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12900 SW KATHERINE STREET (J 1 rr 0 1 � T T 12900 SW Katherine St CITY OF TIGARD 24-Hour BUILDING Inspectiovi Line: (503)639-4175 :2 -4 INSPECTION DI;VI`;IOA business Line: (F03) 639-4171 MST _"�-' �_7Y OUP - Received Date Roque ted �G AM-_ PM BLIP .ocation _ (.\.i ^�.f `'s Suite __ . MEC -- Contact Person -- � ice— — Ph( _3 4 2--e 3"4 y PLM Contractor --- --_ --t-- Ph( ) _ — _ swR BUILDINr 'renanuowner CLC Footing - Foundation w•�-.--- ELC 9 Ft Drain Access: - 1=.- LR Crawl Drain _----- - Slab Inspecti otos: SIT _- Post&Boam Shear Anchors Ext Sheath/Shenr Int Sheath/Shear Framing Insulall n Drywall Nolling - Firewall - - Fire Sprinkler - Fire Alarm Susp'd Ceiling - Roof Other: - Final PASS FART FAIL _ -___----------- ----- PLUMBIN_G Post& Beam Under Slab Rough-In Water Service Sanitary Sewer --- Rain Drains Catch Basin/Manhole - Storm Drain — Showar Pan U er. -- --- _ - --- ---- PAPT FAIL - -- — --- — --- ---- -- _ ANIC Post&Beam — - ------ ------- ---- _.__—---- ---------------- Rough-In -- - --- -- --_ - - --------- -- -- Gas Line Smoke Dampens -- - - --- -_ - - ------ -T--. ------ -" Final PASS PARS;_ FAIL - --- --- ----- - -- - ---- — --- -- ELECTRICAL Service Rough-In UG/Slats -`---- -------..._.- —..__ --- _.---._ Low Voltage Fire Alarm — -— - -"---- Final Heinspection fee of$----required before next inspection. Pay at CityHall, 13125 SW Hall Blvd. PASS PART FAIL SIT — [� Please cn�l for ei spection R7 __ -___ ___-_— __ __ u Unable to inspect-no access Fire Supply line a ADA /'� roact�/Sidewalk d��"- _ _ Inspector._ -,��- _ III;1tt IOther:., LFinal DO NOT REMOVE this Irispectloe record from the Job site. PASS PAR t FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 - MST) -- INSPECTION DIVISION Business Line: (503)639-417-1 -- _- L"r BLIP - ----- Received _ __�- Date Requested_ ;SLG AM_ PM U'.10 Location - - Su;.e_ MEC' Contact Person .A-L4 -- Ph(—) _' =� j PLM Contractor - _ _ aL�—_ Ph( ) __ — SWR BUILDING Tenant/Owner ---------- ------------_----_ ELC Footing Foundation ELC ELR Access: Lo Cect 4,s c.1-c,.2�✓, a r' ...�, Ftg Drain �3' Crawl Drain Slab Inspection Notes.- - SIT - I Post&Beam - _ - - Shear Anchor;: Ext Sheath/Shear Int Sheath/Shear /� >� 4�• Framing r Insula:,'on Drywall Nailing ---- - Firewall Fire Sprinkler ------ --- - Fire Alarm Susp'd Ceiling Roof Other, ��F(ria�l SLP s 'ART AIL PLUMBING Post&Bee m Under Slat - I!�O -------- ---- - --------------_--_.--_ Rough-In Water Service -- ---- - ------- - ----- —_.—� - - Sanitary Sewer .� Rain Drains C,� _.----------- --- ------- --- Catch Basin/M 6hole Storm Drai - - - ----- -- — -— - Shower PE n ---_..---------- � Final ----- ----- PASS PART FAIL --- - ---- --- - ----_----- - ECHA - Post&Beam Rough-In _-- Gas Line V/ Smoke Dampers V ina, _ASS PART FAIL --- --- -- TRICAL --Ti _ Service --- - - ----- -- - Rough-In --- --- - —_— — _-- __ ----- UG/Slab Low Voltage Fire Alarm ✓ Fir•,al L� Reinspection fee of$- required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE [� Please Bali for reinspection RE: _ _ [� Unable to inspect-no access Fire Supply Line ADAApproach/Sidewalk Date G Inspector C-�� Ext �{Z Other: Final DO NOT REMOVE this Inspection record from the job site. PASS BART FAIL CITY OF TIGARD 24-Hour BUILDING In cpection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503) 639-4171 Bili- AM —PM____-__-_ BUP Received _______ Date Req sled ---MEC ----- �- �i GIC. �� Suite ----- __ -- Location _ � `J� ' _ - Contact Person ��V - Ph( -) '� — �3- � PLM _ Conttacto r _ - -- SWR - - _ Ph( -) BLILDING Tenant/Owner _-- ELC --- Footing ELC - Foundation -Access: Ftg Drain ELR Crawl Drain —. -- - - Slab Inspection Notes: SiT - -- Post& Beam ShearAnchn Ext Sheath/',,inw Int Sheath/Sher --- Insulation Drywall Nailing - Firewall Fire Sprinkler - - - Fire Alarm Susp'd Ceiling Roof O,her: .. Final ---� �- - - PASS PART FAIL. PLUMBING Post&Beam Under Slab - - — Rough-In Water Service - - — Sonfh,i y Sewer !"lain Drains -- - --- --- Catch Basin/Manhole Storm Drain - - -- Shower Pan Other:--- ---.. �_- Final PASS PART FAIL - MECHANICAL _- _�.- ---- - ----- ._. - -- ----- Post& Beam - Rough-In --- Gas Line Smoke rampers - Final T FAIL .- L.ECTRICA Rough-In -- ---- UG/Slab v Low Voltage _- - - ------ --- Fire farm Fin � Reinspection fee of required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ASS RT FAIL S -,_- [� Please call for reinspeolon RE: ❑ Unable to Inspect-no access Fire Supply Line ADA ' Approach/Sidewalk Dets _ _ � impede __ �. Ext Other: Final DO N@Y REMOVE this Inspection record from the Jab site. PASS PART FAIL CITY OF 'rIGA:R® --- MASTER PERMIT PERMIT#: IVIST2002-0017 DEVELOPMENT SERVICES DATE ISSUED: 3/29/02 12125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 12900 SW KATHERINE ST PARCEL: 2S104AA-11300 SU601VISION: BELLWOOD NO. 3 ZONING: R-4.5 BLOCK: LOT: 122 JURISDICTION: JIG REMARKS: Relocate washer acid dryer In utility roo 1. B, LDING REISSUE: v T�^ STORIES: FLOOR AREAS REQUIRED SETBACKS _ REQUIRED CLASS OF NORK: ALT HEIGHT FIRST: SI _ BASEMENT at LEFT: SMOKE DETECTORS' TYPE OF USE: SF FLOOR LOAD: SECOND: at GARAGE- at FR)NT: PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: at RIGHT: VALUE: $5,000 00 OCCUPANCY GRP: R3 BDRM: BATH. TOTAL: n 0(� SI REAR: PLUMBING SINKS: WATER CLOSETS WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN TRAPS: LAVAL DRIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES. SF RAIN DRAINS: CATCH BASINS TUSISHOWERS. GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR. GREASE TRAP v OTHER FIXTURES: MECHANICAL FUEL.TYPES FURN a 100K I BOIL/CMP�JHP: VENT FANS: 1 CLOTHES DRYER: CAS FURN>•110014: UNIT HEAT,?RS: HOODS: OTHER 11:41TS: 1 MAX INP: htu FLOOR FURNAKES: VENT:,: 1 WOODSTOVES. GAS )UTLETS: 1 ELECTRICAL RESIDENTIAL JNIT SERVICE FEEDER TEA.°SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS AVJ'L INSPECTIONS 1000 SF OR LESS: 0 200 amp: I o :no amp: WISVC OR FDR. PIIMPIIRRIGATION, PER INSPECTION' EA AUD'L S00SF: 201 -400 amp: 201 400 amp. IatW/O SVCIFDR: SIGNIOIIT LIN LT: PER HOUR: LIMITED ENERGY: 401 Dao amp: 401 000 am%. EA ADDL BR CIR: SIGNAUPANEL: IN PLANT: MANU HMISVCIFDR: flat • 1000 AMD: 601.anlpa•'u'Dv: MINOR LABEL: 1000+•amplvoll: Pi IN REVIEW SECTION Reconnect only: »4 RES UNTS: SVCIFDR-=225 A.: >&0 V NOMINAL: CLS AREAISPC OCC: EL:CTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO&STEREO: VACUIIM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPFARRIG PROTECTIVE SIGN-L GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR HVAC: DATAITELE COMM: NURSE CALLS: TOTAL a SYSTEMS: Owner: Contractor: TOTAL FEES: $ 430.00 This permit Is subject to the regulations contained in the VERNON HENTZ HATTERAS CONSTRUCTION INC 12900 SW KATHERINE 2131 GOO(1.'+LL CT Tigard Municipal Code,State of OR. Specialty Godes and TIGARD,CR 97223 LAKE OSWEGO,OR 97034 all other applicable laws. All work will be done accordance with approved plans. This permit will expire M 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 Rea#: LIC 115793 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)248-1987. REQUIRED INSPECTIONS Slab Insp Plumb Top Out Electrical Final Underfloor insulation Electrical Service Mechanical Final Plin/undslab Insp Electrical Rough In Plumb Final PLM/Underfloor °raming Insp Final Inspection Mechanical Insp Insulation Insp Issued By t4 c A Permittee Signature Call (503) 639-4175 by 7:00 p.m. for an Inspection needed the next business,da �ataaa�aaaaw A Building Permit Application i Ah l bate t/apped:o. Permit date: City of Tigard �' r, Aildt ,s: 13 i 25 SW I lall Blv i �t'E �ject/appl•n°• Expire date: ' Litt of Tigard TT / Pho:t_: (503) 639-4171 Ili bate issued: By: Receipt no.: Fax: (503) 598-i960 Case file no.. -- Payment type: Land use approval: Gl! x UP I I(JAKU M2 ramily:Simple complex: ❑ 1 &2 family dwelling or accessory ❑Commercial/industrial U Multi-family ❑New construction ❑Demolition ❑Additio,n/alteration/replacement ❑Tenant improvement J I m prinkler/alarm ❑Other: _ Job address: ` L� Bld f�.no.: 5 :., no.: Lot: uck: — Subdivision:— - Tax map/tax IoVaccotntt no.: Project name: _ �- Description and locatio of ortgagk or,piscs/special conditions:- a -w�-vr_Q l(l Name: V -Mailing address: j �� ` �-- _ u t 6t 2 family dwelling: City.-ZC c�sa State Z : ` Valuation of work .... ................................... Phone: Fax: I E-mail: No of hedruomrvlreths.................................. _ Owner'srepresentative: — 4,t- ` Total number of floors .................................. ? Phone: ax: E-mail G cs- New dwelling area(sq.it.) ........................... Garage/carport area(sq.ft.).......................... NameM : Gy7. -�+ �' Covered porch area(sq.ft.) .......................... --- — ailingeddress: Deck area(sq.ft.)................... ...................... City: ^— State: _j Zip: Other structure area(sq.ft.). ___ ............... Phone: Fax: E-mail CommerehUitedustrial/muld-family: Valuation of work ......_.. ....................... .... S Business name: Existing hldg.arca(sq. ft. ................ ........ Address: New bldg.area(eq.ft.)........... ....... ............ Number of stories....................... ................ city: sratt _ z P: �, — Type o .... ...... y .... ........ Phone:�7 -�7 d' : ��,j E-mail: r f construction.........u^ mu .— CCB no.: / � 3 � � ,r.- ,-Occupancy g Ptsl: rxistt City/metro lir..no.: Nodee:All contractoA and subco,ttractors are regrired to he .ensed with the Oregon Construction Contractors Board under Name: - provisions of ORS 701 and may he required to he licensed in the Address: jurisdiction where work is being performed If the applicant is city: - State: --- exempt from licensing,the following reason applies: 7.IP: Contact person: Plan -- -- --------- ------- -- Phone: Fax U-mail AMMILIMMIlf Name: Contact person: Fees due upon application....... ............. ....... Address. -- Date received: _ _ State: 7.IP: ---- Amount received......................................... .S Phone: Fax: — E-mail: Please refer to fee schedule. - hereby certify I ha-c read and examined thin application and the Ntr t a imisdici me/Rept ovht canis.plow call m+adirtftm kir more inkxmumn attached checklist.Ad provisions of laws and ordinances governing this u%im u M.det(•wd work will he comp led wi o Specified herein or not. Cmle cited mrrrdrr p Authorved sig ��� --- a _.._ __ N�tne of e�nlder as ethortt an credit cml S Print name: __._. _ -- - — – --------- WCinifiolt-tn�Ipalttn� ..._ _. . Atmtmt �� Notice:This permit application expires if n pcmtit is not obtained within Ileo days tiller it has been accepted as complete. 1404M 1 0,art ort, Electrical Permit Applicatim Gate received:_ Permit no. 16 ' City of Tigard Project/appl.no. Expire date: City of Tigard Address: 131^5 SN I lal I l;lvd,Tigard,OR 97223 pate issued: By: Roceipt no.: Phone: (503) 63913171 Fax: (503) 598-1960 Ccse file no: Paymenf type: Land use approval: _. I & 2family dwelling oraccessory ❑Commercial/industrial JMSulti-family CJ'IenanIimprovement LJJew construction 0 Addition/alteration/replacement J Other: - _ _0 Partial NUNN Job address:_ 5W TC7T Bldg.no.: guile no.: Tax map/tax lot/account no.. Lot: Block: Subdivision: _ - f Project name: e- Description and location of work on Estimated date of co rnpletion/inspection: I �_ Job no: VU wa. Business name: -_ Ileuripthn - Qty. (to.) Intal no.lasp --- N ra re.Meallal vinair nr multi-famlly per Address: s e sIDY dar111nganh.In(Inds•,"ItarhedRaraer City: I Stat ZIP: Soo'trriorlrMvl: Photic: Fax 31 ...t/d E-mail: LION)vl It CCD no.: _� Flec.bus.lic_no: 3�// O� Fadi edditianal urn,y n nrniinninkmaf 1 Limited enettiy�ncsidentiat 2 City/metro tic.nn.: Limited encrigy. non-residential 2 I.wh marwl'actnrel home or modular dwelling _ 119 lactrician (required - Date Service and or feeder Su elect.name(prim): L- I.ieeroe no:t s So 'keaerfeetltrs-IaslagaMer, a tenlMearrelocrdor: 20(1 s a less 2 -II Name(print): t01 ini °t.°fK>�� 2 Mailing address: 401 amps to foal.mom 2 "�'r 601 amps it, Iow amp, 2 City: State' 7.IP: _ over loon amps or volt, -- 2 Phone: Pax: F-mail: Reconnect onlyI Owner installation The inetallatiun is being marls (in property I own services or fee ter. which is not intended for sale,lease,rent,or exchange according to IralalhHor,■Iteratloo,ort-location: URS 447.455,479,670, 701 200 amps or Ides - 2 201 amirm to 4111!Tp! 2 Owner's Iii ature: Date: ant h,(rn),rep, - 2 a►trach rlrreltr new,attender, air cxteasion per tared: Nerve' A Fee fa branch circuits with purchase of Address: service or feeder fee,each branch circuit City. ---- I - ----- - Stat,. 71P: n— Fre ar Manch cirruiti wNlrad purchase Phone: Fax: I I, .c! of service or reciter fee,rine hrench circuit: 2 Each additional branch circuit: War.(Service or feeder sot Me1Ned): U Service over 225&-in-comm trul U Ilcald)-carr rwility lash p_mnp a initiation circle 2 U Service over 1211 amps-merry of M2 U Ila,ardt"m Inc.aan Tach,ign(ir marlin:lighting 2 family dwellings U Building over 10.0410 square fad tont or %itinal coc"040 or a limited malty panel, U System over film)volh nominal more residential omits in new senclute aNeratiort, or extension, ? U Buikling over tine series U Feedcrr,400 amps of more oDescriplioti, U Occupant load over 419 pera,m J Mannflactawd structures or Rv prk fieb d&d"al IaageetMo die e Moveable In any of the above: U E(gesslllgMLoti part U Other -_� Per bis Luso '�" -- 1-- 1- --T- SabatH tele OhHY ba Wmy of me drove. _ Investigrliun fee - —--------— I The above are not applImMe to fewporary coaaftwilitn service. otber ----�_— _______.�__� Permit fee -.... Not ail ryri+dicriars smepl credit cods.please exit rynisdicfion lnr mom.n,-+marirml Notim: This pennif application --`-LJ Visa Visa LI Mwert•ard I Plan review tat - oroI - espitrs of,n pemm fs not oMnitu�cl --�- l'tedn card mrmeer. _ / within 1130 dnys RN-t it has been State surcharge(H°ill $ y 5 t apre+ accepted as complete I TAL... ......... ...........$ -- Name cal canfh,Iden as shown an credit nod t_dholder siansitura — Am, no 4411 Plumbing Permit Application Dam received: Permit no.: ( ", - ) 76 City of Tigard Serer permit no.: Building permit no.: Address: 13125 SW Hall 111%d,Tigard,OR 97223 Cay gfTigard Phone: (503) 639-4171 Pwimt/appl.no.: Expire nate: Fax: (503) 598-1960 bate issued: By: Receipt no.: Land use approval: Case file n(t: Payment type: ❑ I & 2 family dwelling or accessory ❑Commercial/industrial ❑Multi-family _J 1 eiian, imprw teem ❑New construction ❑Addition/alteration/replacement ❑Foud service J()IFrt 10000111111 ILI 10 0 10 Raj flu ES 0 Miiiiiiiiiiiinnagang Joh address: SW t —Ue.cription —_ Qtr. F�'ee(es.) To ni Bldg.nc Suite no.: — New i_aatd 2-family devc(lings only: 1 ex map/tax IoUaccount no.: - -- - -- (includes 100 ft.few each utNit c-onaeilbn) SFR(1)bath Lot: Block: Subdivision SFR(2)bath Project name: ,�- '�L _ SFR(3)bath City/county: �1 -t.,-_.- X17.I P: � �-- Each additional beth kitchen Desert hon an loca'An of in p ices: U Ske utilities: Catch basin/area drain l tit Hatt t f:,un(It tion/in9 'cti(nl DrywelisAcach line/trench drain Footing drain(no.lin ft.) _ Manufactured home utilities Ii1191nC 95 tl8 nil'. �' �--- __ if r__��•-rt - _ -- Manholes Address: L Rein drain connector City: State 7.IP. Sanitary sewer(no,lin.ft.) Phon / Fax: 3 & f-mail: Storm sewer(no. lin.ft.) - - - CCH / Plumb.bits.reg.no: 47 Watet service(no.lin.ft.) City/metro lic.no.: LI 1_ - Fixture or item: C'ontractor's representative si nature Absorptt ion valve — Ack flowreventer Print nrrnc Date: D D - _ Backwater valve Basins/lavatory Name. - f — - Clothes washer - - Address: _ Dishwasher - -- Drinking fountain(s) -city: ` �.*Q _ State ) 7.IP:� C'ectom/sum Phone: Expansion tank Fizhtre/sewer cap Name(print): •r Floor drains/floor sinks/hub Mailingaddress: _J G-t �r� 'a age dis�sal -- _ Stat 7.I P: Flose Bibb Ci ty: f a rv_� ��� Ice maker _ Phone: Fax: E-mail: Interceptor/grease trap Owner itlstaiNtion/m4idential maintenance only: The actual installation Primer(s) _ will he made by me or the maintenance and repair made by my regular Roof drain(commercial)_ — employec•(m the props i; !o-.-,,n as per ORS Chapter 447. Sink(s),basin(s),lays(i) Owner's sit mantrr: bate Sump - I ubs/showet/shower pan Urinal -' Name: _- _ _- _ Water closet — Address: Water heater _ -- City: State: I.IP: Other; Phone: Far E-mail: Total - --- ----- Minimum fee. .............. S Not all j(rciKdictions urep(cratlit cards plmu salt iumdictl(m for more mformatam N(i ice: This pernit appitctin(Nl a ---�— U vim U Maacn'ant Plan review(at expires if a pcmlit is not ohtnirlecl ('redo card number State surcharge(Ran I spves within IRO(keys ager it hits het ..-Name of cardholder as shown on credis card accepted as complete. ............. ........ -.. - Canlhilder sittr(a(urc__ Ammm( t40-1610,(r,(el('(W) Mechanical Permit Application D ateceived: Permit no.: ^�a-CCI' 7 City of 'Tigard no.: Expire date: CUvafTfgard Address: 13125 SW hall Blvd,Tigard.OR 97221 hate issued- By: Receipt no.: Phon?: (503)639-4171 --- Fax: (503) 598-1960 Cave file no.: Payment type: Land usic approval: Building permit no.: �l &2 family dwelling or accessory OCommercial/industriai 0 Multi-family 0 Tenant improvemenTT., Ll New construction 0 Addition/alteration/replacemc t 0 Other: — Job address: _ (� c. In ligate cqugtmeni quantities in boxes below.Indicate the dollar Bldg.no.: Suite no.: — �.Itiv o'all mechanical materials,equipment,labor,overhead, Tax m_ap/tax lotlaccount no.: — 1.