Permit CITY OF T I G A R D MASTER PERMIT
PERMIT #: MST2003 -00479
Lr, DEVELOPMENT I Tigard, R SERVICES 639-4171
DATE ISSUED: 10/20/03
SITE ADDRESS: 13650 SW 124TH AVE PARCEL: 2S103CC - 07100
SUBDIVISION: WHISTLER'S WALK ZONING: R -4.5
BLOCK: LOT: 018 JURISDICTION: TIG
REMARKS: New SF detached, Path 1.
BUILDING
REISSUE: DM181 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,602 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,698 sf GARAGE: 606 sf FRONT: 20 PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5
VALUE: 322,799.80
OCCUPANCY GRP: R3 BDRM: 5 BATH: 3 TOTAL: 3,300 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 3 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: 4 CLOTHES DRYER: 1
GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4
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:
EAADD'L 500SF: 6 201 - 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: 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: $ 5,722.06
DON MORISSETTE HOMES DON MORISSETTE HOMES INC This permit is subject to the regulations contained in the
4230 GALEWOOD ST #100 4230 GALEWOOD ST, STE 100 all other r applicable cal Code, State work k w l be Codes and
all other applicable laws. All work will be done e in
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 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: 503 387 - 7538 Phone: Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
5Q
Reg #: may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Erosion Control Insp 84 Post/Beam Structural Mechanical Insp Shear Wall lnsp Insulation lnsp Water Service lnsp
Grading Inspection Post/Beam Mechanical Plumb Top Out Exterior Sheathing Ins Gyp Board Insp Appr /Sdwlk lnsp
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Rain drain Insp Electrical Final
Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Storm drain Insp Mechanical Final
Foundation Insp PLM /Underfloor Framing Insp Gas Fireplace Water Line Insp Plumb Final
Issued By : l c�iyn Permittee Signature :
Z_____ _
Call (5 3) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
• B% - /U- 2-0 -Ic.' ice / ° -6 - ° ii:0itPoo5 -oo 36-
,,' . ; At, z rm - �.plication
�- �5V79
$' `. City of Tigard Date received: 9 03 Permit no.: g r 5 —
�' '� t ' Project/appl. no.: Expire date:
CiryojTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By: Receiptno.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1&2 family: Simple Complex:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ,'New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
./r JO O
Job address: ( >.� ' L( /ix Bldg. no.: Suite no.:
Lot: 0 Block: Subdivision: t IFAI Tax map /tax lot/account no.:
Project name:
Description and location of work on premises/special conditions:
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
- _, _ (Floodplain, septic capacity, solar, etc.)
Mailing address: Tr' _ EI 1 & 2 family dwelling:
gimigr =RA zip: - '. i Valuation of work $ 22 79 , , '
Phone:. r ail jn • No. of bedrooms/baths
Owner's representative: • .'" L� � _ Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.) S AV
a. APPLICANT Garage /carport area (sq. ft.) • I i
i w Ji ann Covered porch area (sq. ft.) 9 6
Mailing address: A' , CL Deck area (sq. ft.) / 0 U
City: State: ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial /industrial/multi - family:
CONTRACTOR Valuation of work $
Existing bldg. area (sq. ft.)
Business name: _ I M 2�(,��' New bldg. area (sq. ft.)
Address: & ` i
City: Number of stories
ity: State: ZIP;
Phone: Fax: E -mail:
Type of construction
CCB no.: Occupancy group(s): Existing:
New:
City/metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
provisions of ORS 701 and may be required to be licensed in the
jurisdiction where work is being performed. If the applicant is
Address: i ii, , i Ci�'t/r��
City: State: ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: State: ZIP: Amount received $
Phone: Fax: 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. • .rovisions of 1 ws and o dinances governing this ❑ Visa 1:1 MasterCard
work will be compli" r WI , whether cified 1erei4i Credit card number: / /
k -2 �� t ° — 1 1 1 n P, j Expires
Authorized si � atu � =' _ t
t C: (( v (s' Name of cardholder as shown on credit card
y $
Print name: _ l ( r
Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6i00/COM)
One- and Two - Family Dwelling
Building Permit Application Checklist Reference no.:
Associated permits:
City of Tigard City of Tigard g D Electrical ❑ Plumbing O Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 ❑ Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
TILE 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.
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 Cl 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. J�
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. / X \
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered
systems, see item 22, "Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists
over 10 feet long and/or any beam/joist carrying a non - uniform load. x
20 Manufactured floor /roof truss design details. �(
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required ' \
for four or more appliances.
22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or
architect licensed in Oregon and shall be shown to be applicable to the project under review.
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 & 22 above.
25 Building plans shall not contain red lines or tape -ons.
26 No rolled, reversed or mirrored building plans will be accepted.
27
28
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 440 -4614 (Mr)0/COM)
Mechanical Permit Application
� � Date received: 9 R • 03 Permit no.: s „
y 1, -„ ICI City of Tigard
► "� ty Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223
Phone: (503) 639 -4171 Date issued: By: Receipt no.:
-
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
X Iew construction 0 Addition/alteration/replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: j,- / j0 _ h. # . Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: y Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $
Lot: I I 'Block: ' Subdivision: 6ZJ `See checklist for important application information and
Project name: \ I K- jurisdiction's fee schedule for residential permit fee.
City/county: j ZIP: Ir& 2FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: AND COMMERICAIJINDUSTRIAL EQUIPMENTSCIEDULE
Fee(ea.) Total
Est. date of completion /inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: Ii Air handling •
Is existing space heated or conditioned? 0 Yes 0 No Air condit unit CFM
g P Air conditioning (site plan required)
Is existing space insulated? Cl Yes 0 No Alteration of existing HVAC system
MECHANICAL. CONTRACTOR Boiler /compressors
State boiler permit no.:
Business name: it C ■ ∎ 4 .. Ira r r.,. _- HP Tons BTU/H
Address: ifigirs Fire/smoke dampers/duct smoke detectors _
City: \\ft Li ROW' ZIP: Ilia Heat pump (site plan required)
Phone:_ _ Fax: E -mail: InstalUreplacefurnacelburner BTU /H
� c � Including ductwork/vent liner 0 Yes 0 No
CCB no.: '; 7r9�( InstalUreplace/relocate heaters -suspended,
City/metro lic. no.: N/A wall, or floor mounted
Name (please print): ' . p• (■.EL-I_____. Vent for appliance other than furnace
Absorption CONTACT l'ERSON
Absorption units BTU/H
_ Name: °"��`� Chillers HP
Compressors HP
Address: y"- CIA Caa Environmental exhaust and ventilation:
City: ' State: ZIP: Appliance vent
Phone: Fax: E -mail: ' Dryer exhaust
OWN E R Hoods, Type U IUres. kitchen/hazmat
�� hood fire suppression system
Name: � l� 9 a. _ Exhaust fan with single duct (bath fans)
Mailing address: W I I Egiqg / Exhaust system apart from heating or AC
ry Fuel piping and distribution (up to 4 outlets)
City: State' ZIP q �) Type: LPG NG Oil
Phone:. 1 5 7 -jj Fax: E - mail: Fuel piping each additional over 4 outlets
ENGINEER Process piping (schematic required)
Name: Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: ' State: fZIP: Insert - type
Phone: ���� Fax: E -mail: Woodstove/pelletstove
g „er if� �ig0
Other
Applicant's si natu �� Date: i
Name (print): 1,/ { y { Th(if /
Not all jurisdictions accept credit cards, please call jurisdiction for mac information. Permit fee $
O Visa 0 MasterCard Notice: This permit application Minimum fee $
s
expires if a permit is not obtained Plan review een (at _ %) $
Credit card number: E ( ) z it within 1 days after it has been State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete.
s TOTAL $
Cardholder signature Amount 4404617 (6■00/COM)
• Plumbing Permit Application
Date received:9/r d.5 Permit no 6i4A?3 G1J, /,�J
-a, {�t; City of Tigard
l Sewer permit no.: Building permit no.:
Address: 13125 SW H all Blvd, Tigard, OR 97223 Project /appl.no.: Expire date:
City ofTigarC Phone: (503) 639 -41 1
Fax: (503) 598 -1960 Date issued: By: I Receipt no.:
Land use approval: Case tile no.: Payment type:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
■: New construction 0 Addition/alteration/replacement 0 Food service 0 Other:
JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist)
Job address: �v V
r 5(a ' w l j��.+t.., y5.�f' . Description Qty. Fee(ea.) Total
Bldg. _ E New 1 - and 2 - family dwellings only:
Bldg. no.: Suite no.: (includes 100 ft. for each utility connection)
Tax map /tax lot/account no.: SFR (1) bath
Lot: t Aill Block: Subdivision: �' r M SFR (2) bath
Project name: SFR (3) bath
City /county: { ZIP: Each additional bath/kitchen
_ Description and location of work on premises: Site utilities:
Catch basin/area drain
Drywellsileach line/trench drain
Est date of completion inspection: Footing drain (no. lin. ft.)
PLUMBING CON TRACTOR Manufactured home utilities
Business name: „li L. i • Manholes
Address: rMillii2 , Rain drain connector
�fl►)
/ ZIP: Sanitary sewer (no. tin. ft.)
v � Ew�
Phone: Fax: E -mail: S ormt sewer (no. lin. ft.)
'/ , - � , y Water service (no. lin. ft.)
CC3 no.: ( c9 I Plumb. bus. reg. no: - — VW t Fixture or item:
City/metro tic. no.: N/A Absorption valve
Contractor's representative signature t. Back flow preventer _
1 Inil • / — ik Backwater valve MN
CO`'1ACT PERSON Basins/lavatory MI
Clothes washer
—
Name: ,- , • ' 1 Dishwasher
Address: _. • dia , / b 1c Ai — Dunking fountain(s)
City: State: ZIP: Ejectors/sump MI
Phone: Fax: E -mail: Expansion tank
OWNER Fixture/sewer cap _ I
Floor drains/tloor sinks/hub �—
Name (print): Alt t x -�` Garbage disposal IIIII Mailing address: _ - • • _a► • 4 Hose bibb MN _
City: _ �(I��vg little Ice maker 11111 —
Phone: l , — jr. , Fax: lailffai• Interceptor /grease trap MIME
Owner installation/residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain (commercial)
employee on the property I own as per ORS Chapter 447. Sink(sl, basin(s). lays(s)
Owner's signature: Date: Sump
I
ENGINEER. Tubs/shower /shower pan
Urinal
Name: Water closet
Address: Water heater
City. State: ' ZIP: Other
Phone: Fax: E -mail: Total
Minimum fee ................ $ .
Na all junsdicuons accept credit cards. please call junsdicu rtm
oa for more in(oauon. Notice: This per nit application
C Visa 0 S1sste Card expires if a permit is not obtained
Plan review (at _ %) $
C.edit card number. / w ithin 180 d ays after it ha been State surcharge (8 %) ...• $ �
Expires TOTAL $ ----
accepted as complete.
Name of cardholder as shown oa credit card
S
440 -$616 (bD(X oM>
Cardholder signature Amount
Electrical Permit Application -:,i..y.:0„...***.iiiii-i.61*
Date received: ealgb Permit no.: N5r „3-.
:4 City of Tigard
Project/appi. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement
v New construction 0 Addition/alteration /replacement 0 Other. 0 Partial
JOB SITE INFORMATION
Job address: I INNSIMEMIIIMIONIII Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: 1.3 Block: Subdivision: Tar 1. ,,i,W11 , 7/ TIP
Project name: Description and location of work on premises:
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: Fee Max
Business name: Description Qty. (ea.) Total no. ittsp
_ `/ _ --� , N ew res - single or multi- family per
Address: 4. � _ ,....A ate . dwelling unit. Includes attached garage.
En l< .t 1 � ZIP: i Service included:
Phone: um , .j - i a.j Fax: E -mail:
1000 sq. ft or less 4
4. Each additional 500 sq. ft or portion thereof
CCB no.: y Elec. bus. lic. no: 0 Limited energy, residential 2
C: Limited energy, non - residential 2
Each manufactured home or modular dwelling
nature of supervising electrician /required) Date Service and/or feeder 2
cc Services orfeeders — installation,
Sup. elect. name (print) 9 A License no , J alteration or relocation:
PROPERTY OWNER 200 amps or less 2
201 amps to 400 amps 2
Name (print): , N... , . SW t . o i 401 amps to 600 amps 2
Mailing address: .O Mt ��,� S ' �� 601 amps to 1000 amps 2
City: , r State 11. ZIP: i 7L) Over 1000 amps or volts 2
Phone: , "y Fax: - =7 4, -mail: Reconnect only 1
Owner installation: The installation is being made on property 1 own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation: 2
200 amps or less
ORS 447, 455, 479, 670, 701. . .
201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: i State: [ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E-mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
2
❑ Service over 225 amps- commercial 0 Health-care Each pump or irrigation circle
are facility . 2
O Service over 320 amps- rating of 1 &2 0 Hazardous location Each sign or outline lighting
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or extension* 2
O Building over three stories 0 Feeders, 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan 0 Other. Per inspection [ I
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Permit fee $
Not all jurisdictions accept credit cards, please calf jurisdiction for more information. Notice: This permit application
0 Visa 0 MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number / / 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 (■c(COM)
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A Do h ereby certify that the following location ■ ■
A meets City of Tigard /Washington County ■ ■
A � ■
• land use and development standards for street tree installation. ■
i ADDR E SS: / ;�. SD 5 /21 "± -k . ■
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■ LO / SU BDIVISION: WthcrG -Q� A/114e ■ ■
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CITY QF TIGARD 24 -Hour
BUILDING * Inspection Line: (503) 639 -4175
MST 3 _ .0.o. .0.o. �?
INSPECTION DIVISION Business Line: (503) 639 - 4171
22 // BUP
Received Date Requested J 7 AM PM BUP
Location / 3 Sv / Suite MEC
Contact Person Ph ( ) 2 d > — S/g37 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear r- - l EC S)
Framing � � -- '� / �/ —�- �1so C s)
Insulation ✓ ✓J
Drywall Nailing
Firewall ei�
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
rie PART FAIL
UMBING
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
A O PART FAIL
RICAL
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: nable to inspect — no access
Fire Supply Line - O�1
ADA
/Inspect
Date - �� _
Approach/Sidewalk
Other:
Final DO NOT REMOVE this inspection re rd from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 CD 3 _ (55V179
INSPECTION DIVISION Business Line: (503) 639 -4171
' / BUP
Received` - S. ! Date Requested 3 - £)4' AM PM BUP
Location / 3 b 5 Z c) Suite MEC
Contact Person /54z-04--e Ph ( )... 7 PLM
Contractor d in k 1442 — Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Final .
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
olt
Low ' / ) i L
Low Voltage 1/
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 C.27
Approach/Sidewalk Date • Ins or ' 4 Ext
Other:
Final DO NOT REMOVE this inspection record fro the Job site.
PASS PART FAIL