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Permit
CITY OF TIGARD MASTER PERMIT PERMIT #: MST2004 -00350 lj� DEVELOPMENT SERVICES DATE ISSUED: 11/23/2004 '' - I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 15975 SW CENTURY OAK CIR PARCEL: 2S111 CC - 04500 SUBDIVISION: SUMMERFIELD ZONING: R - BLOCK: LOT: 068 JURISDICTION: TIG REMARKS: Enclose courtyard, move stove, replace fridge waterline. Plumbing fee in building permit. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 12 FIRST: 90 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: THRD: sf RIGHT: 5 VALUE: 10,000.00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 90 sf REAR: 15 PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: 1 MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 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 FDR: 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: EA ADDL ER 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: PROTECTIVESIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 369.89 BUTCHER, NORMAN & BEVERLY MASTERMIND DEVELOPMENTS LL(This permit is subject to the regulations contained in the 15975 SW CENTURY OAK CR DBA TOP DRAWER DEVELOPMENTand all Mu State of All w kwil b Codes n TIGARD, OR 97224 19360 SW 90TH COURT and all other applicable laws. All work will be done in TUALATIN, OR 97062 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. Phone: 503 - 546 - 4058 Phone: 503 885 - 8686 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Rey #: LIC 133962 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 Footing Insp Crawl Drain /Backwater Gas Line Insp Foundation Insp Mechanical Insp Electrical Final Post/Beam Structural Electrical Rough In Mechanical Final Post/Beam Mechanical Framing Insp Plumb Final Underfloo ••-- - '•• Exterior Sheathing Ins[ Final inspection Is ued By : 1 /_ /A 03) 639-4175 Permittee Signature %��„.. � Call 03) 639 -4175 by 7:00 p.m. for an inspection needed the next busiine s day Building Permit Apiicn - Date/B . / �1 — FOR OFFICE USE ONLY _, i t / q %U City of Tigard OEI VEDA Received • , Permit Na. / 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.196 NO 7 h � ' Date/B c. e /B _ 2 2 . Other Permit: Inspection Line: 503.639.4175 � V ( ��� -„_! '-' Date Ready/By: ® See Attached Checklist for Internet: www.ci.tigard.or.us CITY OF r' Notified/Method: Supplemental Information • RUrL®lNG GAAD TYPE OF 0,411,00N, ` , REQUIRED DATA: 1- AND 2- FAMILY DWELLING ID New construction El Demolition Permit fees* are based on the value of the work performed, W Indicate the value (rounded to the nearest dollar) of all [ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the OS ff CATEGORY. OF CONSTRUCTION work indicated on this application. Valuation: g 1 -and 2- family dwelling ❑ Commercial /industrial l 000 Number of bedrooms: $ �Q Accessory building El Multi- family ❑ Master builder ❑ Other: Number of bathrooms: t JOB SITE INFORMATION AND LOCATION. , , Total number of floors: Job site address: (1l c 5 t) ©41c, New dwelling area: 70 square feet City /State /ZIP: `.. o „ _ A I C )aa 4 Garage /carport area: square feet / n Suite/bldg. /apt. no.: • Project name: N k_ Covered porch area: square feet Cross street /directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL USE'CHECKLIST Subdivision: Lot no.: Pe fees* are based on the value of the work performed. �� ' Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the . ', , .. , D ESCRIPTION OF WORK work indicated on this application. i titi • - S ,aU ?L) t zoo_ c V- t'� ,� _ htj _ -fr- t List, • fie Valuation: $ �.� J I Existing building area: square feet New building area: square feet ❑ PROPERTY., OWNER ❑ ' TENANT Number of stories: Name: V I 4'1 ',.(L.0i I l Bt t Type of construction: • Address: 1c39-) S S uo ( „1_0_,-,,,,„6 i Occupancy groups: City /State /ZIP: 4- a_ &A -) ;.-)-t-./ Existing: Phone: (c61) �_ <IctS? Fax: ( ) New: ❑ APPLICANT ❑ CONTACT PERSON NOTICE, Business name: f Q f) 0am>J �) e All contractors and subcontractors are required to be Contact name: !�A �� licensed with the Oregon Construction Contractors Board y x under ORS 701 and may be required to be licensed in the Address: 1 9 `S(o0 ((�� __ �,0 O- , I jurisdiction in which work is being performed. If the City /State /ZIP: \.2tk_4_R_4l' eA/ 9 1 - )3-a Li applicant is exempt from licensing, the following reasons apply: 4 Phone: CD3) < j _ t`j 1 Fax: : ( ) T, /5�� -0 6 E -mail: A N.� . . 1 - 4 d' \ I .QA - , -n� CONTRACTO Business name: - r*'� n p Wimp l,oew.,� 1�e (_.(,PIM-t0'.' , l i B PE FEES* . Address: I G1 z�( 9 c + Please refer to fee schedule. City /State /ZIP: -- p 'Z _ *�L t Fees due upon application ei -� Phone: ( p3) % g X86$ (,,, Fax: ( S &S�dg eo CCB lic.: -� Amount received 1 � l Q a ` J `v Date received: Authorized si , ature: 4 A. a_ _ - This permit application expires if a permit is not obtained r�irl. within 180 days after it has been accepted as complete. Print name: V r = vdt ) ate: � '" * Fee methodology set by Tri -County Building Industry Service Board. i:\ Building \Permits\BUP- PermitApp.doc 12/03 440 .4613T(11 /02/COM/WEB) One- and Two - Family Dwelling - Building Permit Application Checklist FOR OFFICE USE ONLY City of Tigard Received Permit No.: te 13125 SW Hall Blvd., Tigard, OR 97223 ss Aociat Phone: 503.639.4171 Fax: 503.598.1960 ��m,r ssociazedpermits: 24- Hour Inspection Line: 503.639.4175 I,I ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.ci.tigard.or.us " " " " "' ❑ Other: 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. Name of district: . ❑ ❑ ❑ 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑ 6 Sewer permit. ❑ ❑ ❑ 7 Water district approval. ❑ ❑ ❑ 8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑ 9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, . silt fence design and location of catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ 0 building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ , and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- • , ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray _ construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide•elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non . ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore•on and shall be shown to be a, ilicable to the .ro'ect under review. IURISDICI IONAL 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 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain redlines or tape -ons. "Mirrored" building plans will not be 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 and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include tree protection measures as required by conditions of approval. ❑ ❑ ❑ 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\ Building \Permits\BUP- RES- PermitApp.doc 2 Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Received DateB Permit No.: 13125 SW Hall Blvd., Tigard, OR 9722 R ECEIV Plan Review Phone: 503.639.4171 Fax: 503.598.1960 l,, p irkJ I Date/B . Other Permit: Inspection Line: 503.639.4175 ''!1 1 Date Ready/By: 3uris: ® See Page 2 for Internet: www.ci.tigard.or.us NOV 1 7 20 J Notified/Method Supplemental Information TVOITAPerfiGARb . PLAN REVIEW El New construction ® kt A�r ` /: nt Please check all that apply: • m 0 Demolition , Ei Other: ❑Service over 225 amps, com'I ❑ Hazardous location ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of I and 2 family dwellings 4 or more new residential ❑ 1 - and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building 0 System over 600 volts nominal units in one structure ❑ Multi - family ❑ Master builder ❑ Other: ❑Building over three stories 0 Feeders, 400 amps or more ❑Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park Job no.: Job site address: L Sol -1� S) �1 R � V �, � ❑Health - care facility ['Other: U1. o � t Submit 2 sets of plans with any of the above. City/ State/ZIP: 9 a q The above are not applicable to temporary construction service. \ Project name: � - # �� k/' / FEE* SCHEDULE Suite/bldg. /apt no.: °�a1't'.((' "^-'.,pr_,_,.1431- -"` 7. 1 Description I Qty. I Fee. I Total .. Cross street/directions to job site: 1d, QMW1 td✓vw New residential single- or multi- family dwelling unit. Includes attached garage. ty A ' vv ' "` _ J ,,, 6 ,6 0, 6 ,t L, Q 4q 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75 2 . Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular .'t • n I r� .p_ fl - dwelling, service and/or feeder 90.90 2 V' ' `31N"� '�t t0GJC1tn. � ( f1�4:'� Services es or feeders installation, alteration, and/or relocation ki V 200 amps or less 80.30 2 - ❑- ROPERTY OWNER I , ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: (\e. , v..- `z Q or- ��� zi 601 amps to 1,000 amps 240.60 2 r Address: I C is- � "- Over 1,000 amps or volts 454.65 2 �� Reconnect only 66.85 2 City /State /ZIP: Q O •a Temporary services or feeders installation, alteration, and /or Phone: ( ) Fax: ( ) relocation 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch circuits — new, alteration, or extension, per panel tlp APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with (� service or feeder fee, each 6.65 2 Business name: 1-0-P I � lQle ¢--a. ' branch circuit B. Fee for branch circuits Contact name: _ t without service or feeder fee, 46.85 2 Address: [C)(,9(:) S - ) 70 Ea L+. each branch circuit Each add'l branch circuit 6.65 2 City/State/ZIP: ....V`B (9N 9 -7 0 ( 'l_ Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( 8gS _ 0% sscg Fax: : (5 ) % % 0 S V) Sign or outline lighting 53.40 2 E - mail: - ti_. , •_ 5 ( %iA Oy , , A.42-t Signal circuit(s) or limited- . CONTRACTOR . energy panel, alteration, or _ extension. Describe: Page 2 2 Business name: ) 1n - � Sole\ �LC Address: Each additional inspection over allowable in any of the above • Per inspection 62.50 _ City /State/ZIP: Investigation per hour (1 hr min) 62.50 • Phone: ( ) p er; ( ) Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* ' CCB Lie.: Electrical Lie.: a67.,40 (Suprv. Lie.:. / ) Subtotal Suprv. Electrician signature, required: ,7 _ ,4ob /Q -/ _ Plan review (25% of permit fee) Print name: Date: State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board •• Number of inspections per permit allowed. i:\ Building \Permits\ELC- PermitApp.doc 12/03 440- 4615T(10/02/COM/WEB Electrical Permit Application - City of Tigard , Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: 1 RESIDENTIAL WORK ONLY: Fee for all residential systems combined........ $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: G ONNA ERCIAL'WORK ONLY: Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems:. *No licenses are required. Licenses are required for all other installations i:\ Building \Permits\ELC- PermitApp.doc 04/03 Plumbing Permit ApplicaFitECEIV _. D F OR OFFICE USE ONLY Y #' ` '' City of Tigard Received Permit No.: NOV 13125 SW Hall Blvd., Tigard, OR 97223 1 7 004 Date/By: Plan Review • Phone: 503.639.4171 Fax: 503.598.1960 /ti�u� �( Date/By: Other Permit No : 24- Hour Inspection Line: 503.639.4175 CITY OF Ju,is: a rd.or.us _ ., D ate ReadyBy: 0 See Page 2 for Internet: www.cistigard.or.us BUILDING • 1 • Notified/Method: Supplemental Information ,,....,- ..i3d -:�° . .> ry.'.:y. # Y - . '�.K,- -<uV #ih'+i�i, " 'a1 Y :9::.�:� �. �,c �t;5` •r ... :."- ••Y:: ""'� :Sk". ". : .. _. i' ... I FE OF W ORK ; ,- ,, i .,,. _. ..� .„.,..,_ FEE* S .., . El New construction El Demolition For special information use checklist. Description Qty. Ea. Total Addition/alteration/replacement ❑ Other: � repacemen er: ew 1 1 - 2-family mil y dwellings (includes 100 ft. for each utility connection) New 2 f , y li-;`if*Tl `�' <rur-.v.: ;,' : => �s�"i, : :_"rR*: : al ?.s .:..a: °",�;;?�' ,�; #rt",%et .`a, t'V' ',s a i w^ - . m F r = - h .'„ 4t` a Ct1 T G® Y ®` COIVSTR , IYa m ' " s , x % SFR (1) b ath 249.20 \FZ1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 - I=1 Accessory building ❑ Multi - family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fires sprinkler sq. ft.) Pa �n�" P ( 9 ) Page 2 g 1,11119:1 .: OB STT ttTP1E RMA�TI 2#1, A P ��' .., ,:Li Site utilities Job site address: ' .7 5 V Ca/414.4.16 i. Catch basin or area drain 16.60 City /State /ZIP: '� /t 5-701)(4 Drywell, leach line, or trench drain 16.60 - Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: • Manholes 16.60 Rain drain connector 16.60 ' Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no.: t W- ar.:k ., , -, .:: ;:. {,., „.,, q _. -n. = Absorption valve 16.60 ' i t. 9 f` it t �lrtk TL.IS\ O 4&ii11 . l „ �, .. -� , ; � � ... 4 . _, r , ��.r. i.. ._ �__ i / t � � `,`,. ,F ...) ...?, Backflow preven ter Page 2 P.Q� I '...t / Q/i f y ¢_ . 1 IA .4 .Qt2 G''z ^ " - Backwater valve 16.60 _ � Ste Clothes washer 16.60 Dishwasher 16.60 . pROPERTY OWNER "W 4 °*' t N-Wir ' Drinking fountain 16.60 . ....al ., n� _..,i s, -;.., . _i x _ . ,,, . ,. ,. :v...,,.,E,.. ' t ,. Ejectors /sump 16.60 Name: ! 't9/I_WIAiy��4' 0., r...._ Expansion tank 16.60 Address: n ,l, a d Fixture /sewer cap 16.60 City/State/ZIP: . -i 61 j � L / Floor drain /floor sink/hub 16.60 Phone: (5033) S4 ^ (/ 0 Fax: ( ) Garbage disposal 16.60 . .iiavik r ` ..._ 2 � _:.�iiw `;: wdz,r w ri,- > �t,+ ,,:u „is p � _;: "e 2 : , ;,W ` , c; 4i Hose bib 16.60 W Y ; . ti :' " n t �.�. T �" / :C - Ice maker / 16.60 Business name: -I-6p Q ra- u-€_- ! )e_to /)'Y�1� - Interceptor /grease trap j 16.60 Contact name: 1 1 1 (` Medical gas (value: $ ) Page 2 i " Address: I s (o o � Primer 16.60 . City/State /ZIP: , 9 cgog- Roof drain (commercial) 16.60 c o' I Sink/basin/lavatory 16.60 Phone: (5r�3)SS - U6,2)C, Fax: (3) ? b'J- O8' '© t ` , -v .� �� Tub /hower /shower pan 16.60 E -mail: _ WLIr ` \l Urinal 16.60 a ,. �:= <3 a r _ > : , w s m:' - lawdi „:: ;. = sue :, f , t ,::, sat „:. .. ao>i TI�;cTOx z 4 , = , 4 �,a x h rte: ,. - .,r8�� iz.& �- :u��i_h. ._ �.�, Water closet 16.60 Business name: p � - y i Water heater 16.60 Address: I � Other: 1 �D 5 S rr.. / City/State /ZIP: `�Z IAg4 t� 4 e '2 Subtotal Minimum permit fee: $72.50 Phone: (5U) j t f , , g 2k Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: / .. .9,p . ,--A i l 77 Plumbing Lic. no.: Plan review (25% of permit fee) �j - (g - °--5 State surcharge (8% of permit fee) Authorized signature: TOTAL PERMIT FEE 7 33 Print name: Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. (.) *Fee methodology set by Tri- County Building Industry Service Board. i:\ Building \Permits\PLM- PermitApp doc 12/03 ,\ 440- 4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential-Fire Suppression Systems: W ta'airg ,r1---vaw.wANkt-7 :!,&itzcin ASCIttlafej:E9A4gOght Pi1e Footing drain - 1" 100' 55.00 0 to 2,000 $115.00 • • • Footing drain - each additional 100' 46.40 2,001 to - $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 Tee . • - N.41, Awkfo Arm* 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 $viit additional $100.00 or fraction thereof, to and MIN 411 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 each additional $100.00 or fraction thereof, to Inspection of existing plumbing or 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 Prri,WZiltaf:fe PAr ;4 4 MVPCg"' i, iEVACkp sAVP *kit italYekr4at ,4flite0 AggEIV, Comments regarding fixture work: Baptistry/Font Bath -Tub/Shower -Jacuzzi/Whirlpool Car Wash -Each Stall -Drive Thru Cuspidor/Water Aspirator Dishwasher -Commercial -Domestic Drinking Fountain Eye Wash Floor Drain/sink - 2" Car Wash Drain Garbage -Domestic Disposal -Commercial *Note: If the fixture work under this permit results in an -Industrial i Ice Mach./Refrig. Drains ncrease of sewer EDUs, a sewer permit will be issued and Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the Rec. Vehicle Dump Station plumbing permit can be issued. Shower -Gang -Stall Sink -Bar/Lavatory Quantity Total -Bradley Isometric or riser diagram is required if fixture quantity -Commercial -Service total is >9. , Swimming Pool Filter Washer - Clothes Water Extractor Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal Other Fixtures: i:\Buiiding\Pcrmits\PLM-PerniitApp.doc 3/03 Mechanical Permit A 1 i,,,.. 11.. FOR OFFICE USE ONLY ' . - IVES City of Tigard L.' R eceived . Permit No.: Date/By: 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 NOV r ii ylll r l� �\ Date/By: Other Permit: Inspection Line: 503.639.4175 N / L 1 1 � W Date Ready/By: Juris. El See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: Supplemental Information t , ° s.�w ; .. . :�_ <, ." �.��::.�. _. �, r. �t±.:.:s�'"°s:'^3` «'z= :a°�';'i� p� ��� �PaAA .+�'d� �i9�? < . :�= .< < _,:_ - -_-�- - - ��yy �q.,, tat. 1V� a?>! .Ee_ 2 t^.t!..' -w{� o°'W`5• ^..e:`Cia. t S' EI • .t. s5i *' :Cc. >dxtY.= t�d'j �� a[;..a�.e,.pLL�,3 S&�1 ,,. *+`'" ��`� u M � . �'`�.; �� � t�TYPIOFr WORKP ',�� -�;`�� x i � COMMER'CI'AiI. - -, FEE.. - - <;:S iTLE�``= '- USE;CFIECKLIS'T' , � -� - �..rt .� _. � -.._ -. CHED. ° Mechanical permit fees* are based on the value of the work ❑ New construction ❑ Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit In ,.r l" ¢- :t" :d .:x;�rR. , *u , i;� wwu a, ". tr:._ - ... t Value: 4. � ` ;;.vim °� CXTEGQRY OF CONSTRU T ION ""r.' ,li_ . b r RESIDENTIAL EQUIPMEN - /' X 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ..... " " ❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist. Description l Qty. I Ea. I Total ft`x. . " JOB SLT /I Al D r;LOCATI01� " '�" � F g » e, „ ,'�'> ? , w1- .. . _. .. A , ., -., 0, , w = , a, :w,, a. , x; A ,..,1 hq Heatin coolin Job site address: 15 I .-1 - S sv e , Mi-. J (I _ n Air conditioning or heat pump 1 ( ()ea, �(./ -Q„ (requires site plan showing placement) 14.00 City/State /ZIP: �-- (. 01 - 34 0 i 0 1 9'1 a.3 Furnace 100,000 BTU (ducts /vents) 14.00 Suite bldg. /apt. no.: Pro name: 1 Furnace 100,000+ BTU (ducts /vents) 17.90 Gas heat pump 14.00 Cross street/directions to job site: Duct work 1 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), . in -wall, in -duct, suspended, etc. 10.00 Subdivision: i Lot no.: Flue /vent for any of above 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances fi , , 3.' ' t; :°. _ ,,;�'Y€Frsgk �:<: ,:: r a y -, -� . ,,.,� .., -, ,. -, -,° y.,,,,,,.. .: t�,. - - e ,,f Water heate 10.00 ,, ,; < UESGRR O a. RK 1 4 - 1 - :. - ry e � :.,, .: �' Gas fireplace 10.00 Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 , ..:_:: ;k i .r, 1,v r < .,. ., € Chimney /liner /flue /vent 10.00 I ROP.ER i atAlI� �` `� "TA . 4,.. .v , , .' „K - -,..mss. - ,zr.a . .i:. iii v_. n a`11. . �, � ..i..4,.x _ + 3 ',.:s . -1.. Other_ 10.00 Name: n,,,,-,,„„ � Environmental exhaust and ventilation Address: 15 CI 1. 5� 0� �� Range hood /other kitchen equipment 10.00 City/State /ZIP: Q 9). a , Clothes dryer exhaust 10.00 t Single -duct exhaust (bathrooms, Phone: (3) �(� (l Fax: ( ) toilet compartments, utility rooms) 6.80 :` 't , riVI LIM tl ,, ` `" F ,, GONT ,PERS 4, `u Attic /crawlsp fans 10.00 Business name: .�d 1✓ p-a � � � p �-r Other: 10.00 � / Fuel piping Contact name: v�f 4< $5.40 for first four; $1.00 for each additional Address: n 9 7( . ; ,. 0 „ ! ` - Furnace, etc. I Gas heat pump City/State /ZIP: ( 91®� 3- Wall /suspended /unit heater Phone: ( Soy $ g - _ 6, Faxx:: (503) g s.S O %� Water heater Fireplace E-mail: �M ` �+l/V i t &Cc 4 km ' L ��� Range - ^'`, a. - ,r p r„ a. fit' „�" +�. I 3 a: r a�». z i a i . r ' 's :.. : e . -.- rt °. 5 CO �-. + .t Z „ : Barbecue Business name: �� D��� P ._ p o , %'�- C1 ,ehas dryer (gas) f t jP .. • t� ll � t e Address: ( 1 569, 'U� ` J 03 / C7 t , � s 3 � c 'a atFa a +w * n - . I S11AN E II P RMIT FEES . City/State /ZIP: , -FJ , � 9 ? D_Dlit Subtotal Phone: (SO) -- �e ( ' rV- Fax: 6 ) g S - - $ O g(� Minimum permit fee ($72.5 W !� � Plan review (25% of permit fee) ) CCB lic.: 13 . , State surcharge (8% of permit fee) e�r - -- I TOTAL PERMIT FEE Authoriz d signature: - This permit application expires if a permit is not obtained within 180 - �,0410 _rf�.= days after it has been accepted as complete. Print name:' /� ii! 1tI M� * Fee methodology set by Tri- County Building Industry Service Board is Building \Pernvts\MEC- PermitApp.doc 12/03 440 -4617T (1I /02 /COM/ \EB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: otal ' Valuation $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. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. • i:\Building\Pemuts\MEC- PermitApp.doc 12/03 2 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 RECEIVED IMPORTANT PERMIT NOTICE DEC 02 2004 DICKINSONS ELECTRIC CITY OF TIGARD 8449 SW BARBUR BLVD BUILDING DIVISION PORTLAND, OR 97217 Electrical Signature Form Permit #: MST2004 -00350 Date Issued: 11/23/2004 Parcel: 2S111 CC -04500 Site Address: 15975 SW CENTURY OAK CIR Subdivision: SUMMERFIELD Block: Lot: 068 Jurisdiction: TIG Zoning: R -7 Remarks: Enclose courtyard, move stove, replace fridge waterline. Plumbing fee in building permit. 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: BUTCHER, NORMAN & BEVERLY DICKINSONS ELECTRIC 15975 SW CENTURY OAK CR 8449 SW BARBUR BLVD TIGARD, OR 97224 PORTLAND, OR 97217 Phone #: 503 - 546 -4058 Phone #: 246 -3550 Reg #: LIC 65534 SUP 3100S ELE 26 -140C AN INK SIGNATURE IS REQUIRED ON THIS FORM X Signature uperv s ing 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 ROYAL PLUMBING 14035 SW 6TH ST BEAVERTON, OR 97005 Plumbing Signature Form Permit #: MST2004 -00350 nate Issued: 11/230004 Parcel: 2S111 CC -04500 Site Address: 15975 SW CENTURY OAK CIR • Subdivision: SUMMERFIELD Block: Lot: 068 Jurisdiction: TIG Zoning: R -7 Remarks: Enclose courtyard, move stove, replace fridge waterline. Plumbing fee in building permit. 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: BUTCHER, NORMAN & BEVERLY ROYAL PLUMBING 15975 SW CENTURY OAK CR 14035 SW 6TH ST TIGARD, OR 97224 BEAVERTON, OR 97005 Phone #: 503 - 546 -4058 Phone #: 646 - 8824 Reg #: LIC 121274 PLM 34 -311 ob AN INK SIGNATURE IS REQUIRED ON THIS FORM ��S gn �Gre uthorized Prmber If you have any questions, please call 503.718.2433. r CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2004-00350 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/23/2004 Phone: (503) 639-4171 oak , Nfig Inspection Requests (24 Hrs.): (503) 639-4175 ...„._,W ' IL INSPECTION WORKSHEET FOR DATE: 1/3/2006 TIME: 7:01AM PAGE: 69 SITE ADDRESS: 15975 SW CENTURY OAK C1R CLASS OF WORK: SUBDIVISION: SUMMERFIELD LOT #: 060 TYPE OF USE: PROJECT NAME: BUTCHER DESCRIPTION: Enclose courtyard, move. E7tove, replace fridge waterline. Plumbing fee in building permit OWNER: BUTCHER, NORMAN & BEVERLY, PHONE #: 503-546-4058 CONTRACTOR: MASTERMIND DEVELOPMENTS LLC PHONE #: 503-685-8666 Inspection Request Scheduled For: Date: 113/2006 . Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 024177-04 971 N Corrections/Comments/Instructions: , . • la PASS P; - TI , APPROVAL 0 CANCEL 7 NO ACCESS IL pl C OR INSPECTION 7 ADDITIONAL FEES ASSESSED Inspector Ai -../1111. ■ Date: / °1 Phone #: (503) 718- 4 4Ift ‘. - . , . CITY OF TIGARD BUILDING DIVISION PERMIT #: IVIST2004-0050 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1 li2312004 Phone: (503) 639-4171 a I Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 1/3/2006 TIME: 7:01AM PAGE: 70 SITE ADDRESS: 1597,6 SW CENTURY OAK CIR CLASS OF WORK: SUBDIVISION: SUlv1MERFIELD LOT #: 068 TYPE OF USE: PROJECT NAME: BUTCHER DESCRIPTION: Enclose courtyard, move stove, replace fridge waterline. Plumbing fee in building permit. OWNER: BUTCHER, NORMAN & BEVERLY, PHONE #: 503-646-4050 CONTRACTOR: MASTERMIND DEVELOPMENTS I..LC PHONE #: 508,5-8686 Inspection Request Scheduled For: Date: 1/3/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 133 Electrical final 024177-03 971-404-8798 Corrections/Comments/Instructions: PASS P' RTIAL APPROVAL LII CANCEL Li NO ACCESS F FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: 3. OA' Phone #: (503) 718- . IMP CITY OF ��U�������� �pnm n *wrm mn����nn�� BUILDING DIVISION PERMIT #: k4ST2004'00360 , 13125SVV Hall B|vd.. Tigard, ORO7223 DATEISSUED: 11/23/2004 Phono:(503)689'4171 Inspection Raque�s(24Hm.):(503) G3Q'417G a � INSPECTION VVORK8HEETFOR DATE: 1�/ �OO8 TIME: 7:01AM PAGE: 71 ' SITE ADDRESS: 15975 SW CENTURY OAK CIR CLASS OF WORK: SUBDIVISION: SU&4AMERF\ELD LOT #: 868 TYPE OF USE: PROJECT NAME: BUTCHER DESCRIPTION: Enclose courtyard, move stove, replace fridge waterline. Plumbing fee in building permit. OWNER: BUTCHER, NORMAN & BEVERLY, PHONE #: 503-M6-4058 CONTRACTOR: MASTERMIND DEVELOPMENTS LLC PHONE #: 50:885'0686 ' Inspection Request Scheduled For: Date: 1/2VI006 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plumbing final 02417702 971'404879a N Corrections/Comments/Instructions: tPASS . p ri p 0 CANCEL 0 NOACCESS pi FAIL II A OR INSPECTION . 0 ADDITIONAL FEES ASSESSED Inspector: __ ���*�__ ot*: �- \ ^0 Phone #: /603\ 718- CITY OF TIGARD BUILDING DIVISION • PERMIT #: 1AST2004-00350 D ATE 13125 SW Hall Blvd., Tigard, OR 97223 E ISSUED: 11/23/2034 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR . DATE: 1/3/2006 TIME: 7:01AM PAGE: 72 SITE ADDRESS: 15975 SW CENTURY OAK CIR CLASS OF WORK: SUBDIVISION: SUMMERFIELD LOT #: 058 TYPE OF USE: PROJECT NAME: BUTCHER DESCRIPTION: Enclose courtyard, move stove, replace fridge watedine. Plumbing fee in building permit.. OWNER: BUTCHER, NORMAN & BEVERLY, PHONE #: 503-.546-40W CONTRACTOR: MASTERMIND DEVELOPMENTS LLC PHONE #: 503-8858686 Inspection Request Scheduled For: Date: 1/3/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 024177-01 971•404-8798 N. Corrections/Comments/Instructions: T" 4 / c m 0 / PASS IN ". AL APPROVAL 7 CANCEL 7 NO ACCESS FAIL C LL FOR INSPECTION ADDITIONAL FEES ASSESSED lnspecto : Phone #: (503) 718- CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST A DO 3-< INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested 3 AM PM BUP Location / S c 1 75 - Suite �,} MEC Contact Person �-' Ph (9_2L) �� f 7?? PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Ftg Drain Access: L■6DK ELR Crawl Drain '�"" Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing . �y rywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final _ PAS PART FAIL Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post& Beam Rough -In Gas Line Smoke Dampers Final • PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final ❑ Reinspection fee of.$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: 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 (9.0e) T eo 3 5-6 INSPECTION DIVISION Business Line: (503) 639 - 4171 �- 3/ o� BUP Received Date Re•uested AM PM BUP Location 'i/ _...1L. t - Suite MEC Contact Person r Ph. ( � 7 7/) %' ¥ - t ?7 ? PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Ftg Drain Access' l� ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear - Int Sheath/Shear s /� Framing / �t =`E� / �L:y GTl2 (14-e. �G�;��� Tsulation Drywall-Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PA PLUMBING - � Post & Beam Under Slab Rough -In Water Service Sanitary Sewer • Rain Drains - Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post& Beam Rough -In. Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service ,Rough-In UG/Slab Low Voltage Fire Alarm Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. • PASS PART FAIL SITE 0 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 MST ,Z10 INSPECTION DIVISION Business Line: (503) 639 - 4171 BUP Received Date Requested I — 0.14 AM PM. BUP Location _/ii .! . % . l+A_ C Suite MEC Contact Person / Ph ( cl it) (f-b L 87`ry PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes, i �- SIT Post & Beam (� c.Yl/L f� She. Anchors : - 4012100 .hear Int Sheath/Shear ami Insulation Drywall Nailing Firewall Fire Sprinkler • ( • Fire Alarm A Al Susp'd Ceiling • Roof . — I .� Oth F i S S PART FAIL U G Post & Beam Under Slab f � \ Water Service �� Lia 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 J Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE - , . ❑ Please cal or reinsp- ction RE: • � ` Unable to inspect - no access Fire Supply Line - 63 � , ADA • `/ ,�� Approach/Sidewalk Date Inspector �--_ l� Ext Other: Final D I NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 msTa‘)V-e) INSPECTION DIVISION Business Line: (503) 639 - 4171 BUP Received Date Requested / ' 1/ AM PM BUP Location / 5 7, - Suite MEC Contact Person 9ezrY141-- Ph ( ) . PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Slab Inspection Notes: SIT . -os . =ea Shear Anchors Ext Sheath/Shear • Int Sheath/Shear Framing . • • . io,' a./S- a I Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof ' Other: Fin SS PART FAIL BIND Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECH NICAL ost & Beam) Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG/Slab Low Voltage Fire Alarm Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE - El Please call for reinspection RE: ❑ Unable to inspect – no access Fire Supply Line ADA I -- / /' 6" Inspector • Ext Approach/Sidewalk D a t e 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 d D 91' d d INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Reques d / AM PM BUP Location IS 75 w ' Suite Cw MEC Contact Person Ph ( ) PLM Contractor Ph ( ) �gS - �(Q 0�0 SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR C_ c Slag Inspection Notes: SIT -ost = :earn Shear Anchors Ext Sheath/Shear Ina Sheath/Shear �– �� �� 2 j ‘44Z J Framing /ice ,C t ? h l�. « c.d./4 1: �- 2 su atio V " Drywall Nailing f Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART glij 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 ost.& Beau Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 111 Please call for reinspection RE: 111 Unable to inspect – no access Fire Supply Line ADA O �--- Approach/Sidewalk Date / — 1 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 a2�0 %- o 3s6 INSPECTION DIVISION Business Line: (503) 639 - 4171 BUP Received Date Requested / )- AM PM BUP Location 601 L-4- &U Suite MEC Contact Person Ph( �) '/011- - /75 PLM Contractor Ph ( ) SWR B I NG Tenant/Owner ELC Footing ELC un M Access: g 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 Susp'd Ceiling Roof Other: Fin - ART - 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 ELECTRIC AL 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 / ei Inspector Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL t. C 24 -Hour �t Inspection Line: (503) 639 -4175 INSPECTION DIVISION � Business Line: (503) 639 -4171 BUP . Received D Reque ted °')1/41-- AM PM BUP Location g S Q Suite MEC • Contact Person ' # • (q I ) {c ( i — PLM Contractor Ph ( ) SWR _ 'BUILDING Tenant/Owner ELC Footing Foundation ELC A ccess: ' r Ftg Drain ELR 11 ; Crawl Drain Slab Inspection Notes: 13).1jdoce. C�4. SIT ' Post & Beam ,:, Shear Anchors W\4\i'* .5'bh / Ct—e—&-Lik .r - C U-v- • .`;.f Ext Sheath/Shear • . -' Int Sheath/Shear l , . ----X7 ` Framing /I1 i L. * 5.. 1/vA/ JNA i 1L u, Insulation 1 ' !� Tfl L "c:° Drywall Nailing r. Firewall '( * i • Fire Sprinkler 1 ``��' C , n ‹ /3L/ Aar s S lM -\•� ate - - o ." 0- O 3 Susp'd Ceiling ] ) (% Roof Other: • + ' Final - PASS PART FAIL I. jam' . : } 1 , . Under ab \' , -� �.. v .-ou -In = VIA Fx 4 a e ervice \ Sanitary Sewer Rain Drains Catch Basin / Manhole , Storm Drain J Shower Pan _ 3 g Other ?; - . S 4 PAkIT FAIL " CHANICAL — . = Post & Beam , e b _y V i Smoke Dampers (" r Fr, = PART FAIL '` ,RICALa °: Z•Z . �' Service Rough -In UG/Slab ; Low Voltage b `° Fire Alarm I Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvc PASS PART FAIL ' • : - = a # - El Please call for reinspection RE n Unable to inspect - no acces '% Fire Supply Line Date t� ADA Da VA ) 2 � / 11J` jk.......,/,.: � Approach/Sidewalk I n s P ector Ext 'k a 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 ,g66.711 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received _ Date Requested ` '� ,l AM PM BUP Location / 7 S f v■ Suite MEC Contact Person Ph ( ) S / S �9 ,_. PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Ftg Drain Access: L. p ' , v l ELR Crawl Drain l ( v J 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: 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 yr. • Post& Beam Rough -In Gas Line Smoke Dampers Final PASS RT FAIL L CTRICA Sery UG /Slab Fire Alarm Fi a PART FAIL El PART 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 — S Inspector _ Ext Other: Final DO NOT REMOVE this Inspection record fr m the jo site. PASS PART FAIL CITY OF TIGARD 24 -Hour CG BUILDING Inspection Line: (503) 639 -4175 MST " C 40,356 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date ' equested `�Z E AM PM BUP Location - � .ai' . __l.. I�Z. (AL Suite MEC Contact Person Ph ( )S?, 7c) - PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC L Ftg Drain ` K _ J r ,e / ELR Crawl Drain w YV Slab Inspection Notes: SIT Post & Beam Shear Anchors ; l Ext Sheath/Shear �/ Int Sheath/Shear 1 ` ) Y (� `� SA ft / „� ; P� Framing / y� J t \ (� \ °> t 1 �JtJ Insulation � - � 1-� �j \� 1 �� ' 1 '� `- Drywall Nailing Firewall PLQ\ ,a —� PIS, L 1,� c. „ 1`t J �� cir\A.v �? Fire Sprinkler Fire Alarm Ffl'o-Aft Susp'd Ceiling � f l \� pi`t) I Roof Z �' �\. N� \� V1s11 VV �� �Y`� l Final " 1L'A , 0`J 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 RT FAIL Service uq - UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PARK SITE Please call for reinspection RE: ❑ Unable to inspect — no access • Fire Supply Line J �� J ADA Date \ © Inspector In \�� v Ext Approach/Sidewalk Other: Final DO NOT REMOVE this inspection record fro the job s t®. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 6. oo 3 S6 INSPECTION DIVISION Business Line: (503) 639 - 4171 ( BUP Received D Reque ted �,, AM PM BUP Location / S "! Q ° " A (--- Suite MEC Contact Person ( q-21 ) `i 0 v- PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: o C_,a°��� SIT Post & Beam f � Shear Anchors W S , rL LDC..kk 3 Ext Sheath /Shear J Int Sheath/Shear ' • -d■ Framing 1„,J a v„,/k')\` S7 Insulation i 11) I L ai Drywall Nailing Firewall °(l2 „ t Fire Sprinkler V . � Fire Alarm ) 14 3 O� i c Susp'd Ceiling Roof Other: Final PASS PART FAIL eam Under �. < L ab �! ""( rough -In VIA s' Wa er ervice Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Ot pA9T FAIL ,� CHANICAL - Post& Beam � -Aj Smoke Dampers 1^ (19% PART FAIL RICAL 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: El Unable to inspect - no access Fire Supply Line ADA ti di / 01 ,{I ()4. Approach/Sidewalk Date � I nspector Eut 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 c2O6 ( 7 1- 6 0 356 INSPECTION DIVISION Business Line: (503) 639 - 4171 BUP Received Date Requested hl a AM PM BUP Location / X 0,241 (4.44.4.... 0 C1 Suite MEC pontact Person Ph (1._/.._) 1 10 4 7 1 - qr PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner � ELC Footing .b , J C i V. ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab - Ins pection Notes: SIT I. Post & Beam -' s ` -,_ .:. < :-.....a... Shear Anchors F -' Ext Sheath /Shear C -_,—IA ry = - - `s :..: ; , , ,., - , Int Sheath/Shear 1 Framing Insulation Drywall Nailing Q F: reveal l o� vF� / � Zi ec i 2, c *- '., 4 € k � Fire Sprinkler � V� Fire Alarm Susp'd Ceiling _ / Roof ,,ccam�� ✓ 1� ��7 Other: �-E_ —� •L- //rte (-)" 5 1/ ` 1 Final =s PASS PAR ' FAIL r P UMBING , . ■ �g i• ' - r 4z i Po t &Bea - ,� �� ,,,,/ ,. _ Un• -rSla �' /Y�' Rou • -I -- Wate - rvice 7�n-41./_ - - -.�:- . Sanita t Sewer � J Rain :ins 4 - A IrrilrfAr-tri � Cat. B. sin / Manhole P - z .��/ ° • St. m Dr. in / - ice. • ;WA ® _ r ,,i S ower P., i _' ,4 id , A 7, — t ) • her: *ASS P. •T FAIL - = CHA AL � . /_ - ' ' �' : .. �1 Po &B= - m Roils - L_ �i i r _ 6 . Sm' a pampers F al — 75 - p / l 3 /-6 PASS ART FAIL ELECTRICAL 1 /e �_j -=. ©� -70 � ��� Service . - '. 1//D.,V6— i)' . Slab Low Voltage �/YSP6 ( /G - e s `T^ / C.- A/A 7 Low Fire Alarm 7 r p t � 8 �� / /V? — A Final 0 Reinspection fee required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PAR FAIL SITE 0 Please call f r reinspec on RE: ,' R -t. e to inspect - no ccess Fire Supply Line or �� A 2 4 DA he ' Q r >,i 2 2,4 Approach /Sidewalk Date Inspector , , t Other: Final DO NOT REMOVE this inspection .record from the job site. PASS PART FAIL