Permit /\.. CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2000 -00510
zw ,,Ife DEVELOPMENT SERVICES DATE ISSUED: 11/28/00
! 13125 SW Hall Blvd., Tigard, OR 97.223 (503) 639 -4171
SITE ADDRESS: 15597 SW SUMMERFIELD LN PARCEL: 2S111CD -02000
SUBDIVISION: SUMMERFIELD NO.7 ZONING: R -7
BLOCK: LOT: 345 JURISDICTION: TIG
REMARKS: Enclose existing patio on two sides. APPROX 100 SQ FT AREA
BUILDING
REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ALT HEIGHT: FIRST: 100 sf BASEMENT: sf LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: SECOND: • sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT:
VALUE: $ 8,630.00
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 100.00 sf REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP/IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 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: EA ADDL BR CIR: SIGNAUPANEL: ' IN PLANT:
MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: 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/1RRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 294.99
This permit is subject to the regulations contained in the
JOHN TILLMAN OWNER Tigard Municipal Code, State of OR. Specialty Codes and
15597 SUMMERFIELD LN all other applicable laws. All work will be done in
TIGARD, OR 97224 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:
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Reg #: 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
Electrical Service Electrical Final
Electrical Rough In Final inspection
Framing Insp
Shear Wall Insp
Insulation Insp
Issued By : �� • ' - • - Permittee Signatur • — .���.,!
OW
Call (503) 639 -4175 by 7:00 p.m. for an inspection nee ed the n`ness day
tv 091- / / - /60 er
Building Permit Application
• ""'� City of Tigard Datereceived: /l'/ -60 Permitno.:Hvr -,00.570
I
- ° = '�I� Project/appl. no.: Ex ire date: Z
Address: 13125 SW Hall Blvd, Tigard, OR 97223
City of Tigard Phone: (503) 639 - 4171 Date issued: . I Receipt no.: ,
Fax: (503) 598 - 1960 Case file no.: Payment type: 1.
Land use approval: l &2 family: Simple Complex: r
T YPE OF PERMIT Q
• 1 & ily dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 New construction 0 Demolition
• I ' ddition/. teration/replacement 0 Tenant improvement 0 Fire sprinkler/alarm 0 Other:
JOB SITE INFORMATION
I Job address: I'3. 1 S , W - S v_w- _ _ e c 1 . e_ V L . — T'% , Bldg. no.: Suite no.:
Lot: Block: Subdivision: Tax map /tax lot/account no.:
Project name: . \ •
• Description and location of work . premises/special conditions: .) • - . _ • Min ea a
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: '_
o - ,1,\ vK a,,� (Floodplain, septic capacity, solar, etc.)
P InaiLLEAnt.tt .x�W -Mr - 1 & 2 family dwelling: 4.3 • State: &. ZIP: • 1'4 Valuation of work $ 6, __
Phone: • -T1S"ce Erff _ No. of bedrooms/baths
Owner's representative: _ Total number of floors •
Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT Garage/carport area (sq. ft.)
Name: Covered porch area (sq. ft.)
�!: i10 «+t.t.tta���.zr ,1 Deck area (sq. ft.)
u u r
EMIIMWSIMIIMINEMEN ZIP:C a� . Other structure area (sq. ft.) •
Phone: (( 6' g Fax: —e E -mail: `t3::,.- Commercial/industrial/multi- family:
CONTRACTOR Valuation of work $
Existing bldg. area (sq f
New bldg. area (sq. ft.)
Address: k q 1 „vr, . I IKMEN IIIMI Number of stories .- IllEEMMIMIIIIIMIE State: CI. ZIP.' y _ Type of constru o if�
P • . Fax: Occupancy - g up(s): Existing:
CCB no.: l
New:
City /metro lic. no.: •$ Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: _iiiii immumi jurisdiction where work is being performed. If the applicant is
/State: ZIP: exempt from licensing, the following reason applies:
Contact person: _ Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: • ntact person: Fees due upon application/ 4,, r ,, '••••• 0 $ ye, , ?7
Address: 11111111.M.111111 Date received:
— State: ZIP: Amount received $
Phone: E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All proxi s and ordinances governing this Cl Visa 0 MasterCard
work will be compli • • with, - . - cified herein or not. J( -f 4 Credit card number: Expires /
\
Authorized signatur" - tl � °L Date: ` 0 V Name of cardholder as shown on credit card
Print name: C1 to � \ l� vVl t lK Cardholder signature $ Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6A0/COM)
One- and Two - Family Dwelling
„A./4- 1 Building Permit Application Checklist Reference no.: •
City Associated permits:
City of Tigard C �t y of Tigard g and ❑ Electrical ❑ Plumbing ❑ Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 ❑ Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews.
2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc.
3 Verification of approved plat/lot.
4 Fire district approval required.
5 Septic system permit or authorization for remodel. Existing system capacity
6 Sewer permit.
7 Water district approval. •
8 Soils report. Must carry original applicable stamp and signature on file or with application.
9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of
catch -basin protection, etc.
10 effiComplete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed
if copyright violations exist.
11' ite/plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if
there is more than a 4-ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and
driveway; footprint of structure (including decks); location of wells/septic systems; utility locations; direction indicator, lot
area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage.
12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent
size and location.
oor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater,
o13 n,
5 .1. rnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc.
/ oss section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub -floor,
all construction, roof construction. More than one cross section may be required to clearly portray construction. Show
details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs,
fireplace construction, thermal insulation, etc.
15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels.
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
ull -size sheet addendums showing foundation elevations with cross references are acceptable.
16 all bracing (prescriptive path) and/or lateral analysis plans. Must indicate details and locations; for 7
non - prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor /roof framing. Provide plans for all floors/roof assemblies, indicating member sizing, spacing, and bearing
0 ,/.. locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered
systems, see item 22, "Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists
over 10 feet long and/or any beam/joist carrying a non - uniform load.
• Manufactured floor /roof truss design details.
d i p Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required V-
for four or more appliances.
22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or
architect licensed in Oregon and shall be shown to be applicable to the project under review.
JURISDICTIONAL SPECIFICS
23 Five (5) site plans are required for Item 11 above.
24
25
26
27
28
. Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 440.4614 (6ro0/COM)
Electrical Permit Application
Datereceived: //7 410 Permitno.: /M
;.j j l City of Tigard Project/appl. no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: I Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT •
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
0 New construction rr: 4• ' ditto teration/replacement 0 Other: 0 Partial
• JOB SITE INFORMATION
Job address: (j Sq7 S, (.• ,,,,vh v,., ,.e \e, r' 'Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: I Block: 'Subdivision:
Project name: S &,v,"\ aw I Description and location of work on premises: 'e „ „ c t5 t Q o a c, e a rec_iC
Estimated date of completion/inspection:
CONTRACTOR APPLICATION FEE SCHEDULE
Job no: Fee Max
Business name: ,e ` > Description Qty. (en.) Total no. insp
Address: New residential - single or multi - family per
dwelling unit. Includes attached garage.
City: 'State: I ZIP: Service included:
Phone: I Fax: 1E-mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof
CCB no.: 'Elec. bus. lie. no:
Limited energy, residential 2
City/metro lic. no.: Limited energy, non- residential 2
Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder 2
Sup. elect. name (print): License no: Services orfeeders — installation,
alteration or relocation:
PROPERTY 01%'N ER 200 amps or less 2
Name (print): 201 amps to 400 amps 2
401 amps to 600 amps 2
Mailing address: 601 amps to 1000 amps 2
City: I State: 'ZIP: Over 1000 amps or volts 2
Phone: 1 Fax: 1E-mail: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended fo .. - as • , • nt, or exchange according to Installation, alteration, orrelocation:
ORS 447, 455, 47', 670, _ 200 amps or less 2
201 amps to 400 amps • 2
* Owner's signaturL_....., = 410 , Date: I n -1.7 - 00 401 to 600 amps 2
ENGINEER Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: 'State: • I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
•
Phone: Fax: E -mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
O Service over 225 amps - commercial 0 Health -care facility Each pump or irrigation circle 2
O Service over 320 amps - rating of 1&2 O Hazardous location Each sign or outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or extension” 2
O Building over three stories ❑ Feeders, 400 amps or more *Description:
❑ Occupant load over 99 persons O Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
0 Egress/lightingplan ❑ Other. Per inspection
Submit _ sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $
O Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $
Expires accepted as complete. TOTAL $
•
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440 -4615 (6I00/COM)
Electrical Permit Fees: Limited Energy Fees:
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL 0 be
Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR A L SYSTEMS)
Service included: Items Cost Total `, Check Type f Work Involved:
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 ❑ Burgl r Alarm .
Limited Energy $75.00
Each Manuf'd Home or Modular El Garage oor Opener'
Dwelling Service or Feeder $90.90 2
s Services or Feeders ❑ Heating, entilation and A' Conditioning System*
Installation, alteration, or relocation
200 amps or less ____70-V13-1=9,21....„2 ❑ Vacuum Sy terns'
201 amps to 400 amps $106.85 2
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 p Other
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK IN • LVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918-260-2.
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 2 Check Type of Work In olve•:
Over 600 amps to 1000 volts,
see "b" above. I I Audio and • tereo S stems •
Branch Circuits ❑ Boiler •- ntrols
New, alteration or extension per panel
a) The fee for branch circuits
with purchase of service or ❑ Clock = ystems
feeder fee.
Each branch circuit $6.65 2 ❑ Da - Telecommunication stallation
b) The fee for branch circuits
without purchase of service ❑ Fir Alarm Installation
or feeder fee.
First branch circuit _±._ $46.85 ( i 8
Each additional branch circuit $6.65 ❑ AC
Miscellaneous ❑ nstrumentation •
• (Service or feeder not included)
Each pump or irrigation circle $53.40 ❑ Intercom and Paging Systems .
Each sign or outline lighting $53.40 •
Signal circuit(s) or a limited energy ❑
panel, alteration or extension $75.00 Landscape Irrigation Control
Minor Labels (10) $125.00 ❑
Medical
Each additional inspection over
the allowable in any of the above 11:] Nurse Calls
Per inspection $62.50
Per hour $62.50
In Plant $73.75 ❑ Outdoor Landscape Lighting
Fees: ❑ Protective Signaling
Enter total of above fees $ Y6 • s- r7 Other
8% State Surcharge $ 3,15 Number of Systems
•
25% Plan Review Fee
See "Plan Review" section on $ * No licenses are required. Licenses are required for all other installations
front of application.
Fees:
Total Balance Due $ 56 , 6 () Enter total of above fees $
❑ Trust Account # 8% State Surcharge $
. Total Balance Due $
i:\dsts\forms \elc- fees.doc 10/09/00
1 Permit #: H -O olio
o F O
�c1 '
.% Address: 156 9 7 o t -0-if4 frizz zj
47.:2.14..: "''' ° °" Issued by: 2L •c --z rte Date: /7 P/7)
,• 9 9
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required '
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks an initial boxes 1 and 2, and either box 3A or 3B:
11 7- 1. I own, reside in, or will reside in the completed structure.
V IM 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
n 3A. My general contractor is
I I (Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
p i 3B. I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above information is correct and that I have read and do understand the Information
Notice to Property Ow . 1 1 . ' 1 ns r 1 tion Responsibilities on the reverse side of this form.
i I -1
_ _ - 9- 0 c)
(Signat ,- . 't applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
•
Information Notice to Property Owners
About Construction Responsibilities
Note: This Information Notice to Property Owners about Construction Responsibilities
was developed by the Construction Contractors Board in accordance with ORS 701.055(5).
If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure,
you can prevent many problems by being aware of the following responsibilities and areas of concern.
EMPLOYER RESPONSIBILITIES:.
If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the
construction or improvement of a residential structure, you will, in most instances, he ruled to be an employer and the people
you hire will be employees. As the employer, you must comply with the following:
Oregon's withholding tax law: As an employer, you must withhold income taxes from employee wages at the time employ ees
are. paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more
information, call the Oregon Dept. of Revenue at 945 -8091.
Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the
wages of all employees. For more information, call the Oregon Employment Division at the Department of Human Resources
at 378 -3524.
Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must,
obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you may
be subject to penalties and will be liable for all claim costs if one of your employees is injured on the job. For more information,
call the Workers' Compensation Division at the Department of Consumer and Business Services at 945 -7888.
U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will he
liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service
at 1 -800- 829 -1040.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
Code compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements
that may be brought to your attention through inspections.
Liability and property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for
accident.; and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be
re -done.
Time to supervise employees: Make sure you have sufficient time to supervise your employees.
Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough -in and finish
trades, and to notify building officials at the appropriate times so they can perform the required inspections.
If you have additional questions, write or call the Construction Contractors Board (PO Box 14140, Salem, OR 97309 -5052,
503/378 - 4621). The Board is located at 700 Summer St. NE Suite 300, in Salem.
prop- own.pm4
1 /94
7
CIfY4d TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inssiectio`n Line: 639 -4175 Business Line: 6 -4171
MST e4 - 0U J�U
• BU'
Date Requested / 2 -- AM PM BLD
Location / 54r 5v40''.# (I Suite MEC
Contact Person Ph 57 3 G39 - 5 - L.S' PLM ., -
Contractor Ph SWR
BUILD Tenant/Owner ELC
R- ing Wall ELR
ootin. Access:
. undatio • FPS
g • rain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
•
' mal
PASS PART FAIL
• BING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA . -1
Approach /Sidewalk Date I? I l U) Inspector �� I C� Ext
Other Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
1
CITY Of TIGARD BUILDING INSPECTION DIVISION MST 0, 1
24 -Hou r Line: 639 -4175 Business Line: 639 -4171 •
BUP �' 1
Date Requested /2 - / AM PM BLD 1111111W
Location 55 5 Se .nh, ' lc/ 4.11 Suite MEC ''• -
Contact Person Ph .SU 3 -63 y -Sz Sr PLM
Contractor Ph SWR
Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
P. - , u
su on
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
PA RT FAIL
MBING
Post & Beam
Under Slab
Top Out •
Water Service
Sanitary Sewer
Rain Drains
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
Final
I PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date / 2, — / 2 _G o Inspector 7(3 Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OFfiIGARD BUILDING INSPECTION DIVISION
MST ,
24 - Hour Inspectibn Line: 639 -4175 Business Line: 639 - 4171 6
BUP U 6 S p
Date Requested / Z-' t- AM PM BLD •
Location / rS97 .5 w Su/W/ 1-vi 6'; ( ' Suite MEC •
Contact Person J'4.2 Ph 503- 63 -5Z 9 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Nailing D g A0 5 L // / L' Ce 5Y6-;(--/ ea/e0 /) Q f f - C ' H s P-
D
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
• PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
ASS BART FAIL
L_ECTRICAt)
Rough In
R 3 8 X S le' ough
UG /Slab
Low Voltage
Fire Alarm
PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date /7., " / Z —C,C) Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITYtiOF TIGARD BUILDING INSPECTION DIVISION ''
MST 07600-00,, / e
24 - Hour InspectiBn Line: 639 -4175 Business Line: 639 -4171 ,
BCP
Date Requested 2 - 2 - G ' AM V PM BLD
Location /5 5 A) 5&( /71 in 14. rl 4 (d L S uite MEC -
Contact Person Ph a f c2-57 PLM
Contractor Ph SWR
UILDING Tenant/Owner ELC
Re aining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam .
Ext Sheath /Shear
Int Sheath /Shear
Framing A ' / �..��c. �EG�cra�ca� �pPPo -
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:c:
S ASS ART FAIL
PLUMB!
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
Final
PASS PART FAIL
SITE
\ Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Other Approach/Sidewalk Date 2 -- — Z U/ Inspector
Ext
Final \
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST p -1a 1 O SOU
24 -Hou' Inspection Line: 639 -4175 Business Line: 639 -4171
OUP
Date Requested ea- "S ".G AM PM BLD
Location /) (f7 .5 w 5 Uh?4'" - 1 a 4' L'` Suite MEC
Contact Person Ph t5 4 - 0 PLM
Contractor - E 2 Ph SWR
UILDIN Tenant/Owner ELC
RErrairtIN Wall ELR
Footing
Foundation Access: FPS
Ftg Drain <-- �,-��� SGN
Claw
Crawl Drain Inspection Notes: ei\./ /
0 -r `'� SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall S� ��i¢ , 4 /
Fire Sprinkler L
Fire Alarm
Susp'd Ceiling
Roof
MSG.,
in
PART FAIL
PL ING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
< ELECTRI
Service
Rough In
UG /Slab
Low Voltage
Fir- Alarm
r
PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Other oach /Sidewalk
Date cg/S70 6 Inspector / 0 I Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.