Permit A r CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2002 -00089
1� DEVELOPMENT SERVICES DATE ISSUED: 5/22/02
` ��' II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12978 SW PRINCETON LN PARCEL: 2S104DA -QHS39
SUBDIVISION: QUAIL HOLLOW - SOUTH ZONING: R -4.5
BLOCK: LOT: 039 JURISDICTION: TIG
REMARKS: SF rowhouse,Unit #39,BIdg 9,CSB plan. STRUCTURAL FILL, REQUIRES GEO -TECH
INSPECTION AND REPORTS
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: FIRST: 320 sf BASEMENT: a? LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR LOAD: 50 SECOND: 744 of GARAGE: 412 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: 732 of RIGHT:
VALUE: $ 173,305.60
OCCUPANCY GRP: R3 BDRM: 2 BATH: 3 TOTAL: 1,796.00 sf REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: 3 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: 1 BOILJCMP < 3HP: VENT FANS: 4 CLOTHES DRYER: 1
LPG FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 • 200 amp: 1 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 3 201 - 400 amp: 201 • 400 amp: let W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 • 600 amp: 401 • 800 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 ARENSPC 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: LANDSCAPEARRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 5,599.33
BROWNSTONE QUAIL HOLLOW LLC BROWNSTONE HOMES, LLC This permit is subject to the regulations contained ialtC in e the
a l l Municipal other applicable c al Code, State work k w Specialty done Codes and
12670 SW 68TH PKWY STE 200 12670 SW 68TH PKWY all other applicable laws. All work will be done
PORTLAND, OR 97223 PORTLAND, OR 97223
accordance with approved plans. Th is 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 124627 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
Sewer Inspection Plm /undslb Insp Gas Line Insp Water Line Insp Building Final
Footing Insp Electrical Service Insulation Insp Smoke Detector Final inspection
Foundation Insp Electrical Rough -In Shear Wall lnsp Electrical Final
Wtr Proofing Bsm't Wa Mechanical lnsp Firewall Insp Plumb Final
Slab Insp Framing Insp Gyp Board Insp Mechanical Final
Issued By : - Permittee Signature : "A
Call (50 94175 by 7:00 p.m. for an Inspection needed the next business day
. ., 64o6- F 2aoo
• Build.ingFermit Application
City of Tigard RECEIVED Datereceived: �y IV Permit no.: XH Oa_v00 g9'
City of Tigard FEB 4 2002 Address: 13125 SW Hall Blvd, Tigard, OR 97223 Projecdappl.no.: date:
Phone: (503) 639 - 4171 Date issued: By Receipt no.:
N Fax: 598 -1960
d, \ (503) Case file no.: Pa yment type:
Land use approval: nu rp fl DT IOM 1 &2 family: Simple Com lex: P
TYPE OF PERMIT
O 1 & 2 family dwelling or accessory O Commercial/industrial O Multi- family O New construction O Demolition
O Addition/alteration /replacement O Tenant improvement O Fire sprinkler /alarm O Other:
JOB SITE INFORMATION
Job address: 1 r' S A Bldg. no.: • Suite no.:
Lot: Block: Subdivision: Tax map/tax lot/account no.: ,2510 7,4--/ .5 3 9
Project name: /Kw z)
p,� Description and location of work on premises/special conditions:
V ' l OWNER FOR SPECIAL INFORMATION, -USE CHECKLIST
") -
Name: (Flood se ca solar, ,
etc.)
k Mailing address: I _ is . , V* OM _ • 1 & 2 family dwelling:
City: 'e, „_4- �,_,..t State:e•R ZIP: Valuation of work $
i Phone :,5 - ; - Fax: - p I . 1 E -mail: No. of bedrooms/baths
Owner's representative: LW, Total number of floors
Phone: r j _ 8' _ r ';, y E -mail: New dwelling area (sq. ft.)
O
- / APPLICANT Garage/carport area (sq. ft.)
M Covered porch area (sq. ft.)
Mailing address: . • S'W >s tm_ . u rL! Deck area (sq. ft.)
IENIIII•• E` . • _je z •, 4_ Other structure area (s• . ft.)
Phone: S, 8 ` 65 Fax: E -mail: Commercial/industrial/multi- family:
CONTRACTOR Valuation of work $
Business name: Existing bldg. area (sq. ft.)
�' ' ' New bldg. area (sq. ft.)
Address: il._ g q
� '" r g S -- t � � � Number of stories ogmemii Type of construction
Phone- S ,- - _ —. - Fax:620 -
CCB no.:
11111111111M . Occupancy group Existing:
New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
AR CI IITECIYDESIGNI•:R licensed with the Oregon Construction Contractors Board under
Name: 6 LO provisions of ORS 701 and may be required to be licensed in the
Address: r : ■ v C _ St.�k.t . - O jurisdiction where work is being performed. If the applicant is
�' exempt from licensing, the following reason applies:
A�
Contact person: . , I A i, 4 1, � Plan no.:
Phone:206 - - 0 :E:: E -mail:
ENGINEER
IIMMMNINIMIMI Contact person: b , Fees due upon application $
Address: • . • s Cu E, a . • , - e.c - Date received:
_ ZIP: 0 Amount received $
Phone: _ ,. - o Fax: E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application -and the Not all Jurisdictions accept «edit cards, please call Jurisdiction for more information
attached checklist. All provisions of laws and ordinances governing this 0 visa CI MasterCard
work will be complied • • . • , whether _ yr ed herein or not. twit card number: 1 F.xplr s
Authorized sign s • re: 1 % • • Named cardholder u shown on credit card
$
Print name:
C - Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 44o -461i (61VOiCOtd)
00 7v issue . Cry y/ ZL
•
f ,,
• • Plumbing Permit Application
.41 Date received: Permit no.: /7i oo . -D//
Ail I I City of 'g Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd, Tigard, OR 97223
City ofTigard Phone: (503) 639 -4171 Project/appl. no.: Expire date:
Fax: (503) 598 -1960 Date issued: By: I Receipt no.:
Land use approval: _ Case file no.: Payment type:
. TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/mdustrial 0 Multi- family 0 Tenant improvement
O New construction O Addition/alteration /replacement 0 Food service 0 Other.
JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist)
Job address: ( 24' )g' S w Pi r g -6 L t,Lt. Description Qty. Fee (ea.) Total
Bldg. no.: Suite no.: New 1- and 2- family dwellings only
utility connection)
Tax map/tax lot/account no.: (Indades 1000. forma
SFR (1) bath
Lot: 3c? Block: 1 Subdivision: SFR (2) bath .
Project name: SFR (3) bath
City/county: I ZIP: Each additional bath/kitchen
Description and location of work on premises: Site utilities:
Catch basin/area drain
Est. date of completion/inspection: Drywells/leach line/trench drain .
PLUMBING CONTRACTOR Footing drain (no. lin. f .)
Manufactured home utilities _
Wolcott Plumbing Manholes _
PO Box 2007 Rain drain connector
Gresham OR 97030 -0594 Sanitary sewer (no. lin. ft.)
503- 667 -1781 Storm sewer (no. lin. ft.)
CCB:23847 PLM #:26 -208PB Water service (no. lin. ft.)
Fixture or item:
. iIy1ui UO LW. uu.:
Absorption valve
Back flow Contractor's representative signature: preventer ,
Print name: Date: Backwater valve
CONTACT PERSON Basins/lavatory
Name: Clothes washer
Address: Dishwasher
Drinking fountain(s) i City: I State: . 171P: Ejectors/sump _
Phone: Fax: E -mail: Expansion tank
OWNER Fix' sewer cap
Floor drains/floor sinks/hub
Name (print): Garbage disposal
Mailing address: Hose bibb
City: I State: ZIP: Ice maker
Phone: I Fax: 1 E -mail: Interceptor/grease trap
Owner installation/residential maintenance only: The actual installation Primer(s) ,
will be made by me or the maintenance and repair made by my regular Roof drain (commercial)
employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s)
Owner's signature: Date: Sump ,
-- ` D - ENGINEER Tubs/shower/shower pan • —
Urinal
Name: Water closet
Address: Water heater
City: I State: I up: Other:
Phone: I Fax: 1 E -mail: _ Total
Not all judackdoas accept aedit euds. please all *Medan far snore tofemu ko.' Notice: This perm application Minimum fee $
()Visa Cl MasterCard expires if a permit is not obtained Plan review (at 96)
Cox% aid cumber --I —I— within 180 days after it has been State surcharge (896) -- $ $
Elmira Name d cardholder u,born m emit std
accepted as complete. TOTA »�-. $
S
Csdboldrr dpe Amount , • 40.4616 (610010014)
. Mechanical PermitA,pplication
4 4 Date received: Permit no.: M,s72oo,7 -000
° '1 City of Tigard
�• .� Project/appl.rio.: Expire date:
City ofTigard
Address: 13125 SW Hall Blvd, Ti OR 97223 ,
Phone: (503) 639-4171 Date issued: By: I Receiptno.: .
Fax: (503) 598 -1960 Case file no.: Paymentlype:
Land use approval: Building permit no.:
' TYPE OF PERMIT ,
O 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
0 New construction 0 Addition/alteration/replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE -
Job address: D.P g- , w " t' itnGt : ,,,_ Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map/tax lot/account no.: profit. Value $
Lot: 4" Block Subdivision: 'See checklist for important application information and
- Project name: jurisdiction's fee schedule for residential permit fee.
City /county: - ZIP: 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and kication of work on premises: AND COMMERICALIINDUSTRIAL EQUIPMENTSCIIEDLLE
. _ . Fee(ea.) Total
Fst date of completion/inspection: Desai : Res. only Res
Tenant improvement or change of use: AC '
Is existing space heated or conditioned? 0 Yes 0 No Air handling unit CFM
g s P Air conditioning (site plan required) I=
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system -
MEC11ANICAL CONTRACTOR :'tier compressors
State boiler permit no.: I
■■
HP Tons BTU/H
Four Seasons Heating & A/C Service Inc Fire/smoke dampers/duct smokedetectors I=
PO Box 66409 Heat pump siteplanrequired) I
Portland OR 97290 -6409 Install/replace furnace/burner : TU/H III
503- 775 -5919 Including ductwork /vent liner 0 Yes 0 No
CCB: 48283 nstall/rep • relocate heaters- suspended, Ill
wall, or floor mounted
Name (please print): eat for : . diance other than furnace
CONTACT PERSON ■ _-
Absorption BTU/1i _
Name: Chillers HP
-. Address: Co.. - HP ME
D omen test an vex on: II
City: State: ZIP: Appliance vent
Phone: Fax: E-mail: Dryer exhaust :=
011'NER Hoods, Type I -.. kitchen/hazmat
hood fire suppression system
Name: Exhaust fan with single duct (bath fans) .
Mailing address: Exhaust . stein • - from 1 eating or C I _
-"I p .. ,1-1 .7r ... on up to 4 ou ets II
City: State: ZIP: Ty LPG NG Oil
Phone: Fax: E-mail: Fuel . r ' mg each additional over 4 outlets _
_ ENGINEER .� p (schematic required) - __
Name: Number of outlets
Other -, app . . • or -. .. pment: . -
Address: Decomtivefireplace
City: - State: ZIP: Insert -type NM
Phone: Fax: E-mail: oodstov ' let stove I=
Other.
Applicant's signature: t
Date: Other: = —
Name (print):
Not a }uctrBia;ons accept creQ'it cards. please can pcisdiaioo fa mote lof«matioa Permit fee .... .............._. $
0 Visa 0 MasterCard Notice: Ibis permit application Minim fee $
expires if a permit is not obtained Plan review (at _ 96) $
Credit card uomba Expires within 1 80 days after it has ban
a ccepted as complete. State surcharge (896) .$
Name of cardholder a thosvc oc reedit card $ TOTAL - $
Cardholder dboahna Amtamt 4444617 (64:000.310
s Electrical PermitApplication
Date received: Permit no.://57-"26 v e7
• 4 7 . 4 ..l � City of Tigard Project/appl. no.: - Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 • Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT •
O 1 & 2 family dwelling or accessory O Commercial/industrial 0 Multi- family 0 Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other. 0 Partial
JOB SITE INFORMATION .
Job address:1X /9e s W P � .U.d_ w (...... . Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: (Block: (Subdivision:
Project name: ( Description and location of work on premises: .
Estimated date of completion/inspection: _
CONTRACTOR APPLICATION FEE SCI IEDU E
Job no: Fee Max
Description Qty. (ea.) Total no. lnsp
Streamline Electric New residential - single or muld-tamlly per
DBA LaValley Corporation dwelling milt. ln attached garage.
6025 East 18 St Stxrioeimcludetk •
Vancouver WA 98661 1000 sq. ft. or less 4
360 - 993 -5080 Each additional 500 sq. ft. or portion thereof •
CC _ B:116514 ELC #: 34 -432C SUP #: Limited energy, reside s 2
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 - iastallatlon,
alteration or relocation:
• - . PROPERTY OWNER 200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 601 to to 1000 amps 2
City: ( State: ( ZIP: - Over 1000 amps or volts 2
Phone: ( Fax: ( E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to bsshllado rless ratlon,arrelocatlo °'
ORS 447, 455, 479, 670, 701.
26 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am.. 2
ENGINEER 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: ( State: (ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
O Service over 225 amps-commercial O Health-care facility Each pump or irrigation circle 2
O Service over 320 amps- rating of 1&2 O Hazardous location Each sign or outline lighting 2
family dwellings O Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel.
O System over 600 volts nominal more residential units in one structure alteration, or extension* 2
O Building over three stories O Feeders, 400 amps or more *Description:
O Occupant load over 99 persons O Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan O Other. Per inspection I I I I
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all juriadieum o arcept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $
O Visa O MasterCard expires if a permit is not obtained Plan review (at — %) $
Credit card number / / within 180 days after it has been State surcharge (8 %) .... $
Ex accepted as complete. TOTAL $ •
Name of cardholder as shown on credit card
S
Cardholder signature Amount 4464615 (6000/C)
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223 FECEtVED
IMPORTANT PERMIT NOTICE MAY 3 n 2002
Fal. X Uk 1 t'1 A J
STREAMLINE ELECTRICAL BIF DING ri730
DBA LAVALLEY CORORATION
6025 EAST 18TH ST
VANCOUVER, WA 98661
Electrical Signature Form
Permit #: MST2002 -00089
Date Issued: 5/22/02
Parcel: 2S104DA -QHS39
Site Address: 12978 SW PRINCETON LN
Subdivision: QUAIL HOLLOW - SOUTH
Block: Lot: 039
Jurisdiction: TIG
Zoning: R-4.5
Remarks: SF rowhouse,Unit #39,BIdg 9,CSB plan. STRUCTURAL FILL, REQUIRES
GEO -TECH INSPECTION AND REPORTS
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:
BROWNSTONE QUAIL HOLLOW LLC STREAMLINE ELECTRICAL
12670 SW 68TH PKWY STE 200 DBA LAVALLEY CORORATION
PORTLAND, OR 97223 6025 EAST 18TH ST
VANC UVER WA 98661
Phone #: 503 - 598 -7565 Phone 360 -993 -5080
Reg #: E E 34.432C
SUP 4801S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X
a ll
Signature of Supervising Electrician
If you have any questions, please call (503) 639 -4171, ext. # 310
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
F EGEIVED
IMPORTANT PERMIT NOTICE MAY 3 n 1002
WOLCOTT PLUMBING CONTRACTORS Y OF !E'j_4 .
PO BOX 2007
GRESHAM, OR 97030
Plumbing Signature Form
Permit #: MST2002 -00089
Date Issued: 5/22/02
Parcel: 2S104DA -QHS39
Site Address: 12978 SW PRINCETON LN
Subdivision: QUAIL HOLLOW - SOUTH
Block: Lot: 039
Jurisdiction: TIG
Zoning: R-4.5
Remarks: SF rowhouse,Unit #39,BIdg 9,CSB plan. STRUCTURAL FILL, REQUIRES
GEO -TECH INSPECTION AND REPORTS
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the
plumbing permit to be valid, please have the appropriate individual from your company sign below and return
this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
BROWNSTONE QUAIL HOLLOW LLC WOLCOTT PLUMBING CONTRACTOR:
12670 SW 68TH PKWY STE 200 PO BOX 2007
PORTLAND, OR 97223 GRESHAM, OR 97030
Phone #: 503- 598 -7565 Phone #: 667 -1781
Reg #: LIC 23847
PLM 26 -208PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X
Signature o thoriz d Plumber
If you have any questions, please call (503) 639 -4171, ext. # 310
/V STS ,,- cnro $,
• •
TIFI ATION
• E C TREE C R STREET
• .
• , A. �, %i ; -r i ►
• I , , Owner /Agent for //,,,1) :Lai
1
• (PLEASE PRINT) (PERMIT HOLDER) ■
• ►
• ►
•
•
• ►
►
• Do hereby certify that the following location ■
• meets City= of Tigard /Washington County ■ ■
• ■
• land use and development standards for street tree installation. ■
• ■
• ■
• ■
• ■
•
• ADDRESS: I i q7g 5Lo pokoi-o L J\
• • (' () tL LOT: I SUBDIVISION:
• •
•
• •
•
BY: ( 49AAA
DATE: 1 // Z j
•
• /(--
A RECEIVED BY: DATE: • •
4yyyyyyyyyyyyyyyyyyvyyvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvv ••••••••••••••••••••••••••••••■••••••••••••••■•■••••••••• •11k
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 - 4175 MST o OoQJ
INSPECTION DIVISION Business Line: (503) 639 -4171 '�� >>
BUP
Received Date Requested !1oZ — � 2 AM PM BUP
Location / �9 7 8 l �l �c� Suite / b MEC
Contact Person IC»i OVr—c Ph ( O) 3 / 3 — ! 1 PLM
Contractor * a Li ri o 71gCl Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR off' GDa —C't,
Crawl Drain
Slab Inspection Notes: SIT AZ
Post & Beam li za4
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Drywall RA d 7 t, G� YDrywall Nailing � J"(" J
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling /
Roof Cf)ff9,1-iernA A
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
Fire Alarm
Q PART FAIL LI Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA / e
Approach/Sidewalk D ate ! 4 l 0 Inspector .� . _ ♦ ; Ext
I Other:
Final DO NOT REMOVE this inspection record from 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 quested 1 11 / � � AM PM BUP
Location a , Suite EC
Contact Person Ph ( ) 7 3 573LM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC •
Footing
Foundation ELC
Ftg Drain A►CC @SS: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing �
Firewall
fiEr
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
•
dig S 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 El Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line / �
ADA Date / / ( �/ !/
Approach/Sidewalk /� c Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST 2ji a L -U u
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested 1/ AM PM BUP
Location / 97 g Sw 7't' a t-`` „, Suite MEC
Contact Person Ph ( ) 7f-3 — 5 3 c PLM
Contractor Ph ( ) SWR
(CLUDING Tenant/Owner pl.-/ (r sc C 4 -P i v" 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:
'Fin 1
/ V-- '
ASS PART FAIL 7
BING
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
na
S PART FAIL / w^A �
ELECTRICAL i -' r i
Service
Rough -In C / 2) * j /A'i 0 •
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 Please call for reinspection RE: 111 Unable to inspect — no access
Fire Supply Line
ADA / `�
Approach/Sidewalk Date I / v ) Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL