Permit CITY OF TIGARD MASTER PERMIT
PERMIT #: MST1999 -00416
;���� DEVELOPMENT SERVICES DATE ISSUED: 12/27/1999
�
_` 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15730 SW QUEEN VICTORIA PL PARCEL: 2S110CC -09000
SUBDIVISION: KING CITY NO. 3 ZONING:
BLOCK: LOT: 064 JURISDICTION: KIN
REMARKS: Bathroom addition to an existing dwelling.
BUILDING
REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 9 FIRST: 72 sf BASEMENT: sf LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT:
VALUE: $ 7,500.00 '
OCCUPANCY GRP: R3 BDRM: BATH: I TOTAL: sf REAR:
PLUMBING
SINKS: 0 WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: 2 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 1 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 8 STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: EXPIRED DATAfTELE COMM: INSTRUMENTATION: NURSE MEDICAL: CALLS: TOTAL HVAC: AL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 487.54
EARL THORNSFELDT OWNER This permit is subject to the regulations contained in the
Tigard Municipal Code, State of OR. Specialty Codes and
15730 SW QUEEN VICTORIA OWNER RESPONS FORM SIGNED
all other applicable laws. All work will be done in
KING CITY, OR 97224 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
ORIGINAL Reg # Oregon Utility Notification Center. Those 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
Footing Insp Mechanical Insp Insulation Insp
Foundation Insp Plumb Top Out Electrical Final
Post/Beam Structural Electrical Rough In Mechanical Final
Underfloor insulation Framing Insp Plumb Final
PLM /Underfloor Exterior Sheathing InsF Final inspection
Issued By . r / A oW -__-J Permittee Signature : .
•
-- � / A, ' ; i _ _ /_`,
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed , � next bu iness day
CUTY OF TIGARD Residential Building Permit Application Plan Check# -3(, f
Rec'd By _AI
13125 SW HALL BLVD. ,,c, ,. ; Additions or Alterations Date Rec'd 'IS
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. g - R3 - 9
V 503- 639 -4171
�� Date to DST t • v, �t1
F 503 - 684 -7297 Permit #/ri5r/ P99 - oo9 /(
Print or Type Called 1L /L7 /tiq 9: 36 0.--..
Incomplete or illegible applications will not be accepted m"'
•
Name of Project Name
Job �G az13 S F DT 4_2l td 'U - _'
Architect Mailing Address
Address site 7 3 V (Y 9 r 1 1 -4C_
N i n e v V City /State Zip Phone
`LA'IZE —� CP St =CLbr Name
Owner as iling 3 0 Address
. f V )U lc -
City /State Zip Phone / �1 Engineer Mailing Address
peg C q7.2.7-- z -/- /� City /State Zip Phone
General Name
Contractor 6 /I) /2---- Describe work New/0 Addition Alteration 0 Repair 0
Mailing Address to be done:
Prior to permit Additional Description of Work:
issuance, a copy City /State Zip Phone
of all licenses
are required if Oregon Const. Cont. Board Exp. Date PROJECT expired in COT Lic.# VALUATION $ G 5 2)
database
Mechanical Name NEW CONSTRUCTION ONLY:
Sub - ,f9 LO 41 Sq. Ft. House: 114 Sq. Ft. Garage
Contractor Mailing Address -
Prior to permit Indicate the restricted energy installation by the electrical
issuance,.a copy City /State Zip Phone subcontractor in the following areas
of all licenses • Restricted Audio /Stereo
are required if Oregon Const. Co t . N .,,- .:. ,G.;,te Energy System Alarms
expired in COT Lic.#
11 r 1 � Installations Vacuum Irrigation
,
database System System
Plumbing Name (check all that Other:
Sub- _ ent9 AJg( _, apply)
Contractor Mailing Address Corner Lot Y NO Flag Lot YES NO
(check one) (check one)
Has the Subdivision Plat recorded? N/A YES NO
Prior to permit City/State Zip Phone )(,
issuance, a copy
of all licenses are Oregon Const. Cont. Board Exp. Date
required if Lic.#
expired in COT I hearby acknowledge that I have read this application, that the
database . Plumbing Lic. # Exp. Date information given is correct, that I am the owner or authorized agent
of the owner, and that plans submitted are in compliance with
Oregon State laws.
Name of Own
, ,, / e
f / nt D�atf
E lectrical �� &6 1b� L 0 ° /`� �" t/ 2 9
Ma i ling Address tact Person N e Phone # / )
Sub- � ---/91A... S�� Pr Igk / i 47 4
Contractor
City /State Zip Phone
Prior to permit •
issuance, a copy FOR OFFICE USE ONLY:
of all licenses are Oregon Const. Cont. Board Exp. Date Plat #: MaplTL #:
required if Lic.# //O� . -0 q 0 ( 30 expired in COT /5f/t) 6r/ ,M3 p S
database Electrical Lic. # Exp. Date Setbacks: Zwe: Solar:
r F
Electrical Supervisor Lic. # Exp. Date Engineering Approval: Planning Approval: TIF:
•
3 (//t •
6 6U is \dsts \forms\sfaddalt.doc 12/10/99
Permit #: S(M 00416
• O_Fc e
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� ��= ��_ •.��, Address: .�t.�J l'. -�-V �
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\ • Issued by• Llil/ —Date: ( � - 9
= 5
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B:
r' 1. I own, reside in, or will reside in the completed structure.
4 1P .
i M 2. I understand that I must . register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
El 3A. My general contractor is
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
0 ,�/ 3B. I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above information is correct and that I have read and do understand the Information
Notice to Property Ow rs about Construction Res 1 onsibilities on the reverse side of this form.
g i r / 9 / 7 /' /c ' 7 %'
(S gnature of permit a p • icant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
- • Information Notice to Property Owners
About Construction Responsibilities •
Note: This Information Notice to Property Owners about Construction Responsibilities _
was developed by the Construction' Contractors Board.in accordance with ORS 701.055(5).
•
If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure,
you can prevent many problems by being aware of the following responsibilities and areas of concern.
EMPLOYER RESPONSIBILITIES:
If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the
construction or improvement of a residential structure, you will, in most instances, be ruled to be an employer and the people
you hire will be employees. As the employer, you must comply with the following: .
Oregon's withholding tax law: As an employer, you must withhold income taxes from employee wages at the time employees
are paid. You will be liable for the tax payments even if-you don't actually withhold the tax from your employees. For more
information, call the Oregon Dept. of Revenue at 945 -8091. •
Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the
wages of all employees. For more information, call the Oregon Employment Division at the Department of Human Resources
at 378 -3524. -
•
Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, andfrinst
obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you may
be "subject to penalties and will be liable for all claim costs if one of your employees is injured on the job. For more informal on,
call the Workers' Compensation Division at the Department of Consumer and Business Services at 945 -7888. •
U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be
liable for the.tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service
at 1- 800 - 829 -1040. -
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
Code compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements
that may be brought to your attention through inspections. , "
r";
Liability and property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for
accident.; and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be
re -done. .
Time to supervise employees: Make sure you have sufficient time to supervise your employees.
Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate•the work of rough -in and finish
trades, and to notify building officials at the appropriate times so they can perform the required inspections.
If you have additional questions, write or call the Construction Contractors Board (PO.Box 14.14 Salem, OR 97309 -5052,
503/378 - 4621). The Board is located at 700 Summer St. NE Suite 300,..in Salem.
prop- own.pm4
1 /94
KING CITY
15300 S.W. 116th Avenue, King City, Oregon 97224.2693
Phone: (503) 639 -4082 • FAX (503) 639 -3771
Notice To Contractors Working In King City
Due to an intergovernmental agreement with the City of Tigard, many building related permits
for projects in King City are issued and inspected by the City of Tigard.
If your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the
appropriate application legibly and submit it to the King City staff. The King City staff will
collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create
the permit, issue the permit, and perform inspections. Please indicate on the permit application
whether you would like the Tigard staff to call you when the permit is ready for issuance or
whether you prefer it to be mailed without any notification. Any incomplete or illegible
application will be returned to King City staff for correction and no processing will occur until a
complete, legible application is received.
If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a
King_ City staff person. King City staff will simply sign this form indicating land use approval..
Take this signed form to the City of Tigard Development Services Counter located at 13125 SW
Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are
available at 639 -4171 Ext. 304 should you have any questions concerning submittal
requirements. All permit fees will be assessed and collected at the City of Tigard.
The City of King City hereby authorizes applicant to pursue permits at the City of Tigard
Building Department for the following project:
P following P J
located at: /57 J (/IZW/)
g o t- ,.. „‘ King City Representat e
I,'DSTS'XCii•: ST,DOC
CITY OF TIGARD BUILDING INSPECTION DIVISION MST f 9 �y l
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 5(Z OO AM PM BLD
Location I [) O QLLa4A ) ! 7 1 Q.Suite . MEC
Contact Person f Y Ph 2'L -y % 7 Cf PLM
Contractor Ph SWR
•
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: /� SGN
Slab l pi/fOr SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall
Fire Sprinkler
•
Fire Alarm
Susp'd Ceiling
Roof
Misc: �
Final a `; 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 P4ST FAIL
Service
Rough In •
UG /Slab
Low Voltage
Fire Alarm
. 1 10 PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA •
Approach /Sidewalk
Other Date Z30 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST I ggCl -cx)
j/
24 - Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested � 7/0 CD AM PM BLD •
Location 1 57 30 ( e _py, J c.foolsuite MEC
Contact Person �C(�,, Ph PLM
Contractor Ph SWR •
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation )(Near) �/, „-oy^ (4 �J „J riot') 6 f � FPS
Ftg Drain vi,C�IJI �lfoL l / V SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear •
Int Sheath /Shear
Framing
Insulation
M Drywall Nailing � � I PIIMIP or
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
EaCTRICA
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
S PART FAIL
SI
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 ins pect - no access
ADA
Approach /Sidewalk 7 •
Other Date ) ` 1 ` - 0-D Inspector 1 - / Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site..
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 111T-coy/co
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 3 ,1� 00 AM PM BLD
Location / S 1 ? D Q / V osuite MEC
Contact Person EclAA FtWa-s.z.cci PLM
Contractor Ph SWR
ClICILDIEb 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
ailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
F' ..2-
PASS PART FAIL
P • BING
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
3
Approach /Sidewalk / 2 ) ) /, � ( ( „
Other Date � (0 ( Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION f9
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 1 � (! _ DO 1
BUP
Date Requested , /g /� 1 I AM PM BLD
Location S 3 0 Quits) // V l � I� Suite MEC
Contact Person fa4( Ph 1(0K "S2S y 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
at Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall Q / / /�� „A
Fire Sprinkler / ,�+ ff J !'/ 51
Fire Alarm `�
Susp'd Ceiling he 0 /J 74 ' 2
Roof
Misc: f ' 2 / Z C i. 44.1
Final
PASS PART FAIL Al 0 /! 4. rA.43
PLUMBING l I - f 7 / 4 — /4 , ,j
Post & Beam
Under Slab re_
Top Out
Water Service
Sanitary Sewer
Rain Drains S r/ .. ' _
Final
PASS PART FAIL - vim 5,4 (` e' �/�,� 2 d
MECHANICAL n',
Post & Beam //t/—C7/77 / r � L Li fG c
Rough In
Gas Line
Smoke Dampers 3 /A-19 /7 , Pj
Final /'
PASS PART FAIL D 1.0 !•1 Cc—t) i 7 •
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PARTj'CF
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 3 " - off' Inspector . ter Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION 1 q9�- � • o
24 - Hour Inspection Line: 6394175 Business Line: 639 -4171
BUP • Date Requested 5 Cv /00 AM PM BLD
Location IS-7 30 - Q1,1 01 Vl Jl 'Suite MEC
Contact Person ?CV I Ph q_ S Z' '7 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: d r' , I ,, , � , y-to ,� � Post &Beam �.f't1 y " �/'• SIT
Post J
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
UMBIN
Post & eam
Under Slab
Top Out -
Water Service
Sanitary Sewer
Rain Drains
Final
' • PART FAIL
a• b
Post & Beam
ou hln
Gas Line
Smoke Dampers
Final
ea4: PART FAIL
E ECTRICAL
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 5 U Inspector ) 7T - tel l Ext
Final
PASS PART FAIL DO NOT EMOVE this inspection record from the job site.
•
CITY OF TIGARD BUILDING INSPECTION DIVISION sT� ITT q -coy 1(3.
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
- Date Requested /CO AM PM BLD
Location 1 S ) 3r) QLLOLI'\! 1) }Muite MEC
Contact Person . €a/l ) , Ph PLM
Contractor Ph - SWR
rUILDINO Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: – -- -- (� — —
Slab " , SIT
Post & Beam /�'�� r — --
-.:�iE.9T Si1E. c
I ea ear
.:
nsu a ion
Drywall Nailing 6%G Pei cq / -7- /1 6 36- eJJ�, r Ai-to yeak
Firewall //��
Fire Sprinkler /3 G 'CO ne _ dot/t2,
Fire Alarm P/U /� ,�
Susp'd Ceiling
Roof
Misc:,
F
'aft PART FAIL
• NW BING
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 Date /' / l U `i Inspector \ Ext
Other _ --- . _
Final
PASS PART FAIL DO NOT REMOVE- this inspection-ret6fd teem the job site
CITY OF TIGARD BUILDING INSPECTION DIVISION . MST 19 'f7'4C0
24 -Hour Inspection Line:- 639 -4175 Business Line: 639 -4171
BUP
Date Requested I /2,0/OO AM PM BLD
Location 16 l A .° vl ) v Y):?(Suite MEC
Contact Person f aAA Ph 9,g(6. (/7 g PLM
Contractor Ph SWR
I ILDIN Tenant/Owner ELC
R- • all ELR •
Footing Access-
s `" °�' = � "� FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
x Shear •
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
: PART FAIL
BI t"
Un•er lab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PART FAIL
ME ICAL
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 _ V Inspector 0 Ext
Final •
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST ( ci9 9 -004/ /
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 •
2 _ � BUP
Date Requested CP /Ob AM PM _ BLD
Location )S - 50 CjIALF ) I � CtDri suite MEC
Contact Person • CQ/lk Ph 2 114 tic PLM
Contractor Ph SWR
ILDIN Tenant/Owner ELC
Retaining Wall ELR
00 i n Access:
oundatign 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:
PART FAIL
. • • rBING
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 rd Other Date / f N 6 Inspector Ext
Final /
PASS PART FAIL D NOT REMOVE this inspection record from the job site