Permit MASTER PERMIT
A CITY OF T I G A R D PERMIT #: MST2004 -00034
lt DEVELOPMENT SERVICES DATE ISSUED: 2/20/04
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12080 SW WHISTLER'S LP PARCEL: 2S103CC -WW281
SUBDIVISION: WHISTLER'S WALK NO. 2 ZONING: R - 4.5
BLOCK: LOT: 081 JURISDICTION: TIG
REMARKS: New SF detached. DEMO CREDITS FROM BUP2003 -00590 TO BE APPLIED TO THIS PERMIT.
BUILDING
REISSUE: DM199AS STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 26 FIRST: 1,610 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,790 sf GARAGE: 655 sf FRONT: 15 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 ittuo sf RIGHT: 5
VALUE: 330 10
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3,400 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 5 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: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 3 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: 7 201 • 400 amp: 201 - 400 amp 1st W/O SVC/F DR• SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 • 600 amp: 401 • 600 amp: EAADDL 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 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEJIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
•
Owner: Contractor: TOTAL FEES: $ 4,057.08
DON MORISSETTE HOMES INC DON MORISSETTE HOMES INC This permit is subject to the regulations contained in the
4230 SW GALEWOOD ST 100 4230 GALEWOOD ST, STE 100 all other Municipal Code, State work k w Specialty Codes and
LAKE OSWEGO, OR 97034 LAKE OSWEGO, OR 97035 all other applicable laws. All work will be done
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:
Oregon law requires you to follow rules adopted by the
Phone: Phone: Oregon Utility Notification Center. Those rules are set
5 forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
L
Reg #: k3877 -M 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 Insl Rain drain Insp Electrical Final
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Storm drain Insp Mechanical Final
Footing lnsp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Water Line Insp Plumb Final
Foundation lnsp PLM /Underfloor Framing Insp Gas Fireplace Water Service lnsp Building Final
Post/Bea - ral Mechanical Insp Shear Wall lnsp Insulation Insp Appr /Sdwlk Insp
Issue By : / _ �I- '�:0 /-�-_ Permittee Signature : P2 ----,
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
- i P� a "Il q �"'� so Raovq -aob
• ' Building Permit Application It
Datereceived: 1'oZ S' 0 Permit no$t��py 4E2
r City of Tigard R � i 5 �ED
L, �I I, � Project/appl. no.: Expire date:
Address: 13125 SW Hall Blvd, Tig
City of Tigard 2 3
Phone: (503) 639 -4171 /► AI Date issued: By: Receipt no.:
Fax: (503) 598 -1960 � 200- C ase file no.: Payment type:
Land use approval: CITY OF TIAApD I&2 family: Simple Complex: p:.
..,t•
7 "1 PE OF PERMIT
0 1 & 2 family dwelling or accessory ❑ Commercial/industrial 0 Multi- family , 'New construction 0 Demolition t
❑ Addition/alteration/replacement 0 Tenant improvement 0 Fire sprinkler/alarm 0 Other.
JOB SITE INFORMATION
Job address: � %I gl llil i s t_ A irnA ll o i M / MIIIMEMIE Bldg. no.: Suite no.:
Lot: 1_ Block: Subdivision: V Vrif �r MI Tax map /tax lot/account no.:
Project name:
Description and location of work on premises/special conditions:
OWNER
��jj FOR SPECIAL INFORMATION, USE CIIECKLIST'
�� 11 Mir ' • . ,1
Name: _ �f�i ( Iloodplain ,scpticcapacit }�,solar,ctc. )
Mailing address: `�,r � /, wart I & 2 family dwelling:
City: EMA. ZIP: Valuation of work $ �f
Phone:. r" T "`�� { ;
r�l!�Rl�l+�� )� , -mail: No. of bedrooms/baths
��d�J�C�
Owners representative: .' 1� j if G Total number of floors
•,wor , /o)
Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT • Garage/carport area (sq. ft.)
� Covered porch area (sq. ft.)
Name: 1�A�` Ntr ���'p /&:
Mailing address: ftrl(le___, • a., v . Deck area (sq. ft.)
City: 'S�: I ZIP. Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/Industrial/multi-family:
CONTRACTOR Valuation of work..., $
Business name: r_ nd & m A
Existing bldg. area (sq. ft.)
Address: _ v �r DWI New bldg. area (sq. ft )
City: State: ZIP; Number of stories
Phone: I Fax: I E -mail; Type of construction
CCB no.: ?j 5 s?-,-3 Occupancy group(s): Exi sting:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCI I ITECIIDESIGNER licensed with the Oregon Construction Contractors Board under
Name: (lack la 0, 40 . 21 1. provisions of ORS 701 and may be required to be licensed in the
Address: -rAQ t✓- CL,VDSP jurisdiction where work is being performed. If the applicant is
City: State: I ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
Name: Contact person: Fees due upon application $
Address: Date received:
City: (State: (ZIP: 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. • • rovisions of 1 ws and ordinances governing this ❑ Visa O MasterCard
work will be compl - r wt whether ifled ere gpot. I Credit card number. / /
/� �-� I Authorized si a atu 1� A Name of cardholder as shown on credit card
Print name: _ •: t l . Cardholder dgoarare $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6/00/COM)
!
One- and Two - Family Dwelling
.A1►,, a
Building Permit Application Checklist Reference no.:
City of Tigard City f Ti • and . . Associated permits: g 0 Electrical O Plumbing Cl Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 ❑ Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 •
THE FOLLOIVING ITEiIS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
I 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 0 plan O permit required. Include drainage -way protection, silt fence design and location of ,/
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 K
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. 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 •
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 ". 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 (6100/COM)
a jihib Mechanical Permit Application
Date received: Permit nomgr-o?uo5/ -G424)3 q
.414 -':11. :
City of Tigard
Project/appl. no.: Expire date:
CifyojTigard 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: Building permit no.:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
,4ew construction 0 Addition/alteration/replacement 0 Other.
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
. Job address: � 2 �� �� Ind 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: kilo Block: Subdivision: TL.1���'lwffiell '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 COMMERICAIJINDUSTRIAL EQUIPMENTSCIIEDULE
Fee(ea.) Total
Est. date of completion /inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: Air
handling •
Is existing space heated or conditioned? 0 Yes 0 No Air cndiing unit CFM
g P Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No _ Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
� State boiler permit no.:
Business name: t �//_v HP Tons BTU/H
Address: AIR Fire /smoke dampers/duct smoke detectors
WA CZIWM ZIP: "Iri1ga7 Heat pump (site plan required)
Phone: X10' Fax: E -mail: Install replace ittiTiace/burner BTU /H
Including ductwork/vent liner O Yes 0 No
CCB no.: •?.)c��(a) - Install/replace/relocate heaters -suspended,
City/metro lic. no.: N/A wall, or floor mounted
Name (please print): j . .pAig• NEL_ Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/H
Name: ° ;ice 11 • Chillers HP ,
Address: Coin • ressors HP
,. �_ ♦ Env exhaust and ventilation:
City: State: ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
OWNER Hoods, Type 1/11/res. kitchen/hazmat
hood fire suppression system
Milt ... , • 1 Exhaust fan with single duct (bath fans)
Mailing address: �yr� / W.=�!TA11a Exhaust system apart from heating or AC
City: �1�'.121I7��� i Fuel piping and d up to 4 outlets)
Type: LPG NG Oil
Phone: tip Fax: E - mail: Fuel piping each additional over 4 outlets
• ENGINEER Process piping (schematic required)
Number of outlets
Name: Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: ZIP: Insert - type
Phone: Fax: -mail: Woodstove/pelletstove
S* Applicant's signatu" :�� �, r�O,'��- Date:
� Other
Name (print): , r- ■ , ' .
Ir
Not all funsdictions accept credit cards. please call jurisdicuon fo mor information. Petmlt fee $
0 Visa 0 MasterCard Not Th permit application Minimum fee $
/ expires if a permit is not obtained Plan review (at %) $
Crtdit card number Expires within 180 days after it has been
p State surcharge (8%) .... $
Name of cardholder as shown on credit card accepted as complete.
S TOTAL $
• Cardholder signature Amount 440.4617 (M)Q OM)
Plumbing Permit Application
t Date received: Permit no.-/if S . 0063
`g1 City of Tigard Buildin itno.:
� -� Sewer permit no.: 8 P�
Address: 13125 SW Hall Blvd, Tigard. OR 97223 ire date:
City ofTigard Phone: (503) 639 -4171 Project/appl. no.: �P
Fax: (503) 598 -1960 Date issued: By: Receipt no.:
Land use approval: 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 SITEI.NFORI'IATION FEE SCHEDULE (for special information use checklist)
Description Qty. Fee(ea.) Total
Job address: / l/I �t ' ' N ew 1- and 2- family dwellings only
Bldg. no.: Suite no.: (includes 100 ft. foreachtttilityeotmeetfon)
Tax map /tax lot/account no.: SFR (1) bath
Lot: a Block: Subdivision: 31 SFR (2) bath
Project name: TWEILIMIll 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'LU\IUING .CON'I ILAC fOR Manufactured home utilities
Business name: p ` Ip L. i Manholes
Address: . Rain drain connector
�� �'� ZIP: Sanitary sewer (no. lin. ft.)
City: ��� _v� Storm sewer sewer (no. . l lin.
)
Phone :( —jt.f Fax: E -mail:
I Water service (no. lin. ft.)
CCB no.: [ ( 7 L .-( -] 1 Plumb. bus. reg. no: - - - Fixture or item:
City/metro lit. no.: N/A l ) Absorption valve
Contractor's representative signature,. \W / / ' Back flow preventer
Print name: • • ' , • ' l)- c�4 Backwater valve
CONTACT PERSON Basins/lavatory
\ 1 . — t) I t - 1 E Clothes w a s h e r . .
Name: 1 � - Dishwasher
Address: Zr.y., O -2 C3_ 1ve . Dnnking fountain(s)
City: I State: ZIP: Ejectors/sump
Phone: Fax: E -mail: Expansion tank
OWNER Fixture/sewer cap
-
,,}, .,� Floor drains /floor sinks/hub
Name (print): ,j _ale b Garbage disposal
Mailing address: s.► 1 Hose btbb —
City: -1) . State - ZIP:C7 7C 2 ' 2 Ice maker
Phone: j , - I Fax: • ,7-7k . 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 madt 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 ,
Tubs/shower /shower pan
Unnal
Name: Water closet .
Address: Water heater .
City• State: ZIP• Other
Phone: I F ax: I E-mail: Total
Minimum fee $
Notice: This permit application
Na all )unsdtcuotss accept credit cards. please call tuns4,cuon far more information
Plan review (at _ %) $
C Visa O MasterCard expires if a permit is not obtained State surcharge (8 %) •••• $
C.edtt card number. / w ithin 1 80 days after it has been
Expires TOTAL $ —'
accepted as complete.
Name of cardholder as shown on credit card
S .
Cardholder signature Amount , 4404616 (6AORAM)
•
' 4, Electrical Permit Application
Date received: Permit no.t ST DD - OGd
.,5 ..y City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: 1 Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
I New construction 0 Addition/alteration/replacement 0 Other. 0 Partial
• JOB SITE INFORMATION •
Job address: , a l�.ri� Al' • Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot: j Block: Subdivision: TVPIr t ' e . )-
Project name: I Description and location of work on premises:
Estimated date of completion/inspection:
. CON"I RAC' OR APPI.IC'A•I'ION FEE SCIIEDILE -
Job no: �/r Fee Max • B r , Description Qty. (ea.) Total no. limp - �r New residential - single or multi -family per
Address: 4. �i _ �� a � dwelling unit. Includes attached garage.
Eilizatwirgri Servieeinchtded:
Phone: -j - l 4 ;j Fax: E - mail:
1000 sq. ft or less 4
' �'.. ^ Each additional 500 sq. ft- or portion thereof 2
CCB no.: Elec. bus. tic. no: C Limited energy, residential
C' Limited energy, non- residential 2
Each manufactured home or modular dwelling
nature of supervising electrician (required) Date �/ / Service and/or feeder 2
��p Q c Services or feeders — installation,
Sup. elect name (print) _ A.. C 1 , _ A ,. License no / � J alteration or relocat
. PROPERTY O■VNI:R 200 amps or less 2
201 amps to 400 amps 2
Name (print): . . ` ts( ►;�.etttP� 2
401 amps to 600 amps
Mailing address: ir . � �( /�:1TC : 601 amps to 1000 amps 2
City: • • State l ' ZIP: )0 Cj Over 1000 amps or volts 2
Phone: , ,07 all _2 Fax: . -) - -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: 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 0 Health-care pump or irrigation circle 2
e facility 2
O Service over 320 amps -rating of I &2 0 Hazardous location Each sign or outline lighting
family dwellings 0 Building over 10.000 square feet four or Signal circuit(s) or a limited energy panel,
Cl System over 600 volts nominal more residential units in one structure alteration, or extension* 2
O Building over three stories Cl Feeders. 400 amps or more • Descnption:
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. Per inspection I i
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Permit fee $
Na all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application
O Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card cumber: / / within 180 days after it has been State surcharge (8%) .... $
, Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card
S
Cardholder signature Amount 440-4615 (6,VO OM)
/14 6T 14 - 0 - 0 - 0 3
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• CERTIFIcATION THE ET TR EE► ■
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E Z , Owner /Agent for i.01'1) i.01'1) roC(55C He Hov c5
(P
I, S��/ (PLEASE S PRIM) (PERMIT HOLDER) !
• Do hereby cei-ii[y tliAt.tlie following location
j meets City of 1.'igard /Washington County
A land use and development standards for street tree installation.
•
1
I ADDRESS: /ZOO SO L Sk1 rS Loop
a
LOT: 2 1 SUBDIVISION: k)k;5A- / ' Wse I
BY: DA'I'E: S aL� 4y
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RECEIVED BY: DATE: 5 •
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A ivvvvvvVVYTT TVV YT VV®YVVVVYTTY VVVV*VVVVVVVVVV♦TYVVVVVYTV7V7V1
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639.4175 MSTo - 0003Y
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
Received ' . / 5 Date Requested 2 V - 0 `/ AM PM BUP
Location / 2 0 g IL) l,v� Suite MEC
Contact Person C-r -/ Ph ( ) g/0 � f — t 5 2 PLM
Contractor Ph ( ) SWR
BUILDING 4 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 4I COS- e ��> t- g_ l-+ div i1j t 45cijm J 5 O 4--
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
•, ._ •
• ;'ART FAIL
PL MBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART F
MECHANICAL /Q
Post & Beam
Rough -In
Gas Line
C Fina lse,�ampers
Final
SS `FAIL
E ECTRICAL -
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final El 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 5 2 - 4 - 0�-�
Approach/Sidewalk D ate Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OFTIGARD 1 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST -0M-SCI
INSPECTION DIVISION - Business Line: (503) 639 -4171
''// BUP
Received Date Requested Z�) M PM BUP
Location / 2D 20 (' Suite MEC
Contact Person 4 ^ d. Ph ( ) j 9 — 64 S --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 `y' / 2 2
Drywall Nailing lI /
Firewall O( 7
.L 1
Fire S l
Fire Alarm
* C6 r -
Susp'd Ceiling l
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
(�thnr•
/I PART FAIL
717- HANICAL
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 fl Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Datej/40 Inspector / Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour 4(34A6 BUILDING Inspection Line: (503) 639 -4175 ST 04_
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Re uested ` AM PM BUP
•
a () t-e)
Location l / Suite [t MEC
Contact Person . ).:7Q Yg 37 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 L v p p_ iN n ! l . W i � \4 %0 ‘E-
Framing O 1`4 I
Insulation I 5 r G" I on Lin 03. Rfk f
Drywall Nailing
Firewall l (. RE ET 6
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: I Ccre �+
Final 4.: C AL A1
PASS PART FAIL F to Ft
SS SS 1Z R 4, o . L
Post & Beam
Under Slab 1 � r
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
4112:111. PART *
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
PASS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd.
SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA lv Ext
Approach/Sidewalk Date �^ ` Inspector "�
Other:
Final DO NOT REMOVE this inspection recd from the job site.
PASS PART FAIL