14675 SW KLIPSAN COURT-1 14675 SW Klipsan Court
CITY
O— TIGARD MASTER PERMIT
�1 PERMIT#: MST2003-00016
DEVELOPMENT SERVICES DATE ISSUED: 2/12/03
13125 SW Hall Blvd.,Tigard, OR 972.23 (503) 639-0171
SITE. ADDRESS: 1467.5 SW KLIPSAN CT PARCEL: 2S105DD-07000
SUBDIVISION: PACIFIC CREST ZONING: k-7
BLOCK: LOT: 046 JURISDICTION: TI(;
REMARKS: C
BUILDING
REISSUE: STORIES" ! FLOOR AREAS �REOU'RED SETBACKS REQUIRED
CLASS OF WORK: NEW •IEIGHT. 11 FIRST: 1.552 of BASEMENT: 924 of ..EFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD 40 SECOND. 1,590 at GARAGE: 773 of FRONT- 20 PARKING SPAC'S: 2
TYPE OF CONST. 5N DWELLING UNITS. 1 '11141) of RIGHT: 5
259 1U
OCCUPANCY GRP R3 BDRM. 5 BATH-. 4 1O7tL: 3.142 a1 VALVE: 404, REAR: 24
PLUMBING
SINKS: 1 WATER CLOSETS A WASHING MACH. 1 LAUNDRY TRAYS: 1 RAIN DRAIN: IU0 TRAPS:
LAVATORIES: DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUBISHOWERS: GAR6AGE OISP: 1 WATER HEATERS: WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIA TURES:
MECHANICAL
FUEL TYPES FURN a 10011: BOIUCMP t 3HP: VENT FANS: 6 CLOTNLS DRYER. 1
GAS FURN>•100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 2
MAX INP: btu FLOOR FURNANCES: VENTS! 1 WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL_
RESIDENTIAL UNIT SERVICE SEDER` TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp. o -200 amp: WSVC OR TOR: PIIMPIIRRIGATION: PER INSPECTION:
EA ADD'L 500SF. 6 201 - 400 amp. 201 400 amp: tat WTD S%"DR: SIGN/7U7 1 IN LTPER HOUR:
LIMITED ENERGY: 401 600 amp: 401 600 amp: EAADDL BR CIR: SIJNA1/PANEL.: IN PLANT:
MANU HWSVCIFVF,, 601 1000 amp: 6.1+ampo-1000V: MINOR LABEL
1000+amp/volt: PLAN REVIEW SECTION _
Reconnect only: >-4 RES UNITS SVCIFOR>=225 A.: >600 V NOMINAL CLS AREA/SPC OCC:
ELECTRICAL-RESTRICTED ELERGY
A.SF RESIDENTIAL B.COMMERCIAL —
AUDIO 6 STEREO: r VACUUM SYSTEM: X AUDI( 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARIA: x O1H BOILER: HVAC, I_ANDSCAPFtIRP.IG: PROTECTIVE SIGNL
GARAGE OPENER. x CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: x DATAITELE COMM: NURSE CALLS: TOTAL a SYSTEMS:
Contractor: TOTAL FEES: $ 9,065.55
Owner: This permit Is subject to the regulations contained in the
D R HORTON D.R.HOPTON INC Tigard Municipal Code,Stole of OR. Specialty Codes and
5125 SW MACADAM#145 4386 SW MACADAM AVE. all other applicable laws All,vork will bp 0ne in
PORTLAND,OR 97201 SUITE #102 accordance with approved plans. This pem,lt will expire if
PORTLAND,Ok 97239 work Is riot starteo withir 180 days of issuanoU,or if the
work is suspended for more than 130 days. ATTENTION:
Oregon law requir;s you to follow rul as adopted by the
Phone: 244-5322 Phone: 503-222-4151 Oregon Utility Notification Center. Those rules are set
forth in OAR 9524101-0010 through 952-001-0080. You
Rep N: LIC 130859 may obtain copies of these rules or direct questions to
OUNC by calling(1103)2a 3-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam Mechanica Mechanical Insp Shnar Wall Insp Llsulation Insp Me0anical Final
Sewer Inspection Underfloor insulation Plumb Top Out Exterhr Sheathing Inst Pain drain Insp Plemb Final
Footin?Insp Crawl Drain/Backwater Electrical Service Low V)Itage Water Line Insp f lnal Inspection
Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Line Insp Appr/Sdv+ik Insp
Post/Besm Structural PLM/Underfloor Framing Insp Gas Fireplr,ce Electrical Final
—
Permittee Sipriature
issued By : _1 _22� —
Call (503)t39-4175 by 7:00 p.rn. for an inspection needed the next Uldslneiss day
CITYOF TIGARD SEWER CONNEC",ION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2003-00018
1312z) SW H.AII Blvd., Tigan d. OR 97223 (503) 639-4171 DATE ISSUED: 2/12/03
SITE ADDRESS; 14675 SW KLIPSAN CT PARCEL: 2S105DD-07000
SUBDIVISION: IIACII ICCREST ZONING: k-7
BLOCK: LOT: 046 JURISDICTION: I Ic;
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF .:0. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks:
Owner: -- - FEES
D R HORTONr Description Date Amount
5125 SW MACADAM #145
PORTLAND, OR 97201 [SWUSA]Swr Connect 2/12/03 $2,300.00
[SWUSA]Swr Connect 2/12/03 $0.00
Phone: '-I-1-5s2 2 [SWINSP]Swr Inspect 2/12/03 $35.0
[SWINSP]Swr Inspect 2/12/03 $0.00
Contractor:
- ----- ---- total $2,338.00
P`ione:
Reg#:
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expi.as 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 frorn the distance given. If not so Ionated,the installer shall purchase a "Tap and Side Sewer" Perm
YSi
itt
P
ermee gnarine:
Issued by: —.-.�.^. -?yt . J f'� _� _.__. , • � �`�
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Building Pen-nit ApplPiLation
-a received: --- -_— Permit no.:
oCity ofEk.: - -
Ciqu(Tig,trlAddress: 131AWIF9Tvd.Tigard,OR 97223 -i� Uappl.no.: Expire date:
s�
_
Phone: (503) 639-4171 Date id
' � 20a, ssue : By: f'.� Receipt nu.:
Fax: (503) 598-1960 AN i -----
Case file no.: Paymer t type:
Land use appCt *f TIGNRD" oN i� I&2 family:Simple Comple
� t
TYPE OF PERMIT.
U I &2 family dwelling or accessory 0 Commercial/industrial U Multi-family New construction O Demolition
U Addition/alteration/replacement FJ Tenant improvement 0 Fire slmnklet/alailn 0 Other:
1 ) SITE 1 1
Job address: Bldg.no.: Suite no.:
Lot: Block: Subdivis on: (� Tax map/tax lot/account no.: <
Project name: ,I _ �� ��/ —
Description and location of work on premises/special conditions:—
1 1
Name: V.'p-• Hivi-6k,
Mailing address: 25 1 dr 2 family dwelling:
Cit // C, 7
Y �,Oez Valuation of work.......�I/1. r.2.�.`.r.........
Phone: -Rp 61 Fax: ' - � mail: No.of bedrooms/baths.................................
Owner's representative: NitDlti Total number of floors ,
Phone: I. 1=ax' E-mail: New dwellingf.) .......................... —
arca(sq,ft.) ,...
MEGarage/carpott area(sq.ft.) ......7..7,.3. ... —mow_ __
Name: p• V- t--e V-i Covered porch area(sq.ft.) ........C,!ij..... _
Mailing address: 6A
— If 0 V t'i Deck area(s ft.) .-/% G —_
City: State: ZIP: Other swcture area(so. ft.).........................
Phone: Fax: E-snail: Commercial/industrial multi-family:
CONTRACTOR Valuation of work.......................I............... $ _ -
Business name: y -( D h Existing bldg.area(sq.ft.) ................-.:......
Address: S •,^� -- New bldg.area(sq.ft.). »r� �........•.... --
CitNumber of stone ......................................
Y� _ State:p ' ZIP: —
Phone: -zu 15 Fax: y2VL3? E-mail TYfx of�,�rts6Lction....................................
--—
CCB no.: O - --- _� oeEtipancy group(s): Existing: —_--�
City/metro lic.no.: New:
Notice:All contractors and subcontractors are required to be—
t licensed with the.Oregon Construction Contractors Board under
dame: `���� -f 7) h provisions of ORS 701 and may be required to be licensed in the
Address: corp k1,1 t:- As jurisdiction where work is being performed. If the applicant is
(St ; �'--' State: ZIP: exeript from licensing,the following reason applies:
Contact person: v f� Plan no.: zt—
---- —
Phone: / f Far E-mail: --
Name: ,�; �1�';ul�/ ''ntact person: � Fees due upon applicutijn .....................•..... $—_-
Address: $6 /2(Or~h Date received:
City: State:0ic- ZIP: 0i,-- Amount received .......•............
Phone: Fax:(�rGf 44YE-mail: — Please refer to fee schedule. -
I hereby certify I have read and examined this application and the Not all junsdtctions accept credit cards,please call jurisdiction for more information,
attached checklist.All provisions of laws and ordinances governing this 0 Visa U MasterCard
work will he complied wi ,whether specified herein or not. credit card number
Expires
Authorized signature: Date: ?2 Name of cardholder as shown on credit cud
Print name: �H _ - Cardha!der sidnarue s Amo-um
Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 44:. 13(&QWOM)
Mechanical Permit Application
City of Tigard
Date receiv_d: Permit no.:
T1gi11"d Project/appl.no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued: By: Receipt no.:
Fax: (503) 598-1960 1 Case file no.. Payment type:
Land use approval: Building permit no.: �-
TYPE OF PERMIT
❑ I &?family dwelling or accessory ❑CommerciaUindustrial ❑ Multi-family ❑Tenant improvement
❑New construction ❑A(ldition/alteration/replacement 'J t)thcr
JOB VE INFORMATION1MMERI�_,Ikll, VALUATION SCHEDULE —'
Job address: Indicalc equipmen' unities in boxes below. Indicate the dollar
Bldg. no.: uit� value of all mecitau,�al materials,equipment,labor,overhead, l
Tax map/tax lot/account no,: s profit.Value$
Lot: a4e Block: Subdivision: AGI 'See checklist Cor important application information and
Project name: jurisdiction's fee schedule for residential permit tee.
City/county: 1 &2 FAMILY DWELLING PERMIT FEE CIIEDULE
Description and ovation of work on premises: 7Airiconditioning
1 1 1 1 r1 ' I
I-'ee(ea.) Twal
Est.date of completion/inspection: 11r•veription ply. Res.only Res.only
Tenant improvement or change of use: :
Is existing space heated or conditioned?O Yes UNo dlin unit CFM(site plan required)
Is existing space insulated?❑Yes ❑No Alteration of existing HVACsystem
MECHANICAL CONTRACTOR 01 er compressors
Business name: V State boiler permit no.:
- HP Tons BTU/H
Address: _ irc/smo a am ers/ uct smoke detectors
City: A IPVLA, f SS t a t Heat pump(site plan required)
Phone: Fax: E-mail; nsta rep ace furnac umcr
CCB no.: Including ductwork/vent liner ❑Yes O No
nstal rep ace/relocate heaters-suspended,
City/metro tic.no.: wall,or floor mounted
Name(please pont): Vent for appliance other than furnace
CON I'AC`T PERSON
e gera on:
Absorption units BTU/11
Name: Nicole, J p`7 Chillers _ HP
Addre.s: Lj g 1y Com ressors —__ HP
City: State: ZIP: G Environmental ex ust sm ventilation:
Appliance vent
Phone _ y- / hax: p - 391 E-mail.
Dryer exhaust _
Hoods,Type /res. jtc cn/hazmat
hood fire suppression system
Name: 2. fa1�1wG Exhaust fan with single duct(bath fans)
Mailing address Z r/ Exhausts stem apart from heating or A
City: 'r R State:12, ZIP: ei p p ng an st ut on(up to outlets)
11� Type: LPG __ NG Oil
Phone::::: /-r Fax: /'f E-mail: Fuel i 1n each additional over outlets
Ps
���� ri Nor fj ocess piping(schematic required)
Name: ��'r�Zl -(� _ / _ Number it outlets
Address: 0 e list- app ance or equ pment;
.� 5q 5C l Decorative Fiirc lace
Ctly: � / I risen-type
Phone: Fax: r E-mail: -Woodstove/pellet stove
Applicant's signature: �� Date: Other:
Other:
Name (print):
Not W junsdicuons accept credit cards,piease call junsdicnon for more mfomuuon. Permit fee.....................
❑visa 13 MasterCard Notice:This permit application Minimum fee.. ............$
expires if a permit is not obtained -
Credit cord number _ �_ ____,_,___ / / Plan review(at 96) S _
Expires within 180 days after it has been State surcharge(896),...S
None of cardholder u zhown en credit card accepted as complete. —--
_ _ s TOTAL .......................$ _Cardholder u`netwe � Amount
540-0,11 IN MOM1
•
FROM :CRAFTWORK PLUMBING FAX NO. :5036445989 Nov. 01 2002 08:34PM P2
Plumbing Permit Application lzcl
City of Tigard Date received: Petmit `jl
Address: 13125 SW Flnll Blvd,Tigard,OR 97223 Sewer permit no.: Building permit no.:
CityujTi�nrd Phone: (503) 639-4171 Pro•ect/u I,no.:
1 PP Expire dote:
Fax: (503) 59s-1460 Date issued
Ry. Receipt no.
Land use approval: Cale file no.: Payment type
7
O I &2 fmnlly dwcllina or noccssory U L.olnmercial/industrial 0 multi-family O Te
O New construction U Addition/nllcration O Other:
/ropiacement `1 Food ;ervicc n"°t imprnvemont
Job nddress: L'' �i(J - - 1)e4crl Non �I
Bldg, no.: — �� Qt I ee(en— .T°tnI
Suite no,: Pie„ 1-and 1 (nm V tJwell,tGc only:
Tax m1p/tax lel/account no.: (Includes loo it.foreach utility rn"lle, n) hI
Lot: Block: Su)division: r SFR(1)bath �JI
I'tnjectn me: (2)baig
Srn r3) 3111 ---r—
Cit /conn ZIP: _ Each ad itionr'both/kite un
Description and location ofwork on premises: Sitentllltlevt
_ Catch basin/area drain
Est.date of completion/inspectinn: well a1enc tineArenc 1 t rain `-
1L t Footing drain(no, lits. R.)
Business name: Manu adored humc utillpe$
�r-- �� MAnitales
Address t�� 5y Nir«6,Wx ,�r Roin drain connector — --
' Stnte:i, 'LIP 9ySonite sewer(no. lin.ft,)
Plume:bq4-lo"iL q ' FAX' 4 .1 ail: Storm srwer(no. lin. t.) a��=l
CCH no. (� Plumb.bus. reg,no: •/y p' aterservice no, tin. fl.)
Clty/mcholic.no.: - FlxlurenrItem:
Conlrretoe.q representative signature: Absorption valve
Print name: Back flow prcvcnter
/I Date: Backwater valve —
Basins/lavatO y _
Clothes washer
Address i, Dishwnshcr
Sinter 7.IP Drinking fountain(n)
Phone Fax: Gjectors/;t1m
E-mail: xpansion tank _
Fixture/sewer ca "
Nnrne(print)r Floor rains/floor Finks/hub
Mailing ddress: , Garbs c is osn
I lose hibb
Cily: State: ZIP:A
1301Ice make
-
Phone: Fax;
N-moil: Interceptor/gi:Asc trap
Owner installntion/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintennnee and repair made by my rcgul3► Itoof drain commerewl) `--'---
cmployee on die property I own as per ORS f- -pier 447 Sink(e),basin(s), 3vs(s) _
Owner's signature-_ _ Daft: Sump -
10 M I'ubs/slioweNsllnwer pan
Name. L Urinal �— -- -
Addreirs: Water closet
Water heAter
Cit St
Y� ate: �"-
Phone: Fax; E•mnil: nbl
Not all Jmr-diamnl accept credit annl-,Piton CAR)-Irildlcllnn fro more Inrnrmnrb,n. Minimuln fee ............. S
M V.% G Mlutercani Notice: This permit Application — --
txpirta if a permit is not nhtained I Inn[evlCw(al '
_ %n) S
credit corn nun,lur• •• —J•.p,r�^ within 180 days aGer it has been State surcharge(A%)_,
NnnK in r of_,w er n-tlrovn 7,credo tnrd '— 1ccep1cd as complete, TOTAL...... .......... ..... S
(:nrnnnldR Ilpnnlure �— �''—'^
Amount
440.4616(rV0tVC0MI
h,icctrical1'Ear.mi Application MM
"-�— — Date received: Permit no.: jt5 UW
City of Tigard Project/appl.no.: Expiredate:
City n(Tigard Address: 13125 SW Hall Blvd,Til„ard,OR 97223 Date issued: By: Receiptno.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
n
7L] &2 family dwelling or accessory U Commercial/industrial ❑Multi-family 0 Tenant impruvement
w construction ❑Addition/altcration/replacement L]Other: ❑Partial
11 SITE INFORMATION
Job address: nu_— Suite ^o.: fax map/tax lot/account no.: �_—
Lot—: Bl G/f�i�►/Csf”" _ ____ _ ___� —
Project rr;me: G1 �' — Description and location of work on premises:
Estimated date of colnplctio,Yu,snection.
CONTRACtilfitiit M%ICATIi + SCHEDULE
Job no: Fre Ma
Business name: �.� — -- - ---- Description 1011. r.-a.) Total no.Insx
p
-— —- -- New residential-single or multi-family per
Address: ��� dwelling unit.lnclurlesnrtachsdg:trage
City: State: ZIP: Service Included:
Phone: - Fax: VW E-mail: loot)sq,ft.of ics+ _ 4
Each additional 5W sq.ft.or purtion thereof —
CCB no.: Elcc.bus. lic.nu:
_ Limited energy,residential 2
(^its/IttCtr Z� - -- V— EcLimited energymanufactured
red ho ne on tial _ 2
Each manufactufed home or modular dwelling
Signofurr of supervis n�efecfrieiar, required) Date Service and/or feeder 2
Sup.elect.name(print): I i ,. ,,.110 Serrlcesorfeeders-Installallon,
alteration or relocation:
t t71 200 amps or less
201 amps to 400 amps '-
Name (pont): ]�r A�}> '�� � r%�
401 amps to 600 amps
Mailing address: LSWQ / 601 amps to I000 amps
City: Slate' ZIP: - Over 1000 amps or volts
Phone: - Fax: E-mail: Reconnectonl t
Owner installation:The installation is being made on property I own Temporary services or feeder;-
which is not intended for sale,lease,rent,or exchange according to Installation,alteration,or relocation:
201 amps
ORS 447,455,479,670,701. tless 2
_
20I amps to
4110 amps _ _ 2
Owner's si nature: _ Date: _ 401 to noo amps 2
Branch circuits-new,alteration,
or extension per panel:
Name: 'f 6 v/ A Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit 2
Cjly: StatC: ZIY: _ B. Fee for branch circuits without purchase
of service or feeder fee,first branch circuit 2
Phone: 9 _ FaxVo f F- ;nail Each additional branch circuit:
Misc.(Service urfeedernotIncluded):
O Service over 225 amps-commercial U Health-care facility Eaeh pump or trrtgatton circle 2_
O Service over 320 amps-rating of 1&2 U Hssardouslocation Each signor outline lighting 2
familydwelling; ❑Building over 10.000 square feet four of Signal circuit(s)or a hrmted energy panel,
O Syntem over 600 volts nominal more residential units in one structure alteration,or euem ton' 2
O Building over dm stories Q Feeders,400 amps or more •Dencn tion. _ —
0 occupant load over 99 persons O Manufactured structures or RV park Each additional Inspection u.er the allowable In any of the above:
d Egress/lightingplan 0 Other _ Per inspecuon ;--[—
Submit_sets of plans with any of the above. Investigation fee _
The above are not applicable to temporary construction service. other
Not all jurisdictions accept credit cads,please call junsdicuon Int more infortnation Notice:This permit opplieation Permit fee.....................$
U Visa 0lslasterCard expires if a permit is not ohtained Plat review(at _ %) $
credit card numbe _1—_ within 180 da,s after it has been State surcharge(8%) ....$
—
Expires accepted as complete. TOTAL .......................$
Nacre of cardholder u shown on credit card
Cardholder signature — Amount 446.4615 16KVCOMi
r•-
d.
PACIFIC CRE S-1- SUBDIV ISION
LC)0'1' - 46
CITY CDoF -1-1CGA.RD
THE APPROACH SHALL BE
A MINNMUM Of B"xl2'x2C'
\ OF CLEAN P GRAVEL
LANDSCAPING FOR THE ENTIRE LOT
SHALL BE FINISHED OR TI-E LOT
— SURROUNDED BY EROSION CONTROL
PRIOR TO BREAK OUT CF COMMUNITY
��— EROSION CONTROL, FINISHED SLOPES
T SHALL BE LESS rHAN : TO I
7�',A }- o
o
� NOTE_
I.ROOF DRAINS TO STORM
VO F1 LK %% Ln LAT. IN STREET.
°C T 7 � 2. FOUNDATION DRAINS TO
�� �� ,D4 E WATER 1 Z O. 2 5 \ a"-- BACKYARD SOAKAGE TREMC-
EL-A9e 6 LAT. --------SEL-�9tl'(� SEE ATTACHED DETAIL
IE
EMP.GRAVEL Tw
RIVEUTAY '� v
N
^ PLAN 3902A ^
FIN EL a 4150'
—_ —R- ------------------------
c
------------- ___ aF
------ -----
.7—'f3�"f
i
� n
i
I
M
6 0 . 00 '
l2 / M.AeA'
.�( EL-484'
S
/) 6 SETBACK REQUIRE"_EE' .-
SCALE r-2a'-o' `� FRONT YARD TO GARAGE 20'
5 ' 8 7 9 RIDE YARD
REAR YEARS 15 i5'
.:ZoREgl; 44196WCL1PSANCr D.K. Flortoi� H( mes
PLAN 3-.024
t5C*ALE F - 20
303 5125 S.',.U. rlacadamHvoro�o
L
+CtiE Dc:3T:a,5' rOrtland C-!e c- PAX 5032273`"
CITY OF TIG 4RD 24-Hour
BUILDING Inspection Line: (503) 09-4175 MST
INSPECTION DIVISION Business Line: (503)639-4171
BUIP
Received --- ----F.-_ _-_ Date Requested.__..-- ;�M_.---•--___-- FM _ _._ BUP .__-.-__-___-- ------
r� _--
Location Suite MEC_----------1_�---_---1_:,a_ __ �--� C-�
Contact Person -- - - - __-_ Ph ( _ _—_—) s �'} _ / PLM
Contractor . __._.. -- --- -- - Ph ( ) —_ - - -- SWR
BUILDING Tenant/Ownei __ -- _---_--_--__- -- ---- ELC
r��oting
Fo indation ELC --_
Access:
Ftg Drain ELR
Cral.0 Drain
Slab Inspection Notes: SIT --
Post& Beam -- --- -
Shear Anchors ---
Ext Sheath/Shear
Int Sheath/Shear
Framing �oY; -
Insulation
Drywall Nailing — L /� M�L1� �'`i�_'�_. ��9G✓c� ----
Firewall
Fire Sprinkler -- --
Fire Alarm
Susp'd CeilingRoof
---
Other:vl;A"S;) _PAR_T FAIL
PLU_M_6ING
Post 8 Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain
Shower Pan
Other: _ - --- -
Final —
PASS_ PART FAIL
MEC_HAN_ICAL _
Post R Beam
Rough-In
Gas Line
Ike Dampers$ PART FAIL -------- - .._ ._ - ----- - - --
. .. .......
ELE RICAL
Service W---`^—�--- -_---
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final Ll Reinspection fee of$____— required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE:�___ —_ _ _ t1 Unable to inspect-no access
Fire Supply Line
ADA `Ti —C /
Approach/Sidewalk Dat® -___ Inspotor _ _ r_ Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
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CITY OF TIGARD 24-Hour
BUILDING Inspection _ine: (503)6S9-4175 MST
' 6PECTION DIV''�!ON Businesr Liri.: (503) 639.4171
BLIP - -------
Received ____—__----- Date ReZsted ---� " _ AM --- PM ______ BLIPLocation _ -j. �i .Y, .. __`'lulls ------___-- MEG
Contact Person _ Ph ( __) S163Q0�___- PLM
Contractor _- Ph( ) SWR
BUILDING Tenant]OwncELC
Footing
Foundatic n - EL C
Access:
Ftg Drain ELR
Crawl Drain
Slab Insnection Notes SIT
Post&Beam -
Shear Anchors
-- -
Ext Sheath/Shear _
Int Sheath/Shear
Framing
Insulation
Drywall Nailing ----
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Fina! _
PASS PART FAIL
PLUMBING
Post8 Beam^ - --.- -- --------- --- -------- --_____.__.__.�_.._�.
Under Slab
Rough-In ----------- -------___._�.�
Water Service
Sanitary Sewer
Rain Drains
Catch Basin i Manhole
Storm Drain
Shower Pan
Other --
Final
PASS PART BAIL
MECHANICAL—
Post&Beam
Rough-In _. ..__ —_-----__..._.__ ---_--. ---
Gas Line
Smoke Dampers
Final
PASS PART FAIL - - --�- _ -.._..- ------ ---- ---- ------ --- -
-
ELECTRICAL
Service _�. ------------------ -- --- -- ---
Rough-In
UG/Slab � �----- - — -------
olta a w,..l' 1_ _� > - ----- ---
Fire arm
[:] Heinspection fee of$ require.i before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
ASS PART FAIL
Please call for reinspection RE:_---.� ___�___ � Unable to Inspect -no access
Fire Supply Line
ADA � D
Approach/Sidewalk Date ..' l'G'3 Inspector ~(1�3d✓ ---- -- Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour /-
BUILDING Inspection Line: (503)639-41 5 MST 3-,
INSPECTION DIVISION Business Line: (503) 639-4171
-7 BUP
Received _.__.___..... -- Date Reque fed_..__-!— AM---_- PM -- BUP
Location _____�L � r -- _ --Suite_ - -_-_ MEC --
Contact Person Ph(- ) _SL.-7_- PLM
Contractor - --- Ph SWR - -
BUILDING T-nanVOwrne; -_ - -------- _-- ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain _- --_-�__--. _
Slab Inspection Notes SIT
Post& Bean -.---
Shear Anchors
Ext Sheat 'Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing -- --- ----
Firewall
Fire Sprinkler ------ - -_ ---_-_ ._ _
Fire Alarm
Susp'd Ceiling
Roof oe
Other:
Final �7
PASS PART FAIL - U
PLUMBING ` _ f,�I_ ---_-- --
Postt&Beam
Under Slab -
Rough-In
Water Service - - ---
Sanitary Sewer
Rain Drains -
Catch Basin/Manhole
Storm Drain -
Shower Pan
-•-
PA PART FAIL ----
_M CHANICAL —
Post& Beam _
Rough-In
Gas Line
Srnone Dampers -
Final
PASS_PART FAIL - -��----
ELECTRICAL
Service
Rough-In ---- -- _-�-e-- --- ---- -- _
UG/Slab
Low Voltage
'ire Alarm
Final Reinspection fee of$__ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
g= - [ Please call for reinspection RF: Unable to inspect-no access
Fire Supply Line —
ADA 3
ApproachJSldewalk Date � ! Inspector_ _ _-_ ___.-Ext
Other:
Final �- DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
a