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Permit BUILDING PERMIT CITY OF TIGARD PERMIT #: BUP2005 -00498 A DEVELOPMENT SERVICES DATE ISSUED: 12/1/2005 �'f I- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600-00300 SITE ADDRESS: 09354 SW WASHINGTON SQUARE RD ZONING: C -G SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG Project Description: T.I. REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: ALT FIRST: sf N: S: E: W: TYPE OF USE: COM SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 2N : sf N: S: E: W: OCCUPANCY GRP: M TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: 29 BASEMENT: sf AREA SEP. RATED: STOR: 1 HT: ft GARAGE: sf OCCU SEP. RATED: BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC:Y BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 49,500.00 Owner: Contractor: WASHINGTON SQUARE LLC FUTURE BUILDERS BY THE MACERICH COMPANY 14513 NE 87TH ST 9585 SW WASHINGTON SQUARE RD VANCOUVER, WA 98682 ilkAne: RD, O 50 8865 o Phone: 360 - 907 -0718 FEES Reg #: LIC 136323 Description Date Amount REQUIRED ITEMS AND REPORTS [BUPPLN] Pin Rv 9/27/2005 '$306.02 [FLS] FLS Pin Rv 9/27/2005 $188.32 [PKSDC] COM & IND F 10/26/200f $765.00 [BUILD] Permit Fee 12/1/2005 $470.80 (additional fees not listed here) Total $4,314.80 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 d -ys. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. T, ose rules are -t forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules sr • ect • =' to OUNC by calling 503 - 246-66 9 or 1- 800 - 332 -2344. Issued By: Permittee Signatur 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. .1 Ge.ia.S k )J S6 . U Building Permit AD t,;;, ENE h \� FOR OF HI. IC E. LSE ONLY City of Tigard a 1 7, _r'� Petma No [2(��?aJ � - ,o 6412 13125 SW Hall Blvd, Tigard, OR 97223 ` Ptao Ras �r Phone: 503.639.4171 Fax: 503.59 &1960 SEP eA 2 7 200 l �' "�• 5 i) l � � ', Other Penult Line: 503.639.4175 1) (� - ' __ Internet: www.citigard.or.us i � ri lI CITE OF �,� /� KY) �:: Vz 7 •' ' •• 3+:j o i Tialti)?t a ! . 3 i s z, f ''yy ,, r# . . fi ;,�tw i g• ' r Pi 1'i„I. T 2 �iL \�'ELLDIG x % . i „a ,1 1 t � i- G'�.: � . 'o t . — ...L"1 el' adi AT ? '4 - 4 e+,. • - r . � •{.{ • . '� x�l ia��t�;lt�i:a� '�`:a'tutt�t�(.�'ss :� 'Ei i r.. ❑ New construction ❑ Demolition i I' ii fees' a re based on the t alue of the \volt pertoi med Indicate the value (rounded to the nearest dollar) of all Addition/alteration/replacement ❑ Other equipment, materials, labor, overhead, and the profit for the work indicated on this application. ; t e m bi.,mr „,i.,„,- ,fa„ av,.ti . 2 4;: k, . It „ „ a x .3 . :,- U . ,. �,� r� • Valuation: S �� F art ❑ 1- and 2- family dwelling ■ Commercial/industrial ❑ Accessory building 0 Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: - "O F l f" g ar . � � . r 7 : RI `: Total number of floors: i 5 ' ` i � F re ." pt� . I d • +"�' S ,, ri E s �'kkig:• tl i J = d., d t J - • '.. 3_ i . : t... ,L,z 'x�...Y 1 r,L C'. '4fineiti*;`eCS�4 arlu ..;1�m,. 1 : t' Job site address: 935 9 5 W ,, H / /V (1 c, N SO, 93, j y -- New dwelling area: square feet City/State/ZIP: 774 0 02 q 7 2.2. 3 _ _ Garage/carport area: square feet Suite/bldg /apt. no.: /,.r' I Project name: K i N e . Gp Covered porch area: square feet Cross street/directions to job site: Deck area square feet Other structure area: square feet i i • T ' C±S C¢g,CM T ;'���. . +tit.. b..�TM; • 4=� :: � ..` „. Subdivision: t.✓ s y-r ivGTer ,.J S(t .,,,,2/e 1 Lot no.: Permit fees” are based oo the value of the N‘or1 performed Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: equ pman, materials, labor, overhead, and the profit for the Y � - T .,. " ".. +fig 7. :7G? �'`.a'C•" ' •437:4,ir - r ,.'; , ` 7 ""n.'o- qr a a 7 i...; t 8n 7,�.'Yni,• - �, � //3� ,� i, c �3[] X:' a� �� 1 j . 0 i r A 7 '_�.', i �T �'�, e as��„y i ?�'; y.� '��it d R['z work indicated on this application. , A* -t : �`2? • :.`4'�''` : ` 'n'Ii: ;''LA :ddt'.tv+•�.• �i.'K- . 'si,•,ab.mb&g. 1& •. 611th ld , p Valuation: S i ( , C O .� INTexrorz T. 1. -0/t. 21c7s+/t_ 5 rao2.P I c- c.2o PA-117" r7/ 0/Jr ""/ 1ervKE(� r( n.-, i , '16 Existing building 13 `i Z square feet New building area: square feet '4'1 - +3E '? {` "aA �' A Sla J H }' I S J {� � y y , v41, � 4 , 4 E0 ' ��7.• '• ,it :' d ^ �'•, il,1•�Y) ,'c� `7 fi y 91 i ;. tt�, `•'k' i � F o a ) x I'tv7 Number of stories: 0 •'R ! � kelt, ti Nei i.iitk ltst,:�l s,is.vw��,i1.1.'il4 ,4i s;.A:r �n110.." 1:Ux7:sb .,; t09i^T,ik,k, b4 I (.S et'T -0� Name: AAA. (A-fre 4-( c- r c...p . Type of construction: 1 is Address: 1 ( (,..,(L- ('N r 2 e 3l/i .o, 5 - 7 Pp Occupancy groups: • City/State/ZIP: SS - �/'r A, / r, a.+ (c A r, CA-- t 04 c2 Ong: M 6- it- (/Lr'Tr 1.� Phone: ( - (0) 3 et 4 - boot, % U SK Fax: ( ) New: { 9s •t,,.? � . 3 n x � � �, c r sY � �Y� r c r, ---�-' 1 : 1 . .� " ,,,, _ =a : E t �€ � �,/ �9 � ,;c r a zr Li n a Z :r ry a x cw f ± ,` io q s $ 7 't r5 ;.- " �, ,.s i r ;: :r.t?7.: y. ;�- Y - i�'.' b.• .Ya1�h�SS � ti�nYL9:��iSSxt� .1p'.1,Ss2 %t�rstrui�a;1'rt:2: not. CiiTJ�9� 13'tot�� q!��' (: ���`?d� � � � ., -. is ; . 7i � • " Business name: 7.X pelz5 S (9E 41,..",_ nT All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board Contact name: C 14VVt t S 1? Afar b L under ORS 701 and may be required to be licensed in the Address: /377' p fr A (/ q H jurisdiction in which work is being performed. If the City/State/ZIP: T6 /L.2 A- N G e C.4- 9 Sd f applicant is exempt from licensing, the following reasons Phone:( 33ro) 3 .4 3cx� I Fax: :(3i 3'2y 0 33 .6 / E -mail: ,�. F ;., �x Irkr ifig rI n '...3 f: ;� T',�''' T'24''',.' r f'�R 7 w �Gn�tii'S �r ?fix ts� ,E �. }gs P 'k }f. c A t; o ? .;:1' w o S9 i ��. u iA �i .. fern. N v X ,Z r t l, • _ , bePi�i1 Cti9 et�tl t 3A.A, ? fs?e.i l:iR�� d$ . a n.Sn v Business name: e +r, ; -1'b f V q °r � l � in 0 u 1 ) evS :.tea; " r n Iv W i t .. L• i t a '.A'. .' ;r1 - ,tir.Y 0' Address: ! `/ 5 / 71�N `� S rs r � >& �e. �� +{ ^ cr±A"%i�'S? � ', -..:. a �'. � �� i �� 3 . Please Q d fee cheer City/State/ZIP: 2/k. t.t W tk / i - (9'8 1- �— Fees due upon application Phone:(3667 907 X I ( 3 6 o ) at;o . -d6`rG , J Amount received CCB lie.: / 3 / 6 3 ) 3 !v //- //0 7 — Date received: Authorized signature: Thb permit application expires If a permit is not obtained r -4......----- within 180 days after it has been accepted as complete. Print name: µ 4 F ^fir - r- -r,.cT fie: OS • Fee methodology set by Tti- County Building Industry - Service Board • 1 Peacii1Appdoc 12/03 440- 46I37(11/02/COMIW®) 09/16/05 16:27 FAX 514 844 7646 AEDIFICA _ 2002 � 5 —a el cr Form 5a Project Name: I UI)A - SI(se (,e Il).i►stli.l stoJ So�A0.E I Page: ( LIGHTING - GENERAL -w 1. Interior Exceptions (Section 1313.1) O No Interior Lighting. The building plans and specifications do not call for new or altered int I hti i l to item 5, Exterior building Lighting - General, below. Exceptions ❑ Exceptions. 1. The building or part of the building qualifies for an exception from code li , o _ . requirements. Applicable code exception Is number. CT .bitnims Discussion of waning l 4 _ 6 except,ons In malrualons ii redron J ' - o0 ❑ 2. Lighting equipment that qualities for an excep tion • in addition t general lig a ( tl3lY controlled, Applicable code exception is number. Areas of the b uilding and equipment that qualify fob exceptions: !� VlS y d Plane /Specs �� 1)I Snow compltanee by mans a drawing sheet, dolall number. endlor spadrIcsiion auction and subparagraph. 2. L eat Shut - off controls (Section 1313.3.1.1) Complies. At least one local shut-off lighting control for every 2,000 square feet of lighted floor area and for all spaces enclosed by walls or ceiling height partitions. This control(s) is detailed in the building plans on drawing number. I E( I ❑ Exception. The building or part of the building qualifies for an exception. Applicable code exception Is Section 1313.3.1.1. Exception Portions of the building that qualify: L�A.- 3. Automatic Shutoff Controls (Section 1313.3.1.2) Eell Not Applicable. Office floor erea is not over 2,000 square feet of contiguous office floor area or permitted space is Complies. All interior lighting systems are equipped with a separate automatic control to shut off the lighting during unoccupied periods. Offices less than 300 square feet. meeting and conference rooms. and school classrooms shall be equipped with occupancy sensors that comply with Section 1313.3.1.2.1. Compliance details in plans /specs: ❑ Exception. The building or part of the building qualifies for an exception. The a applicable code exception is Section 1313.3.1.2, Exception: Portions of the building that qualify: — 1 4. Daylighting Controls (1313.3.1.3) E classrooms or atriums with skylights or window to wall ratio greater than 50 %. ❑ Compiles. All classrooms and atriums with window to wall ratio greater than 50% and /or skylights are equipped with automatic daylight sensing controls, as required by Section 1313.3.1.3.1 and Section 1313.3.1.3.2. The daylight sensors specified comply with 1313.3.1.3.3. Compliance details in plans /specs: 7 . I Exterior Building 5. Exterior Lighting (Section 1313.5) Lighting t: lighting directed Er Complies. The plans do not call for incandescent or mercury vapor.lamps for use on building exterior to reuminata ate e>Qenorof Ms 0 Exception. The building plans indicate luminaires with incandescent or mercury vapor lamps, but they are booing and Macon( ens ia specified for use in or around swimming pools, water features, or other locations subject to the requirements or ens boding area: with orwiNOUt canopies. Article 6e0 of the 2002 National Electrical Code. 4s Clock Switches :hie be astronomic (aeaeonai meeane) 6. rior and Canopy Lighting Controls (Section 1313.3.2) type win a a programs roc eerh day of r ins weak end 3011 m Co building plans and specifications include photoelectric and/or clock switches on all exterior lighting Ina P Ires. The g D aP cora energy to mamohr systems which are designed and programmed to extinguish lights when daylight is present, as required by Section limeheeb'ns during power outage: 1313.3.2. .. 7. Interior Connected Lighting Power (Section 1313.4) 0t ?'i , g L�Compiies. The interior lighting power does not exceed the interior power allowance established In either the lam i ,. r j'" f (check the appropriate box): . 4, " rAr;r�'� ;_ ` ❑ Tenant Specs Method (Form 5b) "Space -by -Space Method (Form 5c) St eomehena %Ndn aaaC, effective 01/0 1105 09/16/05 16:27 FAX 514 844 7646 AEDIFICA I 003 Form Sc Project Name: wAL1GP-irot Co • 44.4Sek% d4'=.1 Scto E_ Pa INTERIOR LIGHTING POWER - space -by -spac Meth LightingPowes , TotaEl^tei ^Q P,° r ,; ' e dg h ®neet „, I 22t' H Budget Track Lighting 2S Tota' a l tr noh j !'' , Power u ;Lipei2 000E: , . ,. „ , 4' Total'amp dye; eirr.urbrea`iCr( eeMngvael;lighGngdampa)•,r;,, r" 5 Vo0 96. 1,. oreulr;oreaI r''aorvii 9 a io Ig't ?9 tvolt3)' , i C 0 - Ii odr"Pfn,wsRepecktraUCllght i "(mu,Ri,Plyfne4bYlGieS). „ ,. 0 7:' • Yrac lg, L' IghGhg1Pet wer{reeserirdluaAf!I�16• e r'll r ,�e')6� " ,, „ , „ , ,.' :;' . • , Building's , 81; Tcajlf, Orkietilgtong•Pavici ri3O )1yoncsheet,5lri (gum.aLClurrin'(rn))F,, „; ; „ i � Lighting Power ; ; ' o �� r��ry ! ” o -n„ , , 2Io(P 9 T d ; U�l iung Po wo� Qir , llne ' I , " ,,, „ • q'p; Dees d ine b8 no'greaierthan Ime i 1(ES 5.3 Cempllanoe Mn 055c, effective ono ip5 09/16/05 16:27 FAX 514 844 7646 AEDIFICA __ Z 004 Pepe; 3 Worksheet 5a Project Name: (vAt 4 '— LIGHTING SCHEDULE wtmi■. ° : I' . !�'I GU 1 L7a l7 dirmM: I M'h° I . ,J . , :: , ,;;•, :i. Cu,MTiUor •I. . l :„ ,. "LeT,0 ' n , i 6u nl .. , 41 npou'cr , Frt T9bI • luml. ,• , , „i,, SOC 4:''‘• '..',Na;' Pp' ''_ .1;n p4 ,. 1.Y.14112 --'t 21--124 - G tAe,.�,Pe,:�c C.. -nP eex [m.rabAzia - tom► ^a- J , 32- • f - et- M18c.- 2 CogLAIfttc. .: ... A. L+€4 6 s • — x' - • — ac - 4 _. • 6.- 4x39 c ISb - - - 3Z -A -L- Mill a . =� �..�MC zxiL u 4,4 Groo281►• 4...1e-per. EA - el 4 p fsma , aira►,'lg S4 1 1583s El4CTQ.aic. zB , TV_ t '1V6E LB O+ .•<. ..t.c •t . t1- •c 1 L: . i !i L+ 3r f4 i A .o - t-►<^ tSpIertsIE - r..v.slr1et-. _ L.o. -s1 . - -R" I - I 1 is S .A. — 1.0, C,Aw.P,S ■ - 1:11 V — ' FF ' - - -- t I _ s'A klc u ...r w - ?KlLi _ _fib ,EL /A, - I .tun . • Gat 6a. - ■ - 5-I COmplmnc... CsC, .fl.. (t1/01/05 09/16/05 16:2.7 FAX 514 844 7646 AEDIFICA Zoos j _ l4 Worksheet 5b-1 PyoJeetNeme! Wital.K1N6/ Zap . &4JiWiJ4TOAI Scs.lilge Pape: 4 INTERIOR LIGHTING POWER ... €uam•br 0.wenNbmodAhh+ ., '•!••,!':' , 'H':' , . „Cler pl umn ,n ettoe o c . � 1 i V I ,,, (q u. g eJ: , ■• ' (I), O :PI : (D• ; 0 , (n :1 o I Medfwd Wt ' �'i� ` , �) '• '� ( 1 (,. • , ; k�• 6'' O u' i nI Room � I , : ' o '•,tomnove;• , Lem�i icr Describe nd •9oaceT,YOe , „ • 'F'Bdll^B daweF' ' C � lineal n.laclracc '�»�.( r' : EIce pr� for coon ledlddwl PoDId g.' � f do'n • '"Arco . • .. ;� "' � i( • ; �(E . 1-66044i '.a - pace T,ypd :131,100:, :. '';6 • 'pl , �i9 rim . .. (Ol (III Total ua' fC 1 , mom In Plana. '��OOa�)!•,( 1111,, ,�., 1 9 )k -I, � - �`� PO OVTSIOE v sfp� ,,, �{ ?6 I •,In7�k (e)' �.H) � hphdn0) "r• g I1oo ,. � „ ,FU10 x I rPO�+er lker O , J ISCD /100 j. 5414.5 m w E 2. 1SL Ee 312- 3 t:- ifgaar en veal Moral A 4 76 env lneal feelM A. 300 ,300 -1t1ei sumac column column (e). ❑ own of Column c olu enter a.o 1 8ze . W -WI ❑ b aq sz own of olumn 0) SAFti s 914 {AIL 6 �r 6 5 AgBq low each mote only once et am envy G 2. 32- ❑ 704 for me room. Gee G77 2 •�^��~ e+amPlom G g 3L m1— 2.0b • 9 Twit r1aeK alelNCllalhe. Z 6 6A ❑ 38+1 3 84 151%5 G 9 Z8 el — I a- z•to q i 1 3S E'— 3w. ATI palsv AA 2. S 11f_tb. IL 'an S '— S S- 6btelsgo 0 w°3tao Al ,S likew oahS co-at 42.1 K t Ito ❑ lta Jb 0 9'�•rK(oom et3e ACXWE sems4tker OA 34'‘ P 1 _ ❑ 318 318 F F I 6 - 2 ' — A '-- 11..t , e►taweoc -1 0 0 0 0 ❑ 0 0 0 0 u u 0 0 ❑ ❑ afVr1eh150. 13°tt, • , worksnegt :ao; 'Yolel budoei 27 $ wimhl so-- T.44(.4eeg Powar(aeWol Morel/track enured) 2 lOb other Paget' 1 1 1” Lr et l otciNUmbor of AddldoriaY,WOtkcheet�5b r , , -o tooll? U . . . .. Oar^.w.we ro aaake ,, _ a1 luminaires In '' •, Warm ComOItlO Ic smirch ut0cn mowolhsn,one. ;t � ' tll' e . " 'fPi1' lnl Pasoan BaMMetlefW Pi WW , Paw maty apace.* ' 'Tod a tethi,an(1ornWuale W a rt ^..w q .,lnaar Wcakshcol 9D Ls FOmelelol ' ' B� .awr (Tedlo/w'n we wwwww o l . T.n.nt AMMO) „ c D; .2.21C 2 - 139E ",!^/r VI ” Sum of oudl11lutal dbwonWgeem ,Tynr euama col wlwar &i t it 21.0 co 1392. 6.5 owed-.. mots OB Be .O■W. errD1 OW CITY'OFTIGARD BUILDING DIVISION PERMIT #: Gl)P2005.00498 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/1 /70()6 Phone: (503) 639 -4171 1'1 Inspection Requests (24 Hrs.): (503) 639 -4175, I— INSPECTION WORKSHEET FOR DATE: 1/20/7006 TIME: 7 :00AM PAGE: 27 • SITE ADDRESS: 09351 SW WASHINGTON SQUARE RD CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: THE WALKING COMPANY DESCRIPTION: T.I. OWNER: WASHINGTON SQUARE LLC. PHONE #: 503. 638 -0865 CONTRACTOR: FUTURE BUILDERS PHONE #: 360 -907 -07•18 Inspection Request Scheduled For: Date: 1/20/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 207 Suspended coiling 025378 - 01 360 N Corrections /Comments / Instructions: • tiL)C-5 s 04 • PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL EES ASSESSED • Inspector: I i Date: Phone #: (503) 718- S CITY'®F`TIGARD BUILDING DIVISION PERMIT #: IBUP2005- 0(1198 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 17/1/2006 Phone: (503) 639 -4171 1 gyypir Inspection Requests (24 Hrs.): (503) 639 -4175 . '!!+� INSPECTION WORKSHEET FOR DATE: 12/23/2005 TIME: 7:02AM PAGE: 11 SITE ADDRESS: 09354 SW WASHINGTON SQUARE RD CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: THE WALKING COMPANY DESCRIPTION: T.I. OWNER: WASHINGTON SQUARE LLC, PHONE #: 503- 639 -0065 CONTRACTOR: FUTURE BUILDERS PHONE #: 360 -907- 0718 Inspection Request Scheduled For: Date: 12/23/2005 Pour Time: Code# Inspection Description Confirm # Contact # Message 275 Framing ' 023993 - 01 36U 907 Y Corrections /Comments /Instructions: 1 C) KL/ (k) PEC--ria t0112-- ASS 1; j 4"RT I APPROVAL • El CANCEL ❑ NO ACCESS ❑ FAIL ❑ ALL FOR INSPECTION ❑ ADDITIO AL FEE ASSESSED Inspector: • � 4 Date: Phone #: (503) 718 - ' � CITY O1 TIGARD BUILDING DIVISION PERMIT #: BUP2006- 0049t3 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/1/200; Phone: (503) 639 -4171 i fl Inspection Requests (24 Hrs.): (503) 639 -4175 . ill INSPECTION WORKSHEET FOR DATE: 1/3012006 TIME: 7 :01AM PAGE: • SITE ADDRESS: 09364 SW WASHINGTON SQUARE RD CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: THE WALKING COMPANY DESCRIPTION: - .1. OWNER: WASHINGTON SQUARE L.LC, PHONE #: !a03- 639 -Ot366 CONTRACTOR: FUTURE BUILDERS PHONE. #: 360 - 907.0710 Inspection Request Scheduled For: Date: 1130/2006 Pour Time: Code # Inspection Description Confirm # Cohtact # Message 299 Final inspection 025964 -02 360.907 -0710 V Corrections /Comments /Instructions: v _ • s, ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CAL FOR INSPECTION ❑ ADDI ONAL FEES ASSESSED Inspector: �� Date: p Phone #: (503) 718 -Ok73