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Permit CITY TIGARD BUILDING PERMIT PERMIT #: BUP2006 -00211 owe COMMUNITY DEVELOPMENT DATE ISSUED: 2/28/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S126DC-05000 SITE ADDRESS: 09385 SW LOCUST ST ZONING: C -P SUBDIVISION: LEHMANN ACRE TRACT LOT: 003 JURISDICTION: TIG PROJECT: FREEMAN OFFICE BUILDING Project Description: Building 1, addition to existing office building. REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ADD FIRST: j a 3 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: 26 BASEMENT: sf AREA SEP. RATED: STOR: 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: $ 60,000.00 Owner: Contractor: COOPER MOUNTAIN VINEYARD LLC 9480 SW GRABHORN RD BEAVERTON, OR 97007 Phone: 503 - 649 - 0027 Contact #: Reg #: FEES Description Date Amount REQUIRED ITEMS AND REPORTS [BUPPLN] Pin Rv 5/16/2006 $341.58 Reinforced concrete [FLS] FLS Pln Rv 5/16/2006 $210.20 Structural masonry [PKSDC] COM & IND F 2/28/2007 $273.00 [TIF -O] TIF - Office 2/28/2007 $483.61 (additional fees not listed here) Total $2,117.93 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 503.246.6699 or 1.800.332.2344. • Issued By: atZ Permiftee Signature: i -4% 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. FA ieermp , Frioe Apflm, .73s3 5 a..1 id 'Buildine Permit A s') lErt taWnIVED I012 OFFICE USE ON 1.1' City of Tigard Dat 6 I LP' p b 42 EEL IL ... ,-.00., ( 13125 SW Hall Blvd., Tigard, OR 972AP'r 1 6 010. 2006 - Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date/By. Other Permit: Inspection Line: 503.639.4175 _.11,1. A 1 1 Date Ready/By. „. A .., de / i Urj, ta See Attached Checldist for CITY OF TIGARD ''..---- --- Noti .. ethod: / /0 ll f -'" 1 CA Supplemental Information Internet: www.tigard-or.gov , BUILDING DIVISION 4r11111rMWFrjjFMM121P -.....1..e., i A' ' -.:.....: .... A , 6 ' 14 S_ 77, 0, r“ ' ;**0: 0 New construction 0 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 0 Other: equipment, materials, labor, overhead, and the profit for the .1.:?. Y 4 -f 6=ipt,;. P . work indicated on this application. 8, ,' . .,,.:1?-e i.'1 t....1:.7.-1.*11.:IZa:;,::: 0 1- and 2-family dwelling 0 Commercial/industrial Valuation: $ 0 Accessory building 0 Multi-family Number of bedrooms: 0 Master builder 0 Other: Number of bathrooms: ..,'' ...:•.:,.-_'!;.:i-:‘-',,..,i";=/°"..:*.1,;iiiii'kii,:ii(Oi*ivil*Flopiii.,:iloseidiiii4Liv*I..1..;:.-1...,?7,P"..=!!-"',. Total number of floors: - ' ' 1=' rt. T - 1 1 1 - L - iL ---- r - - 1 - ' ' - - . Job site address: q -4 ,a, 5 .,,.„... t , n)c. .,_5.-r -1 rt._ fc c-i- New dwelling area: square feet City/State/ZIP: --r /-, ft _ c= , 1 4 = 1 it _ w_ 4 c p f%.3 Cri a a ... Garage/carport area: square feet Suite/bldg./apt. no.: I Project nare r 1 c„. c .... _ ..it. i Covered porch area: square feet Cross street/directions to job site: L tz_v_ 1,,1 13 it...4 12....t>, Deck area: square feet Other structure area: square feet -. 'REQUIRED DATA. COMMERCIAL-USE 47HECKLIST:c4 Subdivision: I Lot no.: Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all Tax map/parcel no.: 1 c-.124:, c>c_. se:Jo° equipment, materials, labor, overhead, and the profit for the f . ' ..; ':F;' :.:',:'. 6 OF WORK ; '....::-, - ....f:-: work indicated on this application. .. . Valuation: S 40 C) ) C C.. V F % C, Er-- W. lz-e, t-1 cz: I I= I (..,v Or Existing building area:a ) 56i square feet C>C> 1.) . ^ AA -- rt=i 1 %.... tg."1" tt-- t./1 . _ 8Stti) New building area: '. f 2.5 square feet ritoiotti.iiiiks* ji.l.: ::';' Number of stories: I Name: CC) c..1=-g_ it._ t---% t ,)--r,e.,t t ,) NI ,-(,‹ ILT:::. Type of construction: --- r- --r % E.. Mr 123 Address: q 4-- 80 S.Ne./. /..1 iz.—/..t3V.inr—t.1 tkr4-_L-4— Occupancy groups: a Cc' 7 City/State/ZIP: E ic-r-o I . % ) I c)ILIF__6 ot,.. C.i 7 061 Existing: 2 1 57 4i) Phone: (503 (049 — c_ 0 e..--) Fax: ( ) New: 'I 2- . 3 rt • ' - , -R.,- , `,.. , ',•` - '4 . *.C.TSI r■ 1 ; - . ' ::re'. : ' 0 CONTACT i - -r- ',i- --.;-::; /. ;'' ' -' 7,':? ;;; ,; kriki'; .''.."-!. :, ..,., ,.: ,..., i:y ,; ; .p.,. , - :,,, Business name:C c c=v_ft, ‘-1 t ,iv-r / c 76. 1 r l All contractors and subcontractors are required to be , NI I N) Ce"(" L-L—(-- licensed with the Oregon Construction Contractors Board Contact name: ta , I . Cit8,...Cfvr--% under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City/State/ZIP: applicant is exempt from licensing, the following reasons aPPIY: Phone: ( ) I Fax: : ( ) E-mail: .,.:„. .....;,.,;.,-,,, ,,,_...., :--,„, ,,,,,::,:: ,:„:„, ,...!:1,:::‘•1':,';. .-.,:?;56iiiiititibit47,`'.-;...,',.,=...t;::-;,i,-7.-',:':'.,',1 Business name: Address: Please refer to fee schedule. City/State/ZIP: Fees due upon application Phone: ( ) I Fax: ( ) Amount received CCB lic.: Authorized signature: / ,,,./.i Date received: _ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: 17,=,( fwiu—s— , e_ ey.- Date: di(/196 • Fee methodology set by Tri-County Building Industry Service Board. i:\BuildingTermitABLIP-PerrnitApp doc 12/03 440-4613T(11/02JCOM/WEB) FILE COPY Fire Marshal's Offices \ North Division South Division East Division MAY I u *#° 1 14480 SW Jenkins Rd. 7401 SW Washo Court 624 7th Street Beaverton, OR 97005 Tualatin, OR 97062 Oregon City,OWP4AGARL Tualatin Valley (503) 356 -4799 (503) 612 -7000 (503) 657- 12N.D)NG DIVISION Fire & Rescue Fax (503) 644 -2241 Fax (503) 612 -7003 Fax (503) 657 -7913 Page 1 oft Building Survey Report FMZ : (to be filled out by TVF &R) Code Edition: • Name of Facility: Name of Buil ding: F' ]Z MARtiI__Q_]�? ]_�C?a.__�z� ie. I_ 3x5 S.w. I- c> ST It, a- Address: cc, ft \e' 1,..3 - i /°1L Owner: No. (SOS _C P49— C2 Architect: ?ki_ba._S? ^ N •i■ Q - Telephone No. (SCa __(R2_Q ^ e2 e Architect Address: _akatu_Q__ _tresC,__I• ! L Cam__ '_T' -___4) VT i£ i. SO - 1" 1Ca". ft—C> , © rL E. C o N 01-1 /Las :ITEM COMM • DESCRIPTION I. Occupancy ®r t m I G Type — 1 6, I Use C> F 5 I Capacity 2. Construction Type P- g Year Built 3. Area (Sq. Ft.) Total 2 4 , 0 Largest Flooi2 jp 0 Basement 4. Stories No. r Height 12'- p•' High Rise ❑Y 1gi•I 5 a. Exterior Wall Construction Wp d p S I C> I N ( 4„ S . t C vc... 'V E.t.a E. £ b. Opening Protection p 6. Interior Wall Construction L31:) P. Y' 61z , I 7. Floor Construction C: ot-. t I Z • g. r L.../ as 8. Roof Construction ' p(? t-■1 !� 9. Attic Draft Stops No. 10a. Occ. Sep. Wall Construction No. b. Opening Protection I la. Area Sep. Wall Construction No. I b. Opening Protection 12a. Smoke Barrier Wall Construction No. I b. Opening Protection I 3a. Corridor Wall Construction b. Opening Protection I4a. Corridor Ceiling Construction b. Opening Protection ISa. Shafts No. Type I b. Opening Protection ytIcr 71-1 . . 1%.00 Building Survey Report FM Z : (to be filled out by TVF&R) Name of Facility: 16a. Stair Enclosure No. b. Opening Protection • 17. Stairs No. 0 18. Ramps No. (D 19. Interior Finish Class Room Corridor Exit Enclosure 20. Exits No. 2. Total Width 21. Exit Hardware Type 22a. Exit Signs/Illumination b. Emergency Lighting 23. Auto Sprinkler Coverage 24. Standpipe Class/Locations 25. Fire Alarm Type/Coverage 26. Heating, Ventilation & Air Conditioning Type Fuel 27. Electrical Installation 28. Stage/Platform 29. Hazardous Area 30. Other Comments: Alternate Materials & Methods fvf&R LIseiChily Enspected By Date No Attachments - Reviewed By '1?:°e , Updated CITY OF TIGARD BUILDING DIVISION PERMIT #: BUF'2006-00211 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2128/2007 Phone: (503) 639 -4171 1 5V Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 9/24/2008 TIME: 7:00AM PAGE: 29 SITE ADDRESS: 09385 SW LOCUST ST CLASS OF WORK: SUBDIVISION: LEI ACRE TRACT LOT # 003 TYPE OF USE: PROJECT NAME: FREEMAN OFFICE BUILDING DESCRIPTION: Building 1, addition to existing office building. OWNER: COOPER MOUNTAIN VINEYARD LLC, PHONE #: 503 - 649-0027 CONTRACTOR SIERRA PACIFIC COMMUNITIES LLC PHONE #: 503„452 -7600 Inspection Request Scheduled For: Date 9/24/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 075845 -01 503-810-2038 N Corrections/Comments/Instructions: n • P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: V6Ve--- da— Date: / _ Phone #: (503) 718 - V7 2. CITY OF TIGARD BUILDING DIVISION PERMIT #: BUP200 &00211 13125 SW Hall Blvd., Tigard, OR 97223 At jiTE ISSUED: 2/28/2007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 3/20/2008 TIME: 7:02AM PAGE: 55 SITE ADDRESS: 09385 SW LOCUST ST CLASS OF WORK: SUBDIVISION: LEHMANN ACRE TRACT LOT #: 003 TYPE OF USE: PROJECT NAME: FREEMAN OFFICE BUILDING DESCRIPTION: Building 1, addition to existing office building. OWNER: COOPER MOUNTAIN VINEYARD LLC, PHONE #: 503.649 -0027 CONTRACTOR: SIERRA PACIFIC COMMUNITIES LLC PHONE #: 503-452-7600 Inspection Request Scheduled For: Date: 3/20/2008 Pour Tim: 10:00 Code # Inspection Description Confirm # Contact # Message 265 Masonry 066953-01 503- 939-4259 N Corrections/Comments/Instructions: e? 0 ()Le LisL.1_.„2_.e.,,,c l a ❑ PASS r ` PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED 7 Inspector: Date: v Phone #: (503) 718 -2 a CITY OF TIGARD •- s, BUILDING DIVISION PERMIT #: BUP2005 00211 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7128/2007 Phone: (503) 639 -4171 i Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 3/13/2008 TIME: 7:02AM PAGE: 37 SITE ADDRESS: 09385 SW LOCUST ST CLASS OF WORK: SUBDIVISION: LEHMANN ACRE TRACT LOT #: 003 TYPE OF USE: PROJECT NAME: FREEMAN OFFICE BUILDING DESCRIPTION: Building 1, addition to existing office building. OWNER: COOPER MOUNTAIN VINEYARD LLC, C, PHONE #: 503-649-0027 CONTRACTOR: SIERRA PACIFIC COMMUNITIES LLC PHONE #: 503.452 Inspection Request Scheduled For: Date: 3/13/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 265 Masorny 066643 -01 50:3-939-4259 N Corrections /Comments/ nstructio , : ' 4< c -,, I. , -.. AFAINIPIP ' , • / 7 ( ---- _ 6j1 ( ❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES A ESUED Inspector: Vb; 01 / Date: ' 3/ 1— S ( Phone #: (503) 718 -V 2't . CITY OF TIGARD .' BUILDING DIVISION PERMIT #: BUP200S -00211 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/28/2007 Phone: (503) 639 -4171 ,,a�,� ii Inspection Requests (24 Hrs.): (503) 639 -4175 _� JJ— F__.. INSPECTION WORKSHEET FOR DATE: 12/14/2007 TI / 7:01AM PAGE: 47 SITE ADDRESS: 09385 SW LOCUST ST CLASS OF WORK: SUBDIVISION: LEHMANN ACRE TRACT LOT #: 003 TYPE OF USE: PROJECT NAME: FREEMAN OFFICE BUILDING DESCRIPTION: Building 1, addition to existing office building. OWNER: COOPER MOUNTAIN VINEYARD LLC, PHONE #: 503. 649-0027 CONTRACTOR: SIERRA PACIFIC COMMUNITIES LLC PHONE #: 503.452 -7600 • Inspection Request Scheduled For: Date: 12/14/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message J75 Framing 061531 -01 503 - 810.2038 N Corrections /Comments /Instructions: AFL - ,/L�� IA d 6-- r 1 - A SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS El FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: va Date: 1 Lk Phone #: (503) 718 - 2-(f2-(t . . , CITY OF TIGARD BUILDING DIVISION PERMIT #: BUP2006 00211 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: X28!2007 Phone: (503) 639 -4171 /�amu-dgp�l Inspection Requests (24 Hrs.): (503) 639 -4175 .�' °_- INSPECTION WORKSHEET FOR DATE: 12/10/2007 TIME: 7:0 r! PAGE: 81 SITE ADDRESS: 09386 SW LOCUST ST ( ' SS OF WORK: SUBDIVISION: LEI-iMANN ACRE TRACT LOT #: 003 TYP OF USE: PROJECT NAME: FREEMAN OFFICE BUILDING DESCRIPTION: Building 1, addition to existing office building. OWNER: COOPER MOUNTAIN VINEYARD LLC, PHONE #: 503-649-0027 CONTRACTOR: SIERRA PACIFIC COMMUNITIES LLC PHONE #: 503 -452 -7600 Inspection Request Scheduled For: Date: 12/10/2007 Pour Time: 2 :00 Code # Inspection Description L Confirm # Contact # Mess • .! - / . J. 265 Masonry 061081 -01 503 - 939-4259 14 f v ----- Corrections /Comments /Instructions: 1 ■ " A DIN 6 LiknAZit . , Q , ---r-; 4 e-■.i._ ...7-4 e ‘A (2,e-d,rt 6 L4L � v L'Y- \JQ-Q9(t)9--r uL).(‘-l-A -- 6 ❑ PASS [PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 4) D ate: 06/ Phone #: (503) 718- S- Zi Ct P ( ) CITY OF TIGARD BUILDING DIVISION PERMIT #: BUP2006-00211 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/26/2007 Phone: (503) 639 -4171 Atit Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 3/10/2007 TIME: 7:00AM PAGE: 30 SITE ADDRESS: 09385 SW LOCUST ST CLASS OF WORK: SUBDIVISION: LEHMANN ACRE TRACT LOT #: 003 TYPE OF USE: PROJECT NAME: FREEMAN OFFICE BUILDING DESCRIPTION: Building 1, addition to existing office building. OWNER: COOPER MOUNTAIN VINEYARD LLC, PHONE #: 503 - 649 CONTRACTOR: SIERRA PACIFIC COMMUNITIES LLC PHONE #: 503-452 -7600 • Inspection Request Scheduled For: Date: 9110/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 235 Shear walls/anchors 055389 -01 503. 810.2038 N Corrections /Comments /Instructions: • t$ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Cam. Date: Yi v d Phone #: (503) 718- �� �� CITY OF TIGARD . , • BUILDING DIVISION PERMIT #: BUP2006-00211 13125 SW Hall Blvd., Tigard, OR 97223 0------ DATE ISSUED: 2/28/2007 Phone: (503) 639 -4171 qi�l Inspection Requests (24 Hrs.): (503) 639 -4175 F: _.. INSPECTION WORKSHEET FOR DATE: 8/28/2007 TIME: 7:00AM PAGE: 45 SITE ADDRESS: 09385 SW LOCUST ST CLASS OF WORK: SUBDIVISION: LEHMANN ACRE TRACT LOT #: 003 TYPE OF USE: PROJECT NAME: FREEMAN OFFICE BUILDING DESCRIPTION: Building 1, addition to existing office building. OWNER: COOPER MOUNTAIN VINEYARD LLC, PHONE #: 503- 649 -0027 CONTRACTOR: SIERRA PACIFIC COMMUNITIES LLC PHONE #: 503-452 -7600 Inspection Request Scheduled For: Date: 8/28/2007 Pour Tim 10:0p ) Code # Inspection Description Confirm # Contact # Message 220 Slab 054738 -01 503-810 -2038 n N Corrections /Co ments /Instructions: r t. t- • 17 -(_. (///‘ h.e../64-VC___ g7 5 //‘ 4--e s ( nJ 14) fhi PASS [D ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: \ "(..% \i Date: V-V(i--) Phone #: (503) 718- Z7 1 CITY OF TIGARD ` k BUILDING DIVISION - S PERMIT #: BUP2006 -00211 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2128/2007 Phone: (503) 639- 4171 �e Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 8122/2007 TIME: 7:01AM PAGE: 23 SITE ADDRESS: 09385 SW LOCUST ST CLASS OF WORK: SUBDIVISION: LEEfiFANN ACRE TRACT LOT #: 003 TYPE OF USE: PROJECT NAME: Ff I A1", OF :ICE Bt11LDING DESCRIPTION: o a d ':li .'1 ' (At tin&) office building. OWNER: €_' €t, } VIA.) It` "A k tr;N r °D LLC, PHONE #: 503-649-0027 CONTRACTOR: Z . ! !.:'? I � ' , 'I' .I' Yi PHONE #: 503- 4617600 Inspection Request Scheduled For: Date: 3Lp212007 Pour Time: .t:ofi Code # Inspection Description Confirm # Contact # Message 210 Fout'■f. -I:. n v,.:j 1 4, 9 ) l 503-810-2038 0 Corr ctions /Comments /Instructions: V ( *-) '6 -6 ej ) lf:k/ 1 • ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL'FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: l/‘ Date: 241 1'6 Phone #: (503) 718 - -2 V 24 LA Fm:(503)620 -2748 ACS Testing Inc. To:Freeman Office Bldg (15036243681) 17:06 09/10108GMT-04 Pg 02 -03 • 7409 SW Tech Center Dr. Ste. 145 �(7 Tigard, OR 97223 Ph: 503- 443 -3799 Fax: 503 -620 -2748 SPECIAL INSPECTION FINAL REPORT DATE: June 16, 2008 PROJECT: Freeman Office Building #1 PERMIT #: BUP 2006 -00211 ADDRESS: 9385 SW Locust CITY: Tigard STATE: OR To Whom It May Concern: ACS Testing, Inc. attests that their inspectors performed special inspection(s) on a continuous and/or periodic basis as required by the specific jurisdiction and/or IBC. Special inspection(s) were performed for the following: Reinforced Masonry Proprietary Anchors Based on personal observation, inspection and reports reviewed by me for the above project, I attest on behalf of ACS that work was performed to the best of my knowledge, in accordance with approved plans, specifications, and the applicable codes and standards for this jurisdiction. Approved by: ...` BOB BROWN President BB /cs • CITY OF TIGARD I S )647,0at„, 64744, BUILDING DIVISION PERMIT #: — 0 0 Z V� 13125 SW Hall Blvd., Tigard, OR 97223 1 DATE ISSUED: Phone: (503) 639 -4171 : fli t r41 i/ , Inspection Requests (24 Hrs.): (503) 639 -4175 ...' 1 1. ,, I(' INSPECTION WORKSHEET FOR DATE: V I 11 /0 1 TIME: PAGE: SITE ADDRESS: ` -� L . ' o C VS I CLASS OF WORK: SUBDIVISION: / ` LOT it: TYPE OF USE: PROJECT NAME: .r4gA,t/b���, $ 61 d e a'- DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: r I ) Pour Time: Code # Inspection Description Confirm # Contact # Message riii& 2 vV I F) -2 Corrections /Co ments /Instructions: N--; . -� ....... a/ 4__ c_._ <1 _______-. c,A4 Z,_7's„,.. 3 _._____________ • I� ❑ PASS all 'ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 4;0".? Date: 2 / 9( C)--- ) Phone #: (503) 7183-Y