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Permit + dITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2005 -00643 Al AIIIiK DEVELOPMENT SERVICES DATE ISSUED: 1/26/2006 .4.14- R ° 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600-00300 SITE ADDRESS: 09681 SW WASHINGTON SQUARE RD C6 ZONING: C -G SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG Project Description: TI (2,928 so ft area) REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 2N : sf N: S: E: W: OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 78 BASEMENT: sf AREA SEP. RATED: STOR: 1 HT: ft GARAGE: sf OCCU SEP. RATED: BSMT ?: N MEZZ ?: N REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:Y BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 45,000.00 Owner: Contractor: WASHINGTON SQUARE LLC DEFOREST CONSTRUCTION BY THE MACERICH COMPANY 2023 MYERS ST. 9585 SW WASHINGTON SQUARE RD RIVERSIDE, CA 92503 TIGARD, OR 97223 Phone: Contact #: FAX 951 - 359 -3723 PRI 951 - 359 -3710 FEES Reg #: LIC 90284 Description Date Amount REQUIRED ITEMS AND REPORTS [BUPPLN] Pln Rv 12/14/200E $281.65 [FLS] FLS Pln Rv 12/14/200: $173.32 [BUILD] Permit Fee 1/26/2006 $433.30 [TAX] 8% State Surcharl 1/26/2006 $34.66 Total $922.93 This pen is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by calling 503-246-6699 or 1- 800 - 332 -2344. 1 Issued By: 7j �/tJ Permittee Signature:Jj( ak r J t - L.--✓L.. Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. f 1 � ti l v J V� 7 :zt s w $1% s Building Permit Application FOR OFFICE 1 SE oN Ll e Q City Of Tigard 1� ■! A lire B; & i� t� D Permit Nu tad F -taty 13125 SW Hall Blvd., Tigard, OR 97223 pa x gn Phone: 503.639.4171 Fax: 503.598.1960 , LL \ f z' i 1 • � Date By / i 0A V3 H Other Pemut \ o• a _ km.; ®See Attached Check/let for Inspection Line: 503.639.4175 �, t 1� '� �;, Date tteadv.El Internet: www.ci.tigard.or.us It NatifiedIMethod / , o6 I • , Supplemental Information 0.f �e}�4' • x-„ _. • " ,T'. ` "' _ v 'i s c rr '.' iii, 'T ^'i ` p,IPii`5' ` 'i g y�x �T i ;. +p. ',�' y. , �i j 3 y . .,;� t ' " , K ,z,, 44,,i : ',1 4 1410 7 ;, f ,.,,, = : ta'+ r Ee. r1 . r ye 71 %. , ,; in• >t , ",.`s - .., .? 4 r z f+ " ,,,.7 "1,G� xa. , �,1. i ° (h"9��&f� ➢ m:i3�l:� L:. �tS4SiL� � • !, s 3fi: �„v, -i ^ "., �a'T�;?,��q�y2r, , , ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed Indicate the value (rounded to the nearest dollar) of all Addition/alteration/replacement ❑ Other equipment, materials, labor, overhead, and the profit for the ti' 3;.: \=`ni `3,''+^r- Aai-„ ; ii, i '.er;1 ..7,47' s 4: =ir_�i� _ ]'�, is Awe -r` °' 1 f =:, `:. work indicated on this application. � t3e•a� ry � u r •,: . -,i L y'c,'�•c' 'ii"7'iy �i.. a:.�v c( ,'i' t' ',,r -,r •f'04 -•4€.y c ..0 .5i' .=. . r: a;Y ..,, t; .0, .4:, is = V =„ 4?. ss4a, F Valuation: 4 S z-/5 O ❑ 1- and 2- family dwelling Commercial/industrial El Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other Number of bathrooms: v L-Y`� '�"'? c`tir' u:•,.- c 51.:aFn:.M.'=t't.`a:e�„ >.k ' ` �Ia,n..t,.e.; v�ss'°;- :a�'f "�' Total number of floors: ' °,;j •.=� -. t..,_rfr.> lr.• 1 e ,' k T.-:r• �9 . r•: =iF . 'y - Job site address: /i 4,-,,,,, . V v V V ( \ \ VY\ A J - \K./9 s. New dwelling area: square feet ', City/State/ZIP: 0 6 . ( V 1 ' 1 2� Garage/carport area: square feet Suite/bldgJapt. no.: c D ‘�l I Project name: m ? A i v _ Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet Subdivision: 7((4_ U y I Lot no.: Permit fees' arc based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the .',}' 11. � '�, tir- , ,.�. `.. _ 44 0E ri k •�a �s7 3 P .x$41 5 5; work indicated on this application. Y r.� l�l'%.., �7� .s � \�rS �� /fi = .a. , � • f:- r1�, -,..:� � 'a.YN.� ° <ty�i� =` "- ::.'- �'+3ga ,'•�l.Gfi,.�,'ri?�.G'- . • / /'� I' 1 t "` a 1 �0, 0 Valuation: S /.-- • Q U V Existing building area:2A 7 V / square feet New building area: square feet •,��..,•� y our. - ;.�.�-xx.:; ,,:s:�; =�; ••.,- � ya��z : a. - , el,,�.. „��. � rr ti,r,..,z, r n ,� e � r ., axr a� .: y y ,,T4. a i i �; F `” I ; ; 11, 't: Number of stories: Name: -e Of . Q ' • Q Type of construction: N F-- Address: S ?, CO 1 A d , 1/I c,e , Occupancy groups: W rCO —h 1 . City/State/ZIP: G I r� al / t c11-7,--11p. Existing: 1 �I' g � "1 1 Phone: (b 9 90) \ ., Is— ) New: • ; ax: ( ll II 'bF �. �ti : ii- s d= ' '• cC•i ` ' 4c: Yr.e 'r'k ; ilr:. .. : it, . 4 ` < x ; •s%i " „ - .c 4 - 10 ' K 'r'r ; _ - . J, �xi� - 1 t .` =. �'tf.. �, t� Z�ry��,�'�+. c,• >2�: �.:rFf; :t l� :: 5 �., k � - ,r�n :., > : ' -� `;; _ >�-��\s;•.,,�rryF Y' 4, n t: - N ri• a 3'4i2.4&P,., 10*.` 15,'i Pt a� . l2/ %.;ii:::'.r.';', 147 <'•tr•"�` "j.+ ��'?�` _ r .. = -�� s. ':'" � s � G� .�, ,als. .. .. , �< . .. •� F .�':. ��i'�„;r�nF�• (�� 3r'�' ��. u.. =, °�' r� cc . -e � ` _ll a Business name: s All contractors and subcontractors are required to be Contact name: i l cum a S licensed with the Oregon Construction Contractors Board Cj M under ORS 701 and may be required to be licensed in the Address: l 2. 2 0 5'r- q v, P s �� jurisdiction in which work is being performed. If the • City/State/ZIP: �V q C..�"t l V rl o C O ( applicant is exempt from licensing, the following reasons aPPIY: Phone: 3 z 6 ;52.8. ( ; � I Fax: (31 ) 3 -7 " 0 ro � l �, ' °3 t - E -mail: 0, I ` e x 1-e 551.c., t11�///��,/��_'y/^,,• _ co . — rc4,1 �'f 1 - +:p\ '.i iT4'" K! :S:. -', Flair' : / f ,a WR",- „ ? i aw- Y � rat:Ac ettetW .j'�-•t,�` .#'' `'=�' 7:... , -:��° ∎:&-t„. :&- % "'i '�s,�`,. , :J �y,..:r.C` -1,.. F' r4 - ¢a >, -r �F?�.. M.. ��'M , Business name: G d`t: 6 — \ 1 41-)6' . �a A- Tim - =1- - _r�, x ,,, . �:x �=�f s r4r Address: 2,10 3 yctzs "\-' br 4� i ,..; ,t Q -., -: : }n: � ::} 41...,.:,4,-.: . Please refer to fee schedule City/State/ZIP: T m ' -Ac (er C q , eta Fees due upon application Phone: (q51) 3 `li - 'Z y) I Fax: ( 461) -3 5 6 - l ar 3 Amount received CCB lic.: CIO $1.I I .! Di. Date received: Authorized signature: 1 1 , ( - t This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: u�� ig•►rdirm. Date: L MI 0 S • Fee methodology set by Tri- County Building Industry Service Board. i \BuildmgkPem its\BUP- PaantApp don 12/03 440- 4613T(I I/02/CAM/WEB) 01/12/2006 14:38 8585928829 6, J am- - 04 PAGE 08 01 /0t/21306 12:21 + J 1MRAD C5',5". PAGE 02 4144,4 Pag Project Name: ilif E 171' 1C aC — hi 11-S Al r M G T 0/1! .5 QC/. 4 ' er / I ..,... Form Be ` LIGHTING — GENERAL 1. intadoi Babeeptione (Section 1313.1) I �� MI No Mortar Lighting. 1110 building plans an0 Specifications do not can for new or altered I Inl nq l`s.' Item 5. Exterior building Lighting - General. below, �� eptilorAS t3 Exceptions. 1. The building or part of the building qualifies for an exception from • u;y- •� requirements. Applicable code exception Is number \ ,� • o rasetaea of dredeyhtq • `l' nRrnpllen , m ter tUtttfenn < auction. Q 2. Lighting equipment that qualifies for an exception • In addition to ganoral lighting and is aeperatel ` 4 > controlled. Apptceble Coda exception Is number ' . ) . .. _ j 0 Plans /SP's Areas of the builorrng end equtpmem that quedtty for entax_ tons. _ .,. „ � 1 shrew aomwhet10 by Indwhnw „ 9 Q walla mast Oeaoa Crafter, end/nr adectranker atralker end _,. -- . -_ .. .. _,.,. . succe bttraon 2. Local S6tpbt -off controls (Section 1313.3.:1.1) Cattpltes. At lewd one Waal shut-off lighting control for every 7000 square feet of righted floor are and for all spaces enclosed by walls or Coiling height partitions. "�"� Title control(a) le detailed in the building pions or dfcwine ndmber: I - 1 Exception The building or pert of the building quafifes for an exception. ApplicAbie code exception Is SeCSen 1310.3. - xroption: L______, port)ons of the buitdtng that quality: f 3. Automatic Shute' Controls (Section 12:12.3.1.2) U Not Applicable. Office floor circa Is not over 2.000 square feet of contiguous office floor area or permitted specs. Is not over 5,000 square feet. No offices less than 300 scuore feet. meeting or cp *rence rooms. or &drool classrooms.. Complies. All Intenor lighting systems are equipped with a separnfe drnorrolic Control to sheet off the lighting during unoccupied porlode. Offices less than 300 square feat mooting and conference rooms, end school Classrooms shall be equipped with occupancy sensors that comply with Section 1313,8.1.2.1. Compliance detaibi In plans/specs! ___,.J Q Exception. The building or part of the building qualifies for on exception. The�plioable rode a: xce�n _ is Section 12133.1.2, Exception Portions of the buldine that qualify: I - _.. • 4..1104ighting Controls (1313.3.1.3) M - , No classrooms or atriums with skylights or window to wall rare greater than 50 %. . ❑ Compiles. All cltrsarooms and atriums with window to wets ratio greater than 50% and/or skylights era equipped with automate daylight 2Rrolng controls. as required by Seehion 1313.3.1.3.1 a Section 1313.3.1.3.2. The daylight sensors epedfled comply with 1313.3,1.3.3. Comprianoe details in pi011s/spec3: L_ __ Ebrterlor Building 3, Natenlor Lighting (Section 1318.14 Lighting r. lighting gimlet +{fib Complies. The pilots do not coil for tncende9o0nt Or mercury vapor temps for uea on building exterior. b tlgbminote taco erdbxbr ar rho Q p Exeeptlon. The building ins Indicate lumtnerreo with incandescent or mercury vapor lamps, but they are ;MO trranntI draw mmmnq MO sdl�anL I or Y li e spee7ied for use in or around swimming ate pools. water features, or other locations 9tebject to the regtw'rr rents oh or Article 680 of the 2002 National Electrical Code. Ci t wit ch" b a 6. Exterior anal canopy Lighting Controls rlccticn 1313.3.2) raramenla eralranorrar bee *IN teartexe program rbx Cl Compiles. The building plans and sperJflcaiiona include photgie ctic and/or clock gerntaa on all exterior lighting nnrn+gey of Meek and limn systems which are designed end prow:Terned to eatrngelph lights when daylight is present as =mired by Section vbmw mnrxgy t0 nthlftten 1313.32 Urnnttecong fumnrb Purer enrev r: "r r 7. Interior Connected Lighting Pourer (Section 1313.4) : u, ,.� EO Cl Compllbt. The Interior l+SMing power dorm not o coon the Mailer bower allowance established In either the 0,1 r (cn00 the aPpfoprlx*e box). Q Tene tit apace Mcthcd (Form 7b) N4 sp rco•bySpece Metnud (Fern 13c) J-7 CIImpylnM WI CaaaC, nIrrciSM 0t/tirin6 01/12/2006 14:38 8585928829 PAGE 09 01/@8/2006 12:21 + J1MRAD RAGE 03 So - Proton! : �vl 4501.)74M. r� u4 �„a:l 2 — T Ferrn INTERIOR LICIIITING POWER - Space-by-Space Meth ughting Power I Teal interior wi ng pew Budget boo uebrlaettoe t SRO pro or Column RJt L5 Teaelm Lightlog e 2. To r ef q a l cma ,1C,ee £,T* Cr, rvarl tz.0 et V/ f, - Pomo - : a. IHne 2 muldpIIeq by 3T,6 Wetlerlt 4. Total aef:pwoge at c ream . bf r(e eerefp Mk RPM (Amps? S. Voltage of drool, brenker Soon track Itien9Nob) e. Merin m mange of Inds Wang (170518y atria a by One 5) 7. Track LtgMing hoer (tes®r value of Noe 3 or Poo 8) Thatlategs 8. Total Inteflor Ltphtleo PoWeritem Wmlmtteet 8b- 1(SU:1► of eo1ann ($) MghtIng room 9, Tetra Atha Ligteno Power (afe • nnm 8 ) _ S/ 10. Does desk maw bollgot L1ne 9 must be no (,fester Vion Me 1. ■lo c � common um onso, wove. ammo 01/12/2006 14:38 8585928829 PAGE 10 01/0€s/200b 12:21 + J1MRAD PAGE 84 - wonaned51).1 prole:04mm MEMO Pig' — "Sff1/419. / 6Qcf1e 1 WTERIOR UGB G POW e (q) I wm tre 2m Blot berow gem ID OM WON vh Prow rreusi tumMeWee( !urinate .: 1 Melt aMAW mree W x eeeM net keue .. But n 6ucdrt* Pewit( neck gem' Rnempt fNEM4S muff w•a 114 Dome. ' �-/ AR^ , .5 fl C j .w seer WO lad IR �, • A • . . rte ° . Cdlortm (w wag' .. _ r ' Sa t. pun dafte n ror eastroom ,lit I o Q ' .S�� nes mnrx Drat fer eieroem.s4e -- 0 . a4 V gi exanale M �� , — iM1Iu eena. I �QA� , r IF.l%I/L` E. . • WA / u / MEIN 111111111111MMIIIIIIMI 0 t .. q LA a 2 • I eES7 &V ' . 4ce co. , �d',li � a �' ENE 23 ° , . CI gra III Mil / _ 6TM ' / _/.1 W. MI p �,-� a � MN ra MI 470 1E4, R0014 N = n Z3 EN . ME 0 EOM E .. _ . ca EMIL: um , a cl um EN E = - - =AM 01 =NI E 0 mum - alwEE no nim mil . - 1 • im miL) E . - I M , 1.111 . f3 =1 EMIll - la well raL w641181'. - : MIIIII1==:C:S::::S/G2 : WWII BSI Tote Urn POrt7r ICOMMIPIMMOTIM eThlry4 . 6.-,.. Lcsa � Weft, Told t arOf Addillenel WaMOtlol!D - - -- .„,,,y ro =lop uP nanMMlee M fuming PI �M�,k .:•;:. — yea •W SUMO tl AelfOtrCflo sift MIIIIIMIIIIM cornm .neartc,mammas 01/12/2006 14:38 8585928829 PAGE 11 01/06/2006 12:21 + J11 AD PAGE 05 Prof Ns • MF T • e h/Ashibit6^PO SQ ' 0,7, LIGHTING SUHEUULE . .... . .:. ...._. .... ......, (a) -1 to ( y t".- ' 0) lti) ( « Y minallc , .. . Sp01R _gat, t Frott+T * ti Lupht Mn Na Utmmpunn 1 ND. Unn0+ti „ tan _ (+e14) Bd, B 'McRae) MaTRL wQ'E M Paw, 2 32 ti e# I M4G sr 72 Y $ G l/ 1y(446 Tie , C) NE 4 I 3:514 4 I E P 38 Y ' LJV _, 7,e+14ci / E►4-.D SW twig C E PS FiB YE,F RECESSED ME7■ Hy9[I�'E MOLT /s7OT .i 82ftf/ f14C ST,) 7 ' Y6ES FL voA?ESC ivy` ST,�I P c Fe/,l T F 2 7, LFC /10 YES' _ FcvoRESGAIvr f.,"Tiei f 7' 4.10,4 F3278 r EG 'o 2`7• 0 M D i i ,.. :5 1- 9 YES ' MI tpttgA4CT F44 ve P O'/ 4 i W 0 / '4 " T 12 23_. YE$ J.i,TVC4V2 - cc EPPT" ReCEs.saP Pew 4/45iPm.1PA "?4 50 Y.eS F STsRl_f G /6 HT IS P257'e ri E .EC AT Ar L.lua,e CE /7' sniAt 7 se c r f fiszr8 2 E, G C Y E S ! IOC/14V EsCENT" _ PE,,.t' F / V/9` © 7 � 7 ” YES • „/ W C 04 4/ AP .a E o p . A'.O4 .