10335 SW VIEW COURT 15 r
J • / •
_ -_------ ------ - thy, LANG. OREGON
s
OF 0�
- REF.!I BATHROOM RENOVATION NOTES PROJECT INFORMATION
.... .....
s
-- _ - _ - _ 1. ALL NEW FIXTURESAT BATHROOM3 ORIGINAL OCCUPANCY ASSIFIGATIL)N
I r SINGLE FAMILY DWELLING
r
i
2. ALL NEW FIXTURES ARE OFCI
r - - 3. ALL FLOOR,W ALL,CEILING SURFACES DISTURBED TO BE 3,
112' GREAT ROOM KITCHEN ' I - - - - - - - - PATVHED REPAIRED,AND FINISHED SIMIL:: TO EXISTING
_ _ _ _ - _ - _ _ -
_ «..
(COMMON) (COMMON) PB4P2S � IEI�IlQM
4. REPAINT ENTIRE ROOM AT BATHROOM 1 & BATHROOM 3 (SR3.3)WITH(5)(PROMPT)RESIDENTS
CPTS.v - - - - - -' 5 ALL FINISHES ARE OFCI CONTROLLED EGRESS ~
. I
- - - - _ - - - - - - - - - NO CONTROLLED EGRESS DEVICES
6. RELOCATE EXISTING ELECTRICAL SWITCHES&OUTLETS AS
5 REQUIRED SPRINKLER SYSTEM:
NOT REQUIRED
%. RESIZE AND REPAIR EXISTING VANITY IN BATHROOM 1
` - - - - - - - - - -
- - - - - - - AS REQUIRED RELOCATE, RESIZE, OR REPLACE EXISTING
- MIRROR bJILDING AREA:
- - — > -' 3,054 SQ FT
d. EXHAUST FAN SHALL COMPLY WITH REQUIREMENTS FOR CFM
CAPCITY AS STATED IN SECTION 1203.2.5 OF THE UNIFORM
BUILDING CODE. EXHAUST FAN SHALL BE VENTED DIREC' LY TO 1121 S.IV Salmon
T14E OUTSIDE. P.M.
Suite 100
1
ACCESSIBILITY COMPLIANCE Portland, OR 97205
TeL 503.221.1121
r - - - - - - - - - - - - - - - - - - - - -
r - - - - Fnac503.�11.2077
_ - - - - - - PER OSSC:FACILITY IS"SINGLE FAMILY RESIDENCE." FACILITY IS n
STAFF OFFICE NOT"MULTI-FAMILY RESIDENCE"SO CONFORMANCE TO
54" (COMM ,N) SECTION 1110 IS NOT REQUIRED. FACILITY IS CONSIDERED
X --- 60"X42" �` "SOCIAL SERVICE ESTABLISHMENT"SO 1 ACCESSIBLE
PARALLEL ONT ' BEDROOM, 1 ACCESSIBLE BATHROOM IS REQUIRED AND IS
APPROACH PI APP ACH - - - 7 7777 '._ PROVIDED. AN ACCESSIBLE ROUTE TO ACCESSIBLE SPACES,
COMMON SPACES,AND WORKSPACES IS REQUIRED(SEE ROOM
NAMES).
- - - - - - - - - BARRIER REMOVAL PLAN :PER RS 447.241
_ LIVING ROOM 1 AR ORS(COMMON) THE COST OF THE"PRIMAR,'FUCTION"ALTERATION
A r -- - ------ - ------ --.-rr _t::r_- --- - -- -------------- -
IS315,000.00, SOTASKS Q�8 QWILL$E
COMPLETED AS PART OF THIS PERMIT; EXCEEDING
1 1 THE 25%($3,750.00) LIMIT FOR ALTERATION COSTS.
L 1 1
I LIGHT FIX RE ABOVE MIRROR -
3 1 I& PROVIDE ACCESSIBLE ROUTE REQUIREMENTS
CPT WD
ATDOOR PER 83/A2.2
1 4" ilm5" - - - - - - PROVIDE ACCESSIBLE TOILET ROOM PER
24'X36'MIRROR I I 1 ® B1/A2.2
EXIST EXIST i O PROVIDE ACCESSIBLE LAUNDRY ROOM
— 12'TOWEL BAR PER C1/A2.2
- _ GFI OUTLET 046*AFF I 1
BATHRO M 1 I GHT/FAN SWITCH- I ___ 1 EXIST EXIST
- 1 SID---WALK
RELOCATE EXISTIN a('\ ) I 1
LIGHT FIXTURE AS REQUIRED v I - - - - - - -
j CONSULTANTS
EXkAUST FA-SEE NOTL g ' ' —I ILL HUNG LAV- I
EPLACE%RELOCATE TOWEL BAR PROVIDE SOLID I 6'-3" 6'-5" 1 GENERAL NOTES
TP HOLDER I '` Sv PT BLOCKING AS REQUI D I
I FOR SUPPORT I I
UEMU EXISTING f, BATHROO 3 - - - - " - - - - I- '- - - - - - - - - - - - - - - - - - - - - -
I PARTIAL HEIrHT I I I I B3 I 1. ALL ITEMS ARE EXISTING UNLESS OTHRTWISE NOTED
WALL -PROVIDE NEW
' �� EXISTING C NDIfIONS SHOWN HERE-
COVERED DECK 3 I - c 2'-6"DOOR BEDROOM 2 1 .2 SEE ENLARGED PLAN FOR PROPOSED 2. COMPLY WITH BUILDING, MECHANICAL, PLUMBING, & Uj
> &ASSOCIATED ( )
11
ELECTRICAL CGDES
RELOCATE J �� '�' HARDWARE
112'1/2' BEDROOM 5(2) 1' EXISTING ' `
(ACCESSIBLE) TP HOLDER n - TOILET 3. (X)NUMBER IN PARENTHESES NEXT TO ROOM NAME o
--� - - - - - - - - - , I REPRESENTS NUMBER OF RESIDENTS PER SLEEPING ROOM
'� RELOCATE EXISTING
60"X BATHROOM DOOR-FEILD FO FINISH - I 4. PROVIDE hDA COMPLIANT LEVER FAUCET HANDLES AT ALL w
FR VERIFY CLEARANCE AT TO FO FINSIH + a U
APP OCH EXISTING TOILET ACCESSIBLE LAVATORIES
- - - - -- - - - - - - 5. PATCH&REPAIR ALL DISTURBED AREAS TO MATCH EXISTING
ADJACENT FINISHES O pi p
` - - - - - - - - - - - LUl 0
LU �
UL j
atC/) a
I 1 1 FLOOR PLAN KEY NO TES O p ti
1
cn
BEDROOM 4(1) 1 _ LAUNDRY 1 BEDROOM 3(1) EXTEND EXISTING PARTIAL HEIGHT WALL TO EXISTING CEILING
1 _ w P i 1 1 (ACCESSIBLE) 1
WITH MATCHING WOOD STUD CONSTRUCTION W/1/2"GYP BD
1 I 1 1 i t EACH SIDE-PATCH&REPAIR
1 BATHROOM 2
1 (ACCESSIBLE) Won I I t� PATCH&REPAIR EXISING CARPETED FLOOR TO MATCH EXISTING 1
I I I I WOOD FLOOR AT THIS SIDE OF DOOR
t
3 E E TING CONCRETE WALK
O NOT USED
1 _
-- — ----_� — ---�r----� ��, __ ---- mu–
PROJECT NAME
C1 `\ O REMOVE 8"EXISTING CO Tp Q� AS SHOWN.EXISTING CONDITIONS SHOWN HEFlE EX.STING CONDITIONc;SHOWN HERE- PATCH&REPAtR EDGE AU3�L QT �EXIST I
SEE ENLARGED PLAN FOR PROPOSED A2.2 SEE ENLARGED PLAN FOR PROPOSED .2 PATOLAM&WOOD 6006d................................STING I
�.inoitionally A; proved.................... I I
or only the wo ,iascribed / I
PERMIT NO. eel��--
See I tel to: Follow........................ ( I
Ah
Job A dr -- �<-.
FLOOR P'�L �GE�1j oZ I-----
NEW WALL-20 WOOD STUDS W/ 1/2"GYF dD EACH SIDE A 05.02.02
04.23.02
- - - - - - -- -
- - - - - - - - -
DEMOLISH EXISTING WALL-PATCH&RE-PAIR AS REQ'D I DATE 03.04.02
EXISTING ' ILL TO REMAIN I CHECK: DCP
I DRAWN BY: JCC
NEW 3'•-0x6'-8"DOOR(U.O.N.)-MATCH EXISTING
W/LEVER HARDWARE MEETING ADA REQUIREMENTS
PROJECT. 202001
EXISTING DOOR
B 1. FIRST FLOOR PLAN --______-� _�— ---�-- �� - —�
Z _ ~`1 WD HARDWOOD FLOOR
LE: 114"=1'0" ��'
�..__------ -- ----------------�.__._ CPT CARPET
------_---------- -._.�-----___.._.-- ---- _ ---------------_.____ _.— _ SV SHEET VINYL
A281
C � 1 2
3 s 4
_'LRS Architects Inc.2001
. 1
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ITIS DUE TO THE QUALITY OF THE No.38 01:�m
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CITYOF TI CARD CERTIFICATE OF OCCUPANCY
DEVELOPMENT SERVICES PERMIT#: Bt1P2002-00161
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/2/02
PARCEL: 2S111 BC-03200
ZONING: R-3.5
JURISDICTION: TIG
SITE ADDRESS: 10335 SW VIEW TERR
SUBDIVISION: DOUGLAS HEIGHTS
BLOCK: LOT:009
CLASS OF WORK: ALT
TYPE OF USE: SF
'TYPE OF CONSTR: 5N
OCCUPANCY GRP: SR
OCCUPANCY LOAD:
TENANT NAME:
REMARKS: Construct entry ramp to front of house, create (1) new bathroom, make existing bathroom ADA
accessible. This permit was reviewed as residential group home, 5 or less, Occupancy SR3.3.
Owner:
LUKE-DORF INC
10313 SW 69TH AVE
TIGARD, OR 97223
Phone: 598-1186
Contractor:
PERFECTION HOME RENOVATION INC
2124 SE OAK ST
PORTLAND. OR 97214
Phone: 503-2.81.2043
Reg #: LIC 99419
This Certificate issued 0/7/011 grants occupancy of the above referenced building or
portion thereof and confirms that the bt,ilding has been inspected for compliance with the
State of Oregon Specialty Codes for the gro--p, occupancy, and use under which the
referenced permit was issuOd.
BUILDING INS ECTOR BUILDING OFFI IAL.
POST IN CONSPICUOUS PLACE
CELECTRICAL PERMIT
CITY OF TIGARD
PERMIT#: ELC2002-00199
DEVELOPMENT SERVICES DATE ISSUED: 5/3/02
13125 SW Hall Blvd.. Ticlard, OR 97223 (503) 639-4171 PARCEL: 2S111BC-03200
SITE ADDRESS: 10335 SW VIEW TERR
SUBDIVISION: DOUGLAS HEIGHTS ZONING: R-3.5
BLOCK: LOT : 009 JURISDICTION: TIG
Proiect Description: Alteration of(5) branch circuits.
RESIDENTIAL UNIT TEMP SRVC/FEEDERS _ MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: sPUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG-
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS --_ _ ADD'!-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: 4 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION —
1000+ amp/volt: >=4 RES UNITS: > GUO VOLT NOMINAL:
Reconnect only: SVC/FDR >=225 AMPS: — CLASS AREA/SPEC OCC:
Owner: Contractor:
I UKE-DORF INC .APOLLO ELECTRIC
10313 SW 69TH AVE ?O BOX 80783
1 IGARD, OR 97223 PORTLAND, OR 97280
Phone: 598-1186 Phone: 244-4410
Reg #: SUP 4123C
ELE 34-394C
LIC 102291
FEES Required Inspections _
Type By Date Amount Receipt Rough-in
PRMT CTR 5/3/02 $73.45 27200200001 Elect'/ Final
5PCT CTR 5/3/02 $5.88 2720020000(
Total $79.33
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 952-001-0010 through OAR 952-001-0080. You rnay obtain copies of these rules or direct questions to
r%'
Permit Signature: Issued B�/ - � �" � � y'
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent
OWNER'S SIGNATURE: _ _ DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: ___ DATE:—
LICENSE NO:
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit Application
jFate�reccived: 5 C` �Pcru.it .: Rpc,
City of Tigard Project/appl.no.: edate:
Address: 13125 SW Hall Blvd,,ripard,OR 97223
Date issued: B Receipt no.:
Phone: (503) 639-4171 _
Fax: (503) 598-1960 Case file no.: Payment type: -
Land use approval: —
t
&2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction U A(Idition/alteration/repl icemen, U Other: U Partial
t
Joh address: liMg. no.: Suite no.; Tax map/tax Iol/account no.:
Lot: Black: Subdivision: —
Pro'ect name: ---- -
.I .,P ' Description and location of work on premises: �%�,t,l,�A'r ;/y�'j ,c �/� �
Estimate(]date of.completion/inspection: --
CONTRUTOR APPLICATION
Job no: Pee Mar
Business name: _ Ik�criplion [Jty. (ea.) li tal no.line p
Nen nwidenfial-single or multi-fumlly jx-r
Address: (�, l X �(,7c: ___ F_ dwellinguril-Inclurlesattaclredgarage.
City: )✓ ^/'t, Slalc� ri; Li l'J"/'({ ? Seri ireincludrrl:
Phone: 3 vY/iCj Fax: I E-mail: IWO sq.It.or less 4
CCB no.: jeVElec.bus.lie.no: Each additional 5(x)s .A.or portion thereof
Limited energy,residential 2
City/metrotic.no.: 7C� Lintitedenergy.nun-residential 2
Each manufactured home ar modular dwelling
Sign uie o surpmery s g e ectricion(required) Date Service and/or feeder 2
Sup.elect.name(prini): TTrr' % Licenseno: t/77zServices or feeders-installation,
alteration or relocation:
200 amps or less 2
Nance(print): 201 snips to 400 snips 2
Mailing address:— - - -- 401 amps to 600 strips 2
-- --- — 601 amps to IW)amps 2
City: — _ Stale: 1/11,: Ove, Mitt amps or volts 2
Phone: I;tx: Frltlilll: Reconnect only 1
Owner installation:The installation is being made on propcily Iown Temporary services orfeeders-
which is not intended for sale,lease,rent,or exchange according to InslaHatton,alteration,orrelocation:
ORS 447,455,479,670,701. 21X1 amps or less
201 amps to 40O amps 2
Owner's signature: Dale: 401 in 6Mant,s
M toBunch circuits-new,alteration,
Name:
or extension per panel:
-- w_ A. Fee for branch circuits with purchase of
Address: _ service or feeder fee,each branch circuit
City: Sate: Zlp; B. Fee for branch circuits without purchase ' -
-� F of service or feeder fee,first branch circuit: 2
Phone: hax; l:-mail: Each additional branch circuit:
Mhc.(Service or feeder nol Included):
U Service over 225 amps-comnrcrcial U Itenith-care facility Bach pump or irrigation suck
U Service over 320 amps-rating of IRr2 U liaxantouslocatlon Eachsignoroutline lighting -- - , -
famdydwePings U Building over 10,M)O square feet four or Signal circuit(s)or a limited energy panel.
U System over600 volts nominal nacre residential units in one structure alteration,or extension* 2
U Building over Three stones U Feeders,4011 snips or more •Icscrition
U occupant load over 99 persons U Manufactured structures or RV park Each addifional Inspection over the allowable in any of the above:
U F:gress/hghlingplan U Other f'erinspe:tion
Submit—sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service, outer
Not all juriul,c0ons accept credit cauls,please cull judMlicrion fur more informeutsi Notice:"i his permit application Pennrt fee.....................$ ZJ
U Visa LJ MasterCard expires if a permit is not obtained Plan review(al ____ "G,► $
credit cud number- .__— __J--L— within IRO days after it has been Stale surcharge(8%) ....$
Name of cardholder u snon:redN—card >'
Bsplres accepted as complete. TOTAL $ _ - J—
Cardholder sips-am Amount 440-4615(WWOM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Complete Fee Schedule Below: Restricted Energy Fee...
..................................... ............. $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total
Check Type of Work Involved
Residential-per unit
1000 sq ft.or less —_ $145 15 _ 4 Audio and Stereo Systems'
Each additional 500 sq ft.or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00 _
Each Manufd Home or Modular
Dwelling Service or Feeder $9090 Garage Door Opener'
Services or Feeders LJ Heating,Ventilation and Air Conditioning System' I
Installation,alteration,or relocation
200 amps or less $8030 _ 2 r�
201 amps to 400 amps $106.85_ 2 L Vacuum Svslems'
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 E] Other
Over 1000 amps or volts $454.85 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Installation,alteration,or relocation Fee for each system.......................................................... $75.013
200 amps or less $88.85 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
New,alteration or extension per panel ❑ Boller Controls
a)The fee for branch circuits
with purchase of service or ❑ Clock Systems
feeder fee.
Each branch circuit $6.65 ❑ Data Telecommunication Installation
h)The fee for branch circuits
without purchase of service ❑ Fire Alarm Installation
or feeder fee.
First branch circuit _ $46.85
Each additional branch circuit $6.55 ❑ HVAC
Miscellaneous ❑ Instrumentation
(Service or feeder not Included)
Each pump or irrigation circle $53.40 ❑
Each sign or outline lighting _ $53 40— Intercom and Paging Systems
Signal circult(s)or a limited energy
panel,alteration or extension $7500 ❑ Landscape Irrigation Control'
Minor Labels(10) $12500
Each additional inspection over ❑ Medical
the allowable in any of the above ❑
Per inspection $62.50 Nurse Calls
Por hour _ __ $62.50
In Plant _ $73.75 ❑ Outdoor Landscape Lighting'
Fees: ❑ Protective Signaling
Enter total of above fees $ Other
8%State Surcharge $ _ _Number of Systems
25%Plan Review Fee
See"Plan Review"section on $ No licenses are required Licenses are required for all other installations
front of application ------- Fees:
Total Balance Due $
— —�_ Enter total of shove tees $_
❑ Trust Account N
8%Stake Surcharge $__
All New Commercial Buildings require 2 sets of plans. Total Bala•tce Due $
i:idsts`dnmu\Ac-fces.doc 08/30/01
CITYOF T I GAR D MECHANICAL PERMIT
DEVELOPMENT SERVICES DATE #: MEC2002 00180
E ISSU ISSUED: 512/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PARCEL: 2S111dC-03200
SITE ADDRESS: 10335 SW VIEW TERR ZONING: R-3.5
SUBDIVISION: DOUGLAS HEIGHTS JURISDICTION: TIG
BLOCK: LOT: 009 _ _
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 1
OCCUPANCY GRP: LINK VENTS W/O APPL: VENT SYSTEMS:
STORIES: _ BOILERS/COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
-- — 3 15 HP: COMML. INCIN:
MAX INPU BTU 15 - 30 HP: REPAIR UNITS:
FIRE Dt s0PERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS: 1
FURN < 100K BTU: v AIR HANDLING UNITS OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Moving existing dryer vent and adding (1) vent fan in new bathroom.
Owner: -
FEES
LUKE DOBE INC Type By Date Amount Receipt
10313 SW 69TH AVE FRMT CTR 512/02 $72.50 272.002000C
TIGARD, OR 97223 5PCT CTR 5'''_/02 $5.80 2720020000
Total $78.30
Phone:598-1185
Contractor:
PERFECTION HOME RENOVATION INC
2124 SE OAK STREET REQUIRED INSPECTIONS
PORTLAND, OR 97214 _
Mechanical Insp
Phone:503-281-2043 Final Inspection
Reg #:LIC 99419
This permit is issued subject 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. Tf:ose rules are set forth in OAR 952-001-0010 through OAR
952-001-0080. You may c',tcin copies of these rules or direct questions to OUNC by calling
resin A))AA-Q1RQ
Issue By: Permittee Signature: ^ _z _.
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application
-- —� Uatereceived: !j Permit no.: -a p
City of Tigard Project/appl.rI Expire date:
City of Tigard Address: 13125 SW hall Blvd,Tigard,OR 97223 $
Date issue6: y Receipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: __- Building permit no,:
1EMM2111,3111I
1 &2 family dwelling or accessory Conuucrcral/ntdustrial U Multifamily -J'I•enant improvement
U New construction U Aeldition/alteration/replacement U Other: _
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE,
Joh address: j u 3•?S 15W 4,c r/ Indicate equipment quantities in boxes below.Indicate the dollar
Bldg.no.; I Suite no.: value of all mechanical materials.equipment,labor,overhead,
'Fax map/tax lot/account no.: C),j profit.value$ kQ()-
lot: 111 jBlock: Subdivision: p,, 'See checklist for important application information and
1) -ect name: 0 jurisdiction's fee schedule for residential permit I'ce.
City/county: >, ,H; fog ZIP: 1 Z
Description and Iocatiin of work A premises: w ke P ���, .,.t. 1 t t 1
IBU
r't7t.e.� ,.� Fdv(ca.) Tolul
Est.date of completion/inspection: Co t I p? Dcsdripliun tpy. Res.only.Res.only
Tenant improvement or charge of use: Au handling unit CFM _
Is existing space heated or conditioned?�8 Yes U No Air conditioning(site plan required)
Is existing.,race insulated?Ibl"Yes U Nt+ Alteration of existing f VAC system
Boiler/compressors
State boiler permit no•:
Business name: Pt.r'� l�s%V �fr6vrE/f 4 r u_ HP Tons IBTUAI
Address: ;Z/4Y 4B' a41< %r7- _ Fire/smoke camper, uct smoke electors
City: plrj 7t�w!� State:�2 !_.I P: q1 4,- Heat pump(site p un require )
Phone: Jtl / u y rax:j j s� Email: nsla rep uce urnac mmner TU/f
Including ductwork/vent liner U Yes U No
CCR no.: yyt//g Instal I/replace/relocate heaters-.suspended,
City/metro lic.no.: P U I wall,or floor mounted
Name(please print): s l��lr wiff' Vent fora liance of ter than furnace
Refrigeration:
ON'FACT PERSON
Absorption uim, -._ BTU/H
�Name: ,$ tw I:os+e ofr Chillers--
- Com ressun 111'
ddress: 0031;; 0. ?nv ronmental exhaust an ventilation:
City; Slate:02 ZIP: R-722-3 Appliance vent
Phone: Fax:so3 E-mail:srosaafn: C. )ryerex aust
0o s.Type 1/res. ilchen azmat ,44
hood fire suppression system
Name: wi<c Do r_ Tn� Exhaust fan with single duct(bath fans)
Mailing address: s w 6 � G . A taus(s stem apart from heating or AU
- ue p p ng andistribution(up to out ets)
City: r d state:OR ZIP: 9.7 Z23 r LPG NO Oil
Ypc:
P11onc',rov S I I:IX So) S9$ dfsjL l -n1a11:5rascn .UC I m tae A IllOna pVCf outlets
rocess piping(schematic required)
Number of pullets
Name: Other Ilitel-i-p-plisince or egupment:
Address: -- - Decorative fireplace
City: 1State: ZIP: nsert-type
Phone: Fax: E-mail: oo stove/pc et stove
Ot ter:
Applicant's signature: ( Date:_S �, t er:
Name A"cnta
;
Permit fee.....................$ ' -
Not an jurisdictions accept credit cards,please call j an fin ounr infotmntion Nolice:This permit application _
U Viso U MasterCard P pp Minimum fee................$ (�:�-�-,•>--�.
expires if a permit is not obtained Plan review(at 7..5 %) $ _ a
Credit card mmnher. ___—_ —1--- witbin 190 days after it has been c
r•.apirrs Slate surcharge(896) $
accepted as complete. ....
Nome of cerdhol res shown on ctedlt cad s p p TOTAL. .......................$ #
Cadholdersi`nature Amount 440-4617 OAXW'OMl
CITYOF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2002-00149
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
DATE ISSUED: 516/02
PARCEL: 2S 111 BC-03200
SITE ADDRESS: 10335 SW VIEW TERR
SUBDIVISION: DOUGLAS HEIGHTS ZONING: R-3.5
_BLOCK: LOT: 009 JURISDICTION: TIG _
CLASS OF WORK: GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: 1 BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: 2 CATCH BASINS:
_ FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS:
^ SINKS: 0 URINALS: GREASE TRAPS:
LAVATORIES: 2 OTHER FIXTURES:
TUB/SHOWERS: 1 SEWER LINE: ft
WATER CLOSETS: WATER LINE- ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Remodel existing house to convert to residential group home of 5 or less residence.
FEES _
Owner: _ Type By Date Amount Receipt
LUKE-DORF INC PRMT CTR 5/6/02 $99,60 27200200000
10313 SW 69TH AVE 5PCT CTR 5/6/02 $7.97 27200200000
TIGARD, OR 97223 - --
�_ _ Total_ $107.57
Phone 1: 598-,1186
Contractor: _
STANDARD PLUMBING + HEATING
PO BOX 19205
PORTLAND, OR 97280 REQUIRED IW3PFC;TIONS
Rough-in Insp
Phone 1: 246-3338 Top-out Insp
Reg #: LIC 00007309 Final Inspection
PLM 2672PB
This permit is issued subject to the regulations contained ir, 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. These rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080.
You >1ay obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
Jssued BY - C ell y Permittee SignatureU9 :
Call (503) 639-4175 by 7:00 P.M. for an inspection neede the next business day
Plumbing Permit Application
Datere.-eived: Pe itno.:
City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Sewer permit no.: Building permit no.:
C"ty of hKarrl Phone: (503) 639-4171 Project/appl.no.: •date:
Fax: (503) 598-1960 Date issued: ByjXj Receipt no.:
Land use approval: Y— Case file no.: Payment type:
154 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant im,irovement
U New construction A(ldition/alteration/replacenu•nt U I-ood urs tce U Other:
.1011 S1 111'. INFORMATION 11-11" SCHED11 IF(for special itifcotination use checkli%l)
Job address: 10 33UU-4t" ,.`.- 14&1�lze Description "y. Pec(ea.) 'Total
Bldg.no.: Suite no.: New I-and 2-family dwellings only:
- --- (Includes 10011.for cacti ulilitvconnect Ion)
Tax map/tax lot/account no.: SIR(1)bath
Lot: Plock: I Subdivision: -- -
SfR(2)bath
Project name: _ SFR(3)bath
City/county: 'fq,CI 7.IP: 722 Each additional bath/kitchen
Description and location of work ol,premises:-__ Site utilities:
_ L) L Catch basin/area drain _
Est.date of completion/inspection: Drywells/leach line/trench drain
Footing drain(no.lin,ft.)
Manufactured home utilities
Business name: T ?e-i.) I t "ri,l- ^ Manholes
Address: P.p. Ojc) Rain drain connector
City: -eel'_ I Statc:Q/►- I ZIP: 7,2 "'v Sanitary sewer(no. lin. ft.) _
Phone:SC - Faxv3 y-/ E-mail• ekv9l;� /f/lA/ Storm sewer lin.ft.) _
CCB no.: 'L9173& Plumb.bus.reg.no: z (3 Water service(no. lin. ft.)
City/metro lie.no.: Fixture or item:
Contractor's representative signature: Absorption valve
' Back flaw preventcr
Print name: t T t-' Date: S- ®/- Backwater valve
Basins/lavatory tc33
7plr(L'�;
o Clothes washer-- Dishwasher
Drinkin fountain(s)
�j State ZIP Ejects s/sump
, '' Fax: E-mail Expansion tank
Fixture/sewer cap
Name
"(print): �� n t= Floor drains/floor sink.Oiub —
Mailing address: V a0 Sul -V- u„ _ — Garbage disposal - -
� 1L llttse nibb
_City. (; i► - Stat . ZIP: u Ice maker
Phone: 03 �j - Fax: Email: Interceptor/grease(rap
Owner installation/residential maintenance only: The actual installation Primer(s)
will be made 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(s),basin(s),lays(s)
Owner's signature: _-_--- Date: Sum }
Tubs/shower/shower pan _ 4
Name: Urinal
_ _ - ___-- Water closet
Addrc�s: Wate,heater
City: State: ZIP: Other:
Phone: � �ax: E-mail: ota
NM all judedictimu accept credit cants,please cell jurisdiction for mom infannoidu.. Notice:This permit application Minimum fee................$ '_9/•�
U visa U MasterCard expires if to permit is not obtained Plan review(at _ %) $
Crrdit card nurrther -—, / /_- State surcharge(8%) ....$
-
Expire, within 180 days after it hes been �j—�---
-- — -- accepted as complete. TOTAL ..................... $
Name or cardholder—0 shown on credit t carom
s /4 /• -'5
` ('ardhoider siguuure — Amount 440.1616(60YCOM)
440
r.
PLUMBING PERMIT FEES:
PRICE TOTAL New 1 and 2-family dwel':igs only:
FIXTURES (individual) QTY ea AMOUNT (includes all plumbing fixtures In PRICE TOTAL
Sink 1660 the dwelling and the first100 ft. QTY (ea) AMOUNT
Lavatory 1660 for each utility connection _ 1I
One(1)bath $249.20
Tub or Tub/Shower Comb 1660 Two 2)bath $350.00
Shower Only _ 16.60 Three 3 bath $399.00
Water Close( 1660SUBTOTAL
Urinal 16.60 8%STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL
Garbage Disposal 1650 ___TOTAL —
Laundry Tray 1660
Washing Machine 16 u0
Floor Drain/Floor Sink 2" 16.60
- PLEASE COMPLETE;
3" 1660
4" 16 60 —
Waler Heater O conversion O like kind 16.60 Quantity b e Work Performed
Gas piping requires a separate mP.hanical 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 _
Tub or Tub/Shower
Ilose Bibs 16,60 _ Combination
Roof Drains 16.60 Shower Only —�
Drinking Fountain 1660 W�aef Closet
--- Urinal _
Otter Fixtures(Specify) 16.60 _ Dishwasher
Garbage Disposal _
-- "— Laundr Room Tray _
------ Washing Machine
Floor Drain/Sink: 2"
Sewer-1 at 100' 55.00 3"
Sewer-each additional 100' 46.40 4"
Water Servl,^e-1 at 100' 5500 Water Heater _
Water Service-each additional 200' 46.40 — Other Fixtures
Storm&Rain Drain-1st 100' 55.00 _
Storm&Rain Drain-each additional 100' 46.40 —
Commercial Back Flow Prevention Device 46 40
Residential Backflow Prevention Device' 27.55 — —"
Catch Basin 16.60
Inspection of Existing Plumbing or Specially 62.50
Requested Inspectionsper/fir _�— COMMENTS REGARDING ABOVE:
Rain Drain,single family dwelling 65.25
Grease Traps 1f+.60 ------- — — ---
QUANTITY TOTAL Y _
Isometric or riser diagram Is required If
ouantlty Total Is ?9 _ --- --- -- --
*SUBTOTAL ----
-- 8%STATE SURCHARGE ---- - ------ ---- ----
"PLAN REVIEW 25%OF SUBTOTAL
Re ulred only if fixture qty total is>9
TOTAL S
*Minimum permit fee Is$72 50 4 8%state surcharge except Residential Backflow
Prevention Device,which Is$36 25.8%state surcharge
"All New Commercial Bulldings require 2 sets of plans with Isometric or riser
diagram for plan review.
I:Wsts\forms\pim-fees.doc 12/26/01
� BUILUING PERMIT
CITY OF TIGARD _
PERMIT#: BUP2002-00161
DEVELOPMENT SERVICES DATE ISSUED: 5/2/02
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S11113C-03200
SITE ADDRESS: 10335 SW VIEW TERR
SUBDIVISION: DOUGLAS HEIGHTS ZONING: R-3.5
BLOCK: LOT: 009 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: 0T§ FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N sf N: S: E: W:
OCCUPANCY GRP: R3 TOTAL AREA: 000 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT?: MEZZ?: REQD SETBACKS _ REQUIRED _
FLOOR LOAD: psi LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 24,000.00
Remarks: Construct entry ramp to front of house, create (1) new bathroom, make existing bathroom ADA accessible. This
permit was reviewed as residential group home, 5 or less.
Owner: Contractor:
LUKEDORF INC PERFECTION HOME RENOVATION INC
10313 SW 69TH AVE 2124 SE OAK ST
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: 503-684-2860 Phone: 503-281-2943
Reg #: uc 99419
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Framing Insp
PRMT GTR 5/2/02 $273.70 27200200000 Final Inspection
5PCT CTR 5/2/02 $21.90 27200200000
PLCK CTR 5/2/02 $177.91 27200200000
Total $473.51
This permit is issued subject to the: regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will he done in accordance with approved plans. This permit will expire if work is
riot started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION- Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OARS 52-001-1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503)246-6699 or 1",0-332-2344.. ,
Permittee j% /
Signature: - r— t
Issued By: ld
`\" Call 639-4175 by 7 p.m. for an inspection the next bu Aness day
Building Permit Application
Datereceived: J Permitno.
City of Tigard :r
Address: 13125 SW Hall Blvd,Tigard,OR 97223 f'rojecUappl.no.: date:
City of Tigard Yt no.:Date issued: g Receipt Phone: (503) 639-4171 P
'rax: (503) 598-11960 Case file no.: Payment type:
r
Land u / t 1&2 family:Simple Complex:
s� �vel; i
'XI &2 family dwelling or accessory Commercial/industrial U Multi-family U New construction U Dellmlition
U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alarm U 011ier:
Job address: to 3 65 5 V;euj -F&rr 0-co-, -V _Bldg.no.: I Suite no.: —_-
Lot: of Bl(xk: Suhdivision: (a Tax map/tax IoUaccount no.: o- D
Project name: jn
Description and location of work on premises/special conditions: Moi Kt. 11�,nuav ADAs� .J./�•rd foe�-4 leery tte AT LI)
a�Ch ree M d c.rr�l�t dur �.SiJ b_(' G,,,A.ALGA 4,r (Floodplain,%eptic capacity,%ollar,etc.)
ad
�g1S . — --
(MNIN tOWS111111 IAL INFORMATION, USE' CHECKLIST
Name: Luke-7je�� r�G.
Mailing address: (o 3 l (;110, a-J<, 1&2 fandly d"elling:
City:Ti r t Istatc:OILIZIP: 91 7-Z Valuation of work......................... ............ $ L Al 00 _
Phone: 5 Il Fax f-mail: No.of bedtooms/haths.................................-Mi
O', er's representative: n 6 roL der P.° Total number of floors................................. t
Phone: 6*111011tf. x Fax: .% 51 - 1 tutil:SrcSeAbl"9 01, New dwelling area(sq.ft.) ..........................
Garage/carport area(sq.ft.)......................... c=�
Covered perch area(sq. ft.)
Name: yl�-DOrF' Ing—, Z �
Mai Iing address: 1 o 'N Aim, Deck arca(sq. ft.) ........................................ p_�-_._.
City: r State: ZIP: 9"1Z2-3 Other structure area(sq.ft.)........... .............
Ph,mr: s; S?8. t Fax 594 g�51_ F. nlailsr�,�„ �,LuwJ+ Commercial/industrialimulti-family:
Va'uation of work........................................ $
Exi:tting bldg.area(sq.ft.) ..........................
Business name:t "� /L.ve A Irvnl �� -u—�—
��ftx 7ioN jef)At _ ✓ New bldg.area(sq.ft.)................................
Address: /Ail 4
State: ZIP: 7 Number of stories........................................
City:'& -1&V0 pC 1/4 Type of construction...............................
Phone:Jo le y3 Fax: ss i& I E-mail:;yur C✓,y,.,mea. Occupancy group(s): Existing:
CCB no.: y>4 y _ New:
City/metro lie.no.: c �. 7 1_Z 7 Notice:All contractors and subcontractors are required to 1,e
licensed with the Oregon Construction Contractors Board under
Name: po-,r, 1P, 114-Q5 Arck, c,+5 provisions of ORS 701 and may he required to be licensed in the
Address: "_I oIOU
,jurisdiction where work is being performed. If the applicant is
Cit 5tate:0/Z ZIP: exempt from licensing,the following reason applies:
Y: Sr I�
Contact person: b.„ P kt- Plan no.: 'Z. c'P4ch.7
Phone: ZZ(-112,f ax:Z-1 '7 Email:
Name: _ _ Contact person:_ Fees due u application $
Address: Date received:
City: State: ZIP: Amount received ......................................... $
Phone: Fax: I E-mail: Please refer to fee schedule.
1 hereby certify I have read and examined this application and the Not all Jurisdictions accept.relit cards,please call jurisdiction for more inGttrnation.
attached checklist. All provisions of laws and ordinances governing this U vigil U MasterCard
work will he complied with,whet) specified herein or not. Credit card number
Expires
Authorized signature: Date: t O.2 Name of cardholder as shown on credit cud
Print name: 5e �I` Rneocn Cardholder signature $
Amount
Notice:This pennit application expires if unit is not obtained within 190 days alter it has been accepted as complete. ao-at a lrrvacoMt
Commercial Plan Submittal
Requirement Matrix
City of Tigard
TYPE OF SUBMITTAL # of Plans
(Includes New, Additions or Alterations) Required at
Submittal
Site Work l 4,/
(must include location of all accessible parking)
Plumbing - Site Utilities 2
Building 1*
Fire Protection System 3**
Mechanical
Plumbing - Building Fixtures 2
Electrical 2
Plan review is dependent upon submittal of a completed application and plans. After
plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for Contractor, City of Tigard,
Washington County, and Tualati,i Valley Fire & Rescue).
*For over-the-counter commercial tenant improvements, submit 2 sets of plans.
**"New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire suppression engineer, or NICET level "3" technicians.
iAdsls\forms\COM-matrix doc 9/24101
Accessibility:
Barrier Removal Improvement Plan
City of Tigard
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation,alteration or modification to affected buildings and related
facilities shall be made to insure that the path of travel to the altered area and the restroom,
telephones and drinking fountains are readily accessible to individuals with disabilities unless
such alterations are disproportionate to the overall alterations in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed disproportionat, to
the overall alteration when the cost exceeds twenty-five per-cent(25%).
VALUATION: of all renovation, alteration or mo,:ification being dune 0
excluding painting,wallpapering. [1J $^Z H� 00
mult 125% Barrier removal requirement. 25 _
BUDGET FOR BARRIER REMOVA' [2] $_hof 00 a
In choosing which accessible elements to provide under this section, priority shall be given to those
elements that will provide the greatest access. Elements shall be provided in the following order:
(a) Parking $ 300
(b) An accessible entrance:
$ $I 00 0
(c) An accessible route to the altered area: $
310 ,00
(d) At least one accessible restroom for $
each sex or a single unisex restroom:
00
(e) Accessible telephones: $ -
(f) Accessible drinking fountains: and $ _..--------
(g) When poss:ble, additional accessible
elements such as storage and alarms: $— --
TQTAL: Shall et�ual Ifne 2 of Value om^utation $__ZO 38i� --
c\dsts\forms\Accessibility.doc 09/24/01
CITY $-F TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST - ----- -_.
INSPECTION DIVISION BusinesF Line: (503)63'1-4171
BUP --
i
Received —_ Date Requested_ , AM— PM BLIP
I-ocation -_ -- ==`"�"`"� �1 Suite MEC
- Ph( ) 'J �� �� - q I l6 PLM
C ---- -- —
Contact Person _- C
Contractor __../!�3l rte,?�����i C Ph( ) _ -� ��"� SWR
_ cy
_BUILDING Tenant/Owner — _ ELC
Footing _ ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain - SIT �
Slab Inspection Notes:
Post& Beam _ - --
Shear Anchors
Ext Sheath/Shear IF --
Int Shoath/Shear
Framing -
Insulation
Drywall Nailing - -
Firewall
Fire Sprinkler ---- -----
Fire Alarm
Susp'd Ceiling --
Roof � 72
Other: -_ �-
Final
PASS PART FAIL
PLUMBING - - - -- --
Post R Beam
Under Slab
Rough-In
Water Service
?anitary Sewer
Rain Drains - -
Catch Basin/Manhole _
Storm Drain —�
Shower Pan
Other -�
Final
PAS3 PART FAIL
MECHANICAL --
Post&Beam
Rough-In —
Gas Line
Smoke Dampers
Final
PASS PART FAIL ----------_.__.—_�—
_ELECTRICAL
Service
Rough-In -
UG/Slab
Low Voltage -
Fire Alarm
t� ❑ Reinspection fee of�..—_ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SIT _ E] Please call for re inspection RE: Unable to Inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date - � �' Inspector1 _ Ext—---
Other:_
Final DO NOT REMOVE this Inspection record from the job site.
7ASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
MST
INSPECTION DIVISION Business Line: (503) 639-4171
BUP
Received Date Reque'ted,___ __ ._..._ AM _-_ __ PM BUP
Location �� - �'J `'` uite T - -- -_- MEC —
Contact Person ___ .__ Ph(--) v PLM
Contractor. __ _ Ph( ) _ _
SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Fig Drain ? ELR -
Crawl Drain
Slab Inspection Notes: SIT --
Post&Beam -_-__ _._� ,•
Shear Anchors
Ext Sheath/Shear —r -- - --
Int Sheath/Shear
Framing - - _ - --- -
Insulation
Drywall Nailing .... -- --
Firewall
Fire Sprinkler - -- --- - - _
Fire Alarm
Susp'd Ceiling --- --- - - -`-"� "
Roof _
Other:
Final _
PASS PART FAIL %'z.
PLUMBING _ - --_-- -- ----
Post& Beam
Under Slab -- -- -
Rough-In
Water Service __-
Sanitary Sewer
Rain Drains - -- ---- - - -
Catch Basin/Manhole
Storm Drain —
Shower Pan
S PART FAIL - -- - --
HA_NICAL _-----__....-_ -- _-- - -- -
Post&Beam
Rough-In - ---- ------- - --- - ----
Gas Line
Smoke Dampers - - -- - - -
Final
PASS PART FAILScirvice
--�--
ELECTRICAL
Rough-In
UG/Slab
Low Voltage _-------
Fire Alarm
Final
lPART FAIL F] Reinspection fee of$_— _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
-PASSSITE F] Please call for reinspection RE:�__ - - [-] Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date ___ Inspector __ _ Ext
Other:
Firal DO 40T REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
BLIP
Received --..-.-----Date Reque ed � / 7 —_ AM__-__ _ PM — BLIP
Locationt�-�-J �`-` -�-� Suite MEC _------- _-_-_- ,-
Contact Person _ __— Ph(�__ 1 n,j —X1-3.5 7 PLM _
Contractor --- __-- — Ph ( _- ) SWR
UILDIN Tenant/Owner -_ _ ELC
Foundation Access: ELC _
Ftg Drain ELR
Crawl Drain
Slab Inspection 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:- - -- -
1`inI�
AS PARTFAIL
Post& Beam
Under Slab
Rough-In
Water Service ----- -- --------------- -- --- -
Sanitary Sewer
Rain Drains __- -------_-__--_ _
Catch Basin/Manhole
Storm Drain — - - --
Shower Pan
Other: -- --- -- -- -
Final
PASS PART FAIL ---- ----
M_E_CHANICAL _
Post& Beam - -- -- —
Rough-In ------ --- -- --- -- —
Gas Line
Smoke Dampers - --
Final
PASS PART FAIL —
ELECTRICAL
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
SITE F] Please cs!t for reinspection RF: El Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector _-
Other:
Fina! DO NOT REMOVE this Inspection record from the job site.
PA
IL PART FAIL
SEE.. 35MM
ROLL # 20
FOR
OVERSIZED
DOCUMENT