13261 SW ESSEX DRIVE i
BUILDER : DANDA CORPORATION
PHONE : 274-6480 OR 619-4960
SITE ADDRESS : 13261 SW. ESSEX. DRIVE TIGARD, OREGON
LOT 10 HILLSHIRE MAP 2-SI04CA - omoo
LOT SIZE 9,214 SQ. FT. Z0,1iflo. — -pt,7
'Propertty C>u3neq 'SOAS+ ,
i
/ ?
h �q
ol
Ass
i
i / / / / � / / // � ,r_ f/� /moi� ✓'i
S .0 _
(/,
576 c
P-LOT PLAN.
SCALE 1" = 20'
� � w
a � � IN
NIMAGE IS NOT AS CLEAR AS THIS NOTICEOTICE: IF THE PRINT OR TYPE ON ANY
IT IS DUE TO THE QUALITY OF THE 6 rCi� il � IIIIIII IIIIIII iltllli ili � tll iltltlt ► Illtli 11111 (1 illllll VIII I IIIIIII IIIIIII IIIIIII IIID I IIIIIII 111 ( 111 IIIItIi 1111111 IIIIIII 1111111 ► IIII"�1 �1 �-111 IIIIIIi � Illllll �, y�
1 2 3 4 l 6 II II 9 - i 1Q 11. � 12
, _
---- ---� ------ _ ----.— -- ._ �._ _ •--- - --- Np.3
_ _ _-- -_- __- --_ - ._ _ .__ -r� -__-- - -_._-- ---- _- 6 -
ORIGINAL DOCUMENT f; 6 Z 89 IIII� IIII IIII Ii �l IIII IIII II I IIlI�IIII IIII IIil,1�1�.�� .It�I.,Il � I« IIIIIII ►IIIIl111110
II Ilig II IIII IIII IIII II II IIIII II lollll IIII u1 JL
_ II. II . ll II � ► IIII IIII IIII II1111'
I IIIi IliIIII� I! IIIIIll l_l ll� ull IIII 9a1ILI 111 9 I� U � l_E lllI lll.1 III�II�tl
i43w
1
a
W
N
J
Cl)
s
rn
N
I m
x
v
M
rn
1
13261 SW ESSEX DRIVE
CITY QF TIGARD 11PSTER F,ERMIT
DEVELOPMENT SERVICES F,ERMIT #. . . . . . . : MST98-0513
13125 SW Hall Blvd., Tigard,OR 97223(503)639.4171 DATE: 15SL1E D: 02:'/17/99
F'ARCE=.L.: 2)104CA-01000
SITE ADDRESS. . . : 13261 ;3W ESSEX DR
SUBDIVISIO14. . . . :HILL-3HIRE Zt71VING: R-7 FID
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :01.0 J(_IRISDICT'T(jN: TIG
Remarks: PATH 1: New single family dwelling w/attached garage and deck.has signed intent to haul form. SEE CARLSON REPORT BEFORE INSPECT
ION FOOTING
----------------------------------------------------------------- BUILDING -----------------------------------------------------------------
REISSUE: STORIES.......: 2 FLOOR AREAS----------- BASEMENT...: 260 sf REQUIRED SETBACKS---- REQUIRED-------------
CLASS
-----------CLASS OF WORK.:NEW HEIGHT........: 29 FIRST....: 1698 sf GARAGE.....: 660 sf LEFT..........: 5 SMOKE DETECTRS: Y
TYPE OF USE...:SF FLOOR LOAD....: 40 SECOND...: 0 sf FRONT.........: 20 PARKING SPACES: 2
TYPE OF CONST.:5N DWELLINr, UNITS: 1 FINBSMENT: 0 sf RIGHT.........: 5
Lk`.CUPANCY GRP.:R3 BDRM: 3 BATH: 3 TOTAL -----: 1698 sf VALUE—$: 152086 REAR..........: 70
-_..-- -------------------------------------------------- ------ PLUMBING --------------------------------------------------------- --
51NK .........: 1 WATER CLOSETS.: 2 WASHING MACH... 1 LAUNDRY TRAYS.: 1 RAIN DRAIN ft: 100 TRAPS.....,...: 0
LAVATORIES....: 3 DISHWASHERS...: 1 FLOOR DRAINS.. : 0 SEWER LINE ft: 100 SF RAIN DRAINS: 1 CATCH BASINS..: 0
TUB/SHOWERS...: 3 GARBAGE DISP..: I WATER HEATERS.: I WATER LINE ft: 100 BCKFLW PREVNTR: I GREASE TRAPS..: 0
OTHER FIXTURES: 0
---------------------------------- --------------------------- NEC14ANICAL ----•-------------------------------------------------------------
FUEL TYPES----------- FURN ( I00K ..: I BOIL/CMP f 314): 0 VENT FANS.....: 3 CLOTHES DRYERS: 1
GAS FURN )=100K ., : Q UNIT HEATERS..: 0 HOODS,........: 1 OTHER UNITS...: I
MAX INP.: 0 BTU FLOOR FURNWFS: 0 VENTS.........: 0 WOODSTOVES....: 0 GAS OUTLETS...: I
------------- ------------------------------------------------ ELECTRICAL - - --- - -------- ----------- ---- ----------- ------- - --
- RESIDENTIAL UNIT--- --SERVICE/FEEDER---- --TEMP SRVC/FEEDER5-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADD`L INSPECTIONS--
1000 SF OR LESS: 1 8 - 200 amp..: 0 0 200 amp..: 0 W/SVC OR FDR..: 0 PUMPiiRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 56@SF.; 4 201 - 400 alp..: 0 201 - 400 amp..: 0 1st W/O SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 amp..: 0 EA ADDL BR CIH: 0 51GNAL/PANEL...: 0 IN PLANT......: 0
Wff HM/SVC/FDR: 0 601 - 1000 amp.: P 601+amps-1000 v: 0 MINOR LABEL -10: 0
1000~ amp/volt.: 0 ----------------------------------- PLAN REVIEW SECTION ---------------------•---------------
Reconnect only.: 0 1=4 RES UNITS..: SVC/FDR)=225 A.: r 600 V NOMINAL: CLS AREA/SPC OCC:
------------------------ --------------------------- ELECTRICAL - RESTRICTED ENERGY ----- - ------ - --
A. SF RESIDENTIAL---------------------------- B. COMMERCIAL-----------------------------------------------------------------------------
AUDIO 6 STEP,EO.: VACLkM SYSTEM..: AUDIO 6 STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..; 0TH: :: BOILER.........: LAVAL:...........: LANDSCAPE/IRPIG: PROTECTIVE SIGNL:
GARAGE OPENER... CLOCK........... INSTRUMENTAi1ON; MEDICAL......... OTHR:
HVAC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL M SYSTEMS: 0
Owner: ------------------------------------Contractor: ----------------------------- TOTAL FEES:$ 5073.62
WORSE CONSTRUCTION DANDA CORPORATION This permit i5 subject to t;,e regulations contained in the
2901 NW FRONT 2901 NW FRONT Tigard Municipal Code, State of Ore. Specialty Codes and all
SHITE D SuiTE u other applicable laws. All work will hn dnne in accordance
PORTLAND OR 97210 PORTLAND Of 97210 with approved plans. This permit will expire if work is
Phone is 274-9520 Phone N: 274-9520 not started within 180 days of issuance, or if the work is
Reg C.: 130036 suspended for more than IPA days. ATTENTION: Oregon law
—--------r_—------____------------------------------- requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in DAR 952-001-0010 though OAR 952-001-0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503)246-1987.
----------------------------------------------------------- REQUIRED INSPECTION] ------------------------------------------------------------
Erosion 844-8444 Post/Beam Mechan Electrical Servi Gas Line Insp Electrical Final —
Brading lnspecti Crawl Drain/Back Electrical Rough Insulatior Insp Mechanical Final _
Footing Insp PLM/Underfloor Framing Insp Rain drain Insp Plumb Final _
Foundation Insp Mechanical Insp Shear Wall Insp Water Service In Building Final
Post/Beal St uct Plumb Top t _ �� Eyn Voltage Appr/SdMlk Insp
I5SUPLI By : �� ��F-!alv,mittee Signature :+++t++t+ •4•++++++++++F+++ +++•F......4..++�l-t..*+ �+Ft F Ft++ +'t.4
F t +� F F4 +L1
Call 639-4175 by 7:00 p. m. foi, an inspection needed the next IYusiness day
CITY OF TIGARD
DEVELOPMENT SERVICES FEWER CONNECTION
13125SWHall Blvd., Tigard,OR97223(5U3)639-1171 PERMIT
PERMIT #. . . . . . . : SWR98-0361
DATE ISSUED: 02/17/99
PARCEL: 2SI04CA--01000
SITE ADDRESS. . . - 1,326! SW ESSEX DR
SUBD I V I S I ON. . . . :1111_.[-.511 I HE ZONING: R-7 RD
BLOCK. . . . . . . . . . 1_07. . . . . . . . . . . . . :010 JURISDICTION: TIG
'TENANT NAME. . . . . :NORSE CCINSTRUC r I L"iV
USA NO. . . . . . . . . . : FIXTURE UNITS. . . : 0
CL.ASS OF WORK. . . :NEW DWEL.I...I NG UN I TS. . : i
TYPE OF' USE. . . . . :SF NO. OF BUILDINGS: t
INSTALL TYPE. . . . .LTPSWR IMPERV SURFACE: 0 _>f
Remarks : Sewer rorrneciton for a new single family dwelling.
Owner... ________..___.__._________________._._�._ __............... .. ..._._-__----___-.- FEES -_._.....___.............._....
NORSE_ CONSTRUCTION type amo•_knt by date recpt
2901 NW FRONT F'RMT $ 23OO. 00 GEO 02/17/99 99-3129
SUITE D INSP `C 35. 00 GEL] 02/17/99 99-312993
PORTLAND OR 97210
Phone #:
Contractors
OWNER
Phone # : f 2335. 00 TOTAL_
Reg #. . -
--- -- REG?UI RED INSPECTIONS -- _ -This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires IN 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 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 installer shall purchase
a "Tap and Side C^wer" 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
952-081-00IB the mi;h OAA 95214Wl-M. you may obtain copies of
these rules or direct questions to OLK by calling 'SA31246-1981.
/'
l ,s1.:ed b v Permittee Si gnati.rre :
++++++++++++++.+++++++-+...++++++++++++.j-+++++++++++++.+++++++++++++++++.+++++++++.+++++
Call 6.39--4175 by 7:00 p. m. for an inspection needed the next biIsiiless day
+++•f++++++++++++++-+++++4+a•+++•+++++++•++++++++++4-+++•++++++++++++++•+++++++++++++++
JF TIGARD Residential Building Permit Application Plan Check#'/
125 SW HALL BLVD. New Construction Rec'd By <'
Date Recd
IGARD, OR 97223 Single Family Detached Date toP.E '0q -g$'-�-
V 503-639-4171 Date to DST /— - /I Y
F 503-684-7297 .� Permit#/MSS' V-o 13
Print or Type Called /-;Zw434111.
Incomplete or illegible applications will not be accepted e--9r-r-AO"4 F-
Name of Pro ect �` Name
JOb - 1�IY�-j � c
Architect Mailing Address
Address site ddress — i ; i tk v4..
City/State Phone
Nam
Owner Mailing Address
Nam
Cit /State l Phone Engineer Mailing)Address ' `Jt y ,} `�
avJ A .�}
- r 14 � lIII 71 Q-,)L", City/State , 4- Zip Phone /
General Nam,,
Contractor r ,r ,. Describe work New Addition O Aiter„tO Rep
air O
Mailing Ad ress tobedone: j,A m V-, ) µ -,
Prior to permit ,�
I{o, D Additional Descriotion of Work:
issuance,a copy City/State Zip Phone
of all licenses 1' + I~�a1 i c f l '-' t
are required if Oregon Const.Cont. Board Exp Date PROJECT
expired beseOT Lic# �,✓1 food VALUATION
P�o7
Mechanical Name _ NEW CONSTR�U�CTION ONLY:
Sub- }�P� „A. ,?4 Ft. House: �)C% "f
Sq. Ft.Garage
Contractor Mailing Address
A Indicate the restricted energy installation by the electrical
F nor to permit `f1, ,- � r�r t �) a ,
issuance,a copy ty/state Zi hone — subcontractor in the followin areas
of all licenses (� -aac.- �1 "c�,(,�- Restricted Audio/Stereo
are required if Oregon C nst Cont uard Exp. Date Energy _—_ S stem — Alarms
expired in COT Lic# Installations Vacuum Irrigation
database f/� _ __ /" 3 4- t1� S sty en1 System
Plumbing Narne (check all that Other:
Sub- T.,f,. ��,>^!,1 �•. apply)
_
Contractor Mailing Address � - Number of units in Building Unit Number Designation
Has the Subdivision Plat recorded? N/A YES NO
Prior to permit City/State II Phone (/
issuance,a copy 4r, +, y� �t�l , Y. `�
nf all licenses are Oregon Const Cont. Board Exp. Date
required if Lic#
expired in COT —
database Plumbing Lic # Exp Date I hearby acknowledge that I have read this application,that the
information given is correct,that I am the owner or authorized agent
_ RiF of the owner, and that plans submitted are in compliance with
Name Ore on State laws.
Electrical TyV kA J.", i(�rtnpL Signature of Owner/Agert� �� / Date
Sub_ Mailing Address r
Contact Person!Name Phone#
Contractor
-'A
r j�► `_�V ' i`t `i�C
City/State Zip Phone
Prior to permit ; . If
issuance,a copy lJY �CtN^ Of 176-L' 75% d" c
_FOR OFFICE USE ONLY: ,Z /r.�/���,�_rl� 0
of all licenses are Oregon Const Cont Board a e---, —
required if Lic# Plat lit Map
expired in COT N n(� � ----' �L '
database Electrical Lic # Exp Date S backs: Zone
NA A6- & 7 l�bl yrs _
— Electrical Supervisor Lic # Exp.Date Engine�rin�Approval Planning Planning Approval: TIF:
lD-0/-Ol �i 4 � r
i\dsts\forms\sfd-new doc 11/20/98
CITY OF TIGARD
OREGON
INTENT TO HAUL EXCAVATION
(LOTS STEEPER THAN 20%)
"._, Z\ (print name); hereby certify that ALL excavation
material on the subject property will be removed from the site and not be placed as fill,
except for that amount necessary to back-fill the foundation ONLY. I understand
that failure to remove the excavation material will result in the requirement to remove
the material or obtain a grading permit by submitting grading plans prepared by a
licensed engineer accompanied by a geo-technical report regarding the placement of
the excavation material as fill.
I further understand that my footing inspection will be denied if that inspection
reveals that excavated material has not been hvuled, and that work will be
stopped and no further inspections conducted until the City has received and
approved a plan and report from a geo-technical engineer regarding placement of
the fill material.
Signature Date
Permit #:
Job Address: I s2_61—s oi
Subdivision:—d, i 1 �1, � _ Lot:
I haul doc(DST)7/98
13125 SW Hall Blvd., Tigard, OR 97223 (503)639--4171 TDD (503)684-2772 ----
SEE 35MM
ROLL# 22
FOR
LARGE
DOCUMENT
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
TIKKA PLUMBING
1500 E 4T" PLAIN BLVD
VANCOUVER WA 98661
Plumbing Signature a-orm
Permit # . • . • : MST98-0513
Date Issued. : 03/08/99
Parcel . . . . . . : 2S104CA-01000
Site Address : 13261 SW ESSEX DR
Subdivision. : HILLSHIRE
Block . . . . . . . . Lot : 010
Zoning. . . . . . . R-7 PD
Remarks :
PATH I : New single family dwelling w/attached garage and deck.has signed
intent to haul form. SEE CARLSON REPORT BEFORE INSPECTION FOOTING
Your company has been indicated as the plumbing contractor for the permit indicated above. In order
fer the plumbing permit to be valid, please have the appropriate individual from your company sign
below and return this Plumbing Signature Form prior to the start of work.
No plumbing inspections will be authorized until this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
f )W�1E:'R : PLUMBING CONTRACTOR:
NORSE
CTiKKA ONSTRUCTION 15b 9 NEUCAPLES "AD 15DU 15 4114, f'la�" $lv�
SUITE D #67
PORTLAND OR 97210 BRUSH PR klia-E- -M Cel 0e e'c�i
Phone # : 274-9520 Phone # : � (Ycl
Reg # . . : 111675
X r --
- -- -� - -
Signature of Authorized Plumber
Please return this completed form to the address above.
ATTN: Building Dept.
If you have any questions, please call 639-4171 , ext. #/310
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
EDISON CONNECTION LTD
PO BOX 301505
PORTLAND OR 97294
Electrical Signature Form
Permit # . . • . : MST98-0513
Date Issued. : 02/17/99
Parcel . . . . . . : 2S104CA-01000
Site Address : 13261 SW ESSEX DR
Subdivision. : HILLSHIRE
Block. . . . . . . . Lot. : 010
Jurisdiction: TIG
Zoning. . . . . . • R-7 PD
Remarks :
PATH I: New single far.i?y dwelling w/attached garage and deck.has signed
intent to haul form. SEE CARLSON REPORT BEFORE INSPECTION FOOTING
Your company has been indicated as the electrical contractor for the permit indicated above. In
order for the electrical permit to be valid, the signature of the supervising electrician
is required.
Please have the appropriate individual from your company sign below and return thir- Electrical
Signature Form prior to the start of work to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
(MNF'R: ELECTRICAL CONTRACTOR:
NORSE CONSTRUCTION EDISON CONNECTION LTD
2901 NW FRONT PO BOX 301505
SUITE D
PORTLAND OR 97210 PORTLAND OR 97294
1,11c:rle # : Phone # :
Reg # • • : 75839 '
K _
Si a to o isingiectn is an
If you have any questions, please call 639 4171, ext. #310
CITY OF TIGARD ELECTRICAL -
ENER
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR1999-00229
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 10/01/1999
PARCEL: 2S 104CA-01000
SITE ADDRESS: 13261 SW ESSEX DR
SUBDIVISION: HILLSHIRE ZONING: R-7
BLOCK: LOT: 010 JURISDICTION: TIG
Proiect Description: Install burglar alarm.
A.RESIDENTIAL B.COMMERCIAL
AUDIO& STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: X BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL#OF SYSTEMS:
Owner: Contractor:
GAIL RYAN ADT SECURITY SERVICES, INC
13261 SW ESSEX DR 2815 SW 153RD DR
TIGARD, OR 97223 BEAVERTON, OR 97006
Phone: Phone: 503469-7100 ORIGINAL
Reg #: LIC 005994
ELE 26209CLE
_ FEES Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT KJP 10/01/199 $60.00 99-318787 Elect'I Final
5PCT KJP 10/01/199E $4.20 99-318787
Total $64.20
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all cther applicable laws. All work will be done in accordance with apuroved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for morF 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 thrOU-OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246-1987 %1
Issued by �7 Permittee Signature 7?7 6i_�CC_c
_ OWNER INSTALLATION ONLY —
The installation is being made on property I own which is not intonded for sale. lease, or rent.
OWNER'S SIGNATURE: �,y� �ctJ _— DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N _ DATE:
LICENSE N O: ----
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD RECEI\/Fi RESTRICTED ENERGY ELECTRICAL APPLICATION Recd by:
13125 SW HALL BLVD Date Recd: u f
TIGARD OR 972231 II 199E PRINT OR TYPE ' I l
V- 503-639-4171 X3(4 I Permit#1 L 6 199 r1 cezzy
F - 503-598-1960 UMMU IYuuI-V � ll(va lhINCOMPLETE OR ILLEGIBLE APPLICATIONS Cust Call'd: _
c1L ' 14 -1 431 -ol WILL NOT BE ACCEPTED
Name of Development Project _TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Restricted Energy Fee........................................ $60.00
(FOR ALL SYSTEMS)
JOB Street Address Ste#
ADDRESS
3 ') G I -S 0Check Type or Work Involved
JJ
CNState Zip `P �ne# C� Audio and Stereo Systems
Q,R q Ida3 4
Name Burglar Alarm
Garag^Door Opener'
OWNER Mailing Address
� (`,,
13 a(0 S �^'
City/State Zip Phone# Heating,Ventilation and Air Conditioning System'
w Nam Vacuum Systems'
Other
CON"RACTOR Mailing Address brRVI{'
v 153rd DR. TYPE OF WORK INVOLVED -COMMERCIAL ONLY
(Prior to issuance a City/State _!PhWil Fee for each system......... .................................... s60A0
copy of all licenses l)Ar,y 7100 (SEE OAR 918-260-260)
are required if Oregon Contr Brd Lic # Ey.p Date
expired in C O T !Cl 14 y Check Type of Work Involved
data base) Electrical Contr. Lic # Exp Date
)-(.1 :)U 9 C_ r)10 1 IL) 1' ❑ Aud,,r and Stereo Systems
--- C O T or Metro Lic #� Exp. Date ❑
Boder Controls
Owner's Name
� Clock Systems
OWNER - Meiling Address
APPLICANT Data Telecommunication Installation
City/State _ Phone# ❑
Fire Alarm Installation
This permit is issued under UAE 918-320-370 This appli ant aorees to ❑
make only restricted energy installations(100 volt amps or less)under this HVAC
permit and to do the following ❑
Instrumentation
1 Only use electrical licensed persons to do installations where required
Certain residential and other transactions are exempt from licensing Intercom and Paging Systems
These have asterisks(') All others need licensing,
1. Call for inspections when installation under this permitare ready for Landscape Irrigation Control'
inspection at 503-639175; Medical
3 Purchase separate permits for all installations that are not ready for an Nurse Calls
inspection when the inspector is out to inspect under this permit;
4 Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting'
inspector are done,and.
Protective Signaling
5 Assume responsibility for calling for a final inspe ion when ell of the
corrections are completed n Other
Permits are non-transferable and non- able and expiry if work is not
staled within 180 days of issuanc - work is suspended for 180 days _ I Number of Systems
The person signing for r 1 must be the applicant or a person No licenses are required Licenses are required for all other installations
authorized to bind nt
FEES:
--7 --
SI re — ENTER FEES
7
.5%SURCHARGE(.85 X TOTAL ABOVE) $ 4 �(✓
Authority if other than Applicant TOTAL $ JO
i WSWformsVesele doc 198
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-417 �3/
Date Requested 2 AM PM BUPBLD
Locationi,�i ��� f s Suite _ MEC
Contact Person Ph /lT 20 PLM
Contractor r_ Ph SWR
1dL5 Tenant/Owner ELC
Reteining Wa!I ELR _
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: __ / ,/fin -------
Slab _ _ O4-' � 1 e
----- SIT
Post&Beam - — --v'
Ext Sheath/Shear
Int Sheath/Shear
Framing --
Insulation
Drywall Nailing .3. _ �vs---'�C'� v� —
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling __ .-._ C-^'� Yt� �� tf Ck—�
Roof
Misc: 1 ----
ma
PASS PART AIL - --- --- -----_...----------�.... ---�_�_--
PLUMBING -
Post 8 Beam ��1/ _�_�.4�✓C (��_�^��� NS—_
Under Slab ^ -
Top Out
Water Service C'J
Sanitary Sewer -
Rain Drains
Final ^�—
PASS PART FAIL
Post 8 Beam
—
Rough In
Gas tine
Smoke Dampers
SS PART FAIL_
TRICAL
Service -_1 ��.y�
Rough In `^
UG/Slab
Low Voltage l
Fire Alarm ��_ _ �.__—__ �✓� — �_ _
Final
PASS PART FAILSITE
Backfill/Grading ---
Sanitary Sewer
Storm Drain [ I Reinspection fee of$— required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ I Please call for reinspection RE: ___ — [ )Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk CV3 Of 6`1! ` _-
Other DateI- Inspector _ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
f
n c
CD
c
w �
o On
D
CL
o
r ° t
s n
r �
s
01
,, tJ
Is J
F
0
zz
S
r_
CITY OF TIGARD BUILDING INSPECTION DIVISION MST �00��_
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
/ BUP
^Date Requested ( AM PM BLD
Location__ l � �; Su) - S1Z►C Suite MEC
Contact Percon Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall _ ELR
Footing Access: -
Foundation FPS _
Ftg Drain SGN
Crawl Drain Inspection Notes: -�C.�C��C C'�[.E.�_ - ---
Slab _ SIT
Post& Beam ---
Fxt Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
----------
Roof - - -- -
M -
----- ---- ---- ---------------
�ASSPART Mt. — -- - -- ----------- -- - -------
INC
Post& Beam
Under
-
Under Slab _ I
Top Out -
Water Service V y I
Sanitary Sewer --- - -
Rain Drains
Final
PASS PART FAIL
MECHANICAL -- - - - - -- - -
Post& Beane - - --
Rough In
Gas Line - — - ----
Smoke Dampers
Final _— -
PASS PART FAIL_
ELECTRICAL ----_- -
Service _
Rough In
UG/Slab _
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading ---- --- ----- -- —
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ J Please call for reinspection RE:_ [ J Unable to inspect-no access
ADA
Approach/Sidewalk Date ,� _ Inspr?ctor
Other _-_-_ Ext
Final
PASS PART FAIL J DO NOT REMOVE this inspection ecort fron, the job site.