�. r /5•0 _... , ,, /5D Y 1. El II T - EMI II IIM II Ill _ i ill IN ■ 1 ■ II CIT IGARD - BUILDING DIVISION PERMIT #:.::.24X5 5 13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: - f 6 ( W f S & • C,6). CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: Uwe© 7 DESCRIPTION: v �� OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 3 - a 3 - 0 1 p Pour Time: p . Code # Inspection Description Confirm # Contact # Message 56A6 301 Corrections /Comments /Instructions: - /4- . ('1 • � n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS _ ❑ FAI ❑ CALL FO' INSPECTION ❑ ADDITIOINAL FE S ASSESSED Inspector: Ohl \ I Date: Z- hone #: (503) 718 - -"AZ._ CITY OFTIGARD BUILDING DIVISION PERMIT #: .20 ©S- DO 4o43 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: g 6g1 vi Ast ` S7 Pd C-G CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: AA P H O N E #: — 1 3- 30 /b CONTRACTOR: - 1 I j�t.— PHONE #: Inspection Request Scheduled For: Date: 3 - Pour Time: Code # Inspection Description Confirm # Contact # Message oar] S b6 Corrections/Comments/Instructions: 11.1 10% • • • ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS IL ❑ CALL FOR INSPECTION ❑ ADDITIONAL ES ASSESSED Inspector: A we' Date: r...40L `Phone #: (503) 718 ir v CITY CF TIGARD BUILDING DIVISION PERMIT #: ead20 czS =DO6 '3 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: f1 W asL PCP CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: �, DESCRIPTION: T4 � L.fO ,t _ OWNER: PHONE #: CONTRACTOR: M K2'- PHONE #: Inspection Request Schedule • Date: 3 r = O (O Pour Time: Code # Inspection Descriptio Confirm # Contact # Message 9V/ 41- Correctio s /Comments /Instructions: • C U • • • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑, FAIL ❑. CALL FO' INSPECTION ❑ ADDITION FEES ASSESSED Inspector: awe Dater Phone #: (503) 718 • CITY OF IGARD BUILDING DIVISION PERMIT #: i3UP 2111)`,.00643 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1 /2612oou Phone: (503) 639 -4171 fa r �� Inspection Requests (24 Hrs.): (503) 639 -4175 '� I INSPECTION WORKSHEET FOR DATE: 2/22/2006 TIME: 7:02AM PAGE: SITE ADDRESS: 0r3681 SW WASHINGTON SQUARE RD tab CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: METRO PARK DESCRIPTION: C flI 928 sq ft area) • OWNER: ASI IlNtry ON SQUARE I.LC<, PHONE #: CONTRACTOR: WASHINGTON CONSTRUCTION PHONE #: 951 - 359.3710 Inspection Request Scheduled For: Date: 2122/2006 Pour Time: Code # Inspection Description • Confirm # Contact # Message 28.E Drywall nailing 027291-01 961. 463.3016 Y Corrections /Comments /Instructions: OA ( KC • • • L • • , • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAI CALL FOR INSPECTION ❑ ADDITI • AL ' ES ASSESSED F 1116. • 4111 ! Inspector: Date: v Phone #: (503) 718 - 2:3 CITY O'F TIGARD (4 e BUILDING DIVISION PERMIT #:. 0S b0 ( ( 13 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 - --< h+rw Inspection Requests (24 Hrs.): (503) 639 -4175 "'IL INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: T( 8 1 Wig-- _ 5 Q . f D CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: """rytthz � - PHONE #: Inspection Request Scheduled For: Date: a1— ( L{ —0 co Pour Time: Code # Inspection Description Confirm # Contact # Message (i. zgq cc) p( QJ� gst - `IS 3 - 3 r Corrections /Comments /Instructions: CLI c C PASS P , AL APPROVAL ❑ CANCEL 111 NO ACCESS ❑ FAIL LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector . _ Date:Z 1 ,0a: Phone #: (503) 718: