Permit CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2003 -00071
II 1 DEVELOPMENT SERVICES DATEISSUED: 3/17/03
..� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12440 SW WINTERVIEW DR PARCEL: 2S110BC -TS015
SUBDIVISION: THORNWOOD ZONING: R -
BLOCK: LOT: 015 JURISDICTION: TIG
REMARKS: New SF detached model home.
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1.584 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,830 sf GARAGE: 420 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 Dm. sf RIGHT: 11
VALUE: 329 60
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3,414 sf REAR: 19
. PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 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: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOILJCMP < 3HP: VENT FANS: 4 CLOTHES DRYER: 1
GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1
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: 1st W/O SVC/FDR: 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: 801 +amps 1000x. MINOR LABEL:
1000+ ampNolt :
PLAN REVIEW SECTION
Reconnect only:
>=4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS ARENSPC 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: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 8,154.68
DON MORISSETTE HOMES DON MORISSETTE HOMES INC This permit is subject to the regulations contained in the
4230 GALEWOOD ST #100 4230 GALEWOOD ST, STE 100 al other r applicable Municipal Code, State work k w Specialty Codes and
all other applicable law All work will be done i
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 t
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: 503 387 - 7538 Phone: Oregon Utility Notification Center. Those rules are set
5o forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
Rep #: LI 38737 may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Erosion Control Insp & Underfloor insulation Plumb Top Out Exterior Sheathing Ins Rain drain Insp Plumb Final
Sewer Inspection Crawl Drain /Backwater Electrical Service Low Voltage Water Line Insp Final inspection
Foundation Insp Footing /Foundation Dr; Electrical Rough In Gas Line Insp Appr /Sdwlk Insp
Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical Final
Post/Beam , , - . anical Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final
Issue By : i !_ �� ' I ..-4 a. Permittee Signature : A,/l ei 2117 f/f—
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day,
•
. ( PA P- 946 cor) ,
A . , B u i l di ng Permit Ap licat�i9�
t. V L� I V Date received: X11 Permit no.: W61 &a,7/
City of Tigard
R
�`� '� g Project/appl. no.: A p i : date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, QP 7230 2003
Phone: (503) 639 -4171 rCCDD Date issued: OEM. Receipt no.:
Fax: (503) 598 -1960 CITY OF TIGARD Case file no.: Payment
p IV ISIO ` 1&2 f amily: Simple Co
Land use approval: LC 1a�00�� Complex:
TYPE OF i'l
0 1 & 2 family dwelling or accessory 0 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 - t�".
Job address: /ay/ya _ - Bldg. no.: Suite no.:
Lot: I '' Block: Subdivision: M/ A7 141111.11= Tax map/tax lot/account no.:
Project name:
Description and location of work on premises/special conditions:
OWNER . FOR - SPECIAL INFORMATION, USE Ch ECKLISC
I *' t ,�`�
(Floodplain. seplic capacity, solar, etc.)
Mailing address: ' erlDi f Ara n RA_" rtal 1 & 2 family dwelling:
�� EM A ZIP: "3J Valuation of work $ 311 G
Phone:. r` � Errh ,. No. of bedrooms/baths L i
Owner's representative: , L �� i i _ Total number of floors a'
Phone: Fax: E -mail: New dwelling area (sq. ft.) --3V � i :a2 3� /1/ IOW
APPLICANT Garage/carport area (sq. ft.) Y w � /
Covered porch area (sq. ft.) 1 2'--r.)
Mailing address: a ra _ Deck area (sq. ft.) /U
City: State: ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commerclal/industrlaUmulti- family:
CONTRACTOR Valuation of work $
Existing bldg. area (sq. ft.)
�"� �' ftfl V "� New bldg. area (sq. ft.)
Address: , 7v `� Tr Number of stories
City: State: ZIP:
Phone: Fax: E -mail: Type of construction
^B no.: Occupancy group(s): Existing:
• _ New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCIIII ECI /DESIGNER licensed with the Oregon Construction Contractors Board under
cmgramwmr provisions of ORS 701 and may be required to be licensed in the
Address: . jurisdiction where work is being performed. If the applicant is
'& h7` 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. - . rovisions of 1 ws and ordinances governing this 0 Visa 0 MasterCard
work will be compl • wt .• , whether Hied ilereAntrot. Credit card number. / /
n A fin// it e Expires
Authorized si a atu _ , ' / 1 i_ : Name of cardholder as shown on credit card
Print name: �! 4 I ( .� 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 (6o000M)
• � One - and Two - Family Dwelling
' ' Permit Application '
Building Permit Application Checklist Reference no.:
City of Tigard Cl of Tigard Associated permits:
`J b O Electrical 0 Plumbing 0 Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 0 Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Ye; 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 CI permit required. Include drainage -way protection, silt fence design and location of i /
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, 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. J�
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 ".
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)
/45 c03- ao-to 7/
Mechanical Permit Application
� Date received: Permit no.:
� ; ' ' .:f 1 ►!: City of Tiga Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223
Phone: (503) 639 -4171 Date issued: By: 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
Iew construction 0 Addition/alteration /replacement 0 Other.
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE -•
. Job address: /A gi) 0,N \AANA, '/ • Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ .
Lot: `jam'' Block: Subdivision: 7 RWM11 'See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: ZIP: 1 &.2 FAiMILY. DWELLING PERMIT FEE SCHEDULE •
Description and location of work on premises: 'AND.COi IMERICAI:/INDUSTRIA 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 condiing unit CFM
8 P Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
MMECI IAN ICAL CONTRACTOR Boiler/compressors
�����}� State boiler permit no.:
�i�_y�s 1��(r, HP Tons BTU/H
' Address: fr�M Firelsmoke dampers/duct smoke detectors IN
13121M672112117RMINAIIONA Heat pump (site plan required) II.
Phone: __4 _ ' Fax: E -mail: lnstall/replacefurnace/burner BTU /H ■ --
CCB no.: Including ductwork/vent liner 0 Yes 0 No
4/ Install/replace/relocate heaters – suspended, ■ --
City/metro lic. no.: N/A wall, or floor mounted
Name (please print): �rj 1 I I I Vent fora.plianceotherthanfurnace --
'CONTACT PERSON
Refrigeration: BTU/H tiuni ■ --
Absorption
�/ Chillers HP
Com.ressors HP al
Address:
w L (' r Environmental exhaust and ventilation:
City: I State: rZIP: Appliance vent
• Phone: Fax: E - mail: Dryer exhaust
OWNER Hoods, Type 1/ lures. kitchen/hazmat
� hood fire suppression system
_�. i q—sli •A 411 Exhaust fan with single duct (bath fans)
Mailing address:
i x _
/ s'_��M AITA Exhaust system apart from heating or AC
�� �, •
.. . Fuel piping and distribution (up to 4 outlets) III Type: LPG NG Oil
Phone: .Irpljt Fax: E - mail: Fuel piping each additional over 4 outlets IIM
- ENGINEER Process piping (schemauc required) MIN .1.=
Number of outlets
Name: Other listed appliance or equipment:
I
Address: Decorative fireplace
City: State: ZIP: Insert – type
Fax: E -mail: Wdstove/pelletstove
Phone: F
� Other: .
tw
.T\ Applicant's signatu" ���i o Date: J �'�� Other. MI
Name (print): AlliniMagnillillEIMINIMI 1.
P
Na credit all jurisdicuons accept edit cards. please call junsdtcuon for more information. Permit fee $
Notice: This permit application Minimum fee $
0 Visa 0 MasterCard expires if a permit is not obtained
Credit card number: E
Expires w i t hin 180 days after it has been Plan review (at — %) $
x
p State surcharge (8 %) .... $
Name or cardholder as shown on credn card accepted as complete.
S TOTAL $
Cardholder signature Amount 440 -4617 (61000OM)
A4.5T -c - ao7/
Plumbing Permit Application
•A , Date received: Permit no.:
' City of Tigard Sewer permit no.: Building permit no.:
`"`'� Address: 13125 SW Hall Blvd, Tigard, OR 97223
City o phone: (503) 639 -4171 Project/appl. no.: Expire date:
Fax: (503) 598 -1960 Date issued: By: I Receipt no.:
Land use approval: Case file no.: Payment type:
TYPE OF PERMIT •
0 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
ew construction 0 Addition/alteration/replacement 0 Food service 0 Other.
JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist)
Job address: / e Q k IL I Description Qty. Fee(ea.) Total
New 1- and 2- family dwellings only:
Bldg. no.: Suite no.: (includes 100 ft. for each utility connection)
Tax map /tax lot/account no.: SFR (1) bath
_
Lot_ laN Block: Subdivision: Th � �� li ‘ SFR (2) bath
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.)
Manufactured home utilities
Business name Q. N L- 1) M1i I t l(7 Manholes
Address: ' P 7 ` A )� l Rain drain connector
City: State ZIP: Sanitary sewer (no. lin. ft.)
Phone:&W -- jL.J Fax: I E -mail: Storm se wer (no. t )
` � (� I _ � Water s e rvice (no. lin. lin. f ft ))
CCB no.: L. l Plumb. bus. reg. no:
VIP
Fixture or item:
City/metro lie. no.: N/A ;/ / Absorp valve
Contractors representative signature .,/ '_�� B ack fl ow preventer
Print name: .• II ` i7�k. Backwater valve ,
\ CONTACT PERSON Basins/lavatory
Name: �-
l 1 SN -tI ,_.1 e Clothes washer ,
Dishwasher
Address: 1- 70:vy , P, Q/" (.Le J Vt° _ Dnnkingfountain(s)
City: State: ZIP: Ejectors/sump
Phone: Fax: E -mail: Expansion tank
OWNER Fixture/sewer cap ,
Floor drains/floor sinks/hub
Name (print): , !►�att Garbage disposal
Mailing address: ,, _ - • " • �i, 1 • , 2 Hose bibb
City: -() State ZIP:Li`70 , Ice maker —
Phone: c?- [Fax: &157- . 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 ,
Tubs/shower /shower pan ,
Urinal
Name: Water closet
Address: Water heater
City: I State: I ZIP: Other.
Phone: [Fax: I E -mail: Total
unsdreuons xcept creel c cards, please call unsdreuon for more information Minimum fee $
Not all
� pt � N otice: This permit app
0 Visa 0 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 TOTAL $
accepted as complete.
Name of cardholder as shown oo credit card
S
Cardholder signature Amount .140 -1616 (6&VaCOM)
A4 5 '7 a - COT) 7/
Electrical Permit Application
.4 , Date received: Permit no.:
r ,y *: City of Tigard J PP p
Pro ect/a I no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd. Tigard OR 97223 Date issued: By: I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
❑ I & 2 family dwelling or accessory ❑ Commercial/industrial 0 Multi - family ❑ Tenant improvement
►' New construction ❑ Addition/alteration/replacement ❑ Other. ❑ Partial
�_ JOB SITE INFORMATION,
Job address: ` figi Bldg. no : Suite no.: Tax map/tax lot/account no.:
Lot: '1111 Block: Subdivision: F AVIIIVIN" ^
Project name: Description and location of work on premises:
Estimated date of completion/inspection:
CON] RAC I OR APPLICATION ION FEE SCHEDULE
Job no: Fee
Description
N ew residential -single Qty. (ea.) Total NM
- gle or multi-family per
Address: r0 _ M `` sea dwelling wilt. includes a ttached g rage.
NLSitil ��Xa Servicemcluded:
Phone: - � 22 j r • � Fax: E -mail: 1000 sq. ft or less 4
'J Each additional 500 sq. ft or portion thereof __ _—
CCB no.: Elec. bus. lie, no: pZ � Li energy, residential 11111111.1 2
C: Limited energy, non- residential ___ 2
Each manufactured home or modular dwelling ■■
nature of supervising electrician (required) Date � vdta) Service and/or feeder 2
` Services
tion feeders— Installation, 11111
in! �l License no: p1
' � � alteration or relontion:
L itO I IL 'I' O \1'NI {It 2 00 amps or less
Name riot : ■ 201 amps to 400 amps ___ 2
(P ) �� ,�. 'I ►.�-w 401 amps to 600 amps ___ 2
Mailing address: '�in - igrt / S. ' , 601 amps to 1000 amps ___ 2
City: l.1 Ez ra. ZIP: oWi Over 1000 amps or volts ___ 2
Phone:,, 2112 r Reconnect only 1.111_ I
Owner installation: The installation is being made on property I own Temporary services or feeders -
11117 .
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation: 2
201 1
ORS 447, 455, 479, 670, 701.
200 amps or less amps to 400 amps __ 2 _
Owner's signature: Date: 401 to 600 amps MOB 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
City: State: ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E -mail: Each additional branch circuit: •_
PLAN REVIEW (Please check all that apply) Misc . (Serviceorfeeder not included): ■■
O Service over 225 amps-commercial 0 Health -care facility Each pump or irrigation circle 2
n
O Service 320 amps - rating of 1&2 0 Buz location Each sign or outline lighting 2
g :■ 2
family dwellings 0 Building ding 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
O Building over three stones 0 Feeders, 400 amps or more •Descri . tion:
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/lightingplan 0 Other. Perinspecuon M_ Submit sets of plans with any of the above. Invesugation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application
Permit fee $
O Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card Dumber: / / within 180 days after it has been State surcharge (8%) .... $
Ex accepted as complete. TOTAL $
Name of cardholder u shown on credit card
S
Cardholder signature Amount 440-4615 (600OCOM)
AA S I a- CcD3 --_c)-c)--co 7 i
► �AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA
A •
. •
. •
T EE CERTIFICATION ET T E R S R 0.
►
• .
• I � ��\C f -r , Owner/Agent for ►
• g D �ar�; SS��� r►5 ■
•
(PL SE PRINT) (PERMIT H LDER) ►
• ►
• .
• - ►
• "
I 0
• Do hereby certify that thef'llowing location ■ ►
• 1 ' ■
• meets ( City=of Tigard /Washington County ■
• •
• land use and development standards for street tree installation. ■
• ■
• •
A •
.
• ADDRESS: - /�6 s pi/a vi£� LnJ •
12
• •
• •
• LOT: / SUBDIVISION: 7 2N wo v p ►
• ►
• ■
• ■
• BY DATE: S - /6 - b3 ►
•
►
• ►
• RECEIVED BY: DATE: ►
A
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 (r J
INSPECTION DIVISION Business Line: ' /503) 639 -4171
BUP
Received 1 ' 3 7 Date Requested _ 5 1 / AM PM BUP
Location 10 ( 7 4 y6 w ✓ /-€:4,,) Suite MEC
Contact Person �Ta" Ph ( ) Sf 5- ZO ` PLM
Contractor Ph ( ) SWR
411,IILDthI ? Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: 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:
RT FAIL
•
Post & Beam -
Under Slab
Rough -In
•
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
0th = :
i
- T FAIL
Po Beam
Rough -
Gas Line
Smoke Dampers
/r%'
A RT FAIL
11�1 : •
•
Se -
Rough -In
UG/Slab
Low Voltage
Firms� rm
i 'Y'— ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
•ASS PART FAIL
❑ Please call for reinspection RE: ❑ Unable to inspect – no access
Fire pply Line
ADA Date ", / 1( p /6 3
Approach/Sidewalk Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (5 MST 3 6 7
INSPECTION DIVISION • Business Line: (50 39 -4171
L BUP
/
Received Date Requested —1 T AM � 51i /PM BUP
Location / a Li Lk) � j � - 3 Suite MEC
Contact Person �� 4 Ph ( ) 6-7 I — 4' 4 5 ' -- PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation /� 1 / /� ELC
Ftg Drain Access: / �t� �2 QC l¢ f1 17-f ' ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear _
Framin. `�/, , — ( �— -�
D rywall Nailing
Firewall
Fire Sprinkler
Fire Alarm 4 V e--tx
Susp'd Ceiling
Roof n S I � S
Other: e ) t.
Fin -
*- FAIL
• - 'BING
Post & Beam
Under Slab
Rough -In <›A-e_•
Water Service i
Sanitary Sewer g
Rain Drains �---�.�
•
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
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 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 4 j\ 4/° 3 Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 j
MST — bad
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Reque ted'' ' � ( I AM PM BUP
Location / , ?N 1 1 L / t r#L ( Suite MEC
Contact Person Ph ( ) 57 — 4 o (4.5 2 --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
�
Framin
sul o
Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART CA
PLUMBING
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
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 ❑ Please call for reinspection RE. ❑ Unable to inspect — no access
Fire Supply Line
ADA D �""— 1 � � U
Approach/Sidewalk Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour .
BUILDING Inspection Line: (503) AF ,' • • 7
INSPECTION DIVISION [Y Business Line: (50 ~ t MST 3 --06 7/
BUP
Received Date Re ested 9 AM PM )2 74 BUP
Location / d iNo vtr._, Suite MEC
Contact Person OL-v..L Ph ( ) ‘.5.--/q--(v '- 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 .
aSheath/S0 a/ 1 0
heath/S i .
1 /-_, '
ation - / ' $'g .A--e‹ -�
Drywall Nailing
Firewall • 04s �-P / _ `3 D --- / Z3 d f Z cf
Fire Sprinkler
Fire Alarm �¢ ! (/ � (/
Susp'd Ceiling "( I
Roof "‘C t t _
Other: ``
Final 1 1 C c - 6 :"Xe , --T , CY - _
PASS PART
M : N 7 C�� c�J /� /
Post & Beam r `� c \ — Z
Under Slab � •
ough- n �ti? "1/��
Sa
Wa n it ervice ` �_`� 4-.3–,,
Sanitary Sewer A. S -- ' �� Z (-A./
Rain Drains
Catch Basin / Manhole \ �•�.•/� ,�2�(� ' �/
- U k •-12") A `i S `
Storm Drain O – 1 O OY
Shower Pan
Other: I –
Final ^ l�1�
PASS PART a;113 g _ P /' Col - j
MECHANICAL S 20 5� N C I N e--e"1--- Post & Beam _ _ 0 c n Q – L < -k p � N .i t5 .
'•ough - e _ -- )A.0.1 /11t.� ZVC •
moke Damp�rs'0 O A� 1 ∎ , �• A , ,
Final e
PASS PART �' � A _ . - A. ��`°��'�/
ELECTRICAL _ G c — L A Z U
Service i � � l , ^ ,�
Rough -In V S / � ��* t----. Y v `�. � o�r
UG/Slab
Low Voltage �� r v t.,►S Gk".9'-ik..r
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: 0 Unable to inspect – no access
Fire Supply Line
ADA
Approach/Sidewalk Date a � I nspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour 007/
BUILDING Inspection Line: (503) 639 -4175 MST 3--
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested AM PM BUP
Location Suite MEC
Contact Person Ph ( ) 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 11) . ' o "/' ` � , .�•, aZ h Framing aittii�
Insulation I J / O PF 1 1 �� s a
Drywall Nailing I � _ `
Firewall ' _ 1 1 -A 5A 58 - j C An
Fire Sprinkler -� � 14
Fire Alarm 4' n n
Susp'd Ceiling ) 4 �.-�C�
Roof i . MISFAIEWARMEMEHEIM
Other: g I
Final � , C1� '-d•' v�S .�- M __
PASS PART FAIL /
PLUMBING «') SN - e AP1C -". S - -
Post & Beam kS _V �� T) k L A C
Under Slab �/ /�^ 1 '`��`C
Rough -In 17 , 1 ✓�/��,., 1 T--
Water Service
Sanitary Sewer VNA-Q
Rain Drains .
Catch Basin / Manhole \. 6 S -
) L /� 6,e,,,---Os- ^
Storm Drain / �/ . � \�
Shower Pan o A , — .' 'l IQ_ `ma
Other:
Final I. •1 2 _ C� S (k�► Vt‘meA iI-- PASS PART FAIL
MECHANICAL • C - k--1/4r
Post & Beam
Rough -In elAb SL-Q6 � ' &cam 1 ^4-0._ sAkrA As-4
Gas Line p
Smoke Dampers ---- __,Q. J N P
Final 1 c v2 4 5-e
PASS PART FAIL
ELECTRICAL 47 -P . `9--e
Service
Rough -In 1
UG/Slab r t ' 4 9 . _ Low Voltage , .14, .0_ _ ;m.LJ_
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date 4/ d Inspector - Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
2.----
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST 3 6 a0 7
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested —� AM PM BUP
Location f? - IZ Suite MEC
Contact Person Ph ( ) 519 _G 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
V heath/SO
heath/S
Framing S77 PS 4/• .• P u//4-izg
Insulation
Drywall Nailing ' //04‘. /'' 4 v'V ' '" ��� S LG�r� 2.."7"*" Si ' " C4-
Fire Sprinkler ' ' S�k
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART O
PLUMBING
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
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 ❑ Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date 'V dam Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST 3 -Coo -z i
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
Received Date Requested 3 — a' (� AM PM BUP
Location / - V �!� �-l/ t, I IA -c.�c) &A— Suite MEC
Contact Person Ph ( ) St S - (o LI s - PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access.
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
l.s & Be. u
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Fin
PART FAIL
PLUMBING
Post & Beam
. Under Slab
Rough -In
• Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MEC L
st & Bea
Roug - n
Gas Line
Smoke Dampers
Fina
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 tr
Approach/Sidewalk Date — Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST 3 - 40071
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested PM BUP •
Location / ° t ti e/0 Gt/wri btsuite MEC
Contact Person Ph ( ) _ —4 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/ er ELC
Footing
Foundation ELC
Ate
Ftg Drain ELR
Crawl Drain
Slab Inspection Note: SIT
ost 8 Beam
Shear Anchors
Ext Sheath/Shear
Int Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART _ 61
PLUMBING -
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECH A L
ost & ea
Roug h
-ln
Gas Line
Smoke Dampers
Final
PASS PART FAI
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 Date I v Inspector / Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
•
BUILDING Inspection Line: (503) 639 -4175 im" MST 3 7/
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested ' L i - 1g AM PM BUP
Location 1 Suite MEC
Contact Person �i Ph ( ) .% ye. 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.Anch • ti
xt Sheat Sf l--
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Fi
ASS ART FAIL
Post & Beam ■
Unde lab
.'ou.h -Ii
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
F'-_
PART FAIL
CHANICAL
Post & Beam
e g -
s ine
Smoke Dampers
Fi
PAS _ RT FAIL
tit AL
erv ic
oug -In
a
Low Voltage
Fire Alarm
Fi ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
ASS PART FAIL
❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA �// b / /
O
Approach/Sidewalk Date Inspector: Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
• BUILDING Inspection Line: (503) 639 -4175 MST —Qo v 7 /
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Reque ted' -' AM PM BUP
Location / a 1 c iv win etk Suite MEC
Contact Person Ph ( ) J c� 1 c , _G (ts PLM
Contractor /, Ph ( ) SWR
— a
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:
Final
PASS PART FAIL
PLUMBING
st & Beam
nder Sla •
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Fin
PART FAIL
ECHANICAL •
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 ❑ Please call for reinspection RE: D Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk iD v Inspector 17 �( Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD I 24-Hour n U
BUILDING Inspection Line: (503) 639 -4175 MST 3- dad 7/
INSPECTION DIVISION Business Line: (503) 639-4171
BUP
Received Date Requested 3 a` I _ AM �1PM BUP
Location / P / 6 £ L c L La. -3 Suite �\ MEC
Contact Person t 1/yt� Ph ( ) 9 -6 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
VI?
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:
Final
O:IN
PART FAIL
G
Post & Beam
Under Slab
Rou • h -I
Mallo
ain Drell •
Catc Basin / Manhole
Storm Drain
Shower Pan
Other: V
4 . r. PART FAIL
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 II Please call for - inspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Dat . �h Inspector Ext
PP
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639 -4175 MST 3 — 660 71
INSPECTION DIVISION Business Line: (503) 639 -4171
d BUP
Received ,, Date Re ested .� '�d _ AM PM BUP
[[
Location ! o T° (J�- t,P -•t� k )'L Suite MEC
Contact Person Ph ( ) . V/ _6 445 Z PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
0o ing
Foundatio ELC
Access:
g rain ELR
Crawl Drain
Slab Inspection Notes: /
Post & Beam 1
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear 46 eD SSE /L i-r� -t l�� iii — �sOo�-
Framing
Insulation
Drywall Nailing UF�' � �� e57
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
,SS ART FAIL
MBING
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
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 ❑ Please call for reinspection RE: 111 Unable to inspect - no access
Fire Supply Line
•
ADA
Approach/Sidewalk Date 3 ����� Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL