Permit •
M
CITY O TIGARD MASTER PERMIT
PERMIT #: MST2001 -00023
Y DEVELOPMENT o
T SER 2 639 -4171 DATE ISSUED: 2/20/01
13125 SW Hall Blvd., Tigard,
SITE ADDRESS: 15299 SW REGENT TERR PARCEL: 2S111 DA -10800
SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R -7 •
BLOCK: LOT: 101 JURISDICTION: TIG
REMARKS: S/F Path 1
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 23 FIRST: 1,054 sf BASEMENT: sf LEFT: 4 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 992 sf GARAGE: 482 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: sf RIGHT: 4
VALUE: $ 187,511.00
OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2,046.00 sf REAR: 29
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: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 4 CLOTHES DRYER: 1
GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS AMYL INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: 1 PUMP/IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 3 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 00 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: X VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: X OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: X CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: X DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 3,959.62
This permit is subject to the regulations contained in the
LEGEND HOMES LEGEND HOMES CORP
all other r applicable cal Code, laws. All work k will l b Specialty Codes and
12755 SW 69TH AVENUE #100 12755 SW 69TH AVE #100 all other applicable approved All work will by done i
PORTLAND, OR 97224 TIGARD, OR 97223 t
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 60563 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
Erosion Control lnsp & Post/Beam Mechanical Mechanical Insp Framing Insp Gas Fireplace Electrical Final
Sewer Inspection Underfloor insulation Mechanical lnsp Shear Wall lnsp Insulation Insp Mechanical Final
Footing Insp Crawl Drain /Backwater Plumb Top Out Exterior Sheathing Ins Rain drain Insp Plumb Final
Foundation Insp Footing /Foundation Dr; Electrical Service Low Voltage Water Line lnsp Final inspection
Post/Beam Structural PLM /Underfloor Electrical Rough In Gas Line Insp Appr /Sdwlk lnsp Building Final
Issued By : Permittee Signature :.—/, •(
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
• I" pr et-zee-of `5W R a,006— aoo
jil‘ Building Permit Application
Datereceive rd az20 / „00 Z
x, i y City of Tigard
c!,>� °! Project/appl.no.: Expire date:
Bard Address: 13125 SW Hall Blvd Tigard, OR 97223
City o
Phone: (503) 639 -4171 Date issued: By: I Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: l &2 family: Simple Complex:
TYPE OF PERMIT
& 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family New construction • 0 Demolition
0 Addition/alteration/replacement 0 Tenant improvement 0 Fire sprinkledalarm 0 Other.
JOB SITE INFORMATION
Job address: is A 9' 4-w4 . -, 6 r • CrefL Bldg. no.: Suite no.:
Lot 0 Block: ubdivision: ' 4) 1D.P0 Pk- Tax map/tax lot/account no.:
Project name: •
Description and location of work on premises/special conditions:
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
/�`. ( Floodplain ,septiccapacity,solar,etc.)
. Mailing ad' • _ j , 1 & 2 family dwelling:
State:0' ZIP: f 7 Valuation of work $ i813%/ •°Zd
Phone: •420 -,•off ; --, ee E -mail: No. of bedrooms/baths —.3_. 3
Owner's representative: ea”- 11Of,E_DNL/1 Total number of floors .Z
• Phone: F.22.0 ) 'ax: S' ''YNOD E -mail: . New dwelling area (sq. ft.) a? ‘'S/40
APPLICANT Garage/carport area (sq. ft.) ydc
Name: . „ ,tr s.l� • .
Covered porch area (sq. ft.)
Mailing ad. c a. A - 4 1 41
Deck area (s(1. ft.) .
IIEW'�,t•1 ., State p ' ZIP: - _ _ Other structure area ( .. ft.)
:
Phone: ; (' o • ,I. E -mail: CommerdaUlndustrlaUmultl- family: •
CONTRACTOR Valuation of work $
Existing bldg. area (sq. ft.) ....
Business name: Z •-
A T..14/ 625' New bldg. area (sq. ft.)
Address: /,i 7, \ •
N um b er of stories
o + . Stated ' ZIP: 9' 7d2aL Type of construction ..
Phone. . D Jargall ',' .i'.i E -mail:
CCB no.: r 6 O - Occupancy P(s): .� . • ew:
City/metro lic. no.: 7 Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: D /L , f - provisions of ORS 701 and may be required to be licensed in the
Address• • y jurisdiction where work is being performed. If the applicant is
City:
• d, & o• Stated ZIP: 97_ exempt from licensing, the following reason applies:
Contact person: & , : , _ ,y.do - Plan no.:
Phone:42O - ,"4 i a ORM= &mail:
-
ENGINEER
IIMIIMEMPAMMEM Contact person: Fees due upon application $ V
r ' ' r . a ' /1 o. ' Date received: V
State ' ZIP: q 74) Amount received $
Phone: , - p, Fax: E-mail: ' Please refer to fee schedule.
I hereby certify I have read and examined this application and the • Not all jodsificdom accept swirl ends. taws call juriotetioo for more informal=
attached checklist. All provisions of laws and ordinances governing this o visa Cl MasterCard
work will be complied•with, whether s • ifted he 1 or not. Credit and camber Pacpir /
Authorized //-
• - �/ ,„,,,„1; V ( : / — /y — C r t Name of cardholder as drown ea credit card
Print name: ea/ # / Cardholder d Amount
Notice: This permit appli • n expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (600/OOM)
• .
. _
A Electrical Permit Application
Hate received: o,rl�l f f -�
._ l;� r ; II I Ci of Tigard Project/appl.no.: Expire date:
City o gard
Address: 13125 SW W Hall Blvd, Tigard, OR 97223 Date issued: B f Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: P ayment type:
Land use approval:
TYPE OF PERMIT
1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
New construction 0 Addition/alteration/replacement .. 0 Other. 0 Partial
JOB SITE 1NFOR19ATION
J.13 A z -. j — R, Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot a/ Block: ubdivision: ZS0• • t
_
Project name: Description and location of work on premises:
Estimated date of completionfinspection:
(OM RA( 1OR API'I.ICA'1 ION FEE SCHEDULE '
Job no: _ w 0
•
Business name: Descd. , on ' Total Ell
d� Newreaidmdl- a r
atogieom am1lyper II
Address: b . News ddenda mul dgarage.
IENESAMM111.11111 Stare ' ZIP: ' r MI Serviceloduded:
Phone. 3 — _ • mail: 1000 sq. R or less • 4
r Each additional 500 sq. ft. or portion thereof , _ —
10..: CH
E lec . • bus. • no: d . 1.1 Limited energy, residential
r n T 2a f i - Limited energy, non- residential MN 2
�;,7;
',LE ' ��/��' s Each manufactured home or modular dwelling
! , , . • - is r g el - -. 'clan -. uired) Date Service and/or reeds 111 a ■ 2
Services or feeders— Instellation,
Sup. elect name (prints I , I i ► Liman °O' Q ' alteration or relocation:
I'R Illi 2
Ol'I R I l' OW NFit 200 or
1 to 400 amps
Name (print): • . �✓ ® A f 401 amps to 600 amps ' _ _ _ 2
• Mailing address: 601 amps to 1000 amps =_ • 2
OM ZIP: 2 Over 1000 amps or volts _ _ _ 2
Phone: caw 74r6 Fax:6'9,' -,i%,• E-mail: Reconnect oni ___ 1
Owner installation: The installation is being made on property I own Temporary ser+l«sorfeedess
which is not intended for sale, lease, rent, or exchange according to Inamllatlon ,alteration, orrelotwtlom
200 amps or less 2
ORS 447, 455, 479, / 670, 701. 201 amps to 400 amps MR 2
Owner's signature: V 0 - .. A'.L/; . ' : 401 to 600 „ Mil.1. 2
. [N G I N cE1t Branch circuits- new, alteration,
Name: or extension per panel: • ' A Fee for branch circuits with purchase of
Address: • • ■ - , service or feeder fee, each branch circuit 2
City: f' e. . AMINIMMII State' ' boy7 „AN B. Fee for branch circuits without purchase II 1111
Phone: pp Fax: E - mail: of service or feeder fee, first branch circuit: ■ 2 •
• Each additional branch cinuit NM _ _
l'LAN REVIEW (Please check all that apply)
O Service over 225 Eili • `. - ■■ 2
amps - commercial O Health-care
0 Service over 320 amps -rating of 1&2 0 Hazardous location Each signor outline lighting ME _ _ 2
family dwellings CI Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, III III
0 System over600 volts nominal more residential units in one structure alteration, or extension' ■ 2
0 Building over three stories 0 Feeders, 400 amps or more •D� , ;
0 Occupant load over 99 persons 0 Manufactured structures or RV park lEach additional inspection over the allowable In any of the above:
0 Egress/lighting plan 0 Other. Per inspection . __
Submit sets of platys with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not ail accept aedlt cards, please call Wormed= Jurisdiction for more med= Notice: This permit application Permit fee $
s pa
0 Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: I / within 180 days after it has been State surcharge (8%) .... $
Expires accepted as complete. TOTAL • $
Name of cardholder as shown on aedit card
$ •
Cardholder signature Amount 440 -4615 (600XCOM)
VI •
•
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
4. Complete F ee Schedule Below: .
Number of Inspections per permit allowed Restricted Energy Fee-...-...-......--....-...:.. '$75.00
. Service included: Items Cost Total 4' (FOR ALL SYSTEMS)
4a. Residential - per unit . Check Type of Work Involved:
• 1000 sq. 8. or less $147.15 4
Each additional 500 sq. ft. or • ❑ Audio and Stereo Systems
portion thereof $33.40 1
•
Limited Energy - $75.00 0 Burglar Alarm
Each Manufd Home or Modular •
Dwelling Service or Feeder $90.90 2 •
❑ Garage Door Opener'
4b. Services or Feeders -
Installation, alteration, or relocation ❑ Heating. Ventilation and Air Conditioning System*
200 amps or less $80.30 2 .
201 amps to 400 amps • . $106.85 2 ❑ Vacuum Systems'
401 amps to 600 amps $160.60 . 2 '
601 amps to 1000 amps $240.60 2 ❑ Other
Over 1000 amps or volts $454.65 2
•
Reconnect only ' $66.85 2 TYPE OF WORK INVOLVED - COMMERCIAL ONLY
4c, Temporary Services or Feeders • . _ _ •
installation, alteration, or relocation Fee for each
200 amps or less $66.85 2 sy stem..-.. ......- .........:.- ...... - -. --. $75.00
(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
4d. Branch Circuits .
New, alteration or extension per panel ❑ Boiler Controls .
a) The fee for branch circuits -
•
•
with purchase of service or ED Clods Systems
• feeder fee. •
Each branch circuit . • $6.65 2 •
b) The fee for branch circuits ❑ Data Telecommunication Installation
•
•
without purchase of service ❑ •
or feeder fee. -- ' Fire Alarm Installation
First branch circuit $46.85 •
Each additional branch circuit $6.65 ❑ HVAC
•
4e. • .
0
(Se or feeder not included) Instrumentation •
•
Each pump or irrigation circle $53.40 .
Each sign or outline lighting . $53.40 • ❑ Intercom and Paging Systems
Signal circult(s) or a limited energy
panel, alteration or extension • $75.00 ❑ Landscape Irrigation Control'
Minor Labels (10) . $125.00
• 4f. Each additional inspection over ❑ Medical
the allowable in any of the above
Per inspection $62.50 .0 Nurse Calls
Per hour $62.50 •
In Plant $73.75 ❑ Outdoor Landscape Lighting' .
5. Fees: . ❑ Protective Signaling
Sa. Enter total of above fees $ • •
8% Surcharge (.08 X total fees) $ ❑ Other
Subtotal $
rib. Enter 25% of line 5a for . . Number of Systems -
Plan Review if required (Sec. 3) $
Subtotal $ . • No licenses are required. licenses are required for all other Installations
❑ Trust Account 0 • FEES: .
1 Total balance Due $ , ENTER FEES $
' 8% SURCHARGE (.08 X TOTAL ABOVE) $
TOTAL • . $
Mechanical Permit Application
Date received: Permit no. A 70
: ' City of Tigard s � I , j` �•'f : j � i t�i g Proecdappl. 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: Building permit no. •
TYPE OF PEIt[ILC
.Cr 8c 2 family dwelling or accessory O Commercial/industrial O Multi - family I Tenant improvement
N ew construction Cl Addition/alteration/replacement . 'l] Other.
.1011 SITE INFORMATION CONIMFRCIAL VALUATION SCHEDULE
. Job address: f. - "d 5'f . 4'4 ' Z- T a-. c � Indite 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 fa/ (Block: (Subdivision , ,J ' /'r *See checklist for important application information and
Project tee jurisdiction's fee schedule for residential permit fee.
City/county: • —� r ( ipgI S 2 FAMILY DWELLING PERMIT EEL SCHEDULE Descriptionand on of work on premises' AND COMMERICAL /INDUSTRIAL EQUIPMENTSC11EDULE
Fee(ea.) Total
Est. date of completion/inspection: Deseripdon Qty. Res.only Res.only •
Tenant improveme • r change of use: �g unit CFM •
Ise ' ; , : space heated or conditioned? O Yes Cl No Air conditioning (site plan required)
Is e • 1 g space insulated? O Yes Cl No Alteration of existing HVAC system
MECHANICAL CON "I RAC TOR Boiler/compressors .
boiler permit no.:
St
Business name ate
d(,n 1 B�v HP Tons BTU/H
Address: „ 7y s e JA5 Fire/smoke dampers/duct smoke detectors
Ci I Statge� I ZIP: 976J 4, Heat pump (site plan required)
ty ' ?err � - Install/replace furnace/burer BTU/H
Phone: ,_ - 7 7, - Fax :. 71 E-mail: Including ductwork/vent liner O Yes Cl No
CCB no.: / meta /replace relocateheaters- suspended,
City/metro lic. no.: a 7 /p. • wall, or floor mounted
Name (please print): D on a. Vent for a Hance other than furnace
on:
CONTACT PERSON Absorption units BTU/H
.
Name: GC
Chillers HP •
Co .. .ressors HP
Address: „Z 11.2 d i /4 r • Fn nmeatal eahaast and ventilation:
City: Poi �1 a J - `State: I ZIP: 97.4.43 Appliance vent _
Phone -77 Faxo4o3•. t .7 E - mail: Dryer exhaust
res. tc e
hood fire suppression system
Name: 1,401,.0.7101 „? 3 Atom Q t Exhaust fan with single duct (bath fans)
• Mailin g adds ass: / --- - f t- • �_ - Exhaust stem apart heating or AC
S - ZIP - ' Fuel pip and disMbution (up to 4 outlets)
City: tate� ' LPG NO Ohl
Phone: , . • - . �� A in E Fuel piping each additional over 4 outlets
Phone:
ENGINEER Process piping (schematic required)
Number of outlets
•
. Name: `-,.,Q f G ti Other listed appliance or equipment
Address: 4 9lo y yajvpiO/I Decorativefireplace
City: ` o7 l State: I ZIP: -type
Phone: coati- 7a',.3 I Fax: I B -mail: Woodstove/pelletstove
Other
Applicant's signature: g_ - -_ 5 : : 1 - I9 - ‘ , /____Cojler:
Name (print): Pey m / - -
udadiedma accept aedit cards. ' . - call Ju rar m infaemalim, Permit fee $
Na all
1 Notice: This permit application Minimum fee $ .
O Visa O MasterCard expires if a permit is not obtained Plan review (at . %) $
Credit card number: / Fspir es within 180 days after it has been State
red as complete. State surcharge (8%) ...• $ •
Name of cardholder as shown on credit card $ p TOTAL $ •
Cardholder signature Amount • 440- 4617 (6/00/G0M)
•
•
Commercial Schedule
•
• 182 Family Dwelling Schedule
•
ASSUMED VALUATIONS PER APPLIANCE • _
• Furnace to 100,000 BTU Table Description Mechanical Code • sty Price Total
induding duds & vents 955 1) Furnace to 100,000 BTU
induding duds 8 vents 14.00
Furnace > 100,000 BTU 2) Furnace 100.000 BTU• vents
induding duds 8 vents 1,170 3) Floor Fug a 17.40
floor furnace 4) `rent 14.00
4) Stspended heater, was heater
induding vent 955 • • or floor n heater 14.00
•
suspended heater, wall heater. • . 5 ) vent nor the led In appliance pemua 6.90
or floor mounted heater 955 e) Repair units 12.15 •
Check as that apple 'Boller Heat Air
Vent not included in appliance permit 445 For Items 1.10. see . or Pump cone Qty Price Total -
Repair units , 805 footnotes 1,2 • comp - '-
7) 4HP; absorb and to
< 3 hp; absorb.unit • • 100% BTU ' 14.00
a) 3-15 HP; absorb unit •
to 100k BTU 955 loolk to 5oolk BTU 25,60
3-15 I. absorb.unit - 9)15-30 HP; absorb
• unit .5-1 ma BTU 35.00
• 101k to 500k BTU - 1700 to) Soso: absorb
unit 1 -1.75 ma ens 5220
15-30 hp; absorb.unit 11) >50HP: absorb unit >1.75 ma BTU
501k to 1 mil. BTU 2310 87
12) Air handarg unit to 10.000 CFM .
•
30-50 hp; absorb.unit 10.00
1 -1.75 mil. BTU 3400 13) Air
handling ants 10.000 (« 1720
> 50 hp; absorb.unit 14) Non-portable eva cooler .
10.00
> 1.75 mil. BTU 5725 15) vent ran connected toe single duct
6.80
Air handling unit to 10,000 dm 656 16) ventilation system not Induded In
•
•
Air handling unit > 10,000 dm . 1170 . 17) Hood served by mechanimechanical n exhaust 10.00 by
Non-portable evaporate colter 656 10.00
18) Domestic i dnerators
vent fan connected to a single dud 446 .17.40
19) Commercial or Industrial type brdnerator
Vent syst not included in appliance permit 656 69.95
Hood served by mechanical exhaust 656 20) Other units, +nmalm wood stoves 10.00
Domestic Indnerator . 1170 21) Gas piping one to four outlets
5.40
•
Commerdal or industral Indnerator 4590 22) More than 4-per outlet (each)
wood stoves, inserts, etc. 656 100
Other unit, Including M inimum Pemrk Fee 572.50 SUBTOTAL egg NENE
Gas piping 1-4 outlets 360 - e% SURCHARGE NIX
Each additional outlet • 63 PLAN REVIEW 25% OF SUBTOTAL .
Required for All commercial penults only _I' : .i= ? - ; - .
• TOTAL
•
•Oarer Mupaeaan and ryes:
1. kept:Wore outside dronrW business ham (minimum dwge4wo Ines)
572.50 per hat
.. 2. h,pecdan sard(minimum ddi no tee is opeoay iedosed (minimum demo ad hue
Total Valuation Fee a. w a roes. ada s o ma ce,lskena 10 pins (oilman
•
. drweorrhsa maul S72.50 «
ao per
'state Cameleer Beer Ceanaon required
•
$1.00 to $5,000.00 Minimum $72.50 "'Resider/he/VC mine site °"n showing placement et unit
• $5,001.00 to $10,000.00 $7250 for the first $5,000.00 and $1.52 for •
each additional $100.00 or fraction thereof; .
•
to and including $10,000.00
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54
for each additional $100.00 or fraction
•
thereof; to and including $25,000.00
•
$25,001.00 to $50,000.00' $379.50 for the first $25,000.00 and $1.45 .
for each additional $100.00 or fraction
•
•
thereof to and including $50,000.00
•
•
$50,000.00 and up ,. $742.00 for the first $50,000.00 and $1.20 .
•
for each additional $100.00 or fraction
' thereof
•
•
•
• A Plumbing Permit Application
. Date received: Permit no. 5j ( - �3
h: City of Tigard
,- - Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd, Tigard, OR 97223
City of Tigard phone: (503) 639 -4171 Project/appl.no.: Expire date:
Fax: (503) 598 -1960 Date issued: By: 1 Receipt no.:
• Land use approval: Case file no.: Payment type:
TYPE OF PEIt11lT
I & 2 family dwelling or accessory 0 Commerciallmdustrial 0 Multi - family 0 Tenant improvement
Lif ew construction 0 Addition/alteration/replacement , Food service 0 Other:
• JOB SITE INFORMATION FEE SCIIEDULE (for special information use checklist)
Job address: 3 d 9 9 l d- *',off 6 r_-._ Description Qty. Fee(ea.) Total
Bldg. no.: Suite no.: New 1 and 2- family dwellings only:
Tax map/tax lot/account no.: (includes 100R.[oreachutWtyconnection)
SFR (1) bath
Lot: k„.2/ Block: I Subdivision: SFR (2) bath • Project name L -ip czaQ Q e— SFR (3) bath
City/county: / r ix. ZIP: Ti Each additional bath/kitchen
Description and 14.alion of work on premises: Slte Wades: .
Catch basin/area drain
Est. date of completion/inspection: Drywells/leach line/trench drain
PLU111IING CONTRACTOR Footing drain (no. h°' ft.)
Manufactured home utilities
Business name: [, JDl call- P/ /d/Y . ; ,7�1 Manholes
Address: pa /30 ,24e, 7 / Rain drain connector
City:( /4 j 0yryY1 1 State:pA I ZIP: 9 703. Sanitary sewer (no. lin. ft)
Phone: Gb 7 -/ / I Fax: 4G 7 -?flJ I E -mail: Storm sewer (no. lin. ft.) .
CCB no.: a l, 3'J7 I Plumb. bus. reg. no: 0 ?Ale f le Water service (no. lin. ft.)
City/metro lin no.: Fixture or item:
. Contractor's representative signature: j> If).• en Back fl valve
' Bow preventer
Print name: A - / o/I I Date: Backwater valve
CONTACT PERSON Basins/lavatory
Name: 63 j t a, Clothes washer
Address: ,40c2 R d ,L-,,DO 7 Dishwasher
Ci ty : 6I" � s/ n Oat II S ZIP: .9.70..35 Ejectors/sump (s)
Phone: „ - 4 " Fax: E-mail: Expansion tank •
OWNER Fixture/sewer cap
Name (print): Li 0 74 41 'S Floor drains /floor sinks/hub
address: / 7 i — ,S' du" G " Garbage disposal •
City: ,P0/7 e m • State: a it ZIP: 97.24.6.1 I � ma k er
Phone: t 3 - m Fax: d"�8 # - t 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 per ORS Cher, 447. Sink(s), basin(s), lays(s) •
Owner's signature: • -, . , e- t� +•:.. / - /9 - % Sum.
• EIN G IN f.ER Tubs/shower/shower pan
/ L • Urinal
Name: r r ✓ 1 Water closet
Address: G' /. adli ,f lY'rn, 404 Water heater
City: •7•1 ofa,i. J I Stateo4 I ZIP: 9YJ 7 Other: . •
Phone: 4 ,5- Fax: I E -mail: Total
Not an JmisdIcdro e2iit o accept a cads, please Call jwtsdiWm for mace infamatioo. Notice: This permit application Minimum fee $
O vtaa O MasterCard Plan review (at %) $
expires if a permit is not obtained
Credit cad number —I-1— States a (8%) ... $
Expires within 180 days after, it has bee uccharg ( )
Name cardholder as credit card
as complete. TOTAL $
$
Cardholder signature Amount 4404616 (6100/COM)
•
• PLEASE COMPLETE:
FIXTURES • (individual) , .Qty. -- 0 tTofal Fixture Type Quantity by Work Performed
Sink 16.60 J Now Moved Replaced Removedicapper
• Lavatory 16.60 Sink
Lavatory
Tub or Tub/Shower Comb. 16.60 Tub or Tub/Shower Combination
Shower Only • 16.60 Shower Only
Water Closet . .16.60 Water Closet
Urinal
Urinal 16.60 Dishwasher
Dishwasher - 16.60 Garbage Disposal
Garba Disposal 16.60 Laundry Room Tray
9 p Washing Machine
Laundry Tray 16.60 Floor Drain/Floor Sink 2"
•
3 '
Washing Machine 16.60 _ 4.
Floor Drain/Floor Sink 2' 16.60 Water Heater •
Other Fixtures (Specify)
3' 16.60
4' 16.60
Water Heater 0 conversion 0 like kind 16.60
Gas piping requires a separate mechanical permit.
MFG Home New Water Service 46.40
MFG Home New San/Stonm Sewer 46.40
• • COMMENTS REGARDING ABOVE:
Hose Bibs 16.60
Roof Drains 16.60 -
Drinking Fountain 16.60
Other Fixtures (Spedfy) 21.75 .
•
Sewer -1st 100' • 55.00
•
Sewer - each additional 100' • 46.40 -
Water Service - 1st 100' • 55.00
Water Service - each additional 200' 46.40
Storm & Rain Drain - 1st 100' 55.00
Storm & Rain Drain - each additional 100' 48.40
Commercial Back Flow Prevention Device 46.40
•
Residential Badcflow Prevention Device• 27.55
Catch Basin 16.60
Insp. of Existing Plumbing or Specially Requested 72.50 •
Inspections per/hr
Rain Drain, single family dwelling 65.25
Grease Traps 16.60
QUANTITY TOTAL _;:, •
Isometric or riser diagram b required C Quantity Total is > 9
'SUBTOTAL ' •
8% SURCHARGE ��,y, •
'li!:`'i :r F. 41
"PLAN REVIEW 25% OF SUBTOTAL
Required ordy r fixture qty. total Is > g -
TOTAL ' =
'Minimum permit fee Is 872.50 + 8% surcharge. except Residential Baddbw Prevention
Device, vhhkh b $38.25 • 8% surcharge. •
"AU New Commercial Buildings require plans villh isometric or riser diagram and plan review.
•
•
CITY OF TIGARD
. 13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
GARNER ELECTRIC
21785 SW TUALATIN VLY HWY #C
ALOHA, OR 97006-1249
Electrical Signature Form
Permit #: MST2001 -00023
Date Issued: 2/20/01
Parcel: 2S111 DA -10800
Site Address: 15299 SW REGENT TERR
Subdivision: APPLEWOOD PARK NO. 3
Block: Lot: 101
Jurisdiction: TIG
Zoning: R -7
Remarks: S/F Path 1
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:
LEGEND HOMES GARNER ELECTRIC
12755 SW 69TH AVENUE #100 21785 SW TUALATIN VLY HWY #C
PORTLAND, OR 97224 ALOHA, OR 97006 -1249
Phone #: 503 - 620 -8080 Phone #: 503 - 648 -4552
Reg #: Lic 121159
SUP 37075
ELE 34 -305C
AN INK SIGNATURE IS REQUIRED ON THIS F RM
4,4;
•
• Signature of Supervising Electrician
If you have any questions, please call (503) 639 -4171, ext. # 310
•
CITY OF TIGARD BUILDING INSPECTION DIVISION .
MST GG / -�0oZ3
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
�J BUP
Date Requested � / AM PM BLD
Location /5 f 5 w gel axv t-f' ✓ Suite MEC
Contact Person Ph -alp G U9 Z-3 PLM
Contractor Ph 2e, j f 3 3 7U 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
ost & Beam
Rough In
Gas Line
Smoke Dampers
Wm � ART FAIL
EL CTRICAL
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 6 — 2 7 - D/ Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
-
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 260/ 4 ?Z3
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/' ' / BUP
G
Date Requested z� AM PM BLD
Location I Ley r".. Suite MEC
Contact Person Ph S9Y' 0,2-3 PLM
Contractor Ph SWR
I Tenant/Owner ELC
detaining 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:
i SS PART FAIL
UMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
AlkiMEISM
Post & Beam -
Rough In
Gas Line
Smoke Dampers
Ana
SS PART AI
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: [ I Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date d--ZS -a/ Inspector Ext
Final
PASS PART FAIL • DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISIO U
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MSTL� �UZ3
/ . BUP
Date Requested ( - Z) •
AM PM BLD
Location /,.5 5 w *�j Suite MEC
Contact Person Ph 5 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain / C - � O n c- J. K
Crawl Drain f �i4ction Notes: SGN
ns{
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
CPLUMBII -
o3's 8 Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain ' rains
PART FAIL
' ANICAL
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 62/ Approach /Sidewalk Date � l6 / Inspector j� � r /t L d/T. Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
-CITY OF TIGARD BUILDING INSPECTION DIVISION
MST ��V/ GUa
24 -Flour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Date Requested / � 4e Z ' AM PM BLD
Location �f S�� !'�-� f ' ��� �' Suite MEC
Contact Person Ph 4.D PLM
Contractor Ph 5 9 e , 9 Z) SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain 4 i� SGN
Crawl Drain Insp Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear ) ` /A �
Framing /, � ,4 4i' & iPr to I l } A h yA S 9 (y / 1
Insulation /
Drywall Nailing LP¢/Cm . a S NO J-e i
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
ASS PART FAIL
P
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Brains /7
PASS PART
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 -1 - S�
Storm Drain 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 D (0/2_c,/e/ I �(`/ .e L'-t, O Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
/ CITY OF TIGARD BUILDING INSPECTION DIVISION MST 7,0,0r
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP
Date Requested r AM PM BLD
Location / � �W aL J Suite MEC
Contact Person Ph 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
LE L
Service
Rough In
UG /Slab
Low Voltage
Fire A - rm
a _
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 t
- t
'Dae �/ � ® / Inspector
Other Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST de 02,
�� P BUP
Date Requested �/� AM PM BLD
Location q 5 C /4) Atge-id Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain x I Gt./ cl
Crawl Drain Insa tion Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear /1 � 0 Y1 f
Framing / � �� t S�[� To." N �I"ci sue►
1 e�
Insulation // ff
•
Drywall Nailing i h TQer (Or v, +2,10". Firewall ' /
Fire Sprinkler , i? 5 `4 . g5 c-t, S Ioc� �— p ref 1 -4 r N
Fire Alarm L 7
Susp'd Ceiling hi 40 54c w Q � /1 ,[
Misc: �) Q in s4, / d , �� 1 - .44A9 l-� -Ci op
Final Q4 o,
PASS ART FAIL /
UM —72- .- jS c 1-ec�- t hpl..e,,,— 7 1 t.4 ft 4 fZ 641e,
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
in
PASS PART le
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
Otheoach /Sidewalk Date6 / /�/0 / Inspector �� �1 to / v-L. E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
• CITY OP TIGARD BUILDING INSPECTION DIVISION ( j A-,- MST � •
/ -ov 0 .43
• 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
• • Date Requested `I 2 5 AM PM BLD
Location / 2 -999 Sw lase-d' Suite _ MEC
Contact Person Don Ph j77 07 Z� 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 -GA6.44
Post & Beam
Under Slab
i_
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
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 fo reinspe ion RE: [ ] Unable to inspect - no access
ADA . th
proach /Sidewal 1 2 < ( ` Q , ( ,. .) .
Date Inspector
Other Ext4I1
PASS PART FAIL DO NOT REMOVE this inspection record from the job. site.
• _ TY OF TIGARD BUILDING INSPECTION DIVISION MST li_ 4). 3
24:Hour. Inspection Line: 639 -4175 Business Line: 639 -4171
4' BUP
Date Requested AM PM BLD
Location l � 29 Suite MEC
Contact Person Ph 971 6 9 Z 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 n/Or 4A-9
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 •
S
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
AD
Other /Sidewalk Datelf 23!01 Inspector Pike Ext 4(Y
Final
PASS PART 0 DO NOT REMOVE this inspection record from the job site.
•
•
• • . QJTY'OF TIGARD BUILDING INSPECTION DIVISION MST ? y1 • •
24- Hour,lnspection Line: 639 -4175 Business Line: 639 -4171
BUP •
Date Requested `/ AM PM BLD
Location /S Sw �� � 7 f'�' Suite MEC
Contact Person Ph 267- PLM
Contractor Ph SWR
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
‘
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
F
PART FAIL
BING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
cJ ECH I L
Post & Beam
<218111:
Gas Line
Smoke Dampers
Fi
AS 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 p
D z / —/7— 0/ Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
,s- z-- •
•
' . • JJTY OF TIGARD BUILDING INSPECTION DIVISION MST Ul 6 6Z3
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
'/ BUP
`
Date Requested 4 3 AM PM BLD
Location ‘54" Suite MEC
Contact Person // Ph 3 PLM
Contractor Ph SWR
IUdILDIN_6' 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 ,�
e1) 4 5 r'g « c � a c .= co
Insulation
Drywall Nailing 6 5e7 " � ;3. mot,r/v ,�/.//sc;7c
Firewall
Fire Sprinkler -7T c/c 6/ - . s ' � — 114%'-e
Fire Alarm
Susp'd Ceiling 415 s ' G ev/- /'VGSc4- A77'o,./ �/ ED-
Roof �Lc'c��CA /!�✓1G`
Misc:
Final /�
PASS PART FAI 1. � �=� � L am= 4;1f416' s W 2=
PLUMBING
( P «: c ?T - MSC" - = 14- ►?c • r re- I C me
Post & Beam
Under Slab 6:771-S7 -y
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
ECHAI�J
Post & eam
�..u
" e Da pers
F al
f;PASS - ART Al
EL' CtRICAL
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 y /3 e Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
• • • • • S TIGARD BUILDING INSPECTION DIVISION dial 7
24-Hour o Z 3
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 T
BUP•
Date Requested — AM v PM BLD
Location / .SZ— ? l , Sw �� �.,�. �� Suite MEC
Contact Person Ph 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 � V / c
Fire wall � P O 5 V I / Y7
Fire Sprinkler � S
Fire Alarm
Susp'd Ceiling r9 CL / )
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
Gov.`•
Rough I
C l 1 1
L. Voltage
Fi
PASS PART. FAIL
t1TE`
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 Inspector �/ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from -the job site.
•
/
• . •
' £ CITY'OF TIGARD BUILDING INSPECTION DIVISION MST 03Doi-°- z
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 7 AM PM BLD inWr
Location /3 2 q f & - - " . Suite MEC S
Contact Person Ph 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
PA PART FAIL
I r a i d a - 317re4
Post & Beam
Under Slab
a er Service
Sanitary Sewer
Rain Drains
PART FAIL
ECHANICAL
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 /Z / (1 inspector ( Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
' . CITII' OF TIGARD BUILDING INSPECTION DIVISION
• •
MST t+J6g Z
24- HourJnspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested , 3sG AM PM BLD
Location /5'2. 9, Suite MEC
Contact Person Ph PLM
Contractor Ph SWR
UILDIN Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
most & Be)'
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Fi t PART FAIL
•
ea
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
a
P A PART FAIL
HA N A
ost & Bea
Roug In
Gas Line
Smoke Dampers
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 3
Other D J /6 Inspecto E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
i --
-
• CITY OF TIGARD BUILDING INSPECTION DIVISION 3,wp
MST -/ ' - GUI Z3
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 :.
BUP
Date Requested Z- AM PM BLD
Location / 2 -4 S4v R-e f Suite MEC
Contact Person Ph fo €G 3/ PLM
Contractor Ph SWR
Tenant/Owner ELC
e aining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
f eriwl D Inspection Notes:
Siab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Fig
PART FAIL
• ost & Beam
Under Slab
Top Out
a ' ewers
F' -
PART FAIL
• ANICAL
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 Z /
Other Date 1/ U Insp Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
Z 2 4 7
, CIT,Y'OF TIGARD BUILDING INSPECTION DIVISION MST 0 o'
24 -Hour Inspection Line: 639 -4175 Business Line: 6 -4171
BUP
Date Requested /fi Z I AM PM BLD •
Location % 5 9 9 5 w ` .o f ...„ " -ew Suite MEC
Contact Person Ph 7) 5 / 7 PLM
Contractor / Ph SWR
Tenant/Owner 2 / ' -✓ / /�-`� ELC
Retaining Wall ELR
zt ga;;;,. Access: FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
•
Int Sheath /Shear
Framing
Insulation
Drywall Nailing r 1-' '
Firewall
Fire Sprinkler
Fire Alarm
. Susp'd Ceiling
Roof
Misc:
Fi
olp PART FAIL
'' 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 , 1 ''U J Ext
Other Date Inspector . '
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
C4W TIGARD BUILDING INSPECTION DIVISION
MST ,Z01. GUD Z�
X 14 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
•
•
// BUP
•
Date Requested Z' 7 -4 AM PM BLD
Location / 5 t 4 9 Sw gd / y 7 r r` Suite MEC
Contact Person Ph 2 S 5 -5 PLM
Contractor / Ph SWR
BUIL Tenant/Owner pm_ a/�/ 4 -'-- ELC
a all ELR
Foundation Access: FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing •"/ C' 6 • . C
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
_ ART 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 Inspector, Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.