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CERTIFICATE OF OCCUr'ANCY
CITY OF TIGARD
PERMIT#: MST1999-00244
DEVELOPMENT SERVICES DATE ISSUED: 07/20/19E'9
13125 3W Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S111DA G93G0
ZONING: R-7
JURIS-):CTION: TIG
SITE ADDRESS: )8949 SW GRAVENSTEIN LNFL.
SUBDIVISION: APPLEWOOD PARK NO. 3
BLOCK: LOT:086
CLASS OF WORK: NEW
TYPE OF USE: SF
TYPE OF CONSTR: 5N
OCCUPANCY GRP: R3
TENANT NAME:
RE=MARKS: SF PATH I
Final Building Inspection and Certificate of Occupancy
Approved 11/30/99 by rieorge St-,-ie, Building Inspector
Owner: —
MATRIX DEVELOPMENT
6900 SW HAINES STREET
PLAZA 2, SUITE 200
TIGARD, OR 97223
Phone: 620-80810
Contractor:
LEGEND HOMES CORP
6900 SW HAINES ST
PLAZA 2, SUITE 200
TIGARD, OR 97223
Phone: 620-8080
Reg #: LIC 00060563
'This Ceitit;^ate grants occucancy of the ab-)ve referenced building or portion thereof anti
confirms that the building has been inspected for compliance with the Stcte of Oregon
Specialty Codes for the grout. occup.incy, and use under which the refer anted permit was
issued. -- �] l
BUILD NG INSP�OR BUII_DIN OFFICIAL
POST IN CONSPICUOUS PLACE
s
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
2'#-Hour Inspection Line: 639-4175 Business Line: 639-4171
br1P
Date Requested AM _PM _ BLD
Location kW1e44 9 `,) ti, _ Suite `4EC
Contact Person 17 > Ph 7C2 PLM
Contractor Ph _ SWR
t _ TinanUOwner -----------
Retaining Wa'I ELR
Footing Access: FPS
Foundation ---- ----- ---
Ftg Drain SGN
Crawl Drain Inspection Notes
Slab _ —_----_— SIT _
Post& Beam
Ext Sheath/Shear -- __---
Int Sheath/Shear
Framing --- — ----
Insulation
Drywall Nailing - _---- _
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling — -- - — -
P sof
PS PART FAC_ ---- ------
PLUMBING _ _
I'ost Beam
I Inder Slab _
Top Out
Water Service
Sanitary Sewer --
Rain Drains
Final —
PASS Ri FAIL
Post& Beam __ --- --- -
Rough In
Gas Line --- -- -- ---_
Sm
o e Damneu
ia v — -- -. -- --- -- — --- - ---------
PART FAIL
ELECTRICAL --- - �—_ - --- -- --
Service
Rough In
UG/Slab - ------ -- ----- --- --- --- - -
Low Voltage
Fire Alarm --- — - _— ---- ---------� — �._ -- -- ---
Final
PASS PART FAIL ------ -- ------------- - -----
SITE ----- ------—
Backfill/Grading --_-- -- --
Sanitar, Sewer
Storm Drain [ j Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ]Please call for reinspection RE [ ] Unable to inspect- no access
ADA
A`proach/Sidewalk Date
Other '' % Inspector Ext —_
--- -
Final
PASS PART FAIL UO NOT REMOVE this inspection record from the job site.
TIGARD
�.•'����� MASTER PERMIT
\\
CITY O F ' PERMIT#. MST199r)-00244
DEVELOPMENT SERVICES DATE ISSUED: 7/20/99
13125 SW Hall Blvd., Tiga,,;, OR 97223 (503) 639-4171
SITE ADDRESS: 08949 SW GRAVENSTEIN LN PARCEL: 2S111DA-09300
SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7
BLOCK: LOT: C86 JURISDICTION: TIG
REMARKS: SF PATH I
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: :? FIRST: 1.031 st BASEMENT: of LEFT: 5 SMOKE DFT'ECTORS: J
TYPE OF USE: SF FLOOR LOAD: 411 SECOND: I.;73 sf GARAGE'. 473 of FRONT: 22 PARKING SPACES
TYPE OF CONST: SN DWELLING UNITS: I F'INBSMENT. sf RIGHT: 5
VALUE: $177,14662
OCCUPANCY GRP: R3 BDRM: 2 BATH: 3 TOTAL. sf REAR: IS
PLUMBING _
SINKS: i WATER CLOSETS: 3 WASHING::.ACH, I LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS
TUBISHOWERS. I GARBAGE DISP: 1 WATER HEATERS: I WATER LINES: ILO BCKFLW PREVNTR: I GREASE TRAPS
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN<100K: BOILICMP<3HP: VENT FANS: 4 CLOTHES DRYER: 1
r,n8 FURN)-HOOK: I UNIT HEATERS: HOODS: 1 OTHER UNITS: I
MAX INP btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: I
_ ELECTRICAL
_RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp: 0 - 200 amp: WISVC OR FDR: 1 PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 4 201 400 amp: 201 400 amp: 1st WIO SVCIFDR: 00 SIGN/OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 - 500 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HMISVCIFDR: 501 - 1000 amp: 501+amps•1000v: MINOR LABEL:
1000+amplvolt:
PLAN REVIF.JV SECTION
Reconnect only:
>•4 RES UNITS: SVCIFDR>-225 A.: >600 V NCMINAt CLS AREAISPC OCC:
ELECTRICO L•RESTRICTED ENERGY
A SF RESIDENTIAL e.COMMERCIAL
AUDIO B STEREO VACUUM SYSTEM: ALDIO 6 STEREO: Fh•e..::.RM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM OTH: BOILER: HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL:
GARAGE OPENER. CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATAITELE COMM: NURSE CALLS: TOTAL 4 SYSTEMS:
TOTAL FEES: $ 5,746.53
Owner: Contractor: This permit is subject to the regulations contained in the
LEGENn HOMES LEGEND HOMES CORP Tigard Municipal Code,State of OR Specialty Codes and
6900 SW HAINES STREET 6900 SW HAINES ST all other applicable laws. All work will be done in
PLAZA 2,SUITE 200 PLAZA 2,SUITE 200
accordance with approved plans. This permit will expire N
TIGARD,OR 97223 TIGARD,OR 97223 work is not started within 180 days of issuance,or if the
work is suspended for more then 180 days ATTENTION
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center Those ru.,s are set
Rey N: 1 IC 00060563 forth in OAR 952-001-0010 through 952-001-0080 You
may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion 844-8444 Undedloor insulation Electrical Service Gas Line Insp Appr/Sdwlk Insp Building Final
Fooling Insp Footing/Foundation Dr; Electrical Rougt 'n Gas Fireplace Electrical Final
Foundation Insp PL.&Underfloor Framing Insp Insulation Insp Mechanical Final
Post/Beam Structer.' Mechanical Insp Shear Wall Insp —ain drain Insp Plumb Final
Post/Beam Mechanlca PIUmD Top Out Low Voltage Water Line Insp Final inspection
Issued By �--- — Permittee signature
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the r,erxHx*rne9y4ay
\ CITY OF TIGARD _SEWER CONNECTION PERMIT
_
DEVELOPMENT SEIVICES PERMIT#: SWR19�)900148
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7120/99
SITE ADDRESS; 08949 SW GRAVENSTEIN LN
PARCEL: 2S 111 DT,-09:00
SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7
BLOCK: LOT: 086 JURISDICTION: TIG
TENANT NAME: LEGEND HOMES
U"4 NO: r'XTURE UNITS:
CLASS OF WORK: N=W DWELLING UNITS: 1
TYPE OF USE: SF NU. OF BUILDINGS: 1
INSTALL TYPE: LT°SWR IMPERV SURFACE:
Remarks: Sewer connection for new single gamily dwelling.
Owner: — —---- ----—
FEES
LEGEND HOMES
6900 SW HAINES ST Type By Date Amount Rc,:2ipt
TIGARD, OR 97223 PRMT BON 7/20/99 $2,300.00 99-317010
INSP BON 7/20/99 $35.00 99-3i-/U10
Phone: Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
-'Viv°k, 1Y1510�'Ct�'Y�
on
NA L
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires
180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not
guarantee the accuracy of the side sewer laterals. If the sewer is no, lo.,ated at the measurement given,the installer
shall prospect 3 feet in all directions from the distance given. If not su located, the installer shall purchase a"Tap and
Side Sewer' Permit and the Agency will install a lateral. ATTENTION: 0—gon law requires you to follow rules adopted
by the Oregon Utility Notification Center. Those rules are set forth in Of r. 052-001-0010 through OAR 952-001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
7 `^l
Issued by: . Permittee Signature: , ` may
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
ao�
CITY OF TIGARD Residential Building Permit Application Plan check
13125 SW MALL BLVD. Additions or Alterations Recd By
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date Recd
V 503-619-4171 Date to P E.
F 503-6$4-7297 Date to DST
Permit#
Print or 'Type Called
Incomplete or illegible applications will not be accepted 3,wfl /yyy- ou J (/,V
C'
Name of Pro,ect -- --� W
//y� Name
Job A ik)4 l PD
Address S to Address Architect Mailing Addfess
Nam City/State Zip! Phone
Owner Mailing ress'/ Narne
*� Mailing city ` e 7 /Z' Phone Engineer g Addres-��
7 r� _ :/
General Na �', city/ tat zip
`� Ph
ContractorL+d ► {/ .l Describe work tiw.New Addi<bn 0 Afteratlon 0
Maa��U nsss ';,a �a, to he d6 . ;:.`",14e,,y r
Prior to parmR (. Gl✓, " r fir.��� '� Addttlo'NI Descrlptlon bt WOrk •t� << I a s-;a
Issuance,a copy �/
of all licenses ` p Phone .
tate i
aro required If Oregon Monst Cont. 5oa►d Exp.Date PRO.IEC:T
expired in COT ' 11-1c.0 <'• ,� /
database `�03 VALUA'►,•ION �.4 ,
Mechanical Name NEW CONSTRUCTION ONLY:
Sub- / I igC� Sq. Ft. House: Sq. Ft.Oarag�
Contractor Mailing AddreAp r Az-
Prior to permit v� J J �, Indicate the restricted energy instaffatfon by the electrical
Issuance,a copy C' /State Zip Phone subcontractor in the follow in areas
of all licenses `_A,' S�3-711, Restricted Audio/Stereo
are required if Oregon Const.Cont.Board Exp.Date Energy S stem Alarms
expeed in COT UC# L _`3 Installations Vacuum Irrigation
_ database n System S stem
Plumbing Name n �eck all that Other �—
Sub-
Contractor Mailing Address ,•.,'er Lot Y=NOag Lot YE5 NQ(check oneck one) r•
Has the Subdivision Plat recorded? N/A YI=,S NO
Pnor to permit C /State Zap Phone �l
issuance, a copy
of all licenses are Oregon Cohat.Cont.Board .p Date
requited d Uc.# _
expired in COT 3 acknowledge that I have read this application,that the
database Plumbing Llc.# Exp.Date information given is correct, that I am the owner or authorized agent
r of the owner, and that plans submitted are in compliance with
"3% - Ore on State laws. _
Name Sign ure r,f mneyAgent - Date
Electrical ,ry 7,-,L
Sub Mailing Address Cont,�t ear on ame ' Phone
Contractor � �' " i .�
City/State ZIP Phon
Prior to permit 6
Issuance, a copy ;) 5 FOR OFFICE USE ONLY:
of all licenses are Oregon Const.Cont.Board Exp Date
required it Llc.a ��77 // _ / Plat it: Map/TL#:
rl
expired in COT 7l / 5 ._ ��/'G1�i �' �i 0
database Electrical 4Ic.X. Exp. Date Setbacks Zine Solar.
j-<l _ US C �G, -/_
r
Electildl Supervisor Lic # Exp. nate Engineering Approval lanninrd.Approval: TI^:
_ + .1 70 7 s 167- 1 _V
iAdsts\forr,;%sfaddalLdoc 11/20r'9t!
Rl25111IDA
TAX LGIT 0 e3OO
8949 SW C;RAVEN5TE IV LANE
S.E. 1,'4 OF 5ECTION 11, T.2, R.1W, W.M.
C: TY OF r IC- ARC)
W,45�41NC,sTON COUNTY, 0fZFG0N
LEGENDHOMES
11130 SW DARDR D
ULVD P(1RTI.APID, Oi 6GON
97219
OFFICE (5M) 244-8159 FAX (1503) 244-8291
2o6 ,
N
Lor 90 S 89'54'25" w LOT 91 L� X92
2Q��.m' 62IA0' 206.1'
_ J
206.r
Lo
LOT 87 ��5�' LOT 8�
� "
� WATER METER
LU-- ---- WATER LINE
SS— ——— SANITARY LOT 8�
SEWER �� / j i�lb SQ. Ft.,
SD— - - — STORPI DRAIN
4•- -- -- t OF STREET j COURTLAND IIS
m
• MANNO!-E FIN.FLR a 20hb,'1,�
® CATCH BASIN 1941 GARAGE FLR 204.1'
STREET TREtS
® STREET L,GNT
FIRE HYDRANT 204B' 203.!-:'
_- ----- ------- 1
8' UTILITY gg�g ----- - --
EASEMENT S C�2 0 ;25" l'J I 1
SIDEWALKatl I
—
PROVIDE EROSION l�A CURB ��
(P
CONTROL FENCE —�—�--e-—BS—--————--—--—.._L.e _
PER COMMUNITY E
EROSION PLAN
-- --- _. — -------�-- ---W------
5LJ GRAVEN5TE IN L,4NE
CITYO F TI GA R® __ PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2001-00217
13125 SV;1 Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 05/29/2001
SITE ADDRESS: 01249 SW GRAVENSTEIN LN PARCEL: 2S111DA-09300
SUBDIVISION: t PLEWOOD PARK NO. 3 ZONING: R-7
BLOCK:------ LOT: 086 _ JURISDICTION: TIC
CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MAr,H: BACKFLOW PREVNTRS: i
OCCUPANCY GRP: R3 FLOOR DRAINS:
STORIES: TRAPS:
WATER HEATERS: CAI ,:H BASINS:
___-_ FIXTURES LAUNDRY TRAYS: SF RAIN DRAIN:::
SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Installation of back flow preventer valve.
Owner: FEES
MATRIX DEVELOPhIENT CORP Type By Date Amount Receipt
6900 SW HAINES ST STE 200 ^5PCT CTR 05/29/2001 $2 90 27200100000
TIGARD, OR 97224 PRMT CTR 05/29/2001 $36 25 27200100000
Phone 1:
Total $39.15
---- _
Contractor:
GROVER'S LANDSCAPE SERA/ICES, 1
26485 S MERIDIAN RD
AURORA, OR 97002
REQUIRED INS'ECTIONS
Phone 1: RP/Backflow Preventer
Reg #: Final Inspection
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 if work is suspended for more
than 180 days. ATTENTION Oregon law requires you to ;ollow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 95220001-0,080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-19$7.:
Issued By: Permittee Signature:
Call (503) 639-4175 by 7:00 P M. for an inspection needed the"ne-If business da#�
Plumbing Permit.�� 1ication
� T� Date received : _— Perri no 1!` ))A, /- 06 2
City of Tigard Sewer permit no.: wilding permit nn.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223 —
City ofTigard Phone: (503) 639-4171 Project/appl.no.: Expire date:
Fax: (503) 598-1960 Date issued: By: Receipt no.:
Land use approval: Case file no.: payment type:
1.,;, &2 family dwelling.Of accessuty U Commercial/industrial U Multifamily U Tenant improvement
U New construction l7 AdJition/alteration/replace men( U Food service U Other:
OB SITI!1-WRMAJON
Job address; / Cj l/G.r1-d�Lw CTP r Ucxcripti.n Qty. Fee(ea.) "Total
Bldg.no.: Suite no.: New I-and 2-family dwellings only:
Tax ma /tax lot/account no.: (Includes Ilio n.for each unlit connc coon)
P SFR(1)bath
Lot: Block: _ Subdivision_ SFI,(2)bath --- - --- -
Project name: SFR(3)bath _
City/county: / , f`,,,¢ _ ZIP: J y Each additional bath/kitchen
Desciiption and locatio of work on premises: — Siteutilitt—
_ Catch basin/area drain _
Est.date of completion/inspection: —J Drywells/leach line/trench drain
PUINIhING CONUAcril, Footing drain(no.lin,ft.)
Manufactured home utilities
Business name: v/ 1'e fe-*¢vi�e ovC, Manholes _
Address: -,It Ce fr?�'��y>� /<<J Rain drain connector
City: 2co< — S(atC P: 7iiG 2 Sanitary sewer(no.lin.ft.) `
Phone:,�rv3 0 -t ?f Fax:S. F' I E-mail: Slorm sewer(no. lin.ft.) _
I Plumb,b .reg.no: Water service(no.lin.ft.)
City/metro lic.no.: Fixture or Item:
Absorption valve
Contractor's represeBack flow prever.ter
Print name: ?�L�i r /Z_ Date 2 Backwa'�^valve
Basins/i.. tory `-
Name: i /�t'/P.� -_ Clothes washer
Dishwasher _
Address: Drinking fountain(s) _
City: 0 State: ZIP: Ejectors/sump
Pho ^ tFax: E-mail: Expansion tank
Fixture/sewer ca
Name(print): L12 .S Floor drains/floor sinks/hub
Mailing address: WI/41ai 5,44).44). Aq,1"7e;-/ L.ti Garbs a disposal
_ Hosc bibb _
City: , �/ Stater'/c�_Z[F Ice maker _
Phone: I Fax: I E-mail: r Interceptor/grease trap
Owner installation/residential maintenance only: The actual installation Primer(s)
"Owner's
ill bdby me or the maintenance and repair made by my :rgular Roof drain(commercial) _
e property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s)
ure:_ Date: Sum
Tubs/showerlshower pan
Urinal
Name: Water closet
\ddress: _— WatencC;.ler
City: Slate: ZIP_ Other:
Phone: Fax: E-mail: Tota
Na all Jurisdictions ecceq credit cards,please call utirdkdan fa nuKr inranWitxt. Minimum fee................
_�
Notice:'This permit application Plan review(at _ %) $
❑Visa U MasterCard expites if a permit is not obtained
credit card number _. I 1.--- within 190 dad s after it has been State surcharge(8%) ....$ .9
Eaplrcx
Name of cardholder as shown on credit cwd
accented as complete. TOTAL .......................S .- 9 /S
S
Cardhol dsrtatwe Atrwwtl 440.1616(6WCOM)
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2-family dwellings only r
FIXTURES (individuate QTY mea _AMOUNT (includes all plumbing fixtures in PRICE TOTAL
Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT
Lavainry _ 16.60 for each utility connectloIn
One 1 bath $249.20_
Tub or Tub/Shower Comb. 16.60 Two(2)bath _ $350.00 _
Shower Only 16.60 Three(3)bath $399.00
Water Closet 16.60 - SUBTOTAL _
Urinal 16.60 8%STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL
Garbage Disposal 16.60 TOTAL -
Laundry Tray 16.60
Washing Machine 16.60
Floor Drain/Floor Sink 2" 16.60
3" 16.60 PLEASE COMPLETE:
4" 16.60 -- ---- - -- - -
Water Healer O conversion O like kind 16.60 QuantitrLb Work Performed
Gas piping requires a separate mechanical Fixture Type: Now Moved Replaced Removedl
permit. _ Capped
MFG Home New Water Service 46.40 Sink _
MFG Home New San/Storm Sewer 46.40 Levator_
Tuh
Ca of T-h';hawer
Hose Bibs 1660
Roof Drains 16.60 Slr
Drinking Fountain 16.60 N/a.�i cluset
Other Fixtures(Specify) 16.60 U at
Dishwasher _
Garbage Dis osal
Laund Roomra T _ _
WashingMachine _
Floor Drain/Sink: 2" �~
Sewer-1 sl 100' 55.00 3„
Sewer-each additional 100' 46.40 4"
Water Service-1st 100' 55.00 Water Heater
Water Service-each additional 200' 46A0 Other Fixtures
S�eci
Storm8 Rain Drain-1st 100' 55.00 _
Storm 8 Rain Drain-each additional 100' 46.40
Commercial Back Flow Prevention Device 46.40 - -
Residential Backflow Prevention Device- 27.55
Catch Basin 16,60
Inspection of Existinq Plumbing or Special y 72.50
Requested Inspectionsper/hr COMMENTS REGARDING ABOVE:
Rain Drain,single family dwelling 65.25
Greas,,Traps 16.60 _ --
- QUANTITY TOTAL
isometric or riser diagram is required If
Quantity Total is >9 _
'SUBTOTAL
9%STATE SURCHARGE --- --
"PLAN REVIEW 25%OF SUBTOTAL
Required only If fixture qty total Is>9
TOTAL S
'Minimum permit fee Is$72 50+8%slate surcharge,except Residential Backflow
Pnwention Device,which Is$36 25.8%stale surcharge
"/,II New Commercial Buildings require plans with isometric or riser diagram and
4an review
i:\dsts\forms\plm-fees.doc 10/10/00
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Lane: 639-4175 Business Line: 539-4171 -- --
BLIP _
CJ ,Date Requested$ Li AM_ �PM _____ BLD
Location 112406"JeNtquite MEC
Contact Person _— rAyr Ph -- PI-M
Contractor Ph SWR
BUfLDING -----� Tenant/Owner — �_— ELC
Retaining Wall EI_R
Footing Access: -^
Foundation n FPS
Ftg Drain '.' �.PC4-/0 :'� / � , SGN
Crawl Drain Inspdcfion Notes: - ----
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
RT FAIL. ----- ---
PLu
Post& Beam --— ----- -- -__
Under Slab ;�
Top Out 1✓,�IQ[� ---__--- ------- ---------- - ------------._._�__
Water Service
Sanitary Sewer
R ains
S ART FAIL
AtIlCAL -
Post F Beare --- -- --- --
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 f )Reinipection fee of$ required nefore next inspection. Pay at City Hall, 13125 SW Heli Blvd
Catch Basin Please call for reinspection RE:
Fire Supply Line ( ) p _ _.__ ( )Unable to inspect-no access
ADA
Approach/Sidewalk �' /S--Cl
S- Gi Inspector Ext
Other Date - p1 l�l��
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.