Permit CITY OF T I G A R D MASTER PERMIT
PERMIT #: MST2004 -00017
.i,�, r 141 DEVELOPMENT SERVICES DATE ISSUED: 2/27/04
r 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 15870 SW AVON PL PARCEL: 2S112CC -D0002
SUBDIVISION: DURHAM OAKS ZONING: R -12
BLOCK: LOT: 002 JURISDICTION: TIG
REMARKS: New SF detached
BUILDING
REISSUE: BVH1605 -1 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 22 FIRST: 616 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y -
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 989 sf GARAGE: 307 sf FRONT: 15 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5
VALUE: 156,293.30
OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 1,605 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: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: 1 BOIUCMP < 3HP: / VENT FANS: 4 CLOTHES DRYER: 1
GAS FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 W0ODSTOVES: 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:
EA ADD'L 500SF: 2 201 - 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+am ps-1 000v: 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: $ 7,228.18
This permit is subject to the regulations contained in the
BUENA VISTA HOMES BUENA VISTA HOMES Tigard Municipal Code, State of OR. Specialty Codes and
6932 SW MACADAM #C 6932 SW MACADAM HOMES 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. ATTENTION:
Oregon law requires you to follow rules adopted by the
Phone: 503 443 - 6033 Phone: 503 443 - 6033 Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through 952 -001 -0080. You
Reg #' LIC 152235 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 Insl Rain drain Insp Electrical Final
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Storm drain Insp Mechanical Final
Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Water Line lnsp Plumb Final
Foundation Insp PLM /Underfloor Framing Insp Gas Fireplace Water Service lnsp Building Final
Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Appr /Sdwlk Insp
/
Issued By : - ' Permittee Signature : i ,_ __ — _ _ _
l -
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
/3
Building Perm Application Fo • Rc� N�F�sc'rr: csE:ONLY
Received / ,--- 0 R Building
Date/By: / - 'r D 4 / 411212 Permit No.:01 alp V -000/ 7
Other
City of Tigard RECEIVED Date/By: Approval
Pp Permit No.: t]1 CY .214 ,��
13125 SW Hall Blvd. Plan Review Other -
Tigard, Oregon 97223 JAN Z Q1} Planning
/OA t) P- 2'7 - Ur4 PermitNo.:
Phone: 503 -639 -4171 Fax: 503 -598 ' b0 _ I r i l `
Post-Rev iew C ase U
I www.ci.tigard.cCILTY OF TIGARD Contact Case
See Page 2 for
2-4 -hour Inspection Req � i)VISION Name/Method: T L Supplemental Information
a� i l aC.C- De) � --K--12.- -
. TYPE OF WORK REQUIRED DATA: _' : :z. ' . ` : . .
,Xl New construction ❑ Demolition 1 & 2 FAMILY DWELLING - " ::
❑ 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 LJ Multi- Family
❑ Master Builder ❑ Other: Valuation $
. JOB SITE INFORMATION and LOCATION No. of bedrooms: �j No. of baths: 2' 5
Job site address: I S110 SI,� r4 Total number of floors
New dwelling area (sq. ft.) ` l� F
S
Suite #: 1 Bldg. /ADt. #: Garage /carport area (sq. ft.) • F s ,4 3P
Project Name: Rte' L& \<:.,5 Covered porch area (sq. ft.) 2.4 SF
Cross street/Directions to job site: Deck area (sq. ft.) (�
Ot her structure area (s ft .) '
" D\\) N C' 1 �1v�1 4 s v\I DON h ow I,,, J .
. - :REQUIRED DATA:
COMMERCIAL - =USE CHECKLIST . ';.• '.
Subdivision: ow( ham Oo KS I Lot #: 7--
Tax map /parcel #: 2.5 I I 2_C-G.- - !7 OOO 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,
("AA] n DTI f - M' cs' overhead and profit for the work indicated on this application.
- . „ A - . I I , 1 Valuation S
— ' Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
i} PROPERTY OWNER .. 1 ❑ TENANT - • • . Type of construction
Name: VAAfxu'\ \I Is Gil \Dm 5 Occupancy group(s): Existing:
New:
Address: t.POl J7 So M darn m
City /St to /Zi : pcYA V OI. - 1' -1c1
Phone:�5Q I44.' , . FO Fax: (5-- i}2}? 2 -qz NOTICE: All contractors and subcontractors are required to be
licensed with the Oregon Construction Contractors Board under
❑ APPLICA
CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the
Business Name: &v('- jurisdiction where work is being performed. If the applicant is exempt
Contact Name: M'\ n a \ -my eAis from licensing, the following reason applies:
Address: C- 3 y e ( c a we,
City /State /Zip:
Phone: I Fax: -.. •
':BUILDING:PERMIT *. =:: " -.•
E -mail: • al t s M e \Amu 1 J I n know s t D 1 • ;- .Please"i-kivi ;:- , -
CONTRACTOR - -
Business Name: f ginel V I MA Fees due upon application S
Address: 4 4 4 . / `/, i /, #1 ii 11--6
Cit /State /Zi • : ►r]ed Amount received S
_Phone: . 14, ' II , , ' s� 3 , Date received:
CCB Lic. #: 1 c, �? -: 1 r7 et/
Authorized
Signature: 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)
is \Dsts\Permit Forms \BldgPermitApp.doc 01/03
01/20/2004 16:08 5036425815 ROSS ELECTRIC INC PAGE 01
I.
•
' El e ct r ical Pe - on
Received >; Icc trical
Date/By: Permit No.: /' l6) OoDG/ ✓000 17
City of Tigard JAN Z 2 200k Planning Approval
°a Sign
13125 SW Hall Blvd. n P.CV Permit No,:
Tigard, Oregon 97223 Plan Review Other
CITY OF TIGARD Date/By: Permit No.:
g�
Phone: 503-639-4171 g y��a
V I�CTt19V►�vVh 71 ® „ , , Land Use
Internet: www.ci.tigard.or.us 1'.:4 T' I `i” Post-Review
Date/ case No.:
24 -hour Inspection Request: 503 -639 -4175 sl�. ,"' Narn kris. Su pee Page 2 for
amc/lvlethod: Supplemental Information.
' YP ..T OF WORC ..., ..:.. '> w.. Il se ihecicgult • li New c Ii Demolition ❑ service over 225 amps. Health -care facility
• Addition /alteration/r- elacement gOther:
o ❑ ❑ Hazardous location
commercial
Service over 320 amps - rating of Building over 10,000 square feet,
'CATS R.Sf OFCONSTRXJi;"PI'EIN. 1 & 2 family dwellings four or more residential units in
N & 2- Family dwelling ❑ Cotnmercial/Industrial C1 System over 600 volts nominal one structure
ID Accesso Btiildi]1L ❑ Building over three stories or
Multi -Famil ❑ M aduf a , to a amps ed struc ru more
res or RV par
iA Master Builder ❑ Occupant load over 99 persons ❑
Egress/li plan ivla uf 1� Other: ❑ Egn ❑ Other:
• 0113SITE iPIFORMA IOPiII TEOCii TION' Submit sets of plans with any of the Above.
Job site address: .' Q s The above are not applicable to temporary construction service.
Suite #: Bldg ./Aet #: � •... . ' •Ii •s, i�l�.: .i t
Pro act Name: _ Number of inspections per permit allowed
,i ♦ 1< A i ig In.. K s Description Qty Fee (ea.) . Total
Cross street/Directions to job site:
New residential-tingle or ttmltl -family per
1 I I {� dwelling unit. Includes Anached garage.
1 I Rot + V - o 1 1 if-71 v ck • Service included:
ttl l /// 1 V I iC/ V v 1000 sq, ft. or less 145.15 4
Each additional 500 sift. or portion thereof 33.40 1
Subdivision: h 4. AAA Nom Lot #: Limited Eno." , residential 75,00 2
Fax map /parcel #: Limited nu energy, non residential 75.00 2
Each manufactured home or modular dwelling • : ' 'DESCRIPTION. OF WORK :::... • : • service and/or feeder 90.90 2
��t Eg 7�V! IZPA. v Services or feeders - Installation, ��� ��1�1�I AltaratMq Or relocation:
1 INAT , Mir O , 200 am.s or Iris 80.30 2
201 amps to 400 auras 106.85 2
401 amps to 6(10 amps 160.60 2
Y , 4 . P R O 7 ' E R T Y o w N . • • • .., am •'1CIS k • ' ' 6o I am to 1000 amps 240.60 2
Name: ��. � / , • D C Over 1000 amps or volts 454.65 2
Reconnect on 66.85 2
Address: a �� -�' u / 4 #. 1 AI 41 & Temporary services or feeders - installation,
;ta!_�i /L : / 'I alteration, or relocation:
���� �,/� �t��] 200 amps ooless
u1 1 O V vroj � nt� 66.35 1
Phone ► �gg i 201 am to 400 amps ioo 30 2
�� — 4 . *n 1:.GOI f .PFRSOIY: .' 401 to 600 am 133.75 2 • I u . M e‘ Branch extension per s - e ew. alteration, or
o per panel:
Addre v�at.r /A L� j �, i service or feeder fee, each branch circuit Fee for branch circuits with purchase of
Address:
l•l : uit 6.05 2
City/State/Zip: B. Fcc for branch circuits without purchase of
Phone: „ r D
UN ,. Z4 4 I service or teaser fee. t'ast b rat,e h circuit 44.85 z
E-mail: . Misc. addidonal brattch citrun 6,65 2
' u �14 L nja 1 I P5Y! JS . coin (Servicc nr feeder not included);
•• - " ....:.COPPER CTOR .. Each pump or irrigation circle 53.40 2
Job No:
Each sign or outline lighting 53.40 2
Signal circuit(s) or a limited energy panel.
Business Name: OS.5 alteration, or e xtension 2
/: 2
Address: 370 3k) Description:
Ci !State /Zi.: H-( S 60 -.Q d r 1 Each Additional inspection over the allowable In any of the above:
■
Phone:S�3 _Per inspection ver hour (min. l hour) 62.50 T
T Z 2800 F ax: 6V3 61 7Z n/ S Investigation fax:
Cal Lie. #r;: /S
f -. I i i ` . #: 3 V-4 4,6. other: :.
Supervising electrician 1 r Eteetdt LPeti fCp'et _ :- ?:: r.. .:, ,..
a Subtotal $
si attire re uired•
Print Name: )�OS S Plan Review (25% of Permit Feel $
Lic. #: C�2� State Surcharge (5% of Permit Feel S
— Authorized TOTAL PERMIT FEE $
Authorized Notice: This permit application expires if a permit is not obtained within
Date: ISO days atter it has been accepted as complete.
"Fee methodology set by Tel- County Building Industry Service Board.
•
(Please print name)
i:\bsts\Permit Forms \E 01/03
01/20/2004 16:22 5032537693 SUN GLOW INC PAGE 02
rvRUhFTt 1 . , U . .
, 'I e Per mit Applicati Mechanical
RECEIVES Plan . Permit ThsT�� —(200/ Planning APpravnk .
City of Tigard
13125 SW Hall Blvd. Plat Review other
Tigard, Oregon 07223 JAN 2 20i , Date/l3 , - emit No.:
Pone: 503 - 6394171 Fax: 503 - 598 -1960 poet•Rsview Land Use
Datrla : Csae rio.
1,ntenaet: WWW.ci.tigard.Qt.us CITY 0 • . = ' j j _ conk �-
24 -hour Inspection Request: 503-6391401E01 ' t j 1 Name/Mcthod
. CO t, i)1* ' FEE'.SC.HEDUILEvEt ' '' $,�' ....
►O New construction a Demolition Mexhanles) permit fees• are based on the total value of the work
per{brmed- indicate the value (rounded to the nearest dollar) of alt
PI Addi> �ioRt/ � + l ` tera � ti � o y n � l @ re } jj7lacez NST 7� O mec h an ical materials, equipment, labor, overhead and profit
� =_ 1 & 2- Farrel dwellin_ f Commercial/Industrial Velum S See yP�agge 2 for Fee Schedule
_ `111 F.t y.. $ V 1:11 . 1ViZEGG:-' �.
11111 )/ Aso Building 110 Multi -Famil . Des i, :on ILTMEEMZTMI Total
A! Master Builder • Other: Hoasng/Cooring
' '. JOB SITE ENFORMATttON•and L • ...T( ON '' Furnace - add•on air cenditionln - " 14.00
Job site address: r Zs" o .S t....1 a v'e"^ ' Gas beat pump .—.— 14'00 MI
Suite #: Bl • : JA• • t. #: Duct work 14.00
Pro eCt Name: lawariraiwimisimi Residential boiler
Cross street/Directions to job site: thr radiator or h • •`tie e stem 14.00 •
�, , / ^� / I � � � L1nw all, i fvt
vl/r v, / I K l `/ in w all, heaters (fuel, , not e
a electric)
etc) 14.00
Flue/vent for an of above 10-00
UMW 't u nits 12.15
UM UMW Subdivision: Other Fuel Ap.lia ce5
Tax tag. /.: e1 #: Water heater 10.00
• • t ESCRWFLON OF WO • jrr ' Gas fireplace 1 0,00
Al A _/ E _ .14 _. IAw fi �AW W Flue vent wot¢r karutxl. 'II .lace) 10.00
0 :r :
Lo_ li: ,a9 10 -00
7Wi �i , Waod/Fellet stove _ 10.00 MI
�/y /� .1Pw *'''/,�H/Ja - Wood fire•laceli.nsert 10.00
Ghimr1e /liner/flue/vent 10.00 MINN
E TEN. •F „, �'*'.
�I:c ERfJ�R� Y'OWPIEIt'" Other: 10.00 Enviroameatsl Exhaust & i Yeats `ion
Name: . '.� /�►� ►�' � [�� a ge hood/other kitchen equipment 10.00
Address: ►' aye /, A t!. /. 1� 10.00
�_�„ , � I . Ci nches u cer exhaust
Ci /St. tP./Zl • : ���� ♦�`.�T. W■ Single duct exhaust
Phone: 0 F M:i; (bathrooms, Collet compatztnetts,
WI.AIPPLIC NT Iii :c utiti rooms 6.80
Name: V /, l �/� l �7 ��� I D I Mil Atticierawl space fans 10.00 In
7 ,.: 711/.' aunt IJ Fuel Piping
Cit IS . te/Zi • : • SS$.4O for firs! 4, SU•DO cacti addicio al
Furnace, etc. "` MEM
Phan En 0 .. F aas;: EMI •*
E tt -.R 1 ,'J ` {/� / ]AIM_ Wall/suspended/unit heater
�I
. -. . ., CONTRACTOR . Water heater
Fireplace "'
Business Name: ► •.
Address: Z . 3 r to R _ .
Ci /Statef Zi • : • . A it C Z .b Clothes dyer (gas) ilailliM
Phone 1 - 256- 77N Fax: ".I - 235— 7 Oche`-
Total:
�
CCB Lit, #: t-} (3) ue cA tokal a tea
- t.
Authorized ( - Subtotal: $
Signature: (l1 : :otd e i bate: 2.0109 Minimum Permit Pee $72.S0 S
• _5,10.12211 ID O) Pitt` Review Fee 25% of Permit Fee)
l t� t gel State Surch _ A of PERMIT FEE TOTAL PERMIC �E S �_�
+Fee oaetbodoloO set by Tni- County Building Industry SeIce Soird
Notice: This permit application expired K2 permit is not obtained within "Site ptau required for exterior A/C mitts.
ISO days alter it has been accepted as eoaplete•
1 ADstskeerini I Per ccPermitApP.doc 01/03
01/20/2004 16:03 FAX 5036284633 THE MULLEN COMPANY 21002 /002
- Plumizin Permit A ' ion Received Plumbing
�•y t ate/a : PermitNo. / ` U �UD'( `f9OO/ I 1
City a Tigard F1 EC Planning Approval Sewer
g Dam/ : Pcraiit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard. Oregon 97223
JAN 2 �oo Date/B Permit No.:
Phone: 503 - 639 -4171 Fa posy- Rpvlew 1
Intern www t i.t and or.LL D Y 1S 1 I . , Li' •1 1' Jobs.: =- See Page 2 for tan
24hour Inspection Requez. 6 -41 7 Name/Method: Su. dements( t rormatioa
1C(FE OF WORK r`. •'' ^'" . - FEE ttor' 'to[otm`atfnlr'terdi dtlist }''
0 New construction ■ Demolition Description Q!'• Pce(a.) I Total
• Addition/alteration/replacement I • Other; `'' :`'" u' ;- :'r �_
� greGo' r3 O1, 50 t?, KM tl :7 Y . ON .. .i,. •..' . L am'-. 1'u .IO F'
''�Oi:egiiiialsi C i�• . .- . �a •..
SFR (1) bath 249.20
/O 1 & 2 -Famil dwellin • Ur Commercial/ltndustrial SFR (2) bath 350.00 -
0 Accessory Building ■ Multi- Family S FR (3) bath 399,00
■ Master Builder LI Other: Each additional bath/kitchen 45.00
'IOR SITE INFORM TIOraaid .LOCATION F ire sprinkler • sq. ft.: Page 2
O .;. .
