Permit N ;,c: MASTER PERMIT .
4 1111, CITY O F T I G A R D PERMIT #: MST2003 -00052
4:�� DEVELOPMENT SERVICES DATE ISSUED: 4/10/03
. If 13125 SW Hail Blvd., Tigard, OR 97223 (503) 639.4171
SITE ADDRESS: 11375 SW SUZANNE CT PARCEL: 1S134DC -12000
SUBDIVISION: CASCADIAN PLACE ZONING: R
BLOCK: LOT: 009 • JURISDICTION: TIG
REMARKS: Construction of new SF detached dwelling.
BUILDING
REISSUE: MAS22133A STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW . HEIGHT: 25 FIRST: 1,736 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,066 sf GARAGE: 647 sf FRONT: 20 PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 TwRD: sf RIGHT: 5
VALUE: 277
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2,802 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 1 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 1 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL - ,
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 5 - CLOTHES DRYER: 1
GAS , FURN > =100K: 1 - UNIT HEATERS: HOODS: 1 OTHER UNITS: 2
MAX INP: btu FLOOR FURNANCES: • VENTS: 1 WOODSTOVES: GAS OUTLETS: 3
, ELECTRICAL -
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS • BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS .
1000 SF OR LESS: 1 0 - 200 amp: 0 : 200 amp: W/SVC OR FDR: PUMP/IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 5 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR:
. LIMITED ENERGY: 401 - 600 amp: 401 600 amp: EAADDL BR CIR: SIGNAL/PANEL: IN PLANT:
.MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: .
1000+ amp/volt :
PLAN REVIEW SECTION
- Reconnect only:
, >=4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL • RESTRICTED ENERGY
A. SF RESIDENTIAL . . B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: . . AUDIO & STEREO: . FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: - BOILER: HVAC: LANDSCAPE/1RRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: • OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL N SYSTEMS:
TOTAL FEES: $ 7,689.18
Owner: Contractor:
This permit Municipal
C Code, , S he regulations contained in , the
KEYSTONE DEVEOPMENT INC. KEYSTONE DEVELOPMENT Tigard Municipal Code, State of OR. Specialty Codes and
PO BOX 476 PO BOX 476
LAKE OSWEGO, OR 97034 LAKE OSWEGO, OR 97034 all other applicable laws. All work will be done i
accordarice with approved plans. This permit will expire if
work is not started within days of issuance, or if the
work is suspended for more than 180 days. ATTENTION:
Oregon law requires you to follow rules adopted by,the
Phone: 503 635 - 4736 Phone: 503 635 - 4736 Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through 952 7001 - 0080.. You
Regis: LIC 71135 may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS .
Erosion Control Insp 84 Post/Beam Mechanical Plumb Top Out Exterior Sheathing Ins l • Rain drain Insp Mechanical Final
Sewer Inspection Underfloor insulation Electrical Service • Low Voltage Water Line lnsp Plumb Final •
. Footing Insp Crawl Drain /Backwater Electrical Rough In Fireplace Insp _ Water Service lnsp Building Final •
Foundation Insp PLM /Underfloor Framing Insp Gas Line Insp Appr /Sdwlk Insp
Post/Beam S ral Mechanical Insp Shear Wall Insp Insulation Insp Electrical Final
/ /
Issue 1 .,i _, �. / 1d/� t. ., . 1, Permittee Signature : , I li L �
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed th - next busi ess day
f
i o ' &I - 3-03 _" ,► ,,
• ' 1 ' ,A✓ -000
Bu Permit Application . .
411"
Date received: Permit no.: '�iir City of Tigard '� / 5,..._ t- >� ,1 r IUD , D ��
y' Projecd no.: Expire date:
City of Tigard Address: 13125 S W Hall I t r ,
Phone: (503) 639 Date issued: By: Receipt no.:
Fax: (503) 598 -1960 FEB 0 5 2003 Case file no.: Payment type: k Land use approval: CITY OF TIGARD 1 &2 family: Simple Complex:
9 • • I.
TYPE OF PERMIT
od
t I & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family t'• New construction 0 Demolition
0 Addition/alteration /replacement 0 Tenant improvement 0 Fire sprinkler /alarm O Other:
- JOB SITE INFORMATION
Job addressi %Mae ' gv Z/ttJ , • L1315 Bldg. no.: Suite no.: r
Lot: el I Block: 'Subdivision: 4 ,4Dlat tJ Pt/fCe./ I Tax map /tax lot/account no.: /S/ /x ...000/97
Project name: ( •t4 .,
Description and location of work on premises/special conditions: N 5f1
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: K p l�V P• III• ( Floodplain ,septiccapacity,solar,etc.)
ft, address: ) 1.-V1(0 1 & 2 family dwelling:
City: I.4 a ko 0 I State: OF I ZIP: 1103 Valuation of work $
Phone: 63 5 - 41SC" "I Fax: tA4 - 11'll IE -mail: i?oLP1Y —Se, No. of bedrooms/baths
Owner's representative: JA 1 0-5 Pohl= +` Total number of floors
Phone: - /r-yt/.n. Fax: S}fw- .. E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
Name: . S¢ Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: I State: I ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: - Commercial/industriaUmulti- family:
CONTRACTOR Valuation of work $
S/°( Existing bldg. area (sq. ft.)
Business name: � New bldg. area (sq. ft.)
Atidress:
City: I State: I ZIP:
Number of stories
Type of construction
Phone: I Fax: I E -mail: Occupancy group(s): Existing:
CCB no.: 1113rj New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCIIITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: tiviscogp . provisions of ORS 701 and may be required to be licensed in the
Address: 1305 NW�� jurisdiction where work is being performed. If the applicant is
: exempt from licensing, the following reason applies:
City: �P09- 11./1ND 1 pp- I State: O I Z IP: li s o('
Contact person: Plan no.: ?.2-1 aO-
Phone: Fax: E -mail: o tAAS
i ENGINEER "
Name: 4Z Contact person: Fees upon application $
Address: 4c ,5r._ (02,{,12 Date received:
City: e0 'State: (ZIP: g121 Co Amount received $
Phone: Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of la and • dinances governing this 0 Visa 0 MasterCard
work will be complied with r °ers - rein or not. Credit card number: / /
I Expires
Authorized signature: 41111111 .. . 1I' Date: 1 1 5-1 � Name of cardholder as shown on credit card
. ,
Print name: ' 1 Y _ -A ` P.91,0- Cardholder signature $ Amount
Notice: This permit app • ation • pires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6ro0/COM)
4 ie
1
r A Mechanical Permit Application f `..
Date received: Permit no.: /I _ , -0005
a " h r Y ' �" City of Tigard �,�; � � � ty b Project/appl. no.: Expire date:
CiryafTigard Address: 13125 SW Hall Blvd, Tigard OR 97223
Phone: (503) 639 -4171 Date issued: By: Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
•
Land use approval: Building permit no.:
TYPE OF PERMIT
ii 1 2 family dwelling or accessory 0 CommerciaUindustrial ❑ Multi- family 0 Tenant improvement
New construction 0 Addition/alteration /replacement 0 Other:
JOB SITE INFORMATION . - • • COMMERCIAL VALUATION SCHEDULE
Job address: -' -t r '• Ale. 5 V2ielNNE. Cr. Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no. It 1S J value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.:
profit. Value $
Lot: IBlock: I Subdivision: GA& On-J1 flf ,Fi *See checklist for important application information and
Project n e: jurisdiction's fee schedule for residential permit fee. •
City /county: 1(91A2) / vJPt . I ZIP: cri'ZL'>j 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location 9 f work on premises: AND COMMERICALIINDUSTRIAL EQUIPMEN'TSCIIEDULE
N �\%" S Fee(ea.) Total
Est. date of completion/inspection: 12102- 'f0 al C' Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Air
Is existing space heated or conditioned? 0 Yes 0 No c unit CFM
Air conditioning onditioning (site plan required)
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
�� 1- �� 1,a;ir( e. �h pL. State boiler permit no.:
Business name: HP Tons BTU /H
Address: 1' SO 6, CAC ,ti'rN1fl 1 Fire /smokedampers/duct smoke detectors
City: bg n o r t , I State: 01 ZIP: i0 '4'5 Heat pump (site plan required)
� 51 -y 0551_ 0'lq I
Phone: ` '2c ax: E -mail: lnstalUreplacefurnace/burner BTU /H
Including ductwork/vent liner 0 Yes 0 No
CCB no.: -1242-5 Install/replace/relocate heaters - suspended,
City /metro lic. no.: l 12Co wall, or floor mounted
Name (please print): /: [CIS Sg i c1-M-7, Vent for appliance other than furnace ,
CONTACT PERSON Refrigeration:
Absorption units BTU/H
Name: `(SI PNr- \NC' Chillers HP
Address: o P )- t -trlik, Comyressors HP
Environmental exhaust and ventilation:
LA Y$
City: L dSv --&t I State:0— 1 ZIP: 110'5 4 Appliance vent
Phone: 3 — L to Fax: 41'14 - E -mail: Dryer exhaust
OWNER Hoods, Type U lures. kitchen/hazmat
hood fire suppression system
Name: 56 V1t. Exhaust fan with single duct (bath fans)
Mailing address: Exhaust system apart from heating or AC
City: I State: I ZIP: Fuel piping and distribution (up to 4 outlets) .
Type: LPG NG Oil
Phone: Fax: E -mail: Fuel piping each additional over 4 outlets
Process piping (schematic required)
Number of outlets
Name: Other listed appliance or equipment:
Address: Decorative fireplace
City: State: I ZIP: Insert - type
Phone: E -mail: Woodstove/pelletstove
� tt Other:
Applicant's signature: I L•1a^44 ' ` t6 Date: 11 j'1 /01' Other.
Name (print): .)R 1' ' lv1- �G+ AY"
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $
0 Visa ❑MasterCard Notice: This permit application Minimum fee $
expires if a permit is not obtained Plan review (at _ %) $ '
Credit card number: E xpi wi 180 days after it has been ( )
State surcharge (8%) .... $
Name of cardholder as shown on credit card accepted as complete.
$ TOTAL $
Cardholder signature Amount 440.4617 (6/00/COM)
11/07i'2002 07:01 5033310501 ., =50C PLOG ==.137 ;-_• :
TEL NG.E354736 May 10. <0 6:45 P.01
a Plumbing Permit Application
ante reeelved: ; Permit sa:n15i2 .0005
City of Tigard
Addroae: 13121 SW Hall Blvd. Ti arJ, OR 07223
Se.+rr permltno.: Buildlnlprlmlttro.:
Cu7 °8ani Phone: (3103) 639.4171 Pro)ocVeppl.no.: 6tpIredete:
Fax: (S03) 598•1960 Dateiesued: By; I Receipt no.:
Land Ilse approval: Gec file no.: Payment type:
I11'I Iit 1•1i10l1l
. 1,& 2 (unity dwelling or meetsaery O CommetelaJ/induati al CI Multi- fMtlly I O Tenant Improvement
trhiew construction O Addition/alteration/replacement ❑ Food service O Other.
It Pit sill 1 \1IPIO wit P‘ 111 1 4 Ill ID) II I1.• r•. pvrial bane i tt.•Ilntaat.e•/'heck /1
C .11� 15 t - . • _ _:_ -. r - r,� Total
Bldg. no.: Suite nn.:,
New 1• ., ?In y. -ilk. . r.
V R (t ba
Tax roepha:e lot/aboottrtt no,: S e B•� eyesonlyde d.*
FR (1) bath
Cot ' Block: Subdivision: j- ie - • (2 I IIIIII6.
• . 'ad n • a . ; ( ..
Cityfamn :1"fo. ,,. Y► ' �' .. ..
Description and � tlen Of wee* on premise,: ,
Bit. date of - • •Idiom/Ms - dote D .ell c t .. a• ..1Millni
1'11 \Iltl \I. 4 f►\ 111%1 1011 Footle: •rain n0 n. It
r Y ana .clot- •
• Addreer jar .• din l . .. ..
City: jarece a _ .L� , L_ ' Sani tow szoras
Phone: I — o . % IMEZEUN
: ea.: • 5 n, • Plumb. bunt re , no: wfii Ware: u ea no. n, 1111.111111111
CI. Imes o lie. no.: 1:4111111MMIIIIIIIMMIIIII
Contractot'n repteaeotative a • tune: /�.er
It, :■-�• emu' Backwater valve
111\ I 1i I 1 I(.. \fl\ Bislni/lavitory
Name: Clothes washer
Address: Dishwasher
a 'ding foonteln(a)
City: Stud; ZIP: �Icetera/turn QQ
Mom Pau 13 - mail: Ba tatt>r
111% \I Il � III
Name • nt): yr . haw Q. LNG • Floor •.1't n1/floor NI ... u •
Mai1i _ • • rest: is eem, , e .
Cis: }, • ,, • State:. ZIP: - '7 . =11 e r iribb
mow: !g 101 iga (I &mall: . Interco• • • . • . •
Owner Instal a8an/realdenlla1 malnlrnan a only: The actual Insullation - redr(s
will be made by me or the intcrtance and repair made by my muter Root' akin n (commercial)
employee on t e ptopaty 1 own as per ORS Chapter 447. Sink(e) bade e), lava(,) l
Ovmda Data: _ Sum
I \t.l \ 1 I It Tub a owe met ,an MIIIIIMMEI
Urinal ■�
Water closet
Water ales
City: • State: ZIP: Other —
phone: ^ IFNI: Email: Total .
r+e )eusateelamp swig "°as:J.444m tom. intomitali+ Noliee:TAit Minimum fee S
ovba Ow
MCud perrrl i tapplieat;on Planro�lew(at it) S _
` mires
ew° '' • d M' AS o wllhin 110 days aver it hat been Stale attitharge (8%) ...• $
mowed as oom TOTAL S
N../ • / ater*, u duets, a mai we plate.
:
ortbe er drdowe ..._
l Ammo .. - .. ... 4404616 (60000M)
•
06/23/2003 11:23 5036254455 LIGHTHOUSE ELECTRIC PAGE 03
Electrical Permit Application
City Date received: Permit no.:0/57ap03 — OOOS,Z ,
41:1 l City of t Tigard Prvject/appl.no.: - Bxpiredate:
Cory ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date ham: By: 1 Receiptno.:
Phone: (503) 639 -4171 ,
Fax: (503) 598 -1960 Cue file no.: Payment type:
Land use approval:
'i 1TE OF 1'la(llfi
-
t & 2 family dwelling or accessory 0 • erclal/industrial 0 Multi- family 0 Tenant improvement
• New construction 0 A ... ition/alteration/replacement 0 Other, 0 Partial
•
JOB SITE INFORM Ai ION
Job address: j j; r� Bldg. no.: Suite no.: Tax ma • tax lot/account no.:
Lot: A' Block: Subdivision: ;� `r"
Project name: a - ri . • n and location of work on premises: A S t ,
Estimated dare of coca • letion/inspection:
COMERA(7'OI( A l'PLlCA'flON FEE SCHEDULE
;
Job co: _ Fee Max
Business name: d /A -V ' , ' Description Qtr. (ea) Total no. Imp
New raddential -fanny per
Address: �s�i � _ [ i� �� 1)2_ New
eh
'. . J
es aeraed prop.
l �iiM7 IOW , . Sg7'IaIICkolok
Phone: , 'lr. -r ,EZ'l: 1000 •.ft. orless 4
CCB no.: / / 89 7 Elec. bus. lic. n • .3 SGZG Each additional SOO sq• ft. or portion thereof
Limited energy. residential 2
,may metro lic. no.: _ Limited , non. esidential 2
ul / , _z3.03 Each manufactured home or modular dwelling
15 :, . re of su• •• ' ing el _ «r tan (required) Date Service and/or (ceder 2
Sup. elect. name (punt): i Lt
, ceese no: 3a5ZJ' Souk:norfelders- Installation,
alteration or relocation;
PROPEBTV OWNER 200 amps orless 2
Name (print): ' , W 201 amps to 400 amps 2
l��l _ _, / 1 . 401 amps to 600 amps 2
Mailing address: 601 imps to 1000 amps _ 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: 1E- . 1: Recomuctonly 1
Owner installation: The installation is being made on property I own Temporary services or feeden •
which is not intended for sale, lease, rent, or eat ge according to leds0atloa, alteration, orrelo atloa:
ORS 447, 455, 479, 670, 701. too a m less 2
201 antes to 400 amps 2
Owner's signature: _ Date: , 401 to 600 am • s 2
EN GIN E':ER 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: TZIP: B. Fee for branch circuits without purchase '
Phone Fax: p. ); of service or feeder fee, first brooch circuit: 2 •
Bach additional branch circuit:
I'LAN• l(LVIl :1ti (I'Iease check all that apply) Misc. (Service or feeder not included):
O Service over 225 amps•oommerdd 0 Health-care r ility Bach ptunp or irrigation circle 2
O Service over 320ampe- ratingof lde2 0 Hasardoual• •adon Each sign or outline lighting 2
family dwellings 0 Building ov - 10,000 square feet four or Signal circuit(s) or a limited energy panel.
O System over 600 volts nominal more resxdcn. al units in one structure alteration. or extension• 2
0 Building over three atones Cl Roden, 400 • a or more °Dmcription:
O Occupant load over 99 persons O Manufactu • • structures or RV park Each additional Inspection over the allowable In any of the above:
O Egress/lightingplan O Other. Per inapeclion 1 1 1 I
Submit _ sets of plane with any or he above. Investigation fee
The above are not applicable to temporary c .. . - ' la service. Other
' Not sit jortsatcd weep oeweep credit cards, plears eau jurisdiction fix . • - informs/Mo.' Notice: This permit application Permit fee $
O Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $ irl.
Credit card number. I within ISO days after it has been State surcharge (8%) .:.. $ rh'i/n
accepted as complete. TOTAL $ ��
Name of cardholder as shown on eredJJ end S , Il: ►
Cardidder dam - i 440.4615 (6O COM)
X4 1- o 3 —
\ r
• •
. •
1 TREE C • E TI FI CATI O N 1�
S
. ►
• , . ,
• • I, J a5 pi. Po , Owner /Agent for S1 'O IJ - 17 1 NL()01W-01 k4�
•
• (PLEASE PRINT) (PERMIT HOLDER) •
• •
• •
• •
'1
• r. •
1 Do hereby certi t the t• following location
• meets ,Cityof;Tigard /Washington. County ■
• - ■
• land use and development standards for street tree installation. ■
• ■ ■
• ■
• ADDRESS: I 1131 Cj £ J $ U 2,� i )& G' T' . ►
• • •
• LOT: • 1 SUBDIVISION: GOSC —,0 .0 elA cit k•
• •
'1 •
• •
• BY: DATE: 10 121 V ►
't •
• •
I RECEIVED BY: _ / DATE: /Q -l---e/ 2 • •
1 J \
IVTV ,YVVYYYYVVVVVVVYYVVVVVVV YYYVYYYVYVVVVVVVYYYVYVY /eve
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST 3 -000
INSPECTION DIVISION - Business Line: (503) - 4171
BUP
Received — Reque te _ $ 7 AM PM BUP
Location / / 3 7S & Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) ry a SZ () J, SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Acces
Ftg Drain si D _ 3 , 7 ELR
Crawl Drain C—
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing 1 / LAG-
Firewall Fire Sprinkler 1 ' FTC CD \ y D -)i\) \)\ ( As
Fire Alarm tai ��'\
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
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
gh -In
Fire .larm
111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
•ASS PART FAIL
SITE ❑ Please call for reinspecti•n RE: ❑ Unable to inspect – no access
Fire Supply Line /
ADA 6 .6 1 .
Approach/Sidewalk Date In • or -� = ��� Ext
Other:
Final DO NOT REMOVE this Inspection record•fro the job sl .
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 •3 -0 o05`D-
INSPECTION DIVISION - Business Line: (503) 639 -4171
BUP
Received Date Requested C —/ o AM PM BUP
Location I /315 5��� n- GI Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain 1 3 <O 7
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm ' r
Susp'd Ceiling � -
Roof :41 Other: - ����
Final � .t L � VAMILMIlow
SS PART FAIL —
PLUMBING
Toss & Ism
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Other: Pan
Other: Re.- t.15n 2G4 o.1
b
PART eipO\
- HANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final J 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
Approach/Sidewalk Date z F Inspector Ext
Other:
Final DO OT REMOVE this inspects record from the job site.
PASS PART FAIL
CITY OF TI.GARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 CP3--- re 2_
INSPECTION lVISION Business Line: (503) 639 -4171 BUP
?.p
Received 3 : 2 q pvw. Date Requested (07 2..- I AM PM BUP •
Location l / 3 7c" SlcZ-- s wi._p (..)-- Suite MEC
Contact Person ?`VVt_ fo /l o c Ph ( ) 3 �73J ' PLM
Contractor P l .l S r'` Ph ( cJ-r•) J 2 2 -- Z--g5Q 7 SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation 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
OW
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
Dampers
v_1`- . 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 ❑ Please call for reinspection RE: 0 Unable to inspect - no access
,-*Fire Supply Line
'' ADA
D Date �G — 2/ -- Inspector - Ext
Approach/Sidewalk D 3 ector P
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL