Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00653
DEVELOPMENT SERVICES DATE ISSUED: 9/19/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09390 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT : JURISDICTION: TIG
Project Description: TI
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L- 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: 4
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 2 W /SERVICE OR FEEDER: 20 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
WASHINGTON SQUARE LLC DICKINSONS ELECTRIC
BY THE MACERICH COMPANY 8449 SW BARBUR BLVD
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97217
TIGARD, OR 97223
Phone: 503 - 639 -8865 Phone: 246 -3550
FEES Reg #: LIC 65534
SUP 3100S
Description Date Amount ELE 26 - 1400
[ELPRMT] ELC Permit 9/19/2005 $593.60
[ELPLCK] ELC Pin Rev 9/19/2005 $148.40 REQUIRED ITEMS AND REPORTS
[TAX] 8% State Surcharge 9/19/2005 $47.49
Total $789.49
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Speaalty 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 at
503-246-6699 or 1 8 32 2,3�} L�(�i/J� .
Issued c
Issued By: y: / f /� , .(i Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
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.
ElerctI. 3l Permit Application P c t l: l t l F I c I. I F. c a. I. l
Cif of � ' i gard " % ff/_� Perm No. f1 .6r- x(o53
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review „ , �- z��
7 C0
� Other 30 Phone: 503.639.4171 Fax _� �-
503.598.1960 . � "P-� {
np� D : ... a —• -
Inspection Line: 503.639.4175 ` y - '� Date Read 1By. S Pi A,,``11 ® See Page 2 for
Internet www.ci.figard.m.us gapd Notified/MU� hod: l M L / Q • Supplemental Information
.,, ...N. g,1 _ . name:
® New construction El Addition/alteration/rep ' ," :'R
'
❑ Demolition ® Other Tenant Improvement Please '.` ease check all l that apply:
_ CAFE Y SOP t✓d Is1C i., • .... ❑Service over 225 amps, comm'I ['Hazardous location '
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., `
❑ Multi- family ❑ Master builder ® Other: Tenant of I- and 2- family dwellings 4 or more new residential
Improvement ''
['System over 600 volts nominal units in one structure
_ . , s o , b t .. '1 o' , - ❑Building over three stories ['Feeders, 400 amps or more
❑Occupant load over 99 persons 0Manufactured structures or
Job no.: I Job site address: ®Egress/iighting RV park
❑Health-care facility ['Other.
City /State/ZIPij,�O SW Washington Sq, Tigard, OR 97223 Th
FEE* SCHEDULE
Suite/bldg/apt. no.: R09 I Project name: Naartjie Custom Kids, Inc. Description I Qty. I Fee. I Total I **
Cross street/directions to job site: New residential single - or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft or less 145 15 4
Subdivision: Ea. add'I 500 sq. ft. or portion 33 40 I
Lot no.: Limited energy, residential 75 00 2
Tax map/parcel no.: ' Limited energy, non - residential 75.00 2
' - •' „ ,D S TQit O1 WORK '' Each manufactured or modular
- , r:•.,. . .
...- t , : ' - - .., . . ;.. . •.,...,.-
Retail tenant improvement dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 2 80.30 1 60. 1 2
- : jt 201 amps to 400 amps 106 85 2
- I' T - 401 amps to 600 amps 160.60 2
Name: Naartjie Custom Kids, Inc 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
Address: 2369 W Orton Circle Reconnect only 66.85 2
City/ State/ZIP: Salt Lake City, UT 84119 Temporary services or feeders installation, alteration, and /or
801 relocation 00 m
Phone: amps ( }.550 5`'1 I F ax: (801)975 200 amps or less 66 85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
c ='_ ' A. Fee for branch circuits wash
• CbNl�1 `I • ,. , . service or feeder fee, each
Business name: Naartjie Custom Kids, Inc. branch circuit 2 0 6.65 133 00 2
B. Fee for branch circuits
Contact name: David Forbush without service or feeder fee, 46.85 2
each branch circuit
Address: 2369 W Orton Circle Each add'I branch circuit 6.65 2
City /State/ZIP: Salt Lake City, UT 84119 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53 40 2
Phone: (801) 550 - 5300 I Fax: : (801) 975 - 8144 Sign or outline lighting 53.40 2
E -mail: dforbushOnaartjie.com Signal circuit(s) or limited-
, -. , , • 4� ON'aC2'Uk' energy panel, alteration, or 1- 1 I extension. Describe. Page 2 3° 2
Business namez--TH , D i
Address: ' Each additional inspection over allowable in any of the above
Per inspection 62.50
City / State/ZIP: Investigation per hour (I hr min) 62 50
Phone: ( ) I Fax: ( ) Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic/66 a Electrical Lic.A (7 - ""to C I Suprv. Lic.31 005 Subtotal 59 3 .1
Suprv. Electrician signature, required: Plan review (25% of permit fee) j 41. 1.4 0
1 D State surcharge (8% of permit fee) L+ 7.4 9
Print name: - � ' f t 0 p• - ��/z ate` � g f 7 � � TOTAL PERMIT FEE 1 7 89.11 9
� v
Authorized signature: , r This permit application expires if a permit is not obtained within 180
_ days after it has been accepted as complete
• Fee methodology set by Tn- County Bwldmg Industry Service Board
•• Number of inspections per permit allowed
1
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
r * 5;
DICKINSONS ELECTRIC �� �
8449 SW BARBUR BLVD SEp 91 2005
PORTLAND, OR 97217 cirrop-
FI
utt.D1NG DI
iS �Q�
Electrical Signature Form
Permit #: ELC2005 -00653
Date Issued:
Parcel: •00 -00300
Site Address: 19390 :W WASHINGTON SQUARE RD
Subdivision: W SHINGTON SQUARE
Block: Lot:
Jurisdiction: TIG
Zoning: C -G
Remarks: TI
Your company has been indicated as the electrical contractor for the permit indicated above. I n order for
the electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN: Building Division.
No electrical inspections will be authorized until this completed form is received
OWNER: ELECTRICAL CONTRACTOR:
WASHINGTON SQUARE LLC DICKINSONS ELECTRIC
BY THE MACERICH COMPANY 8449 SW BARBUR BLVD
9585 SW WASHINGTON SQUARE RD PORTLAND, OR 97217
TIGARD, OR 97223
Phone #: 503 - 639 - 8865 Phone #: 246 -3550
Reg #: LIC 65534
SUP 3100S
ELE 26 -140C
AN INK SIGNATURE IS REQUIRED ON THIS FORM,
" ,<-4.1110
Signature of Supe' ising lectrician
If you have any questions, please call 503.718.2433.
CITY OF TIGARD
BUILDING DIVISION PERMIT #:&u,' s -% 5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 =4171 at
�i
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET R DATE: ►l , 1 a , 07 TIME: PAGE:
SITE ADDRESS: CLASS OF WORK:
•
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: N fs4NR i I PHONE #:
CONTRACTOR. ..------. PHONE #:
Inspection Request Scheduled For: Dat— Pour Time:
Code # Inspection Description Confirm # Contact. # Message
Vcq �l -'fit 2■ �I� •� .
•
Corrections/Comments/Instructions:
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: et1�� N ok8 LE Date: 1.1(101‘\5
i I O ‘'\ 2.40 Phone #: (503) 718 - [�
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00653
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 - 4175
INSPECTION WORKSHEET FOR DATE: 11/9/2005 TIME: 7:09AM PAGE: 74
SITE ADDRESS: 09390 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: NAARTJIE CUSTOM• KIDS
DESCRIPTION: TI
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 -639 -8865
CONTRACTOR: DICKINSONS ELECTRIC PHONE #: 246 -3550
Inspection Request Scheduled For: Date: 11/9/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 020687 -01 801 - 859 -5687 N
Corrections /Comments /Instructions:
v S F b.4a LE c- sN - \-\\11\ L
•
•
X15 COP N v L iN .
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
yi FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: CrSq ' V ob t Date: WI 9, Phone #: (503) 718-1-4110
CITY OF TIGARD
BUILDING DIVISION . / PERMIT #: ELC2005 -00653
13125 SW Hall Blvd., Tigard, OR 97223 r. DATE ISSUED: 9/19/2005
Phone: (503) 639 -4171 I C I
Inspection Requests (24 Hrs.): (503) 639 -4175 V
INSPECTION WORKSHEET FOR DATE: 11/6/2006 TIME: 7:00AM PAGE: 98
SITE ADDRESS: 09390 SW WASHINGTON SQUARE RD CLASS OF WORK: 1
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: NAART,JIE CUSTOM KIDS
DESCRIPTION: TI
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503-639-8865
CONTRACTOR: DICKINSONS ELECTRIC PHONE #: 246
Inspection Request Scheduled For: Date: 11/8/2005 Pour Time:
Code # Inspection Description Ce Contact # Message
196 Misc:. inspection 020560 -02 801 - 859 -6687 Y
Corrections /Comments/ Instructions:
6 1 C N N1.1. F-L Ac L 1. / Q c.4N∎
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
[FAIL j6LCALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
, 1 .
l.S
Inspector: h 1\\ X4
•iil Date: ,i pl O� Phone #: (503) 718- 2V
CITY,_OF TIGARD - '
BUILDING DIVISION PERMIT #: ELC2005 -00653
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005
Phone: (503) 639 -4171 +� -
Inspection Requests (24 Hrs.): (503) 639 -4175 .' r' !
INSPECTION WORKSHEET FOR DATE: 11/7/2005 TIME: 7:05AM PAGE: 18
SITE ADDRESS: 09390 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: NAARTJIE CUSTOM KIDS
DESCRIPTION: TI
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503.639 -8865
CONTRACTOR: DICKINSONS ELECTRIC PHONE #: 246 -3550
Inspection Request Scheduled For: Date: 11/7/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 020484 -02 801-859-5687 N
Corrections /Comments /Instructions:
C3 `T i - y.3 it l_ V' t. [,�' era N� ��` cbN ^' Ee-n
C ts S"G -t_ .�X1 e�13 LE 4 -00% v ii P cA :
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n PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I l FAIL ' 1K CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
�1 ,t
Inspector: Q- N bBL� Date: \. 11 1 ' Phone #: (503) 718- -0-4. •
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005.00663 . 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/27/2005 TIME: 7:16AM PAGE: 15
SITE ADDRESS: 09390 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: NAARTJIE CUSTOM KIDS
DESCRIPTION: TI
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503- 639 -8865
CONTRACTOR: DICKINSONS ELECTRIC PHONE #: 246.3550
Inspection Request Scheduled For: Da • 10/27/2005 Pour Time:
Code # Inspection Description • Confirm Contact # Message
115 Electrical service 019535 -01 503 - 515 -2922 N
Corrections /Comments/ Instructions:
•
y PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
0 FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ./1/V
Date: 1427E ' Phone #: (503) 718 - Z y tg6-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 -00653
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005
Phone: (503) 639 -4171 �a
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/26/2005 TIME: 7:07AWi PAGE: 93
SITE ADDRESS: 09390 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: NAART,IIE CUSTOM KIDS
DESCRIPTION: TI
•
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503.639 -8865
CONTRACTOR: DICKINSONS ELECTRIC PHONE #: 246-3550
Inspection Request Scheduled For: Date: 10/26/2005 Pour Time:
Code # Inspection Description • • Contact # Message
115 Electrical service 019353-01 801- 859 -5687 Y
Corrections /Comments /Instructions:
'Pctz.v %ts. to Li) wir.0 csAb
Pecs t AO 14 cr 3
•
•
•
•
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION, ADDITIONAL FEES ASSESSED
Inspector: NW Date: _ Phone #: (503) 718- ZA"tn
1
CITY OF TIGARD •
BUILDING DIVISION . e- PERMIT #: ELC2005-00653
4 .. 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19 /2005 _
Phone: (503) 639 -4171 1§ r�,
Inspection Requests (24 Hrs.): (503) 639 -4175 "'I ..:
INSPECTION WORKSHEET FOR DATE: 10/25/2005 TIME: 7:10AM PAGE: 70
SITE ADDRESS: 09390 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: NAARTJIE CUSTOM KIDS
DESCRIPTION: TI
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503- 639 -8865
CONTRACTOR: DICKINSONS ELECTRIC PHONE #: 246 -3550
Inspection Request Scheduled For: Date: 10/25/2005 Pour Time:
Code # • Inspection Description Confirm # Contact # Message
635 Low volta e 019219 -01 801- 859.5687 V
115_ \Act" OfrAW '
Corrections /Comments /Instructions: •
we P . 2 E- 3 c •. J2s:A i Dt .e.o.0 ► et Crkow n i 1 ilk, � ►1
. V �.ct, c�D� , I
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•
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1
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
174 FAIL ,CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:
(3 'v Date: \ 2 - 6- (05 -
Phone #: (503) 718- IMO
'cilLOF TIGARD • .
BUILDING DIVISION PERMIT #: 9/19/ 00508653
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 4 .
Inspection Requests (24 Hrs.): (503) 639 -4175 II
10/24/2005 7:02AM 78
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
09390 SW WASHINGTON SQUARE RD
SITE ADDRESS: WASHINGTON SQUARE CLASS OF WORK:
SUBDIVISION: NAARTJIE CUSTOM KIDS LOT #: TYPE OF USE:
PROJECT NAME: TI
DESCRIPTION:
WASHINGTON SQUARE LLC, 503 - 639-8865
OWNER: DICKINSONS ELECTRIC PHONE #: 246 -3550
CONTRACTOR: PHONE #:
• 10/24/2005
Inspection Request Scheduled For: Date: Pour Time:
Codd # I e�tio Descri tion c f
11 igectnca s e p 0� i 1 g01 8g•g Me
922 g
Corrections /Comments /Instructions: n ^
czabo
•
•
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N Date: 10(2ti1 C�7 Phone #: (503) 718- 1\410
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005.00653
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 1 ���
INSPECTION WORKSHEET FOR DATE: 10/21/2005 TIME: 7:08AM PAGE: 70
SITE ADDRESS: 09390 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: NAARTJIE CUSTOM KIDS •
DESCRIPTION: TI
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639 -8865
CONTRACTOR: DICKINSONS ELECTRIC PHONE #: 246 -3550
Inspection Request Scheduled For: Date: 10/21/2005' Pour Time:
Code # Inspection Description Confirm # ' Contact # Message
130 ailing cov - 018995 -01 503-515-2922 Y
Corrections /Comments/ Instructions:
y ' S �, s , 1� ! ` CY\
•
•
' gji PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Q® Date: 2.1 1 cb Phone #: (503) 718- 614)
CITY - OF TIGARD : ` • •
BUILDING DIVISION PERMIT #: ELC2005 -00653
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005
Phone: (503) 639 -4171 ArA
Inspection Requests (24 Hrs.): (503) 639- 4175jl��
INSPECTION WORKSHEET FOR DATE: 10/5/2005 TIME: 7:00AM PAGE: 73 -
SITE ADDRESS: 09390 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: NAARTJIE CUSTOM KIDS
DESCRIPTION: '
OWNER: WASHINGTON SQUARE LLC. PHONE #: 503 - 639-8865
CONTRACTOR: DICKINSONS ELECTRIC PHONE #: 246.3550
Inspection Request Scheduled For: Date: 10/5/2005 Pour Time:
Code # Inspection Description Confirm # Contact # ' Message
120 Electrical rough -in 017482 -01 801-859-5687 N
Corrections /Comments /Instructions:
\-1/4ACLb L:►13 NA10 (A) AaL ks
•
��PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v ►' Q'W I` V � �Cl (ff Date: 6 Phone #: (503) 718-
•
CITY_OF TI 'b• • _ -:
BUILDING DIVISION PERMIT #: ELC2005r00653
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/1912005
Phone: (503) 639 -4171 Ite`'
Inspection Requests (24 Hrs.): (503) 639 -4175 �'I ��
INSPECTION WORKSHEET FOR DATE: 9/�8/�005 TIME: 7:08AM PAGE: $3
SITE ADDRESS: 09390 SW WASHINGTON SQUARE RD CLASS OF WORK: '
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: NAARTJIE CUSTOM KIDS
DESCRIPTION:
TI
OWNER: PHONE #:
CONTRACTOR: WASHINGTON SQUARE LLC. PHONE #: 503 - 639-8865
DICKINSONS ELECTRIC 246-3550
Inspection Request Scheduled For: Date: 9/29/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 Wall cover 016974 -01 801-859-5686 N
Corrections /Comments /Instructions: / I
A tS Q 6C ►`i ARD L1 5 P lD
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
a� a'
Inspector: t' �� Date: 1� l+ Phone #: (503) 718- 24
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELG2005 -00653
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/19/2005
Phone: (503) 639 -4171 y
Inspection Requests (24 Hrs.): (503) 639 -4175 '�� ^ 'I I..
INSPECTION WORKSHEET FOR DATE: 9/23/2005 TIME: 7 :07AM PAGE: 81
SITE ADDRESS: 09390 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: NAARTJIE CUSTOM KIDS.
DESCRIPTION: TI
OWNER: PHONE #:
CONTRACTOR: WASHINGTON SQUARE LLC PHONE #: 503 - 639-8865
DICKINSONS ELECTRIC 246-3550
Inspection Request Scheduled For: Date: 9/23/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
105 Underground/slab cover 016414 -01 801 - 859-5686 N
Corrections /Comments/ Instructions:
•
•
•
e PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
(�ri N B�� ni f 21 [ b
Inspector: V T'�2- �p �-L� Date: Phone #: (503) 718 - 7-��