Permit _ MASTER PERMIT
CITY OF TIGARD
PERMIT #: MST2004 -00248
4 iiil DEVELOPMENT SERVICES DATE ISSUED: 9/16/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 07916 SW LEISER LN PARCEL: 2S112BD -LP016
SUBDIVISION: LEISER PARK ZONING: R - 4.5
BLOCK: LOT: 016 JURISDICTION: TIG
REMARKS: New SF detached.
BUILDING
REISSUE: LP016 -A1 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,358 sf BASEMENT: sf LEFT: 15 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,470 sf GARAGE: 622 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5
VALUE: 277,550.60
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2,828 sf REAR: 15
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: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 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: 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: 5 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/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: $ 8,169.51
This permit is subject to the regulations contained in the
LEGEND HOMES LEGEND HOMES CORP Tigard Munidpal Code, State of OR. Specialty Codes
12755 SW 69TH 12755 SW 69TH AVE #100 and all other applicable laws. All work will be done in
SUITE 100 TIGARD, OR 97223 accordance with approved plans. This permit will expire
PORTLAND, OR 97223 if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
Phone: 503 - 620 - 8080 Phone: 620 - 8080 ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those
Reg #: LIC 60563 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 Insl Rain drain Insp Electrical Final
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Storm drain Insp Mechanical Final
Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Water Line Insp Plumb Final
Foundation lnsp PLM /Underfloor Framing Insp Gas Fireplace Water Service Insp Building Final
Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation lnsp Appr /Sdwlk Insp
Issued By : t i,a,e . Permittee Signature .■ ` 1.
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next busines • ay
•
R ECE \I E®
Building Permit Applicatii g t 0 2ppq FOR- OFEICE USE 6 NLY. ;
Clt Of TL aC(1 Received
Y g Date/By: o /D4 � Permit No. / / / ✓ / a�/� dv�
13125 SW Hall Blvd., Tigard, OR 97223 Y '
F T1GP D Plan Rev
Phone: 503.639.4171 Fax: 503.598.1960 �1� 0 � "'ka� NOV I& A rJ � - 1 r,1 - o � Other Permit: SW�y Op 0C:01 p ►V►SI l Date/By: /�
Inspection Line: 503.639.4175 �11.D IN •�' I Al O � Date Ready /By: ] uric: H See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Methodd: /D'1 G 7 - Supplemental Information
� .. :, TYPE OF WORK REQUIRED'DATA9 AND 2 FAMILI�DWELI.4 G ,
® 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
work indicated on this application.
Valuation: $276,421.80
® I - and 2- family dwelling ['Commercial/industrial
[I Accessory building El Multi-family Number of bedrooms: 4
1:1 Master builder CI Other:
Number of bathrooms: 3
-.
: JOB SITE LNFO AND L t • Total number of floors: 2
Job site address: 7916 SW Leiser Lane New dwelling area: 2828 square feet -
City /State /ZIP: Tigard, OR 97223 Garage /carport area: 622 square feet
Suite/bldg. /apt. no.: Project name: Leiser Park Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED:DATA COMMERCIAL USE,CH1 CKLTST..
Subdivision: Leiser Park Lot no.: 016 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
"DESCRIPTION OF WORK
At work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
. ®PROPERTY' OW ER � TFNANT ,. Number of stories:
Name: Legend Homes Type of construction:
Address: 12755 SW 69 Avenue, Suite #100 Occupancy groups:
City /State /ZIP: Portland, OR 97223 Existing:
Phone: (503)620 -8080 Fax: (503)598 -8900 New:
® APPLLCAN I € E ' r ,: : ®CONTAC I;' PERSONS : ; < NOTI
Business name: Legend Homes All contractors and subcontractors are required to be
Contact name: Steve Lucas licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 12755 SW 69 Avenue jurisdiction in which work is being performed. If the
City/State /ZIP: Portland, OR 97223 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 620 -8080 Fax: : (503) 598 -8900
E -mail: slucas @legendhomes.com ,
4 ,
Business name: Legend Homes BUILDING)PE 'FEES* " '
�., v:<.�.�.�.�e., �.•, ...„,� ... _. ; � � ter,
Address: 12755 SW 69 Avenue, Suite #100
Please refer to fee schedule.
City /State /ZIP: Portland, OR 97223
Fees due upon application
Phone: (503) 620 -8080 Fax: (503) 598 -8900
Amount received
CCB lie.: 060563
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: Steve Lucas Date: S /ZG /Cs4 * Fee methodology set by Tri- County Building Industry
Service Board.
is \ Building \Permits \BUP- PermitApp doe 12/03 440- 4613T( I l /02 /COM /WEB)
. ,
1r .1eCE.V14 ED
' 4 Plumbing Pe mit Apytettign - - . .,: ;., .. .FOR OFFICE USE ONLY
City of Tigard P1/4k Received
Date/13y: Permit No.:VI/tSlocii - c , a
13125 SW Hall Blvd., TigarcIp I
MIABlaNBC) Plan Review
Phone: 503.639.4171 FaxL.40 W
" VOW IS1°k\t 4 A
• ilVA71111 Date/By: Other Permit No.:
24 Hour Inspection Line: au t o4 , v Aids.
a "_. .1 . . 6 - . . . . a Date Ready/By: 10 See Page 2 for
Internet: www.ci.tigard.or,ors Notified/Method: Supplemental Information
TYPE:' OF WORK 4%-.. ' t; ;l ; ' • '•In'; : ,,,K,:;;' ' ...-if ' -!:Igt , ',,;' • Fit* SCHtDUI.41:' - •" - 7. 4' , :: , :ll , ' ''',: t ,'', ' '
El New construction 0 Demolition For special information use checklist.
Description I Qty. I Ea. I Total
p Addition/alteration/replacement 0 Other: New 1 - 2 dwellings (includes 100 ft. for each utility connection)
,CATEGORY OF CO '' ''Z SFR (1) bath 249.20
Z 1 - and 2-family dwelling 0 Commercial/industrial SFR (2) bath 350.00
0 Accessory building 0 Multi-family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
0 Master builder 0 Other:
Fire sprinkler ( sq. ft.) Page 2
, 40WSITEANFOIRNIATION, ANIAO,CATION ,, , " .,,i.r.-2.-,. Site utilities
Job site address: 7940 SW Leiser Lane Catch basin or area drain 16.60
City/State/ZIP: Tigard, OR 97223 Drywell, leach line, or trench drain 16.60 .
Suite/bldg./apt. no.: Project name: Leiser Park Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00 -
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision Leiser Park Lot no.: 017 Water service (no. linear ft.: ) Page 2
:
Fixture or item
Tax map/parcel no.:
Absorption valve 16.60
. „DiSCRIFTION WORK . ./."-,, p, %, , ,,,,,:-
Backflow preventer Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
Y:6iorik 6. .,,. .: . ''' ;Ili :)rEk'Akt ,...A''' ' ,
16.60
Name: Legend Homes Expansion tank 16.60
Address: 12755 SW 69 Avenue, Suite #100 Fixture/sewer cap 16.60
City/State/ZIP: Portland, OR 97223 Floor drain/floor sink/hub 16.60
Phone: (503)620-8080 Fax: (503)598-8900 Garbage disposal 16.60
Hose bib 16.60
`?:, .:4; ' SZ
APPLICANT : 4,, ., .% -' ' CONTACT iiitS9N
Ice maker 16.60
Business name: Legend Homes
Interceptor/grease trap 16.60
Contact name: Steve Lucas Medical gas (value: $ ) Page 2
Address: 12755 SW 69 Avenue, Suite #100 Primer 16.60
City/State/ZIP: Portland, OR 97223 Roof drain (commercial) 16.60
Phone: (503) 620-8080 Fax: : (503) 598-8900 Sink/basin/lavatory 16.60
Tub/shower/shower pan 16.60
E-mail: slucas@legendhomes.com
Urinal 16.60
• ..-.,,, - - ia : , - i CONTRACTOR ;.K-- ' ::' ''''''' ' " '''''' ' Water closet 16.60
Business name: Wolcott Plumbing Water heater 16.60
Address: P.O. Box 2007 Other:
Subtotal
City/State/ZIP: Gresham, OR 97030
, Minimum permit fee: $72.50
Phone: (503) 667-1781 Fax: (503) 667-9891 Residential backflow minimum permit fee: $36.25
CCB Lic.: 23847 Plumbing Lic. no.: 26-208PB Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Authorized signature: ' TOTAL PERMIT FEE
Print name: Steve Lucas Date: g:V2.6/.0.1-- This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
i: \ Building \ Permits \ PLM-PermitApp.cloc 12/03 440-4616T(10/02/COM/WEB)
Mechanical Permit Applic t FOR OFFICE USE ONLY • ' • .
City a Tigard ��►► Received oO � tg
Date/By: Permit No.: />,1� `
13125 SW Hall Blvd., T ta0i;.!' -' Plan Review ��/��11//
2 0 Lu _4. 411: Other Pernut
Phone: 503.639.4171 Fax: 503.598.1960 4 /dnru Date/By:
Inspection Line: 503.639.4175 A � Notified Method. t ? Date Ready /By: Juris: !3 See Page 2 for
www.ci.tigard.or.us N U
g C�jY C 7 pD 0. pp
COY ` 1 �G�n 4+Sa Supplemental Information
i .,; f e :- O O "rr E * . _ 'x se; a f r o
�;
�.�.�.,.. : ' Y ., " .y� � ���� .,. WORK �- � �. "���� _ ; USECHECICI:IST. u"
® New construction ❑ Addition /alteration /replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
0 e "r ION Value $
. RES DENTIAL EQUIPMENT / SYSTEMS "FEES , s 1
® I and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building` "' ` ` `��
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total
jr : " JOB &SITE ,INFORMATIO ,A # 7:1 1 Heating/cooling
Air conditioning or heat pump
Job site address: 7940 SW Leiser Lane
(requires site plan showing placement) 14.00
City /State /ZIP: Tigard, OR 97223 Fumace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: Leiser Park 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: Leiser Park Lot no.: 017 Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
Water heater 10.00
"..w.� _ N� s ll ," ., ORK ' ` k r " 3 mtgvi
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
''' .. n i° OPERTY.:.OWNER' ' i ' , " TENANT 3011 Y
i . •:' . „. , Mfg . a ,,. '_ .., L, e, . , ,. Other: 10.00
Name: Legend Homes Environmental exhaust and ventilation
Range hood /other kitchen
Address: 12755 SW 69 Avenue
equipment - 10.00
City/State /ZIP: Portland, OR 97223 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
L °z , ` ' Attc /crawls ace fans 10.00
ZAPPLICANTT _ C 'A,9 PERSON ii ° . a i P
Other: . 10.00
Business name: Legend Homes
Fuel piping
Contact name: Steve Lucas $5.40 for first four; $1.00 for each additional
Address: 12755 SW 69 i Avenue, Suite #100 Furnace, etc.
Gas heat pump
City /State /ZIP: Portland, OR 97223 Wall /suspended /unit heater
Phone: (503) 620 -8080 Fax: : (503) 598 -8900 Water heater
Fireplace
E -mail: Range
` ; - ei ' x ,. Barbecue
... v a,_ .. .._,<a .e.t P , ,. v _. <
Business name: Tri County Temp Control Clothes dryer (gas)
- Other:
Address: 13150 Clackamas River Drive ' . MECHANICAL PERMTT FEES* t4
City/State/ZIP: Oregon City, OR 97045 Subtotal
Phone: (503) 557 - 2220 Fax: (503) 557 - 0919 Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lie.: 72623 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized sl nature: This permit application expires if a permit is not obtained within 180
g �` / days after it has been accepted as complete.
Print name: Steve Lucas Date: �j /2rj/ * Fee methodology set by Tri - County Building Industry Service Board
i:\ Building \Permits \MEC- PermitApp dos 12/03 440 -4617T (11 /02 /COM /WEB)
10/03/2002 23* 59
„ ' '7":.= i' ' -
6427925
PAGE 01
AUG -19-2004,TNU 0340 PM Legend Holsyr_N FR NO, 503583 P . 02
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City of Tigard 0 200 !i.... tya . 9,1 ,,,
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13125 SW Rail Siva.. Tigard, Ott 97223 AUG 2 r.• a Review War Pernic
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t: ,039 ,4171 r ev D3 5S r."'' [•,::::,-..!' • • •• :
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Inspootian Lbw 503439-4175 Gay OF . ,-- ,. !hIL , .tottaa• /By; On , $11 Pistil for
intend! wwW.c1.001ni.or.1 7. 1 to . , 14°°*(444$°1°°' 5 . aunoist taformatlas
•:' ! 'i': . !' I . : .:1' , ' !. : ',.1 , :. il ■ :: :.' !' + i ii i ; ' ' : iiii . :0...1*,41 ' '. li113;lill ' 1' A il 1 : 1 :Jiti ,, :11.1rY;261,-1—.—.11 1 04.11. tiOirti'l!!::::0 : ?.!: tV t Al
New conatruction . 1:3 Addition/alteration/replacement Piggott cluck an that apply:
CSerViC0 over 215 amps, contin'l 0 Hatardous location
0 00121olition CI Other 0 wilco ovcr 320 rano. - taring 01912ildat artr . .0, 000 PS- ri-
r :;j..:';Y::. 1 I 1.1:1416*,r112•9;.ii..4000R,"*., , '0 . ! 1:1•Xt";,•!.,.:11 .: !! P. i , of 1- end 1-family dwelilnwt 4 or more nsw residential
. ... , , . .
tg 1. and 24,mily dwelling rj Commarcial/induetrial C3 AceeSSory building MSystcro over 600 volts norninel units in one structuro
ch three goriag Clqucatri, 400 amp; or Mere
II MUltisfiktfilly C ivuoter 129119ei Ei Other: ClOcianumt Mud over 99 porton* 0 Menaliactured /minium or .
't.11,:f•!,':, ''. ;lc I.': I..•''..!i 't . 'i '' `' ' 'rt .11.4=ILMIII" . i i' il". •I' !•:IL'i'!1..5'g.,1: rlEgmeitillIniiiiti PInn RV pit
C)71colth-care facility C
Job no.: lob slit/ iddrossi 7916 SW Laser Una Submit 2„ tett of plsro with ow of tlCnhart he above-
__,,.
City/St:no/ZIP: Tigard, OR 97213 mg apo.. are not applicable to temporary construction amigo,
. t.',. 1, :':'":'::Vii:; 0.':: !ri:'. !I'M. -, E • ': , : t"...'1 :.''
Suite/bldg./apt no.: PrOjea nOrna! Leismr Perk - . •
, --- Docrittui rIBIlEall_ 'row
...
&nes etract/directione to job site: Now reoidenitot itnalo- er trtulti•ternIty dwelitna unit.
— includes attached Mars e.
1,000 . , A. ay Ings 11111 143.13 4 ..110 .
Subdion: Leiser Park Lot no.: 016 Ea, add'l 300 so. ft, or portion ...,_ 33.40 'Minn
-...•■•■--.....*...... .■•■••••••■•■•••••■ IMEECM2121131.115111111 75 IEMIEN
Tax map/parcel no.. Limited enety,rea-residontIal ' elle. '" 15.60 NM 2
,']., 1.".;:;,177:7777.74,, - 14, ;, T 7a, 07.: *04t x tr., , . , .. , ..,..,thally.1.1 .' 1,1:.ii:014; 'Jan marufoo Wed or ritidulor
dvestims,setvica an ar feeder 90.90 MO 2
,...—.--------,„,..---------- Selvtai or leaders letrallation alteration, ant9or roboblkIn
206 amps or lets 80.50
•
;•41, ;y0 .art 19,1r.rtg7 it " .; i , , ...cif i;:..• t i 0,10 • . ,,,,.. w -. ,...9. 1.1 : ,t 1 . 201 rote to 400 imps 176.85 OBI
,.. , . .gla , L 1 ,•',... „ t:1- ,',11:0 h.. . ;..1 :. WV; • ;'.I.'.. i..__L r4s ; ,i_'; , o;At! 'dill 40/ amp to 600 willw• U 160,60 IIIIIIIMEll
Nome: Logend Homes 601 am•s to 1.000 AM.,- 240.60 1.111.E.
Address: 12155 SW 69 Menus:, SO lit 9100 ' Over 1,000 'moo or VOlt I 4 34.63 MIMES
.....---■■•.–..-----......^'" ROCairleCt onl 11.1111112101M1 2 '
City/StateIZIP: Portland, OR 97223 - • • Tomporttry servioes or feeders Inotoliarien, anon:deo, end/eV
...... _ relocation
Phone: (03)62040P .. Pox; ($03)690-8900 —,,,,--- 100 amps or ten
MI 663 EMI'
Owner installation: This installation is being vat or property that 1 ovin Which is nOt 20i a n i . to 400 arn,s .111 10030 11.1
int,„,id.ci ibr 5ale, lean, rent, or exchansc. oecoyding 10 OS 447, 449, 670, and 701, i 401 a , ,.. t am, amps 123-7 111M1113
Owner Signatures . . . _ 1:723:11 Ill
, 1 I ' I ii.'; '1;', ,:•?'' . 4I'. ,L ii' EINEAR 7 •*:•,' . ivi..:.,31::' ,;;! A ' s br ot e r t or elee tte, alm cw wi r
DUeinees name; Legend KUM . Manch cinlUlt
.
■.---_– """""'""--- 8, FA Or bintich pinnOts
Contact Mallet Stove Lucas wrrheirs service or Soder foot
each branch oircuit •
Addreste 12755 SW 6e Avosuo, Soho Roa ,
.. WI: sal branch circuit 6.65
City/Stote/Z1P1 Porgene, OR 97223 . Misrellaimons lervica or feeder not ladodet0
—............----..— Pu • or itri : , don circle 1.11 53.40 ' • 2
Phones ($03) 6204080 , fres: : (503) 590-8900 -
1..1■M 3i,:. or catiltrtel'I• nag 53.40 MIEN
E-inal II alucasel , 01111benniS,0011t Signal eimuit(e) or lirrti I
II
-I /!•:”:!..i.4.11;*.7.:1. ,..ILtio.,,,m2.1=tra.,11 I ,vi...1,; i i , IL.,1..,;!!,;:!!:,;,•.. ::.1.1 or ellen") Prfn u ite ' °°° "' or
extension. Deacribo: Page 2
Business name: Garner Electric •
---..--
Ad4re5e1 2920 SW 24," ••• ue 9 A . Each additional inm su
eetion over owsbie in any of the dam:
,
Per itunotales In 6240 111.111111111
City/Soo/21P: Hill:bona OR 971 . . 23 . Er1=27:11.1 4210 1111=1111111
—
PliOnet ($03) 5511-1340 . ' 117,r).642•79 , , . • industrial eittat par hour Mill 7 111.111111
.1:!;TIi■ii•i; ;:,*; r I, gnu mer TelallgEnrei
CCB Lig,: 121159 1312:11rAISrArirrv• Lie.: 3701-s Subtotal se,-i-. 1 S'
Suprv. Elecoichin Siflintittra, required: glir4rilW, ,•-< . • - S Yin review (35% Opinion leo)
' Catc:
• , . Tr 9ntto Wm hargc (896 of permit ;et) SO all
1 ---- 7 —!7"- TOFAI.. l7' rim 4 t 8 . tZ--1
A uthorizod Signaturo • . • ?Mu uortutt opuu6•604 ewitteeugunit to mon aluullomemithili 140
day, ear it luUl been Peapt‘i pi mowers
Print name: I Oster • pot Ing piodalogy fat by 'frit away Sttlidins taattscY 9001
---. "" Number of inorvtica* PO WNW WOW'''.
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: 003) 639 -4175 MST E-v 4- t `
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received �7 Date Requested 1 ° AM PM BUP
Location I 1 (P,IC� Suite MEC
Contact Person (.--P Ph ( )r-,0 33 7b PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing � � � .(41 i
Firewall
- Fire Sprinkler
Fire Alarm
R oof Ceiling `
R• A gpv Other: � �� w iiir
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
PA PART FAIL
CHANICAL
Post& Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ri Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
Approach/Sidewalk / oach/Sidewalk Date � Inspector � r F Ext
PP
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
• BUILDING Inspection Line: ,(50 ) 639 -4175 MST ?z V vgi
INSPECTION DIVISION Business Line: (5 ) 639 -4171
BUP
Received Date Requested 1 - PM BLIP
Location 7 ' /?°,c.�o -2it� Suite -7 MEC
Contact Person 7T.��Z Ph ( ) 9 3 0 7 '" 33 / 6 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing L� /� F , y R 0 o — FR. ov �Ac�
Framing
Drywall VtSVA - L , t oi— �PP +e. 6 veb F�4 loo '
Dryll Nailing � N
Firewall ti ! i,+q- v bc, sc w -S A4a7 d6rtet off( e:ro .el
Fire Sprinkler �
Fire Alarm dI •IZ• Or ( h t t '
CC /
— 3' t' •2_17 (&
Susp'd Ceiling
Roof 2) PR- - C - OV m4- -Z - 6 'Rev / A✓
Other:
Final F �A � C - r) K t'T�
PASS PART FAIL
PLUMBING 1 S ,
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL •
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service L'
Rough -In ■ L.4'
UG /Slab
w oa
Fire Alarm
ina 0 , Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART :+ i
SITE 0 Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk ®ete � ' / inspector Ext
Other:
Final DO NOT REMOVE this inspection record the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: • (503) 639 -4175 MST g0 — ��
INSPECTION DIVISION Business Line: ( 3) 639 -4171
BUP
Received Date Requested ` ° AM PM BUP
Location 1 Suite MEC
Contact Person ( ) c, -�3 7a PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear _ f/ —/
Framing C�1 B7
z (c \ J ��
Insulation �4 ^� N
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fi - larm
RT FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
� •
TE Please call for reinspection RE: r C Unable to inspect – no access
Fire Supply Line
ADA
Approach/Sidewalk Date r t D v Inspector Ent
Other:
Final DO NOT REMOVE this inspection recor rom the Job site.
PASS PART FAIL
CITY OF TIGARD . 24 -Hour
BUILDING Inspection Line:_ (503) 639 -4175 MST
INSPECTION DIVISION - Business Line: (503) 639 -4171
BUP
Received � • Date Requested 3 AM PM BUP
�-/
Location 9 7 P Suite MEC
-
Contact Person J` Ph ( ) �7 3.3 7C' PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing •
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
re
rS�PART FAIL •
-PLUMBING `
Post & Beam
• Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
.Catch Basin / Manhole
Storm Drain
Shower Pan •
Other:
Final
PASS PART FAIL •
MECHANICAL . - `
Post& Beam
Rough -In
Gas Line
Smoke Dampers
ART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage •
Fire Alarm
Anal ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE. ❑ Please call for reinspection RE. LI Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date 2 - 3- 0 5 Inspector - Ext
Other:
Final DO NOT REMOVE this inspection record from the job site. •
PASS PART FAIL