Permit CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2001 -00014
/li DEVELOPMENT SERVICES DATE ISSUED: 02/01/2001
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10733 SW LADY MARION DR PARCEL: 2S11 ODA -08300
SUBDIVISION: ERICKSON HEIGHTS ZONING: R -3.5
BLOCK: LOT: 044 JURISDICTION: TIG
REMARKS: New SF detached dwelling. path 1
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 23 FIRST: 1,646 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,528 sf GARAGE: 711 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: sf RIGHT: 5
VALUE: $ 291,823.00
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3,174.00 sf REAR: 43
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: 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 AREAISPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL •
AUDIO & STEREO: X VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: X OTH: 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: $ 7,205.83
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 84 Post/Beam Mechanical Mechanical Insp Framing Insp Gas Fireplace Electrical Final
Sewer Inspection Underfloor insulation Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final
Footing Insp Crawl Drain /Backwater Plumb Top Out Exterior Sheathing Insl Rain drain Insp Plumb Final
Foundation lnsp Footing /Foundation Dr Electrical Service Low Voltage Water Line Insp Final inspection
Post/Beam Structural PLM /Underfloor Electrical Rough In Gas Line lnsp Appr /Sdwlk Insp Building Final
r� n n J'
Issued By : 1 &r ytr2 --� Permittee Signature
Call (50:,) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
/(J p5/ /°( r3 ; zoo/ -000i .
A " ` Building Permit Application
Date received: ///_( Permi �1yik City of Tigard Permit no.: ��� 20 ai oDo /
Projectiappl. no.: . Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By;6 ff Receipt no.:
Fax: (503) 5981960 Case file no.: Payment type:
Land use approval: / 1 &2 family: Simple Complex:
• TYPE OF PERMIT
V & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family gNew construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm Cl Other:
• JOB SITE INFORMATION
Job address: l 113; ' I , . ! 0. D i Bldg. no.: Suite no.:
Lot: 44. Block: Subdivision: suGg-6e? WE. 14 HTS Tax map /tax lot/account no.:
Project name: +
Description and location of work on premises/special conditions: GIOP 61Q4 ue. Piv14 1 L H e l e n e
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: RENA RE. 166ANCE. C.V5r11 lirvIl E 5 (Floodplain, septic capacity, solar, etc.) •
Mailing address: Z % WI X11 11 S /' . 1 & 2 family dwelling: t2 /, 8 23
City: 14/F'61. LI N State: ZIP: Ojidfj j Valuation of work $ arms � "
Phone:54 j 'T . o Fax: E -mail: No. of bedrooms/baths _
Owner's representative: g a sni rrl4.. Total number of floors 2.
• Phone: ' v .. A F. • •$(,b E -mail: New dwelling area (sq. ft.) - N74
APPLICANT • Garage/carport area (sq. ft.) 1 1
Name: Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.) • 1/1
City: ( I State: I ZIP: Other structure area (sq. ft.)
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.)
City: ` State: ZIP:
Number of stories
Phone: I F ax: I E-mail:
Type of construction
Occupancy group(s): Existing:
CCB no.:
New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: FOLLAIL0 • 141950 provisions of ORS 701 and may be required to be licensed in the
Address: 1 I t a F l� LW? jurisdiction where work is..being performed. If the applicant is
jl A,,t p I exempt from licensing, the following reason applies:
Cit y: •JJ �� h 6 . State: ZIP: 1/22,5
Contact person: $rtj/y% Plan no.:
Phone: ' 41 2,61 Fax: ( 4 .1 , /- mail: W Wit,. PAP ,,
ENGINEER
Name: CtA Contact person: 4A-ivy Fees due upon application $
Address: ? I 41,0 Alt_ Date received:
City: Demit, Np State: ZIP: a11.O4 Amount received $
Phone: of • 9b4' F4,2,45-04151E 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 ovisions of laws and ordinances governing this ❑ Visa ❑ MasterCard
work will be complie whether specified herein or not. Credit card number: / /
1 Expires
Authorized_signature: Dates Ate Name of cardholder as shown on credit card
Print name: rj11.-- 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 (6i00/COM)
- -Cw2zoa i - 0 0 042,
A- Mechanical Permit Application
Date received: 5 /( /Q'/ Permitno_/yS7746,/_ 0
i i � City of Tigard r__.. Y b P roject/appl. no.: Expire date:
of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223
City f Phone: (503) 639-4171 Date issued: By:49 Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
4 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
NCNew construction 0 Addition/alteration /replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: 10133 LAIN /linu. pit. Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: 1 Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ .
Lot: 4.4. (Block: (Subdivision: :mast.' HIS . *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: 'LAP( I ZIP: d'1 Z23 1 &,2. FAMILY DWELLING PERMIt FEE SCHEDULE
Description and location of work on premises: I COMMERICALIINDUSTRIAL EQUIPMENTSCHEDULE
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 0 No Air handling unit CFM
space insulated? O Yes ❑ No Air conditioning (site plan required)
Is existing P Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
Business name: `iI' r Ii t~ iA P4 i State boiler permit no.:
HP Tons BTU/H
Address: Z. iy, , ? 12 Fire/smoke dampers /duct smoke detectors .
City: Ritth sego I State: ff ZIP: A'11Z3 Install/replace at (site BTU/H
plan
furnace/burner required)
Phonekt01. Oulu_ 1 1E-mail:
Including ductwork/vent liner 0 Yes 0 No
CCB no.: 012 Install/replace/relocate heaters - suspended,
City /metro lic. no.: wall, or floor mounted
Name (please print): Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/H
Name: E03 (1•E 1 Chillers , HP
Address: Compressors HP
Environmental exhaust and ventilation:
City: �� I S tate: I ZIP: Appliance vent .
Phone: Fax: E - mail: Dryer exhaust
OWNER Hoods, Type 11 II/res. kitchen/hazmat
� A i+1 19- hood fire suppression system
Name: Exhaust fan an with single s
le duct (bath fans)
Mailing address: 1 Lilt WILL Ml1f olf 5 90 Exhaust system apart from heating or AC
City: WE (, ill I State ZIP: a(? tb Fuel piping an d dis (up to 4 outlets)
(/_ Type: LPG NG Oil
PhotuS4 1. Fa E - mail ... Fuel piping each additional over 4 outlets
ENGINEER Process piping (schematic required)
Name: G�j Number of outlets
Other listed appliance or equipment:
Address: 'OA ilitl 4' ' Decorative fireplace
City: • ti State:Qt. ZIP: 4112, F • Insert - type
Phone _ j/ , !'%i %1acg 1t " E - mail: Woodstove/pellet stove
Other:
Applicant's signature: Date: I 1 & d f Other:
Name (print): etylefri G. n u
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $
0 Visa 0_MasterCard Notice: This permit application Minimum fee $
Credit card number: / / expires if a permit 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 440 -4617 (6 /170 /COM)
-ca) zety -- 400 /.2
Plumbing Permit Application
Date received: � /4/ Permitno.: /y�7 /00/9
A City of Tigard /
Address: 13125 SW Hall Blvd, Tigard, OR 97223 Sewer permit no.: Building permit no.:
City of Tigard Phone: (503) 639 -4171 Project/appl. no.: Expire date:
Fax: (503) 598 -1960 Date issued: g
Y;5" [ Receipt no.:
Land use approval: Case file no.: Payment type:
TYPE OF PERMIT
X I & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
New construction 0 Addition/alteration /replacement 0 Food service 0 Other:
JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist)
Job address: • 1 P7 35 . .514 . LAN MAtICN p P. Description Qty. Fee(ea.) Total
Bldg. no.: Suite no.: New 1- and 2- family dwellings only:
Tax map/tax lot/account no.: (includes 100 ft. for each utility connection)
SFR (1) bath
Lot: 44 Block: Subdivision: SFR (2) bath
Project name: p4t644,60,j 14. E41 HT5 • SFR (3) bath
City /county: 'n 1 ZIP: init,25 Each additional bath/kitchen
Description and location of work on premises: Site utilities: .
CONSI tLX.T S1NALE. P,**lH N 1-101446 Catch basin/area drain
Est. date of completion inspection: Drywells/leach line /trench drain
PLUMBING CONTRACTOR Footing drain (no. lin. ft.)
G Manhetured home utilities
FT Wel4
Business name: H A VF+- Manholes
Address: 1') ?,t i p sw NitviaMS . Rain drain connector
City: a • le State:gL• ZIP: el/OP& Sanitary sewer (no. lin. ft.)
Phone: , . . _ Mt Storm sewer (no. lin. ft.) .
CCB no.: 11 („„&L Plumb. bus. reg. no: LO -141, re ) Water service (no. lin. ft.)
City /metro lic. no.: Fixture or item:
Contractor's representative signature: Absorption valve
Back flow preventer
Print name: Pa D Date:
Backwater valve
CONTACT PERSON Basins/lavatory
Name: fllt E AA t-- . Clothes washer
Address: Dishwasher
Drinking fountain(s)
City: / State: ZIP:
Phone: 6 Fax: Ejectors sump
E -mail: Expansion tank
OWNER Fixture /sewer cap -
Name (print): RENAAlvLE- Floor drains /floor sinks/hub
Mailing address: 1 /AL 114) W!(„L E.T D Hos bi disposal
� �"'''� Hose bb •
(„
City: W NN State:*. ZIP: /�'nvej Ice maker
Phone: ", - Mb Fax 4 i. - #6.3E-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 y wn as per ORS Chapter 447. Sink(s), basin(s), lays(s)
Owner's signature: Date: . / Sump
ENGINEER Tubs /shower /shower pan
•
Name: GSA Urinal
Water closet
Address: 32.1 •,�Af 4-41B. Water heater
City: 1 / 1g.4N} 1 Stater I ZIP: "7 ]2v4 Other: •
Phon. i • 34 Faxt00411 E -mail: Total
•
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application MlnimU . fee $
iew (at %) $
Credit card number: / / ., . • expires if a permit is not obtained
Expires withirtl80 days afte? iChas been State- sureharge -(8 %) .. -. $
p TOTAL
Name of cardholder as shown on credit card accepted a5 complete. $
$
Cardholder signature Amount
440 -4616 (6 /00 /COM)
•
y2-2ooi — 000s 2.-
Electrical Permit Application
Date received: / /4/ %/ Permit no.: Mnoo f. ..DUV / f
4`11111 City of Tigard Projectiappl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 9722 Date issued: By: Receipt no.:
Phone: (503) 639 -417
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
X I & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi family ❑ Tenant improvement construction ❑ Addition /alteration/replacement ❑ Other: ❑ Partial •
JOB SITE INFORMATION
Job address: 33 !� r S/ ) LA , al) F 1 • Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: 44 1 Block: !Subdivision: E, at4,4* N its.14 141'
Project name: I Description and location of work on premises: LE. PAM 1 L
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE SCHEDULE
Job no:
Fee M
Business name: 4A4 E t{ / �� G Description Qty. (ea.) Total no. insp
ff i+l A _ � New residential - single or multi- family per
Address: TV , " - l dwelling unit Includes attached garage. •
City: CLPst.kliWIS I State:, I ZIP: 011015 Service included:
Phone: • O142. I Fax1047 6/7331E-mail: 1000 sq. ft. or less 4
CCB no.: s7i 4.4
v�C 1 I Elec. bus. lie, no: 61 " Each additional 500 sq. ft. or portion thereof
Limited energy, residential 2
City /metro lie, 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 orfeeders — installation,
alteration or relocation:
PROPERTYOWNER 200 amps or less 2
Name (print): QE Io f ,� f4'I/N p f 5 201 amps to 400 amps 2 •
L 12. ov m I M FALL-e2 401 amps to 600 amps 2
Mailing address: l T'xr 1.w.rrti• f + f t? J A � • 601 amps to 1000 amps r 2
City: W - N State: A elf, ZIP: 7p.. "/ Over 1000 amps or volts 2
Phon-"ilE 11/M 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:
ORS 447, 455, 479, 6 1. 200 amps or less 2
'� O' 201 amps to 400 amps 2
Owner's signature: Date: ' 401 to 600 amps 2
. ENGINEER Branch circuits - new, alteration,
Name: L or extension per panel:
Address: )'t) 41A) 41)1- A Fee for branch circuits with purchase of
service or feeder fee, each branch circuit 2
City: i _11.ArOP State: ALI ZIP: 0J'11474 B. Fee for branch circuits without purchase
Phone j _, ', Fax2 ., • 15 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):
❑ Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps - rating of 1 &2 ❑ Hazardous location Each sign or outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2
❑ Building over three stories ❑ Feeders, 400 amps or more *Description:
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lightingplan ❑ 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. Notice: This permit application Permit fee $
O Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
-Credit-card-number: / / witliin 180 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)
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- 00
Date Issued: 02/01/2001
Parcel: 2S110DA -08300
Site Address: 10733 SW LADY MARION DR
Subdivision: ERICKSON HEIGHTS
Block: Lot: 044
Jurisdiction: TIG
Zoning: R - 3.5
Remarks: New SF detached dwelling. 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 97066 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
X �
Signature of Supervising EI trician
--- Ifyou- have- any - questions; please -call- (503) -639- 41- 7- 1— ext— # -31 -0
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 -00014
Date Issued: 02101/200
Parcel: 2S110DA -08300
Site Address: 10733 SW LADY MARION DR
Subdivision: ERICKSON HEIGHTS
Block: Lot: 044
Jurisdiction: TIG
Zoning: R - 3.5
Remarks: New SF detached dwelling. 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 UNA OP 9 058 IRT[ OR q 0 8
WEST � iri�� V.'� V7 V�I.IV BC I= O
++ � "aL o s�a d* .. Sti n
- 7 `.�
Phone #: 503 - 557 -8000 Phone #: 644 -8698
Reg #: LIC 79666
PLM 20 -148PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of Authorized Plumber
If -you- have -any- questions, — please -call- (503)- 639 -4 t7_1_,_ext._ #_31.0
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST Z ®J ed 00 /Y
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested �� AM PM BLD
Location /6) 733 56. l-G� mQ J -�� Suite MEC
Contact Person Ph W- 3.3"G 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
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
Rain Drains
Final
PASS PART FAIL
MECHANICA - °:.'' .:
Post & Beam •
Rough In
Gas Line"
Smoke Dampers
Final
PASS PART FAIL
ice
Rough In
UG /Slab
Low Voltage
. - Alarm
• _ ' = ART . 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 � 4 / Inspector `e_ (/�fru2A___ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site. • •
' 1
• ITY OF TIGARD BUILDING INSPECTION DIVISION MsT �i �
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 27/" AM PM BLD
Location /0'133 („ MAY b Suite MEC
Contact Person Ph 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
PA '_' T FAIL -
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Ra • : ins
w
i " PART FAIL
s NICAL��
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
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date / t e -- Ext
^Z .
Other _ /� Inspector l 1
Final
PASS PART FAIL • DO NOT REMOVE this inspection record from the job site
CITY OF TIGARD BUILDING INSPECTION DIVISION MST /_ ' ' 1
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested r/ AM PM BLD
Location /0733 5 cz-d ee y Suite MEC
Contact Person Ph ��� � 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 : / - a' r5"
Insulation
Drywall Nailing _ z '--
Firewall
. Fire Sprinkler
Fire Alarm
Susp'd. Ceiling // /i . L L - ' • / ex-LC:
Roof
Misc:
Final .
PASS PART FAIL
PLUMBING:
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains •
Final
PASS PART FAIL
•
- Post & Beam
Rough In
-- Gas Line
Smoke Dampers
Fi V
T FAIL
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 •
- A - DA
Approach /Sidewalk � � �
Other Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
• CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 6- a AM PM BLD
Location / 0 7 33 S w Let d? Suite MEC
Contact Person Ph f (,7- 3J Z_- PLM
Contractor Ph SWR
_SUM 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
•
- AS PART FAIL
~UM BING.r, a ::
•
Post & Beam
. Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MEC HANICA_ L
- 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
S,ITEaa . 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 �-- /- 0/ Inspector E
Final
PASS PART FAIL . . DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 2061 600 /4-(
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested / / 1' AM PM BLD
-
Location .^. i� . 4_4 uite JO MEC
�
Contact Person Ph 9 7 O 3/ UZ 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
PLUMBING:,.
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL ;, : i. .
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL:r w tMg` a F
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
P S 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
Other poach /Sidewalk Date Zit/ l /� / Inspector / �%" ' / Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.