SUBDIVISION: SWARTWOOD PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: SWARTWOOD PARTITION DESCRIPTION: New SF OWNER: SWARTWOOD, PHONE #: 503-639-9203 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 6/22/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 009884 -01 503 - 639 -9203 N Corre ions /Comments /Instructions • }3 ‘ 'PPL} R\NiG fit"� ► • :L G .L P `ry- Ty\ S 6 .. � 1 (A,(Zb 01 .is ort,1�CIQAU Lv‘C> P)whc04 C-0\t V(vpm V ,L1s - \AD \r4& 1i `' o NLy a c,'- iA 8 H K \ c �� u k).. 5 4 [)\-k- ? uk -- N e*- 't C4(. 1 ( )\N*‘V ❑ PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED Inspector: # Date: "j� Phone #: (503) 718- CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST � ' J �� (3( INSPECTION DIVISION Business 'Line: (503) 639 -4171 BUP Received Date Requested I a� AM PM BUP Location /6 q o /) O Suite MEC Contact Person Ph ( ) � - 7a 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' :x" , Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final • S • FAIL Po - - ∎ - n Gas Line Smoke Dampers Fi PART FAIL E _ ICAL �: -ou. U /Slab 4 ' •wVo .. Fire Alarm Fin 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 Approach /Sidewalk Date 1 1 Inspector ,, - . / Ext Other: Final DO NOT REMOVE this inspection recor . from e job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST Z � e)d l3 c:: INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested l' � AM PM BUP j Location c 6 a /0 g Suite MEC Contact Person s � Ph ( ) 6 39 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 ` Q ` Insulation Drywall Nailing ( ��,0 , v r\ 1 �` r u 14 u ` (a-f\ h r � I Firewall l `, �) �JJJ��� (� ` `` OL- `, v Ou\No U✓ (,1 q T D Fire Sprinkler v l ( ��j Fire Alarm (� f Susp'd Ceiling \ t \ (' ,� 1 i ,� I �(� - Roof Other: S � I� 1 �` 1 9 v\ix b ,) 146 (- �� Final G �V eC1 j 0 PASS PART FAIL FP Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain • Shower Pan Other: Final �P SS FAIL � 'MECHAN ANICA CA - . ... Post & Beam Rough -In Gas Line Smoke Dampers Final P T FAIL Service Rough -In UG /Slab Low Voltage Fire Alarm Final PASS PART AIL � El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access Fire Supply Line ADA �1 Approach /Sidewalk Date , a6-05 Inspector I' N 2, CD A W 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 „.706 --d c) /3 INSPECTION DIVISION Business Line: (5 639 -4171 BUP Received / ` Date Requested l / PM BUP Location / Co ;46 A Suite MEC Contact Person Ph ( ) 3 PLM Contractor Ph ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: bogs - rl rte, Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear tnt Sheath/Shear P Cr: Framing V r " �fi" i,': n ,t) 1i '� A/ i &- Insulation Drywall Nailing Firewall Ct,� ® , "re) C� i .6 Fire Sprinkler Fire Alarm � 1 /D Q v ��feo t/A / esk SY.fZeli Susp'd Ceiling Roof 0` c� �®� FrV Other: Final R (010VC �1 ��� i l� : � P `.! l P PASS PART FAIL 1 , ILI g4 ,1� � � J � � � � �� � �.� 1 � d PLUMBING Post & Beam ? �,� %'�� - ! � ' . y e � _ „ � -/ � ;�! . , Under Slab s _ . -� � ..� � ., - ..6. Rough -In .Ada o cult a Water Service �' Sanitary Sewer L✓ . O 'V Rain Drains Catch Basin /Manhole -7' °v'./D��r �'Lz � ° Storm Drain ov Shower Pan F L 0 y l /Q /71 /Lt) 1 Other: Final / P PART FAIL P� v c--7 MECHANICAL .: Lf"J b Post-& Beam PO-K Rough -In Gas Line • Smoke Dampers Final PASS PART FAIL ELECIRIICAL ‘Ro FitfrA CVS Gwe cr/Pr xo 0 g reewr Sery c� UG /Slab Low Voltage Fire Alarm Final PASS PART 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125. SW Hall Blvd. SITE Please call for reinspection RE: Unable to inspect - no access Fire Supply Line - J ADA PP Approach/Sidewalk Date / Inspector Ext Other: Final DO NOT REMOVE this inspection record fr e job.site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST A001./ —O0 / 34/ INSPECTION DIVISION Business Line: 503) 639 -4171 BUP Received / Date Requested — 7 AM PM BUP Location / ;' `r v �0 0 G Suite MEC Contact Person ( ) C 39 - 9D--03 PLM Contractor h ( ) 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 nsu = io Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling • Roof Other: Fi AS PART FAIL MBING 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: e Unable to inspect — no access Fire Supply Line ADA e -- Approach/Sidewalk Date /! Inspector Ext Other: Final DO NOT REMOVE this inspection record ft he Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639-4175 MST INSPECTION DIVISION Business Lin.: (503) 639 -4171 BUP Received 3 I Date Req c'27; BUP AM PM BUP Location / 4w Suite MEC Contact Person 4 - Ph ' 3 / � - PLM Contractor Ph ( ) SWR VILDIN 9) Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear I� tWShear ` , MOTT Insulation Co Drywall Nailing Firewall Fire Sprinkler Fire Alarm O r je: T .S771- Susp'd Ceiling ' \�✓ q Aka) /`a� p 7 Other_ Roof 1V� < F !� W. • AS PART FAIL BI NG 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: ❑ Unable to inspect — no access Fire Supply Line Approach/Sidewalk Date / ® Inspector Ext Other: Final DO NOT REMOVE this inspection record fro he Job site. PASS PART FAIL • CITY OF TIGARD . 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST �� �' �� 3 7 INSPECTION DIVISION Business Line: (503),639 -4171 BUP Received Date Requested / 'a " AM PM BUP Location / is ( 16 /0 e ci-k_, Suite MEC Contact Person Ph ) Z ;q — 9Q- PLM Contractor P ) .SWR BUILDING Tenant/Owner ELC Footing Foundation , EL C Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear nsulation t. A i � 1 ? � � CL . E 3 . � - Drywall Nailing Firewall SO� Fire Sprinkler A o ) > , d 0-0 „dm - 0( ii `" Fire Alarm . • 141 j P� l Susp'd Ceiling .1 Roof --4,. /`kb6 U 0 L i J _U iZe ' ' _.L. Other: Final >l L .� Nigtl ar 0 1- 7 -, -'?'". II PASS PART AIL i'' ,�! r 1 r< O V 1p e h C ' 4 -T ( j k__ - Post & Beam 7- ��� /4 1�7�s Under Slab c � Rough -In Water Service a7 0 '/ Pc el Sanitary Sewer V' ,Po ov / &-- � c Q �' ;mil Rain Drains - Catch Basin / Manhole b Vf ,l l o � ��/ �a (.60 a x6 (5 f� - Storm Drain Y Shower Pan (I/ / / f L � Other: ) Final I jA I FW O 1l l 1JC� t 3 / 7 1 /� Go oNt R/ L (_-- PASS PART FAIL MECHANICAL t,a / LV `L 47 -- 4 itc. / b> 4_4-v"L Post & Beam F Rough - In IV L • frCL -- A ■‘ / ar . 1._ L.- - L ___ Gas Line i ,, U — Eezv ( - a h/At (..._2 — 7 ( L - V A J1 Smoke Dampers 4' j _ P F PASS PART FAIL rk_ ? _ 0 V / .� CF-:- ,q E C4 U? xi -7--f-- � ( 1 1.—.74 ELECTRICAL - F- - L. d v 2 SyS 7 Service Rough -In _ I - Ng - uz_L (L "CC//vg� -:, o ,/,/ LowSlolt It (f f� I Low Voltage C Fire Alarm / 62_3 i0 f� 3 a Final Lj Reinspection fee of $ 1G requir d before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL • SITE Rv _ ', ❑ Please call for reinspection RE: I .. ❑ Unable to inspect - no access Fire Supply Line /�j f ADA D �� L_ C v Inspector ` _— Ext Approach/Sidewalk Other: Final DO NOT REMOVE this inspection record fro ob site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 - 4175 MST ;3 DOY - 6o G INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested / eR L t AM PM BUP Location / Co qb /0 cr Suite MEC Contact Person . Ph ( ) 693q-9.20) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Nt9tc : SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing 1 �; /� Insulation 1 ..? (9`V r 1 ' r - Es:''N. A 11. � �1� ' o c) 1 'LI , • Drywall Nailing Firewall ).. I V CV N-1 14� . 1� 0 , � f w6 ©- � ,"a Fire Sprinkler "'� Fire Alarm I''� tfk r k Susp'd Ceiling i1 (�� y� Roof ' � 'O v M .. c1 N $'INbK ( ►1 G ,16 /1 ) NA 1 Other: Final c\.\% N /v W\ 64V V 0 W ('"'``N \PO la LL PASS PART FAIL �� IN� , A ,� O _ ��� � PLUMBING °. '„ obit � �,� '?N � �i \\I 1 \ i '`l `� Post & Beam d 2 Under Slab t� �c - ll b Rough -In E- / MJ L3 � \O 01 �� CLIV \V S - S 4" \\"1v C V Water Service v � y \1 ( A l Sanitary Sewer ,AO C (- . 0 '1 - % ) s t ,11 Rain Drains t \c ` Catch Basin /Manhole \ \N1l C),-.-- D _ � � Storm Drain vvv Show hewer Pan ) \ GY \ 't; yq� \' , g J e Final PASS T FAIL CHANI " J. ....- Post ea ot u < as Lme Smoke Dampers Final PASS PART n ECTRIL_ , -- Service Rough -In UG /Slab Low Voltage Fire Alarm Final 0 Reinspection fee of $ required before next inspection. • Pay at City Hall, 13125 SW Hall Blvd. PASS PART Fill - SITE ❑ Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line � ADA Date I - ' ] �, " ► - 0 6 Inspector \\i t 1� �`��L \ j 9 \7 • Ext Approach/Sidewalk Other: irom Final DO NOT REMOVE this inspection record the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST ,? d cw INSPECTION DIVISION Business Line: (503) 639 -4171 • BUP Received Date Requested / — 7 AM PM BUP Location / as Lf v /6 F ✓ Suite MEC Contact Person Ph ( ) 6 39 ,/2 3 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 SheathlShej Int Sheath/Sh�v Framing Insulation Drywall Nailing Firewall Fire Sprinkler - Fire Alarm Susp'd Ceiling Roof Other: Fi •-� PASS J PART FAIL . BINGE ' 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 . 0 Please call for reinspection RE: , 0 Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk Date , 7 '-` �S Inspector % • Ext Other: Final DO NOT REMOVE this inspection record the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST' Y INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested � /' 3 AM PM BUP Location d / \/-4 Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING . Tenart t Co 3 Cj 9a 3 ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam _ Ext Sheath/Shear Int Framing - th/Shear 4 /9 /2Z,e ���+ r.vtiS Insulation Drywall Nailing °' =, Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof � Other: ,e Final PASS iL PLUM 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: Unable to inspect — no access Fire Supply Line ADA --- Approach /Sidewalk Date / ' 3 " ® S 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 o 2 "6 j 4(- 0 - 0 /3 y • INSPECTION DIVISION Business Line: (503) 639 -4171 MST l" br; BUP Received ate Requested AM PM BUP Location k e a 2 4 / 0 l � / 7 ' 41,..c, Suite MEC Contact Person 7VGL�- --- Ph ( [ ' - �� PLM Contractor Ph ( ) SWR B • LDI = Tenant/Owner ELC Foo ing ELC Foundation Access: Ftg Drain `- ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/14=o Int Sheath/Shear Framing tai t� G Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PAR 4 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 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: El Unable to inspect — no access Fire Supply Line 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: (503) 639 -4175 INS CCTIO DIVISION Business Line: (503) 639 -4171 S s�✓� BUP Received ileacurafrDate Requested / i 7 AM PM BUP Location /' J" Ve / ©:4 Suite MEC Contact Person G y' CA Ph ( ) 6.39-q PLM Contractor Ph ( ) SWR ILDI Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear An • • Int S eath/Shear # f / ". Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final . PASS PA 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 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 / _r 7 3 - 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 MST -0 of-3e/ INSPECTION DIVISION Business Line: (503) 639 -4171 j{ BUP Received Date Requested /, AM PM BUP Location ) aZ t1 1 fd / A-0-Q— Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner .Cc��� ELC Footing " eO, c I _ �D ELC Foundation Access: Ftg Drain ELR Crawl Drain efliP 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: Fina PA 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 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 Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Dat 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 MST alOct - 3 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested I 7 AM PM BUP Location /Co o2 `t� /c U �``� Suite MEC Contact Person Ph ( ) 6 —c fA6 PLM Contracto Ph ( ) SWR • LDI ►. e Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes:. ( SIT 6 it st &Bea J Shear Anchors Ext Sheath/Shear Int Sheath /Shear Framing Insulation Drywall Nailing Fi rewal I Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Fin - AZ :" 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 Post.& Beam ou Gas Line Smoke Dampers Final a S tc 5, 2 ART 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: ❑ Unable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Date Inspector /.9 Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD • 2 -Hour BUILDING Inspection Line: (503) 639 -4175 MST c-0 3 INSPECTION DIVISION Business Line: (503) 639 - 4171 BUP fgra r. Received 1 7 g t M _ Date Requested 7 0 AM PM BUP Location /6 g- /® Suite MEC Contact Person re4 GQ Ph ( 5 2 7 ) 9 'P2Z 3 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 /11 J� _ raming Insulation +� `� Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling i Roof - Other: tri Final PASS PART FAIL PLUMBING Post Beam Undder r Slab • Rough -In Water Service �siusrli7 r Rain Drains Catch Basin / Manhole ower Pan Other: Fi 40 A PART FAIL NICAL 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 El Please call for reinspection RE: / El Unable to inspect — no access Fire Supply Line ADA Ext Approach /Sidewalk Date Inspector Other: Final DO OT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 -- po( INSPECTION DIVISION Business Line: (503) 639 - 4171 MST BUP Received 3 ` Date Requested AM PM BUP Location / oZ `, 7 6 / v 3 Suite MEC Contact Person Ph ( ) 6 3? - 7;03 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Fos 'ng Foun• : 'on ELC F:� Access: taan 0 ELR Slab Inspection Notes: SIT Post & Beam Shr Ext SShea th / e: / . Ext heah /h Int Sheath /Shea Framing — /MEI Insulation r /AV Drywall Nailing Firewall / ` - 9 14 C - I Fire Sprinkler �� Fire Alarm V 0 V� EL/00a- WW Susp'd Ceiling Roof II IMIIMIMMIIIEr Other: final Milik' . 'T` FAIL PLC' -G _ Post & Beam Under Slab Rough -In Water Service Sanitary Sewer ,,z Catc :asin/ .nhole Storm Drain Shower Pan Other: F. • :I 'ART FAIL M ' ANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE _ E] Please call for reinspection RE: 0 Unable to inspect – no access Fire Supply Line ADA Approach/Sidewalk Date b A Inspector GA(? 1 ~n�� � J Ext Other: Final - DO NOT REMOVE this inspection recd d from the job. site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST 2 CO 66 137 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested 62 `T AM PM BUP Location / D-1-to /D r (-' --, Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BU Tenant/Owner L ELC noting ? v 9 — ELC ati Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath /Shear Framing / lli Elm ` I L7 c- ry ) Insulation Drywall Nailing glik • a r 5 ! r "4. • /Q-5 - Ca .✓ Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Fina t . OP PART FAIL P '' 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 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 Inspector - Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour - 'G / BUILDING Inspection Line: (503) 639 -4175 MST / ��7 — b 0 13 " INSPECTION DIVISION Business Line: (503) 639 - 4171 BUP Received Date Requested 6 a 3 AM_ PM BUP Location / 4 a► y 0 Suite MEC Contact Person Ph ( ) 42.3cl 9 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC mgt �Foundatio ELC Access: Ftg Grain ELR Crawl Drain Slab__ __ Inspection_ Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath/Shear 4 C Framing "A //�/S77A-L ( — U �' v�cr� -roc a Insulation Drywall Nailing :•G Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART F 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 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 ar 2- 3 --_ Approach/Sidewalk Date Inspector Est Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour k. BUILDING Inspection Line: (503) 639 -4175 MST 00(3 4 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received / Date Requested 3' AM PM BUP 6 Location / a- L /U V " ` Suite MEC Contact Person Ph ( ) . 6 3? ° 7: 03 PLM Contractor Ph ( ) SWR BUILDING _ Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain v ELR Sla. Inspection Notes: SIT Post & Beam Shear Anchors ' Ext Sheath/Shea .. Int Sheath/Shear Framing Insulation Drywall Nailing Firewall ? ‘ 1-1 S C O Fire Sprinkler ,v G1� Fire Alarm v 1v bk Susp'd Ceiling Roof Other: Final 44 'ART' FAIL P G . Post & Beam Under Slab Rough -In Water Service Sanitary Sewer <ttalifDrains Catch Basin / - nhole Storm Drain Shower Pan Other: F. :I PASS 'ART FAIL M ' 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 SITES _ El Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA 4 n � Approach/Sidewalk Date Inspector 1 `@ Ext Other: Final DO NOT REMOVE this inspection rec d from the job site. PASS PART FAIL CITY OF TIGARD - BUILDING DIVISION PERMIT #: NI� - 1001 11011 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/2&2004 Phone: (503) 639 -4171 Ja �h Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 6/21/2005 TIME: 7 :07AM PAGE: 34 • SITE ADDRESS: 16240 SW 108TH AVE CLASS OF WORK: SUBDIVISION: : aWARTWOOD PARTITION LOT #: 002 TYPE OF USE: PROJECT NAME: SWARTWOOD PARTITION DESCRIPTION: New SF OWNER: SWARTWOOD, PHONE #: 503 038 - 9 2 0 3 CONTRACTOR: OWNER PHONE #: I Inspection Request Scheduled For: Date: 6121/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 03 205001 503 Y / Corrections/Comments/Instructions: :2/ A..i ' ,1.-A. Ifo t2 , i Z•vY i - .. 6 q---e vPASS n PARTIAL APPROVAL n CANCEL n NO ACCESS n FAIL I I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: -,e.._1 -,9L� Phone #: (503) 718 - "z4-4--S— CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST A00 ci D6 3 INSPECTION DIVISION Business Line: (503) 639 -4171 1 BUP • Received Date Requested ? -9 AM PM BUP Location / t ?-(40 /0S" J Suite MEC Contact Person Ph ( ) 4 39 - % la Q3 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 Other: Final PASS PART FAIL PLUMBIN Post & Bea • Un•er lab Water Servi - Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Fi 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 Anal 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 G Inspector "/ " � Ext Other: Final DO OT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 a y--O0 r3 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received ``" / Date Requested � o f AM PM BUP Location ) �A ?/ a to c'F � Suite MEC Contact Person v/ _Q. Ph ( ) ( 9' � 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 / ' / r Firewall Fire Sprinkler ' Fire Alarm Susp'd Ceiling / Roof Other: Final pASS, PART FAIL ING Post & Beam Under Slab Rough -In c Rain Drains Catch Basin / Manhole rm ower Pan Other: Fin PART FAIL HANICA L 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 I nspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL