Permit / r.
CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2004 -00069
jlh1 DEVELOPMENT P M ENT oR OR 3 639-4171
SERVICES 171 DATE ISSUED: 4/22/04
13125 SW Hall Blvd., SITE ADDRESS: 12485 SW WINTERVIEW DR PARCEL: 2S110BC -03100
SUBDIVISION: THORNWOOD ZONING: R -
BLOCK: LOT: 002 JURISDICTION: TIG
REMARKS: New SF detached.
BUILDING
REISSUE: DM170 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,570 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,620 at GARAGE: 406 sf FRONT: 15 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 TwRD: sf RIGHT: 10
VALUE: 306,198 80
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3,190 st REAR: 15
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: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < BHP: 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: 4
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W/SVC OR FDR: PUMP/IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 6 201 - 400 amp: 201 - 400 amp: 151W/0 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: 801 +amps- 1000v: MINOR LABEL:
1000+ amp/volt :
PLAN REVIEW SECTION
Reconnect only:
>=4 RES UNITS: SVC /FDR> =225 A.: > 800 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL • RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 6,095.49
DON MORISSETTE HOMES DON MORISSETTE HOMES INC This permit is al Code, State Specialty to the regulations contained Co i ode s and
the
4230 GALE WOOD ST #100 4230 GALEWOOD ST, STE 100 all other applicable cable la v. All work w ill be d o n e e Ce
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 all applic w done it
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
5p3 forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
LIC
Reg #. 387 8 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 Insg Gyp Board lnsp Appr /Sdwlk Insp
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Rain drain Insp Electrical Final
Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Storm drain Insp Mechanical Final
Foundation Insp PLM /Underfloor Framing Insp Gas Fireplace Water Line Insp Plumb Final
Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation lnsp Water Service Insp Building Final
Issu: d By : / 4 . � w � � . Permittee Signature : � .
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
Building Permit Application _ ,
,) -4,-,":1'11' Da te received:. ArgrA „ Permit no.: 4 ,� /Pi ,, •
• .. J
` City o f Ti RECEIVED Project/appl. no.: A u Expire date:
Ciryo}7gard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 tb 2 5 2004 Date issued: By: Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
CITY OF TIGARD 1&2 family: Simple
Land use approval: y: p Complex:
+ TYI'E OF PERMIT
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
Job address: _ 'F MUI� %1� i ��1� Bldg. no.: Suite no.:
Lot: - Block: Subdivision: V�,1j Tax map/tax lot/account no.:
Project name:
Description and location of work on premises/special conditions:
•
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
M1r' I► _7.111[s14At� (Floodplain. septic capacity, solar, etc.)
Mailing address: A MDJ - � _ R/ '� 1 & 2 family dwelling:
�� A ZIP: X1.`7 Valuation of work $
Phone:. r`, fill p"`d n No. of bedrooms/baths 4 1 �. �, l)
Owner's representative: , _ L t, if Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
lttl ��:�'r
Covered porch area (sq. ft.)
Mailing address: Ara •� Deck area (sq. ft.)
City: St ZIP: Other structure area (sq. ft.)
Phone: Fax: E - mail: Commercial/industrial/multi family:
CONTRACTOR Valuation of work..., $
Existing bldg. area (sq. ft.)
Business name: - L fd] AiL
New bldg. area (sq. ft.)
Address: .R.. `� WA. ilr7 . 1101.1111=
City: Number of stories
ity: State: ZIP;
Phone: Fax: E -mail: Type of construction
CCB no.: Occupancy group(s): Existing:
. New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCI Ill ECT /DESI611 It licensed with the Oregon Construction Contractors Board under
a r �_i - provisions of ORS 701 and may be required to be licensed in the
Address: • jurisdiction where work is being performed. If the applicant is
City: State: ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: State: 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 comp s wr ., whether ified tiere�n � Credit card number: / /
A t Expires
Authorized si atu _ / i Name o f cardholder as shown on credit card
Print name: _ •:_ 4" t (
$
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 (6/0O/COM)
One - and Two - Family Dwelling •
•
Building Permit Application Checklist
Reference no.:
City of Tigard Cl of Tigard Associated permits:
`, g 0 Electrical ❑ 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 REQUIRE!) 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.
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 0 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 g
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 x
area; building coverage area percentage of coverage; impervious area; existing structures on site; and surface drainage.
12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent
size and location.
13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater,
furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc.
14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub -floor,
wall construction, roof construction-More than one cross section may be required to clearly portray construction. Show
details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs,
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." `,X
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 (dooicoM)
Mechanical Permit Application
Date received: Permit no.: • H „,.,• •
AM
_.- i - - City of Tigard RECEIVED Project/appl. no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 -
Phone: (503) 639 - 4171 Date issued: By: I Receipt no.:
Fax: (503) 598 - 1960 FEB 5 2004 Case file no.: Payment type:
Land use approval: CITY nF TIAARD Building permit no.:
• , _ a ..
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement •
XNew construction 0 Addition/alteration /replacement 0 Other.
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: ��`� M Y IIIM Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map/tax lot/account no.: profit. Value $
Lot: Block: Subdivision: V'�i111 nai 'See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: I ZIP: 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: AND COMIMERICAUINDUSTRIAL EQUIPMIENTSCIEEDULE
Fee(ea.) Total
Est_ date of completion /inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: Air
space heated or conditioned? 0 Yes 0 No Ai handling unit CFM •
Is existing P Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
' MECHANICAL CONTRACTOR Boiler/compressors
t _ State boiler permit no.:
�.l�Si �. fa �I.� HP Tons BTU/H
Address: ear afr Fi re/smoke dampers/duct smoke detectors
City: t�� o_____ bil Heat pump (site plan required)
Phone: � . 'Fax: E - mail: nstalUreplacefurnace/burner BTU /H
Including ductwork/vent liner 0 Yes 0 No
CCB no.: •? .91 - Install/replace/relocate heaters suspended,
City/metro lic. no.: N/A wall, or floor mounted
Name (please print): •'elec "Aid' (■IEL� Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/H
i Chillers HP
i �� Comp ressors _ HP
Address: 41 Environmental exhaust and ventilation:
' City: State: ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
O W N 1:12 Hoods, Type U IUres. kitchen/hazmat
hood tire suppression system
_�.5. !rigre •� Exhaust fan with single duct (bath fans) .
Mailing address: Wi / i�_ � aril Exhaust system apart from heating or AC
��� Iiii»�
,,.-, Fuel piping and distribution up to 4 outlets)
� Type: LPG NG Oil
Phone: t�i1 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: I ZIP: Insert - type
Phone: Fax: E -mail: Woodstove/pelletstove
Ne pp g r �� i 511-1411 Othe
A Applicant's si Harr" :� p, � u Date: �, �� Other.
Name (print): k : { ' p f (b(.if'nr' l
Permit fee $
Na all junsdicuons accept credit cods, please call jurrsdreuon for more informauan Not Th permit application Minimum fee $
0 Visa 0 MasterCard expires if a permit is not obtained
Credit card number: Expires / w 180 d a ys a fter it has been Plan review (at %) $ •
State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete. TOTAL $
cardholder signature Amount 440.4617 (6100/COM)
Plumbing Permit Application • ,
Datereceived: Permit no.:) ,,,, M i .
►t� I Sewer permit City of Tigard ����
M,) �t t no.: Building permit no.:
Address: 13125 SW Hall B
City of Ti phone: (503) 639 -4171 Project/appl. no.: Expire date:
Fax: (503) 598 -1960 I- Et3 se, 0 2004 Date issued: By: Receipt no.:
Case file no.: Payment type:
Land use approval: OF TIGARD
' !'1'F' OF PERMIT
•
0 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
v New construction 0 Addition/alteration/replacement 0 Food service 0 Other.
JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist)
Job �^J Description s • . Fee(ea.) ' Total
Bld address: i V J New 1- and 2- family dwellings only:
Bldg. no.: Suite no.: - (includes 100 ft. forma utility connection)
Tax map/tax lot/account no.: SFR (1) bath
Lot. c- Block: Subdivision: 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.)
MI
I'LL IING CO�i " IL \CfOlt Manufactured home utilities
Business name: iN .__7 L. • Manholes
Address: , Rain drain connector
City: Cj - / ZIP: Sanitary sewer (no. lin. ft.)
at _vim �'a
Phone: ftip — 4-' I Fax: E -mail: Storm sewer (no. lin. ft.)
_ ;�� -. Water service (no. lin. ft.)
CCB n o.: , ( 9 Pl umb. bus. reg. no:
�� — Fixture or item:
City/metro fie. no.: N/A / Absorption valve
Contractors representative signature - - Back flow preventer
Print name: , • ' , • / U. — Backwater valve I
—
CONTACT PERSON Basins/lavatory
1 ���� D
Name :� �- I t--1E lothea washer , Dishwasher
Address: Z,Yy,e 0.2) c .)r V ve _. Dnnking fountain(s)
City: I State: ZIP: ` Ejectors/sump
Phone: Fax: E -mail: Expansion tank
OWNER N Ii R Fixture/sewer cap
Floor drains/floor sulks/hub
Name (print): j - =�Q Ga r b age disposal
Mailing address: �{� [ HI V? b Hose bibb
City: L - fl State , ZIP :q�C " .. Ice maker
Phone: 27 - IFax:52?7-7k E -mail: Interceptor /gre trap
Owner installation/residential maintenance only: The actual installation Pnmer(s)
will be made by me or the maintenance and repair made by my regular Roof drain (commercial)
employee on the property I own as per ORS Chapter 447. Sink(s), basin(s). lays(s)
Owner's signature: Date: Sump _
ENGINEER. Tubs/shower /shower pan
Unnal
t ,
Name: .
Water closet
Address: . Water heater
City I State I ZIP: Other.
Phone: — 1 Fax: I E-mail: Total
Minimum fee $
Notice: This permit application
Na all lunsdscutxu accept credit cards. please call iunsdreuon far more informinformation. fortrua+. ti Thtion
Plan review (at _ %) $
0
Visa 0 MasterCard expires if a permit is not obtained State Surcharge (8 %) .... $ �
C.edit card number / w ithin 180 days after it has been $
Expires accepted as complete. TOTAL -�--
Name of cardholder as shown oa cnxLt card
S 440—$6 lb (6/CesC'OM)
Cardholder signature Amount
- A Electrical Permit Application
Date received: Permit no.: , _ '
WO
_ = '::►'► r City of Tigard Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall B lv Date issued: By: I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
l-kt .4 5 2004,
Land use approval:
'f Vk :.W PERMIT
- . ..
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
v New construction 0 Addition/alteration /replacement 0 Other. 0 Partial
JOB SITE INFORMATION •
Job address: la ' `/U( ��felli w Bld:. so.: Suite no.: Tax map/tax lot/account no.:
Lot: (Block: (Subdivision: ' a VW
Project name: I Description and location of work on premises:
Estimated date of completion/inspection:
CONTRACTOR A \I'I'LI('A ZION FEE SCHEDULE •
Job no: _T" ' Fee Max
_ Business name: G V . ] ( E c —'t, s iphon Qty. (a) Total no. hasp
New residential -single ormulti- fatwiy per
Address: rD or � ` a le ` • c" - dwelling unit. Includes attached garage.
CiLiL g Service included
Phone: r V I Fax: E -mail: moo sq. ft. orless 4
Each additional 500 sq. ft. or portion thereof
CCB no.: Elec. bus. lit, no: - - O � • / � Linuted energy, residential 2
C' Limited energy, non- residential 2
Each manufactured home or modular dwelling
nature of supervising electrician (required) Date." % el — Service and/or feeder 2
Q Services orfeeders— Installation,
Sup elect name (print) �� 1 ' A'Jl License no / � alteration or relocation:
PROPERTY OWNER 200ampsorless 2
•
201 amps to 400 amps 2
Name (print): �][ tl��:'�A 401 amps to 600 amps 2 •
Mailing address: � ��_ �( /,�, �• r _f 601 amps to 1000 amps 2
City: �� • r � � p Over 1000 amps or volts 2
Phone: '��� n e1%. Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
lease, rent, or exchange according to �tallatiott ,alteration, orrelocadon:
which is not intended for sale, g g 200 amps or less 2
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 ern 's 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):
Cl Service over 225 amps - commercial Cl Health-care facility Each pump or irrigation circle 2
O Service over 320 amps -rating of 1 &2 0 Hazardous location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or extension* 2
O Building over three stories 0 Feeders, 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or 1W park Each additional inspection over the allowable in any of the above:
O Egress/lighting plan 0 Other Per inspection ► I I I
Submit _ sets of plans with any of the above. Invesugation fee
The above are not applicable to temporary construction service. Other
Not all junsdictions 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 number. / / 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 (600'COM)
/V ST 1-4- Co 6 1
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STREET TREE CERTIFICATION
14 .
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013.,AsErumo __d /Agent for .Dor•J Mia-t$SErr
(PERMIT /WIPER)
• I )o hereby (-dill) that the fullowing location
1 1
meets Of y of Tigard/Washington County
41
41 land use and development standards 1(n st I ect I ree installation.
1 .
,. . . .
i .. • ADDRESS: .) ILO 5 5 vi GO/ it 7n/1i/ )01 . • ,
s 1 LOU: 2 SI.MDI MON: ____T_Apvrt, 90_,e1-- • .
i 1 .. .
i - •.
I BY: I DATE:
1 cy r • .
.`,.- 44
RECEIVED B Y: I )AT1•
jfi-***7*--*■-f-fTTTYVVYTTTVVVYTYTYTTVTTV*VTITTVVIVVVVVVYVVVITTTITTITTT1 '
CITY OF TIGARD 24 -Hour
•
BUILDING Inspection Line: (503) 639 -4175 MSTo1GO V '64:=6
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
Received Date Requested 1 `/ AM PM BUP
Location Suite MEC
Contact Person Ph ( ) oZ 0 9 — g837 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 P pB g vep r„v""
�
Drywall Nailing 1 `(�`� VV �J�
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
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
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
AA� PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA I Ext
Approach/Sidewalk Date Y Inspecto ) e,z y
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 a.dd OCO6g
INSPECTION DIVISION - Business Line: (503) 639 -4171 '
BUP
Received Date Requested 7 - / AM PM BUP
Location ) 2 � ' S (.cJ�c� Suite MEC
Contact Person / o Ph ( ) 09 - V837 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
40. i 7
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 ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA //o Date
Approach/Sidewalk / ` Inspeato 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 o�00 1 # — °° 06 ?
INSPECTION DIVISION Business Liner (993) 639 -4171
BUP " _
1
Received Date `` Requested 7 �` ' , -AM PM BUP
I
Location ?-?�S w , lSaite MEC
Contact Person Ph ( ) ° 2 d — t( X37 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 ` °� �l.J z�S'.7�LL, =�� ��r7s S �i Xi[`
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Ot : r:
1
a,PART FAIL
P ING
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
m
ASSN 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 7—�c� �'G�4—
Approach/Sidewalk Inspector - Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL