Permit i
CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2004 -00144
1IiI DEVELOPMENT SERVICES DATE ISSUED: 5/27/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12459 SW ASPEN RIDGE DR PARCEL: 2S110BC -04600
SUBDIVISION: THORNWOOD ZONING: R -7
BLOCK: LOT: 017 JURISDICTION: TIG
REMARKS: New SF
BUILDING
REISSUE: DM17D STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 27 FIRST: 1,268 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,551 sf GARAGE: 460 sf FRONT: 15 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 10
VALUE: 273,147.60
OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2,819 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 5 CLOTHES DRYER: 1
GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FOR: PUMP /IRRIGATION: PER INSPECTION:
EAADD'L 500SF: 5 201 - 400 amp: 201 - 400 amp: 1st WIOSVQFCR: SIGN /OUT LIN LT: PER,HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 5,707.37
This permit is subject to the regulations contained in the
DON MORISSETTE HOMES DON MORISSETTE HOMES INC Tigard Municipal Code, State of OR. Specialty Codes
4230 GALEWOOD ST 4230 GALEWOOD ST, STE 100 and all other applicable laws. All work will be done in
STE 100 LAKE OSWEGO, OR 97035 accordance with approved plans. This permit will expire
LAKE OSWEGO, OR 97035 if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
Phone: 503 387 - 7538 Phone: ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those
Reg #: g 387 7 5 S3 rules are set forth in OAR 952 - 001 -0010 through
952 - 001 -0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Ersn Cntrl 681 - 4444 Post/Beam Mechanical Plumb Top Out Exterior Sheathing Ins Gyp Board Insp Appr /Sdwlk Insp
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Rain drain lnsp Electrical Final
Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Storm drain lnsp Mechanical Final
Foundation Insp PLM /Underfloor Framing Insp Gas Fireplace Water Line Insp Plumb Final
Post/Beam Structural Mechanical lnsp Shear Wall Insp Insulation lnsp Water Service lnsp Building Final
Issued B P ermittee Signature : ;(-
` t-
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
�: A ,. Building Permit Application ''/
Datereceived:6 1 g f at( Permit no.: T�oj� - GUU`f`
.' � � - � City of Tigar � � fl �
b r
n ' Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Ha la ig !1 t_ R L97223
Phone: (503) 639 -4171 Date issued: By l,.° Receipt no.:
Fax: (503) 598 -1960 MAY 18 2004 Case file no.: Payment type:
Land use approval: n I A ... utr1 l &2 family: Simple Complex:
PP ` r IT.v .. FT.G..,
:TYPE OF PERMIT -
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family , 'New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
' JOB SITE INFORMATION '
Job address: arl r J M�� g Bldg. no.: Suite no.:
Lot: I ill Block: Subdi sion: IIERTNINMEI Tax map /tax lot/account no.:
Project name:
Description and location of work on premises/special conditions:
OWNER ' FOR SPECIAL INFORMATION, USE CHECKLIST ,
I , (Floodplain, septic capacity, solar, etc.)
Mailing address: V�i y� � ' an 1 & 2 family dwelling:
'4 ZIP: ' ' ,Z'). '' Valuation of work $
Phone: r GMEMMEM No. of bedrooms/baths
Owner's representative: A A ,, Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.) '
APPLICANT' Garage /carport area (sq. ft,) I
IIMIPMILIIMIDIMMI Covered porch area (sq. ft.)
Mailing address: ' , 1 L: , Cie Deck area (sq. ft.)
City: State: ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commerciallindustrial/multi- family:
CONTRACTOR - • Valuation of work $
Business name: ‘, _ ` .,,_,A Existing bldg. area (sq. ft,)
New bldg. area (sq. ft.)
Address: dr _a Number of stories
City: State: ZIP: Type of construction
Phone: Fax: E -mail:
` CCB no.: Occupancy group(s): Existing:
New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER - licensed with the Oregon Construction Contractors Board under
raffentt provisions of ORS 701 and may be required to be licensed in the
Address: ► jurisdiction where work is being performed. If the applicant is
`L b C( ` exempt from licensing, the following reason applies:
City: State: ZIP:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER ;
Name: Contact person: Fees due upon application $
Address: Date received:
City: State: ZIP: Amount received $
Phone: Fax: 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. A I rovisions of laws and o dinances governing this 0 Visa 0 MasterCard
work will be complt wt , whether sb cified kiereifi r�t Credit card number: / /
� J �
Authorized Si atur , ! A i -t_ t 1Ce: Name of cardholder as shown on credit card
$ Expires
Print name: 1 �` 2.22 l (
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 (6r00/COM)
One- and Two - Family Dwelling -:`
as, Building Permit Application Checklist Reference no.:
Associated permits:
City of Tigard City of Tigard
❑ Electrical ❑ Plumbing U Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 O Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
TIIE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes - No NIA
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. X
8 Soils report. Must carry original applicable stamp and signature on file or with application.
9 Erosion control ❑ plan Cl permit required. Include drainage -way protection, silt fence design and location of l
catch -basin protection, etc. J�
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. J�
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 , ,1
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. ' x \
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered
systems, see item 22, "Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists
over 10 feet long and/or any beam/joist carrying a non - uniform load.
20 Manufactured floor /roof truss design details. •
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required \,
for four or more appliances.
22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or
architect licensed in Oregon and shall be shown to be applicable to the project under review.
y _ ~ 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 17 ".
24 Two (2) sets each are required for Items 16, 19, 20 & 22 above.
25 Building plans shall not contain red lines or tape -ons.
26 No rolled, reversed or mirrored building plans will be accepted.
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)
' 'A Mechanical Permit Application ..
Date received: Permit no.: S I c./ - 00/ •
-� .k
. �•� I City of lgar•E NEE
ProjecUappl. no.: Expire date:
CiryojTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 6394'171 1 8 20 Date issued: By: Receipt no.:
Fax: (503) 598 - 1960 Case file no.: Payment type:
CITY OF TIGARD Building permit no.:
Land use a reYa1a4r`_' rivAn
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory Cl Commercial/industrial 0 Multi- family 0 Tenant improvement
,ew construction 0 Addition/alteration /replacement 0 Other:
JOB SITE INFORMATION, ' ' ' • - COMMERCIAL VALUATION SCHEDULE -
. Job address: a • Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: 'uite no.: 1 value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit_ Value $
Lot: l'7 [Block: I Subdivision: mi l ( y\ AW rma... `See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: ZIP: . '1 & 2 FAMILY DWELLING FEE SCHEDULE' ..
Description and location of work on premises: AND COMMERICALIINDUSTRIAL EQIIIPMENTSCHEDULE
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? 0 Yes Cl No Air handling unit CFM
g P Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
• : MECHANICAL ;C Boiler /compressors
��}!� State boiler permit no.:
Business name: a��TA ( ■ 4 %& (/ _ • . HP Tons BTU/H
Address:etilk Fire/smoke dampers/duct smoke detectors •
City: Vti inir MO ZIP: lir 1/a Heat pump (site plan required)
Phone: Fax F E -mail: Install/replacefurnace/burner BTU /H
2 "� R Including ductwork/vent liner 0 Yes 0 No
CCB no.: ( - 7(i ' ) InstalUreplace/relocateheaters - suspended,
City/metro lie. no.: N/A wall, or floor mounted
Name (please print): W �� PALM' I•-i-8 -1. _ Vent for appliance other than furnace
r ; CONTACT' I'ERtiUN Refrigeration:
Absorption units BTU/H
Name: - 1 P,,(`■..k Chillers HP •
Address: " � CIA �� t -- Environmental
Compressors HP
� � Environmental exhaust and ventilation:
City: State: ZIP: Appliance vent
Phone: I Fax: E -mail: Dryer exhaust
OVt N E R Hoods, Type U II/res. kitchen/hazmat
1
. hood fire suppression system
Name: tIC )._A Exhaust fan with single duct (bath fans)
Mailing address: W jiiii=raffraffIMIWASE1r Exhaust system apart from heating or AC
City: State IA ZIPq-- )e) Fuel piping and distribut (up to 4 outlets)
Type: LPG NG Oil
Phone: . ' y )7 - j2 Fax: E -mail: Fuel piping each additional over 4 outlets
ENGINEER . `. Process piping (schematic required)
Number of outlets
Name: Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I ZIP: Insert - type
Phone: I Fax: E -mail: Woodstove/pelletstove
r/ �� Other:
Applicant's signatu - : J', r�' Date: Ey Other.
N (prin (.<< i ` �i { 11/i I1r' I ✓'
Na all jurisdictions accept credit cards. please call jurisdiction for more information. Permit fee $
0 Visa 0 MasterCard Notice: This permit application Minimum fee $
expires if a permit is not obtained Plan review (at _ To) $ / / Credit card number: Expires within 180 days after it has been
p State surcharge (8%) .... $
Name of cardholder as shown on credit card accepted as complete. TOTAL $
Cardholder signature Amount 440-4617 (600+COM)
Plumbing Permit Application ` : .
Date received: Permit no.•u , r,0 Ll 73201 [f
�l l�'j City of Tigard Sewer permit no.: Building permit no.:
cf'+r Address: 13125 1 B`lv1 I T tg d R 97 Project/appl.no.: • Expire date:
City ojTigard Phone: (503)'6396177
Fax: (503) 598 -1960 j 8 2(10k Date issued: By: Receipt no.:
MAN 1 O UU Case file no.: Payment type:
Land use approval: ur I ILHt - 1U
' • TYPE OF PERMIT - ,
0 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
►: New construction 0 Addition/alteration/replacement 0 Food service 0 Other.
- -JOB SITE INFORMATION FEE SCHEDULE (far special nfomuatian use checklist).- , 4
G. . . �� Description Qty. Fee(ea.) ' Total
Job address: LI � , . New 1- and 2- family dwellings only:
Bldd g. no.: Su to no.:
(includes 100 ft. for each utility correction)
Tax map /tax lot/account no.: T SFR (1) bath
Lot: Block: Subdivision: L_Ij, Alp SFR (2) bath
• Project name: SFR (3) bath
_ City /county: I ZIP: Each additional bath/kitchen
_ Description and location of work on premises: Site utilities:
Catch basin/area drain
Drywellsileach line/trench drain
Est date of completion inspection: - Footing drain (no. lin. ft.)
°. `.' ~' . P LC�11lili G•: CONTRACTOR t•'' Manufactured home utilities
Business name: ` p L r Manholes
Address: .I 2 , Rain drain connector
• City. - y �i _v� of ZIP: Sanitary sewer (no. lin. ft.)
� o, �� Storm sewer (no. lin. ft.)
Phone: . 11 Fax: E -mail: _,� Water service (no. lin. ft.)
CCB no.: [ �. — 1 t- I Plumb. bus. reg. no: - Fixture or item:
City/metro tic. no.: N/A � , Absorption valve
• Contractor's representative signature �� ✓L� 'oisl Back flow preventer
Print name: , \ ` ' , ' - 69]�i Backwater valve
CONTAC P PERSO. " . Basins/lavatory
\ '. `` Clothes washer
Name: lei � ���� N E Dishwasher
Address: , • A ' . / 0 V, ,V Drinking fountain(s)
City: State: ZIP: Ejectors/sump
Phone: Fax: E -mail: Expansion tank
';G 4 1 O W \liit' • . Fixture/sewer cap
r-�cT- -t-472-)4'-in , Root drains/floor sinks/hub
Name (p -'U`;`� 1.�� 1 1e Garbage disposal
Mailing address: J-1;-?-2---r) ( . • A�,77,AM .J Hose bibb
City: -() . State . t ZIP:q 7O 3 Ice maker
Phone: f , - Fax: ard. 0 E -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
I NGINEL'R . - Tubs/shower/shower pan
?.. Urinal •
Name: Water closet
Address: Water heater
City. I State: I ZIP: Other. .
Phone: I Fax: I E -mail: Total j
n
Minimum fee ................ $
Na all Jurisdictions ai.cept credit Garda, please call jurisdiction for more in(orrruuon. Notice: This permit application �a
Plan review (at %)
$
C Pisa 0 titu[erCard / expires if a permit is not obtained �
)
C.cdit card numbs.—. 1 ` w ithin 130 d ays after it has been State surcharge (8%) $ ------
Expires TOTAL $ ____--__—
accepted as complete.
Name of urdholdcr as shown oo credit card
S 440 -4616 (600/C040
Cardholder signature Amount
,.. Electrical Permit Application ;
Date received: Permit no.: (_o / if
- a;� . City of Tigard Q q rr-" Project/appl. no.: Expire date:
A ddress: 13�125'SW Hall Bhvd,� i gard, OR 97223 Date issued: By: Receipt no.:
City of Tigard u e=• y' P
Phone: (5 03) 639 -4171
Fax: (503) 598 -1960 1 8 2001 Case file no.: Payment type:
IAI 1
Land use approval:—.– r,--.
utTY LIt- t tvtrw MO
TYPE OF PERMIT • - .
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement
V New construction ❑ Addition/alteration/replacement ❑ Other. ❑ Partial
- - i '' JOB SITE INFORMATION • . - ..:-
Job address: , N,I� I a lEe Bid_. no.: Suite no.: Tax map /tax lot/account no.:
Lot: 1' Block: Subdi lion: 'Tr\ 4 Vl./
Project name: `Description and location of work on premises:
Estimated date of completion/inspection:
*...,CONTRACTOR APPLICATION FEE SCHEDULE :.
Job no: 02 0- Fee Max
Description Qty. (ea) Total no. bap
Business name: _ ' � New residential -single or multi - family per
Address: `i _ �L Asrt�`. �' dwelling unit Includes attached garage.
:`�ktia ]it�'Zl Service included:
Phone: .' - I ■ Fax: E - mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof
CCB no.: Elec. bus. lie. no: i Limited energy, residential 2
C: Limited energy, non - residential 2
Ai Each manufactured home or modular dwelling
nature of supervising electrician (required) Date - Nil Service and/or feeder 2
�� Services or feeders – installation,
_ Sup. elect. name (print): � 9 1'l— A �l License no: 9 • alteration or relocation:
' PROPERTY' • OWNI R • 200ampsorless 2
201 amps to 400 amps 2
Name (print): I. ter • at IMP 401 amps to 600 amps 2
Mailing address: NIMIM 1 • 44 % Wt. 5 ' • 601 amps to 1000 amps 2
City: r. State ,V ZIP: 703 Over 1000 amps or volts 2
Phone:, 4 07 Fax: _ ) - ar -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary servicesorfeeders - -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation: 2
200 amps or less
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER- Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2 ,
Phone: Fax: E Each additional branch circuit:
' -PLAN REVIEW (Please check all that apply) .. • . Misc. (Service or feeder not included):
irrigation circle 2
i
i
Each pump or t ga
❑ Service over 225 amps-commercial ❑ Health -care facility Eac 2
❑ Service over 320 amps- rating of 1&2 ❑ Hazardous location Each sign or outline lighting
, family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2
❑ Building over three stories ❑ Feeders, 400 amps or more •Description:
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lighting plan ❑ Other Per inspection I I I I
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Permit fee $
'Not all jurisdictions accept credit cards, please call jurisdiction for more information' Notice: This permit application $
❑ 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%) .... $
Ex accepted as complete. TOTAL $
Name of cardholder as shown on credit card
S
Cardholder signature Amount , 440 -4615 (6r0O/COM)
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CITY QP TEGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST c2. 61/ q/
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Re uested g AM PM BUP
Location f ' L + 7 P� Suite MEC
Contact Person (.Q_1 _'--- Ph ( ) ° 0 ct — 4 g'37 PLM
Contractor Ph ( ) / SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath /Shear
Framing tom/ ( a/ .G / .4i 4 % �1 /..r�a1 - /CLL te 7- a 7 — G'¢
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
ASS 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
C7
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 I I Please call for reinspection RE: 111 Unable to inspect – no access
Fire Supply Line
ADA
Approach /Sidewalk Date - - 7— C ¢" 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 a b0 Y q
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received ` r Date Req :sted 0 - 7 AM PM BUP
Location o - `i t ' uite MEC
Contact Person Ph ( ) 00 - q8. 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors '1e1 / / f 6 • �/ c�
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fi rewal I
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
•
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
SS PART FAIL
ANICAL
P &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 E Please call for reinspection RE: n Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date 7 r Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY CIF TIGARD 24 -Hour �
BUILDING Inspection Line: (503) 639 -4175 MST O 7 66)/7v
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Ree..�uested ? r? i AM PM BUP
Location / —� -; ' Suite MEC
Contact Person _j Ph (/ ) c20 — (40 3 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing 1
Firewall W P -NIA \� D) D .L149\ t/
Fire Sprinkler V �,�
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage /2)e) C) C. L
Fire Alarm
111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
ca'. PART FAIL
SI E Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line A /
ADA Approach /Sidewalk Date — ( `-' Inspecto / ./ Ext
Other:
Final DO NOT REMOVE this inspection record from t job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639-4175 MST °.:P0.0 �
0d f Lj
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received rr Date Requested ?° AM PM BUP
Location l � 1 ,” , Suite MEC
Contact Person Ph ( ) /`(� � 7 g PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: ; , SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
�E
Susp'd Ceilin Remove, 8.40 Gvreg SE,�o�rs .4s m.42aEo
Roof ( Sw TKon.AvwooD a2.)
Other:
Final Gor+- i / a 4 L
PASS PART FAIL
PLUMBING
Post
e r S lBeam
U O To
Under lab L Pa v
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADAoach /Sidewal Date 6 — o Inspector 4 4-7 Ext -2116
Fin- 1 DO NOT REMOVE this inspection record from the job site.
ZIP FAIL
1 /rte. irr