Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00561
DEVELOPMENT SERVICES DATE ISSUED: 9/1/2004
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 -4171
PARCEL: 2S 112AA -01000
SITE ADDRESS: 14100 SW 72ND AVE
SUBDIVISION: PP1992 -007 ZONING. I -H
BLOCK: LOT : 001 JURISDICTION: TIG
Project Description: T.I. (41) branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 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 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 40 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
WILLIAMS CONTROLS INDUSTRIES INC WILLAMETTE ELECTRIC INC
14100 SW 72ND AVE PO BOX 230547
TIGARD, OR 97224 TIGARD, OR 97281
Phone: Phone: 503 - 624 - 3631
Reg #: LIC 75059
SUP 1965S
FEES ELE 34 -283C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 9/1/2004 $312.85
[TAX] 8% State Surcharge 9/1/2004 $25.03 Rough -in
Elect'I Final
Total $337.88
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699 or 1 -800- 332 -2344.
Issued By: Permit Signature: -Q__ 4 ��
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
•
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:OOpm for an inspection the next business day
SEP 01 2004 7:53RM HP LASERJET 3200 p.2
b Ele Permit Appl a FOR OPTIC F_, USE ()NE1'
City of Ti and Received ' - or*,
PcrinitNo.:
SEP 01 2004 G
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit
Phone: 503.639.4171 Fax: 503.598.1960 114,'..1 , Date/B
Inspection Line: 503.639.4175 _ D ate ReadyBY: WI See Page 2 for
Internet: www.ci.tigard.or.us CITI(O TI N otifiedlMeOnd : �• Supplemental Information
i ► VISION
VISION
!��I, .Ilra 31i,"d'11t:'�'Y1 71 !I c . , • - ; ,i Inl ii +•: t I m e:T 1, Iti'r» I i f I i : ; ; T -gut" il". • 1,; t�
,I4,. N. 1 .�. JJ�I 1 1 I '��'t ft t L i �`j� 1 1 5 t U7 � v �il l'� 7 7 i ,r t�[tG "y',�i'e p Q l �N frY,�,rl,A tl �7 1' �, i , f.' 3 } i :• r.n u 1 MY U t - �� °yl ,': �t � :' ' .
.
!Y 1 ':U1{! r . t _.L..: l.d �- Cr 5 !..F. I nt.:.i..!. _111.11 i t 71 fie _:: , L+ .:11 ' f.". ` � :tF a 1 ota v,.
❑ New construction RI Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑ Other: ❑ rn Service over 225 amps, com 1 ['Hazardous location
}} f a• J f ..+ s G' , '• A /l3M1L ee: t_1 1.� .�. "'v�. , . , . .. ['Service over 320 as -rating ❑ Buildng over 10,000 sq. ft.,
1. '�j! PLVA5} l�If. , I ,+I `u,, a qm f'Ixi 1 n 1 , ,', p, . lr ,:y of 1- and 2 -family dwellings 4 or mom new residential
n._, 1 1l tl1IM ,1 11' I',1„ I � J.. .1.1 +n__I.. 1_vld�Ni. tiii.:1r�tizr..a..si .611 ,
,tikIt ■
❑ l- and 2- family dwelling El Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
['Building over dace stories ❑Feeders, 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other: ['Occupant load over 99 persons ❑Manuctured structures or
I l :. �t,� 3 r :n 1 a i ,ra�,s u , I I I . j , ! I 6t 11 YPI'
'J 411 I ,, I ;�M1 x t�'' !I Itl i I ¢ � t t u1 I`. 111 r r , j�� ti 1 1 ( U r l l 111 i j '' . ' & sp 1 11 I, :'' " ., �! , 'Lli ;i 1 L, ' i � ❑ Egress /liShting plan RV. park
r
z. �, lit6.11l��_.mESi�ku �L.Fi11,_,ai' slr3_IILI,IL..., ,.... - - . 11ur.>;�i.�_:1Lia.n r,l,tttdlLil'ne.,ll�,.r ,._,, t, r'
Job no.: 4 3s — Job site address: / ti t p p tom,, ?. Z , p ,, ❑Health - carp facility ❑ =
Submit 2 sets of plans with any of the above.
City/State/ZIP: e- 444 n The above are not applicable to temporary construction service
S Mt� �t,l3''.1y� 1 1 ' ��'j� j 7• i �a P,.F �r+,n�h. � " :.: + �: .
�'.., ( 6� I {r (',(. I J � � ;[ Y••�il "II SI � i'l i � � �,� C �4" . S
Suite/bld f t. no.' I Project name J 1'Hr-•1" 1}=9 f+i liivi::: }•a<' E- • ,_,.,:esaurc�, ° f f ..
g / u 1 I; et, S CO r ho / Dmcription Qty. Fes Total
Cross street/directions to job site: ,µ,,,, ? l A 2/0 A V New residential single- or multi-bunny dweiling unit.
~l 1 ..c Indndes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.: 75.00 2 •
r • v h �e =tint •:,�cw " "2up I: )Ir, !nrc,t aj;. I psfl ' ?iEip a :,�` " ,: s �" Epy'rrs Limited energy, non- rL4ldentl8l
i Ir i lt i;:Fl 3, iirlIN 07•W .1 ad P { ItL 1 , g t r i I �, q P r 1, J 1 :11 I � n1 ; 1, - r E , i�,r rry J ^il
i ,, III r bl i 1.. u..!l�{ [11.1c diut ii, iL,..a.,.a::::,1 1. 74,7,j, Vit J. l+,, r.. 1� .x,U:L,,,,,,.,,, ;;1 ;s4.0. i..�.,„1. r,,�+ -_ r Each manufactured or modular
_ dwelling, service and/or feeder 90.90 2
e44. 1 ts (1'.i tL . &4
a J ' Services or feeders Installation, alteration, and/or relocadon
1 _ 200 amps or less 80.30 2
r. ` _; tl JR2�a iir,isi y ,{n {1 a t t IVtll I ; 1 F �i I RII'11 F ':;ti llliulr I -:s i egl 201 111113S ps to 400 amps 106.85 2
( '1-}.:1 �:r 1 r. t •w II 1'i i tlr• , ih li .__ k• t, -,,tk 11111 1 11 n' 1-.x. 5 . •
! G.,a .r ��� i X111! I„, a , - ;ark t u nFi IF �,. +:1k1r:II,G ,li
,1 I ..y , Ln 141,,, k., I .m_ti 401 aitps to 600 amps 160.60 2
Name: Wt kit 4.s.,..5, e'e µ, tot,* k 601 amps to 1,000 amps 240.60 2
Address: <0,-€ Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Temporary setvlces or feeders installation, alteration, and/or
Phone: ( ) I F ( ) relocation
�D 2 7 9 . � 200 amps or less 66.85 1 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
A
. , l 0 . 151ir i t 1 " 1 N .�l lr, I L :3'"�I tl', W, 11 1 r1 ' It I \I$ Ii;y1 II irvl Ik i II n 1 I i L y i . I' P I II I ,7 A. Fee for branch circuits with
{ 1,-r I
r i ,. � � , f S :L I 3.4 that, 1:g ..1111.,,c,. ?a1, ...- ,.,:rivi ):a hionitell1d1.
= •.�. s ti T - service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee, / GG
46.85 7 6 r 2
each branch circuit
Address: Each add'l branch circuit - ) 6.65 24,( a � 2
City /State/ZIP: Miscellaneous (service or feeder not Included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax. ' ( ) Sign or outline lighting 53.40 2
E-mail: p( j� Signal circuit(s) or limited -
' 1 1,, I EI 0,1.Ill� 1 t�•w Ifj.,i I l d 1 _� �� Wi y_?4 11!l.ilr%�il_ t I, 1 f i . P. ify r y � F en el, alias iiOn, er
1 a �� , >t • 1_ r� r i �,�c � 1j �`. � �/�pj I-. _:.1 i extens Describe: Page 2 2
Business name: 14 r l (ct Itta tie 1C1.[c rtii, four
Each additional Inspection over allowable in any of the above
Address:
0 Ad -? O 5 '' 7- Per inspection 62.50
City /State/ZIP: ?' 14 ti d O'K. ¢f 7 ZF 1 Investigation per hour (t br min) 62.50
( I F ax' K � 2 5 8 Industrial plant per hour 73.75
Phone 563 ) 6L4 3b31 ($d'$) L 1t- I,i ? > ,,. U,[t "lyigp tl i�l '��t)n'a'ii::s,�Z�••Au i 1 G='i i7 ':.- *' :,:*
{ +;_:ia. u. i idC�171u�:: _ � tJv .. ,.:;ti : �,Ilf: ) : ~ ~. < ...
CCB Lic.: 7. 1 Electrical Lic.: T4 - ZlF3 L Sup . Lic.: (G S'S Subtotal 3 s t,
Suprv. Electrician signature, required: Plan review (25% of permit fee)
[[ State surcharge (8% of permit fee) 2's03
Print name: r7 N . t a Date: ?.../ —O y TOTAL PERMIT FEE 33 e 4.'
Authorized signature: This permit application esptres If a permit 6 not obtained within 180
days after It etas been accepted as complete
Print name: Date: • Pee methodology set by Tr. -County Building ladusery Service Board
•• Number of inapectiom per permit allowed.
ismBuildiat pemals■EIC.PermitApp.doc 12/03 440-4615T(10/02'OOMIWBB
CITY OF TIGARD 24 -Hour
BUILDING Irrspectiion Linea(503) -4175
INSPECTION DIVISION Business Line: -(503) 639 -4171 MST
BUP
Received ) Date Requested / 741_ AM PM BUP
Location l ' ' 7 41q Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) k L 1 - 36),3/ SWR
BUILDING Tenant/Owner 'l.L) m • C 01- P ELC 7
Footing
ELC
Foundation
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler c �
Fire Alarm ®N
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service `o 3) 1 ~ ' QAt�
Rough -In � Leg f � � �
UG/Slab
Low Voltage
Fire Alarm
j. ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
./; ;;fp FAIL
❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line 10 I ppg ADA D Inspector 16,t4 Ext
Approach/Sidewalk iP i
Pp
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (5031'639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received (! Date Requested � — �S AM PM BUP
Location / T / a 6 �i�G( Suite MEC
Contact Person Ph ( ) PLM
Contractor // '' ll Ph ( ) l� �� �� 3� SWR
BUILDING Tenant/Owner (�(/ ELC Y - col
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fire wall
Fire Sprinkler (j—
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PART FAIL
RI L
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line l
ADA Date . ~ I D '�� Ins actor eg Ext
Approach/Sidewalk ! P
Other:
Final DO NOT REMOVE this inspection record rom job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection' LIne: 1503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 - MST
BUP
Received Date Requested � ' l J 2 d AM PM BUP
Location / �/ D C� 7c ri Suite MEC
Contact Person Ph ( ) PLM
Contractor ,,)) Ph ( ) �n �� — .36 3/ SWR
BUILDING Tenant/Owner (.CJ//J'j'1 1 t Q -'i _Q ELC q--oc j
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: / SIT
Post & Beam Sr Anchors
' �� 9�
Ext Sheath/Shear h /Sh ear . _ J2.12 .,. 4 )
Ext eah/h
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Are Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL � /
PLUMBING `�//
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Serv
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire -g'•
valk Date - aO — Inspector `� ` \\ � d 1 y Ext
DO NOT REMOVE this inspection record from the job site.
FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: '(503) 639 -4175
INSPECTION DIVISION Business Line: (503) 69 -4171 MST
BUP
Received II Date Requested 7 6 AM PM BUP
Location / `rf ` 7pZ Suite MEC
Contact Person Ph ( ) PLM
Contractor ' ` , Ph ( ) �P ? ' —3(e 3 ( SWR
w
BUILDING Tenant/Owner , /7) &. ELC d y —Ud .5 I
Footing
ELC
Foundation
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: 7 SIT
Post & Beam
Shear Anchors O( �,,, „/�
Ext Sheath/Shear /I K.r ,
Int Sheath/Shear
Framing
Insulation LA/ C-6 g i 4(rr 2i,-)/\/(9 �(9 r1 I�,� vv )3
Drywall Nailing ! �l
Firewall (
Fire Sprinkler U' 1�
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final r •
PASS PART FAIL
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 (\
UG/Slab
Low Voltage
Fire Alarm
Fi Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE 0 Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from th job site.
PASS PART FAIL
r CITY OF TIGARD 24-Hour
BUILDING Inspection Line: •(503) 539 -4175
INSPECTION DIVISION Business Line: (503) 639'=4171 MST
BUP
Received Date Requested / 7 AM PM BUP
Location / 91 6 7 a 4v Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) G 2 9' -36 31 SWR
•
BUILDING Tenant/Owner ELC °1,e --610-/
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: ,Q /__. SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation e,it‘ (Lvookb\ s \ S 1 \ -)
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service •
■11 . . 1
UG/Slab
Low Voltage L i&S
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART IL
SITE ❑ Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA D ��'' �' /6/ It Ext
G ��~� � L'�
Approach/Sidewalk r
Other:
Final DO NOT REMOVE this inspection record from the b site.
°ASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Liner: (503) 69 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / ( °) C AM • PM BUP
Location / '/d 0 - 7 "77 Suite MEC
Contact Person Ph ( ) PLM
Contractor , Ph ( ) 4, ��. 3 .3/ SWR
BUILDING Tenant/Owner Q.) / 0 r1� / 2&—I? ELC _____
Footing
Foundation ELC c,
Ftg Drain ELC �� )� Y2 h t r 1` ELR 3 -' 96 L � \ U v �� I
Crawl Drain ,Y 1�' U )
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear ' 0
Framing ^ 11 11 ' `� `` ,
Insulation 1) C ��'-V , f ) C N 1i" C T ' 14 A , .0 i 1 0
Drywall Nailing ,
Firewall
Fire Sprinkler (_.._\"\t-C-0 \ N �v� iNt)
Fire Alarm �
Susp'd Ceiling
Roof
O
) ,... P (
ther:
Final
PASS PART FAIL �('�
PLUMBING ky tq .,. '1 C L--\\ L\- Yu 4s �s AN b .5,31/am '
Post & Beam )
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole � NWNI I I TO ) ) �S ECk 0), ) 5,1 l ' N _ l EiVi
Storm Drain / /
Shower Pan \..\ L* c1t-C1 1, \-4 6 .
Other:
Final A"N - QAckM0(f ) E7 4)
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers (�
Final �d t7 1 "' - oo w 1"" W PS PrA �i�1 0 L Y1 koom
PASS PART FAIL .„--______,'
ELECTRICAL ,
Service
Rough -In :.Aitire at t V ---
UG/Slab
L owVoto•:
k Fire Alarm
FAIL 0 Reirispection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
gidliiiii ~ 0 Please call for reinspect • n RE: 0 Unable to inspect — no access
Fire Supply Line 1
A
Other:
/ / - a
Date J Inspector y Ext c
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour .
BUILDING Inspection Lihe:. (503) 639 -4175
INSPECTION DIVISION Business Line: `(5b3) 639-4171 MST
BUP
Received 1 Date Requested // _ / �° AM PM BUP
Location 4 -1/06 7 AAA Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) L ?-'{ - 3( SWR
BUILDING Tenant/Owner �/ �� J1 -� ELC c t — 06LS - ea(
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: krV.
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service oi
Rough -In
UG/Slab 1 �
Low Voltage z Z - 0 -- o d 3/ y 0 f�"/
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
41=3" PART FAIL
SITE I=1 Please call for einspection RE: El Unable to inspect - no access
Fire Supply Line
//
ADA
Approach/Sidewalk Date / ' - 6 Inspector �/ iLi . toottrielltr Ext
Other:
Final DO NOT REMOVE this Inspection record from the Jo . site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection ,Line: (503) 639 -4175
INSPECTION DIVISION Business Line: '(503) 639 -4171 MST
BUP
Received 1 Date Requested /6 ' 2 7 AM PM BUP
Location l 4 7 / / D O Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) b ?-'f - .3 (' 3/ SWR
BUILDING Tenant/Owner -e_ ELC c am Oslo I
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: , ( `�� 3 jj, % j � bO 1/ SIT
1 �
P
• ost & Beam 1 1\
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing I �
Firewall �F3 V ��� �Oa- ��&
I
Fire Sprinkler V I " �\ _
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL V
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain C
Shower Pan l_IZtH C ®N W - 1\(Q ' 17
Other:
Anal
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough-In
Slab
l� 51ab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SS PART FAIL
SITE Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line n
ADA D A Inspector . -�C - Ext
Approach/Sidewalk -
Other:
Final DO NOT REMOVE this Inspection record rom t Job site.
PASS PART FAIL _