Permit fi. t R
CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2003 -00136
A;ri t i DEVELOPMENT SERVICES DATE ISSUED: 5/12/03
�� 13125•SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11360 SW SUZANNE CT PARCEL: 1S134DC -12200
SUBDIVISION: CASCADIAN PLACE ZONING: R -4.5
BLOCK: LOT: 011 JURISDICTION: TIG
REMARKS: Construction of new SF detached residence.
BUILDING
REISSUE: MAS 22126A STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,252 sf BASEMENT: sl LEFT: , 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,168 sf GARAGE: 418 sf FRONT: 20 PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5
VALUE: 218,848.20
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2,420 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
• TUB /SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: ", - GREASE TRAPS:
t OTHER FIXTURES:
MECHANICAL
FUEL TYPES - FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 5 - CLOTHES DRYER: 1
GAS FURN > =100K: 1 UNIT HEATERS: - HOODS: 1 - 'OTHER UNITS: 1 '
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4
- 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: 4 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EAADDL BR CIR: SIGNAUPANEL: IN PLANT: -
MANU HM/SVC /FDR: 601 • 1000 amp: 601 +am - 1000x. ' , 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/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: , - CLOCK: •INSTRUMENTATION: MEDICAL: OTHR:
. HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 7,249.78
KEYSTONE DEVELOPMENT INC • KEYSTONE DEVELOPMENT INC. This permit c to the regulations contained C o i the
Tigard Municipal Code, State of OR. Specialty Codes and
PO BOX 476 PO BOX 476
LAKE OSWEGO, OR 97034 - LAKE OR 97034 all other applicable laws. All work will be done i
accordance with appved plans. This permit will expire if
• work is not started within 180 days of issuance, or if the
work is suspended more than 180 days. ATTENTION:
Oregon law requires you to follow rules adopted by the
Phone: ' 503- 635 -4736 Phone: 503- 635 -4736 Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
Reg #: LIC 71135 may obtain copies of these rules or direct questions to
_ OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Erosion Control Insp 84 Post/Beam Mechanical • Plumb Top Out Exterior Sheathing Insr - Rain drain Insp Mechanical Final
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Water Line lnsp Plumb Final
Footing Insp Crawl Drain /Backwater, " Electrical Rough In ' Gas Line Insp Water Service Insp Building Final
Foundation lnsp PLM/Underfloor Framing Insp . Gas Fireplace Appr /Sdwlk Insp
Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Electrical Final
Issued By : 1 Permittee Signature : .
• Call (503) 639 -4175 by 7:00 p.m'. for an inspection needed the usiness day
'r r , Li -as -03 /A.,0 J
5 I`' 3- /01.__
. Building Permit Application
Date
�Ahli Dae received://- f -p 3 Pe no.: a� -zed 0 111 City of Tigard ' 3 -
Project/appl. no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd Ti 73n
Phone: (503) 639 -4171 R C LJ Date issued: B Receipt no.:
Fax: (503) 598 - 1960 , • Case file no.: Payment type:
Land use approval: APR 04 2003 1 &2 family: Simple Complex: i I
TYPE OF PERMIT
r` 1 & 2 family dwelling or accessory 0 e .. mercial/industrial 0 Multi- family r: ew construction 0 Demolition
0 Addition/alteration /replacement 0 Tenant improvement 0 Fire sprinkler /alarm 0 Other: 4
JOB SITE INFORMATION
Job address: i t' o0 'W SV ?, -i►JE. G . Bldg. no.: Suite no.: r
Lot( I ) I Block: (Subdivision: GAScA DAN) PLHCe I Tax map /tax lot/account no.: /6/ ?f,./ft _4,,W,)
Project name: �, -t
Description and location of work on premises/special conditions: ME3 " 5
W
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: V--V S p 4 b , i (Floodplain, septic capacity, solar, etc.)
Mailing address: FO ''- I,)16 I & 2 family dwelling:
Cit LA gr,O5 'J.i O (State:0(LIZIP: G11v Valuation of work $�
Phone: t.,3g - t-41 (p I Fax: K1-11111E-mail: No. of bedrooms/baths
Owner's representative: JA M.0- pOld3 Total number of floors 2•
Phone: L Me Fax: - • E -mail: New dwelling area (sq. ft.) 1,1-120
APPLICANT Garage/carport area (sq. ft.) Li bb
Name: AYv1L • Covered porch area (sq. ft.) 11,0
Mailing address: Deck area (sq. ft.) I2.O
City: I State: I ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/industrial /multi- family: .
CONTRACTOR Valuation of work $
Business name:
till Existing bldg. area (sq. ft.)
New bldg. area (sq. ft.)
Address:
Number of stories
City: I State: I ZIP: Type of construction
Phone: I Fax: I E -mail:
( Occupancy group(s): Existing:
CCB no.:
New:
City /metro lit. no.: Notice: All contractors and subcontractors are required to be
ARCIII IECf /DESIGNER licensed with the Oregon Construction Contractors Board under
Name: MASLIfr2P , provisions of ORS 701 and may be required to be licensed in the
Address: 1 5 NW 1brik jurisdiction where work is being performed. If the applicant is
Cit y: POK,AND Sta az _ I ZIP: Cri "' ,t exempt from licensing, the following reason applies:
o 1
Contact person: Plan no.: ev2,10.40 p
Phone: 112,rj -q 161 Fax: e2,25-,•33 E -mail: S�PIRNs
ENGINEER
Name: ROVJ4,l, Contact person: Fees due upon application $
Address: 4 5 (Q21'1) Date received:
City: P012 -1• A} O (State: O f.....IZlP: c 1'12L1p Amount received $
- Phone: 1,6 -t1. ' - I Fax: e2,51,1 -0611E-mail: Please refer to fee schedule.
1 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 provisions of laws . .d ordinances governing this 0 Visa 0 MasterCard
work will be complied with, heftier sp; , 1 erein or not Credit card number: /
j Expires
Authorized signature: t ,t�, p, Date: 1 1 331 Name of cardholder as shown on credit card $
Print name: a ]!T v • M I " PO ^ " � '' Cardholder signature Amount
Notice: This permit applicati r expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6r00/COM)
/4457-,7 ,03 - � ► 30 •
..
A M echanical Permit Application . .. . . .
D ate received: Permit no.:
` �.�.. t� City of Tigard Project/appl. no.: Expire date:
rv,ij7i�nrd Address: 13125 SW Hall Blvd. Tigard, OR 97223 Date issued: By: Receipt no.:
• Phone: (503) 639 -4171
Fax: (503) 59R -1960 Case file no.: • Payment type:
Building permit no.:
Land use approval:
TYPE OF PERMIT
r I 2 family dwelling or accessory ❑Commercial /industrial ❑ Multi - family 0 Tenant improvement
f New construction 0 Addition/alteration/replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCIIEDULE
Job address: III0j( SW !";' 1,40o .5%17-AWE CT. Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suite no.: value of all mechanical materials, equipment. labor, overhead,
g profit. Value $
Tax map /tax lot /account no.:
Lot: I L Block: 1 Subdivision: 6,A-SC; n .) 0.-/Y-:•-f-/ "See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: j l(7) -\ /t,,'A 'ri • I ZIP: i1.7)2, 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and Iqcation f work on premises: AND COMMERICAL /INDUSTRIAL EQUIPMENTSCIIEDULE
1.; f�W S P- Fee(ea.) Total
Est. date of completion/inspection: 11402 - TO 7-- Description Qty. Res. only Res. only
HVAC:
Tenant improvement or change of use: Air handling unit CFM
Is existing space heated or conditioned? 0 Yes O No conditioning (site plan required) 1
Is existing space insulated? O Yes 0 No Alteration of existing HVAC system
MECIIANICAL CONTRACTOR Boiler /compressors
t GV State boiler permit no.:
Business name: 'r{=1'C� v.` �`( P. G J O f` �� HP Tons BTU /H
' Address: 1 .S. Cj!9 - P - • • Fire /smokedampers/duct smoke detectors
lty: c)2 • ,J W State: Q( - ZIP: \'f0 4r"7 Heat pump (site plan required)
Install /replacefurnace / burner BTU /H
Phone: 5S 7'LLC ax: ' Oq�q E-mail: Including ductwork/vent liner O Yes O No
CC B no.: 1 262 3/2E1042 Install /replace/relocateheaters - suspended,
City /metro lie. no.: 1 1 wall, or floor Mounted •
Name (please print): /; L .S - Vent Vent foraipliance other than furnace
Refrigeration:
'_ CONTACT PERSON '
Absorption units BTU/H
Name: V. `t'S Pr'?. 1NC' Chillers HP
��
l Address: C b c la ,II Compressors Environmental exhaust and ventilation:
City: A )4, 0.0'; -6-0 I State:4- I ZIP: G1l,C'?� `5 Appliance vent
Phone: ?)t - Li 1. Fax: .r{q - rn'( - E Dryer exhaust -,
OWNER Hoods, Type 1/ II/res. kitchen/hazmat
• hood fire suppression system
Name: S e., Exhaust fan with single duct (bath fans)
Mailing address: Exhaust system apart from heating or AC
Fuel piping and distribution (up to 4 outlets)
I Ci (State: I ZIP:
Type: LPG NG Oil
Phone: Fax: E - mail: Fuel piping each additional over 4 outlets
Process piping (schematic required) ,
Number of outlets
Name: Other listed appliance or equipment:
Address: ?, Decorative fireplace
City: State: ZIP: insert - type •
E-mail: W oodstove/pellet stove
Phone: Other: —
Applicant's signature: AW' 190" Date, Other: ,
•
Name (print): . %l'AA M - �
Permit fee $
( Not all jurisdictions accept credit cards, please call jurisdiction for more information, Notice: This permit application Minimum fee $
I Visa 0 MasterCard expires if a permit is not obtained plan review (at %)
.:rcdii card number: p / within 180 days a it has been State surcharge (8 %) ... $
Ex irc ,
Name of cardholder as Chown on credit card accepted as complete. TOTAL $
3
Cardholder signature Amount 440.4617 (M ICOMI
/ 1 / 1 5 7 c r o 3- a-o ! 3 G
11/07/2002 07:04 5033310581 ASSOC PLBG PAGE 01
TEL NO.6354736 May T0,<O 6 :45 P.01
Plumtbing Permit Application
Oats rcrehad: Await law
City of Tigard &wetpotmn pnfldtng gamin no.;
• � � Ammar, 1l12? $W Hall Blvd. Tigard, OR 97223 1?ojoeV I.tb: karat; owe
Phones (369) 639.4171 . app
Put: (S03) 5911•1960 Data Jaunt 1 By: 1 Receipt no.:
Land use approval: Cuo etr no.: — Pigment type:
I1I'i (H Ptit'iii
X e fYml(y dwelling no
or oaaloty 0 Comnteteiallindwtrlal 0 KtRI -lmily 0 Tenant Improvement
w construction 0 Poldidonhlteantionkaplacamant 0 Pood omit* ' 1 0 Othett •
.I111: 1111 1 \t IlU11\1111\ I•I I ♦( III III II II••1'•li,, ial nrllnuu.11mml•PCllt•C1,11
Job Odium , p ' p • 1,,, . Fee ea. Total
awl. ,. r^:,. .il'r. .
B • rat Sulann.: pntlseeeIISA s
.Ibrebatllky.. .11 -. )
Tax • lotlaboount no,: SPR 1) bath
lAt 11 • Block: Subdivision: " "1' M _ SPR 2 bath
' •. col name: IWO . .
Description and l ooatl • of • on ptealleer She • . - ,
• • Catch baslehtea drain ,
• 11]:4:11M?s711tIT!!7T Y tCl n
1'II VIt1\1.1 III %I111It rZ nR =
i si7• ` •nn • noon •• - r .
[__Jfillt ]U L3 ifdi riMIIIIINi*Il ► . fib)•
k1Q B-mat : - • 111=11MMII
. a : . T t1 41111 plumb. bra. re _ .. no: 'Armi ` � m1II_
CI vtrotlIWnch: ♦.?;%1/ A. , on valve
ContaanWell • • • utivo a , 0. ?..n r/� __ ; ao • • o v - (a t • It !:, . tUE '- �ar`r� y. 74 '� : seta ro
( n\ I \( I PI ItsO\ Bulna/lIvaco
Name: • Clothes amber
v. , ruse: PithwuYr .
Ia, Staro ZIP ■a;I71S7,., nRO'
1
111, \1 It . J R1111:11 •
None yr , .T} u Q. ‘14c,. • ' �Ciamr „1�il i:_•'77nr,�7
['!C arT r- , . ..r [i'•'. a z>P: rli t,
Owner I , .. ... 1 ma • . on y: ecru inanition • O
will bo rode by one or the mtlmcnutoo and 1.r made by my regular R.. . n b'•'„r1 - P nth
employee oh the property I own as per ORS Mpor 447. 11EXIMETIEW111111
Owns - • • Wool
.. .._
I \t.l\I11( ligriMilii
01y: • I p.� Stain: VP: ii _
Atone: tone: � +
`%x:: T ali: ,--- -. ...'.1
,
►rs III lalas.Iuu 51 1 al enti.ouprlr e+T a t � a en Mfa+.rla i Notice: This perm it application MI " ' • ft.............L.. $
OWa 0/Autocad flan (at _ 96) $
exotica inn a permit le cotes been t within I!1 d 0 ay. snot it hu hean r TOT owl ul'a mom — M - • ' (a96) .... $ •
Mum to aattalrl u Ulcers iii WM life mated as *staples.
S
41e4416 (fIDd00AA
06/23/2003 11:23 5036254455 LIGHTHOUSE ELECTRIC PAGE 02
Electrical Per 't Application
Date received: Permit no.: /!1s fZ 003 - DD/
;:1:1 = ; iy City of Tigar 1 V
Project/appl.no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, igard, OR 97223 Date Issued:
Phone: (503) 639 -4171 it N 2 -, 2003 - By: _ I Receiptno.:
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval LA t ter 1 lui.04 �
r LaNtVu ZiENuuVccrilhlta
'I 1, P1: 01.. in/till [I
1 & 2 family dwelling or accessory Cl . mmenelal/industrial ❑ Multi - family ❑ Tenant improvement
• New construction ❑ • . dition/alteratlon/replacement ❑ Other O Partial
JOB sin; INFORMATION
Job address: , llWilI M. Bldg. no.: Suite no.: Tax map/tax lot/account no.:
Lot: Block: Subdivision:
Project name: s ription and location of work on premises: CA 581 �,L,4
Estimated date of cons . Iction/inspection:
CON] RACI'OR APPI.ICA 1'II ON 171E St ll J• D1 ti,E
Job no: Foe Max
Business name: . d a .i `! Descxiptlon Qty. (ea) Total no.lasp
Address: silal ��� C , / Net►resi& aI -angle ormuld- romllyper
iii�►7�� .� / 1/ `� �l e2.- d rgtmt,Includes attadiedgar age,
� & i ' . ;15/ IZIM2 r ZIP: � , , ' Ssraoelndnded:
iiL
� 42: / 4:1:61.4g • 1: 4
Each additional SOO.q- ft. or portion thereof
CCB no.: / e9 7 Elec. bus. lic. n.: . (o ff
United energy. residential 2
ii iiikA, • Sic. no.: tirnitedenergy, non non-residential ' 2
i /. t�l. i l,� 1_4 J j -10 Each nunufaaued home or modular dwelling
• r . • it of sit. - sinj el • • clan (required) Date Service and/or feeder 2
Sup. elect. name (print):
4 ( et , if Hi pp Seniors
alteration or relocations
PROPER l'v (MINER INEIt 200 amps or leas 2
1012 LL ' 1 / , • 201 to 400 • s 2
Mailing address: 401 amps to 600 amps 2
601 amps to 1000 amps 2
City: State: ZIP: Over 1000 amps or volts 2
Phone: I Fax: IE- :'1: Reconnect only 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exc ge according to Installation, alteration, or/elocution:
ORS 447, 455, 479, 670, 701. 200 amps or less 2
201 amps to 400 amps 2
Owner's signature: Date: • 401 to 600 .. 2
ENGINEER Branch circuits - hew, alteration,
Name: or extesnion per panel:
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 - m il: Each additional branch circuit:
PLAN ItFVlI :w (Please check all that al)pl) ) Mc. (Service or leader not lncluded):
O Service over 225 ampa•aoaunencial O Health -care f ility Each pump or irrigation circle 2
❑ Service over 320 amps-raring of I8t2 O Hazardous l • -. on Each signor outline lighting 2
family dwellings O Building over 10.000 square feet tourer Signal circuit(s) ore limited energy pane).
O System over 600 volts nominal mom • . units to one structure alteration, or extension* 2
Cl Building over throe stories Cl Feeders. 400 , • or mono *Description: O Occupant load over 99 persons Cl Manufactured structures or RV park ' Each additional Inspection over the allowable hi any of the above:
❑ Egreasilightingplan 0 Other - Per Inspection I I I I
Subtult _ seta of plans with any of . • above. investigation fee
The above are not applicable to temporary co , . , Lou service. Other
' N« on Jett ®
adiceona accept credit cards. pta a jj
lt .dictiaa fa ama
wore • . iuu Notice: This permit application Permit fee $
O Visa O MasterCard expires if a permit is not obtained Plan review (at _ 96) $ SU
Credit Card =umber. / within ISO days after it has been State surcharge (8%) _: -. $ ,MP
Phu
Name of cardholder u shown oo caulk card accepted as complete. TOTAL $ . ���.` f a
i
Cadhol0er sifaestms . • 5 (6iaNCOM)
/1AS racl -cso 1 (o II
1 or
I ■
• ■
• ■
1 TREE C • E TIFICATION
R
STREET
• .
• .
• .
• I, ►��S M • 'PDI./'r�- , Owner /Agent fo V.e-`(51 - 0N ON'. V ' G . ►
, (PLEASE PRINT) (PERMIT HOLDER) ►
• ►
• ►
•. ►
• ►
• ►
• Do hereby certify that the following location ■
• ■
• meets City of TigardAVashington County ■
• land use and development standards for street tree installation. ■
■
I ■
• ■
• ■
• ADDRESS: 1 I3 /O 5W .5 vl(r* C 1 • ■ ■
• ■
• LOT: I l SUBDIVISION: CASC �'�►, O '� °�- o• •
• •
• ►
• BY: 06141' •
DATE: lo�� �� • •
• •
1 RECEIVED BY: /; /j, 4!_ ,i / DATE: M--,''S. • •
• •
IVY\ ,••••••••••••••••••••••• ••••••••••••••••••••••• ♦vv'u
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 3 _6 i ?�
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested /0 — 1 AM PM BUP
Location . 2-6?-1444. e_ Suite MEC
Contact Person Ph ( ) PLM
Contractor hi- / se • Ph (b r 562 SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: 4/3 ELR
Crawl Drain (L
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation l Ik` � 1 \\114 ` ` 1b ` p J )
Drywall Nailing 1. W ✓ / l
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
PAS - ART FAIL
Rough -In
UG/Slab
ta9e-,
• larm
Fin. I �G Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
"AMP PART FAIL
SITE Please call for reins ect'on RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date . l d' Inspecto Ext
Other:
Final DO NOT REMOVE this inspection record from the j site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 - CO v?•,._ l
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested 0 -73 r■q PM BUP
Location 772 (OD . - G( - - r at- Suite -r7 MEC
Contact Person c� [ MA 01 I ei2L< Ph ( ) ‘/ S 4 3 ( PLM
Contractor Ph ( ) .51 7 2-1K4P SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access: te'
Ftg Drain 43 (07 ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall /� / I J P
Fire Sprinkler - —
Fire Alarm
Susp'd Ceiling ..•r
Roof
i
Other:
��
Final ����'1/
PASS PART FAIL
C L
•
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Final
S PART FAIL
M CHANICAL
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 [] Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date b Inspector 1 73 Ext
Other:
Final 0 NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 635 =4175 " — 00/3 6
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested I D —a-9 AM PM BUP
Location / /3GO S 4 tv'ne- Suite MEC
Contact Person Ph ( ) CP 3S 4 47 3 (4. PLM
Contractor Ph ( CP—II S7 7 v-9 $ ' SWR
f'3 UILDI Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Fami FAss y6 -Zq-m3
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
•i i er:
•AS 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 PAT FAIL
(firCHANICAL)
Post & Beam
Rough -In •
Gas Line
S •ke Dampers
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 D Please call for reinspection RE fl Unable to inspect – no access
Fire Supply Line
ADA
Approach/Sidewalk Date /O 2 — 03 Inspector Ext -
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL