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Permit
:r,' ® MASTER PERMIT I PERMIT #: MST2006 -00080 r DEVELOPMENT SERVICES DATE ISSUED: 6/21/2006 f 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S 103RD -11200 SITE ADDRESS: 11740 SW ERROL ST ZONING: R - 4.5 SUBDIVISION: CAPPOEN ESTATES LOT: 003 JURISDICTION: TIG Project Description: New SF. BUILDING . REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 26 FIRST: 1,769 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 893 sf GARAGE: 493 sf FRONT: 20 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5 VALUE: OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2,662 sf 259,276.70 REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 4 CATCH BASINS: TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 4 CLOTHES DRYER: 1 NAT FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 2 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 4 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 • 200 amp: 0 - 200 amp: WISVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 5 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 • 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FOR> =225 A: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL • RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other FOUR D CONSTRUCTION CO FOUR D CONSTRUCTION applicable laws. All work will be done in accordance with approved PO BOX 1577 PO BOX 1577 plans. This permit will expire if work is not started within 180 days BEAVERTON, OR 97075 BEAVERTON, OR 97075 of issuance, or if the 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 952- 001 -0080. You may obtain copies Phone: 503 - 590 - 0805 Contact #: PRI 503 590 - 0805 of these rules or direct questions to OUNC by calling 503 - 246 -6699 FAX 503 - 590 - 1751 or 1- 800 - 332 -2344. Reg #: LIC 71037 TOTAL FEES: $ 10,299.27 REQUIRED ITEMS AND REPORTS Ersn Cntrl 681 -4444 Issued By : .C/ . Permittee Signature : CaII 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Buildhn2 Permit A" !,. -..;ti ci- FOR OFFICE USE OINI_� City of Ti and Received E. n '' _ g Date/B : Y (/ , Permit No.. / ado`, 4 13125 SW Hall Blvd., Tigard, OR 97223 µ ^00C Plan Review Phone: 503.639.4171 Fax: 503.598.196�1p i,' r [ U "' " +''h; t l "' ^ Date/B , Other Penn& r /� ;'4i ' � i / " v l 4 �ir • 1. _all- ' 1 Inspection Line: 503.639.4175 I Date Ready/By: Juris: See Attached Checklist for Internet: www.ci.tigard.or.us r € 'to h -I' - Notifi /',�ti T f( r Supplemental Information � pi\Tj4JO�I \ -e,-)- ?hd \..i ve.3M - li l"1-AWW WdRK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ig New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. ig1- and 2- family dwelling ❑ Commercial /industrial Valuation: $ ❑ Accessory building ❑ Multi- family Number of bedrooms: T" Master builder El Other: Number of bathrooms: //2„,_ JOB SITE INFORMATION AND LOCATION Total number of floors: 74J (. Job site address: l/ 74/0 J, �*0 0Z, Si' New dwelling area: 62 square feet City /State /ZIP: l G h/� U � x_ 9 ?� Garage /carport area: 493 square feet Suite/bldg. /apt. no.: J (Project name: Covered porch area: c::: square feet Cross street /directions to job site: //6 !r 'L ttidG,/tJ` Deck area: square feet Other structure area: -• square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: eit a , ,S7- Q J Lot no.: 3 Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the • DESCRIPTION OF WORK work indicated on this application. ` / ,I f _ Valuation: $ Existing building area: square feet New building area: square feet t< PROPERTY OWNER ❑ TENANT Number of stories: Name: i1C1- (� S C >/a - ,r Type of construction: Address: I 0. /S ox /6 ' 7 Occupancy groups: City /State /Z1P: � % a X - 7 7 d 7S Existing: Phone: (n)3) - S 2 _ C c ' ps Fax: (1--z) 5 v —/ 7s-( New: p' APPLICANT ❑ CONTACT PERSON NOTICE Business name: Sg2.-7L -z /IS 4, 0 u-se_. All contractors and subcontractors are required to be Contact name: �a U E?- licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City /State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax::( ) E -mail: CONTRACTOR Business name: S /91.11'-- h/ 6 J a BUIL DING PERMIT FEES * Address: Please refer to fee schedule. City /State /ZIP: F Ca ees due upon application Q Phone: ( ) Fax:( ) CCB Iic.: '7 O3 7 Amount received / / Date received: C, --/ L/ _40‘ Authorized signature�!�4�/ This permit application expires if a permit is not obtained ice'/ 7� within 180 days after it has been accepted as complete. Print name: fiLe„. /eli/ ipb,e7--- Date: 2--/5 v b * Fee methodology set by Tri County Buildinglndustry Service Board. i:\ Building \Pernits\BUP- T1- PermitApp.doc 12/03 410.4613T(II /02/COM/WEB) Building Fixtures �, -� �U Pluming Permit Applica ion , " 4 4044,1,7-,: � l.1.' 0a u I is u i 'CO: % �3 ; City of Tigard ApR i 4 2p r I Received Date/By: Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 , 1 / r Fa - Other Permit No.: 24- Hour Inspection Line: 503.639.4175 i" ��' Date /By. � •,;, ! % y Date Ready/By: mtig El See Page 2 for Internet: www.ci.tigard.or.us T .r Noti6ed/Method Supplemental Information TYPE 'OF WORK FEE* SCHEDULE 0 New construction ❑ Demolition For special information use checklist Description 1 Qty. 1 Ea. 1 Total ❑ Addition /alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) . CATEGORY OF CONSTRUCTION . SFR (1) bath 249.20 I- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 Iii Master builder Each additional bath/kitchen 45.00 ❑ Other: Fire sprinkler ( sq. ft.) Page 2 JOB SITE INFORMATION AND LOCATION ' Site utilities Job site address: „ 74/ Q ' -u - CR R a L Catch basin or area drain 16.60 City /State /ZIP: 7q,4/ (/ O � 5' 7223 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Jl f Project name: Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street /directions to job site: / Manholes 16.60 //6 !� rJ /« Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: Lot no.: 3 Water service (no. linear ft.: ) Page 2 !! Fixture or item Tax map /parcel no.: Absorption valve 16.60 DESCRIPTION OF WORK Back flow preventer Page 2 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ' PROPERTY OWNER `I ❑ TENANT Drinking fountain 16.60 Ejectors/sump 16.60 Name: O �,C, ' nl c-�.� c - / C�7,1 C - n t - Expansion tank 16.60 Y Address: Q 2 v/,_-..-- ' 7 Fixture/sewer cap 16.60 City /State /ZIP: gp.„... tf,�� ( 7 s- Floor drain/floor sink /hub 16.60 Phone: �3) S 2 4 &Po- Fax: (9)3) S" 7U / 7,3--/ Garbage disposal 16.60 g APPLICANT ❑ CONTACT PERSON H ose bib 16.60 Ice maker 16.60 Business name: .S/9-yn42 #7....1 /4',Z A (1 Interceptor /grease trap 16.60 Contact name: c ,4 C)e____ Medical gas (value: $ ) Page 2 Address: Primer 16.60 City /State /ZIP: Roof drain (commercial) 16.60 Phone:( ) Fax::( ) Sink/basin/lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 CONTRACTOR Water closet 16.60 Business name: �./.._ 2? w / .. / Aij Water heater 16.60 Address: 15 S' e" ,...5-/ /52t! -ei Other: City /State /ZIP: '/ L L S , d, ,6 D - 7? 1 2 3 Subtotal l Minimum permit fee: $72.50 Phone: ( 5b3) 6z _ „2_3 /7 Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: 1 99, 7 Plumbin g Lic. no.: 7 75` 4 � /PL Plan review (25 %ofpermit fee) / / State surcharge (8% of permit fee) Authorized signature: A , n Y om- / TOTAL PERMIT FEE Print name: k /�c ii--- /�,.) Z _J Date:3 - 2 -- d t , This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. i:\ Building \Pennits\PLMF- PermitApp.doc 06/05 440-4616T(10/02/COM/WE13) r , r \umbing Permit Application City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Site Utilities Qty. - Fee (ea) Total , Square Footage: Permit Fee: Footing drain - 1" 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 Valuation: • Permit Fee: Storm &Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each Qty. F ee (ea) Total additional $100.00 or fraction thereof, to and Fixture or Item including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof, to specially requested inspections - per hour 72.50 and including $50;000.00. Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: Plan Review for C omplex Structures -` Are you capping, adding or replacing fixtures? If "yes", A "complex structure" is defined as an installation of a plumbing please indicate work performed by fixture. Failure to system that meets any of the following criteria accurately report fixtures could result in increased sewer fees *. Please check all that apply. Quantity by (Fixture) Work Performed ❑ Any new commercial building. Fixture Type: Replace ❑ Any new exterior plumbing site utilities. Previous Capped • Added Existing ❑ A commercial building with installation, alteration or addition Baptistry/Font of nine (9) or more new or relocated plumbing fixtures. Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities - Jacuzzi /Whirlpool providing services to human beings. Car Wash - Each Stall ❑ Plumbing installations, alterations or additions to food service - Drive Thru facilities where new plumbing fixtures, including interceptors, Cuspidor /Water Aspirator are being installed for the food service area. Dishwasher - Commercial ❑ Any new residential building containing three (3) or more - Domestic dwelling units. Drinking Fountain ❑ Any NFPA 13 -D multipurpose fire sprinkler system. Eye Wash • Floor Drain /sink 2" Submit 2 sets of plans with any of the above. -3" -4" Car Wash Dram Isometric or Riser Diagram Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings Disposal -Commercial three (3) or more stories in height. - Industrial Ice Mach. /Refrig. Drains Oil Separator (Gas Station) Comments regarding fixture work: Rec. Vehicle Dump Station Shower -Gang -Stall Sink - Bar /Lavatory - Bradley - Commercial - Service Swimming Pool Filter Washer - Clothes *Note: If the fixture work under this ermit results in an Water Extractor p Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and Urinal fees assessed for the sewer increase must be paid before the Other Fixtures: plumbing permit can be issued. is \Building\Pern its\PLM- PemtitApp.doc 07/06/05 ;�+ C 4 A 3.7+' S 4-, N , Electrical Permit AD lj1:� O .4,,, , . ° t'"4„ " "I ()12`01•I,IC { USI O \'1 1 ,, 7 ,r '-" - !lei , 64 Vcn. A. ', ,ar 1 N'f 4 ' +Xl"^�r+!Y Y�+^ti�f1 tti �+9a 1 ii:}9.Z ;YYj tli I'i x'1' 1. L.. , f- - . :- City o Tigard Received Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 PR 1 A 20 t . n +�� ijl ° �� ! � Date/By. Other Permit: Inspection Line: 503.639.4175 ' 'a. _ °: Date Ready/By: Juris: ® See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information . N ji I C - vlrT TICTON: PLAN REVIEW . New construction ERWIN to hOn/replacement Please check all that apply: ❑ Demolition ❑Other: ❑Service over 225 amps, comm'I ['Hazardous location ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., • CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential 1 - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure Multi - family Master builder ❑Other: ['Building over three stories ❑Feeders, 400 amps or more ❑Occupant load over 99 persons ❑Manufactured structures or - JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park #74,10 ❑Health -care facility ❑�cr: Job no.: Job site address: - C41, ( P rC a ST Submit 2 sets of plans with any of the above. City /State/ZIP: ---- i } ,n, A' �j 7223 The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: J Project name: FEE* 'SCHEDULE Description I Qty I Fee. I Total I .. Cross street/directions to job site: New residential single- or multi- family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: !3 /..—..?.?::12)---.-. T� Lot no.:_..? Ea. add'I 500 sq. ft. or portion 33.40 1 �� t1 -B� v . Tax map /parcel no Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 , DESCRIPTION OF WORK Each manufactured or modular dwelling, service and/or feeder 90.90 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 N PROPERTY OWNER . ' I ❑ TENANT 201 amps to 400 amps 106.85 2 / _ 401 amps to 600 amps 160.60 2 Name: u� ` 62.--7 �S't7L ct r' A Al a- 601 amps to 1,000 amps 240.60 2 Address: CP V 4 )2 ,- /3 7 7 Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City/State/ZIP: % a _, vc „ o • f ' '7 0 7 -; Temporary services or feeders installation, alteration, and/or f Phone: 3) U _ vp v� Fax: (1'133 -- -p , relocation 7�r1 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel It APPLICANT ? ' : I . ❑ CONTACT PERSON :,: A. Fee for branch circuits with ^/� �t bran o , 4 0 £ branch feeder fee, each 6.65 2 i " Business name: /T h ci circuit Contact name: B. Fee for branch circuits lJ� without service or feeder fee, 46.85 2 Address: each branch circuit Each add'I branch circuit 6.65 2 City/ State/ZIP: Miscellaneous (service or feeder not included) Phone: ( ) I Fax: • ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited - CONTRACTOR' . energy panel, alteration, or / extension. Describe: Page 2 2 Business name: Tomf 4 2s C Address: � 6- S 1 -' 4�Z` � 0...., Each additional inspection over allowable in any of the above Per inspection 62.50 City / State/ZIP: ( Po 0 w, / 6 / 777_2/ Investigation per hour (I hr min) 62.50 Phone''( 3)� , 7 `'` / L Industrial plant per hour 73.75 V . 7 I F ( ) ELECTRICAL PERMIT FEES* . CCB Lic.: Electrical Lic.3 C Suprv. Lic.:3J ' g Subtotal Suprv. Electrician signature, required: " /h / k Plan review (25 % ofpermit fee) Print name: TO 4� /67 -- AA` 6 1 Date: State surcharge (8 % of permit fee) v TOTAL PERMIT FEE Authorized signature: __� This permit application expires if a permit is not obtained within 180 ■ days after it has been accepted as complete Print name:D3 AZT P / ,/f! ( � Date: 2 j O • Fee methodology set by Tri- County Building Industry Service Board *• Number of inspections per permit allowed. i:\ Building \Pennits\E1.C- PennitApp.doc 12/03 440.4615T(l0/02/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL .VIWURK ^ ONLY: -.�._ � Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: . COMMERCIAL; WORK ONLY. Fee for each commercial system 575.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems • ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems Ei Landscape Irrigation Control* ❑ Medical El Nurse Calls El Outdoor Landscape Lighting* El Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i:\ Building \Permits\ELC- PertnitApp.doc 04/03 AL 2v • , ?c) • Mechanical Permit_ p ticati. ,, �� ,, � . ' ti ; ),�Irotzsoh,l Ic,l lust t�,,,,,. S1 t� ` ,, Received City Of Tigard 1 , Id Date /By Permit No.: 13125 SW HaII Blvd., Tigard, O 9 �{ 22 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 i /,,,, . t i <I1 Date/By. Other Permit: Inspection Line: 503.639.4175 ,"t ; , i APR 1 2°1316 _� Date Ready/By: Juris ® See Page 2 for Internet: www.ci.tigard.or.us u Notified/Method Supplemental Information 'h.ii4 q'�� A 1WOit4Cl�� ! ` COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Vi New construction Addition/alteration/replacement Mechanical permit fees' are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ 1 -and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES* y g ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family cir Master builder ❑ Other: Description Qty. I Ea. 1 Total . s . JOB SITE INFORMATION AND LOCATION Heating/cooling / // _ Air conditioning or heat pump Job site address: l / 7Y 0 S, L� L , 1? %? ) L .ST (requires site plan showing placement) 14.00 City /State /ZIP: ' M'R ,( l 6/ ‹ . _ 7 , ' Furnace 100,000 BTU ( ducts/vents) 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street /directions to job site: Duct work 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision: gi/ d Div /��rSl .�� Lot no.: Flue /vent for any of above 10.00 �' Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 Gas fireplace 10.00 Flue vent for water heater or gas fireplace . 10.00 Log lighter (gas) 10.00 Wood/pellet stove . 10.00 Wood fireplace /insert 10.00 ' ' PROPERTY OWNER • ❑ TENANT Chimney/liner/flue/vent 10.00 Other: 10.00 Name: FO u /e- 0, -tsJ -t , S c-c f'T ' a , t) a t-- Environmental exhaust and ventilation �qq / Range hood/other kitchen Address: C/,2 l S 7 equipment 10.00 City /State /ZIP: .gPiqu ,n` OA_ f 7 a 7 S Clothes dryer exhaust 10.00 l Single -duct exhaust (bathrooms, Phone: (..s Fax:_(.., Q? ),S p -/7s toilet compartments, utility rooms) 6.80 APPLICANT , ❑ CONTACT PERSON Attic/crawlspace fans 10.00 Other: 10.00 _g ,3 2 t ; / / ,x Business name: , d C► -- Fuel piping Contact name: , 7 v,� $5.40 for first four; $1.00 for each additional /7 Furnace, etc. Address: Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax:: ( ) Water heater Fireplace E -mail: Range CONTRACTOR Barbecue Clothes dryer (gas) • Business name: /4.7-/ Other: Address: 7� z c S �, ^T� G, C-e_- .- - MECHANICAL PERMIT FEES* City /State /ZIP /9 / ()/ . 9 223 Subtotal Phone: (_503 62d ___,_5 </ 3 Fax: ( ) Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lic.: ' 4 S7? State surcharge (8% of permit fee) • TOTAL PERMIT FEE Authorized signature: �� This permit application expires if a permit is not obtained within 180 c..0 days after it has been accepted as complete. Print name: a � M /)/J ,4,4 u s Date: 3 — ,6 * Fee methodology set by Tri County Building industry Service Board i:\ Building \Permits\MEC- PesmitApp.doc 12/03 440- 4617T(1I /02/COM/WFB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation:' 'Permit Fee. $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. i:\Building\Permits\MEC- PermitApp.doc 12/03 2 02/22/2007 13:24 5033579159 ARLOELECTRIC PAGE 02/02 02/22/2007 12:12 FAX 5036981950 CITY OF TIGARD 1 A001 NW CIT' F TI D a. COMMUNITY DEVELOPMENT , 13129 SW Hall Blvd., Tigard, OR 97223 503.639.4171 Electrical Signature Form D IMPORTANT PERMIT NOTICE RECEIV E ARLO ELECTRIC INC i- 6 2 1 2007 50705 NW CLAPSHAW HILL RD CITY OF T IGARD FOREST CLOVE, OR 97116 BUILDING DIVISION Permit #: MST2006 -00080 Date Issued: 6/21/2006 Parcel: 2S103BD -11200 Site Address: 11740 SW ERROL ST Subdivision: CAPPOEN ESTATES Lot: 003 Jurisdiction: TIG Zoning: R -4.5 Project Name: CAPPOEN ESTATES Description: New SF, Your company has been Indicated as the electrical contractor for the permit referenced above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work. Please mall the form to: City of Tigard, Building Division, 13125 SW Hall Blvd., Tigard, OR 97223, or you may fax the form to: 503.6243681. If you have any questions please call 503.718.2433. No electrical inspections will be authorized until thls completed form Is received OWNER: ELECTRICAL CONTRACTOR: FOUR D CONSTRUCTION CO ARLO ELECTRIC INC PO BOX 1577 50705 NW CLAPSHAW HILL RD BEAVERTON, OR 97075 FOREST GROVE, OR 97116 Phone #: 503- 590 -0805 Phone #: 357 -2350 Reg #: ELE 34.1,18c LIC 35763 SUP 33215 AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Supervising Electrician Name (printed) SUP LIC # k k/ v 57)3-69$—/ cm( OF TIG-;. +e' RESIDENTIAL PERMIT APPLICATION REVIEW Pu�nut g • it- jx n"ry� G 4 ?dw H° A h a \deli« 1 0 SW !R0t. .f r bm�.y� O ill Y ICY 1i11Lj 1r Co w� u;!» d ttl M Fus mess. 1 ob • C.42 I ` 1,Q • � ,i �x , •0 B t • / � ) h ! t iP F� f rY p �h (r r l � p' iC� �� (i t 13 , �i Q State MI. Zip • l7 S As required by the 1999 Legislative action (Senate Bill 587), your residential permit application and plans have been reviewed to determine if it is complete and if the plans are deemed "simple" or "complex" as defined in ORS 455.467 and 455.469. The application is complete. The application is incomplete for the following reason: The submitted plans will be reviewed; however, a permit cannot be issued until the above information is reviewed and /or approved. The submitted plans cannot be reviewed until the above information has been submitted and /or approved. The plans are deemed "simple ". )( The plans are deemed "complex ". If you have any questions, please call Chad Williams at (503) 718 -2708. 01,1`449 - /(1 -QC Name of Plans Reviewer Date 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 TDD (503) 684 -2772 Arvasico 22103 I I FOUR D CONSTRUCTION CO b 11 02 , POST OFFICE BOX 1577 • BEAVERTON, ORE STREET Am 590 -0805 • FAX (503) 590 -1751 BE PER APPROVED DEVELOPMENT TREE PLAN R ECEIv E r P2.07 4A/ APR 14 2006 `7 �/ �� a ,L ST CITY OF IIueacif // / `1V Saw, 'WILDING DIVISION 40 ' Tom" 14 ..-- 2 ` 2"400,14L 4- / 7u e Z 07 3 _ o ._._ ItA ik \__. (Nt ark e ppo �eAi FS?��,s sT. 4,-*" S' 7u E 719 144.,1 ,, aii- \It>1?4/ ,\sz. 6� 3 llo SC/44c- 1 2 �.vq 0 42 301 I �l '2 a/ 2 0 — I N. -"f2 X32 � CITY OF TIGARD - SITE PLAN REVIEW .2 I 111 llrs.r awes .. �...t r 23 3 �� PLANNING DIVISION: ' , 0 Required Setbacks: jo Approved A ❑ Not Approved Side: 5 Street Side: 1 /5 Front. Garage: . Rear: Visual Clearance: 01 Approved 0 Not Approved Maximum Building Height. 1. feet CWS Servi • • Provider Letter Required: ❑ Yes No �/ ❑ Rece ed B� : l� Date: y / Li0 L ENGINEERING DEPARTMENT: Actual Slope: S % VApproved ❑ Not Approved Site PI Et Approved Nod Approved By: Date: r- CC, Notes: /Y1 spa. oo 6 - ao ° 3 " ST h E'r T tc,-',i _ E CER'rIFICATI•N f l i ' I , , } I, f9/=' trip �e �� �� ' , O v,Tner /Agent for ©uv-. T)! Cogs Tlzuct/ovv (PLEASE PRINT) f 1 . (PERMIT HOLDER) i s , ---- r Do hereby; cer that t `following location meets City of Tigar ` W as hin gt o n County ,� , i land use and develo merit,standards \for street tree ins iii 5i:o. .' 0 - loi i 1U - E ADDRESS: 1 I Li o ,5; W E o S.r = SUBDIVISION: Cp•P'c jj STA7 LOT: ----, / SIGNATURE: DATE: 7 [ r3-, d 7 OI22NE ENT RECEIVED BY: /it i / DATE: 7 /f�a7 (CITY OF TIGARD) 1:\ Building \Forms \Streetl'reeCertificate 01/19/07 CITY OF TIGARD'‘ `j?,06 6 - 0O0 BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 A Inspection Requests (24 Hrs.): (503) 639 -4175 l' '°'I . INSPECTION WORKSHEET FOR DATE: 1/i 11 /l) 7 TIME: PAGE: SITE ADDRESS: l 1 ) L( 0 t ((® CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: 4 J PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message 61 , .. 3 ,- 4 C rections /Comments /I structions: . „_ ... 4, ( • - 7/ 1D/D A\ \ i . \ ,-.%_.-A MA-The 4 ® bit D . L.-N.^ .„° om/ t , 0"e 01--A,-. cir _,,Eii vv, 6 ciA-c- ) V Q..,v4” -C--; A-Sr — citt—, .-c I► PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS (l FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Utr.----- Date: �/1 c( /0 /Phone #: (503) 718 - si CITY OF TIGARD BUILDING DIVISION PERMIT 19 —D°6114) 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2 Phone: (503) 639 -4171 A I, Inspection Requests (24 Hrs.): (503) 639 -4175 .. �'L . INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: `/, L 5k ekke) 4SV CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: 41ft_ PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description -/ Confirm # Contact # Message / q9 � � � � / //41- 2-q � 9 r�/, . > itj- �_ kA( Corrections /Comments/ Instructions: 6/2Aer___>.7,6445-- aile.p,46;- d(J/ )--42 9 4- 7 8s e`` g.0 � _c J L ✓ Ce' - Rio- ADt} .e l - f / / r PASS ❑ PARTI ' /APPROVAL_ n CANCEL n NO ACCESS n FAIL ❑ �. .' If ••N ❑ P' = FEES ASSESSED i 40r , Inspector: Date: - one #: (503) 718 --* CITY OF TIGARD BUILDING DIVISION PERMIT #: MSr 2006 -00080 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/21/2006 Phone: (503) 639 -4171 ` "'��� q :�� A, Inspection Requests (24 Hrs.): (503) 639 -4175 �! INSPECTION WORKSHEET FOR DATE: 7/10/2007 TIME: 7:00AM PAGE: 13 SITE ADDRESS: 11740 SW ERROL ST CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: New SF. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503 590 - 0805 Inspection Request Scheduled For: Date: 7/10/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 051727 -02 503- 720 -7445 N Corrections /Comments /Instructions: A / 1 // % • , 91C) s ,, ' v._ /4.9 , '. / Ap i o a / Lc..J2 t, At. , SAR -- - x_ ) WA - 379Ce - PASS n PART' i L APPROVAL 1 1 CANCEL n NO ACCESS 7 . - /1 F• : rNSPt' TION 1 1 ADDITIONAL FEES ASSESSED / r -rte _ 4' Inspector: Date. Phone #: (503) 18 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006; -00080 • 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/21/2006 Phone: (503) 639 -4171 ''' p 0. Inspection Requests (24 Hrs.): (503) 639 -4175 .. INSPECTION WORKSHEET FOR DATE: 319/2007 • TIME: 7 :01AM PAGE: 31 SITE ADDRESS: 11740 SW ERROL ST CLASS OF WORK: • SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: Nell, SF. OWNER: FOUR D CONSTRUCTION Co, PHONE #: 503-590-0805 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503 - 590030' Inspection Request Scheduled For: Date: 3/9/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 Electrical ssetvit:e. 041594 -01 603-720 -7445 N • Corrections /Comments/ Instructions: • A PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL n CALL FOR INSPECTION 1 j ADDITIONAL FEES ASSESSED Inspector: Date: B Phone #: (503) 718 -2- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006-00080 13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: 6121/2005 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 ka41- INSPECTION WORKSHEET FOR DATE: 3/13/2007 TIME: 7:01AM PAGE: 9 SITE ADDRESS: 11740 F.AN ERROL ST CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES . LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: New SF. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503-5900805 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503-590-0805 Inspection Request Scheduled For: Date: 3/8/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 Electrical services, 044528-02 503 Corrections/Comments/ Instructions: N o 6 1 1174 a . ezeci o v•,324, 1104/a4e. zP-v- 1 0a/lkei (>0-v-ev a} w h-zPiA,1 dot-vile - h -01 chr v ot,T4t, fr i_t i viz- • I PASS ri PARTIAL APPROVAL 7. CANCEL ri NO ACCESS FAIL IX CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: 1',1) Date: Vo7 Phone #: (503) 718- �` . CITY ��N�~�� ������U�������� ��m� mw���mmn�� BUILDING DIVISION PERMIT #: .M[T2006-00080 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/21/2005 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639~4175 INSPECTION WORKSHEET FOR DATE: 3/E12807 TIME: 7:01A&4 PAGE: 8 SITE ADDRESS: 11740 SVVERR0LST CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: New SF. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503,590 01305 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503-590-0806 Inspection Request Scheduled For: Date: 3V812007 Pour Time: Code # Inspection Description Confirm # Contact # Message 135 Low voltage 044528-03 60'3-7Z0 N Corrections/Comments/Instructions: k PASS � ��|ALAPP��L ���EL | | NOA�E� / / -- / / FAIL | | CALL FOR INSPECTION | | ADDITIONAL FEES ASSESSED . 4§767 Inspector: Date: Phone #: (503) 718- �..._ - CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200S. 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 612.112C106 Phone: (503) 639 -4171 ' Inspection Requests (24 Hrs.): (503) 639 -4175 .„.141 _- INSPECTION WORKSHEET FOR DATE: 212712007 TIME: 7:01AM PAGE: 49 SITE ADDRESS: 11740 SW ERROL ST CLASS OF WORK: SUBDIVISION: C:APPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: New SF. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503-590-0805 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503.590-0805 Inspection Request Scheduled For: Date: 212712007 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough-in 043982 -01 503- 357 -2360 N Corrections /Comments /Instructions: • ytw B ad PASS PARTIAL-- APP_ROYAL___ -- '" CANCEL n NO ACCESS FAIL 1 I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 0 LE Date: 272--1 n7 Phone #: (503) 718- 2-41.0a CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006- 000ti0 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/21 /2006 Phone: (503) 639 -4171 A °��i �i� ��it Inspection Requests (24 Hrs.): (503) 639 -4175 ': �__� INSPECTION WORKSHEET FOR DATE: 7/10/2007 TIME: 7:OOAM PAGE: 10 SITE ADDRESS: 11740 SW ERROL ST CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: Now SF. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503 - 500 -0805 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503 - 530 -0805 Inspection Request Scheduled For: Date: 7/10/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 051727 -04 503 - 720 -7445 N Corrections /Comments /Instructions: V F . -1 -- t. /Goiff- & Pfri-44 Ate-LCvr A 4e l 07-Z--e/lt--- t fl PASS _ P' 'TIAL APPROVAL U CANCEL I I NO ACCESS 7 FAIL A ALL FO'p .P TION ADDITIONAL FEES ASSESSED � - /v O Inspector: /// �,�L��� Date: 9L- Phene #: (503) 71E CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200G- 00080 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/21/2006 Phone: (503) 639 -4171 °' ^ • ic'�I Inspection Requests (24 Hrs.): (503) 639 -4175 �. INSPECTION WORKSHEET FOR DATE: 7/10/2007 TIME: 7:OOAM PAGE: 14 SITE ADDRESS: 11740 SW ERROL ST CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: New SF. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503 - 590 -0805 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503- 590 -OI805 Inspection Request Scheduled For: Date: 7/10/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 399 Plurnbing final 051727 -01 503 - 720.7445 N Corrections /Comments /Instructions: • ' SS n PARTIAL APPROVAL n CANCEL _ NO ACCESS Li FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: h lit/ Date: 1 0 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005.00080 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/21/2006 Phone: (503) 639 -4171 ICI ` Inspection Requests (24 Hrs.): (503) 639 -4175 J 1. INSPECTION WORKSHEET FOR DATE: 7/10/2007 TIME: 7:OOAM PAGE: 11 SITE ADDRESS: 11740 SW ERROL ST CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES ATES DESCRIPTION: New SF. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503 -500 -0805 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503 - 590.0805 Inspection Request Scheduled For: Date: 7/10/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 051727 -03 503 -720 -7445 N Corrections /Comments /Instructions: .PASS PARTIAL APPROVAL fl CANCEL n NO ACCESS FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: / Date: 7, 67 Phone #: (503) 718- CITY ���l��� ������H�������� n m�`m� m am�U������ BUILDING DIVISION PERMIT #: A4ST2OO6-ODU8O 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: E/21/2006 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 302007 TIME: 7:O1AM PAGE: 7 SITE ADDRESS: 1i740 SVVERR0LST CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES LOT #: 803 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: New SF. OWNER: FOUR O CONSTRUCTION CO, PHONE #: 503 CONTRACTOR: FOUR [} CQNSTRUCT\[)N PHONE #: 503'590-0805 Inspection Request Scheduled For: Date: 3/02007 Pour Time: Code # Inspection Description Confirm # Contact # Message 320 Pk/mbing»ough'in O44528'84 503-720-7445 N Corrections/Comments/Instructions: �,�/ /(?'/ / �� PASS pi CANCEL | 1 NO ACC _ . -_ n FAIL CALL FOR INSPECTION ADDITIONAL FEB ASSESSED Inspector: Date: 0 / Tr() Phone #: (503) 718- / � CITY OF TIGARD BUILDING DIVISION PERMIT #: mm1006.000130 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/21/2006 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 9/18/2006 TIME: 7:01AM PAGE: SITE ADDRESS: 11740 SW ERROL ST CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES S LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: New SF, OWNER: FOUR D CONSTRUCTION CC), PHONE #: 503.590 -0805 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503_590,0005 Inspection Request Scheduled For: Date: 9118/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 315 Post/beam plumbing 036716 -01 503- 720 -7445 N Corrections /Comments/ Instructions: . ri • SS ❑PARTIAL APPROVAL n CANCEL 1 I NO ACCESS 1 FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED 4 ii;////1/7 Inspector: ' Date: / / • Phone #: (503) 718 - ,._ CITY OF TIGARD .; BUILDING DIVISION PERMIT #: MST 2006 ' 0000 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6121/2006 Phone: (503) 639-4171 A Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 7/612006 7.3 TIME: 0AM • - PAGE: 35 SITE ADDRESS: 11740 SW ERROL ST CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: New SF. FOUR D CONSTRUCTION CO, 503 OWNER: PHONE #: FOUR D CONSTRUCTION 503 CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 7 Pour Time: Code # Inspection Description , Confirm # Contact # Message 340 Storm drain 032731-09 503-969-4631 N Corrections/Comments/Instructions: 4 2 3 ASS n PARTIAL APPROVAL 7 CANCEL III NO ACCESS n FAIL fl CALL FOR INSPECTION ADDITIONAL FEES ASSESSED /.. Inspector: ! iv i i V t. Date: I ) t 6,. Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MS 200G -000B0 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/21/2006 Phone: (503) 639 - 4171 "�y0 � ek Inspection Requests (24 Hrs.): (503) 639 -4175 , , _- 1 INSPECTION WORKSHEET FOR DATE: 7'6(2006 TIME: 7:03AM PAGE: 38 SITE ADDRESS: 11740 SW ERROL ST CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: New SF. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503 - 580 -080f; CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503- 510.0805 Inspection Request Scheduled For: Date: 7/6/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 310 Crawl drain 032731 -06 603.969 -4631 N Corrections /Comments/ Instructions: PASS 1 1 PARTIAL APPROVAL 7 CANCEL n NO ACCESS FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: 1 ( [/ 6,, 5 / — Date: I Phone #: (503) 718 - `/ 3 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST200 &00080 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6 Phone: (503) 639 -4171 ��p����h' Inspection Requests (24 Hrs.): (503) 639 -4175 ��''_I INSPECTION WORKSHEET FOR DATE: 7/62006 TIME: 7:03AM PAGE: 31 SITE ADDRESS: 11740 SW ERROL ST CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: New SF. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503 -590. 0805 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503'590 -0805 Inspection Request Scheduled For: Date: 7 Pour Time: Code # Inspection Description Confirm # Contact # Message 330 Water service 032731 -07 503 -969-4631 N Corrections /Comments /Instructions: PASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS n FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: " 1- ( v Date: // l --17 Phone #: (503) 718 -) i 7 1 CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006-00080 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2112006 Phone: (503) 639-4171 .0 1 Inspection Requests (24 Hrs.): (503) 639-4175 ,_-_,.. - ..... • INSPECTION WORKSHEET FOR DATE: 7/6/2006 TIME: 7 PAGE: 36 SITE ADDRESS: 11740 SW ERROL ST • CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: N(3W SF. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503 CONTRACTOR: FOUR D CONSTRUCTION 601-590-080r) PHONE #: - - Inspection Request Scheduled For: Date: 7/612006 Pour Time: Code # Inspection Description Confirm # Contact # Message 335 Rain chain 032731-08 503-969-4631 N Corrections/Comments/Instructions: j PASS 1 1 PARTIAL APPROVAL r7 CANCEL El NO ACCESS fl FAIL H CALL FOR INSPECTION 71 ADDITIONAL FEES ASSESSED Inspector: V itlialr - , - A„ Date: - - /11 / Phone #: (503) CITY OF TIGARD BUILDING DIVISION PERMIT #: MSr2006 -00010 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6121/2006 Phone: (503) 639 - 4171 Via''' 7 �'b kb Inspection Requests (24 Hrs.): (503) 639 - 4175` "'f I INSPECTION WORKSHEET FOR DATE: 7 « 2006 TIME: 7:03AM PAGE: 34 SITE ADDRESS: 11740 SW ERROL ST CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: New SF. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503580 - 0805 Inspection Request Scheduled For: Date: 7/6/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 505 Sanitary sewer 032731 -10 503-969-4631 N Corrections /Comments /Instructions: I PASS El PARTIAL APPROVAL n CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ADDITIONAL FEES ASSESSED - \/\6-4 ti ,-- Inspector: 1 " r Date: Phone #: (503) 718- _27C__/±Y_ CITY OF TIGARD BUILDING DIVISION PERMIT #: MS 2006- 00080 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 6121/2006 Phone: (503) 639 -4171 �� Inspection Requests (24 Hrs.): (503) 639 -4175 ,. ' '"' INSPECTION WORKSHEET FOR DATE: 3/27/2007 TIME: 7:02AM PAGE: 0 SITE ADDRESS: 11740 SW ERROL ST CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: New SF. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503590.0805 Inspection Request Scheduled For: Date: 3/27/2007 Pour Time: Code # Inspection Description Confirm # tact # Message 280 Insulation 045503 -01 3720 -0012 N Corrections /Comments/ Instructions: PASS n 'ARTIAL APP' • ■ A L CANCEL n NO ACCESS n F AIL C L ► ' PECTION ADDITION L FEES A - SSED Inspector: Date:/ one #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006-00080 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6121/2006 Phone: (503) 639-4171 * I Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 31812007 TIME: 7:01AM PAGE: 10 SITE ADDRESS: 11740 SW ERROL ST CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: N :WY SF. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503 CONTRACTOR: FOUR D CONSTRUCTION _ _ PHONE #: 503-690-0805 Inspection Request Scheduled For: Date: 318/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 276 Ffarnilig 044528-01 503-720-7445 N Corrections/Comments/Instructions: NO le / ke-fa relii,fie:A i-e/V i C. 9 .--- r - 0 e---(- K PASS PARTIAL APPROVAL 71 CANCEL _ NO ACCESS i l FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: MIP Date: 3 /0 Phone #: (503) 718- CITY OF ��uo m w^�m� mw�������� BUILDING DIVISION PERMIT #: hA5J2OO�0DO8O 13125SVVHaUBkd, Tigard, ORQ7223 DATE ISSUED: 6/21/2006 (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639+4175 n � �� INSPECTION WORKSHEET FOR DATE: • 3102007 TIME: 7:O1AM PAGE: 4 • SITE ADDRESS: 11740 SWERR0L5T CLASS OF WORK SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: New SF. OWNER: FOUR D CONSTRUCTION CO, • PHONE #: 5O3-590-0805 CONTRACTOR: FOUR D CONSTRUCTION PHONE 4: 503-590'0806 Inspection Request Scheduled For: Date: 3/0/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 235 ShearvwaUs/anchoro 044528'07 5037207445 N Corrections/Comments/Instructions: PASS | | PARTIAL APPROVAL -- CANCEL NO ACCESS , FAIL CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED Y9/4 |nInspector: �� ~ Oata� / Phone #: (503) 718- CITY ��N~��� ������0�������� OF mn���mnm�� • BUILDING DIVISION PERMIT #: MSJ200 O008 13125SVV Hall Blvd, Tigard, ORQ7223 DATE ISSUED: 021[2005 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 630~4176 ~��a�`� • INSPECTION WORKSHEET FOR DATE: 5/812007 TIME: 7:01Ak8 PAGE: ' SITE ADDRESS: 11740 SW ERROL ST CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: New SF. OWNER: FOUR DC0NETRUCA0NCO, PHONE #: 503-590-0806 CONTRACTOR: FOUR DCONSTRUCTION PHONE #: 503-530-0005 Inspection Request Scheduled For: Date: 318K2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 816 hilmnhanice| 044628-06 503-720-7445 N Corrections/Comments/Instructions: � 2;-1/.0 � h� �� �u fipr �� � °v'/ �C�^�—^ k/.71 4�� p r 6� &��. �^�^�w�� ' -~^/ - , - • /� ' PASS ri PARTIAL APPROVAL 7 CANCEL • 7 NO ACCESS | [ FAIL 1 CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: KV Date: Phone #: 8503\ 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2006-00080 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2112006 Phone: (503) 639 -4171 -'' IInspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 3/812007 TIME: 7:01AM PAGE: 3 SITE ADDRESS: '11740 SW ERROL ST CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: New SF. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503-59G.0805 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503-590 -0805 Inspection Request Scheduled For: Date: 3/8 /2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 212 Interior : lhaar walls 044528-08 503 - 720.7445 N Corrections /Comments/ Instructions: PASS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS n FAIL 1 1 CALL FOR INSPECTION 1 I ADDITIONAL FEES ASSESSED Inspector: Date: �/� Phone #: (503) 718 - p ) CITY OF TIGARD • BUILDING DIVISION PERMIT #: IVIST2006- 00080 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/21/2006 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639 -4175 „Vi ca l l;. INSPECTION WORKSHEET FOR DATE: 3/8/2007 TIME: 7: 01AIVI PAGE: 6 SITE ADDRESS: 11740 SW ERROL ST CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: New SF. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503-59a 0805 Inspection Request Scheduled For: Date: 3/8/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas lines 044528.05 503720 -7445 N Corrections /Comments /Instructions: ( O7 1 7 / I PASS n PARTIAL APPROVAL — CANCEL n NO ACCESS FAIL 1 I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED • O Inspector: Date: Phone #: (503) 718 - CITY OF TIGARD BUILDING DIVISION PERMIT #: ST 0D&-0 0 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: E /21h ?008 Phone: (503) 639 -4171 i ,���4i r i i Inspection Requests (24 Hrs.): (503) 639 -4175 s �.�!i INSPECTION WORKSHEET FOR DATE: 3/5/2007 TIME: 7:OOAM PAGE: 50 SITE ADDRESS: 1I1i740 SIN ERROL ST CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES LOT #: ()03 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: New SF. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503-590-0805 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503-5900805 Inspection Request Scheduled For: Date: 3/5/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 044275-01 503 - 720 -7445 N Corrections /Comments /Instructions: • ❑ PASS n PARTIAL APPROVAL ❑ CANCEL NO ACCESS AIL n CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED 4 Inspector: Date: 7 — a 7 Phone #: (503) 718- Z1-1 . . CITY OF TIGARD BUILDING DIVISION PERMIT #: - IvIST2006-00000 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/21/2006 '! ; Phone: (503) 639-4171 , • di 1 Inspection Requests (24 Hrs.): (503) 639-4175 ...It.- --... INSPECTION WORKSHEET FOR DATE: 2115/2007 . TIME: 7:00AM PAGE: trr s)...F SITE ADDRESS: 11740 SW ERROL ST CLASS OF WORK: • SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: New SF. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503-590-0805 4 Inspection Request Scheduled For: Date: 2115/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 742 Interior sheaf walls 043424-03 . 503-720-7445 N Corrections/Comments/ Instructions: ; ..... / ) et . z.%---e-r7zy '''. (.3 Ale,44 ---[.-_-- \ \ . '■ \,,, ..,., ,..- ,. fl PASS PARTIAL APPROVAL 1 CANCEL — NO ACCESS FAIL 1 1 CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED r.....7 ti , , , , ,/ Inspector: , ) ,,, Date: 91 7 Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION 411,0 PERMIT #: MST2006-000B0 D ATE 13125 SW Hall Blvd., Tigard, OR 97223 E ISSUED: 6/21/7006 " • Phone: (503) 639-4171 411111' Inspection Requests (24 Hrs.): (503) 639-4175 J _ ..-.. INSPECTION WORKSHEET FOR DATE: 2/15/2007 TIME: 7:00AM PAGE: 56 SITE ADDRESS: 11740 SW ERROL. ST CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOFN ESTATES DESCRIPTION: fqebY SF. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 803-590-0005 .. CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 803-590-0805 .. , Inspection Request Scheduled For: Date: 2/18/7007 Pour Time: Code # Inspection Description Confirm # Contact # Message 235 Shear walls/anchors 043424-02 603-720-7446 N Corrections /Comments/ Instructions: €1) A/A i /.. -- ;77/:',1; . i. - f - --,-r.., I% c (-° 1 U: - '77‘ A 5 • ,--'" I I PASS 111 APPROVAL n CANCEL 1 1 NO ACCESS FAIL 1 CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: '../ / Date: 2-/S Phone #: (503) 718- 2.4-4- . . __,•,.•:,,_ • ( CITY OF TIGARD BUILDING DIVISION A PERMIT #: MST2006-00080 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2112006 Phone: (503) 639-4171 —,,,, P,...,,, i i t eit■ , Inspection Requests (24 Hrs.): (503) 639-4175 ..T.,4 41---• INSPECTION WORKSHEET FOR DATE: 2/15/2007 TIME: 7:00AM PAGE: SITE ADDRESS: '11740 SW ERROL 5'T CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: .. PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: Novv SF_ OWNER: FOUR D CONSTRUCTION CO, PHONE #: 503 CONTRACTOR: FOUR D CONSTRUCTION PHONE #: 503-590-0805 . Inspection Request Scheduled For: Date: 2115/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 240 Exterior Sh e .9th i n g 043424-01 503-720-7445 N Corrections/Comments/ Instructions: 6 ./— -- 7 - 71 .-,, • ,„-. . , ... „.,. 1 0 PARTIAL APPROVAL fl CANCEL 0 NO ACCESS 7 FAIL 7 CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: ', Date: 'Z - 7 Phone #: (503) 718- 2-544-5--- CITY ����~�� ���������������� OF wm���m�m�� BUILDING DIVISION PERMIT #: NiST2006-O008O 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/21/2005 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (50] 639-4175 N�`�� , ; INSPECTION WORKSHEET FOR DATE: 9/19/2006 TIME: 7:06AM PAGE: 8 SITE ADDRESS: 11740 SW ERROL ST CLASS OF WORK / SUBDIVISION: CAppOENEETl\TES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPPOEN ESTATES DESCRIPTION: N SF, OWNER: FOUR Q CONSTRUCTION CO, . PHONE #: E.,03- 590-0805 CONTRACTOR: FOUR DCONSTRUCTION PHONE #: 503-590-0805 Inspection Request Scheduled For: Date: af18V2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 605 P4st/baamnmechanimm) 030808-02 503'720-7445 N Corrections/Comments/Instructions: / . . | PASS 1 1 PARTIAL APPROVAL CANCEL 7 NO ACCESS ri FAIL 1 I CALL FOR INSPECTION | | ADDITIONAL FEES ASSESSED Inspector: ito�� ~ Oote: / Phune #: 85O3> 718- ' . CITY OF ~~ ` ��w8 K ��n� wm�������� BUILDING ��D��U������� - ~°~°"~~~~""°~= ~~"�"~,"~~"� PERMIT #: k1[�[2O�G0ODOO � � =°"� 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 601/2006 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 630'4175 i�m��°� INSPECTION WORKSHEET FOR DATE: 9/19/2006 TIME: 7:064N1 PAGE: 9 ' SITE ADDRESS: 11740 SW ERR0LST CLASS OF WORK: SUBDIVISION: CAPPOEN ESTATES LOT #: 003 TYPE OF USE: PROJECT NAME: CAPP0ENESTATES DESCRIPTION: New SF. OWNER: FOUR D CONSTRUCTION CO, PHONE #: 502-580-O805 CONTRACTOR: FOUR [>CONSTRUCTION PHONE #: 503-590'0805 Inspection Request Scheduled For: Date: 9/19/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 226 Pnsilbmamntructurai 036808-01 509-720-7445 N Corrections/Comments/Instructions: . , / , / X �� PARTIAL APPROVAL ��� ACCESS |ALAPPR�L CANCEL � NO�BS / 7 FAIL CALL FOR INSPECTION | 1 ADDITIONAL FEES ASSESSED . Inspector: �� � � �r� �& Da ��� � �~���--��� Phone #� (5O3) 718' CITY OF TIGARD 4 l Sr p BUILDING DIVISION PERMIT #:a"�0 — 000 80 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639-4171 ■ ,. FI1I Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: I I b CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: - z g- o our Time: Code # Inspection Description Confirm # Contact # Message dos alO T a o — looi -� L ifrfec o s/ omments /Instructions: 0 Ast■il ' A — ' —Ill— PASS ❑ PARTIAL APPROVAL 7 CANCEL ❑ NO ACCESS n FAIL CA L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 4 ,./Z_ , Date: ‘ Phone #: (503) 718- 244