Permit MASTER PERMIT
CITY OF TIGARD
PERMIT #: MST2000 -00535
j , _ DEVELOPMENT SERVICES DATE ISSUED: 12/15/00
I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 14340 SW WALNUT LN PARCEL: 2S104BC -04300
SUBDIVISION: HILLSHIRE WOODS ZONING: R -7
BLOCK: LOT: 054 JURISDICTION: TIG
REMARKS: Add 280 square feet to rear of existing house
BUILDING
REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 11 FIRST: 280 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT: 20
VALUE: $ 24.164 00
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 280 00 sf REAR: 17
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER:
GAS FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: 1 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: $ 744.49
This permit is subject to the regulations contained in the
JENSEN, RONALD D +ANN H TRS JAMES E. BIRD Tigard Municipal Code, State of OR. Specialty Codes and
14340 SW WALNUT LN 1348 SE 19TH CIRCLE all other applicable laws. All work will be done in
TIGARD, OR 97223 TROUTDALE, OR 97060 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: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Reg #: LIC 57655 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
Footing Insp Footing /Foundation Dn Shear Wall Insp Rain drain lnsp
Foundation Insp Mechanical lnsp Exterior Sheathing Insf Electrical Final
Post/Beam Structural Electrical Service Gas Line lnsp Mechanical Final
Post/Beam Mechanical Electrical Rough In Gas Fireplace Plumb Final
Underfloor insulation Framing Insp Insulation lnsp Final inspection
Jib
Issued B ./ %'i - - Permittee Signature :
4 2. :_ 442_)
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the -xt business day
Dds /2 -7
Building Permit Application
A: Date received :�1- Permit no.: y' — e 0 J'
7j v4i City of Citf Tigard
Project/appl.no.: Expire date:
City ojTigard 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:
&2 family: Simple Complex:
Land use approval: N
N.
TYPE OF PERMIT Nt
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ New construction ❑ Demolition
Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address: 113-40 ‹, U) - (A) Act( UT t\ iJ p. Bldg. no.: Suite no.: 1
Lot: �..4 I Block: (Subdivision: i-4- LLS N•r r Welej D5 I Tax map /tax lot/account no.:
Project name:
Description and location of work on premises/special conditions:
/ADD r n ISO - ro e 1-
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: RD ri 4-h IA 115_ t(5, ( (Floodplain, septic capacity, solar, etc.)
Mailing address: /4340 u ' £...41E. 1 & 2 family dwelling:
City: a . p 'State: Q4, I ZIP: ' 7 z 2_3 Valuation of work $
Phone: IFax: I E -mail: No. of bedrooms/baths
Owner's representative: S'I pory lam- 1 12D Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.) o276 9
APPLICANT Garage/carport area (sq. ft.)
Name: ZTJ M i a b \ U r C..,D 5 a.. Covered porch area (sq. ft.)
Mailing address:) 3' 4 g c, 2, i ce - ' C ,G (ix Deck area (sq. ft.)
City:( 0 . r I State: ,,4ZIP: 9 7D6'0 Other structure area (sq. ft.)
Phone: A . , / 0 - : E -mail: Commercia l /industrial/multi- family:
CONTRACTOR Valuation of work $
Existing bldg. area (sq. ft.)
Business name:
, ,ihk33i 1 2 . b t car LbIiYL
New bldg. area (sq. ft.) --
Address: I 'shg ‘, *-, (9-11A a_
City:TkourpkOz.ga I State 9' � ZIP: 7cNsv Number of stories
Type of construction
Phone•. ` -L,/ • _ '04.3 Fax: s _ 41, ` E - . • - 1:
CCB no.: Occupancy group(s): Existing:
57�� New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: , j p p 05 provisions of ORS 701 and may be required to be licensed in the
Address: M� 5� jurisdiction where work is being performed. If the applicant is
City: VI/ p i i , , ( ( r4 State:t�Z. I ZIP: y 70 3 exempt from licensing, the following reason applies:
Contact person: I Plan no.:
Phone: • - gif .493 :; ax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: (State: IZIP: 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. All provisions of laws and ordinances governing this ❑ Visa ❑ MasterCard
work will be complies whe r specified herein or not. Credit cord number. / /
/ 4 Expires
Authorized si • nature: ' D ate: '/ /� Name of cardholder as shown on credit card
Print name: _ • . 7U 1 2y Cardholder signature $ Amount
Notice: This pe ..' application expires if a permit is not obtained with 180 days after it has been accepted as complete. 440-4613 (6/00 /COM)
"6/5 o . 9S 'LA i'''' EcO
One- and Two - Family Dwelling
Building Permit Application Checklist Reference no.:
Associated permits:
City of Tigard City of Tigard ❑ Electrical ❑ Plumbing ❑ Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 ❑ Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
TILE 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 ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of
catch -basin protection, etc.
10 _ 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
if copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if
there is more than a 4-ft. elevation differential, plan must show contour lines at 2 -ft intervals); location of easements and
driveway; footprint of structure (including decks); location of wells/septic systems; utility locations; direction indicator, lot
area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage.
12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent
size and location.
13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater,
furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc.
14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub -floor,
wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show
details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs,
fireplace construction, thermal insulation, etc.
15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels.
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. -
Full -size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing (prescriptive path) and/or lateral analysis plans. Must indicate details and locations; for
non - prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor /roof framing. Provide plans for all floors/roof assemblies, indicating member sizing, spacing, and bearing
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered
systems, see item 22, "Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists
over 10 feet long and/or any beam/joist carrying a non - uniform load.
20 Manufactured floor /roof truss design details.
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required
for four or more appliances.
22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or
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.
24
25
26
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 (6/00 /COM)
Electrical Permit Application ,
Date received: lot— -cv Permit no.: STTzz3 - z2053 ,
A yli6 . . ,.� I� City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receiptno.:
Phone: (503) 639 -4171
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other: ❑ Partial
JOB SITE INFORMATION • .
Job address: Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: I Subdivision:
Project name: I Description and location of work on premises: .
Estimated date of completion/inspection:
CONTItACTOlt APPLICATION . FEE SCIIEDL>LE •
Job no: Fee Max
Business name: �p rj *7> f�, Description Qty. (ea.) Total no. insp
L2C /'� /�� /� New residential - single or multi- family per
Address: /SO U, C ;rO�Y 6 dwelling unit. Includes attached garage.
City: G --/—j I State: 002-•I ZIP: 970,30 Service included:
Phone: I Fax: I E -mail: 1000 sq. ft. or less 4
K' CCB no.: I Elec. bus. lic. no:
Each additional 500 sq. ft. or portion thereof
Limited energy, residential 2
City /metro lic. no.: Limited energy, non-residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder 2
Services or feeders — installation,
' Sup. elect name (pri License no: `D alteration or relocation:
:: PROPERTY OWNER ,.; 200 amps or less 2
Name (print): 201 amps to 400 amps • 2 •
• d 401 amps to 600 amps 2
• Ma address: 143 • •! 4)4," 0 V7 ' • �- 601 amps to 1000 amps 2
City: I t � 1 /A,-jg �t° L I ZIP: (7.4 3 2 Over 1000 amps or volts 2
Phone: I Fax: I E -mail: � Reconnect only 1
I Owner installation: The install ' in is bpi made on property I own Temporary services or feeders -
•U which is not intended for e, lease, rent, or change according to
installation, alteration, or relocation:
v ORS 447, 455, 479, , 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signatur : 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):
❑ Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle 2
❑ Service over 320 amps- rating of 1&2 ❑ Hazardous location Each sign or outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2
❑ Building over three stories ❑ Feeders, 400 amps or more *Descnption:
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lightingplan ❑ Other. Per inspection
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card •
$
Cardholder signature Amount 440-4615 (6/00 /COM)
Electrical Permit Fees: Limited Energy Fees:
•
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total 4, Check Type of Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular Door Opener
Dwelling Service or Feeder $90 90 2
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System'
Installation, alteration, or relocation
200 amps or less $80.30 2 Vacuum Systems'
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 2 Other
601 amps to 1000 amps $240.60 2
Over 1000 amps or volts • $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918 - 260 -260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see "b" above. Audio and Stereo Systems
Branch Circuits • n Boiler Controls
New, alteration or extension per panel
a) The fee for branch circuits
with purchase of service or 7 Clock Systems
feeder fee.
Each branch circuit $6 65 2 n Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service D Fire Alarm Installation
or feeder fee.
First branch circuit • 1 $46.85
Each additional branch circuit 1 $6.65 .
Miscellaneous ❑ Instrumentation
(Service or feeder not included) _
Each pump or irrigation circle $53.40 ❑ Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s) or a limited energy ❑
panel, alteration or extension $75.00 Landscape Irrigation Control
Minor Labels (10) $125.00 ❑
Medical
Each additional inspection over
the allowable in any of the above Nurse Calls
Per inspection $62.50
Per hour $62.50
In Plant $73.75 n Outdoor Landscape Lighting
9
Fees: n Protective Signaling
Enter total of above fees $ n Other
8% State Surcharge $ Number of Systems
25% Plan Review Fee No licenses are required Licenses are required for all other installations
See "Plan Review" section on $
front of application.
Fees:
Total Balance Due $
Enter total of above fees $
❑ Trust Account # 8% State Surcharge $
Total Balance Due $
i:\dsts\forms \elc- fees.doc 10/09/00
CITY OF TIGARD BUILDING INSPECTION DIVISION nn - " §"c
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -417
151 BUP
Da Re ,r AM/ ���PM BLD
Location 2`/Z3 , / Suite MEC •
Contact.Person Ph PLM
Con Ph SWR
DI Tenant/Owner ELC
m ing Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear /r
Framing
Insulation
Drywall Nailing _
Firewall
Fire Sprinkler a t
Fire Alarm 11\//>;.-1
Susp'd Ceiling
Roof
FAIL
• 'BI
•
Post & Beam -
Under Slab
Top Out -
Water Service •
Sanitary Sewer •
FAIL
ME ANIC
• . : Beam
Rough In
Gas Line
-mpers
—'� PART FAIL
ECTRICAL
_ Service
-
Rough In
. UG /Slab
Low Voltage
Fire Alarm .,
Final
PASS . PART . FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: - [ • ] Unable to inspect - no access
ADA
Approach /Sidewalk Date 412-6/ CA Inspector Ext ( 9
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
} : CFT'f'C'3F''TIGARD BUILDING INSPECTION DIVISION `• �'° ' �'�'
MST 2 /47 l
• 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
J.S.�')
BUP
Date Requested / —G Z "_ D I AM PM BLD
Location / (f 7 d -> K- k 4 Suite MEC
Contact Person Ph 57)3- /al- /0 � 3 PLM
Contractor Ph SWR
UILDINC? Tenant/Owner ELC
(=tsWalI ELR
1� Access:
FPS
Ftg rain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing Z'U ���/� �/� TE" 42, rTv / S o/
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
. Fire Alarm
Susp'd•Ceiling
Roof
Misc:
Final•
2S5,2PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
PASS PART FAIL
SITE
•
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date
Other / 2 - 6 / I nspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
r -^ CITY OF TIGARD BUILDING INSPECTION DIVISION
MST i(i 6 'U
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
(� BUP
Date Requested v ` AM PM BLD -
Location / (( 7 /6 Se,/ G��(h Suite M C '
Contact Person Ph 5Z 5' q gr P M
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
•
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing mil /v' TL c-w /‹;2
Insulation
Drywall Nailing 14 ft . e- .g-, .7-S Ai41c_ S.S. >.
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
ECHA
Post & Beam
Rough In
e
SIfilike Dampers
Final _
PASS PART (FAIL)
ELECTRICAL
Service
Rough In
UG /Slab .
Low Voltage
. Fire Alarm
Final
PASS - PART FAIL
SITE
Backfill /Grading
•
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ • required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk — _ G
Other Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
ITY OF TIGARD BUILDING INSPECTION DIVISION
MST c- �r�:
'` `24 -Hour Inspection Line: 639 -4175 Business Line: 639 1
BUP
Date Requested -2- Z✓ AM PM BLD
Location / 3 '1 0 S 4 ' &ci / ,. Suite MEC
Contact Person Ph 736 Y 4(5.- PLM
Contractor Ph SWR
442ca ►r'- Tenant/Owner ELC
Retaining Wall ELR
Footing ' Access: •
Foundation FPS
Ftg Drain
•
Crawl Drain Inspection Notes: SGN
Slab SIT
�P eath/ ar
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall GA l� V�- \ J\) IL 1 nl�� +D ( C�l� 4N '�L.. � �
Fire Sprinkler
Fire Alarm �, W �1 N 3 ' C - Or t�
Susp'd Ceiling � W_
Roof
Misc:
PART. FAIL \.) ? 2 �C4� _ }7c�S O N ' %
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
_ Rain Drains
Final
PASS PA T FAIL
C ANICAL
Post & Beam
R In
• � as Lir�
Smoke Dampers
P A PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
. Fire Alarm
Final
. PASS PART .FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ • required before next • pection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please I for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk •
D Z ' Inspector
Z.
Other Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site. •
_ r
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST .,U 6 "7;
• 24 -Hour Inspection Line: 639 -4175 Business Line: 63 '171
BUP
Date Requested " PM BLD
Location' / (13 ci 0 L G Suite MEC
Contact Person Ph .(f lO 3 PLM
Contractor Ph SWR
L Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: (r'.6b) SGN
Slab \' SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
rams
ns ulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -
Roof .
Misc:
P ASS PART FAIL
1MBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
PASS PART FAIL
SITE
•
Backfill /Grading
Sanitary Sewer •
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please cal for reinspection RE: f [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
717-
CITY OF TIGARD BUILDING INSPECTION DIVISION MST v'ivU 'GG 53
•
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested , 2.3 AM PM BLD
Location I (./3 6/6 5 w , 1 G Suite MEC
Contact Person J1 ?r- Ph G I V -/ 0 t% 3 PLM
Contractor Ph SWR
MILD Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
.ing
Firewall
. Fire. Sprinkler
Fire Alarm
Susp'd Ceiling
Roof -
Misc:
F
�A'SS PART FAIL
PLUMBING •
Post & Beam •
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line •
Smoke Dampers
Final
PASS PART FAIL -
ELECTRICAL
Service
Rough In •
UG /Slab
L
•
ow Voltage
• Fire Alarm _
Final
PASS - PART - FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: / , [ ] Unable to inspect - no access
ADA
Approach /Sidewalk D �� InS ector ' Ext
Other p
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.