Permit 41
CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2000 -00504
IP DEVELOPMENT SERVICES DATE ISSUED: 12/11/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 13411 SW 129TH AVE PARCEL: 2S104DA -04100
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5
BLOCK: LOT: 027 JURISDICTION: TIG
REMARKS: S/F PATH 1
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,720 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,743 sf GARAGE: 650 sf FRONT: 21 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: sf RIGHT: 14
VALUE: $ 315,286.00
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3,463.00 sf REAR: 39
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: 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: 1
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: 1 PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 6 201 • 400 amp: 201 • 400 amp: 1st W/O SVC /FDR: 00 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: $ 4,911.93
This permit is subject to the regulations contained in the
BRIAN MATTEONI BROOKFIELD DEVELOPMENT INC
Tigard Municipal Code, State of OR. Specialty Codes and
P.O. BOX 3468 5335 SW MEADOW ROAD all other applicable laws. All work will be done in
SARATOGA, CA 95070 SUITE 365 accordance with approved plans. This permit will expire if
LAKE OSWEGO, OR 97035 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 #: LIC 132229 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
Erosion Control lnsp 8 Post/Beam Mechanical Mechanical lnsp Framing lnsp Gas Fireplace Electrical Final
Sewer Inspection Underfloor insulation Mechanical lnsp Shear Wall Insp Insulation lnsp Mechanical Final
Footing lnsp Crawl Drain /Backwater Plumb Top Out Exterior Sheathing Insl Rain drain Insp Plumb Final
Foundation Insp Footing /Foundation Drs Electrical Service Low Voltage Water Line lnsp Final inspection
Post/Beam Structural PLM /Underfloor Electrical Rough In Gas Line lnsp Appr /Sdwlk lnsp Building Final
Issued By : TC ,yt r Permittee Signature :. ■
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
, - _ . Zero - i d3Sz
Building Permit Application
Date received: • Permit no.:/ 15T o DO - "IV q
,, City of Tigard
City of Tigard
Address: 13125 SW Hall Blvd, Tigard, OR 97223 Project/appl. no.: Expire date:
Phone: (503) 639 - 4171 Date issued: By: Receipt no.:
Fax: (503) 598 - 1960 Case file no.: Payment type: 11
Land use approval: 1 &2 family: Simple Complex:
TYPE OF PERMIT QQ
CI & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family New construction ❑ Demolition d
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION A
Job address: 3 ,/ /.. - / ,- /-e Bldg. no.: Suite no.:
Lot: Block: Subdivision: .. ..� Q!.� ax map /tax lot/account no.:
Project name: AA _, f a ��
Description and location of work on premises/special conditions:
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
(Floodplain, septic capacity, solar, etc.)
Mailing address: . o ,‘e,_ 1 I & 2 family dwelling:
11311 State: C ZIP: O e, Valuation of work $:315 23(
Phone: Fax: E -mail: No. of bedrooms/baths V _
Owner's representative: Total number of floors 7
' one: is P4 Fax: E -mail: New dwelling area (sq. ft.) 2 c"`i ..7
APPLICANT Garage /carport area (sq. ft.) 4—c-
IMMIIIIIMME Covered porch area (sq. ft.) / ' _
Mailin address: Deck area (sq. ft.) C
M State: ZIP: Other structure area (sq. ft.) o
Phone: Fax: E -mail: Commercial/industriaUmulti- family:
CONTRACTOR Valuation of work $
Business name: '' Existing bldg. area (sq. ft.)
,i „� �� / . New bldg. area (sq. ft.)
Address: ° i
Number of stories
Phone: ' , Type of construction
��� Occupancy group(s): Existing:
CCB no.: / 2 -'
New:
City /metro lic. no.: /1./' _ Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
MM 9 provisions of ORS 701 and may be required to be licensed in the
Address: t? Q 4 e - - t� /
jurisdiction where work is being performed. If the applicant is
f, -•'' — _ .JL exempt from licensing, the following reason applies:
Ean ZIP: -i
Contact person: ..• y Plan no.:
Phone: 5' e _ E -mail:
ENGINEER
Elar j r Affigair Contact person: ' A gal Fees due upon application $
A, ' : MI M /Wl1 iid Date received:
=Mr , - A , 6 State: at ZIP: el t e9 Amount received $
Phone: 6.57 -- f : ZINO= 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, whether pecified herein or not. Credit card number: / /
Expires
Authorized signature ! G/ /F' , Date: �� Name of c ardholder as shown on credit card
sf�l�
Print name: e-� ' Cardholder signature $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (M)0/COM)
One- and Two - Family Dwelling
• • • • ' •
"01— Building Permit Application Checklist Reference no.:
Associated permits:
City ofTigard 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
1 Land use actions completed. See jurisdiction criteria for concurrent reviews.
2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc.
3 Verification of approved plat/lot.
4 Fire district approval required.
5 Septic system permit or authorization for remodel. Existing system capacity
6 Sewer permit.
7 Water district approval.
8 Soils report. Must carry original applicable stamp and signature on file or with application.
9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of
catch -basin protection, etc.
10 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 x
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 X
over 10 feet long and/or any beam/joist carrying a non - uniform load.
20 Manufactured floor /roof truss design details. 1�
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required t `
for four or more appliances. j�
22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or
architect licensed in Oregon and shall be shown to be applicable to the project under review.
JURISDICTIONAL SPECIFICS
23 Five (5) site plans are required for Item 11 above.
24
25
26
27
28
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 440 -4614 (6/00 /COM)
Mechanical Permit Application
Date received: Permit no.:
�'�i City of Tigard • _„ ty g Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 - 4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement
fNew construction ❑ Addition/alteration/replacement ❑ Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: / , f! / 4.. 7 � 7, / .� _��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.: profit. Value $ •
Lot: 2 7 (Block: I Subdivision: aadi,'� ��� *See checklist for important application information and
Project name: �l /�erl/ ,�QJt✓
jurisdiction's fee schedule for residential permit fee.
City /county: 77, e rr� ZIP: 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and 15cation of work on premises: AND COMMERICAL /INDUSTRIAL EQUIPMENT SCHEDULE
Fee(ea.) Total
Est. date of completion/inspection: Description Qty. Res. only Res.only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? ❑ Yes ❑ No Air handling unit CFM
g p Air conditioning (site plan required)
Is existing space insulated? ❑ Yes ❑ No Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
/ State boiler permit no.:
Business name:
Sri z.- to'.2 ..� HP Tons BTU /H
Address: Fire/smoke dampers/duct smoke detectors
City: I State: I ZIP: Heat pump (site plan required)
Phone: /°4 jyy j 7-- E - mail: Install/replace furnace/burner BTU /H
Including ductwork/vent liner ❑ Yes ❑ No
CCB no.: 5 T ! / 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: 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 II/res. kitchen/hazmat
hood fire suppression system
Name: Exhaust fan with single duct (bath fans)
Mailing address: Exhaust system apart from heating or AC
City: I State: I ZIP: Fuel piping and distribution (up to 4 outlets)
Type: LPG NG Oil
Phone: Fax: 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
Phone: 1 Fax: I E -mail: Woodstove/pelletstove
Other:
Applicant's signature: I Date: Other:
Name (print):
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $
❑ Visa CI MasterCard Notice: This permit application Minimum fee $
expires if a permit is not obtained Pl review i _ %
Credit card number: / � (at %) $
Expires within 180 days after it has been State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete. TOTAL $
Cardholder signature Amount 440 -4617 (6/00 /COM)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: FEE: Description: Price Total
$1.00 to $5,000.00 Minimum fee $72.50 Table 1A Mechanical Code Qty (Ea) Amt
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and 1) Furnace to 100,000 BTU
$1.52 for each additional $100.00 or including ducts & vents 14.00
fraction thereof, to and including 2) Furnace 100,000 BTU+
$10,000.00. including ducts & vents 17.40
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and 3) Floor Furnace
$1.54 for each additional $100.00 or including vent 14.00
fraction thereof, to and including 4) Suspended heater, wall heater
$25,000.00. or floor mounted heater 14.00
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and 5) Vent not included in appliance permit
$1.45 for each additional $100.00 or 6.80
fraction thereof, to and including 6) Repair units
$50,000.00. 12.15
$50,001.00 and up $742.00 for the first $50,000.00 and Check all that apply: Boiler Heat Air
$1.20 for each additional $100.00 or For items 7 -11, see or Pump Cond
fraction thereof. footnotes below. Comp **
7) <3HP;absorb unit
to 100K BTU 14.00
ASSUMED VALUATIONS PER APPLIANCE: 8) 3 -15 HP; absorb
Value Total unit 100k to 500k BTU 25.60
Description: Qty (Ea) Amount 9) 15 -30 HP; absorb
Furnace to 100,000 BTU, including 955 unit .5 -1 mil BTU 35.00
ducts & vents 10) 30 -50 HP; absorb
Furnace > 100,000 BTU including 1,170 unit 1 -1.75 mil BTU 52.20
ducts & vents 11) >50HP: absorb
Floor furnace including vent 955 unit >1.75 mil BTU 87.20
Suspended heater, wall heater or 955 12) Air handling unit to 10,000 CFM
floor mounted heater 10.00
Vent not included in applicance 445 13) Air handling unit 10,000 CFM+
permit 17.20
Repair units 805 14) Non - portable evaporate cooler
< 3 hp; absorb. unit, 955 10.00
to 100k BTU 15) Vent fan connected to a single duct
3 -15 hp; absorb. unit, 1,700 6.80
101k to 500k BTU 16) Ventilation system not included in
15 -30 hp; absorb. unit, 501k to 1 2,310 appliance permit 10.00
mil. BTU 17) Hood served by mechanical exhaust
30 -50 hp; absorb. unit, 3,400 10.00
1 -1.75 mil. BTU .
18) Domestic incinerators
>50 hp; absorb. unit, 5,725 17.40
Air >1.75
handling mil. BTU 19) Commercial or industrial type incinerator
Air handling unit to 10,000 cfm 656 69.95
Air handling unit >10,000 cfm 1,170 20) Other units, including wood stoves
Non - portable evaporate cooler 656 10.00
Vent fan connected to a single duct 446 21) Gas piping one to four outlets
Vent system not included in 656 5.40
appliance permit 22) More than 4 -per outlet (each)
Hood served by mechanical exhaust 656 1.00
Domestic incinerator 1,170 Minimum Permit Fee $72.50 SUBTOTAL: $
Commercial or industrial incinerator 4,590
Other unit, including wood stoves, 656 8% State Surcharge $
inserts, etc.
Gas piping 1-4 outlets 360 25% Plan Review Fee (of subtotal) $
Each additional outlet 63 Required for ALL commercial permits only
TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE: $
VALUATION:
Other Inspections and Fees:
1. Inspections outside of normal business hours (minimum charge -two hours)
$72.50 per hour.
2. Inspections for which no fee is specifically indicated (minimum charge -half hour)
$72.50 per hour
3. Additional plan review required by changes, additions or revisions to plans (minimum
charge -one -half hour) $72.50 per hour
* State Contractor Boiler Certification required for units >200k BTU.
"Residential A/C requires site plan showing placement of unit.
is \dsts \forms\mech- fees.doc 10/11/00
• A Plumbing Permit Application
Date received: Permit no.:
g, . , City g
Cit of Tigard •� � "J 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 Cl Multi - family ❑ Tenant improvement
V New construction ❑ Addition/alteration/replacement ❑ Food service ❑ Other:
JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist)
Job address: ii c/6/ /2 y' f ,,,,l/e, Description Qty. Fee(ea.) Total
Bldg. no.: I Suite no.: New 1- and 2- family dwellings only:
Tax map /tax lot/account no.: (SFR ( 1 )1 ba .for each utility connection)
Lot: 2 7 I Block: I Subdivision: aVa0 "/ . e2z/SFR (2) bath
Project name: q ‘40/7 ,4 4 re ,/� ' SFR (3) bath
City /county: 770 I ZIP: Each additional bath/kitchen
Description and location of work on premises: Siteutilities:
Catch basin/area drain
Est. date of completion/inspection: Drywells/leach line/trench drain
PLUMBING CONTRACTOR Footing drain (no. lin. ft.)
Manufactured home utilities
Business name: �� ' . .�'A' , / r-e'C,- Manholes
Address: Rain drain connector
City: I State: I ZIP: Sanitary sewer (no. lin. ft.)
Phone:6' ?. (79I Fax: I E -mail: Storm sewer (no. lin. ft.)
CCB no.: 9i' f7 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
CONTACT PERSON Basins/lavatory
Name: Clothes washer
Address: Dishwasher
Drinking fountain(s)
City: I State: I ZIP: Ejectors/sump
Phone: Fax: E -mail: Expansion tank
Fixture/sewer cap
Floor drains/floor sinks/hub
Name (print): Garbage disposal
Mailing address: Hose bibb
City: I State: I ZIP: Ice maker
Phone: I Fax: 1E-mail: Interceptor /grease trap
Owner installation/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain (commercial)
employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s)
Owner's signature: Date: Sump
ENGINEER 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. Minimum fee $
Notice: This permit application Plan review (at _ %) $
expires it is not obtained
❑ Visa ❑ Plan / / res if a permit State surcharge (8 %) .... $
Credit card number: within 180 days after it has been TOTAL OTAL $
Name of cardholder as shown on credit card accepted as complete.
$
Cardholder signature Amount 440 -4616 (6/00/COM)
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2- family dwellings only:
FIXTURES (individual) QTY (ea) AMOUNT (includes all plumbing fixtures in PRICE TOTAL
Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT
Lavatory 16.60 for each utility connection)
One (1) bath $249.20
Tub or Tub /Shower Comb. 16.60 Two (2) bath $350.00
Shower Only 16.60 Three (3) bath $399.00
Water Closet 16.60 SUBTOTAL
Urinal 16.60 8% STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25% OF SUBTOTAL
Garbage Disposal 16.60 TOTAL
Laundry Tray 16.60
Washing Machine 16.60
Floor Drain/Floor Sink 2" 16.60 PLEASE COMPLETE:
3" 16.60
4" 16.60
Water Heater 0 conversion 0 like kind 16.60 Quantity by Work Performed
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
permit. Capped
MFG Home New Water Service 46.40 Sink
MFG Home New San /Storm Sewer 46.40 Lavatory
•
Tub or Tub /Shower
Hose Bibs 16.60 Combination
Roof Drains 16.60 Shower Only
Drinking Fountain 16.60 Water Closet
Urinal
Other Fixtures (Specify) 16.60 Dishwasher
Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain /Sink: 2"
Sewer - 1st 100' 55.00 3 „
Sewer - each additional 100' 46.40 4"
Water Service - 1st 100' 55.00 Water Heater
Water Service - each additional 200' 46.40 Other Fixtures
(Specify)
Storm & Rain Drain - 1st 100' 55.00
Storm & Rain Drain - each additional 100' 46.40
Commercial Back Flow Prevention Device 46.40
Residential Backflow Prevention Device* 27.55
-
Catch Basin 16.60
Inspection of Existing Plumbing or Specially 72.50
Requested Inspections per/hr COMMENTS REGARDING ABOVE:
Rain Drain, single family dwelling 65.25
Grease Traps 16.60
QUANTITY TOTAL
Isometric or riser diagram is required if
Quantity Total is > 9
*SUBTOTAL
8% STATE SURCHARGE
* *PLAN REVIEW 25% OF SUBTOTAL
Required only if fixture qty. total is > 9
TOTAL $
* Minimum permit fee is $72.50 + 8% state surcharge, except Residential Backflow
Prevention Device, which is $36.25 + 8% state surcharge.
* * All New Commercial Buildings require plans with isometric or riser diagram and
plan review.
is \dsts \forms \plm- fees.doc 10/10/00
Electrical Permit Application
A,.
Date received: Permit no.:
,7,L1 dill City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW W Hall Blvd, Tigard, O 972 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement
0 New construction ❑ Addition/alteration/replacement ❑ Other: Cl Partial
JOB SITE INFORMATION
Job address: y / /Z 9 „i Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: ,Z, I Block: 'Subdivision: 4 r,/ lei !'
Project name: 4569,, /�� I Description and location of work on premises:
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: Fee Max
Business name: E 'lt.c -fi/ - l 7' 2� /,/,L f � �� Description Qty. (ea.) Total no. insp
Address: New residential - single or multi - family pe
dwelling unit. Includes attached garage.
City: I State: I ZIP: Service included:
Phone: 706"—.0:22 VI Fax: I E -mail: 1000 sq. ft. or less 4
CCB no.: 66 V/Z I Elec. bus. lic. no: • Each additional 500 sq. ft. or portion thereof
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): 201 amps to 400 amps 2
Mailing address: 401 amps to 600 amps 2
601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only i
Owner installation: The installation is being made on property I on Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
Name: or extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
Phone: Fax: E-mail: of service or feeder fee, first branch circuit: 2
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 signor outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or extension* r 2
0 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
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card
$
Cardholder signature Amount
440-4615 (6/00/COM)
Electrical Permit Fees: Limited Energy Fees:
•
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
/� Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total
Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular
Dwelling Service or Feeder $90.90 2 n Garage Door Opener*
Services or Feeders n 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*
401 amps to 600 amps $160.60 2
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. n 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 ❑ 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
or feeder fee. Fire Alarm Installation
First branch circuit $46.85
Each additional branch circuit $6.65 ❑ HVAC
Miscellaneous n Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40
Each sign or outline lighting $53.40 n Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 ❑ Landscape Irrigation Control
Minor Labels (10) $125.00
Each additional inspection over ❑ Medical
the allowable in any of the above ❑
Per inspection $62.50 Nurse Calls
Per hour $62.50
In Plant $73.75 n Outdoor Landscape Lighting
Fees: ❑ 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 $
1:\dsts\fomu\elc- fees.doc 10/09/00
J8/04/00 14:29 PACIFIC NW TITLE -0 5032547542 t' 1U . 2 L.
CITY OF TIGARD
Credit No.: 3
A'
Date Issued: June 8, 2000
Engineering
'' Authorization
r'
Date: June 8, 2000
TRAFFIC IMPACT FEE
CREDIT VOUCHER Land Use
Casefile No.: 97- 517 -PD/ /DMA
In accordance with Ordinance 379 Cypress Ventures
(name of dMp.� lo �•�
is entitled to $ 292,24.1 in Traffic Impact Fee Credits that can be applied to TIF
FAvr .64.64.4 r
charges for development on lot(s) all of the Quail Hollow' WEST Developments. To use
this credit, present this form at the time of issuance of the building permit.
Q .;.1-. e. ai.�...-... - .._.._
okicill
Date Permit Numbers Lot Numbers Credit Used Balance 1
Beginning Balance $ 292.254.91
Balance carried forward to TIF Credit No.
• Ordinance 379 provides for an expiration 7 years from authorization.
Use Additional pages if necessary.
iopirw.ola \tifoB I
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
NORTH STAR PLUMBING
1445 SE OREGON ST
SHERWOOD, OR 97140
Plumbing Signature Form
Permit #: MST2000 -00504
Date Issued: 12/11/00
Parcel: 2 S 104DA -04100
Site Address: 13411 SW 129TH AVE
Subdivision: QUAIL HOLLOW - WEST
Block: Lot: 027
Jurisdiction: TIG
Zoning: R -4.5
Remarks: S/F PATH 1
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:
BRIAN MATTEONI NORTH STAR PLUMBING
P.O. BOX 3468 1445 SE OREGON ST
SARA 1 OGA, '.JM trout SHERVVC,0D, LIr 97140
Phone #: Phone #: 625 -2679
Reg #: IC 00090697
PI M 34 -255PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
reti:/)
Signature of Authorized Plumber
If you have any questions, please call (503) 639 -4171, ext. # 310
Electrical Innov., Inc. 503 - 632 -6564 p.2
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
ELECTRICAL INNOVATIONS
22300 S LEWELLEN RD
BEAVERCREEK, OR 97004 -8733
Electrical Signature Form
Permit #: MST2000 -00504
Date Issued: 12/11/00
Parcel: 2S 104DA -04100
Site Address: 13411 SW 129TH AVE
Subdivision: QUAIL HOLLOW - WEST
Block: Lot: 027
Jurisdiction; TIG
Zoning: R-4.5
Remarks: S/F PATH 1
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:
BRIAN MATTEON( ELECTRICAL INNOVATIONS
P.O. BOX 3468 22300 S LEWELLEN RD
SARATOGA, CA 95070 BEAVERCREEK, OR 97004 -8733
Phone #: Phone #: No business phone
Reg #: E 26
LIC LE 000664 12
SLIP 3621S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
25/ _
Signature of pervis ni g Electrician
If you have any questions, please call (503) 639 -4171, ext. # 310
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• (PLE PRINT) (PERMIT HOLDE
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• Do hereby certify that the following location ■
• meets City of Tigard /Washington County ■
• land use and development standards for street tree installation. •
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• • ADDRESS: �7 ' // /i9 ,.5-e
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• • LOT: 2 7 S UBDIVISION: e?GeOr / ` ��s.) G� i ► •
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STREET TREE. CERTIFICATION
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(PLEASE PRINT) (PERMIT HOLDER)
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DO HEREBY CERTIFY THAT THE FOLLOWING LOCATION MEETS
WASHINGTON COUNTY LAND USE AND DEVELOPMENT STANDARDS FOR
STREET TREE INSTALLATION.
DDRESS: /5.1Z/
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LOT: SUBDIVISION: 1�� /„ / /7 )' , f
DATE: /4 O/
SIGNATURE
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RECEIVED BY:
DATE: /U - 3
SIGNATU+ E
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CITY OF TIGARD BUILDING INSPECTION DIVISION
MST oete do-6 4/
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested /() AM PM BLD
Location 1 .1 'f / 1, 9 /?-z' Suite MEC
Contact Person c`31 Ph ,--lO J 370 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
� S PART FAIL
P NG
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
A S PART FAIL
ICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date p Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST , 6 ( J'SOy
. 24 -Hour Inspection Line: 63, 175 Business Line: 639-4
BUP
Date Requested > / --4 AM PM BLD
Location / -a 91/ l D-7 � 4 Suite MEC
Contact Person Ph 76 9 6 3 9U 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 A 'a4C,I -a w C\t_ 1 N t DK1
Insulation w j
Drywall Nailing Ch S\??z �'C.7�t1 R -r E c ) j W j' LZcicidL
Firewall
Fire Sprinkler 410 " t i� 11..1 . 1" - ./ 27115..I A - a
Fire Alarm s J
Susp'd Ceiling rt ' v iz0 10 'az 1tg" I Pit - f2r30
Roof
Misc:`� ��ZdV t 1► �_
final
ASS PART AIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
•ke Dampers
`
PASS PART AIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date )0 2 - c Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD RIJILDING INSPECTION DIVISInN MST 0-51-6 (
24 -Hour` Inspection Line: 9-4175 Business Line: 61 ..171
"� BUP
Date Requested 7 - AM PM BLD
Location / 3 / / Sr.-) /2,7 t / .w' Suite MEC
Contact Person Ph 96/ 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 Do ' ArO % ,2) r t"/
PASS PART FAIL
-PLUMBING / 0 ryiFrE /Al iT
Post & Beam
Under Slab
Top Out
Water Service • rEt-- o GA. -T-E /IA
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL 4It ///.517-(( t,o f o /106 p p F'
MECHANICAL
Post & Beam —w E /'L- f o, L-0 7',
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS 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
a pproach ewa c Date 4 7 L— / a- vy
Inspector `/1/cv7 Ext Q7
, Final
PASS PART DO NOT REMOVE this inspection record from the job site.
5i .
• CITY OF TIGARD RIJILDING INSPECTION DIVISInN MST OD "'
24 -Hour Inspection Line: 3-4175 Business Line: 63. A71
BUP
Date _ Requested 3- if AM PM ) BLD
Location /3 (/ l / S w /Z- Suite MEC
Contact Person Ph � Y ..3 9/ PLM
Contractor ``3 - StZ SWR
Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation C!� C � . FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int S eath /Shear
ins
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
PPART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call or reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date . \ Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection re ord from the job site.
' CITY OF TIGARD `Pr 1ILDING INSPECTION DIVISInN MST 2t tib v ° `(
24 -Hour' Inspection Line: 3-4175 Business Line: 63. ,171
BUP
Date Requested 3 °/ f AM PM BLD
Location / c/ /2.4-6144.,e Suite MEC
Contact Person Ph � f - &3'/ PLM
Contractor Ph SWR
Tenant/Owner ELC
Retaining Wall ELR
Footing Access: FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab 11 119C> )7'4 SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
S E 9
Insulation
Drywall Nailing <Zs ` gla, r !_ 1111, -
Fire Sp 1
Fire Sprinkler I 4
Fire Alarm
Susp'd Ceiling
Roof AN )Tt C�7 '*..(I`)
Misc:
Final
PASS PART FAI - � �=- �' A � ti■ _ t O
PLUMBING —v V 3A` ,�
Post & Beam -J
Under Slab �j P Rwn
Top Out
Water Service i5 Gyinr2A
Sanitary Sewer
Rain Drains !, _ 1.4* A & L
Final
PASS PART FAIL 7■LS3G� • V.3 ►' !
MECHANICAL 11.1 S
Post & Beam
Rough In ?1:5S-T '1)
Gas Line
Finale Dampers 40 11\1 -51
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 f reinspection RE: 4 [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection ecord from the job site.
u� •
+ CITY OF TIGARD RVILDING INSPECTION DIVISIn MST �
24-Hour Inspection Line: 9 -4175 Business Line: 63 ,171
BUP
Date,Requested / � AM PM BLD
Location /3 y // S w Suite MEC
Contact Person Ph 3 y ) 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
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
o C HA a
Smoke Dampers 3 41 — P C: 18 .
F '
PA PART FAIL
E' ECTRICAL
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 Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA / I
Other oach /Sidewalk Date P\ Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY. OF TIGARD P' JILDING INSPECTION DIVISInN MST -6 ci
24 -Hour Inspection Line: 9 -4175 Business Line: 63 :171
BUP
• Date Requested ,3-- / AM PM BLD
Location / ,3 l / w /2 &I Suite MEC
Contact Person Ph j 6 f G; PLM
Contractor Ph SWR
CSWL DDLe ) Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
2_.. _
' near
eath /S e
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
'�i ja- PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
P FAIL
. CHANI - . L
P eam
Rough In
Gas Line
Smoke Dampers
Fi
PA,V PART FAIL
E CTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date ` Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspectio record from the job site.
CITY, OF TIGARD PVILDING INSPECTION DIVISInN MST , r�o trv
24 -Hour Inspection Line: ,9 -4175 Business Line: 6:. ,171
BUP
Date Requested 2-- 2 7 AM PM BLD
/ 3 «//s
Location Li/ /2-f G
Suite MEC
Contact Person Ph 9 � / -Of PLM
Contractor Ph SWR
Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Shea /She
Int Sheath/ hear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling 1 i ■r;
Roof
Misc:
# 1 ; 1 ; .-
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
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date Inspector
Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site
}CI 1( OF TIGARD . JILDING INSPECTION DIVIS J •
MST d - c/
- 4lou r Inspection Line: 639 -4175 Business Line: 639 -4171
f "----5 BUP
- Date' Requested AM PM B LD A ��� •
Location /2 Suite MEC `II►
Contact Person Ph 19 - 4 f 3 PLM
Contractor Ph SWR
�BUILDiRI� Tenant/Owner ELC
Retaining Wall ELR
Footing
Access:
Foundation
FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab
SIT
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc_
F1na1
PAS PART FAIL
ost & e
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
F'
PASS PART FAIL
ANI
Rough In
Gas Line
Smoke Dampers _
Final - '=
ART FAIL -
I CA L , - ;-
Service .
Rough.ln
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 0/C0 Approach/Sidewalk Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY-Of TIGARD RVILDING INSPECTION DIVISInN MST IUGSU
24 -Hour Inspection Line: ,9 -4175 Business Line: 6;. 471
� BUP
Date Requested / Z / `( AM �/ PM BLD
Location / I 1 11 S w /2.y Suite MEC
Contact Person / Jo-P Ph 361 OZ, PLM
Contractor Ph SWR
iLp1NG Tenant/Owner ELC
Retaining Wall ELR
Foun Access:
R FPS
ut- /2 /? kah
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing ' / c /7 4 -7 - 11.1
Insulation
Drywall Nailing ') `reS144 o it � ALL So " h? RTr/Lr 4L (P-Z e o 2) -r
Firewall
Fire Sprinkler Cc:vac/n =7a
Fire Alarm
Susp'd Ceiling 1 L..c_ i4 #c /-/,,< - 6o2 .5" 9 AS 51.4w
Roof
Misc: rt - 7,ciE T>7 G'aL c-c/e4T1 16/C. ("0w r'G7
Fi
PART FAIL t-'r0`'"4_ ' Z
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: [ ] Unabie to inspect - no access
ADA
Approach /Sidewalk
Other Date l ad Inspector A Ext
Final •
PASS PART FAIL DO NOT REMOVE this inspection record from the job si a.
'6 •
ICY OF TIGARD Pi JILDING INSPECTION DI
24 -Hour Inspection Line: ,9 -4175 Bus iness L ir>� e: :. X 171
BUP
Date Requested 1 3 AM PM BLD
Location / 3 S Lsi / 2- �J 6 'L "2 Suite MEG
Contact Person Ph 3a7 D Z 3 7 PLM
Contractor Ph SWR
=
ILDIND Tenant/Owner ELC
Retaining Wall ` ELR
Footing Access:
owns. ion• Aei 7/ A �/ I FPS
g Drain �y'-�` /�i f/V ✓� SGN
Crawl Drain Inspection tes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: \C"\
Final
PASS PART AI
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
P - •:T FAIL
IT;1 " r
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
AD;A
A • • roach /Sidewalk - / \ �` t_ et
'grv5p, 0.rosv,,„ Date ) 2/ 3/6 Inspector Ext
Final
PANS PART FAIL DO NOT REMOVE this inspection record from the job site.
•
•
•
' CITY OF TIGARD RUILDING INSPECTION DIVISION Msr 2O0) erd '
24 -Hout Inspection Line 39 -4175 Business Line: 6 4171
BUP
Date Requested ? —/ 3 AM PM BLD
Location / 3 L l j Ia9 Suite / MEC
Contact Person 1)Q_ j— --- Ph �o 9 — cP tic)? 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
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
PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk t
I
Date / w / Inspector Other Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD RIJILDING INSPECTION DIVISInN MST - 02)50
24- Inspection Line: 9 -4175 Business Line: 63 ,171
BUP
Date Requested - ( / AM PM BLD
Location /. 5 «/1 S r„- / 7 b( 4 U-e Suite MEC
Contact Person Ph 7,‘f- 3 f 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 � Y VI C' t'
Roof t 9' r l t � QSS
Misc: Cj
Final D L) I
PASS PART FAIL Q /
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
I :Rot L
I •ww Volt ag-
F'
PASS ART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date ,? _� � — ( Inspector i∎ /„ . A / A E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIOARD PI 1ILDING INSPECTION DIVISI( a vrvi
9- co ,S6
24 -How Inspection Line: 3 -4175 Business Line: 635 X 71
BUP
Date Date Requested D 13 AM PM 1 Z gLD
Location - 3 9 ( ( l D Suite MEC
Contact Person D Q Ph 9 9 L Q 7 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 �i��
Ina Sheath /Shear i�1J
Framing . � � � � � L—
Insulation
Drywall Nailing ?fie �� r
Firewall
Fire Sprinkler �, '_ — f " .�
Fire Alarm
Susp'd Ceiling
Roof I C/� S k..A.rGd LA
Misc: �/�;
Final
PASS PART FAIL
PLUMBING
Post & Beam �1
Under Slab V
4‘‘
Top Out
Water Service -
Sanitary Sewer � �'
Rain Drains SLi iV�� ' l '
AS PART FAIL vim,/ c ,Q \ S T C
NICAL
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
S PP Y
ADA
Approach /Sidewalk g(\'3( ( (?
Other
Date In spector J C ✓� Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
Z Wit
t ITY OF TIGARD PIJILDING INSPECTION DIVISIr'N - MST 00 :GV 5 b c/
24 -Hour Inspection Line: ,9 -4175 Business Line: 63;. .171 ''
BUP
Date Requested .�� 3 ) AM PM BLD
Location / 3 '(// S `- /21 Suite. MEC
Contact Person Ph f �/ 4 3' / PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing
Foundation Access: VAC _ \9 - — 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
PART FAIL
Post & Beam
Under Slab a �✓zi..
Top Out
Water Service P
Sanitary Sewer
Rain Drains
a
SS PART FAIL
ANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA /— /
Approach /Sidewalk Date r ' I nspector 7,1/1 � `� f V '� , Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITYpF - 4 INSPECTION DIV N / - *Mir _,0
• 24 -Hour Inspection Line: ,9 -4175 Business Lin . 6 1 UU �,
BUP
Date Requested - I f AM PM BLD
Location /. 3 '/ // S 4✓ / 24 e Suite MEC
Contact Person Ph [(f c 91 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ft SGN
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
.
Under Slab 1
op Out
ani ary ewe
O)4/Rain Drains
O d Z PART 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
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
Othe
Date 1001 oach /Sidewalk Inspector Ex
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
•
• ' CITY OF T'I'GARD WILDING INSPECTION DIVISIr`l nnsr A-- ®.t
24 -Hour Inspection Line: -4175 Business Line: 639--g7
` BUP
Date Requested S° AM PM BLD
Location / 3 9'// ,5 i I2 9' i/!/' ' Suite MEC
Contact Person Ph 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
Ina Sheath /Shear
Framing
C4,1_1/ ci r3; "`- C f C ,3 Q
Insulation
Drywall Nailing
Firewall
Fire Sprinkler ( w . Z- e- / , ,.�c!'� r r r1 T - 'ss_ ... Z.491 c/, e n
Fire Alarm
Susp'd Ceiling
Roof l. .r i .•-� St_.,ti✓i c .� / f "7-25 7
Misc:
Final
PASS PART FAIL
PLUMBING
P ost & Bea
Under Drab -
C Water Se 4 x/1/4 F SlYI cevi " (b/ .5
Sanitary Sewer /J
Rain Drains �f �irJ7 PC-/� �
Final ` / f / r
PASS PART FAIL ffbe 41 ` ry 4Q Ceccd , Gt
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date 3 — / 2) / I nspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspectio - ord from the job site.
CITY OF TIGARD B INSPECTION DIVISIO" ? j 7 .60 - 6
• 24:-Hour Inspection Line: L ,-4175 Business Line: 639..11
BUP
/L` Date Requested (D � AM PM BLD
Location 1 -3 „(( ) t \ 2J Suite MEC
Contact Person Ph 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 , /� - h
Framing V �J �XJ '"--
Insulation 0000 3 0
Drywall Nailing
Firewall - 6
Fire Sprinkler
Fire Alarm ,g-
Susp'd Ceiling
Roof
Misc:
Final
PART FAIL
Post & Beam
Under Slab
Top Out
er Service
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 /1 1 \�/'
Otheoach /Sidewalk Date - 3 I \ (o / U ` Inspector ” v Ext (9
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
- . , _
' CITY OF TIGARD RIJILDING INSPECTION DIVISIr'N . . ,,
2'4- Hourinspection Line: 9 -4175 Business Line: 63. ,171
BUP
/a
(lI/Q Date Requested - V16 AM PM BLD
Location /3 lif <a) (77 Suite MEC
Contact Person ,L'C- Ph `6 3q( PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Inspection Notes:
SIT
Post & Beam
Ext Sheath /Shear -
Int Sheath /Shear ii •�
Framing ' / W
Insulation ` 0
Drywall Nailing (/V\ 4 Ak cN �, _
Firewall
Fire Sprinkler ■ L-� A '-- - -
Fire Alarm , / ` - / C
Susp'd Ceiling I ' T --zJ
Roof r
Misc:
Anal i VV•- LIA( "`�� 1 5 S� i Q dl
PASS • _ RT /al
a+I ' 1 9-�w� ` mi. nd /`
� � b�` ► : L.-4- 1
` ani a ewer
, Rain Drains A- • 6 65 4- f ' L 64 -•ti 6.�
Anal PASS PART in VI- . �. , MIMI/
MEC B NI n CAL — C--- get c?-- kkic � ) t ', WY:
Rough In ei) .kr l/► 3...e- E_cE)--: t > G as Line /
Smoke Dampers Iv c. ` e��,� ,� •
Final / ' I
PASS PART FAIL �••✓l. `�, rvv-y/L
ELECTRICAL
Service o_ L W r- r U.��J‘
Rough In t 1 . �/. 5 I „ `
UG /Slab
(..t �..r.�.. IJUr.I fit}
Low Voltage
Fire Alarm C) tL / . k vir 1 - AL1C
Anal
PASS PART FAIL -17 U' �/ `r"lj`f era'
SITE //+ i
�0. I � 1 � J
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 - 3 14' 01 Inspector Y Ext J l (
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
•
CITY OF TIGAR,D'PU.ILDING INSPECTION DIVISI ^N .
' C 00-i) �U, U 50 of
24 -Hour Inspection Line: .9 -4175 Business Line: 63_ ,171
r BUP
Date ,Requested .5 -- / ) AM PM BLD
Location / 3 ` f ll S 12-4 v-P Suite MEC
Contact Person Ph '4,i- 9 / PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ft. Drain SGN
Inspection Notes:
SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear l (�
Framing 1 ` i
D ywal Insulation g 0 /� � � `' 5 �t c"f-
D all Nailin
Firewall
Fire Sprinkler .
Fire Alarm
Susp'd Ceiling -
Roof
1 I /
MSC: r) 1 ' n f �J ( , \ 1• / ..—r v
Final i
PASS PART FAIL I . - I '_ �'
. C'�"Nr
i II CI
I -•
� p: Water Service - 1A.A.. S' �K - L.: Q l
Sanitary Sewer e...-.7. r fi
1
�� � RRain Drains ' e- •
Final
PASS PART A
MECHANICAL ; - � S 6A/ll. t ,
Post & Beam 0>
Rough In V r
Gas Line (A
Smoke Dampers d4 W V — 6V ` /
Final
PASS PART FAIL _
ELECTRICAL
' `-� .. 1
Rough 2,15 Service �
4
b I'J�
UG /Slab J
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 3 ` S O l Inspector � � Cr. )2 - Ext? ? ( {
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
4
• • ',CITY OF TIGARD RUILDING INSPECTION DIVISI ^N qq p
M ST l�Gd _G 'j
7 -Hour Inspection Line: .9 -4175 Business Line: 63_ +171
BUP �1
• Date' Requested / AM PM BLD
Location /3 4/t/ Ski /24 Suite MEC �
Contact Person Ph p -'3 P 3 PLM
Contractor Ph SWR
BUILD Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Find
PAS PART FAIL
R1jd'li:11 fir►
- ost : :e.
n . er Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
F'•
PASS PART FAIL
Rough In
Gas Line
Smoke Dampers
Final
• • ART FAIL
`` M MAL
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 Oth /Sidewalk Date 0/Cle,
Inspector E -
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
J
. CITY OF TIGARD P' 1ILDING INSPECTION DIVISI''N
• MST Ze -- 661 . . .5G (-r'
24- HourInspection Line: .9 -4175 Business Line: 63a _•171
BUP
Date Requested /7-- Z AM PM BLD '
Location /3 ( // S w /2 ' e'AL." Suite MEC
Contact Person Ph 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 ,"7
Drywall Nailing
Firewall --
Fire Sprinkler
Fire Alarm II p...1 /_�
Susp'd Ceiling J
Roof f
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam ,>
Under Slab / ` _ -
T•p_Qut
ater Se. • . �,�.-
,.r- Nk sr-
Final
PASS ; PART" FAIL
MECH
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
'r ..� ,.� e
MST - Master Permit eiooe -o S o
J Inspection Description Date Passed By N tes
Grading
Footing /Setback iz - -ao
Foundation walls 1Z -14_ oo
Slab
Footing drain -
Waterproof basement walls
Plumbing underslab
Crawl drain 3 (.ort t 7 �� Cl�7 ` -'"`�
_ Q
Post/beam plumbing 4)/ ? j 1-? 1 (-✓ L.t."S C -6 /0
Post/beam mechanical / f —Of
Underfloor insulation -
Post/beam structural
Shear walls /anchors 2 1-)IZA
Exterior sheathing /a
Plumbing top -out 3/ 1 415
Gas line Sc. test 419 t 3V •
Mechanical rough -in 14lo TAP
Electrical rough -in 3 -1- p /
Electrical service 2 ""/ - ° /
Low voltage 3_/ - a/ g//'/
Sprinkler rough -in
Backflow preventer
Roof nailing
Firewall ;�
Framing `/ ` O/ 0 k
MFG -Home set -up -
Insulation ,-g/ .. -
Drywall nailing - 0( -e- °x—A
Masonry/Reinforcement -
Rain drain /
Sanitary sewer (i>
Water service *1. Q -' 3 ro- l.tn-S it r
Pump /fill septic tank
Approach /sidewalk / / ill
final
Mechanical final 10th{ o� T'4.6
Plumbing finals l l 3/ > d 4
Electrical final ?- 3- s
Final inspection 1 o (�q /p
Special Reports
SWR - Sewer Permit
Inspection Description Date Passed By _Notes
Sanitary sewer
Final inspection •
• INSPECTION RECORD - MST (MASTER) PERMITS
. :•
■ ': • I 0 - ' •
I . ' • -
. . - • ■
.
. , A A : . CITY OF TIGARD MASTER PERMii _� •
PERMIT #:- MS1 0050;
. -� DEVELOPMENT SERVICES DATE ISSUED: 12/11/C.0
s �� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 13411 SW 129TH AVE PARCEL: 25104DA -04100
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5
BLOCK: LOT: 027 JURISDICTION: TIC.
REMARKS: S/F PATH 1
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,720 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,743 sf GARAGE: 650 sf FRONT: 21 PARKING .SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: sf RIGHT: 14
VALUE: $ 315,286.00
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3,463.00 sf REAR: 39
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: 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: 1
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: 1 PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 6 201 • 400 amp: 201 • 400 amp: 1st W/O SVC /FDR: 00 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: 631 • 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:
GARP GE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 4,911.93
This permit csubject to the regulations contained in the
BRIAN MATTEONI BROOKFIELD DEVELOPMENT INC Mu
Tigard Municipal Code, State of OR. Specialty y Codes s and
P.O. BOX 3468 5335 SW MEADOW ROAD all other applicable laws. All work will be done in
SARATOGA, CA 95070 SUITE 365 accordance with approved plans. This permit will expire if
LAKE OSWEGO, OR 97035 work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days. ATTENTION: Am
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Reg #: LIC 132229 forth in OAR 952- 001 -0010 through 952 -001 -0080. You O
may obtain copies of these rules or direct questions to O
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Erosion Control Insp & Post/Beam Mechanics Mechanical Insp Framing Insp Gas Fireplace Electrical Final 111
Sewer Inspection Underfloor insulation Mechanical lnsp Shear Wall lnsp Insulation Insp Mechanical Final
Footing lnsp Crawl Drain /Backwater Plumb Top Out Exterior Sheathing Insj Rain drain Insp Plumb Final
Foundation Insp Footing /Foundation Dr: Electrical Service Low Voltage Water Line Insp Final inspection
Post/Beam Structural PLM /Underfloor Electrical Rough In Gas Line Insp Appr /Sdwlk Insp Building Final
Issued By : (C. ----jyt �a Permittee Signature :,-
--______Z
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day .f
rirMp- e f y 00 ' V ,
iit r r •