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ITIS DILE TO THE QUALITY OF" THE _ _ _ No.36
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12830 SW 116"' Avenue
a
MASTER PERMIT
CITYOF T I GARD PERMIT#: MST2002-00434
DEVELOPMENT SERVICES DATE ISSUED: 10/25/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 12830 SW 116TH AVE PARCEL: 2S103BD-10300
SUBDIVISION: HUNTER'S WOODLAND ZONING: R-4 S
BLOCK: LOT: 015 JURISDICTION: I I1
REMARKS: Construction of new SF detached residence.Path 1
BUILDING
STORIES. FLOOR AREAS _ PEOUIRED SETBACKS REQUIRED
REISSUE: --
CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,068 at BAF-MENT: of LEFT °;�. SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOIID: 1,312 at GARAGE: 440 of FRONT: PARKING SPACES: 2
'
TYPE Or CONST: 5N DWELLING UNITS: 1 FINBSMENT: of RIGHT:VALUE:
229,680.00 REAR. 1'
UCCJPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 2,970 of
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS, RAIN DRAIN: 100
TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
tUBiSHOWERS 1 GARBAGE DISP: 1 WATER HEATERS: i WATER LINES! 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
_ FUEL TYPES FURN<10OK: BUILICMP 13HP VENT FANS: 5 CLOTHES DRYER: 1
.1n:;
FURN1=100K: 1 UNI"i HEATERS, HOODS: 1 OTHER UNITS: 1
MAX INP: hlu Fl OOR FUkNANCES:
VENTS 1 WOODSTOVES: GAS OUTLETS:
ELECTRICAL
-- r
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
,
1000 SF OR LESS: 1 0 - 200 atilt 0 - 200 amp: WISVC OR FOR: 1 PUMPIIRRIGATION: PER INSPECTION:
EA ADC'L SOUSE. •t 201 - 4011 amp.
201 - 400 amp: lot WIO SVCIFDR: 00 SIGN/OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 800 atilt)
401 Goo amp: EA ADDL eR CIR: SIGNALIPANEL: IN PLANT:
MANU HMISVCIFDR.
601 • 1000 amu. 601-amps-1000v: MINOR LABEL:
1000•amplvolt: PLAN REVIEW SECTION
Reconnect only >-4 RES UNITS! SVCIFDR>•225 A.: >600 V NOMINAL: CLS AREAISPC OCC:
ELECTRICAL•RESTRICTED ENERGY
— B.COMMERCIAL
A.SF RESIDENTIAL
AUDIO&STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH BOILER, HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL:
G..'AGF OPENER:
CLOCK INSTRUMENTATION: MEDICAL: OTHR:
HVAC:
DATAITELE COMM NURSE CALLS, TOTAL N SYSTEMS:
TOTAL FEES: $ 7,251.01
Owner: Contractor: This permit Is subject to the regulations contained In the
LEGACY HOMES LLC LEGACY HOMES LLC Tigard Municipal Code,State of OR. Specialty Codes and
PO BOX 446 PO BOX 446 all other applicable laws. All work will be done In
SHERWOOD,OR 97140 SHERWOOD,OR 97140 accordance with approved plans. This permit will expire 1f
work is not started within 180 days of issuance,or if the
work is suspended for more than',, J days. ATTENTION.
Oregon law requires you to follow rules adopted by the
Phone: 503-74_21 O(J Oregon Utility Notification Center, Those rules are set
Phone! 503-925-0506 forth In OAR q52-001-0010 through 952-not-0080. YOU
Reg r: 111 G46R7 may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam Mechanica Mechan^•al Insp Shear Wall Insp Insulation InBp ElEctrical Final
Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Insl Rain drain Insp Mechanical Final
Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Plumb Final
Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Line Insp ApprlSdwlk Insp Final inspection
Post/Beam Structural PLM/UnderfloorFraming Inst Gas Fireplace Backflow Pre entor
/ �' Pe.;rnitter Signature :Issued ey : CMI (503) 639-4175 by 7:00 p.rn. for an inspect,on needed the 1'*s�Iit tzss day
SEWER CONNECTION PERMIT
CITYOF TIGARD PERMIT#: SWR2002-00289
DEVELOPMENT SERVICES DATE ISSUED: 101215102
13125 SW Hall Blvd.,Tigard, OR 9722: (503) 639-4171 PARCEL: 2S i 03BD 10300
SITE ADDRESS; 12830 SW 116TH AVE ZONING:
SUBDIVISION: JURISDICTION: --
BLOCK: LOT: —
TENANT NAME: FIXTURE UNITS:
USA NO: DWELLING UNITS: 1
CLASS OF WORK: NEW NO. OF BUILDINGS:
TYPE OF USE: SF IMPERV SURFACE:
INSTALL TYPE: I-TPSWR
Remarks: Sewer connection permit for new SF detached residence
Owner, FEES _ -- _
-_ Date Amount
Lha=,ACY HOMES LLC Lip —
PO EtOX 446 10/25/02 $2,300.00SHERWOOD, OR 97140 Connect 10(25IU2 $35.00
Inspect
Phone: 503-925-0500 Total - $2,335500
Contractor:
Phone:
Reg #:
Required Inspections —
This Applicant agrees to comply with all the rules and
will be foafeitedtions tif the permit expf the Clean ires Services.
7he Agency doeslnot Aires 180
days from the date issued. The total amountp the
guarantee the accuracy of the side sewer latethe distance given.if the elfinot so�ocated tthe installerrshallnpurlven,the
installer
llercl
shall prospect 3 feet in all directions from
es adopted
Side Sewer" Permit and the Agency will Those ruteral. ATTENTION: Oregon law requires les are set forth in OAR 952-001 0010 thryugh 0 119 r�i1001 0100.
by the Oregon Utility hlotification Cerlte
You May obtain copies of these rules or direct questions to OUNC by calling(503) 246 9 .
Permittee Signature:
Isdued by:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
j r
Building Permit Application
City of Tigard Datereceived:�_ t Permit no. '
Project/appl.no.: Expire date:
i�uyojrigard Address: 13125 SW Hall BIvtI,•1'rgarJ;OR 0'U3 ---
Phone: (503) 639-4171 Date issued: — By. ( Receipt no.: G
Fax: (503) 598-1960 y/"1 Case file no.: Payment type:
7 �
Land use approval: _��/ / I&2 family:Simple Comatcx: O
OF
U I &2 family dwelling or accessory O Commercial/industrial U Multi-family )(New construction ❑Demolition I`,
U Addition/alteration/replacement ❑Tenant improvement O Fire sprinkler/alarm 0 Other:
JOB a
Job address: " Bldg.no.: Suite no.:
Lot: 15 1 Block: Subdivision: f ntcr l J�nr�-(((�t� Tax map/tax lot/account no.:L, J joL 1>IO J
Project name: Z 2 09r I Oto
Description and location of work on premises/special conditions: _
OWNER FOR
Name: 1 ('.t 0►Ylt'S 1. '
plain,septic capacity,solar,etc.)
Mailing add ss: 1 & 2 family dwelling: .»
City: " i State: ( ZIP: 'j Valuation of work.......12.... � J !.,....., $ �. �1
Phone: -)'(-)L) Fax r1113--mail: No.of bedrooms/baths.................................
Owner's representative: j 1- IP' Total number of floors................................. L
Phone: Fax: E-mail: New dwelling arca(sq.ft.) Z t^
..........................
Garagc/carport arca(sq.ft.)
Name: ��/]1Y r �j (�' :� t'r Covered porch area(sq. ft.) ......................... �I
Deck area(sq. ft.) ........... ...........................
Mailing address: _
-�- Other structure area . ft.)....................
City: State: ZIP: •.•••
--
Phone: Comotercial/industriat/ntulti.family:
I',t r [:-mail:
r r , Valuation of work............. .......... ... $
Business name: �fl r" Existing bldg.arca(sq.ft.) ............ ...........
- -- - New bldg,area(sq. ft.)
Address: --- Number of stories ................... ...... ............
Phone: 'a"'.
City:
--J''t"tc• Zi P' Type of construction
I ,�� : ..
-- - Occupancy group(s): Exis ng:
C-mail
CCB no.: (�,I(y_i New: --
City/mctro lic. it,, . Notice:All contractors and subcontractors are required to be
'ARCIlliftcluDESIGNER licensed with the Oregon Construction Contractors Board under
Name: -7- ;r,r provisions of ORS 701 and may be required to be licensed in the
Address: -",,_, s jurisdiction where work is being performed. If the applicant is
-�-� -- --- exempt from licensing,the following reason applies:
City: /
Contact person: flan nu.: �� 1(-)
Phone: G` < j ~, Fax:(v'' E-mail:
Name: _ Contact person: _ Fees due upon application ........................... $_
Address: Date received:
City: State: 7,IP: Amount received ......................................... $
Phone: Fax: I E-mail: Plearc refer to fee schedule.
hereby certify I have read and examined this application and the No all juriadictiona accept credit cudr,Idcw call jurikkdon for more Information
attached checklist.All provisions of laws and ordinances governing this U Visa U himtercard
work will be complied with,whether s eciftrrd herein or not. Credit cud number:
r mu '—ti,pirer
Authorized signature: � („/,/Ci Date: It) l.1 11,. Nae of cudholder ahown on credit cud
Print name:�(� Cudho r NRnuurc Amount
Notice:This permit application expires if a permit is not obtained%%illim 180 days allcr it has been accepted as complete. Ot0-4613 t6WCOMl
Mechanical Permit Application
�^
City of Tigard Date received: Permit no.:An r( j-00 Lj
Citof Address: 13125 SW Hall Blvd,'T'igard,OR 91223 Pro;ervappl.no.: Expire-date:
Phone: (503) 6394171 Dace issued: By: IReceipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: Building permit no.:
1 '
0 1 &2 farnily dwelling or accessory U Commercial industrial U Multi-family Ll Tenant improvement
"XNew construction U Addition/alteration/replacrnu'fit O Other:
Job address: ' '_ Indicate equipment quantities in boxes below. Indicate the dollar
Bldg,no.: Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.:,Z'- IF- profit. Value$
Lot: Block: Suhdivision:
"See checklist for important application information and
Project name: jurisdiction's fee ,ckt�dulc lire residential In•nnit (ct�.
City/county: ZIP: 1
Description and ocallotl Of work oh pIWIN
rernlscs: 1 1 1 1 1
Est.date of completionlinspection: — Descripition _ Qty. Re.s.only Res.anly
Tenant improvement or change of use:
Is existing space,heated or conditioned?0 Yes U No Airhandling unit ,_Cnl____
Is existing space insulated?U Yes U No ircon itioning(site plan require ) - -
A teration of existing HVAC system
CONTRACTOR tol rr eompressors -
Business name: l ) State boiler permit no.:
Address: L% S(� Hp Tons BTU/H
Fire/smoke dampers/duct smoke electors
City: J State: ZIP: ILYJ(i eat pump(site plan require )
Phone:(D(y j IIS Fax:(„f;; pal' I E-mail: Install rep acefurnac urner__
CCB nrl Including ductwork/vrnt liner U Yes U No
-- nstull//rep ac re ocate healers-suspenr e ,
City/metro lic.no.: wall,or floor mountvl
Name(please print): eat ora r ianee of ,r than urt�iace-
CONTACT1 e r g�rst on:
Absorption units_ BTUM
Name: brrt M i to u i C: , Chillers __ HP
Address: po ux r - Compressors )Ip #=
City: ^ State: Zip: r Environmental ex suit rn rent at on:
�ll Appliancevent
Phone: J(,;: Fax:1-1�t r-I E-mail: pplianzlyylex suit
Hoods,Type /Wres. itc a tazmat
hood fire suppression system
Name: J2r-Ir- Exhaust fan with single duct(bath fans)
Mailing address: Exhaust system apart from linting or�C-
-�
State: 7.IP: 'ue'piping and distribution(up to out els)
City:
1. nrn� 'Type: LPG NG Oii
I horn: I ;1 I ur iping Each additional over 4 outlets
ENGINEER roceis piping(schematic re-- 1
Nantes Numher of outlets qure
--- - �dliserIFfe-dapp anceorequpmcT—ni—
Address: Decorative fireplace
City: -- -- State: — Zip: _—� -Insert-type —
Phone: I.ax' G mail oo stove pe et stove
- !SOther:
t er:Applicant's signature: t er
:
Name (_pr_)
— _
Permit fee --
Nor nit Imiulicllon+;w�crpl crrJil ca,dti please calljurirdicliun fur mor!inrnnnnrion .,.....$
U Visa U Maslert'nrd No(ice:This permit application Minimum fee................$
rt iris ifs ,cnnil is not obtained -
�"rrdir cart number _....------. ..__ p (
__ clan review(ret � ^/r.) 1•
—_
t1Rpi,rs vv11 in 180 days utirr it has been
-'--- ---- State surcharge(87i) ....$
Nucor ur cnnaur r,oe xhuwn on ere II con = nCCCplyd as enmpll'te. I OTA I
�__----(>uJhubk,drnnrurc Amuuni� -
W 4617(rifllw:'oM)
f
Electrical PermitApplication nn,,
Date reccivc;d: _ Permit no.: �—,
City of Tigard Project/appl.no_: Expiredate:_
City of Tigard
Address: 13125 SW Hall Blv(1,T)gardi)A 97223 Date issued: By: Receipt no.:
-
Phone: (503) 639-4171 Case file no. Payment type:
Fax: (503)598-1960
Land use approval:
TYPE OF PERMTF
U I &2 family dwellin)c or icce,;sh,ry U commercial/industrial U Multi-family O Tenant improvenh�-nt
XNew construction U Addition/alteration/rrhl.i m n U Other: - _ U Partial
1 1 1
Bldg.no.: Suite no.: Tax map/tax lot/account no.:
Job address: )L,& 6 0 5 4 tlh .� c . g
Lot: 15 1 Block: Subdivision: r ._�V 2� Iy 3 e,i:)10 3(�c- / R Z 09�I
ur I� �_ �lcirtCl
Project name: I Description and location of work on premises:
Estimated date Ot Lompletion/inspection:
l
1112 11 fix a
I ee 10
Max
Job no: Description QIY. I-) Total no.Ins
Business name: rl,IT,i 1('k I e E I C G-tt 1 c_ New residential-stock or multi-family per
Address: - dwellingunit.Includei;attached gmge.
y Ji, r t State.. ZIP: C1 3U Serviceincluded:
Cit 4
�'.� .- Fax: " `j3 �"IZl E-mail: Io00sq.n.ortess
Phone:j 12,1. J Each additional SW s .ft.or portion thereof _
CCB no.: I III'LI Elea bus.tic.no: 3�` Limited energy,residential 2
City/t lr0 tic.n .: Limited energy,nor.•�esidential 2
I O 1�� 0 2 Each mar ufactured home or modular dwelling 2
�^— — Service and/or feeder
Signature f su rvising elect clan requirod) D01 Servicesorfeeders-Installalion,
Sup.elect.name(print): t \J r J License no: alteration or relocalion:
1 1 200 amps or less 2
201 amps to 400 snips 2
Name(print): I C c n r t. I I, , I_.r.. 401 snips to 600 amps 2
Mailing address: ,ion 601 anips to I000amps �— 2
State:; ZIP .- ('i Over I(NNi amps or volts
C 2
City: ` ' C,o I — 1
) E-mail: Reconnect only
Phone:' fir.; )r.)OCP' Fax: ) 1 'remponrry services or feeders-
Owner installation-The installation is being made,on property l own installation,alteration,orrelocation:
which is not intended for sale,lease,rent,or exchange according to 2txt amps or less 2
ORS 447,455,479,670,701. ?.o I amps to 400 amps _ 2
Oltiner's signature: Date: —_ 401 le 600 ams 2
Branch circuits-ness,alteralion,
or extension per panel.
Nome: A, Fee for branch circuits with purchase of 2
Atldh ess: service or feeder fee,cacti branch circuit
State: ZIP: H. Fee for branch circuits without purchase 2
t'ily: of service or feeder fee,firsl_branch circuit:
I'htrtu^ F:IX 1:-nt,hil liachadditional branch cirLutt.
M lvc.(Service or feeder not Included):
F.ach pump or irrigation circle 2
U Service over 22S nmps•eaumrrcial U Health-ewe lachht Each sign or outline lighting_ 2
U Service over.120 amps-rating of Idr2 U Ha.ardouslocalion Si,tial circuit(s)cr A limited energy panel,
family dwellings UBuildingoverlo,mosquarefeetfuuror alteration,or 2
U Sy%tem over 600 volts nominal more resitimlial units 1n one structure _
U'Building over three stories U reeden,4110amps ormom •fkscri tion:
U Occupant load over 99 persons U Manufactured structures cr RV park Fitch addllional Inslwrlion Msrr 0hr alto»able in any of lire shore:
U 1-gress/lightingplan U Other perinspection
Submit-_-_sell of plan+with any of the above. Investigation fee ---)
The above are not applicable to temporary con+truction service. triter _
rr Perlllit fel'.......... $ —
Not all iuhisdictiuMs accept credit rands,plea a call jmluhpermit for msxe inGMMutlun. Notice:TiliS a lication Plan review(at /,) $
Visa U MnstclCnnl expires if n P'ennit is not obtained State surcharge(8'Y,) ....$ -_
U
Cledu cord nutotser.-_---- -_- _-- —.- / within 180 days oiler it has been
F%pllet accepted nti colllplele. TOTAL AL .......................$
- Nnh,.�of raihhholi4s nr ihuwn hm err it can ----
$
4•I0 Mils lralsttt'OMI
a LI
Plumbing Permit Application'
— - --�-
City of Tigard Date received: Permit no.: �'S-7 �)OOa _ 0,0!f 3
tf4 Address: 13125 SW Hall Blvd,Tigard,OR 97223 Sewer permit no.: Building permit nu.:
City ofTigard Phone: (503) 639-4171 Project/appl.no.: Expire date:
Fax: (503)598-1960 Date issued: By: Receipt no.:
Land use approval: Case rile no.: Payment type:
OF PERMIT
Q I &2 family dwelling or accessory O Commercial/industrial U Multi-family O Tenant improvement
Q New construction Q Additioti/alteration/replacemcnt Q Food service Q Other:
JOh SITE INFORMATIONSCHEDULE
7no.:
2 , I)escripNon Qty. Fee(ea.) 'I otal
Suite no.. New 1-and 2-family dnellin}s only: -
(includes 100 R.for each utility connection)
t/accountno.: Z:; Ip3BDIO-6go /RZ4 r SFR(1)bath
block: Subdivision: Hufjfrrs Wco.x l lcry SFR(2)beth
Project name: SFR(3)bath
City/county: -1,,. I�Fu, ZIP: Each additional bath/kitchen
Description and Ideation of work on premises: __-- Siteutilitles:
Catch basin/area drain
Est.date of completion/inspecticn: Drywells/leach line/trench drain
MIEN Footing drain(no,lin.ft.)
Manufactured home utilities
Business name. M.L'r Cr III C r )'L1 Irl I' r)T _ _ Manholes --
Address: - ) 3��" Rain drain connector _
City: - r(i State: ZIP:c/�Z''�I Sanitary sewer(no.lin. ft.) - T
Phone: ;g' Fax: Storm sewer(no.lin.ft.)
CCB no.: Z L _Plumb.bus.reg,no:• ,./ T1 z r Water service(no. ft.)
City/metro lie.no.: l:ixinre or item:
Contractor's representative signature: b orption valve
Print name: t Date: MkIflow reventer
Backwater valve
Basins/lavatory
Name: br V) LeWlcw e L L. Clothes washer
Address:
Dishwar'ter
FU L�cJx yd(Y Drinking fountain(s)
Y
City: JllzrwDUcl - State: (il ZIP: _I —
I'honc: Ejectors/sump
1 Email: Expansion tan
1 Fixture/sewer cap
Name(print): ;n MC A , ( yt 17AC' T floor drains/floor sinks/hub ^
Mailing address: Garbage disposal
Hose bibb _
City: State: 7.IP: Ice maker
Phone: Fax: t •maiL�— -- Interceptor/grease trap
(honer installation/residential maintenance only: The actual installation Primer(s)
will he made by me or(tic maintenance and repair made by my regular Root'drain(ccmtmercial)
employee on the property I own as per QRS Chapter 447. Sink(s),basin(s),lays(s) _
Owner's si nature: Date: Swn
---ENGINEER_ - Tubs/s ti ower%shower
Name: Urinal
Address: - - atercloset
` ---
Water heater _
City: ---Mute: ZIP: Other:
Total _
Not ill Jurlad olons accept credit tarda,please coil Jurisdiction for more Information. Notice:flMinimum fee................
us p��nntt application ,
U Visa O hidsterCanl f Ian review(at _ %)
expires Hit pennil is not obtained
r•redit cmd number: ,plica within 180 days after it has been State surcharge(8%)....
cu
-_— ted as complete.d r r occe con TOTAL ..................•....$
Name of cudhnbkr ar rtnwn un credo — ---
-. C'a—�tfhnki er ilg1T— imimee - - �� Amount 4J0 4616 16KXY mNn
e
SEE 35MM
ROLL. #21
FOR
OVERSIZED
DOCUMENT
CITY OF TIGARD 24-Hour ��,, UU
BUILDING Inspection Line: (503)639-4175 MST `00
INSPECTION DIVISION Business Line: (503)639-4171 BUP
Received _Date Requested 3==�-�- _ AM-- PM ----- BLIP
Location _ �2 30 -1 ��_ --Suite MEC —
PLM
_-
Contact Person ? —. Ph( ) -� ''2 D
Contractor -——
— Ph( -- -- S+;rR —
BUILDING TenanUOwner __ __ —_____ -_ ELC --
Footing ELC _ -----
Foundation ~"'
Flns�pection
;^ ,� � � � r�,��„..,� _ / �� ` ELR
Ftg Drain
Crawl Drain SIT --
Slab otes:
Post&Beam -- — -- — _-- _ -
Shear Anchors —_
Ext Sheath/Shear "�—
Int Sheath/Shear _ -{----//-
Framing L'
Insulation
Drywall Nailing -----Firewall
Fire Sprinkler
Fire Alarm _
Susp'd Ceiling -`-- - -
Roof
Other:
Final
PASS PART FAIL_ — f
---
s earn _
Under Slab
Rough-In
Water Service — -- - -
Sanitary Sewer o --
Rain Drains -
i—
Catch Basin/Manhole _
Storm Drain — —
Shower Pan
Ot r:
TAIL
ANIC _ - —_ _ \------
Scam
Gas Line
Smoke Dampers
PASS ART FAIL --------------
--
Rough-In — -
10�
Fir rm
Fi j ❑ Reinspection fee of$— -_required before next inspection. Pay at City Hell, 13125 SW Hall Blvd.
AS PART FAIL rE]1 Unable to inspect-no access
S -- ❑ Please call for reinspection RE: L_l
Fire Supply Line
ADA Date / I __ Inepedor Ext -
Approach/Sidewalk
Other: __—
Final DO NOT REMOVE this Inspection record from the jobs te-
PASS PART FAIL
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 1_ Gid c
INSPECTION DIVISION Business Line: (503)639-4171
'-t BLIP — —
Received _ — __--Date Requested 3 !'AM PM BUP
Location ) — ��� �"��---Suite _ MEC _ —
Contact Person — _. —_ _— Ph(_ ) PLM -- —_
Contractor ___ .__ .—.--
Ph(— ) SWR —
Tenant/Owner _ _ — ELC _--
Footing ELC ---
Foundation Access:
Ftg Drain ELR -_- -.-
Crawl Drain ..
Slab Inspection Notes: �/�11--
SIT
Post&Beam --
Shear Anchors S < � -- -
Ext Sheath/Shear ----
Int Sheath/Shear -
Framing - _-
Insulation
Dgwall Nailing -C�. -
Fireviall _
Fire Sprinkler -- -
Fire Alarm
Susp'd Ceiling _- ------------------__.- _----
Roof
Fi ? _
_✓ PARTFAIL -
PLUMBING -- ---____ _-_-- ------ --
Post&Beam
Under Slab - _ - _ .... - -_--- ----_ _ --- ------ -- --- -
Rough-In
Water Service -------- - ------ - --
Sanitary Sewer
Rain Drains --- ------ - - -- - - - --- - --
Catch Basin/Manhole
Storm Drain -
Shower Pan
Other: _-_-.-------
Final
PASS PART_FAIL
MECHANICAL - ----_-_ ---- - - -_- - - - - - ----- .... -- -
Post&Beam
Rough-In _ .---- - -- -_-_ ---- - -- - - - -- -- -
Gas Line
Smoke Dampers ---------- - ------ ---- - - -- ------- _ .,_. ----
Final
PASS PART FAIL _-
ELECTRICAL
Service ---- ------ -__- -----_ _-.--- ---_- -__._-____ ----_ _
Rough-In
UG/Slab _- -_ ------ ---_-
-----
LowVoltage -- - --- - --- - --- -... --- -- -
Fire Alarm
Final Reinspection fee of$-_____-__ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL r,
SITE Please call for reinspection RE: ___ a lj Unable to inspec'-r+o access
Fire Supply LineADA �/ G
App oach/Sidewalk Dab�-- a _4_ Inspector
Other: __--
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL