Permit CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2003 -00245
� DEVELOPMENT SERVICES DATE ISSUED: 7/22/03
'� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12240 SW THORNWOOD DR PARCEL: 2S110BC -TS026
SUBDIVISION: THORNWOOD ZONING: R -7
BLOCK: LOT: 026 JURISDICTION: TIG
REMARKS: Construction of new SF detached residence.
BUILDING .
REISSUE: DM170 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 27 FIRST: 1,497 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,693 sf GARAGE: 494 sf FRONT: 15 PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5
VALUE: 310
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3,190 sf REAR: 15
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: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOILICMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1
GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4
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: 6 201 - 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 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPERRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 5,870.19
DON MORISSETTE HOMES DON MORISSETTE HOMES INC This permit is subject to the regulations contained in the
4230 GALEWOOD ST 4230 GALEWOOD ST, STE 100
Tigard other r applicable a law State work k w Specialty Codes and'
all other applicable law All work will be done i
STE 100 LAKE OSWEGO, OR 97035 t
accordance with approved plans. This permit will expire if
LAKE OSWEGO, OR 97035
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 adopted by the
Phone: 503 387 - 7538 Phone: Oregon Utility Notification Center. Those rules are set
5 3 � 3g forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
L
Reg a: R3 3 87 3 7 5 5 5 8 may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Erosion Control Insp & Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Water Service Insp
Grading Inspection Post/Beam Mechanical Plumb Top Out Exterior Sheathing Insl Rain drain Insp Appr /Sdwlk Insp
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Storm drain Insp Electrical Final
Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Roof Nailing Mechanical Final
Foundation Insp PLM /Underfloor Framing Insp Gas Fireplace Water Line Insp Plumb Final
Issued By S _ ✓i1 Permittee Signature : , — a- ?
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
I o ?T: 7_,, - 03 'x:,.03 4,0,,—
._
, A . Building Permit Application
�• j��i Cl of Tigard , : , . . Date received6 G j Permit no.: j l '7 __69,6,944 S
�=- �- Project/appl. no.: Expire date:
City ofTigard 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: : ," , , ,_ ,, 1 &2 family: Simple Complex:
TYPE OF PER111T
0 1 & 2 family dwelling or accessory O Commercial/industrial O Multi- family ,'New construction O Demolition
O Addition/alteration /replacement O Tenant improvement O Fire sprinkler /alarm O Other.
;,, .,, ^.,. JOB SITE Ii TOlt lATION........
Job address: (a i IZEW r Y Bldg. no.: v ,,
Suite no.:
Lot: fir' Block: Subdivision: f Oi)� Tax map /tax lot/account no.:
Project name: Z -1 . r 11 O 1`„,: _ • 1 .
Description and location of work on premises/special conditions: , ` - 8: ` - r
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
_tli 7; Milivit.41611 (;lsloodplain,septiccapacity , solar,etc.)
Mailing address: 'empxi mragga�� rai I& 2 family dwelling:
EsitanommummEmA ZIP: /WA= Valuation of work $
Phone :. roilfir.alUffiga�': No. of bedrooms/baths i
Owner's representative: , Wri e Mr if _ Total number of floors i, } �(
Phone: Fax: E -mail: New dwelling area (sq. ft.) . l . l ir,
APPLICANT Garage/carport area (sq. ft.) .f . -1 maw
�� � Covered porch area (sq. ft.)
Mailing address: �Lv ♦ _ Deck area (sq. ft.)
City: State: ZIP: Other structure area (sq. ft.) •
Phone: Fax: E -mail: Commercial/industrial/multi- family:
CONTRACTOR Valuation of work $
, Business name: bk,A L (I] �
Existing bldg. area (sq. ft.) •
Address: R. v `i New bldg. area (sq. ft.)
Number of stories
City: State: Type of construction
Phone: Fax: E -mail:
CCB no.: Occupancy group(s): Existing:
New:
City/metro lic. no.:
Notice: All contractors and subcontractors are required to be
' ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
=y provisions of ORS 701 and may be required to be licensed in the
Address: ,L ` • c i I jurisdiction where work is being performed. If the applicant is
City: State: ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: State: ZIP: Amount received $
Phone: Fax: 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. A . rovisions of 1 ws and o dinances governing this 0 visa 0 MastesCard
work will be compll wt • • , whether ified i1erei pr�ot. � ` � Credit card number. / /
� � �
Authorized sly ate / . � e. - (P Name of cardholder as shown on credit card Expires
Print name: �!> T .-Fe Vial
(._ Cardholder signature $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6AO/COM)
One - and Two -Family Dwelling
..,,, Building Permit Application Checklist Reference no.:
Associated permits:
City of Tigard an
City of Tigard 'J g 0 Electrical 0 Plumbing ❑ Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 O Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 •
T11E FOLLOWING ITEMS:ARE REQUIRED FOR PLAN REVIEW - Yes 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.
•
3 Verification of approved plat/lot.
4 Fire district approval required.
5 Septic system permit or authorization for remodel. Existing system capacity
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 0 plan ❑ permit required. Include drainage -way protection, silt fence design and location of �/
catch -basin protection, etc. J�
10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state
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 t/
if copyright violations exist. J�
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 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 x
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 and location. ` X \
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, X
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
over 10 feet long and/or any beam/joist carrying a non - uniform load. x
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
architect licensed in Oregon and shall be shown to be applicable to the project under review.
JURISDICTIONAL 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 ". x
24 Two (2) sets each are required for Items 16, 19, 20 & 22 above.
25 Building plans shall not contain red lines or tape -ons.
26 No rolled, reversed or mirrored building plans will be accepted.
27
28 •
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 4404614 (6+t70/COM)
. Mechanical Permit Application
Date received: Permit no.: /y /7 ;416 0, -
l I!, City of Tigard E I V L1_
.. �
�,I:° "1 Project/appl. no.: Expire dace:
City of Tigard Address: 13125 SW Hall Bl Igar , OR 97223 Date issued: By: I Receiptno.: _ •
Phone: (503) 639 -4171 O ZU
Fax: (503) 598 -1960 J I 1 %1 Case file no.: Payment type:
Land use approval: CITY OF TIGARD Building permit no.:
.I r DIVISIUIv
TYPE OF PERMIT
•
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement •
X New construction 0 Addition/alteration /replacement 0 Other.
JOB'.SITE INFORiMATION COMMERCIAL VALUATION SCHEDULE •
. Job address: 1 Ta U ' = k y , Indicate 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: 4 ., / Block: Subdivision: r 114L a. 4 'See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: I ZIP: 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: AND COMMERICAL/INDUSTRIAL EQUIPMENTSCIIEDULE
Fee(ea.) Total
Est. date of completion/inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? 0 Yes 0 No Air handling unit red)
g P Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No _ Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
��}� State boiler permit no.:
�S /�i� /��i HP Tons BTU/H
Address: delirwb_ Fire/smoke dampers/duct smoke detectors
City: I,I r IIMMEM ZIP: irec7 Heat pump (site plan required)
Phone: _Aop _ Fax: E -mail: Install/replacefurnace/burner BTU /H
Including ductwork/vent liner 0 Yes 0 No •
CCB no.: '?,r9' -- (,) Install/replace/relocate heaters –suspended,
City/metro lic. no.: N/A wall, or floor mounted
Name (please print): • ip t "Aim' ( / _ Vent for appliance other than furnace
Refrigeration:
CONTACT PERSON
�_ IM Absorption units BTU/H
i1Vii'ii Chillers HP
Address: Com.ressors HP
— ♦ �t Environmental exhaust an ventilation:
City: State: ZIP: Appliance vent
i Phone: Fax: E -mail: Dryer exhaust
OWNER Hoods, Type U 11/res. kitchen/hazmat
�.� hood fire suppression system
_�.iu GJ•!� J �l <L Exhaust fan with single duct (bath fans) •
Mailing address: littj r / � 7 _ s�drj7il Exhaust system stem apart from heating or AC
., Fuel piping and distribution (up to 4 outlets)
City: • rj♦� Type: LPG NG Oil
Phone: 2 E - mail: Fuel piping each additional over 4 outlets
ENGINEER Process piping (schematic required)
Name: Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: [ State: I ZIP: Insert - type ,
Phone: / Fax:
lsff E Woodstove/pel
•T\ PP g _�.f f r l� ak= Other A licant s si Hats" : Date: o
Name (print): .e••• - * .'a , ' I _
Na credit all jurisdictions accept edit cards. please call jurisdiction for more information. Permit fee $
Notice: This permit application Minimum fee $
r edit card number: Visa 0 MasterCard expires within ISO days after it has been ires if a permit is not obtained Plan review (at _ %) $
Cr Expires ( )
complete.
red as lete. State surcharge (8 %) .... $
Name of cardholder as rhown on credit card accepted P TOTAL $
Cardholder signature Amount 440 -4617 (600/CON)
Plumbing Permit Application . .
Date received: P e rmit no.: yye !,-1 2i3�?! .� � c� :2(45
>> {dt • City of Tigard 2 I y g I�:1 r Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd. Tigardi 972�23z....,
. •
Ciry ofTigard Phone: (503) 639 -4171 ls..i 1 Y U f- j i+af4,-1 Projecdappl.no Expiredate:
Fax: (503) 598 -1960 BUILDING DIVISION Date issued: By: I Receiptno.:
Land use approval: Case file no.: Payment type:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
Vew construction 0 Addition/alteration/replacement 0 Food service 0 Other -
' JOB SITE'INFORMATION' - FEE SCIIEDUE (for special information use checklist)
Job address: I .. i • 0 G 0 1110f \ I -`• D f Description Qty. Fee(ea.) Total
New 1 - and 2- family dwellings only:
Bldg. no.: Suite no.: (indudes 100 ft. for each utility connection)
Tax map /tax lot/account no.: SFR (1) bath
LoL r ' Block: Subdivision: /�,�] �;� SFR (2) barb
Project name: SFR (3) bath
City /county: I ZIP: Each additional bath/kitchen
_ Description and location of work on premises: Site utilities:
Catch basin/area drain
Est. date of completion/inspection: Drywells/leach line/trench drain
— Footing drain (no. lin. ft.)
I'LL11131NCr CONTRACTOR Manufactured home utilities
Business name: IN ` 7 L. ' Manholes
'
Address: ° Rain drain connector
City: . ��
�/, ZIP Sanitary sewer (no. lin. ft.)
�' Storm sewer (no. din. ft.)
Phone:( -'3L.+ Fax: E-mail: ' Water service (no. lin. ft.)
-
CCB no.: [ (Q; Z L( -] I Plumb. bus. reg. no: - - Fixture or item:
City/metro lic. no.: N/A l ' -- Absorption valve
Contractor's representative signature /] .� _ Back flow preventer
` all
Print name: , n� ot Backwater valve •
CONTACT PERSON Basins/lavatory \ ` Clothes washer
Name: ` 1 � ��I lJ E Dishwasher
Address: _ iliA / , V ' Drinking. fountain(s)
City: 1 State: ZIP: ' Ejectors/sump
Phone: - Fax: E -mail: Expansion tank
Fixture/sewer cap
,i., �, Floor drains/floor sinks/hub
Name (print): \ \S h 1 E 't , I , Garbage disposal
-Lb?. [-
Mailing address: -y " • �1rvT ` -L Hose bibb
City: L..0 , State , ZIP:q - )0? , Ice maker
. Phone: j . - [F _7-7I 1 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 as per ORS Chapter 447. Sink(s). basin(s). lays(s)
Owner's signature: Date: Sump
Tubs/shower /shower pan
Urinal
Name: ' Water closet
Address: Water heater
City: I State: ZIP: Other.
Phone: I Fax: I E -mail: Total
Minimum fee $
Na u
all jurisdicons accept credit cards, please rill jurisdiction for more information. Notice: This rmit a lication
Pe PP Plan review (at _ %) $
0
Visa 0 MasterCard expires if a permit is not obtained State surcharge (8%) .... $
C.edit card number. Expires w ithin 180 days after it has been TOTAL $ ----
accepted as complete.
Name of cardholder as shown ors credit card
S
Cardholder signature Amount 410-1616 (6K000M)
Electrical Permit Application
Date received: Permit no.: #157,90A • 6Q�
. • ,
w. t fit) . I
_ j, I � City of Tigard p r p I `, Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall BI d, Figand!OR 9V22.3.1.., Date issued: By: I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 JUN 1 0 2003 Case file no.: Payment type:
Land use approval: CFT 'i OF T IC;
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
v New construction 0 Addition/alteration/replacement 0 Other. 0 Partial
. - - JOB SITE INFORMATION. , • • . ..
Job address: % 1 �% -Bldg. no.: Suite no.: Tax map /tax lot/account no.: .
Lot: , J Block: Subdivision: 1 VU7)7
Project name: I Description and location of work on premises:
Estimated date of completion/inspection: .
CONTRACTOR Al'I'I.ICA I l(N FEE SCHEDILE -
Job no: Fee . Max
Business name: CA`jt. -) a_E[��*_.1 C, Description Qty. (ea.) Total no. Iasp
New residential - single or multi - family per
Address: . , II `` e(g. - �" dwelling unit . Includes attached garage.
City: "1 (•A State: ! ZIP: Ct - 7 2, Service included:
Phone:4424.3 I Fax: 1E -mail:
1000 sq. ft. or less 4
a ed a C.--
Each additional 500 sq. ft_ or portion thereof
CCB no /40.44,....4. I Elec. bus. lic. no: Limited energy, residential 2
C: Limited energy, non - residential 2
Each manufactured home or modular dwelling
Ma ture of supervising electrician (requ Date (l/ �z Service and/or feeder 2
Q cc Services or f
installation,
Sup. elect. name (print): 1 License no:
/ OZ7 alteration or relocation:
l�r 200 amps or less 2
a
Name (print): , ` 1 5 . 1-kr* l� ? 201 amps to 400 amps 2 2
! 401 amps to 600 amps •
Mailing address: 01 _• *C 601 amps to 1000 amps 2
City: L,O, State ZIP: '7D Over 1000 amps or volts 2
Phone: /7- =j? Fax:f 57- 71, E-mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
installation, alteration, or relocation:
which is not intended for sale, lease, rent, or exchange according to 200 amps or less 2
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER 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: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) MLsc. (Service or feeder not included):
irrigation circle 2
or irri
ump g
O Service over 225 amps- commercial 0 Health -care facility Each pump 2
O Service over 320 amps - rating of 1&2 0 Hazardous location Each signor outline lighting
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or extension* 2
O Building over three stories 0 Feeders, 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lighting plan 0 Other. Per inspection I I 1
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Permit fee $
Na all jurisdictions accept credit cards, please call jurisdiction for morn information. Notice: This permit application Plan review (at _ %) $
0 Visa 0 MasterCard expires il'a permit is not obtained
Credit card Dumber. / / within 180 days after it has been State surcharge (8%) .... $
Expires TOTAL as complete. TOTAL $
Name of cardholder as shown on credit card
S •
Cardholder signature Amount 440-4615 (6,VWCOM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MS —00 2 qs
INSPECTION DIVISION - Business Line: 1503) 639 -4171
BUP
Received 1 /hi 3 (• 5 2Date Requested / Z42/2 3 AM PM BUP
Location 1 2 Z 4/0 �7 c. Z'?C -t' r Suite MEC
Contact Person 2 / Ph ( ) q — «f 37 PLM
/
Contractor Q �`) i44' Ph ( ) SWR
�UIL�[ 1Pr� 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:
P IIDIIP � FAIL
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
• PART FAIL
AN1CAL
Post & Beam
Rough -In
Gas Line
A e Dampers
.
�0' FAIL
- RIC
Service
Rough -In
UG /Slab
Low Voltage
Final )
Ap PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
El Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA D a/ Z / �� Inspector Ext
Approach/Sidewalk P
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 7' 02 y s�
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date RR-quested 9 AM PM BUP
Location / - Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing ``
Insulation 1 (ZON o �. W { R� No) 01 01.Eo S�A�
Drywall Nailing
Firewall
!!!
Fire Sprinkler
Fire Alarm /
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING 0O 1 J- -0 LED E W 1 RAN
Post & Beam V� O 11 a
Under Slab �EhJ S' - N N E
Rough—In
Water Service EX—
Sanitary Sewer
Rain Drains $cri
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
ervice
ou /0-a'
UG /Slab
'CrATcria&Z=
Fire Alarm
�,�� Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA n , �Q
Approach/Sidewalk Date 1 , b 63 Inspector N W Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL