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13421 SW ASCENSION DRIVE
Sign�hture Form prior to the start of work. No electrical inspections will be authorized until
this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
WTIPR : ELECTRICP.L CONTRACTOR:
R W FULLERTON CO WRIGHT 1 ELECTRIC INC
6426 SW BEAVERTON-HILLSDALE HWY 5618 SF 135TH AVF
PORTLAND OR 97221
PORTLAND OR 97236
Phone # : Phone # :
Reg # • • : 0000097
Signature uperv�.sing 16ctrician
Please return this completed form to the aodress above.
ATTN: Building Dept.
If you have any questions, please call 639-417 1 , ext. #310
I
CITY OF TIOARD MASTER PERMIT
PERMIT #. . . . . . . : MST97-0226
DEVELOPMENT SERVICES DATE ISSUED: 07/07/97
13125 SW Hall Blvd., Tigard, OR 97223 (503)639.4171
PARCEL: 2SI04CB-00400
SITE ADDRESS. . . : 13421 SW ASCENSION DR
SUBDIVISION. . . . :H I LLSH I RE: WOODS ZOt1' 19: R-*7 PID
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :020 JURISDICTION: TIG
Remarks: New SFD Path I
------------ BUILDING
REISSUE: STORIES...,...: 2 FLOOR BASEMENT...: F sf REQUIRED SETBOS---- REGIRRED—
CLASS OF WORK.NEW HEIGHT...,....: 26 FIRST....: 1455 sf GARAGE.....: 653 sf LEFT.,........: 5 WE DETECTRS: Y
TYPE OF USE...:SF FLOOR LOAD....: 50 SECOND...; 1131 sf FRONT,..,.....: 29 PARKING SPACES: 2
TYPE OF CONST.:5N DWELLING UNITS: I FINBSPENT: 264 sf RIGHT.........: 5
OCCUPANCY BRP.:R3 BDRM: 3 BATH: 3 TOTAL--i 2849 sf VALUE..$: 282143 REAR..........: 29
------ PLUMBINB
------
SINKS........,: 2 WATER CLOSETS.: 3 WASHING MACH..: I LAUNDRY TRAYS.: I RAIN DRAIN ft: 110 TRAPS.........:
LAVATORIES....: 4 DISHWASHERS—.- I FLOOR DR!1INS,.: 0 SEWER LINE ft: 110 SF RAIN DRAINS: 0 CATCH BASINS..: 0
TUB/SHOWERS...: 2 GARBAGE DISP..: I WATER HEATERS.: I WATER LINE ft: IN BNrLW PREVNTR: I GREASE TRAPS„.- 0
OTHER FIXTUPES: 0
------------------—------ -----—------------------------- MECHANICAL
FUEL TYPES---------- FURN ( IBM I BOIL./CMP i 3HP: 9 VENT FANS.....: 3 CLOTHES DRYERS: I
GAS FURN ):-INK 0 UNIT HEATERS..: 0 HOODS.........: 0 OTHER UNITS—: 1
MAX INP..- 258888 BTU FLOOR FLVWaS.- I VENTS.........: I WOODSTOVES....-, 8 GAS OUTLETS...: I
--------------------- ELECTRICAL -----------------------
—RESIDENTIAL UNIT- ---SERYICEIFEEDER--- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS-- --MISCELLANEOUS-- --MIL INSPECTIONS—
IM SF OR LESS: I @ - 2" assp..: 0 9 20 amp..: I W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 5885F.: 5 201 - 400 amp..: 8 201 488 asp..: I 1st W/O SVC/FDR: I SIBN/OUT LIN LT: I PER HOUR....,.: 8
LIMITED ENERGY.: 0 481 - W amp...- 9 401 698 alp_- 0 EA ADDL BR CIR: I SIM/PANEL...: I IN PLANT....... I
MAW HM/SVC/FDR-. I rat - IM alp.: @ 601+61ps-188 v: 0 MINOR LABEL -10: 0
low amp/volt.: 0 -------- PLAN REVIEW SECTION --------------------------------
Reconnect
------------------------------
Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)=M A.: 601 V NOMINAL: CLS AREA/BPC 017:
------------ ------—------------- ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL-- B. CMRCIAL—-------
AUDIO I STEREO.: VACUUM SYSTEM..: AUDIO I STEREO.: FIRE ALARM.....: INTERCOM/PARING: OUTDOOR LNOBC LT:
BURGLAR ALM-: 0TH: 11: BOILER.........i HVAC........., : LANDSCAPE/IRRIBi PROTECTIVE SIKt
GARAGE OPENER... X 0.0............ INSTRUIDTATION: MEDICAL........: OTHR: 11.
HVAC...........: DATA/TELE COW.: NURSE CALLS....; TOTAL # SYSTEMS: 0
Owner: ----------------------------------Contractor: ----------------------------- TOTAL FEESO 4530.01
R W FULLERTON CO R FULLERTON COMPANY This permit is subject to the regulations contained in the
6426 SW BEAVERTON-HILLSDALE HWY 9700 SW CAPITOL HWY Tigard Municipal Code, State of Ore. Specialty Codes and all
PORTLAND OR 97221 STE 026 other applicable laws. All work will be done in accordance
PORTLAND OR 97219 with approved plans. This permit will expire if work is
Phone 0: 297-4433 Phone #: 297-4433 not started within 188 days of issuance, jr if the stork is
Reg C.: NOW suspended for more than 188 days. ATTENTION: Oregon law
—------- requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 95?-*I-8818 through OAR 952-01-8888. You may obtain copies of these rules or
direct questions to OUNC by calling (383)246-1987,
---------- REQUIRED INSPECTIONS -------
Erosion Contol Post/%@&m Mechan Electrical Servi Gas Line Insp Water Line Insp Plumb Final
Brading Inspecti Crawl Drain Electrical Rough. Gas Fireplace Water Service In Building Final
Footing Insp PLM/Underfloor Framing Insp Insulation Insp Appr/9dwIk Insp
Foundation Insp Pechanical Insp Shear Wall Insp Gyp Board Insp Electrical Final
Past/Beats Struct Plumb 'lop Out Low Voltage Rain drain Insp Mechanical Final
Issi.ted By : A_(_ ✓ Permittee Signature: f:J
4-i......4................................4..............................
Call 633-4175 by 6:00 p. m. for an inspection needed the next business day
CITY OF TIGARD
DEVELOPMENT SERVICES SEWER CONNECTION
PERMIT
13125 S V Hall Blvu., Tigard,OR 97223 (503)639.4171 PE RM T T #. . . . . . . : SWR97-0219
DA'EE ISSUED: 07/07/97
PARCEL: 2:5104013-004 00
SITE- ADDRESS. . . : 134-21 SW A SCENS T ON DR
GUBDIVI51ON. . . . -.HILL_SHIRE WOODS ZONING: R---7 PD
BL..00K. . . . . . . . . . LOT. . . . . . . . . . . . . :020 JURISDICTION: TIG
'TENANT NAME. . . . . :R W FUL.L..ERTON CO
LISA NO. . . . . . . . . . .. FIXTURE UNITS. . . : 0
CLASS OF WORK. . . :NEW DWELLING UNITS_ :: 1
TYPF OF USE. . . . . :SF NO. OF BUILD 1 NGS: 1.
INSTALL. TYPE. . . . :BUSWR IMPERV SURFACE: 0 sf
Remarks : New SFD
FEES
R W FUL_LERTON CO type amorant by date r,ecpt
6426 SW BEAVERTON.-HILLSDALE, HWY PRMT $ 2200. 00 B 07/07/97 97-296814
PORTLAND OR 97221, INSP $ 371. 00 B 07/07/97 97-29681.4
EROS $ 88. 00 B 07/07/97 97-296814
f4hone #: FRPU 'S L8. 60 B 07/07/97 97 29681.4
ERPC $ 28. 60 B 07/07/97 97-2`'36814
Contractor: -- - __._..__...._. ___---...__.____-._... _GUN $ 2'90. 00 B 07/07/97 97--296814
rlt,INFR
Pl-r o n e #: F 2670, 20 TOTAL.-
Rey #. . :
REDUIRED INSPECTIONS - -.- -
This Applicant agrees to comp'y with all the rules and regulations Sewer In�ipecti.on
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. The total amount paid will be forfeited if the �-
permit expires. The Agency does not guarantee the accuracy of the
sid- sewer laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installe^ shall purchase __--
a "Tap and Side Sewer" Permit and the Agency will install a lateral.
ATTENTION: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR _-
952-001-0010 through OAR 952-9001-0080. You may obtain copies of
these rules or direct questions to OUNC by calling (503)246-1987,
Issued by : �
La
L ._.__--_._ Per-mi.ttee Signatrar-e :
+4•++++++++++++++++•+++++4•++++++++•++++++4++++++++++i++++++++++++++4-++++4+i 4-+4•+ f-+4
Call 639-4175 by 6:00 p. m. for an inspection needed the ne>(t bi_tsiners day
++++++++++++++i++++++++++++++... +++++++++++-F++++++++++++++++++++++++++++++a-+++i++
Plan Check 8
.TY OF TIGARD Residential Building Permit Application Recd By _
3125 SW HALL,BL.VD. New Construction Additions or Alterations Date Recd - r✓ 71
CARD, OR 97223 Single Family Detached or Attached (Duplex)
Qate to P E X!'/(a
503-539-4171 �j'� Dato to DST /
503-684-7297 ( Permit•/'' >7c"'? 7'r
1
Print or Type Called ,
,�I(/j, • , `
Incomplete or illegible applications will not be accepted
Name of Prolect ` Name
.dab r )t_k-,V, r
Address SjteAddresa Architect Mailing Addreu
City/State ,� . Zip Pho
Name v
Madi Address Nims
t)wner n9 ! I faces t– lit. -1z
Mailing Address
Engineer n�
crtyrsaro. I^1 Phone 1 ? L"'7 :7\,�
C.01state Zip Phone
Name % r
, R
General . \�..) � 'i�.r.12'i•(�1 ` Describe work New'Q Aodihon 0 Alteration 0 Repair 0
>ntractor IAailin4 Address to be done:
l r i
J, Additional Description of Work:
cly/State 29,11"A
Oregon Const.Cont.Board Ur.N Earp.Date) --
lttach Copy of C)(
Current l COT Business Tax or Metro B F.xp. ale PROJECT
V, VALUATION
"a`r"' NEW CONSTRUCTI�NN ONLY:
Ulecha- ical >K,y Sq. Ft. House: ~-- Sq. FL Garage
Sub- Mailing ZE7=
Contractorl
�•L' -• JFK rJ to hN-t-n Comer Lot YES NO Flag Lot YES NO
Citlr/staite Ph" (check one) (check one)
i�n a 4\10 r)V' l Restricted Audio/Stereo Burglar
Oregon Const.Cont Board ur-is
%Match Copy of Energy System_ Alarm
Current COT Business Tax or Metro Mate Installation Garage. Door HVAC
Licenses r ? i _ Opener Systems
Name (check all that Other:
c-lumbing ^ n �/Y l ,rvie'�ir, �, apply)
Sub- Mailing Address — Will the electrical subcontractor wire for all YES NO
�: r restricted energy installations?
:ontractor I Z1 i ( tZt' > l
c.i�r/State Zip Phone Has I .e Subdivision Plat recorded NIA YES NO
r ltiav�,, r ,C' y7?r,t� —
Oregon const.Com Board Ucia � .Date } Reissue of MST#: Solar Compliance
�.ttach Cupp of 1-1,S 1�,� f �.> k- � _— (Calculation Attached)
Current Plumbing Lia.S Ex D • 1 hearby acknowledge that I have read this application, that the
Licenses i ..U" •I -)' y information given is correct. that' I am the ownei or authorized
cor sinTax or Metro tK p.D to
i agent of the owner, and that plans submitted are in compliance
V --- with Oregon State laws.
Name -- --- '
Si acture of Owner/R,gent Datg _
lectrica! t �+�_'i.t. _ to
Sub- Mailing A(dress Cgntact Person Name P ne#
.ontractor `.�tyi �t. I r
Cyt/i State ZpPhone FOR OFFICE USE ONLY:
D ( Vr lass (� MapRlf{ ;IC�f/ j,
Oregon Const Cont. Board L c M Exp Dete r (' .—i
,ttach Copy of `� rj _ f`' t, Setbacs: Zone. Solar 1
Curren! E!_ectncal Lie.0 — p.Di t -- � —
Licenses _ 1
J/ ' `� Engines ApprovpL` I Planni g Approval TIF
COT Business Tax or Metro s I Exp Da
l: l l'•?_Ci l I iAtfepp.doc(dst) 1/97
t1r'
P iL As&ount Des II AQI4sll]S AalL-PA.
__-- MST. Permit (BUILD) qP v
Plumb. Permit (PLUMB) ✓ el-
Mech.
Mech. Permit (MECH)
ELC/ELR Permit (ELPRMT)
State Tax (TAX) (n� V —_
Bldg:
Plumb:
Mer,h: __ V
ELC/ELR:
Plan Check t/
MST: BUPPLN 1-I'-ly IV/
Plumb: (PLMPLN) _
Mech: 6t (MECPLN)
CDC Review (LANDUS)
Sewer Connection (WUSA) n—"✓ �s
Reimbursement District ( }
Sewer Inspection (SWINSP) 1r
Parks Dev Charge (PKSDC) /'0 �>
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Water Quality (WOUAL) (.,4-1
Water Quantity (WQUANT)
Erosion Control Permit (ERPRMT)
Erosion Planck/USA (ERPLAN) "= 10$
Erosion PlanckjCOT (EROSN) 1;2 g do
Fire Life Safety (FLS)
L TL
TOTAL S: � •.,''? C� / ���C;<
1lstad .doc (dst) 1197
Solar Balance Point Standard Worksheet
Address
Box A calculations: North-South dimension for the lot. Box A.
This dimension is detennined by finding the midpoint of the North lot line and drawing
an intersecting line perpendia:lar to that point.
First, determine whicl-i property line is the North lot line. The North lot line is the line
with the smallest angle from a line drawn east-west and intersecting the northern most
point of the lot-
I
.o...e. 1 w....+
.a w N w North-South
Dimension for Lot:
Measure the distance from the midpoint of the North lot line cc the South lot line along
the described line.
feet
1
-1 N
wnsaam aR�waa�
v
Box 3 calculations: shade point height for your resi&mce_
Box B:
i. Determine whether measurements will be based on the peak or eave of your Which describes
structure The orientation of the ridge �s also important.
your residence?
1 a: If the roof line runs North-South, measurements will (cirde one)
based on the peak of the roof.
towo a ,�
1B 1C
I b: If tf'e roof line runs East-West and the roof pitch is
less 6nan D-0 2, measurements will he based cn t! e
eave
s.•oe e•r c..�
1 c. If the rcof line runs East—vest and the roof pith is �
3/12 cr steeper, measurements will be based on the .n...,.,
peak G-�c
Pam W=
Box B. continued Box B:
�teisure change .n elevation from franc property line to Finished floor elevation. If
the !ot slopes up from the front lor, line to the foundation, the figure is positive. If _
the lot slopes down from the front lot line to the foundation, the figure is negative. -� �� ft
3. Measure distance from finished floor elevation to the affected peak/eave. + ft
4. If the roof line runs North-Soutrl, deduct three feet. If the roof line runs East-West, A �
deduct.nothing.
5. Subtract one foot for each foot of difference in elevation from the front property
line to the rear property line, if the lot slopes up from the front to the rear. If the
lot has no slope or slopes up from the rear to the front, deduct nothing. ft
b. Total figure for box 8: ft
Box G Distance to the shade reduction line. Box C:
1. Measure the distance from the North property line to the foundation near the j ft
affected peaWeave.
2. Measure the d'i=nce from the foundation to the affected peak or eave. + } ` _ ft
3, Total figure for box C. -
It is mmt usOul to draw a verOd Gne to represent the apprap6aw fide bund in box'A'and a horizontal Fine to represent the
apprgx:m r-Sumv found in boar'C:'.The inner Pam of the ve"kal and horizontal eines detem+ines the value hound in box 'tY. The value
in box 'O' +auld be compared to the value in box'8'; if the vahm in box'8'is les,than or equal to the value found to boot'O',then
the building IS in mrt+pfianrs with the solar halance code. If you have any questions,pkaw cortaa us at 639-417"1,x304 or at the
Commurrtr Oevelofxnem Counter.
MAXIMUM PERMITTED SHADE POINT HEIGHT (la Feet)
Disonce to North-south lot c5mension(in feeo
dude 100+ 95 90 85 80 75 70 63 60 55 50 45 40
redumcr+ fine
from northern
70 40 40 40 41 42 43 44
65 38 38 38 39 40 41 42 43
60 36 36 36 37 38 39 40 41 42
55 34 J4 34 35 36 37 38 39 AO 41
30 32 32 32 33 34 35 36 37 38 39 40
-3 30 30 30 31 32 33 34 35 ;6 37 38 39
-0 23 28 23 29 30 31 32 33 34 35 36 37 38
35 26 26 26 27 28 29 30 31 32 33 34 35 36
.0 24 24 24 25 25 27 2S 29 30 31 32 33 34
:5 2-1 2-11 22 23 24 25 26 27 23 29 30 31 32
20 20 20 20 21 22 23 24 25 26 27 28 29 30
15 18 18 1S 19 20 21 22 23 24 25 26 27 28
10 16 16 16 17 18 19 20 21 22 23 24 25 26
5 14 14 14 15 5 17 18 19 20 21 22 23 24
Box 0. maximum allowed shade point height_ < _ _ feet
y.` �%)Ilm ctiU
Re"%-d
1
Friday. March 28, 1997 05:57:06 PM Carrollton Designs Inc. Page 3 of 3
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CITY OF TIGARD Plumbing Application Recd By
13125 SW;-TALL BLVD. Commercial and Residential Date Recd_
Dale to P.E.
TIGARD, OR 97223 Date to DST. 'a
(503) 639-4171 Permit i 'c
Print or Type Related SWR x-
Incomplete or illegible applicatio^s will not be accepted Called__
Name of DevelopmenliProject
Job FIXTURES (Individual) QTY PRIG:= AMT
Address Street Address ^ TSuite Sinu 900
/.S 3-, 7 r�` / ~AJC (/ -pry _ Lavatory 900
'Allf 7, Bldg 0 City/State Zip Tub or Tub/Shower Comb. 900
L N li Jr r'J __ %.(�AL-1!) Ok X171 c�
Name Shower Only 900
Water Closet 9"'o
Owner Mailing Address Suite• Dishwasher _ �9 r'0
Garbage Disposal 9.00
City/State Zip phone Washing Machine — 9.00
�^ Name - Floor Drain 2' 9.00
3" 9.00
Occupant Mailing Address Suite 4• 9.00
Water Neater O conversion O like kind 9,00
City/State Zip Phone ----
Laundry Room Tray 9.00
Name Unnal 9.00
/" (%Jn CL F ///'o ; :, Other Fixtures(Specity) �— 900
Contractor Mailing Address Suite 900
/' /),A �,;
(Prinr to issuance CityrState Zip Phone _ 9.00
applicant must v w,C I 0 J- `i 7,Id r &3<1- 214 —. _�— — 900
provide all Oregon C nst.Cont.Board Lic.0 Exp.Date 9.00
contractors (p /1 ? 7 l r 1_ �;� 4.00
license "lumbmg Lic.• Earp.Date Sewer-1 st 100' 30.00
informati—if _
expired 4'` -?A3-3 IVIG cl-5 U Sewer-each additional 100' 25.00
in COT COT Business Tax or Metro* Exp.Date Water Service-1 sl 100' 3000
database) /1 •; �S_ t -I -rt 1 Water Service-each additional 200' 25.00
Name
Storm d Rain Drain-1 st 100' — 3000
Archit:)ct Storm&Rain Drain-each additional 100' 25.00
i Or Mailing Address Suite Mobile Nome Space 2500
Er ineer City/Slate Zip Phone Commercial Back Flow Prevention De,nce or Anti- 2566
9 Pollutinn Device __
Residential Backflow Prevention Device' ,i 00
Nscnbe work New O Addition O Alteration Repair O -- - f __ 5_J
to be done Non-re
Residential sidential 0 Any Trap or Waste Not Connected to a Fixture 900
Additional description of work Catch Basin 900
'LL Insp.of Existing Plumbing 4000
per/hr
Specially Requested Insper:tions 4000
Existing use of I _ _ _ perthr
building or property- kca,Llt-.J 1 t _ Rain Drain,single family dwelling 3000
Proposed use of Grease Traps 9.00
building or property_—_ _ -
QUANTITY TOTAL
Isometric or mer uiagram is required R Quanity Total,s >9
Are you capping, moving or replacing any fixtures' Yes p No _ 'SUBTOTAL
(If yes see back of form)
I hereby acknowledge that I have read this application,that the information - -- 5"/a SURCHARGE
given is correct,that I am the owner or authorized agent of the owner,and
that plans submitted are in compliance with Oregon State Laws. PLAN REVIEW 25%OF SUBTOTAL
Signatu of OwnerrAgent Date tt
1 � squired on A fixture q total is>9 _— -- --
- t .( .i._ — TOTAL
Co�dlhlt Person Name Phone Mlnlmum permit fee is S25- 5%surcharge,except Residential Backflow
`
/�, I7�r'�_ 5, )- ;lamPrevention Device.which is$15-5%surcharge
�<-. �� l� V'
-snwwnW doe 9XI
PLEASE COMPLETE A APE RQPBJATE TQPROJECT:
_Fixtures to be capped, moved or replaced Qty
Sink
Lavatory
Tub or Tub/Shower Combination —�
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
_ 4" _
Water Heater —_—
Laundry Room Tray_
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
I mfn`m►naW d=W97
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 639-4171
Dui aiueetcd: I i A.M. P.M. MST:
Location: C �L� n I � A _ BUP:
;envtt: Suite: Bldg: MEC:
Contractor: Phone: _ PLM: _ CI
Phone: ELC: -------
SIT:
BU11—lie to BLDG(con't) LUMBIN MECHANICAL ELECTRICAL SITE
Site Post/Berun Nos Post/Beam Cover/Service Sewer/Storm
Footing Roof UndFI/Slab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Iiood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Thain A/C UG Slab
Shear/Sheath Fire Spkh/Alm Crawl/Found Ur Heat Pump Low Volt
Approved pro Approved Approved Approved
Appr/Sdwlk Not Approved o oved Not Approved Not Approved Not Approved
FINAL - AIL FINAL FINAL FINAL
0 Call for reinspection 0 Reinspection fee of Srequired before next inspection C1 Unable to inspect
Inspector: _ � -- Date: /_ 2/ 9 — Page —of —
CITY OF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall Blvd., Tigard,OR 9722^ (503)639-4171
CERTIFIC14TE OF
OCCUPANCY
PERMIT #. . . . . . . : MST'97-02 ',
DATE ISGUED: 03/27/98
PARCEL; 29104CS_00400
,ITE ADDRESS. . . : 1.3421 SW ASCr=NS i ON DR
UPDIVISION. . . . HIL.LSHIRE WOODS ZONINGtR--7 PI)
iALOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . 1020 ,JURISDICTION:T1(3
.:;LASS OF WORK. 6 4EW
C YPE OF USE. . . :SF
I YPE OF CON ST R:5N
17CCUPANCY GRP. t R3
OCCUPANCY LOAD:2
Remark S : New SFD Path L
Owner:
R W F'UL.LE.RTON CO
kc'6 SW BEAVE RTON--H I LL_SDALF HWY
nPTL.AND OP 97221
t 'tiorie� #: 297--443.3
font tact or
F'ULIJ-RTON COMPANY
,:,426 SW BEAVERTON HIL_LSDALE NWY
z-'JR'TL AND OR 97221- 1128
"hone #x 297-44:33
F?.-g W. 1 000406
chis Certificate {gents oCCUP&T1Cy of the above +-eferenced building or portion
thereof and confirms that the building has been inspected for complianr-e with
the State of Oregon S3pvcialty Codes for the pruUp, or-cupot-ovyr and use 'mder
which i.he r ferenr_ed pormi.t was issued. �1
r F31JIL_DING INSPECTOR 90ILMMSm AL., INGPEC Pd rTnrrr'
I
POST IN CONSPICUOUS PLACE
v CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Linc: 6394175 Business Phone: 6394171
2
Uate Requested: ". �� 9J A M. MST:
Location:.-- /3 q.� I/ AV-) - --- BUR
Tenant: T_ _ Suite: B1dg: MEC:
Contractor < = Phone: - :�-�C, ? _ PLM:
)WnCr WL�Phone: �— ELC:
ELR:
_ SIT:
BUIL:1.�'G �'BLDG n't) UMBDV � +CHANICALN ELECTRICAL SITE
Site Post/Beam ryBearn•T_ Cover/3c-rvice Sewer/Storm
Footing Roof UndFl/Slah Rough-In Ceiling Water Line
Slab , Frtunmg Top Out Gras Line Rough-In UGi Sprinkler
Foundalio I Insulation Sewer Ilood/Ducl Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry ,10; n Ceiling Rain Drain A/C UG Slab
Shear/Sheath ���� Fire S m Crawl/Founrd Dr 112L.Ewup Loi•Volt
Ap ove Approve Approved Approved Approved
Appr/Sd Ik roved o tT ved t7I prove) Not Aptttnv J Not Approve)
IAL' —� FINAL FINAL
i
0 Call for reins 0 Reinspection fee of S_ r uimd befpre gc�t i on C]Unable to in.4pec',
tnspector: 1 _�,.__ Date: ? -Z / Page of