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Permit -le (_. CITY OF TIGARD MASTER PERMIT PERMIT #: MST2004 -00157 � II DEVELOPMENT SERVICES DATE ISSUED: 6/30/2004 �^^ r=-- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 15150 SW 93RD AVE PARCEL: 25111 DB -KE001 SUBDIVISION: KESSLER ESTATES ZONING: R -4.5 BLOCK: LOT: 001 JURISDICTION: TIG REMARKS: New SF detached BUILDING REISSUE: BVH3684 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 22 FIRST: 1,652 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 2,032 sf GARAGE: 782 sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 10 VALUE: 361,595. OCCUPANCY GRP: R3 BDRM: 5 BATH: 3 TOTAL: 3.684 sf REAR: 15 a PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES, FURN < 100K: BOIL/CMP < 3HP: ' VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 2 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 6 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: 7 201 - 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: $ 8,610.62 This permit is subject to the regulations contained in the BUENA VISTA CUSTOM HOMES BUENA VISTA HOMES Tigard Municipal Code, State of OR. Specialty Codes 6932 SW MACADAM AVE STE C 6932 SW MACADAM SUITE C and all other applicable laws. All work will be done in PORTLAND, OR 97219 PORTLAND, OR 97219 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: 503 443 - 6033 Phone: 503 443 - 6033 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: LIC 152235 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 Mechanical Plumb Top Out Exterior Sheathing Ins[ Rain drain lnsp Electrical Final Sewer Inspection Underfloor insulation Electrical Service Low Voltage Storm drain Insp Mechanical Final Footing lnsp Crawl Drain /Backwater Electrical Rough In Gas Line lnsp Water Line Insp Plumb Final Foundation Insp PLM /Underfloor Framing lnsp Gas Fireplace Water Service lnsp Building Final Post/Beam Structural Mechanical Insp Shear Wall lnsp Insulation lnsp Appr /Sdwlk Insp Issued By : �� 1 -. _ - ►� � _// i Permittee Signature : P Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the nex usines day r� ;. Buildin Permit A Beat' - FOR OFFICE USE O N L Y Received / Building 1 REC Date/B : I i �' ,� Permit No.:ri ! . •,I 20 City of Tigard Planning Approval Other Date/B Permit N e, ' ° ,..•A - "O (66 13125 SW Hall Blvd. JUN 1 Zoo Plan Review Other Tigard, Oregon 97223 Date/B : /�IAV - ,7S 'C.) Permit No.: Phone: 503- 639 -4171 Fax: 503 -59 ' lsas ti Post - Review Land Use G % ��.�TIG ��'. I Internet: www.ci.tigard.or.us M.' -'f Contact : Case o. • R u _DING D ' - - Contact V 0 See Page 2 for 24 - hour Inspection Request: 503 - - 4175 Name/Method: ,� Su..lemental Information TYPE OF WORK © New construction • - _ REQUIRED DATA:;. ::. •_, .; ❑ De molition � l & 2 FAMILY . D WELLIlYG .: • .:•:. '`'i:'; , ' ' . ❑ Addition/alteration/replacement ❑ Other: CATEGORY OF CONSTRUCTION • Note: Permit fees* are based on the total value of the work performed. Indicate © 1 & 2- Family 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 ❑ Master Builder ❑ Other: Valuation S . JOB SITE INFORMATION and LOCATION No. of bedrooms:1 No. gf, baths: 3 Job site address: I512 500 q %x fvo Total number of floors , / • New dwelling area (sq. ft.) - ' .$ - - Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft.) 7 na . L . Project Name: Covered porch area (sq. ft.) Cross street/Directions to job site: Deck area (sq. ft.) Other structure area (sq. ft.) REQUIItED DATA:.: :: • COMMERCIAL' =USE CHECKLI . Subdivision: .. , : - Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate 'DESCRIPTION OF WORK - • the value (rounded to the nearest dollar) of all equipment, materials, labor, NEW CONSTRUCTION — SINGLE FAMILY RES , overhead and profit for the work indicated on this application. DEATACHED RESIDENCE Valuation S Existing building area (sq. ft.) - New building area (sq. ft.) Number of'stories ® PROPERTY OWNER . { .0 TENANT-% , 2 - Type of construction Name: Buena Vista Custom Homes Occupancygroup(s): Existing: Address: 6932 SW Macadam Ave. Ste C New City /State /Zip: Portland, OR 97219 Phone: 503-443-6033 Fax: 5 0 3- 4 4 3 - 2 4 4 3 NOTICE: All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under [) APPLICANT Q CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the Business Name: SAME AS ABOVE jurisdiction where work is being performed. If the applicant is exempt Contact Name: El i abeth Moore from licensing, the following reason applies: Address: City /State /Zip: • Phone: Fax: .. ... •- • -�• • ... E -mail: • _'BUILDING.PERMITFEES* -. - • CONTRACTOR ' -: - • Please refer to fee schedule: •••:: • Business Name: Buena VIsta Custom Homes Fees due upon application S Address: 6932 SW Macadam Ave. Ste C City /State /Zip: Portland, OR 97219 Amount received S Phone: 503- 443 -6033 Fax:503- 443 -2443 Date received: CCB Lic. #: 152235 Authorized _ /ni Signature: U•� Date: 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. (Please print name) i:\Dsts\Permit Forrns\BldgPermitApp.doc 01/03 A 03/04/2004 16:21 FAX 5036284633 THE MULLEN COMPANY -, BUENNA VISTA Z002 /003 f Plumbing Permit A.nli - ' , sl u Received Milting 1 " �i .) ° Jf O Datcatt: Permit Na.: ''C/ 57 , City of Tigard Planning Approval Sewer `J b " 13125 SW Hall Blvd. ju l X004 DaSi/Bv: Plan Review Permit No.; Qther Tigard, Oregon 97223 Data/By: - _ Permit No.: Phone: 503- 639 -4171 Fax: S jspg{191ochARD Post- Review Land Use Date/Hy: Case No.: Internet www.ci.tigard.or.tts milli N(„ DIVlSl ! a' ' ' ( Contact ' Juris; -( See Page 2 for -�" 24 -hour Inspection Request: 50'43 '-� Name /Method: SuvalomeantIntarmatioa. . - rime OF.WO `' -r "' .. - ISE,r•Se ULE.(for 9peetatinfauiatroVn'4e 1' =1Y ■ Demolition Descri . Lion Qty. Peo(c,.) Total �� olition I New construction • .la cement I■ Other '_MAR.., .�L ti �1. T IK:.• �, Addition/alteration/r •I.dce t ��t�:�N �7 { i'PF f �w+rWZDFR ! c WK g$''�•.:� J��r.l "::h�i:,� 1, E/iTECUR $ . :-4 n u a r . •.� . , ::`nd 'o' Jett '.•y6e lh 'I�>b:be�iteo`sIIecbToo j T 3 , " •; SFR (1 bath 249.20' C, 1 & 2 -Famil dwellit% • Commercial/Industrial SFR (2) bath 350.00 ■ Accesso Buildin: ■ Multi- P alnil SFR (3) bath — 399.00 _ IN Master Builder • Other: Each additional bath/kitchen 4.00 ' OB STrE VWORMATIOI kitILOC/ lTION ' ' Fire . • ler - - • , ft,: Pa_e 2 Job site address: 6 0 5 c,A ci 3 i-Ar ... ,... _ Stte lJtiiities '. :, .; L4., ; ' ':.;I.' �r' t :7. - •_ . _ . Suite #: Bld _ ./A • t, #: Catch basin/area drain 16.60 Project Name: Drywall/1=h line/trench drain 16.60 Footit[drain (no. linear ft.) Page 2 Cross street/DireCtioi15 to job site: Manufactured home utilities 1 10.00 - Manholes 16.60' _ Rain drain connector 16.60 Senitery sewer (no. linear ft.) Page 2 Subdivision: I Lot #: I Storm sewer (no. linear ft.) Pape 2 Tax map /parcel #: Water service (no, linear ft.) Page 2 1DFBCRIT•TION OF WORK F'ixtttrt or Item , NF,tN „CONSTRUCTION — SINGLE FAMILY Rackfl w valve 162• Batieflow pm/enter Page 2 FAMILY DETACHED RESIDENCE , Backwater valve 16.60 Clothes washer 16.60 - Dishwasher _ 16.60 Drinking fountain 16.60 ' .101PROPERTICOWNER '• . .,:r :4T NATIT ,,,:.....".:•.:..:.: Si:atom/aump 16.60 'Name: Buena Vista Custom Homes Expansion 16.60 Address: 6932 SW Macam Ave _ S t P C Fixture/sewer ca- 16.60 City /State/Zip: Portland, OR 9 7 21 9 • Floor drain/floor sittklhub 16,60 Garbage disposal 16.60 Phone: 503 --443 - 6033 t Tax: 503++443 - 2443 Hose bib 16.60 APPLICANT • • . , • CONTACT:PERSON ' • ' . Ice maker 16,60 ' J Name: Ray Mullen interceptor /Rreascttap . 16.60 Address: Medical Ras • value: S Page 2 Primer 16.60 Ci /StaSe/zi . : Roof (commercial) 16.60 Phone: Fax: Sink/basin/lavatory 16.60 E -mail: Tub /shower /shower pan 16.60 + . CONTRACTOR • • • • Urinal 16.60 _. Business Name: ED Mullen Plumb�.na � Watcrcloset 16.60 _ Water heater 16.60 Addhess: SW Rainbow Lane Other: _ _ City /State /Zip: Hi l.bn -. ` DR Q 71 7' Other. Phone: 503 628 - 1632 Fax:5rl -6 2- • G :Piutab><e�PecmJe: • — CCB Lic. #: Plumb. Lic. #: - p a • -- subtotal S , e ! .: • � Minimum Permit Fcc ST1..50 S Authorized % (- Residential Bacl�low Minimum Fee336.25 Signature: . 1 4 y • c: �� / Plan Review (2556 of Permit Fee) S Ray ul en State Surcharge (8% of Permit Fee) S -----^ (Pl»se print name) TOTAL PERMIT FEE S Notice[ Tbli pouch application expires Ira permit is not obtained within All now commercial bulldInge rtqulre 2 sets ofpians with isometric or 180 days after It has been accepted as complete. riser diagram for plea review. •Fcc methodolozy set by Tri -County Building Industry Service Beard. i:\DSts \Pettnil Pornv■PlmPermltApp.doc 01/03 03/04/2004 16:-2.6 5032537693 SUN GLOW INC • ...., —. , . PAGE 02 • Mec Pernl A liCatiOn FOIL M41( Il., .Si 1 QM. \ Received . Cfate./13 : - WEN .. .M City of Tigard RECEIVF, Planning Approvai De : : Building Permit No.: 13125 SW Hall Blvd. i Pion Review IiiIIIII111111111111 Tigard, Oregon 97223 in . p. DAUM . phone: S03-639-4171 Fax: 503 2 Post-Review Land Use Date/I3 : Cue No. 1.1dierllgt: www.ci.tigard.or.u8 . 1 1; - 'i 11 Contact lulls.: IgRERIMMIll . 24-hour Inspection Request; 503 BUILDING DIVISION • .7- • ... .'•. , :c .. ' , ..., ;:•':. :E OF WORK. ,.s,:i;i - : ‘,.....! t...::' f New construction ■ Demolition Mechanical permit fees* are based on the total value of the work • Addition/alteration/re • Other: performed. Indicate the value (rounded to the nearest dollar) of all .oP.corfsTRIrcira ,....VP:i.--....,v,ff!,:li...... mechanical materials, equipment, labor, overhead and profit. L 1 & 2-Famil dwellin: IN COmmercialfindu.stria1 Value: S See Page 2 for Fee Schedule PA Accesso Buildin: 5 Multi-Farnil ....: nEs1or1AL.E.42 : .•. DI EgR ... Due?. don HeatintiCeotit Fee(es4 Total gis Master Builder • Oth er; • ..J4;:l: •ME INTORMATION and LOCATION .' . • • .. : . • Furnace • add-on air conditioning" 14.15:1 Job site address: 411W11, PINLE/WillrtilEMIIII Gas heat • .• 14.00 Suite*. sidS./AQt.#: Duct work IIIIIII 14 MEM Pro ect Name: , Hydronic hot water I tern 14.00 ill Residential boiler Cross street/Directions to job site: fbr radiator or h . rank system 1410 Unit heaters (fuel, not electric) (in wall, in.duct, suspended. etc.) l4.0 Flue/vent for any of ebov_s) 10.00 Subdivision: Lot #: R . air units 12.15 1 • Fuel A • dances lr. Water heater — 10.00 • • - ' • • .. Ds fa- r (ON * P WOitK ..• ...-1 • - . • • Gas fireplace 10.00 1111 NEW CONSTRU TION GL T• I* • Flue vent (water heater/pa tit7place) 10.00 DETACHED RESIDENCE Lo... li. ter ,- - 10.00 Wood/Pellet stove • 10.00 Wood. - •lace/insert lino 111111111.11 . Chimn • iliner/flue/vent M. 10 NMI - OPERIVO ' - A' r.'!••••: Ril ISNA/fe:fir4.,, .......! Other, III. 10 Milli • Environmental exhaust & Vendltdott Nallie: 13 _ = .,_ . V i s - . • n - .1. si - Range hood/other kitchen equipment 10.00 Address: 6952 SW Macao_ ,..31 • V --_ S - C Clothes dryer exhaust 10.00 Ci /State/Zip: Portland OR 9721 9 Single duct exhaust • Phone • _ . . _ . I I Fax: I _ . . _ , . (bathrooms, toilet compartments, • Armoort .. . ar.I COM • ' • PERSON .... iulli rooms . 6.80 Name: David Goloba • Attic/crawl spec fans 10.00 ME Other; 10.00 Address: n:6 ......is tru.7;rmvs. n Limb 1 .*tiona 111/1/11111.M Phone: Fax: Furnace, etc. Gas heat u .1 13 . E-mail: ________ wants. el:lc:led/unit heascr ' • :T..'• : - '....... CONTRACTOR ,,:.. ;'„ : • ::- • .. 6MallEIMIIMIN Business Name: , G .w ,.. Address:2428 SE 105th — Ave. FAZI 1 MIMI BB, EIM City/State/Zi . :rot t lan cl , OR 97216 Clothes . em .. as M PhOtle; SD3— 253-7789 Fax:503-25 - ": i ' .5 otter: NM • 4 Total: . CCB Lic. #: 48131 • Mechanical Permit Fees' _ Au thorized... Jo . • Subtotal: S Signature; 4 c Date:4 2Koui — Minimum Partnit Fee r/1.50 S David Goloq Plan Review Fee (25% of Permit Fee) S State Stire large (8% of Permit Fe) S (Please print name) l TOTAL PERMIT FEE S — Notice: Ttits permit application expires If a permit is not obtained +vithin *Fee methodology set by 714County Building Industry Service Board. 180 daze after it lira been accepted as complete. Site ptan required for exterior A,/C unitl. iN;)StsVermit Form\ MetPerrnitApp.doe 01)03 I 03:04/2004 1.5:11 5036425815 ROSS ELECTRIC INC PAGE 02 • • Electrical Peril Elio 'Nab ri FOR 011: l F:.�� 1., Received Electrical Oavc,B : PermitN..: 11 r: 'DO II "? City of Tigard JUN 1 2004 Planning Approval Sign 13125 SW Hall Blvd. Date/By: Permit No.: Plan Review Other Tigard, Oregon 97223 TIGARrr Date/By: Permit No.: Phone: 503-639-4171 Fax; 5 Q j 6 tIVl >` Post - Review land Use Internet: www.ci.tigard_oi.us ��U , I' j `4 � Case No.: 24 -hour Inspection Request: 503 -639 -4175 � -•k Contact - 1uris.: Su pee Page for NatneiMethod: I Supplemental infbrmatian. • .TYPE .-OF WORK ' . •.:: • .. • • , > • - ... Flea.ce'cliectt :•411' t>iat':ietilt)k}'k.`. New constr Demolition ❑ Service over 225 amps - In Health-care facility ❑ Addition /alteration/replace ment Other; commercial ❑ Hazardous location a ❑ Service over 320 amps - rating of ❑ Building over 10,000 square fect, txz 1TEG( Y.i)F'CONSTR CFTOL�1. 1 & 2 family dwellings four or more residential units in .N.' & 2 -Famil dwellin l • Commercial/Industrial ❑ System over 600 volts nominal one structure • Accesso Buildin Multi-Family Building over three stories ❑ Feeders, 400 amps or more Master Builder ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park ❑ A cces Other: ❑ Egreseilighting plan ❑ Other: ' ' '. JOB SITE INFOR1►IATIOR•unii•E 'CION • . Submit seta of plans with any of the above. -- - , The above are not applicable to temporary construction service. Job site address; 15 1,50 5K - q " Suite #: Bldg. /Apt. #: 'FJE;ILI*:SC1�ULJE,.; `::: `.:' ;= F ;`'•,.::.. • Number of inspections per permit allowed _' - Project-Name: Description Qty Fee (ea.) Total Cross street/Directions to job Site: New reeldeottat- single or mold-family per dwelling and. includes attached garage. Service Included; 1000 sq. R. or less 145.15 4 Each Additional 500 sq. tic or portion thereof 33.40 Subdivision: s(✓ 1111 ' Lot # , Lanitcd cnerply, residential 75.00 2 Limited craergy, non residential 75.00 2 Tax map /parcel #: Each manufactured home or modular dwelling `DE ' ,. • • I. oN'orwoItK > service and/or feeder r t V "�''�'�-' Services or feeders - Instigation, 90.90 2 �G1� s � � � J f�L _ aheenllon or relocation: 1 e g r e t (-IA e L n i d e a Ck— 200 amps or less ' 80.30 2 201 amps to 400 a mps 106.85 2 401 amps to 600 amps 160.60 2 8OI ERi'Y OWNER • :.1; X TEN. • • , • ..: '' . . . - 601 amps to 1000 amps 240.60 2 Name: .t en a- / s-f-a.., Gu S Cl ar Reconnect amps or volts 454.65 2 a, Reconttnest only 66.85 2 ' Address: (p ci ,� 5Gt1 " l a( ,Ire. L ` Temporary services or feeders - installation. City /State /Zi s ; port( p,• 0 9 7 2000 0 a am o a�9 4 m ps le or relocation: r sv 66.85 1 . ... W Phon . d5 ye/3- (an-i3 Fax . ' j 201 amps to 400 amps 100.30 2 401 to 600 am C' • }.J NT CT :P'ID O N F 134,75 2 Name: '> 1e . v � / � - _ • 55 extension n trcgitS • non, alteration, or /�� � extension per panel: Address: A. Fca for branch circuits with purchase of service or feeder fee, each branch circuit 6.65 2 City /State /Zip: B. Fee for branch circuits without purchase of Phone: — service or feeder fee, first branch circuit 46.85 2 Fax: Each additional branch circuit 6.65 2 E -mail: Misc,(Scrvice or feeder not included); .. .. •. co xliA4ToR Each pip or irrigation circle - 53.40 2 Job No: Each s or outline lighting 53.40 2 ' Signal circuits) or a limited energy , ;cruel, Business Name: li 053 67_,t alteration, or extension Page 2 2 Address: QS S k) et i I'h # ,' 3 Description: Cit Fi- t S jp0 y- 0 1.1 a3 Each additional inspection over the allowable In an of the above: Per inspection per hour (min. I hour) 62.50 Phone:5123 CO 1 1 1 Z Z300 Fax: W3 41z M S` investigation fee: CO3 Lic. #: IS / .Lie. #: 3 3 &G other: -- Supervising elec r ciart� // l� :: ]Efectiieal Fekm} ' li,, : . '. ;, � ; . ...... X signature require 4 ��x '3^- Subtotal 3 � Plan Review (25% of Permit Fee) $ v' Print Name: .S oe R20SSI Lic. #: r ,/2,3OS State Surcharge (8% of Permit Fee) $ Authorized TOTAL PERMIT FEE S Signature: Date: Notice: This permit appllcation 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. (Please print name) - i:\Dsto \Permit Fornts\ElcPcr nitApp.doc 01/03 CITY OF TIGARD 24 -Hour BUILDING 4111 Inspection Line: (50 639 -4175 ; G INSPECTION DIVISION Business Line: (5 ) 639 -4171 /075 BUP Received A Date Requested _ AO' PM BUP Location / .7l CD 3 1- -1 Suite MEC Contact Person Ph ) — 7f 6 PLM Contractor Ph ( ) SWR Tenant/Owner ELC ooig Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear O o Framing - + Insulation Drywall Nailing ■ -•1 ' �� 1 � Firewall Fire Sprinkler ASalk Fire Alarm Susp'd Ceiling Roof arilUgU. Other: anal S PART FAIL � PLUMBING .. Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final P ART FAIL auc_HANICAL Post -& Beam Rough -In Gas Line Sm Dampers mal 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 ! Inspector Ext Other: Final DO NOT REMOVE this inspection recofrom the Job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST 4. i l- 4 96 7 INSPECTION DIVISION Business Line: (503) 639 -4171 BUp q Received Date Requested l - AM PM : SUP Location C s CD 9 3 Suite MEC Contact Person C- Ph ( ) 7/ — gf (S PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear �/ Framing c Sy" GLtJ J i`® C ' .SCO/✓/✓Ec- Insulation �=/'r �'�7�C -LF¢✓ - of eikilt Alb . Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final • PASS PART FAIL : Post & Beam • Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Kfirr-0 ® 3C �® Shower Pan PART FAIL ',�J ANICAL. �� / 3 •G Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL • ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm PART FAIL Reinspection fee of $ required before next ins•ec iO4 Pay at City Hall, 13125 SW Hall Blvd. ?MP/ ' Please call for 'einspe on RE: Unable to inspect — no access Fire Supply Line ADA D a t e I ns p ,e ,,<< AP," Approach/Sidewalk Other: Final . DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL T C .c. . S .. Y, 111 I, akt --../#0/.7 , O I wner /Agent for ,'_ , . c o 0 Ant, (PLEASE PRINT) / (PERMIT HOLDER) 44 " , ,\ Do hereb ce rtif f at 4ie fdllo g location 0. - iti .: ., r :.. a , . , 1,7,.4 1 meets d C t) o Tigard /Wa t on Count y 0. l and use and development standards for street tree installation. ,ADDRESS: is U) ci; � -0"- 0. 0,. 0. - q 0. LOT: 4 1 SUBDIVISION: N.5d, v 0. BY: DATE: /%� ' ► ',' lO � 0. y / 0- RECEIVED BY: A � _ DATE: ; — O