Permit MASTER PERMIT
CITY OF TIGARD
PERMIT #: MST2000 -00569
`'''' 711'. DEVELOPMENT SERVICES DATE ISSUED: 1/2/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 08465 SW PFAFFLE ST PARCEL: 1S136CB -00900
SUBDIVISION: ZONING: R -12
BLOCK: LOT: JURISDICTION: TIG
REMARKS: Remove and replace existing carport. approx 462 sq ft
BUILDING
REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: 15 SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: 462 sf FRONT: 25 PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT:
VALUE: S 12,000.00
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0.00 sf REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES:• GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 . 200 amp: 0 . 200 amp: W /SVC OR FDR: PUMP/IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 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: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 324.81
GROSHART, JAY ROBERT AND ES LINGER BUILDERS INC This permit is subject to the regulations contained in the
BETTY R 11575 SW PACIFIC HWY Tigard Municipal Code, State of OR. Specialty Codes and
8465 SW PFAFFLE TIGARD, OR 97223 all other applicable laws. All work will be done in
TIGARD, OR 97223 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 62363 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
Footing Insp Final inspection
Electrical Service
Electrical Rough In .
Framing Insp
Electrical Final
1 N.
/
Issued y : ■ , : 4%,I_ / - I , . Permittee Signature : , 1 / !! ./ _ /L6,
Call (503) 6 9-4175 by 7:00 p.m. for an inspection needed th next business day
p Zl-01 W ",
A a
Building Permit Application
IN
Date received: 42- Permit no.: l67 - Aim,- ooS6 ; f ,
�,�,,;� .� I City of Tigard Project/appl. no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By: Receipt no.: i
Fax: (503) 598 -1960 Case file no.: Payment type: 3
Land use approval: l &2 family: Simple Complex:
r
TYPE OF PERMEE
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family O New construction O Demolition N
Addition/alteration /replacement ❑ Tenant improvement O Fire sprinkler /alarm O Other:
t
JOB SITE INFORMATION
Job address: 4,S_ (,(� p- if (.L°. �. , . Bldg. no.: Suite no.:
I
Lot: Block: (Subdivision: I Tax map /tax lot/account no.:
Project name: 1 - -
Description and location of work on premises/special conditions: � ° R_. and v ie. da r 44
OWNER FOR SPECIAL INFORMATION, USE CIIECKLIST
EMEPAIIIMMMTIIIIIIM (Floodplain, septic capacity, solar, etc.)
Mailing address: - - _ - . I & 2 family dwelling:
g . .ci . ��� e� Y g:
113111111111011 ZIP: /Ar� I Valuation of work $ /2 Gse°
Phone: Fax: E -mail: No. of bedrooms/baths
Owner's representative: J 1 -- I Lf Total number of floors
Phone: , j' ,1] ArT;I E -mail: I New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
__ MM C A FM Covered porch area (sq. ft.)
Mailing address: ,A3�� _ _ql./M Deck area (sq. ft.)
i q Other structure area (sq. ft.
!_ ZIPr � ft.) "I
Phone: �„��' IEFirff/`',jk 11 E- mail: Commercial/industrial/multi- family:
CONTRACTOR Valuation of work $ `,\
EZEIRM ,. �► Existing bid:, area (sq. ft.)
; L:�'�� � New bldg. area s'. -
Address: ( ) S 7 . 6 at' (G '' • Number of stories ...
City:"
ity: - i / � J State4# ZIP:
irP ;,�/I,lf /' Type of constru 'on
Phone:
eI = `' f'u "� 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
IZE �r
.� IL J/ , provisions of ORS 701 and may be required to be licensed in the
Address: `� jurisdiction where work is being performed. If the applicant is
City: I State: ZIP:
exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: (State: IZIP: Amount received $
Phone: I Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisio of . ws and governing 's CI Visa 0 MasterCard
work will be complied wi '� �
herein or not. Credit card number: Eapi /
��
Authorized signature:. /I -'.J - ' •� r 4 �I / • ate: gi 0 0 Name of cardholder as shown on credit card
$
Print name: 14.✓�J ■ .. '- Cardholder signature
i. rL Amount
i
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6J00/COM)
One- and Two - Family Dwelling
• Permit ' '
A - Buildin• g Permit Application Checklist Reference no.:
City of Tigard City of Tigard Associated permits:
ty g ❑ Electrical Cl Plumbing O Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 Cl Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews.
2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc.
3 Verification of approved plat/lot.
4 Fire district approval required.
5 Septic system permit or authorization for remodel. Existing system capacity
6 Sewer permit.
7 Water district approval.
8 Soils report. Must carry original applicable stamp and signature on file or with application.
9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of
catch -basin protection, etc.
10 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed
if copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if
there is more than a 4-ft elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and
driveway; footprint of structure (including decks); location of wells/septic systems; utility locations; direction indicator, lot
area; building coverage area percentage of coverage; impervious area; existing structures on site; and surface drainage.
12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent
size and location.
13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater,
furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc.
14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub -floor,
wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show
details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs,
fireplace construction, thermal insulation, etc.
15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels.
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full -size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing (prescriptive path) and/or lateral analysis plans. Must indicate details and locations; for
non - prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor /roof framing. Provide plans for all floors/roof assemblies, indicating member sizing, spacing, and bearing
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered
systems, see item 22, "Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists
over 10 feet long and/or any beam/joist carrying a non - uniform load.
20 Manufactured floor /roof truss design details.
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required
for four or more appliances.
22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or
architect licensed in Oregon and shall be shown to be applicable to the project under review.
JURISDICTIONAL SPECIFICS
23 Five (5) site plans are required for Item 11 above.
24
25
26
27
28
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 440 -4614 (6/00/COM)
Electrical Permit Application
� ' Date received: M /--co Permit no.: /-4rA , - oes 7
a.x y l � • •
X1 :.I City of Tigard Poject/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: I Receiptno.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERIMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other: • 0 Partial
JOB SITE INFORMATION
J Job address: � 66,5 (,fir -pF tir FPL - Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: Subdivision:
Project name: I Description and location of work on premises:
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE SCHEDULE
--- no: Fee Max
Business nar t (� yy(,� . . Description Qty. (ea.) Total no. insp
New residential - single or multi- family per
Address: dwelling unit. Includes attached garage.
City: i-/i'1M &,-rO I State ZIP: Service Included:
Phone: Sgs4.. Fax: E -mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof
CCB no.: I Elec. bus. tic. no: Limited energy, residential 2
City /metro lic. no.: Limited energy, non- residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder 2
Sup. elect. name (print): License no: Services or feeders — installation,
alteration or relocation:
1'ROl'ERI'Y OI%'NElt 200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only
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,orrelocation:
20 amps or less 2
20
ORS 447, 455, 479, 670, 701. 201 1 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am s 2
Branch circuits - new, alteration,
•
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State :. J ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Servlceor feeder not included):
0 Service over 225 amps - commercial O Health - care facility Each pump or irrigation circle 2
• 0 Service over 320 amps - rating of 1&2 O Hazardous location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
0 System over 600 volts nominal more residential units in one structure alteration, or extension' 2
0 Building over three stories 0 Feeders, 400 amps or more *Description:
0 Occupant load over 99 persons 0 Manufactured structures or RV park Each additional Inspection over the allowable in any of the above:
0 Egress/lightingplan 0 Other. Per inspection I I
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 $
0 Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 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 4404615 (6&00/COM)
Electrical Permit Fees: Limited Energy Fees: . 2
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
/� Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total 4, Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular Garage Door Opener
Dwelling Service or Feeder $90.90 2 El
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System'
Installation, alteration, or relocation
200 amps or less $80.30 2 Systems*
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 El Other
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918 -260 -260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts, ❑
see "b" above. Audio and Stereo Systems
Branch Circuits ❑ Boiler Controls
New, alteration or extension per panel
a) The fee for branch circuits
with purchase of service or ❑ Clock Systems
feeder fee.
Each branch circuit $6.65 2 ❑ Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch circuit $46.85
Each additional branch circuit $6.65 ❑ HVAC
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 ❑ Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s) or a limited energy
alteration or extension $75.00 ❑ Landscape Irrigation Control
Minor Labels (10) $125.00 ❑
Medical
Each additional inspection over
the allowable In any of the above Calls
Per inspection $62.50 EI
Per hour $62.50
In Plant $73.75 Outdoor Landscape Lighting
Fees: ❑ Protective Signaling
Enter total of above fees $ n Other
8% State Surcharge $ Number of Systems
25% Plan Review Fee
See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations
front of application.
Fees:
Total Balance Due $
Enter total of above fees $
El Trust Account # 8% State Surcharge $
Total Balance Due $
i:'.dstskfomu\elc- fees.doc 10/09/00 •
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
•
DAVID JEROME ELECTRIC
PO BOX 751
HILLSBORO, OR 97123
Electrical Signature Form
Permit #: MST2000 -00569
Date Issued: 1/2/01
Parcel: 1 S136CB -00900
Site Address: 08465 SW PFAFFLE ST
Subdivision:
Block: Lot:
Jurisdiction: TIG
Zoning: R -12
Remarks: Remove and replace existing carport. approx 462 sq ft
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:
GROSHART, JAY ROBERT AND DAVID JEROME ELECTRIC
BETTY R PO BOX 751
8465 SW PFAFFLE HILLSBORO, OR 97123
TIGARD, OR 97223
Phone Phone #: 648 -5144
Reg #: SUP 877s
• ELE 34 -119C
AN INK SIGNATURE IS REQUIRED ON THIS FORM
.....1
Signature of Supervisin• lec ncian
If you have any questions, please call (503) 639 -4171, ext. # 310
1v3_/
CITY OF TIGARD BUILDING INSPECTION DIVISION
et �U o - 4
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 3 - L AM PM BLD
Location 6'C/ G) sw A ( /.P , Suite MEC
Contact Person Ph 9yfr Q/l 5 PLM
Contractor Ph SWR
Tenant/Owner ELC
ining 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:
XCAttor fir1/.
PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach/Sidewalk
Other Date - 2 — 2 0 / Inspector E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
91y4
CITY ®F TIGARD BUILDING INSPECTION DIVISION .SST l ib -61 y
241-Iourinspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 3 - z 7 AM PM BLD
Location El i) SW 1 (fie $/ Suite MEC
Contact Person Ph f`"f (1 GS V 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 /1 1 „ / I � S
PASS PART FAIL ✓(
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
/ €LECTR1CA
— Scrvice
Rough In
UG /Slab
Low Voltage
Fire -.1 \ w fh r
:ART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ I Reinspection fee of $ required before'] • pection. Pay - City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: nable to inspect - no access
Fire Supply Line
ADA /gf.
Other oach /Sidewalk Dat C Inspector OF Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY . F TIGARD BUILDING INSPECTION DIVISION •
24 -Hour In pe Line: 639 -4175 Business Line: 639 -4171 i1pST G—vU
BUP
Date Requested — a— C / AM PM BLD
Location g y 6,‘" Y'v- 7 Z /--( S T Suite MEC
Contact Person Ph Vt/ P (- ( G ) 73 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
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
�E LECTRICA
Service
UG /Slab
Low Voltage
Fire Alarm
1• 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 In
Dae ", 1
Other Inspector E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
rJ
24 -Hour ST 1rU -66 , 3 -- t ection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested Z - G / AM PM BLD
Location f'(( (go Suite MEC
Contact Person Ph yCf ti J 3 PLM
Contractor Ph SWR
UILDI 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
nsl uTation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
.13 PART FAIL
ING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ J Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ J Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date �' Z�' � ( I n spec t or Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.