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Permit
/0' - e7(7 ---g,-,,,,,,,,3-_e_d,_--,d,..A.L,c,,. C IT Y OF TIGARD MASTER PERMIT 4,4, PERMIT #: MST2004 -00148 ""I D EVELOPMENT SERVICES DATE ISSUED: 6/18/2004 i t t' - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 15784 SW 79TH AVE PARCEL: 2S112CD -07100 SUBDIVISION: PP1991 -063 ZONING: R - 12 BLOCK: LOT: 003 JURISDICTION: TIG REMARKS: New SF detached. 10 -1 -04: Added NC. BUILDING REISSUE: CUSTOMA STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 20 FIRST: 2,050 sf BASEMENT: sf LEFT: 10 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 600 sf GARAGE: 814 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 10 VALUE: 271,280.20 OCCUPANCY GRP: R3 BDRM: 3 BATH: 2 TOTAL: 2,650 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: 0 RAIN DRAIN: 100 TRAPS: LAVATORIES: 3 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 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: BOIL/CMP < 3HP: 1 VENT FANS: 2 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 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: W /SVC 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: SIGNAL/PANEL: 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: $ 8,326.71 This permit is subject to the regulations contained in the DANIEL SLIMICK DANIEL R. SLIMICK Tigard Municipal Code, State of OR. Specialty Codes 11345 SW 97TH CT 11344 SW 97TH CT and all other applicable laws. All work will be done in TIGARD, OR 97223 TIGARD, OR 97223 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. Phone: Phone: 503 684 - 6496 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: LIC 107487 rules are set 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 Ersn Cntrl 681 -4444 Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Water Service Insp Footing Insp Post/Beam Mechanical Plumb Top Out Exterior Sheathing Insc Gyp Board Insp Water Service Insp Footing Insp Underfloor insulation Electrical Service Low Voltage Rain drain Insp Appr /Sdwlk Insp Foundation Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Storm drain Insp Electrical Final Foundation Insp PLM /Underfloor Framing Insp Gas Fireplace Water Line Insp Mechanical Final Issued By : . Z5'./../....-' 10, ' Permittee Signature : _ Z Qs\e .q CaII (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day Sep 01 04 06:20a 4 r , S ' 7 p.2 Electrical Permit Application 1' cl lr011? OFFICE USE ONLY Received City of Tigard �Tigard ,C�1 ' _ - Date/n Plan Permit No ^ t 3125 SW hall Blvd., Tigard, OK 97223 ; By. ay 2� / dj / ` Phone: 503.639.4171 Itax: 503.598.1960 ! H ^+ M:�,itl�{v+ �p \ p� Other Permit: Inspection Line: 503.639.4175 1 Q n '' Date Ready /tl y - Aim, El See Page 2 for Internet: www.ci,tigard, SE.? ( Notified/Method: Supplemental Information Please check all that apply: "� i °M t �q(�y ": s ;i�jf'���ti,` }�`:'�`Ya 11'';F'e +* �� � » j t �l�t��; m s�:. a P h, 3� it * zr• ",. f"T �qn`� ;. �* ,;, , ., �.t ; ,_. ., ,r- . - . I i : ,. , +, ! p M1, 1 �i�; ytti,T1A jk !.'1 � �4 y 5 r ! f �{ $ I N ;/1" �.�t .. ' V .< r' lr "^ 2,1R e `th.1 . C llh {f�, .i, Y gf t.R Et"tG1 .,,i,: Cr°iWt�'n 3k,_'21.�N 4:' 'nl nit *:'.f�A � f� , ter �i:kg.. `' �' A llw .4, J ' I . `i, � � y ., _ 1'1 •Ncw construction 11' AdditiOn/ttlterh{1 r14 t1 } - -` ❑ Other. gW`etn@e� L DScr over 225 amps. camm'1 • Demolition rrtp . ❑Hazardous location F , r m ['Service over 320 amps - rating ❑Bulking over 1 0,000 sq. ft„ ' ttr � ,..d' y `i<fN� 43 r aw vh t Y d- y�' , t.'' ;is f 4 a ¢ i i i . § § . �t4� ff i riJ te ) ' e gr via c y i t A , of l - and 2-family dwellings 4 of more new residential 17. 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ■ Multi-family [] Master builder ❑ Otlter: ❑Building over three stories ['Feeders, 400 amps or more n l a l MS } +n1 } t r .r t„,� v t u r » , t� , a „ DOccuparit load over 99 persons ❑Manufactured structures nr v 42 l ty : 1 tY ,. , ma id" iklifr a 1 0 1 b ilt "-0(1 e k. . : t L in , ink y 44 1. sr .,10 , ,t,f A:i r. ,r ke,l 0.,,e M , y6 gtr0 __,4A, ax,:,.1,.4‘. " �,.. , ∎,;.�, . ,Lit; a f W ,t ,', RV plan RV park Job no.: i� t2j-j Job sitc address: ‘ - 5 1 � � c u i 1. ❑Ilealthcue facility ['Other: _ _.- ,_._.. _.._ s--- - Submit 3_ sets of plans with any of the above. City/State/ZIP; \ • .- ....._.--, © CZ. The above are not applicable to temporary construction service. ti , Suite /bldg. /apt. no.: Project name: : ta�f 'ir,'k t'tu. rMM t e 1'' MU„) ; a _ ':,9c _ Description Qty. if'.o, Tout -- Cross street/directions to job site: New residential single- or multi- family dwelling u nit. -- Includes attached garage_ 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: _E i. add'1 500 sq. tt. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no. y, is ru�l r s a u- t � m , �v,�Y ,.,. Limited energy, non - residential 75.00 2 .+ Mal 1:!.l�r,`V 1�S`I1 �Ietti, ) ` `+,i14..:' r'k�ii-hi Al i, ?# , .r .i,`.lii et4i : 't ,i I iI'.a nV i.4:gt l!! ti "tI Each manufactured or modular dwelling, service and /or feeder 90.90 2 e.--L`j ����' Services or feeders installation, alteration, and /or relocation 200 amps or Tess 80.30 2 „,1 1F a 9Y, lik +n st t�ez t rah s q 'f ,KWA i �I ,, �+ .,. yak ! �i,r rips to 400 amps `Olcend,we'rki,, '5?k � A ?' . .. t � � +� 7aq'Ali*OPtr' ^' � �I 1 • .°° 7 ' �' ti`� t tigiii dll> -" 20 t amps - _ . . 106.85 2 s.: r.. v a S M eo, �,,.,c r is,: 401 amps to 600 amps 160,60 2 Name: 1 t C { r �t ` - I1 v _ A 601 amps to 1,00(} amps 240.60 2 Address: �� C �_ Over 1,000 amps or volts 454.65 2 City/ Reconnect only 66.85 _ 2 n _ \ • 1 �� Temporary services or feeders installation, alteration, and /or Phone: relocation Fax: ( ) ^. 200 amps or less 66.85 1 Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rcnt, 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 t� (�!. ^ gy✓/Yr T dS , rb F , ,;+..', "a4°.r R e r+ r a. t YV �� Ri � ��.i` ;"� bs .. "l j 5 rl 1g 1bs 4 [ ti : ,. f, ^ ikv,v r -Vl M: [vti1 A > A. Fcc for branch circuits with - � - I 1'.ti t. lM.. + ,,. ,7 „ ra,,. fl� 1., 9a, }�, t; ., I r,<ri,a a,,, yx, lvnt service or feeder fee, each Business name: branch circuit 6.65 2 B. Fee for branch circuits Contact name: wityo +Wt service or feeder fee, Address: each branch circuit 46.85 2 __.. -. Each add'l branch circuit _ 6.65 2 City /Statc/ZIP: Miscellaneous (service or feeder not included) -.W Pump or irrigation circle 53.40 2 Phone: ( ) Fax: : � ( ) Sign or outline lighting_ ! 51.40 2 E -mail ,-- • •- �1 T Signal cireUit(s) or limited - *Si' l�a7,>K �S °�!+iETtr ]ia w d14 M'ea.. %.?,t a B% "zi a� i,' "lAi,r :l"f 1 qd f� s energy panel. alteration, or T- extension. Describe: Page 2 2 13usincss narnc: • hb t_te_ �f\c� _ / Address: . Each additional inspection over allowable in any of the above 4' ^•..•- Pcr inspection 62.50 • City/State/ZIP: t � L c - �" V ` r ug 17/ O lk Investigation per hour (1 hr min) 62.50 PhOnc: ( ) _" t _c'a -1`1 F a x: ( ) l__ I intlustrialplant perhour 73.75 CCB Lic.: ` (�� lech'ical Li -- 1 • 4 p cU tit"ti ' � 5'*34.."Z4 . ba".1,:�t R G s ,ti ,. ,., ': :, Subtotal Suprv. Electrician signature, required: �„ ■ / 1 Plan review (25% of permit fee) T " 1 State surcharge (S% of permit fee) Print flan= C - e:n \ \ D e: _ �_ ' " ��1e1 � ~ TOTAL PERMIT PEE Authorized signature: . "4 'hie permit application expires if a permit is not o btained within 180 • days after It has been accepted as complete Print name: 10 - i ,1 * .K . Date: ( - " j - e - Fee methodology set by Tri -Co,m y Building Industry Service Board �, '---- " Number of inspections per permit allowed i:\Duild.ng1PormesU'd.C.r ni App.do 12/03 440 - 40I 37(loIo'cOM/WELD ■ ■ CITY OF TIGARD MASTER PERMIT PERMIT #: MST2004 -00148 �i�., DEVELOPMENT SERVICES DATE ISSUED: 6/18/2004 _INfr Iv 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 15784 SW 79TH AVE PARCEL: 2S112CD -07100 SUBDIVISION: PP1991 -063 ZONING: R -12 BLOCK: LOT: 003 JURISDICTION: TIG REMARKS: New SF detached. BUILDING REISSUE: CUSTOMA STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 20 FIRST: 2,050 sf BASEMENT: sf LEFT: 10 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 600 sf GARAGE: 814 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 10 VALUE: 271 OCCUPANCY GRP: R3 BDRM: 3 BATH: 2 TOTAL: 2,650 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: 0 RAIN DRAIN: 100 TRAPS: . LAVATORIES: 3 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 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: 2 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 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: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EAADD'L 500SF: 5 201 - 400 amp: 201 • 400 amp: 1st W /OSVC/FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: 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 8 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: $ 8,311.59 This permit is subject to the regulations contained in the DANIEL SLIMICK DANIEL R. SLIMICK Tigard Municipal Code, State of OR. Specialty Codes 11345 SW 97TH CT 11344 SW 97TH CT and all other applicable laws. All work will be done in TIGARD, OR 97223 TIGARD, OR 97223 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. Phone: Phone: 503 684 - 6496 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: LIC 107487 rules are set 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 Ersn Cntrl 681 -4444 Underfloor insulation Electrical Service Low Voltage Rain drain Insp Electrical Final Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Storm drain Insp Mechanical Final Foundation Insp PLM /Underfloor Framing Insp Gas Fireplace Water Line Insp Plumb Final Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Water Service Insp Building Final Post/Beam Mechanical Plumb Top Out Exterior Sheathing Insi Gyp Board Insp Appr /Sdwlk Insp • Issued By : Permittee Signature : z_ _J. _ __ CaII (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day Building Permit Applcalt�'pin FOR OFFICE USE ONLY , ' Cit y g of Tigard G �,� R eceived Date/By: Permit No.: � :/1 „ er /L t7 13125 SW Hall Blvd., Tigad, R 97223 Plan Review Phone: 503.639.4171 Fax: 503. 8r,1960 n u' �'u l , 1\ 6-9— p ! Other Permit Q y�y J 6 / is v � . //tha ,�"B�h!jl i Date/By: �/y4l�l � [ /<.V �+� ( W r Inspection Line: 503.639.417 � �J�► 6 11' Date Ready/By: Juns: 0 See Attached Checklist for Internet: www.ci.tigard.or.us o �� `6 ��Q� � NG Notified/Method. f 7fiL/ w Supplemental Information to r';t' .,.L: >"�".�Ars4 � '. ., i.ir s ; v... ::,xF ?�„ ! 4r i t It; t. REQ[, YIRE AA r 1 AND 2- F AMILY D,W ELL ,I NG - w. :,_ w- i,+L,4 :....d w �d"€:.,.r.z..'§?�'e 's'<S,�r,. Tt t Eg 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 3 a. ` .. r ATr ' � a- � - i A” *�° - work indicated on this application. 'i> .'. w ,� .. NCEGOR ®; a C . ONS '4 TR U C T I®N : A;:..' C at; { V.V c Valuation: $ l ig — 1- and 2- family dwelling ❑ Commercial /industrial © I Ch9� ❑ Accessory building ❑ Multi - family Number of bedrooms: 3 ❑ Master builder ❑ Other: Number of bathrooms: f "` , IOBSIT INFO AIO`AN LOATLON Total number of floors: a_ Job site address: `- 7 / 5 (A) 7/ ..4 ND A-,.4,_ New dwelling area: „9 ‘ 3-o square feet City/State /ZIP: `r';' 90 ,.. OJ e 7 'a- . - 3 Garage /carport area: 73,x- square feet Suite/bldg. /apt. no.: Project name: Covered porch area: /B square feet Cross street/directions to job site: ,[� a Deck area: square feet N . ti rej ciPr. S oA T 1 J t) f L ,--.. F d . , 6.P S t c& ,Q , Other structure area: af square feet • EQUrIREDNDATA :,COMMER.CIAL� US,E (CHECKLIST Subdivision: '►'- -11 • Hag/ . MO 1 I Lot no.: o 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 f equipment, materials, labor,.overhead, and the profit for the e d DESCR TION�OF � 4.ub. WORIC ..m . ', 4 . work indicated on this application. - rs a 1,:g.ii . .. -d ,. o ;iu.oA, .. t`u ..aw. . 5 .il a�. T �;.r✓ :i. .se's .0. ... ' . 4'/m J„ ` � c:- ✓ ` 1 Valuation: $ 9'v C� T 'F \,0 Existing building area: square feet New building area: square feet ,t< . ! - * « 1 � , PROPERT:Y,K Q WNER a F , n k Ek ANT 'q f t}s Number of stories: Name: ' i e. 1 9 6 1 1 t • G ., : ` _ Type of construction: Address: ii 3 y S S tdJ Cl `( Lc { " Occupancy groups: City/State /ZIP: �~;�� a 44 (5J- 4 '7 a D >' � Existing: Phone: (6 g / _ t ( let lc Fax: (`jU 6 3tf -c, tr a 6 New: ar" �r � MUM, :a ° �'" � irk ��� m ., ray x, r Y " , 'i$ x. rk ( A + PERSON 1 ,1 �+ a ., O t ; `,`.r Business name: All contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board rA L" 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: • 9 W 1 Y .;` . , 6P v AA t 33"k'�Vii / x'° �i Y .s ,.,n St �. Az u N CON i� 4 . O N , ' � � v — .e � s�... ,. n, ,xi,�en,,....r,��w s ,..... x� ,xs..,P�.. �..z �... ..,'�n Business name: a-A-N. i . ( 5 f i� c&.Q N BUILDING P ERMIT F Address: / / (.(` 5 c..J C( >4-4- C.a-- p0 Please refer to fee schedule. City/State/ZIP: % i r1 0 v ). & ( C( > �- D Fees due upon application Phone: (' �l 6. (( " t,, Fax: ( 6 qf( -6 c( 4 c CCB lic.. r ®7 cl S' 7 Amount received Date received: Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: I j Date: 1 ) ' /J (./' * Fee methodology set by Tri- County Building Industry ( ' Service Board. i:\ Building \Permits \BUP- PermitApp.doc 12/03 440- 4613T(11 /02 /COM/WEB) Building Division Plan Submittal Requirement Matrix `L' Commercial & Multi- Family - New, Additions or Alterations City of Tigard ypeofSubmittal� # ofPlans ' nc1udestnew additions`and aIteirations) �' 1 Re at Demolition Permit 2 (site plan required showing location and square footage of all buildings to be demolished) Site Work 2 (must include location of all accessible parking) Plumbing (site utilities) ,2 Building 1* Fire Protection System 3 ** Mechanical 2 Plumbing (building fixtures) 2 Electrical 2 Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue) * For over - the - counter commercial tenant improvements, submit 2 sets of plans. ** "New" fire protection systems require that plans bear the original seal of an Oregon licensed fire suppression engineer, or NICET level "3" technicians. i:\Building \Forms \COM- PlanSubReq.doc 12/24/03 Building Fixtures RECEIVED Plumbing Permit Appiiction 1004 FOR OFFICE USE ONLY City of Tigard + Received rlTY OF TIGARD Date/13y: Permit No. :�_//}9 J__OD)7 (J 13125 SW Hall Blvd., Tigard, 017223 Plan Review // pp �/ - Phone: 503.639.4171 Fax: 503 8.1:960 I - yr ■ 4F , di� yi 44.01 ,I\ Date/By: Other Permit No.: ' 24- Hour Inspection Line: 503.639.4175 c- 5 Date Ready /By: Juris: p See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information ¢� r tk�#'e a rf 3 4- h ? sv`= ir . `�. fir' '° 'r- ✓.v,. t` 4 x*k �.s' !n x,r 't -. t ._E lx k' u` �TYaPE OF WORKS , e _ l aka ms`s EE *�`SCI3EBiILEr . .:..�r� �;". a � �,.. 5?r t '�. R. lay. .. »,e§e:3..1. -...4, ius+*.:€.., r:.,r,. i.a,, .. _ ... New construction ❑ Demolition For special information use checklist Description 1 Qty. Ea. 1 Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEG0R� ii EONS T1CTION 0 1 2 s t �s `4 SFR (1) bath 249.20 b �,` �; a � � .. .. u� t ° S., .2..� ,., �^t7.u*� #�ir : ...,.mss' tai- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 I SFR (3) bath 399.00 ❑ Accessory building ❑ Multi - family Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: r " Fire sprinkler ( sq. ft.) Page 2 _, , dOB SI F A T3 NSA D OC ON - t Site utilities Job site address: / 5 - r) g(( L) 7 C( II" Catch basin or area drain 16.60 City/State/ZIP: 1 ' / 0 '4 o 4 S D--D- 3 Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: J l Project name: Footing drain (no linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: r �( •+'. ._� Manholes 16.60 S�1 tT, C1 -• , bl ' 1J14/1, , 4 -• C k_4() Rain drain connector 16.60 Sanitary sewer (no. linear ft.: ) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: l Lot no.: Water service (no. linear ft.: ) Page 2 Fixture or item Tax map /parcel no r x , . A bsorption valve 16.60 . e r'� �r . 1 . t ;x � DESCRIPTIQN OF R? r'I ; . ,.r gg g 4 11, ,... ° Backflow preven[er Page 2 fit/ 9._,,,J2_ + it `'A Backwater valve 16.60 J Clothes washer 16.60 Dishwasher 16.60 1 ,� > '01 € , Drinking fountain 16.60 ". °' .„ �,t.'ROPE T OWNERl 11 r. A { t, ' ] TE i N r Ejectors /sump 16.60 Ft Name: .l t Q 1 V ..._ 'c k t-, ll L-lC. Expansion tank 16.60 Address: / 3 t( s sc.() q 7 c .-f-- Fixture /sewer cap 16.60 City/State /ZIP: / r ` 4 4_ Or 4.7 tea 3 Floor drain/floor sink/hub 16.60 Phone ( L ! c i ( q c, Fax ( 5 - 0 3 c L (_/ t �O q ( Garbage disposal 16.60 : '14-1141?---r. ' `` i.� _x_ -. ,,... -'' APPLTC T �' ,'ia # �.. CO N . 4 Hose bib 16.60 Ice maker 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City/State /ZIP: Roof drain (commercial) 16.60 Sink/basin/lavatory 16.60 Phone: ( ) Fax:: ( ) Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 � r r A s. d CON RACTOR Sat' ¢ 1: ,1211, , '� ..a..�t.... ,,� m=. � �,' _ �.: .,.r � � ���i , �r'�` a,,..�s Water closet 16.60 � Business name: ' -) i( , 4 f ,q - 1 p Water heater 16.60 Address: 155150 Late p(`7 X 4 . AWL Other: City/State /ZIP: e, (, f} 1..4,9 lj ®12 '97o/5. Subtotal Minimum permit fee: $72.50 Phone: ( • ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: / "T -7 Plumbing Lic. no.: Plan review (25% of permit fee) 1 State surcharge (8% of permit fee) Authorized signature: TOTAL PERMIT FEE Print name) Date /, /o C� This permit application expires if a permit is not obtained within J 180 days after it has been accepted as complete. *Fee methodology set by Tri -County Building Industry Service Board. i:\ Building \Permits\PLMF- PermitApp.doc 12/03 440- 4616T(10 /02/COM/WEB) Plumbing Permit Application - City of Tigard , " Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: Slte tII1t1 Qty ¥Fee ;(ea) : Tofat � a R a r a �s-Ave #.. _,quarOootage , : � Permit_Fee R. . 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 1 rte., =.,. Storm &Rain Drain - 1st 100' 55.00 alilatlA r "" P 1T* W $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 F11tt1= 80 I , . Q ty r � ee (ea) �To "tal additional $100.00 or fraction thereof, to and .„. t 1, . A.� x - .s , �� 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: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . Fig MiE 'Quautrt (Fixture Wor 1i rformed FrxtureaType� 7 °R ` F" e , i N ew ; Moved 1 `Ext on capped Comments regarding fixture work: Baptistry/Font Bath - Tub /Shower - Jacuzzi /Whirlpool Car Wash -Each Stall -Drive Thru Cuspidor /Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash Floor Drain /sink - 2" - -3" -4" Car Wash Drain Garbage - Domestic Disposal -Commercial *Note: If the fixture work under this permit results in an - Industrial Ice Mach. /Refrig. Drains increase of sewer EDUs, a sewer permit will be issued and Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the Rec. Vehicle Dump Station plumbing permit can be issued. Shower -Gang -Stall Sink - Bar/Lavatory • Bradley Quantity Total Commercial Isometric or riser diagram is required if fixture quantity -Service total ig >9 . • Swimming Pool Filter Washer - Clothes Water Extractor Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal Other Fixtures: is\ Building\Permits\PLM- PermitApp. doc 3/03 Electrical herml> tp' +'itlk a I n: F OR OFFICE.USE ONLY , -� A ' x , 'l w' City Tigard Recened Perini[ Vo.. / Y Tigard Date /By: nrc9.Or1 -- 0 0/ 13125 SW Hall Blvd., Tigard, OR ' Plan Review Other Permit: Phone: 503.639.4171 Fax: 503. 60� tl Date /By Inspection Line: 503.639.4175 R !' i Date Ready /fay: Jurls 0 Sec Page 2 for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: Supplemental information i- tRiNiigfptgiw F aiNG PLAN REVIEW . ew construction ❑Addition /alteration /replacement Please check all that apply: ❑ Demolition ❑Other: EService over 225 amps, cunmil ❑ hazardous location Service over 320 amps - rating ❑ Builc!ng over 10,000 sq. ft.. CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential no - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ Multi family (1 Master builder ❑Other: ❑Building over three stories ❑Feeders, 400 amps or more ❑Occupant load over 99 persons ❑ 1 lanufacturcd structures or JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park C r, 4 ❑ Health -care facility ❑Other: Job no.: Job site address: �� �T� y J J� . ,-.L Submit 2 sets of plans with any of the above. City /State /ZIP: -, et R ®4 q .� . - I - he above are not applicable to temporary construction service. Suite /bldg. /apt. no.: Project name: _l FEE* SCHEDULE Description 1 Qty. Fee. 1 Total i ' Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. 11. or less 145.15 I 4 Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 I . Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non- residential 75.00 2 _ DESCRIPTION OF WORK Each manufactured or modular f dwelling, service and /or feeder 90.90 2 tad.l) "".-'e - 16 - 4Gf"' I Services or feeders installation, alteration. andior relocation 200 amps or Tess 80.30 I PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.83 I 2 l 401 amps to 600 amps 160.60 I 2 Name: i s S' t G \� 601 amps to 1,000 amps 240.60 Address: /r y s ( q) Over 1,000 amps or volts 154.65 • Reconnect only 66.85 1 2 /S tate /ZIP: Cit � y , t..`' G v O q *).- Temporary services or feeders installation, alteration, and /or Phone: (; () g 6 t(a ( Fax: ( "-3, C3 tf - CY q b relocation 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 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 1 33.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension. per panel APPLICANT S.-CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each Business name: �aM , e/1 5 1, LA,, x C� branch circuit 6.6 2 B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 z each branch circuit / Address: / /J ((S Q C"! Each add'I branch circuit 6.65 2 1.,_ T 'C'f e � ' 0v q.---? .. 9- .> Miscellaneous (service or feeder not included) Pump or in'igation circle 53.40 2 Phone: (t 9c(.- G y l Fax: : ( ) gi'-6 q Sign or outline liahtin: 53.40 -- E - mail: Signal circuit(s) or limited - CONTRACTOR energy panel, alteration. or z__-__— extension. Describe: Page 2 2 Business name: C� 1 EA_L e..- / ( , �- / Address: pc, � �{ Each additional inspection over allowable in any of the above 4 Per inspection 62.50 City /State /ZIP:LC((...,50A) LL B._ Ql_ 070 - Investigation per hour (I hr min) 02.50 I Phone: ( ) Fax: ( ) Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lic.: 157 6 / Electrical Lic.: 3-1-3-75 3!f '� Suprv. Lic.: g3 L J Subtotal Suprv. Electrician signature, required: Plan review (250 of'permit fee) State surcharge (80 of permit fee) Print name: Date: � /� n TOTAL PERMIT FEE Authorized signature') _ t/ ' {.l �_� This permit application expires if a permit is 1101 obtained within IXIt f' � days after it has been accepted as complete " Print name: If e' C .�� 777���"' --- ' J ( _ ,- xM 1 L` Date:(j / /Q t( " Fee methodology set by Tri- County Building Industry Service Board f '• `umber of inspections per permit allotted. i.lBuilding \Permits \ELC- PermitA pp doe 1103 440- 4615r1100)2/CW.1 /WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: Audio and Stereo Systems* n Burglar Alarm ❑ Garage Door Opener* n Heating, Ventilation and Air Conditioning System* n Vacuum Systems* Other: COMMERCIAL WORK ONLY: Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: n Audio and Stereo Systems n Boiler Controls n Clock Systems n Data Telecommunication Installation n Fire Alarm Installation I I HVAC n Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* n Medical PI Nurse Calls n Outdoor Landscape Lighting* n Protective Signaling T1 Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i. \Building \PemitslELC- PermitApp. doc 04(03 Mec ianic'a!l ermii.AppIic tion . FOR OFFICE USE ONLY - o . 16ma �-• ° City of Tigard Received / 13125 SW Hall Blvd., Tigar ORS 9722 Date/By: Permit No.: 5 &o �, _ ©v l A t i 4 Plan Review Phone: 503.639.4171 F'aicc 503- 598.1 //�iers i A Date/By: ther Permit: Inspection Line: 503.639.4175 g � ��W Date R 1 y Ready/By: H y: Juris: See Page 2 for Internet: wWw.Ci.tigard:, j- sy' OF TIGARD Notified/Method: Supplemental Information PLAN SIN /ENGREERING �� r „ , . K > t TVfAMK t i ' g � y t ;C011SM FEE. *�S i3 ' ew 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. O . a fTw' "rCATE OR.OF ONSIR CT '';'* 4" 'r; Value $ 1` RESIDENTIAL EQUIPMENiPkSYSTEMS EEES* /_ m 01- and 2- family dwelling ❑ Comercial /industrial El Accessory building x °' For special information use checklist. ❑ Multi family ❑ Master builder ❑ Other: Description Qty. Ea. Total 'l d JOB S IT IN ORkVIAT 0 �1 ANI ;L ATI ` , x +" , „ „ ° ! Heating/cooling Job site address: "5 g i; 5 ,.t) ,(f \ {-L` lT Air conditioning or heat pump (requires site plan showing placement) 14.00 City/State /ZIP: *.-- j: 1 Q 44 e1._ q.-73--a- 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 �/ �, ( o - Hydronic hot water system _ 14.00 �/ �C� �� �viT. Ck�[� Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Flue /vent for any of above 10.00 Subdivision: Lot no.: ' Other: 10.00 _ Tax map /parcel no.: Other fuel appliances M " DES RIP ' +ION O rt*Sib~ ' M >° a g` Water heater 10.00 ...,, . . om o. kln , .. cv,4, . .. ...,,, , . za:,ze , ,.. V,AP M ,. ' ti 2.P .f , ,` • Gas fireplace 10.00 A ( �t.t) / /4 eGly -,u�t i . Flue vent for water heater or gas 11 °P fireplace 10.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 f Chimney /liner /flue /vent 10.00 PROPERTY WNER aTEN NIP Y ' Ocher: 10.00 Name: c---- ` e 1 S 1 Environmental l exhaust and ventilation Address: /I 3 r{ S --- S cr t c- Range hood /other kitchen equipment 10.00 City/State /ZIP: q Clothes dryer exhaust 10.00 C Fax: / Single -duct exhaust (bathrooms, . , g (f -� j � ( 3, 6 gt ( -(y q (D toilet compartments, utility rooms) 6.80 m n om o K PL IGA T a " L C r GT PERSON rn Attic /crawlspace fans 10.00 Business name: Other: 10.00 Fuel piping Contact name: � - $5.40 for first four; $1.00 for each additional Address: °- Furnace, etc. • Gas heat pump City/State /ZIP: Wall /suspended /unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace E -mail: Range 4 r 4 '' `'� CONT °" F �. -. ' � . Barbecue Business name l'(- 1)• v t ! _ Clothes dryer (gas) Other: Address: L',' ax - a, '.�...t�r ra m sr-a+ * -:r, h MECHANICAL PERMIT FEES City/State /ZIP: Subtotal Phone: ( ) Fax: ( ) 'z z Minimum permit fee ($72.50) ' ' . 1V) \ Plan review (25% of permit fee) CCB lic.: 1 ik r 4, % .., 1 .- \I-6 .-0 i D 6 State surcharge (8% of permit fee) i� TOTAL PERMIT FEE 1 I This permit application expires if a permit is not obtained within 180 Authorized signature: t days after it has been accepted as complete. Print name QM �l (i ` Un e < Date: / - 0 0 * Fee methodology set by Tri-County Building Industry Service Board i:\ Building \Permits \MEC- PermitApp.doc 12/03 440-4617T (11/02 /C WEB) Mechanical Permit Application - City of Tigard s Page 2 - Supplemental Information Commercial Fee Schedule: I zwou Tot Valuation $ 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 $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. i:\ Building \Permits\MEC- PermitApp.doc 12/03 2 JUN. 23.2004 8:47AM NO.956 P.1 CITY OF TIGARD 13125 S.W. HALL BLVD.. • TIGARD, OR 97223 IMPORTANT PERMIT NOTICE ECEIVE,1r, RMH PLUMBING CONTRACTORS INC JUN 23 21954 S LARKSPUR AVE 2004 a OREGON CITY, OR 97045 CITY OF TIG � B U11.0/ NG DIVI SRD Plumbing Signature Form _ Permit #: MST2004.001,48_ ..- . „ . . Date Issued: 6118/2004 Parcel: 2S112CD -07100 Site Address: 15784 SW 79TH AVE Subdivision: PP1991w063 Block: Lot: 003 Jurisdiction: TIG Zoning: R -12 Remarks: New SF detached. Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Division. No plumbing Inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: DANIEL SLIMICK RMH PLUMBING CONTRACTORS INC 11345 SW 97TH CT 21954 S LARKSPUR AVE TIGARD, OR 97223 OREGGN.CITY, OR 97045 Phone* Phone #: 503- 632 -8688 Reg #: LIC 140418 PLM 34.362PB AN INK SIGNATURE IS REQUIRED ON THIS FORM X ;' t Signature of Authorized Plumber If you have any questions, please call 503.718.2433. 1 STREET TREE CERTIFI€ATION .. 1, c �G Owner /A ent f or . .ct`t c �.\ \ ■ ∎� „� `c 1 - (PLEASE PRINT) � " (PERMIT HOLDER) y N RECEIVED 0. . N DEC 0 7 2004 0. Do hereb ce thatpthe followi location CITY OFTIGARD l ?3 ' ` BUILDING DIVISION meets Ctyof Tigard /W a s `hington, County 0. land use and development standards for street tree installation. ADDRESS: / -7 i S (-c.J 7R fk � , i . ceVV\ LOT: SUBDIVISION: 0. 1 BY: �`�-�/ DATE: /(D- 7 1 l 1 RECEIVED BY: DATE: ! 2° / 2r ° 7/ PI. 4vvvvvvvvvvvvvv •f 6. CITY OF TIGARD 24 -Hour BUILDING Inspection Line: 503) 639 -4175 MSTZ"(-- ©/4,$ INSPECTION DIVISION Business.Line:- 503) 639 -4171 BUP Received Date R equested AM PM BUP C�� J Location / o ( 1 A"4 Suite �7 MEC Contact Person P S ea '7 _ SZ 2 / PLM Contr P ( ) SWR UILDING Tenant/Owner ELC Footing Foundation ELC Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear /f Int Sheath/Shear K Gp©g - d ,{� /z , 0 7 V Framing Insulation (� l 7/l 7 / ��� l Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof 4 As 6 • - ,aa SS PART FAIL PLUMBING Post & Beam TA TA V415- Under Slab Rough -In Water Service Sanitary Sewer Rain Drains — Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage_ Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE El Please call for reinspection RE: )� El Unable to inspect — no access Fire Supply Line / ADA 9 j , • Approach/Sidewalk Date / / a Inspector _ �/� Ext Other: Final DO NOT REMOVE this inspection reco ; ° roan the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Lin (503) 639 -4175 MSTgO © 60 / INSPECTION DIVISION Business Line (503) 639 -4171 BUP Received Date Requested a- AM PM BUP Location '` /AL- Suite MEC Contact Person P ( ) PLM Contractor ( ) SWR BUILDING Tenant/Owner PO So 7 ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear L Framing OSA 1 OW Insulation ; Drywall Nailing ��� Firewall ,-- Fire Sprinkler (40"/ v L ew ` Fire Alarm � -� OV ! i!�t "� ,A-t� V� SLcslo& Susp'd Ceiling Roof t, Other: Pr ∎ef A f� CZ;�vr4 -T' L�GLC Dv % •ASS PART OAP PLUMBING 0 LI t S lS� Post & Beam Under Slab n2v'1C'/ t—Ji r C '-( Pv g t' f cr�� Rough -In S 5 �Z / f r ` Water Service Sanitary Sewer " L_L S Rain Drains Catch Basin / Manhole Cam(__ Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post -& Beam Rough -In Gas Line • e Dampers / • PART FAIL *L Service Rough -In UG /Slab Low Voltage N b (Z I N 6 '4 - r!/• /C6M , Fire rm mal ASS PAR i 111 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd: SITE Please call for reinspection RE: `] El Unable to inspect — no access Fire Supply Line /2-1(7- �/ ADA Approach/Sidewalk Date y Inspector D Ext Other: Final DO NOT REMOVE this inspection record from e Job site. ` PASS PART FAIL CITY OF TIGARD 24 -Hour _ ' BUILDING Inspection Line: 503) 639 -4175 MST `� / / eU Q INSPECTION DIVISION Business•Line :' ) 639 -4171 BUP Received Date Requested o AM PM BUP Location - �7 ! - Suite MEC Contact Person Ph (.. ) EL17 PLM Contractor Ph ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Ftg Drain Access: ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear , Framing ∎� d ��/ O / 7 Insulation off bM Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: th��er: S PART F AIL 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 P FAIL ELECTRICA Ser�Ce Rough -In UG /Slab Low Voltage F' ` Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL • Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line - ADA Date 72- Inspector Ex# Approach/Sidewalk Other: Final' DO NOT REMOVE this inspection record from the ite. PASS PART FAIL CITY OF TIGARD 24 -Hour /Q � BUILDING Inspection Line: (503) 639 -4175 MST o7QO `f' — � / ' 4O INSPECTION DIVISION Business.Line:' (503) 639 -4171 • BUP Received l / Date Requested ( 1 AM PM BUP Location /-C7 7 7 gam / ^- - Suite MEC Contact Person Ph ( ) PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner r r�� - - � - 57,? ELC Footing Foundation ELC Access: Ftg Drain 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 / ..4,41-`" `" - Susp'd Ceiling —y= 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: ,` PART FAIL ECHANICAL . Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: ri Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date f Inspector 177-7' Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL •