Permit CITY OF T I G A R D MASTER PERMIT
PERMIT #: MST2002 -00098
DEVELOPMENT SERVICES DATE ISSUED: 5/22/02
:.4.'111.. =- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 13255 SW YALE PL PARCEL: 2S104DA -QHS40
SUBDIVISION: QUAIL HOLLOW - SOUTH ZONING: R -4.5
BLOCK: LOT: 040 JURISDICTION: TIG
REMARKS: SF rowhouse,Unit #40,BIdg 9,As plan. STRUCTURAL FILL, REQUIRES GEO -TECH INSPECTION
AND REPORTS
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: 733 sf GARAGE: 547 sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: 733 of RIGHT:
VALUE: $ 162,203.80
OCCUPANCY GRP: R3 BDRM: 2 BATH: 2 TOTAL: 1,638.00 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 c 100K: BOIL/CMP < 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 ADDL 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:
>04 RES UNITS: SVC /FDR >o225 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: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL N SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 5,500.08
This permit
BROWNSTONE QUAIL HOLLOW LLC BROWNSTONE HOMES, LLC Mu is subject , the regulations contained C o i the
Tigard
12670 SW 68TH PKWY STE 200 12670 SW 68TH PKWY other applicable Municipal Code, State work will Specialty e Codes and
all
PORTLAND, OR 97223 PORTLAND, OR 97223 othr applicable law All wok will by done i
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
Rea n: LAC 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 Plm /undslb Insp Framing Insp Firewall Insp Electrical Final
Footing Insp Electrical Service Gas Line Insp Gyp Board Insp Plumb Final
Foundation Insp Electrical Rough -in Insulation Insp Rain Drain Insp Mechanical Final
Wtr Proofing Bsm't Wa Mechanical Insp Shear Wall Insp Water Line Insp Building Final
Slab Insp Plumbing Top Out Exterior Sheathing Insf Smoke Detector Final Inspecti
Issued By : '4 f&J Permittee Signature :
Call (503) by 7:00 p.m. for an inspection needed the next business day
r - • Plumbing•PermitApplicstion / • - • .
Datereceived: ' air Permitno•: W000 -40 0/) , K
` Ji ul City of 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 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
O New construction O Addition/alteration /replacement 0 Food service 0 Other.
JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist)
Job address:132s5 CO L_ _ Qty. Fee (ea.) Total
g. no.: ( C4J e
. � New 1 - and 2-family dwellings only: Tax map/tax lot/account no.: (des100IL for each utility connection)
SFR (1) bath
Lot: 'O I 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: Siteutilities:
Catch basin/area drain
Est. date of completion/inspection: Drywells/leach 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
Contractor's representative signature: Back flow flow valve
Back 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
q ' t's°O111\1•:It • . - . • Fixture/sewer cap
Floor drains/floor sinks/hub
Name (print): 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 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 • ? °. rt Tubs/shower/shower pan
Urinal
Name: Water closet
Address: Water heater
City: I State: I ZIP: Other: —
Phone: I Fax: I E -mail: Total
Not all Jim' tit =fit cards, please call Jim for more Inf41m Notice: This perm application Minimum fee $
O Visa ()MasterCard expires if a permit is not obtained Plan review (at _ 96) $
t and amber: — within 180 days after it has been State surcharge (896) .... $
Name d cardholder es shown m weld aid
accepted as complete. TOTAL »... $
$
s, Cardholder slgoaAmami ae Amami , 440-4616 (6031C000
Mechanical PermitApplication• i
A , Dateiuceived: Permit no.: ► ' l� � ,,, `' ,0 D 0 9g
�!.1.1! City of Tigard Project/appl. no.: Expire date:
Ciryof7igard Address: 1312.5 SW Hall Blvd, Tigard OR 97223
Phone: (503) 639-4171 Dateissued: By: Receipt no.:
Fax: (503) 598 -1960 - Case file no.: Payment type:
Land use approval: Building permit no.:
. TYPE OF PERMIT .) -
❑ 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: .25 s W ''' a, a . 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: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: ZIP: 1 & 2 FAM11L1• DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: AND COMINIERICAIJINDUSTRIAL EQUIPMENTSCIIEDULE
Fee(ea.) Total
Est. date of completion/mspection: Descri . ' .. Qty. Res. only Res. only
Tenant improvement or change of use: . AC '
Is existing space heated or conditioned? ❑ Yes ❑ N o Air handling unit CFM
g P Au conditioning (site plan required) M
Is existing space insulated? ❑ Yes ❑ No Alteration of existing HVAC system -
)\1ECHANICAL CONTRACTOR Boiler compressors
Sttp I ■�
State boiler permit no.:
HP Tons BTU/H
Four Seasons Heating & A/C Service Inc Fire/smoke. ..- _ duct smoke detectors IM
PO Box 66409 Heat pump site plan required)
Portland OR 97290 - 6409 Install/replace furnace/burner BTU/H 111
503 Including ductwork /vent liner ❑ Yes ❑ No
CCB: 48283 nstall/replaceirelocateheaters suspended, 1
wall, or floor mounted
Name (please print): eat for : u Hance other than furnace NM
CONTACT PERSON ■ _ -
Absorption units BTU/H
Name: Chillers HP -
Address: Co ", ressors i HP
omen - . asst and vea • bent . --
City: State: ZIP: Appliance vent
Phone: Fax: ' E -mail: I ryer exhaust MI
OWNER Hoods, Type ll/res.kitchen/hazmat ■ __
hood fire suppression system
Name: Exhaust fan with single duct (bath fans) -
Mailing address: Exhaust . -., a. • from heating or AC ' ' . ' on up to 4 ou ets I
. p .
City: State: ZIP: : ' '
Type: 120 NG Oil 111
Phone: Fax: E -mail: Fuel 1 i , ing each additional over 4 outlets I
•1.: _,. - ENGINEER • • . . . , (schematicre MN ��
Number of outlets -
Name: Other - app . e or eq .1 pment: -
Address: Decorativefireplace 1
City: State: ZIP: nsert - i' MI
Phone: Fax: E - mail: oodstov , Iletstove IIII
Other:
Applicant's signature: Date: Other: = ==
Name (print): I
Not au kui."1 aioas accept credit cat. please call jwisdicrioa far more inrarmstim Permit fee $
O Visa CI MasterCard Notice: This permit application ]Minim fe $
Credit card Dumber: / / Plan review (at )
expires if a permit is not obtained Pli at _ % $
Expires within 180 days after it has been State surcharge (8 %) .... $
Name of cardholder as Moan m credit card accepted as complete.
$ TOTAL _. _ $
Cardholder sly Amount 440-4617 (601COM)
•
P .. E lectrical Permit Application r r . ..
Date received: Q® Permit no.: r. (cot— ?
1 -- :�, ' ,.. 1 1 i ti' City of Tigard Project/appl.no.: • Expire date:
City of Tigard 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:
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 • ,- . .
Job address: 1 3.2S5's W cc / e P L Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: 4/ o I Block: I Subdivision:
Project name: '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. Imp
Streamline Electric New residential -tdtngleor multi-family per
DBA LaValley Corporation dwelling mill. banks attached garage.
6025 East 18 St Servialnciude& •
, 1000 sq. ft. or less 4
Vancouver WA 98661 ; Each additional 500 sq. ft. or portion thereof -
360 - 993 -5080 Limited energy. residential 2
CC_ B:1 16514 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: 1E-mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary servtoes or feeders -
which is not intended for sale, lease, rent, or exchange according to lnjallation,alteratloo , orrelocatlon:
ORS 447, 455, 479, 670, 701. 2 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 am . s 2
-r.( „ - :. - ' 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: 'ZIP: B. Fee for branch circuits without purchase
Phone: Fax: E -mail: of service or feeder fee, first branch circuit: 2
Each additional branch circuit:
•• PLAN 'REVIEW (Please check all that apply) .. - Misc. (Service or feeder not included):
O Service over 225 amps - commercial O Health-care facility Each pump or irrigation circle 2
O Service over 320 amps- rating of 1&2 Cl 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,
Cl System over 600 volts nominal more residential units in one structure alteration, or extension* - 2
O Building over three stories 0 Faders, 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:
Cl Egress/lightingplan 0 Other. Per inspection I I 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 fee more information. Notice: This permit application Permit fee $
0 Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number. / I within 180 days after it has been State surcharge (8%) .... $
Exp11ts accepted as complete. TOTAL $
Name at cardholder as rbowo on credit card
S
Cardholder signature Amami 440-4615 (6o0/COM)
∎A AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAI - .
• •
• •
• ►
• •
T
TREE CER IFICATION •
STREET
4�.
• ' 9°A1A
►
• I, , Owner /Agent for J II ' A 0 PI IIILIA &c' itt
(PLEASE PRINT) (PERMIT HOLDER) ■
• ■
• ■
• II ■
• ,, ,, . O•
• :, "
•
• Do hereb following g
ce � i that the followin location ■
• meets City of" Tigard /Washington County ► I.
• land use and development standards for street tree installation. ■
• t•
• ■
■
e ADDRESS: S7, u... : ►
• • LOT: SUBDIVISIQN: (0( A/ i ■
• •
• • BY: DA V 5 L ►
A RECEIVED BY: 71 DATE: /(- / ■
• •
•
Buildineermit Application . .
j' ' �1'lil. City of Tigard
1 6a- Permit no.: @(sr g
Address: 13125 SW Hall Blvd, . €EVED " Projecdappl. no.: date:
City nj7igard i ! Phone: (503) 639 -4171 Date issued: T Receipt no.:
Fax: (503) 598 -1960 FEB s a 2002 Case file no.: Payment type:
FEB Land use approval: 1 &2 family: Simple Complex:
(Lll It OF ILI
0 I & 2 family dwelling or accessory O Commercial/industrial 0 Multi- family 0 New construction 0 Demolition
0 Addition/alteration /replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other: •
JOB SITE INFORMATION
Job address: 3 , UJ 4., / E a L. Bldg. no.: ' Suite no.:
Lot: Li n Block: Subdivision: . Tax map /tax lot/account t no.: e • - 5 40 Project name: i2-Y.5 �j-
Description and location of work on premises/special conditions:
. OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: (kr0(so Ks ..4 -nt.�c t ll,er_.t, Lk. f1r,1 ( Floodplain ,septiccapacity,solar, c.)
Mailing address: I s � (2 � a • � ~ • _ S t � A . d • i & 2 family dwelling:
City: F'o r'k- l State:O1Q ZIP: -A?) 3 Valuation of work $
Phone:,5 $ -V4sr Fax: 620 -9:70E-mail: No. of bedrooms/baths
Owner's representative: c Total number of floors
Phone: e E -mail: New dwelling area (sq. ft.)
Garage/carport area (sq. ft.)
Covered porch area (sq. ft.)
Name: f f u , to .. ‘....c. - Po q. di
Mailing address: 1 ,2.6?Q S(J A S� Deck area (sq. ft.)
City: Po r . o ,.._,0L ,.._,0L � � 6..E..
t ate:OIR-ZI • . q) 3 Other structure area (sq. ft.)
Phone: - 8 ` 6.5 Fax: E -mail: Commercial /Industrial/multi- famlly:
CONTRACTOR Valuation of work $
�( II rr Existing bldg. area (sq. ft.)
Business name:
8 .r a W v∎,NO i^c_ t 0%/ ".LS L ..0 New bldg. area (sq. ft.)
Address: /-7-60 o SW 6 g l S �� �„ - Number of stories
City: R `.c� Type of construction
PhoneL p - 25 Fax:62.0 -9 E -mail:
y 6 Occupancy group(s): Existing:
CCB no.:
I 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: G 6 Lp provisions of ORS 701 and may be required to be licensed in the
Address: j 2 01 7t r k v c. - .5 3O jurisdiction where work is being performed. lithe applicant is
City:. State � ZIP:g�(p / exempt from licensing, the following reason applies:
Contact person: a,,,N, !t(v,.prx Plan no.:
Phone: _ 0 - a E-mail:
Name: T'; j ift ., a 1 ti E Contact person: p � Fees due upon application $
Address: 6, q /-,9 s Cl...) i4a -,,,,pin �.,,. cc<}- Date received:
City: 's1 ,-,_., IState: I ZIP: cf. 1,2,1,3 Amount received $
Phone: 6 c! f)') p 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 mote iaformatioo.
attached checklist. All provisions of laws and'ordinances governing this 0 Visa 0 MasietCard
work will be complied •' .,, whether .,r4ed herein or not. Credit card number. i
Expire/ s
Authorized sign. re: _ 2 —:. Name of cardholder as shown on credit card
Print name: e . $
Cardho algmtu Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6/00/COM)
— 62 /0c2. /t , ]� J5S 6 E/� '
A
. �� /i �t j / 111,6 -64-7
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
7Fr9V1
IMPORTANT PERMIT NOTICE
MAY 3 n 2002
WOLCOTT PLUMBING CONTRACTORS t;f y % 1 g ;?�;��":i,
PO BOX 2007 BULD �y D1. 31t3N
GRESHAM, OR 97030
Plumbing Signature Form
Permit #: MST2002 -00098
Date Issued: 5/22/02
Parcel: 2S104DA -QHS40
Site Address: 13255 SW YALE PL
Subdivision: QUAIL HOLLOW - SOUTH
Block: Lot: 040
Jurisdiction: TIG
Zoning: R-4.5
Remarks: SF rowhouse,Unit #40,BIdg 9,As plan. STRUCTURAL FILL, REQUIRES
GEO -TECH INSPECTION AND REPORTS
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 #: LIC 23847
PLM 26 -208PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
)( Signature Aut rized Plumber
If you have any questions, please call (503) 639 -4171, ext. # 310
CITY OF TIGARD
13125 S.W. HALL BLVD. 7 =_ �� �� I L7D
TIGARD, OR 97223 " ���'�
MAY 3 n 2002
IMPORTANT PERMIT NOTICE Co . IC Uk 1�
STREAMLINE ELECTRICAL
DBA LAVALLEY CORORATION
6025 EAST 18TH ST
VANCOUVER, WA 98661
Electrical Signature Form
Permit #: MST2002 -00098
Date Issued: 5/22/02
Parcel: 2S104DA -QHS40
Site Address: 13255 SW YALE PL
Subdivision: QUAIL HOLLOW - SOUTH
Block: . Lot: 040
Jurisdiction: TIG
Zoning: R-4.5
Remarks: SF rowhouse,Unit #40,BIdg 9,As plan. STRUCTURAL FILL, REQUIRES
GEO -TECH INSPECTION AND REPORTS
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 #. E E 34 .432C
SUP 4801S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X a
Signature of Supervising Electrician
If you have any questions, please call (503) 639 -4171, ext. # 310
0.- 0 0 WO COD
MST Master Permit
Inspection Description Date Passed By Notes
Grading
Footing /Setback
Foundation walls
Slab
Footing drain
Waterproof basement walls
Plumbing underslab
Crawl drain
Post/beam plumbing
Post/beam mechanical
Underfloor insulation •
Post/beam structural
—
Shear walls /anchors
Exterior sheathing
Plumbing top -out
Gas line & test
Mechanical rough -in
Electrical rough -in •
Electrical service
Low voltage
Sprinkler rough -in
Backflow preventer
Roof nailing
Firewall
Framing
MFG -Home set -up
Insulation
Drywall nailing
• Rain drain
Sanitary sewer
Water service
Pump /fill septic tank
Approach/sidewalk
Street Tree Certificate
Grading final
•
Mechanical final
Plumbing final
Electrical final
Final inspection
Special Reports
SWR - Sewer Permit
Inspection Description Date Passed By Notes
Sanitary sewer
Final inspection
•
• Inspection Record — MST (Master) Permits
i:\dsts \forrru \nspRecordMST.doc 04/17/01
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 • MST .��J2--r/e
BUP
Received Date Requested f /— / 9 AM PM BUP
Location / 3 2S r ��v �l �� Suite MEC
Contact Person Ph ( ) 7P3 — 5 3c/5" PLM
Contractor Ph ( ) SWR
Tenant/Owner 724-4 4-e C// �r.� �/ rk i v/ ELC
Footing l
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:
Fin '
PAS PART FAIL
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 •
MECHANICAL
Post & Beam
Rough -In
Gas Line
SmDampers
e PART FAIL
CTRICAL Sr -4--
/ p
'V`1/4 C
Service
Rough -In c� / 0
�
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 v � v i
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 24L .moo v70
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested /1- / AM PM BUP
Location /3ZSs r 4 l e Oil Suite MEC
Contact Person Ph ( ) /tom -'$3 v h' 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
Ilati
D s y u wall on g (h
D all Nailing 7IV 6_ C 2 Fire Sprinkler J d
Fire Alarm f - J • 3
Susp'd Ceiling
Roof 1- a r /S
Other: ` C1
Final
PAS PART FAIL
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other
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 LI Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE fl Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA (7710( O Approach/Sidewalk Inspector Est
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour p�
BUILDING Inspection Line: (503) 639 -4175 MST `000 90
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested I I ( ID— AM t " PM BUP
Location L3 2 SS PL' Suite EC
-17
Contact Person Ph ( ) 7- £ 3 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain
64/44
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 Q,/ Susp'd Ceiling `f i
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:
air
*ASS PART gip
MECHANICA
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 [J _ Ins ector Ext Approach/Sidewalk P
Other:
Final DO OT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour c}
BUILDING Inspection Line: (503) 639 -4175 MST /
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested 9/3 AM PM BUP
Location / 3 SS 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
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
S PART FAIL
CHANICAL
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 E Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date I 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 -68z,6981
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested �s° AM PM BUP
Location � 3 - 2-SS Lr et_ Suite MEC
Contact Person Ph ( ) 40 7 —/ 7g? 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 ,1)14i 4<r•
Insulation
Drywall Nailing / ���
Firewall
Fire Sprinkler
Fire Alarm , p
Susp'd Ceiling r��� `�' a-.4'" ,/ �'j0 •
Roof
Other: �/
Final &4 4
PASS PART FAIL
PLUMBING
ost
der Slab
Rou - n
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Fin
ASS PART FAIL
M 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 ne section. 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 Inspector Ext
Other:
Final DO NOT REMOVE this insp ion record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST -066 7
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received - Date Requested � f AM PM BUP
3�
Location ( 7. J 0 Suite MEC
Contact Person Ph ( ) T7� ' C3 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
Rou h -In
n �*111�
:PO"
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 1 Approach/Sidewalk Date .- Z 41 . Inspector Fat
Other:
Final DO OT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
MST d 7g) INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
Received Date Requested ( ( I AM PM AA
i
Location oZ s ;G % L- Suite / ��� MEC
Contact Person Ph ( d) 1 O PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access: /�
Ftg Drain ELR AO MIVAA* Crawl Drain
Slab Inspection Notes: SIT 4 71
Post & Beam era NI 14ic * ON/L
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm 4)
Susp'd Ceiling ! � rg
Roof
•
1 n L p<yet `so t " / L, h*
SS 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
Fir- . m
SS PART , ❑ 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 //. / a Q ,R 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 G z---e/00 �j p
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested / —/ AM PM BUP
Location / 3 255 Su) / 4/ e /2.(� Suite MEC
Contact Person C/ Ph (- O ) ff3 5) PLM
Contractor S'' //:+` ekf� is Ph ( ) ' //Wft5 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 ■ alk PASS PART FAIL -.ma �.
PLUMBING V .O
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
co
Rough -In
UG/Sla•��
arm
Fin. Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
E ❑ Please call for reinspection RE: ❑ Unable to inspect – no access
Fire Supply Line
ADA t Date JClo C� oZ Inspector — /P • ` I�,� Ext
Approach/Sidewalk 6 .
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 e2 ODn,g
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested /1 - 0,0 v2 AM PM BUP
Location /. b /i( PeC12 Suite MEC
Contact Person - 7 - 1:3w) (7it'r Ph (3() .L —1 E PLM
Contractor Li n c FG,19^ic Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg ELR 2 nD a-C7�
Drain
Crawl Drain
Slab Inspection Notes: SIT 42) i41 v41.
Post & Beam a 2 1 �i
Shear Anchors m ��
Ext Sheath/Shear
Int Sheath/Shear
Framing
D Insulati
ywalon �„�( l /iS /'�- -�p S" � T z,
Drywall Nailing C/ _ • f
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final Cff ch`c -, O k -15d
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
Cn E Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SI 0 Please call for reinspection RE: 0 Unable to inspect – no access
Fire Supply Line
ADA
Approach/Sidewalk Date NiRs 02... Inspector — • Est
Other: 1
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL