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11624 SW LOMITA AVENUE-2
�1 Q� N N 3 a rr 11624 SW Lomita Ave C-5 _u— ELECTRICAL PERMIT CITY OF TIGAR,D PERMIT#: ELC2000-00520 DEVELOPMENT SERVICES DATE ISSUED: 8/30/00 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 1S135DD-03703 SITE ADURESS: 1 1624 SW LOMITA AVE C-5 SUBDIVISION: PLAZA GARDEN WEST ZONING: BLOCK: LOT : JURISDICTION: TIG TIG Proiect Description: Repair of electrical service due to fire damage. _ RESIDEN_TIA UNIT _ TEMP SRVCIFEEDERS MISCELLANEOUS - 1000 SF OR LESS: 0 - 200 amp: P/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'L INSPECTION_S__ — 0 - 200 amp: WISERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA AUD'L BRNCH CIRC: 4 IN PLANT: 601 - -1000 amp: _ PLAN REVIEW SECTION _____ 1000+ amp/volt: >=4 RES UNITS:— > 600 VOLT NOMINAL: Reconnect only: SVC/FDR >= 2.25 AMPS: _ CLASS AREA/SPEC OCC: Owner: Contractor: PARKER, JEROME W TRUSTEE VANDER STOEP ELECTRIC BY SUMMIT REAL ESTATE MANAGEME 23765 THIRD ST NE 5320 SW MACADAM AVE AURORA, OR 97002 PORTLAND, OR 97201 Phone: Phone: Reg#: LIC 89417 SUP 43605 ELE 24-304C FEES _ = Required Inspections — Type By Datc Amount Receipt Elect'/ Service PRMT CTR 8/30/00 $58.90 2720(,()0000( Elect'/ Final 5Pr,T CTR 8/30/00 $4.71 2720000000( 'Total $63.61 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 160 days of issuance,or if work is suspended for more than 180 days ATTENTION Oreqon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules ire set forth in OAR 952-001-0010 through OAR 952-001-0080 =: may obtain copies of these rules or direct questions to OUNC at(503) 246-.1987 PERMITTEE'S SIGNATURE �( �(���1 �� f� ,,� , )� �(lED'8Y._ " , ,•" OWNER INSTALLA ION 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 NLY —SIGNATURE OF SUPR. ELEC'N: qc-C _1141 i �' i' ' r' DATE:__ LICE14SE NO: �L�lLLL---- ---- -- -- – - -- �— Call 639-4175 by 7:00pm for arr inspection the next business day CCITY OF T!GARD Electrical Permit Application PlanrB ck a 13125 Sall HALL BLVD. Rer Date R c'drS '1 TIGARD OR 9,223 Date to P.E. -_ Phone (503)6",9-4171, x304 Date to DW _ Inspection ('.03) 639-4175 Print or Type Permit Fax (5031 684-7297 Incomplete or illegib!� will not be accepted Called 1. Jea address: �1 ^ / / r�A� a. Complete Fee Schedule Below: Name of Development-A7,f 1t- ,1 `-T/tPy` r`t U Number of Inspections per permit allow-1 - Nr,me(or name of business.)- � J/Vr� J Service included: stems Cost Sum Addressu6 Z ./` 2, 46tsm 4a. Residential-per unit �rj,t•,' 1000 sq.ft.or lass $110.00 _ n City/State/Zip_ CEach additional 500 sq.ft.or portion thereof $25.00 1 Commercial ❑ Residential Limited Energy $25.00 Each Manul'd Home or Modular Dwelling Service or Feeder - $88.00 2a. Contractor installation only: (Attach copy of a'1 c)irrent licenses) r� 4b.Services or Feeders Electrical Contractot� e--k-, C'q Elr-1�=�- Installation,alteration,or relocation �y 200 amps or less $60.00 Addre 5_' ; [ ) 201 amps to 400 amps $80.00 2 it ' State Zip` 401 amps;to 600 amps $120.00 2 Phone No. _2 -.5 I-?- 801 amps to 1000 amps $180.00 2 .Job No. --TeOver 1000 amps or volts $340 00 2 Reconnect only $50.00 2_ __ E'2c Cont. Lice. No. �,1 �Exp.Dat �-- �-C'� OR State CCB Reg. No._ Exp.Date I�- 1 •0n 4c.Temporary Services or Feeders COT Business Tax or Metro No.z.- ��xp.Dated-_C11 Installation,alteration,or relocation --- 200 amps or less $50.00 J' 201 amps to 400 amps $75.00 Signature of Supr. Elec'n__ !'L , 40)amps to 600 amps $100.00 Over 600 amps to 1000 volts, License No. �� •�, L _EAp.Date_ ©-d/-� see"b„above. Phone No, _ ' -- 4d.Braich Circuits New,alturatfon or extension per panel 2b. For owner installations: a)The lee for branch circuits with purchase of service or Print Owner's Name-_ _ feeder fee. Addres^_ Each branch circuit $5.00 - ,)The fee for branch circuits City State Zip _ , without purchase of Phone No. ___ service or feeder fee. 37• '� ? r�i First branch circuit / $ 6 The installation is being made on property I own which is not Each additional branch circuit . `/ ' 2 intended for sale,lease or rent. 4e.Miscellaneous (Service or feeder not included) $40.00 Owner's Signature _, Each pump or Irrig-1tion circle ------ Each sign or outline fighting $40.00 3. Plan Review section (if required):' Signal circuit(s)or a limited energy' panel,alteration or extension V $40.00 2 M nor Labels(10) $100.00 Please check appropriate item and enter fee in section 58. 4 or more residential units in one structure 4t.Each additional Inspection over _ Service and feeder 225 amps or more tire allowable In any of the above Systeni over 600 volts nominal Per inspection $35.00 Classified area or structure containing special ncrupancy Fler hour _ $55.00 M as described In N.E.C.Chapter 5 n Plant _ $55.00 ' Submit 2 sets of plans with application where any of the above apply. . Fees: Not required for temporary construction services. 5a.Enter total of above fees $ 5%Surcharge(.05 X total fees) $ , 7/ NOTICE subtotal $ 5b.Enter 251,,.^f line 59 for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review If mquired(Sec,3) $ NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY G TIME AFTER WORK IS COMMENCED LJ ?rust Account,'! 7 Total balance Due t �� hr)SMELM APP A-VW" CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -- BLIP _ _Date Requested_ zf AM —PM BLD Locatio.i / G Z S w L� -_ -— -- Suite MEC ^� Contact Person — _— Ph G �-j// Z- _ P_M --- - Contractor Ph SWR BUILDING Tenant/Owner ELC 2=gdc: a -UPJ 5 I Retaining Wall ELR _ Footing Access: Foundation FPS Fig Drain crawl Drain Inspection Notes. 3GN _ Slab SIT - ----------------- -lost& Beam -- -- - -.--- r-xt Sheath/Shear Int Sheath/Shear Framing Insulation �— Drywall Nailing _ Firewall �' C Fire Sprinkler Fire Alarm — Susp'd Ceiling Roof Misc Final --- ------ ---- — PASS PART FAIL PLUMBING Post& Heam Under Slab 1 op Out Water Service Sanitary Sewer Rain Drains Final PASS PARI FAIL MECHANICAL — Pnst& Beam Rough In Gas Line Smoke Dampers Final PASL- RT FAIL ELECTRICAL Ser t _ ough n a Low Voltage Fir arm ial PASS PART FAIL !.. S _ Backfill/Grading ---- ----�---` -- -�-` — -- - Sanitary Sewer Storm Drain [ ) Reinspection fee of$— _required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Suppry Line ( ) Please call for reinspection RE: — _-- _ ( ) Unable to inspect no arcess ADA Approach/Sidewalk 'z Other Date Inspector _ Ext Final PASS PART FAIL DO NO'T REMOVE this inspection record from the job site. CITYOF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM2000-00314 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED- 8/24/00 SITE ADDRESS: 11624 SW L-OMITA AVE C-4 PARCEL: 1S135DD-03703 SUBDIVISION: PLAZA GARDEN WEST ZONING: R-12 __ BLOCK: _ LOT__ JURISDICTION TIG CLASS OF WORK: REP GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R 1 FLOOR DRAINS: TRAPS: STORIES- WATER HEAT ERS: CATCH BASINS: FIXTI'RxES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 1 URINAL;.: GREASE 1 RAPS: LAVATORIES: 1 OTHER FIXTURES: TUB/SHOWERS: 1 SEWER LINE: ft WATER CLOSETS: 2 WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Fire repair, replace one sink, one lav, one tub/shower, and two toilets. No new fixtures Gamer: _ _ -- _FEES--------------- PARKER, JERnME W TRUSTEE Type By Date Amount ReceiptT BY SUMMIT REAL ESTATE MANAGEME PRMT CTR 8/24/00 $57.50 27200000000 5320 SW MACADAM AVF 5PCT CTR 8/24/00 $4 60 27200000000 PORTLAND, OR 97201 _ Total $62.10 Phone 1: Contractor: NELSON PLUMBING PO BOX 818 BATTLE GROUND, WA 58604 REQUIRED INSPECTIONS Phone 1: Rough-in Insp Reg #: l l', 125759 Top-out Insp F'I_M 37-171 PB Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specia!iy 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 sus ended for more than 180 days. ATTENTION: Oregon law requires you to foliovi rules adopted by the q egos Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952 001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued by: Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day CITY OF TIGARD Plumbing Permit Application PIa cnea�. '13125 SW HALL BLVD. Commercial and Residential Recv* 'TIGARD, OR 97223 -Dale Recd_ (503) 639-4171 Date to P.E Print or 1 ype Date to 0 Permit ell Incomplete or illegible applications will not be accepted Related SWR � _ _ Called— Name of Developm�en`UProject FIXTURES (individual) QTY PRICE AMT j Job \ � , r l.U��� sink 11.50 'i Address Street Add as Lavatory 11.50 C>U Z •. W I v Sult I Tub or TublShower Comb 11.50 r- Bldg N Cit�y(/SSllatteh[ /�(Zip Shower Only 11.50 Name Wafer Closet 11.50 Urinal 11.50 Mailing Address Suite Dishwasher - —� Owner 9 1150 --_- _--_----_------_- -_� ------- Garbage Disposal 11950 Uty/Slate Zip Phone Laundry Tray 11.50 Name - Washing Machine/)sundry Tray 11.50 Floor Drain/Floor Sink 1' 11.50 Occupant Milling Address Suite �3' (,11y/State /ip Nhnno Weter Heater O conversion O like kind 11 50 -- — Name Gas piping regilires a separate mechanical permit - We I on I ,!I mbl ) ,, MFG Home New Wafer Service _ 3200, Contractor cling Address � g Giy MFG Home New San/Storm Sewer 3200 9 119 Hose Bibs 11.50 Prior to permit clry State Zin W Phone:319,1 Hoof Drains 11.50 issuance,a copy � Drov.►�� -()if 1- 7 L, Drinking Fountain 11.50 of all licenses am 0,agon Const Co 1t.Board Llc a Flip.Lite / Other Fixtures(Specify) 15.00 required H expired In COT Plumbing Lie k Exp.Date database Name Architect __ Sewer-1st 100' -~ 38.00 or Mailing Addtebs —~ Suite Sewer-each additional 100' 32.00 City/State liPhone Water Service 1st 100' _ 38.00 r Engineer wales Service-each additional 200' 32.00 Uescnbe work to be dorsa Storm 8 Rain Drain-1st 100* 3800 Ncw O Repair 0 Replace with II'ee kind Yes (t No O Storm 6 Hain Drain-each additional 100 3200 Residential * Commercial O _ -' Additional description at work Commercial Back Flow Prevention Device 3200 Realdnnlial rlacktlow Prevention Device' 1900 Catch Basin 11.50 Are you capping,nrev'.ng or replacing any fixtures? Insp of Existing Plumbing or Specially Requested 50 03 _ Yea O No 4r Ina coons _ or/hr If yes,see back of form to indicate work performed by Rain Drain,single family dwelling 4500 fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease traps i1 50 WORK COULD RESULTtIN INCREASED SEWER FEES. — QUANtITY TOTAL 1 hereby acknowledge that I ve read this applicAtfon,Ihat the information r given is correct.that I am the .r or authorized agent of the nwner,and i50rnetrsc m roar dugram Is required d Quantity total is %a that tans subrngled ate in c liance with Oregon State Laws 'SUBTOTAL SI t a of Owner/Age Q , 1 — 8'19 SURCHARGE _ 12A, Cowct Pers Name Phone - .s '��r� ' 'PLAN REVIEW 25%OF SUBTOTAL 1 HATH HOUS;4.._ . - ]] rteguded only n rixldrs fry teal is>9 _ 2 BATH HOUSE S250 00 } NOTAL , 3 BATH HOLI5E f'45.D0 -- Phis tee Include,all plumbing 6xfures In the dwelling end(fin lost Minimum pa,, J Ne,s$50 r a%sxcharge,except ResdenrnelBW*Pow"raventrar, 100 foot of saniiary sewer sten fewer and water servirv) Devine.which is$25#a%sumharQa -All Now Commercial Buildings reorxre plant with laometm.:rx neer draoram amt plan review I%dstsHo1m%V1U"soe dm r,i 1h"Zi Zouln IINI'!I.f lu LI I 1 0961 tog £Og Ctrl 9£:90 111. 00/77.90 PLEASE COMPLETE_:_ Fixture Type _ Quantity by Work Performed New Moved Replaced Removed/Capped Sink Lavatory - Tub or Tub/Showar Combination Showe, Only Wa. -ter Closet - - - _ Urinal --------------- -- _ Dishwasher Garbage Disposal Laundry Room Tray _ Washing Machine Floor Drain/Floor Sink 2" Water Heater --^-- Other Fixtures (Specify) COMMENTS REGARDING ABOVE: I MlfltlEtmf4MJ110Pp O% !I,e/y9 CITY �� ������ ELECTRICAL PERMIT _ PER MIT#: F_LC2000-00519 DEVELOPMENT SERVICES DATE IS,' UED: 8/30/00 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PAR0:L: 1S135DD-03703 SITE ADDRESS: 11624 SW LOMITA AVE C-4 SUBDIVISION: PLAZA GARDEN WEST ZONINI_- R-12 BLOCK: LOT : JURISDICTION: TIG Proiect Description: Electrical work for fire repair, work to be based on residential unit of less than 1000 square feet. _ RESIDENTIAL UNIT TEMP SRVCIFEEDERS MISCELLANEOUS 1000 SF OR LFoS: 49 0 - 200 amp: PUMP/IRRIGATION: _ EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER _ BRANCH CIRCUITS _ ADD'L INSPECTIONS 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amw 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA A1)D'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:' Reconnect olity: SVC/FDR-225 AMPS: _ CLASS AREA/SPEC OCC. Owner: Contractor: PARKER, JEROME W TRUSTEE VANDER STOFP ELECTRIC BY SUMMIT REAL ESTATE MANAGEME 23765 THIRD ST NE 5320 SW MACADAM AVE AURORA, OR 97002 PORTLAND, OR 97201 Phone: Phone: Reg #: LIC 89417 SUP 43605 ELE 24-3040 FEES _ Required Inspections__ Type By Date Arnnunt Receipt _— , Elect'I Service PRMT CTR 8/30/00 $117.75 2720000000( Elect'I Final SPCT CTR 8/30/00 $9.42 272000000( ---�— Total $127.17 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 appi-med plans This permit will expire if work is not started within 180 days of issuance,or if �cr4 is suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notif r;at on Center 1 r,')se rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain oopies of these rulas ordirect questions to OUNC at(503) 246-1987 J PERMi r T'EE'S SIGNATURE I/, ; ,M r', r" j ISSUED BY: (, i OWNER INSTALLATION ONLY _ The installation is being made on property I own which is not intended for sole, lease, or rent. OWNER'S SIGNATURE: _ i DATE:___ CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE:_ LICENSE NO: Call 639-4175 by 7:00pm for an inspection the next husiness day CITY OF TIGARD Electrical Permit Application Plan lock ft 13125 SW BALL BLVD. Rec'd - TIGARD OR 97223 Date Recd Date to P.E. Phone (503)639-4171, x304 Date to DST Inspection (503) 639-4175 Print or Type Permit 0 '. Fax(503)684-7297 Incomplete or illegible will not be accepted Caned-___ 1. Job Address: ` 4. Complete Fee Schedule Below: Name of Development ,44 � 1l'' i KD" /WE-5T I Number of Inspections per permit allowed Name(or name of business) vr�"T Service included: Items Cost Sum Address I/&V141 .5r 0, L L�/YI l I _ 4a. Residential-per unit ci 61 1000 sq R.or less -L_. $ssenfi _1 4 N/Stare/Zi P_ � nI Each additional 500 sq it or 11-171 - Residential Lb portion thereof $25.00 1 Limited Energy $25.00 Each Manurd Horne or Modular Dwelling Service or Feeder ____ $68.00 2 2a. Contractor Installation only: (Attach copy olfsR current lies a 4b.Services or Feeders Electrical Contractor N����P �Ty__G C-_-��.E� Installation,alteration,or relocation ., �� - 200 amps or less $i0.00 2 Address_= ��1Tl`� r. 201 amps to 400 amps _ $8000 2 City A Li�g��I-i4-_-_ State (n A-z , Zlp '17 401 amps to 800 amps __ $120.00 2 Phone No. bV >�,�//�- 601 amps to 1000 amps $180.00 2 Job No. Over 1000 amps or volts _- $340.00 _ _._ 2 Elec.Cont. Lim.N�c> Exp.Date C.3 ev Reconnect only $50.00 2 OR State CCB Reg.No. LV. Y1L Exp,Dete 0 • - 4c.Temporary Services or Feeders COT Busine is Tax or Metro No. Exp.Dater-/-6t Installation,alteration,or relocation -- 200 amps or lass ___ $50.00 2 Signature of Supr. Elec n201 amps to 400 amps $75.00 2_�if/l� _ 401 amps to 600 amps $100.00 _. 2 l Over 600 amps to 1000 volts, License No �I 7[c>L Exp.Date_�� 'al-�l see"b"above. Phone No. L�"7-5 4d.Branch Circuits New,alteration or extension per panel 2b. For owner installations: a)The fee foi branch circuits with purchase of service or Print Owner's Name feedrr fee. -� - Each branch circuit $5.00 _ 2 Address h)The lee for branch cirrults City--___ ;tate_ _ Zits without purchase of Phor 9 No._. _ - service or feeder too. First branch circud $35DO 2 The installation is being made on property I own which is not Each additional branch circuit $5.00 2 intended for sale,lease or rent. 4e.Miscellaneous (Service or tender not kxcluded) Owner's Signature__ "�- _ Each pump or Irrigation circle $40.00 2 Each sign or outline lighting $40.00 ------ 2 3. Plan Review section (if required): Signal circult(s)or a limited energy $4o.00 _ _ panel,alteration or extension $100,0002 ----- Please check appropriate Item and enter fee in section 58. Minor Labels(10) 4 or more residential units in one stnicture 41.Each additional Inspection over Service and feeder 22.5 amps or more the allowable In any of the above v System over 800 volts nominal Per Inspection $3500 Classified area or structure containing special occupancy Per hour _ $55.00 as described In N E C.Chapter 5 In Plant $55.00 Submit 2 sets of plans with application where any of the above apply. F. Fees: '7 Not required for temporary construction services. 8a.Enter total of above fees $ 5%Surcharge(.OS X total fees) $ � NOTICE Subtotal $ - Sb.Enter 2G%of line So for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if rgWiro(Sec 3) $ NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ElTrustAccount k-_„�__ $ Total balance Due ,nsrsEMN AIT n«srar CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 ---- --- BUP _ Date Requeste,.1_ffy' 3 D __—AM-----FM . BLD Location / G Z 5 G / r Suite �� MEC Contact Person Ph �' Z t� 1.1 M 2"sc"U -Gy 31 y Contractoi _ Ph _. _ SWR .—. F��UILDING _- Tenant/Owner _ ELC Retaining Wall ELR Footing Access Access FPS Foundation ---- Fig Drain SGN _ Crawl Drain Inspection Notes Slab -- --- - SIT Post&Beam Ext Sheath/Shear --- ---- Int Sheath/Shear Framing Insulation Drywall Nailing --- Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling - - - - Roof Misc: Final PA PART FAIL - LUMBING r o-s rieam Under Slab, - __-_ Top Out �u6 4,04 Water Service--�- - Sanitary Sewer Rain Drains --- - - F final _ r PASS >PART FAIL _ *ECRANICAL Post& Bean, — — —_ Rough In — Gas Line Smoke Dampers Final — --- PASS PART FAIL ELECTRICAL Service -- - _- - Rough In UG/Slab --- Low Voltage Fire Alarm Final PASS PART PAIL --SITE - Backfill/Grading J Sanitary Sewer Storm Drain [ J Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ J Please call for reinspection RE: [ ]Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date �Jo .- e>0 Inspector -___PExt Other Fiial PASS PART FAIL DO NOT REMOVE this inspection record frorn the job site. i CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP Date Requested__G' ,- --AM PM _ BLD Location "A /Z(f e-7`l 5C✓ Lu/rt 4 Ek- Suite MEC `— Contact Person L�/ Ph �� `� �'Got/PLM 641 3/ y Contractor Ph SWR BUILDING Tenant/Owner — ELC - Retaining Wall ELR Footing Access: Foundation �i FPS Fig Drain �j(i C `���' (� . � l �- D - Crewl Drain Inspection Notes: SGN Slab -- -- - SIT _ Post&Beam Fxt Sheath/Shear Int Sheath/Shei,r Framing Insulation Drywali Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling _ Roof Final ---------- PASS PART FAIL ------.--_ --— - --- ---- - -- UMBI an — -------- ------------ - Under Slab Top Out Water Service J Sanitary Sewer Drains _ PAR"r FAIL MECHANICAL Post&beam -- Rough In , Gas Line — Smoke Damper — Final PASS PART FAIL ELECTRICAL ---.-.--..--- Service --- Rough In UG/Slab Low Voltage Fire Alarm _ _—_-- —_---- - Final PASS PART FAIL _ -------SITE Backfill/Grading Sanitary Sewer Storm Drain [ J Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ]Please call for reinspection RF _ ( J Unable to inspect-no access ADA Approach/Sidewalk Date Inspector Ext Other _ Final PASS PART FAIL DO NOT REMOVE this inspection record frocn the jots site.