Permit MASTER PERMIT
A. C ITY OF TI Ca A R ® PERMIT #: MST2002 -00106
�y1 DEVELOPMENT SERVICES DATE ISSUED: 5/22/02
' ` - --"- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 13295 SW YALE PL PARCEL: 2S104DA -QHS44
SUBDIVISION: QUAIL HOLLOW - SOUTH ZONING: R -4.5
BLOCK: LOT: 044 JURISDICTION: TIG
REMARKS: SF rowhouse,Unit #44,BIdg 9,CSB plan
BUILDING
REISSUE: STORIES: 3 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: FIRST: 320 sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SFA FLOOR LOAD: 50 SECOND: 744 sf GARAGE: 412 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: 732 sf RIGHT:
VALUE: $ 173,305.60
OCCUPANCY GRP: R3 BDRM: 2 BATH: 3 TOTAL: 1,796.00 sf REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: 3 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: 1 BOIL/CMP < 3HP: VENT FANS: 4 CLOTHES DRYER: 1
LPG FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: 1 W00DSTOVES: 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: 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 & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 5,599.33
BROWNSTONE QUAIL HOLLOW LLC BROWNSTONE HOMES, LLC This perm Mu n is al C d , the regulations ec C o in the
T
12670 SW 68TH PKWY STE 200 12670 SW 68TH PKWY Tigard Spe s and
PORTLAND, OR 97223 PORTLAND, OR 97223 all other applicable l ic cal pable a laws. All work will will by done e C
In
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 a: LIC 124627 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
Sewer Inspection Plumb Top Out Exterior Sheathing Insl Firewall Imp Mechanical Final
Footing lnsp Electrical Service Gas Line lnsp Rain drain Imp Plumb Final
Foundation Imp Electrical Rough In Gas Fireplace Water Line Imp Final Inspection
Slab lnsp Framing lnsp Insulation Imp Water Service lnsp Building Final
Plm /undslab lnsp Shear Wall Insp Gyp Board Imp Electrical Final ,/ 2
Issued By : t/ C Permittee Signature
Call (503 639 -4175 by 7:00 p.m. for an inspection needed the next buslnes da
- Y Mt. tea -tag/
BuildingPermit Application
i City of Tigard r� ®
Date received:, (57 (57 Permitno.: -��o 4
'' „
' = Project/appl. no.: • e date:
City of Tigard
Address: 13125 SW Hall Blv 4 1. ;� . !`' •� „ • —
Phone: (503) 639 -4171 Date issued: By Receipt no.:
Fax: (503) 598 -1960 FEB - d 2002 Case file no.: Payment type:
Land use approval: alit OF "IlliA ce l &2 family: Simple Complex:
JUN
TYPE OF PERMIT .
•
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial O Multi- family ❑ New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
.. • JOB SITE INFORMATION
Job address: 1 3 . 5 S jib _ 4 L F • . ' I_ " Bldg. no.: Suite no.:
Lot: Li -/ Block: Subdivision: Tax map /tax lot/account no.:
Project name:
Description and location of work on premises/special conditions:
• OWNER FOR SPECIAL INFORMATION, USE CIIECKLIST
+
Name: ��f"O C9.; ttisV-n ttic OLk.a-L ( Floodplain , septic capacity�,solar,etc.)
� � nV1
Mailing address: ( ` S/0, 4, t a fi c _,SZC & 2 family dwelling:
City: Po v --k- i. State:OR ZIP: q 7 3 Valuation of work $
Phone - y - -9 Fax: 6,2p -7 E -mail: No. of bedrooms/baths
Owner's representative: . c'' , Total number of floors
Phone: e' Fax: E -mail: New dwelling area (sq. ft.)
Garage/carport area (sq. ft.)
r r r Covered porch area (s ft.)
Name: r 6 C.A3 IAA .54-6 t� c Q t l �� Deck area (s ft.) 9
Mailing address: j a,6' St,J ( ' e ZIF! -S‘.--4.. Other structure area (sq. ft.)
City: (p r. a � State:O�j )a .3,3 Other
Phone: -- ,. t 3 Fax: E -mail:
. CONTRACTOR Valuation of work $
Business name: Existing bldg. area (sq. ft.)
( W 1",.54'61 Nc_ 40 - c_S � New bldg. area (sq. ft.)
Address: • . g — r - - 0 ' Number of stories
City: li n r 4- `c, _ Stater(,, 9 /23 Type of construction
Phone, rys .')y 5 Fax:6 ..o -yqistE-mail:
CCB no.: y 6 Occupancy group(s): Existing:
New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCIIITI (.I /DLSIGNER licensed with the Oregon Construction Contractors Board under
Name: G 6 LQ provisions of ORS 701 and may be required to be licensed in the
Address: j 3 O 1 F r A V c, - Sc.� 1, 3o jurisdiction where work is being performed. If the applicant is
City: a {_ StatetU ZIP: / exempt from licensing, the following reason applies:
Contact person: //A„ it,(. s Plan no.:
Phone: _ 0• E -mail:
Name; . T,,,. i.---4,3,2i;,- I F. Contact person: p IJ Fees due upon application $
Address: F, 9 l,9 s (,v . o 1'4- cc Date received:
City: �` c,_-4 St ate:OR Z IP:9),2.�3 Amount received $
Phone: 6 Y -qr)') 0 I Fax: 1E-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 informadoo.
attached checklist. All provisions of laws and•ordinances governing this ti Visa 0 MasterCard
work will be complied , whet .., ed herein or not. Credit card number .Expires
Authorized sign: re: iplit � Name of cardholder as shown on credit card
Print name: 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 w0olooM)
SfrO 70 /$SU -6 / - c-14-y /t/.° 6-4t-
. , .
• Plumbing Permit Application _ ;D
,}� s Tigard
Date received: Permitno.: 1 / 900, / ,
' ( City Ol Sewer permit no.: Building permit no.:
`� Address: 13125 SW Hall Blvd, Tigard, OR 97223
City ofTigard Phone: (503) 639-4171 Project/appl. no.: Expire date:
Fax: (503) 598 -1960 Date issued: By: Receipt no.:
Land use approval: Case file no.: Payment type:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory Cl CommerciaUndustrial 0 Multi- family 0 Tenant improvement
O New construction 0 Addition/alteration /replacement 0 Food service 0 Other.
JOB SITE INFORMATION - FEE SCHEDULE (for special information use checklist)
Job address: 32 ys - S• W . C.(, / /(IL Description Qty. Fee (ea.) Total
Bldg. no.: (Suite no.: New 1- and 2- family dwellings only:
Tax map/tax lot/account no.: (�� 100 ft. for each utility connection)
SFR (1) bath
Lot: iii: '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:
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:
Absorption valve
Contractor's representative signature: Back flow preventer
Print name: Date: Backwater valve •
CONTACT PERSON Basins/lavatory
Name: Clothes washer
Dishwasher
Address: Drinking fountain(s)
City: I State: I 7131: Ejectors/sump /
Phone: Fax: E -mail: Expansion tank
-.., • . ; . :;O11N1'7Z :.- Fixture/sewer cap
Floor drains/floor sinks/hub
Name (print): Garbage disposal
Ong address: Hose bibb
City: 'State: (ZIP: Ice maker
Phone: I Fax: I E -mail: Interceptor/grease trap
Owner installation/residential maintenance only: The actual installation Primer(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: ( State: I ZIP: Other.
Phone: I Fax: I E -mail: Total
Nat all jatdidiom were aedit cards, please all 1ur" 100 far more ua°rm"m Notice: This perm application Minimum fee $
O Visa O MasterCard expires if a permit is not obtained Plan review (at _ %) $
CM& sad camber: p within 180 days after it has hoes State surcharge (8%) .... $
Name of cardholder as shown as emda card
accepted as complete. TOTAL »... $
S
s Cedholder tl Amami 4104616 (6i01C014
. . . : • '_ , :F _ ,
. Mechanical Permit Application i ,
Date received: 0 I/ Permit no.: ( -/ 10Ved, ` 0
..44 '...1. City of Tigard P 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 U Multi- family 0 Tenant improvement
0 New construction 0 Addition/alteration/replacement 0 Other:
. JOB SITE INFORMATION. COMMERCIAL VALUATION SCHEDULE
Job address: X3.2 50.i a_ _ _ ■ / d G. • 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: 4 (Block: (Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: I ZIP: 1 & 2 FAn11LY DM'ELLING_,PERMIT FEE SCHEDULE
Description and location of work on premises: AND COMMERICALIINDUSTRIAL EQUIPIENTSCI DULE
Fee(ea.) Total
Est_ date of completion/inspection: Description Qty. Res.only Res.only
Tenant improvement or change of use: NVAC:
Is existing space heated or conditioned? 0 Yes O No Air handling unit CFM
g P Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
r - ::i_ MECHANICAL CONTRACTOR Boiler /compressors
State boiler permit no.:
I HP BTU
• Four Seasons Heating & A/C Service Inc Fire/smoke dampaa /duct smoke detectors
PO Box 66409 ' Heatpump(siteplanrequired)
Portland OR 97290 -6409 , Install/replace furnace/burner BTU/H
503- 775 -5919 . including ductwork /vent liner O Yes O No
CCB: 48283 Install/replace/relocate heaters—suspended,
wall, or floor mounted
-
Name (please print): Vent for other than furnace
b
CONTACT PERSON Absorption units BTU/H
Name: Chillers HP
Compressors HP i
Address: DM :mental :mental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: Fax: - E -mail: Dryer exhaust
Ow1'r ti Hoods, Type U llhes. 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: ZIP: Type: LPG NG Oil
Phone: Fax: E -mail: Fuel i ing each additional over 4 outlets
p (schematic required)
Number of outlets
Name: Other listed appliance or equipment:
Address: Decorativefireplace
City: I State: I ZIP Insert —type
Phone: I Fax: I E-mail: Woodstove/pelletstove
Other.
Applicant's signature: I Date: Other:
Name (print):
Not as jurisdictions accept a edit cards. please call jurisdiction tor more iafamanoa Permit fee $
0 Visa 0 MasterCard Notice: This permit application Minimum fee $
expires if a permit is not obtained
Credit card number
Expires within 180 days after it has been Plan review (at %) $
accepted complete.
State surcharge (8 %) .. $
Name of cardholder a shown on credit as com edit card $ P P TO'T'AL » _» $
Cardholder signature Amount 440-4617 (6,00C M)
' A - Electrical Permit Application P r
Date received: , t'4 1) r Permit no.: it /76 MO , i
' ,,4: ,) i ll k City of Tigard Project/appl. no.: • Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
- - • ' . Tl'PE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other. ❑ Partial
JOB SITE INFORMATION
Job address: ,Ss Lk.) 'a..,./ A ' L . - Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: L/ C f lock: Subdivision:
Project name: I Description and location of work on premises: .
Estimated date of completion/inspection:
- CONTRACTOR APPLICATION • . FEE SCHEDULE .. • .
Job no: Fee Max
_ — Description Qty. (ea.) Total no. tnsp
Streamline Electric New r thd- ringleormulti- family
DBA LaValley Corporation dwellingmlt .loeludcs attached garage. .
6025 East 18 St Service includte
Vancouver WA 98661 1000 sq. ft. or less - 4
360 -993 -5080 Each additional 500 sq. ft. or portion thereof
CCB:116514 ELC#: 34-432C SUP #: Limited energy, residential - 2
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: [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, ''ti0O'orrelocation:
200 amps or less 2
ORS 447, 455, 479, 670, 701.
201 amps to 400 amps 2
Owner's signature: Date: 401to600 am. 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: I
: -J. :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 1 &2 ❑ 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
❑ Building over three stories O Feeders, 400 amps or more •Description: •
O Occupant load over 99 persons Cl Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lighting plan O Other Per inspection L 1 1 1
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 $
❑ 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
$
Cardholder signature Amount 4404615 ()
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
WOLCOTT PLUMBING CONTRACTORS
PO BOX 2007 MAY 3 n 2002
GRESHAM, OR 97030 _ y O ftWLYI
3.711�JS.�i.1SdA. d � --
Plumbing Signature Form
Permit #: MS7'2002 -00 i 06
Date Issued: 5/22/02
Parcel: 2S 104DA -QH S44
Site Address: 13295 SW YALE PL
Subdivision: QUAIL HOLLOW - SOUTH
Block: I nt: 044
Jurisdiction: TIG
Zoning: R-4.5
. Remarks: SF rowhouse,Unit #44,BIdg 9,CSB plan
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 Dept.
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 STE 200 PO BOX 2007
PORTLAND, OR 97223 GRESHAM, OR 97030
Phone #: 503 - 598 -7565 Phone #: 667 -1781
Reg #: LAC 23847
PLM 26 -208PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Si a • af Aut '. rized Plumber
If you have any questions, please call (503) 639 -4171, ext. # 310
CITY OF TIGARD
13125 S.W. HALL BLVD. �_ -__ ��
TIGARD, OR 97223 -
IMPORTANT PERMIT NOTICE g
_ MAY 3 n 2002
a 1T. ,
STREAMLINE ELECTRICAL
DBA LAVALLEY CORORATION
6025 EAST 18TH ST
VANCOUVER, WA 98661
Electrical Signature Form
Permit #: MST2002 -00106
Date Issued: 5/22/02
Parcel: 2S104DA -QHS44
Site Address: 13295 SW YALE PL
Subdivision: QUAIL HOLLOW - SOUTH
Block: Lot: 044
Jurisdiction: TIG
Zoning: R-4.5
Remarks: SF rowhouse,Unit #44,BIdg 9,CSB plan
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
start of the work to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
BROWNSTONE QUAIL HOLLOW LLC STREAMLINE ELECTRICAL
12670 SW 68TH PKWY STE 200 DBA LAVALLEY CORORATION
PORTLAND, OR 97223 6025 EAST 18TH ST
VANCOUVER WA 98661
Phone #: 503- 598 -7565 Phone 360 -993 -5080
Reg #: EL 34.432C
SUP 4801S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X J
Signature of Supervising Electrician
If you have any questions, please call (503) 639 -4171, ext. # 310
/1 5 T Qt oq — c_ro 16
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• Do hereby' : cettif thafth`e following location ■
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•
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• land use and development standards for street tree installation. •
• •
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• •
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• • LOT: 1 1,4 SUBDIVISION: ►
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• RECEIVED •
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 - 4175 MST o7 GU ,2 _p U/ 0 rr
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested — /) AM PM BUP
Location I .3 2- S ' yc 1,0 p/ Suite MEC
Contact Person Ph ( ) 2,3 -53 c PLM
Contractor Ph ( ) SWR
Tenant/Owner ELC
Footing
Foundation Access: ELC
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:
cg16) 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
AN IC
Post & Beam
Rough -In
Gas Line
S • e Dampers
Aar
PART FAIL
RICAL
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
Approach/Sidewalk Date l/ — 1 / inspector / Ext
I i
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 _06 `6;6
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested / / J / a AM PM BUP
Location IT L— Suite MEC
Contact Person / Ph ( ) 9 3 - S 3 Y 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
Fi rewal I
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
O ther:
• PART FAIL
ANICAL
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 Date l /
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) 639 -4175 MST —60 f o
INSPECTION DIVISION • Business Line: (503) 639 -4171
BUP
Received Date R uested ) / ( 7 AM PM BUP
Location / 3 9S - Suite MEC
Contact Person Ph (_ ?(o 0 571116 r PLM
Co ractor Ph ( ) SWR
B ILDIN t Tenant/Owner ELC
Fo i ting
Fo datio ELC
Ftg'1rain Access: ELR 2OOa" 61
Cra I Dr••in
Slai Inspection Notes: SIT 17 Zikkii_JilLsbel
Pos & '• eam
Shear nchors
Ext ' - ath/Shear _
Int S i -ath/Shear
Fra g
Ins .don
D . I Nailing
Fir -wa
Fi e Sp inkier
F e Ala m
' usp'd S eiling
" oof
• ther:
•
- ASS •ART 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
T FAIL
- e
Rough -In
UG /Slab •
Low Voltage
Fir= ' arm
Q Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
S LI Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date `! 1 > - C9R Inspector _ • _ Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL