Permit IP l
J
CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2002 -00391
DATE ISSUED: 9/12/02
ji�� DEVELOPMENT SERVICES
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11620 SW TERRACE TRAILS DR PARCEL: 2S103CA -04200
SUBDIVISION: TERRACE TRAILS ZONING: R -4.5
BLOCK: LOT: 010 JURISDICTION: TIG
REMARKS: Remodel of kitchen.
BUILDING
REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT:
VALUE: 5 16,000.00
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0.00 sf REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: 1 WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 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 SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1009 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 & 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:
Owner: Contractor: TOTAL FEES: $ 476.72
MOONIER, DENNIS + VICTORIA JEFF HIGDON This permit is subject to the regulations contained in the
MOO
MOO IE TERRACE TRAILS DR JEFF
BOX 309 Tigard Municipal Code, State of OR. Specialty Codes and
TIGARD, OR 97223 FOREST GROVE, OR 97116 all other applicable laws. All work will be done i
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: (503)81 -3732 Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Reg #: LIC 93478 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
PLM /Underfloor Insulation Insp
Plumb Top Out Electrical Final
Electrical Service Plumb Final
Electrical Rough In Final inspection
Framing Insp ;,!��
Issued By : .. - . _ . ___ _ 1 ti ,_ Permittee Signature : ' , -l `• � y
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
s • n :IC: OFFICE USE ONLY
Building
1 Blail�dli>t Per mit A Received 9 Permit No. � 2-0O Q
Date/By: 5 / /
City of Tigard Test Form Planning Approval
Date/By: PermitNo.:
13125 SW Hall Blvd. Plan Review q -9 -6 2 O Other
Tigard, Oregon 97223 Date/By: L /, Permit No.:
l+ Post -Revie ( .. Land Use
Phone: 503-639-4171 Fax: 503 - 598 -1960 � �` ��1 � Date/By: 4 -tO .02 — Case No.
Internet: www.ci.tigard.or.us a . L �"` Contact � s.: ❑See Page 2 for -- D
24 -hour Inspection Request: 503- 639 -4175 Name/Method: -- 4- Supplemental Information I
TYPE OF WORK REQUIRED DATA: 0
❑ New construction ❑ Demolition 1 & 2 FAMILY rq'Addition/alteration/replacement ❑ Other:
CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate
H & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor, r
overhead and profit for the work indicated on this application. C-
F Accessory Building ❑ Multi- Family
❑ Master Builder ❑ Other: Valuation $ 16 000
1
JOB SITE INFORMATION and LOCATION No. of bedrooms: No. of baths:
Job site address: j ) 6„90 `I ,arhic Q j mil ssll Total number of floor
De New dwelling area (sq. ft.) 7
Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: Man 1 i Q Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
Other structure area (sq. ft.)
REQUIRED DATA:
COMMERCIAL - USE CHECKLIST
•
Subdivision: Lot #:
_ Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
ii It / /
Valuation $
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
ROPERTY OWNER ❑ TENANT Type of construction
,7), ,12 Occupancy g Existing: ;
Name: D , c 1 fi ,Wt New:
Address: 116:111 ¢rr4cc.7i41 // D2
City /State /Zip: 7 gie 02 9 7 .9.9 c
Fax: NOTICE: All contractors and subcontractors are required to be
Phone: •
❑ APPLICANT Fa CONTACT PERSON licensed with the Oregon Construction Contractors Board under
/ / provisions of ORS 701 and may be required to be licensed in the
Business Name: ,Z,/,5 �,, epa3 4 M/ jurisdiction where work is being performed. If the applicant is exempt
Contact Name: J., it from licensing, the following reason applies:
Address: Pd. Q 301
City /State /Zip: Frt<T-1 6riVf O(e 97 i/G
Phone: 7P- ) 3' Fax: i5Q - 7749
BUILDING PERMIT FEES*
E -mail: A ee,,s' {/4vc94f,, 4. eory Please refer to fee schedule.
CONTRAC
Business Name: 174,,,,,, /7/ Fees due upon application $
Address: AO. .. , f
City /State /Zip: rES7 Gieve 9 2 / /d Amount received $
Phone: I P- 2 3.2 Fax: 9f a- 9 9 9 ( Date received:
CCB Lic. #: 4 73 / 9e y 6
Notice: This permit application expires if a permit is not obtained within
Authorized 5 d / 180 days after it has been accepted as complete.
Signature: - Date:
/ / *Fee methodology set by Tri- County Building Industry Service Board.
VEFF /711 "
(Please print lame)
•
- l
. Commercial Plan Submittal
Requirement Matrix
City of Tigard
TYPE OF SUBMITTAL # of Plans
(Includes New, Additions or Alterations) Required at
• Submittal
Site Work 4
(must include location of all accessible parking)
Plumbing - Site Utilities 2
Building 1*
•
Fire Protection System 3 **
Mechanical 2
•
Plumbing - Building Fixtures 2
•
Electrical 2
Plan review is dependent upon submittal of a completed application and plans. After
plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for Contractor, City of Tigard,
Washington County, and Tualatin Valley Fire & Rescue).
*For over - the - counter commercial tenant improvements, submit 2 sets of plans. "
• ** "New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
•
is \dsts \forms \COM- matrix.doc 9/24/01
, Pluinl5in g Permit Application FOR OFFICE lu USE ONLY
R ece i ve d Plumbing
Date /By: Permit No.:
Sewer
City of Tigard Test Form Date /By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.: Planning Approval
Phone: 503 639 - 4171 Fax: 503 - 598 - 1960 Date /By:1ew Land Use
Case No.:
Internet: www.ci.tigard.or.us = ** Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name /Method: Supplemental Information.
TYPE OF WORK FEE* SCHEDULE (for special information use checklist)
❑ New construction ❑ Demolition Description I Qty. I Fee(ea.) I Total
ddition/alteration/replacement ❑ Other: New 1- & 2- family dwellings
CATEGORY OF CONSTRUCTION (includes 100 ft. for each utility connection)
SFR (1) bath 249.20
B-1-6r2-Family dwelling ❑ Commercial/Industrial SFR (2) bath 350.00
❑Accessory Building ❑ Multi- Family SFR (3) bath 399.00
❑ Master Builder ❑ Other: Each additional bath/kitchen 45.00
JOB SITE INFORMATION and LOCATIO Fire sprinkler - sq. ft.: Page 2
j/42 Job site address: / /� /44/ �f4, /�Q Site Utilities
Suite #: B ldg. /Apt. #: Catch basin/area drain 16.60
Drywell /leach line /trench drain 16.60
Project Name: /122,4 Footing drain (no. linear ft.) Page 2
Cross street/Directions to job site: Manufactured home utilities 110.00
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.) Page 2
Subdivision: Lot #: Storm sewer (no. linear ft.) Page 2
Water service (no. linear ft.) Page 2
Tax map /parcel:#: Fixture or Item
DESCRIPTION OF WORK Absorption valve 16.60
//, At, -ir,,d /..L Backflow preventer Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
EROPERTY OWNER I ❑ TENANT Ejectors /sump 16.60
Name: Dim it. /7206,4.-z Expansion tank 16.60
�
Address: //AV l�' 04t,172;, � �i Fixture /sewer cap 16.60
City /State /Zip: l�,/ 97,90g e Floor drain /floor sink /hub 16.60
f Garbage disposal 16.60
Phone: Fax: Hose bib 16.60
❑ APPLICANT �� • D eONTACT PERSON Ice maker 16.60
Name: tJ/ ' h' /^' Interceptor /grease trap 16.60
Address: ,4QG ,� ,_ rd Medical gas - value: $ Page 2
- .0v��j+Q 97/ Primer 16.60
City /State /Zip: , : �JJ�� Roof drain (commercial) 16.60
Phone: 9 &-37?.'/ I Fax: Sink/basin/lavatory 16.60
E - mail:
Tub /shower /shower pan 16.60
CONTRACTOR Urinal 16.60
Business Name. f�� � /G_ ,n� Water closet 16.60
,
d' Water heater 16.60
Address: ' (> 1 a I d.) r ? r Other:
City /State /Zip: (-. : I I+ VOro 0 q1 I Z L! Other:
Phone: 93 9- cYe2 V9 Fax: 6 5 `16 l' Plumbing Permit Fees*
Subtotal $
CCB Lic. #: /SO 93 Plumb. Lic. #:.a ? V - voim Minimum Permit Fee $72.50 $
'. Residential Backflow Minimum Fee $36.25
Authorized J'�
Signature: Date / ' / Plan Review (25% of Permit Fee) $
_
.-
/ o
/ State Surcharge (8% of Permit Fee) $
E6
i i't� TOTAL PERMIT FEE $ -
(Please print na e) Notice: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
All new Commercial building require 2 sets of plans with isometric or *Fee methodology set by Tri- County Building Industry Service Board.
riser diagram for plan review.
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information • R "
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - 1" 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' 55.00 7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
-
Water Service - each additional 100' 46.40 Valuation: Permit Fee:
Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
additional $100.00 or fraction thereof, to and
Fixture or Item Qty. Fee (ea) Total including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to
(minimum permit fee $36.25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 $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
Inspection of existing plumbing or and including $50,000.00.
specially requested inspections - per hour 72.50 $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
Subtotal: each additional $100.00 or fraction thereof.
•
Fixture Work:
Are you capping, moving or replacing existing fixtures? If
"yes ", please indicate work'performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees *.
Quantity by (Fixture) Work Performed Comments regarding fixture work:
Fixture Type: Replace
i New Moved Existing Capped
Baptistry/Font'
Bath - Tub /Shower
- Jacuzzi/Whirlpool
Car Wash -Each Stall
-Drive Thru
Cuspidor/Water Aspirator
Dishwasher - Commercial -
- Domestic
Drinking Fountain
Eye Wash
Floor Drain /sink - 2"
-4 "
Car Wash Drain *Note: If the fixture work under this permit results in an
Garbage - Domestic
Disposal - Commercial increase of sewer EDUs, a sewer permit will be issued and
- Industrial fees assessed for the sewer increase must be paid before the
Ice Mach. /Refrig. Drains plumbing permit can be issued.
Oil Separator (Gas Station)
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar /Lavatory
- Bradley _
- Commercial
- Service
Swimming Pool Filter
Washer - Clothes
Water Extractor
Water Closet - Toilet
Urinal
Other Fixtures:
. A4 5Ta� -0
Electrical Permit Application Received FOR OFFICE t U SE ONLY
Date /By: Permit No.:
Of Tigard Planning Approval Sign
City g Test Form Planning Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use
fa Date/By: Case No.:
Internet: www.ci.tigard.or.us � Contact Juris.: ❑ See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 ' W Name/Method: Supplemental Information.
TYPE OF WORK PLAN REVIEW (Please check all that apply)
❑ New construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility
commercial ❑ location •
Addition/alteration/replacement ❑ Other: Hazardous
❑ Service over 320 amps - rating of ❑ Building Building over er 10 10,,0 000 square feet,
CATEGORY OF CONSTRUCTION I & 2 family dwellings four or more residential units in
E -r& 2- Family dwelling n Commercial/Industrial El System over 600 volts nominal one structure
Building Multi -Famil
ID Building over three stories CI Feeders, 400 amps or more
❑ ACCPSSO
Accessory g ❑ y ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder n Other: ❑ Egress/lighting plan ❑ Other:
JOB SITE INFORMATION and LOCATION Submit sets of plans with any of the above.
7---/ The The above are not applicable to temporary construction service.
Job site address: Reale -- etmc,r ..+ Q FEE* SCHEDULE
Suite #: I Bldg. /Apt. #: Number of inspections per permit allowed
Project Name: MA/4 A/C_ Description Qty Fee (ea.) Total
Cross street/Directions to job site: New residential - single or multi - family per
1 dwelling unit. Includes attached garage.
Service included:
1000 sq. ft. or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 1
Subdivision: Lot #: Limited energy, residential 75.00 2
Limited energy, non residential 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
DESCRIPTION OF WORK service and/or feeder 90.90 2
Services or feeders - installation,
/ C / /dL /u /V / alteration or relocation:
200 amps or less 80.30 2
•
201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
®'PROPERTY OWNER El TENANT 601 amps to 1000 amps 240.60 2
Over 1000 amps or volts 454.65 2
Name: a nise _ e _ 0/4 w i t Reconnect only 66.85 2
Address: )/o V re " / / /01 Temporary services or feeders - installation,
alteration, or
City /State /Zip: , �` e 0. 2 / c 2 1 / 200 amps less elocation:
Y
66.85 1
Phone: Fax: 201 amps to 400 amps 100.30 2
❑ Q'CONTACT PERSON 401 to 600 amps 133.75 2
Branch circuits - new, alteration, or
Name: J � / 4,3., / extension per panel: .
A. Fee for branch circuits with purchase of
Address: ,� � /�+ service or feeder fee, each branch circuit 6.65 2
City /State /Zip: (9-
,5 ,'d✓e- c2 9 7// B. Fee for branch circuits without purchase of
Phone: 9 �/ - 3 7 3 02 I Fax: service or feeder fee, first branch circuit 46.85 2
Each additional branch circuit I 6.65 2 .
E -mail: Misc.(Service or feeder not included):
CONTRACTOR Each pump or irrigation circle 53.40 2
• Job No: Each sign or outline lighting 53.40 2
Signal circuit(s) or a limited energy panel,
Business Name: Xgnsss C, 4 G / 04/ a alteration, or extension* 75.00 2
*Description:
City /State /Zip: 1 I g 1° Each additional inspection over the allowable in any of the above:
r
V I l l o Per inspection (per hour - min. I hour) 62.50
Phone: S3 Q - a /(o a 7 Fax: Investigat fee:
CCB Lic. #: '- 9 Lie. #: zit/ -.233 e . Other:
Supervising electrician Electrical Permit Fees*
Subtotal $
si _ ature re. wired: / f� Plan Review (25% of Permit Fee) $
Print Name: 4 /i,v
-- 2 AIM Lic. #: _ . ,. i.s State Surcharge (8% of Permit Fee) $
' ' TOTAL PERMIT FEE $
•
Authorized
l Notice: This permit application expires if a permit is not obtained within
Signatur • �� Date: g //" 180 days after it has been accepted as complete.
�,���Ai/✓ *Fee methodology set by Tri- County Building Industry Service Board.
(Please print ame)
•
CITY OF TIGARD 24-Hour
Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested 0 AM PM _ BUP
Location Z U �ite L MEC
Contact Person 9'10 Ph ( ) 7r3/ _ 373 - z— PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain (J
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors " ti /� „ ,,,,
Ext Sheath/Shear /!X/,/
Int Sheath/Shear n (!
Framing V / �J . ` lJ 1,p,cJ—c;
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
i a I
PASS PART ail
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain •
Shower Pan
Other:
PART FAIL
ANICAL
Post & Beam •
Rough -In
Gas Line
Smoke Dampers
inal
•ASS PART FAIL
E ECTRI • L
Se ice
Roue_ -I I •
UG /S
Low ge
Fir- a lar I
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
"ASS P J FAIL
ITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA /
Approach /Sidewalk Date ® / y �
3 Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST -Th(3'63
INSPECTION DIVISION Business Line:' (503) 639 -4171
BUP
Received Date Requested /� AM BUP
- [.Q�1
Location 1 / c� a l) ` -�P . , Lu-4 Suite P MEC
Contact Person
911 Ph ( ) ? S) - 3 7 3 - PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear _
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
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
Smoke Dampers
Fin
ASS PART FAIL
CTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Anal 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 9
Approach /Sidewalk Date /. ^ 2 d Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST i Z- 3 y
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested / v / AM PM BUP
Location / / c ' Z) -S c-c) Teera ce Tru r ( Or Suite MEC
Contact Person Ph ( SZ3 ) 7e/ -3 73 2 - PLM
Contractor Ph ( ) SWR
_ Tenant/Owner ELC
noting ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear �� Alo
Framing «'
Drywall Nai'ng
Fi rewal I
Fire Sprinkl -r
Fire Alarm
Susp'd C- ing
Roof
Other:
Fi -
PART FAIL
• BING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
VECTIKRIC
Post & Beam
Rough -In
5rnoke Dampers
Final
PASS PART FAI
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Anal ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA Date ` ' ! �
Approach /Sidewalk Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST — X
INSPECTION DIVISION Business Line: ' (503) 639 -4171
BUP
Received Received Date Requested / AM PM BUP
Location • _III - %- / uite — MEC
Contact Person ' / Ph ( ) 7S ( 3 3 2- PLM
Contractor / / Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear _
IntSair.Shear 0/Li L Ear e-,/ 44_4 J
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Fi
PASS PART FAIL
P BING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
•
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for rei spection RE: El Unable to inspect — no access
Fire Supply Line
ADA 2 Y., p
Approach/Sidewalk Date C/ Ins actor E7ct
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGAF3®
24 -Hour ■
BUILDING Inspection Line: (503) 639 -4175 MST Z D 39 (
INSPECTION DIVISION Business Line: ' (503 639 -4171
BUP
Received _ Date Requested 9—, Y' AM PM BUP
Location ll' 2-U 5 c /tt,vru ce t / D)' Suite MEC
Contact Person Ph ( ) 78/ - 37. 2 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation
Access: ■
Ftg Drain ` ELR
Crawl Drain r
Slab Inspection • t -s: SIT
Post & Beam /
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final 1)
PASS PART FAIL
Post & Beam
Under Slab
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
QV Fi
—
PART FAIL
CHANICAL
Post& Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Anal 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 / I Inspector /` i Ext
Other:
Final DO OT REMOVE this inspection record from the job site.
PASS PART FAIL
ep
CITY OF TIGARD _ 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST ,„/ -0 03 /'
INSPECTION DIVISION Business Line: • (503) 639 -4171
BUP
Received Date Requested / — o AM PM BUP
Location 2.0 / Ge � Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Anal AMM7a=ffrAttaki&m,
PASS PART FAIL
PLUMBING C
Post & Beam —
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain —
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post& Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
1 4 •ART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
E] Please call for reinspection RE: 111 Unable to inspect — no access
Fire Supply Line
ADA `? Approach/Sidewalk Date Y' l Inspector " etici Est
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST 2 — O o 3'/
INSPECTION DIVISION Business Line: " (503) 639 -4171
BUP
Received Date Requested 0AM PM BUP
Location 2— • — -' J. _ Suite MEC
sk
Contact Person Ph ( ) 53 7 -- (Co - PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation Access: G7=41-) 16).4-sr
Ftg Drain ( / (``
' � ( v ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
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 FAIL
• CTRICA °°
Service
ab
Low Voltage
Fire Alarm
Fi ��,�� El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
c f !�) PART FAIL
Please call .r reinspecti• n RE: El Unable to inspect – no access
Fire Supply Line
Approach /Sidewalk Date ( — inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL