Permit 5 /62/6 c i - t 4 -•-t 7/4 e 'it-A- 4 ( e-e4-
CI TY OF TIGARD
PLUMBING PERMIT
� DEV ELOPMENT SERVICES P ERMIT #: PLM2004 -00155
�' �� 13125 SW Hall Blvd., Tigar OR 97223 (503) 639 -4171 DATE ISSUED: 5/5/2004
SITE ADDRESS: 09725 SW DURHAM RD PARCEL: 2S111CD -00400
SUBDIVISION: ALDERBROOK FARM ZONING: R -7
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ADD GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS: 1
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 2
TUB /SHOWERS: SEWER LINE: 200 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: 450 ft
Remarks: Site utilities for church addition. Other fixtures: (1) trench drain & (1) rain drain connector. 375' of rain drain &
75' of storm sewer.
FEES
Owner:
Description Date Amount
SOUTHWEST CHURCH OF
CHRIST [PLUMB] Permit Fee 5/5/2004 $400.40
9725 SW DURHAM ROAD [PLMPLN] Plan Review 5/5/2004 $100.10
TIGARD, OR 97223 [TAX] 8% State Surcharl 5/5/2004 $32.04
Phone : Total $532.54
Contractor:
WESTERN PLUMBING
9460 SW TIGARD STREET
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone : 503 Sewer Inspection
Storm Drain Insp
Reg #: LIC 2439 Storm Drain Insp
PLM 34 - 29PB Rain Drain Insp
Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR
952 - 0001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)
24. .699.
Is ed By: • N, 4-4 4 • ' Permittee Signature: �-1 < ":-• -- ()
- Call (503) . ` -4175 by 7:00 P.M. for an inspection needed the next busin s day
.q 1•
CITY TIGARD PLUMBING PERMIT
I�j DEVELOPMENT SERVICES PERMIT #: PLM2004 -00155
� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/5/2004
SITE ADDRESS: 09725 SW DURHAM RD PARCEL: 2S111CD-00400
SUBDIVISION: ALDERBROOK FARM ZONING: R -7
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ADD GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS: 1
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES: 2
TUB /SHOWERS: SEWER LINE: 200 ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: 450 ft
Remarks: Site utilities for church addition. Other fixtures: (1) trench drain & (1) rain drain connector. 375' of rain drain &
75' of storm sewer.
FEES
Owner:
Description Date Amount
SOUTHWEST CHURCH OF
CHRIST [PLUMB] Permit Fee 5/5/2004 $400.40
9725 SW DURHAM ROAD [PLMPLN] Plan Review 5/5/2004 $100.10
TIGARD, OR 97223 [TAX] 8% State Surcharl 5/5/2004 $32.04
Phone : Total $532.54
Contractor:
H & A CONSTRUCTION
PO BOX 23755
TIGARD, OR 97281 REQUIRED INSPECTIONS
Phone : 503 Sewer Inspection
Storm Drain Insp
Reg #: LIC 1341 Storm Drain Insp
Rain Drain Insp
Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR
952 -011 -1 SO. You may obtain copies of these rules or direct questions to OUNC by calling (503)
•-6699.
I _ ued By: L ,A,/M�i `� ' �i , /�_ Permittee Signatu : tea 4. _ .r
Call (50 .39 -4175 by 7:00 P.M. for an inspection needed the next business day
Site Utilities.
Plumb Pe rmit App,VE® F OR. OFFICE USE ONLY -
`t City of Tigard f_ Date/By: ya 1 Permit No.: F , / s
13125 SW Hall Blvd., Tigard, OR 97223 PR 1 3 200 A Plan Review Phone: 503.639.4171 Fax: 503.598.1960 4 ,11 i0 1 DaDate/By: 02 Other Permit No.:
24- Hour Inspection Line: 503.639.4175 ��. c ! I 11 1\ Date Ready /By: Juris: 10 See Page 2 for
`
Internet: www.ci.tigard.or.us CITY OF TIG' Notifed/Method: .6 Supplemental Information
. a a ^a §4 „ x �g z' • "'- �� t' i £. �a 'i a ,i; aCasir c, =J �; * ... . ,
,�, . e TYEE; d : ^ ` 0 �I € r . 40:=1.,. S* , r _ I ; -FEE ,* SCHEDULE 4 , . ,
,��'�x�,'�a�����^�.:�'� '&':' �a�e =r n��6s,�,�ua.��'�A„�.i.. ..wh ,. �'�F- , �.Lr, . . ll ?.�,. +a.. bra ^r >l�� ".
❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. 1 Total
❑ Addition/alteration/replacement ❑ Other: New 1 2 family dwellings (includes 100 ft. for each utility connection)
,'.it' »� =asaa:s.£�a; - >�a ^.; :�J��:oR'ak - a., °k..:£:4�as3a.3S? '�"*:xs °.w: -J 2�tm'.` "'.,£_: .��,`.c. - ' F,R�
s:. >z ir? �;,-;�w y �, ,�' - '� � SFR 1 bath 249.20
7 ' ; ' ' :4`' . r , ro °�, �&. ? CATEGORY OF ,CONS RUCTION { 414 - r/ �'a . ( )
� k�,)"a�s:?:d���c -�.. =+.., ,.?�kn.,.� *ra:.c+.,.±�a. �r-.e a ,�s.�..,�t�e*. r � :r�^o�;�"�.Sraazsk�t'�ar.a`.�� h� �_ "AVM* as���
❑ 1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Y € °' 1= � ,mac,,.. .: _, . :_. _° :, - c w ,,, Fire sprinkler ( sq. ft.) Page 2
a s 17 t' -, JO °S ITE IIYF ION A =TsIQN'
"tsa='E '.�',(. 4: ;!pit.; A,,,Ikrix•.Aav�3a6 ,DP:mnVsK _ra m Agg ?,.: `*r ,,, ^ , ,. _ . " '4•?ZI0i :P, S ut
Job site address: Gil --1,5 S LA. No e.,r.t.t tet ,,, R, Catch basin or area drain ' 16.60 /4 4,6
City/State /ZIP: - "r1,G• O L .-Lr Drywell,,,�l,✓/ aln leach line, or trench dr ain i f 16.60 /4, , (00 Suite bldg. /apt. no.: Project name: .Eo 8r (no. linear ft.: 11rl') • 5 Page 2 /9y, C u�'� C� t�l Manufactured home utilities 0 110.00
c ab
Cross street/directions to job site:
Manholes ! ! 16.60
Rain drain connector i 16.60 X4.46
Sanitary sewer (no. linear ft ) /'Op Page 2 /D J, t1
Storm sewer (no. linear ft,'lS) 1 _,. Page 2 - 60
Subdivision: Lot no.:
Water service (no. linear ft.. ' / 4 � .. � Page 2
Fixture or item
Tax map /parcel no.:
t ,' it£4r :u k Absorption valve 16.60
yfpg y ' 4 t /DESCRIPTIO q o' ORIC' - ` ; gr: `,,%
.IC,. 1t , tv .. IAR_: , A o -., aM ,- _ _ , l a � ,R...4 r Backflow preventer Page 2
_e _ . _ e. G_ _.9/ to t. ALAI r �. i = _ Backwater valve 16,60
O F 4- Pave -wlv Q re- ^.� e. , G.X► t 5- - Gf- LLiRC, Clothes washer 16.60
Dishwasher 16.60
. y r = "^`r;0 -- mr e ek: w, : , ;:': Fn, _ ,. ,;.,,. - .:_< " , s• .: ".gi Drinking fountain 16.60
'" v RIREMERITR WI .'�'_ 2 r a ® TE ANM s � `arm`
=•" __ »_ -��> 11 Ejectors /sump 16.60
Name: G
vim_ v',A„t l...t.-0111LST CArt a F. Gk-4r.,1 57 Expansion tank 16.60
Address: - ea
` - .� 2 S s �u..., viv k . ' - (2-1 Fixture /sewer cap 16.60
City/State /ZIP: rt C"4-21,_3Q i 02_ 4:k12,1_,30--- Floor drain /floor sink/hub 16.60
Phone: (S0 3) cozL, �.. e, Z 1 Fax: ( ) Garbage disposal 16.60
,. s p;, s °,�q° . sags ^pv� - �� > + 0 : ; 54' -. #t :a r s s:,:a, ,s..c. v m S; Hose bib 16.60
, R a i: � q , 3 l n . s J- .v . .` g,',t f , ' 5 - CON C_ PERS V� A l Ice maker 16.60
Business name: t p c�� S ZfbV ���., Interceptor /grease trap 16.60
Contact name: 1,r) ? Z( 2-r_ Medical gas (value: $ ) Page 2
Address: PQ y- '2= 5 C7 Primer 16.60
City/State /ZIP: Ti.. c...0o 10 otZ of --1 2E
2, Roof drain (commercial) 16.60
1 i Sink/basin/lavatory 16.60
Phone: (>)p C� I ^ C t4• t Fax: ( )
� , r /d 5 (j" �� Tub /shower /shower pan 16.60
E -mail: T/P'p �Df� ^� Urinal 16.60
" la>' �o�� � r,« :5 . � Si i' s�:.. .,w;'n -x�=ti �. ° �: . � : <:��'�s�i'- �h" ' w•�t;�4^ €'I; %;"« "`'�;i ° ` "`irs?
, 't " ac ? § r ; ,, C ON T RA6TO Rt r; x t�'k� Y : , Water close 16.60
Business name: Water heater 16.60
Address: Other:
Subtotal
City/State /ZIP: ■ < ,/
Minimum permit fee: $72.50
Phone: (:1.11 t Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lie.: Plumbing Lic. no.: Plan review (25% of permit fee) /06, /0
State surcharge (8% of permit fee) a, 0
Authorized signature: 52a
TOTAL PERMIT FEE JJ
Print name: iforoaer I Date: 4i* 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\PLMU- PermitApp.doc 12/03 440- 4616T( 1 0 /02 /COM/WEB)
9
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
•
Fee Schedule: . ., Residential Fire Suppression Systems:
6•".: r;ThyZi* :d"rie7(eill KTtitar; '' '4 FCe.' ''--
P..',.4.cawAii-41,01Te!,A4r,Atli.:.11i! 40-A;! 0.,At _Sr.,--L,,,,,...•., ..., , ;;L„t,.....t,„...... i-',,!... - -,.,-;,:, -, • -
Footing drain - l' 100' t ••-• ,,"." 55.00 0 to 2,000 $115.00
,-? ,..'■ e d6.7_
2,001 to 3,600 $160.00
Footing drain - each additional 100' 2 ' 46.40
3,601 to 7,200 $220.00
Sewer - 1st 100' .1 55.00 7,201 and greater $309.00
Sewer - each additional 100' 1 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
Water Service - each additional 100' 46.40 4w f
fx
Storm & Rain Drain - 1st 100' I t , 55.00 $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' , ,..tifi l „ 7 46.40 • $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
ovgov rovtil - re , - ni 4''r:IVPrpgrd; A 11.0 Eitteit.)11 at,tailiV, , additional $100.00 or fraction thereof, to and
fil'...4.2,...L....-1,-*.--t. ,..;,-..: 1 ';'4.' • ' ,jikrir : AZ,; .,'''' , ' ,, i.'" , 'O• W:1, 41i.Apt aiN.-,,,, 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) 2755 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 $106.00 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.
, •
. • .
.. .
i
•,. ,
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
pgarirRiTi; zw,gx., groivitiowflortwimbiloreioriiiiiiri
0 47)k10
1 ;a:•:' ,i': 6"4,
eit ffiw ITO:po t . : Comments regarding fixture, iyoyk:
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 workuniier this permit results in an
-Industrial i
Ice Mach./Refrig. Drains ncrease of sewer EDUs 5 a sewer permit will be issued and
issued
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 ' '
. Watei Extractor Plan Review
Water Closet - Toilet Plan review is required iffixture quantity total is >9.
- -
• Urinal
Other Fixtures:
. .
. ,
i: \Buildineermits\PLM-PermitApp.doc 3/03
PERMIT } PLAN � �
Fib Edit Options Window He D
Exit Ntw opae Tack List QBE
,,►,
Clot Edit ProIact Group Add Clona Pareal Actmtp Popk Fats Valuation Coadtion . Casa Notas Tags Oocumeatc GIS
• ik • rr -- • r\ 1 a - $ a Staff ` ' -1 D LJ
Name: SOUTHWEST CHURCH OF Updated: 12/29/2004 JMT> fl
;ddress:O725 SW DURHAM RD Jur: fIG
description: Master # Sli uii4 -00013 Project: SOUTHWEST CHURCH OF CH Fides
>, K
Site utilities for addition. Other fixtures: (1) trench drain (1) rain drain connector. 375`
of rain drain & 75' of storm sewer, 12129104 revised to split occupancy. This permit M SC.
Class of Work: fAOD ,�j ,
. ' Type of Use: ICOM
Occupancy Group: I Dates .
Number of Stones: Received; J13004 .. .
Target:
Issued: '1512004
Expired: I11/1Q004
Finaled:
t)
.
I Save current work
Start j '► Novel I GrcWi ... J « 12 ,18 PM
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line:' (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested � AM PM BUP
Location ? �7 z ����f Suite MEC
Contact Person Ph ( ) PLM2 1'5'
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Access:
Ftg (TE 077 ELR
Drain � `���
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam //
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation -
Drywall Nailing
Firewall
Fire Sprinkler d i i' f) 'l/ AO
Fire Alarm ki Susp'd Ceiling �� L sue•
Roof
Other:
Final
p S PART FAIL
"LUMBI,'
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain -
Shower Pan
Oth- •
PART FAIL
ANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final 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: MI Unable to inspect — no access
Fire Supply Line
ADA D ate .__ � '_ 0 y�� , , t / r � Q
Approach /Sidewalk I 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 Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 6 `'3 AM PM BUP
Location ' 73 i�r ) Suite MEC
, Contact Person Ph ( ) PLM c:Poe) '1-d DOI`
Contractor Ph ( ) ��f �� SWR
BUILDING Tenant/Owner o/d— v.. c 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
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Rain i rains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
C ,1 Cr,1- PART FAIL
ECHANICAL
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 cp
Approach/Sidewalk Date 6 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
INSPECTION DIVISION Business Line: (503) 639 -4171 •
— _ ,
BU
Received 3 Date Reques / -d AM PM BUP
Location "e_A J el4Z Suite MEC
Contact Person Ph ( ) PLM® ° Z 0 6)/ 5 757
Contractor Ph ( ) SWR
BUILDING Tenant/Owner _ / (`a r % &C.L/Ldii . 0-6(-/bCA- 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
Susp'd Ceiling
Roof ��1 � ir �` dllaV
Other: -
Final
PASS PART FAIL f J /
PLUMBING
Post
& Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
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
Final El 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 o 6 L
Approach/Sidewalk Dat = Inspector Est
Other:
Final DO OT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour 4
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received 3- 3 � � Date Request Ad ` - 2 -�� AM PM BUP
Location Z �5 , g 7.2 / cr�r t Suite MEC
Contact Person Ph ( ) _ PLM? l S _
Contractor (.{) /v -e4 4't. 4 Ph ( ) ' 3 '9-- 529,6 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 _ V
Drywall Nailing
Firewall I Ag�� / �
f"`
Fire Sprinkler ` �-
Fire Alarm
Susp'd Ceiling
Roof t
Final , �
' 1 _ f
PASS PART FAIL
PLUMBING
Post & Beam
<II erS
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basi / Manhole
(Storm Drain
Shower an
Other:
Fina -
f' P ART FAIL
AN ICAL
' ost & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final 0 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 f
Approach /Sidewalk Date r� y Inspector ) i 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 Business Line: (503) 639 -4171 MST
BUP
•
Received G Date Requested g AM . PM BUP
Location _/ 7? S Suite MEC
Contact Person Ph ( 97/ ) 5703 ' /3 &' 2 PLM a00 'F 00 lSs
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 - L
Firewall , � 0 �� Fire Sprinkler �� — �!
Fire Alarm
Susp'd Ceiling
Roof "
Other:
Final
PASS PART FAIL •
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary yjr
Rain Drains
Catc Basin / Manhole
or rain
Shower Pan
Other:
Fir
PASS PART FAIL
' ANICAL
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: Ei Unable to inspect — no access
Fire Supply Line
ADA l
Approach/Sidewalk Date r Y Inspector Ext
Other:
Final DO NOT R MOVE this inspection record from the job site.
`, PASS PART FAIL