•~!: Value R Lot: Block: Subdivision: 'Sec cherkhst for important application information and Project name: _ lurls•'-ction's tee whedule for residential permit fee. City/county: ZIP:: � � Description and locitiq of wor"on plremise-.c I JIM_ Fee(OL) Total Est.date of completion/inspection: lkarri;lrinu QtY. Res.itionly Res.ossly Tenant improvement or change of Use: ASC' Is existing space heated or conditioned?J>Ii,Yes 0 No Air handling unit CFM _ space insulateol'! Yes J No Air conditioning_(site len uired) Is existing P ternu--'ori oT existing IIVAC system, Bailer/compressors Business name: —.� r C_ ate boiler permit no.: 1L t .- ------ IIP Tons _ BTI1/H Address: -I/Zle,- Fire/smoke damptnslduct smoke detectors City: Std : <; ZIP: � C/ T eat imtp(snit an requ ) _ Phone: ax �� _mail nsta rep ace urrwc urrter3(tT1IT` Including ductwork/vem liner J Yes No CCB nn.- � _<nsta tir7l cc f6i.ate eters suspended, City/metro lic.no.: � wall,or floor mounted. Name(please print) y, t. Vent for liance otherthan furnace r Absorption units BTL'/II Nsntc: .j Vc (' (- Chillers IIP ompressors Addles' c _ r .wx'Kno p1 eKnnusr end ven ■(nn: --- — City: pQ _- Stat ZIP: Appliance vent Phone: - �'7 Fax:+ E-mail: Dryer ex us►- --- - — Honds�ype U 11,rus kitcjten Tw/inot hocA fire suppression system Name: - Exhaust fan with single duct .,o fans) Mailing address: Ex 1*syatein apart frim,he Cit Stat�y_2111': � ng rind d�lnrftma o 4 out cls)) Y� _—_ _ 'Ldr y 7 _ Typte-. LPG N(t Oil Phone: Fax: 1-mail -TUet i encTaaHt-mmTov&4 outlets —7— seen;I;Q - (schematic—regw ) Name: Number of outlets _ — _. -- Wow ap ace or cue — Address: v Ihcorative fireplace City: State: ^17.IP. Insert type _---- — - Phone: _ _. FuY. C mail ix- ov pe et stove— O Applicant's signature: Date n 1 Name(print): _ - ------ Petmil fee S NM ail hrriadklitma aacepl credit cards.please call prriadictwn thr mtxe ntrameann. """"'""'' V viae U Megct('ani Notice: This p!-rmit application Minimum for................ >; etyires if it permit is not obtained cord numt,er: / / Plan review(at °.r1 5 - I,p„e within 181)days after it has been State aureharge(9%) ...s -_1 5• SCJ Nome or nrr�loidir n almwn an cred.l card accepted as complete. L'uditolderaiprture — Anwrmt tin-la 1 6IeIt0MI t,1 TY OF TIGARD 24-;dour 31,111-DINu Inspection Line: (503) 639-4175 INSPECTION DIVISION Busir,ess Line: (503) 629-4171 BLIPReceived ---.--- Date Requested _ ! ! f�. AM PM BUP _- Ll I.ocationG'C �L - L'_e___ Suite MEC Contact Persun _ ' 'L�� Ph PLM Contractor __ _._ - - Ph( ) — SWR BUILDING Tenant/Owner -_ _ _ ELC Footing Foundation ELC -_- Ftg urs in Access: ELR Crawl Drain - Slab Inspection Notes: - SIT Post& Beam _ - Shear Anchors Ext Sheath/Shear Int Sheath/Shear l7mming ----- Insulation Drywall Nailing -- Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling --- - 1-- .- Roof Other.__--- - SS PART FAIL _ ING Post& Beam Under Slab _ _ — Raugh-In Water Service — ---- _ - - ----- ---- Sanitary Sewer Rain Drains _ Catch Basin i Manhole Storm Drain -- - Shower Pan Other: -- Final PASS PART FAIL. -- — M_ECHANI_GAL Post&Beam -- --�-_ -- Rough-In aas Line Smoke Dar.rpers Final ------ PASS PART FAIL -- - ELECTRICAL _ Service Rough-In UG/Slab v - Low Voltage Fire Alarm 1 Final 1 Reinspection fee of$—v required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL_ SITE _- " F-1 PlePse call for rr in�hecrr.n RF Unable to inspect-no access Fire Supply Line 1 ADA Approach/Sidewalk Date _ -�' Inspector ��I fEXt__ Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL.