Permit ,
CITY TIGARD SITE WORK PERMIT
COMMUNITY DEVELOPMENT PERMIT #: SIT2008 -00001
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED : 4/16/2008
PARCEL : 2S104AD -04500
SITE ADDRESS: 12617 SW WALNUT ST ZONING : R
SUBDIVISION: TVF &R FIRE STATION LOT: JURISDICTION : TIG
PROJECT: TUALATIN VALLEY FIRE AND RESCU
Project Description: Site work for new fire station.
CLASS OF WORK: NEW PAVING ?: Y RESO. NO:
TYPE OF USE: COM GRADING ?: Y VALUE: 380,000.00
EXCV VOLUME: 1,409 cy LANDSCAPING ?: Y
FILL VOLUME: 2,972 cy SITE PREP ?: Y
ENG FILL ?: Y STORM DRAINS ?: Y
SOILS RPT REQD ?: Y IMPERV SURFACE: 43,572 sf
Owner: FEES
TUALATIN VALLEY FIRE & RESCUE Description Date Amount
20665 SW BLANTON ST [BUPPLN] Pln Rv -Valu 1/30/2008 $944.32
ALOHA, OR 97007
[FLS] FLS Pln Rv 1/30/2008 $581.12
[BUILD] Prmt Fee -Valu 4/16/2008 $1,452.80
Phone: 503 - 649 -8577 [TAX] Valu 12% State Surcha 4/16/2008 $174.34
[ERPRMT] Erosion Control 4/16/2008 $140.00
Contractor: [ERPLN] Erosn Pln Rv CWS 4/16/2008 $45.50
[EROSN] Erosn Pln Rv COT 4/16/2008 $45.50
DON BURKE EXCAVATION & CONSTRUCTION Total $3,383.58
15604 SE RUBY DRIVE
MILWAUKIE, OR 97267
Contact #: PRI 503 652 - 0175
REQUIRED ITEMS AND REPORTS
Ersn Cntrl 681 -4444
Reg #: LIC 150901 Structural observation
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. 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 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 copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B �� �/-- Permittee Signat � Vii• ill— .
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.
III ling Permit Application
N Site Work , FOR`OFFICE= ONLY •
City of Tigard ^1 n C ) Una Received / n J /D7, Permn NS r. S'-DODO
514
1`t ( J L DateBy i oC
13125 SW Hall Blvd , Tigard, OR 97223 .. Plan Revi= A �
C Phone. 503 639.4171 Fax 503 598 196Q y ot. (MAW Date/B edict, ' � Other Permi � ,
/ lOO8 �00� vi
T I G n R. D Insp ection Line 503 639 4175 i111 nv /�{� Dat ReadyBy. tens ®'• Page 2 for
Internet www tigard -or gov B ®`'Yt3 No ufied/Method !y 6s._ Supplemental Information
`' - , TYPE OF WORK . - `� IEE TA: 1- AND 2- FAMILY DWELLING
*New construction ❑ Demolition Permit fe 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 u Commercial/industrial Valuation: $
•
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: / 2. g s L , ( J 1)C� I Pt cu. t- 5 7 . New dwelling area: square feet
City/State /ZIP: T) 612_ .1 1-'LZ� Garage /carport area: square feet
Suite bldg. /apt. no.: l CJ1 "" ^ " Project name: -1- 5 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: I Lot no.: 1LS'OO Permit fees* are based on the value of the work performed.
Tax map /parcel no.: S /04- AD 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.
klt e.4) ± L( 1-oo � 3 . 1 AIP. Valuation: 7- $ 3 $ Q O O 0
� ' � w J 2 cc II I L o Q 0 Existing building area: -- p ^ s feet
,/ rte Gc � I--C-44 / 5/ /1K (i•vt r ' 4'4' - New building area: / 1 6,14 square feet
PROPERTY OWNER � ❑ TENANT Number of stories:
Name: r� //,,,, V D� tY ( 4,(4 e' ere 7 /ZeS -c Type of construction: V1:5 el / S' p VI el G�
Address: 2,0 e0 J 4.1 ...,/ [JLC✓t t j , Occupancy groups: •�� ( ��
City /State /ZIP: 14 - 1 4i14_ / d .11-00-4- Existing:
Phone: ( so3 (, ¢2 - 033 / Fax: ( ) - New:
-3 1 D, 2 -2 S- Z
,' APPLICANT .4 CONTACT PERSON NOTICE
Business name: / L ; / 0 ` 4� All contractors and subcontractors are required to be
Contact name: ��� �� 8��� licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: .ogeV 5 z ( r . b e lf jurisdiction in which work is being performed. If the
City /State /ZIP: o t/ �— f a lea 0 1 3 applicant is exempt from licensing, the following reasons
1 � -1 apply:
Phone: ( 03 4�1 1-(o (2 Fax:: ( y )5 • z' . l_o
E-mail: , i e ff F GI.V'cli S ,. 'i 0 psi
v CONTRACTOR
Business name: P 61 f G 8 id - 7'b 1, . BUILDING PERMIT FEES*
Address: Q t? 7 e1 (N ' (Please refer io fee schedule)
Structural plan review fee (or deposit): 19W 3 y
Cit /State /ZIP: I - ,
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable): 523 / 2,--
CCB lic.: Total fees due upon application:
—
Amount received: / 5 . ` tJ
Authorized signatur . — This permit application expires if a permit is not obtained
t�J��Nro IT` ' � �� within 180 days after it has been accepted as complete.
Print name: G V � Date: O 7 * Fee methodology set by Tn -County Building Industry
Service Board.
I \Building\Permits \SIT - PermitApp doc 12/27/06 440- 4613T(I 1 /02 /COM/WEB)
City of Tigard: Site Work Permit Checklist
Page 2 - Supplemental Information
Commercial, Multi- Family and One- and Two - Family Dwellings:
No permit is required if fill is less than 50 yards (5 dump truck loads), or less than 3 feet deep and will
not be supporting a structure. If a building will be constructed on the fill, it must be engineered fill. If
fill is in a flood plain, drainage way, or wetland, the applicant must apply for a sensitive lands review
(SLR).
Please complete all items below, unless otherwise noted.
Excavation Volume: cu. yds.
Grading Volume:
(Soils report required for >5,000 cu. yds.) cu. yds.
Fill Volume:
(Fill exceeding 12" in depth shall be
compacted to 90% of maximum density) cu. yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU
❑ Concrete
❑ Other:
*Total new impervious area including all
buildings, sidewalks, and paving: sq. ft.
Site Utilities Plumbing Work:
Complete the Plumbing Permit Application for site utilities plumbing work.
Plans Required: See "Site Work Permit Application - Plan Submittal Requirements"
attached. The following must accompany this application:
❑ Site Plan with Vicinity Map showing ❑ *Parking (including ADA) and
ADA compliance Lighting Plan
❑ Grading Plan and details ❑ *Landscaping Plan
❑ Erosion Control Plan and details ❑ Soils Report (if required)
❑ Retaining Structures
*Does not apply to One- and Two - family dwellings.
# of Plans
TYPE OF SUBMITTAL Required at
(Includes New, Additions or Alterations) Submittal
Commercial 2
Multi - Family R -1 Occupancy 2
One- & Two - Family Dwelling 2
I \Bwldmg\Permits \SIT - PermitApp doc 12/27/06 2
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` 111/30/2008 ED 13:32 FAX 85034965401 1 f 003/003
City of Tigard: Site Work Permit Checklist JAN " 0 2008
Page 2- Supplemental Information CH r� I Us: I i uA
BUILDING DIVISION
Commercial, Multi- Family and One- and Two - Family Dwellings:
No permit is required if fill is less than 50 yards (5 dump truck loads), or less than 3 feet deep and will
not be supporting a structure. If a building will be constructed on the fill, it must be engineered fill. If
- -- fill is in a flood plain, drainage way, or wetland, the applicant must apply for a sensitive lands review
(SLR).
Please complete all items below, unless otherwise noted.
Excavation Volume: 1,409 cu. yds.
Grading Volume: .
(Soils report required for >5,000 cu. yds.) 2,972 cu. yds.
Fill Volume:
(Fill exceeding 12" in depth shall be
compacted to 90% of maximum density) 2,972 cu. yds.
Retaining structure? (Check one) ❑ Rock
❑ CMU
❑ Concrete
® Other: graded 48% max
*Total new impervious area including all
buildin:s, sidewalks, and . avin 43,572 s • . ft.
rYar ' ow + �' ` 1' P T,Hv il � "ry -�t 1iu ' . 1n it i , , A i11�1,f ;;uIt;tWmitF 1 "h 1 i : , r imsz'{ �n , �,14,7;J ry Cq
•p,J+�'tiw1:11 tu � .. i {. .iLl , r r<._,,,9ti L ;f� lib t, ii i*, n Y r y _ !X t&i A 11iitith ilit:R3 E n 21?�1 ��y it
Site Utilities Plumbing Work:
Complete the Plumbing Permit Application for site utilities plumbing work.
Plans Required: See "Site Work Permit Application - Plan Submittal Requirements"
attached. The following must accompany this application:
❑ Site Plan with Vicinity Map showing ❑ *Parking (including ADA) and
ADA com.Hance Li: tin: Plan
• Grading Plan and details • *Landscaping Plan
❑ Erosion Control Plan and details ❑ Soils Report (if required)
❑ Retaining Structures
*Does not apply to One- and Two - family dwellings.
, Ja r 1 +, t 11� 4 r Fig 1 * ' %V ,P , > di, moss., is, , 1 I �! i , ,1{n+' 3 r, ol ,
l ; f ir[0,4f, It r -� r , , 1 °! ' 171 4 I 1 1 n r
li it ir, t ®,� i , i ,' '' ii 4 � '9,• , ri 1 yllw 4 � 4! .� ,hill fi� '� �R�d9 , , +� �t �� j' �Plvwuuitali 1 � a � 4� rw i , , i,
sinith4� igia L a!1�. i r : ' v i :1 , � �+ 1 ,., ,
Commercial 2
Multi - Family R -1 Occupancy 2
•
One- & Two - Family Dwelling 2
1:1Buildirtg\Pennits\Srr- PermitApp.doc 06/26 /06 2
rl
Site Work Permit Application
Plan Submittal Requirements
TI G A R D, Commercial, Multi- Family and One- & Two - Family Dwellings
A site work permit is required for all commercial projects including new buildings, additions,
accessory buildings larger than 120 square feet, modular structures and multi - family R -1
occupancies. A site work permit is required for excavation, fill, grading, paving, retaining walls, fire
hydrants and fire department access on private property for work on individual lots not covered
under the subdivision development.
Note: A separate "plumbing" permit for site utility plumbing work is required for sanitary
sewer, storm sewer and potable water systems on private property. Please see the Site
Utilities - Plumbing Permit Application for plan submittal requirements.
1. SITE PLAN and vicinity map (fully dimensional, drawn to scale) showing the geographic
location labeled with:
A. ilemap & tax lot # Ot,project name [site address a- to number
zoning L plicant name a applicant phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Building pads (drawn to scale) with project location.
2. BUILDING PLAN submittal requirement: Two (2) complete sets, Civil only.
All details listed below shall be incorporated into the plans:
A. Site plan showing:
1) Required parking spaces and driveways.
2) A route, accessible to persons with disability, leading from the public way to an
accessible building entrance.
3) Accessible parking spaces and adjacent access aisle connecting with the accessible
route.
4) Curb ramps along the accessible route, curb, sidewalk and gutter.
5) Finish grade elevations along the accessible route.
B. Topographic survey plan showing grade elevations crossing the entire site.
C. Overall grading plan.
D. Utilities plan showing:
1) Fire hydrant location and pipe size if on private property.
2) If the building is to be protected with an automatic fire sprinkler system, show
location of the water service vault and the fire department connection (FDC)
within 70 feet of a fire hydrant.
3) Size of underground water service for the sprinkler system.
E. Erosion control plan complying with the requirements of the Clean Water Services
(CWS) agency showing:
1) Silt fence locations.
2) Bio- filter bags /other approved barrier material surrounding catch basins.
3) Illustrations detailing the correct installation of the silt fencing and catch basin
I:\ Building \Forms \SIT - PlanSubRcq doc 06 /29/06
N
•
protection.
4) Any other measures to ensure compliance with CWS standards.
F. Landscaping plan.
3. ADDITIONAL REQUIREMENTS:
A. Soils (geotechnical) report. A soils report is required for new buildings and additions
to contain the following:
1) The report shall address the potential of soil liquefaction and instability (OSSC Sec.
1804.2).
2) Fills to be used to support foundation of buildings (OSSC Sec. 3301.1).
3) Foundation and lateral pressures exceeding 1,500 lb. /sq. ft. (OSSC Sec. 1805).
B. Fire flow and hydrant worksheet.
C. Plan review deposit based upon project valuation.
•
I. \Building \ Forms \SIT- PlanSubReq doc 06/29/06
CITY OF TIGARD Ap ,/
BUILDING DIVISION PERMIT #: SIT2008 -00001
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/1612008
Phone: (503) 639 -4171M
Inspection Requests (24 Hrs.): (503) 639 -4175 "'II
INSPECTION WORKSHEET FOR DATE: 12/1Q/2008 TIME: 7 :01AM PAGE: 6
SITE ADDRESS: 12617 SW WALNUT ST CLASS OF WORK:
SUBDIVISION: TVF &R FIRE STATION LOT #: TYPE OF USE: .
PROJECT NAME: TUALATIN VALLEY FIRE AND RESCU
I DESCRIPTION: Site work for new fire station.
OWNER: TUALATIN VALLEY FIRE & RESCUE, PHONE #: 503 - 64945%7
CONTRACTOR: DON BURKE EXCAVATION & CONSTRUCTION PHONE #: 603G52 -0175
Inspection Request Scheduled For: Date: 12/1812008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
499 Final inspection 079113-01 503 -'1 -7634 N
Corrections /Comments /Instructions:
•
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Y /j1)
•
4A ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:
A&•.(2.....,..........„- Date: 17 /I /(S O Phone #: 503 718 -
_
PERMIT NO. A%�6�8f
CleanWater Services
\):II (Qlllllllllli Clll IS (lea! LOT - 4/4
EROSION
CONTROL L
INSPECTION REPORT
DATE / INSPECTO' A I •' SUBDIVISION Al--•c i ,�,� 7)
OWNER/PERMITEE /fr
SITE ADDRESS o
FINAL INSPECTION
A .
THIS SITE MEETS THE POST - CONSTRUCTION
EROSION CONTROL REQUIREMENTS SET
FORTH IN CLEAN WATER SERVICES
RESOLUTION AND ORDER
NOTE: IF POST- CONSTRUCTION EROSION CONTROL MEASURES ARE STILL BEING
EMPLOYED ON THIS SITE TO MEET CRITERIA FOR AN APPROVED FINAL INSPECTION,
THE MEASURE(S) MUST REMAIN IN PLACE UNTIL LANDSCAPING IS COMPLETE
OR PERMANENT GROUND COVER IS ESTABLISHED.
A COPY OF THE FINAL EROSION CONTROL INSPECTION REPORT MUST BE
FORWARDED TO THE NEW OWNER, AT WHICH TIME NEW OWNER ASSUMES
THE RESPONSIBILITY FOR MAINTENANCE, REPAIR AND REMOVAL.
OTHER
THANK YOU FOR YOUR COOPERATION!
INSPECTOR PHONE 5 ) 00/
CITY OF TIGARD ` ..
BUILDING DIVISION 7 PERMIT #: SIT2000 -00001
13125 SW Hall Blvd., Tigard, OR 97223 A 7 DATE ISSUED: 4/16/2008
Phone: (503) 639 -4171 }I
Inspection Requests (24 Hrs.): (503) -4175 __.. .
INSPECTION WORKSHEET FOR DATE: 1218/2008 TIME: 7 :00AM PAGE: 25
SITE ADDRESS: 12617 SW WALNUT ST CLASS OF WORK:
SUBDIVISION: TVF &R FIRE STATION LOT #: TYPE OF USE:
PROJECT NAME: TUALATIN VALLEY FIRE AND RESCU
DESCRIPTION: Site work for new fire station.
OWNER: TUALATIN VALLEY FIRE & RESCUE, PHONE #: 5O3.649_8577
CONTRACTOR: DON BURKF EXCAVATION & CONSTRUCTION PHONE #: 503.652 -0175
Inspection Request Scheduled For: Date: 12/8/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
499 Final inspection 078851 -01 503 - 341.7634 N
Correcti ns om jents /Instruc
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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Inspector Date: R /- / Phone #: (503) 718 - -247
,. CITY .OF TIGARD . t,. ,; -'"
BUILDING DIVISION '' PERMIT #: SIT2008-00001
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/1612009
Phone: (503) 639 -4171 MI,'
Inspection Requests (24 Hrs.): (503) 639 -4175 4
INSPECTION WORKSHEET FOR DATE: 10/212008 TIME: 7 :00AM PAGE: 17
SITE ADDRESS: 12617 SW WALNUT ST CLASS OF WORK:
SUBDIVISION: TVF &R FIRE STATION LOT #: TYPE OF USE:
PROJECT NAME: TUALATIN VALLEY FIRE AND RESCU
DESCRIPTION: Site work for new fire station.
OWNER: TUALATIN VALLEY FIRE & RESCUE PHONE #: 5036438577
CONTRACTOR: DON BURKE EXCAVATION & CONSTRUCTION PHONE # : 503 -652 -0175
Inspection Request Scheduled For: Date: ia2 2008 Pour Time:
Code # Inspection Description Confirm # Contact # Mes •.ge
495 Misc. inspection? 076219.01 503 341 -7634 Y
Corrections /Comments /Instructions: /n,
alit / -,r
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector,: Date: /a Phone #: (503) 718 -
1 , ■
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: iT2oo8 00001
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4116/2000
Phone: (503) 639 -4171 ^ � � 1
. Inspection Requests (24 Hrs.): (503) 639 -4175 ^ `I L
INSPECTION WORKSHEET FOR DATE: 10/1/2008 TIME: 7;p2AM PAGE: 37
SITE ADDRESS: CLASS OF WORK:
ST
' SUBDIVISION:
12617 SW WALNUT LOT #: TYPE OF USE:
PROJECT NAME: TVF &R FIRE STATION
DESCRIPTION: TUALATIN VALLEY FIRE AND RESCU
Site work for new fire station.
OWNER: TUALATIN VALLEY FIRE & RESCUE, PHONE #: 503G�y�t 8x77
CONTRACTOR: DON BURKE EXCAVATION & CONSTRUCTION PHONE # : 503-652 -0175
Inspection Request Scheduled For: Date: 10/1/2008 Pour Tim-: d
`/"
Code # Inspection Description Confirm # Contact # Mes : ge
P 0
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495 Misc. inspection 2 076139 -01 503.311 -7634 Y
Corrections /Comments /Instructions:
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[ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSES D
Inspector:
Avy Date , D/ ( v Phone #: (503) 718- 242-(
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CITY OF TIGARD 4 1 T of -00 o I
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: -
Phone: (503) 639 -4171 / °'91u
Inspection Requests (24 Hrs.): (503) 639 -4175 „AA- IL
INSPECTION WORKSHEET FOR DATE: ' 1 ' / ' O /O" TIME: PAGE:
SITE ADDRESS: jQ Vim+ aA N ( 4 CLASS OF WORK: •
SUBDIVISION: LOT #: TYPE OF USE:
. PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
l - � r - e C C envy \ ,� ; ri, � C H 4 1 eSr)
Corrections /Comments /Instructions:
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t g FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
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Inspector: � Date: ° 1(3� � Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: SIT2008 -00001
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/16/2008
Phone: (503) 639 -4171 Vit Inspection Requests (24 Hrs.): (503) 639 -4175 _
INSPECTION WORKSHEET FOR DATE: 9/19/2008 TIME: 7:00AM PAGE: 29
SITE ADDRESS: 12617 SW WALNUT ST CLASS OF WORK:
SUBDIVISION: TVF &R FIRE STATION LOT #: TYPE OF USE:
PROJECT NAME: TUALATIN VALLEY FIRE AND RESCU .
DESCRIPTION: Site work for new fire station.
OWNER: TUALATIN VALLEY FIRE & RESCUE, PHONE #: 503-649-8577
CONTRACTOR: DON BURKE EXCAVATION & CONSTRUCTION PHONE #: 503-662-0176
Inspection Request Scheduled For: Date: 9/19/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Mess- :,;
420 Spriniker supply Tines 075668 -01 503-341 -7634 • --
Corrections/Comments/Instructions:
6 // A l - for r -- J.._
❑ PASS \ , . RTI AL APP' • ❑ CANCEL ❑ NO ACCESS
❑ FAIL I CALL FOR INSPECTION ❑ ADDITI NAL FEES ASSESSED
Inspector: Date: q J � 0 0 Phone #: (503) 718- ZV
I 1
NW
CITY OF TIGARD
• BUILDING DIVISION PERMIT #: SIT2008 00001
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/16/2008
Phone: (503) 639 -4171 �4r
Inspection Requests (24 Hrs.): (503) 639 -4175 p'I L
INSPECTION WORKSHEET FOR DATE: 9/18/2008 TIME: 7:00AM PAGE: 13
SITE ADDRESS: 12.617 SW WALNUT ST CLASS OF WORK:
SUBDIVISION: TVF &R FIRE STATION LOT #: TYPE OF USE:
PROJECT NAME: TUALATIN VALLEY FIRE AND RESCU
DESCRIPTION: Site work for new fire station.
OWNER: TUALATIN VALLEY FIRE & RESCUE, PHONE #: 503 - 646.8577
CONTRACTOR: [)ON BURKE EXCAVATION & CONSTRUCTION PHONE #: 503 -652 -0175
Inspection Request Scheduled For: Date: 9/18/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Messase
420 Spiinklc r supply lines 075631 -01 503-341 -7634
Corrections /Comments /Instructions:
❑ PASS 0 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL • CALL • = ' ' •N ❑ ADDITIONAL FEES ASSESSED
Inspector: . Date: (" - " Phone #: (503) 718- 7 --6
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: SIT2008.00001
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/16/200F
Phone: (503) 639 -4171 "14011,
Inspection Requests (24 Hrs.): (503) 639 -4175 e7 �
INSPECTION WORKSHEET FOR DATE: 9/17/2008 TIME: 7:00AM PAGE: 24
SITE ADDRESS: 12617 SW WALNUT ST CLASS OF WORK:
SUBDIVISION: TVF &R FIRE STATION LOT #: TYPE OF USE:
PROJECT NAME: TUALATIN VALLEY FIRE AND RESCU
DESCRIPTION: Site work for new fire station.
OWNER: TUALATIN VALLEY FIRE & RESCUE, PHONE #: 503649.8577
CONTRACTOR: DON BURKE EXCAVATION & CONSTRUCTION PHONE #: 503-652-01M
Inspection Request Scheduled For: Date: 9/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Mess.. -
420 Sprinkler supply lines 075554 -01 503.341 -7634
Corrections /Comments /Instructions:
v 7+
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L i n PASS j, ' ±: ` - - - : Y ∎ L ❑ CANCEL ❑ NO ACCESS
( FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 4/ /0 Phone #: (503) 718 -Z-4'
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: SIT200400001
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/1642008
Phone: (503) 639 -4171 VI �,I�
Inspection Requests (24 Hrs.): (503) 639 -4175 .,' °__-.
INSPECTION WORKSHEET FOR DATE: 9/1512008 TIME: 7:00AM PAGE: 26
SITE ADDRESS: 12617 SW WALNUT ST CLASS OF WORK:
SUBDIVISION: TVF &R FIRE STATION LOT #: TYPE OF USE:
PROJECT NAME: TUALATIN VALLEY FIRE AND RESCU
DESCRIPTION: Site work for new fire station.
OWNER: TUALATIN VALLEY FIRE & RESCUE, PHONE #: 503 - 649.6577
CONTRACTOR: DON BURKE EXCAVATION & CONSTRUCTION PHONE #: 503662
Inspection Request Scheduled For: Date: 9/15!2008 Pour Time:
li Code # Inspection Description Confirm # Contact # Messa•e
420 Sprinkler supply lines 075443 -01 503. 341 -7634 0 1(
Corrections /Comments /Instructions:
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El PASS I , 'ARTIAL APPR ❑ CANCEL ❑ NO ACCESS
❑ FAIL El ' o ' INSPECTION ❑ ADDITIONAL FEES ASSESSED
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nspector: Date: S lg Phone #: (503) 718 -
CITY OF TIGARD = - .
BUILDING DIVISION PERMIT #: SIT2008 -00001
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/16/2008
Phone: (503) 639 -4171 Au ^ „ , i ,; , �
Inspection Requests (24 Hrs.): (503) 639 -4175 I il,
INSPECTION WORKSHEET FOR DATE: 5/1212008 TIME: 7:01AM PAGE: 1
SITE ADDRESS: 12617 SW WALNUT ST CLASS OF WORK:
SUBDIVISION: TVI &R FIRE STATION LOT #: TYPE OF USE:
PROJECT NAME: TUALATIN VALLEY FIRE AND RESCU
DESCRIPTION: Site work for new fire station.
OWNER: TUALATIN VALLEY FIRE & RESCUE, PHONE #: 503-649-8577
CONTRACTOR: DON BURKE EXCAVATION & CONSTRUCTION PHONE #: 503 652
Inspection Request Scheduled For: Date: 5112/2008 Pour Ti • -: ( S)
Code # Inspection Description Confirm # Contact # Mes -- •
CP Misc. it °pection 069748 -01 503.868.6168
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Corrections /Comments / Instr
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❑ PASS ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ‘n )....J i A Lk----- Date: Cl ( 2./Ib4' Phone #: (503) 718 -
4'�
CITY OF TIGARD
BUILDING DIVISION PERMIT' #: 5IT2008.00001
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/16/2008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 e7 I I..
INSPECTION WORKSHEET FOR DATE: 6/6/2008 TIME: 7:01Atv1 PAGE: 42
SITE ADDRESS: 12617 SW WALNUT ST ' CLASS OF WORK:
SUBDIVISION: TVF &R FIRE STATION LOT #: TYPE OF USE:
PROJECT NAME: TUALATIN VALLEY FIRE AND RESCU
DESCRIPTION: Site work for new fire station.
OWNER: TUALATIN VALLEY FIRE & RESCUE, PHONE #: 503-648 -8577
CONTRACTOR: DON BURKE EXCAVATION & CONSTRUCTION PHONE #: 603 -652 -0175
Inspection Request Scheduled For: Date: 6/6/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Mess• ge it
420 Sprinkler supply lines 070983 -01 503.341 -7634 V .
Corrections /Commen /Instructions: e
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❑ PASS KARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: lI / Date: " l Phone #: (503) 718 -
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