Permit CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2001 -00113
X DEVELOPMENT SERVICES DATE ISSUED: 3/27/01
°" '= --' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10651 SW LADY MARION DR PARCEL: 2S110DA -07900
SUBDIVISION: ERICKSON HEIGHTS ZONING: R -3.5
BLOCK: LOT: 040 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: 21 FIRST: 1,646 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,241 sf GARAGE: 711 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: sf RIGHT: 5
VALUE: $ 266,528.00
OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2,887.00 sf REAR: 60
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 5 CLOTHES DRYER: 1
GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 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: 5 201 - 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 ENCOMP BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: X CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: X DATAITELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 7,003.25
This permit is subject to the regulations contained in the
RENAISSANCE CUSTOM HOMES RENAISSANCE CUSTOM HOMES Tigard Municipal Code, State of OR. Specialty Codes 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 Insp 8 Post/Beam Mechanical Electrical Service . Gas Fireplace Electrical Final
Sewer Inspection Underfloor insulation Electrical Rough In Insulation Insp Mechanical Final
Footing lnsp Footing /Foundation Dr¢ Framing Insp Rain drain Insp Plumb Final
Foundation Insp Mechanical Insp Exterior Sheathing InsI Water Line lnsp Final inspection
Post/Beam Structural Plumb Top Out Low Voltage Appr /Sdwlk Insp Building Final
Issued By : ��iYh Permittee Signature
Call (5 3) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
. v pi- 3 -u -U/ Rf
Building Permit Application
•
� City of Tigard Date received: a of Pcnnitno.: /�/yia F- -� !/,3
.. Address: 13125 SW Hall Blvd, Tigard, OR 97223 Projecdappl. no.: - Expire date:
City ofTigard
Phone: (503) 639 -4171 Date issued: By: I Receipt no.:
Fax: (503) 598 -1960 Case file no.:
etype:�
Land use approval: 1 & Complex:
2 family: Simple Complexx:
TYPE OF PERMIT
X i & 2 family dwelling or accessory 0 CommerciaVindustrial 0 Multi- family New construction 0 Demolition
❑ Addition/alteration/replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other:
JOB S1TE;INFORMATION
Job address: 10 - 5 (A) • DY ' ♦ 1(N P r • Bldg. no.: Suite no.:
Lot: 40 Block: Subdivision. iN 1! S Tax map /tax lot/account no.: - /J j) * -617 -
Project name: R -3.6 .i0
Description and location of work on premises/special conditions: c.0/1) tT 11,J/ LE FAM 1 LV
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: RENA 166ANIGE O./Spiel 117V.) E 5 ( Fl oodpiain ,septiccapacity,solar,ete.)
Mailing address: 1(/72 / W11. Am Er FALLS O . 1 & 2 family dwelling
.. /
City: 4/ 1 -1 N IState: - ZIP: in p j Valuation of work ' $ 2'r s
Fax: 4
Phone: 7 -__
��7 ' �� E-mail: � No. of bedrooms /baths `�, ' ��.
Owner's representative: WI E.g.y sPi' 1' Total number of floors
• Phone: v. - .. . Fa.. ' . '5(y E -mail: New dwelling area (sq. ft.) 2.
APPLICANT Garage/carport area (sq. ft.) 1 ] 1
•
Name: Covered porch area (sq. ft.)
Mailing address: _ �1 Deck area (sq. ft.) s.
City: Cj State: ZIP: Other structure area (sq. ft.) '--
Phone: Fax: I E -mail: Commerciallindustriallmulti- family:
• CONTRACTOR Valuation of work $
Business name: Existing bldg. area (sq. ft.) .
Address: �/ New bldg. area (sq. ft.)
Cit Number of stories
Y: L I State: I ZIP:
Phone: I Fax: I E -mail: Type of construction
CCB no.: Occupancy group(s): Existing:
City /metro lie. no.: New:
Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER - licensed with the Oregon Construction Contractors Board under
Name: pO t'U - iio iko- provisions of ORS 701 and may be required to be licensed in the
Address: D J w 11 1 jurisdiction where work is being performed. if the applicant is
City: eriA p State: .1 ZIP: '1 exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: G 4 .4 011.461 I Fax: (, - .141) mail • W WM+. QGie0 , ■
ENGINEER
•
Name: CtA Contact person: Gm Fees due upon application $
Address: 32, .9„„..0 4 Date received:
City: n, 4D IState: at. IZIP: 4 112174 Amount received $
Phone: 2.L - 9f2,41r7 IF 7,,,tu -7.51 -mail: Please refer to fee schedule.
1 hereby certify I have read and examined this application and the
Not all jurisdictiau scup[ credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this O visa O MasterCard
work will be complied w m whether specified herein or not. Credit card number: / - - -
�/ Expires
Authorized Signature: Date; (( Name of cardholder as shown on credo card
Print name: E 1 4p! 1.1.4
Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. a4o -1613 (es cona)
•
• Electrical Permit Application
Date received: ie O/ Permit no.: M%' / —e6//5
-'`'" ' City of Tigard Y � y � Projecdappl. no.: Expire date:
City ofTibard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639-4171 Date issued: By: I Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
X 1 6 2 family dwelling or accessory Cl Commercial/industrial 0 Multi - family Cl Tenant improvement
le.w construction 0 Addition/alteration /replacement 0 Other: 0 Partial
JOB SITE INFORMATION
Job address: 10&51 SW Q)ON ;Rave_ no.: Suite no.: Tax map /tax lot/account no.:
Lot: 4Q Block: Subdivision: E Q.ILk /.,j H'E-(r 1 41
Project name: , Description and location of work on premises: -J1 Q/ LE. FA144 ) LL' J344 E_
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE SCHEDULE
•
Job no:
p � Fee Max. Business name: G E . L b Description Qty. (en.) Total no. hop
Address: pQ Box 14.z..01 New residential - singleormulti- fauulyper
dwelling unii includes attaclied
City: LLk,.(cAsi State: ZIP: 611 j71s Serviceincluded:
Phone: [#/1. 0142,... I Fax447 S470 E =mail: 1000 sq. ft. or less 4
�� �� Each additional 500 sq. ft. or portion thereof
CCB no.:
� Elec. bus, lie. no: Limited energy, residential
City /metro lie. no.:
Limited energy, non - residential i
Each manufactured home or modular dwelling
Signature of supervising electrician (required) D ate Service and/or feeder 2
Sup. elect. name (prior): I License no: Services or feeders — installation,
PROPERTY OWNER alteration or relocation:
200 amps or less 2
Name (print): R. t.1,tv Vj&j 6v91144 H implE 5 201 amps to 400 amps 2
j 9 11 $ wr' ' Af t t L r . �
401 amps to 1000 am
Atailiag address: 1911 �� v t+ µ � 601 amps P amps 2
to 1000 amps 2
City: W j _) I State: L ZIP: 7/7 Over 1000 amps or volts 2
Phon . 1IF / Fa E - mail: Reconnect only 1
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:
less ORS 447, 455, 479, 6� 200 amps or
400 2 .
3145 r ®� 201 amps to 400 amps
Owner's sie,nature: Date: t 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration, I
Name: CL>A or extension per panel:
3,�r ,y A. Fee for branch circuits with purchase of
Address: 4 service or feeder fee, each branch circuit 2
City: /„ V State ZIP: 1 1 Z L3 B. Fee for branch circuits without purchase
Pbon a, -. 4 , it) I Fa • 0 E -mail: — of service or feeder fee, first branch circuit: 2
Each additional branch circuit:
PLAN REVIEW (Please -check all that apply) PP y) Mdse. (Service or feeder not included):
O Service over 225 amps - commercial 0 Health -care facility Each pump or irrigation circle 2
O Service over 320 amps - rating of 1 &2 0 Hazardous location Each signor outline lighting 2
family dwellings O Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, l
O System over 600 votes nominal more residential units in one structure alteration, or extension* J I 2
0 Building over three stories 0 Feeders, 400 amps or more
Description:
O Occupant loud over 99 persons O Manufactured structures or RV park
Each additional inspection over the allowable. to any of th above:
O Egress/lighting plan 0 Other:
Per inspection I I I I
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
PP P Y
Nor all jurisdictions accept credit cards, plrv,r call jurisdiction for more information. Permit fee
Notice: This permit applications
0 Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
_ Cteditcard_number: - - - - -- — / / within 180 days after it has been State surcharge (8 %) .... $
Expires
Name of cardholder as shown on credit card accepted as complete. TOTAL
Curdnolde, siguature Amount
4-40 -1(515 (a'OOJCOM)
Plumbing Permit Application
A '� City of Tigard Date received; 1 O' / Permit no.: A j.,,/_ i .{
Address: 13125 SW Hall Blvd, Tigard, OR 97223 Sewer permit no•: Building permit no.:
City o Tiyurd Phone: (503) 639 -4171 Projecda 1.no.:
� PP Expire date:
Fax: (503) 598 -1960
Date issued: By: I Receipt no.:
Land use approval: Case file no.: Payment type:
• TYPE OF PERMIT
*X 1 S 2 family dwelling or accessory 0 Commercial/industrial O Multi -famil
New construction 0 Addition/alteration/replacement ❑ Food servicy CI Tenant improvement
0 Other:
JOB SITE INFORMATION FEE SCREDULE (for special information use checklist)
Job address: IOW SW LAjyy MA D escription
�f�/ - DR - Qty. Fee (ea.) Total
Bldg. no.: I Suite no.: New 1- and 2- fatuity dwellings only:
Tax map /tax lot/account no.: (includcxlo0 ft. for mchutility counection)
1--°t: , 40 (Block: 'Subdivision: SFR (1) bath
SFR (2) bath
Project mane: _ _ �i 5 SFR (3) bath
City/county:
1Wcit-D Z 2.3 Each additional bath/kitchen
Description and location of work on premises: Site utilities: .
'- 4 Sit LX.T Si N L, LE. FA* 11.1/ }'E Catch basin /area drain
Est. date of completion/inspection; Drywells/leach line /trench drain
• PLUMBING CONTRACTOR Footing drain (no. tin. ft.)
Business name: [ 4/01244- Manufactured home utilities
Address: 11 51,E )J11M u,� Manholes
Rain drain connector
City: BEAVFit,' I State: I ZIP: ail pot& Sanitary sewer (no. lin. ft.)
Phone: (/Q„4.. fi Faxf 441 $1 E -mail: Storm sewer (no. lin. ft.) .
CCB no.: 1 al GLL I Plumb. bus. reg. no: LC/ _L4 r$ Water service (no. lin. ft.)
City /metro lie. no.: Fixture or item:
Contractor's representative signature: Absorption valve
Print name: p E, ' QU I Date: Back flow preve
aloe er
• m,fl
CONTACT PERSON • Backwater valve .
Basins /lavatory
Name: PEA E Pc- Clothes washer
Address: Dishwasher
City: jti\Z4
State: I ZIP: Drinking fountajn(s) NM
Phone: Fax: Ejectors/sump
I E -mail:
Expansion tank
OWNER Fixture /sewer cap
Name (print): RE- NAIL.- /h0tiE. Floor drains/tloor sinks/hub
ill Mailing address: I /AL .114.) W IL.L E F,,� I4) f /2 DI Hos bi disposal
b
City: A y` U N Stater, ZIP: `` Hose � Ice maker ker Phone: - 'j • 'i t I I Fa - $4i E -mail: . Interceptor /grease trap
Owner installation/residential maintenance only: The actual installation Primers)
will be made by me or the maintenance and repair made by my regular Roof drain (commercial) employee on the pro y I own as per ORS Chapter 447. Sink(s), basin(s), lays(s) Owner's signature: Date: . ICJ 1 Sump
ENGINEER Tubs /shower /shower pan
Name: G Urinal
Address: ' ij f -• } Water closet
1 ' 1t- Al<tvD State :(X, ZIP: .1 -72,v. Water heater Other: • Phone2,'1,7 . yki Fa - % II .1 E -mail: Total
Not all jurisdictions accept credit card, please call jurisdiction for more infonnnion:\ 1Vlinimum fee
U Visa G MasterCard Notice: This permit application
Credit card number: I / $
expires if.a permitis_notobtained Plan review (at — %) $
Expires wi thin 180 days after irhas been
State surcharge (8 %) .... $
p
Ex O TAl
Name of cardholder as shown on credit card accepted as complete.
Cardholder signature $ Amount
44014616 (6100 /COM)
Mechanical Permit Application
Date received: 1 ( O/ Pernutro.:� ��/�! /5
' `"'
City of Tigard
y g Project/appl.no.: Expire date:
Ciry ajTisurd 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: Buitdingpermitno.:
TYPE OF PERMIT
4 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - fancily 0 Tenant improvement
XNew construction 0 Addition /alteration/replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: t W 1 5 LADY M A I D } � .' Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suite no.: ` value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ .
Lot: 40 Block: Subdivision: f t. ,,7(J 147f . *See checklist for important application information and
Project name: • jurisdiction's fee schedule for residential permit fee.
City /county: ( PrIZZ) ZIP: - 1 2 1 &2FAMILY DWELLING PERMIT FEE SCHED D
Description and location of work on premises: ■ COMMERICAIJINDUSTRIALEQUIPMENTSCIIED P
Fee (ea.) Total
Est. date of completion/inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? 0 Yes Cl No Air handling unit CFM
° p Air conditioning (site plan required)
is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
Business name: GN" r iV n N k . State boiler permit no.:
HP Tons BTU /H
Address: /1: .5 e, ',101 /12 L, p Fire /smoke dampers/duct smoke detectors
City: giLL," gl I State:pp, ZIP: Al 1/5 Heat pump (site plan required)
Phone/AA. 02,„42„ Fax: E -mail: Install/replacefurnace/burner BTU /H
^ �,y,� Including ductwork/vent liner 0 Yes 0 No
t ,�
CCB no.: [�.' 4. Install/replace/relocate heaters -suspended,
City /metro he. no.: wall, or floor mounted
Name (please print): Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU /H
Name: Ej ¢,ELI Chillers • HP
Address: Compressors HP
Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent .
Phone: tIV I Fax: I E -mail: Dryer exhaust
- - OWNER Hoods, Type l/ II/res. ki tchen/h azmat
hood fire suppression system
Name: per Exhaust fan with single duct (bath fans)
Mailing address: I L'1'L,, Att..5 pit Exhaust system apart from heating or AC 1
City: 1 v („ N State ZIP: 91 Fuel piping and distribution (up to 4 outlets)
Type: LPG NG Oil
Phon �
7 _ W I Fa. , l/ E -mail: Fuel piping each additional over 4 outlets
ENGINEER Process piping (schematic required)
Name: C. 4 Number of outlets
Other listed appliance or equipment:
Address: 1 41. Decorative fireplace
• City: F '[ Stater ZIP: Si ZO4 Insert -type
Phone2'1� . "a�Z.Z.�?'�'T E -mail: Woodstove/pelietstove
Other:
Applicant's signature: -- -- ''Date: 61 D I Other:
Name (print): laJ G [[f
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $
_ _ _ -__ O Visa_ Cl MasterCard Notice: This permit applicatio Minimum fee expires if a permit $
Ctunt card uumlxr: ex p p fmlt 1S not obtained
/ / Plan review (at _ %) $
Expires 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
4- 10 -4o17 (5/00 /COM)
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
GAGE ENTERPRISES INC
PO BOX 1429
CLACKAMAS, OR 97015 -1429
Electrical Signature Form
Permit #: MST2001 -00113
Date Issued: 3/27/01
Parcel: 2S110DA -07900
Site Address: 10651 SW LADY MARION DR
Subdivision: ERICKSON HEIGHTS
Block: Lot: 040
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
LIC 34544
ELE 3 -128C
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of Supervising Electrician
If you have any questions, please call- (503) - 639 - 41 - - 1, ext# -310
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 -001 1 3
Date Issued: 3/27/01
Parcel: 2S110DA -07900
Site Address: 10651 SW LADY MARION DR
Subdivision: ERICKSON HEIGHTS
Block: Lot: 040
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 97 068 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
. .
Signature of Authorized umber
If you have any questions, please -call- (503) -639- 41 -7 -1, ext. - # -31 -0
.CITY. OF TIGARD B''ILDING INSPECTION DIVISI( ' MST /-ZOO / I j
24 -Hour Inspection Line:.. ,-4175 Business Line: 639 -4171
BUP -
Date Requested ?.-' I ( a AM `------PM BLD
Location o � � � h A I _. __. ` Suite MEC
Contact Person -e- Ph 96 9-302_ ( PLM
Contractor Ph SWR
BUILDING: n.= •;r 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:
F i n a l PART FAIL / ----'r--- / 4 / — 5
PLUMBING; :''
Post & Beam
Under Slab
Top Out
Water Service
■
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
4
MECHANICAL; " wL -;_
Post & Beam
Rough In
• Gas Line
Smoke Dampers
F'
PASS PA FAIL
E,LECTRICA 4 . ,
i ce
Roughln
UG /Slab
Low Voltage
Fire • arm
• RT FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before ne. ' ` spection. 'ay at City Hall, 13125 SW Hall Blvd
Catch Basin A
Fire Supply Line [ ]Please call for reinspection RE: [_ ] Unable to inspect - no access
ADA y
Otheoach /Sidewalk Date L' /Z — L0/ Inspector ��� "� fct
Final
PASS PART FAIL • DO NOT REMOVE this inspection record from the job site. .
.CITY OF TIGARD P' IILDING INSPECTION DIVISION MST (3
24 -Hour Inspection Line: 4 -4175 Business Line: 63;. . X71
BUP •
Date Requested 3-- (Jo AM PM BLD
Location / 6 (4 5 / £ d o, n w ., Suite . MEC
Contact Person Ph - :30 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
Framing
Insulation
. Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
- Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rai _rains
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
SITE `4 e„ _
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 Date / _ 0 / Inspector / >_o ��
Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD P' IILDING INSPECTION' DIVISKIN
MST /
24 -Hour Inspection Line:. ,9 -4175 Business Line: 63. .171
BUP
Date Requested -( AM PM BLD
i
Location l 0 Co ,. (n0)1 Suite MEC
Contact Person Ph �6. 30 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
Framing Mg o.fl i -Si " ciJ
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
- A S PART FAIL
PLU.._... , __F e
Post & Beam
Under Slab
Top Out
Water Service, -�� f ! L i -P •
Sanitary Sewer
Rain _Drains
Final
PASS PART FAIL
MECHANICAL. ,' °,a&
Post & Beam
Rough In
Gas Line
Smoke Dampers
- inal
_ ASS PART FAIL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm •
Final
• • PASS PART FAIL
SITE,a...
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 - 2/ Inspector 4 E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site