Job site address; S • .Sw �� e�✓• P / .'- ..'::- >:`�:.:�.. � % •..�• . SftEI]t$ftfiGS.- .1 � :iy� r�';wti.:;,r • .. ' ,'
Suite #: 1 Bldg. /A• t. #: _ Catch basin/area dram _ _ 1 16.60
Pro ect Na AL A& 4 Drywell leach line. trench drain 16.60
Footing drain (no, linear ft.) Page 2
Cross street/Directions to jeb site: Manufactured home utilities 110.00
l% V� t K1 U ► 1 44. bs 11 (/ J I I B1 V • Mettho 16.60
Rain drain catmec[or 16,60
. Sanitary sewer (no. linear ft.) Page 2
Subdivision: %, i / A t IAA Pd M Lot #: Storm sewer (no. linear ft.) Page 2
Tax map/parGel #: Water service (no. linear ft.) Pa 2
DESCRIPTION OF • • 6tstareocltem : '
� Absorption valve 16.60
''ZZ t . , ig 0 ' `, p Bacicfiow preventer Page 2
algifiiargle �u �nSIV ^ O t l Backwater valve 16.60
Clothes washer - 16.60
pishwasher 16.60
' -
a:+ PROPERTTO�'IfI�:K ; SIM' TEI�i`A Drinking fountain _�,_^ 16.60
r " `` EjectoWsump 16 .60
Name: j �JA I (`7.ti= twl Al ' i11` 11'" _ Expansion tank _ 16.60
Address: 1 i * /� / /. ii 1� iii Fixture /sewer cap 16.60
Floor drain/floor ivaWt ub 16.60
' � �I �� 'Garbage disposal 16,60
Phone: �1 L1 - L4O • sue•, w .JE r u Hose bib 16.60
1-v _._.._.. nl ,, 4 � col,r_..., , - EDSON lee maker 16.60
pl ��� u
Name: llli l Interceptor /grease a - 16.64
Address: i A LL. / / AUM Medical gas - value; $ Page 2
P 16.60
City /State/Zi
P' R000fof d drain (commetcia 16.60
Phone: . • - 1 O � i 17. Fax: a 4 2 Slnk/hasin/lavatory 16.6
'rl�% /i s ieL1 '. • 0 Tub /shower /shower pan 16.60
: sobr RtAgroR • . Urinal 16.60
siness Naive: Z. U ,o � ' Water heater 16.60
Bu
4�� �� '� � im Water heater _ 16.60 • a a / r! . .. 4 Other:
INGETIMEMIR Otlier
Phan- 3 • . r - F . - So 4TN ✓�'�n ,,- - .,, _Y, _:rlittni ec» Fwas ''
i Subtotal 5
CCB Lic. #: " . " ` lumb. L c. #: -2 &O y>: Minimum Permit Fee 572.50 s
Authorized _ Z Residential Backflow Minimum Fee 536.25 -
Signet : �- Date /' 4 `t PIat1 Review (25 % of Permit Feed S
(4 , f / Steel Start ha e (6% 4t Permit Fee) S
(Pleas print nattte) TOTAL PERMIT FEE 5
Notice: This permit application espird if a permit is not obtained within • MI new cottuaterdal bulldlags require 2 sees or plans with isometric or
11)0 days atter it has been leeepted as complete. riser diigrvn foe plan rrview.
•Fee methodology set by Tri County Building Industry Service board•
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CITY OF TIGARD 24 -Hour
BI LDING Inspection Line: (5' ) 639 -4175 MST Zo V- co /7
INSPECTION DIVISION Business Line: ( ) 639 -4171
BUP
Received Date A-quested AM PM BUP
Location i i brat& Suite MEC
Contact Person .42- -4 Ph ( ) 1/ d — gq t- 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 = a.
•
Other:
ma
s .��" PART FAIL a
- MBING , A 1.721■1■C.
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
S ske Dampers
` PART FAIL
CTRICA L
Service
Rough -In
UG /Slab .
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next in section. 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 7. ,
Approach /Sidewalk Date /2 Inspector . Ext
..-
Other:
Final DO NOT REMOVE this inspection recor the job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MSTo�� ° dam 7
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Datq Requested {p _ g AM "PM BUP
Location 27e � Suite MEC
Contact Person 6 - Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm /� �P 1 /
Susp'd Ceiling
Roof 7 (1 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
O • - r:
= PART FAIL
t ECHANICAL
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 )972, Approach/Sidewalk Date / i Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour 1 7
BUILDING Inspection Line: (503) 639 -4175 MST 57 —U FO
•
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
Received Date Requested 6 _a AM PM BUP
Location /5 Pz_ Suite MEC
Contact Person Ph ( ) 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 JJ
Roof
Other: FAWarAFAIMV
Final PASS PART FAIL
PLUMBING
•
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL '
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
ut. Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA (�
Approach /Sidewalk Date ^ � Inspector` v Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL