Permit •
' MASTER PERMIT
C ITY OF TIGARD
PERMIT #: MST2004 -00252
,, DEVELOPMENT SERVICES DATE ISSUED: 9/21/2004
�� � �� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 07988 SW LEISER LN PARCEL: 2S112BD -LP019
SUBDIVISION: LEISER PARK ZONING: R
BLOCK: LOT: 019 JURISDICTION: TIG
REMARKS: New SF detached.
BUILDING
REISSUE: LP019 -A1 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 24 FIRST: 1,367 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,752 of GARAGE: 566 sf FRONT: 20 PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 TI62P. sf RIGHT: 15
VALUE: 302,696.40
OCCUPANCYGRP: R3 BDRM: 5 BATH: 3 TOTAL: 3.119 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: ' 1 LAUNDRY TRAYS: 1 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: 1 VENT FANS: 5 CLOTHES DRYER: 1
GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 2
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 5
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: 6 201 • 400 amp: 201 - 400 amp: tat W/O SVCIFDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 • 600 amp: 401 • 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HWSVC /FDR: 601 • 1000 amp: 601 +ampe•1000v. MINOR LABEL:
1000+ amp/yolt :
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: ALL - ENCOMP BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 8,423.57
LEGEND HOMES LEGEND HOMES CORP This permit is subject to the regulations contained in the
L Tigard Municipal Code, State of OR. Specialty Codes
12755 EGE D 69TH 12755 LEGEND D
SUITE 100 TIGARD, 69TH AC AV R and all other applicable laws. All work will be done in
PORTLAND, OR 97223 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: 503 620 - 8080 Phone: 620 - 8080 ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those
Rep #: LIC 60563 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 Plumb Top Out Exterior Sheathing Insr Storm drain Insp Mechanical Final
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Water Line Insp Plumb Final
Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Water Service lnsp Building Final
Foundation Insp PLM /Underfloor Framing Insp Insulation Insp Appr /Sdwlk In
Post/Beam Structural Mechanical Insp Shear Wall Insp Rain drain lnsp E • ctrical Final \
Issued B . c.- r64_,,v Permittee Si nature : ,, , �_ \MIk
• y 9
Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day
RECE
Building permit Application, 0 + 20O' FOR OFFICE USE ONLY
City of Tigard DateBea a �IJI Permit No.: �' ��_
cm(
13125 SW Hall Blvd., Tigard, OR 97223 C OF TIG' Plan Review
%A. -u .1 Date / B : P't/ov C / - N - o t ♦ � D Other Permi . �
Phone: 503.639.4171 Fax: 503.598.1960 Dl
Inspection Line: 503.639.4175 BUILDING ^� P I Date Ready/By: 1u ® See Attached Checklist for
Internet: www.ci.tigard.or.us Notified/Method: , CI. Supplemental Information
TYPE OF WORK 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
CATEGORY OF CONSTRUCTION work indicated on this application.
® 1- and 2- family dwelling ❑ Commercial /industrial Valuation: $301,949.40
❑ Accessory building ❑ Multi- family Number of bedrooms: 5
❑ Master builder ❑ Other: Number of bathrooms: 3 C
JOB SITE INFORMATION AND LOCATION Total number of floors: 2
Job site address: 7988 SW Leiser Lane New dwelling area: 3119 square feet
City/ State/ZIP: Tigard, OR 97223 Garage /carport area: 566 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
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Leiser Park Lot no.: 019 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 work indicated on this application.
Valuation: $ ' -"k
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER ❑ TENANT 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:
® APPLICANT ® CONTACT PERSON NOTICE
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
CONTRACTOR
Business name: Legend Homes BUILDING PERMIT FEES*
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 lic.: 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- PennitApp.doc 12/03 440- 4613T(t1 /02 /COM/WEB)
Mechanical PernFitE8ERVED FOR OFFICE USE ONLY
CI of Ti ak d Received
Permit No.
13125 SW Hall Blvd., Ti ard, OR 9 223 Date/By: I ,.I / r — I_ /, 5
g , - Plan Review
Phone: 503.639.4171 Fax: 503.598 :i960 2004 a I R� DateBy: Other Permit:
Inspection Line: 503.639.4175 s r� n!I Date Ready/By: See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
® New construction ❑ 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.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning or heat pump
Job site address: 7988 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.: 019 Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 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
►� PROPERTY OWNER ( ❑ TENANT Chimney /liner /flue /vent 10.00
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
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
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/Statc /ZIP: Portland, OR 97223 Wall /suspended/unit heater
Phone: (503) 620 -8080 Fax: : (503) 598 -8900 Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: Tri County Temp Control Clothes dryer (gas)
Other:
Address: 13150 Clackamas River Drive MECHANICAL PERMIT FEES*
City /State/ZIP: Oregon City, OR 97045 Subtotal
Phone: (503) 557 -2220 Fax: (503) 557 -0919 Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: 72623 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: Steve Lucas Date: 8/25/04 * Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Permits \MEC- PermitApp.doc 12/03 440-4617T (I I /02/COM/WEB)
Plfimbini Permit App
CEIVER FOR OFFICE USE ONLY
City of Tigard Received .:
/ r iJ(a00//� 0
13125 SW Hall Blvd., Tigard, OR 97223 w%. ®1 200 Date/By: Permit No
Phone: 503.639.4171 Fax: 503.598.1960 Grey �. Plan Review
Other Permit No.:
CI O T I G � � i l DateB
24- Hour Inspection Line: 503.639.4175 p p �w � / u c, Date Ready /By: brie: El See Page 2 for
Internet: www.ci.tigard.or.us BUILDING DIV • Notified/Method: Supplemental Information
TYPE OF WORK FEE* SCHEDULE
® New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION 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
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: 7988 SW Leiser Lane Catch basin or area drain 16.60
City/State /ZIP: Tigard, OR 97223 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project name: Leiser Park 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: Leiser Park 1 Lot no.: 019 Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.:
Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Paget ,.
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
® PROPERTY OWNER ❑ TENANT Drinking fountain 16.60
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
./ APPLICANT ❑ CONTACT PERSON Hose bib 16.60
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
CONTRACTOR 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 permit fee)
State surcharge (8% of permit fee)
Authorized signature: 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 \Pcrmits\PLM- PermitApp doc 12/03 440 -4616T(10 /07KOMIWEB)
10/09/2002 04:11 6427925
REGEIVEIrr------- PAGE 03
I. I I `• I WO 1
EiggelighrODAVIA"i 1 .,
' . 0 1 I 91 R . Pefolli No, Li pp
City of Tigard Y: m rlim.
1 3113 SW nel 1vd,, Tigard, OR 97223 CITY OFT". ,' r ' =view 042tar Wait;
nom 503.639.417i nee S03398.1960 , (' 'fi. • • - ' .. - -
Inspection Use: 503,639AI 75 BUILDING n lj: -
''' . 1" Thi.
7T 11 bail .,,,,,„,.......
rd,
tummy wawa! slieuslorsts „„fifi,A
• . •
UNIMMIMMIlitiMil,%7,,gartrittnfingt ... 7 ..'" .fr. limiammie24., L. .
Lak thlitappiyi
■4 Nam coottruutloo it Additionitheradontrwitte Demos over 215 arms. cconre ID Mezedoes
ram mouton
o Dornolitton 0 Other: 1:18ervice over 310 ono - nelng Cleutleta ever 10.000 eq, it.
af1 .„"3.0mcydwano
0 m mere now residentiol
WINOWNSWE'',1:iiHI'';.; .. lor
Mem over 600 vole nominal unle In ale nrstUre
,:.• 1. an d 241=4 dwelling W COMMOTaittifietenstriat • Accessory building
ClBuildirig ovor throw moles OFoidert, 400 snips ce mow
W Multi-9111* El Molter builder 0 Odin: 00ocupost toad aver op terns 04sauferaured stneasres se
IIIMAIRMICH', 7,,,JM,ILZ-ZIEME17.7a7EL5.ilrangMl' lit ' Elag mlini g htili P1.71 RV part
Male:
Disolth.oare feebly
Job no.: Job site addrees: MS SW Lew Lane Submit .I. tea of plane with any (Idle above.
CItyrStaterLIP Tigard, OR 97223 The above ITS net oppricable to memory conenuction sorviee.
:
IENtigNkiNiiit.ti,iab.•;.,C,7 1 ::.
Sulto/bldg/apt. no.: Project nom Leiser Park asereame CIIIIMI=1111111110=110
Cross strorldireetione to job site: Now residential 11 - or so f rilly dutiful; treet.
bedlam aresebed , ra •
1 .10 Aterlsis 1111111111226111T=i11131
...
Subdivision Leser Para Lot no.: 019 . IL .611'1500 • .0. urns:Atm 1 3140 Mr11111
Limited writ neideittal n 75.00 aili
Limited liner , nen.reeidandal 75.00
CliffilMigkiitaNiat•LZiag:ZZaltiMMEMEMA Bub moth= -- Of • ., .
Otwcingi frvift ind/or fad • 'F•51/3 2
Semite. sr feeders leetanstie . alteration, inalgr fokochl
300 - Or lest 110.30 3
R3ZTV'MEZ;::''Si=7:,aiafdfilLiEEZVM:f t,..,,Z.' . ' Mt a . to 400 .11 100.8$ 2
401 4 *600 . 4 1111111 100 •al IIIIIIMEO
Nem Legend Howes 601 s . to 1.000 amp I= 2 43 • 00
II
Addrenc 12/83 SW 89 Avenue, Salto d1110 Over 1 , ar volts 04.63
-- Reconnect al OM OA EN
City/Stntelln Portland, OR 97223 Imporari xerncs ter beadle*" antra os, eadior
Flamm: (503)6204080 I . Fax: (503)594900 relocadon
100 unos or kw 66. 85 1 -
Owner Wand.116011: This nate - 1 on Is - - - . . on property that oval wind In tiot 301 , .1 to 40 0 4ife ,,, Ma 10030 lei
Wended for tale, lease, rent, or exchange, scolding to ORS 447, 449, 670, and 701. 401 amps to 600 traps 133.7S 2
Owner /signet= Date 0macb drtults newt eltsradon, Or *t miss, W Inlaid
12591111S . q.tillariMtigne A" Re na rgyr bhVeliCifeUiliWilh r
Min � feeder OM, cull
SWIM. me: Led Ho 6,63 2
_IL &emit
Contact name Steve tunes • . cc . r . - e re IS
wifinuti orrice or (Seder feo, III
Address: 12785 SW snith Memo, Suit* 4100 each brawl: el -,_,, 40.25 II
. Each adril brinth nimvil MI 6 INN. U City/Sum/UP: Portlaad, OR 97223 lelseellaneorie OurvIes or Coder not leek**
Phone: (503) 004009 iFee : (503) 598-8900 . Pumper irrigation circle 53.40 2
E-mail: el .- • , r,t , - endhosnimeorn Stan or outline Iighttng 53 40
Scat eirenV) or liked-
Il
talefililfiettiffirKiiiiMPLiti1.1-±EAUIRMINEXC awn' Wel. allergia. tir
Buenos Innen CUM Eleetmc cestendon. Desoribc; PRP 2
.. --------..=.
Addrae: 2920 SW Zee Avenue 1 A Bash edditionol laspection Over dlowable In a of the &env
_..
City/Surto/Mt R11141101, OR 97 133 Par lespenton _ 6230 1
Inveingssion per how (1 hr min) 62.50
Phone: (503) 5314320 -
- 643492 Indueirtal .1snt
491 , t: i vitt 11J.. i .1 :... ILLI
COI Na: 131159 E:=E;r4,ZAIREr- . Lie.: 37074
C = 2 I = ' , WA Flig-1 OF, ;-'MIIIII Subtotal
Ras review (25% of permit fro
MN fliancLa Loa 6. 64,,, " I - f ' •
31111101N1111121 (3% of permit Ste)
Authorized signature Thu, licnits TOTAL P • - I. 5.111 aneI k oo l
.
Print nem
syt eller it hes Ian ceroplei of aumplott
C1114C— • P I , 0140 Mb, Tri•Cormriasinints mean s n
,
nasemennusionne.e.a.eveu, 12/03 w' NOt4of efleaneneas pm pen,dr dimpi
enatripeuncownwe
•
CITY OF TIGARD
13125 S.W.' HALL BLVD.
l
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
0)) * -1
WOLCOTT PLUMBING CONTRACTORS
P$- BOX -2007 L ®-1 W 14-1 5 c.. CwU L � � i' Y •
Tro , 042— 970
•
- Plumbing Signature Form
Permit #: MST2004 -00252
Date Issued: 9121/2004 .
Parcel: 2S112BD -LP019
Site Address: 07988 SW LEISER LN
Subdivision: LEISER PARK •
Block: Lot: 019
Jurisdiction: TIG
Zoning: R-4.5
Remarks: New SF detached.
Your company has been indicated as the plumbing contractor for e permit indicated above. In order for
the plumbing permit to be valid,. please have the appropriate in•' idual from your company sign below and
return this Plumbing Signature Form prior to the start of the w, rk to the address above, ATTN: Building
Division.
No plumbing inspections will be authorized until thi completed form is received
OWNER: PLUMBING CONTRACTOR:
LEGEND HOMES OLCOTT PLUMBING CONTRACTORS
12755 SW 69TH
SUITE 100 _ 30
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
Sig thor ` - d Plumber
•
If you have any questions, please call 503.718.2433. •
A 5T LI --c1.)2-S
m
:
m
• L
• • r,33; . • STREET TREE
•
• ► _ al
u.,
• ► . q TI
�NEy , . ► 4 er :� GZ J� ACS 71
A pLEAsz PRINT) jPEPJIITHOM w co
I
►
• JI LL,S80ROl OR 87124 Ow i
• Do hereb - location 4, i
r..v f
►
A m e e t s . on • ounty S xi
l and use and development standards f o r street tree installation. • 1 T rn
1 `° m
1.
• ' _
r
! ADDRESS: 796 Laser G4 / D
t I • � ` ► I- cP
1 LOT: ft SUBDIVISION: f "-- ■ a
1 :: 1
w.- o r
A BY: DATE: Z D
1 -. . , , ■ i
•
RECEIVED BY: _ DATE: `' m
I.
FVVVVVVVVYVVI'VY•711VVVVVVV7VVVYVVVVVVVVVIITVVVVVVVVVVVVVVVVV .-
CITY OF TIGARD' 24 -Hour
BUILDING Inspection Line: , " ? 3) 639 4175 MST
INSPECTION DIVISION Business Line: - :a3) 639 -4171 -
BUP
Received Date Requested e72 M PM BUP
i
Location • �`' _ M i ► Suite MEC
Contact Person ( 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 1�1 10 e -- Z
Framing - � _
►�[ 1� I (fi -1-
Insulation
Drywall Nailing ����� P (-
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
Fire Alarm
'ASS PART FAIL El Reinspection fee of $ required before ne inspection. Pay at City Hall, 13125 SW Hall Blvd.
Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA 2 9 -
Approach/Sidewalk Date O Inspector ` Ext
Other:
Final DO NOT REMOVE this inspection record from b site. •
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
MST �d b q 06 oZ,�Z
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
•
Received Date Requested b AM PM BUP
Location / g �'�" 1 Suite - MEC
Contact Person Ph ( ) O 7�3 3 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 -� s U
Insulation
Drywall Nailing I ('O iZ 4 �3 v^<T _ /L/ - ZzL F J - -reASS
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
C EM 1 4 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
s
-. 'T 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 _Q Please call for reinspection RE: El Unable to inspect - no access
Fire Supply Line
ADA Date — 1 0 — 65 —
Approach /Sidewalk 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 MST °)Ca`f - Ste'
INSPECTION DIVISION Business Line: (503) 639 - 4171
BUP
Received Date Requested — 3 AM PM BUP
Location 2 � e,r.rI,P -J Suite MEC
Contact Person • 1..-40 / Ph ( ) 2 0 9 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
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:
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
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
'PASS PART FAIL
SITE El Please call for reinspection RE: Unable to inspect — no access
- Fire Supply Line
ADA Date 2' OS Inspector t/l' n Ext
Approach/Sidewalk D 3 � ector P
Other:
Final DO NOT REMOVE this inspection record from the job site. - .
PASS PART FAIL