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Permit
CITY OF TIGARD MASTER PERMIT PERMIT #: MST2001 -00225 � DEVELOPMENT SERVICES DATE ISSUED: 4/24/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 15900 SW 76TH AVE PARCEL: 2S112CD -07700 SUBDIVISION: PP1995 -049 ZONING: R -7 BLOCK: LOT: 002 JURISDICTION: TIG REMARKS: New 150 sq.ft. dormer /bathroom BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 150 sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT: VALUE: $ 23,000.00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 150.00 sf REAR: PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: - RAIN DRAIN: TRAPS: LAVATORIES: 2 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL /CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 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 /FDR> =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: Owner: Contractor: TOTAL FEES: $ 875.29 This permit is subject to the regulations contained in the SANDERS, RODNEY E + KANA M OWNER Tigard Municipal Code, State of OR. Specialty Codes and 15900 SW 76TH all other applicable laws. All work will be done in TIGARD, OR 97224 accordance with approved plans. Th is permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set Reg #: forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Mechanical Insp Exterior Sheathing Insl Plumb Final Plumb Top Out Insulation Insp Final inspection Electrical Rough In Rain drain Insp Framing Insp Electrical Final Shear Wall Insp Mechanical Firial ir Issued By : Permittee Signature . - Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day 1010 • Building Permit Application 4 , City of Tigard Date received: y y /Of Perthit o.:M (-- p 0c) .R,.5 Y' I' '+� "= Project/appl. no.: Expire date: City ofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Phone: (503) 639 - 4171 Date issued: By: Receipt no.: 4 Fax: (503) 598 -1960 Case file no.: Payment type: C Land use approval: 1 &2 family: Simple Complex: TYPE OF PERMIT o 1 & 2 family dwelling or accessory Cl Commercial/industrial ❑ Multi - family ❑ New construction 0 Demolition 0 Addition/alteration /replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other: JOB SITE INFORMATION Job address: • • (A.) , 4 '` T. , e o ' 9 Bldg. no.: Suite no.: Lot: Block: Subdivision: — Tax map /tax lot/account no.: Project name: Description and location of work on premises /special conditions: A e..w 10 0.{-k room. i N 6-1 e-4.-% 1 of me.- l 60. sQ Fr QWNER ,,. FOR SPECIAL INFORMATION, USE CHECKLIST (Floodplain, septic capacity, solar, etc.) :. • Mailing address: t - 00 ( I. VC- 1 & 2 family dwelling: IIIMMI State: 0 12, ZIP: • .2 '/ Valuation of work $ 2 3 j 000 Phone: So "4rr -40S Fax: 6 • e - 0 Q• IIMMUMMMIM. No. of bedrooms/baths Owner's representative: $ u P P • ae ^•► Total number of floors Phone: Fax: E -mail: New dwelling area (sq. ft.) APPLICANT Garage /carport area (sq. ft.) Name: 5A • Covered porch area (sq. ft.) Mailing address: -- Deck area (sq. ft.) City: -- State: — ZIR Other structure area (sq. ft.) • Phone: _ Fax: ,- E -mail: Commercial/industrial/multi- family: CONTRACTOR Valuation of work $ Business name: Existing bldg. area (sq. ft.) 0 e L_- New bldg. area (sq. ft.) Address: City: State: ZIP: Number of stories Type of construction . Phone: Fax: E -mail: Occupancy group(s): Existing: CCB no.: New: .City /metro lic. no.: Notice: All contractors and subcontractors are required to be ARCIIITECT/DESIGNER licensed with the Oregon Construction Contractors Board under IMIFEEMMIIMIIIMIIMII provisions of ORS 701 and may be required to be licensed in the Address: �} x jurisdiction where work is being performed. If the applicant is b 32 , , �a, exempt from licensing, the following reason applies: �... . - r ZIP: i 2.1 Contact person: , LASke -n_ Plan no.: Phone: So 3.2,gq •pO l b Fax: E -mail: A - • ENGINEER Contact person: q„ Fees due upon application $ Address: 3 1 o r'`/ A o; .+ Date received: City: . ?oe I _., =MI ZIP: 0 Amount received $ Phone:505 -, L , • DY .1121MIM E -mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information. attached checklist. All provisions of laws and ordinances governing this ❑ Visa 0 MasterCard work will be complied with, / hether specified herein or not. Credit card number: / / _ �/ Expires Authorized signature: .. 4. -- Date: G -o/ Name of cardholder as shown on credit card � 5 M $ Print name: Card holder signature Amount Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6ro0/COM) A One- and Two- Family Dwelling - -1, r 1 , Building Permit Application Checklist Reference no.: . Associated permits: City of Tigard City of Tig ty b ❑Electrical CI Plumbing CI Mechanical Address: 13125 SW Hall Blvd, Tigard, OR 97223 ID Other: Phone: (503) 639 -4171 Fax: (503) 598 -1960 THE FOLLOWING ITEMS ARE REQUIRED FOR P R EVIEW I Yes No N/A Land use actions completed. See jurisdiction criteria for concurrentreviews. Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. Verification of approved plat/lot. ■ Fire district approval required. 5 Septic system permit or authorization for remodel. Existing system capacity Sewer permit. Water district approval. Soils report. Must carry original applicable stamp and signature on file or with application. Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of ca b poei, e 10 3 tc omplete asin rt sets ct on of legible plans. Must be drawn to scale, showing conformance to applicable local and state C .-. mg codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. . 1'1 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if the more than a 4-ft. elevation differential, plan mustshow contour lines at 2 -ft. intervals); location of easements and ; footprint of structure (including decks); location of wells/septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage. 12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent size and location. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. • 14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub -floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, . fireplace construction, thermal insulation, etc. 15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels. Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and/or lateral analysis plans. Must indicate details and locations; for non - prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered systems, see item 22, "Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists over 10 feet long and/or any beam/joist carrying a non - uniform load. 20 Manufactured floor /roof truss design details. , 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required for four or more appliances. 22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or architect licensed in Oregon and shall be shown to be applicable to the project under review. . JURISDICTIONAL SPECIFICSI 23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". 24 Two (2) sets each are required for Items 16, 19, 20 & 22 above. • 25 Building plans shall not contain red lines or tape -ons. 26 No rolled, reversed or mirrored building plans will be accepted. 27 28 Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only. 440 -4614 (6/00 /COM) • Mechanical Permit Application Date received: Permit no.: I • ,'� 4,.Li City of Tigard Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 - 1960 Case file no.: Payment type: Land use approval: Building permit no.: TYPE OF PERMIT al & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement U New construction 0 Addition/alteration /replacement 0 Other: JOB SITE, INFORMATION COMMERCIAL VALUATION SCHEDULE Job address: /S9 oo S 7Gr., 4vc 1 fica n Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot/account no.: profit. Value $ Lot: IBlock: 'Subdivision: *See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City /county: I ZIP: 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE g. Description and location of work on premises: AND COMMERICAL/INDUSTRIAL EQUIPMENT SCHEDULE Fee(ea.) Total Est. date of completion/inspection: Description Qty. Res. only Res. only Tenant improvement or change of use: HVAC: Is existing space heated or conditioned? 0 Yes 0 No Airc Air conditioning unit CFM (site plan required) Is existing space insulated? O Yes 0 No Alteration of existing HVAC system ' MECHANICAL C Boiler /compressors 1 Business name: 0 W N i ' State boiler permit no.: HP Tons BTU /H Address: Fire /smoke dampers /duct smoke detectors City: I State: I ZIP: Heat pump (site plan required) Phone: I Fax: 1 E - mail: InstalUreplacefumace/burner BTU /H CCB no.: Including ductwork/vent liner 0 Yes 0 No Install/replace/relocate heaters — suspended, City/metro lic. no.: wall, or floor mounted Name (please print): Vent for appliance other than furnace j CONTACT PERSON Refrigeration: Absorption units BTU /H Name: Chillers HP Address: Compressors HP Environmental exhaust and ventilation: City: 1 State: I ZIP: Appliance vent Phone: Fax: E -mail: Dryer exhaust ,OWNER Hoods, Type I/ IUres. kitchen/hazmat 1 hood fire suppression system Name: f Exhaust fan with single duct (bath fans) Mailing address: p p 5 w ) (f a^ Exhaust system apart from heating or AC City: 77 4 1 State: ) L.i ZIP: c( 7 2. y �/ Fuel piping and distribution (up to 4 outlets) ( Type: LPG NG Oil Phone: {,o3 - . a 5 Fax: E -mail: Fuel piping each additional over 4 outlets Process piping (schematic required) Number of outlets Name: Other listed appliance or equipment: Address: Decorative fireplace City: State: I ZIP: Insert — type Phone: 1 Fax: 1 E -mail: Woodstove/pelletstove Other: Applicant's signature: . I Date: Other: Name (print): Not all jurisdictions accept credit cards, please call jurisdiction for mote information. Permit fee $ ❑ Visa ❑ MasterCard Notice: This permit application Minimum fee $ � expires if a permit is not obtained Plan review (at _ %) $ Credit card number: w ithin 180 days after it has been Expires y State surcharge (8 %) .... $ Name of cardholder as shown on credit card accepted as complete. $ TOTAL $ Cardholder signature Amount 440-4617 (6/00 /COM) • MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: FEE: Description: Price Total $1.00 to $5,000.00 Minimum fee $72.50 Table 1A Mechanical Code Qty (Ea) Amt $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and 1) Furnace to 100,000 BTU $1.52 for each additional $100.00 or including ducts & vents 14.00 fraction thereof, to and including 2) Furnace 100,000 BTU+ $10,000.00. including ducts & vents 17.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and 3) Floor Furnace $1.54 for each additional $100.00 or including vent 14.00 fraction thereof, to and including 4) Suspended heater, wall heater $25,000.00. or floor mounted heater 14.00 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and 5) Vent not included in appliance permit $1.45 for each additional $100.00 or 6.80 fraction thereof, to and including 6) Repair units $50,000.00. ' ' 12.15 $50,001.00 and up $742.00 for the first $50,000.00 and Gheck all =that apply Boller Heat -, Air, $1.20 for each additional $100.00 or For 'items 7 -11, seek or ;Pump °fond i • fraction thereof footnote below ` Comp*- .`** - ° °_ 7) <3HP;absorb unit ASSUMED VALUATIONS PER APPLIANCE: to 100K BTU 14.00 • 8) 3 -15 HP; absorb Value Total unit 100k to 500k BTU 25.60 Description: Qty (Ea) Amount 9) 15 -30 HP; absorb Furnace to 100,000 BTU, including 955 unit .5 -1 mil BTU 35.00 ducts & vents 10) 30 -50 HP; absorb Furnace > 100,000 BTU including 1,170 unit 1 -1.75 mil BTU 52.20 ducts & vents 11) >50HP: absorb Floor furnace including vent 955 unit >1.75 mil BTU 87.20 Suspended heater, wall heater or 955 12) Air handling unit to 10,000 CFM floor mounted heater 10.00 Vent not included in applicance 445 13) Air handling unit 10,000 CFM± . • permit 17.20 Repair units 805 14) Non - portable evaporate cooler < 3 hp; absorb. unit, 955 10.00 to 10 BTU 15) Vent fan connected to a single duct hp 3 -15 hp; absorb. unit, 1,700 6.80 101k to 500k BTU 16) Ventilation system not included in 15 -30 hp; absorb. unit, 501k to 1 2,310 appliance permit 10.00 mil. BTU 17) Hood served by mechanical exhaust 30 -50 hp; absorb. unit, 3,400 10.00 1 -1.75 mil. BTU 18) Domestic incinerators >50 hp; absorb. unit, 5,725 17.40 >1.75 mil. BTU 19) Commercial or industrial type incinerator Air handling unit to 10,000 cfm _ 656 69.95 • Air handling unit >10,000 cfm 1,170 Non - portable evaporate cooler 656 20) Other units, including wood stoves 10.00 Vent fan connected to a single duct 446 21) Gas piping one to four outlets Vent system not included in 656 5.40 appliance permit 22) More than 4 -per outlet (each) Hood served by mechanical exhaust 656 1.00 Domestic incinerator 1,170 Minimum Permit Fee $72.50 SUBTOTAL 1 , $ Commercial or industrial incinerator 4,590 Other unit, including wood stoves, 656 8% State Surcharge s , $ inserts, etc. �a- I4uoa,AZxkau� %..: ..i Gas piping 1-4 outlets 360 25% Plan Review Fee (of subtotal) v k ",,` $ Each additional outlet 63 ,- ,F . Required for AL co mmercial permits only ' t, , TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE g n., y $ VALUATION: '; Other Inspections and Fees: 1. Inspections outside of normal business hours (minimum charge -two hours) $72.50 per hour. 2. Inspections for which no fee is specifically indicated (minimum charge -half hour) $72.50 per hour 3. Additional plan review required by changes, additions or revisions to plans (minimum charge -one -half hour) $72.50 per hour * State Contractor Boiler Certification required for units >200k BTU. ** Residential A/C requires site plan showing placement of unit. is \dsts \forms\mech - fees.doc 10/11/00 Plumbing Permit Application Date received: Permit no.: r , W 3 1 City of Tigard `J b Sewer permit no.: Building permit no.: - Address: 13125 SW Hall Blvd, Tigard, OR 97223 City ofTigard Phone: (503) 639 - 4171 Project/appl.no.: Expire date: Fax: (503) 598 - 1960 Date issued: By: Receipt no.: Land use approval: Case file no.: Payment type: ' TYPE OF PERMIT ' Eli 4 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Food service ❑ Other: JOB SITE INFORMATION FEE SCHEDULE (for special infori ation use checklist) k Job address: / 5900 SW 7 6 . Aye 1 G 412-0 1122,0 Description Qty. Fee (ea.) Total Bldg. no.: I Suite no.: New 1- and 2- family dwellings only: (includes 100 ft. for each utility connection) Tax map /tax lot/account no.: SFR (1) bath Lot: IBlock: I Subdivision: SFR (2) bath Project name:5,6 s 2,«...elo1 SFR (3) bath City /county: I ZIP: Each additional bath/kitchen Description and location of work on premises: Mew ltl'\ Site utilities: _ /.iew D✓trheA /So Sea Pr Catch basin/area drain Est. date of completion/inspection: Drywells/leach line /trench drain PLUMBING CONTRACTOR Footing drain (no. lin. ft.) Manufactured home utilities Business name: ow a R Manholes Address: Rain drain connector City: I State: I ZIP: Sanitary sewer (no. lin. ft.) Phone: I Fax: I E -mail: Storm sewer (no. lin. ft.) CCB no.: I Plumb. bus. reg. no: Water service (no. lin. ft.) City /metro lic. no.: Fixture or item: Contractor's representative signature: Absorption valve Back flow preventer • Print name: Date: Backwater valve CONTACT PERSON Basins/lavatory Name: Clothes washer , Dishwasher Address: Drinking fountain(s) • City: I State: . I ZIP: Ejectors /sump Phone: Fax: E -mail: Expansion tank . OWNER Fixture /sewer cap Name (print): K �,,,� S' v,c64s Garbage drains/floor disposal sinks hub SC.-.) Horsbage disposal Mailing address: /59 00 S 7�v� �L Hose bibb City: - p a_ (- !State: 0 2I ZIP: q 7 1..2... if Ice maker Phone:so3 744 j55 I Fax: I E -mail: Interceptor /grease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain (commercial) employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s) Owner's signature: Date: Sump ENGINEER Tubs /shower /shower pan Urinal Name: . Water closet Address: Water heater City: State: ZIP: Other: Phone: Fax: I E -mail: Total Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Minimum fee $ Plan review (at _ %) $ ❑ Visa 0 MasterCard expires if a permit is not obtained Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ Expires TOTAL $ Name of cardholder as shown on credit card accepted as complete. $ Cardholder signature Amount 440 -4616 (6/00 /COM) PLUMBING PERMIT FEES: PRICE ' TOTAL _ , New 1 and'2 famil dwellin FIXTURES. (individual) • QTY ,(ea) AMOUNT. (indlUdeS.falf plumbing fixtures in ` " PRICE TOTAL Sink 16.60 the dwelling•and fir,"st100 ft. - `QTY �(ea) AMOUNT Lavatory 16.60 'for`each�utillty,connection) , One (1) bath $249.20 Tub or Tub /Shower Comb. i- 16.60 Two (2) bath $350.00 Shower Only 16.60 Three (3) bath $399.00 Water Closet 7 16.60 SUBTOTAL Urinal 16.60 8% STATE SURCHARGE ' . Dishwasher 16.60 PLAN REVIEW 25% OF SUBTOTAL Garbage Disposal 16.60 TOTAL Laundry Tray 16.60 Washing Machine 16.60 Floor Drain /Floor Sink 2" 16.60 PLEASE 166.60 60 LEASE COMPLETE: 4" 16.60 Water Heater 0 conversion 0 like kind 16.60 Quantity by Work`P,erformed . Gas piping requires a separate mechanical Fixture Type:' ' , New •:Moved,.:- .Replaced _ °Removed/ permit. Cap MFG Home New Water Service 46.40 Sink MFG Home New San /Storm Sewer 46.40 Lavatory - Tub or Tub /Shower . Hose Bibs 16 Combination Roof Drains 16.60 Shower Only 'Drinking Fountain 16.60 Water Closet Other Fixtures (Specify) 16.60 Urinal Dishwasher Garbage Disposal Laundry Room Tray , Washing Machine Floor Drain /Sink: 2" Sewer - 1st 100' 55.00 3. ' Sewer - each additional 100' 46.40 4" Water Service - 1st 100' 55.00 Water Heater Water Service - each additional 200' 46.40 Other Fixtures (Specify) Storm & Rain Drain - 1st 100' 55.00 Storm & Rain Drain - each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 Residential Backflow Prevention Device* 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specially 72.50 Requested Inspections per/hr COMMENTS REGARDING ABOVE: Rain Drain, single family dwelling 65.25 Grease Traps 16.60 QUANTITY TOTAL - , ., • Isometric or riser diagram is required if _ . . Quantity Total is > 9 * SUBTOTAL `'s •‘'4> 8% STATE SURCHARGE * *PLAN REVIEW 25% OF SUBTOTAL Required only if fixture qty. total is > 9 '. ' .,,, .. TOTAL $ * Minimum permit fee is $72.50 + 8% state surcharge, except Residential Backflow Prevention Device, which is $36.25 + 8% state surcharge. ** All New Commercial Buildings require plans with isometric or riser diagram and plan review. is \dsts \forms\plm- fees.doc 10/10/00 Electrical Permit Application Date received: Permit no.: �, j ei, °,,,,, . City of Tigard Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT 8 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration /replacement ❑ Other: ❑ Partial JOB SITE INFORMATION Job address: /59'00 a.) 7& --' 4uc. 77 4 0 12 Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: I Block: I Subdivision: Project name. J_ , ,. I Description and location of work on premises: Estimated date of completion/inspection: . . CONTRACTOR APPLICATION . - FEE SCHEDULE Job no: Fee Max Business name: 0 lJ N I art_ • _ Description Qty. (ea.) Total no. insp New residential - single or multi - family per • Address: dwelling unit. Includes attached garage. City: I State: I ZIP: Service included: Phone: I Fax: I E -mail: moo sq. ft. or less 4 Each additional 500 sq. ft. or portion thereof CCB no.: I Elec. bus. lic. no: Limited energy, residential 2 City /metro lic. no.: Limited energy, non- residential 2 Each manufactured home or modular dwelling Signature of supervising electrician (required) Date Service and/or feeder 2 Sup. elect. name (print): License no: Services or feeders — installation, alteration or relocation: PROPERTY OWNER 200 amps or less 2 Name (print): 201 amps to 400 amps 2 401 amps to 600 amps 2 Mailing address: - 601 amps to 1000 amps • 2 City: I State; I ZIP: Over 1000 amps or volts 2 Phone: I Fax: I E -mail: Reconnect only 1 • Owner installation: The installation is being made on property I own Temporary services or feeders - which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation: 200 amps or less 2 20 ORS 447, 455, 479, 670, 701. 201 1 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 ENGINEER Branch circuits - new, alteration, or extension per panel: Name: A. Fee for branch circuits with purchase of Address: service or feeder fee, each branch circuit 2 City: I State: • I ZIP: B. Fee for branch circuits without purchase of service or feeder fee, first branch circuit: 2 Phone: Fax: E-mail: Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): ❑ Service over 225 amps- commercial ❑ Health -care facility Each pump or irrigation circle 2 ❑ Service over 320 amps - rating of 1 &2 ❑ Hazardous location Each sign or outline lighting 2 family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, ❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2 ❑ Building over three stories ❑ Feeders, 400 amps or more *Description: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ Egress/lightingplan ❑ Other: Per inspection Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ m ❑ Visa ❑ Master expires if a permit is not obtained Plan review (at %) $ ' Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ Expires accepted as complete. TOTAL $ Name of cardholder as shown on credit card $ Cardholder signature Amount 440 -4615 (6/00 /COM) Electrical Permit Fees: Limited Energy Fees: . TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Complete Fee Schedule Below: Restricted Energy Fee $75.00 . Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total si, Check Type of Work Involved: Residential - per unit 1000 sq. ft. or less $145.15 4 n Audio and Stereo Systems Each additional 500 sq. ft. or portion thereof $33.40 1 n Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular n Garage Door Opener Dwelling Service or Feeder $90.90 2 Services or Feeders n Heating, Ventilation and Air Conditioning System* Installation, alteration, or relocation 200 amps or less $80.30 2 n Vacuum Systems' 201 amps to 400 amps $106.85 2 • 401 amps to 600 amps $160.60 2 601 amps to 1000 amps $240.60 2 n Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system $75.00 200 amps or less $66.85 2 (SEE OAR 918 - 260 -260) • 201 amps to 400 amps $100.30 2 . 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, see "b" above. p Audio and Stereo Systems Branch Circuits n Boiler Controls New, alteration or extension per panel a) The fee for branch circuits with purchase of service or n Clock Systems feeder fee. Each branch circuit $6.65 2 n Data Telecommunication Installation b) The fee for branch circuits without purchase of service n Fire Alarm Installation or feeder fee. First branch circuit 1 $46.85 Each additional branch circuit 1 $6.65 n HVAC Miscellaneous n Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 n Intercom and Paging Systems Each sign or outline lighting $53.40 Signal circuit(s) or a limited energy panel, alteration or extension $75.00 n Landscape Irrigation Control Minor Labels (10) $125.00 . • Each additional inspection over n Medical the allowable in any of the above Per inspection $62.50 n Nurse Calls Per hour $62.50 In Plant $73.75 n Outdoor Landscape Lighting Fees: n Protective Signaling • Enter total of above fees $ n Other 8% State Surcharge $ Number of Systems 25% Plan Review Fee See "Plan Review" section on $ No licenses are required. Licenses are required for all other installations front of application. Fees: Total Balance Due $ Enter total of above fees $ ❑ Trust Account # 8% State Surcharge $ Total Balance Due $ i:\dsts \forms \elc- fees.doc 10/09/00 • Permit #: / (204:7 d 0 -a- -2--s _ .(6F O .): o Address: N: x .1 7 : Issued by:1 t Date: —a c � �85 Q Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: p ."-- 1. I own, reside in, or will reside in the completed structure. 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. I 3A. My general contractor is _ _ — (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR 3B. I will be my own general contractor. M r---- If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify th . t the above information is correct and that I have read and do understand the Information Notice to ' 1 . • t ■ wners about Construction Responsibilities on the reverse side of this form. 411411 16 - o i (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) IIn nmlalU©n L' loo pCe © pre©P 2 V Ckeners GEC @art Conzar ct n ° esporiebrilMe Note: This Inforination Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with CRS 701.055(5). If you are acting as your own contractor to construct a new ".come or make a substantial irn ?r ovetnent to an existing structure, you can prevent many problems by being aware of the following responsibilities and area of concern. If you hire persons not registered with the Construction Contractors Board to do tabor ;r constricting or assisting in t?ie construction or improvement of a residential structure, you will, in most instances, be ruled to be an e$nployei and the peop:e you hire will be employees. As the employer, you must comply with the following: Oregon's withholding tax lays: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be fable for the tax payments even if you don't actually withhold the tax frc m your employees. For more information, call the Oregon Dept. of Revenue at 945 -8091. Unemployment ;insaararcc max: As an employer, you are required to pay a 'tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Did: sion at the `„apartment of !Inman Resources at 378 -3524. Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain woek:e ?s' compensation irsirarce, you may be subject to penalties and will be liable for all claim costs if one of your employees is injured on the job. For mot• information, call the Workers' Compensation Division at the Department of Consumer anti Business Services at 945 -7888. U.S. Ilnternatll Revenue Service.: As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For more information, call t':e :nternal Revenue Service at 1 -800 -829 -1 040. OTHER M ESP O NSIIMLITES AM." AREAS COO (IC5RN.z Code compliance: As the permit holder for this project, you are responsible for resolving any failure to meetcode requirements that may be brought to your attention through inspections. (Liability and property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be re -done. • Time to supervise emplloyees: Make sure you have sufficient time to supervise your employees. ]Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough -in and finish trades, and to notify building officials at the appropriate times so they can perform the required inspections. • If you have addi 'tic nal questions, write or call the Construction Contractors Board (PO Box 14]40 - S OR 97309 -5052, 503/378 - 4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop- own.prn4 1 /94 CITY OFTIGARD BUILDING INSPECTION DIVISION MST loaf - 00 2_z 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested —`� 0 AM PM BLD Location ) 9 U T �'1` o Suite MEC Contact Person Ph PLM Contractor Ph 3) 3 42- z g' SWR BUILDING Tenant/M ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: a --r— /g' /'n SIT Slab �/� 1 Post & Beam / Ext Sheath /Shear f1 , Int Sheath /Shear Framing 5 1 it C re i fi ? "t r■E � • /UGT 4 AT572,!.5/ Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof ina SS PART FAIL Y MBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final • PASS PART FAIL ELECTRICAL • Service Rough In UG /Slab Low Voltage Fire,Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk Date — 3l%' — '/ Inspector - Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from'the job site. ur - (ITY OF TIGARD BUILDING INSPECTION DIVISION (� v 1 Z S � 24 -Hour. Inspection Line: 639 -4175 Business Line: 639 -4171 MST ?�lU� BUP Date Requested 1 AM PM BLD Location 1) 9 w s w 7 I Suite MEC Contact Person • 3 / PLM Contractor UIL Tenant/Own -r f n-r� ELC Retaining Wall R Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab - SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing ;C/a / C_ L Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd.Ceiling Roof Misc: Final ASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date 7 Other "- 27 ( Ins Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. 2.7' CITY O TIGARD BUILDING INSPECTION DIVISION / MST ' g1? 24 -Hour Inspection Line: 639 -4175. Business Line: 639 -4171 BUP Date Requested 7 -/ 6 AM PM BLD Location if Ot 5A' ?G u Suite MEC • Contact Person Ph 3/) c/ Z Z S/ PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing /449; lL, ( Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING. Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL Post & Beam Rough In Gas Line Smoke Dampers Fm � PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer • Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk Other Dat 7 l — 0 ( Ins Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. ,Zfr . CITY OF TIGARD BUILDING INSPECTION DIVISION MST Z.61"eyb 2 3.0 24.;Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested "' ' L AM PM BLD Location (79 G v Sw 7 ( Suite MEC Contact Person Ph . C(3 Z 7 PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS • Ftg 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 • PASS PART FAIL a .7 — PLUMBING' ` Post & Beam Under Slab Top Out Water Service . Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL , Post & Beam 1 ' Rough In �s Line Smoke Dampers Final PASS PART FAIL Service ~ Rough In UG /Slab . Low Voltage Fire Alarm S PART FAIL e S l: L Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: Ai [ Unable to inspect - no access ADA Approach /Sidewalk /' Date 6 O ` 2 2 - 0 i Inspector ' — � 1 Ext Other — Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. fV OF TIGARD BUILDING INSPECTION DIVISION MST of—e./e.) 24 ;'lour Inspection Line: 639 -4175 Business Line: 6 =4171 BUP Date Requested "� 9 AM PM BLD Location /5 S&-' X. Suite MEC Contact Person Ph 3/3 —1 / 2 -- Z8 PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg 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 PASS PART FAIL ELt1NG Post & Beam ab Top Out �G «« ervice Sanitary Sewer Rain Drains ASS ART FAIL 01 f OCi 6 ( d714 MECHANICAL Post & Beam - Rough In Gas Line Smoke Dampers 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 [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date I 0 - C / Inspector73r 1 f � ' � / Qv�c Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF 1`IGARD BUILDING INSPECTION DIVISION MST Vic — 24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171 " BUP /� gq �,, ) Date Requested 6 C: A PM BLD Location /6 07 '{ Suite MEC Contact Person Ph 31 stiff- PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Ina Framing \ y v' ii_ • " ,/Z Framin 1 �I�lo�tf� / ' �., r ,P- Insulation / Drywall Nailing S 4 o er• 7—co �✓ C`- t /, /krc--, Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final ART FAIL �LU G Post & Beam Under Slab Top Out Water Service /I Sanitary Sewer �l Rain Drains Final PASS PART FAIL MECHANICA, Post & Beam Rough In Gas Line • Smoke Dampers 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 [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA D' Approach /Sidewalk Date lr7 — / O / Inspector • a // trez -€ _ Ext Other Final PASS PART FAIL • DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST `et-. 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested o5)(/( S AM PM BLD Location Kq ' Suite MEC Contact Person 71/1C- Ph (v PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear — 1 Framing 1'l� eL /)e ' 1 Z Ao E -' C C Insulation // t Drywall Nailing `�a''� S / / O Lt et- / t Firewall Fire Sprinkler ^e��" c - s ✓ t Fire Alarm Susp'd Ceiling Roof 7 _ Final • PA ,5,, PART FAIL Crgi ltjalG Beam Under Slab 41r", ,- Top Out • Water Service • Sanitary Sewer Rain Drains • Final PASS PART OP - MECHANICAL Post & Beam Rough In Gas Line .}- Smoke Dampers �I fe S C l (j S--e Q -o .1 yr '4 � 7/d?ir • Final PASS PART FAIL Ce T/ (e) Va II/ X f4 //G 71 /e>/ ELECTRICAL Service .<7 Y /4 ' 71YT Rough b CJ 2 7 C�� UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ • required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date b' ( � / Inspector - 5' 11 // Od �� -� Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. („/ - CI Y OF TIGARD BUILDING INSPECTION DIVISION MST / -U (1—'Z z j 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 /� BUP Date Requested 6 - y AM f PM BLD Location /5 S(7 6T $Y ' Suite MEC Contact Person Ph 3/5-g7 Zr PLM Contractor Ph SWR Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int SheathL hear I/ Framing -K..5 �Z.ltit bo\ CS 7 'i r �!�E�C -� 7l <ia 7-Z= / Drywall Na in. v. /cK. 6 % , Firewall ABLVAIDT Sprinkl r Fire Alarm 71 /�/���/ Susp'd Ce' ing i Roof Misc: Fi AS R FAIL PL ING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date ( o Ins /7 Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site '' e}FY OF -TIGARD BUILDING INSPECTION DIVISION MST U/ eI) 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 r BUP 6 Date Requested - AM BLD Location /5'92O Sw 7(, ( /}v -r Suite MEC Contact Person Ph 3/ 3-g Z Z e PLM Contractor Ph SWR eff, LDING- Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath / Shear rywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PAR( F PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam - Rough In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain • [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Approach /Sidewalk Other Date Ins Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. . r 1T OF.TIGARD BUILDING INSPECTION DIVISION MST �U' ' ' •' Z S 24 -Hour Inspection Line: 639 -4175 Business Line: 639-4 1 BUP Date Requested 5-- 3) AM PM BLD Location /) 9' O o S fit Ave Suite MEC Contact Person Ph 1/45 -' Z PLM Contractor Ph / SWR U� IND-->-- Tenant/Owner Pe4 X (eve( h^ )` , it ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear ram ! // � 57Ja� i'S �Xi Sr7 - g 1 nsulation Drywall Nailing s r, .4Z 5 —i = .4 ,5 T i Firewall Fire Sprinkler 'Y1 - .ter - L" �Sa.� - �<�! J/1 -C- %C Fire Alarm Susp'd Ceiling 4 %e) Glif'3a,eR‘re CX/IzAv� y Roof Misc: .. Final PASS 40 AI PLUMB`'' Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL Post & Beam s Line Smoke D r Final t. PASS P FA ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date S / Ins Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. 7. 3 7 b` 'CITY OF TIGARD BUILDING INSPECTION DIVISION • ✓ MST ?vvJ_ co ZZ 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 5.30 AM PM BLD Location / S yaa 5 w 7G s/- if Suite MEC Contact Person Ph PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall Si ` + °g - - j ELR Footing Foundation Access: FPS Ftg 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 PASS PART FAIL L o & Beam Z Ot er- t 3 Water Service Sanitary Sewer Rain Drains Final PASS T FAIL d f T e ° 001-kf 1/41 -2— kr 9 // 1 ` MECHA L. - 7'h / ` loci r - � If/ T/a�r Post & Beam S 4 Rough In Slyw /5,10 21.4 Ic/(4. -. Gas Line Smoke Dampers r � de, / 7 C—e7 .4 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 [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date Inspec f Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. . WOF.TIGARD. BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 51 AI 93 PM BLD Location / d _7 t Suite MEC Contact Person Ph 3 1 3 Z Z is PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Ina Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLI� QBlA Post & Beam Under Slab op (Jut er ervice Sanitary Sewer Rain Drains Final PASS • ' FAIL MECHA Post & Beam Rough In Gas Line Smoke Dampers 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 [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA � Approach /Sidewalk Date � 2 p E 6 ` Inspector Ext Other ' Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.. 7- ///7 -. r7dITY'OF TIGARD BUILDING INSPECTION DIVISION off O E. 24 -Hour Inspection Line: 639 -4175 Business Line: 639 71 i 'y0 BUP Date Requested ) — Z AM PM ® BLD Location /5 U 5 w Suite MEC Contact Person Ph 3/ VZ Z g PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam • Ext Sheath /Shear Int Sheath /Shear Framing 4 Insulation Drywall Nailing Firewall Fire Sprinkler �' !/� Fire Alarm � Susp'd Ceiling �A� � AJ Roof Misc: Final ) v PASS PART FAIL �yMBIN0 Post & Beam Under Slab Ou Water Service Sanitary Sewer Rain Drains Final PASS PART "I MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers 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 [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA GJ Approach /Sidewalk Date `J 1 2A J 1 Inspector E:t5 I Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. /r Y/ '9 ,Ctry. BUILDING INSPECTION DIVISION ` J. MST e.G 1 ZJ 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 5 Z- Y AM PM BLD Location / 5 U . Suite MEC Contact Person Ph �S «/3 a 7 PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing t_ Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer • Rain Drains Final PASS PART FAIL MECHANICAL .4/ Post & Beam Rough In • Gas Line • Smoke Dampers Final PASS PART FAIL <— CTRIC Service C611-en Rough In UG /Slab Low Voltage Fire Alarm RT FAIL - Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] able to inspect - no access ADA � / Approach /Sidewalk Date �f Other 0, Ins � -�� L /� � t Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.