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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST
BLIP _
Date
''Requested ____ _ AM PM BLD
Location_ ` ?c/ /c' _ Suite 16 a�
MEC
Contact Person _ _ Ph PLM �' �CJ 3 3
Contractor Ph jai Oo SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftp 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
PASS PART FAIL -----.-.-_- — __
UM IN
Post& Beam ——
Under Slab
Top Out "----`— ---
Water Service
Sanitary Sewer
Rain Drains
AS PART FAIt.
ANICAL
Post& [Seam —
Rough In
Gas:_ine —--
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL — \ —
Service _
Rough In
UG/Slab
Low Voltage —
Fire Alarm _
Final Y
PASS PART FAIL _
SITE
BackfilliGrading --
Sanitary Sewer
Storm Drain [ 1 Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ]Please ca;7i
pection RE: [ J Unable to inspect-no access
ADA
Approach/Sidewalk Date
other _—L _Inspector Ext
Final
PASS PART FAIL 00 NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION nnsr
�
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 r —
Date Requested_ AM PM — ��I
Location r` G{.�'Y�ttl S� 124 Suite � r3 MEC
Contact Person Ph VLM
Contractor— Ph SWR
WLl1t� Tenant/Owner ELC _
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab vu-�S ( —
�' SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing O 1 7 >
Insulation
Drywall Nailing V V ✓ L� �,(�,�
Fir e It
Susp'd Ceiling ---L—
Roof
Misc:
n ---
� 14A �' Rt ' FAIL
LIMBI J O
Post Beam
Underr Slab
Top Out I
Water Service �,.�1/'�'T—t--r� C�C►(�--� �1t}
Sanitary Sewer c
Rain Drains
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
PASS PART FAIL
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain [ j Reinspection fee of S required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ j Please call for reinspection RE: _ [ J Unable to inspect- o access
Fire Supply Line
ADA
Approach/Sidewalk
Other _ Date 9/3 / `� Inspector .`� _ __ Ext
Final
PASS PART FAIL DI NOT REMOVE this inspection record from the Job site.
CITY OF TIGA.RD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4176 Business Line: 639-4171 MST A —
G y C BUD
Date Requested �-0 � � AM PM BLD
LocationMEC
---- --
l
Contact Person rQtiLQ� — Ph Z � - r � PLM
Contractor Ph SWR p
BUILDING — Tenant/Owner ELC
Retaining Wall ELR
Footing Access
Foundation FPS
Ftg Drain
Slab Crawl Drain Inspection Notes. GJL `��� �^ SGN
Post&Beam ( ,/' ( - SIT
Ext Sheath/Shear
Int Sheath/Shear , ~
Framing ,T - fS,f,�r�r-s ��/
Insulation ' � �LdA l l Oa-Ts - --_
Drywall Nailing
Firewall O^� Y _Q
Fire Sprinkler �M
Fire Alarm ,--�
Susp'd Ceiling — —
Roof —
Misc.
Final - - --- Z —rl-_ - --- ----- -------
PASS PART FAIL
PLUMBING
Post& Beim ---
Under Stab
Top Out --- --
Water Service �[�I
Sanitary Sewer ` ' ---- - —
Rain Drains
Final --- - -- - ---
PASS PART FAIL -- -- - �/-
MECHANICAL
Post& Beam ------ _ _ _
Rough Inr'C�1� --- ----- --�
Gas Line
Smoke Dampers
Final - - -- ----- --- --
PASS PART FAIL
aECTR --_ - — ---
Service
Rough In -- -
UG/Slab _
Low Voltage
Fire Alarm
PASS PART FAIL
S V
Backfill/Grading —
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$ required before n*-xt inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ( J Please call for reinspection RE:_ _ _ ( J Unable to inspect-no access
ADA
Appror„n/Sidewalk �� /
Ot►.rr Date J�' _ Inspector ! Ext _
rens! -
PASS PART FAIL j DO NOT REMOVE this inspection record from the Job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
Date Requested AM PM BLD
Location_ -4ny. -til s Suite! 3 (MEC-\ qr(—,(,76V1 3
Contact Person _ Ph PLM
Contractor Ph 0 �� SWR
BUILDI q Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Slab Crawl Drain Inspection Notes: SIT
Post A Beam
Ext Sheath/Shear L
Int Sheath/Shear
Framing
Insulation , �—Q (�
Drywall Nailing '� �„'� ZL� 1 �''�'� `t
Firewall
Fire Sprinkler
Fire Alarm �'1� �'►
IC �
S-5:
Susp'd Ceiing -�
Roof AS
ASS j PART F
ik:gKING
Post& Beam
Under Slab 2 1�, `i «. `�/\ ` ` C--
Top Out
Water Service
Sanitary Sewer
Rain Drains _ —
Final
P&IS RT FAIL _
IMECHAN!SLL
Post&Beam
Rough In
Gas Line
Smoke Dampers
dv" 4EF — ---
AS PART FAIL _
EL CTRICAL
Service
Rough In
UG/Slab ——
Luw Voltage
Fire Alarm —
Final
PASS PART FAIL —
SITE
Backfill/G•ading
Sanitary Sewer
Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin Unable to Inspect-no access
Fire Supply Line [ J Please call for reinspection RE:_— _ [ i P
Approach/Sidew-ilk l
OlDher Date �Z(� � � Inspector_ `� �.� �-� Ext� \
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the Job site,
/xxx -
CI TY OF T I G A R D BUILDING PERMIT
PERMIT#: BUP1999-00122
DEVELOPMENT SERVICES DATE ISSUED: 4/19/99
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 1S133CC-00400
SITE ADDRESS: 14194 SW BARROWS RD 3XXX
SUBDIVISION: SCHOLLS VILLAGE TOWNHOMES ZONING: R-25
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: FPS FIRST: sf N: S: E: W:
TYPE OF USE: MF SECOND: sf _ PROJECT OPENINGS? _
TYPE OF CONST: 5N sf N: S: E: W:
OCCUPANCY GRP: R3 TOTAL AREA: sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: 3 HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: M. –'Z?: REQD SETBACKSREQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft _ FIR SPKL: SMON DET: —�
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 827.00
Remarks: Add fire alarm system.
Owner: Contractor:
POLYGON NORTHWEST PRAIRIE ELECTRIC
2700 NE ANDRESEN 6000 NE 88TH STREET
D-22 VANCOUVER, WA 98665
VQ6 OUVAT-6&7?8861 Phone: 360-573-2750
Reg #: LIC 60178
FEES REQUIRED INSPECTIONS
Type By Date Amount Rei lot A Fire Alarm
FIRE GEO 4/1/99 $10.00 99-314187 Final Inspection
PRMT BON 4/19/99 $25.00 99-314626
5PCT BON 4/19/99 $1.25 99-314626
Total $36.25
This permit is issued subject to the reaulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable law. 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 the rules adopted by the Oregon Utility
Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You
may obtain a copy of these rules or direct questions to OUNC by calling (503) 2.46-1987.
Pennitee
Signature:
Issued By:
fUall 639-4175 by 7 p.m. for an inspection the next business day
Fire Protection Permit Application Plan Check 0
CITY OF TIGARD Commercial or Residential Recd By
13126 SW HALL BLVD. Date Recd_ V•1�9Y
TIGARD, OR 97223 Print or Type Date to P.E. r._
(603) 639-1171, x. 304 Incomplete or Illegible applications will not be accepted Lata to DST
Permit o t
Galled _
Job Na °of g°d Type of System(Complete A or B as applicable)
/ows'1�1I�as[.f
Address nwmw A.)Sprinkler Wet ❑ Dry p
Standpipes
rl
Owner Ma �• +�' Additional Hasa a torp r
e
zip
Phone Information Denso
Nam° Design Area
Occupant M°Uing Address K.Fedor
city/suft zip Pttaro A.1) Sprinkler Project Valuation $
Contractor N .�' B.► Fire Alarm
(M�n�►or N/'Ci/I'/�G Fi u/�i/y
AWra caMPINe) Address / SUbmitMl Shell Inclterls Battery Cslrulatlona YES(]
Prior to Wit* coo r � Individual Curnponent YES[]
Issuance,a CRYM" Zip Phone cut Sheets _
Copy
km U4 /i,(s J(sa-S B.1)Fire Alarm Project Valuation $ p _
d all lioartses D Gni•-�g
are requUsd M Stahl Const. Exp Date D
expo aT Project Valuation Subtotal(A b or B) $
Permit fee based on valuation $
(see chart on back) 2 15'.d0
Architect Mailing AddressS� S '^ 5%Sumharpe $
t,ny tete zip I Phone FLS Plan Review 40%of Permit $
0
beselft waft A.)Me Addition O AMeraUon O Repair O TOTAL
$
to be dons.,
B.) eto aprhlklar heeds only Plans requlre& SubmA three sats of plans,Including a vicinity map and
I 1-j 1-10 he Mads■No plans requhed the location of the nearest hydrant. _
2. 11+=Plan review rvqulnd 1 hi4by scWroMgdge VW I have reed this application,that the info i wila g1w+Is
Number of aprktkler hMdo- carract,that I Wn We owner or suWalned agW d We owner.and Wsu
al plans bmMed
are In oompuanoe with Oregon Sh to Mws.
Additional Descr%*0n of Work
Signature of Delis+/ 9
A.j—In Existing Building Q New Building ---
Building Conta Pe 111arnip Phone
!
Data B.) Ct>rrtmerdal ❑ Residential
FOR OFFICE USE ONLY:
No.ds<storlar
4
Sq.Ft
artcy as-�
— of C dion
pocup _. .1�T�~1stru�__._
i\dsts\forms\firesupr.doc 11/5/98
CITY OF TIGARD BUILDING PERMIT
DEVELOPMENT SERVICES PERMIT #. . . . . . . .. BUP98-0380
13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 DATE ISSUED: 04/01/99
SITE ADDRESS. . . : 14194 SW BARROWS RD #3XXX PARCEL: I5133CC-00400
SUBDIVISION. . . . : ZONING:R-25
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . JURISDICTION:TIG
-------------------------------------------------------------------------------------
REISSUErFLOOR AREAS---- --- --- EXTERIOR WALL CONSTRUCTION—
CLASS OF WOnK. :��Wo -FIRST. . . . : 0 sf N: S: E: W:
TYPE OF' USE. . . :MF SECOND. . . ". 0 sf PROTECT OPENINGS?----------
TYPE OF CONST. :5--IHR
0 sf N: S.- E: W:
OCCUPANCY GRP. -.R1 TOTAL------: 0 sf ROOF CONST: FIRE RET? :
OCCUPANCY LOAD: 0 BASEMENT. : 0 sf AREA SEP. RATED:
STOR. : 0 HT: 0 ft GARAGE. . . : 0 sf OCCU SEP. RATED:
SSMT?: MEZZ? : REOD SETBACKS—.-------- REPUIRED----------------------
FLOOR LOAD. . . . : 0 psf LEFT: 0 ft RGHT: 0 ft FIR SPKL:Y SMOK DET. . :
DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM: HNDICP ACC:
BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORR: PARKING: 0
VALUE. $ : 6449
Remarks : Sprinkler system for a new three (3) unit multi-family dwelling.
Owner: FEES --------------
BARROWS LLC/POLYGON NORTHWEST type amount by date recpt
2700 NE ANDRESON PRMT $ 62. 50 GEO 04/01/99 99-314210
D-22 SPCT $ 3. 13 GEO 04/01/99 99-314210
VANCOUVER WA 98661 FIRE $ 25. 00 DRA 03/16/99 99-313704
Phone #1 360-695-77005
Contractor: --------------------------
FIRE SYSTEMS WEST INC
600 SE MARITIME AVE #300
VANCOUVER WA 98661
---------------------------------------------
Phone #- 360-693-9906 $ 90. 63 TOTAL.
Reg #. . : 49732
ACTIONS or INSPECTIONS-----
This permit is issued subject to the regulations contained in the Sprinkler Rough—
Tigard Municipal Code, State of Ore. Specialty Codes and all other Sprinkler Final
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 189 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow the
rules adopted by the Gregon Utility Notification Center. Those
rules are set forth in CPR 952-01-010 through CAR 952-11111987.
You espy obtain a copy of these rules or direct questions to UK
by calling (503)246-1987.
Permittee Signature : Issued BY: TIE!-
�q
4..............................................................................
Call 639-4175 by 7:00 p. m. for an inspection needed the next business day
...........................................................................
Fire Protection Permit Application Plan Cfre G
CITY OF TIGARD �� Commercial or Residential Recd B
13125 SW HALL BLVD. Date Recd - -al-
TIGARD, OR 97223 Print or Type Date to P.E -
(503) 639-4171, x. 304 Incomplete or Illegible applications will not be accepted Date to D§T
PermN o —L, ' , G 33 U
Called
Job Na ofgave Isver, r Type of System (Complete A or B as applicable)
I1.o N !e
Address Address dw --
i r r. JS A.)Sprinkler Wet Dry U
Nanaill, .t� Standpipes --
Oil or
Owner Mallin as Hazard G
E.r4rl h__ - Additional S' /a
C y/ tote zip j Phone Information Density --
Name fDesign Area
-
Occupant Mailing Address K r for
City/State S
zip Phone — A.1) Sprinkler Project Valuation $
Contractor Name B.) Fire Alarm i
(Sprinkler or
Alarm Company) Mailing A res" "-- Subrnittal Shall Include Battery Calculations' YES Q
Prior to permit Z160 sE i0facib;,� tit sic 3
Issuance,a City/State Zip Phone Individual Component YE$n
Copy _ Cut Sheets
of all license" JIGGt/&4 XL--0-N% B.1) Fire Alarm Project Valuation
are required If State Conat.Co t.Board Lie.N Exp.Date
expired In COT Project Valuation Subtotal(A dr or S)
_database �� Z S
Permit fee based ovaluation
I n r �b✓Av1 ri__ ___ (see chart on back) $
Architect Marring Address T i _ 5% Surcharge 1[�lS SE. 00 rg $i .'S
cNy/state Of Phone� - Ft.S Plan Review 40% of Permit $
Describe work A.)NewAddition O Alteration U Repair O 5
to be done. TOTAL �.�
B) NuIiflcation to sprinkler heads only =- —,
1. 1-1n heads-No plans required Plans required Submit three sets of plans,including a vicinity map and
2. 11*=Plan review required the location of the nearest hydrant.
--_---.. I hereby acknowledge that I have read this arolcatlon,that it)-.information given is
Number of sprinkler heads: correct,that I am the owner or authorized agent of the owner,and that plans submitted
Addltlonal Description of Work:
aie In complianm.will,Oregon State laws
Signature of Owner/Agent Deb
y A.)In EKiating Building ❑ New Building
Building Contact n arpe, Phone
Data B.) Corn�nrdal ❑ Residential 'Si�J -
FOR OFFICE USE ONLY:
Plot
No of stories
Sq Ft�
Notes
A_ Occupancy CI' _ Type of Construction
iAdstslfotmsltiresupr.doc 11/5/98
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC98-0` 70
DEVELOPMENT SERVICES DATE ISSUED: 03/05/99
13125 SW Nall Blvd., TigarL, orf 97223(503)639-4171
PARCEL: 1S133CC-00400
SITE ADDRESS. . . : 14194 SW SARROW5 RD #3XXX
SUBDIVISION. . . . : ZONING:R-25
BLOCK. . . . . . . LOT. . . . . . . . . . . . . JURISDICTION: TIG
ProJ ect De scr•i pt i on: Electrical for a new three (3) unit multi-family dwelling.
---------------------------
-- RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS---- -------MISCELLANEOUS-----
1000 SF OR LESS. . . . : 3 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 500SF. . . : 3 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMI•I`ED ENERGY. . . . . : 11 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 10) . . . : 0
----SERVICE/FEEDER---- -----BRANCH CIRCUITS--•--- --- -ADD' L INSPECTIONS----
0 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
201 -- 400 amp. . . . . . : 0 1 st W/O SRVC OR FDR. : 0 PER HOUR. . . . . . . . . . . : 0
401 - 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . . : 0
601 - 1000 amp. . . . . : 0 -----------------PLAN REVIEW SECTION-----------.•--_.
1000+ amp/volt. . . . . : 0 ) -4 RES UNITS, . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR ) = 225 AMP'S. . : CLASS AREA/SPEC OCC. :
Owner-: ---------------------------------------------------- FEES ------•-----_ ---
BARROWS LLC/POLYGON NORTHWEST type amol.int by date r~ecpt
2,700 NE ANDRESON PRMT $ 405. 00 BON 03/05/99 99-31347;='
D-22 PLCK $ 101. 25 BON 03/05/99 99-313472
VANCOUVER WA 98661 5PCT $ 20. 25 BON 03/05/99 99-313472
Phone #:
Contractor: -------------------------.-....-
PRAIRIE ELECTRIC INC t 56. 50 TOTAL
6000 NE 88TH STREET
-------- REQUIRED INSPECTIONS
VANCOUVER WA 98665 Rot.tgh-in Elect' l Final
Phone #: 360-373-2750 Elect' 1 Service
Reg #. . : 00060'.
This permit is issued subject to the regulelti•.as contained in the Tigard Municipal Code, State of Oregon 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 188
days of issuance, or if work is suspended for more than 188 days. ATTENTION; Oregon awe you to follow the rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAA 952-:1 1N through OAA -•A11-1987. You may obtain a copy
of these rules or direct questions to OUNC by calling (513)246-1987. j
Permittee Signatttr-e : -- IssLied
T
---------OWNER INSTALLATION ONLY----------_
The installation is being made on property I own which is not intended for-
sale, lease, or, rent.
OWNER' S SIGNATURE: DPTE:
--t^ TRACTOR I NSTA SAT I ONLY---- ----------------- -----.-
SIGNATURE OF SJPR. ELEC' N: t DATE:
LICENSE NO: --
f++++++++++++++++++++++•+++i.+++++++++++++++++++++++++++++I•++++++++++++++++++++++
Call 639-4175 by 7:00 p. m. for an inspection needed t`le next bvisiness day
++++++++++++TL++f'++++'++++++++++++++++++++'F++++++++++++++++++++++.....++++++++++++
CITY 00:TIGARD Electrical Permit Application Plan Check M -9
13125 SW HALL BLVD. Rec'dBy =T
TIGARD OR 97223 !�� Date Roc'd_ 9 -�Y,
Phone (503)639-4171, x304 Date to P.E. 9-7;2 "'1r
Print or Type Date to UST i 7
Inspection (503) 639-4175 Incomplete or illegible will not be accepted Permit s C OS /
Fax (503)684-7297 Called-
f. Job Address: 4. Complete Fee Schedule Below: ,�yEL
Name of Development_ _ V �� I Number of Inspections per permit allowed
Name(or name of bosinees), � �« Service Included: Items Cost Sum
Address ��)�� �__ 4a. Residential-per unit
City/State/Zip- I Q. d ' -7 j �j loon sq.H.or less j $110-00 _ 4
__- Each additional 500 sq.ft.or `
Commercial ❑ Residential portion thereof S $25.00 _.__ 1 /)
Limited Energy $25.00
Each Manuf'd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $68.00 2
(Attach copy of all curt II enses) 4b.Services or Feeders
Electrical Contractor_ '/ t �� Installation,alteration,or relocation
Addie sOU 200 amps or less $60.00 2
201 amps to 400 amps $80.00 2
CityU V State _Zip 401 amps to 600 amps _ $120.00 2
Phone No. U 5 2 3 7 N-D 1 601 amps to 1000 amps $180.00 2
Job No. I Over 1000 amps or volts $340.00 2
Elec.Cont. Lice. No. Exp.Date_ffJ -%' `ne Reconnect only $50.00 _ 2
OR State CCB Reg. No. _ W xp.Date���Cl 4r.Temporary Services or Feeders
COT Business Tax or Metro No. xp.Date i 9Installation,alteration,or relocation
200 amps or less $50.00 - 2
Signature of Supr. Elec'n�'-0 L 201 amps to 400 amps _ $75.00 2
401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License Nr 3 x ,Date U -l- see"b"above.
Phone N f¢=7dO 4d.Branch Circuits
New,alteration or extension per panel
2b. For owner installations: a)The fee for branch circuits with
purchase of service or
Print Owner's Name_____ _ feeder fee.
Each branch circuit $5.00 2
Address ---- b;The fee for branch circuits
CityState___. Zip __. without pu-chase or
Phone No. service or feeder fen.
First branch circuit $35.00 2
Tf1e installation is being made on property I own which is not Each additional branch circuit_ $5.00 2
intended fnr sale,lease or rent
4e.Mlsce'laneous
Owner's Signature (Service of feeder not Included)
9 - Each pump or Irrigation circle $40.00 2
Each sign of outline fighting - $4000 2
3. Plan Review section (if required):* Signal circuit s)or a limited energy
panel,alteration or extension $40.00 2
_
Please check appropriate Item and enter fee In section 5B. Minor Labels(10) $100.00
_4 or more residential units in one structure 41.Each additional Inspection over
Service and feeder 225 amps or more the allowable In any of the above
System over 600 volts nominal Per Inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described in N.E.C.Chapter 5 In Plant _ $55.00
"Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required to,temporary construction services. 5a.Enter total of above lees $
5%Surcharge(.05 X total fees) $ e
NOTICE Subtotal $
5b.Enter 25%of line 5a for ted"
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review ff_reuii .(Sec.3) $
NOT COMMENCED WITHIN 180 DAYS.OR IF CONSTRUCTION OR WORK Subtotal
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account 0 _ .S�Y$ 5_0
Total balance Due
IMAT,WLM,AVr n«IbW
CITY OF TIGARD PLAJMBING PERMIT
DEVELOPMENT SERVICES PERMIT #. . . . . . . :
13125 SIN Hall Blvd., Tigard,OR 97223(503)639-4171 DATE ISSUED- 03/05/99
PARCEL: IS133CC-00400
sjTE ADDRES5. . . : 14194 SW BARROWS RD #3XXX
SURD I V 19 1 ON. . . . : ZONING: R-25
BLOCK. . . . . . . . . . : L.nT. . . . . . . . . . . . . JURISDICTION: TIG
CLASS
OF WORK. . :NEW GARBAGE DISPOSALS. : 3 MOBILE HOME SPACES. : 0
TY171E OF' USE. . . . :MF WASHING MACH. . . . . . : 3 BACKFLOW PREVNTRS. . : 0
OCCUPANCY GRP. . - R1 F1 OOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . : 0
!TORIES. . . . . . . . . 3 WATER HEATERS. . . . . - 3 CATCH BASINS. . . . . . . . 0
I.,A(.JI\IDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . - 3
f'sINKS. . . . . . . . . . 3 URINALS. . . . . . . . . . . : 0 617EASE TRAPS. . . . . . . : 0
LAVATORIES. . . . : 11 OTHER FIXTURES. . . . : 0
TIJB/SIAOWERS. . . : 6 SEWER LINE (ft: ) . . . : 300
WATER CLOSETS. : 9 WATER LINE (ft ) . . . : 300
DISHWASHERS. . . . : 3 RAIN DRAIN (ft ) . . . : 300
Remarks : P1.1-imbing for a new three (3) it mLilti—family dwelling.
Owner: FEES
BARROWS LL/POLYGON NORTHWEST type amoi-(nt by date V-er-pt
C'700 NE ANDRESON PIRMT $ 674. 00 BON 2713/05/99 99-313472
D—2 E! P L C V, $ 16A. 50 BONI 03/05/99 99--313472
VANCOUVER WA 98661 5PCT $ 33. 70 BON 03/05/99 99-313472
Phone #:
Cont r-a C t;or -- ------ - - -_...____._.___.__--- _________
DAYTON
t-
DAYTON PLUMBING INC
1150 INDUSTRIAL WAY
#I
NEWBERG OR 97132'
Phone #: 5317-5036, $ 876. 20 TOTAL
Reg #. . : 000113
REQUIRED INSPECTIONS
This pewit is issued subject to the regulations contained in the Sewer- Inspection Rain Drain Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Water Line Insp Rain D-i-ain Insp
applicable laws. All work will be done in accordance with Water Line Insp Misc. Inspection
approved plans. This pervit will expire if work is not started Water, Service In RP/Backflow Pr-ev
within 180 days of issuance, or if work is suspended for @ore Water Ser,vic,p In Final Inspection
than 180 days. ATTENTION: Oregon law requires yogi to follow rules Ro�_tgh—in Insp Final Inspection
adopted by the Oregon Utility Notification Center. These rules are PLM/Underf I oov-
set forth in OAR through DAR 952--988'-808?. You oay Pi-m/undet-f 1 oor-
obtain copies of these rules or direct questions to 9_IK by calling Top—o�.it Insp
(503)246-1987, Top—oitt Trisp
Storm Drain Insp
Storm Drain Insp
Tssi.ted By : Permittee Signati-tre -
rr
11 - - +++++++++++++++1 .
++•+++++++ 1�::+4-++++++4........................4-++++4....
Call 639-4175 by 7:00 p. m. for LAn inspection needed the next bi.tsiness day
+-+4-++-++4-+-1.........4+++++++4-+++++++++++............f+ .......I......
CIF ' of I'GARD Plumbing Permit Application Plan Che 9,-G '
13125 5 N HALL P'..VF•. Commercial and Residential Recd
TI(;ARD, OR 97223 i Date Recd_ 944-!i-8
(503) F:9AI71 r �. Date to P.E.
` Print or Type Date to DSTt-
Im.amplete or Illegible applications will not be accepted Pe""rcekV4A)%1fr_0
Related SWR# 90;?
Called hC4,K
(` Name o`'?"Velopment/PSo)ect ndll/..Idual) CE
I Job � � �� �.J�L � Sink � 9.00 �,0
Address SUeetAd ss� I Suite Lavatory 9.00 .e.
r(1l►f� � Tub or Tub/Shower Comb. � 9.00 � .0
Bldg* �y/Stale ZIp . Shower Only 900
Riat'a DQ
Na 1 f - Water closet 9.00
' 3rrr�► ) l`�/� Dishwasher --��-- 9.00 n
Owner Mailing Addles Suke Garbage Disposal 9.00
rtse Z.2 - Washing Machine 9.00
CA /State Zip Phone
Floor Draln/Floor Sink 2' 9.00
�CI�--UL�v�t'`c `nbG•1 "�I c' �• 9.00
Name / _
•� 4• 8.00
Occupant Mailing Address Suite Water Heater O conv+rslon O like kind J 9.00
Gas piping requires a separate medlanlral permit.
Clty/Stale Zip Phc+ne Laundry Room Tray 9.00
Urinal 9.00
1azr 'lgw��'
p Name + Other Fixtures(Specify) 9.00
actr2all ash Suite9.00
rew 9.00
Prior to permit /Slate D Phone 6 03 Sewer-1 at 100' 30.00
Issuance,a copy L � X,` 1 C,11 Sewer-each additional 100' 25.00
of all licenses are Orego Co at Co Soft UcJ Exp.Dale
required H F r Water Service-1st 100' 30.00
' Z- l
expired In COT Plumbing UC^'� \ Dale c7 Water Service-each additional 200' 25.W
database - p '{ , _ j 1-30-��C Storm&Rain Drain-1 sr 100' 30.00
Name Storm&Raln Drain-each additional 100' 25.00
�...,
Architect m 1 `( An Mobile Home Space 25.00
or X11 Address
c ,v) 4(a4t's
he Commercial Back Flow Prevention Device or Anti- 25.00
t� Pollution Device
Engineer y/Stele phone Residential Backflow Prevention Device" 15.00
- v (Irrigation timing devices require a separate
Descri work to be done: restricted ene permit.)
New Repair O Replace with like kind: Yes O No O Any Trap or Waste Not Connected to a Fixture 9.00
Reskle al O Commercial O Catch Basin 9.00
Additional description of work: -
Insp of Existing Plumbing 40.00
per/hr
Sperlally Requested Inspections 40.00
fitr
you capping,moving or replacing any fixtures? y PW^[lain,single faintly dwelling 30.00
Yes O No O Grease Traps 9.00
If yes,see back of form to Indicate work performed by QUANTITY TOTAL
fixture. FAILURE TO ACCURATELY REPORT FIXTURE lsoa w4ric r,dw dlapnrn Is regaled If ouarft_q Total Is >e
WORK COULD RESULT IN INCREASED SEWER FEES. _ *SUBTOTAL r'/��• '
1 hereby acknowledge that I have read this application,that the Infornatior.
given Is torted,that I am the owner or authorized agent of the owner.and I 6%SURCHARGE
thatIp ans-�rbmltted are In compliance with Oregon Stale Laws.
Signature of QwnedAgent Dab ••••. - -PLAN REVIEW 25%OF SUBTOTAL
I «h lr fixture .Ictal h>9
- ---
% r..._,-. ... -; TOTAL
C-0ii0a para me Nahone
-Minimum permit fee Is$25 4 5%surcharge,except Residennal Backflow i
C ` Prevention Device,which Is$15+50A surcharge
"All Now Commercial Buildings require plans with Isometric or user diagram
$ and plan review
1rl/ss
CITY O TIGARD SEWER CONNECTION
DEVELOPMENT SERVICES PERMIT
13125 SW Hall Blvd., Tigard,OR 97225(503)639-4171 F'E RM I T #. . . . . . . : SW F,98--02 48
DATE ISSUED: 03/05/99
PARCEL.: 1 S 133,CC-00400
SITE: ADDRESS. . . : 14194 SW BARROWS RD #3XXX
SUBD I V I S I ON. . . . a ZONING: 11-25
BL_OCK. . . . . . . . . . LOT. . . . . . . . . . . . . : JURISDICTION: TIG
TENANT NAME. :BARROWS I_LC/F'OL_.YGON NORTHWEST
USA NO. . . . . . . . . . : FIXTURE UNITS. . .. : 0
CI...ASS OF WORK. . . :NEW DWELL..I NG UNITS. . : 3
TYPE OF USE. . . . . :Mr NO. OF BU I LD I N1tiS: 1
INSTALL TYPE. . . . :L...TPSWR I MPERV SURFACE: 0 s f
Remarks : Sewer for a new three (3) iail:} mi.tlti—family dwelling.
Owner: FEES --
BARROWS LL/POLYGON NORTHWEST type amoi_mt by date recpt
2700 NF ANDRESON F'RMT 4 6900. 00 BON 03/05/99 99-31347 :
D-22 INSP $ 45. 00 BON 03/05/99 99--313472
VANCOUVER WA 98661
Phone #:
1WNFR
Phone #: $ 6'345. 00 TOTAL.
--- ---- REOU I RED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 188 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 —
side sewer laterale. 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 installer shall purchase -__.__^
a "Tap r,nd Side Sewer" Permit and the Agency will install a lateral. ---
ATTENTICIN: Dregoo law requires you to follow rules adopted by the
Oregon Utility Notification Center. (hose rules are set forth in DAP
952401-0110 through OAR 952-WI-AW. You may obtain copies of ___ _.--------_
these rules or direct gnstions to O11NC by calling 15031246-1987, �..
1 �l Permittee Sign i-t r,e
by
- +++++++•+++.+-F+++-++++++++++++++++++.L++++++++++++++++++++++++++++++++++++ + +�-F + +
Cal l 639-4175 by 7:00 P. M. for an inspect ' on needed the next bl.1s iness day
+ + +.+++++++++-F++++++++++++++++++++++++++++++++++++++++++++F+++++++++++++•s-++++++++
CITY OF T MECHANICAL
F ERMIT
DEVELOPMENT SERVICES PERMIT #. . . . . . . : MEC98-0413
13125 SW Hall Blvd,. Tigard,OR 97223(503)639.4171 DATE ISSUED: 03/05/99
1_'ARCEL: 1.S 133CC--.00400
SITE ADDRESS. . . : 14194 SW BARROWS RD #.LXXX
SUBDIVISION. . . . : ZONING: R--5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTION: TIG
Cl.-ASS OF WORF!.. . :NE'W FLOOR FURN. . . . : 0 EVAF' COOLERS- 0
TYPE OF USE. . . . :MF UNIT HEATERS. . : 0 VENT FANS. . . : 7
OCCUPANCY GRF'. . :R1 VENTS W/O APDL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 3 BOIL.F..RS/COME:'RES SORS HOODS. . . . . . . : 0
F L)EL TYPES __.._._.._...__.-- 0-;3 HF'. . . . : 0 DOMES. I NC I N: 0
:GAS 3-15 Hr.,. . . . : 0 COMML. I NC I N: 0
MAX I Np'UT: 0 BTU 15- 30 HF"'. . . . : 0 REF'A I R UNITS: 0
FIRE DAMF''ERS?. . : 30- 50 HP'. . . . : 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 50+ HP. . . . : 0 CL.O DRYERS. . : 3
NO. OF UNITS-.._____..._....______ AIR HANDI_IN(:i UNITrOTHER UNITS. :
FURN ( 100K BTU: 0 (- 10000 cfm : 0 GAS OUTLETS. : 3
TURN ) =100K BTU: 3 1.0000 1-fm : 0
Remarks: Mechanical for a new three (3) unit multi-family dwelling. - Units
identified as DBD
Owner: -----_.__.-_.___----__-_...._--------._______.---..__. ---_._...__..-. _-...__.-____.--- FEES
BARROWS LLC/POLYGON NORTHWEST tyf�ie anol.int by date recpt
2700 NE ANDRESON F'F.MT $ 88. 00 BON 03/05/99 99--3134.71-,
D-22 F"'LCK L 2;:_. 00 BON 03/05/99 99--313472'
VANCOUVER WA 98661 5PCT $ 4. 40 BON 03/05/99 99-313472'
Phone #:
(,ontTacto1-. -------------------------.-----
FROSTY' S HEATING R COOLING
FROST ENTERr,RISES INC
75P2 SE HWY 21.2 ' f 114. 40 TOTAL
BORING OR
E!hone #: 695 -3447
Reg #. . : 017754
- -- -- - REQU1 RED I NSPECT I ONS
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other M e r_h a n i c a I Insp
applicable laws, All work will be done in accordance with Heating Unt Insp
approved plarn. This permit will expire if work is not started DL1ct Inspection
within 188 days of isc.aance, v if work is suspended for more Final Inspection
than 188 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Thos- ules are —
set forth in OAR 952-081-NII through OAR 952-001 0P80. -foil may
obtain copies of these rules or direct quietions to CUNC by calling
(5@3)216-9127. _ --
1 By : _. _ F'ev^mittee Signati.tre:
++++ 1.++++++•r+ .+++++++++++++++•+++++++++++++++++++++++•1•+++++++++++++++++f+4-++++++
Call 639-0.75 by 7:00 p. m. for inspections needed the next bLisiness day
+++++++++++++++++++++++•F++++h++++++++++++++•++++++++++++++++-!-+++++++4•+++++++++•++
L__
Plan Check# y`
CITY OF TIGARD Mechanical Permit Application Redd By
13125 SW HALL BLVD. Commercial and Residential DateRec'd a� ifr
TIGARD, OR 97223 Date to P.E.
(503) 639-4171, X304 �< I ,.I J Date to DST I i
Print or Type Permit#Ajlre M-01:11-3
Incomplete or illegible applications will not be accepted Called �'" r '
Namer of Devewpmernmroled 1 Description 5 Table 1A Mechanical Code Oty Price Amt
Job street �i _ K� A Permit Fee 10.00
r 1) Furnace to 100,000 BTU , �i�
Address Includin duds&vents 'S 6.00
61dg# city/State 2) Furnace 100,000 PTCI+
Oe
Aa�A '' z:� including duds&vents 7.50
Name(or nam,of bushess) 3) Floor Furnace
LLC
' 7- Indudin�vent 6.00
LLC
Owner U�(( �L��`� -��- Q��� 4) Suspended heater,wall heater
Mailing Addoess
or floor mounted heater 6.00
6) Vent not Included In appliance permit
cltyrstme Zip ,� Phone
3��L7 3.00
C c ..C-�-��� CHECK ALL Boiler Heat Air
—— Name(or name d business)
THAT APPLY: or Pump Cond Qty Price Amt
Com "'
6)<311P;absorb unit to
Occupant Mailing Address 100K BTU 6.00
7)3-15 HP;absorb unit
c1tyrstate ZIP Phone 100k to 500k BTU 11.on
8)15-30 HP;absorb
unit.5-1 mil BTU 15.00
contractor , / 9)30-50 HP;absorb
Dr (6&Al+Lk111A– unit 1-1.75 mil BTU 22.50
Ptior to permit Mailing Addr*ns 10)>50HP;absorb unit
Issuance,a copy I? >1.75 mil BTU 1 37.50
of all licenses CYrBtate Zip Phone 5,, 11)FJr handling knit to 10.000 CFM
nm required if `(� 1 Aj.� – 4.50
expired in COT orv,Const. pard Uo MC rn Date c� 12)Air handling unit 10,000 CFM+
database y- /75 " /- 7.50
Architect Name II 13)Non-portable evaporate cooler
��, l b C�l 4.50 —
or Mailing Address 14)Vent fan connected to a single dud 3.00
11115 „_ ' ` 15)Ventilation system not Included In
Engineer cltyrstateZip
Phone 7?`� appliance permK 4.50
(��� 194a , 16)Hood served Fy mechanical exhaust
Cksscnbe work to be done: k� 4.50 �
17)Domestic Ir cnerators
New`l( Repair O Replace with like kind: Yes O No O 7.60
Realdential O Commercial O 18)Commercial or Industrial type incinerator
30.00
Additional information or description of work: 19)Repair units
4.50
20)Wood stove
4.50
21)Clothes dryer,etc. i 4.50 ( I
Type of fuel: oil O natural gas O LPG O electric O 22)Other units Y '
4.50
I hereby acknowledge that I have read this application,that the Information 23)Gas piping one to four outlets 2
given Is cored,that I am the owier or authorized agent of _
the owner,that plans submitted are in compliance with Oregon State ILiws. 24)More than 4-per outlet(each)
_ .50
SlgnaWm of OwnerfAgent� --- Date — � '�. >�
"SUBTOTAL
5%SURCHARGE
40-
conua Perfi Name Phone PLAN REVIEW 25%OF SUBTOTAL
Requlred for ALL commemlal permits onl '
l>>Cl 51 ���LJ 1p 7S-7�X TOTAL
"Minimum permit fee Is$15+6%surcharge
Residential A/C requires site plan showing placement of unit
I:ynedtprn3.doc rev 06/23/98
CITY CF TIGARD
DEVELOPMENT SERVICES BUILDING PERMIT
13125SWHall 9lvd., Tigard,OR9121.3(503)6394111 PERMIT #. . . . . . . : BUP98--0378DATE ISSUED: 03/05/99
PARCEL: 1 S 133CC--00400
31 TE ADDRF..SS. . . : 1.4194 SW BORROWS RD #3X X X
3UBDI VISION. . . . : ZONING: R--25
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . JURISDICTION:TIG
REISSUE: FLOOR AREAS------- --- EXTERIOR WALL CONSTRUCTION-
CLASS OF WORK. -.NEW FIRST. . . . : 2072 sf N: IHR S: 11-IR E. IHR W: IHR
1Y1-1_ OF USL. . . :Ml- SE_L;UNU. . . : 1.818 s1- PROTECT' OPEN INOS"'-__.._._._. ._ -
TYp'E OF CONST. :5--1 HR DECKS . . . . 486 sf N- S. E: W:
OCCUPANCY GRP. .-RI 'TOTAL-----------: 4436 s f ROOF CONST:BF"I RE RET" :
OCCUPANCY LOAD: 9 BASEMENT. : 0 sf AREA SEF'. RATED:
sTOR. : 3 NT: 18 ft GARAGE. . . : 2163 sf OCCU SEF'. RATED. IHR
ITSMT"?:N ME77.7:N REDD SETBACKS - - - - REQUI RE=D__._..__.________._.______._.__._..
F I__OOR LOAD. . . . : 40 ps f LEFT: 0 ft RGHT: 0 ft FIR S�'KL:Y SMOK DET. . :Y
TOWELLING UNITS: 3 FRNT: 0 ft REAR: 0 f - FIR ALRM:Y HNDICP ACC:N
BEDRMS: 8 BATHS: S IMF"' SURFACE: 0 PRO CORR:N PARI',I NG: 21
VALUE. $ : 3,06394
Remarks :
flwners - - - __--.--___._____._-.----•---___._._..._.______.__.____.__..-----....__.__.•____. FEES
BARROWS LL./POLYGON NORTHWEST type amoi.tnt by date rer_pt
x:'700 NE ANDRESON PLCK $ 617. 83 DEB 03/22/98 98--309358
D-22 PRMT $ 950. 50 PON 03/05/99 99•-31:3471
VANCOUVER WA 98661. 5PCT $ 47. 53 BON 03/05/99 99-313471
171hone #: 369-695-7700 FIRE $ 380. 20 8ON 03/05/99 99-313471
C:DCP $ 125. 011 PON 03/05/99 99--313471
Contractor: ----- ------_._____ ____._____.___ CDCP $ 125. 012.r BON 03/05/99 99-313471
P01._YGON NORTHWEST CO EPOS $ 112. 00 PON 03/05/99 99--31347t
PO BOX 1.349 ERF'C $ 36. 40 BON 03/05/99 99-31.3471.
DELL-VUE WA 98009 Additional fees not shown here. . . . . . . . .
Phone #: 360--695--i 747)0 $ 6954 83 TOTAL
Rey #. . 10'912
-----REOU I RED ACTIONS or INSPECTIONS——
This permit is issued subject to the regulations contained in the Erosion Cont r,o l Re i n f. Concrete
Tigard Municipal Code, State of Ore. Specialty Codes and all other Footing T n s p St r1_rct r.ira 1 we 1 d i
applicable laws. All work will be done in accordant• with For.mdation Insp Final Inspection
approved plans. This permit will expire if worts is not e{.arted Post /seam Insp
within 180 days of issuance, or if world is suspended for more Slab Insp
than 180 days. ATTENTION: Oregon law requires you to follow the Framing Insp
rules adapted by the Oregon rJtility Notification Center. Those Fireplace Insp _...
rules are set forth in OAR 952-001-0010 through OAR 952-00101987. I n s!_r 1 at i.o n Insp
You many obtain a copy of these rules or direct questions to 3LK Shear- Wall Insp
by calling (503)246-1987. Fir,ewal I Insp _
Gyp Soar-d Tnsp
Appr/
r
F'Pr,mittee Si.ynati.ire : ? Tssl_re Py : ,�..___
+ + f+++++++++++.++++++ +++ +++++ ++++++.+++4•+++++++++++++++++++++++++++++++++++++++
Call 639-4175 by 7:00 p. m. for- an inspection needed the next bi.rs.iness day
++..++++++•+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
CITY OF TIGARD Multi-Family Building Permit Application Plan Checks
13125 SW HALL BLVD. New Construv1;on and Additions DateRec'd 9-t
Date to P.E. "
TIGARD, OR 97223 Date to DST
(503) 639.4171 Permit*/}C//9$Q $r
Print or Type called 4:Hrgf, fi1E!�• , s9
Incomplete or illegible applications will not be accepted
Na7fI oevelopmenVProjeV1,11acy—
Address
ct Existing Building ❑ New Building
.Job � ' p/�5 Site Address U Building Number of Units -3
r ,u`�' Data
Bag s City/Slate Zip Existing Use of Building or Property:
Nam
Property W/ Sq. Ft. of Dwelling: Sq. Ft. of Gara e:
Owner Mailing Address sultp 1-a 0-7I 1 Cj '
n
760 A/ 14vvexn bZZ_- Proposed Use of Bui!ding or Property:
7y,/Stale 1 tZip Phone &60
_ VU11couW i �1��� --770b
Name No. Of Stories:
Nam
General
Mailing Addre s Suite Occupancy Class(es)
Contractor 1
Type(s)of Con$Uu 1 pn
rice to pertnN CkylSlate Df,�,�lp Phone �� V t^
Issuance,a copy fiOld V�IV n�(1// /.-?3 r 1
of an Ncxenses '"/V C10 r Will this project have a Fire Suppression System?
are required If Oregon Const.Cont.Board LIn.# Exp.Date Yes No ❑
expired In C.O.T.
database '�j / Americans with Disabilities Act(ADA)
__— Valuation X 25%=$ Participation
- Name Complete Accessibilit Form
Architect � � Project $ --
Malling Address suite Valuation nIV �C, � (�
117 v" s /bo -- - -
Clly/State Zip Phone ZS Plans Required: See Matrix for number of sets to submit
�Zt f, 6dH A'f S - 3 on back
Engineer Nara. / �-- — - --—
(A ,`c� J / 1 I hereby acknowledge that I have read this application,that the Information
X Mailing Address Suite given Is correct,that I am the owner or authorized agent of the owner,and
/d 05 )P,4 that plans submitted are In compliance with Oregon State Laws. —
clty/State Zipot& Phones b5 Signature of Owner/Agent Date
_ 7Zz3 -
tad Piton Name Phone
1 hid lest@ type of work: New�( Addit'on O Demolition O /
Accessory Structure O Foundation Omy O AMeration O ��� V 0 J rr,�
Repair O ether O
Description of work: -- -- FOR OFFICE USE ONLY
7 .
r
oft: Site Work Permit Application must precede or accompany Building � }— /1 i)` 1
wmlt Application f_C r / / Q
,MULTINEW.DOC (DST) 8198
Main Office Branch Office
P.O. Box 23814 4060 Hudson Ave., NE
Tigard, Oregon 97281 Salem, OR 97301
Carlson Testing Inc. Phone (503) 684-3400 Phone (503) 589-1252
FAX (503)684-0954 FAX (503) 589-1309
SpEcial Inspection
FINAL SUMMARY LETTER
September 3, 1999
#99-1123B
City of Tigard
13125 SW Hall Blvd.,
Tigard, OR 97223-8199
Attn: Building Department
Re Scholls Village Condominium Development— Building #3
14194 SW Barrows, Tigard, OR
Permit No. BUP980378
Dear Sir or Madam:
This is to certify that in accordance with Chapter 17 of the Uniform Building Code, we have performed special
inspection of the following item(s) per our inspection reports only:
Reinforced Concrete
All inspections and tests were performed and reported according to the requirements of Project Documents
and, to the best of our knowledge, the work was in conformance with the approved plans and specifications,
approve. change orders and applicable workmanship provisions of the State Building Code and Standards, as
well as the structural engineer's design changes, approvals and verbal instructions.
Our reports pertain to the material tested/inspected only. Information contained herein is not to be
reproduced, except in full, without prior authorization from this office.
If there are any further questions regarding this matter, please do not hesitate to contact this office.
Respectfully submitted,
CAR .S N TESTING, INC.
I i
J F Hietpas
Q J} Assurance Manager
r
JF141J k
cc Polygon Northwest Company— Ron Lightner
CT Engineering
Milbrandt Architect
Isley Welding Services -- Jim Murphy
P,WORMREPORtST1NLTR199 11238
CITY OF T I G A R D CERTIFICATE OF OCCUPANCY
DEVELOPMENT SERVICES PERMIT#: BUP98-00378
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 03/05/1999
PARCEL: 1 S133CC-80031
ZONING: R-25
JURISDICTION: TIG
SITE ADDRESS: 14194 SW BARROWS RD 03XXX FILE
r 0- r'
SUBDIVISION: SCHOLLS VILLAGE I
BLOCK: LOT:3-1
CLASS OF WORK: NEW
TYPE OF USE: MF
TYPE OF CONSTR: 5-1 HR
OCCUPANCY GRP: R1
OCCUPANCY LOAD: 9
TENANT NAME:
REMARKS: Scholls Village Townhomes - Building 3, Units 1, 2, 3
Final Building Inspection and Certificate of Occupancy Approved by Rick Bolen, Building
Inspector
Owner:
BARROWS LLC
2700 NE ANDRESON #D22
VANCOUVER, WA 98661
l
Phone: 369-695-7700
Contractor:
POLYGON NORTHWEST CO
PO BOX 1349
BELLVUE, WA 98009
Phone: 360-695-7700
Reg #:
This Certificate grants occupancy of the above referenced building or portion thereof and
confirms that the building has been inspected for compliance with the State of Oregon
Specialty Codes for the group, occupancy, and use under which the referenced permit was
issued.
BUILDING INSPECTOR BUILD14d OFFICIAL
POST IN CONSPICUG�JS PLACE