Permit A ..
CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2004 -00115
1V. DEVELOPMENT SERVICES DATE ISSUED: 5/14/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12077 SW WHISTLER'S LP PARCEL: 2S103CC -WW286
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R -4.5
BLOCK: LOT: 086 JURISDICTION: TIG
REMARKS: New SF detached
BUILDING
REISSUE: DM169A STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 19 FIRST: 1,890 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1.070 sf GARAGE: 624 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 TRIM sf RIGHT: 5
VALUE: 289,563.60
OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2.960 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 2 CLOTHES DRYER: 1
GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 • 200 amp: 0 - 200 amp: W/SVC OR FDR: PUMP/IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 6 201 - 400 amp: 201 - 400 amp: let 1MOSVCJFDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 • 800 amp: 401 • 600 amp: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT:
MANU HM/SVC /FDR: 601 • 1000 amp: 601 +ampe•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: LANDSCAPEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 8,082.97
DON MORISSETTE HOMES DON MORISSETTE HOMES INC This permit is subject to the regulations contained in the
4230 GALEWOOD ST 4230 GALEWOOD ST, STE 100 Tigard Municipal Code, State of OR. Specialty Codes
STE 100 LAKE OSWEGO, OR 97035 and all other applicable laws. All work will be done in
ST
ST EE 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
7 -7 adopted by the Oregon Utility Notification Center. Those
Reg #: iq 38 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 Ins 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 Building Final
Issued B - _ _ _ - . _ _ -_ . _ �
Y• , Permittee Signature : ..-.0.----
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
lb r 6 - /t / -D - PO / /`!'
,. .3
Building Permit Application
Date received! /WA Permit no.k.g f/
City of Tigard tao� ��i5
1 y �I I ! Project/appl.no.: Expire date:
City ofTigard Address: 13125 SW p , `_t g �� ��
Phone: (503) 639-4191 �' = Date issued: By: Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
APR 0 8 2004 y: Simple I &2 fam;i
Land use approval: p Complex:
Y OF TIGARU
1'1 !.1 OF PERi1IT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial 0 Multi- family , 'New construction 0 Demolition
0 Addition/alteration/replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other.
JOB SITE INFORMATION
Job address: . r/ �_� ■TRE'1Lffido Bldg. no.: Suite no.:
Lot: I,ni Block: Subdivision: ry l lE`Mi' Tax map/tax lot/account no.:
Project name:
Description and location of work on premises/special conditions:
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
; 0 .e. (Floodplain. seplic capacity, solar, etc.)
Mailing address: £ r o artl 1 & 2 family dwelling:
EMINWr EMA ZIP: . 7) . Z jn Valuation of work $
Phone:. ne at'« rs'�tjgffrigalM, o No. of bedrooms/baths
Owner's representative: , e _ Total number of floors or
Phone: Fax: E -mail: New dwelling area (sq. ft.) ■ qr,
APPLICANT Garage/carport area (sq. ft.) /I7
Covered porch area (sq. ft.)
Mailing address:
, a. /"w Deck area (sq. ft.)
City: State: ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/industrial /multi - family:
CON'TRACI.OR Valuation of work $
Existing bldg. area (sq. ft.)
IMMETZDI7IMIMMIMMMIE New bldg. area (sq. ft.)
Address: rr 1Va.. Number of stories
City: State: ZIP:
Phone: Fax: E -mail:
Type of construction
CCB no.: Occupancy group(s): Existing:
City/metro lic. no.: T New:
Notice: All contractors and subcontractors are required to be
. r ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
4.__ /�TL. 4 provisions of ORS 701 and may be required to be licensed in the
Address: , r ' jurisdiction where work is being performed. If the applicant is
" � c ��'` ` exempt from licensing, the following reason applies:
City: State: ZIP:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: State: ZIP: Amount received $
Phone: Fax: 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 ❑ Visa ❑ Mastercard
work will be compl • wt • , , whether cified ilere�n t. Credit card number / /
1 Expires
Authorized si l4 atu • ' i f A 1 Name of cardholder as shown on credit card
$
Print name: r>_ - 4- 21:0. ( 1' .K._ 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 (6l00ICOM)
One - and Two - Family Dwelling
Building Permit Application Checklist Reference no.:
a
CuyofTigard City f Tigard Associated permits:
J g 0 Electrical ❑ Plumbing Cl Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 0 Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
TIIE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
I Land use actions completed. See jurisdiction criteria for concurrent reviews. V
2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc.
•
3 Verification of approved plat/lot.
4 Fire district approval required.
5 Septic system permit or authorization for remodel. Existing system capacity
6 Sewer permit.
7 Water district approval. �(
8 Soils report. Must carry original applicable stamp and signature on file or with application.
9 Erosion control 0 plan 0 permit required. Include drainage -way protection, silt fence design and location of �j
catch -basin protection, etc. J�
10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed t/
if copyright violations exist. J�
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if
there is more than a 4-ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and
driveway; footprint of structure (including decks); location of wells/septic systems; utility locations; direction indicator, lot x
area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage.
12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent
size and location.
13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater,
furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc.
14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub -floor,
wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show
details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, X
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."
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. / x -
22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or
architect licensed in Oregon and shall be shown to be applicable to the project under review.
JURISDICTIONAL SPECIFICS
23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". x
24 Two (2) sets each are required for Items 16, 19, 20 & 22 above.
25 Building plans shall not contain red lines or tape -ons.
26 No rolled, reversed or mirrored building plans will be accepted.
27
28 •
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 440 -4614 (6/VO/c0M)
•
Mechanical Permit Application
�, Date received: Per no.:,l}�r9pjp.1 -00 S
�� R EVE ED mit
-11!. C ity of Tiga i t EC Project/appl.no.: Expire date:
City of Tigard Address 13125 SW all Blvd, Tigard OR 97223
Phone: (503) 639 - 4171 0 8 Date issued: By: Receipt no.:
Fax: (503) 598 - 1960 PR Case file no.: Payment type:
Land use approval: G�TY OF TIGAKU Building permit no.:
:U1L'DIN(a DlViolO "1
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement •
iew construction 0 Addition/alteration/replacement 0 Other.
JOB SITEINFORMAT1ON COMMERCIAL VALUATION SCIIEDULE -
. Job address: atiii u J Dt� 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: 2A Block: Subdivision: vi (ffr ' See checklist for important application information and
Project name: - jurisdiction's fee schedule for residential permit fee.
City/county: [ZIP: I & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: AND COMMERICAL/INDUSTRIAL EQUIPIIIF.NTSCIIEDULE
Fee(ea.) Total
Est. date of completion /inspection: Description Qty. Res.only Res.only
Tenant improvement or change of use: Air •
Is existing conditioned? 0 Yes 0 No Air handling unit CFM
g s P ace heated or conditone es Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No _ Alteration of existing HVAC system
M ECH ANICA\L CONTRACTOR Boiler /compressors
State boiler permit no.:
0=1/Lfi �L 1 HP Tons BTU/H
Address: ��� Fire/smoke dampers/duct smoke detectors
City: �� L State' 7MIZEWIII: Ira7 Heat pump (site plan required)
Instal /replace furnace /burner BTU /H
Phone: �6. . 'Far: E-mail: Including ductwork/vent liner O Yes CI No
CCB no.: .?jr94-j(1) Install/replace/relocate heaters - suspended,
City/metro lic. no.: N/A wall, or floor mounted
Name (please print): j gp l 1 1/Jj d (• Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/1-1
Name: . Chillers HP
Com. ressors HP
Address: t L b[
Env exhaust and ventilation:
City: State: ZIP: Appliance vent
' Phone: Fax: E -mail: Dryer exhaust
. OWNER Hoods, Type 1/ IUres. kitchen/hazmat • hood fire suppression system
�� .ir _ !lgr, il Exhaust fan with single duct (bath fans)
Mailing address: g r�� ) / SM raral Exhaust system apart from heating or AC
Fuel piping and distribution up to 4 outlets)
�� ., ��� Type: LPG NG Oil
Phone: "SEIVOirli Fax: E - mail: Fuel piping each additional over 4 outlets
• - • ENGINEER ' Process piping(schemaucrequired) ,
Name: Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City I State: 'ZIP: Insett type
Phone: Fax: E -mail: Woodstove/pelletstove
e �b1f/�' 1 /EMI Other.
Applicant's si�fratu" : Date:
Name (print): (.(c . i y r f n 1, / I
T
Not all junsdicuons accept credit cards, please call junsdicuon for more information. Permit fee $
0 Visa 0 MasterCard Not Th 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
accepted as complete.
State surcharge (8 %) .... $
a cce
Name of cardholder as shown on credit card P p
S TOTAL $
Cardholder signature Amount 440-1617 (6R) OM)
,
Plumbing Permit Application . .
• E G E B' ®I � D Date received: Permit no.: In 5.7-.. DN - �/ /
"�l City of Tig !! Sewer permit no.: Building permit no.:
Address: 13125 SW Hall B lvd. Tigard, OR 97223
City ofTigard P r ojec t/a pp l.no..
(503) 639 -4171 APR 0 8 1UU4 Project/appl.no.. Expire date:
Fax: (503) 598 -1960 Date issued: By: Receipt no.:
CITY OF TIGHhU
Land use approval:BUILDING niviRi i." Case tile 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 FEE SCHEDULE (for special information use checklist)
Job address: Q - 2 1 / �� Description Qty. Fee(ea.) Total
P
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 (I) bath
Lot: VIA I_ll� i SFR (2) bath
��' Block: Subdivision:
Project name: SFR (3) bath
City /county: I ZIP: Each additional bath/kitchen
_
_ Description and location of work on premises: Site utilities:
Catch basin/area drain
Est- date of completion/inspection: Drywells/leach line/trench drain
—. Footing drain (no. lin. ft.)
I'LLI\lIll G CONTRACTOR Manufactured home utilities
Business name: Pc(Z Lu � I ti1b Manholes
Address: T l lQ Rain drain connector
• ZIP: Sanitary sewer (no. lin. ft.)
City: tip • t _vim ■ State� Storm sewer (no. lin. ft.)
Phone: -' E -mail:
(L'�,l✓ �� Fax: ti Water service (no. lin. ft.)
CCB no.: C9+
I " 7 Pl umb. bus. reg. no: - - ' t Fixture or item:
City/metro lie. no.: NSA /' � Absorption valve
, Contractors representative signature ........>,..--S.--\\ ✓(/ dm Back tlow preventer
Print name: • • , I u • ' I E2.IIII Backwater valve
•
CONTACT PERSON Basins/lavatory ,
Clothes washer
Name: 1 {\ s��DI „le Clothes
--I
Address: A / b c ., ,Ni - Drinking fountain(s)
City: I State: ZIP: Ejectors/sump
Phone: Fax: E -mail: Expansion tank
'`:- <` T:' - - .` ., OWNER Fixture/sewercap
Floor drains /floor sulks/hub
(print): - _alt ( Garbage disposal
Mailing address: <{r} [ " • (�IV7 1 Hose bibb •
City: L _ -) . State glia ZIP: lipr Z� Ice maker
Phone: f - Ar Fax: •,7-7IL1 E -mail: Interceptor /grease trap
Owner installation/residential maintenance only: The actual installation Pnmer(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' State. ZIP: Other.
Phone. I Fax: E -mail. Total
Minimum fee ................ $
Not all )ttnsdicuons xcept credit cards, please call lunsdtcuon for mom tnfomuuon Notice: This permit application
Plan review (at _ %) $
C Visa 0 MasterCard I / expires If a permit is not obtained State surcharge (8%) $
C.edit card number w ithin I80 days after it has been $
Expires accepted as complete. TOTAL _---
Name a( cardholder as shown on credit card
S
Cardholder signature Amount 4.I0s616 (60 COM)
Electrical Permit Application
Date received: Permit no.: T Et — Qe / / /
, . 4 i - .: - I l .
,L .. I r City of Tig . t Project/appl.no.: Expire date:
City ojTigard Address: 13125 , f�" ' , 223 Date issued: By: J Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
APR 0 8 2004
Land use approval:
CTfYOI- 1TGARD
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 Other. 0 Partial
- JOB SITE INFORMATION •
Job address: 0 r ” cv ' ' • '- "\ p , Bldg. no.: Suite no.: Tax map/tax lot/account no.:
V�J
Lot: 010 Block: 'Subdivision: . J ',(1 J
Project name: I Description and location of work on premises:
Estimated date of completion/inspection: .
CON"I RAC I OR r \I'I'I.ICA ZION FEE SCHEDULE -
Job no: Fee Max
Business name: , 1 Description Qty. (ea.) Total no. hasp
_ `/ '� New residential -single or multi-family per
Address: 11 • �-t� Ply dwellingunit . includes attached garage.
EMI ' , =� . �:� ZIP: # Service included
Phone: I ��
1 • Fax: E -mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft or portion thereof
CCB no.: Elec. bus. tic. no: � 0 Limited energy, residential 2
C Limited energy, non - residential 2
1 f Each manufactured home or modular dwelling
nature of supervising electrician (required) Date %/ 0 Service and/or feeder 2
Sup elect name (print) 1 _ ir12j License no' alteration 1� Services or feeders—Installation,
A IL ion or relocation:
PROPERTY OWNER 200 amps or less 2
P 201 amps to 400 amps 2
Name (print): - . Mit f,[1 2
401 amps to 600 amps
Mailing address: �aa � I� �• 601 amps to 1000 amps 2
City: . State r'� ZIP: D over 1000ampsorvolts 2
Phone: , , #7 -3 Fax: M-- -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation: 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: k Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
Cit I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E-mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
O Service over 225 amps-commercial 0 Health -care facility Each pump or imgation circle 2
0 Service over 320 amps - rating of l &2 ❑ Hazardous location Each signor outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel.
O System over 600 volts nominal more residential units in one structure alteration, or extension' 2
O Building over three stones ❑ Feeders. 400 amps or more 'Description:
O Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable hn any of the above:
❑ Egress/lighting plan 0 Other. Pertnspecuon 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
Na all lurisdtcuons accept credit cards, please call junsdictioo 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 u shown on credit card
S
Cardholder signature Amount 440 -4615 (60000M)
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1 I )c) ketch)/ cettiI' that the ((Mowing location
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i A land use aiRI development standards for street tree iinstallatic)1I.
ADDRESS: / oi1 St"' GJ isTLie_s ci°-- -- - - - - - --
LOT: '5 — -- SIMI)IVISION: Wh PILCAs_- kS_ - —
I BY: DATE: 8- t?--.05/
/; IMM'I I ;: 6- i - cam—
iTTTTTTTTTTTTTTTT-T'/®
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST 200 f—
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested 8 - / 7 AM PM BUP
Location 1 2.&) 7 7 W ttism - (1. Suite MEC
Contact Person 73 LAX-6 Ph ( ) 207 - y$ 3 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC ,,1210k
Footing
ELC /� ,�
Foundation Access:
Ftg Drain ELR
Crawl Drain J
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing pp
Drywall on V NE1) 7V S W �x Es IA/ IA V l 'tG- 'l
Drywall Nailing v
Firewall /WO /aAr � LOOM / 7 WE
AE /1(D
Fire Sprinkler - l
Fire Alarm F - / F s a t i j _ Mr)
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING _ 0 i
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL •
MECHANICAL
Post & Beam
Rough -In
Gas Line ( F,yC Tn (o-) 6.2 5 - 36 5 2 —
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
Low 6
Voltage
�+ �� D ( � r� Q
Low Voltage �`� 1 ' �J LC
larm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SI Please call f. -' • - on - : - Unab = = • spect — no access
Fire Supply Line ,
ADA S _ 1 7- y � ' /
Approach/Sidewalk ate (/ Inspector . / u I f( 1,61 Pi Ext
Other:
Final DO NOT REMOVE this Inspectio _ e job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST c; 7005 //
INSPECTION DIVISION Business Line: (503) 639 -4171
p BUP
Received Date Requested, D /g AM PM BUP
Location / a o 7 7 Suite p MEC
Contact Person 61,T Ph ( ) � 3 7 PLM -ann.
Contractor Ph ( ) SWR Ar
•
BUILDING Tenant/Owner ELC /
Footing
Foundation Access: ELC /
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
int Sheath/Shear yin n" y 2 6 I ` Q I �-- ® L v 9 - -
Framing ' 1T� �r • 1 ` 1
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm .
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
R�UMBNNG
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
O r:
i I
PAS PART FAIL
M NICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PA • - T FAIL
= L
Service
Rough -In
UG/Slab
Low Voltage
Fi = • larm
11 PART FAIL
El Reinspection fee of $ required before next inspectio . Pay at City Hall, 13125 SW Hall Blvd.
SI Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
71/1/
Approach/Sidewalk Date I • Inspector Ext
Other: �
Final DO NOT REMOVE this inspection re rd from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) -639 -4175 MST c= / /5"-
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Reque L 4 l/I).2 AM PM BUP
rr ,, 11 Location /, 0 7 7 t- Suite MEC
Contact Person ' "40 Ph ( )ao9 ¥ f'3 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
PART FAIL
- LUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
_ - • SS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 8 1 R - a ¢ Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL