Permit CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2001 -00212
�i� DEVELOPMENT SERVICES
' DATE ISSUED: 4/18/01
^ — --•' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10669 SW LADY MARION DR PARCEL: 2S110DA -08000
SUBDIVISION: ERICKSON HEIGHTS ZONING: R -3.5
BLOCK: LOT: 041 JURISDICTION: TIG
REMARKS: Construction of new single family detached residence. Path 1
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,704 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,762 sf GARAGE: 501 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: sf RIGHT: 5
VALUE: $-3:13,22850.
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3,466.00 sf (0Y9, REAR: 47
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
•
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 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: 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 • 200 amp: 0 • 200 amp: W /SVC OR FDR: 1 PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 6 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 00 SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 • 600 amp: 401 - 600 amp: EA ADDL BR CIR: 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: X VACUUM SYSTEM: X AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: X OTH: ALL ENCOM BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: X CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: X DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
•
Owner: Contractor: TOTAL FEES: $ 7,391.97
RENAISSANCE CUSTOM HOMES RENAISSANCE CUSTOM HOMES This d Municipal c al Code, , the regulations contained C o i the
Tigard Municipal Code, State of OR. Specialty Codes s and
1672 SW WILLAMETTE FALLS DR 1672 WILLAMETTE FALLS DR all other applicable laws. All work will be done in
WEST LINN, OR 97068 WEST LINN, OR 97068 accordance with approved plans. This permit will expire if
work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days. ATTENTION:
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Reg #: LIC 049955 forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Erosion Control lnsp 8 Post/Beam Mechanical Mechanical Insp Shear Wall Insp Rain drain lnsp Plumb Final
Sewer Inspection Underfloor insulation Plumb Top Out Exterior Sheathing Insr Water Line Insp Final inspection
Footing lnsp Crawl Drain /Backwater Electrical Service Low Voltage Appr /Sdwlk Insp Building Final
Foundation Insp Footing /Foundation Dr; Electrical Rough In Gas Line Insp Electrical Final
Post/Beam Structural PLM /Underfloor Framing lnsp Insulation Insp Mechanical Final
Issued B C�' Permit Signature :
_ `
Y �� g
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
. . c o.) —aolYO
Building Permit
o f Permit no.:
• V ?�yi City of Tigard � "°a!A
City of Tigard
Address: 13125 SW Hall Blvd, T. Expire date:
Phone: (503) 639 -4171 Date issued: By Receipt no.:
Fax: (503) 598 -1960 /leP Case file no.: Payment type:
Land use approval: _ 1 &2 family: Simple Complex:
TYPE OF PERMIT
S i & 2 family dwelling or accessory 0 Commercial/industrial O Multi- family XNew construction 0 Demolition
0 Addition/alteration /replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other:
JOB SITE INFORMATION
Job address: 10 "; 9 sw ' DV MARION PR- . Bldg. no.: Suite no.:
Lot: 41 I Block: (Subdivision: E?I,L 0.4 H'i's I Tax map /tax lot/account no.: .4/ /0'06 —O gape)
Project name: b- - S
Description and location of work on premises/special conditions: Si 04LE f Ikw1%L 1 •
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: P.E 1 � f ∎,6 CV f1 E 5 (Floodplain, septic capacity, solar, etc.)
Mailing address: I 1/ Z 6pv WLLLI .1 FAIL .5 Dt.1 & 2 family dwelling:
City: W f L-1 N N I State:. IZIP: 1104 Valuation of work 3 3 27 ? $
Phone. 7 - 00100 I Fax: 1E-mail: No. of bedrooms/baths 4 2.112-
Owner's representative: Al 511.1 11+ Total number of floors
• Phon:' - Z Fax: E -mail: New dwelling area (sq. ft.) ?j I31
APPLICANT Garage /carport area (sq. ft.) $ 0
Name: Covered porch area (sq. ft.) / eV
Mailing address: Deck area (sq. ft.) ommo
� Other structure area (sq. ft.) "'
City: I State: I ZIP:
Phone: Fax: E - mail: Commercial/industrial/multi family:
CONTRACTOR Valuation of work $
Business name: Existing bldg. area (sq. ft.)
Address: �/ New bldg. area (sq. ft.)
2K
City: v1 I State: I ZIP: Number of stories
Phone: I Fax: I E -mail: Type of construction
Occupancy group(s): Exi\ting:
CCB no.: New:
City /metro lie. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
•
Name: F.Vt.PpEU. A wyr provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: State:
y: G `Atrn P (ZIP: - l A •7O` 4 exempt from licensing, the following reason applies:
Contact person: YY11leE Plan no.:
Phone 4,Q. 124Q Fax: E -mail:
ENGINEER
Name: FA-t„. kIN fAJ4 . Contact person: Pb1/ rLtC- Fees due upon application $ •
Address: 41_4L 61L4./ fift. FALJh D I, T • Date received:
City: S IL.V1,f¢. PJ (State: pp (ZIP: Al 3$ t Amount received $
Phone: $ - - WM I Fax/Y1.310 sjE -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this 0 Visa 0 MasterCard
work will be complied , whether specified herein or not. Credit card number: / /
Expires
Authorized Signature: Date: PI Name of cardholder as shown on credit card — -- -
Print name: ,N01,4 ' 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 (6/00 /COM)
,
Plumbing Permit Application
Date received: Permit no. :M.0 / _�2 1Z
A � �� of Tigard sewer ermit no.: Building
Address: 13125 SW Hall Blvd, Tigard, OR 97223 p gpermitno.:
City of Tigard Phone: (503) 639 -4171 Project/appl. no.: Expire date:
Fax: (503) 598 -1960 Date issued: By: Receipt no.:
Land use approval: Case file no.: Payment type:
' TYPE OF PERMIT .
X 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement
•§i New construction ❑ Addition/alteration/replacement ❑ Food service ❑ Other:
JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist)
Job address: LQ 5w LADY /11/41.1014 p(. Description Qty. Fee (ea.) Total
Bldg. no.:. . I Suite no.: New 1- and 2 -family dwellings only:
(includes 100 ft. for each utility connection)
Tax map /tax lot/account no.:
SFR (1) bath
Lot: 4% IBlock: I Subdivision: SFR (2) bath '
Project name: Kitt' vi j H4 4 H m SFR (3) bath
City /county: '[ Apc ,,p I ZIP: Each additional bath/kitchen
Description and location of work on premises: Site utilities:,
5I Y A LE f - /hMlLY 141,61E. . Catch basin/area drain
Est. date of completion/inspection: Drywells/leach line /trench drain
PLUMBING CONTRACTOR Footing drain (no. lin. ft.)
Manufactured home utilities
Business name: G'/; ' T. W V • Manholes
Address: 11$te ,1 Ni! M $VS Rain drain connector
City: Bep� I State:,. I ZIP: 017,) Sanitary sewer (no. lin. ft.)
Phone4 I Fax: I E -mail: Storm sewer (no. lin. ft.) .
CCB no.: 141eptA' I Plumb. bus. reg. no 20 . t"147 re Water service (no. lin. ft.)
City /metro lic. no.: Fixture or item:
Contractor's representative signature: Absorption valve
Back flow preventer
Print name: Date: Backwater valve
CONTACT PERSON Basins/lavatory
Name: PVT2. POU -D Clothes washer
Address: Dishwasher
Drinking fountain(s) .
City: I State: (ZIP: Ejectors/sump
Phone: Fax: E -mail: Expansion tank
OWNER . Fixture/sewer cap
Name (print): a.E JA 16A1■I(,� 41,6 N a g Floor drains/floor sinks/hub
g 10 �l.L/�h�. fdLt1 DIL . Garbage disposal
Mailing address: Z. �j(i(! W Hose bibb
City: WEJ 1. jnJ I State:Q� I ZIP: a'1nbit Ice maker
Phone j ) . *wV I Fax: I 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 prop I own as per ORS Chapter 447 Sink(s), basin(s), lays(s) •
Owner's signature: Date: I ' rn1 Sump
ENGINEER Tubs/shower /shower pan
Name:
Pitt, NW . EWA IN firii -f JVL. Urinal
Address: 4142.. . .4,01 F/d L S P P. ^ j . • Water closet
Water heater
City: %WA/4Jnj State: OPP ZIP: 11 >$1 Other: .
Phone: l? • 34 �ra. Fax :03 . 0, E -mail: Total
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Minimum fee $
Notice: This permit application
Plan review (at %) $
❑ Visa ❑MasterCard
expires 'if a permit is not obtained
Credit- card - number. ExPir/ within after irhas been Slate- surchar- ge- (8 %)- .... -$ •
•
accepted as lete. TOTAL $
acce
Name of cardholder as shown on credit card p P
$
Cardholder signature Amount
440 -4616 (6/00/COM)
• Electrical Permit Application
Date received: Permit no.:
'I'I City of Tigard � 5 1a �� - ��
�: W y g Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 9722 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
)41 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement
R New construction ❑ Addition /alteration/replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION
Job address: t0 • gi,V j41Ay,.tj Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: 41 Block: Subdivision:
Project name: 00toriON Ore, I Description and location of work on premises: '1 N4 LE FAO I Ly
Estimated date .of completion/inspection:
CONTRACTOR. APPLICATION FEE SCHEDULE
Job no: Fee Max
Business. name: e. . gL l C„ Description Qty. (ea.) Total no. insp
P y �� '� Z � New residential - single or multi - family per
Address: box dwelling unit Includes attached garage.
City: 6L- 1CALAYrlAS I Statent, I ZIP: /7/215 Service included:
Phone:01► Q t4 Z I Fa4 • 5p34 E -mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof
CCB no.: 03544 I Elec. bus. lic. no: (p J G Limited energy, residential >" 3 2
City /metro lic. no.:
Limited energy, non - residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician (required) . Date Service and/or feeder 2
Sup. elect. name (print) • . License no: Services or feeders — installation,
alteration or relocation:
PROPERTY OWNER,. 200 amps or less 2
Name (print): g.E14A Y!' Gt>91M 201 amps to 400 amps 2
g tU �, L GI ' WI y „
� 1tm � '_ -I - ' n I 401 amps to100amps 2
Mailing address: 1 7YV �1 / h t tjwj,,� 601 amps to 1000 amps 2
Y
City: W L1 Si State: M. ZIP: ' 1&' ! Over 1000 amps or volts 2
Phone. , i • ' . Fax- E -mail: Reconnect only l
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation:
ORS 447, 455, 479, , 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: I. 4 01 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
f
or � t0 � A. Fee branch circuits with purchase of •
Address: 414=. *4 t„..0 0-. N . service or feeder fee, each branch circuit 2
City: ' 1L' if .1VN I State 1... J ZIP: I B. Fee for branch circuits without purchase
Phonetel$ • tr4 Fax01 •YIP E - mail; of service or feeder fee first branch circuit: 2 .
Each additional branch circuit:
PLAN . REVIEW (Please check all that apply) Misc. (Service or feeder not included):
O Service over 225 amps - commercial 0 Health -care facility Each pump or irrigation circle 2
0 Service over 320 amps- rating of 1 &2 0 Hazardous location . Each sign or outline lighting 2
family dwellings o Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
0 System over 600 volts nominal . more residential units in one structure alteration, or extension* 2
O Building over three stories 0 Feeders, 400 amps or more *Description:
LI Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lighting plan 0 Other:
Per inspection
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $
p p N otice: This p a pplication
O Visa Cl MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within ISO days after it has been State-surcharge-(8 %) .... $
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card
_$
Cardholder signature Amount
440-4615 (6 /00 /COM)
A • Mechanical Permit Application
Date received: Permit no. L lv,_ 617,11
yi�I1p City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639-4171 Date issued: By: Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: _ Building permit no.:
TYPE OF PERMIT
1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
New construction 0 Addition/alteration /replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
. Job address: to '' • ' '2V) (,Ay It fl..) CINI Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: ' I Suite no.:
value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ .
Lot: 41 IBlock: Subdivision: jt %C... J }}72 *See checklist for important application information and
Project name: e4,1,04,91.4 l-4TS jurisdiction's fee schedule for residential permit fee.
City /county: •114 MO I ZIP: all 22 3 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: AND COMMERICAL /INDUSTRIAL EQUIPMENTSCHEDULE
St 0 41 a.- PAM I Ly £ Fee (ea.) Total
Est. date of completion/inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Air handling unit CFM •
Is existing space heated or conditioned? Cl Yes 0 No Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
HA _ RE A � ` o t State b permit no.:
Business name: ti N/r`+ t"� K� 1v HP Tons BTU /H
Address: 2130 SE An Fire/smoke dampers /duct smoke detectors
City: H IU-. I State:N Fr. ZIP: 11 l $� Heat pump (site plan required)
Phone: rim - /72.4 2.I Fax: I E -mail: Install/replace furnace/burner BTU /H
Including ductwork/vent liner 0 Yes 0 No
CCB no.: OIZZO b Install /replace/relocateheaters- suspended,
•
City /metro lic. no.: wall, or floor mounted
Name (please print): Vent for appliance other than furnace
Refrigeration:
CONTACT PERSON
Absorption units BTU /H _
Name: gee ) jf Y,l Y J Chillers HP
Address: Compressors HP
Environmental exhaust and ventilation:
City:
003/. I State: I ZIP: Appliance vetit
Phone: Fax: E -mail: Dryer exhaust
. - OWNER Hoods, Type I/ II/res. kitchen/hazmat
hood fire suppression system
Name: Pt4A 1, fj L Exhaust fan with single duct (bath fans)
Mailing address: 11/72.,.. goVti !/i/ILL Mf.. pi to Do-„ Exhaust system apart from heating or AC
Fuel piping and distribut (up to 4 outlets)
City: W j L. N p..) State: eft. I ZIP: 17 MR) . Type: LPG NG _ Oil
Phone j - ` i I 0 • Falir • . k E-mail: . Fuel piping each additional over 4 outlets
ENGINEER Process piping (schematic required)
•
• P �tKt_ NW Q A � ( r N � N of outlets
Name: L �M1+ Other listed appliance or equipment:
Address: 4 , 2,- 4% WAIL h1./, D . 1 • Decorative fireplace
City: (,. " i Stater ZIP: D(? .-, Insert - type
Phon- '� ��y� ' E -mail: Woodstove/pellet stove
��� "�'� �j Other:
Applicant's signature: 1 .. Date: If 4 Pi Other:
Name (print): Ainfoi 5,01 `' m
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $
Notice: This permit application Minimum fee $
O Visa 0 MasterCard ires.if -a. ermit.is_not_obtained_ o
Credit card number: p p Plan iew (at To) E xpir /s ex within 180 days after it has been State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete. TOTAL $
Cardholder signature Amount 440-4617 (6 /00 /COM)
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
CRAFTWORK PLUMBING INC
7736 SW NIMBUS AVE
BEAVERTON, OR 97008
Plumbing Signature Form
Permit #: MST2001 -00212
Date Issued: 4/18/01
Parcel: 2S110DA -08000
Site Address: 10669 SW LADY MARION DR
Subdivision: ERICKSON HEIGHTS
Block: Lot: 041
Jurisdiction: TIG
Zoning: R -3.5
Remarks: Construction of new single family detached residence. Path 1
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the
plumbing permit to be valid, please have the appropriate individual from your company sign below and return
this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
RENAISSANCE CUSTOM HOMES CRAFTWORK PLUMBING INC
1672 SW WILLAMETTE FALLS DR 7736 SW NIMBUS AVE
WEST LINN, OR 97068 BEAVERTON, OR 97008
Phone #: 503 - 557 -8000 Phone #: 644 -8698
Reg #: LIC 79666
PLM 20 -148PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X i dA
Signature of Authorized Plumber
If- you - have -a ny- questions,— please -ca II -(503) - 639- 41- 7- 1- ,- ext.- # -31 -0
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE RECEIVED
GAGE ENTERPRISES INC APR 2 3 ZO®
PO BOX 1429
CLACKAMAS, OR 97015 -1429 Gfl�USaari D�vEtePt�E�i
Electrical Signature Form
Permit #: MST2001 -00212
Date Issued: 4/18/01
Parcel: 2S1 I ODA -08000
Site Address: 10669 SW LADY MARION DR
Subdivision: ERICKSON HEIGHTS
Block: Lot: 041
Jurisdiction: TIG
Zoning: R - 3.5
Remarks: Construction of new single family detached residence. Path 1
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
RENAISSANCE CUSTOM HOMES GAGE ENTERPRISES INC
1672 SW WILLAMETTE FALLS DR PO BOX 1429
WEST LINN, OR 97068 CLACKAMAS, OR 97015 -1429
Phone #: 503 - 557 -8000 Phone #: 503 - 657 -0142
Reg #: SUP 618s
uc 34544
ELE 3 -128C
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of Supervising Electrician
if -you- have - any - questions, - please -cal l- (503) -639- 41- 7- 1 -ext -# -310
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meet ,, 0 A . r . 'a • i ''a : on t ounty
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CITY OF TIGARD B' IILDING INSPECTION DIVISION
MST z-4 e6
24 - inspection Line: %._4; k Business Line: 63;. 471
BUP
Date Requested - }7 4 `--/ • AM PM BLD
Location [ Q t!o �n ' �� � J Suite - -- MEC
Contact Person ` - - v Ph '4 C -3 J 0 'L.ao t
Contractor-- Ph SWR
BUILDING . ~ a. Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
. Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING. 'T _
• ay e .._,�
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
ME CHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL `° M u
Service
Rough In
UG /Slab
Low Voltage
Fir -
• ' FAIL
Backfill /Grading"
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
. Approach /Sidewalk Date Other D a , Inspec . r Ext
• Final •
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
'CITY OF TIGARD Si IILDING INSPECTION DIVISIPN
MST € .2. - 0 U ! —2 2-1
24 -Hour Inspection Line: J -4175 ` Business Line: 63. 171
BUP
Date Requested AM PM BLD
/
Location , JA Suite MEC
Contact Person / .c�yyl Ph 8' 4 QI _ 3 /6 Z PLM
Contractor Ph SWR
,BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear 4 -
Framing / \ / ,� / '
J �Df -` 0 4 ✓ t U u �.� iD/ 1 7 v� 6
Insulation . /
Drywall Nailing 4 / 1.--t /``4 / 97/S �+<
Firewall ,
Fire Sprinkler G7j // �r' �''' ( p 40, -e d» U' ti o lc)c -c i ro 7 (
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
•
Rain Drains
+rliiur -t��
, r �� PART FAIL •
Post & Beam
Rough In
Gas Line
Smoke Dampers
• Final
PASS PART FAIL
ELECTRICAL, "
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
Backfill /Grading
Sanitary Sewer
. Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: - [ ] Unable to inspect - no access
Fire Supply Line
ADA . �
Approach /Sidewalk Date 9- / ) 7 - / Inspector j ` 1 Q - i ay - Ext
Other
Final
PASS PART FAIL V DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST ' b 2( Z
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested " AM PM BLD
Location (d LO G G k -Suite MEC
Contact Person Ph q& q z gg3 PLM
Contractor Ph SWR
•
BUILDING.` = Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing a L C Nzoa A./
Insulation
Drywall Nailing
Firewall
. Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: -
ASS ART- FAIL
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
:MECHANICAL ; ,_
Post & Beam
Rough In
Gas Line
Smoke Dampers
44-0*_ _ - ART FAIL
ELECTRICAL :
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date � v/ Inspector E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.