11676 SW NACIRA PLACE 4
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11676 MV Nacira Blare
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CITY- S �� ������ MASTER PERMIT
PERMIT #: MST2002-00243
DEVELOPMENT SERVs w ES DATE ISSUED: 5/24/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS. 11676 SW NACIRA PL PARCEL: 1S135CD-NP006
SUBDIVISION: NAC'RA PARK ZONING: R-4.5
BLOCK: LOT:006 JURISDICTION: TIG
REMARKS: Construction of new SF detached residence. Path 1
BUILDING
---REISSUE STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,402 of BASEMEN r: of I EFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: MF FLOOR LOAD: 40 SECOND: 1,600 of GARAGE: 462 of FRONT: 30 PARKING SPACES: 2
TYPE OF CONST: 5N DWELLING UNITS: i FINSSMENT: of RIGHT: 5
VALUE: S 285,082 60
OCCUPANCY GRP: R3 SDRM: 4 BATH: 3 TOTAL: 3,00200 of REAR: 48
PLUMBING
SINKS: I WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: I RAIN DRAIN: 100 TRAPS:
LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS. SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUBISHOWERS: 4 GARBAGE DISP: I WATER HEATERS: I WATER LINES: 100 BCKFLW PREVNTR: I GREASE TRAPS:
')THER FIXTURES:
MECHANICAL
FUEL TYPES r•URN<10OK: SOIL/CMP•7HP: VENT FANS: 5 CLOTHES DRYER: 1
GAS FURN>•t00K: 1 UNIT HEATERS: HOODS: I OTHER UNITS: 1
MAX INP: Iu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: t
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp: 0 203 amp: WISVC OR FDR: 1 PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 500aF. 5 201 400 amp: 201 400 amp: lot WIO SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL OR CIH: SIGNALIPANEL: IN PLANT:
MANU HMISVCIFDR: 601 • 1000 omp: 601+e111po•1000v: MINOR LABEL:
1000♦amplvolt
PLAN REVIEW SECTION
Reconnect only.
>•1 RES UNITS: BVCIFOR>•225 A.: >600 V NOMINAL: CLS AREAlSPC OCC:
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL S.COMMERCIAL
AUDIO A STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: IN fERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH rOILER: HVAC: LANDSrAPE/IRRIG: PROTECTIVE SIONL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MFD G 1: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS:
Contractor: TOTAL FEES: $ 7,532.80
Owner; This permit is subject to the regulations contained in the
WHITFORD/SI;OTT LLC. JLS CUSTOM HOMES Tigard Municipal Code,State of OR. Specialty Codes and
4688 NW BETHANY K5#381 17200 NW CORRIDOR CT #110 all other applicable laws. All work will be done In
PORTLAND,9R 97229 BEAVERTON,OR 97006 accordance with approved plans This permit will expire M
work Is not started within 180 days of Issuance,or if the
work is suspended for more than 180 days. ATTENTION:
Plume: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Reg N: LIC 139970 forth in OAR 952-001-0010 through 952-001.OU80. You
may obtain copies of these rules or direct questions to
OUNC by callinL:(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final
Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Insl Rain drain Insp Plumb Final
Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Final inspection
Foundation Insp Footing/Foundation Drl Electrical Rough In Gas Line Insp Appr/Sdwik Insp
Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical FiJ181
Issued By : Permittee Signature :-,4 i
Call (503 639-4175 by 7:00 p.rn. for an inspection needed the next ousiness day
� ^_SEWER CONNECTION PERMIT
CITY
f�F TI G /� p D `
DEVELOPMENT SERVICES PERMIT#: S4/02 00160
1125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/22 4/02
PARCEL: 1 S135C0-NP006
SITE ADDRESS; 11670 SW N/\LIRA PL
SUBDIVISION: rJAC:IRA PARK ZONING: R-4.5
BLOCK: LOT: 006 _ JURISDICTION: TIG _
TENANT NAME-
USA 140: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection permit for new SF detached residence.
Owner: FEES
WHITFORD/SCOTT LLC. Type By Date Amount Receipt
4888 NW BETHANY K5#381
PORTLAND,OR 97229 PRMT CTR 5/24/02 $2,300.00 27200200000
INSP CTR 5/24/02 $35.00 27200200000
Phone: 503-533-2255 Total $2,335.00
Contractor:
Phone:
Reg #:
Required Inspections
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 sev•cr laterals. If the sewer is not located at the measurement given, the installer shall prospect
3 feet in all directions from lha distance given. If not so located, the installer shall purchase a"Tap and Side Sewer" Perm
Issued by: —^� ---- Permittee Signature:��e��- --
Call (503) 39.4175 by 7:00 P.M. for an Inspection needed the next business day
t
Building Permit Applicatim, 1 ermil no.: -
Dalc received:�j O 'O,y
city Of I igard I'rojecNappl no.: Expired
Address: 13125 SW Fiat Blvd.'l'igard,Olt 97223 bate issued. H ec ipt no.:
r rtr,�11V:au,l Inn,ne. (501) 639.4171
Tn k'ase file no Paym nt type', ---
I:av: (501) 599.1960 I tY � /
1 M famlly:Sunple Complex: !r
Land use appr0val: _. —
7LUJ &2 lamily tt\s'rlhng or accessory U('onunercial/inJustrl;,l U �1ulu 'nn4.l`+/:d:u'll Netsu 011t�clinn U C)entolillan ---
ddition/allcraUon/n•plarcntcltt U'fcnanl nnpr„vrtnrnl J I I t
11 t �
111dg.no. Suite no.:
Job address es�V` - ? I 1i.r ap/tax lot/account no.:1:jla)e:/�71�-
Suhdivision. Int _IZI
Project mote: _---------
- , ,
Uesctiption:,nd location of work on premises/spccial conditions: _ -
1
r•
Nantr: � _c:2�L •---- - -
�� >41_ - � I & 2 Tamil) d,rellin(;: ,,, L 5 t7��•�,�
Nlailhtg adrhrss: L� (1 - t 1t �"
Valuation
wolf.
l 11\:' ••(CA LU—C No ul hrdruuin; 1,11ll,
Total nunll,Pl of Il,,,ul
()N Ill'I � I�'I,I CSC 11(Itl\'C `t_1 �� 1JCl-. - 1 'L•�-+ -
- � - rl, ,I Nr\,'d\\rllun• are,l 1••q It l .
I'll,.m•: Itit{. It.l --
UrcLrarrll1(r,,ll��ri,i t,.q ll l -.
L '
N um.;
M ulutg address' ------_-_ I• l
011lel sLtttclure are I(sq I' ) =--
Il ('otnmcrciallindus(riat11 uitl-famll):
( Ily:J- - -.-- - I n, it
I'hunr: I ax: valuation of work. .
t r I:xistillg hid{! arca(sy. IL) ...............
r
I 1r- d.' - Nt'w bldg.area(aq It . ........ .. _- -
Business name: _I t -- ----
-----� Numlx•r ul stories _..
�F,f f t _ __ . ......
Address:.-.LL-�C��. - it;,t R 'I.II'
t I'�pe of eon�tl+,cttotl. . ..
f hone' I'.,
Orcupanc) t;ruul,lsi. ---_
,may :_ --- --- ---
� NcH: --
CCB nc l -.. ------
Cityhnetro lir.no Nofice:All c4 lot and suhcontrlcurrs are required t, he
licensed with the()regon Construction('ontractors Board under
provisions nl ()16 7111 and ntay ill,required to he licensed it,the
!
jutl`dlClJ011 "'here \+'ork 1\hcing Iletionned If the app{icatt I•
Name: _._
Address: �..` - - e,<cmpt tocol hccnshtg,the tullnwme tr;ranl app Ies:
Stat %IP: _
Contact (+rtv'n \,,kk L
rt-
1'hunr.
:gq,ltcatioll $ -
l.i r ,, rtil,n �
N;ui►�. l _.�\'�;: �L�� .'ti 1_ Utile tccct\rd - -
Addo L to " \� \hl.t ' lI
,trjI Amount Ir;cned
_ l
( Ilk t st4 1 1 ' v - , I'Icase refer to-tcc schedule
--
� ti�a all poral,,.U n,..►repr creJ4,LII'. t,ll':I4•IJII�111,4tllllllrl r.,l .......w
hrlrl,\ crrtils I have 101d and e•;unnn•d'hn appilcarn„1 and the
Ali po,vnn� >1,1 I•n\', uul ntdul;ulu e„v.rntnl'tht`
�Ul;n Ir•�I�Inl �nd�� u.i �,,..d.•. 1 ,i,.
\sln1. \\111 I,�•,,nnl,hrd \sltl u•Ih,:r `I+ r Ihrd lu•trm of n„I � „' '
Authu„,r,{ •,il•nalurr` `/ -”- .�1 - ���[ CSS \��.. ,•
I-11111 none
K„ucr I hi,Iu•nn,l al,l+l��,,li' n' .� � �� i nut r,nnl nht, n'�I,olio„ 1811 da\ti tiller ti h 1,h�,rn.0 r c{,Icr'.r,c,nnt,l••Iv
Mecil-lllic-,tl 911crm;t Applicatic>,11
----
--- -- -- - Date received: 0 D Permit no..
�'1t5' O` Tigard F'rojcct/appl.no.: Expircdatc:
C'iryr�/17/urd Adds••, 13125 SW lfall131vd.'flganl.OR 97221 Date issued: By: Rcceiptno..
I'b u1r (503) 639.4171
I •1, (,,(I 1) 598.1960 Case file no.: Payment.ypc:
Building permit no.:
Land use approval: _ _ _
U 1 &2 family dwelling or accessory U Cornw.crcial/indusulal
U Multi Gundy ❑Ten:Inl improvement
New constnlction U Addi„ion/alteration/replacentcnt U Other:
rOurl Win I1
It
�4 A 1!C,r,��� —__ Indicate cgwpmcnt quantities In Ixlxcs beltM- Indlcatc file dollar
Job:rddress_ �� value of all mechanical materials,equipment,labor,overhead,
Bldg.no.: Suite no.:
Tax map/tnx lot/account no.:
5 � profit.Value$
Block: Subdivision: -�-- •Sec checklist for important application information and
Lot: - jurisdiction's fee schedule for residential 1,errnit fee.
project name: _ - I t
City/county' 7.11: t 1
Description and I tion of work an premises: LL� 1-� - pee(ra.► ford
Qly. Riw.only It".oul,,
dills of compli- 'tion/insperuun _------ AC:
fcn;lnl Impruvcnlcltt or chan{tr 111 uu': Air handling unit cfT1-_,- I _. --
I.cel unv r,h,lrc heated,n rluullunncd'lJ Ycs U No AirconTiowng(siteplanrequired) --
Iti rxtsun)' sp:lrc insulated I IJ Yv� U No A tcratio I o existing VA system - ----_
' , ,*oiler compressors I
11 Slate boiler permit lit).
Busincs�nano. ( 'c,�I�,�U� ' i.�c.`1 f, 111' --
Arklress: �` ' TreA1114cfirnpersrustsmo ctcckm41 - (_ l r n� cat pu- mp tc plan required)
Sldl Lll Insla rep acefurnaceAwrner-- ; ll/
('Ity: , L,_l -
1'hone7- l: mail: -_- Including ductwork/vcnt line) U Yes U No —
CCH no.: r � _2 ns(a /rep acclrc ocatc Imatuts suspended,
City/metro lic.no.; — wall,or floor mounted
cnt for ap Mance of ter t Ian furnace
Name(please print): a geration:
911101 Vila Absorption units
Chillers- ------- lit'
Name. — cola ressors^- �_-- tit'
Address:_ - _ _ _--- .nv ronmenta ex ausl an vent tat on:
7.11': Appliance vent
_
Email• I)ryc�exfausi--
Phone: I'I I ooc s, ype I/ /res. Itchen aI.mat
F
hood fire suppression system
Exhaust fan with single duct(bath fans)
Name:_1 _ .� t- A1C - ;x Iaust systi`m a.in rom satin or AC'-
Mailing address`C; 1 ue p p ng an st t on Iup to 4 our cts) , f w,
It y: Stat' 1rZ 7.11'._ � - Typc:
phonC,, Fa mail: ue i in each a itluna over 4 outlets —
'rocessp p ng(schcmaticrcquircdl
Number of outlets �( ----
Name: __ --- --- -0 er st app ince orequpmenl;-
,� k Decorativef mplace --
A1'..Iress. L L�. �J1l-.f`1-. L 7.1 -�- nscn type ---- —
--- Stat - -'
� oot stave/xakt stove -------
- s .•mail: I .. --_- _.
Phor - f:
-�i ---,
N:unl ( ,nal I Ipnaolrc __DarG U---I-er-: -- ---
--(� r
AppIIcInn Permll -
--
fee
•;.�.JI p ud� 1. . .•pl,I du,wl,.ph...i. .dl pu v ,uun Irn uuur udlnu,uluu' Notio- l lu.In•nnll BpI,IlUlnlll' MIIIIIIIIIIII Iry
I ,r .ud / / I%lift”.It it t,cnull 1�not nhlan1c11 1'lall fc,n•%c t-II )
dd,.o l l„ ,I• „Rhin IRO d;I„•lltrr 11 II.1,been Slate sufcll:u}.c (M'7,) ... 4
a.cepted a,,(milllb•t,• T OTA1, 'i•
.nn.•• d�.�nlhabM•,a,,In,wn nu.ir.M�.u•1 1
.WIJrII IrJ,1 tv i1`.1
I'mdhuldr,.glu;tl„1,, Annum
Electrical Permit Application
- --- i t.nc fc'll'I,'l`l►. / l0 1'CI Illlt IIU.'
C 1t0 of I igar/I I'I IIIlt/app) nn.: I:'.plt c datc:
1 Alllbr 11125 S\\' hall 111vd,•1•igar'd,OR 9722.1 U;ueIssued: - -- - - Hy.=1I—.
I'll' n 'till 011)-•'171 -�
('ase Ole lit) Payment lype:
t) 598 1900
I ,ulll 11" altltl0V1I1' ---- ---..
1111111 a Ill I tit]
_1 ".11Itu I,nnlly U'1'en;un imptuvenlent
U I .l .' t o"II, .I "•IIInCI,I .Ir.rsslay U('onunrrcl;tl/ullhl',ul;ll I ul J I'alual
U New corl.I,u, IWO U nlitlllinn/,III I.ull,n lrl,larrnu nl 1 -- .
J013 SITIE NIFORMAfft
Uld Ito
II II, i,l, ntap/tax I a/account nl, .�� 1
- -- -- _.
1 „1 - Illork tiubdivisiall LC�'► f[t - - ---- --
11 • III Inm and location of work on picim ,
I'I.)fee(llmlle: - - ----- - ----
1-.'•I111lall'll delle III „nlld ll'li'In I" I I.III I '
1 1 1 1
Ice �1a\
Julr uu: p -- - Ilc.uipliou Qty. (eu.) 'Total nu.iucp
ISusinrv:n;unl' 0 --G IINeNmcidr•nr4d 01191enrmullifandiyprr
�Illbl �3�`U SW . ,,V 'tet \!� , dnrllinp,unir Imludlsaltaclw•dlaro�e.
'��I.Illor 111 X71;.3 •'I,LLIII,I11•,I
I,Ip ' LIS borO 1
ud I 'lt. s vatn�E 1
I'lunit' �y�-a� I F. null.
14 l g��.l / �I'ar•. 1,11, III 11,. 3 y-Y3� � I - - ,
t•II)'/Illellol�c Ilu
1(...^�Y /� I rh�uduntllu -� -
-- - � '.,I hi"I - I iii :I I• I,, Ilnlr- __ - - -
I l,n�. '"r lu•aIIIVoI l'''''I'1 _ - - -- - --- -
titl'n,(luu' of Sul"'I,r,mr,cls,uI,Iau(rey~lluc`11 -_ `,1,in„u Il rd'•r,-{nSl.11lalino.
',ul, sial nen,r'I•nml aheron'nw n•Inc:lliun'
,
' 1 ' + 1 ' ?I10lure
' n
- -
�, ) !III.11❑In II VIII unl•s _- ._ -, ___.— -.__-
N11me(pi lilt). v.YV\�. f _ �!- }i--7
S fit . _ -
2
\l,llllllt addles. _ hill vnps«t I1111U cups,..-----_--- -- -- _--' -_ 2
Slate' I -— Over 1111N1 alups ul vnllc-- ---- --- _ _----_---- —
�� lticonneClonly l
Him
1'empurary tier lice or fcedem-
IA,'ner in,tullydirnl I'hc installo0 n Is being mode on properly I wall in+lallnliou.dleroliun,urrclocuthm:
ur t r Ilan+l tccoidin+to _ ?_
winch is 1101 inlelidt-d Iltl ;.11 ase.Ienl, } 't 1 ,tro alnpslu Iess _
ORS.111, .155, 1111,h71), / I 2ol at ills to'MO anills - ---- --- _-- ---- Z -
n
()11IICI ;I�;Illll 111 l'.
11J /Ie. 4I11 to G(N10111 s
Ilr allrh r{I'CIIIN•IICN,dleralioa,
> ur e\Icns{oll per panel:
N,unr LU '`• l \ Ire rnr hraach,newts,,1111 purchase of
- - t + IVlleorlec'hlcl eachltranchcucult --
;\IIJi',� L�SLI _ _'J,-lsl1,� 1`�1�, � - ---
lt�
_Z_,'yr" •I n I IeII h I Ir,nIS,vuhnut purelmac
�I SInIC II til'Ihranchulcuil
,IsIa_h.l:binl'n.11l��.h,,u,nn
I'In'm'
�1isc.(tienice ur feeder not in(luded)!
--
.I ,.1 I:!s-u,I•. .. ,II � .,I 1II .II .0 I�,II�I --- .. -_. _ .- _. , -
I r.h'.Igu ul nulla,hghtnll• __ _ ---
IJ',I.nl Ir 1'I)Lnl inF nl Ik: J —Ill.,lt
1 n.dcn lill(0nrahulorll III', '.u„•1 -
J Ilnlldul'u,rl III INIII uln:ue li•el bnu rn F
I ysivi ll•.S' t(,lot 1• a1h.Iatlotl,ol e\Irusunl' --
UtirSlrulrvcl61N1vnlnnmunl,,l nnncresulcnualuunsulnuecuuchnc - .-- - -
IHI'1 Illic" --
U I vedels.AINI amps n1 nun,
'J II1111111111', '.Inlll', -'--
J I lu upam load mrl'11)errs„Its U MLulufalune,l snucuncsor Itv p;uk 1 v 11 AtllllNooal imps lino rarer Ihr p1lnNable h1 au,al the abtnlr:
IJ I I,,L..S/llrllluq'.11l•III 'J I)(lies I', "1.1 u_r, - 1 I
Submit u't,nl plauv"lilt wily of the tlbllle.
1 he allott.All.11111 111111111 able In 14-nlporary cuu\Irucllon\4--1,1,c
1 Idn•r
- - I'I'111111 IIT '�
.•e .11 pal�I�,I��nr. 'll pn r.�ll ......
i n L,,n. I.,nl.nn�ll1 Nu11ce Ihr,lu nlul ulq till alnnl
Phil I, ,I lc I.r I
•_1�� .I _1 Ni� I I I�,I cvlalcs 11.1 Is-:1.1111 r,nal nlo,um 11 ,
',I.IL I' .III' It,ll l'.' It"`; I 'I
' / Wlllltll lRll ll.n•.1111'1 1111.1.I�',II
.L1. .,.I....,.,I. ' 111 I,\1.
S I 'I' I .0 I,•lnrll.l,,ntnlll,l�• „
Il r l 'I
IIUA-7-2U't71 07:0411 1"ROPI:EDWf1RD HULL-01 Pl-u loj 503 628 1633 TO:5035334306 P: I,1
iuy. v rri an: i r FAX r'. 2
I
Plumbing Permit Apr lication
bate reedvod: �PwrWd �Fj
City of Tigard Sewer permit no.: Building pemdt no.:
City of77aard Addrm: 13125 SW}fell Blvd,1'19.".0 97223 NO)ect/appt•en.; Beplredale:
Illmne: (503)639-4171
Fax: (50.1) 598.1960 betelsdued - By: Necelptno.:
Land use approval: _ . ___ Cue me no.: Payment type:
J,l 1 Bt 2 family dwelling or acceserxy (J Commemll industflal (]multi-futilly LI Tenant Improvement
New cortstrvcurxt U Addiuun/al1.rtttlon/replacrm,n: U Fa)1&ervice U Other:
thscrt ttt.,n - FK ea. Total
lob address: 11'' r,��Sc�- i
.1.1� —"' Nin.t-and 2-tatetany d;Al milyt
Bid .no.: tiuiir m . (ncNdrs leo n.lbrearlroff lttyco-110o)
Taxmep/ta><Itt✓eu:clUnt nu,: 1' $f-it(1)bath
i nt: l lock:_ Subdlvlefon: I -. t _Snit(Z)beih --_--
th
Prv)cct mune: — -- 5� —ad a -
CII /cuunl_ - - ?.I C: _ Hach adt)itTcrn a k rt en
—y "—'—- lgltautllitiur
1ksc:riptk,n end location fwd on ptrmiaen _.�-� Catch basin/area drain
List.dale al ctrtnplctiu n t;.<tinn �( —((i C'.' ' Dry I cTi line/trcnct�—itlreln --_
�,-----
enufecture ine utlilues
Businr name: tua.z�-1 L1�(144_ �I U 1-14�t Yl `-- an o ea
tta
u drain connector --
City: 1 �r Stetc a✓ 7JP �' - ) nnT -e�eW.0rr an•11
Phrme: pne:(p' C mall: Storm rrwet(no•
-1-��- -- stet icrvtce(no. Irl i�t.�-
C"no.: nth.bus.re nu:
�0(o_f 3...c ..__�I'lue:---�i -� 8+lxttre or Ilrmi
Cit /mew Iia nu.:
3s�� � - Ahsn tion valve —_
Contcrtc(Ot'a_ r�e;tresealallre ai[nature + 1 low venter
Print oeme: - v Date: d ackwetar calve
eai avMa
CTaea
was r
Name: - -- his washer
AddmsA: ---fountaln(a)
eclote/sump
Plane: F'ex: IS-mail; _ span tm tank _
xtu newer cs
;� -fiucx ala oot sit ru r
Nome Optica,: (.0 �a ` �✓ twat x�eli a ,a, _
Mallin addre+e: �j- �_ . 's 0e h '—�-
0ty, )_ State ZIP: 1 'Z _ ce m er
I'txrnc: -tl t', tZZ E ruti1: ntuce or`M4"trap
(honer IreallatinnIms*ntial t•tai5tenanoe only: 'Ihe actu 1 imtallallon merle)
will t1e trade by me or the mei '_ere aril repair made by my mpular oof noncomma al)- _
emitloyee at uta prtt"y I n�r ORN Cytnpler Ml7. � � bealn(a). (e) --
lltvrter's sit ature; (Eu c; y z Um
u owe ower pan -
n-Tl'ii -
Nacnc,_ r�C--- _ � _ _ f. - -Water c oset
Addnw; —
ell State: ZIP. Tff
r H mall: OfA
Mt
- i
mraP.IWS.;K"e.«uP;MuuI-W*fm
caM. Mmea'd6 MIfIInlUfrl fee ......
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11676 SW N a ci ra PI , Applicant:
Whitford/Scott
Tigard, OR 4888 NW Bethany BlvO K5 381
Lot 6 Nacira Park Subdivision Por'-land, OR 97221;
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CITY OF TO RD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST � � '7� --
INSPECTION DIVISION Business Line: (503)639-4171
BLIP - -
Received — Date Requested 3 v — AM_— PM BU P
Location
12 suite C Suite MEC
Contact Person . Ph(—)
- v 2. _ _ PLM
Contractor _ —_-._ Ph(____—) SWR
ILDITonant/Owner ELC _
- ELC -
Foundation Access:
Ftg Drain ELR -_
Crawl Drain - SIT
Slab Inspection Notes:
Post&Beam — _--- .-- ------._----
Shear Anchors
Ext Sheath/Shear _
Int Sheath/Shear ��� (� r �. S 1 -- �- tj 2 12 (T��
Framing - �"`�►
Insulation
Drywall Nailing \ `
Firewall 1, � C� Z 2-�<-% Z- b< S)_
Fire Sprinkler ,
Fire Alarm ��—�/1,� ,r�.�-.� 1.- -.�tt--•._,� �t� "'4` c
Susp'd Ceiling
Root
— -r
O he_r.
Fi
ART FAILA11
Post& Beam _
Under Slab --- -
Rough-In
Water Service _
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain -
Shower Pan
Other:
-POS' PART FAILAMOA
Post& Bearn
Rough-In
Gas Line
Smoke Dampers — - - --
WSS
PART FAILICAL -
Service
Rough-In ---- — - -- ---- - --------
UG/Slab
Low Voltage ------------_ — _ -------- ----
Fire Alarm
Final Reinspection fee of$ - required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
_ PASS PART FAIL-
-#I-TE
AIL_
SITE Please call for reinspection RE: - Unable toInspect -no access
Fire Supply Line
ADA Delia _1. ,/. t')/U I inapectar -- � CGG/// � _ ut
ApproachlSidewalk
Other:_..—_ __
Final DO NOT REMOVE this Inspectloril record from the job si4e.
PASS PART FAIL
CITY OF TIGARD 24-Hour
B:IILDINO Inspection Line: (503) 639-4115liU 2
INSPECTION DIVISION Business Line: (503) 639-4171 MST 2 - Y3
BLIP
Received �__ Date Requested �U � AM- PM - BLIP
Location 1_ l �G Sw�aci),-/ _ Suite_ _ MEC
Contact Person — Ph(—) _ti!�Z -Zx&y PLM
Contractor f'C`�7"� Ph SWC+
BUILDING Tenant/Owner - -__-_ ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl rain
Slab Inspection Notes: ' SIT
Post&Beam
Shear Anchors
Ext Sheath/ShAar
Int Sheath/Shear - -
Framing
Insulation --
Drywall Nailing
Firewall ,
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: —
Final ----- ` ?)
PASS PART FAIL —
PLUMBING
Post&Beam --- --
Under Slab
Rough-In -�
Water Service
Sanitary Sewer
Rain Drains ------
Catch Basin/Manhole
Storm Drain
Shower Pan
Other:
sinal ------
PASS PART FAIL - -
MECHANICAL
Post&Beam
Rough-In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
LECTRIC _
"service --_-- — _-- --
Rough-In
UG/Slab v —--
Low VoltageLpm _
larm �— -- —
Fin next Reinspection fee of$_.___ required before t ins
PART SAIL pectior, Pay at City Hell, 13125 SW Hall Blvd.
SITE C] Please call for reinspection RE: _ LJ Unable to inspect-no access
Fire Supply Line
ADA -,
Approach/Sidewalk Otltlb • loc-)\ Inspec t«r _ k��__�--Ext
Other: ------- —---
Final DO NOT REMOVE this; Inspection record from the job site.
PASS PART FAIL