Permit '
CITY OF TIGARD MASTER PERMIT
#: MST2003 -00437
I DEVELOPMENT SERVICES DATE ISSUED: 8/29/03
III' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 10230 SW 90TH PARCEL: 1S135AA -00906
SUBDIVISION: TOWN OF METZGER ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
REMARKS: Remodel existing laundry area into dining area with laundry closet.
BUILDING
REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 TMRD: sf RIGHT:
VALUE: 840.00
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: 1 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: BOIUCMP < 3HP: VENT FANS: 1 CLOTHES DRYER: 1
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:
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: 1 W /SVC OR FDR: oo PUMP /IRRIGATION: PER INSPECTION:
EAADD'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: EAADDL 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: PROTECTIVESIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 311.97
BRYAN HARRIS OWNER This permit is subject to the regulations contained in the
Tigard Municipal Code, State of OR. Specialty Codes and
10230 SW 90TH AVE all other applicable laws. All work will be done in
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. ATTENTION:
Oregon law requires you to follow rules adopted by the
Phone: 503 977 - 2374 Phone: Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
Reg #: may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Footing Insp Framing lnsp
Mechanical lnsp Electrical Final
Plumb Top Out Mechanical Final
Electrical Service Plumb Final
Electrical Rough In Final inspection
l
Issued By : 1 -8--7/4 Permittee Signature :
Call ( t41 ) 75 by 7:00 p.m. for an inspection needed the e t business day �_
To ? r g — --e-3
' Building Permit Applicati
Date received: /a 0 3 Permit no o5 — j 7
_,,,1 ��, City of Tigard RE �'
Address: 13125 SW Hall Blvd, Tigard, OR 97223
City of Tigard
P7O)aPPI• no.: Expire date:
Phone: (503) 639 - 4171 AUG 13 2003 Date issued: By: Receipt no.:
Fax: (503) 598 - 1960 T Case file no.: Payment type:
Land use approval: CITY OF n1 VISION 1 & 2 family: Simple Complex:
gw� -�I�� Y
11 Pt. 01 1'112,111
D 1 & 2 family dwelling or accessory ❑Commercial/industrial 0 Multi- family O New construction 0 Demolition
0 Addition/alteration/replacement D Tenant improvement ❑ Fire sprinkler /alarm D Other:
.10RR SI I I I\l ()RN! \ I ION
Job address: Bldg. no.: Suite no.:
Lot: I Block: I Subdivision: I Tax map /tax lot/account no.: /c a.SAA tp9„, 0
Project name:
Description and location of work on premises/special conditions: c 1 ; 1
II h . _ ill kh ,
01■ \1 tt I OR S I ' 1 t 1 \ l 1 \1 tlit \I V 1 I!) \. I tit ( III t 1.1 is t
Name: ' -. )s'*.«\ ! t } l ary - ( I lu , %rini'Capacil%.,olar.
Mailing address: / ' • - TN/ r"1 'd . , . 1 & 2 family dwelling:
City: " , t A I State:NC I ZIP: ' Valuation of work $ U (0 , eD
Phone!? 77 I Fax: I E -mail: No. of bedrooms/baths
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
\ I' I' I HI V\ I Garage/carport area (sq. ft.)
Name: Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.) _ �/ a t ��
City: I State: I ZIP: Other structure area (sq. ft.) ,t� 1� o 1.e_N
Phone: Fax: E -mail: Commercial/industrial /multi- family:
(O \ I R \ t wit it Valuation of work $
� Existing bldg. area (sq. ft.)
Business name: Ott ) New bldg. area (sq. ft.)
Address:
Number of stories
City: I State: I ZIP: Type of construction
Phone: I Fax: I E -mail:
CCB no.: Occupancy group(s): Existing:
City/metro lic. no.: New:
Notice: All contractors and subcontractors are required to be
\ 14 ( 111 1 1 ( I / I l 1 , ..1(.N.1 it licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
City: I State: I ZIP:
exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
I. \(,I \II It 1)1 i It I I , sI ()\I 1
Name: Contact person: Fees due upon application $
Address: Date received:
City: IState: [ZIP: Amount received $
Phone: Fax: I 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 ❑ Mastercard
work will be complied with, whether specified herein or not. Credit card number: I /
s Expires
Authorized signature: - Date: O ' 7 - • e° 3 Name of cardholder as shown on credit card
Print name: • n Cardholder signature $
l � I Amount
Notice: This permit lication expires if a permit is not obtained within 180 days after it has been accepted as comple te. 44o -4613 (6I00/COM)
4 Plumbing PerH 1 4*bn
d o Date received: i( ) d3 Permit no.: 3 �li
City of Tigard ,,�� (�; 1 ,(�(j
4,144- T ,J - Address: 13125 SW Hall Blvd, 1t .id, dR3943 �yj Sewer permit no.: Building permit no.:
City of Tigard Phone: (503) 639 -4171 CITY OF TIGARD Project/appl. no.: J Expire date:
Fax: (503) 598 -1960 BUILDING DIVISION Date issued By: Receipt no.:
Land use approval: Case file no.: Payment type:
1 NNE OF 1'112\111
❑ 1 & 2 family dwelling or accessory ❑ Cpmmercial/industrial ❑ Multi - family ❑ Tenant improvement
❑ New constniction AAddition/alteration/replacement ❑ Food service ❑ Other:
JOB SITE IN1 OR \ I k I Ill\ Ft :L S(HLDI LL (for special information use checklist)
Job address: Mr a ,, O N -1,,,,• , ' + Description Qty. Fee (ea.) Total
Bldg. no.: 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: 'Block: I Subdivision: SFR (2) bath
Project name: SFR (3) bath
City/county: — 17 , 11 t' PI '' -,':t -R a I ZIP: e ja Each additional bath/kitchen
Description and loca�n f work on premises: rivvirt Site utilities:
' Ca tch basin/area drai
Est. date of completion/inspi•etion: Drywells / leach line /trench drain
pi l 1 it I \ (. ( () \ 1 It \ ( I O K Footing drain (no. lin. ft.
Manufactured home utilities
Business name: Manholes
Address: 0 t.() N U2 _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 lie. no.: Fixture or item:
Absorption valve
Contractor's representative signature: Back flow preventer
Print name: Date: Backwater valve
Basins/lavatory
Name :. tj A5 OW C Clothes washer I
Address: 4 n • f lee Dishwasher
t° Fie Drinking fountain(s)
City: State: Z IP: 7 Ejectors/sump
Phone: Fax: E -mail: Expansion tank
Fixture/sewer cap
Name (print): -? 43 I` '(- Floor drains /floor sinks/hub
' Garbage disposal
Mailing address: a,3a ' Hose bibb
City: - Till I State: I ZIP: �' a Ice maker
Phone :' T - 1 - P' i 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 props I own as per ORS Chapter 447 Sink(s), basin(s), lays(s)
Owner's signature: Date: '" J Z' G t./ Sump
Tubs /shower /shower pan
Name:
Urinal
Address: Water closet
City: I State: I ZIP: Der heater
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 o $
()Visa ❑ MasterCard Plan review (at _ /o) $
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 accep as complete.
$
Cardholder signature Amount 440.4616 (6/00/COM)
A ' Electrical Permit Application OFFICE USE I
M ' 1 �"" ` Date received: Mill 1 emtit no.:
' / Ft• -OG 4
. City of Tigard 11� Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, 7d, 4I 916$'3 Date issued: By: Receipt no.:
Phone: (503) 639-4171 CITY OF TIGARD
Fax: (503) 598 -1960 BUILDING DIVISION Case file no.: Payment type:
Land use approval:
IN PE OF PI.R\III
O 1 & 2 family dwelling or accessory D Commercial/industrial D Multi- family D Tenant improvement
❑ New construction CI Addition/alteration /replacement ❑ Other: D Partial
Job address: /C : � t ' Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: 'Subdivision:
Project name: I Description and location of work on premises:
Estimated date of completion/inspection:
( ()\ I H ■( I OR V'I'I I(' VI ION FLt. Si 111,01 Lt.
Job no: Fee Max
Business name: ( 5 i )JJ E k_ n Qty. (ea.) Total no.insp
Newrafdeatiat- sinker nnki•troay per
Address:
dwethnitudt.Indmiesaitached garage.
City: I State: I ZIP: Service red:
Phone: I Fax: I E - mail: 1000 sq. ft. or less 4
-
CCB no.: 1 Elec. bus. lic. no: Each additional 500 sq• ft. or portion thereof
City /metro lic. no.: Limited energy, residential 2
Limited energy, non-residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Vice and/or feeder 2
Su Sup. name (print): Services or feeders— last:Madan,
p (print : License no:
alteration or relocation
200 amps or less 1 2
Name (print): 201 amps to 400 amps 2
Mailing address: 401 amps to 600 amps 2
601 amps to 1000 amps 2
City: ), I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: ' ' ' ' �,{> �11 Reconnect only 1
Owner installation: The installation is being made on ptYiperrbpert ° ty I 1 T °Rorar7 servicesorfeeders
which is not intended for sale, lease, rent, or exchange according to installation, ''O°'OirelmadOm
ORS 447, 455, 479, 670, 70 200 amps or banns 2
p . / t . ()3 201 amps to 400 amps 2
Owner's si tore: Date: D 401 to 600 amps 2
Branch circuits . new, alteration,
Name: or extension per panel:
A. Fee for branch circuits with purchase of
Address: service or fear See, each branch circuit L / 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
Phone: Fax: E-mail: of service or feeder fee, first branch circuit: 2
Each additional branch circuit:
l'L X\ RI's IIH (I'Icaa• died, all that apply) Misc. (Service or feeder aotincladed):
Cl Service over 225 amps - commercial D Health-care facility Each pump or irrigation circle 2
D Service over 320 amps - rating of 1&2 D Hazardous location Each sign or outline lighting 2
family dwellings D Building over 10,000 square feet four or Signal circuits) or a limited energy panel,
0 System over 600 volts nominal more residential units in one structure alteration, or extensim* 2
0 Building over three stories D Feeders, 400 amps or man *Description:
0 Occupant load over 99 persons Cl Each Manufactured structures or RV park adI
0 Egress/lighting plan .Cl Other :; • • , h d inspection over the allowable in any oftbe above:
Per inspection I I I I
Submit sets of plans with any of th&above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, lease call jurisdiction for more information. Permit fee $
p r Notice: This permit application
D Visa D MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: _1 / 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/OOICOM)
t Mechanical Permit Application 1I l(1 ‘,1 I � O \I 1
Date received Permit no.: Sr,it 5-eoc 37
; '..1, City of Tigard > Y ED Projectiappl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blv _:,t I •
Phone: (503) 639 -4171 Date issued: By: Receipt no.:
Fax: (503) 598 -1960 AUG 13 2003 Case file no.: Payment type:
Land use approval: CITY OF TIGARD Building permit no.:
- - , . •
I11'I Ol I'i_ It\III
❑ 1 & 2 family dwelling or accessory 0 Commercial /industrial ❑ Multi- family 0 Tenant improvement
0 New construction f . Addition/alteration/replacement 0 Other:
JOBSIII. I\LOR01kIION (O1111I It( l. \1. 1 U.! \110\ S( 111:1)1 LI
Job address: 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 $ (D. SO .
Lot: (Block: I Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: T . ♦ y r * I frr} e , ZIP: LL I S . 21 .\ N I I I 1 1)tt I I I I\ (i PF R 111 I 113. S( Ill DI I F
Description and'. ationofworkonpremises: , \ \I) (U11M IIt1( \III\DI tiIRI11 I 01 IPIIL\I 4 4( 111 DI I I
Fee (en.) Total
Est. date of completion/inspection: , /ci Dunn Qty. Res. only Res. only
Tenant improvement or change of use:1inEt CFM
Is existing space heated or conditioned? 0 Yes -19 ,No conditioning (site plan required)
Air Is existing space insulated? 0 Yes - No Alteration of existing HVAC system
11 I ( H \,\ 1 ( U. ( 0\ I R \( 10 k Boiler /compressors
Business name: QZ ) 1 d Erg 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: 1E-mail: Install/replace furnace/burner BTU/H
CCB no.: Including ductwork/vent liner 0 Yes Cl No
Install/replace/relocate heaters - suspended,
City/metro Tic. no.: wall, r floor mounted
Name (please print): Vent for appliance other than furnace
R efrigeration:
e.. 11111111111111111111PERMENIMINIMIN Absorption units BTU/H
Name: d1/ \re ` - Chillers HP
Address: . [�, Compressors HP
h 1e- ei "z`- - Ile Environmental exhaust and ventilation:
City:: Appliance vent
Phone: P; Dryer exhaust
Hoods, Type I/ II/res. kitchen/hazmat
�}- hood fire suppression system
Name: &h �J • rr15 Exhaust fan with single duct (bath fans) I
Mailing • . • 1 A ' • h a I , Exhausts stem ..: from hen / . _ or AC
City: I .,1.. ►� t • 1' '' and : � ` �s . , up to ou ets)
�.+��' Type: LPG NG Oil
Phase: ' ' i a t Far E"�: Fuel pi Ong each additional over 4 outlets
i . , ; -..1 i . , Process (schematic required)
Name: Number of outlets
Address: - Other listed appliance or equipment:
- Decorative fireplace
City: I State: I ZIP: Insert - type
Phone: , Fax: I E - m a il: Woodstove/pellet stove
��J Other:
Applicant's signature: "I$ s r Da g f Z
Name (print): ,, ygvn. rr I S
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee S
la Visa 0 MasterCard Notice: This permit application Minimum fee $
Credit card number: / / expires if a permit is not obtained Plan review (at _ %) $
Expires within 180 days after it has been State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete. TOTAL $
Cardholder signature Amount
440-4617 (600KOM)
����', t � i r Permit #: �`(� -� - � �3 7
V V Address: I4 $) ?D , 4) i
AUG 13 1003
CITY OF TIGARD Issued by: Date: 7 /03
BUILDING DIVISION
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:
I;vi 1. I own, reside in, or will reside in the completed structure.
to
v 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
j 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
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 C struction Responsibilities on the reverse side of this form.
iL% (6113b
0 Signature of permit app (Date)
(White copy to issuing agency permit . file,
pink copy to applicant)
information Notice to Property Owners
=
About ����K�����l���'����w��K�o�X���'y'U't
�����
��� - . --
. !
Note: This In/in-motion Notice /o Property Owners about Construction Resp«uihilltis
was developed hr the (ons!r C Bo in accorthince with ORS 01, ()55(5,.
It von arc act rig as your own contractor to construct a new home or make a substantial improvement to an existing structure,
you can prevent many problems b:N. being aware of the following responsibilities and areas of concern.
EMPLOYER RESPONSIBILITIES:
If you hire persons not registered with the Construction Contractors Board to do labor in constructing or asststin in the
construction or improvement ofa residential structure, you will. in most instances, be ruled to be an employer and the people
you hire sill be employees. As the employer, you must comply with the following:
Oregon's withholding tax law: t\san emplo'yer. you must withhold income orxeshomonp|oyccwagexau\hedmocmp!o!oee
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. o( Revenue mq45'800\.
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. most
obtain workers compensation insurance for your employees. lfyou fail to obtain workers' compe insurance, you ma
be subject to penalties and will bc liable for all claim costs i[mncofyour employees io injured mn/hcjokFurmoreiufonnution,
call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888.
U.S. Internal Rc%'enne Service: As an employer. you must withhold federal income tax from employees' wages. You will be
liable forthe tax payment even ifvou didn't actually withhold the tax. For more information, call the Internal Revenue Service
at 1'880'829'1040.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
Code compliance: 4yihe perm it holder for this project. yoomemxp000ih|c[6r000|viogun}hxUoretomectcodcrcqoinoene
that may he brought to 'our attention through inspections.
Liability and property damage insurance: Contact your insurance agent to see ifvou have adequate insurance coverage for
accidents and omissions such as thlling toots. paint overspray, water damage from pipe punctures, tire. or work that must be
re-done.
Time to supervise employees: Make sure von have sufficient tune 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 additional questions, write or call the Construction Contractors Board (P0 Box 14140, Salem, OR 97309-5052,
50]/378-4621). The Board is located at 700 Summer St. NE Suite 300, in Salem.
prop-own.pm4
1/94
CITY OF TIGA.RD . 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST ,
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested - AM PM BUP
Location / O a 3 U 9v Suite MEC
Contact Person »e'vl Ph ( ) - 77 - .P-34 PLM
Contractor C 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 i !/ 5n1G".�E 'T rte— ��C� S /s4 vim. „ i h - 1-1. =�
Insulation
Drywall Nailing `"`S•
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof /l/4
Other:
•ART FAIL
1 BING
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 ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: ' 1 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date — Z Co — �_ Inspector 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) 639 -4175 MST 07003 Od' 37
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested / g AM PM BUP
Location / Q 2- 30 Suite MEC
Contact Person Ph (_ )T7 PLM
Contractor Ph ( ) SWR
BUILDING 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
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:
4!F
PA PART FAIL
M 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 ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Dateg'' )o Inspector TO "‘-r ' ' ' Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour .
BUILDING Inspectiot -Line: 4503) 639 -4175 dp 3_, Da 437
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested 12 -1 (tc , AM PM BUP
Location /23D ostA ,'v`e • Suite MEC
Contact Person `I P.✓►' Ph ( ) q77- .371 PLM
Contractor v Ph SWR
(BUILDING) Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: Goa) C . ( 2e Q SIT
Post & Beam '
Shear Anchors n _ � � w co l ^ , �G� , O"vl •
Ext Sheath/Shear `^"`�' si
Int Sheath/Shear
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm `
Susp'd Ceiling
Roof ) \--\ 1O
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
T FAIL
ECHANIC
eam
Rough -In
Gas Line
S • ke Dampers
- - FAIL
ELECTRICAL , A<
Rough - In 1 cv� — ( `al 0
UG/Slab
Low Voltage /✓c� 1 - �
Fire Alarm
Final J Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE E Please call for reinspectio► RE: • nable to inspect - no access
Fire Supply Line
ADA Approach/Sidewalk Dates / Q I ns or� ! /� .
Other:
Final DO NOT REMOVE this inspection record fro . the job sl .
PASS PART FAIL
CITY OF TIGARD 24 -Hour •
BUILDING Inspection Line:' (503) 639 -4175 MST - of) to
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested 3 -3 AM PM BUP
Location 7- 30 9z) Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner Y - a 3 - &/ ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Framing hath/Shear e'payeD ( h i / 1/►�� y� ��l a
Insulation i'�/
�
D
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:.
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
L olt
g 'V f-�/)
Low Voltage �
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SS PART FAIL
SIT El Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line /
ADA Approach/Sidewalk Date $ _ 1/ Inspecto �� i Ext
Other:
Final DO NOT REMOVE this inspection record rom the ob site.
PASS PART FAIL