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Permit CITY OF TIGARD MASTER PERMIT PERMIT #: MST2001 -00239 I/w DEVELOPMENT SERVICES DATE ISSUED: 5/30/01 ` t � I JI 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 11573 SW WOODLAWN CT PARCEL: 1S134BD -09400 SUBDIVISION: PENN LAWN ESTATES NO.2 ZONING: R -4.5 BLOCK: LOT: 022 JURISDICTION: TIG REMARKS: Interior alteration of approximately 1,700 square and addition of aproximately 300 square feet to second story. No change to footprint of building. BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: 28 FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 300 sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT: VALUE: $ 38,885 00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 300 00 sf REAR: PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: . TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 2 CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: W00DSTOVES: 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/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 1,134.44 KALBASKY, JAMES + CAROL SY2 CONSTRUCTION CO This permit is subject to the regulations contained in the 11573 SW WOODLAWN CT STEVEN D YOUNG a l l o Municipal Code, State Specialty Codes and BOX 66638 all other applicable laws. All work will will l b be done e in TIGARD, OR 97223 PO if accordance with approved plans. This permit will expire PORTLAND, BOX 66638 8 97290-6638 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 #: LIC 64537 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 PLM /Underfloor Shear Wall lnsp Roof Nailing Final inspection Mechanical lnsp Exterior Sheathing Ins[ Water Line Insp Plumb Top Out Insulation Insp Electrical Final Electrical Rough In Gyp Board Insp Mechanical Final Framing Insp Rain drain lnsp Plumb Final I _ Issued y : k ,.... �, ,g ,k a / 1 's II , Permittee Signature : /\.e1 -- -Call (503) 6 -4175 by 7:00 p.m. for an inspection needed the next business day r 6111/ Building Permit Application Date received: y � Permit no.: K f ,,r -00 u y „ >�y , City of Tigard "= Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Phone: (503) 639 - 4171 1 Date issued: By: Receipt no.: Fax: (503) 598 -1960 r n Case file no.: Payment type: Land use approval: �`(/ 1 &2 family: Simple Complex: va t ‘T-1114.' = 114.' OF PERMIT l & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ New construction ❑ Demolition ! y (Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other: S JOB SITE INFORMATION )( Job address: 1(s Sc,,, u)oo(L(aw CI. Bldg. no.: Suite no.: Lot: a I Block: ( Subdivision:' ,fi ( ,,, Est .44.5 I Tax map /tax lot/account no.: n, Project name: Description and location of work on premises/special conditions: , � r� cX ri'� ct F pAa' /700 x A - 1 / Zap .. OWNER FOR SPECIAL INFORMATION, USE CHECKLIST 7 Name: i,nt 4 earl Kgl(ocvSky ( Floodplain ,scpticcapacity,solar,ctc.) Mailing address: 05'1 St, 3 i (ct w t ) (Z , 1 & 2 family dwelling: yv City: rj�g2Gt IState:ptZ IZIP: C 2.23 Valuation of wor $ 3 g, a0-:03 Phone:Sca3 5a10.ct1S3 (Fax: (E 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.) Mailing address: Deck area (sq. ft.) City: I State: I ZIP: Other structure area (sq. ft.) Phone: Fax: E -mail: Commercial/industrial /multi - family: - CONTRACTOR Valuation of work $ Business name: S■/ aC t CAA . C o , Existing bldg. area (sq. ft.) Address: ToZ I®lolo New bldg. area (sq. ft.) Number of stories City: f oitt' l cx.t..� I State :62 _IZIP: �'i a4 C7 Type of construction Phone: tro Abp- 6$6'LI Fax: 1E Occupancy group(s): Existing: CCB no.: (, 5 3') 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: jurisdiction where work is being performed. If the applicant is City: State: IZIP: exempt from licensing, the following reason applies: Contact person: I Plan no.: Phone: Fax: E -mail: ENGINEER Name: Contact person: Fees due upon application $ Address: Date received: City: (State: IZIP: Amount received $ Phone: I Fax: I 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 provisions of laws and ordinances governing this ❑ Visa ❑ MasterCard work will be complied with, whether pecifred herein or not. i I Credit card number: / / Expires V Authorized signature: • Date: 4/tole/ Name of cardholder as shown on credit card / Print name: c 2�•e..r■ • 7 Cardholder signature $ / Amount Notice: This permit application expires if a pe t is not obtained within 180 days after it has been accepted as complete. 440 (6 0/COM) r) P .9)° 1 7 ° 11 One- and Two - Family Dwelling • • • ' ' Checklist Reference no.: ,�. „ „:. ,� Building Permit Application Checklist Associated permits: City of Tigard City f Tigard ty g ❑ 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/ 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. 3 Complete 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. 0 Site/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. 13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater, furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc. 14 Cross section(s) and details. Show all framing - member sizes and spacing such as floor beams, headers, joists, sub -floor, wall 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. Full -size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing (prescriptive path) and/or lateral analysis plans. Must indicate details and locations; for 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 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. 20 Manufactured floor /roof truss design details. 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas- piping schematic is required 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. Site plans must be 8 -1/2" x 11" or 11" x 17 ". 24 Two (2) sets each are required for Items 16, 19, 20 & 22 above. 25 Building plans shall not contain red lines or tape -ons. 26 No rolled, reversed or mirrored building plans will be accepted. 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 (6 0 /COM) r e . Electrical Permit Application , Date received: 4/ / o Permit no.: iii-p< -;3- City of Tigard Project/appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By: Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 - 1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT V1 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement ❑ New construction Ad Addition/alteration /replacement ❑ Other: ❑ Partial JOB SITE INFORMATION Job address: 115 73 6d..t•, id. , x II G-tr)a.) CV . Bldg. no.: Suite no.: Tax map /tax lot/account no.: Lot: 'g2 IBlock: (Subdivision: ? k 0 eshtkes it .4. Project name: I Description and location of work on premises: al.D ES add r; 4..: o .) Estimated date of completion/inspection: // CONTRACTOR APPLICATION - FEE SCIIEDU.E Job no: Fee Max Business name: (.kd 1e c,i , Description Qty. (ea.) Total no. insp Address: a (74 Q 6,4) Cetelo .d -y e.T • New nguni residential Includes attached garage. dwelling mrit lacludes attadted garage. City: A ( I State I ZIP:q Serviceincluded Phones 3- l94-1'.1:- 461 I Fax: I E -mail: 1000 sq. ft. or less 4 CCB no.: 700 47 I Elec. bus. lic. no: 3 L/ - a4 a e Limited _ Each ed energy, r , 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 or feeders — installation, alteration or relocation: - i PROPERTY OWNER 200 amps or less 2 Name (print): _V a Ca 2 Jk teal (GAS k 201 amps to 400 amps 2 �r`.' Y 401 amps to 600 amps 2 Mailing address: 1($13 St.d t c93od law01 el . 601 amps to 1000 amps 2 City: •T; #p, ( I State0Q. I ZIP: qi a a3 Over 1000 amps or volts 2 Phone.Co3- 5a.\ - 9r 63 I Fax: mail: 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 exchange according to installation, alteration, ORS 447, 455, 479, 670, 701. 200 amps or less 2 201 amps to 400 amps 2 Owner's signature: Date: 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: I 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): ❑ Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle 2 ❑ Service over 320 amps- rating of 1&2 ❑ 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, ❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2 ❑ Building over three stories ❑ Feeders, 400 amps or more •Descnption: ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above: ❑ 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 $ rm ❑ 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 (6100/COM) Electrical Permit Fees: Limited Energy Fees: . . Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY Restricted Energy Fee $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total 4, Check Type of Work Involved: Residential - per unit 1000 sq. ft or less $145.15 4 0 Audio and Stereo Systems Each additional 500 sq. ft or portion thereof $33.40 1 E Burglar Alarm Limited Energy $75.00 Each Manuf'd Home or Modular Garage Door Opener Dwelling Service or Feeder $90 90 2 Services or Feeders 0 Heating, Ventilation and Air Conditioning System' Installation, alteration, or relocation 200 amps or less $80 30 2 Vacuum Systems' 201 amps to 400 amps $106.85 2 401 amps to 600 amps $160.60 ^ 2 601 amps to 1000 amps $240.60 2 n Other Over 1000 amps or volts $454.65 2 Reconnect only $66.85 2 Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY Installation, alteration, or relocation Fee for each system' $75.00 200 amps or less $66.85 2 (SEE OAR 918 - 260 -260) . 201 amps to 400 amps $100.30 2 401 amps to 600 amps $133.75 2 Check Type of Work Involved: Over 600 amps to 1000 volts, n see "b" above. Audio and Stereo Systems Branch Circuits n Boiler Controls New, alteration or extension per panel a) The fee for branch circuits with purchase of service or 0 Clock Systems feeder fee. Each branch circuit $6.65 2 n Data Telecommunication Installation b) The fee for branch circuits without purchase of service n Fire Alarm Installation or feeder fee. First branch circuit $46.85 Each additional branch circuit $6.65 ❑ HVAC Miscellaneous 0 Instrumentation (Service or feeder not included) Each pump or irrigation circle $53.40 0 Intercom and Paging Systems Each sign or outline lighting $53 40 Signal circuit(s) or a limited energy panel, alteration or extension $75.00 n Landscape Irrigation Control Minor Labels (10) $125.00 n Medical Each additional inspection over the allowable in any of the above Nurse Calls Per inspection $62.50 Per hour $62.50 ❑ In Plant $73.75 Outdoor Landscape Lighting Fees: 0 Protective Signaling • Enter total of above fees $ n Other 8% State Surcharge $ 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 $ Enter total of above fees $ ❑ Trust Account # 8% State Surcharge $ Total Balance Due $ — i:\dsts\forms \elc -fees doc 10/09/00 Mechanical Permit Application Date received: V /0 6/ Permit no.: /4/-239 �j '.i i City of Tigard Project/appl. no.: Expire date: City of Tigard 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: Building permit no.: 7'YPE OF PER Iii 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction WAddition/alteration/replacement ❑ Other: JOB SITE INFORMATION COMMERCIAL VALUATION SCIIEDULE Job address: ! 1S13 SL) L4) cc..." a a Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: Suite no.: value of all mechanical materials, equipment, labor, overhead, Tax map/tax lot/account no.: profit. Value $ Lot: 9.0, IBlock: I Subdivision:PeAA Izko...41.3 1s -444.kr *See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City /county: ZIP: 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE Description and locatio ofwork on premises: 02 nd S+ y AND COMMERICAL /INDUSTRIAL EQUIPM ENT SCIIEDULE -a d ti -' 4'°' Fee(ea.) Total Est. date of completion /inspection: Description Qty. Res. only Res. only Tenant improvement or change of use: HVAC: Is existing space heated or conditioned? ❑ Yes ❑ No Air handling unit CFM _ _ g p Air conditioning plan required) __ _ Is existing spaceinsulated ?`❑Yes o ❑ N Alteration of existing HVAC system _ MECIIANICAL CONTRACTOR Boiler /compressors State boiler permit no.: Business name: ©� A) '- HP Tons BTU/H Address: Fire/smoke dampers/duct smoke detectors City: I State: I ZIP: Heat pump (site plan required) Phone: I Fax: I E -mail: Install/replacefurnace/burner BTU/H Including ductwork/vent liner ❑ Yes ❑ No CCB no.: Install/replace/relocate heaters - suspended, City /metro lic. no.: wall, or floor mounted Name (please print): Vent for appliance other than furnace CONTACT PERSON Refrigeration: Absorption units BTU/H Name: Chillers HP Address: Compressors HP Environmental exhaust and ventilation: City: I State: I ZIP: Appliance vent Phone: Fax: E -mail: Dryer exhaust OWNER Hoods, Type U lures. kitchen/hazmat hood fire suppression system Name: .) % A.. 4 - Oa.ttol kaikNot L`r Exhaust fan with single duct (bath fans) • Mailing address: 1 1 513 ,Si Li o,,c4 (a m, , , Exhaust system apart from heating or AC City: '1 w I State&t. I ZIP: c - T 2 Z � el piping and distribution (up to 4 outlets) Phone -6 I -4t63 Fax: E -m ail: Type: '� Fuel i ing each additional over 4 outlets cos piping (schematic required) Number of outlets Name: Other listed appliance or equipment: Address: Decorative fireplace City: I State: I ZIP: Insert -type Phone: I Fax: I E -mail: Woodstove/pelletstove Other: Applicant's signature: I Date: Other Name (print): Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ ❑ Visa ❑ MasterCard Notice: This permit application Minimum fee $ Credit card number: / / expires if a permit is not obtained Plan review (at %) $ Expires within 180 days after it has been State surcharge (8%) .... $ Name of cardholder as shown on credit card accepted as complete. TOTAL $ Cardholder signature Amount 440-4617 (600/COM) MECHANICAL PERMIT FEES • - COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: FEE: Description: Price Total $1.00 to $5,000.00 Minimum fee $72.50 Table 1A Mechanical Code Qty (Ea) Amt $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and 1) Furnace to 100,000 BTU $1.52 for each additional $100.00 or including ducts & vents 14.00 fraction thereof, to and including 2) Furnace 100,000 BTU+ $10,000.00. including ducts & vents 17.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and 3) Floor Furnace $1.54 for each additional $100.00 or including vent 14.00 fraction thereof, to and including 4) Suspended heater, wall heater $25,000.00. or floor mounted heater 14.00 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and 5) Vent not included in appliance permit $1.45 for each additional $100.00 or 6.80 fraction thereof, to and including 6) Repair units $50,000.00. 12.15 $50,001.00 and up $742.00 for the first $50,000.00 and Check all that apply: Boiler Heat Air $1.20 for each additional $100.00 or For items 7 -11, see or Pump Cond fraction thereof. footnotes below. Comp* " 7) <3HP;absorb unit to 100K BTU 14.00 ASSUMED VALUATIONS PER APPLIANCE: 8) 3 -15 HP; absorb Value Total unit 100k to 500k BTU 25.60 Description: Qty (Ea) Amount 9) 15-30 HP; absorb Furnace to 100,000 BTU, including 955 unit .5-1 mil BTU 35.00 ducts & vents 10) 30 -50 HP; absorb Furnace > 100,000 BTU including 1,170 unit 1 -1.75 mil BTU 52.20 ducts & vents 11) >50HP: absorb Floor fumace including vent 955 unit >1.75 mil BTU 87.20 Suspended heater, wall heater or 955 12) Air handling unit to 10,000 CFM floor mounted heater 10.00 Vent not included in applicance 445 13) Air handling unit 10,000 CFM+ permit 17.20 Repair units 805 14) Non - portable evaporate cooler < 3 hp; absorb. unit, 955 10.00 to 100k BTU 15) Vent fan connected to a single duct 3 -15 hp; absorb. unit, 1,700 6.80 101k to 500k BTU 16) Ventilation system not included in 15-30 hp; absorb. unit, 501k to 1 2,310 appliance permit 10.00 mil. BTU 17) Hood served by mechanical exhaust 30 -50 hp; absorb. unit, 3,400 10.00 1 -1.75 mil. BTU 18) Domestic incinerators >50 hp; absorb. unit, 5,725 17.40 >1.75 mil. BTU 19) Commercial or industrial type incinerator Air handling unit to 10,000 cfm 656 69.95 Air handling unit >10,000 cfm 1,170 20) Other units, including wood stoves Non - portable evaporate cooler 656 10.00 Vent fan connected to a single duct 446 21) Gas piping one to four outlets Vent system not included in 656 5.40 appliance permit 22) More than 4 -per outlet (each) Hood served by mechanical exhaust 656 1.00 Domestic incinerator 1,170 Minimum Permit Fee $72.50 SUBTOTAL: $ Commercial or industrial incinerator 4,590 Other unit, including wood stoves, 656 8% State Surcharge $ inserts, etc. Gas piping 1-4 outlets 360 25% Plan Review Fee (of subtotal) $ Each additional outlet 63 Required for ALL commercial permits only TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE: $ VALUATION: Other inspections and Fees: 1 Inspections outside of normal business hours (minimum charge -two hours) $72 50 per hour 2 Inspections for which no fee is specifically indicated (minimum charge -half hour) $72.50 per hour 3. Additional plan review required by changes, additions or revisions to plans (minimum charge-one-half hour) $72 50 per hour `State Contractor Boiler Certification required for units >200k BTU. "Residential A/C requires site plan showing placement of unit. hdsts\fomis\rnech- fees.doc 10/11/00 Plumbing Permit Application Date received: y //, p Permit no.: g�jrQppp— 3 y ' ''.,•=- City of Tigard ; , i I Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd, Tigard, OR 97223 City of Tigard Phone: (503) 639 -4171 Project/appl. no.: Expire date: Fax: (503) 598 - 1960 Date issued: By: I Receipt no.: Land use approval: Case file no.: • Payment type: TYPE OF PERMIT • 1i 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement ❑ New construction riaddition/alteration/replacement ❑ Food service ❑ Other: JOB SITE INFORMATION FEE SCHEDULE (for special inforn ation use checklist) Job address: 1 1573 sL (A. uctw,j CV, Description Qty. Fee(ea.) Total Bldg. no.: Suite no.: New 1- and 2 -family dwellings only: (includes 100 ft. for each utility connection) Tax map /tax lot/account no.: SFR (1) bath Lot: d a I Block: I Subdivision:9ov. \awia FA AA SFR (2) bath Project name: SFR (3) bath City /county: I ZIP: Each additional bath/kitchen Description and location of work on premis s: 0.-5 %oil bf4-■ Site utilities: _ c , 4 4 c j e(t+, o, 1 ) biFeid o h oi. ' Catch basin/area drain Est. date of completion/inspection: Drywells/leach line/trench drain PLUMBING CONTRACTOR Footing drain (no. lin. ft.) Manufactured home utilities _Business -name: -4,10 V e Fikk ? (IA.,,,,_b = Manholes Address: Rain drain connector City: I State: I ZIP: Sanitary sewer (no. lin. ft.) Phone: I Fax: I E -mail: Storm sewer (no. lin. ft.) • CCB no.: .23E41 I Plumb. bus. reg. no: Water service (no. lin. ft.) City/metro lic. no.: Fixture or item: Contractor's representative signature: Absorption valve Back flow preventer Print name: Date: Backwater valve • CONTACT PERSON Basins/lavatory Name: Clothes washer Dishwasher Address: Drinking fountain(s) City: I State: I ZIP: Ejectors/sump Phone: Fax: E -mail: Expansion tank OWNER Fixture/sewer cap Floor drains/floor sinks/hub Name (print): Sw + Cas Dk W.,:c(bC k y Garbage disposal Mailing address: k( S")3 SW W oxi taw A,I CI . Hose bibb City: 1 - "R.' I StatedQ, I ZIP: q-( 123 Ice maker Phone:So - 621 - %531 Fax: I E -mail: Interceptor /grease trap Owner installation/residential maintenance only: The actual installation Primer(s) will be made by me or the maintenance and repair made by my regular Roof drain (commercial) employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s) Owner's signature: Date: Sump ENGINEER Tubs/shower /shower pan Urinal Name: Water closet Address: Water heater City: I State: I ZIP: Other: Phone: I Fax: I E -mail: Total • Not all jurisdictions accept credit cards, please call jurisdiction for more information. Minimum fee $ • Notice: This permit application Plan review (at _ %) $ ❑ Visa ❑ MasterCard expires if a permit is not obtained Credit card number: / / State surcharge (8 %) .... $ Expires within 180 days after it has been TOTAL $ Name of cardholder as shown on credit card accepted as complete. $ . Cardholder signature Amount 440 -4616 (6/00/COM) PLUMBING PERMIT FEES: PRICE TOTAL New 1 and 2- family dwellings only: FIXTURES (individual) QTY (ea) AMOUNT (Includes all plumbing fixtures in PRICE TOTAL Sink 16.60 the dwelling and the first100 ft. QTY (ea) AMOUNT Lavatory 16.60 for each utility connection) One (1) bath $249.20 Tub or Tub /Shower Comb. 16.60 Two (2) bath $350.00 Shower Only 16.60 Three (3) bath $399.00 Water Closet 16.60 SUBTOTAL Urinal 16.60 8% STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25% OF SUBTOTAL Garbage Disposal 16.60 TOTAL _ Laundry Tray 16 60 Washing Machine 16.60 Floor Drain /Floor Sink 2" 1660 PLEASE COMPLETE: 3" 16 60 4" 16.60 Water Heater 0 conversion 0 like kind 16.60 Quantity by Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ permit. Capped MFG Home New Water Service 46.40 Sink MFG Home New San/Storm Sewer 46.40 Lavatory - Tub or Tub /Shower Hose Bibs 16.60 Combination Roof Drains 16.60 Shower Only Drinking Fountain 16.60 Water Closet Urinal Other Fixtures (Specify) 16.60 Dishwasher Garbage Disposal Laundry Room Tray Washing Machine Floor Drain /Sink: 2" Sewer- 1st 100' 55.00 3" Sewer - each additional 100' 46.40 4" Water Service - 1st 100' 55.00 Water Heater Other Fixtures Water Service - each additional 200' 46.40 (Specify) Storm & Rain Drain - 1st 100' 55.00 Storm & Rain Drain - each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 Residential Backflow Prevention Device' 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specially 72.50 Requested Inspections per/hr COMMENTS REGARDING ABOVE: Rain Drain, single family dwelling 65.25 Grease Traps 16.60 QUANTITY TOTAL Isometric or riser diagram Is required if Quantity Total is > 9 *SUBTOTAL 8% STATE SURCHARGE **PLAN REVIEW 25% OF SUBTOTAL Required only if fixture qty. total is > 9 TOTAL $ * Minimum permit fee is $72 50 + 8% state surcharge, except Residential Backflow Prevention Device, which is $36.25 + 8% state surcharge ** AII New Commercial Buildings require plans with isometric or riser diagram and plan review. iAdstsWorms\plm- fees.doc 10/10/00 • Permit #: H 0 ?p0 /- 60 a 39 Address: 11573 t000 -4- u.)l eT Issu. d by: A _ fel,Ad , ,i i Date: Statement: Information Notice to Property Owners About Construction Responsibilities Note: 4 Oregon Law, ORS 701.055 , requires residential construction permit a li- g () 9 P PP cants who are not registered with the Construction Contractors Board to sign the g g 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 and - initial boxes 1 and 2, and either box 3A or 3B: - - 1. I own, reside in, or will reside in the completed structure. . 2. 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale I / y before or upon completion. 3A. My general contractor is S y °Z C'OA/s u e T/DA/ r0/`1Pr9/Jv 6 3 2 (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 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 Owners about Construction Responsibilities on the reverse side of this form. ✓ /,_ 9 . -__ _ _ ✓�J - �v -off • (Signature of permi,, .plicant) (Date)' (White copy to issuing agency permit file, pink copy to applicant) • • 'information Notice to'Prr®pe ty l ikwners About Construction Respo sibiiities -Vote: This Information :Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board iii 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 ofa residential structure, you will. in most instances, be ruled to bean 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, yoti must withhold income takes from employee wages at the time employees are paid. You will be liable for the tax payments even ifyou 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 Department 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 Coral' claim costs ifone ofyour 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 be liable forthe tax payment even ifyou didn't actually withhold the tax. For more information, cal l the Internal Revenue Service at 1 -800 -829 -1040: . OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code compliance: As the perm it 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 ifyou have adequate insurance coverage for accidents 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 supery ise 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- 462 -1). The Board is located at 700 Summer St. NE Suite 300, in Salem. ; _ prop -own pm4 1/94 • CITY OF TIGARD B1 DINQ INSPECTION DIVISION • • Msr 6 v a37 24 -Hour Inspection Line: 1 75 - ,. Business Line: 639-4 BUP Date Requested �'�� - AM LPM BLD Location 7 (w D Suite • MEC Contact Person ,__,_ Ph -6,c. g"6? PLM Co Ph SWR LDING Tenant/Owner ELC -- Retaining Wall ELR Footing Access: Foundation /� FPS Ftg Drain C / SGN Slab Crawl Drain Inspection Notes: / /c7� � SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling . Roof Misc: PART FAIL UMBIN . Post am Under Slab Top Out Water Service Sanitary Sewer Ran Drains FAIL HANICA • - Post & Beam Rough In Gas Line Smo e Dampers RT FAIL • • Se �— Rough In . UG /Slab • Low Voltage rm 'AS 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 oach /Sidewalk Date 7Zt Inspector Ext Final ��� PASS PART - FAIL DO NOT REMOVE this inspection record from the job site. s- �� . ��` ''CITY OF TIGARD BUILDING INSPECTION DIVISION a /MST �j >D /'GO Z,37" - 2our Inspection Line: 63! l5 . Busine Line: 639 ' .... AM Date Requested 7-2- - PM I' �� BLD Location • / /5 S c✓ c lie4 A w , Suite MEC . Contact Person Ph 0 Z UF7 3 PLM • Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Foundation Access: tc, 6 UV/ //r FPS Ftg Drain Crawl Drain Inspection Notes: SGN . Slab Post & Beam SIT - Ext Sheath /Shear Int Framing th /Shear e it h (A ^ ��� Insulation / _ Drywall Nailing / /^ tSC)�-��• 5. L 7 U e D A Firewall Fire Sprinkler , Fire Alarm . _ Susp'd Ceiling Roof - Misc: Final PASS PART FAIL , cerMilE ice Poat ",Beam> Under Slab Water Service Sanitary Sewer g (-6/t.-- Rain Drains �'4.� A SS .�� Final PASS PART AIL v I MECHANICAL ` • Post & Beam I , I CV "t) C R Lv,' ( t 11 Rough In C V c.,. � e Dampers L� • Gas Smoke Dampers 6 Final PASS PART FAIL r. t ELECTRICAL e Service re .S -off V�.� CMS 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 rei spection RE: [ ] Unable to inspect - no access _ ADA !�j Approach /Sidewalk Date - b v b \ Ins ector E x Other P Final PASS PART FAIL • DO NO REMOVE this. inspection record from the job site. "CITY OF TIGARD BUILDING INSPECTION DIVISION sT vJ =D0 • - 24our Inspection Line: 63! T5 Business Lin : 639-4' '13 BUP Date Requested 7 - 3 AM .4r /t PM BLD • Location '11573 Cvoac �4&." Gt Suite MEC Contact Person Ph t/o -cf 73 PLM Contractor Ph SWR BUILDING Tenant/Owner p(// 'G c 4 ELC Retaining Wall ELR • Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: C�QS c,/l3 o SIT Slab Y Post Beam r �` Ext Sheath/Shear Ina Sheath /Shear Framing 1 , ..k yv✓1 7 1 Insulation D rywall Nailing Firewall . Fire Sprinkler Fire Alarm Susp'd Ceiling Roof _ S N � �� s • Fina F U V PASS. PART FAIL n • : abm / f � ►' l/ ckej-e,C Under Slab 5 Water Service Sanitary Sewer Rain Drains Final PASS PART 4 0 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 Approach /Sidewalk Other Date 7/ 3 /0 1 Inspector Ext Final PASS PART FAIL V DO NOT REMOVE this inspection record from the job site.. /GJ "CITY OF TIGARD BUILDING INSPECTION DIVISION �7 24 -Hour Inspection Line: 63! 15 Business Line: 639-4' MST G� D i - 00 23 BUP Date Requested AM PM BLD Location ' . 1) 3 5 "-di W6w l / " - Suite MEC Contact Person Ph F40-6k PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall - ELR Footing Access: Foundation FPS Ftg Drain - � . � Gc Q'k IiS I ` 7 A4 e ; ,l &f Crawl Drain Inspection Nbtes: SGN Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear • Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling . Roof Misc: A - -- Final • PASS PART FAIL • UM /lam .sL ost & Beam S Under Slab Top Out Water Service Sanitary Sewer Rain Drains '4k Final PASS PART FAIL C t 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 /e- Approach /Sidewalk Date 7 — - d / Inspecto t / " 7'V e E x t Other Final PASS PART . FAIL .. DO NOT - REMOVE this inspection record from the job site. • ,) CITY OF TIGARD BUILDING INSPECTION DIVISION MST p0O/ 0 24 -Hour Inspection Line: 63 75 Business Line: 639-4 237 BUP Date Requested J AM - PM BLD Location //573 `A-M171/ -ccr"l Suite MEC Contact Person Ph 4G7...- G 97_3 PLM Contractor Ph 2-° G� SWR BUILDING Tenant/Owner gC c /` l - 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 Drywall Nailing Firewall Fire Sprinkler. Fire Alarm Susp'd Ceiling Roof er)((_ Misc: Final PASS PART FAIL I / LU Bal> — / Post & Beam / _ Under Slab (e""Afi-- Ct. ( f t "' Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART I _ 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 Approach /Sidewalk Date 5 V Inspector //' / C.� �� ✓"' E x t Other - - p Final PASS PART FAIL DO NOT REMOVE this inspection recort the job site. '111 - . • Ci r 1 OF TIGARD BUILDING INSPECTION DI MST 2 66 / — e e5 Z37 24 -Hour Inspection Line: 63 75 Business Line: 639-4 , • // BUP' Date Requested , 1'/ �14M PM BLD Location / /S7 So (,)Gvdkc,."- c - Suite MEC Contact Person Ph 20 4 G Z Ce.(PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing • AC S 74,9 Foundation / V ' ' f- - --1 / / S `"' n1 ` C/o o �/c k FPS Ftg Drain G Crawl Drain Inspection Notes: / Ls, /) /� .� _ , / „ SGN Slab SIT Post ost /Cf �G' (�l G ee/ 'y & Beam , V Ext Sheath /Shear Int Sheath /Shear Framing Insulation TrOV // Drywall Nailing 1 (i - Q v Q dc,e /f 77-e r -e S• -ems„/ 24/4/ .� Firewall Fire Sprinkler _ � � r► 9, _e t / 0-4 "-' - Fire Alarm Susp'd Ceiling - Roof I ( --p / Misc: Final (CQC-.- C1 // -fd PASS. PART FAIL M -ar avt Post & Beam . Under Slab � y h 1 7 - 0 i).tcf"/(7,, / r— �c2)24 Top Out Water Service _M2.e. b • Sanitary Sewer . pp Rain Drains L-ed'l /yt - -SS v.. Final PASS PART daP Qyi (/Q!rt h-t a41 MECHANICAL • Post & Beam No Zip. S -e c.' Rough In ��JJ � Gas Line 0 L ' 1'✓( rf— /- i ar_ Smoke Dampers '2* Final PASS PART FAIL ELECTRICAL Service _ Rough In . UG /Slab Low Voltage Fire Alarm . Final PASS PART FAI SITE q' 3 o JJ _ Backfill /Grading Sanitary Sewer Storm Drain - [ einspection 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 -1 / / f Other Date 1 / Inspector : f / (�/ �'V� • Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. . • 5, op - _ • .CITY OF TIGARD BUILDING INSPECTION DIVISION MST ,.-ol -oo 2. 24 -Hour Inspection Line: 63 75 Business Line: 639-4 a ...436 . P Date Requested 7 �AM . 4kI'7 PM BLD . ' Location /1_573 .5 (41 d / C./- Suite MEC Contact Person Ph 26 d G 6, 2— PLM Contractor Ph SWR UILDI 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 S ath /Shear. (t_c/Lklik5 j ` n f� ,� tl 9y`j Insulation Drywall Nailing � ✓ - • Firewall Fire Sprinkler Fire Alarm 4 ‘ 5 Susp'd Ceiling . _ . Roof S�- Misc: Final PASS PART FAI` --PEPIA VAL.-- - \*I2, ' 4 -1 - ( ,, %--Q Post & Beam Under S b ( - • k /( 0 . L. , C \ 4- op Ou atit Service Sanitary ry Sewer � _ Rain Drains lam\ �fZ�.� d 4 a l .:WPART FAIL c -f V2--- C ve' s--) . L Post & Beam • I - oug In �� l - Gas Line - ` L , �^' ^ \ S Smoke Dampers Final - PASS PAR 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 Approach /Sidewalk /� Other Date l l 6 ` Inspector t. Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUII DING INSPECTION DIVISION MST� cc��'' 4 1ti0 �3( �j 24 -Hour Inspection Line: 63 75 Business Line: 639=4 BUP Date Requested 7-/ S ' AM - PM BLD Location /1 73 5 4 , wvvW ' ' d („1 Suite MEC Contact Person Ph ZA L-C8i 7-- 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 . Drywall Nailing Firewall Fire Sprinkler Fire Alarm Q / / 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 PASS PART FAIL • • • Service Low Voltage Fire Alarm . • PASS ART FAIL bi • / Ba Baclifill /Grading ( 1 Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before n 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 Date 7 _( / ns 6 - / inspector �l Q� Ext Other p Final PASS .PART FAIL DO NOT REMOVE this inspection record from the job site. 5 ;6 8. CITY_,OF TIGARD BUS' DING INSPECTION DIVISIOP MST ed 24 -Hour Inspection Line: 63 75 Business Line: 639 Date Requested 7 ,f . AM • PM BLD ' i �� Location I /5 73 3 c.-' wiivci &r e4 Suite MEC • ' �' Contact Person Ph Z 'O C �G Z PLM Contractor Ph SWR = UILDI ! _ 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 S _ C irdi por • all Nailing c J S U 'T"lritt�1 Firewall �� S _ _ Q f �� Fire Sprinkler � Fire Alarm I n Susp'd Ceiling Roof 7 , Misc: 1 ^ Finy i" ` �-�- PART FAI P• BING H' V c_� L-r L X 6 . Post & Beam Under Slab / _ C Top Out ��� Water Service / [e) �` Sanitary Dr Sewer `� ^ n Le $ S Rain Drains L� a Final PASS PART FAIL CHANT ' Post & B am - (-Rough In aline • Smoke Dampers Fin - ASS PART FAIL CTRICAL 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 Approach /Sidewalk G V(- i3 � 1 Other Date I I I I nspector 1 �/ Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. .CI OF TIGARD BUILDING INSPECTION DIVISION MST �/ 24 -Hour Inspection Line: 63 '5 ' Business Line: 639-4' - BUP Date Requested 6 - Z I . AM - PM BLD Location / S Gc A/ ( JAI.) "_ �. Suite MEC Contact Person s/ "- y40-7 , Ph PLM Contractor Ph SWR (BUILDING Tenant/Owner ELC Retairn'ng Wall ELR Footing Access: Foundation FPS Ftg Drain SGN • Crawl Drain Inspection Notes: Slab SIT . Post & Beam • • Ext Sheath /Shear_ • Int Sheath /Shear gaming] v / Insulation Drywall Nailing • . * .111 Firewall Fire Sprinkler .. h ')•rte Fire Alarm Susp'd Ceiling . . Roof Final PASS PART . FAIL . T —— 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 - 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 Approach /Sidewalk Other _ Date Inspector Ext Final • PASS PART FAIL DO NOT REMOVE this inspection record from the job site. . cITYbF TIGARD BUIL DING INSPECTION.DIVISION MST .7tie1 —batiA3 24 -Hour Inspection Line: 63E '5 Business Line: 639-41 BUP Date Requested -'' At° , . AM PM BLD Location l ( 7? Wigeee m Suite MEC . Contact Person (AV/ K .4llhi y b Ph5t3 q21 5 PLM Contractor �h 4' N S t ei I 5 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 InLSheath /Shea /l / /' f /CCE L i(rCtal r /4.) !,_ _4... O hL I . Drywall Nailing r 3,rarr2A -r - ;, ,C' 'L, ,Soi - r — • Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final - PASS PART 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 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 Approach /Sidewalk Date Oa — 2d — 1/ Inspector Other E x t Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. •