10888 SW KABLE STREET f, , Z 3�
� f r �
?0 0
_i, � - • EL 32rzs � �s
Caws �� � '1 lr✓a•�� �}Q
I�• ' ` 1 � �'i tuq� G=am--�e
KG,nc�r�„ 2 `.1t
S
f WSJ
��l.s e
12
O \\ �, G— S N 20.004
n ai
..rt
so' `'"eye FfE •0
aly4u,0 3-z
Pu°I IJP
r
C?
y \\ ~
:3 'S
?400
D ---s. 200,0
1 e e,& S
1aOO'
Z < N >
C N
mW :110
\ J oS
CA
0
Q� -- NEW HOUSE 10/3/01 MSG.
13 c c
SCtiLE DRAWING LOT 1 ERICKSON HEIGHTS
S.E. 1/4 SEC. 10 T.2S.t RAW.,W.v W.M.
CITY OF TIGARD
s fa•M �a�'�• �` - WASHINGTON COUNTY, OREGON
Ft z9z EL APRIL 19, 2001 Centerline Concepts Inc .
--A 7..5 FOOT LANDSCAPE EASEMENT SHALL EXIST N 8941 '53" E 60.00' DRAWN "Y: MPW CHECKED 8Y; WGDIII
SCALE 1 "=20' ACCOUNT 115 E
ALONG All STREET FRONTAGE ANDA 7.5 FOOT PUBLIC MAIL WWW. CCtEh4AIL®AOL. COM
U640 82nd Drive Gladstone, Oregon 97027
UTILITY EASEMENT SHALL EXIST BEHIND THAT, M: \NLI\1_1 ERICA( 503 650- 188 fax 503 650-0189
T � Ir 1111111 III ►IIII VIII 11111111 IIIIIIT � I1Trlf f.l.r.�_.i.�ar.._.T.-In�� f� 11Tif II � IIIi i11IIlf lfC1.11�f I ( � � r �-f.
11-1 1-1 i ( 1111 � 11r[ I-11VI� � 1ilr� � rCf � r( i 11 -1,
fJill 11111111111Ii 1
NOTICE: IF THE PRINT OR TYPE ON ANY I II
IMAGE IS NOT AS CLEAR AS THIS NOTICE, 1 3i 4 7 $ 10 11 I �•
IT IS DUE TO THE QUALITY OF THE No.38
ORIGINAL DOCUMENT
E 16i 8Z LZ 8Z QZ �Z EZ I ?; TZ OZ 6I 8I LT 91 9i � T ET ZT TT i 6 1111 IIII IIII 111. 1111 IIII 1111 II11 [1 _(1Jle ffl IIIl1111 IIIA I( 1 Ilfl (III ILII 111( 1111 ILII IIII IIII IIII IIII :1111 IIII Illi I,II IIII IIII IIIc IIII I�il 1111 la 1111.11 llll,llll�lll 11.1.1 11111 �1
i
aM. MIMIeiMM�Ael+rrwr. tit ?�1,�;,Y.ryk, �,�„k'6"''�''�7
x.,:... .._..,. ,„ ...:....:... ..�... ...._ _ . .,. ,. ,..... ...,..�.:.. _ ,. .,. id a,.u^$•H.t '.+c �:1t:A.',a... ., .v_;�N«YNM�d��r'°r,.v�r.,w�mw:�:::r�.z.�1;�bX«:'s..r C3nr�.A'ydd�.rE.� .S�C--p,. -
0
co
co
Go
SA
G
d
Q
F
CA
10888 SW Kable Street
MASTE
ERMIT
CITY OF TIGARD PERMIT
: MST2
PERMIT#: MSTZ001-00550
DEVELOPMENT SERVICES DATE ISSUED: 1/31/02
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 10888 SW KABLE ST 13ARCEL: 2S110DA-04000
SUBDIVISION: ERICKSON HEIGHTS ZONING: K-3,37
BLOCK: LOT:001 JURISDICTION: TIG
REMARKS: New SF detached,path 1
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS 0:WORK: NEW HEIGHT: 20 FIRST: 1 764 at BASEMENT: at LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,310 at GARAGE: 659 at FRONT: 20 PARKING SPACES: 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: al RIGHT: 17
VALUE: $302994 60
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 3 134 00 at REAR: 67
PLUMBING
SINKS: I WATER CLOSETS: 3 WASHING MACH: I LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS.
LAVATORIES: 5 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUBISHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN<100K: BOIL/CMP c SMP: VENT FANS: 5 CLOTHES DRYER: 1
,qg FURN>-100K: I UNIT HEATERS: HOODS- 1 OTHER UNITS: I
I.tAx INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS, I
ELECTRICAL
RESIDENTIAL UNIT _SERVICE FEEDER TEMP SRVCIFEEDEFS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS 1 0 200 amp: 0 200 amp: WISVC OR FDR: i PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 900SF: 6 201 400 amp: 201 400 amp: tat WIO SVC/FDR! 00 SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL BR CIR: SIGNAL(PANEL: IN PLANT:
MANU HMISVCIFDR: 601 1000 amp: 601+8mve-10001/: MINOR LABEL:
1000-amp/volt: PLAN REVIEW SECTION
Reconnect only: >*1 RES UNITS: SVCIFOR>•225 A.: >600 V NOMINAL: CLS AREAISPC OCC:
ELECTRICAL•RESTRICTED ENERGY
A.Sr RESIDENTIAL B.COMMERCIAL _
AUDIO 6 STEREO VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM: INTER jWPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANuSCAPEARRIG: PROTECTIVE SIGNL:
GARAGE OPENER,: CLOCK: INSTRUA:cNTATIONMEDICAL: OTHR:
HVAC. DATA/TEL.E COMM NURSE CALLS: TOTAL 0 SYSTEMS:
TOTAL FEES: $ 7,957.70
Owner: Contractor: This permit is subject to the regulations contained in the
RENAISSANCE CUSTOM HOMES RENAISSANCE CUSTOM HOMES Tigard Municipal Code,State of OR. Specialty Codes and
1672 SW WILLAMETTE FALLS DR 1672 WILLAMETTE FALLS DR all other applicable laws All work will be done in
WEST LINN,OR 97068 WEST LINN,OR 97068 accordance with approved plans. This permit will expire if
work is not started within 180 days of issuance,or if the
work is suspended for more than 180 days. ATTENTION:
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Rap N: LIC 049955 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 Control Insp 8, Slab Insp Crawl Drain/Backwater Plumb Top Out Exterior Sheathing Ins{ Rain drain Insp
Gradirg Inspectio, Wtr Proofing Bsm't Wa Footing/Foundation Dr; Electrical Service Low Voltage Water Line Insp
Sewer Inspection Post/Beam Structural Plm/undslab Insp Electrical Rough In Gas Line Insp Appr/Sdwlk Insp
Footing Insp PosUBeam Mechanica PLM/Underfloor Framing Insp Gas Fireplace Electrirl Final
Foundation Insp Underfloor insulation Mechanical Insp Shear Wall Insp Insulation Insp my
C11f,
ical Final
Issued BY t 11 �� —>�L� L Permittee Signature
Call (503) 639-4175 by 7:00 p.m. for an Inspection needed the next business day
CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: S00295
13125 SW Hall Blvd., Tigard,OR 97223 (503) 639-4171 DATE ISSUED: 11331/021/02
PARCEL: 2S110DA-04000
SITE ADDRESS; 10888 SW KABLE ST
SUBDIVISION: ERICKSON HEIGHTS ZONING: R-3.5
BLOCK: —LOT: 001 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: S1 NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF detached dwelling.
Owner: _ - FEES
RENAISSANCE CUSTOM HOMES Type By Date Amount Receipt
1672 SW WILLAMETTE FALLS DR
WEST LINN, OR 97068 PRMT CTR 1/31/02 $2,300.00 27200200000
INSP CTR 1/31/02 $35.00 27200200000
Phone: 557-8000 Total $2,335.00
Contractor:
Phone:
Reg#:
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 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 Sewer" Perm
Issued b r=r t /C (� L ((,[s Permittee Signature: 1--`�-
Call (503) 639-4175 by 7:00 P.M. for an Inspection needed the next business da -- -
i
Building Permit Application
Gate received: l 1 .7 (2 i Permit no.;
City of Tigard —
Project/appl.no.: r3xpire date:
Cityol figard Address: 13125 SW Hall Blvd.Tigard,OR 97223
Phone: (503) 639-4171 U `j Date issued: 13y:� -( Receipt no.:
Fut: (503) 598-1960 J�r2(/ Case file no.: Payment type:
Land use approval: _ _ 1&2 family:simple Complex: v C-
C`
we]0 11 go 113 11
)(I & 2 family dwelling or ack-essory U Commercial/industrial U Multi-family XNew construction U Demolition
U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U Other:
Job address: if iq /,/e I Bldg.no.: Suite no.: L
Lot: _L_—" Blo k: Subdivision: C_p�rcI_f t, Tax map/tax lot/account no.:
Project name: E.-te/�swr ��� �► —_ _ i �Gl --3
Description and location of work on premises/special conditions r%N9�P
t
Mull
Name: _�gN
Mailing address: 1672 s(✓ h/r//ire a /ea/s 0 , 1 &2 fondly dwelling:
City: l,/ .:?.t State: Zll': Valuation of work........................................ $.
Phone:Spy �o>s0 Fix:So�Ls6it: Email: No.of hedroorrrsJbaths................................. -- Z• s
Owner's representative: T,,R�y a'-C'C' tl 'Total number of floors................................. ?
Phone: f, a Fax: E-mail: New dwelling area(s ft. 3 'S Y
Cr g y. ) ......................... �—L -
Garage/carport area(sq. ft.)......................... _ �f
Marne: au.�i� Coveted porch area(sq. ft.) .........................
Mailing address: Deck area(sq. ft.)
City: State: I_IP: Other structure area(sq. ft.)......................... q
Phone: Fax: h.-mail: CommerclaUlndustrial/multI-family:
Valuation of work........................I......I........ _J
Business name: Jaffe Existing bldg.area(sq. ft.) ................. .......
— --- ... �^-- New hldp ama(sq. ft.)............ ......
Address: Number of stones.........................
City: State: 7_.IP: ... ........ -- --
I l.ype of construction................ ......... ......
Phone: _ Fax: E-mail: —`---�
-- — Occupancy group(s): t' Existin
CCB no.: 97597_ e N Z m'Z —__ New:
City/metro lic.no.: a Z 06 Notice:All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
Name: , / "p, �4,�;r� provisions of ORS 701 and may he required to be licensed in the
Address. 1 ) st t t <r z Jurisdiction where work is being performed. If the applicant is
City: State: l.II': exempt from licensing,the following reason applies:
Contact person: I Plan no.: '--
Phone: , a" ' ;2,j5 -, Fax: I E-mail: ---�— --` --
Name /brv�l //;t,, , ,, Contact person: Fees due upon application ........................... S
Address: y2 y2 , Date received:
City: ,f, , State: 7r ZTP: Amount received ......................................... $
Phone: _; tr 7 3 ;•/o Fax: E-frail: i_ — Please refer to fee schedule.-
I hereby certify I have read and examined this application and the NM all iurisdictions accept credit card% please rail jurisdiction rrn more information
attached checklist. All provisions of laws and ordinanr;:s governing this U Visa U MasterCard
work will be complied with,whether specified herein or not. Credit card numberExpires
—
Authorized signature: ��lt..�. art': - _ Name of cardholders eP
aawn nn credii card
Print name: _ 1114f �— —� cardholdersi�nuure —�� Amaonty
Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted is complete. W-4613 tWWOM)
One- and Two-Caraily Dwelling
Building Permit Application Checklist Reference no,:
City nJ l igurd Associated permits:
C
City of Tigard U Electrical U Plumbing U Mechanical
Address: 13125 SW Nall Blvd,Tigard,OR 97223 U Other;
Phone: (503) 639-4171 -
Fax: (503) 598-196��0IIENIS ARE RFQUIRF1) FOR PLAN REVIEW Yes No NiX-N
����!►
tlaiiY`{►_
I Land use actions completed. 5ce jurisdiction criteria for concurrent revic
2 Zoning.Flood plain,solar balance points,seismic soils designation,historic district.etc
3 Verification of approved platflot.
--- - - I
- ---- -
4 IF
district_ approval required.
-- - - -
5 Septic system permit or authorization for remodel.Existing system capacity
6 ,Sewer permit.
7 Water district approval.
8 Soils report.Must carry original applicable stamp and signature on file or with application. _
9 Erosion control U pian U permit required. Include drainage-way protection,silt fence design and location of
catch-basin protection,ctc. _
10 3 Complete sets of legible plans.Must be drawn to scale,showing conformance to applicable local and state
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between pian location and details. Plan review cannot he completed
if copyright violations exist.
11 Site/plot plan drawn to scale.The plan must show lot and building setback dimensions:property comer elevations(if
there is more 1 Lan a 4-fi.elevation d.ffere:ntial,plan must show contour lines at 2-ft.intervals);location of easements and
driveway;footprint of structure(including decks);location of welis/sepdc systems;utility locations;direction indicator,lot
arca;buildini;coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage.
12 Foundatioti plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent
size and locetion. _
I-�' )or plans.Snow all dimensions,room identification,window size,location of smoke detectors,water heater,
turnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross sections)and details.Show all framing-member sizes and spacing such as floor beams,head"rs,joists,sub-floor,
wall construction,roof construction.More dtan one cross section may be required to clearly portray(onstruction.Show
details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings anc foundation,stairs,
fireplace construction, thermal insulation,etc.
15 Elevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels.
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references a., acceptable.
16 Wall bracing(prescriptive path)ant!/or lateral analysis plans.Must indicate details and locations;for
nun---prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing.Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing
locations,Show attic ventilation. _
18 Basement and retaining walla.Provide cross sections and details showing placement of rebar. For engineered
systems,see item 22,"Engineer's calculations."
19 Beam calculations.Provide two sets of calculations using current code design values for all beams and multiple joists
over 10 feet long and/or any beam/joist tarrying a non-uniform load. J
20 Manufactured floor/roof truss design details. _
21 Energy Code compliance.identify the prescriptive path or provide calculations.A gas-piping schematic is required
for four or more appliances. _
22 Engineer's calculations.When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or
architect licensed in Oregon and shall be Shown to be applicable to the project under review.
23 Five(5)site plans are required for item I 1 above. Site plans must be 8-1/2"x 1 I"or I I"x 17".
24 Two(2)sets each are required for Items I6, 19,20&22 ab•lve.
25 Building plans shall not contain red lines or tape-ons.
26 "Reversed"building plans must meet criteria outlined in die Permit 8c System Development Fees document.
27 No"mirrored"building plans will be accepted.
28 "Drawn to scale indicates standard architect or engineer scale. _
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use o-ly. 440-4614(doaIcoM)
Plumbing Permit Application
Date received: Permit no.:
City of Tigard Sewer perrrnt no.: Build;ng permit no.:
Address 11125 SW Ifall BI,d,Tigard, OR 97223 —
(irt of Tigard Phone: (503) 639-4171 I'r6tcctlappa.no.:_ Expire date: _ T
Fax: (503) 598-1960 Date Issued: By: Receipt no.
Land use approval: Case file no.: Payment type:
I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
New construction U Add ition/alteration/re placernenI U Food service U Other-
JOB
Job address: —Description Qty. Fee(ea.) Total
Bldg. n(,.-- Suite no.; New 1-and 2-fam0y dwellings only:
(includes 100 ft.for each utlllly counectIon)
Tax map/lax IuUaccount no,:,- ___ SFR(1)bath
Lot: _ Block: Subdivision: Er. /�so.� />/�r's/rSFR(2)hath ---�
Project name: /=,�/ ,•,,, , /fir. its — SFR (3)hath
City/county: �ic� �„�n of s "L.I P: Each additional hath/kitchen
Description and location of work on premises:---I All �,, Site utilitles:
/4J7nCatch basin/area drain
Esi.(late of completion/inspection: Drywells/leach line/trench drain
Footing drain(no. lin. ft.)
PLUMBING CON I 11ACI OltManufactured home utilities
Business name: :: ftt .�/< /�/, , 4,01Y Manholes
Address: 77,; 1L_- fj/, 4t(., Rain drain connector
City: /5,,,:,r,->•,., State: t'+ I ZIP: 9 7 005' Sanitary sewer(no. lin. ft.)
i I ax E-mail: Storm sewer(no. lin. It.)
Phone: i�'�-bl y-fr Water service(no. lin. It.)
CCB no.: 7.9l 6 Plumb.bus.reg.no: 2rD_ 5 �' fixhtre or Rem:
City/metro lic.no.: Z j,2(/ Absorption valve
Contractor's representative signature: `�' Back flow preventer
Print name: �rfe /�� Date: Backwater valve _
Ke No IRI Basins/lavatory —
Name: jay to Clothes washer
Dishwasher
Address: pnni ing I'ountain(s)
City: State: IziP: Ejectors/sump _
Phone: I Fax: I E-mail: Expansion tank _
Fixture/sewer cap
Name(print): ��,,rte Floor drains/Boor sinks/hub _
p /F'���r,.rroNr ;,, a Garbage disposal _
Mailing address: (6 72 —Hose bibb
City: __]State: ^R 1t11`: )7 _ ice maker
Phone: I E-mail: Interceptor/grease trap
Owncr instillation/residential maintenance only: The actual installation Primer(s)
will he(rade by me or the maintenance and repair made by my regular Roof drain(commercial)
employee on the property I own as per ORS Chapter 447. —sink Fs).basin(s),lays(s)
0%t ner's signature: Date: Sump
Tubs/shower/shower pan
Urinal --"N,nw: ___-- — Water closet �.
Address: _ Water heater
Citv; —� State: ZIP: Other:
Phone: — -- I f';r ------� '1'otal
Not nil jurisdictions acce t ctrdit cwds lease call iunsdiction for more mfomation MIItImURI fee................$ _
i P v Notice:albs permit application Plan review(at __ %n) $
U visa O MasterCard expires if a permit is not obtained
Credit card number within 180 days afler it has been State surcharge(8%)....$
accepted as _
Fspires complete. TOTAL ...
Name or cardholder m shown on credit curd
--
_ _ S
Cardholder miltnature Amount 4461616(60WOM)
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2-family dwellings only:
FIXTURE_S (individual) _ QTY ea AMOUNT (includes all plumbing fixtures in PRICE TOTAL
Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT
for each utility_connagtion _—
Lavatory 16.60_ 1 bath_ $249.20
Tub or Tub/Shower Comb 16.60 T rvo 2�bath —_ $350.00
-- 16 60 Three(3)bath $399.00
Shower Only _
Water Closet _ 1666 SUBTOTAL
Urinal 16.60 8%STATE SURCHARGE
6ishwasher16.60 PLAN REVIEW 25%OF SUBTOTAL
TOTAL —_-_
Garbage Disposal 16.60 -- —�
Laundry Tray �— 16.60
Washing Mychine 16.60
Floor Drain/Floor Sink 2" - 16.60-16
6.60 PLEASE COMPLETE:
3^ 16.60
4 16.60 —_
Quantity b r Work Performed
Water Heater O conversion O like kind 1660 Fixture Type: New Moved Replaced Removed/
Gas piping requires a separate mechanical Capped
permit. Sink
MFG Home New Water Service 46.40
46A0 Lavatory _
MFG Home New San/Storm Sewer —_ Tub or Tub/Shower
Hose B!ts 1660 Combination
Roof Drain, 16.60 Shower Only _
16.60 Water Closet
prinking Fountain Urinal
Other Fixtures ISpecify) 1660 Dishwasher —
Garba-ge Dis osal _ _
Laundry Room Tray
- WashingMachine --
Floor Drain/Sink. 2"
Sewer•151 100' 55.00 __ 3•'
Sewer-each additional 100' 46 40 —_ 4•,
5.5 00 Water Heater
Water Service-1st 100' _— Other Fixtures
Water Service-each additional 200' 46.40 S ecify)
Storm 8 Rain Drain-1st 100' 55.00 _
:,form 8 Roin Drain-each arlrlitinnal 100' 46.49
Commercial Back Flow Prevention Device 46.40
Residential Backflow Prevention Device' 27.55 _—
Catch Dasln —7-6-60 —-------
Inspection of Existing Plumbing or Specially 72.50 COMMENTS REGARDING ABOVE:
Requested Inspections et/hr
Rain Drain,single family dwelling 65.25
Grease Traps 16.60
—
Isometric or riser diagram Is required if _
Quantity Total Is >9 _
'SUBTOTAL
8%STATE SURCHARGE
"PL.AN REVIEW 25%OF SUBTOTAL
Required only if fixture total is>9
TOTAL --J
'Minimum permit fee Is$72.50+8%state surcharge,except Residential Bac"ow
Prevention Device.Hhich is$36 23+8%stale surcharge
**All New Commercial Buildings require plans with isometric or i.ier diagram and
plan review
ldsts\forms\plm-fet:3 doC 10/10/00
Mechanical Permit Application
Dote received: Pet mit no.:
City of Tigard Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW hall Blvd,T;gard,OR 97223 Date issued: — fly: Receipt no,:
Phone: (503) 639-4171 ----
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: Building permit no
I &? Gitmih dwelling or accessory U Commercial/industnal U Multi-family U Tenant improvement
New construction U Addition/alteration/replacement U(hher:
OB SITE INFORMATION COMMERCIAL �Al
Job address: Indiatte equipment quantifies in boxes below. Indicate file dollar
Bldg,no.: Suite no.: value of all mechanical materials,equipment, labor,overhead,
Tax map/tax lot/account no.: profit. Value$
Lot: I I Block: Subuivlsirin: �i "See checklist for important application information and
Project name: „t!� / �n _ jurisdiction's fee schedule for residential permit fee.
City/county:'r-�; ./1�n,1.,. ,, "1_I P:
Description and location of work on premises:_3:r�/� Ase.,/(_ t
rr e/r rf7et.+ t-v(ea.)
Total
Est.date of completion/inspection: Desert on Qty. Res.only Res.only
Tenant improvement or change of use:
Is existing space heated or conditioned'?U Yes U No Air handling unit ___CFM_
Air conditioning(site plan required)
Is existing space insulated?U Ye- U No A teration of existing HVAC system
oiler/compressors
State boiler permit no.:
Business name:
�•t��"'f HP Tons--BTU/II
Address: 2 7 Fire/smoke dampers/ uct smo a detectors , w
City: //+/,lf State: ol� I LIP: 7 7/7 3cfi ct pu-inp(site plan required)
Phone:f'�3 .;7�Z JZ I Fax: _ E-mail: Installfreplace furnace/burner B /
Including ductwork/vent liner U Yes U No
CCB no.: <<._,7 Tf rrQ_ Vill oil Instep aT ceTrelocateheaters-suspende ,
City/metro lic.no.. >I,��_�_ %.II,or floor mounted _
Name( lease print): (�-, /„ Vent I rr a )lance other than furnace
e gerat on:
Absorption units BTUAI _
Name: y�,,<,r Chillers _ _ lip
('nrtt tessors HP
Address:
h`n ronmental exhaust and ventilation:
City: State: ZIP: I Appliancevent
Phone: Fax: I: mail Dryercx aunt
floods,Type l/I 11r, kitchen/--- /iazmat
�f u hood fire suppression system
Name: /r r.ta ssp.+r r {s���t / �^.s Exhaust fan with single duct(hath fans) —
Mailine•ddress: /� J j S'H/ (,i,./ ,� F.b iii— 'oeaust systema part from ontre (ii or outlet-s)
Cit •— State: �,Q 7.IP: — ,Foe.piping—anti t itr ut on(up n; out els)
Y i,/r s t �,'�+ , Hype: LPC NU _ Oil --
Phone:yJ?SS'f%j CC, Fax: j i1,;(,S d/G n1:ul: Fuel piptrip,.ach addit:final over 4 outlets
rocess p.pfag(schemati-required) _
Narne: Number of outlets —
_ ter limed app-Hance or equipment:
Address: _ Decorative fireplace
City: State: Zll': _ Insert-type
Phone: Fax: 1: mail oo stove pellet stove —
Other
Applicant's signature: / �"' _i.- Date: (.)t er:
Name (print): �,,�: ,,AJ —� —
Not all jurisdictions accept credit cards,please call jurisdiction for mote informationPermit fee.....................
U visa U MasterCard N-dice: ]'his permit application Minimum fee-..............$
—1�� expires if a permit is not obtained Plan review(at -_ %) $
credit recd numhec _ — within 180 days oiler it has been
_ Expires State surcharge(8%) ....$
Naax of cardholder as shown on credit card accepted as complete. 1,
— Cardholder signature Amount 4444617(60WOM)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION:_ PERMIT FEE: rTabcri1A : Price Total
$1.00 to$5,0_0_0.00 _ Minimum fee$72.50 l Table 1A Mechanical Code Qty
(Ea) Amt
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU
$1.52 for each additional$100.00 or including ducts&vents 14 00
fraction thereof,to and including 2) Furnace 100,000 BTU+
$10,000.00. including ducts&vents _ 17 40
-_---_- -- _ _. _-_-- - 3) Floor Furnace
$10,001-.00 to$2.x,000.00 $148.50 for the first$10,000 00 and 14.00
$1.54 for each additional$100.00 or includin vent _
fraction thereof,to and including 4) Suspended heater,wall healer
_ _ $25,000.0_0. or Floor mounted heater 14.00
$25,001_.00 to$50_,000_.00 $379.50 for the first$25,000.00 and 5) Vent no:�-ciuded in appliance permit
$1.45 for each additional$100.00 or _ 6.80 ---
fraction thereof,to and including 6) Repair units
$50,000.00. 12 15
$50,001.00 and up $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air
$1.20 for each additional$100.00;)r For Items 7-11,see or Pump Cord
fraction thereof. footnotes below. Comp
Minimum Permit Fee$72.50 SUBTOTAL: $ f 7)<3HP;absorb unit
to 100K BTU 1400
-- --- -- - ------ 8)3-15 HP;absorb y -
8%State Surcharge a nit 100k to 500k BTU 2560
25%Plar,Review Fee(of subtotal) a -_ U)155-1 HP;absorb ff20
Required for Ar.'_commercial permits only unit.5-1 rnil BTUTOTAL COMMERCIAL PERMIT FEE: S ni 301.7 mi absorb unit 1-1.75 mil 8TU 11)>50HP;absorbunit>1.75 mil BTU
ASSUMED VALUATIONS PER APPLIANCE: 12)Air handling unit to 10,000 CFM 10.00
Valise Total 13)Air handling unit 10,000 CFM+
Uescri ition_� r] _ _ Ea Amount - _ 17.20
Furnace to 100,000 BTU,including-t---!Y 955 a 14)Non-portable evaporate cooler
ducts&venLa _ 1000 _
Furnace> 100,000 BTU including 1,17015)Vent fan connected to a single duct
ducts&vents _ _ __ 6.80 _
Floor furnaceinGudin vg ent _ _ 955 16)Ventilation system not included in
Suspended heater,wall heater or 955 appliance permit 1000
floor mounted heater 17)Hood served by m^:hanlcal exhaust
Vent not included in applicance 445 _ 1000
ermit_.�- -- - H05 - 18)Domestic incinerators 17 a0
fair units e� _ _
3 hp;absorb.unit, v� 955 19)Commercial or industrial type incinerator
to 100k BTU __ 6995 _
3-15 hp;absorb.unit, 1,700 20)Other units,including wood stoves
101k to_500k BTU _ 1000
15-30 hp;absorb unit,501k to 1 2,310 21)Gas piping one to four outlets
mil.BTU _ _ _ G.40
30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each)
1-1.75 mil.BTU 1 00
>50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $
>1.7_5 mil.BTU _
Air handling unit to 10,000 cfm 656 _ 8%State Surcharge $
Air h3rdling unit>10,000 cfm 1,170 _
Non_:portable evaporate cooler - 656 TOTAL RESIDENTIAL PERMIT FEE: �I
Vent fan connected to a single duct i 446 _
Vent system not Included in 656
appliance permit
Hood served by mechaniwi exhaust ^656 Other 1 Inspections I peed lonss oiii and Fees:
rnrn
_ - 1 17� outside of normal business hours(mium charge-two hours)
Domestic incinerator $72 50 per hour
Commercial or industrial incinerator 4 4,590 2 Inspections for which no fee is specifically indicated ( ..nimum charge-holt hour)
Other unit,including wood stoves, 656 $72 50 per hour
inserts,etc. 3 Additional plan review required by changes,additions or revisions to plans(minimum
Gas piping 1-4 outlets - 360 charge-one-half hour)$72 50 per hour
Each additional outlet _. 63 Stale Contractor Boller Certification required for units>200k BTU.
TOTAL COMMERCIAL "Pesldential A/C requires site plan showing placement of unit.
VALUATION:- All New Commercial Buildings require 2 sets of plans.
i:\dsts\formsUnech-fees.doc 08/29/01
Electrical Permit Application
Date received: F mit no.:
City of Tigard Project/appl.no.: Expire date: _
City of Tigard Address: 13125 SW Hull Blvd,Tigard,OR 97223 Date issued: By: Rec.1ptno.:
Phone: (503) 639-4171 -
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
LWAIJ
& 2 family dwelling or accessory U Cotninercial/industrial U Multi-family J Tenant improvement
New construction U Add ition/a4r rat ion/re place i v1 U f)lher: U Partial
11 SITE INFORMATION
Job address: 0$ r l4 e S t. I I I d ITax map/tax lot/account no.:
Lot: t I Block: Subdivision:
Pro'
ec :scription and location of work on premises:
Estimated date ol'completion/inspection:
Job no: Fcc I NI:rs
/ —--- Description t)ty. (ea.) T'%cal no.insp
Business name: C/pC Ti,G New residential-shiRk or multi-farnliv leer
Address: �n ,�� Z dwelling unit.Includes attached garage.
City: L/ , State: CtQ I ZIP: ) 70/5' Seniceincluded:
Phone:y<i3 2 Fax: E-mail: lobo sq n or less — -� --
SlUr'f
CCB no.: �; ��ye/ Elec.bus.lic.no: j /?iT Each additional SW sq.ft.or portion thereof
Limited energy,residential _ =
City/mctro lic.no.: Z 3 _ Limited energy,non-residential
jEach manufactured home or modular dwelling
�' —
Signature of supervising electrician(required) Date - Service and/or feeder -
Sup rlmt mune(print : C,.-I, i, Licensenn
�/ Ys Servlcesorfeedera-Installallon,
alteration or relocation:
PROPFRTY
200 amps or less
201 amps to 400 amps --
Naftte(print): r,1 c1 ' nc�+ UaS �a+t __^'�'
401 amps to 6(x1 amps -
Mailing address: 16 71 r?41 `_ � 601 amps to IOwl amps 2
City: Li,r,t State:,*1 ZIP: 17 CSf' over 1 W0 amps or volts 2
Phone: f., S �l9e�jhax: sti6S / O I Iltall: Reconnectonl 1
owner installation:The installation is being made on property I own Temporary services ur feeders-
which is not intended for sale,lease,rent,or exchange according to Installation,&Iteration,or relocation:
Yi(J amps or less
ORS 447,455,479,670,701. 201 amps to 400 amps 2
Owner's si nature: Date: _ 401 to 600 ams '-
Branch circuits-new,alteration,
or extension per panel:
7A�dd,.,,,
- - - A f ce for branch circuits with purchase of
service or feeder fee,each branch circuit 2
-�"'- ---- `�— r H Fee for branch circuits••,ithnut purchase
-- ------ -- of service or feeder fee,first branch circuit: 2
Ivhnnc I ax: E mail- Each additional branch circuit - -
PLAN REIVIEW(Please check all flint apply) Mlsc.(Service or feeder not Included):
U Service over 225 amps-connnercinl U Health-care facility Each pump or irrigation circle '-
U Service over 320 amps-rating of 1&2 U Har-ardouslocation Each sign or outline lighting
famiiydwellings U Building over 10,000 square legit four or Signal citcuit(s)or a limited energy panel.
USystem over 6Wvolts nominal more residential units in one structure alteration.or extension* _ '-
U Building over three stories U Feeders,400 amps or mote *Description: _ _ --
U Occupant load over 99 persons U Manufactured structures or RV park Each additional Inspection over the allowable In any of the above:
❑Egress/lighungplan U Other .--- — t'ennipecuon
Submit_sets of plans with any of the above. Investigation fee
'Ilse above are not applicable to temporary construction service. outer
---- a .....................$
Not all jartidicnolL'accept credit cards,pleme call juNrdiction for snore mformalion Notice:thisPermit fee permit application —'— -"
U Visa U MastetCard expire,if a permit is no!obtained Plan review(al _, %) $
Credit card number ___—_ / / within 180 days after it has been State.surcharge(8%) ....$
Expires accepted as complete. TOTAL .......................$
- Nnme of cardholder es shown on credit card
S
Cudholdel signeturo _ Amount 4404615 WXYC'OM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
--- TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
-� ....... 575,00
Complete Fee schedule Below: Restricted EnereY Fee.......................
.......................
NumUer of Inspections per permit alloyed) (FOR ALL SYSTEMS)
Service included: Items Cost Total y Check Type of Wcrl,Involved:
Residential-per unit X
1000 sq ft c�less $145 15 4 Audio and Stereo Systems'
Each additional 500 sy it or
portion thereof $33.401 Burglar Alarm
Limited Energy - $7500
Each Manul'd Home or Modular Garage Door Opener'
Dwelling Service or Feeder $9090 2
Services or Feeders '`Vf Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less $8030 2
201 amps to 400 amps $10685 2 Vacuum Systems*
401 amps to 600 ams $160 60
P 2 / -
601 amps to 1000 amps _ $240 60 2 Other_- �G e. ,__-,r_v'
Over 1000 amps or volts $45465 _ 2
Reconnect only _ $66.85 2
Temporary Services or Fenders _ TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Installation,alteraticn or relo ation Fee for each system.......................................................... $75,00
200 amps or less _ $66 65 2 (SEE OAR 918-260-260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 _ 2 Check,Type of Work Involved:
Over 600 amps to 1000 volts,
see"b"above. Audio and Stereo Systems
Branch Circuits LJ Boiler Controls
New,alteration or extension per panel
a)1 he fee for branch circuits �^
with purchase of service or u Clock Systems
feeder fee.
Each bra;lch circuit - $6.65 2 F-] Data Telecommunication Installation
b)1 he fee for branch circuits
without purchase of service F__] Fire Alarm Installation
or feeder fee.
First branch circuit $46.P5
Each additional bra ich circuit $665 HVAC
Miscellaneous Instrumentation
(Service or feeder not included)
Each pump or irrigation circle _ $5340 _ Intercom and Paging Systems
Each sign or outline lighting $5340 ^
Signal circuit(s)or a limited energy
panel,alteration or extension Y_ $75.00 _ El Landscape Irrigation Control'
Minor Labels(10) $125.00
Medical
Each additional inspection over `� ❑
the allowable In any of the above
Per inspection $62 50 ❑ Nurse Calls
Per hour _ $62.50
In Plant $73.75 Outdoor Landscape Lighting`
Fees: D Protective Signaling
Enter total of above fees $ „ _ Other
V,.State Surcharge $ Number of Systerns
25%Plan Review Fee
See"Plan Review"section cm $ No licenses are required Licenses are required for all other installations
frau of application
Fees:
Total Balance Due $
-- Enter total of above fees
Trust Account# _ 8%State surcharge
Total Balance Due S-� ---
i 1dsts\forms\etc-tees doc 06/07/01
SEE
3 %,h1VIM
ROLL# 23
FOR
LARGE
DOCUMEN ' l
CITY OF TIGARD 24-Flour
BUILDINGS - Inspection Line: (503)639.4175
INSPECTION DIVISION Business Line: (503)639-4171 MST �._S��
/ BUP
Received _.__- --Date Requ step __._!�� AM —� PM BUP
Location Suite --- MEC ---- --
Contact Person _-- — - -- _ Ph 1– ----) ----- PLM --
Contractor-- ------- — Ph(_ } SWR
BUILDING Tenant/Owner _—_ _ _- _ ELC
Footing -
Foundation '�- ELC
Drain
Ftq
Access: ELR
Crawl Drain _ ------Slab Inspection Inspection Notes: 4 SIT
Post& Beam
Shear Anchors -- -- -
Ext Sheath/Shear
Int Sheath/Shear -- -'-
Framing L ..�3e- -
Insulation i T—
Drywall Nailing - --! =cZ���r2�n��1 /L-.�Luc.a
Firewall /
Fire Sprinkler =- t7 H r`i�u�� o� -S�l�r=�s:���_ �. >T Gu�4u•�r� = r4
Fire Alarm
Susp'd Ceiling -------
Root
- ---Roof
Other: ----- -- --- ... --- -- - --- ----
rAS
PART FAIL
MBI --
Post& Beam
Under Slab ---- - - ---- -- - -. -- -- --
Rough-In
Water Service -------___.-._
Sanitary Sewer
Rain Drains --- _�._ - - - - - ---- -- - - -- ---- -- - -��
Catch Basin/Manhole
Storm Drain
Shower Pan
Other: -------- - - - --------- �. --- - - --- -
Final
PASS PART FAIL
MECHANICAL
Post& Beam
Rough-In
Gas Line
Smoke Dampers - - - -- - - -- ---- - -- -- --- ------
'5-na
S PART FAIL - - ----- -- -_ - — - - -- - _ ---ELTCTRICAL
Service -------- ---- --
Rough-In
UG/Slab - --- ------
Low Voltage
Fire Alarm
Final Remspection tee of$ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
PASS PART FAIL
SITE ] Please call for reinspection RE:___ Unable to inspect-no access
Firp Supply Line
ADA
Approach/Sidewalk Date Inspector -----------__ -- _ – _ _.Ext-
Other:
xt-Other:
Final DO WOT !REMOVE this inspection record from the Job site.
PASS PART FAIL
:9
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)$39-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
i BUP
Received -- �, Dattee Pequested___1 d� _ AM_ MI BUP
Location .__...__ --��r� a n-L�-- G � Suite LIft ) MEC -- — _
Contact Person __--- _ —�� ==- Ph ) c��� ��� PLM ---- —__
Contractor __ _ Ph(__.—�) SWR
BUILDING Tenant/Owner _ ELC
Footing ELC ------ ___
Foundation Access: --
Fig Drain FLR
Crawl Drain
Slab Inspection Notes: SIT
Post& Beam
Shear Anchors - -- --------
Ext Sheath/Shear
Int Sheath/Shear -�-
Framing "(( 1'� ✓�.___ -_� ,._
Insulation
Drywall Nailing _-
Firewall
Fire Sprinkler
f=ire Alarm , ! S
Susp'd Ceil:ng - n =:d J-,A- _-- .31
PASS PART AIL
i�LUMBING
Post 8 Beam /
Under Slab
Hough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole _ !'
Storm Drain
Shower Oan -7 %
Other: 1=%� � '� J•�''�` '"" -- _...--- - ----
Final
PASS PART FAIL --
MECHANICAL1.�--
Post& Beam —-- �`-
Rough-In
Gas Line
� ke Dampers
S
ina5 PART FAIL
TRICAL In !` �M,� �� 7
k2L -�
Service
Rough In
UG/Slab
Low Voltage -
Fire Alarm ---- -- - --
Final
Rei
PASS PART FAIL_ r� nspection fee of$_- required before next inspection. Pay at City 'Aall, 13125 SW Hall Blvd.
L] Please call tot reinspection RE _ _ -_ L Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date -' _� � �Y� inspector - �/ - - -- -- Ext_ ---
no-el. - —
Final DO NOT REMOVE this Inspection record from the job site.
r PASS PART FAIL
� e►
4 ►
l \1A ►
!_
x
t �
o o O O
ISI ►
►
,� �; G o ti ►
o � -Ln
71
Q C� ►
t-4 � I poll
� en
cl
A
►
C r ►
r1 U `� ►
op
w 01 00.►
►
44
, "' Q ►
44 p w 10-
pop.
Q O w ►
rvvvl'vvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvv\
Friday, October 11, 2002 CITY OF TIGARD
Steve HuntOREGON7
Renaissance: Properties
1672 SW Willamew; Falls Dr,
West Linn, OR 97068
RE 10888 SW Kable St., Tigard, OR 97223, Lot fill Erickson Ileights.
Dear Steve:
Congratulations on your correcting the violations regarding the retaining walls at the
above property.
This confirms my statements to you on-site today:
■ The corrections that you have made to the retaining walls at 10888 SW Kahle
(reducing the height of the lower wall where it had exceeded 4 ft. and rebuilding the
upper wall as two walls, one 4 ft. or less and a new 2 -3 ft. wall with a level 6 to 8
ft. setback) has brought that property into compliance by making each of the walls
exempt from permit requirements. Well done.
■ We have lifted the "hold" on this property. You may schedule final inspection
under per r
ST2001-00550 and rest a Certificate of Occupancy.
Regarding Lots #-2 through 10, the violations noted in my letter of September 24"' still
stand as does the timeline set firth in that letter. For your information, the thirty (30)
day period that we allowed for removal of the violations or the submission of complete
plans and permit applications will expire at close of business on Monday, October 28,
2002. That timeline was designed to provide ample and generous opportunity for
geotechnical investigation and the development of plans. With winter weather soon to
arrive there will be no extension of that deadline.
I appreciate your cooperation in taking care of the situation on Lot #1 and I look
forward to lear 'ng of your plans to resolve the issues on the other lots. Please let me
know if yo ave any que: on or if I can be of assistance.
her 5 fie ds
C
Building Codes :iforcetnent Officer
cc: Robert Wood, Ga v Lampella, Hap Watkins, Brian Rager, Gary Firestone
13125 SW Hall Blvd., Tigard, OR 97223(503)639-4171 TDD(.503)684-21;1 -
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Received _ _...____._./______—. ate Requested_�—l_1—.�Z-�' AM_____—_ PM _ BUP
Location -_-- --1�_ V';_ - Suite—_- --_ MEC
Contact Person _____— Ph _ I- 310 -2-- PLM
Contractor ---- ----- ---- -- ----.. Ph(—) _ SWR - ----- -
BUILDING TenanUOwner _--__-__ __�__—�__.—_� __ ELC
Footing
ELC
Foundation Access:
Fig Drain ELR
C,awl Drain
Slab Inspection Notes: SIT
Post& Beam
Shear Anchors --------- - "----- -_--
Ext Sheath/She ir
Int Sheath/Shear
Framing --------- ---- _-------
Insulation ;
Drywall Nailing r— -�4— —-- ------�—--- -----
Firewall
Fire Sprinkler -------------
Fire Alarm -
Susp'd Ceiling -
Roo} _
Other: _
Final
PASS PART FAIL
PLUMBING __—
(lost& Beam --
Under Slab
Rough-In
WaterServii,e _—_---
Sanitary Sewer
Hain DrainsCatch Basin Basin/Manhole
Storm Drain - -- -- --
Shower Pan
0-1her'
— -- - - ---- - _--
i
P S PART FAIL
CHANICA_L
Post& Beam
Rough-In - ------ - - --- ----- — ---- - ---- --
Gas Lire
Smoke Dampers ---- -- -- -- - - - --- --- -----_ .. ---- --- ----
Final
PASS PART FAIL - _--- --- ------ -- -- ---- ----------- - -__-- --
ELECTRICAL
Service
Rough-In
UG/Slab _...------ -------- -
Low Voltage
Fire Alarm
Final Reinspection tee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
—�_
SITE Please call for reinspection RE:� Unable to inspect-no access
Fire Supply Line
ADA ��- G�
Approach/Sidewalk Date _. — Inspector Ext
Other
Final DO NO REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST �J -
INSPECTION DIVISION Business Line: (603)639-4171
Blip
Received -------Date Requgsted Y1(0-- AM PM_— Blip —
Location --__ U Fly _ / �� —.Suite _— MEC
Contact Person _� ___ �.�V'-�'- Ph PLM
Contractor ---------__-- _ Ph SWR _
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT _�--
Post& Beam _—_- - -
Shear Anchors —�-u
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing - --- - ----— - ---
Firewall
Fire Sprinkler --�►—�-�� �----�-- 1_J_,�2_P_ -
Fire Alarm
Susp'd Ceiling ---- - --- --- - —
Roof
Other: r
Final
_PASS PART FAIL
PLUMBING
Post& Beam ---- ►n i a --�`- / `C 0 G�' --- J -r•.�-
Under Slab
Rough-In
Water
Water Service -- ---- -- ---------- --
Sanitary Sewer
Rain Drains —
Cat,:h Basin/Manhole
Storm Drain -----_ .�_-- --------- -- -- _
Shower Pan
Other. - ----_ —
Final
PASS PART_ F_AIL - ------- - ---- - — --- ���
MECHANICAL
Post& Beam
Rough-In
Gas Line
Smoke Dampers --- -- - - - —---- -_ —_—_.—_T— - — —
Final
PASS PART FAIL - --
ELECTRICAL __
Service - ---- _--
Rough-In
UG/Slab --------- -- --
Low Voltage
Fire Alarm
S PART FAIL Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
STM Please call for re;nspection RE: __ �� Unable to inspect-no access
Fire Supply Line
ADA DateExtApproach/Sidewa,;
-
Other
Final AO NOT REMOVE this inspection record from the job site.
PASS PART FAIL