Permit A b iii
CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2004 -00140
�P' DEVELOPMENT SERVICES DATE ISSUED: 7/20/2004
'=� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171
SITE ADDRESS: 12074 SW WHISTLER'S LP PARCEL: 2S103CC -13100
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R - 4.5
BLOCK: LOT: 078 JURISDICTION: TIG
REMARKS: New SF detached.
BUILDING
REISSUE: DM192 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW ' HEIGHT: 25 FIRST: 2,070 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,630 sf GARAGE: 616 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 T889 sf RIGHT: 5
VALUE: 358,774 40
OCCUPANCY GRP: R3 BDRM: 5 BATH: 4 TOTAL: 3,700 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 4 WASHING MACH: 1 LAUNDRY TRAYS. RAIN DRAIN: 100 TRAPS:
LAVATORIES: 6 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 5 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 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: 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:
EAADD'L 500SF: 7 201 - 400 amp: 201 - 400 amp: 1st W/OSVC/FOR: 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 REVIEWS ECTION
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: INTERCOWPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: 0TH: BOILER: HVAC: LANDSCAPE/IRRIG: ' PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 8,938.86
This permit is subject to the regulations contained in the
DON MORISSETTE HOMES DON MORISSETTE HOMES INC
4230 GALEWOOD ST 4230 GALEWOOD ST, STE 100 Tigard Municipal Code, State of All work k will b o ne i n
and all other applicable laws. All work will be done in
STE 100 LAKE OSWEGO, OR 97035
LAKE OSWEGO, OR 97035 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.
Phone: 503 387 - 7538 Phone: ATTENTION. Oregon law requires you to follow rules
�`+ adopted by the Oregon Utility Notification Center Those
Reg #: 9 387 7 35 rules are set 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
Ersn Cntrl 681 -4444 Post/Beam Mechanical Plumb Top Out Exterior Sheathing Insr Gyp Board Insp Appr /Sdwlk Insp
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Rain drain Insp Electrical Final
Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Storm drain Insp Mechanical Final
Foundation Insp PLM /Underfloor Framing Insp Gas Fireplace Water Line Insp Plumb Final
Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Water Service Insp Final inspection
Issued By : Permittee Signature
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
SW i2 _ 'a4 v v 3;►
Building Permit Application
Datereceiv -. ' / jgb PermitnoA/9:,20a7v .9/ /
' ' •= j City a Til
t1 ® Project/appl. no. Expire date:
City of Tigard Address: 13125 SW 1 ilf: hitf,Waxa, ont 97223
Phone: (503) 639 -4171 ,�/ Date issued: By: Receipt no.:
Fax: (503) 598 -1960 ;~Y " % 6.1011 Case file no.: Payment type:
Land use approval: C IT`i OF TIGARD 1&2 family: Simple Complex:
TYPE OF1'ERN11T '
0 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ›'New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement 0 Fire sprinkler /alarm 0 Other.
JOB SITE INFORMATION
Job address: atriri AIIVA f I A TMi" I T triA Bldg. no.: Suite no.:
Lot: 'AI Block: Subdivision: 1 v .�(lw;<i Tax map/tax lot/account no.:
Project name:
Description and location of work on premises/special conditions:
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST'.::
\ 1•.lood lain septic capacity, solar, etc:
Mailing address: !>li'�JIT
g ���� �• 1 & 2 family dwelling:
ZIP: ' 7. i� Valuation of work $
Phone: . r,- AJ l ' � , r No. of bedrooms/baths S
Owner's representative: , L�, ( _ Total number of floors �
Phone: Fax: E -mail: New dwelling area (sq. ft.)
. .. APPLICANT Garage/carport area (sq. ft.) N
IM11671-• 111111 Covered porch area (sq. ft.)
Mailing address: t , yY1e/ , a CL. V Deck area (sq. ft.)
City: I State: I ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commerciallindustrial /multi - family:
CONTRACT-Olt Valuation of work $
Existing bldg. area (sq. ft.)
VOI tt. z:i� (2=1 New bldg. area (sq. ft.)
Address: . 0. a i
City: Number of stories
ity: State: ZIP:
Phone: I Fax: I E-mail: Type of construction
CCB no.: 5 Cj"�j " 7�- Occupancy group(s): Existing:
City /metro lion no.: New:
Notice: All contractors and subcontractors are required to be
ARCIIITECT /DESIGNER ' licensed with the Oregon Construction Contractors Board under
Name: c a. l4t✓r � 1 k ., provisions of ORS 701 and may be required to be licensed in the
Address: _ ,L S • C(,/ 1 01 ,._ jurisdiction where work is being performed. If the applicant is
City: State: ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
. ENGINEER ':
Name: Contact person: Fees due upon application $
Address: Date received:
City: (State: 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. A . rovisions of 1 ws and o dinances governing this 0 Visa ❑ MasterCard
work will be comp] - • wr. whether ified lerein t. Credit card number: / /
/
Authorized sly atu • . /1 - A j v I �/ Name Na of cardholder as shown on coedit card Expires
Print name: • m._ - , +.2-pet.'.-
.2 e' - i ( yy $
�`- -F-- 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 (6i00/COM)
1
One- and Two - Family Dwelling
' ' Permit Application Checklist ;``:,_y;; Building Permit Application Checklist Reference no.:
Associated permits:
City of Tigard City of Tigard `J g ❑ Electrical ❑ Plumbing 0 Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 ❑ Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
THE- FOLLOWING ITEMS ARE REQUIRED FOR 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. 4
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 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 v .
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, `l
fireplace construction, thermal insulation, etc. J�
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 K
systems, see item 22, "Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists
over 10 feet long and/or any beam/joist carrying a non - uniform load. x
20 Manufactured floor /roof truss design details. •
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required
for four or more appliances.
22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or
architect licensed in Oregon and shall be shown to be applicable to the project under review.
JURISDICTIONAL SPECIFICS
23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". )C
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 (6/00/COM)
/
Plumbing Permit Application , - ' ..
Date received: Permit no li S f ✓, c/ .0/ %,
° --� 1' City of Tigard
s!' �.) � Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd. Tig kiOR 7
City of Tigard Phone: (503) 6394171 �I`V/�IAT 04 Project/appl. no.: Expo date:
Fax: (503) 598 -1960 CITY OF TIGARD Date issued: By: Receiptno.:
Land use approval: BUILDING DIVISION Case file no : Payment type:
TYPE OF PERMIT •
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi family 0 Tenant improvement
►. New construction 0 Addition/alteration/replacement 0 Food service 0 Other.
- . _ JOB SITE INFORMATION ' • - ' ma
FEE SCHEDULE (for special information use checklist)
Job address: . I���� / ' �/31 Description Qty. Fee(ea.) Total
�� 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: A P - SFR (2) bath
Project name: SFR (3) bath
City /county: I ZIP: Each additional bath/lcitchen
Description and location of work on premises: Site utilities:
Catch basin/area drain
Est. date of completion/inspection: Drywells/leach line/trench drain
completion/inspection: p Footing drain (no. lin. ft.)
- - . PLUMBING . CONTRACTOR Manufactured home utilities
Business name: ,p L i Manholes
Address: ��bTin , • Rain drain connector
ri_;. 1,.. ZIP: Sanitary sewer (no. lin. ft.)
• Fax: E -mail: Storm sewer (no. lin. ft.)
one y� ti Water service (no. lin. ft-)
CCB no.: [ C9`7 L•( —] - W�� Plumb. bus. reg. no: - ' Fixture or i tem
City/metro lic. no.: N/A ; /' , Absorption valve
Contractor's representative signature �`.�/ Back flow preventer
Print name: , 1MIL • il 4 / S Backwater valve
C•ON•1•ACI.,,- PERSON . ' , - Basins/lavatory
Clothes washer
Name: �1 �-( sP'c�Dl E Dishwasher
Address: - a • / 0 [ , ,V - Drinking fountains)
City: I State: Ejectors/sump
Phone: Fax: Expansion tank
' ; _ " <r. • . 0V \I:R Fixture/sewer cap
' Floor drains/floor sinks/hub
Name (print): :ail t i•�` l Garbage disposal
IN
Mailing address: ,-2-r) ( - • 1:4V7 1111 • Hose bibb
City L_ State &a Ice maker
Phone: j - Ar Fax: E-mail: Interceptor /grease trap
Owner installation/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain (commercial)
employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s)
Owner's signature: Date: Sump
ENGINEER • - Tubs/shower /shower pan
Urinal
Name: Water closet ,
Address• Water heater
City SHat_e_:________I ZIP. Other.
Phone. I Fax: E -mail. Total
Minimum fee ................ $
'Not 3.11 Jurisdictions accept cards, please call iufls cuon far more mtomuuon\ Notice: This permit application % $
Plan review (at _ )
C Visa ❑ MasterCard ! / expires i a permit is not obtained State surcharge (8 %) •••• $
C.e ii card number,
w ithin 180 days after it has been $
Expires TOTAL __—___—
accepted u complete
Name or cardholskr as shown on credit card S
Amount 440-4616 (6.vodCOM)
•
■ Cardholder signature �
, , .
A " Mechanical Pe .,•; lg. ) t 1 III n
� Date eceived: Permit no.r)1,5'T�p V -00/ , i
'� *Iy� City of Tigard MAY 7 2004 Projecdappl.no.: Expire date:
City ofTigard Address: 13125 SW Hall BIvdCArdbF TIGARD -
Phone: (503) 639 - 4171 Date issued: By: Receipt no.:
Fax: (503) 598 - 1960 BUILDING DIVISION Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial Cl Multi - family 0 Tenant improvement
,New construction 0 Addition/alteration /replacement 0 Other.
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: ir j �(M'1/ Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $
Lot: IIM Block: Subdivision: wgrologno ' See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: ZIP: 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE` •
Description and location of work on premises: AND COMMERICAIJINDUSTRIAL EQUIPMENTSCHEDULE
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? Cl Yes Cl 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 ME
MECH 1NIGAL'. 'CON I Rr1C "fO R _ Boteboomprermit II
gall ��} � State boiler permit no.:
aIil HP Tons BTU/H
Address: gairl� Fire/smoke dampers/duct smoke detectors _
L MEE/11111:41 1 Heat pump (site plan required) I
Phone: a10 - ' Fax: E -mail: Install/replace furnacelburner BTU /H ■ --
Including ductwork/vent liner 0 Yes O No
CCB no.: , j Install/replace/relocate heaters - suspended, ■ --
City/metro lic. no.: N/A wall, or floor mounted
Name (please print): VI, G 4 /Jjt A
� Vent for appliance other than furnace ME
CONI'�1C :' fI RtiC)N . Refrigeration:
Absorption units BTU/I-1 II
■iL illI Chillers HP _
Address: Compressors HP �
4_ ♦ �l Environmental exhaust and ventilation: Ill
City: State: ZIP: Appliance vent
' Phone: Fax: E -mail: Dryer exhaust
- O WNER- Hoods, Type U IUres. kitchen/hazmat ■ __
hood fire suppression system — _
MIN >r q� • tti Exhaust fan with single duct (bath fans ) -
Mailing address: rri / i _im EITo
T al Exhaust system apart from heating or AC _
EIMIIMPROMIIMIE ETNA
�� y � Fuel piping and distribution (up to 4 outlets) ■ --
Type: LPG NG Oil
Phone _rw Fax: E -mail Fuel piping each additional over 4 outlets - -_—
IN G IN E h R : ' Process piping (schemauc required) -
N ame. - Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace III
City State: ZIP: Insert - type
Phone: 121111.1M E - mail: Woodstove/pelletstove
Other: i _�
Applicant's signatu ":0 J�� , r jr' Date: � I Other. ME
Name (print): • , • • /
Not all jurisdictions accept credit cards. please call jurisdiction for more information. Permit fee $
Not Th permit application Minimum fee $
0 Visa 0 MasterCard expires if a permit is not obtained
Credit card number E
Expires within 180 d ay s after it h as been Plan review (a[ _ %) $
x
p State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete.
S TOTAL $
Cardholder signature Amount 440 -4617 (600/COM)
. . .
. .
. A • Electrical Permit Application - . Y _ . •
/ p� G L,J
p ; pp
ect/a
Pro Date received: Permit no.:�l � r � -! /
• �/
1 y, f lI
t I'� City of TigarP 1 no.: Expire date:
_ �/
City ofTigard Address: 13125 SW Hall Blvd tgard,7Q{�trp722 Date issued: By: Receiptno.:
Phone: (503) 639 -4171 MA (�U�U�4
Fax: (503) 598 -1960 Case file no.: Payment type:
CITY OF TIGARD
Land use approval: RUIII DING DIVISION
TYPE OF PERMIT •
❑ 1 & 2 family dwelling or accessory 0 Commercial/industrial ❑ Multi- family ❑ Tenant improvement
►'. New construction 0 Addition/alteration /replacement ❑ Other. ❑ Partial
• JOB SITE INFORMATION
•
Job address: po- am! n -" ` - 1 Bl dg. no.: Suite no.: Tax map /tax lot/account no.:
—
Lot: 4 6 !Block: !Subdivision: \/`f �.9 ` J�
Project name: I Description and location of work on premises:
Estimated date of completion/inspection:
. CON FRAC`I`01Z Al'I'LICA I ION FEE SCHEDULE -
Job no: Fee Max
Business name: (—[\---) a.ELTV-1 L Description Qty. (p•) Total no. Insp
New residential - single or multi- family per
Address: t, _ IP �` ilt`t ■t • ( -- .,_4v dwelling tmit Includes attached garage.
= _ IIMI i l ZIP: i Service included:
Phone: I • Fax: E -mail: 1000 sq. ft. or less 4
`� Each additional 500 sq ft. or portion thereof
CCB no.: Elec. bus. lit. no:
Limited energy, residential 2
C Limited energy, non - residential 2
Each manufactured home or modular dwelling
n ature of electrician (required) Date ,;(r('y Service and/or feeder 2
Sup elect. name (print) 1 A � , License no ., a Serncesorfeeders — lrtstallation,
AIL t" F alteration or relocation:
PROPLIZTY OWN I:R .. • 200ampsorless 2 • 201 amps to 400 amps 2
Name (print): ` • • 1110.0111-11161/ 401 amps to 600 amps 2
Mailing address: l 1011111111 S. ' 601 amps to 1000 amps 2
City: 4. • State ' ZIP: 70 L Over 1000ampsorvolts 2
Phone:27 -j Fax:57-'7/ E-mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary servicesorfeeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, or relocation: 2
200 amps or less
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
- , ENGINEER .. Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: ! State: ! 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):
circle 2
u
i
Each pump or mgaon c
❑ Service over 225 amps-commercial 0 Health -care facility Eac 2
O Service over 320 amps - rating of 1&2 0 Hazardous location Each signor outline lighting ,
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel.
❑ System over 600 volts nominal more residenual units in one structure alteration, or extension* 2
O Building over three stones ❑ 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. Perinspecuon I I I I
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all junsdicuons accept credit cards, please call jurisdic000 for more information Notice: This permit application Permit fee $
O 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 (6.0(VCOM)
',, 445 i c cr - off -v l o
4 _ __________ _ c
CERTIFICATION
STREET TREE
1
A !-)wnci /A (car AIL/ go�t,SS6.77� livt
1, _ eti4x 1 +76. ?� - -- (1'liltAllY'IlO1.Il1 RJ
0.EASE PRIM) 1)c> I►c•ICI) cei that the following location
meets City of 'I'igatcl /Wasltittgton County
i 44 Lund use and development standards lot stuff! It installation.
A
ADDIt ESS: _moo Pi 54 X,-I/5 ft- G rzs - —
i A
' , LOU: ' - 70 _ - SI IBI)IVJSR )NI: - y►011p gJ2S w.4-c- X,1Z
4 BY: / Z.-- As A -..,,,,, DATE: /0 - 9-6'
illy _ .
d IiECI.IVIU) BY: -
-- TTTTTTTT � 4 ' ITTTTTTTTTgTTTy 'TOTTTTT`PYTTTTTTTTTTTTVYTTT11
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST .400
caw
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested /4 --- ?' ‘ 7 AM PM BUP
/
Location / j;,/, Suite MEC
Contact Person �/� Ph ( _ • -- ..e. PLM
Contractor Ph ( ) SWR
ILD�N Tenant/Owner ELC
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear /
Int Sheath/Shear
Framing OS At C O s � o �� '(A �—
Insulation S7—R
Drywall Nailing
Firewall
AI Fire Sprinkler C 7
Fire Alarm
Susp'd Ceiling
Roof _P / ' a/1
Other: _ _
.ASS PART gi0
PLUMBING
Post & Beam
Under Slab
Rough -In Wri � Q • c:74-/
Water Service l -G�
Sanitary Sewer Co w 1'0
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL •
CHA AL
cam
Rough -In
Gas Line
Smoke Dampers
Fin
PA: FAIL
ANIVIHIP -
Rough -In
UG/Slab
Low Voltage
Fire rm
•
S
T FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE fl Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line �j
ADA /o Z -/ - U
Approach/Sidewalk Date I nspector E7ct'
Other:
Final DO NOT REMOVE this inspection record f the job site. - -
• PASS PART FAIL
CJTYOF TIGARD 24 -Hour ,
BUILDING • Inspection Line: (. 3) , 75 MST !/4
INSPECTION DIVISION Business Line: (5 ;t , - .
BUP
Received Date Requested /0 q A PM BUP
/
Location / -O 71/ (O� ' , ite MEC
Contact Person l e, - ems Ph ( ) ' • � � PLM
Contr Ph ( ) SWR
Tenant/Owner ELC
ooting
oundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: axe,s \A d 1/4 - -- L.4 SIT
Post & Beam
Shear Anchors a (I" 1/4'J L ���
Ext Sheath/Shear z ' `' ,/ � '
Int Sheath/Shear l �j
4.)
o
Framing `'1 �" �� ` f / Zt)
Insulation
Drywall Nailing C �Q / .. ) "� °� a
Firewall th l .- �-. % /1 / • /
Fire Sprinkler
Fire Alarm / 5 fZZ S
Susp'd Ceiling — u
Roof 7 S S l e,--.,. 2— c ) / t O e
i
j RT FAIL
PTY'
Pos ; Beam •
Under Slab _ _
Rough -In MIlli
Water Service ,� :. -
Sanitary Sewer
Rain Drains
Catch Basin /Manhole IlfgriTar,A
Storm Drain
Shower Pan I •
Other: -
Ina 'i
PART FAIL "
CHANICAL • =
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 0 Please call / (e)L for reinspection RE: El Unable to inspect - no access
Fire ADASupply Line i O / Vl ‘w
Approach/Sidewalk Date 111 Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the. job site.
• PASS PART FAIL