Permit .
CITY O F TIGARD MASTER PERMIT
PERMIT #: MST2000 -00417
1Ii D E V ELOPMENT SERVICES DAT ISSUED: 10/02/2000
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12040 SW 119TH AVE PARCEL: 1S134CD -03000
SUBDIVISION: LERON HEIGHTS NO.3 ZONING: R -4.5
BLOCK: LOT: 058 JURISDICTION: TIG
REMARKS: 320 sq ft addition
BUILDING
REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 11 FIRST: 320 sf BASEMENT: sf LEFT: 15 SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT:
VALUE: $ 24,000.00
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 320.00 sf REAR: 47
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: 2 W00DSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp: 1 0 - 200 amp: W /SVC OR FDR: 1 PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 • 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp/volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL • RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 651.86
PLUNKETT, BRUCE A AND This permit is subject to the regulations contained in the
Tigard Municipal Code, State of OR. Specialty Codes and
JANICE E all other applicable laws. All work will be done in
12040 SW 119TH accordance with approved plans. This permit will expire if
TIGARD, OR 97223 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
Underfloor insulation Electrical Rough In Plumb Final
Footing Insp Crawl Drain /Backwater Framing lnsp Final inspection
Foundation lnsp Footing /Foundation Dr Rain drain Insp
Post/Beam Structural Mechanical Insp Electrical Final
Post/Beam Mechanical Electrical Service Mechanical Final
A
Issued By : /(12 E '-fr .. Permittee Signature :'J '
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the nex business day
II-^ nn 1 ' Plan Check #
I 'Y C7F TIGARD Resi --.J 1 �/ �� icati
13125 SW HALL BLVD. Recd By Date Rec'd g— 31-00
TIGARD, OR 97223 Sin! uplex) Date to P.E.
V 503-639-4171 & ........ _ Date to T 5 1 — / Z '" °
F 503 - 684 -7297 l Permit 2000 —00 Y/
Print or Type Called ? 0 0
Incomplete or illegible applications will not be accepted Z e
Name of Project Name
Job Z /vie' 7 4Z7 7-r / C44:1 ,T °�.> Agcy .
Architect M ilin Address
Address s i ddress o� 7-././ /_ / SE V5T
90 SLR / � / City /State Zip Phone
Name / 411444 0«7 97067 7 ?� �a
84c, 4 - I' 179 /102zzi Err Name
Owner Mailing Address y
City/State Zip Phon g
En ineer Mailing Address
7 t24 Ara air 91 ) -.7 5851r City/State Zip Phone
General Name
Contractor foG_ O /lo6.t- 60.+7/Xlen".1/G Describe work New 0 Addition i Alteration 0 Repair 0
Mailin Address to be done: /� �t
Prior to permit B// sy/PE $T Additional Description of Work:
issuance, a copy City/State Zip Phone ell / " Z) / �M i 7'G�y tQ�� N( ,r
of all licenses / qp pe9'�3 /77/� /
are required if Oregon Const. Cont. Board Exp. Date PROJECT -/`Q'°‘' expired in COT Lic. #� / � 2,..„.„." 7 3/_ o VALUATION T
database
Mechanical Name NEW CONSTRUCTION ONLY:
Sub- !iii w4'1''i2 ,4/ 6 Sq. Ft. House: Sq. Ft. Garage
Contractor Mailing Address 32' sf WEti/
Prior to permit Indicate the restricted energy installation by the electrical
issuance, a copy City/State Zip Phone subcontractor in the following areas
of all licenses Restricted Audio /Stereo
are required if Oregon Const. Cont. Board Exp. Date Energy System Alarms
expired in COT Lic.# Installations Vacuum Irrigation
database System System
Plumbing Name (check all that Other:
Sub- �rcl ,V/v/99 /7Lfj 21v6 apply)
Contractor Mailing Address / Corner Lot YES 110 Flag Lot YES y
(check one) /� (check one)
Has the Subdivision Plat recorded? p YES NO
Prior to permit City /State Zip Phone b
issuance, a copy
of all licenses are Oregon Const. Cont. Board Exp. pate/
required if Lic.# U/
expired in COT 4 7 / 7// 7 6 ( I hearby acknowledge that I have read this application, that the
database Plumbing Lic. # Exp. D ate information given is correct, that I am the owner or authorized agent
/ of the owner, and that plans submitted are in compliance with
`.////°/ Oregon State laws.
Name Signatur .. •wner /Agent Date
Electrical J1 �rGerAe14 7 it. .../,•■ , S 3/ -a e
Sub- Mailing Address C• :-:ct • -r�so? Name Phone #
? TOorG
Contractor ENf '77 //?
City /State Zip Phone
Prior to permit
issuance, a copy FOR OFFICE USE ONLY:
of all licenses are Oregon Const. Cont. Board Exp. Date Plat #: Map/TL #:
required if Lic.#
expired in COT
database Electrical Lic. # Exp. Date Setbacks: Zone: Solar:
Electrical Supervisor Lic. # Exp. Date Engineering Approval: Planning Approval: TIF:
is \fists \forms\sfaddalt.doc 11/20/98
Oregon Construction Contractors Board » License Details Page 1 of 1
OREGON CONTRACTOR BOARDS
Query Details
Details on Oregon License: 111221
NAME: SOLID ROCK CONTRACTING CO
ADDRESS: 6611 SW PINE ST TIGARD OR 97223 -0000
WORK PHONE NUMBER: 503 - 977 -1687
LICENSE STATUS: Active ENTITY TYPE: Corporation
EXPIRATION DATE: 7/31/2002 LICENSE CATEGORY: General Contractor /All
DATE FIRST LICENSED: 1/27/1996 EMPLOYER STATUS: NON - EXEMPT
BOND COMPANY: FINANCIAL PACIFIC INSURANCE COMPANY: ZURICH INS CO
INSURANCE COMPANY
BOND AMOUNT: $15,000 INSURANCE AMOUNT: $1,000,000
BOND EFFECTIVE TO: 7/31/2002 INSURANCE CANCEL DATE: 10/6/2001
View Bond History View Insurance History
View X- Reference
View Claims History Licenses
View Associated Names View SIC Codes
QUERY MENU
CCB HOME
Send mail to Web Administrator with questions or comments about this web site.
Last modified: October 07, 2000
oreplWa
State of Oregon Liability Statement
http: // ccbed. ccb .state.or.us /Bill /regno222.asp 10/9/00
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
WHITE LIGHTNING ELECTRIC CO.
1101 NE 133RD CIRCLE
VANCOUVER, WA 98685
Electrical Signature Form
Permit #: MST2000 -00417
Date Issued: 10/02/2000
Parcel: 1 S134CD -03000
Site Address: 12040 SW 119TH AVE
Subdivision: LERON HEIGHTS NO.3
Block: Lot: 058
Jurisdiction: TIG
Zoning: R
Remarks: 320 sq ft addition
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
PLUNKETT, BRUCE A AND WHITE LIGHTNING ELECTRIC CO.
JANICE E 1101 NE 133RD CIRCLE
12040 SW 119TH VANCOUVER, WA 98685
TIGARD, OR 97223
Phone Phone #: 360 571 - 9611
Reg #: Lic 132683
ELE 37 -817C
SUP 4475S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of Supervi g Electrician
If you have any questions, please call (503) 639 -4171, ext. # 310
Not). 28 ' 88 8:32 FAX P.
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
KENT'S PLUMBING
1702 DIKE RD
WOODLAND, WA 98674
Plumbing Signature Form
Permit #: MST2000.00417
Date Issued: 10/2/00
Parcel: 13134CD -03000
Site Address: 12040 SW 119TH AVE
Subdivision: LERON HEIGHTS NO.3
Block: Lot: 058
Jurisdiction: TIG
Zoning: R-4.5
Remarks: 320 sq ft addition
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the
plumbing permit to be valid, please have the appropriate individual from your company sign below and return
this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept.
•
No plumbing Inspections will be authorized until this completed form Is received
•
OWNER: PLUMBING CONTRACTOR:
PLUNKETT, BRUCE A AND KENT'S PLUMBING 0,
JANICE E 1702 DIKE RD
12040 SW 119TH WOODLAND, WA 98674
TIGARD, OR 97223
Phone #: Phone #: 360- 225.5761 •
Reg #: LIC 131442 i.
i r_M 37.451PB
•
AN INK SIGNATURE IS REQUIRED ON THIS FORM
rA •
Signature of Authorized Plumber
w.w
r you have any questions, please call (503) 639 -4171, ext. # 310
r
•
Q.,--,
CITY OF TIGARD BUILDING INSPECTION DIVISION Msr Z Gv 97
24 ;pour Lpspection Line: 639 -4175 Business Line: 639 -4171
BUP s
Date Requested / — V AM PM BLD
Location / ZZO 4 1 0 5 tf-' // 47,.( Suite MEC
Contact Person LC ilv Ph X3 6,- y 7 yo PLM
Contractor / a Ph SWR
SWR
UI
BLDI ,0.--' Tenant/Owner A/plod 4 TI 4 // ELC
eta Wall NO at t /f R( 'i 9 J? , ELR
Footing Access: Loy I l1 L .J'a� Foundation S
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab / SIT
Post & Beam ' ..*
Ext Sheath /Shear e ;W ) .2\ ;7X1\111/4 \
Int Sheath /Shear > / y r -i� z16 ' f• I 1 1(-' l�' (
Framing 3-'
Insulation
Drywall Nailing
Firewall _ - - --
Fire Sprinkler Y f
Fire Alarm
Susp'd Ceiling
Roof C � -- / a L i b ` .
Misc: LJ
11141:14 PART FAIL
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Ra' Drains
ina
PART FAIL
NI GAb
Post & Beam
Rough In
Gas Line
Smoke Dampers
PASS PART FAIL
CTRIC
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
•r&H.1> PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA ��
Approach /Sidewalk
/c Date at /1 Lf � �j Inspector E xt
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST � Y7
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested // AM PM BLD
Location / Z v </ 0 sw of. . /kv ( Suite MEC
Contact Person Ph 505 -9P e/740) PLM
Contractor Ph SWR
Tenant/Owner rad AgA.T 1 / J ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Dmin
u wild
• all Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
S ART FAIL
PL ING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspe ion. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: 4 [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date /� 2 f) — G ` ° Inspector i Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION T iG -6 ' 6 ' 1 /(7
124- Ffpfur Inspection Line: 639 -4175 Business Line: 639 -4171
Bup
� ,.
Date Requested ii / p AM PM BLD
Location / 1 ' U Sw //P * Suite MEC
Contact Person Ph ,5 4, c/7y PLM
r
Contractor Ph SWR
4 = 1 ILDI ci. Tenant/Owne I G . - A., : , d "/ 4 vc% ELC
etaining Wall ELR
Footing
Foundation Access: �� FPS
Ftg Drain 4,1:-.2.-4,1:-.24,1:-.2.--- SGN
plly Crawl Drain Inspection Notes:
Slab SIT
o Post & Beam
Ext Sheath /Shear
Int Sheath /Shear i ' ` C �� � s 6 . U-A- vv%
nsulation � , �
Drywall Nailing J2-- L� � ? * Co t ,
Firewall
Fire Sprinkler
Fire Alarm ?ii �p _
Susp'd Ceiling , a 4 uj i , p misc: Final [
PASS PART FAIL 1 � _p_, (�(� � _ 6 `"L_
PLUMBING U UV/�1 (.1 5 Q. \ .
' � Post & Beam
, star CD 0 N OT (- \() c lz U Lam — r
p1 J Top Out
Water Service d k/0 L/ j i G) .
tv Sanitary Sewer
6v Rain Drains g r, s S l _ 6 -� 1 1 �� Final i;j41 1 1 ) . . �,'
PASS PART FAIL j 1 1 . , x. -✓L� "�Y
MECHANICAL 4 s 1 • 1 -- ( x \ S 'r 'I ej z • _
' ough In
Gas Line ti 0�J J `_ v `S k.4■^
Smoke Dampers i ) 2 ( 2 l.7.6 i \ +c --4 .A.._ . \ --- Nr •■tiyfs
Fi � -
I PASS PART FAIL `, C - .
ICAL ii
p Service I• l 'GA_ C 0 -- C •-2.t R--,.:- _ ON S T5
011V 1.
UG S ab 6 1...--vi _ A Tl 1
6-��L.4.--..._ Low Voltage c
Fire Alarm �_ �� 1 v ��S �^^ C\ ( � �U <T �� > ' (�
F PASS PART V F 1 A AI IL A VV) Q C Lt - J Nr - z-e- Ai' i` � � ` 4—
sITE
Backfill/Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA I
Approach /Sidewalk lsc Lr D
Other Date , \ I nspector t v Ext t
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24/UG
'2 FLcSknspection Line: 639 -4175 Business Line: 639 -4171 •
BUP_
Date Requested 1/ / AM PM BLD
Location / 2-0 qv .S w // 6t 41 ✓-( Suite MEC
Contact Person Ph 1t / V? 4/ 0 PLM
Contractor / Ph SWR
BUILDING Tenant/Owner Nee d 4 CcJ/ ,4/J / h ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing '
Firewall i
Fire Sprinkler �
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
Service
ou hln
G /Slab
Low Voltage
Fire Alarm
ART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Otheoach /Sidewalk Date / I Inspector D_, ∎ E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
L
• CITY OF TIGARD BUILDING INSPECTION DIVISION MST rib' -GD /
..24 -r Inspection Line: 639 -4175 Business Line: 639-41
N b B • .
Date Requested /— / ( I AM P I BLD
Location /10 c v $ k✓ rl e4 h� 1 Suite MEC
Contact Person / L- 1/1/7 Ph ? C(7 ci 0 PLM
Contractor Z , -(- e_ 77‘ ,� y Ph SWR
BUILDING Tenant/Owner 77` Ccd. " *. e7 ELC
Retaining Wall Z T y I ^ • ELR
Footing Access: /
Foundation FPS
Ftg Drain / S T � — /K 4'' e 'at' — / ( , SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation 1
Drywall Nailing --Q-__
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
—
ECT
rCfl
UG /Slab
Low Voltage
Fire Alarm
Fina
S /PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ]Unable to inspect - no access
ADA
Opheoach /Sidewalk Date 1 / / Inspector Ext
Final `_
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST Gv l 7
24- 1.torr Inspection Line: 639 -4175 Business Line: 639 -417f .
Date Requested 1/— So AM v PM BLD
Location /2,19 U 5 C-/ //f A .o Suite MEC
Contact Person L- (IYY`, Ph 5 ' c(74 D PLM
Contractor Ph SWR
BUILDING Tenant/Owner Gv/ /Jrize ' 6 ryta./ / sl■ ELC
Retaining Wall Gam— /6 c // `J d U5 ELR
Footing Access:
Foundation / FPS
Ftg Drain f'► ® / i pm SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam /
Ext Sheath /Shear l !� L — Ata- •�I e.r / c — // 9
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final �)
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
E TR
ervi fry? �ftit
bough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site
' CITY OF TIGARD BUILDING INSPEC • k D • ► MST ZP Nr7
2t -I-10 r Inspection Line: 639 -4175 = - s Line: 639 -4171 -
Date Requested / AM P ► / BLD ►W
Location /2:00 GC) //4 4 - 1/ Suite MEC
•
Contact Person Ph 4, 3 '1bg 1 -/7V" PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Ace /j
Foundation /_ /J / y,/" d21 6 / 7"1 q C PE . FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab k- ( e. t/ l e / J 4-
SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
Post & Beam
Under Slab
Water Service
Sanitary Sewer
• -'ns
*• RT FAIL
ICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ) Please call for reinspection RE: [ ] Unable to inspect - no access
ADA // 72C141
Approach /Sidewalk
Other Date U lspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
'` CITY OF TIGARD BUILDING INSPECTION DIVISION
MST 2 41/ 7
24 -Hour Inspection Line: 639 -4175 Business Line: 6394171•
Date „Requested /6-A, AM PM BLD
•
Location /Z0 4 ( 0 - /7! 4. Suite MEC
Contact Person Ph 0 q7 Y e PLM
Contractor Ph SWR • C B ' Tenant/Owner ELC
' aining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
os
Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
PASS PART F IL
BING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for einspection RE: [ ] Unable to inspect - no access
ADA Y1
Approach /Sidewalk Date Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
- " CLT`Y OF TIGARD BUILDING INSPECTION DIVISION - n
s r .g-�U 4/17 /
24 -Ifiout Inspection Line: 639 -4175 Business Line: 639 -4171 BUP
2 ,•
l�
Date Requested /b - AM PM BLD
Location /2-C) v 5 'vi/t' Suite MEC
Contact Person L4 rr�j Ph �if Y7c/U PLM
Contractor / Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
I -
•ost & Beam
Under Slab
Top Out
Water Service
is Sewe
ain Drai V_
Final
SS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service _
Rough In
UG /Slab
1 Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA '-
Approach /Sidewalk O U ~ c ,; r 71 5
Other
Date 1 0 3/ Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MsvG Ga w 7'
l4kHo Inspection Line: 6394175 Business Line: 639417 • •
/�
BUP
Date Requested /� — / � � AM /$ // / PM BLD
Location / Z Q tU 5 11 1 Suite MEC
Contact Person Ph f' YU PLM
Contractor Ph SWR
OUILDIN Tenant/Owner ELC
Retaining Wall ELR
Footing 3
Foundation Access FPS
Ftg Drain SGN
awl Drain Inspection Notes:
a SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear /
Framing ()1 I lit/VV‘ Lj f
Insulation �,
Drywall Nailing i V � 4 k,c c f
Firewall
Fire Sprinkler
Fire Alarm �} 1 _ S ,
Susp'd Ceiling -�
Roof
Misc:
Fin (� ��� - � • • T FAIL 41-
UMBI
Post & Beam
Under Slab �� \-4—A L3/4
Top Out
Water Service `f • •
' Sewer 1(B
Final
PASS PART AI ,e }� t. S -,i� -� 1✓��
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA /J
Ext
Approach /Sidewalk Date I DI k Z Inspector 6 �'' (�
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
_
CITY OF TIGARD BUILDING INSPECTION DIVISION ' �'
o (� =GU
24- HotfrJnspection Line: 639 -4175 Business Line: 639 -4171 •
/SLIP •
Date Requested / b " ) AM(JO PM BLD
Location / 7_& ci 0 5 w /19 Suite MEC • '
Contact Person Ph 70•G 3 civ PLM
Contractor Ph SWR
4 = UILD Tenant/Owner ELC
- - - •.'ng Wall ELR
4 oot' • Access:
oundati • 744 � / 7 FPS
Crawl Drain Inspection otes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Ina Sheath/Shear
th /Shear
Framing �i( ' ' //� _ lU0 C '
Insulation
Drywall Nailing t
Fire Sp I ■ ' o- _� Cam ^�� '- \ _
Fire Sprinkler �� l_/`� \ d✓��..
Fire Alarm ' - cc,_
�� i
Susp'd Ceiling \ f.... _
Roof _ 1 f
Misc: V U MP- 47,t � p /�•
Final
PASS PART FAIL
PLUM: ,
Post & Beam
A g ?'re -- A-- - \ Under Slab / c}.� �` ( \- )
Top Out
Water Service
Sanitary Sewer '3 .
Rain Drains "IA
Final I S�
PASS PART FAIL
MECHANICAL •
Post & Beam U...2'. rs
Rough �
Gaa Li
Gas Line
Smoke Dampers
Final
PASS PART FAIL
Susp'd Cei QI N Q_JA/J: � �
Service r ' ' `
A ZJ
Rough b In rr'vv _ n '
UG /Slab �/�/7 �/ —'�.-
Low Voltage
Fire Alarm
Final
P , SS P ___ FAIL
4SlT " P ali
: ackfi ll /Grading S' 4
Sanitary Sewer
Storm Drain � ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
,
Catch Basin
Fire Supply Lin: [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA �� 2
A. • oach S�dew/alk� Date D I nspector v v ` Ext J 1 9
inal
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
' ` CITY QF TIGARD BUILDING INSPECTION DIVISION
'?4 -Ho " rmnspection Line: 639 -4175 Business Line: 639 -4171 , ,
MSTvv -- rJ - yi 7
SUP
Date Requested / d 7 AM PM BLD
Location / 20 1 C) 5 (.✓ /l f` 4 /5 Suite MEC
Contact Person 7 17n Ph 70 - U PLM
Contractor Ph SWR
UIL� Tenant/Owner ELC
Retaining Wall ELR
°' ' ' Access:
FPS
4g r
SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing / 'T
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART 0 01,
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA // ,7
Approach /Sidewalk Date ` ° 6 v Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
MST L Master Permit
Inspection Description Date Passed By Notes
Grading
Footing /Setback -
Foundation walls
Slab
Footing drain
Waterproof basement walls
Plumbing underslab
Crawl drain /d // L /U tz '
Post/beam plumbing ti I / ` - /Oo 'f'1- t
Post/beam mechanical G/ o c,l ;z,
Underfloor insulation
Post/beam structural /b // Ce
Shear walls /anchors
Exterior sheathing
Plumbing top -out /< — / -/b0 / r/
Gas line & test •
Mechanical rough -in i (/i t, /c
Electrical rough -in / / - / S - crL) eto
Electrical service / / - / q- cri) Ce
Low voltage
Sprinkler rough -in
Backflow preventer
Roof nailing
Firewall
Framing 11-2c -ao
MFG -Home set -up
Insulation / / -Zo - oo
Drywall nailing
Masonry/Reinforcement
Rain drain / ) - / 3 -v
Sanitary sewer
Water service
Pump /fill septic tank
Approach /sidewalk
Grading final
Mechanical final
Plumbing final
Electrical final
Final inspection / 7S /-
Special Reports
SWR - Sewer Permit
Inspection Description Date Passed By Notes
Sanitary sewer
Final inspection
INSPECTION RECORD — MST (MASTER) PERMITS
•
1 r
l r
\ C r ry o 1 TIGARD
MASTER PERMIT
PERMIT #: MST2000 -00417
DEVELOPMENT SERVICES DATE ISSUED: 10/02/2000
1 u 1312.5 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12040 SW 119TH AVE PARCEL: 1S134CD -03000
SUBDIVISION: LERON HEIGHTS NO.3 ZONING: R -4.5
BLOCK: LOT: 058 JURISDICTION: TIG
• REMARKS: 320 so ft addition
BUILDING
REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 11 FIRST: 320 sf BASEMENT: sf LEFT: 15 SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT:
VALUE: $ 24,000.00
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 320.00 sf REAR: 47
PLUMBING _
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GrEASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: 2 WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT _ SERVICE FEEDER TEMP SRVC /FEEDERS _ BRANCH CIRCUITS — MISCELLANEOUS _ ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp: 1 0 • 200 amp: W /SVC OR FDR: 1 PUMP /IRRIGATION: PER INSPECTION:
EA ADD'l 500SF: 201 - 400 amp: 201 • 400 amp: 1st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 • 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps•1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SFC 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 /IPRIG: PROTECTIVE SIGNL:
GARAGE OPENER: •LOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Contractor: TOTAL FEES: $ 651.86
Owner: This permit is subject to the regulations contained in the
PLUNKETT, BRUCE AAND Tigard Municipal Code, State of OR. Specialty Codes and
JANICE E all other applicable laws. All work will be done in
12040 SW 119TH accordance with approved plans. 'this permit will expire if 4
TIGARD, OR 97223 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 O
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Underfloor insulation Electrical Rough In Plumb Final Niiiplb
Footing Insp Crawl Drain /Backwater Framing Insp Final inspection I
Foundation Insp Footing /Foundation Dr< Rain drain Insp
Post/Beam Structural Mechanical Insp Electrical Final
ill
Post/Beam Mechanical Electrical Service Mechanical Final
Issued By : /1�% % �' 'l�/� Permittee Signature : � �� -
— 11114111 kN oto
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
N