Permit �� I MASTER PERMIT
PERMIT #: MST2002 -00099
AvAll DEVELOPMENT T
W OP . EN rd SERVICES DATE ISSUED: 11/26/2002
639 171
SITE ADDRESS: 13175 SW WORCHESTER PL PARCEL: 2S104DA -23600
SUBDIVISION: QUAIL HOLLOW - SOUTH ONING: R - 4.5
BLOCK: LOT: 062 JURISDICTION: TIG
REMARKS: SF rowhouse,Unit 62,BIdg 13,BS plan with deck
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: FIRST: 172 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR LOAD: 50 SECOND: 735 sf GARAGE: 547 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD 735 sf RIGHT:
VALUE:
OCCUPANCY GRP: R3 BDRM: 2 BATH: 2 TOTAL: 1,642 sf REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: 2 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: BCKFLW PREVNTR. GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1
LPG FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS:
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: 1 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 3 201 - 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: SIGNAUPANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 5,500.08
BROWNSTONE QUAIL HOLLOW LLC BROWNSTONE HOMES, LLC This permit Is subject to the regulations contained in the
12670 SW 68TH PKWY 12670 SW 68TH PKWY Tigard Municipal Code, State of OR. Specialty Codes and
STE 200 PORTLAND, OR 97223 all other applicable laws. All work will be done In
PORTLAND, 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:
Oregon law requires you to follow rules adopted by the
Phone: 503 - 598 - 7565 Phone: 503 - 598 - 7565 Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
Reg #: LIC 124627 may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Sewer Inspection Electrical Service Gas Line Insp Gyp Board Insp Plumb Final
Footing Insp Electrical Rough -in Insulation Insp Rain Drain Insp Mechanical Final
Foundation Insp Mechanical Insp Shear Wall Insp Water Line Insp Building Final
Slab Insp Plumbing Top Out Exterior Sheathing Ins Smoke Detector Final inspection
Plm /undslb Insp Framing Insp Firewall Insp Electrical Final
Issued By: A 0.13/6 Permittee Signature
C II 503 639 -4175 by 7:00 p.m. for an inspection needed the next busi es da
� (503) Y P p day
. - 1
• Sa1202 ooa - ®D ®
Building Pe PI wl n
Date received: r ,2 /% e_2__ Permit no.Ws'7- 0 7,a099
i ► City of Tigard FEB ° 4 2002
pro ject/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall W d•�-7 gt , P ., -4...t I
Phone: (503) 639 -4171 ��.•11 11 4 Date issued: By :b43[ Receipt no.:
Fax: (503) 598 -1960 � ��� -
Case file no.: Payment type:
Land use approval: 1 &2 family: Simple Complex:
TYPE OF PERMIT
❑ I & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address: ArVAa Bldg. no.: / Suite no.:
Lot: Block: Subdivision: • -/ /f, _ , , Tax map /tax lot/account no.: •-62 6
Project name:
Description and location of work on premises/special conditions:
OY*NER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: • (Floodplain, septic capacity, solar, etc.)
Mailing address: I _ to . .. 1 : 1 CRM • 1 & 2 family dwelling:
City: • p , e4.‘..,.. State:0g ZIP: Valuation of work $
Phoneme — n - - Fax:. p ,. 1 E -mail: No. of bedrooms/baths
Owner's representative: SMIIMPIMINIII Total number of floors
Phone: A r g =imam E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
' Covered porch area (sq. ft.)
Mailing add ss: , . i SW _ IN 1,W_ E M u T Deck area (sq. ft.)
M - � . Z . 9 - Other structure area (sq. ft.)
Phone: - 8 ` 65 Fax: E- mail: Commercial/industrial/multi- family:
CONTRACTOR Valuation of work $
Existing bldg. area (sq. ft.)
'� New bldg. area (sq. ft.)
Address: ... • . es- r tr
�� - _ Statez� t. _ � Number of stories
Phone - _ _ •� Fax:6.2o — e . - Type of construction
CCB no.: _ Occupancy gro up(s): Existing:
• New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: 6 6 Lip provisions of ORS 701 and may be required to be licensed in the
Address: Q r v �, _ S4i jurisdiction where work is being performed. If the applicant is
• A
D exempt from licensing, the following reason applies:
Contact person: . _ H, j t t, y Plan no.:
Phone: _ .. , Milli E -mail:
ENGINEER -
EMNIMINIMPII Contact person: II , , Fees due upon application $
Address: 6..• s (V „, . , ..• r . 4 - Date received:
IMILKWAPAIIIMMIEEMTA ZIP: 1PME Amount received $
Phone: _ — p 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. All provisions of laws and ordinances governing this o Visa 0 MasterCard
work will be complied ' whether e ' ed herein or not. Credit card number
Expirea
Authorized sign Name of cardholder as down on credit card
Print name: i KAT.:. Cc Cardholder signature $ Amount
�J
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440.4613 (6A0JCOM)
PiumbingPermi - .. C ,
L.
_ _ Datereccived: Permit ao. :Srnf)n2 E ; r,L0 4-_,
• �i I City of Tigard Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd, Tigard,.O1 97223 `): +,''`
City of Tigard Phone: (503) 639 -4171 Project/appl. no.: Expire date:
Fax: (503) 598 -1960 CITY OF TII ARD Date issued: By: I Receipt no.:
3UILDINO DR/EMIT
Land use approval: Case file no .: Payment type:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Food service ❑ Other.
JOB SITE INFORMATION FEE SCIIEDULE (for special information use checklist)
Job address: I 3 [ J 1 S Sco Gvo v-c. iizs Pi
Description Qty. Fee(ea.) Total
Bldg. no.: I Suite no.: New 1 - and 2- family dwellings only:
ft.
Tax map/tax lot/account no.: SFR (1 bath
Lot: 6 2 I Block: I Subdivision: SFR (2) bath
Project name: SFR (3) bath
City/comity: I ZIP: Each additional bath/kitchen
Description and location of work on premises: Site utilities:
Catch basin/area drain
Est. date of completion/inspection:
line/trench drain
PLUMBING CONTRACTOR Footing drain (no. lin. ft.)
Manufactured home utilities
" -- - - Manholes -
Wolcott Plumbing Rain drain connector
PO Box 2007 Sanitary sewer (no. lin. ft.)
Gresham OR 97030 -0594 Storm sewer (no. lin. ft.)
503- 667 -1781 Water service (no. lin. ft.)
CCB:23847 PLM #:26 -208PB Fixture or item:
Contractor's representative signature: Absorption valve
Back flow preventer
Print name: Date: Backwater valve •
- CONTACT PERSON Basins/lavatory
Name: Clothes washer
Dishwasher
Address: Drinking fountain(s)
City: I State: I ZIP: Ejectors/sump
Phone: Fax: E -mail: Expansion tank
. OWN It Fixture/sewer cap
Name (print): Floor drains/floor sinks/hub
Garbage disposal
Mailing address:
Hose bibb
City: I State: I ZIP: Ice maker
Phone: I Fax: I E-mail: Interceptor/grease trap
Owner installation/residential maintenance only: The actual installation Primers)
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: Sum
Tubs/showedshower pan -
Urinal
Name: Water closet
Address: Water heater
City: I State: I ZIP: Other.
Phone: I Fax: I E -mail: Total
Not. ae�t a au 1mrr on for mat � 0® ' d0O i Notice: This permit application mum fee $
a
O Visa O MasterCard expires if a permit is not obtained PIaD review (at _ %) $
Cheat are amber:
within 180 days after it has ban State surcharge (8 %) .... $
&Ores accepted as Clete. TOTAL $
dame d cardholder as rhowo as credit and
$
` Cardholder *mature At , - 440-4616 (6 V OM)
A . - Mechanical Pe 1_' l Vcxtion
�. 1/4.; .+� ... , D Date received: Permit no.:HS 7 0O r e n 7* e)
' w City of Tigard �1,j.._, � g an Project/appl.no.: Expire date:
City of Ti 8 and Address: 13125 SW Hall Blvd, Ti, OR A9 S , 't Date issued: By: I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 CiT OF TAUARD Case file no.: Payment type:
Land use approval: BUILDING DIVISIOY Building permit no.:
TYPE OF P 'KNIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other.
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: / 3 /9,5" SO) We wr Les .t.,,, !P/ 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: 6 2,_ (Block: I Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: I ZIP: I & 2 FAMILY DWELLING PERMIT FIE SCHEDULE
Description and location of work on premises: AND COMMERICALIINDUSTRI AL EQUIPMENTSCIIEDULE
Fee(ea.) Total
Est. date of completion/inspection: Description • Qty. Res. only Res.only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? ❑ Yes ❑ No Air handling unit CFM
g P Air conditioning (site plan required)
Is existing space insulated? ❑ Yes ❑ No Alteration of existing HVAC system
• MECHANICAL CONTRACTOR Boiler /compressors
State boiler permit no.:
HP
Four Seasons Heating & A/C Service Inc Tons BTUM
PO Box 66409 Fire /smokedampers/duct smoke detectors
Heat pump (site plan required)
Portland OR 97290 - 6409 Install/replace furnace/burner BTU/H
503 775 - 5919 Including ductwork/vent liner ❑ Yes 0 No
CCB: 48283 Install /replace/relocate heaters — suspended,
wall, or floor mounted
Name (please print): Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU/1-1
Name: Chillers HP
Co mressors HP
Address: Ea , nmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: Fax: ' E -mail: Dryer exhaust
OWNER Hoods, Type I/ Wres. kitchen/hazmat
hood fire suppression system
Name: Exhaust fan with single duct (bath fans)
Mailing address: Exhaust system apart from heating or AC
Fuel piping and distribution (up to 4 outlets)
City: I State: I ZIP: T LPG NG Oil
Phone: Fax: E -mail: Fuel piping each additional over 4 outlets
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: I E -mail: Woodstove/pelletstove
Other.
Applicant's signature: I Date: Other:
Name (print):
Not au j, dadetiem accept uelit end,. Plrare c jm+dictim or
fa. me infocmatim Permit fee $
Notice: This pe
O Visa Cl MasterCard rmit application fee $
expires if a permit is not obtained Plan review (at %) $
Credit and amber: w 180 days after it has bem
Name of cardholder ss shown as aedit card accepted as complete.
$ State surcharge (89b) .... $
TOTAL .. $
Cardholder danamre Amount 440-4617 (dOQICOM)
1
r
•
. . . Electrical Pert , , 1 , , ,
r, r.. I a a... Date received: Permit no.: 11°9 ol i "r e - <-1
r , �jli City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigd OR •47217 Date issued: By: I Receipt no.:
Phone: (503) 639 - 4171
Fax: (503) 598 - 1960 CITY OF littititD Case file no.: Payment type:
13UILDING DIVIISICW
Land use approval:
. TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other: 0 Partial
• JOB SITE INFORMATION .
lob address: 1 I3 3 I ri S'a) t o o t , , s . pJ Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: A 2 I Block: T Subdivision:
Project name: I Description and location of work on premises:
Estimated date of completion/inspection:
• CONTRACTOR APPLICATION FEE SCIIEDU.E .
Job no: Fee Max
Description Qty. (ea.) Total no. Imp
Streamline Electric New residential - single ormulti- tamilyper
DBA LaValley Corporation dwelling unit. Inchtdes attached garage.
6025 East 18 St 1ppOsgift. rless - 4
Vancouver WA 98661 Each additional 500 sq ft. or portion thereof
360-993-5080 -
Limited energy, residential 2
CCB:116514 ELC#: 34-432C SUP #: Limited energy, non - residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder 2
Sup. elect. name (print) License no. Services or feeders — installation,
alteration or relocation:
. PROPERTY OWNER • 200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation:
200 amps or less 2
20
ORS 447, 455, 479, 670, 701. 201 1 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
' 'ENGINEER . . Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee. first branch circuit: 2
Phone: Fax: E-mail: Each additional branch circuit:
PLAN REVIEW (please check all that apply) Misc. (Service or feeder not included):
O Service over 225 amps- commercial 0 Health -care facility Each pump or irrigation circle 2
0 Service over 320 amps- rating of 18z2 0 Hazardous location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circutt(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 RV park Each additional inspection over the allowable in any of the above:
0 Egress/lighting plan 0 Other. Per inspection
Submit sets of plans with any of the above. Investigation 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 number: / / within 180 days after it has been State surcharge (8 %) .... $
Name of cardholder as shown on credit card Expires accepted as complete. TOTAL $
Cardholder signature Amount 440-4615 (6/00/COM)
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
•
IMPORTANT PERMIT NOTICE
DAVID JEROME ELECTRIC
PO BOX 751
HILLSBORO, OR 97123
Electrical Signature Form
Permit #: MST2002 -00099
Date Issued: 1//26102
Parcel: 25 104DA -23600
Site Address: 13175 SW WORCHESTER PL
Subdivision: QUAIL HOLLOW - SOUTH
Block: Lot 082
Jurisdiction: TIG
•
Zoning: R-4.5
Remarks: SF rowhousa,Unit 62,131dg 13,BS plan with deck
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical permit to be valid, the signature of the supervising electrician Is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
s ".arl of the work to the address above, ATTN: Building Division.
No electrical inspections will be authorized until this completed form Is received
OWNER: ELECTRICAL CONTRACTOR:
BROWNSTONE QUAIL HOLLOW LLC DAVID JEROME ELECTRIC
12670 SW 68TH PKWY PO BOX 751
STE 200 HILLSBORO, OR 97123
PORTLAND, OR 97223
Phone #: 603 - 598 -7566 hone #: 648.5144
Reg #: LIC 360S1
SUP 2877S
ELE 34 -119C
AN INK SIGNATURE IS REQUIRED ON THIS FO
•
•
Signature o Supe sing lectrician
•
if you have any questions, please call (503) 639 -4171, ext. #.2dr
0,4 3,
rooQ saga 9cris « V9LL 3o ALIO t99c$Z9cos gva 9B:tt 436► CO/OZ/TO
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
WOLCOTT PLUMBING CONTRACTORS
PO BOX 2007
GRESHAM, OR 97030
Plumbing Signature Form
Permit #: MST2002 -00099
Date Issued: 11/26/02
Parcel: 2S104DA -23600
Site Address: 13175 SW WORCHESTER PL
Subdivision:
Block: Lot:
Jurisdiction:
Zoning:
Remarks: SF rowhouse,Unit 62,BIdg 13,BS plan with deck
Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the
plumbing permit to be valid, please have the appropriate individual from your company sign below and return
this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Division.
No plumbing inspections will be authorized until this completed form is received
OWNER: PLUMBING CONTRACTOR:
BROWNSTONE QUAIL HOLLOW LLC WOLCOTT PLUMBING CONTRACTOR:
12670 SW 68TH PKWY PO BOX 2007
STE 200 GRESHAM, OR 97030
PORTLAND, OR 97223
Phone #: 503 - 598 -7565 Phone #: 667 -1781
Reg #: LIC 23847
PLM 26 -208PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
i
X _ iv�'�
Signatir .sized Plumber
If you have any questions, please call (503) 639 -4171, ext. # 310
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ADDRESS: 13i 7S" 6 . 2 : l,0O2 E s L L L O Q . 2 — - 10
1;• a ro
44 LOT: Cog SUBDIVISION: ajjatt IiOLL4) Lcury - — -- ►
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a DATE: 5 -14 -�3 — io, _C (
4 RECEIVED BY: %l DATE: �-- — - --
ith.
CITY OF TIGARD 24 -Hour •
BUILDING Inspection Line: (503) 639 -4175 MST a � fr
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received 7 _ pp? Reque ed AM PM BUP
Location / % f 7S v " dlir Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
LDIfj 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
0th- ••
fur"
PART FAIL
'PL O BING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
, MWIECIAL _
Post & Beam
Rough -In
Gas Line
Smoke Dampers
.44110 -
PART FAIL
TRICAL
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 0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line ,,ll A ,
D l ' [/ � ,� ` Ext
Approach /Sidewalk Inspector
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 --666
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received / Date Requested 7 AM PM BUP
Location 13 / 7s" 14) Suite MEC •
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation 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
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
<•hl •a
Fire Alarm
41WV PARR T 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 /
Approach /Sidewalk Date) --' 7 6 ,3 Inspector E xt
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 -/) 7'
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
Received r ate Requested g 1 " 7 AM PM BUP
Location / r2 S 1' ' IL 37 - 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
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
P PART FAIL
L Th G
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Oto - •
Vii►
= 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 /1,
Approach /Sidewalk Date / �3 Inspector
Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL