Permit 7/26/06, REPRINTED TO CORRECT' ',, ,
SUITE ADDRESS FROM 200 TO 202. r BUILDING PERMIT
V I 1 1 V• 11 a./ PERMIT #: BUP2006 -00188
4I11' DEVEL O -639 -4171 DATE ISSUED: 6/22/2006
SW
PARCEL: 1S126DC-04400
SITE ADDRESS: 09430 SW CORAL ST 202 ZONING: C -P
SUBDIVISION: LEHMANN ACRE TRACT LOT: 007 JURISDICTION: TIG
Project Description: TI walls for office space (2,433 sq ft area)
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 34 BASEMENT: sf AREA SEP. RATED:
STOR: 2 HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 63,331.00
Owner: Contractor:
MARTIN BUILDING LLC ROBERT TODD CONSTRUCTION INC
16771 SW BOONES FERRY RD 4080 SE INTERNATIONAL WAY #D -1
LAKE OSWEGO, OR 97035 MILWAUKIE, OR 97222
Phone: 503 - 496 -0610 Contact #: PRI 503 - 653 - 5704
FAX 503 - 653 - 5729
FEES Reg #: LIC 98517
Description Date Amount REQUIRED ITEMS AND REPORTS
[BUPPLN] Pln Rv 5/5/2006 $355.80
[FLS] FLS Pin Rv 5/5/2006 $218.95
[BUILD] Permit Fee 6/22/2006 $547.38
[TAX] 8% State Surchari 6/22/2006 $43.79
Total $1,165.92
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. 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 work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by
calling 3- 246669 r 800 - 332 -2344.
Issued y: ) !2._L41( J Permittee Signature -
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
7`%3o Su CraXfT CO
IBa Permit Application, �< \ , .,� i� j ' "Fox OFFICE' U ONLY . '. ' ---\Ai , . ,.
City of Tigard oa Bv�' 6f bit PR Permit No.: j l X6.6 .
13125 SW Hall Blvd., Tigard, OR 97223 t , Plan Review /�
Phone: 503.639.4171 Fax: 503.598.1960 � \ c3 2 006 i * Date/13 : p , , Other Permit:
Inspection Line: 503.639.4175 VII \ ' " I Date Read B Supplemental Information
�� lu9 H See Attached Checklist for
Internet: www.ci.tigard.or.us U1 Notified/Method: �6 i t � '
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, , ;`a+ " , „ve "" < 474 s ,a � - e re'''' . R 4-1 [SIRED'= DATA: =1.` %AND' Y D'.WE
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❑ 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: Tenant Improvement equipment, materials, labor, overhead, and the profit for the
hr�s�
�; �„� ., t�r� i �,re , �,� ��i, - t � s?� ,� work indicated on this application.
11 °rt. .i_ S O ff._ o, ,k 4 , yy t CAT GORE x O F GONSTRUC iUN .- ..pit „' x . . ft -.i- '.
❑ 1- and 2- family dwelling ® Commercial /industrial Valuation: $
El Accessory building Ill Multi-family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITEttIWIS 1ATI : V AND LOCAT10N ; '�" 5 Total number of floors:
144 „ja,44-41A5V :AI Job site address: 9430 SE Coral Street, 2 " Floor New dwelling area: square feet
City /State /ZIP: Tigard, Oregon 97223 Garage /carport area: square feet
Suite/bldg. /apt. no.: )0 Project name: `1V Wi'2' i ver Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
l .. ,, ;:°o o '.- -, _ -- .,. ... r 3 sa -- fgx. �...,..; , - .;v(�:tr..'
REQ D w ['A C OIVIM ER CtAL US 1 E C -KLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map/parcel no.: Indicate the value (rounded to the nearest dollar) of all
r =s;;' ._67. _ ;' � 3 Y ;� 'ea ry ,1- x,:, ;.=:�„ ai - n .w� ; ; .. ;,T,a- ;;; �: - . .r ~, .. .,err,,»
equipment, materials, labor, overhead, and the profit for the
� ak i n` DES - ,, , 01V OF WORK ;, '� T ,. = work indicated on this a7 lication.
Office tenant improvement to existing warm shell space. Valuation: —. �/(3 J -e Ib�
Existing building area square feet
New building area: 2. square feet
t ,�` v ' ''' S " „, k-l. w ova ,,a. S t- Y P 3 '-�r s .,
_ `® P ,9 ER , { a � , a t T
® ENANT ` V Number of stories: 2
Name: Martin Building, LLC Type of construction: VB
Address: 16771 Boones Ferry Road Occupancy groups:
City/State /ZIP: Lake Oswego, Oregon Existing: B ?611
Phone: (503)496 -0610 Fax: (503)496 -0609 New: B
.. , Y �='2r'��es,�s'^+e #:, 33C?L';. .zy;.;'v "' "da,•F'v:'iM'Y�?r� -t ..a�< "��` � ...��= x :�: °'m'�;°�xr -� �.:�a_ar,?�aa;�:.�+,�ri;., .r::�:":; "- '�= ,� >�.ar
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APPE[ =c r y- y. ®;`CONTACT PERSON ; "<r , X ,` 4.44 a411 4, � "' ** r
<.m..�a. r,�ws fir.' .;at a. �.., �.. a. .._�. � r_aS.rm.. -�»:r�, =" ?C. ,"., _.. �:m.`# a?�:. . ' ,
-_ - - -' d 1 d "r � 3 ale . w.w ia t ; A n>Y � " ,
x r.�5. ,..€ � ��.�.� .._, '' � '. ..:- .aa�tt�3t�§�.k '.,i4m, �.. ?a,.��,* .. «_
Business name: Studio 3 Architecture, Inc All contractors and subcontractors are required to be
Contact name: Gene Bolante licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 222 Commercial Street NE jurisdiction in which work is being performed. If the
City/State /ZIP: Salem, Oregon 97303 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 390 - 6500 Fax: : (503) 390 - 6501
E -mail: gene @studio3architecture.com
i 1 r 2 CONTRACTOR of X� . t t
x.
Business name: Robert Todd Construction *' > ° ° °� a�-- �`� °r�- `= r.��-`-< *i �,, a t.�,
:BUIIBING T'E �'-
Address: 4080 SE International Way Suite B113
Please refer to fee schedule.
City /State /ZIP: Milwaukie; Oregon 97222 •
I_ t✓ Fees due upon a
Phone: (503) 653 - 5704 - . - 4( - Fax: 503) 65 .729
i Amount received
CCB lic.: 98517 QJ � /I i A
%, ,. ,, 0j D ate received:
Authorized signature: fl '' This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Gene Bolane Date: * Fee methodology set by Tri- County Building Industry
f , - . Service Board.
i U3uildmg \Permits \IIUP- PernuiApp.d, 12/03 440-4613T(I i3O2 /COM/WFI3)
Form 2a Project Name: Martin Building Second Floor Page:
SUMMARY
Project 1. Project Name Martin Building Second Floor
2. Project Address 9430 SW Coral St. Second Floor
3. City/Town Tigard 5. County ,
4. Building, Gross Area (ft2) 4,322 6. No. of Floors I 2
7. Construction Site Elevation Above 2,000 ft? ❑ YES El NO
Attached Chapter Type ID Description Attach
Forms and Building Envelope Form 3a Building Envelope - General ❑
Worksheets 3b Prescriptive Path - All Climate Zones ❑
* CodeComp Report for Simplified Trade -off ❑
* In lieu of 3b * Floppy disc with .occ CodeComp file ❑
Check boxes to Worksheet 3a Wall U- factor ❑
indicate attached 3b Roof U- factor ❑
forms and 3c Floor U- factor ❑
worksheets 3d Window /Skylight Schedule ❑
Systems Form 4a Systems - General ❑
4b Complex Systems ❑
Worksheet 4a Unitary Air Conditioners - Air Cooled ❑
4b Unitary Air Cond. - Water & Evap Cooled ❑
4c Unitary Heat Pump - Air Cooled ❑
4d Unitary Heat Pump - Water Cooled ❑
4e Packaged Terminal A.C. - Air Cooled ❑
4f Packaged Terminal Heat Pump - Air Cooled ❑
4g Water Chilling Pkgs - Water & Air Cooled ❑
4h Heat Rejection Equipment ❑
4i Boiler - Gas -Fired and Oil -Fired ❑
4j Furnace & Unit Heaters - Gas and Oil -Fired ❑
4k Simultaneous Heating and Cooling ❑
41 Air Transport Energy ❑
4m Natural Ventilation ❑
Lighting Form 5a Lighting - General El
5b Interior Lighting Power - Tenant Method El
5c Int. Ltng. Power - Space -by -Space Method ❑
Worksheet 5a Lighting Schedule o
5b Interior Lighting Power p
Applicant 7. Name Ge Bolant 10. Telephone 503 - 390 -6500
8. Company St Ar 11. Date 05/04/06
9. Signature
Attached No. of Pages Desc ption of Documentat n
Document-
ation
Compliance with OSSC, effective 01/01/05
1
•
Form 5a Project Name: Martin Building Second Floor Page: 2
LIGHTING - GENERAL
1. Interior Exceptions (Section 1313.1)
o No Interior Lighting. The building plans and specifications do not call for new or altered interior lighting.
Skip to item 5, Exterior building Lighting - General, below.
Exceptions o Exceptions. 1. The building or part of the building qualifies for an exception from code lighting
Discussion of qualifying exceptions requirements. Applicable code exception is number:
in instructions section.
2. Lighting equipment that qualifies for an exception - in addition to general lighting and is separately
controlled. Applicable code exception is number:
Areas of the building and equipment that quality for any exceptions:
Plans /Specs
Show compliance by including a
drawing sheet, detail number, and /or
specification section and
subparagraph.
2. Local Shut -off controls (Section 1313.3.1.1)
i..ompues. Hr least one local snueon ngnung contra Tor every c,uuu square jeer or
lighted floor area and for all spaces enclosed by walls or ceiling height partitions.
This control(s) is detailed in the building plans on drawing number:
o Exception. I he building or part of the building qualities tor an exception.
Applicable code exception is Section 1313.3.1.1, Exception:
Portions of the building that qualify:
3. Automatic Shutoff Controls (Section 1313.3.1.2)
o Not Applicable. Office floor area is not over 2,000 square feet of contiguous office floor area or
permitted space is not over 5,000 square feet No offices less than 300 square feet, meeting
or conference rooms, or school classrooms.
o Complies. All interior lighting systems are equipped with a separate automatic control to shut off lighting
during unoccupied periods. Offices less than 300 square feet, meeting and conference rooms, and school
classrooms shall be equipped with occupancy sensors that comply with Section 1313.3.1.2.1.
Compliance details in plans /specs:
exception. I ne miming or pan or the mooing qualfies for ari ext.epou I. I Ile
applicable code exception is Section 1313.3.1,2, Exception:
Portions of the building that qualify:
4. Daylighting Controls (1313.3.1.3)
o No classrooms or atriums with skylights or window to wall ratio greater than 50 %.
o Complies. All classrooms and atriums with window to wall ratio greater than 50% and/or skylights are
equipped with automatic daylight sensing controls, as required by Section 1313.3.1.3.1 and Section
1313.3.1.3.2. The daylight sensors specified comply with Section 1313.3.1.3.3.
Compliance details in plans/specs:
Exterior Build - ing 5. Exterior Lighting (Section 1313.5)
Lighting o Complies. I he plans do not call for use Dt incandescent or mercury vapor lamps for use on building exterior.
is lighting directed to illuminate the
exterior of the building and adjacent o Exception. I he building plans indicate luminaires with incandescent or mercury vapor lamps, but are
walkways and loading areas with or specified for use in or around swimming pools, water features, or other locations subject to requirements
without canopies. of Article 680 of the 2002 National Electrical Code.
Clock Switches shall be
astronomic (seasonal correcting) type
with separate programs for each day 6. Exterior and Canopy Lighting Controls (Section 1313.3.2)
of the week and shall store energy to
maintain timekeeping during power o Complies. The building plans and specifications include photoelectric and/or clock switches on all exterior
outages. lighting systems which are designed and programmed to extinguish lights when daylight is present, as
required by Section 1313.3.2.
7. Interior Connected Lighting Power (Section 1313.4)
YES Complies. The interior lighting power does not exceed the interior power allowance established
•z in either the Tenant Space Method (Form 5b) or the Space -by -Space Method (Form 5c).
t7 Tenant Space Method (Form 5b) ❑Space -by -Space Method (Form 5c)
Compliance with OSSC, effective 01/01/05
Form 5b Project Name: Martin Building Second Floor Page:
INTERIOR LIGHTING POWER - Tenant Space Method
Lighting Budget
(a) (b) (c) (d)
Occupancy/
Tenant or Building Type Floor Area Max Power Density Lighting Power
Use Types
See instructions for desc- ription _ (Table-13G) (Sq ft) (wlft Budget (W )
of occupancy types Office 4,322 1.0 4,322
Lighting Power 1. Total Interior Lighting Power Budget (Watts) for Building. 4,322
Budget
Track Lighting 2. Total length of track lighting (ft)
Power
3. Line 2 multiplied by 37.5 Watts /ft
4. Total amperage of circuit breaker(s) serving track lighting (amps)
5. Voltage of circuit breaker serving track lighting (volts)
6. Maximum wattage of track lighting (multiply line 4 by line 5)
7. Track Lighting Power (lesser value of line 3 or line 6)
8. Track Lighting Power (line 7)
9. Total Interior Lighting Power from Worksheet 51D-1 (Sum of Column (m)) + 3,629
Building's Lighting 10. Total Adjusted Lighting Power (line 8 + line 9) = 3,629
Power
11. Does design meet budget? Line 10 must be no greater than line 1. YES
5 -2
Compliance witn OSSC, effective 01/01/05
Works Project Name: Martin Building Second Floor Page: 4 -
LIGHTING SCHEDULE
(a) (b) (c) (d) (e) (f)
Lum Luminaire Is Luminaire -
ID Luminaire Lamp Ballasts Power From
Type Description No. Description No. Description (watts) Table 5c
A Fluorescent T8 - 4 foot � 2 -F32T8 -ELECT NO -62W _1 2 F32T8 1 Electronic Normal Output. RS 62 YES '
B Fluorescent Rapid Start T8 - 2 foot 2 -F17T8 -ELECT NO -33W l 2 F17T8 1 Electronic Normal Output. RS 33 YES
3 —
1 .
I
Zj
1 ..d 1 _._1
— I
i .
-1 _
06-24 LightingForms- V2.3.xls
•
Worksheet 5b -1 Project Name: Marlin Building Second Floor Page: 5
INTERIOR LIGHTING POWER
Space -by -Space Method Only
Skip to column (f) if using the Tenant Space Method
(a) (b) (0) (d) (a) (CO (h) (1 (f) (k)
Space Type Lighting Power Lem la from Quantity of Lighting
R301 (do not Area (Table 13-H) Space Type Budget Worksheet e Luminaires (or lineal Luminaire Exempt Power (g) Room Total
kMw any blanks) (ft') (enter space type only once per room) 1-PO (b) x (d) Column (a) ft. for hack lighting) Power (Watts) Fbtures x (h) Llg. Power
Each room 100/101 538 Office plan 1.1 592 A •( 8 62 a 496 496
must be 102 164 Food Preparation 1.2 197 A J 2 62 O 124 124
Identified.
Describe karineires for 103 165 Officearclosed 1.1 182 A 2 62 a 124 124.
each indvidta room in -
OVra 104 103 Office-enclosed 1.1 113 A 2 62 a 124 124
105 1062 Office-open plan 1.1 1,166 A !! 13 62 a 806 806
- B z i 1 33 • 33 -
106 171 Active Storage 0.8 137 A Lri 3 62 a 186. 186
107 94 Office - enclosed 1.1 103 A 2 62 a 124 124
For trek fighting enter 200 177 Lobby - General 1.3 230 A J 2 62. a 124 124
tenet feel in cokmn -
k 201 114 Office-enclosed 1.1 125 A 11. 2 62 • 124 124
202 96 Office - enclosed 1.1 108 A . wi 2 82 a 124 124
Colsmn Qjt (k), enter room sun of 203 153 Office- enclosed 1.1 168 A fi 2 62 a 124 124
coMarn
only once at first entry for 204 95 Office-enclosed 1.1 105 A J 1 62 • 62 62
the room . See example - �
i instructions. 205 155 Omcearxb J
sed 1.1 171 A 2 62 • 124 124
206 130 Office -open plat 1.1 143 A 2 82 0 124 124
201 143 Office plan 1:1 157 A 1 2 62 • 124 124
300 215 Office plan 1.1 231 A J 3 62 a 186 186
301 152 Office-enclosed 1.1 187 A 2 62 a 124 124
302 228 OffIceenclosed 1.1 251 A 3 62 a 186 186
303 55 Conidor/Traraition 0.5 28 A 1 1 62 • 62 62
208 151 Office -open plan 1.1 188 A J 2 62 a 124 124
_ -I - a .
• _ a _
_ a
- _ a
_ -1 - a
- J a - _
-I a
- - J a _ ..
- _ - I - a - -
J - a - _
- - .i - a -
- - - a
- - .1 a -
- '1 - a -
- a - -
1 a - _
_ _ -I - a - -
- _ ■I - a - -
- _ . a -
- _ _ - a - -
- - -I - a - -
4,163 Worksheet 66 -1 Total Budget 4,547 WkslOb•l Total Lighting Power (exckldingexempbtrack fixtures) 3,629
Other Pages Total Number of Additional Worksheet 5b 1 0 =1
List the addtiorrcl
worksheets ree-ssary to
catalog al kmireires in
bnik@g -
(m) (n)
(I) Proposed Binding Lighting Power
Lighting Power Budget Space -by- (Total of column Sr), awarding Area Soft (not required for
Worksheet Number Space only (Total of column (e)) exempt/track) Tenant Method)
5b-1 x,547 3.829 4,163
5b-2
5D-3
4 r,;4.7 ‘ ,
Sum of additional 5b worksheets
s ' + Total Budget (of all worksheets) 4 3,829 4,163
e
CompUace with OSSC, effective 01/01105
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Bt1F�2006 01 2006-01813
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: &22/2006
Phone: (503) 639 -4171 irti 1 i1 -
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/27/2006 TIME: 7:03AM PAGE: 64
SITE ADDRESS: 09 430 SW CORAL ST 202 CLASS OF WORK:
SUBDIVISION: LEHMANN ACRE TRACT LOT #: ow TYPE OF USE:
PROJECT NAME: WESTRIDGE
DESCRIPTION: TI walls for office space (2,433 sq ft area)
OWNER: MARTIN BUILDING LLC, PHONE #: 503.496-0610
CONTRACTOR: ROBERT TODD CONSTRUCTION INC PHONE #: 503- 653.5704
Inspection Request Scheduled For: Date: 7/27/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 Final inspection 033861 -01 503 -381 -6101 N
Corrections /Comments / Instructions:
•
41
() , j iAc .,_ ._.:s ... t-- -
. ' _._.--/..)
C._
P ASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I FAIL CALL Fs •' INSPECTION n ADDITI6NAL F. S ASSESSED
► AO! ►
Inspector: t Date: Z ` • • Phone #: (503) 718�2
-
CITy._.V TIGARD
BUILDING DIVISION PERMIT #: BUP2006-00188
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/22/2006
Phone: (503) 639 -4171 Azfi v
Inspection Requests (24 Hrs.): (503) 639 -4175 ':_..
INSPECTION WORKSHEET FOR DATE: 7/26/2006 TIME: 7:07AM PAGE: 53
SITE ADDRESS: 09430 SW CORAL ST, 6 �1 ' .) CLASS OF WORK:
SUBDIVISION: LEHMANN ACRE TRACT Q LOT #: 007 TYPE OF USE:
PROJECT NAME: PVFSTRIDGE
DESCRIPTION: TI walls for office space (2,433 ..q ft area)
OWNER: MARTIN BUILDING LLC, PHONE #: 503 - 496.0610
CONTRACTOR: ROBERT TODD CONSTRUCTION INC PHONE #: 503 - 653 -57[)4
Inspection Request Scheduled For: Date: 7/26/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
299 • Final inspection 033760-01 503 - 381 -5101 N
Corrections /Comments /Instructions:
----- g Ole-ki R- MOLE A-1-30 e_Et(—io kr -- liat-(_____
r
..,....___ ) , ,_ Ovi( ',._,_' ' - trs -_____._
AN &r b
K)' r ► d I[: ; E C •..-- Ii.A
i 0 �-
n PAS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
AIL I 1 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/10 2 A - Z
Inspector: Dater `-c: Phone #: (503) 718-
,-- _. _
CIT-rAF TIGARD
BUILDWG DIVISION PERMIT #: BUP200&0018B
13125 SW Hall Blvd Tigard, OR 97223 DATE ISSUED: eini2006
1 •,
Phone: (503) 639-4171 A,
,..„,„, -
Inspection Requests (24 Hrs.): (503) 639-4175 „ ,,
1 39
INSPECTION WORKSHEET FOR DATE: 7/9/2006 TIME: 7 : MAM PAGE:
SITE ADDRESS: 09430 SW CORAL ST 0 c\ ocd---- CLASS OF WORK:
SUBDIVISION: LEHMANN ACRE TRACT - d' LOT #: 007 TYPE OF USE:
PROJECT NAME: WESTRIDGE
DESCRIPTION: TI Walls for office space (2,433 sq ft area)
OWNER: MARTIN BUILDING LLC, PHONE #: 503-496-0610
CONTRACTOR: ROBERT TODD CONSTRUCTION INC PHONE #: 503-
Inspection Request Scheduled For: Date: 7/1912006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
287 Suspended ceiling 033323-03 503-381-5101 N
Corrections/Comments/Instructions:
-
,... =11111=Li.•-----....ig■ 111 1111
r ,...._ y ■ -.......-
NEW '
•
I -PASS PARTIAL APPROVAL fl CANCEL fl NO ACCESS
FAIL • CALL FOR 1/4SPECTION fl ADDITI0 AL F ES ASSESSED
Inspector: Agitit Date:
lif Cr Phone #: (503) 718-A23
Isony- w w
CITY( -T TIGARD
BUILDING DIVISION PERMIT #: 2 00 --60/ $v
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 U 7 1 @�0��1 �
Inspection Requests (24 Hrs.): (503) 639 -4175 ,.•
'' I ,,
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
ci SITE ADDRESS: CI � - 9-L-/`' CLASS Or WORK:
SUBDIVISION: LOT #: ' OF USE:
PROJECT NAME:
DESCRIPTION: C I
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 6 z - O Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 r►!- - 3 g - - s�OI
Corrections /Comments /Instructions
r 0
I lr-
- ' ' WWI / A i ■.. I& I •
sat
r
•
✓ n PARTIAL APPROVAL El CANCEL El NO ACCESS ,
FAIL E CALL FOR INSPECTION ❑ ADDITI NAL F ES ASSESSED
�I
Inspector: AIWA Date: 2 g v!O Phone #: (503) 718-