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9018 SW GRAVENSTEIN LANE c0 ILD Cib U) v7 D m z CD M z r z , i AI I I I 9018 SW GRAY NS'TEIN LPL CITY Y r �� TIGARD ��® CERTIFICATE OF OCCUPANCY / PERMIT#: MST1999-00314 DEVELOPMENT SERVICES DATE ISSUED: 10/05/1999 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S111DA-081300 ZONING: R-7 JURISDICT.ON: TIG SITE ADDRESS: 09018 SW GRAVE NSTFIN LN - E SUBDIVISION: APPLF-'HOOD PARK NO. 3 F LCOPY BLOCK: LOT:081 CLASS OF WORK: NEW TYPE OF USE: SF TYPE OF CONSTR- 5N OCCUPANI-Y (3RP: R3 TE NANT NAME: REMARKS: New SF - Path I Final Building Inspection and rertifica+.3 of Occupancy Approved 2/10/00 by Torn Plescher, Bt,ilding Inspector Owner: MATRIX DEVELOPMENT/LEGEND HOME 12755 SW 69TH AVE #100 TIGARD, OR 97223 Pnone: 503-244-8159 Contractor: _ LEGEND HOMES CORP 12755 SW 69TH AVE #100 TIGARD, OR 97223 Phone: 620-8080 Reg #: LIC 00060563 This Certificate Vrants occupancy of the above referenced building or portion tt ereof and confirms that the building has bean inspected for compliance with the State of Jregon Sr)e,:ialty_ fides for the oup, occupancy, and use ur der which the referencr..d permit was i:BUILaDIG d // Lt�� PECTOR B J!LDINGbFFICIAL. POST IN CONSPICUOUS PLACE CITY OF TIGARD BUILDING INSPECTION DIVISION 24•-Hour Inspection Line: 639-4175 Business Lire: 639-44,71 —_ Date Requested BUP � C �% 4A!!Q.} F-M�� BLD location— 7G / �� '�'�Stt-t.- Suite _ _ MEl' Contact Person PI, 0 PLM rW 'JILDING TenarUOwner ELC g Wall ELR Footing "��' ---- Foundation ACC@SS: FPS _ Fig Drain — Crawl Drain Inspection Notes: SGN Slab —� SIT Post Beam — Ext Sheath/Shear Int Sheath/Shear -- Framing Insulation Drywall Nailing Firewall Fire Sprinkler ------------------------- ky Fire Alarm _ Susp'd Ceiling Roof Misc: _ na / PART FAIL Post&Beam ` —— Under Slab Top Out -- Water Service r t 0 4�i,l!ary .ew rains - -ure ►�bSS PART FAIL hiECNAiJ CAL —'- --- --- ---�— --- Post& Bebm -- --� -- _ ----- --- — — Rough In GasLine _—� ----_--------_.__--_ _ _ —_-- _ Smoke Dampers Final ---- ----- —__----- -- --— -- _ -- PASS PART FAIL ELE i RICAL -- Service Rough In — -- --- ----- ---- -- UG/Slab Low Voltage Fire Alarm Final 3S PART FAIL Backfill/Grading D — ----- — --- Sanitary Sewer t Storm Drain Reinspection fee of$ _required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin RE i i ll f Please call reinspection : Fire Supply Line Pl ( J — [ j Unable to inspect-no access ADA Oth roac 5S h/Sidewalk Date C InspectorVL� EMM 9 Fi PART FAIL 00 NOT REMOVE this inspection record from the job site. ' CITY OF TIGARD BUILDING INSPECTION DIVISIONMsr 24-Hour Inspection Line: 639-4115 Business Line: 639-4171 BUP ____-__Date Requested— ��t �AM _PM BLD Location q�01 6�{ i;Ae,,4 Suite MEC Contact Person - � Ph �� /r - '� PLM _ Contractor Ph SWR _ Tenant/Owner ELC Retaining Wall _ ELR Footing Access' Foundation FPS _- Ftg Drain --- II SGN Crawl Drain Inspection Ncces ---- — — Slab ----- _F --- ------ _- --- — SIT Post& Beam --- Ext Sheath/Shear Int Sheath/Shear _ Framing _ Insulation Drywall Nailing — Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: _- i SS PART FAIL PLUMBING Post&Beam Under Slab 1 op Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL RIECHANI Post& BeatT Rough In Gas Line — Smoke Dampers PART FAIL FrE-CTRIQkL 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 Please call for reinspection RE'. Fire Supply Line [ __—_— __ [ )Usable to inspect no access ADA Approach/Sidewalk Other Date 6 __Inspector_ Ext P Final PASS PART FAIL. DO NOT REMOVE this Inspection record frc m thre job site. f CITY OF TIGARD BUILDING INSPECTION DIVISION QST 2�4••Hour Inspection Line: 639-x{175 Business Line: 639-4171 f A!)C) BUI` — ____.Date Requested �`' AM PM BLD Location 1/ `Y, U1�, ,�,�QYy akil1 Suite MEC - Contact Person _—� Ph !�q-�j 7� PLM Contractor Ph SWR BUILDING Tenant/Owner ELC _— Retaining Wall — —! ELR Fooling Access' ------ J-- -..--- Foundation FPS Ftg Drain Crawl Drain Inspection Nutes: SGN Slab ---------- --- ---- SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear --" Framing Insulation - Drywall Nailing _ Firewall Fire Sprinkler Fire Alarm 6s ,s/ ' �-- �up'd Ceiling Roof Misc _ Final PASS FART FAIL L.UMBIN Post& Beam -- Under Slab - �► - �' � Top Out -- ------ Water Service Sanitary Sewer Rain Drains A PART FAIL HANICAL i-ost& 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 a, required before next it. action. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( ]Please call for reinspection RE:__._ _� [ J Unable to inspect-no access ADA Approach/Sidewalk Other Date - - In!wector---`-/ Ext _ Final --- - PASS PART FAIL O if REMOVE this i"spection record from the job sitz?. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Flour Inspection Line: 639--1175 Business Line: 639-4171 `` BLIP Date Requested I C� AM� —_PM _ BLD Loc^tion_ _ _ quite MEC Contact Person _ 1f'.�� Ph L��"? 7 6) PLM _ Contractor Ph SWR BUILDING i enant/Owner ELC -- _ — Retaining Wail ELR Footing Access Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: —- - - - --- Slab SIT Post&Beam — Ext Sheath/Shear G� Int Sheath/Shear VGZ S 0 Framing - -- — _ Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ce1ing Roof Misc: --- Finai PASS PART FAIL --- -- -- --- PLUMBING Post&Beam — - Under Slab Top Out Water Service Sanitary Sewer --- --- -- —1-- --- Rain Drains Final PASS PART FAIL MECHANICAL Post&Beam — -- -- Rough In Gas Line - — Smoke Dampers Final ---- -- — — - - - — PASS PART FAIL LECTRICAL — � -�---- - — -� Service Rough In — UG/Slab Low Voltage FjrA,Alarm _. final SS PART FAIL -- S Backfill/Grading — —!— Sanitary Sewer Storm Drain [ J Reinspection fee of$, required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ]Please call for reinspection RE: [ ]Unable to Inspect-no acce-s Fire Supply Line ADA Approach/Sidewalk Other pate Ir,�p��ctor � - —Elft - Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. ^\ CITY ITY O F TIGARD IGARD - MASTER PERMIT PERMIT P- MST1999-00314 DEVELOPMENT SERVICES �� IGI f ATE ISSUED• 10/05/1999 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639 �� L SITE ADDRESS: 09018 Sw GRAVENSIEIN LPI 1Yt ///"""�� PARCEL: 2S111DA-08800 SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7 BLOCK LOT: 081 JURISDICTION: TIG REMARKS. New SF - Path I BUILDING kEISSUE: STORIES: 2 F,^nR AREAS _ REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 24 FIRST: Ii77 of BASEMENT: of LEFT: 4 SMOKE DETECTORS: v TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,260 of GARAGE: 479 of FRONT: 20 PARKING SPACES: 2 TYPE OF CONST: 5N DWFLu14n UNITS: i FINBSMENT: of RIGHT: 11 VA,UE: 5 168.275 37 OCCUPANCY GRP: R3 BD4M: 3 BATH: 3 TOTAL: of FEAR: 16 PLUMni.0 SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUBISHOWERS; 5 GARBAGE DISP: I WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES TURN<100K: BOIL/CMP<OHr'. VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN>=100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 1 _ ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMlVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS _ADD'L INSPECTIONS 1000 SF OR LESS: 0 200 amp: 0 • . amp: WISVC OR FOR: 1 PUMP/IRRIGATION: PER INSPECTION: FA ADD'L 500SF: 4 201 400&nip: 701 400 amp: tot WIO SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 snip: 4U. 600 amp: EA ADDL 13R CIR: SIGNALIPANEL: IN PLANT: MANU HMISVCIFDR: 601 • 1000 amp: 601+8mpa•1000v: MINOR LABFL: 1000+amplvolt PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS: SVCIFDR>=225 A.: >800 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOM/PAGING: r'UTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: MVAC: LANDSCAPEJIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLUCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: L ,Iter: Contractor: TOTAL FEES: $ 5,729.15 This permit is subject to the regulations cuntained in the ,EGEND HOMES LEGEND HOMES CORP Tigard Municipal Code,State of OR Specialty Codes and 6900 SW HAINES ST 6900 SW HAINES ST all other brnlicable laws. All work will be done in TIGARD OR 97223 PLAZA 2,SUITE 200 accordance with apNreved plans. This permit will expire if TIGARD,OR 97223 work is not started within 180 days of issuance,or if the work is suspended for more than 180 days. ATTENTION 1311011e: Phone: Oregon law req,,ires you to follow rules adopted by the Oregon Utility Notification Ceri Ar. Those rules are set Rep M: LIC 00060563 forth in OAR 952-001-0010 through 952-001-0080. You may obtain copies of these rules or direc!questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Erosion 844.8444 Underfloor insulation Plumb Top Out Low Voltage Water Line Insp Final inspection Footing Insp Crawl Drain/Backwater Electrical Service Gas Line Insp Appr/Sdwlk Insp Building-final Foundation Insp Footing/Foundation On Electrical Rough In Gas Fireplace Electrical Final Pos0eam Structural PLM/Underfloor Framing Insp Insulation Insp Mechanical Final Post/Beam Mechanical, Mechanir.8l inspp S'hhenr Wall Insp Rain drain Insp Plumb Final IsSUed By : -�1 � Permittee Signature Call (503) 639.417 by 7:00 p.m. for an inspection needed t e nex4 butine day CITYOF TIGA►RD _SEWER CONNECTION PERMIT PERMIT#: SVVR1999-00197 DEVELOPMENT SERVICES DAT " I SUED: 10/05/1999 13125 SW Hall Blvd.,Tigard, OP. 97223 1503) 639-417 SITE ADDRESS; 09018 SV','IGRAVF_NSTEIN LN I II�J• fl '\ RCEL: 2S111 DA 08800 SUBDIVISION: APPLEWDOi) PARK NO. 3 ZONING: R-7 BLOCK: LOT: 081 JURISDICTION: TIG TENANT NAME: LEGEND HOMES USP NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: New SF- Path I Owner: _ FEES LEGEND HOMES 6900 SW HAINES ST Type By z Date Amount Receipt TIGARD, OR 97223 PRMT GEO 10/05/1995 $2,300.00 99-318861 INSP GFO 10/05/1995 $35.00 99-318861 Phone: Total $2,335.00 Contractor: Phone,: Rey #: Required Inspections Sewer Inspection 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 wi!I be forfeited if the permit expires. The Agency does not guarantee the ac,uracy 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 Sewer' 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 952-001-0010 through OAR 952-001-0080. You may obtain pies 7of t e rulm or direct questions to OUNC by calling (503) 246-1987 Issued bye .tet _ Permittee Signature:(y2=.�/ Call (503)639 4175 by 7:00 P.M. for an inspection needed, the next b e day CITY OF TIGARD Residential Building Permit Application Plan Check# 7'3,p ,P 13125 SW HALL BLVD. Additi_ -,r Alterations Recd By---L {) TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date Recd �� V 503-639-4171 Date to P.E. F 503-684-7297 Date to DST` Print or Type gilled incomplete or illegible ppp;ications will not be accepted Name of Project A T —�-- Name Job D�L l b� ��t C Pcty� Addres., Site agd►ess /./ Architect Mailing Ad ess � Nam City/Sta a Zip Phone Owner Mailing ress Name 7 '� Cityi ame Z phone Engineer Mailing Address ----- --- / { J , v General Narile city/ tat Zip I Contractor'_ ,} y� �, ; y — dyd' If'' �',*c"at Describe work '-.,Now . Additbn O ARoratbn Ma h res, ? w be dor>e t i. ! r 4 ,,. Additional DeSixiptlar of Won-.: p issuance,a copy / fate i Phone of all licenses y l 1 ' j are required K Oragon��ons-t.cont.Board Exp.Date PROJECT .,' expired In COT Llc.#�T V,ALUATION database (-� !ri's �j-3 Mechanical Name NEW CONSTRUCTION ONLY: ':r'.•,.,:`,;, " r'y , Sq. Ft.House: - I i q Ft. Garage Contractor Mailing Address _ i-/ j C��f Prior to permit Lj S lL, �OS ", i Indicate the restricted energy installation by the rerleclricaI I issuance,a copy C /State Zip phone subcontractor in the followin areas of all licenses Restricted Audla'Stereo —{I are required if Oregon Const.Cont. Board Exp.Date Energy System Alarms _ expired inCOT Uc.# Installations Vacuumdatabase C-1�/k Irrigation 3 S stem Plumbing Name - Y _ stem (check all that Other Sub- • n n` apply) _ Contractor Malting Address Comer Lot YES NO Flag Lot YES NO w G`) 0(11--7 _(check o,2eL (check one) -- Has the Subdivision P 1-at recorded? NO N/A 1(F�S Prior to permit C /State Zlp Phone issuance,a copy ; 1'--' of all licenses are Oregon onst Cont. Board Exp. Dato required if Uc.# r' _ expired in COT ) 3 - >� I hearby acknowledge that 1 have read this application,that the database Plumbing Lic.# Exp.Date information given is correct,that I am the owner or authorized agent v of the owner,and that plans submitted are in compliance with Oregon State laws. I i� Name Sianalure of OwneriAgent 7- Date Electrical , �,yK. ,f, ,, Sub- Mailing Address Cont- or on fiaT.e phone Contractor �- City'State Zip Phon Prior to permit issuance,a copy _ of all licenses are Oregon Const.Cont. Board Exp Date OR OFFICE USE ONLY: required if Lic.e Plat#: expired in COT it C/, P � �/-5- ; �_ l L� LiG� ` 1, r. " 11 database Electrical Lk.#. imp Date Setback Zone: Solar: I Etedric�l Supervisor Lic.# Exp nrov ate Engineering Appal Planning Approval: -- --1 1-._ -- I:ldstsVornslsf9ddaR.doc 1 t 200 FLOT FLAN LOT #81, AFFL E(WOOD FARK Rl 2S1 it DA TAX LOT '*S&O@ 9018 5W GR VENSTE IN LANE S.E. 1/4 OF SECTION 11, T.2, R.IW, W.M, CITY OF TI a,4RD WASHINGTON COUNTY, OREGON LEGEND HOMES 1.1190 311 RARDUR BLVL. PORTIAND. OREGON 97219 OPP1Cp -8169 PAX (603) 214-8261 5W GRAVENSTEIN LANE CURS 2052 -------- WATER METER I I j sIDEWAI W WATER LINE ��5--—- — 6,ANITART- SEWER cn I �� 900' - 8' UTILIT 50— - - - STORM DRAIN 1 I j T a 2 5.4 EA5EME t OF STREET ------ . MANHOLE GATCH BASIN PROP-95ED STREET TREES ® STREET LIGHT U nI i / i 'n FIRE HT DRANT i (Y I i 4 5 1 50. FT. 0 L11 j n ; / WARCOURT 11 z i I F�j r /FIN. FLR. ■ 201.3' GARAGE FLR. ■ 206.0 { 1 )U /� � �� I 201 ' � .01--- b8-co' PROVIDE EROSION I --7-- ----------__—_---_—_---_�../ __—_-- CONTROL FENCE �'o W - -- - - - PER GOMMUNITT I �. 01.0, / r EROSION PLAN j I I CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 – _ _ Date Requested AM BLIP PM BLD Location C ✓1. Suite MEC Contact Person ` Ph PLM Contractor Ph SWFt BUILDING _ Tenant/Owner ELC Retaining Wait ELR _ Footing Access: Foundation FPS Ftg Drain — SGN Crawl Drain Inspection Notes: ---- — Slab _ SIT Post&Beam -------- ---- ------- - _ – Ext Sheath/Shear Int Sheath/Shear Framing _. Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling _ _ du sa_ Roof Misc: _ Final PASS PART FAIL PLUMBING Post& Beam -- -- Under Slab Top Out Water Service Sanitary Sewer Rain D.gins Final PASS PART FAIL MECHANICAL Pust&Beam Rough In Gas Line Smoke Dampers Final PART FAIL LECTRI Sery c _ Rough In --- ----- – - -. — ------- .-- --- -- UG/Slab Low Voltage Fire Alarm PASS PART FA's SI Backfii'/Grading _ SanitarI Sewer Storm Jrain [ ]Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin ease call rens ection RE: Fire Supply gine Plll fi [ j p - I j Unable to inspect-no access ADA Approach Sidewalk I Other Date 0 / .L 0 Inspector /yJ2, A Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. R„ CITY OF TIGARD BUILDING INSPECTION DIVISION MST 22 Hour Inspection Line: 639-1175 Business Line: 639-4171 --- __ I"IP Date Requested_ _AM PM _--_ BLD Location QG 6r4ye -,5 Al� L' Suite / -- MEC -2" "' -rt Person Ph i/ 3 Z'I i.I'LL <�V p I Z z- tractor Ph SWR BUILDING Tenant/Owner ELC _ Retaining Wai Et.R Footinn Access: Foundation FPS Fig Drain ---- --- SGN !crawl Drain Inspection Notes: - -- Slab _ ... - � SIT Post&Beam --- -- Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing _ Firewall L - Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Final PASS. PAR' FAIL --- - -- -- PLU Post& beam - - - ---- -- Under Slab Top Out Water Service' �i`�' k Sanitary Sewer Rain Drains �Y ASS PART FAIL ANI CAL Post& Bearn - - - - ----.-- -- - - - Rough In Gas Line I - - — --- - _ ..-------------- --- - Smoke Dampers Final -- -- ---- ——.-.__ PASS PART FAIL ELECTRICAL - -- - ------- - - --- Service Rough In UG/SIAb ----- --- Low Voltage Fire Alarm - - ---_----—- - —_— Final PASS PART FAIL-SITE Backi.'rC;railing -- Sanitary Sewer Storm Drain ( Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ]Pleasa call for reinspectinn RE: [ J Unable to inspect-no access Fire Supply Line ADA c Approach/Sidewe'k nate _ /5 Inspector —_ Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. \ CITY OF TI G e R D `Y PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PI-M2001-00122 13125 S'.V Hall Blvd., Tigard, OR 9722,1 (503) 639-4171 DATE ISSUED: 3/27/01 Sti'E ADDRESS: 09018 SW GRAVENSTEIN LN PARCEL: 2S111 DA-08800) SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7 BLOCK: LOT: 081 JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: rUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE- ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of residentia' backflow pr(�venticn device. _ Owner: — — _ - Type By Date FEES Amount Receipt CAMPAGNA & ESTEGHALION - 09018 SW GRAVENSTEIN LN Pt1MT CTR 3/27/01 $36,25 27200100000 TIGARD, OR 97223 SPCT CTR 3127/01 $2.90 2/200100000 Total $39.15 Phone 1: 503-431-3121 Contractor: OWNER. REQUIRED INSPECTIONS Phor^ 1: RP/Backflow Prevent--r 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 follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987 Issued By: Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Plumbing Permit Application Da eereceived�2]/� ' Permit no.:rG/` City of Tigard AVOEM Address: 13125 SW Hall Blvd,Tigard,OR 97223 Sewer permit no.: Building permit no.: City of7Fgard Phone: (503) 639-4171 Project/appl.no.: Expire date: Fax: (503)598-1960 `� Date issued By: Receipt no��_ Lar?1 use approval: Case file no.: Payment tvpe: X11 &2 family dwelling or accessory U'�.ntuu::cial/inclustri,d J Multi-family U Tenant improvement ❑New construction i Additiurt,�ttera:Jolr/replacentenl l�Food service U Ocher: .__--_-_ _ .1011 SITE 6,,I..oA1,,%T;0N FFF SUIVIIIII'LE(for special Iniorinution use checklist) Job address: t�/D SGV' LTt�rvC1 -, t,? Description Qt . hee(ea.) 'Total Bldg.no.: Suite no.: -� - New r-and 2-family dwellings only: Tax map/tax lot/account no.: (includes 100 far.for each utility connection) SFR(1)bath _ Lot: 71 Block: Subdivision: SFR(2)bath Project name: h +� SF;t(3)both _ City/county: Each additional bath/kitchen Description and location of work on prelm6es: T, eutWties: Catch basin area drain Est.date of corrpletion/inspection: F �, r Drywells/leach lineltrenrh drain t�ootiug drain(no. lin. ft.) Manufactured home utilities Business name.: �+ he June b or,�pvJ�e�, Manholes _ Address: l Rain drain connector _ City: State: Z_[P: Sanitary sewer(no.lin.ft.) Phone: Fax: E-mail: Storm sewer(no. lin.ft.) CCB no.: Plumb.bus.reg.no: Water service(no.fin.ft.) City/metro Vc.no.: Fixture or Item: Contractor's representative signature: Absorption valve _ Print name: nate. Back flow prevenler ! Backwater valve P11:111SON Basins/lavatory Name: Clothes washer A_ddtess: S a•Vic* L� < . f) Dishwasl-er — -- City: -� State:i' ZIP. °j''._ y Ejectors/sumng fountain(s) Ejectors/sump Phone: -;Qj-;QFax: E-mail: Expansion tank �- Fixture/sewer care Name(print): 1.(2 floor drains/floor sinks/hub _ Garbage disposal Mailing address: /YI S LA, r-.� . ---- Hose hihh city: State: ZIP: Y Ice maker -- ' "hone:c I Fax: I E-mail: Interceptor/grease trap Owaee installation/residential maintenance only: The actual it stallanon Primer(s) will be mala by me or the maintenance and repair made by my regular Roof drain(commercial) _ employee on'he ptr w.tty I own as.per ORS Chapter 447. Sink(s),basin(s),lays(s) _ Owner's sigo,iture: �� Date: Sump _ Tuhs/shower/shower pan Urinal _ Name: -- �— –._-- Water closet _ Address: Water heater _City: State: ZIP: _ Other: Phone: _ Fax_ L' mail: Total Mnt ailjuridictiona .cep'credit cartes,please.:alljurisdiction for more infomwtion, Minimum fee................$ - Notice:'This pennit application plan review(at 96 U Visa U Ma:tercma ___expires if a permit is not obtained ) relit cant number: �_.[_t - Slate surcharge(fid) ....$ Fspires +'tibio I80 days a11cr it hes been y 1� ----WZW ofcar@rolder oahr•vn ..at card accepted as complete. TOTAL. .......................$ S Cardholder sibnature A wuni `_ _� 440ari16(610arCOM) PLUMBING PERMIT FEES: PRfiCE TOTAL New 1 and 2-family dwelllnG•,only: FIXTURES Individual QTY t,a AMOUNT !Includes all plumbing fixtures In PRICE TOTAL Sink 16 60 the dwelliry aad the first100 ft. QTY (ea) AMOUNT Lavatory 16.60 — for each utiles connectlogL One ill bath $249.20 Tub or Tub/Shower Comb. 16.60 Two(2)bath $350.00 Shower Only 1660 i Three(3)bath - $399.00 Water Closet 16.00 -- - ---- _-_ �- _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 Drairi lour Sink 2" 16.60 3" 16.60 PLEASF_ COMPLETE: 4" 16.60 _ Water Heater O conversion 0 like kind 16.60 Quantity b I Work Performed Gas piping requires a separate meL`,anical i Fixture Type: New Moved Replaced Removed/ permit. _ Capped MFG Home New Water Service 46.40 Sink MFG Home New San/Storm Sewer 46.40 -Lavatory _ Hose Bibs 16.60 Tub or Tub/Shower Combination Roo(Drains 16.60 Shower Only Drinking Founti.in _ 16.60 -_ Water Closet Other Fixtures(Specify) 1660 Urinal Dishwasher _ Garbage Disposal ~ Laundry Room Tray -- ---- — Washing Machine Floor Drain/Sink: 2" Sever-1st 100' 5500 3" - -" over-each additional 100' 46.40 i 4" Water Service-1 st 100' 5500 Water Heater Water Service-each additional 200' 46.40 Other Fixtures S eci Storm 8 Rain Drain-1st 100' 55.00 Storm 8 Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 4640 Residential Backflow Prevention Device' 27.55 ('ar„h Basin 16.60 Inspection of Existing Plumbing or Spe&ally 72.50 Requested Inspections perthr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 65.25 - 3rease Traps 16.60 --_- - QUANTITY TOTAL —Isometric or or riser diagram Is required If —-- — — — _ Quantity Total Is >9 -- 'SUBTOTAL — — — - 8%STATE SURCHARGE -- -- --- "PLAN REVIEW 25%OF SUBTOTAL R, uired only If fixture my total Is>9 TOTAL S "Minimum permit fel Is$72 f0+8%stag surcharge,except Residential Backflow Prevention Device,wh ch is$36 25+P%slate surcharge "All New Commercis Buildings require plans with Isometric or riser diagram and plan review I:Wsts1formslplm-fees.doc 10/10/00 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE WOLCOTT PLUMBING CONT. INC PO BOX 2007 GRESHAM, OR 97030 Plumbing Signature: Farm Permit #: MST1999-00314 Date Issued: 1010511999 Parcel: 2S111 DA-08800 Site Address: 091118 SW GRAVENSTEIN LN Subdivision: APPLEWOOD PARK NO. 3 Block: Lot: 081 Jurisdiction: TIG Zoning: R-7 Remarks: New SF - Path I YOUI company has been indicated as the plumbing contractor for the permit indicated above. In order for 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 the work to the address above, ATTN: Building Dept. No plumbing inspections will be authorized until this completed form is received OWNER PLUMBING CONTRACTOR: LECF="ln HOMES WOLCOTT PLUMBING CONT. INC 6900 SW HAINES ST PO BOX 2007 TIGARD, OR 97223 GRESHAM, OR 97030 Phone #: 503-244-8159 Phone #: 667-1781 Reg #: I Ir 00023847 PI M 26-208PB AN INK SIGNATURE IS REQUIRED ON THIS FORM r` X Z5 - Mow — Sig r, r f 0jthWTzed Plumber If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF T I GA R D MECh V41CAL. PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2003-00480 13125 SW Hall Blvd., Tigard, OP 97223 (503) 639-4171 DATE ISSUED: 11 251 PARCEL: 2S111 DA-08800 SITE ADDRESS: 09018 SW GF 'VEN3TEIN LN SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R-7 BLOCK: LOT:081 JURISDICTION: 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 _ 0 3 HP: DOMES. INCIN: 3 15 HP. COMML. INCIN: MAX INPUT: BTU 15 -30 HP: FIRE DAMPERS?: 30 - 50 HP: WOOREPAIR UNITS: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTII: AIR HANDLING UNITS CLO DRYERS: OTHER UNITS: 1 FURN >=100K BTU: <= 10000 cfm: > GAS OUTLETS: 10000 cfm: Remarks: In11;III r'%M'101 A C unit. I k. lilt I I,icr ilhin Ilir icyunr l �rthacks Owner: _ FEES LEITY ESTEGHLALIAN Description Date Amount 9018 SW GRAVENSTEIN LN TIGARD• OR 97223 %Il c'I I I I'rruiit Fcr 818/03 $72.50 11 \N JYslaty t a\ 8/8/03 $5.80 Phone: 503-90-6401 ----_—_ Total $78,30 Contractor: GAROKEN ENERGY COMPANY 3565 SW 182ND AVE BEAVERTON, OR 97006 REQUIRED INSPECTIONS Phone: 503-848-3838 Final Inspection Reg #: LIC 43124 This permit is issued s,lbject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 9.52-001-00 Issued By: ��GTt 1 .,�<.-- Permittee Signature: Call (503) u:9-4175 by 7:00 P.M. for inspections needed the next b6siAess day 08/07/2003 17:45 5033569002 GAROKEN PAGE 01 03 21 01 %sED 12:58 FAf 5o3 598 1930 CITY OF TIGARD �coa Mechanical Perini mile on rDaate, roceiycd: ertnCityof Tigard Q03lProecUappl.no Expire date Cryo/r,gor� Address- 13125 SW Hall Blvd,T�ttfWJjR) 7223 - Phone; (503) 639-4171 _t�� AP� Dnte issued: By: ; ' Receipt nr, Fax: (503) 598.1960 o�w o G0\go0v% Case IIIc no,; t' PYyrneni type. Land use approval: 1N Building permit no 16 2 family dwelling or accessory C1 Comm,:reial/induscrial Q Muld-family O Tenant inipro'.ernen. 0 Nevv construction ZAddific Witheration/replacement 0 Other 1 )co address Favl IL t,- 2\v� `N� %_ Indicate equipment qu n1hies in boxes below indicate the dollar l Bldg rio:; �5uttc no. _ value orap mechanical materials,equipment, labor,overhead. Tax MAP/tax JOIJACCOUM no.: profit, Value$ i L.ot: Block: Subdivision: _ •Sce checklist for imporlent application i4ormation attd I Project mune: jurisdiction's fee schedule for residential permit fee City/cotnty: 'j�,�. rt..1G S� �ZI —LI---� �-_ t 7escnpiton and—lo �Aiolnx of or on p erntses): _ ` ei 14ee(ea.)I Total Est date ofcom letiorymspeclion. - �, l s�� Description Res,oNy,Res.ools Tenant improvement or change of use I '�-- Is existing space heated or conduionrd O Ye; f" No Air cundsite plan requ Is existing space insulated?O Yes iuonl No o cx'( trecTj syuem MECHANICAL (0NiqAU101] J7157t e�compressora - "--� Businessname; ��1_ � � State boiler permit no.: HP Tuns BTU/11_ Address �i,1 it smo e amper ducssma c electors Cl ty: $tate iIP' Qp ea� tR pump(ali en require'e j Phan EU £ 3 ax -' E_-mail: nsta Urep ace urnac6bumr _ f CCD no.. — Including duetwotkJveni liner 0 Ycs D No �3ta4 _ mtallreplacdrelocale eaters-suspen City/metro I is no. f'j4 S`J _ will,cr floor mounted Name(please pnnt)' •\v -Weii-ifor appflinc4ot,er than rurnacc I Refrigeration; W 61 N tial Absorrtionuruts Name: uv��-,. Zbx� C:hille,s_ HP �_—T..- Cam�pr��cuvn � HF' I Address; .� nvfronrneau exFuust anrent at on: City ~ Stair. Appliance vent _ Pr hone. -- Fax E-mail rye-r e a—At --��'- ov s. ype res ,tc a azmat - - -- hood rue suppression system Name 1 _! , �� P c11[c_ ��y Brhaust fan with single duct(bath fans) Jv1a,ling address: T� 5�...e Exhaust system apartfiom heating or AC T" City _ Stele; ;;jp; ur piping an str ut on uo to out els Type LI'U NG __ 011 _ Fh nc rax' w Email• we, nnngeac, diuona�ovcr outlets rocessh p nplsc emaUcregclre ) — Name Number of outlets Address, _ -- 1 er sled app ance or equ pm •tt Decors(1ve fire lace _city - State: ':IP; - insert-t"y`e - Phone Fan --mall .....— oo stay lel stove A ficant's si nstu,CD_ - \ pate r o rr. Name (pnnt��p.nr�•� �_ � ham all runrdct,om,aeeepi cno4i two,please can)uno&eUen for men int rmauon. Permit fee. . ..... .. .....!, O v.se 0 MuterCa,rd Notice:This permit application 'Ainimutn fee..... . ..... .. iC,W1 sae euntxr 1__ rxpires ire permit is not obtained plan review(at 46) ! _ xi, within I80 days after It has been Siete surnharge IS%) _ i — ,Zncofca�al r m sno»eon crtau owd accepted as completo rorAe cadUdet sixnatesa Arrowm - W4617,atfi cc„ 08/07/2003 17:45 5F33569002 GAROKEN PAGE 02 Inc GAROKEN ENERGY CO . INC . S �97 ^_ X565 SW 102Nd AVE • 9EAVERTON. OR 97007 • TEL ISD3) 649-3930 • FAX (503) 3569002 • CG9# 431 2 3 i &va vaq 5i/-A I i �L� t 1 k i Pol-I TY OF T I Gw ^D __ ELECTRICAL PERMIT _ KK PERMIT#: ELC2003-00501 DEVELOPMENT SERVICES DATE ISSUED: 13/22/03 13125 SW Hall Blvd.,Tioard. OR 97.223 (503) 639-4171 PARCEL: 2S111DA-08800 SITE ADDRESS: 09018 SW GRAVENSTFIN LN ZONING: R-7 SUBDIVISION: APPLEWOOD PARK N0, 3 BLOCK: LOT : 081 JURISDICTION: TIG Projekt Description: VORE A/C RESIDENTIAL UNIT _ TEMP SRVCIFEEDERS_ MISCELLANEOUS 1000 SF OR LESS: 0 • 200 amp: �Y PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/SVC/ FDR: 601+amps - 1000 volts: MINOR.LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 • 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: _ PLAN REVIEW SECTION 10004 amp/volt: —4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC/FDR—225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: I f ILY ESTEGHLALIAN HEBERLF ELECTRIC ,n)18 SW GRAVENSTEIN 19680 SW NEUGEBAUER RD I Ic:ARU,OR 97223 HILLSBORO,OR 97123 F. e: 503-968.6401 Phone: 503-628-20'5 Reg #: SUP 3053S _ FEES 1 LIC 152342 ELE 34-100( Description Date Amount Required inspections i I I.11RM1 I I I ( Permit 8/22/03 $46.85 Elecfi Final F,1X)9"n`;tatr'fax 8/22/03 $3.75 Total $50.60 This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR.Specialty Codes and all other applicable laws. All work will be done In accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or 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 0 010 through OAR 952-001-7100. You may obtain copies of these rules or direct questions to OUNC at(503 246699 or 1-800- 2-2?44. Issu By: Permit Signature: OWNER INSTALLATION ONLY _ The installation is being made on property I own which is not intended too sale, lease, or rent. OWNER'S SIGNATURE: _ DATE: CONTRACTOR IN TALLATION ONLY SIGNATURE OF SUPR. ELEC'N: .,Va- _ DATE: LICENSE NO: -_- -_ - ��5 -fig __ Call 639-4175 by 7:00pm for an inspection the next business day 08/14/2003 08:35 5036283076 NEBERLE ELECTRIC PAGE 01 .If lC4L1:Csl1 PCil� M MEN 011 Received , ' Mcciricol onl�uy: Pernut Na.c��G� 3- 5VJ City of Tigard 1 PlannlneApprova Sign AUG 1 !� ��l�t� Dalc/By_--- --- - PcnnilNo 13125 SN/ Find blvd. _.--- I Ian Review other l igard, Oregon 97223 Dato/i3 : Perlrtit t4u. I'hrnte: 503-639-4171 Ii 1'r qp§I G Post•Revicw Land URc Intenlet www.ci.ligard.or. L G DivlSl' Vyle/13___�_—___ ____�_ _rase No.: ___ Contacl )uric soe PaRc 2 far 24-hour inspection Request: 503-639.4175 Name/Method: _ Sur Icurcntal Infonnatloa. 71'I'E'OORK f.'u '�yrnw l rid .;! 1'I: 17EV,llI�W( t'alll�'ehelkillthot;a I Service over 225 am licalth-care facilit New construction _ Demolition amps. y • Addition/alteratioll/re lecement Other: commercial Ilnsnidous location .._ r 1 : �,., { ❑Service over 320 amps-rating of ❑Building over 10,000 squnre feel, ATE1310101Y do 'UNS)< tUG. 'ldN Ail;; Ii;: 1&2 family dwellings four or more residential unita In _ 1 &2-Family dwelling Commercial/Indushial d System over 600 volts nominal one structure Huilding over three El Pm e stories ccdcrs,400 amps or more 8 Accessory Building _ Multi-Fuinfl Occupant load over 99 persons Manufactured structures or RV pork Lj L Mester Builder Other: Egress/lighting plan Other: _ JOB SITE INFORMATION Olid LOC TION Suhinit__sets of plans with ally or the abnve, The above arc not applItAble to tutr_uorary construction service. .rob site address:�6 5W C-1?4 Y€_N_. �1 — r��"'sCL1rnUL>L �— Suile Numbei-of Ins eclitins•ter rt 01114 J411011 1,41 _11r2ject Nilti1c: �1.J �Z Z - Ilcscrlptlnn --- _- Qly I rot(tn.) Total i New resldcntlpl•slnele or mnlr'-family per r C slreeUlAireetions to job site: � . r � dwelling unit.Includes atlnched Range. rService Included: 1000 ag.n,ar less 145 I5 _ _ 4 1'.aeh ndditional 500 sq,n.or InqimUlictcor 3.1.40 1 5uUdivieivn: Liergy,,residential _ 75A0 2 _ v 1.OI : _ mited anLimited cnemy.non reskkntinl 75.00 1 Tax I11A / arcel M linelr mmmrnclurcd home or rrrodular dwelling�. ,,.;Urscttlr'IxVty,V WOItIC,, , y service nod/or feeder 90.90 z Service%or(orders-Intlnllarinn, alteration or reloeallon: 200 amps or Icss 80.30 1 2 -- - - - 201 n to 40U nn�e _ __ _ 106,85 Z 401 un to 600 amps I00- 0 2 I'1{Ol'ER'TX,bWW tL 'I t: "';'I t','f n; , ,j 601 amps l0 11x10 anips -- 240.60 2 Over 1000 gimps or volts 454.65 2 d111C: ( � T A ki A ry Rccunneetonly - — --�- - 6615 42 Ad(1fC95: - g C �,A iK-0 Temporary services or feeders•Inmallm on, , alteration,or relocollon: city/stfltelL11�-r� �� aa, 9-7 ��y 200nm�r lc.,-- - 66,85 Fax! 201 mobs l0 400 nnius 1011130 2 AI'll'I,ICANT --z- CVN'1 !' k5 401 to 600 ams — _ 133.15 2 -- Branch rircuMv-new,niteraUon,of- Name: extemlon per panel: A(l�l'eS3: ��— A.Pee rot limuh circuit!wlih ritwinm of service of ferder fee,each branch circuit _City/Sla_te/7��: _- B.Pee for branch cimufu withoyi4urehose or 1)1�� service or feeder rke, rat ranch circuit 46.65 4 2 Photic. : Lath additional branch circuit 6,65 2 )i:•11111i1 Misc,(Servlce nr ferdc,not included)- r Each unip at irrigation chole 53.40 _ a I '' r,,:,i,,,i I ..r C N71RAC OR.hiajjlls { t tach ai�n or outline lighting___ _ 53,40 Job No: Signal eirctill(s)or it limited energy panel, —"� DU31operation,or exleusinn 1)C9S�VlIl11C: HEBI:RLE ELECT_RI C t I NC. pcwripliea. — -- Address: 1.9680 5W NEUGEF3AUER RD. Cil /Sltlle/Zi HILL BO R O r OR 9 71 2 3 v Each additional lnspecdon over file allowable in an of the above: _ Y ip Pei M tan ser r , 1 Maur 62.50 I'I Ione: 5 0 3-Ei 2 8-2 0 9 Fax: 03-628- 0 7 6 mvaal lion fee: ^_ CCA Lic,0: 152342 Lic, f!: 3 4-16 0 C .,, ;.,�,. , ,, •,, - �� 0111' Or qIf 6+a* i , �..,� J .r Supervising elcch-leint) Subtotra) signature required: ' Plan Review t "D of Permit hce $ - Print Name:J_e f f ry L. Lic,#: 30 3-9 State Surcharge 80N of fetnia Fee S -- 75- I I E B ER L IIEBERL TOTAL PERMIT PKK IS5T. Atilhot'i2 ,(, Nnflcc:7hlb permtl oppneatlan expires Ifo per"M t.riot nMalned wlNrin Signal Date, '�'[ '�3 180 days ager If has been eccepled at complor. - al'ee mrlbndnlnp) trt by'I I Comity flullding rndnttry Frrvice tlaard. (Please print name i�\nsta\permit Pomo\ElcrermiiApp.doe 01 3 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST p c� BUP Received -_-_ Date Requested o �1`/ AMPM ._ _ BUP �_Q/� Location U !-� *'�'► / Sul;.; MECO 4 ``� Contact Person ___. _ Ph PLM Contractor__ -- - _- - - -- Ph SWR BUILDING Tenant/Owner Footing __ -- - ___ SS- - 69 - I LA./ ELC Foundation Access: V Ftg Drain ELR Crawl Drain _ Slab Inspection Notes: ,��._ �� g SIT -_ Post& Beam Shear Anchors -- -- Ext Sheath/Shear _ Int Sheath/Shear Framing - --- -- - - - - Insulation Drywall Nailing - Firewall Fire Sprinkler - - - -- - ---- ------ ----- ------- Fire Alarm Susp'd Ceiling - -- - ----------- - - Roof Other: Final SS PART FAIL PLUMBING Post&Beam Under Slab Rough-In Water Service ---- - -- -- - Sanitary Sewer Rain Drains - - - -- - Catch Basin/Manhold Storrs Drain - -- Shower Pan Other - --- Final PASS PART FAIL - - M CHA ICNICN AL -- ---- -- ---- - ----- Post$Beam / Rough-In Gas Line Smoke Dampers -- , A -pART FAIL - -- -- f C0tt -- Servibe -`— Rough-In - - UG/Slab Low Voltage Fire Alarm — final- � Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL _ _ Plea/callreinspect n RE:_ _ -_ [� Unable to inspect-no access Fire Supply Line ' ^y%/rG ADA ., �Approach/Sidewalk Date � Inspector �'�� Ext j Other:_ Final DO NOT REMOVE this Inspection record hom the Job site. PASS PART FAIL