Permit � � CITY OF TIGARD MASTER PERMIT
A PERMIT #: MST2004 -00345
l j� DEVELOPMENT SERVICES DATE ISSUED: 2/4/2005
'� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 13766 SW LEAH TERR PARCEL: 2S109BA -07500
SUBDIVISION: DAFFODIL HILL ZONING: R -
BLOCK: LOT: 001 JURISDICTION: TIG
REMARKS: New SF.
BUILDING
REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 27 FIRST: 1,527 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,767 sf GARAGE: 527 sf FRONT: 15 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 8
VALUE: 320,126.50
OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 3,294 sf REAR: 15
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: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: 1 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: 1 GAS OUTLETS: 4
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: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 6 201 - 400 amp: 201 - 400 amp: 1st W /OSVC/FDR: 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: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: ALL - ENCOMP BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 8,553.17
LL, GEORGE HILLMAN & INC This permit is subject to the regulations contained in the
MARSHALL, Tigard Municipal Code, State of OR. Specialty Codes
PA BOX LL, G 9 HILLMAN A PORTLAND, & A SOC
PORTLAND, 97291 9408 NE A C K DRIVE 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 the
work is suspended for more than 180 days.
Phone: 503 705 - 7933 Phone: 503 209 - 1794 ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those
Reg #: LIC 159399 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
Ersn Cntrl 681 - 4444 Post/Beam Mechanical Plumb Top Out Exterior Sheathing Ins Insulation Insp Appr /Sdwlk Insp
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Rain drain Insp Electrical Final
Footing Insp Crawl Drain /Backwater Electrical Rough In Fireplace Insp Storm drain Insp Mechanical Final
Foundation Insp PLM /Underfloor Framing Insp Gas Line Insp Water Line Insp Plumb Final
Post/Beam Structural Mechanical Insp Shear Wall Insp Gas Fireplace Water Service Insp Building Final
1
Issue By : `/ ,, Permittee Signature :
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
/:
r ~ l
Building Permit Applicatioi ,I • FOR OFFICE USE ONLY
City of Tigard
Dv
x Received 1 '
Permit Noy : �3
Date/By: j ! - y = j ,' �5 Dd3yS
13125 SW Hall Blvd, Tigard aR 97123 � Pl Review
Phone: 503.639.4171 Fax: 503.598.1960 •'" k Date/By: (✓1 J / - U other Pemmt 4
rte‘ ' r' , may: . 14
Line: ne: 503.639 - 4175 O� �P` `� ' ! .. Date Ready/By: Jam: ® See Attached Checklist for
Internet: w
ww.ci.tigard.or.us ` O � � D` � , S, � ' . �� Notified/Method: )0- � Supplemental Iufonnation
C a.t� \G
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-�.
u n '" `x:. " [ M Cs) r,a ,.'^�°'.'.° - . 4 11 ;�.. a <
.!a w. _� W a s i ` ;� : , e ., + DATA: >i r,AND 2 FAM II.Y DWE .
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® New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
,, ` u'. ..' 'a , . ,,A�. - �,r�`o�;r ., ,�.- �._.. . a ;; ..,�°`° _ ...;r -,..k •�, , 'Yr .;:...Z. . /.. ,,, .aroa work indicated on this application.
P "44 °,, k:)- . a sp . .: iGATECsORY O ,. C - 1 ' `.4.10 ? " ° .'
® 1- and 2 -family dwelling ❑ Commercial /industrial Valuation: $250,000.00
❑ Accessory building ❑ Multi- family Number of bedrooms: 3 CE:k
0 Master builder ❑Other: Number of bathrooms: 2 1/2
x�y,..� :; r € nE.y' py r', g.�e re°:';�: 5i >� h . a, d �"°., .. .,, , i° y ,... -.. � t ; A„r; -°. „— - --,r,.. --,r,.. °
� '';* Z :IO .'i iii - OBMATIONx AND p r $. r t. � '° %,;,,r, Total number of floors: 2 SN
:, ; . . _ 0, Y , V , 4,:.:' y ",,,t x".: <ke W :gx. , 42ZZ:1', ,, WR MW T r," °1&F =varu I :c ^i e " ,., , ...
Job site address: 13766 SW Leah Terrace New dwelling area: 3,294 square feet
City/State/ZIP: Tigard, ORegon 97224 Garage /carport area: 527 square feet
Suite/bldg. /apt. no.: Project name: Daffodil Hill Covered porch area: 178 square feet
Cross street/directions to job site: SW Bull Mtn. Road Deck area: 0 square feet
Other structure area: 0 square feet
r ..R' =aP ` _ ' '" %± ., is ie ' S'Idnt;,” ak. " = x' 4' '5 t -RNi.- slf. ^,
REQUIRED: DAI' -A:C USECHECKL ST`,a
Subdivision: Lot no.: 1 Permit fees* are based on the value of the work performed.
Tax map/parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
h'il' `ii : `x ". j` v`r', ' :I ;_ .�w,•'° dDESCRIPTLON )F,WORKr: ...x.�t' °':
„�., s.�' ��` fi�'��, s� °�', �'� ' �` + work indicated on this application.
54� `s&'�. �'� >��� Y .vi ✓a ..h�,:.�.._�, =, °s:.. - .. n.'ao„ :,o3_SF. , �� � g i�3$ . e d ' �ma
New SFR Valuation: $
Existing building area: square feet
New building area: square feet
; 4% - PROPERTY$ OWNERm V . - .' - n .' ..` " . ®
; '"„TENANT-; ;' ^;' -0.° " `• ' Number of stories:
«..'st ., °tip ®: r ., . �u,. .• =u ,, ,r °# .. u: , ,,W,w. ` ! . CTC, +tti ti'.., . .¢'w.a�• ^�e N,i'' . g " ",: ° ,,.
Name: George Marshall Type of construction:
Address: PO Box 91249 Occupancy u
Pa YP groups:
P •
City/State/ZIP: Portland, OR 97291 Existing:
Phone: (503)705 -1933 Fax: ( ) New:
�'' h, ,f itsr.'.i;`,`�.` ;'" °i, 2.- r-. ,v.- ',`::.: s� '- " .l ..4 ki',dn'• • - •I,
i? " ., 4 ® APPLICANT. ' ',4' ° > r s . Z„ ' ps , ❑ PERSON , :: ; ,,� ,,. ,, E, h. a F ' u ' u
.�:; a��. ,_ f,, c.�'n t»r > - ,. , i � <' ��, t °�;�� � � : 3�,� , s NOTI CE ` " �� °` :.x. "�` �? -
Business name: Patrick Schmitt, Designer Inc All contractors and subcontractors are required to be
Contact name: Patrick Schmitt licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 2414 NW Stimpson Lane jurisdiction in which work is being performed. If the
City/ State/ZIP: Portland, Oregon 97229 � a pplicant is exempt from licensing, the following reasons
apply:
Phone: (503) 768-4573 Fax: : (503) 246-3559 -,
E -mail: schmittdesign@comcastnet ,\
•
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st ..+ , .✓,n:n;;,;e z we-s ta*n "�'•''�: n,^t
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Business name: Brent Hillman & Assoc. Inc. '' a ; „' ' . �;'„ -"��, r „ ,, .,,.,-, ' ' ,' - .s: ,. -•' Fw., ,,, ,,
' RUILDING FEES* :•° ; :,
Address: 9408 NE Hancock Drive
Please refer to fee schede tv
City/ State/ZIP: Portland, Oregon 97220
Fees due upon application
Phone: (503) 209 -1794 Fax: (503) 251 -0821
Amount received
CCB lie.: 159399
Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted.as complete.
Print name: Patrick Schmitt I Date: 10/28/04 * Fee methodology set by Tri- County Building Industry
Service. Heard '
I i
Mechanical Permit Application FOR OFFICE USE. ONLY
Ci>y of Tigard e` D Permit i � /00 ?)41.6 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Pernik: bone: 503.639.4171 Fax: 503.598.1960 (C� /u •, 1 ( if?" Date/By:
Inspection Line: 503.639.4175 ( � at* el I Date /B : huffs: ® See e 2 for
ard.or.us Y
g Notifi�/Method: Supplemental Information
Internet: www.ci.ti
',: � ... ^� ,. , a` M,` °��:; " ='° �..�•.:.�, •`' .� i � �w a: �, � � �. ,,CO ,SCHEDUI:���„,� SE C�HI�IST,�;x
® New construction ❑ Addition /ralleratidrif,4eplaaement Mechanical permit fees* are based on the value of the work
v \ \_V" performed Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: c3 mechanical materials, equipment, labor, overhead, and profit.
�. s �, sir <. ..• �d .... ry Value: $ $
` _CATEGOItY:'OF CONSTRUCTION 0 =n : ;'" W ' `:" ° 5,500. 00
s* 3�N�" §��� � ' v'e � w ,na: •'. >zs - .� _ � °�
'1 : * RESIDENTIAL EQUIPMLNT.',Ii STEMSFEES" a r
1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building "
Multi-family For special information use checklist.
❑ Master builder ❑ Other: Description I Qty. I Ea Total
JOB S ANDII:o,EATION S � $ ` :444' H coo
..,.�_,,„�:. _, �. F..k:�...�.- , ..t�',., : , _ . _,. .- ��'a`.��•x� . °:�'l satins'! 1ing
Job site address: 13766 SW Leah Terrace Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/ State/ZIP: Tigard, OR 97229 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU ( ducts/vents) 17.90
Suite/bldg. /apt. no.: I Project name: Daffodil Hill Gas heat pump 14.00
Cross street/directions to job site: Duct work 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: Lot no.: 1 Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
��..'�� '�' ��° �, a '��'K'" �DE&CRIPTION�OF�,+WO RK: .� "�`-�. ,��%' c - .,:,'�, °�'a Water heater
10.00
�
t t; - � � t 'a� k.E � .... . . .. ... ..... Y ,....a.n _ �° "� ra {� ... � :� � r
New SFR 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
- . -_ • • Chimney /liner /flue/vent 10.00
;
.' ��':° �' �A�% �'►��FROP.ERTY�30W1�ER; P � � �°,�.® TENANTr �' �„��`��'�:°
.� Other: 10.00
Name: George Marshall Environmental exhaust and ventilation
Address: PO Box 91249 Range hood/other kitchen
equipment 10.00
City/ State/ZIP: Portland, OR 97291 Clothes dryer exhaust 10.00
Single - duct exhaust (bathrooms,
Phone: (503)705 -1933 Fax: ( ) toilet compartments, utility rooms) 6.80
s w r - ' a -s., „ Pt 10.00
; ' '�+�'� � }" ._� ° ,l ° ��'�' Attic/crawlspace fans
m .4 ®`tNTACTN PERSON r "_ x '.
. _ , ��, 73 v!nk . � . ,__ 7' ��r,._ •aw aY, , m � � °. a ai
Other: 10.00
Business name: Patrick Schmitt, designer Inc Fuel m
PiP g
Contact name: Patrick Schmitt $5.40 for first four, $1.00 for each additional
Address: 2414 NW Stimpson Lane Furnace, etc.
Gas heat pump
City/State/ZIP: Portland, Oregon 97229 Wall/suspended/unit heater
Phone: (503) 768 -4573 I Fax: : (503) 246 -3559 Water heater
Fireplace
E- mail: schmittdesign @comcast•net Range
", ,,.y,, z1,41
- ' Z V �'I: Barbecue
Business name: Michael's Mechanical Clothes dryer (gas)
Other:
Address: 1241 NE 194th
City/ State/ZIP: Portland, Oregon 97230 Subtotal
Phone: (503) 661 -6183 I Fax: (503) 661-4341 Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lie.: 35795 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.
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Patr 1 ck S c h m i t t , design Ire. (6021 ) 24B - SSS9 11/�2/4 12! SOP P • BM
, . '':::•.;....::
,,if
Electrical Permit Application'
,
City of Tigard 1
, ,, • 0 tk IlderBy: rawa No.: vy6r,9 - 003
13125 SW 11.11 Blvd., Tigard, OR 972TI ..., , i v -.i. Pim Renew '
Otba Pc.
Thom 303.639.4171 Far 503.590.1960 Ayl . txkli' -'7 i , Arreiny
mil
x
losporlion Wm 301639,4173 % N'• -, ...i.,14..- 'it Dm Ready/By: nor 111 Br
heaver worwrili orm gard. - -
6 1 __ .,ta *Am ° 1480Forrairalia4:
''' Soniemeollil Ishronotkra
til 0 FiWeirr '-ailiatilA ' i4; ' '';ftWtW.V&iitgkerff Af
1:81 New coutbuclion 1:1 Ailditiodaltanticashosphicesnad Flaw check di that ripply;
OSavicc over 225p. casual Otlazardnua Incslitm
I: 1 Danotaiun 0 Other. . _ OServica over 320 amps - rating °Hoeft over 10.0000*R.
..t kf,:r4ic ii.; of " "' dweni484 4 or rinne new residential
Egi 1- and 2-family dwelling CI Commareiallindustrial • Accessory building [Wyman over 600 robs nominal 4003 in coo angdmrc
DBuilding ova dnoc dories 1Feeders 400 =Fa or mare
0 Niulti 0 Master builder 0 Or Do fond owe 99 parsom :DI tvlan)fail anucauras or
: ,''.':' .41 ,,,'`' e4,,;:' ii' , ;•:^7:- .., ' ;,,:: .'-',.;''. , W,'; 3 1-1.—_,it-i-i i,._ RV park
-..,.;., - ' .' • t; -,..,,. . L./ rop..ee.m...
[Wealth-care facility jOther _,
Job 00• ; Job site address: 13766 SW Leah Terrace
Submit 2 oetri of plans with eny of the above.
City/StatelZ/P: Tigard, OR 97224 The Am,* ti et Aq( 910846 In 16141ffery conshuaion ticwrice.
Suitelbldgrapi. no.: Project name: Defrudil Hill '.WiWiggi;d3.?ft10.4P0g1.24,..
_ _ Daudges• I Ott, I pm 1 row "
Cross street/directions In job site: SW Illiall Min. Rued New yerldendal liner- or einkl-fandly dwelling or*.
holades ofteared mew. _
. __ _ .
1,000 eq. O. or lees 145.15 II= n
. _
Subdivinicar 1 bit no.: it Ea. addl 500 eq. ft, or portion 33.40 1
Limited energy, resiilen6a1 . '73.00 2
Trot rosepipmeel no.:
limited UMW, non-residential 75.00 2
i.01: t.ch guiiiits, ., modular
New SIM diat _Allis service end/or feeder 90.90 2
Berrien or tbedere hadernation, atlendlon. sued/or won
200 200 amps or loo 80.30 2
201 amps to . 400 ompe 106.85 2
40 to 600 160.60 . 2
Name 6e.a.46. t....Nskrp,..... 601 anffieto 1.000 Mips 240.60 — 2
...
AddiESS: TO %Y. C V ZAel Over 1,000 amps or volts 454.65 2
Rammed ooly 66.85 2
City/Sate/73P: ?ega or feeders Matalhadrin , co.. Ilini _
Temporary services , afferedlan, and/or
Raw; ( ,o3 ) /05 . 1,9 Fax ( ) reloardare
'
- 200 nom or Ion 66.85 1
Own luseallatlen: This instoljation is being made on property that I own which is not 201 w 400 0", r 100.30 2
inteladtd fur sale, brim, taut. or eat according to ORS 447, 449, 670, and 701. , .
401 amps to 600 1113W2 133.75 2
Om= *whirr Date Etrossala abaft - raw, siSectothise, er_febiwijMirszoc/
- 7 ..: V:4' , '..... --- r i iki4 , ..71.4".; A- Fac for brooch rirasita wirk
service or raider Cm, each
Bileincsa mime: Patrick Schmitt, designer be, trend) circuit 6.65 2
— - B. Fee for launch amnia
Conrad mama: Petrick Schmitt 85 Backe or feeder far,
_.-...-- *J5 2
eac bch eui
Address: 2414 NW Sampson Lane h ran ont
Each arirl handl circuit 1— 6.63 _ 2
City/Stair/DP: Portland, ON 97229 %enamoring (Frank:ear foriler opt Melindad
Pump or irrigation circle 33.40
Ell
mine; (540)7 6V-4573 I FOX : (593) 246-3559
- _ Sign or online lieding 53.40 2
Eausil: schmitaloslp@coastssartat Signal cinatio(s) of limited- ._
11414 7 energy Mine. Amnion, or
extension. Describe Patte 2 2
Business name: Jerome Electric X NC ,
AddtC93 PO Boa 751 Each itildiaanal hisprellon over idlernable In any of the shine
Pa impaction 62.30
City/80E021P: Hillsboro, 018 971Z2 irtvestiption pa hour (1 hr ego 62.50
Phone: (583) 648 Fax: (503) 640,9773 Indwaris1 plata per boor 73.75
C:..r
CC13 Lic. I 501 j Electrical Lk.: 34-119C Selprv. tic.: 28775
Subt4401
Supra. Electrician signature, required; ... .2 San review (25% of permit Ike)
Print name: Mini vi j A j vtoke Datc 7 Z c..)y _State nucharge (8% of remit fee)
• TOTAL rExam FEE
AtaboriZel Signature:
rsa mirth soptioarsii aspires if o reran n oat ateattned mina lei
Osarl sIVer h. O m berm accepted ro toroptine
Print um= [ ..7----- . Fee atedadelogy an by tri.Okanly Building Industry Soruicr Bead
-- - .
Plumbing Permit Applicatian� FOR OFF USE ON LY
City of Tigard � 1` � �pP D �� Permit No� yt �j _/7�z,
13125 SW Hall Blvd, Tigard, OR 97223 O� 1 lY p ew ► > �Y � v . ! i
Phone: 503.639.4171 Fax: 503.598.1960 V 1 �r�+ �i Date/By Other Pemvt No.:
24- Hour Inspection Lane: 503.639.4175 `/ OF ' Date Re suds: H See Page 2 for
w
Internet: ww.cLtigard.or.us G � � v rt LL' NotifiedlMethod: Supplemental Information
-:-:" :s+�- .re��.'r as- _ _. *Zas:.er.:w .xrz -€ • ,,�^:w•� ,-;�.�� o '," ";: x � a n '8. 4. ,o_.a;.y r ah:�ra,a:�. » =;;a r1',wr� u >r ;Ys. .j;.
4�,�� m" i OF V�ORK �. ' �+ �� 'r� ; = t �., "r a- ` 'FEE SGHEDUT.E�
I sue, .- .r���',� � �
a_e't� ., u. .����w�� I "t� ar.`K "':,' w��_" � " ,. '`�`
® New construction ❑ Demolition For special information use checklist.
Description Qty. Ea Total
❑ Addition/alteration/replacement ❑ Other: New!- 2 -family dwellings (includes 100 ft. for each utility connection)
,d°•�'.�a;;y�„�'�i"d"�. ; ���;•. .x -.x -_ ,r: ;:.�^sua� °��.ab �,n._a. .x s. mow.° °_ j. `�:".p�wF,t�'u •�.ra kw
CATEGORY OF ,CONSTRUCTION SF : ' "
��,,,. „,�`� sc��,.a,.. ���;A�.,9• ., _ �.,ch.�: � SFR (1) bath 249.20
® 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:
f. JOBxSITE 3 sv'. °= "'x"a' a•^." .ras:v".+�,�ras- ,.. .ro.�.xr.,,.r
Fire sprinkler L__ sq. ft.) Page 2
.,.� 1M ORMATION AND r.LOCATION ' `" Vibes
�;.- �3i�'�!.la;X.: - af• ^� ° � Site
Job site address: 13766 SW Leah Terrace Catch basin or area drain 16.60
City/State/ZIP: Tigard, OR 97224 Drywell, leach line, or trench drain 16.60
Suite/bldgiapt. no.: I Project name: Daffodil Hill Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: SW Bull Mtn. Road
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear f: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: 1 Water Vice (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
.rte ,, ..;�:z�k, �x_�;A,r i�.�re.,<::.�° - t•r a F4
Absorption valve 16.60
u�q. ,'�, ' °'q a " 9 a,:' g_ -uXx
�TIOPT:�OF ^aWORK - "•. � �..� �� +. >.•..o
..�`a.. -_ ..�°� DESC .:e:....,._ zd_... � 4. ' �!�a`��x'tiaY'�'^�Y�m_ '= Backflowpreverrter Paget
New SFR Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
Name: George Marshall Expansion tank 16.60
Address: PO Box 91249 Fixture /sewer cap 16.60
City/State/ZIP: Portland, OR 97291 Floor drain/floor sink/hub 16.60
Phone: (503)705 -1933 Fax: ( ) Garbage disposal 16.60
a: ►�
-•,� . . �.... -.�P� ..� t ,.� ; . ;e ^; � - "a.�,� ,,:.s�.:. . r.; a:� -�; �_,. ,�;,,.'��- - Hose bib 16.60
a ^ NAPP.LICAIVT "[, zi` � CONTAGTvPERSON.;
.., ,xrit „nsa� Y`$- a�,c =; sw,x°.�a.'.ac °._ nro u�'Y:Y.. ,Rt:�'e,ea � � "..'... '> "_m_v a .n .,+. -i._ '. A., ^u..TM��.�•t�v'd
Ice maker 16.60
Business name: Patrick Schmitt, designer Inc
Interceptor /grease trap 16.60
Contact name: Patrick Schmitt Medical gas (value: $ ) Page 2
Address: 2414 NW Stimpson Lane Primer 16.60
City /State/ZIP: Portland, Oregon 97229 Roof dram (commercial) 16.60
Phone: (503) 768 -4573 I Fax:: (503) 246 -3559 Sink/basin/lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: schmittdesign@comcast.net
Urinal 16.60
dI „•`�o-�
CONTRACTORS
.. � b �4� ��s';�r "'�:. Water closet 16.60
Business name: Hoffman Family Enterprises Water heater 16.60
Address: 4808 Lower Drive titer:
City/State/ZIP: Lake Oswego, OR 97035 Subtotal
Minimum permit fee: $72.50
Phone: (503) 675 -0828 Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lic.: 156824 Plumbmg_Lie. no.: 3-497 PB Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Authorized signature:
TOTAL PERMIT FEE
Print name: Patrick Schmitt I Date: 10/28 /04 This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
•0.... ._.4t. a..t......... -s t.. m_ /'...._... n..na:_., r_a.._._. o____.. n_.._4
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
HOFFMAN HYDRONICS & PLUMBING
4808 LOWER DR
LAKE OSWEGO, OR 97035
Plumbing Signature Form
Permit #: MST2004 -00345
Date Issued: 2/4/2005
Parcel: 2S109BA -07500
Site Address: 13766 SW LEAH TERR
Subdivision: DAFFODIL HILL
Block: Lot: 001
Jurisdiction: TIG
Zoning: R -7
Remarks: New SF.
Your company has been indicated as the plumbing contractor for the permit indicated above. I n 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:
MARSHALL, GEORGE HOFFMAN HYDRONICS & PLUMBING
PO BOX 91249 4808 LOWER DR
PORTLAND, OR 97291 LAKE OSWEGO, OR 97035
Phone #: 503 - 705 -7933 Phone #: 503- 675 -0828
Reg #, LIC 156824
PLM 3 -497PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X
Signature of Authorized Plumber
If you have any questions, please call 503.718.2433.
MAY -09 -2005 09 :09 PM MACHOCA CO. 503 638 5124 P.02
•
•
itTriftirrrtaizon fAMTO Build On
TESTED FOR: Machuca and Associates PROJECT Residence
Attn: Fernando Machuca PERMIT NO.; MST 2004 - 00345
1430 SW Borland Road
West Linn, Oregon 97068 •
PROJECT SITE: 13766 SW Leah Terrace
Tigard, Oregon
DATE; March 31, 2005 REPORT NO.: 702- 50118 -1
INSPECTION TYPE (S): Structural Welding, shop (S } gr shop (pe�adtc)
REMARKS:
On this date a PSI representative was at the above referenced site to perform special inspections as requested or
requiredin accordance with job specifications, UBC, and applicable codes.
At Ray Johnson's Fab Shop in Colton, Oregon to perform visual weld inspection per UBC, AWS code,
manufacturer and design specification requirements. Performed visual weld inspection on column mark numbers
IA and 1B, one (I) of each. See Machuca and Associates fax /memo 3/26/05 for welding details,
Welder / material certifications and fhb shop procedures are on tile at the fob shop. Found welding to conform to
AWS D1.1 code visual acceptance criteria and design specification requirements.
To the best of my knowledge, the work was in accordance with the building department approved design drawings,
specifications, and applicable workmanship provisions of the UBC.
INSPECTOR; R. 'Rogers, OBOA 302
Respec /d(y submitted,
Profe.sional Service Industries, Inc.
titatel
an i'i`i(lttii
Construction Services
DU /ak
P; City etT)gerd, Fax to Hii)man (503) 251.0821
Mete teat/inspection results relate only to the spectle test locations noted PSI rs net responsible for any ether location or elevation. Reports
00 owl i i radwed, exCCpt rnfuli, wwtnant written permission of PSI.
6032 N Cutter Circle, Suite 480 Portland, Oregon 97217 Phone (503) 289.1778 Fax (503) 219-1918
CITY OF TIGARD
BUILDING DIVISION
„A . PERMIT #: [visT200400346
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2m/2005
Phone: (503) 639-4171 —441Illiik'
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 2/112006 TIME: 7:02AM PAGE: 6
. .
SITE ADDRESS: 13756 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: OM TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF:
OWNER: MARSHALL, GEORGE, PHONE #: 503.706-7933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503-209_1794
Inspection Request Scheduled For: Date: 2/1/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message itiliEfe,
299 Final inspection 026115-01 503.2091794 'V f°
Corrections/Comments/Instructions: CAA_ /A.VP ME
4 V
ASS 6. -
mf
,...._
..........,,
(
...
..-----
Ass n PART_IALAP_PROYAL._ _ _ _ _ _ .I _ _I _CANCEL NO_ACCESS______.
FAIL CALL FOR INSPECTION pi ADDIT ON ' L FEES ASSESSED
g iEl lh " Isb ili A lri ' 1 4: d
Inspectillgida Date: arii IF di Phone #: (503) 718-
„. ..,
CITY OF TIGARD
4 0
BUILDING DIVISION PERMIT #: MST20O4 -00;
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/3006
Phone: (503) 639 -4171 ... ��AA p���H��1 + .
Inspection Requests (24 Hrs.): (503) 639 -4175 �_!�i T__..
INSPECTION WORKSHEET FOR DATE: 2/1/2006 TIME: 7:02AM PAGE: 7
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: N:v SF,
OWNER: MARSHALL, GEORGE, PHONE #: &)3 -/Of 7933
CONTRACTOR: HILLMAN & ASSOCIATES INC. PHONE #: 503-209.1794
Inspection Request Scheduled For: Date: 21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 026112-01 503 - 109.1794 V
LOLL LA Corrections /Comments /Instructions:
el e
I • ,
I :..P ASS.__ ❑ PARTIAL_ APPROVAL_ _ __ ❑_CANCEL _` n_ NO_ ACCESS
_____
I FAIL El CALL FOR INSPECTION I I ADDITIONA FEES ASSESSED
. 1 dikVik Ii
Inspector: Date 06 Phone #: (503) 718 -
CITY OF TIGARD le
BUILDING DIVISION PERMIT #: NIST20040()346
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2j4/2005
Phone: (503) 639-4171 /Aqi;
Inspection Requests (24 Hrs.): (503) 639-4175 44-
INSPECTION WORKSHEET FOR DATE: it20/2006 TIME: 7:00Alvi PAGE: 22
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF,
OWNER: MARSHALL, GEORGE, PHONE #: 503-70&7933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503-209-1794
Inspection Request Scheduled For: Date: 1120/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
399 Plumbing final 025384-01 503-209-1794
Corrections/Comments/Instructions:
illeaWAP
4 firMrt -1 WAS
A .e.eSS F PARTIALAPPROVAL_ HI. CANCEL_ 7 NO ACCESS
FAIL I I CALL FOR INSPECTION E] ADDITIONAL FEES ASSESSED
Inspector: 4L), Datei i - Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION , PERMIT #:
MST2004- 00345
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/4/2005
Phone: (503) 639 -4171 i#044101111
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/0/2005 TIME: 7:05AM PAGE: 3
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: N SF.
OWNER: MARSHALL, GEORGE, PHONE #: 5037054933 • CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503-209-1794
Inspection Request Scheduled For: Date: 8/9/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
295 Misc. inspection 013184 -01 503-209-1794 Y
Corrections /Comments /Instructions:
f6 (/‘'
j_jj •
•
•
SS_ ❑ PARTIAL APPROVAL _ ____— ❑_CANCEL _ ❑_NO_ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: n — Dater i Phone #: (503) 718-
,
f
CITY OF TIGARD 1 � 1 , ,
BUILDING DIVISION PERMIT #: MST2004 -00346
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/4/2005
Phone: (503) 639 -4171 "'n� /
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/23/2005 TIME: 7 :08AM PAGE: 5
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF.
1
OWNER: MARSHALL, GEORGE, PHONE #: 503 -705 -7933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503-209-1794
Inspection Request Scheduled For: Date: 5/23/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
320 Plumbing rough -in 007507 -01 503.209 -1794 N
Corrections /Comments/ Instructions:
'PASS____ n PARTIAL APPROVAL _ _—❑ CANCEL _ _ ❑_ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ��Yl ) / � Dat -• Ol Phone #: (503) 718-
CITY OF TIGARD (r=- p.=
BUILDING DIVISION #: MST2004.00345
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/4/2005
Phone: (503) 639 -4171 // t /RIypi °j l
Ins Requests (24 Hrs.): (503) 639 -4175 - -- :
INSPECTION WORKSHEET FOR DATE: 3/25/2006. TIME: 7:07AM PAGE: 24
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF. .
OWNER: MARSHALL, GEORGE, PHONE #: 503 - 705.7933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 508.209 -1794
Inspection Request Scheduled For: Date: 3/25/2005 Pour Time:
Code # In • - - : - - - ' - ' Confirm # Contact # Message
315 ` Post/beam plumbing 002862-02 503-209 -1794 N
Corrections /Comments nstructions:
)1El _ ❑ _PARTIAL APPROVAL _ ❑ CANCEL __. _ __ _____ .__-_❑_.NO_ACCESS .__. __-
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C l` `' ' % L
Date: - 61 1 - 6 f'' Phone #: (503) 718 -
CITY OF TIGARD ,,
BUILDING DIVISION ,,, ` PERMIT #: MST200 -00346
13125 SW Hall Blvd., Tigard, OR 97223 "`� DATE ISSUED: 2/4/2005
Phone: (503) 639 -4171 A iiiq ��R � ,� -
Inspection Requests (24 Hrs.): (503) 639 -4175 °'.A—
y
INSPECTION WORKSHEET FOR DATE: 3/11/2005 TIME: 7:27AM PAGE: 46
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL.
DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, PHONE #: 603- 705.7933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503- 209 -1794
Inspection Request Scheduled For: Date: 3/11/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
350 Septic tank 001402 -04 503.209 -1794 N
Corrections /Comments /Instructions:
1 L f 2 t --(73 s s - A ,. / '
Z , Cii i V L vu # - 41 S -_C
! ;1 ' ( ‘f ` c -L.44-74' °
❑ 'ASS_ ___ ❑ PARTIALAPPROVAL — ❑ CANCEL I I NO ACCESS
IA FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: \V Date: Phone' #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION ' PERMIT
:-
#: MST2004 -00345
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/4/2005
Phone: (503) 639 -4171 i P ��° lit
Inspection Requests (24 Hrs.): (503) 639 -4175 ='I �..
INSPECTION WORKSHEET FOR DATE: 3/11/2005 TIME: 7:27AM PAGE: 48
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, PHONE #: 503-705 -7933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503 -2Q9 -1794
Inspection Request Scheduled For: Date: 3/11/2005 Pour Time:
• Code # Inspection Description Confirm # Contact # Message
330 Water service 001402 -01 209 - 179 -4503 N
Corrrections /Comments /Instructions: _
// Al / S b /� Q�_
7 2 3 h—e_ -,Zej / zcX 1 e-vLY: .,..„
❑ PASS__. PARTIAL.AP_PROVAL CANCEL _ ❑ -NO ACCESS
n FAIL n CALL FOR INSPECTION n ADD,ITIONAL FEES ASSESSED
Inspector: " Cam `' Date: t /d �' Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION #: MST2004 -00345
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/4/2005 •
Phone: (503) 639 -4171 i A lin pi�� jl
Ins Requests (24 Hrs.): (503) 639 -4175 ' __..
INSPECTION WORKSHEET FOR DATE: 3/11/2005 TIME: 7:27AM PAGE: 43
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, PHONE #: 503 -fi0J -7933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503 - 209 -1794
Inspection Request Scheduled For: Date: 3111/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
505 Sanitary sewer 001402 -05 503 -209 -1794 Y /'
Corrections /Comments /Instructions: r '1
3 4/
' PASS_ _ _ PARTIAL APPROVAL _ ___ _ ❑_CANCEL _____ ._ . _ _ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \' V v Date: 3 / i / ° Phone #: (503) 718
CITY OF TIGARD -
BUILDING DIVISION #: MST2004-00345
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/4/2005
Phone: (503) 639 -4171 ' 11
Inspection Requests (24 Hrs.): (503) 639 -4175 __-.
INSPECTION WORKSHEET FOR DATE: 3/11/2006 TIME: 7:27AM PAGE: 46
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, PHONE #: 503 - 705.7933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503 - 209 -1794
Inspection Request Scheduled For: Date: 3/11/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
t
340 Storm drain 001402 -03 503 Y
Corrections /Comments /Instructions: / ,_ \ r _
() 7 -, / 3// 4 ,, I / 42,Q—P vlid! L�
11. -Ass__ ❑ PARTIAL_AP_P_ROVAL _ _ ❑_CANCEL -- ❑. NO ACCESS
FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: �' / O Phone #: (503) 718- •
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004 -00345
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/4/2005
Phone: (503) 639 -4171 Muy�ii'�l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/11/2005 TIME: 7:27AM PAGE: 47
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, PHONE #: 503 - 705.7933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503 -209 -1794
Inspection Request Scheduled For: Date: 3/11/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
335 Rain drain 001402 -02 503-2091794 N
Corrections /Comments /Instructions:
, ,
174-FrAs_s___ _. fI PARTIAL APPROVAL . _ _ _ _ ❑CANCEL __. _�I_NO_ACCESS .
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: `" L Dater / 3 t Phone #: (503) 718-
•
CITY OF TIGARD
BUILDING DIVISION a PERMIT #: Ib1S'T 00 01 315
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2J4/20(B5
Phone: (503) 639 -4171 ��l dial 1
Inspection Requests (24 Hrs.): (503) 639 -4175 .�'
INSPECTION WORKSHEET FOR DATE: //512008 TIME: 7 :00AM PAGE: 3
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, PHONE #: 503-705-7933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503- 208.1794
Inspection Request Scheduled For: Date: 115/2006 Pour Time:
' I
Code # Inspection Description Confirm # Contact # Message
399 Pluriibing firm l 024135 - 01 503 N
Cor ections /Comments %Instructions: o
lit Vie _ ( • '7' Z° 4. 1-- ,
C. ) S 0.,c,1A42-e-- e..,ev c--- -1--- 4_ e ,,--0.____re___- -0 ov.) -1/4.--t,J0„e,
7
(. P 4K - k2_,,,,;,„ - -.(ze.,„' uL) __f&. .
( . -2-1 % ) - rte! /k \C -e-k 5(/, ,
�X L-_ k 2-o
C. ,P 1(2 J 5 ,4_9- 4 -.e Li o ..5 (2 \ O.4 .
1 ---\---e..6.±.)2,_ ----- 1A-A" c..,r,;" Li...A .k.t.•/ 12.._„-.. s Qe(--c-e. :
rF f L f ) d c , -e a. 'P L -4 ,r. °,.,� .
-..._______
P c1,�.� La , Q.__I-2_,:_,-o----z_ � �
1 - •, 1 \ ,. 0 „,
b f . ,,
t A(
,
/ \, _ 0 '
n PASS n PARTIAL APPROVAL. . _ _.0_CANCEL ___ _.. NO ACCESS
FAIL n CALL FOR INSPECTION • n ADDITIONAL FEES ASSESSED
1/4, Inspector: Date: ����� Phone #: (503) 718 - (2--‘t
CITY OF TIGARD
BUILDING DIVISION ,..
PERMIT #: m9
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/4/2005
Phone: (503) 639-4171 / sillowAi
Inspection Requests (24 Hrs.): (503) 639-4175 kmfg. - '
INSPECTION WORKSHEET FOR DATE: 1/412006 TIME: 6:59AM PAGE: 2
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, 0 PHONE #: 503-705-7933
CONTRACTOR: HILLMAN & ASSOCIATES INC A PHONE #: 503-2091794
Inspection Request Scheduled For: Date: 1/412006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1094 Electrical final 024363-01 503-.209 N
- Corrections/Comments/Instructions:
/-
, PASS I I _PARTIAL, APPROVAL . _.D_CANCEL_____ NO_ACCES.S__
I I FAIL I I CALL FOR INSPECTION ' I I ADDITIONAL FEES ASSESSED
g we... 4 ...,p
Date: /— V Phone #: (503) 718- 2 L/K‘ _
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: MST2004 -00345
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 214/2006
Phone: (503) 639 -4171 J„„„1/111
Inspection Requests (24 Hrs.): (503) 639 -4175 �
INSPECTION WORKSHEET FOR DATE: 6/21/2005 TIME: 7:11AM PAGE: 4
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT-NAME: DAFFODIL HILL
DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, PHONE #: 503 - 705 -7933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503 - 209 -1794
Inspection Request Scheduled For: Date: 6/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 009786 -03 503. 209.1794 N
Corrections /Comments /Instructions:
v •
\AA/7k01‘T\ii r e / -AAttv Aeirvu -
ah
PASS ❑ PARTIAL APPROVAL _ ❑ CANCEL. _. _ _. _❑_NO_ACCESS
- FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: fir Date: 67 L/ D Phone #: (503) 718-
•
{
CITY. OF TIGARD
BUILDING DIVISION PERMIT #: IviST2004-00345
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/4/2005
Phone: (503) 639 -4171 i u n glmNlrMNll�l ��
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/21/2005 TIME: 7:11AM PAGE: 3
SITE ADDRESS: 13765 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE :: •
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, PHONE #: 503 -705 -7933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503 - 209..1794
Inspection Request Scheduled For: Date: 6/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 00978604 503. 209-1794 N
Corrections /Comments /Instructions:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL_ ❑ NO_ACCESS
Il FAIL El CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
e %
67- Z o �
Inspector: ctor: f Date: Phone #: (503) 718 -
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: MST2004 00345
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 2)412005
Phone: (503) 639 -4171 :,:11.41141111''\
Inspection Inspection Requests (24 Hrs.): (503) 639 -4175 ..—
INSPECTION WORKSHEET FOR DATE: 7/11/2005 TIME: 7 :07AM PAGE: 48
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, PHONE #: 503 - 7054933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503 - 209.1794
Inspection Request Scheduled For: Date: 7/11/ Pour Time:
Code # Inspection Description Confirm # Contact # Message
280 Insulation 011148 -01 603. 359`1303 N
Corrections /Comments /Instructions:
ASS ❑ PARTIAL APPROVAL __ ❑ -CANCEL __ ❑_ NO_AC . CESS. - _ _
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 7- / /-- / Phone #: (503) 718-
CITY. OF TIGARD .
1 BUILDING DIVISION PERMIT #: MST2004 -00345
13125 SW Hall Blvd., Tigard, OR•97223 DATE ISSUED: 2/4/20!,5
Phone: (503) 639 -4171 / /II /I"' NI�G�°1'� \
Inspection Requests (24 Hrs.): (503) 639 -4175 ...' I I- I..
INSPECTION WORKSHEET FOR DATE: 7/6/2005 TIME: 7:12AM PAGE: 2
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, PHONE #: 503- 705 -7933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503-209-1794
Inspection Request Scheduled For: Date: 7/6/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 010838 -01 503-209-1794 Y
Corrections /Comments / Instructions:
f::::) ris-er' ,---- e-s-ez- C._ 4,45cm i-'1______________________A) 7.- 7—/-0C
/
•
PASS ❑ PARTIAL APPROVAL _ _ _0 CANCEL _ __ ❑_NO ACCESS
❑ FAIL n CALL FOR INSPECTION
/ El ADDITIONAL FEES ASSESSED.
Inspector: Date: 7 —G- Phone #: (503) 718-
, .
. . .
CITY OF TIGARD y ,
BUILDING DIVISION - - . . - A - :
PERMIT #: MST2004-00345
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 214/2005
Phone: (503) 639-4171 / A/ 4 091
,.. 1
1
Inspection Requests (24 Hrs:): (503) 639-4175 ..__41- ...
INSPECTION WORKSHEET FOR DATE: 7/1/2005 TIME: 7:14AM PAGE: ' 1
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK: _.
. SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, PHONE #: 503-705-7933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503-209-1794
Inspection Request Scheduled For: Date: 7/1/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 010659-01 503-209-1794 N
Corrections/Comments/Instructions:
..---
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e41- 'i--- Ata T c_- fl/ "'I. C CANCEL_ Li PASS i 1 PARTIAL APPROVAL_ u ANCEL_ D_NO_AC_C_ESS
ig AIL 7 CALL FOR INSPECTION
0 ADDITIONAL FEES ASSESSED
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1-
Inspector: Am. Date: 7 I ' ° -5' Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004- 00346
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/4/2005
Phone: (503) 639 -4171 !��''�4p��lpii����
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/21/2005 TIME: 7:11AM PAGE: 6
SITE ADDRESS: 13756 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, PHONE #: 503 - 705 -7033
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503-2091794
Inspection Request Scheduled For: Date: 6/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas fine 009786 -01 503- 209 -1794 N
Corrections/Comments/Instructions:
e SL - / /\/ 41k. _ : L SO i :
•
PASS ❑ PARTIAL APPROVAL .. ❑_CANCEL_ ❑ NO_ ACCESS
n AIL �] CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
-Z_ 0,5'
Inspector: � - Date: Phone #: (503) 718-
%
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: MST201- 00345
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/4/2006
Phone: (503)'639 -4171 Adt lj�l?�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 612112006 TIME: 7:11AM PAGE: 6
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
- DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, PHONE #: 503 - 706 -7933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503
Inspection Request Scheduled For: Date: 6/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
616 Mechanical rough -in 009786-02 503- 209 -1794 N
Corrections /Comments /Instructions:
Z r
O
PC F ri 2 cam:- i 1- /'
g -ASS ❑ PARTIAL APPROVAL ❑CANCEL _ ❑_NO ACCESS
❑ FAIL 111 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
i
Inspector:. Date: `� Z / d Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004 -00345
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/4/2005
Phone: (503) 639 -4171 . ���� °�r4�mlji•i
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/2/2005 TIME: 7:12AM PAGE: 5
SITE ADDRESS: 13765 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, • PHONE #: 503- 7054933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503- 209 -1794
Inspection Request Scheduled For: Date: 6/2/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
240 Exterior sheathing 006230-01 503 -209 -1794 N
- Corrections /Comments /Instructions:
•
SASS ❑ PARTIAL APPROVAL 0 CANCEL ❑- NO_ACCESS _
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
� , r
Inspector: . Date: (` w r -- `-"`-•-i Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: MST2004 -00345
Phone: (503) 639 -4171 i a a ,ei Nny�iiip��lI` . 2/4/2005
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
6/1/2005 7 :15AM 18
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 13766 SW LEAH TERR LOT #: TYPE OF USE:
PROJECT NAME: DAFFODIL HILL 001
DESCRIPTION: DAFFODIL HILL
New SF.
OWNER: PHONE #:
CONTRACTOR: MARSHALL, GEORGE, PHONE #: 503405"7933
HILLMAN & ASSOCIATES INC 503-209-1794
Inspection Request Scheduled For: Date: Pour Time:
6/1/2005
Code # Inspection Description Confirm # Contact # Message
240 Exterior sheathing 008102 -01 503 - 209-1794 V
Corrections /Comments / Instructions:
AP , 1 ,1 1 L. G�ac _ 0 A.—..i■ �O AvE
I PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS _ _
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: A, Date: 6 - /-SOS" Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004 -00345
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/4/2005
Phone: (503) 639 -4171 �o�w�u41u�Bpi������
Inspection Requests (24 Hrs:): (503) 639 -4175 ,_, "
INSPECTION WORKSHEET FOR DATE: 5/18/2005 TIME: 7 :34AM PAGE: 103
SITE ADDRESS: ' 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, PHONE #: 503 - 705 -7933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503 - 209 -1794
Inspection Request Scheduled For: Date: 5/18/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
240 Exterior sheathing 007120 -01 503- 2091794 Y
Corrections/Comments/Instructions:
#1 / /5) '1 -L 4-4-4, >'T 5 ,,5w /�S
•
❑ PASS El PARTIAL APPROVAL ❑ CANCEL ' _ _ _ _❑_N_O __
1--P AIL --------
n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / S1�`� Phone #: (503) 718-
_(- 4
.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004 -00345
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/4/2006
Phone: (503) 639 -4171 X A, c IU �o l lil
Inspection Requests (24 Hrs.): - (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/17/200 TIME: 71 1AM PAGE: 8
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, PHONE #: 503 - 707033
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503..209.1794
Inspection Request Scheduled For: Date: 6/17/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
236 Shear walls/anchors 007056 -01 603- 209 -1794 Y
Corrections/Comments/Instructions:
? n PARTIAL APPROVAL __ _ _ ❑_CANCEL —. ___ __❑_N.O_ACCESS ___
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: j/7-' 5 Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004 -00345
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/4/2005
Phone: (503) 639 -4171 '�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/9/2005 TIME: 7:10AM PAGE: 32
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, PHONE #: 60-705-7933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 50 3 - 20 -1 79 4
Inspection Request Scheduled For: Date: 5/9/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
235 Shear walls /anchors 006388-01 503-209-1794 Y
Corrections/Comments/Instructions:
/ L !' C r 5
��- 1- L A f - / 4- •
❑ PASS - ❑ PARTIAL APPROVAL ❑ CANCEL - ❑ NO ACCESS -
F AIL ❑ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: S = OS Phone #: (503) 718-
CITY OF TIGARD .3
BUILDING DIVISION PERMIT #: MST2004-00345
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/4/2005
Phone: (503) 639 -4171 �°�iaad�ylm ii P,�'
Inspection Requests (24 Hrs.): (503) 639 -4175 ..._' `'II
INSPECTION WORKSHEET FOR DATE: 3/28/2005 TIME: 7 :10AM PAGE: 46
' SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, PHONE #: 503 - 705-7933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503 - 209 -1794
Inspection Request Scheduled For: Date: 3/28/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
605 Post/beam mechanical 002991 -01 503- 209 -1794 N
Corrections /Comments/ Instructions:
PASS NI PARTIAL APPROVAL ❑ CANCEL __ __ _
FAIL Fa CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: e : 27. 718-
p MI . Date P.ho #: (503) 718
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: MST2004-00345
13125 SW Hall Blvd:, Tigard, OR 97223 DATE ISSUED: 2/4/2006
Phone: (503) 639 -4171 Ne b l�j � l a l \
Inspection Requests (24 Hrs.): (503) 639 -4175 __..
INSPECTION WORKSHEET FOR DATE: 3/25/2006 TIME: 7:07AM PAGE: 26
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, PHONE #: 6037057933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503- 209 -1794
Inspection Request Scheduled For: Date: 3/26 /2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
226 Post/beam structural 002862-01 603-209-1794 N
Corrections /Comments / Instructions:
6 fsTppiKe L Qom: ` (AL. .Iv 0.t,
l� t (A
V•04.,- P( k AN Q A -F-t& .
❑ PASS rj PARTIAL APPROVAL. _ ❑ CANCEL __ _. ❑_ NO_ACCESS
❑ FAIL ❑ ALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: . 9 ' $94 Li Date 3 E
`t Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2004 -00345
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/4/2005
Phone: (503) 639 -4171 �a m'/iiiii i i i gihl A i i ? A _
Inspection Requests (24 Hrs.): (503) 639 -4175 ...'.� __..
INSPECTION WORKSHEET FOR DATE: 3/25/200' TIME: 7:07AM PAGE: 23
SITE ADDRESS: 13756 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL. HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF. •
OWNER: MARSHALL, GEORGE, PHONE #: 503- 705 -7933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503,209-1794
Inspection Request Scheduled For: Date: 3/25/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 002862 -03 503.209-1794 N
Co rections /Comments /Instructions:
1 4 0'V S - _ - -
S c�-z U to l-. C, ()► 66 Le—F-7 a ii — . ,
• Am. 0 [ rte. _ on/
5
/...)
c
❑ PASS ❑ PARTIAL AP_PROVAL._ ❑ CANCEL _ _ ❑_N.O_ACCESS
FAIL 1 CALL FOR INSPECTI El FEES ASSESSED
r �.
Inspector: _ Date: _ i #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST204 -00345
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2'4/2005
Phone: (503) 639 -4171 41m9i Ag \
Inspection Requests (24 Hrs.): (503) 639 -4175 , 1 ' I�
INSPECTION WORKSHEET FOR DATE: 3/10/2005 TIME: 7 :30AM PAGE: 0
SITE ADDRESS: 13766 SW LEAH TERR CLASS OF WORK:
SUBDIVISION: DAFFODIL HILL LOT #: 001 TYPE OF USE:
PROJECT NAME: DAFFODIL HILL
DESCRIPTION: New SF.
OWNER: MARSHALL, GEORGE, PHONE #: 503405 -7933
CONTRACTOR: HILLMAN & ASSOCIATES INC PHONE #: 503 -209 -1794
Inspection Request Scheduled For: Date: 3/10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
242 Interior shear walls 001239-01 603-720-7445 N
Corrections/Comments/Instructions:
t: /J /A. c6 nee7-0P .4.4-5/ffifrictAi t
PASS n PARTIAL APPROVAL ❑ CANCEL ________ _ __ ❑_NO_ACCESS
L n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: . Date: di 3/d-- 4 5 Phone #: (503) 718-
CITY OF TIGARD ' 4') S?-
BUILDING DIVISION PERMIT #: �� -dc) j
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED:
Phone: (503) 639 -4171 / �� e i Nikll6 i1l
Inspection Requests (24 Hrs.): (503) 639 -4175 °`__..
INSPECTION WORKSHEET FOR DATE: 3 -- J -- TIME: PAGE:
SITE ADDRESS: / 376,E CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: HONE #:
CONTRACTOR: 7 � / H ONE #: a / G f - S
/ /.pC )
Inspection Request Scheduled For: Date: • • '
Code # Inspection Description Confirm # Contact # Message
6 - 1:1 2 41.-1 i
Corrections /Comments/ Instructions:
4 / S.= Act.. C ��✓ �� C ed___ — C_ _..
II i ' / .."L� ' `f cv. L■ Ac.IL 4 i - C / II off
� / ' "E 1 A 3 1 A./ /t d7
r / raw - — b. - P.
PASS n PARTIAL APPROVAL_ ❑ CANCEL _ _ __ ___ ___ __ ❑_NO_AC.CESS
I I FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 3- 7 OS Phone #: (503) 718-