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11015 SW COTTONWOOD LANE O J cq n C 0 0 O O CL r c� i 1 11015 SW Cottonwood Lane CITY OF TIGARD ELECTRICAL PERMIT DEVELOPMENT SERVICES DATE SSUIED, 9 25 0101 00471 13125 SW Hall Blvd., Tiqard. OR 97223 (503) 639-4171 PARCEL: 1S134AC-02640 SITE ADDRESS: 11015 ,5W COTTONWOOD LN SUBDIVISION: FNGLEWOOD NO.3 ZONING: R-4.5 BLOCK: LOT : 197 JURISDICTION: TIG Proiect Description: Panel change and (4)circuits. RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: 1 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: 4 PER INSPEC i ION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION _ 1000•~ arnp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC/FDR >=225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: LARRY BELL WEST SIDE ELECTRIC CO INC 1 1015 SW COTTONWOOD LANE 1834 SE 8TH AVE PORTLAND, OR 97214 Phone: Phone: Reg#: W-15f*06 SUP 1556s ELE 26-135c FEES Required Inspections Type By Date Amount Receipt Rough-in PRMT CTR 9/25/01 $113.25 2720010000( Elect'I Service Elect'I Final 5PCT CTR 9/25/01 $9.06 2720010000( Total $122.31 This Permit is issued subject to the regulations contained in the Tigard Municipal Code.State of OR. Specialty Codes and all other applicable laws. All work wi l be done in accordance with approved plans. This permit will expire if work is riot stained within 180 days of issuance, or if work is suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may ohtain copies of these rules or dired questions to Permit Signature: �'t-l✓ e9 1-7`^,11 Issued By: _ OWNER INSTALLATION ONLY The installation is being made on property I own which is riot intended for sale, lease, or rent. OWNER'S SIGNATURE_: _ _. DATE:_ CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 639-4175 by 7:00pm for an inspection the next business day i 1 v _'d 00 I I Electrical PermitApplicatiou_ / 1 jute recurved 9 2/ / 1 error no,: ^;a - 7/ City of Tigard Pro;e,yarry,.n�„ Esyitednle: Crtyn%lrgn,d Address: 13125 SVS'1101 NMI Tiga)•c,Olt bots,i tarred: Hy: Ret eiptuct.: Phone: (303)639-4171 -- Fox:(503)598 1960 C trr Q,c no.: Pay►ntsni typt 1..Glid use approval: 111111111 V CEIIJ ML ! ,''k &2 fondly dµell,nn or accessory J Contrnerrialr Rtl1_Slr'al J Multi-rarudy U Funnnt i:nproveaIent 1 New rmisitijud•ri ❑ l..l Other; Partial lub u-;dr-,m: sw I t� . Bldg.nu.: J.sujte au.: Tax tnapll:uc ioyaccount no,: U4, Mock: _ Subdivision: _Pr_nJect nnme:' „ti ;1e<cdpljnn anti Incation of work on prenllses; �a J- 4 P-mlillattxl(laic l'I'ctntilr<trnl;rinsl<t ion 1 gm t1 Joh out ::5-r-> __ _ Fee N)a. Buainras nlulte: C t X- 1 e c+�'4 _ �_ O.crripttor. (p) (el t oto( 11'' (list, Addrers: 7 y +�� Nen rerF!txlid-einglcormaid•Inmllyper d,x lling ante.Indudra xNat$ed rputlke. Ciry: 3tnte; 'L Z.F'. Z797 ;•�F;JY�O1�t�J,_I.. Itlmn:tirl .3 t- t y PRIc�' /il 2 ntttil ',ekkr' .,e►19t IIf60sit ft.ot'lr s , CCHno.: (�-i_��(�. "-- Ccclt Wdiiiullw!OO sq.1t t r nr.lnn thxreul' - --.-- inutette:+ay,rry t•rrtlul 1 City/metro, nn: 1,1Redertergy,non residuntird 2. �Z©err)I Pueh n,urufu�wral hcrnr,or tnud�l:u tlwellinK Si n d of etii sn c tnrian tn.quned�— tette Service ijulur Imfn - Sup rlrrr Wert"lpRur) �« .-- Li,en:rn0. ,C-'rs �ett'leetnrfeetkt�-Inctsitatlm, rlterntlon or relocation: 2r"•n antp of Irul G•�' �• 7 Z Name(print): l .4I—anem illi-To _Mal ling address1 (' - J - <tii ml1ps to euU,trg+— I ,�_•� \c 1 t..�e>t' H , 10i amps to IOno amp" City' l �- Slate: TIF: tT1•r iou I,rnpa Ur rule 1 Plfone:'-�13 f'ax: E•uwil 1 Owner ingtallatiotr The instal atiun it being made cm property i own Tetaporur)a—lefter Iee&" which to not intended fur salt),louse.rent,tit exchange aecerdit:Q to ilalailotlnn,aMlvntb,n,of relocation! URS 447,455,479,670,701. WUnu,(rs or less - 2 '/ulampf to sur,l,mpa 2 I hm!r's Si tuts•.reAUl n,lints a:orc Z rine c ut-new aUentpre, or enfeaalun per panel: A"' -I K for bntltch ein:uiu well rutchxec of Adtllesa - _ ItIviee at feeder foe,etch�re:Idl r.iremt l ,,�'1 City: sLUC )llll R lie fku hriot Clan;11%Ith,%it pill Olt U6, -- P11URY�-- -_...�-- 1•'p�1: 1'.-11111t! -- orsmiy m ee.h:r fel',fltlt Mmr-'h uirolli, lar;h ndJidnrd hunch 0mvil foe. Ftniccotfeeder not bclul g U Sanrx ave 225 un¢ewsnlmerrlal Ll Ilcallb•eul ioeiat. 17001tut unrri alloncimle U Service ova)M amps-.dirp of 1 k2 U Nurardoot tnc0ucar Fact,Sinn cr cultinc lif hlhlg _ Z fnmilydtceginA+ OHuildinFr:er10.;1N►l:¢L•tleltalf-urur SIQnNcItuIllslurellmheJalcrgypmKl, —� 7Svttetnover6Utivolt;nnnunnl mote rosUrnuxttxdlcintuit suoetue eltetaliln..olextesad,) • U Btdlnfatt wet 01tc c allies C Ftx-k-m 1100 an.1v or lttotu "Demi uorl T- U r)culpa,t load v-er 79 remote U Mi-I r1a.•twed t.ovetir_v or RV pea c ---- - ..----••�- - - ffnchad lnrrallNlpedioaa)e,111,Nlm�abielnanyetthcalmve: I]CRrct>1tglWng;elan U slyer yer11 Tn:nun _—=•---r—"'-�---�- 5ub1nil arts of pinm nith may of IAa ebaee lnvettiadon fee W 'Rte r+8ote ttte twl:r;lpllcalek•lu lrtaprxarr cnsrlrtetNaN stetter. 0 r -- -� r�Cl h,rW lcti-b.ep.cadil tads,plM/e-11 j,r1*J1Y110 Fal ifar i1JnTRl{Un 1 Notice;This permit applicntion 11tlnall fCC............ ....... Jlau UAlccicr r onphes It's permil is nnl ohlointd Plun review(at ere ulu n M. (i}�1 ;��f y(� i 1(�, Wifhin 180 dal•:nfla•It Im been State cu►cit ag: - -- lfa -- s-^=-- -- y. - - aucepled at completR. TOTAT......................$ 1 ., tom r•r,��' '�' t,./���_ i.t Z.; ► __.. ..____�_ -1 uAavl ,t44aTc r _ Araollu W AW Irk 11W0M) F -d LL90-9ELIE051 0;3 of -floal apt5 1S11/M dLes*o to is dr$ CITY OF TIGARD BUILDING INSPECTION DIVISION 24 Hour Inspection Line: 63 ' 75 Business Line: 6394 MST _ BUP Date Requested ))_ AL AM_ _PM BLD _ Location LL_zmzj _ Suite _ MEC — Contact Person —_ Ph �-L 7 PLM Contractor Ph SWR BUILDING Tenant/Owner �� — EI-C Retaining Wall FootinC ELR Fou•dation Access: FPS Ftr, Drain Crawl Drain Inspection Notes SGN Slab -------—---------- -- Post& Beam — SIT — -- Ext Sheath/Shear Int Sheath/Shear -- Framing Insulation ---- —v—_ — - — — Drywall Nailing _ L _ _ Firewall —�� Fire Sprinkler Fire Alarm / Susp'd Ceiling — Roof Mise -- _. - - ------ -- Final PASS PART FAIL PLUMBING Post& Beam -- — ----- --- - Under Rlab Top Out Water Service Sanitary Sewer - -- —�— ' — — Rain Drains _ Final --- '- PASS PART FAIL MECHANICAL — Post& Beam --- - -- - _ Rough In Gas Line ------ Smoke Darnpers Final -- --- PASS PART FAIL — ELECTRICAL - -- - — - Service Rough In --- UG/Slab Low Voltage — ---- Fire Alarm PAS PART FAIL Backfill/Gradiny ____- ---_-----_-__-- --------_—`-- __ -- _-- f Sanitary Sewer Storm Drain [ ] 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 RE — [ ] Unable to inspect-no access ADA Approach/Sidewalk t-') /1 - _ Other Date '<--1.�— Inspector Ext Final PASS PART -FAIL DO NOT REMOVE this inspection record from the job site. a CITYOF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2.003-00392 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/10/03 PARCEL: 1 S 134AC-02640 SITE ADDRESS: 11015 SW COTTONWOOD LN SUBDIVISION: ENGLEWOOD 'AO.3 ZONING: R-4.5 BLOCK: LOT: 1JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP. VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: _ FUEL TYPES V 0 - 3 HP: DOMES. INCIN: 1_11G V 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: FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Installing 3-ton gas togas furnacc anal c\tc6or A1Cunit. I)o not install r1,C within the required sctharl.s Owner: FEES LARRY BELL Description Date Amount 11015 SW COTTONWOOD LN TIGARD, OR 97223 IMl t'll1 Permit I•cc 7/10/03 $72.50 ITA`i 18 Staic fay 7/10/03 $5.80 Phone: 503-52 4-8993 1 Tata/ $78.30 -- -- Contractor: RUSE HEATING CO 9945 NE 6TH DR PORTLAND, OR 97211 REQUIRED INSPECTIONS Phone: 503-283-5183 Gas Line Insp Mechanical Insp Reg #: LIC 00002084 Final Inspection This permit is issued subje,-' to the regulations contained in the Tigard Mur„ ;ode, State of Ore. 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 if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set fo-th in OAR 952-001 -OC Issued By: 1 ._ _ Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day Jul 09 03 0P: 53p P P Mechanical Permitlication p� Received Mahurigl , DrtdlB : _ �emtlt No.• i t[: ��1 t GD plrnntnp Approval Building City of Tigard Da WF +: Petrrtit No.: - 13125 SW Nall Blvd. plan Review Other Tigard,Oncgon 97223 DaWlEty. perrnit No. ?bout: 503-639-4171 Fax: 503-598-1960 PO°t-H"iew LAM Lime Dal dHv CAue No _ Internet: v,,ww.ci.tigarlLar.us Contac- ^- Luria: T N See rape 2 for -- 24-hour Inspection Request: 503-6394175 Nune/MMIhod: — Supplemental Inrormaurn. s"1]riii+. i:�.ki';t.� I�;:II" 'a{tR! QMtPU9r, �I)tUM New 1construe ti0n Demolition Mechanical permit fees•we based omit total value of ft work AnditioNalteration/r lacenient I El Other: performed. Indicate the value(rounded to the nearest dollar)of all • - "� mechaiical materials,cquiprnent,labor,overhead and profit. l &2-Fast»l dwellingConunercial/Winlrial Value- S 5re Pale 2 for Fee Scbrdnle 00 Accessory Buildin Multi-F3nilY - -- Description __-_ Qty I F Ses. Tow Master Builder _Othe:r: _,�_`_ He.t1a •ootui' I .t 11 Furowr-add-on air conditioning" 14 OA- Job site address- ` n Gas hat pump _ 14.00 Suite#: Bld JA t.#: Duct work 14.00 H rpMc hot waters rm _ 14.00 Project Name: _ _�-_ Yc� _ - — Residential boiler Cross street/Directions t0 A b site: for radiator or h dronic em 14,00 Unit heaters(fue),not electric) (in wall,in-duct,suspended.etc_.) 14.00 Flue/veal(for tiny of above) 10.00 1 $ubdivislon: of#: - air units IS ! >'. Other Flie1: iatiee_ ': Talc Map areal#: water heater 10.00 Gar;firoplace _ 10.00 e Fluc vent water heater/ u tire lee 10.00 �� �._.. 1-- Log�hter � Gam- Wood/Pellet _ stove _ 10.00 Wood fireplacclinscri 10.00 Chirrme /liner/llue/vent _10.00 AEW Other 10.00 ,' ii''.�;a'8nil►o�mmtal,�Yifitlbl'.VeiT' ,,:;'=.'iia:>�d"I":.�' N3rue_ Range hood/other kitchen equipment 10.00 - me: Address: - --- Clothes dryerenhauct 10.00 City/State✓Zita:—Ti c- VA Single duct exbouct Phone: Fax: (bailirrenw,toilet comportments, utility morns 6.80 Name: Allticicmwl opw fans 10.00 Address. p� _ � ._ _ —.—_ ` other r�,-,��ta ,,, Ci /5tatdZi — -- — 10.00 -- firml f1.00car,h tlaad Phone: _ --t Fax:_ — - F_ lanece.etc. _ •• Gas heat Puy •• E-mail: WeWsuspended/unitheaw •• _ •: :;i:.t. Water heater .. Business Name: c- Ae a Fire lace •• Address: c LAzlge _ BUQ .. Ci /State/Zi : 1dryer .. — Clothes tis Phone: Fax: Z _�__ _ 60 _ _ �1C� Other: CO3 hlc. #: "��}�� Total: T- Aad+onud , P`.: i Kiatdul�lrttdCFesrN' ' Signature: �_ `� lAl� Date-.19^ ���c.2�J ___-- subtotal S� - Minunum Pettitit Fee 572.50 S_ 1J\ i I's Gt �� _ ---plan teev►ew Fee 25%of Parana rK s -- (Pleoc print name) Stele Surcharp4(9%of Permit Fee $ TOTAL PERMIT pF.0 f Notiec: This parmll appacatloa expires If■permit Is not obtained withi• 'Fee methodology rel by Trr{aunty Bnttding IndustryService IraaeA. Ino days after it hu leets accepted as complete. -•Sive plan required for exterior A/C unite i UNu1Pcrmit Forrru\MccPermitApp doc 01103 Jul 09 03 02: 54p -C'El' EFl p. 3 Y T LOT LINE: FIRST NAME: v Y- LAST NAME: ADDRESS: Cl FY: STATE: ZIP: 7 -lam INSTALLA•1TUiN ADDRESS: CI• : STATE: PROPERTY LINE _ I rT: T FT: , 5 � r•lcun•r O FIN PROPZItTY LINE X OUTSIDE UNIT CITY OF TIGARD _ ELECTRICAL PERMIT PERMIT#: ELC200300422 DEVELOPMENT SERVICES DATE ISSUED: 7/10/03 13125 SW Hall Blvd., Ticiard. OR 97223 (503) 639-4171 PARCEL: 1S134AC-02640 SITE ADDRESS: 1.015 SW COTTONWOOD LN SUBDIVISION: ENGLEWOOD NO.3 ZONING: R-4.5 BLOCK: LOT : 197 JURISDICTION: TIG Project Description: JOB NO. 23774 Furnace and exterior A/C RESIDENTIAL.UNIT _ TEMP_SRVC/FEEDERS MISCELLANEOUS 1000 SF 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: list W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: I IN PLANT: 601 - 1000 amp: _ PLAN RFVIE.W SECTION_ 1000+amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL: Reconnect only: _ _ _ SVC/FDR>=225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: LARRY BELL, ROSL CITY ELECTRIC INC 11015 SW COTTONWOOD LN 4012 NE CULLY BLVD TIGARD,OR 9722.3 PORTLAND,OR 97213 Phone: 503-524-8993 Phcne: 503-287-6164 Reg #: I IC 3507 -- I I.P. 26-I I;(' FEES _ 1�1[1l1 212 7t Description Date Arnount Required Inspections S I I PRM f] I I ( Permit I f i u t -- $53.50 l l \i k° 5r;ir fax 7 In nz $4.28 Elect'I Final Total $57.78- –'- This Permit is issued subject to the regulations onntained in the Tigard Municipal Code,State of OR.Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001.0100. You may obtain copies of these rules or direct questions to OUNC at(503)2466699 or 1-800-332-2344. Issued By: /�m..� _ Permit Signature: _. OWNER INSTALLATION ONLY T` The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: _ DATE:— CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N- _ DATE: LICENSE NO: Call 639-4175 by 7:00pm for an inspection the next business day 07/09/2003 12:57 5032821060 ROSE CITY ELECTRIC PAGE 0 1ElLctrical Permit ApCheation ,,,.,�. Received 131oraie■1 Dale/II-yam _ Pec mit No. �-� Z City of Tigard P12mingApprovA Sign patcay_ _ Pe=t No,; 131.25 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Dalc Permit N°.:_ Phone- 503-639-4171 Fax503-598.1960 Pott-Review Land Use Tnteamet: www.t,i.ti$ard.or.as D''t� Case No.;- Contact Juris.: VO 5oe Pale 2 fir 24-imus Inspwbotl R,Nuegt- 503-639-4175 NrmelMr tliwli 8upplentairwl ;on. .. OXWOl --- �" a. w t ecl�lllititliiit><vl� ► . New construction _I ]Derflolitiou Service over 225 wnro- Q Healtncue ficility Adeornmerciul El Hazardous Iv:atiac dition/alterati lacciflt:nt 0 Other: Service over 370 amps-rating of ❑Building over :v",(00 Square feet. [i� 1&2 family dwellings four or more%sidentiat units in&2�FS�mt1 WCllm COffiII1ETCidI/1xLd13Stna1 ❑System avrr 500 volts nominal One suvetureBuildinover three stories Feeders 400 am ,or moreccesso Buildin Muld-F'2pl a ` �_� �___�r _.—._ Occupant load m+er 99 persons IvSanufaravetl 9fl�cAltes of RV Pak Master Builder 1J Other: lip'essnigbi ft plan Other 1"' +7-";.rCt; IIWFr1RM/lL1At,>t pQ '; (fir Submit_acts of plum with any of the above. The above are not applicable to temerarlcoostrnction service_._ Job site address: 6.J _f all L — ItH1;J't If,S. Suite#: I Bld JA t. Number of ins axions e�ermft auovcrl P:o'cctNeme1 oty Fee($$.) Tetai Cross Street�lT0at1(1n5 to Job s dwe tak utnt.Include er arhed g rr a per dwellliR mrh.InrJ°des attached ganRo. 5ervirr ioclededr 10j0 AQ.R.Ur Ieea 145]5 _ 4 `_ Each addioorul SUD Sa.tt ar ootdtm drerL•a� _ 33.4[1 1 75.00 Subdivision: Lot#: Limiu a r nenty,rendcatial_ t i imited incirgy.non reaidiunial Tax mat)/varcel 0: &4ch manufactured home or modular dwelling TTT" U�BCRSP :OJF 1JV serrviee anNor treder 40.40 1 - -- 9#.TvkeA or feeder-Imtailmian, altarmion or relocation: 1 200 aws sir less _ 10.30 _ 2 101 ami to aao arses__,� _ta0.85_ 1 401 aftleato G9Qan+�rs _ 60.60 __ 2 601 ram-fa00argP"_ 240,60 2 . Aver I�:9 am01 or volts 454-4, _ 2 Narnne: Vii_ Raurtnrctoul 60.85 2 Address: Temporary services or lbeders-installation, altrrution,or relocation: city/state/zip. -- 7 1,t 1 2V".amaze_ (b.AS I Phone: Pax-G S Pax• [ 2ol1 m 400 daV ioo.3o 2 _ 49'ea_!a0 arope 13375 2 At !PPIcICA" —'' OPI'�i4C'f P8;>�190;r1 rr,,,ch elrtalts-new,aiterntinn,or I Name: - emersion far par.el, h Irct for bprleh 6cuitl willi pwclraan a( Address: _ - -- _ 5,65 a rrr�;e.a.•feeder ori,each bcar+en cactus t:it //StatC/.Zie; s Pee fur branch caecums without purohase of �J Phone: I Fax: _ r _ siirvke or[eider 1be,first bench circoh I_ 46.95 z Each additions bnwh circuit 6. 2 E-tnati: Ivfipe.(5rlviet:nr IbMer not includeft �M _ •- Each ttmp or n_tint em 61Le $3,41) Each siLu or mline li ht•n Job No: SIV-3l°ircu (sl car a limited enctd txtiel Business Name: ROSE CITY ELECTRIC CQ_I - 'prose: Address: 1#012 NY, CULLY BLVD --i-_ �;1 /StBtP,/ZI �m +i- ��" - Fach additional ina�ection aver the�Ilouable in" of tee aMve: P'. ----�_---- Per an zea been Amur.1 hourl _ _ 6.50 I __ P $21a BLic.IAF 3 5 6 7 Lia.Ak ()ine CC —`T_ _-- SupcIrvising e1nalcian Sulstvral S - st lttatre xe_ uiied ..� _ Plon Review(25%ofPnmit Fee S IEint Name: K L, f-o them Lic,#: 2127.1; stets str�has e�orkrta�nt ra cl_ Authorized p'ocier: This prTmif apgilestlon ftVIrts if a porinit is not abhiaed Slgnntimc: _ nate. _ 180 days after It his beeo are peed as complete. 'Fre methodelon fol by Tri-Coanry reflding tndertr•y Sm-d a(bard. - _ - (PlClse print nen ) - -- i;Vltts�.°elTllit Ftrrrru�IcPormitAnp.doC 0110? CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639.4175 INSPECTION DIVISION Business Line:' (503)639-4171 MST _ BUP Received — Date RoquestedT AM PM BUP Location � ��� 7 /� C-C1�1 Suite MEC Contact Person _ ----441LX-1 ijk Ph( ) � Z � PLM _ Contractor_ _ — Ph( ) SWR — r BUILDING - Tenant/Owner _ _ ELC ,L�� Footing Foundati,rn ACC@aELC Ftg Drain 3 jl / s� ��� !� ELR Crawl Drain -- Slab InsNr;,,i�i; Noles: / - SIT Post& Beam .�•— 1 L Shear Anchors R Ext Sheath/Shear \ In,Sheath/Shear — Framing Insulation Drywall Nailing -Firewall Fire Sprinkler -`- Fire Alarm Susp'd Ceiling - --- - -- - Roof Other: -- -- — - Final PASS PART FAIT_ -- PLUMBING Post&Beam — Under Slab Rough-In Water Service Sanitary Sewer Rain Drains - ---- __ Catch Basin/Manhole Storm Drain -- Shower Pan Other: — Final RT FAIL - --^--` - --- -- - Pos earn Rough-In Gas Line Smoke Dampers i AS PART FAIL - ---- ------- -- - Rough-In _ UG/Slab Low Voltage Fir. &farm '— PART FAIL �J Reinspection fee of$ 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 / 7 J �''--`.. ADA t� Approach/Sidewalk Date �L�__ Illap@�6tOr_ _. _ Ext_- Other: Final - DO NOT REMOVE this Inspection record from the job she. PASS PART FAIL