Permit • ' �
CITY OF TIGARD MASTER PERMIT PERMIT #: MST2001 -00564
it DEVELOPMENT SERVICES DATE ISSUED: 12/31/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11259 SW 84TH AVE PARCEL: 1 S136CI3 -ACM12
SUBDIVISION: ASH CREEK MEADOWS ZONING: R -12
BLOCK: LOT: 012 JURISDICTION: TIG
REMARKS: New SF detached residence. Path 1
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 24 FIRST: 709 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 892 sf GARAGE: 413 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: sf RIGHT: 5
VALUE: $ 154,880.00
OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 1,601.00 sf REAR: 19
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: . 1 BOIL/CMP < 3HP: VENT FANS: 4 CLOTHES DRYER: 1
GAS FURN > =10OK: UNIT HEATERS: HOODS: 1 OTHER UNITS:
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: 1 0 • 200 amp: 0 - 200 amp: W /SVC OR FDR: 1 PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 3 201 • 400 amp: 201 - 400 amp: 1st WV SVC /FDR: 00 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 8, STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANOSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 6,979.49
This permit is subject to the regulations contained in the
ESLINGER BUILDERS INC ESLINGER BUILDERS INC Tigard Municipal Code, State of OR. Specialty Codes and
11575 SW PACIFIC HWY. 11575 SW PACIFIC HWY all other applicable laws. All work will be done in
PMB160 TIGARD, OR 97223 accordance with approved plans. This permit will expire if
TIGARD, OR 97223 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 #: LIC 62363 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
Erosion Control Insp 8 Post/Beam Mechanical Mechanical Insp Shear Wall Insp Gyp Board Insp Mechanical Final
Sewer Inspection Underfloor insulation Plumb Top Out Exterior Sheathing Insr Rain drain Insp Plumb Final
Footing Insp Crawl Drain /Backwater Electrical Service Low Voltage Water Line Insp Final inspection
Foundation Insp Footing /Foundation Dr Electrical Rough In Gas Line Insp Appr /Sdwlk Insp
Post/Beam Structural PLM/Underfloor Framing Insp Insulation Insp Electrical Final
\
I
Issued By : Permittee Signature : Alta /. 1 IA /.l .
503
( ) b Y P .m.
Call 175 7:00 for an inspection needed the next business day if
P
7 a l st v / co
'
Building Permit Ahhlical:io��
. ll Date received: (Z -°S -"J 1 l'ermil nO Z[19l_
�,� „_1� e City of Tigard i «CC���� eRia,
City a il �gard
Address: 13125 SW Hall Blvd, Tigard, t roject /appl. no.: Expire date:
Phone: (503) 639 -4171 Date issued: Ily15V Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: I &2 family: Simple Complex:
.TYPE Or PENI111s .. . .. .
❑ I & 2 family dwelling or accessory U Commercial /industrial U Multi - family ,'New construction U Demolition
❑ Addition /alteration /replacement U Tenant improvement U Fire sprinkler /alarm U Other:
. / .JOII SITE INFOIIMATION '.. .
Job address: 112- 59 5w t Rh” A. 1;9« d, P. 19T z. Bldg. no.: Suite no.:
Lot: (Z I Block: !Subdivision: 4 • 1 , e.c...k.. ea Tax neap /tax lot /account no.: 15 131pCg WO
Project name: A.,, k (0_, P -k_ , -1 [s 13 (aCt lg - ' I3.- 13Fs
JJ ,..I--.).D....
Description and location of work on premises /special conditions: _ "6 1 rl 1� `�Ci ii. i C V Hb i e_.
.. .. 011'NER . .. •. , .: ,; FOR SPECIAL INFORMATION, USE CHECKLIST
N: —r ' _ r /ill.` to is &. i le} Ir. YI- C . (rloadplaln, septic capacity, solar, etc.) • Mailing address: �/ 0h— (t,i c_ luny p►1.(1S 160 I & 2 family dwelling: u.
City: 1 crt State: 'JZIP: 97 ) .r„1-3 Valuation of work /54 . f / 8 0
Phone: 6910 C�, j"/5 tFax :6. .4'
75 - mail: No. of bedrooms/baths 3 _277_e__ /
Owner's representative: : f o Ivvi — SI hilt (' re- Total number of floors .2.
Phone: �j`. , ,.e_, Fax: L Vyue_ E -mail: V New dwelling area (sq. ft.) 1(0 0
.. •- ... _'.. APPLICANT..'_: " .:.. :.:.:`.:;::.. Garage/carporl area (sq. II.) ' I
Name: :S / / ,/h i f a r B C.l f (0 ed g :E Covered porch area (sq. ft.) kl/A
Mailing address: . WI. .r f) t.l e Deck area (sq. B.) /■,1 Aik
City: State: ZIP: Other structure area (sq. (t.) .17/4
Phone: Fax: E -mail: Commercial /industrial /multi - family:
. . •.• . CONTRACTOR , Valuation of work $
Business name: 1 ),-1.-42,r- p t
Existing bldg. area (sq. ft.
�� 1 'j
City: New bldg. area (sq. ft.)
Address: �Q m t� �.- 6...5 � 4 ver
Number of stories
Y Stale: ZIP:
Type of construction
Phone: I Fax: I E
CS;j3no.:
Occupancy group(s): . 'sting:
New:
( City/ letro lie. no.: 0 a 6 _
Notice: All contractors and subcontractors are required to be • . . ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: F I (X y-C
• 05 MeV' j4 c 0c r provisions of ORS 701 and may be requited to be licensed in the
Address: 71 ze �w DO 0 r 2490 jurisdiction where work is being performed. If the applicant is
cit I 0 St ev ZIP: ,,2. 3 exempt from licensing, the following reason applies:
Contact person:& a,,L 110.5pyi cr.f Plan no.: 1401
Phone:0 7 . (42. g Fax: E -mail:
Name: poILaIn. t 1-65 y i ems' Contact person: ' yy- r Fees due upon application $
Address: '�i - 1 Wt , a6 C7 DCfe_ Date received:
City: State: I%IP: Amount received $
Phone: 11 ax: [E -mail: I'lease refer to Ice schedules
I hereby certify I have read ant examined this application and the Nut all jwisdictions accept credit cards, please call jntisdiction fur mole inronna' .
attached checklist. All pr ' .'Rat . Lordinanccs governing this U Visa U MaslcuCatd
work will he complied \ 1 It the l l herein or not. Credit cord number: I i
Expires
Authorized signature: , , 4L r4 , M Date: 111/ 140‘ Name of cardholder as shown on ctcdil crud
Print name: V injla F 4 . 1 �1 - Cardholder signature $ Amount
Notice: This permit application expires if a peon • not obtained within 180 days alter it has been accepted as complete. 440 -4613 (M)0/COM)
PIuiiibiuig l'erm it Application
Date received: Permit no.:
r, ' , • City of Tigard . • -- Address: 13125 SW Hall Blvd, Tigard, OR 97223 I Sewperntil no.: 1Buildingpennitno,:
City of Tigard Phonc: (503) 639 -4171 l'rojecUappl.no.: Expire date:
Fax: (503) 598 -1960 Date issued: By: I Receipt no.:
Land use approval: Case tile no.: Payment type:
TYPE OF PERMIT •
0 I & 2 family dwelling or accessory U Commercial /industrial I] Multi- family U Tenant improvement
New construction U Addition /alteration/replacement U Food service U Other:
JOB SITE INFORMATION FEE SCIIEDULE (for specinl lnforluntlon use cliecltllst)
Job address: 11259 5 W VI w A t . 111 i Description Qty. Fcc(ea.) Total
Bldg. no.: Suite no.: New 1- and 2- family dwellings only:
C b 900 (Includes 100 R. for each utility connection)
5
Tax map /tax lot/account no.: I SFR (I) bath
Lot: IL I Block: I Subdivision: /l l, Cfttk Metxdow3 SFR(2)bath
P:ojcc■ nsh::c: A i VI C r ei k i - C. 0 00 w1 SFR (3) bath
City /county: Ti gqgrd \ WA ZIP: `1 72.2:5 Each additional bat /kitchen
Description and Ideation of work on premises: Sileutilities: . .
• F • i I H. - Catch basin/area drain
Est. date of completion/inspection: - -02_ Drywells/leach line/trench drain
PLUMBING CONTRACTOR Footing drain (no. tin ft.)
Manufactured home utilities
Business name: CC(Yle 11A.047in, -,, (Al.0 Manholes
Address: 112. rj(,,) (c tj d U Rain drain connector
City: 5h 4l jo ir\ Rd C I Z1P:GI - 11 4 10 Sanitary sewer (no. Iin. ft.) Phone: (0 /5. 14SZ I Fax: (oL6-14S2 I E -mail: Storm sewer (no. lin. ft.)
CCB no.: CI ( (, I Plumb. bus. reg. no: ?ELI - 2../..5 (45 Water service (no. Iin. ft.)
City /metro lie. no.: 0000 '61 - Fixture or item:
Contractor's representative signature :' , Absorption valve .
- Back flow preventer •
Print name: .UMW Date: (U -Z - ,T 01 Backwater valve ,
•
p CONTACT PERSON Basins/lavatory •
•
Name: c k f(n �rh, a Clothes washer
R i
Address: Dishwasher •
5a1. a 1�5 f\ho v e
• Drinking fountain(s)
City: I State: I ZIP: Ejectors/sump
Phone: Fax: E -mail: Expansion tank .
OWNER Fixture/sewer cap
Name (print): E sI i — 4, r t., ; id c r s 1...„(.. Floor drains/floor sinks/hub
P
Mailing address: 115 5L,/ a c if i Hw g G,n Hos bi disposal
City: � � . Hose Bibb
Y T itarcl � St ate: nl� ZIP: g 7 ,13 Ice maker
Phone: C. 20 0 -95Irr I Fax: ( Zo 75IE-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 'rubs/shower/shower pan
Name: Urinal
Na
N Water closet
Address: Water heater
City: I State: I ZIP: Other: •
Phone: I Fax: I E- mail_: Total
Not all Jurisdictions accept credit cards, please call Jurisdiction for more Information. Notice: This permit application Minimum fee $
❑ Visa ❑MasterCard expires if a permit is not obtained Plan review (at %) $
Credit card number: Ca i / within 180 days after it has been State surcharge (8%) .... $
p TOTAL $
Name of cardholder as shown on credit card accepted as complete.
$ .
Cardholder signature Amount
440 -4616 (CdWICOM)
•
' A Mcclhanucal Permit Applicatimi
Date received: Permit nu.:
i , . City of Tigard .�+� _ " -� +� y g ProjccUappl. no.: Expire (late.:
City n(l'igu,. Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone.: (503) 639 -4171 Date. issued: By: Receipt no
Fax: (503) 598 -1960 Case file no.: I'aymcni type:
1 ,:1110 use approval:
Building permit nu.:
'
U I & 2 family dwelling or accessory U Commercial /industrial U Multi - family U'I'enant improvement
I. New construction U Addition /alteration /replacement U Other:
..: JOB SITE, INFOR MATION :. ? ;.COMMERCIAL :VALUATION; SCHEDULE
Job address: Hz Z 5 ci 5W Btiu A V I V. i i r rti , V R / 9 7z.2.3 Indicate. equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: ' value of all mechanical materials, equipment, labur, overhead,
Tax neap /tax lot /account no.: i 7 ,-, � profit. Value $ .
I.,ot: 12_ Block: Subdivision: 5 1 drec k "Sec checklist for important application inform Ilion and rtz5 Project name: le L . .r -. C� jurisdiction's fee schedule for residential permit fee.
City /county: Tc;a YC 1 /� , ZIP: £7a..a3 : .1: &:I l DWELLI PERMIT FEE SCHEDULE."
Descr )lion and locution f work on premjses: AND COMM UL
ERICALIINDUSTRIAL EQUIPMENTSCHEDE
- - f rig C# � 7w�,Dll 1 i& J 1 . I ec(ca.) Total
list. date of conipletion) 5- 5 -GI Description Qly. Res. only Res. only
Tenant improvement or change of use: IIVAC:
Is existing space heated or conditioned? U Yes O No Air handlin unit CI'M —
Air conditioning (site plan required)
Is existing space insulated? U Yes U No
Alteration of existing IIVAC system
MECHANICAL CONTRACTOR Boiler /compressors —
Business name: 0 1 ,f State boiler permit no.:
_ Re.) -- f e, .;,u s v(� nr Tt,ns 1111/1
r I
A
(Idress: " 7 � , Q � � . c'^ la dampers /duel smoke detectors
City: (1a nth ti Slate 1i9 /f Ileat pump (site plan ieiequircd) - —
Plione:a�0_ Z2. ti 9 T ax: I E -mail: Install /replace furnace /burner ITfIJ /I I
Including ductwork /vent liner U Yes U No
(
CI3 Ito.. ��1,pU Install/replace/relocate heaters - suspended,
City /metro lie. no.: ' I , ... wall, or floor mounted
Name (please print): ( D c • r---67 C r' O Vent for appliance other than furnace
CONTACT PERSON.' .. Refrigeration: •
N Absorption units 13TU /fl
Name: 60 t' 1.i i V 1 G Tied./ 6 Chillers III' —
Address: ... a 10.0 V Compressors I IP
Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
O�VI�IER 13oods, Type If 11 /res. kitchen/llama(
hood fire suppression system
Name: -eis ✓v tom. �"� , F u i , w . ' . I 1
1 -�,w L, • Exhaust fan with single duct (bath fans)
Mailing address • , ' 1---c. l t'Ajo M j - 6 Exhaust system apart from heating or AC
City: / r J r 3 Fuel piping and distribution (up to 4 outlets)
Type: LPG NG Oil
Phone: ,,„ Fax 6,0 # ''.1 y ' -mail: Fuel pi ring each additional over 4 outlets
ENGINEER • . Process piping (schematic required)
- Number of outlets
Name.:
N /1)--, Other listed appliance or equipment:
Address:
Decorative fireplace
_ City: �_ Stale: 17,I1': Inset -• type
I'Itotte: / Wovdstovc/pellet
� �,' 11 ; ►I -mail:
Other:
y
Applicant's signature: p w l g i , Date: 1.44, Other:
Name (print):
'Not all jmisdiclions accept credi1 cards, please call jurisdiction for more infornrnlion.' Permit fee
U Visa U MastCICatJ Notice: This in (applicati Minintutu fee $
Gcdit card n her:
expires if a permit is not obtained
Plan review (at _ %) $
Expires within 180 days eller it has been Slate. surcharge (8%) .... $
Name of cnrdholrkr as shown on credit card accepted as complete.
$ TOTAL _
Cardholder signature Amount 140 -41117 (6/00/COh1)
•
Electrical Permit Application •
Dalcrcccivcd: Permit no.: •
n 'i' City of Tigard ProjccUappl.no.: Expiredatc:
Ciryr! /Tigord Address: 13125 SW Hall Blvd, Tigard, OR 9722 Date issued: Ilya I Receipt no.:
1'I lone: (503) 639 -417
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: TYPE OF PERMIT
❑ I & 2 fancily dwelling or accessory U Commercial /industrial U Multi - family U Tenant improvement
,New construction ❑ Addition /alteration /replacement 0 Other: U Partial
. • . JO SITE INFORMATION
Job address: 112_591 5W gal ti, AVt -(7i axrd.QaIltiz3 Bldg. no.: Suite no.: Tax map/tax lot/account no.:15l3Coe
Lot: a_ Ililock: 'Subdivision: Ash crti lc rl coidow3
Project name: A fh (r e .eK I Description and location of work on premises: Ne u/ Si . r"q i. F et}, i 1
Estimated date of completion/inspection: 5 — _ • J
--. ---' -- --=.1 CONTItACTOR•APPLIEATION -.•.. . .•....,...- 4..,,- '-..---- ..... .. ___
• r
Job no:
Fee Max
Business name: D. A. Jerome Electric
Description Qty. (ea.) Total no. ittsp
New residential -single or multi-family per
Address: PO Box 751 dwelling unit. Includes attached garage.
City: Hillsboro I State° R I ZIP: 97123 Servicelncluded:
Phone: 648-5144 I Fax: 648_9721-mall: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof
3 6 0 51
CCB no.: I Elec. bus. tic. no: 34_119c
City /metro lic. no.: 1063 Limited energy, residential 2
Limited energy, non- residential 2
Each manufactured home or modular dwelling
S igna t ure of supervising c eclrician (required) D Service and/or feeder 2
Stip. elect. name (print): Davie i - t - 1- iccttsctto: Scrrlccsorfccdcrs— irrslallaliorr, • alteration or relocation:
PROPERTY OWNER 200 amps or less 2
Name (print): Estiti. .er F.) utld -er5 I,,C_ 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 115 71 5 w ( Ic }4, elr) I Cl
601 amps to 1000 amps 2
City: T c DvA rd I State:0 ZIP:9 7 Z z.3 Over 1000 amps or volts 2
•
Phonc: [' 20 _`I S l ci I Fax: G 1 G .y1751 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:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER • Branch circuits - new, alteration,
N I or extension per panel:
Name: A. Pee for branch circuits with purchase of
Address: •
service or feeder fee, each branch circuit 2
City: I Stale: • 1 ZIP: It. Fee for branch circuits without purchase
Phonc: Fax: E-mail: of service or feeder ice, first branch circuit: 2
Each additional branch circuit:
PLAN REVIEW (Plense cheek all that apply) • Misc. (Service or feeder not included):
U Service over 225 amps - commercial ❑ l lealtl -care facility Each pump or irrigation circle 2
U Service over 320 amps- rating of I &2 0 Hazardous location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
U System over 600 volts nominal more residential units in one structure alteration, or extension* 2
U Building over three storks U Feeders, 400 amps or Inure * Description:
U Occupant load over 99 persons U Manufactured structures or ItV park Each additional inspection over the allowable in any of the above:
U Egress/lightingplan 0 Other:
l'er inspection r I I I
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 pennit application Permit fee $
U Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been Stale surcharge (8%) .... $
Expires accepted as complete. TOTAL $
•
Name of cardholder as shown on credit card
S
Cardholder signature Amo
410 -4615 (WOO/COM)
� 1
• ■
• ■
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:r TREE CE TIFICATION
• R STREET
f •
• I, CLJ Est i , Owner /Agent for i & , � d� _ z,i L , ■
• • (PL ERINT) ( (PERMIT HOLDER)
• ►
•
. • ■
• ►
• •
•
• Do hereby certify that the following location ■
• ■
't meets City of Tigard /Washing ► ton County ■
•
• land use and development standards for street tree installation. ■
• ■ ■
• ■
• ■
• ADDRESS: i S LA ) 5L1 . Ii OR- 9'71Z3 M� 01- 60s-a ►
• U •
•
• •
• • LOT: 7i SUBDIVISION: / l Vl ( jG{e�.e6 w3 ►
►
• ►
• ►
• BY: DATE: " /a/ z •
• •
• •
• ■
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1 RECEIVED BY: j/ ea �. _,�> DATE: S- -- C ---e____ •
A VVVVVVVVVVV VVVVVV® sVVVVVTVV VVV VVVVVVTVVVVVVTVYVYVYVYVYTVVVY'
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested I I' 3 AM PM BUP
Location / � ' �1 ( 4.i- Suite MEC
Contact Person Ph ( PLM
Contractor Ph ( ) r 3 7 '/'1 SWR
BUILDING Tenant/Owner ELC \ Li
Footing ELC
Foundation Access: (� /l
Ftg Drain [ - . 6 V x ,_ ELR
Crawl Drain r
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation - t; l�
Drywall Nailing
Firewall V %
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
SS ART FAIL
El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date ]` J.*: O 2 Inspecto Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGA RD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 /GO-S"( c,
- INSPECTION DIVISION Business Line: (503) 639 -4171 MST /
BUP
Received Date �
Requeste AM PM BUP
Location / (o2 5 Suite MEC
Contact Person C � `I Ph ( ) F 5 ---( f PLM
Contractor • Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
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
Susp'd Ceiling
Roof
Other: -
m
SS) PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL •
Service
Rough -In -
UG/Slab
Low Voltage
Fire Alarm
Final E Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE E Please call for reinspection RE: 111 Unable to inspect – no access
Fire Supply Line
ADA .
Approach /Sidewalk Date S � — D Inspector Ext
Other: •
Final DO NOT REMOVE this Inspection record from the Job site. -
PASS PART FAIL
CITY OF TIGARD " - . 24 -Hour - -
BUILDING Inspection Lihe: (503) 639 -4175 - •
MST 61e/ dv -5 r/
INSPECTION DIVISION Business Line: (503) 639 -4171 r
BUP
Received Date Requested d AM PM BUP
(( Location �1 �-" Q ( `'e— Suite MEC
Contact Person � Ph ( ) q 0 - PLM
Contractor Ph ( ) SWR
BUILDING. Tenant/Owner ELC
Footing
Foundation Acre ELC
Ftg Drain �f ,�( 6 �� ELR •
Crawl Drain y' " /, ✓
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
•
Fire Alarm
Susp'd Ceiling
Roof
Other:
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
ANICAL
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 D Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line /� /'�
ADA Approach/Sidewalk Date 2 Inspector. - r Z/ w - - Ext
Other: •
Final DO NOT REMOVE this Inspection record from the Job site.'
PASS PART FAIL