Permit CITY TIGARD MASTER PERMIT
� ,�i� PERMIT #: MST2002 -00371
DEVELOPMENT SERVICES DATE ISSUED: 8/26/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 14551 SW 81ST AVE PARCEL: 2S112BC -01201
SUBDIVISION: DURHAM ACRES ZONING: R -4.5
BLOCK: LOT: 070 JURISDICTION: TIG
REMARKS: Install closet in second story and add gas fireplace
BUILDING
REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT:
VALUE: $ 1,000.00
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0.00 sf REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER:
GAS FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1
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: 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: $ 186.43
This permit is subject to the regulations contained in the
SCHIEBOLD; DELLA OWNER Tigard Municipal Code, State of OR. Specialty Codes and
14551 SW 81ST AVE all other applicable laws. All work will be done in
TIGARD, OR 97224 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. 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 lnsp Mechanical Final
Framing lnsp Final inspection
Fireplace lnsp
Gas Line lnsp
Gas Fireplace
Issued By : P ermittee Signature : ,ds , ,,,
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
Building Permit Application FOR OFFICE USE ONLY -
Dae d / � / p D , - Building t I� _ 37 J
Datte': y:it... O � PermitNo.:Y'/
City of Tigard Planning Approval Other
Y g Test Form Date/By: PermitNo.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date /By: ( 2. S -o Z n' r Permit No.:
Phone: 503- 639 -4171 Fax 503 - 598 -1960 -. ''�� 01111 Post- Review Land Use
E + Date /By: Case No.
Internet: www.ci.tigard.or.us -W Contact Juris.: ❑See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name /Method: Supplemental Information
r ;u; TYPE,OF < . s ,,�. t ,. �, , . _
- 41 , _ti' _ ,''. s,. • .'. '' .. s REQUIRED DATA Z >
❑ New construction ❑ Demolition t , , ' ? u z x , y 1 & 2 FAMILY, DWELLING 4
nX Addition/alteration/replacement ❑ Other:
4 7 CATEGORY..OF C ONSTRUCTION •Tt Note: Permit fees* are based on the total value of the work performed. Indicate
[ 1 & 2-Fan dwelling ❑ Commercial /Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor,
overhead and profit for the work indicated on this application.
❑ Accessory Building ❑ Multi- Family . i
111 Master Builder 111 Other: Valuation S /0
' `; J.OB .•SITE INFORMATION a nd'LO.CATION Y . ,, No of bedrooms: No of baths:
Job site address: /( Set) / s f- Total number of floors
New dwelling area (sq. ft.)
Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft.)
_ Project Name: Covered porch area (sq. ft.)
Cross street/Directions to job site: eo.,,°f-d es cross Deck area (sq. ft.)
Other structure area (sq. ft.)
Bdh� f
J. r 9 `} F REQUIRED DATA L ei � , irn X �rf '` COMMERCIAL USE CHECKLIST = �
Subdivision: Lot #: «, „� U ._-s, v., ...a osA.> . ,. ,• 11.'>;
Tax map /parcel #: Note: Permit fees* are based on the total value'of the ark performed. Indicate
P 3 , _;ADESCR•IPT_IONeOFAWOR'K'V!: - PAS , , C f - the value (rou . : • _ e nearest dollar) of all equi. ent, materials, labor,
R� overhead and profit for the : . indicated on t• application.
r. 4-na tic, s - I1 d. 4 "y ea setk- 4. c s A ea ti
uzva f o , r /off Valuation $
Existing building area (sq. ft
i -,, of ✓ da 1, .— 4 c 1' %�� 5o 4rs. New building area (sq. .
5 . fl h' Number of stories..
P,ROPERTY'OWNERt .f io' T AxtioAmaspia Type of constr ion
Name: Del /a Se-4i2.6vtel Occupanc :roup(s): Existing:
New:
Address: pt-.5 SAI V '
City /State /Zip: 7 o— 9 7 1 V
>S' Fax NOTICE: All contractors and subcontractors are required to be
Phone. $'3 43�/—
�? licensed with the Oregon Construction Contractors Board under
_A TLICANT, ' ., ti , .< � `. ”: , i CO PERSON , � �a provisions of ORS 701 and may be required to be licensed in the
Business Name: jurisdiction where work is being performed. If the applicant is exempt
Contact Name: from licensing, the following reason applies:
Address:
City /State /Zip:
Phone. VET ,� ,� p
aX y ;tt. ¢ BUI DIN G PERMIT 1 ,, 4: ;
E-mail: 2 3Please refer to fe
a ., .. ... CONTRACTOR , =,. ` :: °..,,_`x 4 � 41 E �, - .tom .. mss, . ,.. _ _. , .4 ° ;44
Business Name: Se, / 1 06U/de-g- Fees due upon application $ 0,'
Address:
City /State /Zip: Amount received S
Phone: Fax: Date received:
CCB Lic. #:
Notice: This permit application expires if a permit is not obtained within
Authorized
n 1/4s-Lk,", 180 days after it has been accepted as complete.
Signature: a/ �J Date:
*Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
One- and Two - Family Dwelling
. . .
bMs i Building Permit Application Checklist Reference no.:
ryofTigard Associated permits:
City
City of Tigard ❑ Electrical ❑ Plumbing ❑ Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 ❑ Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
"° A , : THE` FOL ^_ITEMS -ARE REQUIRED FOR PLAN REVIEW `,,. ' x° Yes No,. N /A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews.
2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc.
3 Verification of approved plat/lot.
4 Fire district approval required.
5 Septic system permit or authorization for remodel. Existing system capacity
6 Sewer permit.
7 Water district approval.
8 Soils report. Must carry original applicable stamp and signature on file or with application.
9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of
at
ch b in protection, e tc .
10 3 Co plete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state
C g codes. Lateral design details and connections must be incorporated into the plans or on a separate full size
s eet attached to the plans with cross references between plan location and details. Plan review cannot be completed
if copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot d -bu' • ing setback dimensions; property corner elevations (if
sere is more than a 4 -ft. elevation d:_ "e tittl' an m • ow contour lines at a ,ft..inte - s); location of eases. - . and
drive ' , . .. ; a n ' , - ;..- . - using sec '0, ocation o_ . ";' c sl - , , " . ens •' _ on in d. ;"fot
- M
.; ' sing coverage area; percentage of co e , .
g g p g mpervious area; existing structures.�en-�i e; an. su ace 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.
_. , .
.: JLIRISDICTIONAL SPECIFICS .` " . ` ,,' .
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. "Mirrored" building plans will be not accepted.
26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document.
27 "Drawn to scale" indicates standard architect or engineer scale.
28 Site plan to include tree size, type & location per approved project street tree plan (if applicable), and COT Street Tree List.
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 • Received FOR OFFICE USE
Date /By: /41 12- Permit No.: ttwe:0`Ga 3 7)
C of Ti and Planning Approval Building
Y g T Form Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date /By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 MI + Post - Review Land Use
Internet: www.ci.tigard.or.us.a01.1111111., Date /By: Case No.:
. Contact Juris.: ® See Page 2 for
. 24 -hour Inspection Request: 503- 639 -4175 ' ' °- Name /Method: Supplemental Information.
t
t 'i ; g : . $: CONIMERGINOEgEtiSCIIEDULE USO'CHECKLIST > .A raj
'�:���� ;���_ '� �.�::'r._. `, e tc,
❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
�C Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
� t. � - 1 �' .CATE:GORY4OF CONSTRUCTION6 : i . :t A`
mechanical materials, equipment, labor, overhead and profit.
jI 1 & 2- Family dwelling ❑ Commercial/Industrial Value: $ See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi Family 44 << RESIDENTIAL O:gTIPMENT /,SYSTEMSWEE* SCHEDULE , ..
Description Qty Fee(ea.) Total
❑ Master Builder ❑ Other: Ireatin Cooli'n
.* ' ..JOB'SITE INFORMATIONian I OCATION1i 1 ' -3. « Furnace - add - on air conditioning 14.00
Job site address: Ai 55 / W-/ St Gas heat pump 14.00
Suite #: Bldg. /Apt. #: • Duct work 14.00
Praject Name: Hydronic hot water system 14.00
Residential boiler
Cross street/Directions to job site: (for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
- _ Flue /vent (for any of above) 10.00
Repair units 12.15
SUbd1VlSlori: LOt #: lOtIfer_F.`ue1
Tax map /parcel #: Water heater 10.00
746' s DESCRIPT ON QF WORK i, ' t . W. Gas fireplace i 10.00
/'e fnov� . fi dS ate[ a dm' tid.�h A G{�'tcNu Flue vent (water heater /gas fireplace) / 10.00
Log lighter (gas) 10.00
c- /p« 7- d/Qd , - '7 , Wood/Pellet stove 10.00
Gad g at /.ie /'^ bas 51'4' i. Wood fireplace /insert 10.00
1, "v, n rnowj Chimney /liner /flue /vent 10.00
;[PROP 12TY OWNERRA,"„''`a' .WI 4 CM :TNA
ENTS
;� &,„ ' Other 10
t,Envirorimental:Extiaust &.Ventilation;, . 'u
Name: De-/ i S"� /,' ‘a // Range hood/other kitchen equipment / 10.00
Address: /'t-sS/ St' "/ Clothes dryer exhaust 10.00
City /State /Zip: 77: --,/ >,42 .' Single duct exhaust
Phone: So3 6 39 / 4 S FaX (bathrooms, toilet compartments,
y®.APPLICANT ;,,;: ' i `,. . _.... i utility rooms) 6.80
; .CONTACT�PERSON, '" ,,� ry )
Name: s 4s.,,,._ Attic /crawl space fans • 10.00
Other: 10.00
Address:
City /State /Zip: ($5.40 for first 4, $1.00 each additional) **
Furnace, etc. **
Phone: Fax: Gas heat pump **
E -mail: Wall /suspended /unit heater **
`i_ �i # ... ,. „CONTRAC < .,tm . t ,.. .'. Water heater **
Business Name: 0 / IL Fireplace .'I **
Range **
Address: BBQ **
City /State /Zip: Clothes dryer (gas) . **
Phone: Fax: • Other: **
CCB Lie. #: Total:
Me c h anical P.ermit•:Fees*
. Subtotal: $
d f Mi nimum Permit Fee $72.50 $
Authorized � / , Signature: Date: .6" --/6 _ Pl R ev i ew F (25% of Permit Fee) $
°
State Surcharge (8% of Permit Fee) $
Oe //, Sc,/ e ,/,/ TOTAL PERMIT FEE $
(Please print name) Notice: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation:; Permit'
$1.00 to $5,000.00 Minimum fee $72.50
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52
for each additional $100.00 or fraction
thereof, to and including $10,000.00.
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and
$1.54 for each additional $100.00 or
fraction thereof, to and including
$25,000.00. •
•
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and
$1.45 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 and up $742.00 for the first $50,000.00 and
$1.20 for each additional $100.00 or
fraction thereof.
Assumed Valuations PerApplian'ce
Value Total
Description: Qty (Ea) Amount
Furnace to 100,000 BTU, including 955
ducts & vents
Furnace> 100,000 BTU including ducts 1,170
& vents
Floor furnace including vent 955
Suspended heater, wall heater or floor 955
mounted heater
Vent not included in appliance permit 445
Repair units 805
< 3 hp; absorb. unit, • 955
to 100k BTU
3 -15 hp; absorb. unit, 1,700
•
101k to 500k BTU
15 -30 hp; absorb. unit, 50Ik to 1 mil. 2,310
BTU
30 -50 hp; absorb, unit, 3,400
1 -1.75 mil. BTU
>50 hp; absorb. unit, 5,725
>1.75 mil. BTU
Air handling unit to 10,000 cfm 656
• Air handling unit >10,000 cfm , 1,170
•
Non - portable evaporate cooler 656
Vent fan connected to a single duct 446
Vent system not included in appliance 656
permit
Hood served by mechanical exhaust 656
Domestic incinerator 1,170
Commercial or industrial incinerator 4,590 ,
Other unit, including wood stoves, 656
inserts, etc.
Gas piping 1-4 outlets 360
Each additional outlet 63
TOTAL COMMERCIAL 7. <$ { $
VALUATION:
Permit #: W6TA4op. - GYJ3
Address: l 415 "�
Issued by: VIX71870--Se___. Date: �/e Z--
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 o t'ial boxes 1 glK1 Z and either box 3A or 3B:
A
71 1. I own, reside in, or will reside in the completed structure.
a l , 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
le before or upon completion. -
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
tan 3B. I will be my own general contractor.
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 that the above information is correct and that I have read and do understand the Information •
Notice to Property Owners about Construction Responsibilities on the reverse side of this form.-
(Signature of permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
— — -.
Kn&m0l]ation Notice to Property Owners
!'`, bout Construction Restons^b^
Note: This Information &odua:t? Property Owners aboni Construction Responsibilities
was developed by the Construction Contractors Board in accordance with OPS 701.05(5).
If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure,
you can prevent many problems by being aware ofthe following responsibilities and areas ofconcern.
EMPLOYER RESPONSIBILITIES:
If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the
oonsonohonorimproromen1ufurcsidonholsouC{uo:,youvvi||,jnn'ostioxtonocu,hcru|ediobeuncmp)nyuronddhnpzmp|c
you hire will be employees. As the eniployer, you must comply with the folloving:
Oregon's withholding tax law: Amouemploycr,ynumustwdhho|diucomctazes from employee wages at the time employees
are paid, You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more
information, call the Oregon Dept of Revenue at 945-8091.
Unemployment insurance tax: 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 Department 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 yQur employees. lfyou fail to obtain workers' compensation insurance, you ni.av
be subject to penalties and will be I iable for all claim costs i f one ofyour employees is injured oolbcjob.Forn;unoinfbrmo1\on,
call the Workers Compensation Division at the Depamnent of Consumer and Business Services at 945-7888.
,
U.S. Internal Revenue Service: As an employer, ou mustwithhold federal income tax from employees wages. You will be
liableforthe taxpayment even if you didn'tactuallywithhold the tax. Formore informatior, calithe Internal Revenue Service
at 1-800-829-1040.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
Code compliance: /\othcperu ii holder for this project, youurencxponnib|eforreoo|vingouyfai|urct*mcetcodcrcquiremcnts
that may be brought to your attention through inspections.
Liability and prnpor�'dum�u�einsurance: Con�uiyourinsumou�u�cottoeo�i[yomhnvcudcooatc insurance coverage for •
� .
auo�cotxand omissions such onfalling tools, paint overspray water damage from pipe punctures fire, or work that must be
re-done.
Time to supervise em : 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.noti' btiilding officials at the approriate times so they can perform the required inspections.
If you have additional questions. write or call the Construction Contractors Board (P0 I3ox 14140, Salem., OR 97309-5052,
503/378'4621). The Board i located at 700 Summer St. NE Suite 300, in Salem.
•
pmp*vu.pm4
|/94
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (51J • -4175 d-.0O t " .0d3 7/
41, INSPECTION DIVISION Business Line: ,� •-4171
�� BUP
Received Date Requested AM ' .� BUP
Location I Kcl �/ = 521. A Suite MEC
Contact Person Ph ( ) PLM
Contrac Ph ( ) SWR
B s ►. Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear I / o
Framing i _ , N
Insulation � �-
Drywall Nailing /,
Firewall /
U
Fire Sprinkler g I ri?
Fire Alarm
Susp'd Ceiling
Roof
Oth - r:
4 FAIL
PLUMBING
Post & Beam
Under Slab - 1
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: Unable to inspect - no access
Fire Supply Line
ADA \�
Approach /Sidewalk Date Z 7' 5 y Ins p e ctor - 1 - Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503 5 �lT��
S - 6503 - 7/
INSPECTION DIVISION Business Line: (50'
, _ 3UP
Received Date Requested �� AM PM BUP
Location / � - Suite MEC ado3 - 60 4 /9
9
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Ow ��= l�c�tn.c ELC
Footing 6 3, - / 'f 7.5 ELC
Foundation Access/ 8°k f - r'i
Ftg Drain J ...— aM: a. - LR- -
`
Crawl Drain �
1 �
Slab - Inspection Notes: i SIT
Post & Beam ( j ALL_ 1'l6l\4 OtA/A e- i J
Shear Anchors - i �
T6 ® � - 0Y A � r
Ext Sheath/Shear APP l-� JT��� � A ��
Ina Sheath/Shear �_ �//
Framing -
-=-----
Insulation ----- - - -- f - -- --
Drywall Nailing _
Firewall
Fire Sprinkl r a
Fire Alarm I,' _ VVV (,,V. --e �■ S- ( :E-.
Susp'd Cei
Roof *N-,....er r-J-GL-a-
Other:
mal ) _�
r P ASS ^ FAIL
PLUMB -
Post & X tJ ` Lr u ‘ 1 C2/<)3 Lam\ 7 7 Q
Under Slab v `
Rough -In T- S 4- Q -. C 3 L V
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL. I4"
Post & Beam
Rough -In
Gas Line
Smoke Dampers po
anal
PART FAIL
CTRICAL
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: 0 Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date / 2-K % Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL