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Permit MASTER�IT TY O I G A R D PERMIT #: MST2004 -00137 '1I� DEVELOPMENT Tigard, OR 9 RVIC 0 ES 39 -4171 DATE ISSUED: 5/13/2004 SITE ADDRESS: 12365 SW 121ST AVE PARCEL: 2S103BB -BP002 SUBDIVISION: BROWN PARTITION ZONING: R -4.5 BLOCK: LOT: 002 JURISDICTION: TIG REMARKS: Foundation and utility work to place pre- existing structure. Electrical sevice inspection is re- connect only. 7/7/04 added (1) 200amp & (8) add'I circuits. 7/9/04 added add'I (3) circuits to this permit. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: FND HEIGHT: FIRST: sf BASEMENT: sf LEFT: 10 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 10 VALUE: 20 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 2 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 2 GARBAGE DISP: WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: 1 BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 2 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 • 200 amp: 1 0 - 200amp: W /SVC OR FOR: 00 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W /OSVOFDR: 5V / SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: AO SIGNAL/PANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEWSECTION 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: $ 6,130.94 MARTIN T. LUTHER EMMERT INTERNATIONAL This permit is subject to the regulations contained in the 13251 SE 126TH AVE 11811 SE HWY 212 Tigard Municipal Code, State of OR. Specialty Codes CLACKAMAS, OR 97015 CLACKAMAS, OR 97015 and all other applicable p. Atl work will done in accordance with approved ed plans. This permi mitwill expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. Phone: 503 698 - 8931 Phone: 655 - 7191 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: LIC 805 rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Ersn Cntrl 681 -4444 Post/Beam Structural Electrical Service Gas Fireplace Electrical Final Sewer Inspection Post/Beam Mechanical Electrical Service Insulation lnsp Mechanical Final Footing Insp Underfloor insulation Electrical Service Rain drain Insp Plumb Final Foundation Insp Crawl Drain /Backwater Framing Insp Water Line lnsp Final inspection Foundatio• • - • Footing /Foundation Do Gas Line lnsp Water Service Insp Issue. By : _ .. .;,;�' ' / / ) Permittee Signature : / i < all (50 639 -4175 by 7:00 p.m. for an inspection needed the next business day `7/ 9e4 Te. p -T 4 e -)14,9 /u.r :,Lt li. / eif , MASTER PERMIT CITY TIGARD 4 PERMIT #: MST2004 -00137 DEVELOPMENT SERVICES DATE ISSUED: 5/13/2004 '�' �� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 12365 SW 121ST AVE PARCEL: 2S103BB -BP002 SUBDIVISION: BROWN PARTITION ZONING: R - 4.5 BLOCK: LOT: 002 JURISDICTION: TIG REMARKS: Foundation and utility work to place pre- existing structure. Electrical sevice inspection is re- connect only. 7/7/04 added (1) 200amp & (8) add'I circuits. 7/9/04 added add'1 (3) circuits to this permit. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: FND HEIGHT: FIRST: sf BASEMENT: sf LEFT: 10 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THEo: sf RIGHT: 10 VALUE: 20 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 2 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 2 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 2 GARBAGE DISP: WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: 1 BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 2 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 1 0 - 200 amp: W /SVC OR FDR: 00 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: 00 SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL 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: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 6,073.48 This permit is subject to the regulations contained in the MARTIN T. LUTHER EMMERT INTERNATIONAL Tigard Municipal Code, State of OR. Specialty Codes 13251 SE 126TH AVE 11811 SE HVVY 212 and all other applicable laws. All work will be done in CLACKAMAS, OR 97015 CLACKAMAS, OR 97015 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: 503 698 - 8931 Phone: 655 - 7191 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: LIC 805 rules are set forth in OAR 952 -001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Ersn Cntrl 681 -4444 Post/Beam Structural Electrical Service Insulation Insp Mechanical Final Sewer Inspection Post/Beam Mechanical Electrical Service Rain drain Insp Plumb Final Footing Insp Underfloor insulation Electrical Service Water Line Insp Final inspection Foundation Insp Crawl Drain /Backwater Gas Line Insp Water Service Insp Foundation Ins__ Footing /Foundation Dr; Gas Fireplace Electrical Final 260 Issued y : K_ &--4' -1 Permittee Signature Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day CITY OF TIGARD MASTER PERMIT PERMIT #: MST2004 -00137 DEVELOPMENT SERVICES DATE ISSUED: 5/13/2004 4,,,, 1 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 12365 SW 121ST AVE PARCEL: 2S103BB - BP002 SUBDIVISION: BROWN PARTITION ZONING: R -4.5 BLOCK: LOT: 002 JURISDICTION: TIG REMARKS: Foundation and utility work to place pre- existing structure. Electrical sevice inspection is re- connect only. 7/7/04 added (1) 200amp & (8) add'I circuits. 7/9/04 added add'I (3) circuits to this permit BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: FND HEIGHT: FIRST: sf BASEMENT: sf LEFT: 10 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRO: sf RIGHT: 10 VALUE: 20,000.00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR: 15 PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 156 TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: 156 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: 156 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: 1 BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 2 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 1 0 - 200amp: W /SVC OR FDR: 00 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVCJFDR: 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 & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 6,091.25 MARTIN T. L EMMERT INTERNATIONAL This permit is subject to the regulations contained in the MAR MAR N LUTHER 126TH AVE EMMERT SE INTERNATIONAL 212 Tigard Municipal Code, State of OR. Specialty Codes CLACKAMAS, OR 97015 CLACKAMAS, OR 97015 and all ra cer applicable ed laws. Al. This permit mi done in 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: 503 698 - 8931 Phone: 655 - 7191 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: LIC 805 rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Ersn Cntrl 681 -4444 Post/Beam Structural Electrical Service Rain drain Insp Plumb Final Sewer Inspection Post/Beam Mechanical Electrical Service Water Line Insp Final inspection Footing Insp Underfloor insulation Gas Line Insp Water Service lnsp Foundation lnsp Crawl Drain /Backwater Gas Fireplace Electrical Final Foundation lnsp Footing /Foundation Dr: Insulation lnsp Mechanical Final Issued By 4.4- X-e_xj 7 /q/ 1" Permittee Signature : Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day '/ A l CITY OF T I GA R D MASTER PERMIT i DEVELOPMENT SERVICES PERMIT #: MST2004-00137 DATE ISSUED: 5/13/20013/200 4 II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 12365 SW 121ST AVE PARCEL: 2S103BB -BP002 SUBDIVISION: BROWN PARTITION ZONING: R -4.5 BLOCK: LOT: 002 JURISDICTION: TIG REMARKS: Foundation and utility work to place pre- existing structure. Electrical sevice inspection is re- connect only. 7/7/04 added (1) 200amp & (8) add'I circuits BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: FND HEIGHT: FIRST: sf BASEMENT: sf LEFT: 10 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THR sf RIGHT: 10 VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf 2 0,000.00 REAR: 15 PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 156 TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: 156 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: 156 BCKFLW PREVNTR: GREASE TRAPS: MECHANICAL OTHER FIXTURES: FUEL TYPES FURN < 100K: 1 BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 2 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 1 0 - 200 amp: W /SVC OR FOR: co PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 • 400 amp: 201 - 400 amp: 1st W/O 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 & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEJIRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 5,918.34 MARTIN T. LUTHER EMMERT INTERNATIONAL This permit is subject to the regulations contained in the 13251 SE 126TH AVE 11811 SE HVVY 212 Tigard Municipal Code, State of OR. Specialty Codes CLACKAMAS, OR 97015 CLACKAMAS, OR 97015 and all other applicable laws. All work will be done in 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: 503 698 - 8931 Phone: 655 - 7191 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: LIC 805 rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Ersn Cntrl 681 -4444 Post/Beam Structural Electrical Service Rain drain lnsp Plumb Final Sewer Inspection Post/Beam Mechanical Electrical Service Water Line lnsp Final inspection Footing Insp Underfloor insulation Gas Line Insp Water Service Insp Foundation Insp Crawl Drain /Backwater Gas Fireplace Electrical Final Foundation Insp Footing /Foundation Dn Insulation Insp Mechanical Final A ' Issued By : A � -�J 2A.�.� -P-e Permittee Signature o. _ t a Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day CITY OF TIGARD MASTER PERMIT PERMIT #: MST2004 -00137 l DEVELOPMENT SERVICES DATE ISSUED: 5/13/2004 '- .. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 12365 SW 121ST AVE PARCEL: 2S103BB -BP002 SUBDIVISION: BROWN PARTITION ZONING: R - 4.5 BLOCK: LOT: 002 JURISDICTION: TIG REMARKS: Foundation and utility work to place pre- existing structure. Electrical sevice inspection is re- connect only. 7/7/04 added (1) 200amp & (8) add'I circuits BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: FND HEIGHT: FIRST: sf BASEMENT: sf LEFT: 10 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 DHR): sf RIGHT: 10 VALUE: 20 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR: 15 PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 156 TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: 156 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: 156 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: 1 BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 2 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 1 0 - 200 amp: W /SVC OR FDR: 00 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVCIFDR: oo SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEWS ECTION Reconnect only: > =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREAISPC 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: DATAITELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 5,918.34 MARTIN T. LUTHER E INTERNATIONAL This permit is subject to the regulations contained in the MAR MAR N 126TH AVE 1 EMMERT 11 SE INTERNATIONAL 212 Tigard Municipal Code, State of OR. Specialty Codes CLACKAMAS, OR 97015 CLACKAMAS, OR 97015 and other applicable p. Al. s done in accordance anrace with approved ed This permit plans. This permi t will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. Phone: 503 698 - 8931 Phone: 655 - 7191 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: LIC 805 rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Ersn Cntrl 681 -4444 Post/Beam Structural Electrical Service Rain drain Insp Plumb Final Sewer Inspection Post/Beam Mechanical Electrical Service Water Line lnsp Final inspection Footing Insp Underfloor insulation Gas Line Insp Water Service Insp Foundation lnsp Crawl Drain /Backwater Gas Fireplace Electrical Final Foundation lnsp Footing /Foundation Dr: Insulation Insp Mechanical Final Issued By : A i_.4•4_ ii Li Permittee Signature - t Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day + CITY OF TIGARD MASTER PERMIT idik - PERMIT #: MST2004 -00137 . -' DEVELOPMENT SERVICES DATE ISSUED: 5/13/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 12365 SW 121ST AVE PARCEL: 2S103BB -BP002 SUBDIVISION: BROWN PARTITION ZONING: R -4.5 BLOCK: LOT: 002 JURISDICTION: TIG REMARKS: Foundation and utility work to place pre- existing structure. Electrical sevice inspection is re- connect only. BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: FIRST: sf BASEMENT: sf LEFT: 10 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 10 VALUE: 20,000.00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR: 15 PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: 156 TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: 156 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: 156 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: 1 BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 2 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/FCR: no 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 REVIEWSECTION 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: $ 5,918.34 MARTIN T. LUTHER EMMERT INTERNATIONAL This permit is subject to the regulations contained in the MAR MAR N E 126TH AVE EMMERT SE INTERNATIONAL 212 Tigard Municipal Code, State of OR. Specialty Codes CLACKAMAS, OR 97015 CLACKAMAS, OR 97015 and all cer applicable p. Al. work will done in accordance anrace with approved ed p 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: 503 698 - 8931 Phone: 655 - 7191 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: LIC 805 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 Gas Line Insp Water Service Insp Sewer Inspection Underfloor insulation Gas Fireplace Electrical Final Footing Insp Crawl Drain /Backwater Insulation lnsp Mechanical Final Foundation Insp Footing /Foundation Dr Rain drain Insp Plumb Final Post/B- - -• - tural Electrical Service Water Line lnsp Final inspection I, Issu :d By : • ���1: 4_ Mk. 4 d' A !i /. Permittee Signature :. �Irtai =r `�l ■ Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE ELECTRICAL CONTRACTOR SERVICES N.W. RECEIVED 31378 DOWD RD. ST. HELENS, OR 97051 AUG 0 4 200 CITY OF g BUILDING D VASIO Electrical Signature Form Permit #: MST2004 -00137 Date Issued: 5/13/2004 Parcel: 2S103BB -BP002 Site Address: 12365 SW 121ST AVE Subdivision: BROWN PARTITION Block: Lot: 002 Jurisdiction: TIG Zoning: R -4.5 Remarks: Foundation and utility work to place pre- existing structure. Electrical sevice inspection is re- connect only. 7/7/04 added (1) 200amp & (8) add'I circuits. 7/9/04 added add'l (3) circuits to this permit. 7/20/04, replumbing existing 2 bdrm home. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: MARTIN T. LUTHER ELECTRICAL CONTRACTOR SERVICES 13251 SE 126TH AVE 31378 DOWD RD. CLACKAMAS, OR 97015 ST. HELENS, OR 97051 Phone #: 503 - 698 -8931 Phone #: 503- 366 -6060 Reg #: ELE 5 -56C LIC 155460 SUP 3289S AN INK SIGNATURE IS REQU ' ION THIS FORM I Signature of Supervising Electrician If you have any questions, please call 503.718.2433. Building Fixtures , -d/ 1 `� 2 " Plumbing Permit Appl' tion FOR OFFICE USE ONLY City of Ti and Received P ermit No.: �, / 2 13125 SW Hall Blvd., Tigard, OR 97223 DateBy: 7 �� D� f t �T�On -.CO J ard.or.us Plan Review Phone: 503.639.4171 Fax: 503.598.1960 /yni NlM ill Date/By: Other Permit No.: �. � 24- Hour Inspection Line: 503.639.4175 e ,•' I `\ , s Internet: www.ei.ti -Liar '� ---� Date ed/Met y: See Page for g Notified/Method: i! � , Suppleental l Information • ° FEE* SCH :, m For special information use checklist ❑ New construction ❑ Demolition Description I Qty. I Ea. Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) zM °' > Gtr . . .V a . a t .-. .' ' -,, � _ , . _ -: SFR (1) bath 249.20 ❑ 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi- family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: Fire sprinkler ( sq. ft) Page 2 6 4 1,' • a°3: X51 X1 :1 0 ' $t, @ 6" c i . .x , � � S utili Job site address: / , o ( 6 , 5 - .6u) 7, / v Catch basin or area drain 16.60 City/State /ZIP: Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: I Project name: /--N % / g, Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: Manholes 16.60 Rain drain connector 16.60 Sanitary sewer (no. linear ft.: _) Page 2 Storm sewer (no. linear ft.: ) Page 2 Subdivision: I Lot no.: Water service (no. linear ft.: Page 2 Fixture or item Tax map /parcel no.: Absorption valve 16.60 v � . - 1 a,_, �� 1 . � - C � / � , r Backflow preventer Page 2 ,' Q I L/d7 rL C C X / i / /J , L u )-/f C /L- Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 ;�: , ® =r . a )" Drinking fountain 16.60 - . .:. . .M_. ,.n. . . E /sump 16.60 Name: Expansion tank 16.60 Address: Fixture /sewer cap 16.60 City/State /ZIP: Floor drain/floor sink/hub 16.60 Phone: ( ) Fax: ( ) Garbage disposal 16.60 �. Hose bib 16.60 °� � Ice mak 16.60 Business name: Interceptor /grease trap 16.60 Contact name: Medical gas (value: $ ) Page 2 Address: Primer 16.60 City/State/ZIP: Roof drain (commercial) 16.60 Phone: ( ) I Fax:: ( ) Sink/basin/lavatory 16.60 Tub /shower /shower pan 16.60 E -mail: Urinal 16.60 "'V' & .- a_ t y , a ^> g . - , „ = ' a - ,,, •.... "` A .> � Water closet 16.60 Business name: , Water heater 16.60 Address: Other: City/State/ZIP: Subtotal Minimum permit fee: $72.50 6 Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25 CCB Lic.: Plum ing Li / r ,, • •.: _ Plan review (25% of permit fee) State surcharge (8% of permit fee) AS , n d Authorized signature: t - TOTAL PERMIT FEE 3 7 ig , pp Print name: tN[47, tJ ' �� ) .. / • Date ( pt.-0y 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. is\ Building \Peimits\PLMF- PetmitApp.doc 12/03 440- 4616T(10/02/COM/WEB) Plumbing Permit Application - City of Tigard Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: S x ` 1 5f� .�, s tuaar o otag e Permit Fee; Footing drain - 1' 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems Water Service - each additional 100' 46.40 Perz>rut °Fee. Storm & Rain Drain - 1st 100' 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each additional $100.00 or fraction thereof, to and including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof, to specially requested inspections - per hour 72.50 and including $50,000.00. Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees, yy # Comments regarding fixture work: Baptistry/Font Bath - Tub /Shower - Jacuzzi/Whirlpool Car Wash -Each Stall -Drive Thru Cuspidor/Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash Floor Drain/sink - 2" -3" -4" Car Wash Drain Garbage - Domestic Disposal - Commercial *Note: If the fixture work under this permit results in an -Industrial increase of sewer EDUs, a sewer permit will be issued and Ice MachlRefrig. Drains Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the Rec. Vehicle Dump Station plumbing permit can be issued. Shower -Gang -Stall Sink - Bar/Lavatory - Bradley Quantity Total Bradleercial Isometric or riser diagram is required if fixture quantity - Service total is >9. Swimming Pool Filter Washer - Clothes Water Extractor Plan Review Water Closet - Toilet • Plan review is required if fixture quantity total is >9. Urinal Other Fixtures: is \ Building \Permits\PLM- PemtitApp.doc 3/03 1 sup A o — oot-3s Bui?drug Permit Application MAY 4 114 FOR OFFICE USE ONLY City of Tigard Date/By: ,� y a � L , '0 Permit No. :. -00157 13125 SW Hall Blvd., Tigard, OR 97223 CITY OFT '. - ', ., Plan Review Other Permit: 503.639.4171 Fax: 503.598.1960 BUILDING ' „ �' Date/By: Inspection Line: 503.639.4 ■ k I Date Ready/By: lung ® See Attached Checklist for terne www.ci.tig .or. s - - � J N otified/Method: , Supplemental Information , 1 N,,i,,,, s k �1�. D , Q r REQUIRED DATA 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the ``t �q a CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ 80/ e°° ❑ 1- and 2- family dwelling ❑ Commercial /industrial Number of bedrooms: .3 ❑ Accessory building ❑ Multi- family Number of bathrooms: 1 I l a ❑ Master builder ❑ Other: J . y a 4 W+ . JOB SITE INFORMATION AND LOCATION Total number of floors: Murk . I s: t� x ry Job site address: /a 3 6 0 5 St.) /.2./ New dwelling area: square feet City/State/ZIP: 71 c- r ,s -IzD , ■t;R- C( as 3 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Covered porch area: N/A square feet Cross street/directions to job site: Deck area: NIA square feet Other structure area: N/A. square feet REQUIRED DATA: COMMERCI -USE CHECKLIST Subdivision: 3Rew Jf ?A-2T! r4-7-7 a Lot no.: g Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the work indicated on this application. P r_ A�,� P� _ i �'t t -i�i ST P.-1-4 c-- 2 Valuation: $ I---k t--- E .,._L, n.6,7 t o .-1 Existing building area: square feet New building area: square feet Tr � ala1 f� .. dt;w':. „:41., .r" : Number of stories: Name: MART' IQ TRE.xyr. Li. .)?7-f- Type of construction: Address: 5 I - L I a. (s A..,/6 Occupancy groups: City/State /ZIP: IL ,.Ack_ r r) As J cx.E0700,3 ( 7 0 /is- Existing: Phone: ✓ Fax ( ) New: 1C p . A� R I c �a r a.t z t, ' t .. f.k ` NOTICE Business name: All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the applicant is exempt from licensing, the following reasons City/ State/ZIP: apply: Phone: ( ) I Fax: : ( ) E -mail: , avii Business name: CP1M E 4 477oA)A - L ,!, BUI MNG PERMIT FEES* Address: 0 t �j � ( � i` � � � � a Please refer to fee schedule. City/State/ZIP: 1�.�.��� n ,q.c / �e_ � 97 ©/5- Fees due upon application Phone: (503) �9 ..7/ I Fax: ( ) �1r �' ? ff . received CCB lic.: I:30C Date received: Authorized signature: This permit application expires if a permit is not obtained 0,4.7 � ,,� ,gyp * within 180 days after it has been accepted as complete. Print name: 11 -- J' i L„0 �S-4- Date: Fee methodology set by Tri- County Building Industry Service Board. is\ Building \Permits'BUP- PermitApp.doc 12/03 440.4613T(It /02/COM/WEB) One- and Two - Family Dwelling , . Building Permit Application Checklist FOR OFFICE USE ONLY City Tigard Received y of A '' ,, Date/By: Perm t No.: 13125 SW Hall Blvd., Tigard, OR 97223 Associated permits: Phone: 503.639.4171 Fax: 503.598.1960 ^ i ' "� ' �N I k 1 1CI Electrical CI Plumbing ❑ Mechanical � is lid 24- Hour Inspection Line: 503.639.4175 ., Internet: www.ci.tigard.or.us ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 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. Name of district: ❑ ❑ ❑ • 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 catch- ❑ ❑ ❑ basin protection, etc. 10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size sheet 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 and building setback dimensions; property corner elevations (if ❑ ❑ ❑ there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations; direction indicator; lot area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface 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 Ream 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 Ore: on and shall be shown to be applicable to the .ro'ect under review. JURISDICTIONAL 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 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be 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 and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include tree protection measures as required by conditions of approval. ❑ ❑ `❑ / 30 A Cle. ater Servi - s' Sensitive ' -a 're- Screening ' • • • sment form i ' in - : for all building a... ons, ❑ ❑ incl •sing • ecks, • . 110 C' ers o r non -i ,erviou : •rface) and ac - . - ' structures toe .. _ - ', - tial dw- ' • _ • a lot of : . , approve prior to September ', 1995. i:\Building\Permits \One- Two - FamilyChecklist.doc 12/03 Building Fixtures `,G` ® Plunhb ng Permit • ; d FOR OFFICE USE ONLY City of Tigard jk 10 DateBed Permit No.: _�i 6 7 Tigard, SW Hall Blvd., Ti , OR 97223 y g Plan Review Phone: 503.639.4171 Fax: 503.598.19 J Other Permit No.: 24- Hour Inspection Line: 503.639.4175 f'( \v'\ „ r, 1I Date Ready/By: Juns: H See Page 2 for Internet: www.ci.tigard.or.us CA-0 10" Notified/Method: Supplemental Information �.,..,. i4 ❑ New construction ❑ Demolition For special information use checklist. Description 1 Qty. I Ea. I Total ❑ Addition/alteration/replacement ❑ Other: New 1 - 2 family dwellings (includes 100 ft. for each utility connection) }f s; r Y i n SFR (1) bath 249.20 ❑ 1- and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00 ❑ Accessory building ❑ Multi - family SFR (3) bath 399.00 Each additional bath/kitchen 45.00 ❑ Master builder ❑ Other: _ Fire sprinkler ( sq. ft.) Page 2 e.d° 4x #` •i#in"k f l n F p i ! CJ . i rfi t,' �: Job site address: a 3 e ,,,-- 1 a i s r Catch basin or area drain 16.60 City/State /ZIP: i e7,4)-tie.A 1 .-, Drywell, leach line, or trench drain 16.60 Suite/bldg. /apt. no.: Project name: L(}% L-&j� Footing drain (no. linear ft.: ) Page 2 Manufactured home utilities 110.00 Cross street/directions to job site: t.IJArt-.0\1)T to ' aZ Al Manholes 16.60 f .:04-e --- 7-I - ©F (h/ Rain drain connector 16.60 Sanitary sewer (no. linear ft.: /') Page 2 Storm sewer (no. linear ft.: L. Page 2 X Subdivision: I Lot no.: Water service (no. linear ft /6 Co) Page 2 Fixture or item Tax map /parcel no Absorption valve 16.60 �s �a :1 .- , ::; _° „_ Backflow preventer " Page 2 4___ I, L �� • FOig Nita/ ( 7c' Backwater valve 16.60 � 1 /` t I�, Clothes washer 16.60 7�� mc Dishwasher 16.60 ) Jktttig fetait� 16.60 ►,,.._: "_ .._" =�P ` 16.60 ►�/ Name: 1 " � RT71U r reErift Loco- e, Expansiex- tank- 16.60 Address: 13,A51 SE oL ' A- Fixture /sewer cap 16.60 City/State/ZIP: 0 - 0E66,6,0 170/c- E1 d'a 400 k/11ub 16.60 Phone: (9;:r3) ,- - it - i Fax: ( ) Cta ege dis cssk 16.60 r'''.;'-'11i''''. .. , ,,, a _ t� . Hose bib 16.60 f . � � 1� . a_ -:�d 4. _,_,- � - 16.60 � Ic ma � Business name: 16.60 Contact name: .Medicat - gas (value: $ ) Page 2 Address: primer - 16.60 City/State /ZIP: °""`� ra ( 16.60 Sink tr tery 16.60 Phone: ( ) I Fax: : ( ) 16.60 " E -mail: 16.60 - tom` u , .: � 2� ' � .... Wg J set_ 16.60 Business name: / 9 �p -- P���,Jig! a0 (o W3terfieater 16.60 Address: r - Other: I Subtotal City/State /ZIP: '/� Minimum permit fee. $72.50 Phone: ( p I Fax: 60-3) Off ) -7p, 5 R Residential backflow minimum permit fee: $36.25 CCB Lic.: t ti-11 01., l 13 ... O' lumbing Lic. no.: It- 39. -66- Plan review (25% of permit fee) State surcharge (8% of permit fee) Authorized signature: TOTAL PERMIT FEE Print name: Date: 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. i:\ Building \Permits\PLMF- PernvtApp.doc 12/03 440- 4616T(10 /02/COM/WEB) Plumbing Permit Application - City of Tigard • Page 2 - Supplemental Information Fee Schedule: Residential Fire Suppression Systems: g ` ` t -'i . n_ Ae ie a , a ¢, . quare , P Footing drain - 1s` 100' 55.00 0 to 2,000 $115.00 Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00 3,601 to 7,200 $220.00 Sewer - 1st 100' / 55.00 7,201 and greater $309.00 Sewer - each additional 100' 46.40 Water Service - 1st 100' 55.00 Medical Gas Systems: Water Service - each additional 100' 46.40 . . . Valuation . Permit Fee:' Storm & Rain Drain - 1st 100' / 55.00 $1.00 to $5,000.00 Minimum fee $72.50 Storm & Rain Drain - each additional 100' / 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each R0A 1 � c additional $100.00 or fraction thereof, to and u� <r .� ;tom . including $10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for Residential Backflow Prevention Device each additional $100.00 or fraction thereof, to (minimum permit fee $36.25) 27.55 and including $25,000.00. Rain Drain, single family dwelling j 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1 45 for Inspection of existing plumbing or each additional $100.00 or fraction thereof, to and including $50,000.00. specially requested inspections - per hour 72.50 Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for each additional $100.00 or fraction thereof. Fixture Work: Are you capping, moving or replacing existing fixtures? If "yes ", please indicate work performed by fixture. Failure to accurately report fixtures could result in increased sewer fees * . I o- 4 -' e s .k, x "' , t Qt,4$pgt "t lu oktC.. d + loaned .a 5 , Ps � '', Vi, i, w :W , . < tints '„ ,.' Comments regarding fixture work: Baptistry/Font Bath - Tub /Shower - Jacuzzi/Whirlpool Car Wash -Each Stall -Drive Thru Cuspidor/Water Aspirator Dishwasher - Commercial - Domestic Drinking Fountain Eye Wash Floor Drain/sink - 2" - 3" -4 Car Wash Drain Garbage - Domestic Disposal - Commercial *Note: If the fixture work under this permit results in an - Industrial Ice Mach. /Refrig. Drains increase of sewer EDUs, a sewer permit will be issued and Oil Separator (Gas Station) fees assessed for the sewer increase must be paid before the Rec. Vehicle Dump Station plumbing permit can be issued. Shower -Gang -Stall Sink - Bar/Lavatory Quantity Total - Bradley Commercial Isometric or riser diagram is required if fixture quantity Service total is >9. Swimming Pool Filter Washer - Clothes Water Extractor Plan Review Water Closet - Toilet Plan review is required if fixture quantity total is >9. Urinal Other Fixtures: i,\Building\Prnnits\PLM- PermitApp.doc 3/03 Mechanical Permit App]� tE IVED FOR OFFICE USE ONLY City ofifigard �{t Received Permit No.: = MEI 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone. 503.639.4171 Fax. 503.598.1960 ION ^o L o d�i \ Date/By: Other Permit: Inspection Line: 503.639.4175 Ins 'NP�k p ��� Date Ready/By: P ...4A, •I I� eady/By: Juris: El See Page 2 for Internet: www.ci.tigard.or.us F TIGA ON Notified/Method: Supplemental Information CITY G _ ,w'�I ,.. z` Y r � .. . .. -l� .' ". t ;G OMIVI E TiC I AiL )FEE* SCHEDULE — USE CHECKLIS ❑ A ddition /alteration/replacement Mechanical permit fees* are based on the value of the work ❑ New construction performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. r N n ' G EGQR'r0` 4e.Is S C f i Value: $ RESIDENTIAL EQUIPIYIENT / SYSTEMS FEES* ❑ 1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total ; ; = . EJTJ y Tleo 4 I t *OG QN . Heating/cooling Job site address: Air conditioning or heat pump C :J ' I (requires site plan showing placement) 14. City/State /ZIP: 'C',A acerew) 57 a-.' Furnace 100,000 BTU (ducts/vents) t 1 4 . 00 1L},(� Suite/bldg. /apt. no.: I Project name: L u �ts> 9 . 17.90 Gas heat pump 14.00 Cross street/directions to job site: Desk- 14.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision: I Lot no.: Flue/vent for any of above 10.00 Other 10.00 Tax map /parcel no.: y Other fuel appliances t 1'.„ " ' y 4 P a S ri F Water heater ' 1©�f . Gas fireplace I 10.00 10,M Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 l �� 9 y ,,, ,. , ..> F .12 Chimney /liner /flue /vent 10.00 , . _ �, a ' s.. ; --F' a i - i t, �Other: 10.00 Name: ft ` Inc`f1)- LAM-4-t-1- Environmental exhaust and ventilation Address: k'3D,5I " 0401....t-' J equipment hood other kitchen � e ui ment 10.00 City/State/ZIP: A. OPEC,C4,0 974 I <- Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: 5) , c f al 3I I Fax: (3 66- -5 toilet compartments, utility rooms) 6.80 _ ` . 4,.4., 5 $ € M ' - f ° `° Attic /crawlspace fans 10.00 . 5..<_. , _ .�. -.- . ;, ., , . i i ,, 0:» ,4zi Other: 10.00 Business name: Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City/State /ZIP: Wall /suspended/unit heater Phone: ( ) I Fax: : ( ) Water heater I Fireplace E -mail: Range �: . , :I iit . , ,, ' , , � , : : 4: : ;a ,,, ! ,,0,11 2, .4; Barbecue Business name: Clothes dryer (gas) Other: Address: i at £ .. i Hi*GAL I'E EI ES* City/State /ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) Plan review (25% of permit fee) CCB lie.: State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized Signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board i:\Building \Permits \MEC- PermitApp.doe 12/03 440 -4617T (11/02 /COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: dtal Valuatoi%�... ..,rm�t v e x ' .. $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. i:\ Building \Permits\MEC- PermitApp.doc 12/03 2 Electrical Permit A li iv ED FOR OFFICE USE ONLY V City bf Tigard Received Permit No. Date/By: 13125 SW Hall Blvd., Tigard, OR 97223 A 2U Plan Review Phone: 503.639.4171 Fax: 503.598.1960 MAY �•4 L �� ". 'I il I ji l �'r Date/By: Other Permit: Inspection Line: 503.639.4175 •' I� Date ReadyBy: Juris 0 See Page 2 for Internet: www.ci.tigard.or.us •f II GARp Notified/Method: Supplemental Information 1�? e, > � 4 RE'•i)1 a z. .1 ' x ILt N mW Ew ❑ New construction ❑ Addition/alteration/replacement Please check all that apply: ❑ Demolition El Other: ❑Service over 225 amps, comm'l Hazardous location ['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft., � . - ,s1.,;,. - .,,,° t , r " n ",..'"',,,,:,.',,,,q:,4--A,,,,,,,,,, ° of 1 -and 2- family dwellings 4 or more new residential D. 1 and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure ❑ Multi Master builder ❑Other ❑Building over three stories [Weeders, 400 amps or more _, " _ ° ['Occupant load over 99 persons OManufactured park structures or tzt 4 � ) 1 .. I , t , d 1 ,44,0221,„h..- , ❑Egress /lighting plan P ^� 36 5 SiJ I 7 , 1 y" Job site addre ¢ ❑Health - care facility ❑Other: Job no.: + I r -3 Submit 2 sets of plans with any of the above. City /State /ZIP: C .•..,„ D ©y ('� ' Th above are not applicable to temporary construction service. / Suite/bldg. /apt. no.: I Project name: ,• Description Qty. I Fee. Total Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map/parcel no.: Limited energy, residential 75.00 2 Limited energy, non - residential 75.00 2 , � i, - . � . ! � ' Each manufactured or modular dwelling, service and /or feeder 90.90 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 n lD r: -- , t , ,, 201 amps to 400 amps 106.85 2 " °"' '4'44' 401 amps to 600 amps 160.60 2 Name: M i i1 &) ! K1O L 0 Cte_ 601 amps to 1,000 amps 240.60 2 Over 1,000 amps or volts 454.65 2 Address: 1? OAS 1 ICJ r 0`� ( 4,b, `r'1' - Reconnect only i 66.85 &/„ 2 City/State /ZIP: �-yi. S / �' l � ' ) 7 C I ' Temporary services or feeders installation, alteration, and/or � ` relocation Phone: (Le3) c_ c3y I Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, r- t, or exchange acco m: to RS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signa . / ,. Au c ---- Date: t- Branch circuits — new, alteration, or extension, per panel 3 .: A. Fee for branch circuits wit service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 Address: each branch circuit Each add'l branch circuit 6.65 2 City/State /ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) I Fax ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - b : € �, - ener anel, alteration, or ' :;t1 , .sr ",... - `;f iC 4 t'. �. t r3. 0 ; € +y ° ; ,..� .. ex. , ' : , y;a gY P extension. Describe: Page 2 2 Business name: Q ,,l43 u3A-A £L4.-�I 21 Address: Each additional inspection over allowable in any of the above Per inspection 62.50 City /State /ZIP: Investigation per hour (1 hr min) 62.50 Phone: ( ) Fax: ( ) Industrial plant per hour 73.75 CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: Date: State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 - days after it has been accepted as complete Print name: Date: * Fee methodology set by Tri -County Building Industry Service Board ** Number of inspections per permit allowed. i.\ Building \Permits\ELC- PemutApp.doc 12/03 440- 4615T(10 /02/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTA?O�E� Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: 1 Z .fig Fee for each commercial system $75.00 (SEE OAR 918 - 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i:\ Bui lding\Permits\ELC- PermitApp.doc 04/03 City of Tigard Washington County Oregon Voluntary Compliance Agreement and Temporary Certificate of Occupancy For: Martin T. Luther 13251 SE 126 Ave. Clackamas, OR 97015 Re: Temporary Certificate of Occupancy You, Martin T. Luther, as the responsible person for 12365 SW 121 Ave., Tigard, OR 97223, Tax Map 2S103BB, Tax Lot 13400, and the work under permit MST2004- 00137, agree to the following conditions: A temporary Certificate of Occupancy is hereby issued on a conditional basis for a period not to exceed 30 days from this date, by which time the following conditions must have been met and approved by inspection by the City of Tigard Building Department: Permit MST2004 -00137 must be completed and approved, including all outstanding corrections, ancillary permits and fees. Specifically, the corrections listed on inspection reports dated 12- 16 -04. The City of Tigard agrees to withhold any other action regarding occupancy or completion of this permit until 5:00 p.m., January 17, 2003. Upon compliance with all above conditions, this case will be closed and the Certificate of Occupancy will become permanent. I further understand that if these conditions are not complied with fully by the above date and time, this Temporary Certificate of Occupancy will terminate and I may be served with a Summons and Complaint without further notice for violation of provisions of the Oregon One and Two Family Dwelling Specialty Code regarding final inspection approval being required prior to occupancy. V Signed: - Date / /e7 (R= Aonsible Pa ,_ Signed: / "� ��l Date / .0 sing: s nforcement • } CITY OF TIGARD . s BUILDING DIVISION #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: dD 1-00 / 3 - 7 J Phone: (503) 639 -4171 /,, / / /iiiii iii l �� l \ Inspection Requests (24 Hrs.): (503) 639 -4175 .�' INSPECTION WORKSHEET FOR DATE: 3 ` 9 TIME: PAGE: SITE ADDRESS: l 2 3 CPS /-14--4---1- CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: p CONTRACTOR: PHONE #: ({6 I -v o 7 Inspection Request Scheduled For: Date: Pour Time: 1 Code # Inspection Description Confirm # Contact # Message 4 a Corrections /Comments /Instructions: ...----- / / A—.L �_ / 44 sr , G , _ A r, P� - / a.-14-1 , _.e rg /2._ /6. D 7i PA 3, /u• &KZ - --- / z / 4o O / Y`+Cpor-- — /J -G-L' tt Yt_ f / 2 te--kett: /-- Z-e- i i _ i _ l e A r _ Q LS 1-t.. : - 47 1 PASS E PARTIA APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CA OR INS:9 IO■ ❑ ADDITIONAL F ES ASSESSED ,' AIWA 3 Inspector: f Date: 4 Phone #: (503) 718-2 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST 06 -voi37 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested /4 ^ / AM PM BUP Location / l ? l )-1 Suite MEC Contact Person 0 ilLerLd / Ph ( ) eg / - D E67 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 Pf7 Cl/T;( /2' / ©q ( [ , S Insulation Drywall Nailing Firewall -- , f _ Fire Sprinkler "' ` t Ai� �� I \11 -•-• Fire Alarm j J % - Z - 7I � - r - 7ar • c_i— �L ---77 — r - nL1 t . Susp'd Ceiling Roof A/ — A - ht. ' L---17- (r 1 / LL_ Other: Final N ( N L PASS PART FAIL PLUMBING I` leW IS.SU 4 ? / S Post & Beam '� /� Under Slab 4 �, � c: T B L} < C N /4 Rough -In 4 /,.�C /A -- -) g O o i- i k/A'i- s i - N Water Service Sanitary Sewer C} Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Bea Rough -In Gas Line Nab S mpe •ASS PART FAIL E C RICAL Service Rough - UG/Sla Low Vol a by Fire Alarm 4111. El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. AS PART FAIL S III Please call for reinspection RE: -- Unable to inspect — no access Fire Supply Line ADA l 2- /6- c.) Approach/Sidewalk Date ` In spector II �� Ext Other: Final DO NOT REMOVE this inspection record 'om the Job site. PASS PART FAIL - CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MSTOG Y "Ow /3 7 INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Requested /)- —/ I t AM PM BUP Location / 3 c / —0 4 Suite MEC Contact Person C.414 Ph ( ) -O 6 (1 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: PA PART FAIL C HANICAL 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 Date C / L 0Y 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 MS 40 1 { X/ 3 X03 INSPECTION DIVISION Busin ='s Li (503) 639 - 4171 BUP Received Date Re ueste �' AM PM BUP �i1 � Location �- _ � � / �►/ $ MEC Contact Person Ph ( ) PLM Coo actor Ph ( ) SWR BUILDING _ - Tenant/Owner ELC 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 ��1� ✓��� ��� �� () ���� Fi rewall l / �v ,�c� GA9 — ® nom �� 3 69- Fire Sprinkler l Fire Alarm CD/Z Susp'd Ceiling L� Roof .� � � /Clr�}G✓ O - r . ' � ' �'!. PAR FAIL — ' ��+ E) W'V ojto1/� �/`��L� / /61s. Roo.' BING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer ��� „�� � � �` 0� /� Rain Drains DJ`s' Catch Basin / Manhole A � Storm Drain Shower Pan . ' Other: Final ! fpi./ / arse E PASS PART FAIL MECHANICAL � / i`7967- Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final I I Reinspection fee of $ required before next i section. Pay at , • • all, 13125 SW Hall Blvd. PASS PART FAIL i SITE I I Please call for inspec %on RE: /11i Fire Supply Line -able to is .sect — n ccess ADA / Approach /Sidewalk Date Inspect i :' Ext‘_ Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL