Permit A, CITY O F T I G A R D MASTER PERMIT
PERMIT #: MST2000 -00572
I DEVELOPMENT SERVICES DATE ISSUED: 1/8/01
.- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 13555 SW WALNUT LN PARCEL: 2S104BD -09800
SUBDIVISION: SULLIVAN MLP2000 -00004 ZONING: R -7
BLOCK: LOT: 002 JURISDICTION: TIG
REMARKS: Construction of new single family detached residence. Path 1. STREET OPENING PERMIT
REQUIRED
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,082 sf BASEMENT: sf LEFT: 12 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,222 sf GARAGE: 620 sf FRONT: 24 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT. sf RIGHT: 10
VALUE: $ 217,792 00
OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2,304 00 sf REAR: 52
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: 1 GREASE TRAPS:
OTHER FIXTURES'
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 5 CLOTHES DRYER: 1
GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS. 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1
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: 1 PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 4 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 00 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: $ 6,782.05
This permit is subject to the regulations contained in the
J P CONSTRUCTION J P CONSTRUCTION P CONSTRUCTION
SW GULL IO 10 CONSTRUCTION NS GULL IO Tigard Municipal Code, State of OR Specialty Codes and
BEAVERTON, OR 97007 BEAVERTON, OR 97007 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: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center Those rules are set
Reg #: LIC 120868 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.
50 - MP -gYt([ REQUIRED INSPECTIONS
Erosion Control Insp 8 Post/Beam Mechanical Mechanical Insp Framing lnsp Gas Fireplace Electrical Final
Sewer Inspection Underfloor insulation Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final
Footing lnsp Crawl Drain /Backwater Plumb Top Out Exterior Sheathing Ins[ Rain drain Insp Plumb Final
Foundation lnsp Footing /Foundation Dn Electrical Service Low Voltage Water Line Insp Final inspection
Post/Beam Structural PLM /Underfloor Electrical Rough In Gas Line Insp Appr /Sdwlk lnsp Building Final
� , —�� � I4 i �
Issued B . / ♦ ! y ■ i Permittee Signature : . , ..
I llr
• Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the , ext business day
s
r
au ,4;00 e - ao39i,
. Building Permit Application
Date received: / e g g -g2-e0 Permit no.: ►'<W - a 72
�, �y City of Tigard
. Project/appl. no.: Expire date:
CiryojTigard Address: 13125 SW Hall Blvd, Tigard OR 97223
Phone: (503) 639 -4171 Date issued: By: I Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex:
TYPE OF PERMIT
!Id 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family a New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address:;- - -, ,. sesc so L.J LAC Bldg. no.: Suite no.:
Lot: '2- Block: Subdivision: ill Lip 1,000 - 0000 Tax map /tax lot/account no.: ;.,S il I5) - 78(0
Project name: '' -
Description and location of work on premises/special conditions: S Fit
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: • Cpp(y rrUc-- 4- o t.. (Floodplain, septic capacity,solar, etc.)
Mailing address: t 0 7:7,5 S sJ 49' ✓t . )0 ( 1 & 2 family dwelling:
City: i e _pug 0A, State:or ZIP: 970o7 Valuation of work $.i 7 f/
Phone: S ° ), -3 24,E Fax: 54/ E -mail: No. of bedrooms/baths 3 3
Owner's representative: ' o1/ ' ( / $ Total number of floors 2
Phone: . /.L _ Fax: E -mail: New dwelling area (sq. ft.) 23 0 `(
APPLICANT Garage /carport area (sq. ft.) (n0
Name: UP C._ S fu ,_ c,„.... C overed porch area (sq. ft.) 12-
Mailing address: IO2 c C.- ( 0 ( Deck area (sq. ft.) l 9. MISIIIII State: a) ,r ZIP: 9700
Other structure area (sq. ft.) -G4 Phone: • , -3 2. cr S Fax: Scar tR E -mail: Commercial/industrial/multi-family:
CONTRACTOR Valuation of work $
Business name: Sa wS 0k/ever— Existing bldg. area (sq. ft.)
New bldg. area (sq. ft.)
Address:
City: State: ZIP: Number of stories
Phone: Fax: E -mail: Type of construction
CCB no.: J Z O g fv Occupancy group(s): Existing:
New:
City /metro lic. no.: 'P lee Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: g SG p r provisions of ORS 701 and may be required to be licensed in the
Address: 13 1.10 jurisdiction where work is being performed. If the applicant is
EVATIZZ gad State: p r ZIP: 9 7,2o - exempt from licensing, the following reason applies:
Contact person: on& Plan no.: - 721 i(
Phone: 2,2, • / . Fax: E -mail:
ENGINEER
Name: •. - tog. JosJ42. Contact person: - to-es Fees due upon application $
Address: — S>; / .7," Date received:
City: p, fan c State: o t ZIP: 972 I , Amount received $
Phone: 25y -G,2_- -2 GMEMIRE E -mail: Please refer to fee schedule.
I hereby certify I have read and - .. •ned is application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All ' Credit io . s ; l d ordinances governing this Li Visa la MasterCard
work will be compli - 1 ,) 7: - -; fled herein or not. C "' t card number Expires
Authorized signature: ' ' Date: 12 - Z O Name of cardholder as shown on credit card
Print name: Jo avi 5 $
P 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 (6100/COM)
s
One- and Two-Family Dwelling
Building Permit Application Checklist Reference no.:
CiryofTigard City of Tigard
Associated permits:
g U Electrical U Plumbing O Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 Cl Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
Tilt 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 U plan U 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 (6d00/COM)
•
Mechanical Permit Application
4,u Date received: -5-b-( Permit no.:�5�,e X5
-.,,� ., i� City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: I Receipt no.:
Phone: (503) 639 - 4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
(1.1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement
4.New construction ❑ Addition/alteration/replacement ❑ Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCI
Job address: 1 353 - s 5'W O 41 ■ i Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: 2. 5 iii E3 00 -7 800 profit. Value $ -
Lot: (Block: I Subdivision: ma 2000°0()00 H *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fec.
City/county: I ZIP: 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: 5 P`2 AND COMMERICAL /INDUSTRIAL EQUIPMENTSCIIEDULE
Fee(ea.) Total
Est. date of completion /inspection: Description Qty. Res. only Res. only
HVAC:
Tenant improvement or change of use: Air handling unit CFM / •
Is existing space heated or conditioned? ❑ Yes ❑ No Air conditioning (site plan required)
Is existing space insulated? ❑ Yes ❑ No Alteration of existing HVAC system
MECIIANICAL CONTRACTOR Boiler /compressors
Business name: d ( s i t ri,c tQ, State boiler permit no.:
HP Tons BTU/H
Address: 430 SVLt.) '2.3 I S t- Fire/smoke dampers/duct smoke detectors
City: 14 U(5 loot-c, 'State: O I ZIP: 9' 7/ Z f Heat pump (site plan required)
Phone: toll 9 -( S I Fax: I E -mail: Install/replace furnace/burner BTU /H
CCB no.: Zf 8 Including ductwork/vent liner ❑ Yes ❑ No
Install/replace/relocate heaters - suspended,
City /metro lic. no.: wall, or floor mounted
Name (please print): C ta,r (C C a ( ' • Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/H
Name: Chillers HP
Address: Com)ressors HP
Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent i
Phone: Fax: E -mail: Dryer exhaust /
OWNER Hoods, Type U IUres. kitchen/hazmat
L Cl - hood fire suppression system
ut S 1%
Name: J P c - a C-'i't .. Exhaust fan with single duct (bath fans) y
Mailing address: 0775' S- 3 W C ( P Exhaust system apart from heating or AC
City: (3eQ tf'&- f u , I State: � I ZIP: 1 700 7 � Fuel piping and distribution (up to 4 outlets)
Type: LPG x NGc Oil
Phone: 5; `I - 314 5 Fax: E - mail: Fuel piping each additional over 4 outlets
Process piping (schematic required)
Name: Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace j
City: S : te: I ZIP: Insert- type
Phone:
1- Other:
Applicant's signature. • I Date: Other:
Name (print): • AI.' PA:1('AS
' Permit fee $
Not all jurisdictions accept credit cards, please call jurisdiction for more information
CI Visa CI MasterCard Notice: This permit application Minimum fee $
Credit card number / / expires if a permit is not obtained Plan review (at _ %) $
Expires within 180 days after it has been State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete. TOTAL $
` Cardholder signature Amount . 440 -4617 (6/00/COM)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: FEE: Description: Price Total
$1.00 to $5,000.00 Minimum fee $72.50 Table 1A Mechanical Code QtY (Ea) Amt
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and 1) Furnace to 100,000 BTU '
$1.52 for each additional $100.00 or including ducts & vents 14.00
fraction thereof, to and including 2) Furnace 100,000 BTU+
$10,000.00. including ducts & vents 17.40
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and 3) Floor Furnace
$1.54 for each additional $100.00 or including vent 14.00
fraction thereof, to and including 4) Suspended heater, wall heater
$25,000.00. or floor mounted heater 14.00
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and 5) Vent not included in appliance permit
$1.45 for each additional $100.00 or 6.80
fraction thereof, to and including 6) Repair units
$50,000.00. 12.15
$50,001.00 and up $742.00 for the first $50,000.00 and Check all that apply: Boiler Heat Air
$1.20 for each additional $100.00 or For items 7 -11, see or Pump Cond
fraction thereof. footnotes below. Comp* **
7) <3HP;absorb unit
ASSUMED VALUATIONS PER APPLIANCE: to look BTU 14.00
8) 3 -15 HP; absorb
Value Total unit 100k to 500k BTU 25.60 ,
Description: Qty (Ea) Amount 9) 15-30 HP; absorb
Furnace to 100,000 BTU, including 955 unit .5-1 mil BTU 35.00
ducts & vents 10) 30 -50 HP; absorb
Furnace > 100,000 BTU including 1,170 unit 1 -1.75 mil BTU 52.20
ducts & vents 11) >50HP: absorb
Floor furnace including vent 955 unit >1.75 mil BTU 87.20
Suspended heater, wall heater or 955 12) Air handling unit to 10,000 CFM
floor mounted heater 10.00
Vent not included in applicance 445 13) Air handling unit 10,000 CFM+
permit 17.20
Repair units 805 14) Non - portable evaporate cooler
< 3 hp; absorb. unit, 955 10.00
to 100k BTU 15) Vent fan connected to a single duct
3-15 hp; absorb. unit, 1,700 6.80
101k to 500k BTU
absorb. unit, 501k to 1 2,310 16) Ventilation system not included in
15-30 hp; appliance permit 10.00
mil. BTU 17) Hood served by mechanical exhaust
30-50 hp; absorb. unit, 3,400 10.00
1 -1.75 mil. BTU 18) Domestic incinerators .
>50 hp; absorb. unit, 5,725 17.40
mil. BTU 19) Commercial or industrial type incinerator
Air ha
Air handling unit to 10,000 cfm 656 69.95
Air handling unit >10,000 cfm 1,170 20) Other units, including wood stoves
Non - portable evaporate cooler 656 10.00
Vent fan connected to a single duct 446 21) Gas piping one to four outlets
Vent system not included in 656 5.40
appliance permit 22) More than 4-per outlet (each)
Hood served by mechanical exhaust 656 1.00
Domestic incinerator 1,170 Minimum Permit Fee $72.50 SUBTOTAL: $
Commercial or industrial incinerator 4,590
Other unit, including wood stoves, 656 8% State Surcharge $
inserts, etc.
Gas piping 1-4 outlets 360 25% Plan Review Fee (of subtotal) $
Each additional outlet 63 Required for ALL commercial permits only
TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE: $
VALUATION: ,
Other Inspections and Fees:
1 Inspections outside of normal business hours (minimum charge -two hours)
$72.50 per hour.
2 Inspections for which no fee is specifically indicated (minimum charge -half hour)
$72.50 per hour
3 Additional plan review required by changes, additions or revisions to plans (minimum
charge- one -half hour) $72.50 per hour
* State Contractor Boiler Certification required for units >200k BTU.
* `Residential NC requires site plan showing placement of unit.
,
1:1dsts\formsknech- fees.doc 10/11/00
•
Plumbing Permit Application
At 1 Datereceived: p 2 -Ra -00 Pe rmitno.:��jT�) - �$7�
. ", City of Tigard
= .J �.`.� I ! "J g Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd, Tigard, OR 97223
City of Tigard Phone: (503) 639 -4171 Project/appl. no.: Expire date:
Fax: (503) 598 -1960 Date issued: By: I Receiptno.:
Land use approval: Case file no.: Payment type:
TYPE OF PERMIT
iii. 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement
VI New construction ❑ Addition/alteration/replacement U Food service ❑ Other:
JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist)
Description Qty. Fee(ea.) Total
Job address: j 3 55,5" 5 ,.J (Jai 4 L-� l New I- and 2- family dwellings only:
Bldg. no.: I Suite no.:
Tax map /tax lot/account no.: 'J,$' j y J3 0 —780° (includes 100 ft. for each utility connection)
SFR (1) bath
Lot: IBlock: I Subdivision: m &,v J,000 - 0000 4 SFR (2) bath
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.)
PLUMBING CONTRACTOR g
Manufactured home utilities
Business name: C-q tb 6 1 vrl.t� t Manholes
Address: eOS AA .--if L/ Rain drain connector
City: C v b 7 I State: 0 r- I ZIP: 9 7 v I S Sanitary sewer (no. lin. ft.)
Phone: a (v (o --2, Oct l I Fax: I E -mail: Storm sewer (no. lin. ft.)
CCB no.: 13 .5 a., I Plumb. bus. reg. no: S-7 pR Water service (no. lin. ft.)
City/metro lic. no.: Fixture or item:
Contractor's representative signature: pipadi, Absorption valve
Back flow preventer
Print name: 0 i Ph; l (t` i s Date: / 2, 1.7- 00 Backwater valve •
CONTACT PERSON Basins/avatory
Name: Clothes washer
Address: Dishwasher
Drinking fountain(s)
City: I State: I ZIP: Ejectors/sump
Phone: Fax: E -mail: Expansion tank
OWNER Fixture/sewer cap
Floor drains/floor sinks/hub
Name (print): of C S -{i!`v t�-f 't p✓• Garbage disposal
Mailing address: t 0'.7 J 5'4) 6-v0 e t Hose bibb
City: I jpyU - 'State: br I ZIP: 97C07 Ice maker
Phone: 5y- '3 - c I Fax: I E -mail: Interceptor /grease trap
Owner installation/residential mainten . , ce only: The actual installation Primer(s)
will be made by me or th - , . ' : - , T� • d repair made by my regular Roof drain (commercial)
employee on the pro, y. J Chapter 447. Sink(s), basin(s), lays(s)
Owner's signature: .i ' Date: 7 - 7 - 1 - 0 (1 Sump
ENGINEER Tubs/shower /shower pan
Urinal
Name:
Water closet
Address: Water heater
City: I State: I ZIP: Other.
Phone: I Fax: I E -mail: Total
Not all jurisdictions accept credit cards. please call jurisdiction for more information Notice: This permit application
Minimum fee $
on
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan revi
rm ew (at _ %) $
Credit card number: / / State surcharge (8 %) .... $
Expires within 180 days after it has been
Name of cardholder as shown on credit card accepted as complete. TOTAL $
$
Cardholder signature Amount 440 -4616 (6/00/COM)
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2- family dwellings only:
FIXTURES (individual) QTY (ea) AMOUNT (Includes all plumbing fixtures In PRICE TOTAL
Sink 16.60 the dwelling and the flrst100 ft. QTY (ea) AMOUNT
Lavatory 16.60 for each utility connection)
One (1) bath $249.20
Tub or Tub /Shower Comb. 16.60 Two (2) bath $350.00
Shower Only 16.60 Three (3) bath $399.00
Water Closet 16.60 SUBTOTAL
Urinal 16.60 8% STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25% OF SUBTOTAL
Garbage Disposal 16.60 TOTAL
Laundry Tray 16.60
Washing Machine 16.60
Floor Drain /Floor Sink 2" 16.60 PLEASE COMPLETE:
3" 16.60
4" 16.60
Water Heater 0 conversion 0 like kind 16.60 Quantity by Work Performed
Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/
permit. Capped
MFG Home New Water Service 46.40 Sink
MFG Home New San/Storm Sewer 46.40 Lavatory
•
Tub or Tub /Shower
Hose Bibs 16.60 Combination
Roof Drains 16.60 Shower Only
Drinking Fountain 16.60 Water Closet
Urinal
Other Fixtures (Specify) 16 60 Dishwasher
Garbage Disposal
Laundry Room Tray
Washing Machine
Floor Drain /Sink: 2"
Sewer - 1st 100' 55.00 3"
Sewer - each additional 100' 46.40 4"
Water Service - 1st 100' 55.00 Water Heater
Water Service - each additional 200' 46.40 Other Fixtures
(Specify)
Storm & Rain Drain - 1st 100' 55.00
Storm & Rain Drain - each additional 100' 46.40
Commercial Back Flow Prevention Device 46.40
Residential Backflow Prevention Device* 27.55
Catch Basin 16.60
Inspection of Existing Plumbing or Specially 72.50
Requested Inspections per/hr COMMENTS REGARDING ABOVE:
Rain Drain, single family dwelling 65.25
Grease Traps 16.60
QUANTITY TOTAL
Isometric or riser diagram is required if
Quantity Total is > 9
*SUBTOTAL
8% STATE SURCHARGE
**PLAN REVIEW 25% OF SUBTOTAL
Required only if fixture qty. total is > 9
TOTAL $
* Minimum permit fee is $72 50 + 8% state surcharge, except Residential Backflow
Prevention Device, which is $36.25 + 8% state surcharge.
** All New Commercial Buildings require plans with isometric or riser diagram and
plan review.
i:\dsts \forms\plm - fees.doc 10/10/00
1
A -
Electrical Permit Application
. Datereceived: -aa.00 Permit no.: - 4957dt
1 1! City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF I'ERNIIT
1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
a New construction 0 Addition/alteration /replacement 0 Other: 0 Partial
JOB SITE INFORMATION
Job address: /353 5'(.4.) %Ju in l^ Bldg. no.: Suite no.: Tax map /tax lot/account no.: 9,51 ySE2 - <
Lot: I Block: (Subdivision: /114.10 2000 - 0000 9
Project name: I Description and location of work on premises: 5r-12,
Estimated date of completion/inspection:
CONTRACTOR APPLICATION TEE SCHEDULE
Job no: f-/ eC L t i Fee Max
Business name: L.. Sc-b� t O q ✓t t l� .. c c Description Qty. (ea) Total no. insp
K51 Tv Hwy New residential - single or multi -family per
Addres 5co I yV dwelling miLIncludes attached garage.
City: t� i ((S 6 o r'o I State: efer I ZIP: 9 71 9 - " j Service included:
Phone: 61.8 �77-S I Fax: I E -mail: 1000 sq. ft. or less I 4
CCB no.: 9'38 (5 I Elec. bus. lic. no: 39 -37 3 L 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 /a-/ D/ Service and/or feeder 2
' — Services or feeders – installation,
. _ Sup. elect. name (print): LAW _ . ,1 N License no: , 3 alteration or relocation:
PROPERTY OWNER 200 amps or less 2
- Name (print): ;.7tP C on s t ..4-, c 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: /0 '7.5 5 t.J G-ui ( IP ( 601 amps to 1000 amps 2
City: (Qa fo-1- I State: Of I ZIP: 17a2 7' Over 1000 amps or volts 2
Phone:, `( - 2rf s I Fax: I 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, atteration,orrelocation:
200 amps or less 2
20
ORS 447, 455, 479, 670, 701. 201 1 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 ❑ 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 *Description:
❑ 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 $
rm
❑ 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:
TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total `I' 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 Manuf'd Home or Modular Door Opener
Dwelling Service or Feeder $90.90 2
Services or Feeders n 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 ❑
601 amps to 1000 amps $240.60 2 Other
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. n 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 n Clock Systems
feeder fee.
Each branch circuit $6.65 2 n Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service 0 Fire Alarm Installation
or feeder fee.
First branch circuit $46.85 n HVAC •
Each additional branch circuit $6.65 •
Miscellaneous 0 Instrumentation .
(Service or feeder not included)
Each pump or irrigation circle $53.40 and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s) or a limited energy
•
panel, alteration or extension $75.00 n Landscape Irrigation Control
Minor Labels (10) $125.00
Fi 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 0 Outdoor Landscape Lighting
Fees: 0 Protective Signaling
Enter total of above fees $ n Other -
8% State Surcharge $ Number of Systems
25% Plan Review Fee
See "Plan Review" section on $ * No licenses are required Licenses are required for all other installations
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 .
J
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
CANBY PLUMBING
805 NE 4TH AVE
** CCB EXPIRES 8/2/200
CANBY, OR 97013
Plumbing Signature Form
Permit # :. MST2000 -00572
Date Issued: 1/8/01
Parcel: 2S104BD -09800
Site Address: 13555 SW WALNUT LN
Subdivision: SULLIVAN MLP2000 -00004
Block: Lot: 002
Jurisdiction: TIG
Zoning: R -7
Remarks: Construction of new single family detached residence. Path 1. STREET
OPENING PERMIT REQUIRED
Your company has been indicated as the plumbing contractor for the permit indicated above._ In order for the
plumbing permit to be valid, please have the appropriate individual from your company sign below and return
this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
J P CONSTRUCTION CANBY PLUMBING
10275 SW GULL PL 805 NE 4TH AVE
BEAVER TON, ON, OR 97007 t: CCB EXPIRES 8/2/200
CANBY, OR 97013
Phone #: 503 - 524 -3295 Phone #: 266 -2091
Reg #: LIC 33572
PI_M 3 -7PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X iaK.. tot ) Signature of Au orized Plumb
If you have any questions, please call (503) 639 -4171, ext. # 310
ASK h5 - Z -/ — crb-0-0.8
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 2.-el)
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
• Date Requested 4 -1 AM PM v BLD
Location 135 : 54) id/4-41,1 Suite MEC
Contact Person 1 (.31(4 Ph 7r/ / Z PLM
e Contractor Li i C�!/v��TM vwl +') Ph 5 2 - 1/4 4 — --5 7- 9 5 SWR
BUILDIN 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
Insulation N.
Drywall Nailing Mb, ob.
Firewall
Fire Sprinkler �- =�� - ��s_�' 1i .:
Fire Alarm
.. Susp'd Ceiling
Roof
Misc:
PASS 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
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
PART _ .FAIL :
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
Other Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
• .. ---
C.IV Or TIGARD BUILDING INSPECTION DIVISION
24- Hour'j'hsO+ction Line: 639 -4175 Business L'tr : 639 -4171 '
/ , BUP
Date Re9uested % ` �v l — / I AM PM BLD
Location / 5 5 S Sw GCJdti$ L'( Suite MEC
Contact Person Ph 7G 5 -�r/ r PLM
Contractor Ph SWR
Tenant/Owner ELC
Re - • Wall ELR
.oting Access:
FPS
Ftg Drain �f • SGN •
to
Crawl Drain Inspection Notes: U l D ' /
Slab SIT
Post & Beam
Ext Sheath /Shear ,4 4,4,,,l/ / /
Int Sheath /Shear 4 z / p
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm •
Susp'd Ceili Op) Roof
• Misc:
Fi
ASS PART. FAIL
- ING
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 dY ( ( Inspector
`� � `i/
Other 1 Ext
Final
PASS PART - FAIL DO NOT REMOVE this inspection record from the job site.
•
• OP TIGARD BUILDING INSPECTION DIVISION MST -1 0a0
244-lout inspettion Line: 639 -4175 Business Line: 639 -4171 •
/ BUP
Date Requested /--- (k AM PM BLD
Location /3 v ../ L•-• -. Suite MEC
Contact Person Ph� -4 fl PLM
Contractor Ph 6 #6 '.// 7 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
Insulation
Drywall Nailing •
Firewall
Fire Sprinkler -
Fire Alarm
Susp'd Ceiling
Roof
Misc: -
Final e
PASS PART FAIL
411MS.
-
Under Slab
To • Out
ter Se •
•4 . 'n Drains
Final 1
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 p
Other D Inspector • Ext
Final
PASS PART FAIL DO NOT - REMOVE this inspection record from the job site. -
,. : - TIGARD BUILDING INSPECTION DIVISION � . „ � j M�T�lJ�"'�� 7 oZ 2, lip
ouf Line: 639 -4175 Business Line: 639 -417A la
LY BUP
/0/ / ft Date Requested / 1'7-0 / AM PM BLD
Location 1 3 9 - - 4 lam) L ii Suite MEC
Contact Person JO k1/1 Ph W/ (- PLM
Contractor Ph SWR
4: I ! ► Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
awl • _ i (/ 6 � Inspection Notes: SGN
Slab
st & Beam) SIT .
Ext Sheath /Shear
Int n th /Shear �
Framing t n (1A---e, ^ (� S 3 , 1
Insulation X /-� pp
Drywall Nailing 64 LL/ ms-s-° C -� /'
Firewall
Fire Sprinkler _ . i
Fire Alarm , \
Susp'd Ceiling � C 8 l S V -IL:.
Roof CLk,k-e■S i G / 1 `Z C A )
Misc: ` ✓
Final
PASS PART FAI
'!4 ' ' ` I N ` G "-nr PL x L L∎X -■
d Under Slab N v 0
Top Out
V `
1��. - - i'liaZ /J W US S c
� f
nita ewer
lain D ains � l e_ Vvv -
Fi nal �
PASS PART C r9� .
WOMAN 1 L.t■,/� 7 ✓ rk- ` S --- (i
ol, (PFErritil vv._ e--,- C'C��
Rough Line In p y • Gas Line -
Smoke Dampers
Fi- J / -
PART FAIL T& (�V J , r-e v v-. �/ -Q�v` L.A.J.._L„.4,
Service
U ��” -- U� , , w f��2t c-14(..- , \ 1 .
Rough In 1(
UG /Slab
Low Voltage A 01-.1 W „ e r „ , ,�'
Fire Alarm ` ,LL / ' e J (k..A-e.._ 1 Get ,
Final
PASS PART FAIL 4A-V-12* 1 SITE qi../1 �.� ( v �
Q U . No
Backfill /Grading S
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 t /7 l
Other Date Inspector Ex
Final
PASS , PART FAIL DO NOT REMOVE this inspection record from the job site.
r
r
CIT OP TIGARD BUILDING INSPECTION DIVISION MSX ODd�ad- ��
2441' ourrinspettion Line: 639 -4175 Business Line: 639 -4171
BUP
P Date Requested / v 0 AM PM BLD
Location / 3 557 $ z.6 WALAthtil Suite MEC
Contact Person -v/7 �' Ph lD tig $//7 PLM
J
Contractor O 114,1 Ph '7F/ 0/55-2 SWR
jUILDIlit Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
SIT
ost&
Ext Sheath /Shear
Int Sheath /Shear I�p ---b _(
Framing \ J O "� Q. \ x L"� v -�` `
Insulation
D
Drywall Nailing �•rC - l..�C�
Firewall
Fire Sprinkler
Fire Alarm ��
Susp'd Ceiling
Roof I ) P1 e .'-
Misc:
V `
F i _ O •� •/1 �� 0
SS PART FAIL
5.-; Le)
ost & Be0
Under Slab
Top Out
"ei t.cv5Rr
=in
Din •
Fi
•ASS ` 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
Other Date a & Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY'OF TIGARD BUILDING INSPECTION DIVISION • Uv � 6 � 72_,
• 24- Hour,inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM 93 / PM BLD
Location /3.7 .5 64./4h A L Suite MEC
Contact Person Ph 2-01/ PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain 5IAI� Inspection Notes:
Slab SIT
Post & Beam
_ Ext Sheath /Shear
Int Sheath /Shear /� ,.
. Framing Q s2-n }� v � /� x
Insulation
Drywall Nailing .a
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling . -
Roof
Misc:
Final
PASS PART FAIL
611/ 1 IQ a
v wrost & Beam }; .
t slab ) V� J S Z.-.i\ U ,
U"" Wa ce - _ ( GL
GA, Sanitary Sewer -
0,k,Rain Drains
Final /,'
PASS PART Y•)
Lef ev a_ / k
MECHANICAL ✓L%�"` v■/‘G`.c
k-%1"-S
Post & Beam - -
Rough In s
Gas as Line
Smoke Dampers S �_ �^ C �,q
Final Er7 CA
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
Other Date l Inspector Ex3
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
.CITY''OF TIGARD BUILDING INSPECTION DIVISION
61 057 •
24 -Hour, Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 2- fr AM PM BLD
Location /3 5 $ w Gvaii ed. C- Suite MEC
Contact Person Ph 24 - � PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall EL _ R
Footing Access:
Foundation FPS
Ftg Drain SGN •
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Shegath /Shear 4 L n l L t 6 ( 41. ■A/ qxa.
Framin
Insulation
Drywall Nailing �� ,, '/ .
v�
Fire wall �' �' w S L i j kt L � [IV Y C�` `�v v x_/l,/l,� Q
,.. Fire Sprinkler
Fire Alarm O � Qtr
Susp'd Ceiling . �� (..�
Roof
Fina
Final S �� Q
PASS PART FAIL
Post & Beam + A
Un1� / 4 J
op 0
Water Service
Sanitary Sewer S
Rain Drains ,
Fin Fin 1
PART FAIL 4 1 )6t 44
•
Post & Beam
Rou h In
Gas Li
mo a Dampers
Fi -
4 0 PART FAIL
RICAL
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 �
Other
Date ` d l Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY bF'TIGARD BUILDING INSPECTION DIVISION
• i 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST " . �4o. 2 -
Jt P 24-, Hour �`' BUP
' Date Requested �C AM PM BLD
Location 1 "3S SG(/ wd4,Li c-C/ Suite MEC
Contact Person Ph 4�fl —U(..'2 PLM
. Contractor Ph SWR
G Tenant/Owner ELC
- aining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear •
Int S - th /Shear
A/45 :6/ & r7 CAL // 2'7o.«7
nsu ation > /
Drywall Nailing - 577 - e4--P P47 5 S%C(i /�i¢/ 1 < C/dd-4-c v G�Ui�r � C
Firewall
Fire Sprinkler cite ti/ �S� �Le� � .�.� �/LCk1
Fire Alarm
Susp'd Ceiling. O ,e Ar % x_ • w L . CLc. Sc. .
Roof
Misc: 5;74
Final
- PASS PART fi •— '° -
PLUMBING ,Q �.= ` ._ /A16 J o ,� — c — v`.
Post & Beam
Under Slab /104//./7 - -iA-v
Top Out ��
Water Service _ l" % 5 — Z, s
Sanitary Sewer
Rain Drains
Final
PA T FAIL
Pos Beam - •
- ._�,.
Smo e Dampers
Final -
PASS PART Al
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
Other . Dat - 2 - 2.6) - o / Inspector E
Final
PASS PART FAIL • DO NOT REMOVE this inspection record from the job site. -
CITY OF TIGARD BUILDING INSPECTION DIVISION �j `•
• 24- Hour,lnspection Line: 639 -4175 Business Line: 639 -4171 MST !:".a"
� / BUP 4,
Date Requested _ vl AM PM BLD
Location 7,5 g af f J Cedi- -Xe U C4k Suite MEC
Contact Person / Ph PLM •
Contractor L S'a t / o/t4 4-1,) A.) 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 -
Insulation
Drywall Nailing
Firewall
. Fire Sprinkler ,°. YY/ C e
Fire Alarm B c) /
. Susp'd Ceiling
Roof / 1.76 Misc: �'` cc.)
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer V
Rain Drains _ -
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In -
- V Gas Line -
Smoke Dampers
Final
PASS PART FAIL
CTRICAL
e.i
- g n
Low Voltage
�P F' al
ASS ART FAIL -
Backfill /Grading V
Sanitary Sewer
Storm Drain -[- ] Reinspection fee of $ required before n- pection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA I ea I I I F.
Approach /Sidewalk Date � - 7 - , 0 — C� / Inspector �,�� i E x t
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION - DIVISION to
-7 �"
'24 -Hour Inspection Line: 639 -4175 Business Line: 639
MST 2e –`sU5
�7
BUP
Date Requested .2 ' Z 3 AM PM BLD
Location l,3 f 5) $ w eA)4 Suite MEC
Contact Person Ph 7g's /CZ— PLM
Contractor Ph SWR
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
. Fr
Drywall Nailing �► I l�tc - 1 Co►o CtP /0
Firewall
. Fire Sprinkler .. ��— c..otAv . W `C1 � ly1S ` e
Fire Alarm 11..
Susp'd Ceiling _
Roof
Misc: •
F
PART FAIL,
•
'BING
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 [ I Please call for reinspection RE: � [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other D 2 ns P � I ect%IV Ext
Final
PASS PART FAIL DO NOT REMOVE this inspectio record from the job site.
•
CITY OF TIGARD BUILDING INSPECTION DIVI, MST t)5
G - 67�,
24 -Hour Inspecti Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 2 r AM_c_PM BLD
Location /35 5 to �� jj Suite MEC
Contact Person �• • Pk 1 t14 Ph 73''-'/ Z- - PLM
Contractor Ph SWR
ILDING Tenant/Owner ELC
Retaining Wall EL R
Footing Access:
Foundation FPS
Ftg Drain SGN •
Crawl Drain Inspection Notes: 0
Slab ' SIT
Post & Beam
Ext Sheat hear I �
Int Sheath /Shear
rmin
Insu1Ton
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
F ART FAIL
LUMBING
Post & Beam •
Under Slab
Top Out
Water Service _
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam V V
Rough In
Gas Line •
Smoke Dampers
Final V _
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
r Low Voltage
/i' I 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 insp - no access
ADA
Approach /Sidewalk _
Other Date Inspector Ext
Final
' PASS PART FAIL DO NOT REMOVE this inspection record from the job site. •
•
-CITY OF-TIGARD BUILDING INSPECTION DIVISION
MST 2e1.0-1)e
- 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 1 7 1 - AM PM BLD
Location /)$S S waif Suite MEC
Contact Person Ph l/ of s PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing -
Foundation ACC / � ' FPS -
Ftg Drain /L G� � v '� �P °��
SGN
Crawl Drain = • • • • es:
Slab — SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing -
Insulation
Drywall Nailing
Firewall
Fire Sprinkler .
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL -
f Beam
_ Under Slab
Top Out •
Water Service
Sanitary Sewer
Drains •
PART FAIL
ANICAL
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 6/4/0 / Ins actor Ext
Other Date p 773
Final -
PASS PART FAIL DO NOT REMOVE this inspection record from the job site. -
OL •
CITY OF ' TIGARD BUILDING INSPECTION DIVISION . oa - •
6C)5,2-
24 -Hour Inspection Line: 639 -4175 Business Line: 639 171
BUP
Date Requested 4' -1 I' AM PM BLD
Location /55 5 w Gv4,l1( Suite MEC
Contact Person Ph 77/- G/ J z PLM
Contractor Ph SWR
UILD[NG) _ Tenant/Owner ELC
e aining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN •
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
, Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
in
S PART FAIL
•
LUMBING
Post & Beam
Under Slab
Top Out -
Water Service
Sanitary Sewer •
Rain Drains
Final
PASS PART FAIL •
MECHANIC
Post & Beam •
Rough In
Gas Line -
Smoke Dampers
-ASS) 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
Other .. Date 4' /G' — O% Inspector Ext •
Final
PASS • PART FAIL DO NOT REMOVE this inspection record from the job site.
•