Permit 'Building Permit Application ; <. FOR OFFICE;USE ONLY' : ,. -
0 1
2004
Received •'
City of Tigard Jt�' Date/By: / � Pe No. 6 /�D S j
13125 SW Hall Blvd., Tigard, O L4 7 223 Plan Revie ►
Phone: 503.639.4171 Fax: 50 594�o 1 TIGARD 1�1 4 � l Date/By: trIAV q - /N .° Other Perr (�D 1.� -Q/. B (p
Inspection Line: 503.639.4179UILDING DIVISION _ -� Date Ready /By: El See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: , I a, Supplemental Information
. ; . . s F . ., F ;: D Vic
, , _. v . ..- . �' ' r TYPE OF WORK ; t . ` . T» tom R EQ U IRED DA A 1 AND 2 AMILY WELLLING `�`
_. . J t,. �, . A . �,. , -... k., , r .. . _ g..:., _ . '.� : _ , . :a - ... .,.
® 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
_• work indicated on this application. ;:1 4i ; CATEGORY, OF CONSTRUCTION ,_ - 1
Valuation: $200,760.60
® 1- and 2- family dwelling ❑ Commercial /industrial V
1=1 Accessory building ❑ Multi - family Number of bedrooms: 3
❑ Master builder ❑ Other: Number of bathrooms: 2 h
J SITE ` �� floors: 1
it" .. { -„ OB . INFORMATION =AKD� LOCATION' ..�:.. —,� � :� m ��
Total number of
Job site address: 7962 SW Leiser
Lane New dwelling area: 2006 square feet
•
City /State /ZIP: Tigard, OR 97223 Garage /carport area: 634 square feet
Suite/bldg. /apt. no.: Project name: Leiser Park Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
QUIRED DATA COMMERCIALUSE CHECKLIST. :,
_.,
Subdivision: Leiser Park Lot no.: 018 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
equipment, materials, labor, overhead, and the profit for the
_ ,_ DESCRIPTION OF_.WORK _ ox work indicated on this application.
� Valuation: $
Existing building area: square feet
New building area: square feet
7 s ! (PROPERTY O WNE R ' re - r TE NANT Number of stories:
Name: Legend Homes Type of construction:
Address: 12755 SW 69 Avenue, Suite #100 Occupancy groups:
City /State /ZIP: Portland, OR 97223 Existing:
Phone: (503)620 -8080 Fax: (503)598 -8900 New:
®APPLICA T ®CONTAC,f PERSON o : . , OT10E4 5
Business name: Legend Homes All contractors and subcontractors are required to be
Contact name: Steve Lucas licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 12755 SW 69 Avenue jurisdiction in which work is being performed. If the
City /State /ZIP: Portland, OR 97223 applicant is exempt from licensing, the following reasons
apply:
Phone: (503) 620 -8080 Fax: : (503) 598 -8900
E -mail: slucas @legendhomes.com
: %£ 7- CONTRACTORS ,
Business name: Legend Home BUI DING" PERMITFEE *x 1 :'
Address: 12755 SW 69 Avenue, Suite #100
Please refer to fee schedule.
City/State /ZIP: Portland, OR 97223
Fees due upon application
Phone: (503) 620 -8080 Fax: (503) 598 -8900
Amount received
CCB lie.: 060563
Date received:
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Steve Lucas Date: 8/25/04 * Fee methodology set by Tri- County Building Industry
Service Board.
- i:\ Building \Permits \BUP- PermitApp.doc 12/03 440- 4613T(11/02/COM /WEB)
. 10/09/2002 04:1-1 -427925 —_. PAGE 02 •
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pl 503,e39,4171 5015. in l
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I Line: 303.6302411i I L UING DIVISIO '''' - -'. Y". SUPPteffigntli 1140
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Platte c lock ell that aPP y:
71 New emnstwalon • Mdilionialtcretion/roplacemerit OScrricc ever 71 elms, cornm'l pHs/an:km Iticatien
• Demolition, 0 Ottier: OSavice over 220 amps ,- rating 0 Buildng over 10,000 sq. 0.,
4 or mote new realdoltial
. ....,,,, '1'',04i! ' '1 4 ‘.1.4111!:1411114-411141f3 'r'''' .- 1:141.1.1. 1[4'". f'9..:.'7...ii1:1!;":11.,;:,.• „:.,',..■::.:;‘I...:',.'.. 011- and 2-limily dweilinvi
PSystem aver 600 volts noridnal snits in ono Structure
-Trial 2-family dwelling 0 emmtvterclallindWArlal • Accessory building 010!Jitding ova three stories OPcteloTs. 40 Inree < mate
0 hAttltiefattily ill Master budder 0 Palter; COnettiscat load OW 99 persons Umeneraciured structures or
!,, i .. , .: sc,,.::. .,,;;,..,• : ,; .•:, n , Tr , • , Korn I, 31, . 0 :;:.,... !!',1'.:%.: liJ L Ei Egros 0 v ley park
In Nealthvgire %silky 00thcr:
Job nO.: Job site Wren: 7625 SW Leticr Lane Sabmit2. sets of plans with any of the Orme,
City/State/ZIP: Tiprd, OR 97223 The shove sic not applicable to antinomy construction service.
•• ., ••-. , •:••• • 1 ,•1•;,•.T.4•- •:%;-•.1.4
MANW •Miglag6.2:7,17i.k,ratill,-,..,1/1, 4i. •;. • ,. I, 6 •,, „,
Suite/bldg./apt. no.: Project nem: Uhler Park Wre1:11.1 Citr. 11122Matillillin
Cr054 street/directions tojob site: New residential dingle- Of Muhl. trolly dwellins volt
Includes siterhed pro:
1,000 S. 11, or less RIIIIEMII=n ILIII
Subdivision: Lelia Park Lot no.; 011 Thl• aid't 509 oq. it. or • • • irs 21• 40 fr
......—___ ......) E=MIIMIVIIIrA 711 11111111101
Tar, ntaptuarcel AO.: Limited energy. non-residerinal Imo 75.00 2
• • •
NIOAAMBEMBEEr.117.77.1Pr17310.4MBMINNZO@011 bar' h rremorerwred or Inotinlio ”
dwelli _ service en • or Smear 11 90.90 2
. - Sterols:al or *seders imitanotion, alteranto, sower relocation
200 a , 11 GT MS 111111 0130 1111111111111
' 106.DS 11111 •
.I . •:: • • - .....11,,,,,•,, , ,-• 1... , ,•,14,•lis 201 amps to 400 amps .
•• i I
::,....;Cil, 7 '. '' ',' ' ''' .' ;' ,i' .. • 111? ,0
" 11114 MArg il '' '' ' • '' VI '1 '''''
• ' " • ' '. ."" ' 1 • . 401 email to 600 ;AMA 160,60
Name: Loynd Rorie] 001 amps to I 000 a ,. 240 1.11111111111
.
_
Address: 12155 SW 69 guests., Selo 0100 , , - Over 1,000 amps or who NIIMICEMIIIIIIIIIIII11
Reconnect only 66.03 2
Chy/StenalP: PeireleAdr 0 97223 . . Temporary servaces or Mears innallation, alteraden, endier
tdoestion
Phone: (503)62141160 Fax: (503)598-S9110 VA crops or ion 60.05 1111MS
Owner indention in
: is Stallaticni IS being made on property that I men which is not , 201 a ,., t 400 amp, MI 1 00
intended for sale, ken, rent, or exchange, according to ORS 447, 449, 670, and 701 MI a ,, 3 KI 600 a • l i 133 ." 11111111111§31
Owner nirtitUra; _ . Date: ___,..„ Branch circuits - nvri, etteretion, or extension, per • Nisei
______
,,. .1 r ‘-; t . ' , i . ., , ,;•Mini aiLli Lt'‘'44,'",r&VI,:.; ... • A-. " ne - ■ cil a Wit
iingeMiLifai
• ' service or tbedcr fear:soh
Sulam** matte: LegOnd HOMES ---"•••• trench *qua
„ - • II, Fen nen circUitS
Coratact name; Steve Lucas , ' • . . Wiwi dervien nr feeder*,
II Ili
..... . --- ---- . 4615
Address; 12755 SW 59'b Avegui, Suite #100 I ceeh branch ciruit
c
6.65 I
.......—....,—....--• Each add'i branch circuit
ity/StatetZW; Pordand, OR 97223 . - Mfacelleatocut (oorrlint or feeder Vet Inchidol)
Fkons: (503) 6204080 ''' ' Pea' ' (303)5984900 • ' . , 11=1=12133.111.111.11 53 EMMEN
.,x.k...4wLszA4t.MIIIIIIIIII 11-4"0 2
E-mail: olUeeSele . 4 sidhonlori.aent Signet mrcult(s) or limited.
-7i. :'• ... l' ' ...... :....i.•;11 .:4i '' ,5 : : . : ,;11', :•,: : .. '":1::' mar/ Pellet. ltarillieni or
'
extension. Describe: Par I 2
, Business nwest: Censer Electric
[ .. . , . _
e
Address.. 2920 SW 247 l Avenue # A Enna additional inspection Over filletvistde in any artist above
Par irmation 6150 NEM
City/State./ZTP: Rillabare, OR snin - Investigation , hour(' lw olio) 2 62 MIMI
-
PhOWC: (503) S91 IPDX: ( *,,, - ) 6414' Industrial plant 'reher 111111Eal Pill
: : -' Vir.=•diiiii7TUMWOMM
CM Lie.: 121159 • _pectic:al LIc fr i p , ra az 12 :11 i - -
S y p r v , Bleetricrian signature, required; 07/7
r ''7 11111111011 . — 11111=1.1 .
. . .
Print name: 1 IA ,, _., i me ", .-• - •-• --"' " • , Stale surcharge (2'14, disown Om)
— $0.
AlltberiZed 311FIVWV: . .. ,, .. , .. • . . - L TOTAL Ptkmirr FEE
. . • Tos. esparto its porno a net obtskino0 latish ISO
. mat name: I Dote: Joys miter a hop tom accepted an toortericte
. • Poe methodotoLi get b ryi.coosty Sanding We
1 ary novice Board
• nconnalcstooltstnacavretildscass 2103 . Ninalior abettor:liens Da Omit lin9w44,
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• - • 446-stsixa KfolECOMAVIER
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Mechanical Permit Ap i> � FOR OFFICE USE ONLY
�- � /(
:City of Tigard i DateB d Permit No // l i 'I j•a5
13125 SW Hall Blvd., Tigard, OR 97223 SEP 1 1 � Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 V 1 [00aA�p l Date/By: Other Permit:
.Inspection Line: 503.639.4175 CITY lit �. Date Ready /By: kris Ei See Page 2 for
TI q `74 °�_..
Internet: www.ci.tigard.or.us g�l DIN OF r1 � I Notified/Method: Supplemental Information
L31 -111- DIN DI VISION
a. "TY O F"WORK . " -- 'i i COMMERCIAL4FEE* SCHEDULE USECHECKL`ISTt
,:�, "L ".. „�.�n�ri� ^, , - �. ... ..._ Via? _x - ns. - >. - - e.�.,.�,.. �- u.a -:f .�. . .a.,� -. „_ F . . : �.: -t .,:� _ .., .�- - � , . - �:�... ., ._. „ .., x . ..� n H.�
® New construction El Addition /alteration /replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
4 , CALORY O CONSTRUCTION a .G 9 , i, V $
RESIDENTIAL EQUIPMENT /SYSTEMSIFEES r '
® 1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOBSITEINFORMA IIONAND'I OCATION;" ; ' Heating/cooling
Air conditioning or heat pump
Job site address: 7962 SW Leiser Lane
(requires site plan showing placement) 14.00
City /State /ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: Leiser Park
Gas heat pump 14.00
Cross street/directions to job site: Duct work 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: Leiser Park Lot no.: 018 Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
re 4 ' i ' P ` Water heater 10.00
Gas fireplace
� � DESCRIPTION �® �WORIC . ,: .r -� , � 10.00
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
,m ti Chimney/liner /flue /vent 10.00
-PROPERTY OWNER` .M ® TENANT ' '
.. 1-4-'''':Mgr E" ..11— , , „ .. 4,... .., � ,� : . „,, .. „.. . - �' Other: 10.00
Name: Legend Homes Environmental exhaust and ventilation
Range hood /other kitchen
Address: 12755 SW 69 Avenue
equipment 10.00
City /State /ZIP: Portland, OR 97223 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
l A PPUIC�NT 1 ' ® CONTvACT PER ' Attic /crawlspace fans 10,00
,. ,, ', ... . ,. ,, ,-= ,A,._ w. %a .....,...... 1,-,,, ti.... ... �.
Other: 10.00
Business name: Legend Homes
_ __ Fuel piping
Contact name: Steve Lucas $5.40 for first four; $1.00 for each additional
Address: 12755 SW 69 Avenue, Suite #100 Furnace, etc.
Gas heat pump
City /State /ZIP: Portland, OR 97223 Wall /suspended /unit heater
Phone: (503) 620 - 8080 Fax: : (503) 598 - 8900 Water heater
Fireplace
E -mail: Range
°. L' . r� .:,_ CO TI 2 CTO ; � � , ( ` 4 � 2a `° s, Barbecue
Business name: Tri County Temp Control Clothes dryer (gas)
Other:
Address: 13150 Clackamas River Drive ` "' ,
:' 1' MECHANICAL PERMIT' EES� * ; ; ''. 1
City/State /ZIP: Oregon City, OR 97045 Subtotal
Minimum permit fee ($72.50)
Phone:4503) 557 - 2220 - -- — Fax: 4503) - 557 - 0919 —
Plan review (25% of permit fee)
CCB lie.: 72623 State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
g days after it has been accepted as complete.
Print name: Steve Lucas Date: 8/25/04 * Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permits \MEC- PermitApp.doe 12/03 440 -4617T (1 I /02 /COM /WEB)
Plumbing Permit App c� .9r 1 V IA FOR OFFICE USE ONLY
City of Tigard
Received
Permit No.: �- ► 15 A�IOIf _. 71
5.eJ
13125 SW Hall Blvd., Tigard, OR 97223 6E1' 0 1 2004 eko Date /By:
Pl an Review Other Permit No.:
Phone: 503.639.4171 Fax: 503.598.1960 1 4 SNP I Date/B
24- Hour Inspection Line: 503.639.4175 CITY OF TIGAF - _ I I Date Ready /By: Juris: 0 See Page 2 for
Internet: www.ci ngard onus BUILDIf�f1 ni 1 ^' Notified Method: Supplemental Information
.. as ,�c�. _ _� ,Y. E i . . „ is,n der.. 2 �"j,:,:,u :'; i,
_ TYPE OF rWORI{ -a FE) ' SCHEDULE, ..
Wi n» x . ' t, " ..� ., . . : : r� � ... ,: v ,. ,�, ai, �, �_ _ �..., r,a�,,..��.: _ �
® New construction ❑ Demolition For special information use checklist
Description I Qty. Ea. I Total
❑ Addition/alteration/replacement ['Other: New 1 dwellings (includes 100 ft. for each utility connection)
4 i
/ 4 CATEGORY OF tCONSTRUCTION SFR (1) bath 249.20
® I- 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
JOB SITE INFORMATION AND LOCATION' , .
,, , ,. .. -. , .- - . , ^,�., ...,.. - u. -- Site utilities
Job site address: 7962 SW Leiser Lane Catch basin or area drain 16.60
City /State /ZIP: Tigard, OR 97223 Drywell, leach line, or trench drain 16.60
Footing drain (no. linear ft.: ) Page 2
Suite/bldg. /apt. no.: I Project name: Leiser Park
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: Leiser Park Lot no.: 018 Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no
s Absorption valve 16.60
,„ °3. ,:, i DESCRIPTION OF WORK Nt O 3 " 4 r, Backflow preventer Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
.,, *, . Drinking fountain 16.60
`® PR OPER' aiWN R T
j ...' , ::-.%
.rtes. ,, , , :: .. , ,..::; � .,-, - ,r vih , ., :: r .
Ejectors /sump 16.60
Name: Legend Homes Expansion tank 16.60
Address: 12755 SW 69 Avenue, Suite #100 Fixture /sewer cap 16.60
City /State /ZIP: Portland, OR 97223 Floor drain /floor sink/hub 16.60
Phone: (503)620 - 8080 Fax: (503)598 - 8900 Garbage disposal 16.60
® APRLICANT
, CONTRACT PERSON t Hose bib 16.60
�� t . �., - Ice maker 16.60
Business name: Legend Homes Interceptor /grease trap 16.60
Contact name: Steve Lucas Medical gas (value: $ ) Page 2
Address: 12755 SW 69 Avenue, Suite #100 Primer 16.60
City/State /ZIP: Portland, OR 97223 Roof drain (commercial) 16.60
Phone: (503) 620 - 8080 Fax: : (503) 598 -8900 Sink/basin /lavatory 16.60
Tub /shower /shower pan 16.60
E -mail: slucas @legendhomes.com .
Urinal 16.60
ONTR O
r� ` :, .� M. .. �C sue . T: B (: ig lAkz,,_ 4.s :.,. _ ,;-'l Water closet 16.60
Business name: Wolcott Plumbing Water heater 16.60
Address: P.O. Box 2007 Other:
City /State /ZIP: Gresham, OR 97030 Subtotal
Minimum permit fee: $72.50
Phone: (503) 667 - 1781 Fax: (503) 667 - 9891 Residential backflow minimum permit fee: $36.25
CCB Lic.: 23847 Plumbing Lic. no.: 26 - 208PB Plan review (25 % of permitfee) -
State surcharge (8% of permit fee)
Authorized signature: '�!L
O "" TOTAL PERMIT FEE
Print name: Steve Lucas Date: 8/25/04 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 \PLM- PermitApp.doc 12/03 440- 4616T(10/02/COM /WEB)
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
WOLCOTT PLUMBING CONTRACTORS
Re-BOX-200-7 6)75 1 5 re f i L ' �1 c n� i 2 < ��(
- TroLddo c 970 to
Plumbing Signature Form
Permit #: MST2004-00253
Date Issued: 9/21/2004
Parcel: 2S112BD -LP018
Site Address: 07962 SW LEISER LN
Subdivision: LEISER PARK
Block: Lot: 018
Jurisdiction: TIG
Zoning: R -4.5
Remarks: New SF detached.
Your company has been indicated as the plumbing contractor 'or the permit indicated above. In order for
the plumbing permit to be valid, please have the appropriate • dividual from your company sign below and
return this Plumbing Signature Form prior to the start of the ork to the address above, ATTN: Building
Division.
No plumbing inspections will be authorized until thi- completed form is received
OWNER: PLUMBING CONTRACTOR:
LEGEND HOMES WOLCOTT PLUMBING CONTRACTORS
12755 SW 69TH < -
SUITE 100 0
PORTLAND, OR 97223
Phone #: 503 - 620 -8080 Phone #: 503 - 667 -1781
•
Reg #: LIC 23847
PLM 26 -208PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X , �
II.
Signa r hori .='Mr lumber
If you- have- any_questions,_please call 503.718.2433.
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CITY CIF TIGARD 24-Hour
ISOILDING • Inspection Line: (s3) 639-4175
MST ,--;o0c-i -00
INSPECTION DIVISION
Business Line: ( 1 3) 639-4171 -
BUP
—
Received Date Requested AM PM BUP
Location
,10 4
_ _ Suite MEC
Contact Person Ph ( ) D 9 - 3376 PLM
Contractor Ph ( SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation Access
Ftg Drain ELR
, 4
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear Cf(P-11
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Pr"- C/ISC
,40
- AS PART FAIL
- • ING'
Post & Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
• 1111111111111111111111111.r
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough-In
Gas Line
Smoke Dampers
PART FAIL
TRICAL
Service
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final
El PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS
SITE ' - El Please call for reinspection RE: _ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOY REMOVE this inspection record fr e job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour • . -
BUILDING „Inspection Line: (503) 639 - 4175
INSPECTION DIVISION < Bus Line: (503) 639 -4171
BUP
Received Date —43- AM PM BUP
Location / - - 4 _ J ' Suite MEC
Contact Person Ph ( ), z /c PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ► - Lr . , , ��y �� .�!� �„�,� ELC
Ftg Drain ► > �r` ' 'a' ' el-' s -r s �°'r i* ` x � �, "' �s W ELR
Crawl Drain `,'t_ v:._3:t>ti zK s k� o�''tr' �,��:?��? r _�.�..2 :,�
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath /Shear r
Framing AILL ? ?, '— `�vr.���i a��t
Insulation
Drywall Nailing
Firewall a� � H ,r - t" 1 0 ao v — o ''
Fire Sprinkler 11-,, �' "'"J Uw
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PAS_S,< -PART FAIL
-R,LUMBIN :4' VZ, <. ` '
Posi &Beam`
Under Slab
Rough -In
'Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
(PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL ° <a.
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Anal Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
�
SITE`_M ; . Please call for reinspection RE: Unable to inspect — no access.
Fire Supply Line
ADA
Approach/Sidewalk Date n Inspector rT ^ - - " t t I 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 MST 1 `e
INSPECTION DIVISION . • 'Business Line: 1503) 639 -4171
BUP
Received Date Requested AM PM BUP
Location . q J Suite MEC
Contact Person Ph ( ), ° C 3 376) . PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain - ELR
Crawl Drain "
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear 1V� �'t _. "/ /4�I/ / /
Framing �. .. .as rsiicd$ sagrA /il '! ' ,����l��.S l!■..-rlu�s.�sfl�7/3
�— — —. = ��'
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:
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 .
Fi arm
❑ Reinspection fee of $ required before g ext inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line.
ADA
Approach /Sidewalk Date Inspecto 1` Ext
Other:
Final DO NOT REMOVE this inspection reco ., om the Job site.
PASS PART FAIL