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Permit � v CITY OF TIGARD MASTER PERMIT ` . Is., - •. COMMUNITY DEVELOPMENT Permit #: MST1999 00357 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/28/1999 Parcel: 1 S133DC00505 Jurisdiction: TIG Site address: 11655 SW WINTERLAKE DR Subdivision: Lot: Project: ASH VALLEY TRACT Project Description: Residential addition 2/28/13 REPRINT reinstated permit for 30 days for final inspection BUILDING Floor Areas Required Setbacks Requi Stories: 2 Bedrooms: First: 480 sf Basement: sf Left: 5 Parking Spaces: Height: 21 Bathrooms: Second: 432 sf Garage: sf Front: 23 Smoke Dwelling Units: 0 Third: 0 sf Right: 16 Detectors: Yes Total: sf Value: $64,724.64 Rear: 15 PLUMBING Sinks: 2 Water Closets: Washing Mach: 0 Laundry Trays: Rain Drain: Urinals: Lavatories: Dishwashers: 1 Floor Drains: Sewer Lines: SF Rain 1 Drains: Storm Sewer: Tubs /Showers: Garbage Disp: 1 Water Heaters: Water Lines: Catch Basins: Bckflw Prevntr: Footing Drain: Ice Maker: Hose Bib: Backwater Value: , Drywell- Trench Drain: Other Fixtures: • Other Fixture Units: MECHANICAL ' Fuel Types Air Conditioning: N Vent Fans: Clothes Dryers: Heat Pump: N Hoods: Other Units: Furn<100K: Vents: 4 Woodstoves: Gas Outlets: Furn > =100K: ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 1 0 -200 amp: 0 -200 amp: W/ Svc or Fdr: • Ea add'I 500 sf: 201-400 amp: 201-400 amp: W/O Svc/Fdr: Mfd Home /Feeder /Svc: 401 -600 amp: 401 -600 amp: • 601 -1000 amp: 601 +amp- 1000v: 1000 +amp /volt: ELECTRICAL - RESTRICTED ENERGY SF Residential r Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ADD SF 5N R3 Owner: Contractor: HORSLEY, GEORGE & MARY BLUE ROSE ENTERPRISES Required Items and Reports (Conditions) 11655 SW WINTERLAKE DR 3370 SW 173RD TIGARD, OR 97223 BEAVERTON, OR PHONE: 503 =579 -2956 PHONE: 503- 913 -5852 FAX: 503 -591 -5182 Total Fees: $1,611.53 This permit 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 the 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 OA' 9 -001 -0690. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1. 344. Issued By: ( Permittee Signature: 4,e. Call 503.639.4175 by 7:00 a.m. for the next available Inspection date. 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. CITY OF F TIGARD MASTER PERMIT r� PERMIT #: MST1999 -00357 . v ill DEVE R9 ICES 63 DATE ISSUED: 10/28/1999 G SITE ADDRESS: 11655 SW WINTERLAKE DR �'� f 1 NA L PARCEL: 1S133DC -00505 SUBDIVISION: ASH VALLEY TRACT . _ ` ZONING: R -12 • BLOCK: LOT: 005 JURISDICTION: TIG REMARKS: Residential addition BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 21 FIRST: 480 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 432 sf GARAGE: sf FRONT: 23 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: sf RIGHT: 16 VALUE: $ 64,724.64 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: sf REAR: 75 PLUMBING SINKS: 2 WATER CLOSETS: WASHING MACH: 0 LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: 1 WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: 4 WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 • 200 amp: 0 - 200 amp: W /SVC OR FDR: 1 PUMP/IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 • 400 amp: 1st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 • 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp/volt : PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: 1NTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM. NURSE CALLS: TOTAL 0 SYSTEMS: Owner: Contractor:. TOTAL FEES: $ 1,208.33 HORSLEY, GEORGE 8 MARY OWNER This permit is subject to the regulations contained in the all other Municipal a Code, State work k OR. will l b Specialty Codes and 11655 SW WINTERLAKE DR OWNER RESPONS FORM SIGNED all other applicable laws. All work will be done in TIGARD, OR 97223 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Reg 0: 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 Erosion 844 -8444 Underfloor insulation Plumb Top Out Insulation Insp Final inspection Footing Insp Crawl Drain /Backwater Electrical Service Rain drain Insp Foundation Insp Footing /Foundation On Electrical Rough In Electrical Final Post/Beam Structural PLM /Underfloor Framing Insp Mechanical Final Post/Beam Mechanical Mechanical Insp Shear Wall Insp Plumb Final Issued By : e-A. , Permittee Signat e • :�� /� 1I /...' IP% � I, Call (503) 639 -4175 by 7:00 p.m. for an inspection need • • the flex / : usi • s- day �" v CITY OF TIGARD Residential Building Permit Application Plan Check #f -41 13125 SW HALL BLVD. Additions or Alterations Recd By 4 Date Recd /0 0- TIGARD; OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. D zs V 503- 639 -4171 • Date to DST /G- . F 503 - 684 -7297 Permit # (\/SST 1:• — '1 Print or Type Called IO /ts - 9:voa+vl gi Incomplete or illegible applications will not be accepted Name of Project I Name Job 14 C12-S1- Ci Co fl , °t p Ac2K C T. (-ov- 1 Architect Mailing Address Address Site Address '111 S S 1L) Ucu &Llt gaAAte 141 l (l. ss 5L.6 W t +UT L K 1D(t City /State Zip Phone Name 'Portr11tlarD £ Qcr)aa3 . 6te? oope.. -°I- itAar it 40rSt Name v SS t I Owner Mailing Ardress rk -s T F0 IL) Cs) 111. S5 Sly Li) ► I. TER LK b 4 Engineer Mailing Address � Ciy /State Zip Phone g 111 S 5(�) Gicutae }4-p-�e �c * 9 1 l dl OK co 2a3 si9 a45(.. ity /S to Zip Phone General Se-15t Yortt ei 4 ,13.31 G43S5lI Contractor J�l'T - L Ae-orcstll r \ Describe work New 0 Addition • Alteration 0 Repair 0 Mailing Address , be done: Prior to permit (L, Sc SCA (n,) t0TE)2 (JL 2, Addi I Description o Work: ., � , a issuance, a copy City/State Zip Phone QE: � i— EA Fa.wl t 1M'I -1. r N.t4S of all licenses 'T i iar OK 5 SDaB1(o ' fib. V are required if Oregon Const. Cont. Board Exp. Date PROJECT _ ,� 6 expired in COT Lic.# 1 I VALUATION $ _ ' _ im database - _ — -_ Mechanical Name NEW CONSTRUCTIO O LY: -- Sub- 1 Sq. Ft. House - / � .� Sq. Ft. Garage Contractor Mailing Addr Prior to permit Indicate the restricted energy installation by the electrical issuance, a copy City /State Zip Phone subcontractor in the following areas of all licenses Restricted Audio /Stereo are required if Oregon Const. Cont. Board Exp. Date Energy System Alarms expired in COT Lic.# Installations Vacuum Irrigation database System System Plumbing Name (check all that Other: Sub- Ge-8^f eAlse big-t( apply) • Contractor Mailing Addres l Corner Lot YES NO Flag Lot YES NO (check one) (check one) Has the Subdivision Plat recorded? N/A YES NO Prior to permit City /State Zip Phone issuance, a copy of all licenses are Oregon Const. Cont. Board Exp. Date required if Lic.# expired in COT I hearby acknowledge that I have read this application, that the database Plumbing Lic. # Exp. Date information given is correct, that I am the owner or authorized agent of the owner, and that plans submitted are in compliance with Oregon State laws. Name • a of Own - „rent i Date Electrical (�Q '' M ailin Addr to Person ame Phone # Sub- g ” eo o is Pho # Contractor City/State Zip Phone Prior to permit issuance, a copy FOR OFFICE USE ONLY: of all licenses are Oregon Const. Cont. Board Exp. Date Plat #: ^� - � - Ma /TL #: required if Lic.# I U(!�\ D /33 - 66s#7)5- expired in COT database Electrical Lic. # Exp. Date bet¢acle Zone_ /� Solar; n Electrical Supervisor Lic. # Exp. Date En i. Bring Approval: Planramg Approval: TIF / 9021 7 7 J i:\dsts \fomis\sfaddalt.doc 11/20/98 Permit #: hSTl 6 199- 00 3.5 F ; L - A / k FJ A ,,,,V.,-.4- � �' Address: /I �o v� S � � � �- L� Q- c:. -gas__ ___ : o in .. °""`x' Issued by: �_ Date: I /ad /9 Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required ' for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: El 1. I own, reside in, or will reside in the completed structure. ❑ 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. ❑ 3A. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above info mation is correct and that I have read and do understand the Information Notice to ' roperty Owners abo C 1 nstruction ' -1 e uyL; 1 ilities on the reverse side of this form. irk /w AMIlla / V /6/24/i7 (Sig . t e o • p ,, licant) (Date) (Whit copy to issuing agency permit file, pink copy to applicant) _ r abaS ConaruoUon neoponartManse Nate: This Information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5). If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLovEn RERP0WEIFDrLll l_ES: If you hire persons not registered with the Construction Contractors Board to do labor in constructing Or assisting ;n the construction or improvement of a residential structure, you will, in most instances, be ruled to be an employe, and the : eople you hire will be employees. As the employer, you must comply with the following: aregon's MCrnCro°d ding tax Raw As an employer, you must withhold income taxes from employee wages at the timc employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Oregon Dept. of Revenue at 945 -8091. Unemployment unsanrainnce tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Division at the Department of Human Resources at 378 -3524. Wer ers' ceaanpeansaat en ur 1ranee: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you may be subject to penalties and will be liable for all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945 -7888. US. Ilntea -nal Revenue Se ee: As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service at 1 -800 -829 -1040. OTHER RESPOMMilL MES AMO AREZ `-1 Or r'ONCCEMHz Cede enaunpina nce: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. ILuabiility and yroperty damage insurnnee: Contact your insurance agent to see if you have adequate insurance coverage for accident.; and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be re -done. Time to supervise emplloyees: Make sure you have sufficient time to supervise your employees. IE pertilse: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough -in and finish trades, and to notify building officials at the appropriate times so they can perform the required inspections. If you have additional questions, write or call the Construction Contractors Board (PO Box 14140, Salem, OR 97309 -5052, 503/378- 4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop- own.pm4 1/94 Electrical Permit Application RECEIVE' FOR OFFICE USE ONLY City g FEB 2 2013 Date/By: f? S /I S-(' i (T(gq'7. )3. 7 Ci o f Tigard 8 Perm No. III 13125 SW Hall Blvd., Tigard,OR 97223 Plan Review C . Phone: 503.718.2439 Fax: 503.598.1960 1 Date/BY: Other Permit: f I G A R D Inspection Line: 503.639 CITY OF TIG A Date ReadyBy: 1 ® See Page 2 for Internet: www.tigard - or.gov BUILDING DIVISI Notified/Method: t / Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction rg( Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural j a 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "U', "1 -2 ", "I -3 ", Job no.: Job site address: / 1001-EP or more. occupancy. �/ W /'t! / eak /Ak V 1Q. ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: --2-7—A9 OA 9 722-3 ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total I " New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'I 500 sq. R. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) _ . -� L energy, multi - family 75.00 2 ,4, S 4 (?A M/ / OA AD D t �7; - 4 /p residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation RCA /✓` PAC /40M e • 200 amps or less 100.70 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: I: 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and/or City/State /ZIP: relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits– new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee 7.42 2 Role each branch circuit Business name: 13/He Role E„i/;IfC1921 set B Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: 7 branch circuit / DjwWA/ 4-9 Each add'I branch circuit 7.42 2 Address: 3374 sA, /73 Miscellaneous (service or feeder not included) City/State/ZIP: / Each manufactured or modular 67.84 2 � &me R law ® 974 ' dwelling, service and/or feeder Phone: (503) 913 5 , 95 - 2 . Fax:: UO3) 59/ - 5� V .• Reconnect only 67.84 2 / � Pump or irrigation circle 67.84 2 E -mail: �►'10iv7' 3I C 13 f ® //07'2v41) . CD/>I Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited- energy Business name: E`e •` 4r., r - s / ky panel, alteration, or extension. Page 2 2 — J Each additional inspection over allowable in any of the above Address: /t IT 3eI ( 6 4 f % G] Additional inspection (1 hr min) 66.25/ hr ea- ` Investigation (1 hr min) 66.25/ hr City/State /ZIP: cY et 7 Industrial plant (1 hr min) 78.18 / hr Phone: (f i3) 3 35 u p Fax: ($3 ) ` / .., 5 7 Inspections for which no fee is 90.00 / hr specifically listed CA hr min) CCB Lic.: 5,a ( Electrical Lic.: - I4 G �' Suprv. Lic.g/t& ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: u t ✓„ o Subtotal: � � W , _'i "" Plan review (25 /o of permit fee): Print name: A f . 1 o � es Date: 2 L$ 3 State surcharge (12% of permit fee): , Q TOTAL PERMIT FEE: Authorized sig ignatu � G��/ This permit application expires if a permit is not obtained within 180 I r �" Date: { days after it has been accepted as complete. Print name: Y� (,( ff ( It i 2 3 Number of inspections allowed per permit. - \ Quilding \Permits\ELC- PermitApp.doc 07/01/10 J 440- 4615T(1I /05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK 'ONLY: 7 Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* p Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems Fl Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* , ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1: \ Building \Permits\ELC- PermitApp.doc 07/01/10 • • Mechanical Permit ApplicationRECEfTEED ` . FOR oihlcC US ONLi City of Tigard RRetee/ve )g � Permit No S� � � q p 3s7 ° 13125 SW Hall Blvd., Tigard,OR 97223 FEB 2 8 2 013 ® Phone: 503 Fax: 503 Plan Review Other Permit: _ Date/By: ' TI G R D Inspection Line: 503.639 CITY OF TIGA Date Ready/By: runs: El See Page 2 for Internet: www.tigard -or.gov BUILDING DIVISION Y ((p Supplemental Information ",- 4,' ' TYPE O WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST a. Mechanical permit fees' are based on the value of the work ❑ New construction Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. Value: $ i CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES* Eil - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: • ^ Air conditioning Job site address: 1l65S SW wr 407; a j A f 4. (requires site plan showing placement) 46.75 n Furnace 100,000 BTU (ducts/vents) 46.75 City /State /ZIP: 7 0I` 97223 Furnace 100,000+ BTU ( ducts/vents) 54.91 . Suite/bldg. /apt. no.: 7 Project name: Heat pump (requires site plan showing placement) 61.06 - Cross street/diredions to job site: Duct work 23.32 Hydronic hot water system 23.32 Residential boiler (radiator or hydronic) . 23.32 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 Subdivision: Lot no.: Flue /vent for any of above 23.32 Other: 23.32 Tax map /parcel no.: Other fuel appliances: DESCRIPTION OF WORK • Water heater 23.32 Gas fireplace/insert 33.39 F .;• S X ea MiT Flue vent for water heater or gas �` fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 ❑ PROPERTY., OWNER I ❑ TENANT Chimney/liner/flue/vent 23.32 . Other: 23.32 Name: Environmental exhaust and ventilation: Address: Range hood/other kitchen equipment 33.39 City/State /ZIP: Clothes dryer exhaust 33.39 Phone: Single -duct exhaust (bathrooms, ( ) Fax: ( ) toilet compartments, utility rooms) 23.32 • APPLICANT 0 CONTACT PERSON Attic /crawlspace fans 23.32 Business name: 'Dime. Aost■ E...-7;:a S ` O 23.32 S Fuel piping: Contact name: / "DA t✓!D.✓ $14.15 for first four; $4.03 for each additional Fumace, etc. Address: 337 .s - A ., J73 Gas heat pump City /State /ZIP: Sa1edi2/O..4." OA Wall/suspended/unit heater Phone: (5 5..0 Fax: : (5 3) 59/ -5)g2 Water heater Fireplace E -mail: /YIBNT/9 1 c 13R 0 deprA7Ar / . co..- Range CONTRACTOR Barbecue Business name: E!w r nese Clothes s dryer (gas) Other: Address: 33 7v Stv /73 MECHANICAL PERMIT FEES* City/State /ZIP: 3 v« e7 Subtotal Phone: (S''3) • 9 j 3 , 5-15552 Fax: (5O3) .. , J Minimum permit fee ($90.00) S 8 Plan review (25% of permit fee) CCB lic.: 79650 State surcharge (12% of permit fee) TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 . Authorized signature: /1,07Z.".... 1 4 rvs..•/ days after it has been accepted as complete. Print name: : �_ Date: 2 _ 2g / 3 • Fee methodology set by Tri- County Building Industry Service Board • I:\ Building \Permitss\MEC 03/07/12 440-4617T(t1 /02/COM/WEB) • Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi- Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to $500.00 Minimum fee $69.06 • $500.01 to $5,000.00 $69.06 for the first $500.00 and $3.07 for each additional $100.00 or fraction thereof; to and including $5,000.00. $5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and $2.81 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,000.01 to $50,000.00 $347.71'for the first $10,000.00 and • $2.54 for. each additional • $100.00 or fraction thereof, to and including , $50,000.00. . $50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and $2.49 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $2,608.71 for the first $100,000.00 and $2.92 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 1:\Building\Pertnits\MEC- PermitApp.doc 03/07/12 2 Building Permit Application i�1:�CE�D Residential RE FOR OFFICE USE ONLY City of Tigard FEB 2 8 2013 Date Received P No S 4qq ^ OD 35 7 • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ■ Phone: 503.718.2439 Fax: 503.598.19trry OFT IGARD Date/By: Other Permit: .,., C A H D Inspection Line: 503.639.4175 B UILDING DIVISION Date Ready/By: Juri : HI See Page 2 for Internet: www.tigard or.gov Notified/Method: Supplemental Information TYPE OF WORK REQUIRED DATA: I- AND 2-FAMILY DWELLING ❑ 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 CATEGORY OF CONSTRUCTION work indicated on this application. g 1- and 2- family dwelling ❑ CommerciaUindustrial Valuation: $ ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: //6 53 sr,*, WirT02 Lake a . New dwelling area: square feet City /State /ZIP: -7,- 0/it. 9 7,22 3 Garage /carport area: square feet Suite/bldg. /apt. no.: / Project name: Covered porch area square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: Permit fees* are 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 DESCRIPTION OF WORK work indicated on this application. f ' r f ` I r Valuation: S ■ Existing building area square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City /State /ZIP: Existing: Phone: ( ) Fax: ( ) New: or APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* S Business name: c0 /1. /� / E� /RrSo' S view (r d V � Structural plan review fee (or deposit): Contact name: A // ,7j �Ais' '.✓ FLS plan review fee (if applicable): Address: 33 70 s- /73 City/State /ZIP: Veit,✓ dR Total fees due upon application: L3tG4 s G► 2 Amount received: Phone: ( $ « 3) 9/3 5765-2, 5765-2, ,,,,// Fax: : (se) ) s9 / 57 0 E -mail: /VID4YRIG 47R a /rs�M.a�/ • COv-I PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* CONTRACTOR Commercial and residential prescriptive installation of roof -top mounted Photo Voltaic Solar Panel System. Business name: ? // Submit two (2) sets of roof plan with connection details !� /4 P AS! E ,t FL ‘,.. c. and fire department access, along with the 2010 Oregon Address: 33 70 54, ) 73 Solar Installation Specialty Code checklist. City /State /ZIP: 3r✓t�cTo Permit Fee (includes plan review ,r 02 and administrative fees): $180.00 Phone: (5o3) 9/3 ,6152 Fax: (5o3) ST/ .5/ /2- State surcharge (12% of permit fee): $21.60 CCB lie.: 796,19 tdl 0 0 Total fee due upon application: $201.60 Authorized signature: ,,,�/�// This permit application expires if a permit is not obtained /1/O - re - D,ttwsa.✓ within 180 days after it has been accepted as complete. Print name:, .0, Date: /� *Fee methodology set by Tri County Building Industry / G ^.� g �I3 Service ice Board I:\ Building \Petmmits\BUP- RESPermmitApp.doc 02/ 24/2011 440- 4613T(l 1/02 /COM/WEB) Building Permit Application Checklist One- and Two - Family Dwelling FOR OFFICE USE ONLY City of Tigard Received Permit No.: II Date/By: e 1 3125 SW Hall Blvd., Tigard, OR 97223 Associated permits: C Phone: 503.718.2439 Fax: 503.598.1960 TIGARD 24- Hour Inspection Line: 503.639.4175 ❑ Electrical ❑Plumbing ❑Mechanical Internet: www.tigard - or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ • ❑ 2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑ 3 Verification of approved plat/lot. ❑ ❑ ❑ 4 Fire district approval required. Name of district: . ❑ ❑ ❑ 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 if copyright violations exist. 11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size ❑ ❑ ❑ and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, ❑ ❑ ❑ furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑ floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. ❑ ❑ ❑ Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for non- ❑ ❑ ❑ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑ locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑ systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑ over 10 feet long and/or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. ❑ ❑ ❑ 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required ❑ ❑ ❑ for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore:on and shall be shown to be applicable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three (3) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑ 24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑ 28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\Building\Permits\BUP- RESPermitApp.doc 02/24/2011 440 -4613T(I 1/02 /COM/WEB) • Plumbing Permit Application RECEIVED Site Utilities Fo12 OFFICE USE ONLY 2 8 2 013 Re ceived City of Tigard C� Permit No.: . 13125 SW Hall Blvd., Tigard,OR 9722.) Date/By: a -(�/�3 ''I �{iT / �IQ q 120 357 I ,, R Plan Review IN C . Phone: 503.718.2439 Fax: 503.598.1.969 Y OF TIG11 Date/By: Other Permit No.: I' I G A K D Inspection Line: 503.639.4175 t <'ILDING DIVISION Date Ready/By: Juni,:: ® See Page 2 for Internet: www.tigard - or.gov Notified/Method: TN: Supplemental Information TYPE OF WORK FEE* SCHEDULE ❑ New construction 0 Demolition For special information use check list: Description I Qty. I Ea. I Total Addition /alteration/replacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection) CATEGORY OF CONSTRUCTION SFR (1) bath 312.70 18r1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 437.78 SFR (3) bath 500.32 ❑ Accessory building ❑ Multi - family Each additional bath/kitchen 25.02 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION Site utilities: Job site address: //G 55 s ,,, k4 La D Catch basin or area drain 18.76 Drywell, leach line, or trench drain 18.76 City /State /ZIP: 77 ,� OA 9 722 3 Footing drain (no. linear ft.: ) Page 2 Suite/bldg. /apt. no.: I Project name: Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Water service (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Fixture or item: Tax map /parcel no.: Backftow preventer 31.27 DESCRIPTION OF WORK Backwater valve 12.51 Clothes washer 25.02 Fr.. f t 4 pP�¢M / r of AD?? f --- / /o - Dishwasher 25.02 Drinking fountain 25.02 Ejectors /sump 25.02 ❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51 Name: Fixture /sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City /State /ZIP: Hose bib 25.02 Phone: ( ) Fax: ( ) Ice maker 12.51 APPLICANT ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: 1 3 Rost- 4 �a Medical gas (value: $ ) Page 2 Contact name: M T Primer 12.51 / "/O �C JRWS o-' Roof drain (commercial) 12.51 Address: 3 3 70 Sw I /73 'CD Sink/basin/lavatory 25.02 City /State /ZIP: e,l`iy�� 0/2. Solar units (potable water) 62.54 Phone: (505) 9/3 - S r.52_, ,a Fax:: (503) • S9/ - S/ 8z Tub /shower /shower pan 12.51 E -mail: �Q��/ G 3/2. C42 Phr ' , LpM Urinal 25.02 CONTRACTOR Water closet 25.02 Water heater 37.52 Business name: 13/ e Rel 7 #t_/9RI$, Water piping/DWV 56.29 Address: 33 7O sm. / 73 Other: 25.02 City /State /ZIP: /3C4di.T.. Olt Subtotal Phone: (So3) , 9 f 3 S 51 Fax: (03 - 59/ .5l ,2, Minimum permit fee: $72.50 CCB Lic.: 7945-0 Plumbing Lic. no.: Plan review (25 % of permit fee) State surcharge (12% of permit fee) Authorized signature: "IOW DAtvso TOTAL PERMIT FEE Print name: Date: 2�2 S• � 3 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. I:\Building\Permits\PLMU- PermitApp doc 10/01/09 440- 4616T(t0 /02 /COM/WEB) ♦ Y Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. Fee (ea) Total Square Footage: Permit Fee: Footing drain - 100' 50.03 0 to 2,000 $121.90 Footing drain - each additional 100' 37.52 2,001 to 3,600 $169.69 3,601 to 7,200 $233.20 Sewer - 1st 100' 62.54 7,201 and greater $327.54 Sewer - each additional 100' 37.52 Water Service - 1st 100' 62.54 Medical Gas Systems: Water Service - each additional 100' 37.52 Valuation: Permit Fee: Storm & Rain Drain - 1st 100' 62.54 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 37.52 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for Other Inspections or Fees Qty. Fee (ea) Total each additional $100.00 or fraction thereof, to l� and including $10,000.00. Inspection of existing plumbing or for $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for which no fee is specifically indicated 90.00/hr each additional $100.00 or fraction thereof, to (minimum charge - 1/2 hour) and including $25,000.00. Inspections outside of normal business 90.00/hr $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for hours (minimum charge - 2 hours) each additional $100.00 or fraction thereof, to Reinspection Fees 90.00/hr and including $50,000.00. Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for (minimum charge 1/2 hour) each additional $100.00 or fraction thereof. Subtotal: Commercial Fixture Work: Are you capping, adding or replacing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees Quantity by Fixture Type Plan Review for Plumbing Installations Fixture Type for Replace/ Plan review is required for any of the following. Performed: Capped Added Relocate q y g' Baptistry/Font Please check all that apply. Bath Tub /Shower ❑ Any new commercial building with water service 2" and - Jacuzzi/Whirlpool greater, except systems designed and stamped by licensed Car Wash -Each Stall engineer. -Drive Thru ❑ New exterior plumbing site utilities for any complex structure Cuspidor/Water Aspirator as defined in OAR918- 780 -0040. Dishwasher - Commercial ❑ Medical gas and vacuum systems for health care facilities. - Domestic ❑ Any multipurpose fire sprinkler system. Drinking Fountain ❑ Any complex structure as defined in OAR918- 780 -0040. Eye Wash Floor Drain/sink - 2" Submit 2 sets of plans with any of the above. -3" Isometric or Riser Diagram Car Wash Drain ❑ Isometric or riser diagram is required for new buildings Garbage - Domestic- non -food Disposal - Domestic -food related that meet the qualifications above. - Commercial -food related - Industrial -food related Ice Mach./Refrig. Drains Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang -Stall Sink/Lav - Non -food related - Bradley - Commercial- food related - Service Swimming Pool Filter *Note: If the fixture work under this permit results in an Washer - Clothes Water Extractor increase of sewer EDUs, a sewer permit will be issued and Water Closet Toilet fees assessed for the sewer increase must be paid before the Urinal plumbing permit can be issued. Other Fixtures: L:\Building\Permits\PLMU- PermitApp.doc 2 • Ph Site Utilities — Plumbing Permit Application o. Plan Submittal Requirements TIGARD A plumbing permit for site utility plumbing work is required for sanitary sewer, storm sewer and potable water systems on private property. 1. SITE PLAN and vicinity map showing the geographic location (fully dimensional, drawn to scale) labeled with: A. ❑ map & tax lot # ❑ project name ❑ site address ❑ suite number ❑ zoning ❑ applicant name ❑ phone number B. North arrow. C. Scale (architectural or engineering only). D. Street names. E. Building pads with project location. 2. PLUMBING PLANS - Two (2) complete sets, civil only. All details listed below shall be incorporated into the plumbing plans: A. Storm drainage plan showing: 1) Finish elevations throughout the developed site. 2) Grade breaks determining area serving each catch basin. 3) Location of catch basins. 4) Pipe size. 5) Type of material. 6) Slope of piping. 7) Manholes and field drains. 8) Cleanouts provided for each 100 feet or fraction thereof. 9) Roof drain laterals specifying cleanouts at each upper terminal. 10) Location of existing or proposed connection to a public sewer line. B. Utilities plan showing: 1) Sanitary sewer line location, pipe size, type of material, slope of piping, manholes and cleanouts provided as required for storm. 2) Size and location of domestic water piping and drainage. 3) Proposed location of connection to a public water or sanitary sewer line. I: \Building\Permits\PLMF- PermitApp.doc 12/30/05 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 1•99 -000 24 -Hour Inspection Line: 639 -4175 Business Line:- 639 -4171 BUP Date Requested ,� ( 4V/ C/00 AM PM BLD Location I l O SS CAY 4eA kG' r-e_ Suite MEC Contact Person 6e01,2, Ph cr'7A5o PLM Contractor Ph SWR CJILDI Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing �,✓livr , . _e S l �l la _ v T, J� �� Z l— Od (nsulatist*' Drywall Nailing rolW �rec 2 N,r, m% 4.c) va S_ Firewall Fire Sprinkler SQL /44 7 o Fire Alarm � Susp'd Ceiling C" D O#,rte Roof Misc: �� Y a /7S C Final PASS PAR FAIL PLUMB! /411 Je",,L L Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA / Other oach /Sidewalk Date (� —A Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST I9 ? OO 3 S7 . 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested (PA 'O AM PM BLD Location 1 (O (A)111 _ Or: Suite / MEC Contact Person Q, Ph S7 - I ' e'1 ) S (D PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall ..-41177( ..-41177( Fire Sprinkler Ala Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line • Smoke Dampers Final PASS PART FAIL (ECECTRICA service u h UG /Slab Low Voltage Fire Alarm Fi_ PART FAIL Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: _ Unable to inspect - no access ADA Approach /Sidewalk Other Date Inspector _ ` ` Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION ®. / q'9i -Qp 3S 24 -Hour Inspection Line: 639 -4175 Business Line: 639 - 4171 BUP Date Requested /q /nn AM PM BLD Location I / (i2 �A �l / N S S -e/L( , ite MEC V U i n /1 Contact Person i Ph 5 79' ZRSG PLM Contractor Ph SWR �ILDII Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear //�� Framing // `Ig14 c_! /.LDn.� l4Lc. sulat' g 1C5L ailing W ' Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS RT FAIL PLUMB! Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA }� Approach/Sidewalk Other Date Z 1 Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION 14 sT f4 Q? _� S' 37 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 / c fq, BUP Date Requested /? AM PM BLD Location t/45 Eia.) (.1.)(44 kb._ OK Suite MEC Contact Person Ph 579- PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Pos - Framing Insulation Drywall Nailing • I r . ■® _ Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS 02:0 FAIL PLUMBI Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Other Date Inspector _ Ext Final PASS PART FAIL . DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION asd s I DO , 7 24 Hour Inspection Line: 639 -4175 Business Line: 639 -41 / r BUP Date Requested I I (l g AM!' / a PM BLD Location ( r0 SS 1.6::</Y1f12Al2.0 fr 2 . Suite MEC 11 Contact Person C■- ro Ph 5 - PLM Contractor Ph SWR UILDING Tenant/Owner • ELC g all ELR Footing Access: Foundation 0-6)11/(I'd FPS Ftg Drain SGN 4 Inspection Notes: SIT eath /Shear Int Sheath /Shear Framing .• • A-�- Insulation ` � � \ Drywall Nailing ( , I O Firewall Fire Sprinkler Fire Alarm /�j t \n/N Q Q C q �� , _ n �} Susp'd Ceiling ` U V`�\ '-'� -�C C� Roof W03- � Q r 3 • Misc: Final PASS T FAIL laari-L V2/6- v-- 6 ‘4„--- ost & Beam Und a b Q7/\C4-r- \/26%-r- Water Service ✓_�^� Sanitary Sewer 1 . ` X U () , - T FAIL W MECHANI L :am Rough In Gas Line Smoke Dampers Fi • alPART FAIL TRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk ` n Other Date I / � " I Inspector Ext3 Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION cl q Od3S7 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 , Date Requested ` / O AM PM BLD Location 116 L JL.c X ilj'? /' s) k Suite MEC Contact Person jL� Ph S � PLM Contr. e Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footin• Access: FPS ndatio • • i am SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Ina Sheath/Shear \ _ �_`� Framing � j?/\I' CSC_ Insulation `� /, U� \ Drywall Nailing ` n) Firewall Fire Sprinkler Fire Alarm t Susp'd Ceiling Roof (I Misc: G....• .... /..�... `? e! k Final PASS AR AIL PLUMBING - ' I _ • 3 • i - - -4 c Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL - Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk I Other Date Inspecto ' l� Ext Final PASS PART FAIL 0 NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION 4210 � - 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 111?-1491 AM qV PM BLD Location /1 ( 855 — P .s-) Wi mac. , , O', Suite MEC Contact Person C Ph 500 E163 PLM Contractor Ph SWR UILDIy Tenant/Owner ELC RefaininWall ELR Foundation Access: j 4C ' FPS S i : � Ftg Drain Zw� Z Crawl Drain Inspection Notes: SGN Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear �S _ S/ d /�- ,9'2._ Framing - f Insulation Drywall Nailing e- ` Firewall Fire Sprinkler ► ` , \ • U`� 1 --\,7"\ Fire Alarm Susp'd Ceiling , Roof Misc• nal (FrAii ART FAIL � / ING � ` f2_,; S C� Q S Post & Beam Under Slab l�� Q j/� S Top Out Water Service Sanitary Sewer Rain Drains C C Final - - �, ^� PASS PART FAIL ` L�� - CZ∎ .1V f L� MECHANICAL Post & Beam • Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL (SITE) Backfill /Grading Sanitary Sewer Storm Drain ► j I n [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin 1 _ Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Date 11 ( /7i Inspector ►' lam Ex � PASS PART FAIL DO NOT REMOVE this inspection record from the job site.