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Permit / / -7A R /11),0 o�v�� f CITY OF TIGARD MASTER PERMIT PERMIT #: MST2003 -00535 41/i DEVELOPMENT SERVICES DATE ISSUED: 12/8/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 13643 SW ASHBURY LN PARCEL: 1S133CD -03100 SUBDIVISION: COTSWALD MEADOWS ZONING: R -25 BLOCK: LOT: 029 JURISDICTION: TIG REMARKS: Interior remodel. 2/17/04 Adding low voltage. BUILDING REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: VALUE: 26,000.00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR: PLUMBING SINKS: 1 WATER CLOSETS: WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: 1 WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: 1 FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FD R: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 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: EAADDL BR CIR: 3.00 SIGNAL/PANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601+am ps-1 000v: 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: X VACUUM SYSTEM: X AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: X OTH: ALL ENCOMP BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: X CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: X DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 812.83 STIMEK, SUSAN M BREWER BROS CONSTRUCTION IN This permit is subject to the regulations contained in the 13643 SW ASHBURY LN 9011 SW BEAVERTON HILLSDALE H T Municipal Code, State of OR. Specialty Codes and TIGARD, OR 97223 PORTLAND, OR 97225 -2452 all other applicable laws. All work will be done i accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the . work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: 503 - 590 - 6414 Phone: 292 - 1640 Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You Reg #: LIC 50549 may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. _ REQUIRED INSPECTIONS PLM /Underfloor Gas Line lnsp Final inspection Mechanical Insp Insulation lnsp Plumb Top Out Electrical Final Electrical Rough In Mechanical Final Framing lnsp Plumb Final -101/4 Issued By ! __ _ /. �.��i_ _/,�__ Permittee Signature : ‘,..r..., Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the nex business day • CITY OF TIGARD MASTER PERMIT � �t PERMIT #: MST2003 -00535 r l DEVELOPMENT SERVICES DATE ISSUED: 12/8/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 13643 SW ASHBURY LN PARCEL: 1S133CD -03100 SUBDIVISION: COTSWALD MEADOWS ZONING: R -25 BLOCK: LOT: 029 JURISDICTION: TIG REMARKS: Interior remodel. BUILDING REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: VALUE: 26,000.00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR: PLUMBING SINKS: 1 WATER CLOSETS: WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: 1 WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL /CMP < 3HP: VENT FANS: CLOTHES DRYER: 1 FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FD R: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 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: EAADDL BRCIR: 300 SIGNAL /PANEL: IN PLANT: MANU HM/SVC/FOR: 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: $ 731.83 This permit is subject to the regulations contained in the STIMEK, SUSAN M BREWER BROS CONSTRUCTION INITigard Municipal Code, State of OR. Specialty Codes and 13643 SW ASHBURY LN 9011 SW BEAVERTON HILLSDALE Hall other applicable laws. All work will be done in TIGARD, OR 97223 PORTLAND, OR 97225 -2452 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: 503 - 590 - 6414 Phone: 292 - 1640 Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You Reg #: LIC 50549 may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS PLM /Underfloor Gas Line Insp Final inspection Mechanical Insp Insulation Insp Plumb Top Out Electrical Final Electrical Rough In Mechanical Final Framing Insp Plumb Final Issued By : /L.i ` - ,, ,4 , ./ Permittee Signature : : �_ , rn ,ivi Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business Building Pernmi p Uation Received • FOR OFFICE USE ONLY Building � w '' t I- DateB : `/ D D p i Permit No.:I� C . Of • T• an d Planning Ap,ro al Other Y g DEC 8 2QO DateB : Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 DateB : Permit No.: �T Phone: 503 - 639 -4171 ym� >\ Post - Review Land Use �9�-�° uii ( DateB Case No. Internet: www.ci.tigard.or.0 1L Contact Juris.: ® See Page 2 for 24 -hour Inspection Request: 503- 639 -4175 Name/Method: Su..lemental Information rs: w... a.. 5.".-^ b' �� ,$ ®- F��I, ®RI ❑ New construction ❑ Demolitions �o DWTTN . Addition /alteration/replacement ❑ Other: N, Note: Permit fees* are based on the total value of the work performed Indicate �: e�z��oRocois� 1. �� rm 1 & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead and profit for the work indicated on this application. ©O� ❑ Accessory Building ❑ Multi- Family I ❑ Master Builder ❑ Other: Valuation $ I ° , ,..ti. �_• „. f bed No. o y. T� F; ooms: 7 No. of baths: 2 Job site address: l''1 j /'t L-4+ Total number of floors New dwelling area (sq. ft.) 0 Suite #: Bldg. /Apt. #: Garage /carport area (sq. i) t✓ /� Project Name: 9r1vvl . I< 4F11P J - Covered porch area (sq. ft.) Cross street'Directions to job s ite: Deck area (sq. ft.) (3 i 46,.}T Other structure area (sq. i) r✓ /� Subdivision: Lot #:z :. TM •��,��.s�� : _���.,� Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate `' +�'`` "j DES °CRIPT= f() . w l „, , r _ - ' the value (rounded to the nearest dollar) of all equipment, materials, labor, ". 1(J � _„ '� k w A, j' U r �� overhead and profit for the work indicated on this application. �J IV y1'Z W 51Qt1.t,64�' +�/ Valuation $ Existing building area (sq. ft.) New building area (sq. ft.) Number of stories Type of construction Name: 9i/1 ` III Occupancy group(s): Existing: Address: i 36(-3 New: City /State /Zip:1lQ447, cam. °,57 Phone: 1 ?3 9O &i14 Fax: NOTICE: All contractors and subcontractors are required to be sr .._... licensed with the Oregon Construction Contractors Board under �I;Te��, ��,.� m , ���< ,CO�jTACPERSON���� provisions of ORS 701 and maybe required to be licensed in the Business Name: jurisdiction where work is being performed. If the applicant is exempt Contact Name: `1�D /f4Zc9? from licensing, the following reason applies: Address: %7o /r ✓ 1ir& Pt1# 3 t Q-J City /State /Zip: 11c 4f-P .6 9722', Phone: SD3?s[316'f* Fax: 3 3 1�a81 . s' � ��BU'II�DINGP�L+Rtt�Ilti` �ES* E' -mall : � � G � �� OI:I I � `^'' l� —(/� • • �� �" . � �F���,i e �� � '� v �?�� �" ,r';'� , �A Pleases er toy c dule� �3 Business Name: $I2y' 9 CpNs`IizT1Cj{J 'Fees due upon application $ Address: .Ol1 i1( Y 1J I*VY'r City /State /Zip: Y JJZTL,.4 OR Amount received $ Phone: 5a3Z92 V,1-D Fax: D 3 Date received: CCB Lic. #: Authorized / � _ Notice: This permit application s if a permit is not obtained within F. Signature: / Date: 180 days after it has been accepted as complete. • /1� *Fee methodology set by Tr-County Building Industry Service Board. (Please print name) i:\Dsts\Permit Forms\BldgPermitApp.doc 01/03 One- and Two - Family D , A , Reference no.: 2.:� Building Permit Application Checklist of 7 Associated permits: City of Tigard City Y Ol g ar ❑ 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 catchbasin protection, etc. 10 3 Complete.sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state _ building codes'. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached•to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. . , ' 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if . . there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater,. , . - • furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade,.etc. • , • ' 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists,'sub- floor,' . wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. . 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ; Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope: . Full -size sheet addendums showing foundation elevations with cross references are acceptable. . 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for . non - prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ' locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For.engineered • systems, see item 22, "Engineer's calculations." . . . • 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists . over 10 feet long and/or any beam/joist carrying a non - uniform load. .. ' 20 Manufactured floor /roof truss design details. . 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping.schematic is required - for four or more appliances. _ . 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or 1 ' architect licensed in Oregon and shall be shown to be applicable to the project under review, . JURISDICTIONAL SPECIFICS 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x l7, . • . • 24 Two (2) sets each are required for Items 16, 19, 20 & 22 above. • , 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will be not accepted. , 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. 27 "Drawn to scale" indicates standard architect or engineer scale. , - 28 Site plan to include tree size, type & location per approved project street tree plan (if applicable), and COT Street-Tree List. Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink. - Red ink is reserved for department use only. • 440 -4614 (6 /00 /COM) Building Fixtures Plumbing PermlfA pl1 rn - - FOR,OFRICE USE ONLY � �• `. ication -~ Received Plumbing Date/By: Permit No.M`,>T 7a -. 005 �5 City of Tigard DEC 8 2003 Planning Approval Sewer Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 CITY OF TIGARD Date /By: Permit No.: r! �� Phone: 503 - 639 -4171 Faz�l�OB ;5,9;$- iU0O�1ON & Date/By: : Case No.: Internet: www.ci.tigard.or.us L!I Post - Review Land Use II y 24 -hour Inspection Request: 503- 639 -4175 - Na Juris.: Su See Page 2 for P q Name /Method: Supplemental Information. *: 'TYPE`OF':WORK i' ,; : ^* ...a.rs;° - , " *'SCHEDUI;E Fftir: eci ,,m • 3 �.� ; �.: ( sp, al igfo'rinatiotu'`se checklist)�,"�'�;��, ❑ New construction ❑ Demolition Description I Qty. I Fee(ea.) I Total ❑ Addition/alteration/re lacement ❑ Other: N; ".:'- ,' ' a "' ",- g •' , ' Addition/alteration/replacement x '; �Ne rv�- t= '�� &�r2= faniil' "�dwellin s x:��.. �. 't� w�,. '"',,i' ,;. 4;C&TEGORY;OF:CONSTRUCTIONxtr•" * (includ for each utthty ctanneetion) >a ; w', „ SFR (1) bath 249.20 ❑ 1 & 2- Family dwelling ❑ Commercial/Industrial SFR (2) bath 350.00 ❑Accessory Building ❑ Multi- Family SFR (3) bath 399.00 ❑ Master Builder ❑ Other: Each additional bath/kitchen 45.00 - :: - .4..;!:V . 013 S ITE :IIVF•ORMATION•and "L°OGATION.' -,'-: -; .. Fire sprinkler - sq. ft.: Page 2 Job site address: 0• 1".7 t,r , - �,,- } >;-: .f;> ,Y "�Sife.:Utilifies:_ ��`� „ Hr�'amo , ,� �,�> Suite #: Bldg. /Apt. #: Catch basin/area drain 16.60 Project Name: Drywell/leach line /trench drain 16.60 Footing drain (no. linear ft.) Page 2 Cross street/Directions to job site: Manufactured home utilities 110.00 Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.) Page 2 Subdivision: Lot #: Storm sewer (no. linear ft.) Page 2 Tax map /parcel #: Water service (no. linear ft.) Page 2 � , C' 41 D � : 'R.� , . _ u'+y c fi..t' .-Ka^�`' ^mot .. „} s :rr'. or ItC [ll%�'-� ;;�',:F i s' ;' �, ., - '�a�rESCRIPTION:OFWORIC`, � +a � '~ � _ Fiz�t`u`i-e, • �.���� °� Absorption valve 16.60 Backflow preventer Page 2 Backwater valve 16.60 Clothes washer I 16.60 Dishwasher I 16.60 ®',P._ROPERTV0WNER ••f' , ;.. Drinking fountain 16.60 !_ ®;TENANT`?`::` a 't Ejectors /sump 16.60 Name: SVE ST AA 0-1‹ Expansion tank 16.60 Address: 1 ASHISURY Fixture /sewer cap 16.60 City /State /Zip: -p l,ARb t OR.. criz..2.3 Floor drain /floor sink/hub 16.60 Garbage disposal I 16.60 Phone: Fax: Hose bib 16.60 :; ®"APPLICANT ;: le CONTACT'PERSONC` ' ;.a Ice maker I 16.60 Name: /°!R60/ARCAt itt=.,L'`T Interceptor /grease trap 16.60 Address:SV 17E374 9570 SW or ee 4 O b q � Medical gas - value: $ Page 2 City /State /Zip: vi a Primer 16.60 Roof drain (commercial) 16.60 Phone: Fax: Sink/basin/lavatory 1 16.60 E -mail: Tub /shower /shower pan 16.60 • '`.off.; :.. ,.::, ' . ,, CONTRACTOR: ."1'..,-.' s "�" ,-.,.' :. Urinal 16.60 Business Name: Ae--- Mii TP9 j(..VIV1r711 NO- Water closet 16.60 ` 0e0 � Water heater 16.60 Address: � W l� ,l'' J Other: City/State/Zip: o12. °512 Other: Phone: Fl); (0 W4 S Fax: ?,6 erCrf', ,.. , <' ..: .;; :a.la nibing;.Perinif F f ` r;pat; ' :T., CCB Lic. #: 3¢752 Plumb, Lic. #: 57 ,/& Subtotal $ Authorized -�/ 7 ,T� Minimum Permit Fee $72.50 $ Signature: Date: � / 3 I'°Y Residential Backflow Minimum Fee $36.25 Plan Review (25% of Permit Fee) $ State Surcharge (8% of Permit Fee) $ (Please print name) TOTAL PERMIT FEE $ Notice: This permit application expires if a permit is not obtained within All new commercial buildings require 2 sets of plans with isometric or 180 days after it has been accepted as complete. riser diagram for plan review. *Fee methodology set by Tri- County Building Industry Service Board. is \Dsts \Permit Forms\PlmPermitApp.doc 01/03 Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: y Site °Uttlthes = Qty � =,Fee (ay ''Totar' Square Footage; P ermit Fee: Footing drain - 1" 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200. $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Valuation Permit Fee;: Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each additional $100.00 or fraction thereof, to and zm Fiztiire;tir`- :Rein = x y ,a," a ,'aQty ,, 004 03 , jotal , including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $ 1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof, to and including $50,000.00. specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for Subtotal: each additional $100.00 or fraction thereof. Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees *. ='" ° ;° ti : s.` j `y , .Quaiiiity tiy,(Fixtu'r °.e) Work Performed# i Comments regarding fixture work: , *: S xf �; .�s ^s.•. .�:?,a �.r b111oyed;, �.EitsNog ",�k,�Capped Baptistry/Font Bath - Tub /Shower - Jacuzzi /Whirlpool Car Wash -Each Stall - Drive Thru ;74 - "v Cuspidor /Water Aspirator Dishwasher - Commercial - - Domestic •-•• • t` r`•�' -s CSI • • °'i•f ! Drinking Fountain Eye Wash Floor Drain/sink - 2" • Car Wash Drain .•1;'T NI9'C`"t < `j' <)' C.; 4 : , . i r ,Y „- Garbage Domestic *Note: 'if the fixture work under this permit results in an Disposal Commercial increase of sewer EDUs, a sewer permit will be issued and - Industrial fees assessed for the sewer increase must be paid before the Ice Mach. /Refrig. Drains plumbing permit can be issued. • Oil Separator (Gas Station) • Rec. Vehicle Dump Station Shower -Gang • -Stall Sink - Bar /Lavatory - Bradley - Commercial - Service • Swimming Pool Filter Washer - Clothes Water Extractor Water Closet - Toilet Urinal Other Fixtures: is \Dsts \Permit Forms \PlmPermitAppPg2.doc 01/03 Mechanical Permit Application FOR OFFICE USE ONLY :.. . Received Mechanical f-� RECEIVED Date/By: Permit No.: ehSJ;9 0 05 City f Tigard 1� Planning Approval Building Y g Date/By: Permit No.: 13125 SW Hall Blvd. DEC 8 2003 Plan Review Other Tigard, Oregon 97223 Date /By: Permit No.: Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use CI O F TIGARD � am�' ' li t'� Date /By: Case No.: Internet: www.ci.tigard.or.us � 24 -hour Inspection Re uest. 5 3 6 ' 7`'�SIO`,^ - ^ - Na Juris.: Su See Page 2 for p Q Name/Method: Supplemental Information. • .x. ., WORK: i°: 8„" k: :1 :i' . - t - "4: COMMERCIAL=.' . ;; r.; �= u. �,��N , FEE SCHED[JI;Ea`— SE;CHEGKL[ST: =�.': �. ❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work g Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all ''� '°'' =' ^CATEGORY:,OF`CONSTRTJCTION =x' '' mechanical materials, equipment, labor, overhead and profit. J 1 & 2- Family dwelling Li Commercial /Industrial Value: $ See Page 2 for Fee Schedule Accessory Building ❑ Multi-Family _ ,RESIDENTIA VEQUIPMENT /SYSTEMS F EE SCHEDITLEAW Description Qty I Fee(ea.) Total ❑ Master Builder ❑ Other: Heating/Cooling '' ' ` ._'i'. „JOB'SITEIINFORMATION ''LOCATION °:,.' -:= :'' � • Furnace - add -on air conditioning** 14.00 Job site address: 1 3 { ft LI Z( L Gas heat pump 14.00 Suite #: Bldg. /Apt. #: Duct work 14.00 c�t H . r - n , f ,,� pr � Hydronic hot water system 14.00 Project Name: i ll� Residential boiler Cross street/Directions to ob site: q , 'f S ` C din , 0 ► (for radiator or hydronic system) 14.00 � / Unit heaters (fuel, not electric) � FletrrO MiZi tiri '1 RI el-pr op / 2,F11 . p (in wall, in -duct, suspended, etc.) 14.00 Flue /vent (for any of above) 10.00 Subdivision: Cfl AiltAR Lot #: Repair units • 12.15 Tax map/ parcel #: Other Fuel Appliances ax ma P p Water heater 10.00 ,. . _ :: ::: ,t '' ” , : A 1`t SCRIPTION.UF CWORK :'.E „'� ,.... ,. Gas fireplace 10.00 1130 P>( j !{9fl $.j1 t t (AMA* Flue vent (water heater /gas fireplace) 10.00 I l j NOW al c Fy n Log lighter (gas) 10.00 Wood/Pellet stove 10.00 Wood fireplace /insert 10.00 Chimney /liner /flue /vent 10.00 PROPERTY OWNER - n='''ay TENANTS ^; 1 °`t < „; ; "- "i`'tl'"r Other: 10.00 ame: r"� 513E. STS w 11 Environmental Exhaust & Ventilation Range hood/other kitchen equipment 1 10.00 la. Address: 1'30+ - 5 ASHSURY LANE Clothes dryer exhaust I 10.00 to City /State /Zip: TIC.ARD, OK. 97ZZ3 Single duct exhaust Phone: 5CI; 530 1.1- Fax: (bathrooms, toilet compartments, APPLICANT;.•' •y: ' i`: • ' ` 'i'^ ` w ®<CONTACT PERSON, =M utility rooms) 6.80 Name: AS. &/A l'-C-H I `[' E-T Attic /crawl space fans 10.00 q p Other 10.00 Address: t� � 1 ` SW &�enb B�.• Fuel Piping City /State /Zip: T1C.,'!RD O . °l [ ZZ3 * *($5.40 for first 4, $1.00 each additional) Phone:5a3- '5 -1lo� - ( Fax: Zi3 - LOB ! Furnace, etc. ** Gas heat pump ** E -mail: - I- 3o>gr9ecwc.K;-1-e -• p1's Wall /suspended/unit heater ** ="�<: '/ <.CONTRACTOR :r• 0 . ,,kµ.. r ; .i.° . , . _ ... .._ � �.� - �, : _ � ,_ - ":; --. Water heater 4* Business Name: Vilie. 55,660(■5 691,4K C - Fireplace ** Address: 6tv4-00 Range ( ** 5.40 City /State /Zip: ft91a11 7 9 ore- 97230 BBQ Clothes dryer (gas) ** Phone: o MIS Fax:95 775 ((i( Other: ** CCB Lic. #: 4$Z$2j Total: Authorized Mechanical Permit Fees* et / „. / ! eb3 Subtotal: $ Signature: • Date: p. Minimum Permit Fee 572.50 S I `� i "� (h , Plan Review Fee (25% of Permit Fee) $ (Please print name) State Surcharge (8% of Permit Fee) S TOTAL PERMIT FEE $ Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri -County Building Industry Service Board. 180 days after it has been accepted as complete. * *Site plan required for exterior A/C units. i:\Dsts\Permit Forms\MecPermitApp.doc 01/03 Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: TOTAL VALUATION: PERMIT FEE: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,001.00 and up $1,396.50 for the first $100,000.000 and • $1.10 for each additional $100.00 or fraction • thereof. • All New Commercial Buildings require 2 sets of plans. . . • • a.;. ....... • • 1.1 L •..1 a 1- '.. .•ii • :53 4 •► 'tea S' h- 1 C A , r.. r j F (`e , • • • e• i:\Building\Permit Forms \MecPermitAppPg2 09- 01- 03.doc Elect ical Permi;t�A • l`1•cation , FOR OFFICE` USE ONLY -_� : - °' 4 , II�� I1 Received I�� V IL_ Date/B Permi N / jed 3 ' DO / Y Permit No.: l 5 City of Tigard Planning Approval Sign 13125 SW Hall Blvd. DEC 8 2€11 Date /By: Permit No.: Plan Review Other • Tigard, Oregon 97223 Date/By: _ Permit No.• Phone: 503- 639 -4171 GFIa.C:O$03t-(5,9831.960 tai Post- Review Land Use Internet: www.ci.tiga�d`p�LasNG DIVISION -,, ,, VIII Date/By: _ Case No.: 24 hour Inspection Request: 503-639-4175 - Contact luris.: Su See Page 2 for Name/Method: Supplemental Information. El F. 'u,2_r 2"," a ,. +TYPEnOF- WORK:_; r: >,` ,:', x =. `' 1 ;.:: ; ";;_; REYIEW;(Please check allthat aPPly) „ ": El construction Demolition ❑ Service over 225 amps- ❑ Health -care facility [ Addition/alteration/replacement ❑ Other: commercial ❑ Hazardous location ' " =•ar ,_ ❑ Service over 320 amps - rating of ❑ Building over 10,000 square feet, ..,. -.,-.1 `:. - ;:. _ _ CATEGORY`OF%CCONSTRUCaTION ::'- '� •, •' ;. ': I & 2 family dwellings Y g four or more residential units in 1 & 2- Family dwelling ❑ Commercial/Industrial ❑System over 600 volts nominal one structure IE lip r g ❑ Multi- Family 0 over three stories Accessory Building ❑ Feeders, 400 amps or more ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park ❑ Master Builder ❑ Other: ❑ Egress /lighting plan ❑ Other: 1X ''° L ; JOB SITE INFORMATION and` LOCATION' : r' - ,`:°:''," Submit sets of plans with any of the above. Job site address: 1361 / (, fir The above are not applicable to temporary construction service. 4 =:' : \l' _, :. "`,# x 3, :tb :FEE'' SCHEDULE ifi, 5 , ; (A7: „ ;., . s ... >_.,, t.: E Suite #: Bldg. /Apt. #: Number of inspections per permit allowed Project Name: St 1 Description Qty Fee (ea.) Total - Cross street/Directions to lob site: New residential - single or multi - family per 1 T � 2 IS i / ��, dwellin unit. Includes attached garage. P4 !�' I`' 1 �t Service included 1000 sq. ft. or less 145.15 4 Each additional 500 sq. ft. or portion thereof 33.40 1 Subdivision: crypt -V , A p, P Lot #: 2.1 Limited energy, residential 75.00 2 Limited energy, non residential 75.00 2 Tax map /parcel #: '7( 1 7( 5 re-1, Each manufactured home or modular dwelling f ' ` '<'• a = = DESCRIPTION:;OF':W . , ORK , "A , fi ?, . service and/or feeder �i� ,,; 90.90 2 10 PJ`' t� �� Services or feeders - installation, alteration or relocation: 200 amps or less 80.30 2 201 amps to 400 amps 106.85 2 Sz E> 401 amps to 600 amps 160.60 TYOWNER': ; ® TENAT HI NS : , "•`h {;,, > _f' u t ;�; 601 amps to 1000 amps 2 ` P� ROPR Name: S 13e. ST �E Over 1000 amps or volts 454.65 ' 2 Reconnect only 66.85 2 Address: L 3C , -3 PrSM S bR.'' Ug1JE Temporary services or feeders - installation, City/State /Zip: Vt &4 RD. bR • 9/2,2 5 alteration, 0 m relocation: 200 amps or less 66.85 I Phone: (5!:S S (pµ9- Fax: 201 amps to 400 amps 100.30 2 ® APPLICANT,"`: - „:...� z.” - ;:':Y ; CON:TACT:PERSQNr "g :'_ =`x ', 401 to 600 amps !33.75 2 Name: "Rd, 14 RC time 7- Branch circuits - new, alteration, or extension per panel: Address:5U ITE 321 `t tO SW bre�bvr3 •cl * A Fee for branch circuits with purchase of service or feeder fee, each branch circuit 6.65 2 City /State /Zip: J (A P b, O . ei1V-2. > B. Fee for branch circuits without purchase of Phone:`,` - Za�3..) log gf Fax: Z�j- (p$ 1 service or feeder fee, first branch circuit 46.85 2 Each additional branch circuit 6.65 2 E-mail: ' • + 3t�gr•� o o trck∎ ■-� �'. GO Misc.(Service or feeder not included): W ' < ,`[. ^:- , ' CONTRACTORR -' ; ^ "- : "' . Each p ump or irrigation circle " ,`" :aL . - . - _�, . ....a" ?'''., Eh 53.40 2 • Each sign or outline lighting 53.40 2 Job No: Signal circuit(s) or a limited energy panel, Business Name: 1 rc ELX:C .ic • alteration, or extension Page 2 2 - / iption: Address: Dtl / DV City /State /Zip: FIX O,„ 7 ( Each additional inspection over the allowable in any of the above: Per inspection per hour (min. 1 hour) 62.50 Phone: - e; 1 -44 - 775 4 1- Fax: $p 3 244 • Investigation fee: - CCB Lic. #: 93 Fe Lic. #: Other: p .• :; x ., eAffl: .''' : 4 % Ele'cirical:P,eriiiif n , ke a * r ', 7.1. g ;Fees;. Supervising electrician � � - ��'..:_,� : -� 1 �_��� - Subtotal $ signature required: Plan Review (25% of Permit Fee) $ Print Name: Lic. #: State Surcharge (8% of Permit Fee) $ Authorized TOTAL PERMIT FEE $ Notice: This permit application expires if a permit is not obtained within Signature: Date: 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. (Please print name) is \Dsts\Permit Forms \ElcPermitApp.doc 01/03 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all systems $75.00 Check Type of Work Involved: Audio and Stereo Systems • Burglar Alarm n Garage Door Opener n Heating, Ventilation and Air Conditioning System El Vacuum Systems n Other COMMERCIAL WORK ONLY: • Fee for each system $75.00 ,y•,� 3,` (SEE OAR 918 - 260 -260) Check Type of Work Involved: n Audio and Stereo Systems n Boiler Controls n Clock Systems n Data Telecommunication Installation n Fire Alarm Installation , ` ; 5 • 5 1 4 7 • i l HVAC Instrumentation n Intercom and Paging Systems "-17 %9"r A 1 ,c-5 , A 51 1% �'.� . Ate. , t :ta -r n ^s Er :t ^i.�:Wr ; J I2 (.7.}t,-' ri Landscape Irrigation Control '✓ ,. �, f�t_t e `�,, , �; : - .• -• ❑ Medical _,.� ..`• , ; .� ; ?, • E_ :. n Nurse Calls . ��: _,,;• 7i T.� %�'a ate' jaC ,, ) • .. v n Outdoor Landscape Lighting* • ❑ Protective Signaling n Other Number of Systems * No licenses are required. Licenses are required for all other installations is \Dsts \Permit Forms \ElcPermitAppPg2.doc 01/03 CITY OF TIGARD 13125 S.W. HALL BLVD. = j TIGARD, OR 97223 Ca IMPORTANT PERMIT NOTICE ROBERTS ELECTRIC INC / �_�- ��•'�'� 5759 SW 48TH PORTLAND, OR 97213 V Electrical Signature Form Permit #: MST2003 -00535 Date Issued: Parcel: 1 S133CD -03100 Site Address: 13643 SW ASHBURY LN Subdivision: COTSWALD MEADOWS Block: Lot: 029 Jurisdiction: TIG Zoning: R - 25 Remarks: Interior remodel. 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 Division. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: STIMEK, SUSAN M ROBERTS ELECTRIC INC 13643 SW ASHBURY LN 5759 SW 48TH TIGARD, OR 97223 PORTLAND, OR 97213 Phone #: 503 - 590 -6414 Phone #: F- 244 -0560 Reg #: uti44 -7 LIC 9388 ELE 34 -23C AN INK SIGNATURE IS REQUIRED ON THIS FORM X 60 //" Signature of Supervising Electrician If you have any questions, please call 503.718.2433. CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE M D. WHITED PLUMBING 11625 NW LOST PARK DR PORTLAND, OR 97229 Plumbing Signature Form Permit #: MST2003 -00535 Date Issued: Parcel: 1 S133CD -03100 Site Address: 13643 SW ASHBURY LN Subdivision: COTSWALD MEADOWS Block: Lot: 029 Jurisdiction: TIG Zoning: R - 25 Remarks: Interior remodel. 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 Division. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: STIMEK, SUSAN M M D. WHITED PLUMBING 13643 SW ASHBURY LN 11625 NW LOST PARK DR TIGARD, OR 97223 PORTLAND, OR 97229 Phone #: 503 - 590 -6414 Phone #: 636 -9693 Reg #: LIC 34752 PLM 37 -163PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X k � � 011V, • Signature of Authorized Plumber If you have any questions, please call 503.718.2433. CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 AO4,3 - 00 C35 INSPECTION DIVISION Business Line: (503) 63• / BUP Received D ate Requeste / s �4 �M BUP Location 1 362 L V ! Wv • ulte MEC 3 Contact Person 5 %.) Ph ( ) X 004 PLM Contractor Ph ( ) SWR Bt1L - DIN Tenant/Owner ELC Footing ELC Foundation Access: � p � Cr l Drain ie 1 r ELR Crawl Drain d 50( c �! Kav - Cif 7)4 7'4, Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling _ Roof Other: - ii AS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS P RT FAIL tCHA i AL Post .& Beam Rough -In Gas Line Smoke Dampers ASS PART FAIL TRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: ■ Unable to inspect — no access Fire Supply Line / ADA Z-22-: Approach /Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL - CITY OF TIGARD a 24 -Hour BUILDING Inspection Liner (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MSTr� = i / O P BUP Received Date Requested p Z 9' i (/ AM PM BUP Location / o «3 0 -4-4 aI2 Suite MEC Contact Person n ( • ) 793 PLM Contractor Ph ( ) SWR BUILDING Tenant/ wn' (? ) `nQ • ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: ,/ SIT Post & Beam C-C•e�ex e —4-6.- j-1_ `Y) 7�Q0 Sr Anchors Ext � Ext Sheath/Shear Int Sheath/Shear Framing Insulation /e Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof 1/06 Other: 111 Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post& Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In ow Volta ire4 -rm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. 44:10 PART FAIL ❑ Please call for reinspection RE: 0 Unable to inspect — no access Fire Supply Line ADA y"> Inspector Ext � a Approach/Sidewalk Date J� Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST 3 INSPECTION DIVISION Business Line: (503) 639 - 4171 BUP Received - C) 2 Date Requested �"� G L — ' ) /AM PM BUP Location l � � 60q Suite MEC Contact Person it./J/'vl Ph ) 1 793 — 7dZ 3 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC A ccess: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam C l 2- Shear Anchors Ext Sheath/Shear T- Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Fi PART FAIL CHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Anal Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line - ADA Approach/Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION 4 11. Business ine: 03) 9-4171 MST BUP Received ' D / ate Requested . 5 : 7 ' 0 PM BUP Location .1 3 .6 ' 1 3 _ ' U Suite MEC Contact Person � l'1 (s) 7 3 -7t2O 3 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing 01'7' 1 Foundation Acces ' ELC C l Drain C �:��+ ' 0 ELR O Crawl Drain ���� ----�� Slab Inspection Notes: �o p,� SIT Post & Beam . 7Z;X .E/9SP, ( !C— ;0 k! i Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation T / Drywall Nailing �G -/2 G A �L� 5��/bc / /'�lr �� r ,C d f` Fire wall �2r./7. /1 rn � A it fa • l/�.!/`L �l� "C. Fire Sprinkler Fire Alarm JG Susp'd Ceiling �I � �� �° � � Roof y A 7 %-f 4 r T / 6 L� Other: Final � ` ��� ir.e7 C- Lr . "7 ( PASS PART FAIL PLUMBING A X Z-/ f O ° c z �' Post & Beam Under Slab Rough -In 7 / Water Service Sanitary Sewer � ��� 1/1 / % Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post& Beam Rough -In Gas Line Smoke Dampers Final P FAIL ECTRICA Se Rough -In UG /Slab Low Voltage Fire ' larm �� PASS PART FAIL LI Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE LI Please call for reinspection RE: LI Unable to inspect — no access Fire Supply Line ADA Approach /Sidewalk Date / Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST�•�" - ()(D INSPECTION DIVISION - Business Line: (503) 639 - 4171 BUP Received 3V) 2 Date Requested 5 C l '" &� AM PM BUP Location l �� q a ffe., �,I/1 Suite MEC Contact Person 1 4.4 ....• ) . 9 " `7 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation Access: ELC Ftg Drain ELR • Crawl Drain Slab Inspection Notes: �� // /� / n — —SIT Post & Beam (6 CC Shear Anchors j„ C /71 . /- ()4._ Ext Sheath /Shear �� Int Sheath/Shear Framing Insulation ( /� Drywall Nailing / y l ( '/ / /' C4/.. ��/J � Ali ,/ ''AG /tG l r Firewall Fire Sprinkler 7 A'V v 4 //cP Fire Alarm Susp'd Ceiling Roof Z - � Ali .G1�i �S� �✓G A7 i '7 / T ce, /e // - Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post.& Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage larm Final . fl SS PART AI Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line ADA " Approach /Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL /1 5 Afe--04 • 0y3 a / n4 s7 avo3 -0 3 L 4 0iv r ivoputi L U3 — 93 -- 'zoc� CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST 3 - INSPECTION DIVISION Business Line: (503) 639 -4171 • r(I P#41 BUP Received �sZ Date Re�quuested v AM PM BUP Location / 3 Ce 4 19 (.f -'2- h-rAi .0 A Suite MEC Contact Person .c YvY1 Ph ( ) I 3 - 700, PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: / SIT Q Post & Beam sdf Shear Anchors Ext Sheath /Shear Int Sheath /Shear Framin a all Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: 'ART FAIL MBING Post & Beam Under Slab Rough -In WaterService Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access Fire Supply Line ADA - ? -- 5— ' Approach /Sidewalk Date Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL • CITY OF TIGARD ' 24-Hour . . BUILDING 0 Inspection Line: (503) 639 -4175 0 MST 0° 6.--• ---. INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received b 1 Date Requested g /�' 1 5 AM PM BUP Location j 1 # 6) 1 t'1 ` '( 41 Suite MEC . Contact Person' 3 (9 L \i/ P' 1 Ph ( ) /4 7 e ' ' PLM Contractor Ph ( ) SWR BUILDING - Tenant/Owner . ELC Footing Foundation ELC D rain Access: A > / / ■ C, ,� g /(GC v∎ o /Zirti i, 1 �ELR Ft Crawl Drain Slab Inspection Notes: "( chi 2 I � SIT Post & Beam �i Shear Anchors Ext Sheath/Shear rN I�nt he. Shear ��S'�f S/h� ,� U �^ d ' /2-� ( i/� ✓�i'J nsulation 7-1 Lf .�,�,_, L � /e . Drywall Nailing - - T (.4 `� „7 Firewall If 2 1 � -- •- i t e, <. e /7 7G/t y1- \ Fire Sprinkler ,p /� Fire Alarm / L /I /G' i t C� rn �C q i 6/�"� Susp'd Ceiling / Roof Other: Fi -- f ' PART FAIL x �? l a in Post & I C� Under Babm 7 CIe,•` - tt /�� i1✓ J l/ c-c Water Se ' e OM L� `/ l J J /9 � � Sanitary S r Rain Drains Catch Basin / Manhole Storm D rain Shower$an Other: Final PASS PART FAIL MECHANICAL Post & Beam as ine Smo e Dampers Final PASS PART FAIL ELECTRICAL Service uu s Fire Alarm Fi El . Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. . PART FAIL 0 Please call for reinspection RE: 0 Unable to inspect - no access Fire Supply Line ````` AAAAA Ili ADA f ( I6 . Inspector (C 1' \ Ext Approach /Sidewalk Date p Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST 3- dS INSPECTION DIVISION Business Line: (503) 639 -4171 Lt/ m BUP Received g ` (1 " Date Requested 2 — 1 Z AM PM BUP Location / 3 eo _i _ _ L _ .. Suite MEC 4 Contact Person Ph ( ) 2 73 - 7o d 3 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC I Footing 1 - �r---.-\ELC Foundation Access: CeirriELR Cr l Dr V // � rn ��� Crawl Drain '-.4-C Slab Inspection Notes: e- SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath /Shear 44101110 ' 410 nsu ation / Drywall Nailing \ � 1 ` � I� '}' Firewall Fire Sprinkler \)/ 1:3 ���CS L.�. 1:�' e-T b 3 l/ - ��u •. - - A gD l�' I / Fire Alarm �U�1V q . - ( �1 1 ,A , �(1 1)'N/ 6 so jo(d CA X1 Susp'd Ceiling \ ,�I i Roof V\� L-Vc M14 Ili CA I Other: Final PASS PLUMBING 41 , 1----d W VO' \ PN G 4 MY,'� s S Post & Beam Under Slab I J Rough-In Se 5„ 1 / , `1 �%.r, Iry ` t Water Service !- Vak Sanitary Sewer Le / ‘ ► _ e ■ ,�� • Rain Drains �` = 6.--_.... d- _ "= Catch Basin / Manhole - �C .I Storm Drain �' Shower Pan �. ' i � � 1 t. , 4 r . V . G'' 1 Other: - Final - ` .f" di ECH PART FAIL ( { MECHANICAL L1 l � � �� N_ r , t , Post-: Beam • te . V 1(.. Q-C1p 5 `� 4 `�� 42-6-u- Gas Line L Vl 1 ` r A) \l 3C 'J `" ' Smoke Dampers "l / �"v Final ' v PASS PART Al • ° .. ..� i �'� �� r G � r Q ELECTRICAL 6: Qj6.S �,� jy�Q 5+ V�Q " l r Service iough -113 10') � l`0-f5 c \J CL✓ - Za G�/� S 1 ' S -- UG /STab Low Voltage Fire Alarm A� c Final ection fee of $ I ' re fired before i . 131 5 PASS PART sp q re (till City Hall . e t SITE le - W ealth ° sp�c tion -P : _ 4 Q A / . � S Hall Blvd. a ocQss Fire Supply Line IA1 1 n^ vtiVZ ADA .■,Z. Approach/Sidewalk D a t e P- 2//tr . Inspect N W Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST 3- 66 Ts INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested /.�.1I � AM PM BUP Location q �� C4 / � Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ` f7e,r ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath /Shear Framing Insulation Drywall Nailing /P f Firewall � 5/ v f Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLU �� °os Be. nirmis \ - Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PART FAIL HANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA fr2 /`' Approach/Sidewalk Date f Inspector / Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour - BUILDING Inspection Line: (503) 639 -4175 0,3-00 5- INSPECTION DIVISION Business Line: (503) 639 -4171 _ c� BUP Received /` 7 // 1? I d Date Requested ! ' �d =� � AM PM BUP Location /3 6 4 / / Suite MEC Contact Person ?/14/1 Ph (- — PLM Contractor Ph ( ) SWR BUILDING Tena Owne (� e°.t- L-r/� �� �. ELC Footing Y Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: /� SIT Post & Beam l - .Y . ipl.r.04_, `�Q r / Shear Anchors Ext Sheath/Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling - - - Roof Other: Final PASS MBIN�RT FAIL LU �� �� • e - Under Slab Rough In / / O/L �`�- Water Service - ✓ Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAI MECHANICAL Post& Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk Date / Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL