Permit .ti
. A CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2003 -00477
/1+t1' DEVELOPMENT SERVICES DATE ISSUED: 1/20/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12350 SW THORNWOOD DR PARCEL: 2S110BC - 06000
SUBDIVISION: THORNWOOD ZONING: R -7
BLOCK: LOT: 031 JURISDICTION: TIG
REMARKS: Construction of new SF detached residence.
BUILDING
REISSUE: DM170 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,570 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,620 sf GARAGE: 407 sf FRONT: 15 PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5
VALUE: 308,962,10
OCCUPANCY GRP: R3 BDRM: 5 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: 4 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 & 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: $ 5,896.47
This permit is subject to the regulations contained in the
DON MORISSETTE HOMES DON MORISSETTE HOMES INC Tigard Municipal Code, State of OR. Specialty Codes and
4230 GALEWOOD ST 4230 GALEWOOD ST, STE 100 all other applicable laws. All work will be done in
STE 100 LAKE OSWEGO, OR 97035 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
forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
Reg #: may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Erosion Control lnsp & Post/Beam Structural Mechanical lnsp Shear Wall lnsp Insulation lnsp Water Service Insp
Grading Inspection Post/Beam Mechanical Plumb Top Out Exterior Sheathing Ins Gyp Board Insp Appr /Sdwlk Insp
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Rain drain lnsp Electrical Final
Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Storm drain lnsp Mechanical Final
Foundat Ins PLM /Underfloor Framing lnsp Gas Fireplace Water Line lnsp Plumb Final
i�Q �� Permittee Si nature : ,
Is ued By : g . 1� �. ► .1 /
Call (51 .39 -4175 by 7:00 p.m. for an inspection needed the next business day
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Building Pe lion
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"' City of Tigard ► pp Datereceived , / 8 Permit no.:/. C e -avy 77
City ofTigard
Address: 13125 SW Hall B rTi , 337223 Project/appl. no.: Expire date:
Phone: (503) 639 -4171 Date issued: By 1 4, I Receipt no.:
Fax: (503) 598 -1960 CITY OF TIGARD Case file no.: Payment type:
Land use approval BWLDlNG DIVISfON 7l } 1 &2 family: Simple Complex:
. . TYPE'OF PERMIT '
❑ 1 & 2 family dwelling or accessory Cl Commercial/industrial 0 Multi- family y 'New construction 0 Demolition
0 Addition/alteration/replacement 0 Tenant improvement Cl Fire sprinkler /alarm 0 Other:
_ JOB SITE INFORMATION
Job address: . 2j V �'JI f� 0 Bldg. no.: Suite no.: U1
Lot: 3 Block: Subdivision: '1 (1 q) j Tax map /tax lot/account no.:c2S / /O,tg;✓ — 0,4eva
Project name: ? _ 7
Description and location of work on premises/special conditions:
' -OWNER FOR SPECIAL INFORMATION, USE CHECKLIST r
Name: •,1 ' Y' - R p (Floodplain, septic capacity, solar, etc.) S
Mailing address: . .- JA
A; .L l J' f C 4 ) 1 & 2 family dwelling:
- 4 1 ZIP: ' '7'> •3� Valuation of work $
r _______„..
Phone:. �J te r, No. of bedrooms/baths
Owner's representative: , La _ Total number of floors 9
Phone: Fax: E -mail: New dwelling area (sq. ft.) ,
44.� ` Ut.) L ie)
{. 5�- K.a ♦J I ,qR.,> =�APP CA -�.. � , _ „^"wy .. Garage/carport area (sq. ft)
Name: \)Cs ,� vic,,, tyle,S Covered porch area (sq. ft.)
Mailing address: 11 a a Deck area (sq. ft.) -
City: I State: I ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/industrial/multi- family:
CONTRACTOR Valuation of work $
Business name: k Y1 - , .
Existing bldg. area (sq. ft.)
Address: 4 Aka L, �L
New bldg. area (sq. ft.)
C
City: State: ZIP: Number of stories
Phone: I Fax: I E -mail: Type of construction
CCB no.: Occupancy group(s): Existing:
New:
City/metro lie. no.: Notice: All contractors and subcontractors are required to be
. ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: ( - l et i ,k ., � provisions of ORS 701 and may be required to be licensed in the
Address: c ,. �y� CL C Y5 jurisdiction where work is being performed. If the applicant is
City: State: I 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: VIP: Amount received $
Phone: I 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. A . rovisions of 1 ws and ordinances governing this 0 Visa ID MasterCard
work will be compl -' wi whether sb cifiedlere i ot. Credit card number: / /
�
Authorized sl atu, !j �
, ' i i £ - t j V �[e: 'I r U3 Name of cardholder as shown on credit card Expires
$
1/�
Print name: �: ' ; 4'2..41. ! ( .�
Cardholder signature Amount
; : , ice- This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6ro0/COM)
One- and Two - Family Dwelling
,;lny; Building Permit Application Checklist Reference no.: .
City of Tigard City of Tigard Associated permits:
`J g 0 Electrical 0 Plumbing 0 Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 0 Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
THE FOLLOWING ITEMS ARE REQUIRED,EOR PLAN REVIEW Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. V
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. X
8 Soils report. Must carry original applicable stamp and signature on file or with application.
9 Erosion control 0 plan 0 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 r/
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-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 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.
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. J�
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. ' X \
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. /1
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. 440-4614 (doo/COM)
, Mechanical Permit Application .
� Date received: Permit not 67 j 5 1 ) _ ,•:,. >
'`Y'rk• I ^
�,i j, -•� , City of Tigard EC E I vv D Projecdappl. no.: Expire date:
City ojTigard Address: 13125 SW Hall Blvd, Tigard, OR 972
Phone: (503) 639 -4171 .2 Date issued: By: Receipt no.: _
Fax: (503) 598 -1960 SEP 2003 Case file no.: Payment type:
Land use approval: CITY OF TIGARD Building permit no.:
B ■ , _ _
TYPE OF PERMIT .. • .
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement •
X Iew construction 0 Addition/alteration /replacement 0 Other.
' ' JOB SITE INFORMATION - COMMERCIAL VALUATION SCHEDULE - .
. Job address: ? `) Vv i' / * 9 / Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax ma /tax lot/account no.: � profit. Value $ •
Lot: ( Block: Subdivision: ►/ .€r (1,VIJZZ `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 COMMERICALIINDUSTRIAL 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 CFM
g P Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
MECFIAN !CAL .. CON"1RnCTOR Boiler /compressors
�}� State boilerPermit no.:
' _ HP Tons BTU/H
Address: fl��b_ Fire/smoke dampers/duct smoke detectors
City: Wei r Ems ZIP: it m Heat pump (site plan required)
Phone: - Fax: E -mail: Install/replace furnace/burner BTU /H
Including ductwork/vent liner 0 Yes 0 No
CCB no.: '?,, 5(,) install/replace/relocate heaters -suspended,
City/metro lic. no.: N/A wall, or floor mounted
Name (please print): ' . eel
1 1Jj r.la._c___ Vent for appliance other than furnace
Refrigeration: ptio
CONTACT PERSON
Abso units BTU/H
IEEE A % ,-- i EU_. Chillers HP
Address: Compressors HP
' ..a �' � l Environmental exhaust and ventilation:
City: State: ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
OWNER Hoods, Type U lures. kitchen/hazmat
hood fire suppression system
IngfilIMWI 9 airiredi Exhaust fan with single duct (bath fans)
Mailing address: ir joaltira all 7 Exhaust system apart from heating or AC
� �
�� T ,� i . Fuel piping and distribution (up to 4 outlets) II EMS- it:'itif��� LPG NG Oil
Phone: j2 Fax: 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: I State: I ZIP: Insert - type
Phone: Fax: //'' -mail: Woodstove/pelletstove
Other:
PP e rS/i IPSW SIM Other
Applicant's si�natu ": Date:
Name (print): ', ` 1 • '
P Permit fee $
Na all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Minimum fee $
0 Visa 0 MasterCard expires if a permit is not obtained / Credit card number: Expires / w i t hin 180 days after it has been Plan review (at %) $
p State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete.
S TOTAL $
Cardholder signature Amount 440 -1617 (•a'COM)
Plumbing Permit Application _ . . -
Datereceived: Permit no.: ( i - 7
oili; City of Tigard
Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Bgard. OR 97223 ire date:
City ojTigard Phone: (503) 639 -4171 CEr VE Projecbappt. no.: P
Fax: (503) 598 -1960 D Date issued: By: Receipt no.:
SE ' f . Case file no.: Payment type:
Land use approval: 11
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory ltkftnazi5R 7 Qdustrial 0 Multi - family 0 Tenant improvement
►. New construction 0 Addition) alUa ion/replacement 0 Food service 0 Other.
JOB STIEINFORMATION FEE SCHEDULE (for special information use checklist)
Job 1 Description Qty. Fee(ea.) Total
Bld address: S� IAA( X11 �� New 1- and 2- family dwellings only:
Bldg. no.: Suite no.: (includes 100 ft. for each utility connection)
Tax map /tax lot/account no.: SFR (1) bath
Lot: _ Block: Subdivision: lir " I 1 SFR (2) bath MI
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 _ _ _ I'LL'M113ING CON•I RAC TOR Manufactured home utilities
Business name: ` P 1 r Manholes Address: %t�i�MIEM, Rain drain connector IIII ZIP: Sanitary sewer (no. lin. ft.)
Phone: Storm sewer (no. lin. ft.) Fax: / E -mail: Water service (no. ln. ft.) : no.: • "7l- I Plumb. bus. reg. no: _ Fiture or item: Ciry /metro lic. no.: N/A Absorption valve
Contrsctors representative signature ✓ (/ s Back flow preventer
� Print name: m' Backwater valve
CONfAC r PERSON Basins/lavatory Clothes washer Name: - , ` ' Dishwasher Address: ' A i 0 0 e . , - Drinking fountains)
City: State: ZIP: Ejectors/sump
Phone: Fax: E -mail: Expansion tank
O W N E R Fixture/sewer cap _ Floor drains/floor sinks/hub II
Name (print): Garbage disposal
Mailing address: 1 Hose bibb ==
City: L ._ -) . EWA ZIP: o l`Jg Ice maker
Phone: f , - Fax: WerarTIMall 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) IIIII
employee on the property I own as per ORS Chapter 447. Sink(s), basin(s). lays(s)
Owner's signature: Date: Sump
ENGINEER Tubs/shower /shower pan
Urinal
Name: Water closet
Address: Water heater
City: State: ZIP: Other.
Phone: Fax: E -mail: Total i
Minimum fee $ -----
. Not all Jurisdictions accept credit cards. please call lunsdicuon for more infomuuon Notice: This permit application Ol
Plan review (at _ %) $
O Visa 0 MasterCard a spires if a pc-mit is not obtained State surcharge (8%) • -•• $
C.edit card number. w ithin 180 days after it has been
Expires TOTAL $ ---' --
accepted as complete.
Name of cardholder as shown on credit card
S 4.40-4616 ( OM)
Cardholder signature Amount
. , .
. 4,, Electrical Permit Application
Date received: Permit no.: - O/ 5/7 (
11. City of Tigard RECEiv Project/appl.no -: Expire date:
City o f Tigard Address: 13125 SW Hall Blvd, Tigard, 7 Date issued: By: Receipt no.:
Phone: (503) 639 -4171 SEP 2 Case file no.: Payment Fax: (503) 598 -1960 1003 y type'
Land use approval: f;iry O T, QARu
FATE OF PERMIT . .
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial 0 Multi- family ❑ Tenant improvement
v New construction 0 Addition/alteration /replacement ❑ Other. 0 Partial
. • • • - - •• • • - JOB SITE_INFORMATION • -
Job address: L j • / ' / ., Bld:. no.: Suite no.: Tax map /tax lot/account no.:
Lot: ( Block: Subdivision: ‘111vprek, / •
Project name: I Description and location of work on premises:
Estimated date of completion/inspection:
•'• ' '' `--," CONTRACTOR i \PP1 :ICA"LI ON— • ,;- .. SCHEDULE. • • ,
. , ..FEE -.,,:. - ,
Job no: I 06 Fee - Max
Business name: CA" T\.1 EL CV I Description Qty. (ea.) Total no. lase
• N ew res - single or multi- family per
Address: gip Iv dew_ E - dwelling unit. Includes attached garage.
City: a • L 1.♦ i' 4 �j'ra Service included 4
Phone:14L - I .: Fax: E -mail: 1000 sq. ft. or less
� 0 l it � •
Each additional 500 sq. ft. or portion thereof —�
CCB no.: Elec. bus. lic. no: ( Limited energy, residential 2
C Limited energy, non - residential 2
Each manufactured home or modular dwelling
I nn – ature of supervlstng electrician (required) Date Service and/or feeder 2
License no: Services or feeders– installation,
Sup. elect. name (print): ....as 9 Ai.. r!! � alteration or relocation:
PROPLR'FY OWNER 200 ampsorleas 2
( VA c � 1 5 � r � 201 amps to 400 amps 2
Name (print): V]� ` 7 401 amps to 600 amps
Mailing address: X ) l obso 5". 13, 601 amps to 1000 amps 2
Cit (_,C, IState 17 ZIP:9 70 Over 1000 amps or volts 2
Phone:F7 - } Fax: -7b($E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders - -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation:
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: I 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) Misc. (Service or feeder not included):
O Service over 225 amps- commercial 0 Health -care facility Each pump or irrigation circle 2
O Service over 320 amps rating of I &2 0 Hazardous location Each sign or outline lighting 2
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
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Permit fee $
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application $
O 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 credit card
s
Cardholder signature Amount 440-4615 (600/COM)
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Do hereby certify that the following location ■
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A Do hereb h i i;i- I o 1. • 1 a : location ►
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1 RECEIVED BY: DATE: ■
•
CITY OF TIGARD 24 -Hour -7
BUILDING Inspection Line: 031639 -4175 •
MST 3 -- e 0 9 / 7
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested '�7' ~ 4 AM PM BUP
Location ) oZ -3 74 - 7) Suite MEC
Contact Person �'��� Ph ( ) 0 4L(37 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fi rewal I _
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 PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
P PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA 4 II
Date - b Inspector G+ Ext
Other:
Approach/Sidewalk - /1
V
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
9
CITY OF TIGARD 24 -Hour •
BUILDING Inspection Line: (503) 639 -4175 MST 3 ` 4/77
INSPECTION DIVISION Business Line: (503) 639 -4171
/ BUP
Received Date Requested 7 o AM PM BUP
Location /O 3 S) 7 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 1 _
Framing omit
■
Insulation ' ✓ lf
Drywall Nailing — ��'-
Firewall / f
Fire Sprinkler
Fire Alarm A I I Ir7 r7Miri / i
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:
P'
4017 FAIL
MECHA AL
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 III Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line Y
ADA
Approach /Sidewalk Date iln8pecftor 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
4 03 . ---6,0
INSPECTION DIVISION Business Line: (503) 639 -4171
�� �D , / BUP
Received �/ 7'4 Date Requested 7 - 0'7' AM PM BUP
Location / 23 c56 eduite MEC
Contact Person Ph ( ) X 09 — 4"1, 3 '7PLM
Contractor Ph ( ) 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 0 CA - 0 ? �Z- ° �2 �. 67, CI90 X c 5r -- Port "c? 4--
I nsulation
Drywall Nailing S ' / �� AEG 7 w 7 72
Fi reveal I
Fire Sprinkler ell=" T�2..e�2,e�_
Fire Alarm
Susp'd Ceiling
Roof
O 1 - r:
1__:1 FAIL
MBING
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
S 1`. - Dampers
� S 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: Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site. ;
PASS PART FAIL