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Permit CITY OF TIGARD MASTER PERMIT PERMIT MS fib, DEVELOPMENT SERVICES DATE ISSUED: S 002 00288 X 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 11820 SW 113TH PL PARCEL: 1 S134DC -05700 SUBDIVISION: MUTTLEYS ADDITION ZONING: R -4.5 BLOCK: LOT: 018 JURISDICTION: TIG REMARKS: Addition to front entry and new addition to rear of house. BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT: VALUE: $ 69,762.00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0.00 sf REAR: PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 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: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 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: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: SIGN /OUT UN 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: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 1,423.11 MARIUS SMIDT OWNER This permit is subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and PO BOX 230308 all other applicable laws. All work will be done in TIGARD, OR 97281 -0308 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Reg #: 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 Mechanical lnsp Shear Wall Insp Water Line Insp Building Final Foundation lnsp Plumb Top Out Exterior Sheathing lnsK Electrical Final Post/Beam Structural Electrical Service Insulation lnsp Mechanical Final Post/Beam Mechanical Electrical Rough In Rain drain lnsp Plumb Final Underfloor insulation Framing Insp Rain drain Insp Final inspection .� 9 Issued By : ..J A . 'iii. i Permittee Signature Call (503) 639 -4175 by 7:00 p.m. for an inspection needed th�ne_xt business day c i s r - Lf - dZ- sr Building Permit Application Date received: (D 7 E 0 9- Permit no.: }-0/;900A- OD ,2gA r 1 City of Tigard __ Project/appl. no.: Expir ate: CirygfTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Phone: (503) 639 -4171 Date issued: By eceipt no.: Fax: (503) 598 -1960 7 1 Case file no.: .Payment type: Land use approval: (UN - ` 2002 1 &2 family: Simple Complex: TYP1 OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi - family ❑ New construction ❑ Demolition ■ZI ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other: JOB SITE INFORMATION Job address: t g o 5J . 1 1 3 t p • - if G- a , O l; Bldg. no.: Suite no.: Lot: 570 ( / / 4 Block: (Subdivision: fV10Tr y S A r - - 2 . , / no / Zor( Tax ma /t ax ot/ count no.: 5 7 0 0 14 Project name: k,. Description and location of work on premises/special conditions: /VF&✓ " -7 &4'i Ado /270" - 0 QA-Gc A-D 0 i n OA 1- A' a 0mi r- 'A7 /. OWNER FOR SPECIAL INFORMATION, USE CHECKLIST Name: M t h.S SM l DT (Flood plain, septic capacity, solar, etc.) Mailing address: p. 0 . RDA a 3 o3 0$ I & 2 family dwelling: City: 7-1 CrA (� ( State: OR 'ZIP: 97? 8/ .: Valuation of work $ 7L� Phone: 639 9 so (Fax: 962 017 IE- mail: ,S.rlidfiii G4.61, .' o. of bedrooms/baths Owner's representative: Total number of floors Phone: ' Fax: E - mail: New dwelling area (sq. ft.) 77 APPLICANT Garage/carport area (sq. ft.) Covered porch area (sq. ft.) Name: w,11vC --(Z Mailing address: Deck area (sq. ft.) City: ( State: I ZIP: Other structure area (sq. ft.) Phone: Fax: E -mail: Commercial/industriallmulti- family: CONTRACTOR Valuation of work $ Existing bldg. area (sq. ft.) Business name: Q,,,rµa— New bldg. area (sq. ft.) Address: Number of stories City: I State: I ZIP: Phone: I Fax: I E -mail: Type of construction Occupancy group(s): Existing: CCB no.: New: City /metro lic. no.: Notice: All contractors and subcontractors are required to be ARCIIITECT /DESIGNER licensed with the Oregon Construction Contractors Board under Name: Q Lis./ ►. r P provisions of ORS 701 and may be required to be licensed in the Address: jurisdiction where work is being performed. If the applicant is City: I State: (ZIP: exempt from licensing, the following reason applies: Contact person: Plan no.: Phone: Fax: E -mail: ENGINEER Name: Contact person: Fees due upon application $ Address: Date received: City: (State: (ZIP: 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 complied with ,/ peed herein or not. Credit card number: / / * ' Expires Authorized signature: . L I ature: � � Date: � / r / 2_ Z00 Name of cardholder as shown on credit card p Print name: M Pr � SM (.Dr Cardholder signature $ Amount Notice: This permit application expires if a permit is not obtained within 180 ys a r It as bee n accepted as complete. 440 -4613 (M)OICOM) W d0 o . One- and Two - Family Dwelling • Reference no.: , � I ,;� Building Permit Application Checklist Associated permits: City of Tigard City Of Tigard ❑ Electrical ❑ 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 I 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 1 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". 24 Two (2) sets each are required for Items 16, 19, 20 & 22 above. 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will be not 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. 2�8 Site plan to include tree size, type & location per approved project street tree plan (if applicable), and COT Street Tree List. `✓ 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 (6ro0icoM) i „ A Mechanical Permit Application Date received: e., 7// Permit no.:14V?,,,'�® i j i. 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 ❑ Sommercialindustrial ❑ Multi - family ❑ Tenant improvement ❑ New construction I WAddition/alteration/replacement ❑ Other: JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE Job address: (l gG.o SW t (3-1 to 91. 11 Crike.b , 0 re 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.: .# 70 O profit. Value $ . Lot: / , IBlock: I Subdivision: ,1l iTj .'. AZ0 /paid *See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City /county: WA' I ZIP: 97z 3 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE Description and location of work on A i f7ON 70 AND COMMERICALIINDUSTRIAL EQUIPMENT SCHEDULE F24� ^l E AA eAck Fee(ea.) Total Est. date of completion /inspection: Descrion Qty. Res. only Res. only _ Tenant improvement or change of use: HVAC: Is existing space heated or cononed? Yes ❑ No Air handling unit CFM I9 space insulated? `U Yes ❑ No Air conditioning (site plan required) Is existing P Alteration of existing HVAC system MECHANICAL CONTRACTOR Boiler /compressors Business name: D State boile permit no.: �� HP Tons BTU /H Address: Fire/smoke dampers /duct smoke detectors City: I State: I ZIP: Heat pump (site plan required) Phone: I Fax: I E -mail: Install/replace furnace/burner BTU /H CCB no.: Including ductwork/vent liner ❑ Yes ❑ No Install/replace/relocate heaters – suspended, City/metro lic. no.: wall, or floor mounted Name (please print): Vent for appliance other than furnace CONTACT PERSON Refrigeration: Absorption units BTU/H Name: MWj 3 tom?— Chillers HP Address: Compressors HP Environmental exhaust and ventilation: City: , I State: I ZIP: Appliance vent Phone: Fax: - E -mail: Dryer exhaust OWNER Hoods, Type U IUres. kitchen/hazmat hood fire suppression system Name: f � NR \LS 1,:yr Exhaust fan with single duct (bath fans) Mailing address: e • 0 . (3ox Z3 03, d p Exhaust system apart from heating or AC City: T 6-A RI) I State: Q) I ZIP: 97a/ - 034 Fmel piping and distribution (up to 4 outlets) Type: LPG NG Oil Phone: 6 - OJ 0 Fax: 6 P 0 10 E -mail: Fuel piping each additional over 4 outlets Process piping (schematic required) _ , Number of outlets Name: Other listed appliance or equipment: Address: Decorative fireplace City: I State: I ZIP: Insert – type Woodstove/pellet stove s Phone: I Fax E -mail: — / Other: Applicant's signature: ,e{,iti I Date: (77 2002 Other: Name (print): JVIq/QI ilbT Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ ❑ Visa ❑ MasterCard Notice: This permit application Minimum fee $ Credit card number: / i expires if a permit is not obtained Plan review (at %) $ Expires within 180 days after it has been State surc (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: PERMIT 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 ** Minimum Permit Fee $72.50 SUBTOTAL: $ 7) <3HP; absorb unit to 100K BTU 14.00 8% State Surcharge $ 8) 3-15 HP; absorb 25.60 unit 100k to 500k BTU 25% Plan Review Fee (of subtotal) $ 9) 15-30 HP; absorb 35.00 Required for ALL commercial permits only unit .5 1 mil BTU TOTAL COMMERCIAL PERMIT FEE: $ 10) 30 -50 HP; absorb 52.20 unit 1 -1.75 mil BTU 11) >50HP; absorb unit >1.75 mil BTU 87.20 ASSUMED VALUATIONS PER APPLIANCE: 12) Air handling unit to 10,000 CFM 10.00 Value Total 13) Air handling unit 10,000 CFM+ Description: Qty (Ea) Amount 17.20 Furnace to 100,000 BTU, including 955 14) Non - portable evaporate cooler ducts & vents 10.00 Furnace > 100,000 BTU including 1,170 15) Vent fan connected to a single duct ducts & vents 6.80 Floor furnace including vent 955 16) Ventilation system not included in Suspended heater, wall heater or 955 appliance permit 10.00 floor mounted heater 17) Hood served by mechanical exhaust Vent not included in applicance 445 10.00 permit 18) Domestic incinerators Repair units 805 17.40 < 3 hp; absorb. unit, 955 19) Commercial or industrial type incinerator to 100k BTU 69.95 3 -15 hp; absorb. unit, ' 1,700 20) Other units, including wood stoves 101 k to 500k BTU 10.00 15-30 hp; absorb. unit, 501k to 1 2,310 21) Gas piping one to four outlets mil. BTU 5.40 30 -50 hp; absorb. unit, 3,400 22) More than 4 -per outlet (each) 1 -1.75 mil. BTU 1.00 >50 hp; absorb. unit, 5,725 Minimum Permit Fee $72.50 SUBTOTAL: $ >1.75 mil. BTU Air handling unit to 10,000 cfm _ 656 8% State Surcharge $ Air handling unit >10,000 cfm 1,170 Non - portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to a single duct 446 Vent system not included in 656 - - appliance permit Hood served by mechanical exhaust 656 Other Inspections and Fees: 1. Inspections outside of normal business hours (minimum charge - two hours) Domestic incinerator 1,170 $62.50 per hour. Commercial or industrial incinerator 4,590 2. Inspections for which no fee is specifically indicated (minimum charge - half hour) Other unit, including wood stoves, 656 $62.50 per hour inserts, etc. 3. Additional plan review required by changes, additions or revisions to plans (minimum Gas piping 1 outlets 360 charge - one - half hour) $62.50 per hour Each additional outlet 63 * State Contractor Boiler Certification required for units >200k BTU. TOTAL COMMERCIAL $ ** Residential A/C requires site plan showing placement of unit. VALUATION: All New Commercial Buildings require 2 sets of plans. i :\dstslforms\mech- fees.doc 12/26/01 1 Electrical Permit Application Date received: 6) O� Permit no.: /f-% - 8 �A � n:.� � City of Tigard Project/appl. no.: Ai Waii date: City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: . , Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT Cl 1 & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction Addition /alteration/replacement ❑ Other: ❑ Partial JOB SITE INFORMATION Job address: 1■ g ZD 5W (i 314/ &t. i kt-a�, QQ Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: ) 3 I Block: (Subdivision: Mu trt_1E / S ADD, n oN Project name: 'Description and location of work on premises: App, jlo'V TO f ot/r 44c1 Estimated date of completion/inspection: pct.- A004 CONTRACTOR APPLICATION FEE SCHEDIII.E Job no: Fee Max Business name: OW Description Qty. (ea.) Total no. insp New residential - single or multi- family per Address: dwelling unit. Includes attached garage. City: 'State: 'ZIP: Serviceincluded: Phone: I Fax: 1E-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 Each manufactured home or modular dwelling Signature of supervising electrician (required) Date Service and/or feeder 2 Sup. elect. name (print): License no: Services or feeders - installation, alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name (print): l S 5(Nl lir 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: r . 0. 6o.x 2, D30.2? 601 amps to 1000 amps 2 City: T/ (rA ,e2) ,y I State: 0 R I ZIP: ?728/ `O3� Over 1000 amps or volts 2 Phone: 63? 903 (Fax: ?O p 04,70 E-mail: I 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: 200 amps or less 2 ORS 447, 455, 479, 670, 7 201 amps to 400 amps 2 Owner's signature: Date: 6 0 0 Z 401 to 600 amps 2 Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: 'State: I ZIP: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit: 2 Phone: Fax: 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 I I I I 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: I I 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 p Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total 4, Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 n Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 1 n Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular Dwelling Service or Feeder $90.90 2 ri 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 n Vacuum Systems 1 401 amps to 600 amps $160.60 2 n 601 amps to 1000 amps $240.60 2 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. 0 Audio and Stereo Systems Branch Circuits New, alteration or extension per panel n Boiler Controls a) The fee for branch circuits with purchase of service or n Clock Systems feeder fee. Each branch circuit $6.65 2 n Data Telecommunication Installation b) The fee for branch circuits without purchase of service n Fire Alarm Installation or feeder fee. First branch circuit $46.85 Each additional branch circuit $6.65 n HVAC Miscellaneous ❑ Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 El Each sign or outline lighting $53.40 Intercom and Paging Systems Signal circuit(s) or a limited energy panel, alteration or extension $75.00 n Landscape Irrigation Control Minor Labels (10) $125.00 Each additional inspection over ❑ Medical the allowable in any of the above Per inspection $62.50 ❑ Nurse Calls Per hour $62.50 In Plant $73.75 ❑ Outdoor Landscape Lighting* Fees: n Protective Signaling Enter total of above fees $ n 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 $ All New Commercial Buildings require 2 sets of plans. i:\dsts \forms \elc- fees.doc 08/30/01 Plumbing Permit Application Datereceived:(p 2 D ? Permit no. yr . e..1 �, , , 1 City of Tigard b "1 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 ❑ 1 & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction p�Addition /alteration/replacement ❑ Food service ❑ Other: JOB SITE INFORMATION FEE SCIIEDULE (for special information use checklist) Job address: ! I g.O Sw. I {'31-In pl . r GAS , 0e Description Qty. Fee(ea.) Total Bldg. no.: Suite no.: New 1- and 2- family dwellings only: Tax map /tax lot account no.: 700 (includes 100 ft. for each utility connection) , SFR (1) bath Lot: / 3 (Block: I Subdivision: /v/UTTL - EVS A,DD /77O,d SFR (2) bath Project name: SFR (3) bath City /county: TI6f CD/ H/ f} (ZIP: y' 7ZZ 3 Each additional bath/kitchen Description and location of work on premises: A.AA /77ON rQ Site utilities: aA-C1C Rrl) lvew eiv77e.1 Catch basin/area drain 2002- Drywells/leach line/trench drain C. Est. date of completion/inspection: DE PLUMBING CONTRACTOR Footing drain (no. lin. ft.) Manufactured home utilities Business name: 0 WA.Gl Manholes Address: Rain drain connector City: I State: I ZIP: Sanitary sewer (no. lin. ft.) Phone: I Fax: I E -mail: Storm sewer (no. lin. ft.) CCB no.: I Plumb. bus. reg. no: Water service (no. lin. ft.) City /metro lic. no.: Fixture or item: Contractor's representative signature: Absorption valve Back flow preventer Print name: Date: Backwater valve ,� Basins/lavatory Name: /'7AM1uS JM Clothes washer / Address: Dishwasher Drinking fountain(s) City: State: I ZIP: Ejectors/sump Phone: di: 3 659 ?a l° Fax: J o71 E -mail: in Wf4 0Sa (1) 4Th nWExpansion tank OWNER Fixture/sewer cap Floor drains/floor sinks/hub Name (print): / JA,4(Dr Garbage disposal Mailing address: p.0. (goy Z3 030 8 Hose bibb City: 77 G-A kC) I State: OR I ZIP: 9 7 Z 8/ -Wog Ice maker Phone: 44 3 -4 869V I Fax: ?6 Y3 4? 0 I E -mail: dM d44 u SQ 41 1;0. 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 =Chapter 447. Sink(s), basin(s), lays(s) Owner's signature: Date: 7 d 0 Z- Sump Tubs/shower /shower pan - Urinal Name: Water closet Address: Water heater City: I State: I ZIP: Other: Phone: I Fax: I E -mail: Total Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Minimum fee $ ❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $ Credit card number: / / State surcharge (8%) .... $ Expires within 180 days after it has been 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 3" 16.60 PLEASE COMPLETE: 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 Other Fixtures Water Service - each additional 200' 46.40 (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 - 62.50 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 2 sets of plans with isometric or riser diagram for plan review. is \dsts \forms \plm- fees.doc 12/26/01 . • Permit #: ill STr-XX7 .- —OO Qt Address: 1 1 V)-0 S\ l 1 r - Issued by: Date: 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: i i.p 1. I own, reside in, or will reside in the completed structure. ai 7 El 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. ,.. Ai 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. e 1.1.02.. (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 OR 701.055(5). f you 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 bean employer and the people you hire will be employees. As the employer, you must comply with the following: Oregon's withholding tax law: /\sun employer, you must withhold iucumetuxcs from employee wages u1 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 atq45'UOy\. 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 infonnation, call the Oregon Employment Department at 378-3524. W or k ers ! compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers compensation insurance for your employees. lfyou fail to obtain workers' compensation insurance, you may be subject topenaltiesand will be liable for all claim costs i[ one o[rour employees io injured nn1be job. For more information, call the Workers' Compensation Division at the Department of Consumer and BtisineSs Services at 945-7888. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service at 1'800-029-1040. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code compliance: &x the perm b holder for this project, ynuurcn:xponyih|cforocxo|viognnyfui|unctomcctcodercquiucmeo$ that may be brought to your attention through inspections. Liability and property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and om issions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be re-done. 'fime to supervise employees: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough-in and finish trades, and to notify building officials atthe appropriate times so they can perform the required inspections. If you have additional ques iuua write or call the Construction Contractors Board (P0 Box 14140, Salem, OR 97309-5052, 503/370-4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop-own.pm4 1194 CITY OF TIGARD v/1S1'?,4DoZ 0 o 2. BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 - 4175 ...4..14- .ii_.' INSPECTION WORKSHEET FOR DATE: 1 : 0 PAGE: jdp SITE ADDRESS: I I u ? 1 3" Pi....... CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: ,/� - (. � ) d U, r_ OWNER: V � vc .S 1 pl /� PHONE #: `T 3 " 1 !LL 1 CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message 1 6 I C s vitd. ri a ,,,L 46,a 6,0?0,0, c,..,4-...1 0 /0907 -0 / Pv orrections /Co ept IQstruc ons. QJ & • P D /4 ? ? — D / 2 - \ ‘6 t F ot.L___ () - 8ts,i -\, C ( rnv 6e (Z -,t. v"'E S Sly 3 k - CZ0o C ' (AL N S • 1 t C LI_ F4ct. PLAIN‘ pi i3 o i lam`, (- AL., -' o't Lbi 11 : P91.1g l't, sTeke it 4 ST:Eps Q (z..(L 1,--T b m .. (2j) yC 6,, 7 /, - 2- 6 A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G-- \ �+ �C) Date: n 10 Phone #: (503) 718- CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST – 0-0 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested AM PM BUP Location l ( ` 0 //3'" L Suite MEC Contact Person 7'k t'UfD h ( ) 4/ `/ 3 54P`‘ PLM Contractor Ph ( ) SWR UILDING Tenant/Owner ELC Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab In=n N to SIT Post & Beam � 14 (�� Shear Anchors Ext Sheath/Shear Int Sheath/Shear F -'i'n' nsulatio - ailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final A9 ART �� 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: 11 Unable to inspect — no access Fire Supply Line ADA r/A Approach/Sidewalk Date ll — C.' 4-- Inspector Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Lin 503) 639 -4175 MST) ) INSPECTION DIVISION Business LI . (503) 639 -4171 BUP Received Vi' 2 Date Requested �`f A M PM BUP Location 11 ' Suite MEC Contact Person /7.192,6 Ph ( J v -2 ) (C3 ����G�'`/ PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC ion F Drain Access: GS, Z? f �.. ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear / - / � Fr h/Shear r g o j/ ' 0 c / CU f(., Framinn 1 } Insulation Drywall Nailing L ' i ifOft. Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof ASS AIL Arr e o V Cry (. � PLUM �. i� ✓Cs,_ PLUMBING 0 J°Cai°T'g e V AC__ 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 ity Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: J Unable to inspect — no access Fire Supply Line ADA � Approach/Sidewalk Date c l—/ / a C Inspector 1 E Other: Final DO NOT REMOVE this Inspection ecord from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour - BUILDING Inspection Line: (503) 639 -4175 2 - er() Zscp INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received ` ! / ' ' Date Requested `- /( (//u ` / AM PM BUP Location 1/ F 2e /13 Suite MEC Contact Person Ph ( 6o L) p � J — Ga 5 PLM Contractor Ph ( ) SWR Tenant/Owner ELC Footing Foundation ELC Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear t Shear Sk0 %AIM. VALVE It-VE C AN NU FA C5 TbtnlAf Insuation SY'lO�►G-1R. ooh Drywall Nailing " Firewall E trn� tS `.'rr JL Rll\CX CONN. Rvjg.ts'C 1 tui.. IYIr Fire Sprinkler II II L Fire Alarm PkON) G R S5 v L`T 10A N V 0l?1 $tA A Susp'd Ceiling , Roof - • (�p tC£ �- W 1 AU) 5 W11 C i w 4 �w {111 V A . Other: g y -C4 Final l yvr �cA<b • Gb KU. CG --1 N• Vo - • 1 , We`k1 -• P .:■•• • • -T =4, ` � - C cam- MeisA �. 5 -ce4ow • LOMB � « • ��_. (�AM+� P� 5 l2vG V • � Post & Beam Under ?) 1MU cr � P c 1JoWt. t i� 1 \Di 051 a 1 ► '— ough -Ind I "ater Service Sanitary Sewer •- vp Lcit C Pr S � Caciz.F vattiZ3b. Rain Drains Catch Basin / Manhole W tr'" C V e t p.RO-, FC001.•-) Storm Drain Shower Pan Other: Final PASS PART FkIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL ice Roue I -In - 4 C- 111/4-4- * UG /Sla • Low V • ag - Fir- Alarm Fi al Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART F SITE ❑ Please call for reinspection RE: El Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Date " \ a _ 04 • 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 CP 2 - CJ� .- 2� INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received `� g f 2 ° Requested 2) /( 0/6 AM PM BUP Location 1 26 /13 Suite p MEC Contact Person Ph (6o &J r r G a PLM Contractor Ph ( ) SWR ,41111LDFNa Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear �1nt Sh- - Shear S up W aA. VALVE '- CANr\10 FA �� ` � b AJA1 anviWis Insulation SVko o , Drywall Nailing Firewall 2 ELTEM Ramo, CANN , tZMviith its7 (Y170L O i 1s.. Fire Sprinkler Fire Alarm p(ZO \ G R OSS V L.A� I O(� I N �w �Oy 6� spA A - Susp'd Ceiling ( I I _(� NIA) Roof y) PC \ rQ 1- g W / AID 5 VJI �l I 0 ` Q- AIA V A . Other: _ gy -C‘i Final 3 .N/1 ND\ Nod �4`b l ' 4.y% W�`\1- P T A PLUMB �VIZ.b.ric STRve;cv2ftl- - e hYr 1 A=0 - a5 Post & Beam - 7) \ ?) YY\ V i C' boWtJ $ Vas3Q \O s VI P2 lyN4 ► `- nder� � U out gh Ind iz Q .AOtJ - ba'‘ii ocsf. - \,-Pater Service Sanitary Sewer Rain Drains L2 C S� �F •, " �`j V�1 w h�J Catch Basin / Manhole alA, O • W b(iF- C v 8 � p Cn■•C=,) Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL ice Rou • 4-In D# t = 61/4A-- UG/Sla. Low V• ag- Fir- Alarm Fi al Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART F • SITE Please call for reinspection RE: 0 Unable to inspect - no access Fire Supply Line ADA nn ) Approach/Sidewalk Date - 1 0 04 - Inspector T C]n 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 &) ^0 MST �2 INSPECTION DIVISION - Business Line: (503) 639 - 4171 4 BUP Received J Date Requested w AM PM BUP Location / l Fab /13 / ,- Suite MEC Contact Person Ph ( ) 3 9, 90 S'? 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 1 Firewall Fire Sprinkler 4 , Fire Alarm Susp'd Ceiling j Roof .t /`j / `/ ,ilia iLi/ /��. /,/ AT Finhar: / �s.�, .� PASS PART FAIL P Pos eam Under Slab / Rou h -In� /� ater Se is ,,_ �— ✓� ` ��� / Sani ary ewer PP Ca c :assn / Manhole / Storm Drain / / / Shower Pan Other: Final PASS PART l eo ^ IIR C HANIC st & Bea, ougn -In Gas Line Smoke Dampers F'. S PART FAIL CTRICAL 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: E Unable to inspect – no access Fire Supply Line ADA '�j� 47 Approach/Sidewalk Date Inspector )� " 2 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 , ^ ()C) INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested 1# AM PM BUP Location ii Ea 6 l/ , , " Suite MEC Contact Person Ph ( ) 6 3 9, 90 SD 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 Ale Nailing Firewall W • / _ � / Fire Sprinkler - ' ��� ASINIWMIMrAAIMr " �/ Fire Alarm Susp'd Ceiling Roof /�� /�.�/ ,is/ �Li/ /��_ / . Other: / Final ', , L / _i /� Lam. _ / A PASS PART FAIL i `� Pos : :eam Under Slab Rou h In e7 / lir- / ,/ ater Se lc i ��� / A d Sanitary Sewer � I � , f �,` �, .., Ca c :assn / Manhole /,/ Storm Drain Shower Pan Other: Final PASS PART i f CHANIC 4. fri"ea gn Gas Line Smoke Dampers 10S PART FAIL CTRICAL 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 7 Inspector fr fr - 7 77 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 fy S — D 98 INSPECTION DIVISION Business Line: (503) 639 -4171 if c / Y BuP Received Date Requested [ 19 r I� PM BUP Location / ( 2 0 f f 3 PL- Suite �y/ I¢ MEC Contact Person Ph ( ) i f 4 1 3 — 't d PLM • Contractor Ph ( ) SWR Au1LD Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: j� i SIT st & Be L� Shear An chors � 4 ��� (_ _ , Ext Sheath/Shear ■ u ` ` U ' �!/ �Gvti Int Sheath/Shear Framing (� �' Insulation 1-Nr?"klAt-- `v' "'� J Drywall Nailing Firewall c -H U Fire Sprinkler Fire Alarm *IA ` A 4 (�' o f 4 (�, Susp'd Ceiling , 9 - _ A _ A , tr Roof Other: _ Final 4• 3---, 1 • 0 • PASS : ' RT FAIL ,� P, :1I 0, C r — AA , — Post &Beam C---- GlA / R < \— Rough -In ` _ S A C ' , Water Service \ LNG l/� Sanitary Sewer Ar 7 ( f - Rain Drains � Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS FAIL MECHANI 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 El Please call for reinspection RE: 0 Un o inspect — no access Fire ADASupply Line ro Approach/Sidewalk Date I nspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL BUILDING Inspection Line: (503) 639 -4175 1 S — g8 INSPECTION DIVISION 0 Business Line: (503) 639 - 4171 4 ; BUP c Received Date Requested / (9 e PM BUP Location / t g Z 0 / 1 3 - f Suite ` MEC Contact Person Ph ( ) 471. [ `f. 3 `it h ry(/ o� PLM Contractor ) Ph ( ) SWR UILDI Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain Crawl Drain ELR Slab Inspection Notes: SIT cost & Be. ' - r Shear • nchors WjLeit. A .- 011 \a. �s Ext Sheath/Shear � � 4 ` � r ,�� Int Sheath/Shear Framing Insulation 1- n ,1 ( i ne j W Drywall Nailing C A.41......., (� � Q Firewall Fire Sprinkler �!�� _ I• U ' _ ♦ _ Fire Alarm (. �1 A ,(( � �' A ( 4 ( e Susp'd Ceiling Roof /// A Vv Q , It / Other: - s f'�� Final ' 4. , 1._-, i PASS RT FAIL l /1 l."- l."- I - A. LUM 3.1 CA ) !' WatehSe S '� ( r ' ,_ d -C� r� \ Water Service k Sanitary Sewer ^\ Rain Drains l�' - - � s-.� LrM1S . Catch Basin / Manhole , Storm Drain Shower Pan Other: Final PASS 4 20 FAIL MECHANI • L 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 Li Please call for reinspection RE: 0 Un o inspect - no access Fire Supply Line / ADA / �!// , Approach/Sidewalk Date Inspector Eut Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OFTIGARD 24 -Hour �S ,,rrte�� 6 g BUILDING Inspection Line: (503) 639 -4175 MST — `'` o 8. INSPECTION DIVISION Business Line: (503) 639 -4171 g BP Received Date Requested a/� AM �/ PM BUP Location I / S 26 1/3 - ft- Suite MEC Contact Person Ph ( ) r 3 `7 8 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain c1 ELR Crawl Drain Slab Inspection Notes: SIT ost & e Shear Anchors Ext Sheath/Shear Int Sheath/Shear 6-� Q (./.2_:, F C_.4 raming 1 Insulation V 4.--k (5 , — ( �/� �� r " � Q � Drywall Nailing � `� _�" r Firewall Fire Sprinkler 6%\y,,, Fire Alalarm 0, \r'2_,-/* 0E QA ti -e-- f Susp'd Ceiling c ,�� , , l Roof 0 Q_ ., l S w- I y vPC.r N W C.-Of...)--e-f Other: Final , w PASS PART FAIL - A ( • PLUMBING .}= ,, ost Bea . � a -1 1 ��/"/ Gv---e '. �� v.,,,,,,,.., v..� o WOer Slab Rough -In . \ T , ' j I , „ c ,._ Water Service (� Q J' � � ���` W� > �O� Sanitary Sewer l /V -tA /' - Q Rain Drains 14/1.---% .4..-- Catch Basin / Manhole C, ,) ` • T .0 - $ / C �' ∎�/jV� 1(f Storm Drain �` _7 V�� „. Shower Pan t f _ ' r. / 0--r _ _ ' _AA , _ � t _ Other: Final a- `�., i �AM "! PASS 0 FAIL ECHANIC . i Post & Beam 5 ,. ( l _- I ✓ - _ o Rough -In Gas Line / cam- S Smoke Dampers Final 1 • ) < 4� -Pt -- X \ T C. o . 9'- \ fiA/ PASS 0 FAIL ELECTR _ _ L . / .. w Q \ T Service — . Rough -In iIiihill, i _ G - ; UG /Slab Low Voltage \.+- �1/ f c (,.2 a S 2 Fire Alarm \ J Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE El Please call for reinspection RE: ill Unable to inspect - no access Fire Supply Line � � f j Approach/Sidewalk Date tJ �� b Inspector Ext � �i Other: _ Final DO NOT REMOVE this Inspection record fr m the Job site. PASS PART FAIL - DV la a .T UL...4 -e CITY OFTIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 - a 4 *g INSPECTION DIVISION Business Line: (503) 639 -4171 O)nsT Ca Received Date Requested /�' A M BUP ��� PM BUP Location /7 3 6 X13 '- f t- Suite / MEC Contact Person Ph ( ) `7 3 V $'" PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT - ost &:ea ear Anchors Ext Sheath/Shear Int Framing Sheath/Shear 1 ^ � � f ) ( Y-2--- --e Framing �� X c / j Insulation _ — ,� QQ ` Drywall Nailing J " 6 Z �/In 9-� Firewall Fire Sprinkler Fire Alarm 6 \ 2 N t Q t._E f Susp'd Ceiling �-`� e Roof C Q l S 1 / 4 "- -- • 1 Vf W , r f Other: Final A . Vii + _ C: -/... " — PASS PART FAIL - , • PLUMBING `— t 1 tWider Bab Rough -In , _ . ‘...&,,,,,..„ ‘...&,,,,,..„ ‘...&,,,,,..„ ‘...&,,,,,..„ L .�. a 1 `'� 1 4 j '- Water Service J -� f� v `��`�` �""" Sanitary Sewer �, /A _ v i J`v l (� Rain Drains "_ --'� ' Catch Basin / Manhole 1 - L /s- C �� �I Storm Drain '1 Ya T R i As-g 7 ti "`"" " �— S Shower Pan ' -_. f 6--- _ ' I A • , _ � � � Other: Final 0_P ,i.t.N. \'?�1 S \ . PA R FAIL ECHANIC Post &Beam 5 i I ✓ i /� n � _ _ � c --0 Rough -In / �C c -w t Gas Line Smoke Dampers �N `� � -‘ A S Final rl ' ) < � - ,2 O C/ Cit/ PASS Cry FAIL ELECTR C ,�� - -„ Q,, \ STL- / Service Rough-In c .�c , ,Z ^ 5 / u (GJ 4-(---- UG/Slab C f ` �- 1 Low Voltage < �( ,L.2 as 2 �1 Fire Alarm 2 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 Date ? i� v v 0L1 Ext ?`f 4 Approach/Sidewalk ate I nspector Other: Final DO NOT REMOVE this inspection record fr m the job site. PASS PART FAIL - D ■ a 7 a_A 6....Q._ - CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST c-23 g INSPECTION DIVISION Business Line: (503) 639 - 4171 Q` BUP Received _ // t� Date Requested U 0 a AM PM BUP Location / / b Z 0 11 PL Suite C MEC I ► L Contact Person Ph ( LA) ) 3 / -�OSd PLM Contractor Ph ( ) 1 43 ` q 8 SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT -ost & B- Shear Anchors Ext Sheath/Shear Int Sheath/Shear u ) Framing cfiri7e i=- i , r 41 0 S LLE. Insulation Drywall Nailing NEEf9C APA2ow4 ez.. -7-c) r o 54 Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART PLUM ING Post & B 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: 111 Unable to inspect — no access Fire Supply Line ADA �/ 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 BUILDING Inspection Line: (503) 639 -4175 MST O�Z —GU 2. ge INSPECTION DIVISION Business Line: (503) 639 -4 BUP Received Date Requested �� Z 9 AM PM BUP Location // £ Z' -S /13 °• Suite MEC Contact Person Ph ( ) 3 f - f'' S" PLM Contractor Ph ( ) SWR Tenant/Owner i1 /,/ CAI( ELC ELC � Access: g F rain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Ci 4 - - p , ,. r AJf)'T n4S f141.L.� J % Tj /.u_:� Insulation ���� � Drywall Nailing 0.14 --/L. Firewall Fire Sprinkler ���� _ �.� A _> . Si Fire Alarm 501.cJ J Susp'd Ceiling Roof Other: Final PASS id, FAIL PLUMB 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 111 Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Date 7- Zvi -D '�_ 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 2 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested AM PM BUP Location ! 1 a oZ v // 3 V Pt_ Suite MEC Contact Person 414/1./..4Z s Ph ( ) ( o .39 — g 6S'4 PLM Contractor Ph ( ) 1 1"/ 3 / SWR BUILDING Tenant/Owner ELC noting ndatio ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath /Shear Framing r' Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final I I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE I Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Date 7 " -0 ? Inspector 1 :- /1 019 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 � aD o? - 6e) a 2 8 INSPECTI(SN DIVISION Business Line: (503) 639 -4171 P Received Date Requested // - AM q BUP Location / / 3 - 7-6 /13 ''L"- Pi-- Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner %lOuLULr � �t- ELC Footing y — 96 � ELC Foundation Access: U Ftg Drain ELR • Crawl Drain Slab Inspection Notes: SIT Post & Beam 1 � Shear Anchors lei p 1.11.---/./ ©0 A m Ext Sheath/Shear Int Sheath/Shear Framing Insulation d opt GU 772 . D 1 rywall Nailing Firewall Fire Sprinkler Fire Alarm S IL.. .4411.6444` Susp'd Ceiling Roof Qi Other: �`-� Final PASS ^PA IT FAIL FrA C _MB os & Beam 7 Under Slab U —^-/1 0. , Rough -In 1� Water Service 4 1 > C , Sanitary Sewer V Rain Drains / Catch Basin / Manhole / t� Storm Drain Q� � Shower Pan �/L/Cf % �i— ,, �—✓Z —P r L'L_ anal PASS PART MECHANICAL CO Post &Beam S 1-1-----, S .. ve : / . i _ / f' /, Rough VlJ - —� Gas Line f_ a.-1_-:.` Smoke Dampers Final /■ f e_e_eX vC PASS PART FAIL ELECTRICAL / C_ /-74 /-74 - c J e 4 Service 5 rf e Rough -In J� c��f' 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 \ V3 d 6 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 °20 � '� �� INSPECTION DIVISION Business Line: (503) 639 -4171 / BUP Received Date Requested ( L / ( AM PM BUP / Location / / h7)0 //3` ' pL. Suite MEC Contact Person Ph ( ) '/3- PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: � �-- 11/* SIT Post & Beam fi.t0.�i Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final 'ART FAIL PLUM Post & Beam Una -r Slab oug - �a - ervice Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Fi PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final 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 0/ 39 ADA Approach/Sidewalk Date ) / /0 " Inspector Ext Other: < Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL