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10200 SW Century Oak Drive
CITYOF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2001-00123
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 04/18/2001
PARCEL: 2511 1 CC-03700
SITE ADDRESS: 10200 SW CENTURY OAK DF
SUBDIVISION: SUMMERFIELD ZONING: R-7
BLACK: LOT: 060 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT !1EATERS: VENT FANS:
OCCUPANCY GRP: 11.2 VENTS W/O APPL: VENT SYSTEMS: 1
ST DRIES: BOILERS/COMPRESSORS HOODS:
_FUEL TYPES _ 0 - 3 HP: DOME 3. I'VCIN:
GAS _ 3 - 15 HP: COMM1.. INCIN:
MAX INPUT: BTU 15 -30 HP:
FIRE DAMPERS?: 30 -50 HP: ROODSEIINIR UNITS:
GAS PRESSURE: 50 + HP: VlOO�'DRYERS:
FURN < 100K BTU: AIR HANDLING—UNITS CLO DRYERS:
FURN >=100K BTU: � <= 10000 cfm:� OTHER UNITS:
> GAS OUTLETS:
10000 cfm:
Remarks: Installation of water heater vent.
Owner: _ FEES
RALPH LEDMAN Type By Date Amount Receipt
10200 SW CENTURY OAK DR PF'MT CTR 04/18/20( $72.50 2720010000
TIGARD, OR 97224 5PCT CTR 04/18/20( $5.80 272001000C
Phone: -
Total $78.30
Contractor:
GEORGE MORLf N PLUMBING'
9806 SW TIGARD
TIGARD, OR 97223 REQUIRED INSPECTQNS
Mechanical Insp
Phone:503-624-6895 Final Inspection
Reg fit:LIC 2734
PLM 26-600
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. 1 his permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in Vie Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-•0010 through OAR 952••001-G080.
You may obtai cop;es of these rules or direct questions to OUNC by calling (503)246-9189.
Issue By: w z Permittee Signature: �I G C&lL4(Yl
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
APR-17-2001 12'58 �'� P.01
10%11/2000 U9:bI tAA ou.ruv,I
RECEIVED
Mechanical Permit App9M"bron
Datercce(ved• .�� Pamrtno �
t � COMMUNI r` sit�
�� Ol Tigard Rpjcet/tppJ.no;r apue duct
Cl.y vfI7 pard Address: 13125 ;SW Hall Blvd, Tigard,OR 9723 Date issued• By: [tccuptuo.;
Phone: (503) &3`9-4171
rax: (503) 599-0960 iLD/o# /06 5 7C/ Cue Mc na.' P'+ytnentrype_ _
Lat:d use eppr.ival Dvildine.pornutno,-
i
�gl &2 family dwelling a acct:=sory ❑Commercidl/iltdustrial O Mulu•fzmily C)Tenant tm,rorcm_r.l
C)New construction 0(h!r-
Will'ILI 114 10
-I'T 1,17VTOMMMM.
Job iddrtss: in Tndicatc equ(pmeot quindues in boxes below. Ind carr Jce dollu
Didr,no.: Suite Co.: J value of n1l mcch-viica]materials,equlpm:ist,labor. ov,ch.-yd•
Tsx n,sp/tax Iovoccounc no.: _ pro.5L Value S
Lot: ubdiyisro� •Sce r-hecUist for important application ucl'onuation snd
Project name: ^� jurisdiction's fee schedule Cor rc191 1-- �idential permit fee.
Ciry/county: ZlP.
Descri tion and to nn of-ori -.7n premises: _ ' ' t
Total
Est.date of complctionhrupecuort Dew ' tinct Qty. Ra.ontr Res.o Jv
Tenant improvement or change o;• use:
A.irbandVitgunit CFM
Is exishn►space heated or :ond inncd. O Yet O No Airwri iuoninr(slit tsnrequsrea)
Ls custitib space ituuJattd"7 Yes ❑No Aiteraflonofexisting HVAs ystern
AIECIIANICAM CONTRACTIONOoll comptessa[s
Uusiness name: Slice boiler permit ao,:
cIr Tons sTu/x
Address� -- Frr smo a ast]ptxvauct satol'e detectors
City: _ Hcstpurop(site plsn re uired)
Phonc Fax L()<E•ituil Imstajlheplacc urna_dourner BTL/H
CCB oo. IncludiAg ducrwotluvent liner O Yes O No
-_ IrdwUrtpiv. re oute0eatvs-tuspeayed.
Ciry/metroIitS no.: _ wall,or noor mounted
rint
Name(plcssc p ): vent 10t_ApPIianee o thcr th an uttr&cc
r oti
Absorption units BTU/H
Name: ChiUcrs NP
Address: Cnmpretson MP
> 1ro11IMMM tst6tus1 and TtAin an:
City: State: ZIP _ T
1ft10i1C: - ------._. Appian"vent
Fax: E-mail: ryere Aust
Hoods,Type c.'lUret.l-stehrrVhunut
/ L horld fire supprcse;on system
Nam:: G ,L-1Q/ 6uhwtc fin wid single duct(bath fwu)
Mailog sddrr:ss: �Q f�chautc ryrct�o Lc f.os*+hes or A
CI Y: r SUtic: 4�' Z1F z_! EvU pipte6 us Irn UU9e(up to a ou[leu)
Phone frr� E-mail T'pe: LPC NC 00
uel PPlrw taca accitional over 0 ouures
'erocem p i),ta`(s-ch—em rti c tequsr
Name. Numbcr)f ouUeu
tbir sc ria appuaaee or oqutpmeaa
AI--ddress' Oeconti.et;re Uct:
CItY: State: -�7IP inten-type
I Phone. F 6 mail: - oo stoVapc;ictRove
Applicattrs stgna:ure: te:DOWn'e
Uthv:
tltner:
Nar^e (Dtinc):
Nd Yl irni/,ruwe to1Ty1=0 Lvdi,jilmw ua-rw�•4—rw ase,iJO'11MO W� P cttr t fee................
Q Vw 0lfnurOud t N�ucc. This permit appNution ....$
�
Plan revieiam foe........... ...S
txpaes if a ptnait is not obtained Plan review(u
e,p a %ithw 110 days after it hu been
socepted u eompkce $r+rte nue _
hum(t196)....S
1 TOTAL
Ml11NttR Aww�r •.••.,..•.........�...:
�r0�1611 ItL0dC0�0
TOTAL c.01
CITYOF T I G A R DELECTRICAL PERMIT
PERMIT#: ELC2001-00309
DEVELOPMENT SERVICES DATE ISSUED: 6/13/01
13125 SW Hall Blvd.,Tigard. OR 97223 (103) 639-4171 PARCEL: 2S111CC-03700
SITE ADDRESS: 102.00 SW CENTUR" OAK DR
SUBDIVISION: SUMMERFIELD ZONING. R-7
BLOCK: LOT : 060 JURISDICTION: TIG
Proiect Description: Circuit for exterior A/C unit
RESIDENTIAL UNIT v� TEMP SRVC/FEEDERS MISCELLANEOUS
1000 5F OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: _ _ PLAN REVIEW SECTION
1000+ amp/volt: >=4 RES UNITS: �— > 600 VOLT NOMINAL:
Reconnect only- � _ SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC_
Owner: Contractor:
RALPH LIDMAN SHARPE ELECTRIC INC
10200 SW CENTURY OAK DR 22605 SW RIGGS
TIGARD, OR 97224 BEA\';-RTON, OR 97007
Phone: Phone: 642-7937
Reg #: LIC 81518
SUP 3344S
ELE 34-217C
FEES Required Inspections
Type By Date Amount Receipt Elect'I Final
PRMT CTR 6/13/01 $46.85 2720010000(
5PCT CTR 6/13/01 $3.75 2720010000(
-— - Total $50.60 -
This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR Specialty Codes and all other applicable laws
All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance,or r(work is
suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by thF Oregon Utriify Notification Center. Those
rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules ordirect questions to OUNC at 15031
246-6699 or 1-800-332-2344
Permit Signature: /tip v �L — Issued By: � 13�
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: _ _ DATE: _
CONTRACTOR INSTALLATION ONLY
SIGNATURE_ OF St1PR. ELEC'N: _ _ DATE: _
LICENSE NO:
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit Ap pl ication
Date received: (p— _ I Permit no CD , _&)
City of Tigard Project/appl.no,: Expire date:
CityofTigard 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: _
&2 family dwelling or accessory Cl Commercial/industrial U Multi-family U Tenant inipro�cnient
J New construction ;Wdition/alteration/replacement J Other: U Partial
JOB SITE INFORMATION
Job address: (� =Bid . Suite no.: Tax map/tax lot/account no,:
Lot: Block: Subdivisi n:
Project name: Description and location of work on premises: v4 G•
Estimated dote of completion/inspection: 4U
CONTRACTOR APPLICATION "11,V SCIIHIFULE
Job no: Fee twat
BuF'ness name: �� � �>A [�� _ Description Qty. (en.) total no.lnsp
New rcsidenr J-single or multi-randiv(wr
Address: �{(pC 5 JCLI dNellingunil.Inciudesanacimtigarage.
City: t �.��� t�r►'L. tate:( ZIP: QO7 kryiceincluied:
Phone:_Sc 3 !, 7?4 Fax: E-mail: IU00 sq.ft.,r less a
CCB no.: ? j I I Elec.bus.lic.no: Each additi,nal 5p0 sq.ft.or portion thereof
Limited en rgy.residential 2
City/rrletro lie.no.: 3 Limited_e.ergy,non•residential 2
Each mr.iufactured home or modular dwelling
Si nature of supervisiAg electrician(required) Date Service and/or feeder 2
Sup,elect.nameiprintr L- License no: t S Services or feedern—Installation,
alteration or relocation:
PROPERTY OWNER. 200 amps or less 2
Name(print): I kng-t4 201 amps to 400 amps 2
401 amps to 6M)amps 2
Mailing address: SCO O 601 amps to 1000 amps 2
City: State.d)K_I ZIP: 1 z y Over 1000 amps or volts 2
Phone:p6 -O U Fax: I E-mail: Pcconnect oul> I
Owner installation:The installation is being made on property I own Temporary services or feeder.-
which is not intended for sale,lease,rent,or exchange according to Installation,alteration,or relocation
ORS 447.455,479,670,701. 200 amps or less
201 amps to 4(x1 amps
Owner's sipznaturc: Date: 401 to x300 amps
Branch circuits-new,alteration,
or extension per panel:
Name: _ A. Fee for branch circuits with purchase of
Address: _ service at feeder fee,each branch circuit
Cilv: —T;late: L1P: B Fee for branch circuits without purchase
I F•
of service or feeder fee,first branch circuit:
Phone. mail:
F.ach additional branch circuit:
M isc,(Service or feeder not Included):
J Service over 225 amps-conunercud J Health-care facility Lisch pump or irrigation circle 2
J Ser%ice over 320 amps-rating of 18•.2 J Hazardous location Each sign or outline lighting
tawtlr dwellings —1 Building over 10,0(X)square feet fouror Signal circumsI or a limited energy panel. �
J SNsicm over(0)volts nominal more residential units in one structure Aterauun,or extension' _
J Building over*hree stones J Feeders,41X)amps or more 'Description
J t occupant load over 99 persons J Manufactured structure-or RV park Each additional Inspection over the allowable In any of the abose:
J Fgireswlightingplan J Other: --- PL-1 nspection
Submit_V sets of plans with any of the above. Ins esugatr m fee
The above are not applicable to temporary construction service. Other
.+ dl niow6,:mins.keep(credit cools,please call iunsdigion tar marc mformmmn) NOIICC: Vhls :loll dppllCallP❑
J�rsa J Nla_sterCard expires il'a p, iit is nut obtained Plan review(at , �'�1 $
r ,ao,:ud numher —L_L— within 180 days atter it has been Slate surcharge(8%)
Cxp,ret -
Name tit cardholder as shown mr cmdo t cars accepted as complete. TOTAL ............. ).....S '
_ S
Cardholder signature amount 1IU 1615 i&MCOM)
CITY OF TIGARD MECHANICAL PERMIT
°.,.s DEVELOPMENT SERVICES PERMIT#: MEC2001-00206
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/13/01
PARCEL: 25111 CC-03700
SITE ADDRESS: 10'_00 SW CENTURY OAK DR
SUBDIVISION: SUMMERFIELD ZONING: R-7
BLOCK: LOT: 060 JURISDIGAON: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY URP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
_ FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 -50 HP: WOODSTOVES:
GAS PRESSURE: 50+ HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN >=100K BTU: <= 10000 cfm:
GAS OUTLETS
> 10000 cfm:
Remarks: Install exterior A/C unit. Unit must not be placed within the required setback
Owner: FEES
RALPH LIDMAN Type By Date Amount Receipt
10200 SW CENTURY OAK DR PRMT CTR 6/13/01 $72.50 272001000C
TIGARD, OR 97224 5PCT CTR 6/13/01 $5.80 272001000C
Phone: Total $78.30
Contractor:
SPECIALTY HEATING 8 COOLING
9528 SW TIGARD ST
TIGARD, OR 97223 REQUIRED INSPECTIONS
Mechanical Insp
Phone:620-5643 Final Inspection
Reg#:LIC 66578
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accofdance ,Kith approved
plans. This permit will expire if work is not started within 180 days of issuance, cir if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adcpted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-•001-0010 through C)/'n952-001-0080.
You may obtain copies of these rules or direct questions to CUNC by calling (503)246-9189.
Issue By: > Permittee Signature:
Call (k3) 639-4175 by 7:00 P.M.for inspections needed the next business day
Mechanical Permit Application
rProjecvappl.
ved:(�- n( Pe
City of Tigard no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued: By: Receipt no.:
Fax: (503) 598-1960 Case rile no.: Payment type.
Land use approval: - Building permit no.:
TYPE OF PERMIT
1 B&2 family dwelling or accessory 0 Commercial/industrial U Multi-fancily ❑Tenant improvement
New construction Additinn/alteration/replacemcnt U Other:
1 ; SITE INFORMATION. COMM1SCIIEDULF
Jobaddress: M&1.4k, Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: U profit. Value$
Lot: Block: I Subdivision: 'See checklist for important application information and
Project name: LIVM4,jl jurisdiction's fee schedule for residential permit fee.
City/county - WA$/1 1 ZIP: 17 7a .;2 ySCHEDULE
Description and location of work on premises: Llama
Fee(ta.) 'total
Est.date of completion/inspection: (o / (J Descrip(lon (rv. Res.only Res.onh
Tenant improvement or change of use:
Is existing space heated or con 'tinned' Yes U No Air handling unit CFMA r conditioning(site plan require ) - --
Is existing space insulated? Yes 0 No Alteration of existing HVAC system _
1)NTRA!T1 of er/compressors
Business nam y�L 4 n State boiler permit no.:
HP Tons BTU/FI
Address: E ' 6W /: 1 t:G7Fire/smoke ampers uct smoke detectors
City: f al 4 State:0*0-1 ZIP:q 7 :;L 3 eat ump(site p an require
Phone' 1P :5EH FaxSgar V J/ E-mail: nsta rep aceumacelburner
CCB no.;
5 7 Including ductworlu•rent liner O`.'es O No
_ _ nsta rep ac reocate eai-i t -suspended,rs
City/meLrolic.no.: ! wall,or floor mounted _
Name(please print): Vent fnr ap liance other than urnace
PERSONCON I'Arr Refngerat on:
Absorption units_ BTU/H
Name: �Lz? N .�C� P 1� — Chillers . HP
Address: 5 $' S L / �l s'T Compressors 111'
City: T cl Sta e:0 ZIP: q 7""
Environmental a e ventexhaust an ventrlaron:
Appliance vent
Phonc:� 3 G.jo•. Fax.598 v'jig' E-mail: Dryerex aust
I P15 Hoods,Type res. tc c azmat
D60x
od fire suppression system
Nance: r' iW�Q,yt/ haustfan with single duct(bath fans)
Mailing addres :/pd,00 xiausts stcrtr a from tf eatin oCity: / %r�r-{� Stott LI P: Y asee p p ng an st set on(up to out etsype: LPG NG Oil _
Phone "tJ Fax: E-mail: Fuel piping each additional over 4 outlets
rocessp ping(schematic required) _
Name: Nwnber of outlets
- - ---- ----- ter gt app a or equipment:—
Address: _ Decorative fireplace
City: State: 7.11' nsert-t e _
Phone: ax: E-mail: Woodstove/pelletstove
Applicant's signature. Date: 6 /,a G/ er:
Niume(print):7�4--tI4 L{t N .G*41/Nj_t r
Not rdl juriuUctione accept credit cards,please call murisdiction for mute information. NoticePermit fee.....................$
❑Visa U MasterCard :This permit application Minimum fee................$
Credit card number._ / / expires if a permit is not obtained Plan review(at _ 86) $
expires within Igo days after it has been State surcharge(8%) ....$
—�—Name of cardholder N shown on credit card — accepted as complete.
_ S TOTAL .......................$
Cartiholdet signature Amount
.f.tp-.►417(t5i0WCOM1
Commercial Schedule
1842 Family Dwelling Schedule
ASSUMED VALUATIONS PER APPLIANCE
Description
Furnace to 100,000 BTU Table 1A Mechanical Code Oty Priv: Total
1) Fumace to 100,000 BTU
including ducts&vents 955 including ducts&vents _ 1400
Furnace> 100,000 BTU 2) Furnace 100,000 BTU,
including ducts&vents 17 40
including ducts&vents 1,170 3) Floor Furnace
Indudim vent 14.00
floor furnace 4) Suspended heater,%all heater
including vent 955 or floor mounted heater 1400
suspended heater,wall heater S Vent not included in appliance permit__ 680
or'oar mounted hP.Tter 955 8 Repair units 1215
Check all that apply 'Boiler Heat Air
'refit not included it appliance permit 445 For Name 7.10,see or Pump Cond Oly Price Total
Rfootnotes 1,z Comp
Repair units 805
7)<3HP.absorb unit to
<3 hp;absorb.unit IOOK BTU _ 14.W
6)3-15 HP,absorb unit
to 100k BTU 955 100k to 500k BTU 2560
3-15 h absorb.unit 9)15-30 HP;absorb
P unit 5-1 mil BTU t r 35.00
101k to 500k BTU 1700 10)W50 HP,absorb
unit 1-1.75 mil BTU s2.20
15-30 hl absorb.unit 11)►501-115,absorb unit>1.75 mil BTU
97 20
501,.' 1 mit.BTU 2d t 0
_ 12)—Air handling cnN l0 10.000 CFM
to.00
30-50 hp;absorb.unit
17)Air handling unit 10,000 CFM•
1.1.75 mil.BTU 3400 17 20
145 Non-portable waporate cooler
>50 hp;absorb.unit 10 DO
> 1.75 mil.BTU 5729 is)Vent fan connected do a single dud
680
Air handling unit to 10,000 cfm 656 16)Ventilation system not Included in
appliance permit 10.00
Air handling unit>10,000 efm 1170 —1—1)Hood served by mechanical eahaust
Non-portable evaporate colter 656 10 w
P P te)Domestic Incinerators
vent fan connected to a single duct 446 17.40
19)commercial or industrial type incinerator
Vent syst.not Included in appliance permit 656 - ss
Hood served by mechanical exhaust 656 20)other units,including wood stoves 1000 _
Domestic Incinerator 1 170 21)Gas piping one to four outlets
5.40
Commercial or industral Incinerator 4590 22)Moro than 4-per outlet(each)
t.00
Other unit,including wocr1 stoves,Inserts,etc. 656 Mlnlmum Pertnll Fee$72.50 SUBTOTAL
Gas piping 1-4 outlets 160 ex SURCHARGE
PLAN REvicW 25%DF SUBTOTAL
Each additional outlet 63
Required for ALL commercial permits only
TOTAL
Other lnapecl4ens end Fees:
1 inspect-ut anode of normal bowies%hours(minimum Marpa-two hours)
$77 ti0 per hour
1 lmryMulns In-NCh M Ir!e is spaci("Ily indicated(minimum d"half hour)
$72 30 per hour
Total Valuation Fee 3 Adderonal plan,emew reduv d or d angel adddrons n rev sans m pane tmnimum
--'---— eorolue hour)%-ou per hour
_ 'SUIe ronVacld ander CertftStW required
S I.00 to$5,000.00 Minimum$72.50 ••ne,daenlisf AA:I@",%Me din srnowmq pUcemeni-1'Ind
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 51.52 for
each additional$100.00 or fraction thereof,
to and including$10,000.00
510,001.00 to S25,000.00 $149.50 for the first 510,000.00 and 51.54
for each additional$100.00 or fraction
thereof,to and including$25,000.00
$25,001.00 to 550,000.00 $379.50 for the first 525,000.00 and S 1.45
for each additional 5100.00 or fraction
thereof,to and including 550,000.00
S50.000.00 and up S742.00 for the first 550,000.00 and 51.20
f'or each additional S100.00 or fraction
__ thereof I
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—____------ --- -----_ ___ '�-�--___— -------.--- 1
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CITY OF T:GARD BUILDING INSPECTION DIVISION
7.4-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST
BLIP
___—_—Date Requested �' ZG� AM PM BLD —
!ocation / U G`'� `" � 's f i 7 �� �� Suite MEC �—
Contact Person _ Ph 4,- �y, G'� y L_ PLM
Contracts r_ Ph SWR
BUILDINr�_ Tenant/Owner ,��J��},' Cc.-�l_ — ELC
Retaining W;JI ELR
Footing Access: r
Foundation FPS
Fig Drain
Crawl Drain Inspection Notes: SGN
Slab -- SIT
Post&Beam — —
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing _
Firewall -
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final rZ
PASS PART FAIL �(� ��-
PLUMBING
Post& Beam ---"--
Under Slab
Top Out — — — —
Water Service
S
Sanitary Sewer
Rain Drains
Final
PASS PARFAIL
MECHANICAL
Post& B?am
Rough In
Gas Line
Smoke Dampers
Final — —
PASS PART FAIL
F.LECTRI A — —
Service
Rough In
UG/Slab _
Low Voltage
Fire Alarm
ina
SS PART FAIL
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain j j Reinspection fee of$ _ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ( j Please call for reinspection RF _ j j Unable to inspect-no access
ADA
Approach/Sidewalk
Other Date 20 -U / Inspectors, _ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
°L MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BUP
Date Requested �> A _—__PM BLD
Location l U Q �-� v `�-. /ite
Contact Person l r=te j'h (.k — 0>Q PLM
—._ —
Contractor r'� t Ph S;IVR _—
BUILDING Tenant/Owner 1 fi ELC
Retaining Wall J 5 ELR _
Footing Access: —
Foundation FPS _
Ftg Drain SGN
Crawl Drain Inspection Notes: ----
Slab ---—— ------ — SIT
Post&Beam --
Ext Sheath/Shear
Int Sheath/Shear _
Framing — -
Insulation
Drywall Nailing —�_< S/ C-"vim _ <f ,`,��.r�Gr7yi• S.¢�t E
Firewall
Fire Sprinkler -_--------__--- --- _ -_-
Fire Alarm
Susp'd Ceiling ---- - ----- ----— - - ------—
Roof
Misc --- _ - -------
Final
PASS PART FAIL - - ----- - -- - - ----- _.....-.
PLUMBING
Bost& Beam -
Under Slab
TopOut -- -- ------------ ----------- - -------------------
Water Service
Sanitary Sewer
Rain Drains _
Final ----------------------------
PAS T FAIL
ECHA CA
Post&Beam -- — -- -
Rough In
Gas Line -- -- ---
Smoke DaW Zz.)
mpers
PART FAIL
t-LECTRICAL �—
Service
Rough In
UG/Slab
Low Voltage
Fire Alarm _
Final
PASS PART FAIL
SITE
Backfill/Grading -
Sanitary Sewer
Storm Drain [ )Reinspection fee of$ _- - _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ( J Nleasp call for reinsrc!ciion RL _ ( J Unable to Inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk
C1tp Date 5 - �i / Inspector Ext
Final
PASS PART FAIL 1.10 NOT REMOVE this inspection record from the job site.