Permit MASTER PERMIT
CITY OF TIGARD
PERMIT #: MST2005 -00247
_AI, DEVELOPMENT DEVELOPMENT SERVICES DATE ISSUED: 8/30/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S104DB -02300
SITE ADDRESS: 13151 SW ROCKINGHAM DR ZONING: R -4.5
SUBDIVISION: AMESBURY HEIGHTS LOT: 023 JURISDICTION: TIG
Project Description: Interior remodel.
BUILDING
REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 200 sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: NONE DWELLING UNITS: THR sf RIGHT:
VALUE: 14,000.00
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 200 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: BOIUCMP < 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 SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp: 0 • 200 amp: W/SVC OR FOR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 • 400 amp: 201 • 400 amp: 1st W/0 SVC/FOR: 1 SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 • 600 amp: 401 • 600 amp: EA ADDL BR CIR: 2 SIGNAUPANEL: 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:
This permit is subject to the regulations contained in the
Owner: Contractor: Tigard Municipal Code, State of OR. Specialty Codes
MATTHEW & M CONTI and all other applicable laws. All work will be done in
13151 SW ROCKI NGHAM DR accordance with approved plans. This permit will expire
TIGARD, OR 97223 if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
ATTENTION: Oregon law requires you to follow rules
Phone: 503 - 590 -0414 Phone: adopted by the 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
Reg #: direct questions to OUNC by calling 503 -246 -6699 or ,
TOTAL FEES: $ 372.39 1- 800- 332 -2344.
REQUIRED ITEMS AND REPORTS
Issued By : Permittee Signature • , ��
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business ■ . y.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
1 ui1dine Permit Application FOR OFFICE USE ONLY
City of Tigard r / e/ B� 7; 5 - ....?6,11._ Pennit No.� C�� s`�2G.
' 131 SW Hall Blvd., Tigard, OR 97 E V E I !/ E / Plan ��e t ` �J
Phone: 503.639.4171 Fax: 503.598.1960 i.:,,� .•r vi
DateB 9 QS Mc) v Other Pennit:
, t f '1 1I � I
''
Inspection Line: 503.639.4175 JUL 0 +�i•
-, Dale Ready/By. ® � See Attached Checklist for
Internet: www.ci.tigard.or.us ,J Ll 2OO -_ ^^ Notified/M �9 )5 ■ 4/ l U Supplemental Information
CITY OF TIGARn `(1� tt 1-\) c) v■./
AN6'4.11 isIO ( REQUIRED DATA: 1 AND 2 FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees' are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
1 -Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
and 2 -family dwelling ❑ Commercial /industrial Valuation: $ / 9 t cce
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 1 j t Qce .,, �"'1 1, eirav1/4.0 New dwelling area: ZCCI square feet
City /State/ZIP: I\ eia,".A 04. Garage /carport area: square feet
Suite/bldg. /apt. no.: I Project name: (crytfi ‘ t Covered porch area: square feet
Cross street /directions to job site: - Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I Lot no.: Permit fees' are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
//��
�eehh 11 DESCRIPTION OF WORK work indicated on this application.
AeG 1611 CA 1 ov-e, - Vh4101/ Valuation: $
Existing building area: square feet
• New building area: square feet
❑ PROPERTY OWNER ❑ TENANT Number of stories:
Name: c (7 ,�-` \\ ,,,) Type of construction:
1
Address: Occupancy groups:
City /State/ZIP: Existing:
Phone: 0 )5?? ' 0 c// 4 / Fax: ( ) New:
V APPLICANT ❑ CONTACT PERSON NOTICE
Business name: Rya� K2,. 1.4)..r C o, 4 4-t , Ve itrN All contractors and subcontractors are required to be
Contact name: (Z�0.V� Ke�,�� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
• Address: 2 0 j Q O 6(..ti y e �[ + jurisdiction in which work is being performed. If the
City /State/ZIP: A ]01►m I� C17004, applicant is exempt from licensing, the following reasons
1 � apply:
Phone: 45 $ � 39 U I q I Fax:: (5VJ) I 5'47 S
E -mail: Kya Kerner Ue 11 ?cn • l
�4 1'
7 CONTRACTOR � LL``
Business name: Ryan )(e riNe r Co n STY' U �o-n BUILDING PERMIT FEES*
Address: 20140 J c w Yom- 1--
Please refer to fee schedule.
City /State/ZIP:d �� 9-7006 Fees due upon application i /5---5-1 Phone: f;15-31.5--39 I g I .I I Fax: ( - C i , S
CCB lic.: / 43ZgZ. Amount received
Date received:
Authorized signaturillP This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: - a�i, � K ietyt v ,,,, - Date: 7r.7.0 `Zoo 5- • Fee methodology set by Tri-County Building Industry
Service Board.
is\ Building \Pennits\BUP- PermitApp.doe 12/03 4404613T(l1 /02/COM/WLB)
• •
One- and Two - Family Dwelling { r
Building Permit Application Checklist miz OFFlcI t.:sy ON IA
City of Tigard Recei ved Perntit No.:
Da
13125 SW Hall Blvd., Tigard, OR 97223 s
Assoaatoaat
ed permits:
As
Phone: 503.639.4171 Fax: 503.598.1960 ! =M«p I
24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑ Plumbing ❑Mechanical
L }i
Internet: www.ci.tigard.or.us . __. ❑ Other.
THE FOLLOWING FFEI\'IIS ARE REQUIIRED FOR PLAN REVIEW 1 es 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. ❑ 0 ❑
3 Verification of approved plat/lot. 0 ❑ ❑
4 Fire district approval required. Name of district: . ❑ ❑ 0
5 Septic system permit or authorization for remodel. Existing system capacity ❑ 0 ❑
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 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ 0
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 0 0 0
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 ❑ ❑ 0
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 ❑ 0 ❑
architect licensed in Ore:on and shall be shown to be ..'livable to the .ro'ect under review.
JURISDICT SPECIFICS
23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17". ❑ ❑ ❑
24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ Q ❑
25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑
26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. 0 ❑ ❑
27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑
28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ 0 ❑
Street Tree List.
29 Site plan to include tree protection measures as required by conditions of approval. ❑ ❑ ❑
30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑
including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
I:\ Building \Permits\BUP- RES- PermitApp.doc 2
•
Electric& Permit Application FOR OFFICE USE ()NIA City „ of Tigard Received / O `� Permit No.:
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 i'- '0:.�,. i Date/B . Other Permit. S, � [.,
Inspection Line: 503.639.4175 'I � Date Ready/By: rani ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
❑Demolition ❑Other:
o Service over 225 amps, comm'I ['Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder ❑Other: ❑Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
- T7 ❑Health -care facility ❑tea:
Job no.: Job site address: i 3)5 1 i) C r.
\ \�C�^ -� Submit 2 sets of plans with any of the above.
City /State/ZIP: �J The above are not applicable to temporary construction service.
\
FEE* SCHEDULE
Suite/bldg./apt. no.: Project name: C 0 �} \ Description I Qty, I Fee. I Total I ••
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 . 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
et( PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
• 401 amps to 600 amps 160.60 2
Name: C C/ {` k , �/ ∎� ■: 1 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
,,�I I Fax: relocation
Phone:
(`� 6,.. j'� ~ a y i / ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
❑ APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
Contact name: B. Fee for branch circuits
without service or feeder fee, / 46.85 2
Address: each branch circuit
Each add'I branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax:: ( ) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
Business name: l� \_....-e M\.\ 6\ Q c � 1 extension. Describe: Paget 2
r
Address: 1 \ S TQ �� �� l �� Each additional inspection over allowable in any of the above
Per inspection 62.50
City/ State/ZIP: 1` \ t z i. 1")1 q ! S Investigation per hour (I hr min) 62.50
Phone: (366 6 73— 6 C/ j./ Fax: ( (' ) Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic. /'6 0 I Electrical Lic.:3€7 J& /J '-I Suprv. Lic.: - 3,s Subtotal
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: Date: State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: I Date: • Fee methodology set by Tri- County Building Industry Service Board
• • Number of inspections per permit allowed.
i:\ Building \Pennits\ELC•PemtitApp.doc 12/03 4404615T(10/02ICOM/WEB '
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information '
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY: —�
Fee for all residential systems combined........ $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
•
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
•
❑ Other:
TCONIlVIERCIAL WORK ONLY:
Fee for each commercial system. $75.00
(SEE OAR 918 - 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
• ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
• ❑ Nurse Calls
❑
•
Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
•
for all other installations
iNBuilding \Permits\ELC- PermitApp.doc 04/03
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: MST2005 -00247
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 8/30/2005
Phone: (503) 639- 4171'
Inspection Requests (24 Hrs.): (503) 639 -4175 �J
° 1
INSPECTION WORKSHEET FOR DATE: 8/10/2006 TIME: 7 :03AM PAGE: Ott
SITE ADDRESS: 13151 SW ROCKINGHAM DR CLASS OF WORK:
SUBDIVISION: AMESBURY HEIGHTS LOT #: 023 TYPE OF USE:
PROJECT NAME: CONTI
DESCRIPTION: Interior remodel.
OWNER: CONTI, MATTHEW & MARNIE PHONE #: 503- 590.0414
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 8/18/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 035145 -02 503-539-8191 Y
Corrections /Comments /Instructions:
.----
IKPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G' N o8 LE Date: 1'a • Oki Phone #: (503) 718 - 2.44
CITY OF TIGARD
•
BUILDING DIVISION PERMIT #: MST200S-00247
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/30/2005
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 . ' II
INSPECTION WORKSHEET FOR DATE: 8/18/2006 TIME: 7:03AM PAGE: 87
SITE ADDRESS: 13151 SW ROCKINGHAM DR CLASS OF WORK:
SUBDIVISION: AMESBURY HEIGHTS LOT #: 023 TYPE OF USE:
PROJECT NAME: CONTI
DESCRIPTION: Interior remodel_
OWNER: CONTI, MATTHEW & MARNIE PHONE #: 503-590-0414
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 8118/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 035145 -04 503.539 -8191 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: - N 06 LS Date: i NV 36 Phone #: (503) 718- vtiLtp
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: MST2005 -00247
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/30/2005
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639 -4175 . �'I L
INSPECTION WORKSHEET FOR DATE: 9/16/2005 TIME: 7 :01AM PAGE: 100
SITE ADDRESS: 13151 SW ROCKINGHAM DR CLASS OF WORK:
SUBDIVISION: AMESBURY HEIGHTS LOT #: 023 TYPE OF USE:
PROJECT NAME: CONTI
DESCRIPTION: Interior remodel.
OWNER: CONTI, MATTHEW & MARNIE PHONE #: 503 - 590 -0414
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9/16/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
280 Insulation 015819-01 503 - 539 -8191 N
Corrections /Comments /Instructions:
a -ASS ❑ PARTIAL APPROV' ❑ CANCEL ❑ NO ACCESS
❑ FAIL ALL FA S' EC,TIO • ADDITIONAL FEES ASSESSED
Inspector: Date: / 6o /,--- Phone #: (503) 718
r
CITY OF TIGARD
BUILDING DIVISION , PERMIT #: MST2005 -00247
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/30/2005
Phone: (503) 639 -4171 tgi�l
Inspection Requests (24 Hrs.): (503) 639 -4175 .J'
INSPECTION WORKSHEET FOR DATE: 9/13/2005 TIME: 7:05AM PAGE: 80
SITE ADDRESS: 13151 SW ROCKINGHAM DR CLASS OF WORK:
SUBDIVISION: AMESBURY HEIGHTS LOT #: 023 TYPE OF USE:
PROJECT NAME: CONTI
DESCRIPTION: Interior remodel.
OWNER: CONTI, MATTHEW & MARNIE PHONE #: 503590.0414
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9/13/2005 - r. Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 015471 -01 503-539 -8191 Y
Corrections /Comments /Instructions: ct C (_ Ir ■ V
`CC) 3'3 Cj 1.
\ Nc C,- \ ., p o ksti r71- 0')-.
_. _ . .
\U
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector* .r -(___ Cd 1 Date: l' 62 Phone #: (503) 718-