12755 SW 69TH AVENUE STE 201 • �N
ADDRESS :
A.VA:
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THE',!; SPCCIFICATIOP+S ART. GLvERAI,. IN NATURE AND ARC INTENDED CONPJl:CiQRS- TIE STRAPES. + RAH1N3 ANCFIGRS. HANi,ERS.'COLLJHN
TO .F:T MINIMUM STAI"+DARpri FG'R "ATLRIALS. VURKMANSHIP SHALL CAPS. AND BA;f_S TO BE 'Slh1PSON' CR A; SitC1VN F`RIME
!C rONTR'OLE>D AT GOOD GUALITY NY THE GENERAL CONTRACTOR OR COAT N!Sc_IYA'NEOUS STEEL.
DE\.1 LOP", CONTRACTOR TO PROvIDC ALL NECESSARY TEMPORARY I ; I
SUPPORT FOR VALL S AND FLOURS PVlOt TO COWL E T ION OF VER';CAL { I
fi I
AND LATERAL LIL1D !IrTTC11S.
Dlvt51I3.`d 6 CARPEh (RY
t
WIN LOAD LOAD IS PSF SHG'. l ">tiBER SPECIES AND t.,RADES TO BE AS F0.LQV; IM+CESS �?TN R'.ISi_ o
NUIL^ ! I
WIND 117MAD Bo MPH - _ _. - _ --
SEISMIC ZONE I r.;STS, b[AMS AND STRINGERS CiQUGLAS FIR 02
AL.LOVASLE SOIL BEAR.'K 1500 PS►- !!LAMS 6' NOMINAL DOLIGI AS FIR #I
Bl!CKS. BLOCKING AND MIS:... DOUiA-AS FIR STD 1
CI!NTRIR:TCSR SNALL VERIr!' Y ALL DNENSIONS AND CtINDITIONS ON !TUDS DOUGLAS FIR STD -
DRA\ InGS AND IN 'ti!: FIELD. CO[VOINATE C:PLN1NVS THRQJGH SILLS. PLATES AND LEDGERS DOUGLAS FIR 1� PRESSURE TREATED
1"L OOR S, RW AND v AL L S APPLICABLE TRADES. NOTIFY DESIGN
ENGINCER OF ANY DI!;o ?ANCIES. � I
PLYERVI1r INDICATE TO BE CD GRADE VITN EXTERIOR GLUE 11•VLESS L'1-
/-.\\
CODES Alatl STAItiDaRDS. LMIF7RN j►LtILDINr ;C:TE - 1991 EDI:lON diHERVtSE INDICATED- 1N;CKNESi TO )iE AS NU1ED ON PLANS. ,
t Date
AMENDED BY THE STATE (�f JR E GUN ALL O'►C R LOCAL AND STATE' � M
lUILDING REGULATIONS SNALL RE AFF'IiCA�E. NaICiNG TO 13E AS INDICATED a PLANS. � 1 N
Na1LINGr AVL NAILING SHALL COMPLY VITH UBC TAILE 25-0. MAILING
af,TIOHS AND A TERNAT[ MATERIALS, CONTRACTOR NA1 SL13?dT• Sc►tCDIJLE. t-' '
y� L < </�•1 I . I'
�'KPOSALS FOR USE [� ALTERNATE MATERIALS AND KFTHC?D: ROOF JOISTS, RGCIF JOISTS SNALL Bpi- MAt" ACTURED BY 'iC81e Y. ✓'�
"M AP )\ A.L I
T" JOIST CMP. OR PRIOR APF'RDVE D TRUSS MANUF A C T LW R. ALL
BEARING HARDVAK- KANuERS LCT. THAT C.ONRrC1 TO THE TRUSSES
'
OtViS i S METAL SHALL BE PER MANUFACTURER'S STANDARD DETAILS. ' — - f l�I�ir1 ' �.1 (=�� ��( �V'✓�"� Drawn (,
.'CP DRAVIM-JS S'AMPED BY A REGISTERED ENG,NEER ,ti TH STATE _
01 OREGON ARE TO t31< SUBMITTED.
SttCI, ALL S:Ru IiJItAI. STEEL TO OC A 16., r AIl:Ic'A1Q:D IN � .
ACCIxft]ANCS; viT11 AISC E1GtH CDTI,pN. S )rb
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WITH GREY CWtONA TE. S T1RlL'T *AL ST Cr l.. IMS ST C � D I�' I S I CNv 9 FINISHES
N I S HE S
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c"FSUM VALLSOARD• Sig' iHICXNF-SS cL*&CSS INDICATED ~- vr%1CaIkL�, J1 rJ��✓1+J4Afj A � �V1V 1`[— IO �J� K¢ t '� n "� �� lGj�� SheHt
�'CLD1�G ALL, vCIDtNL By CCx'T1Fif.D vt-LDfRS. !ric E1+0xx r
ELECTRIDES QR El(1XX EULTWOOCS, METAL TRIM AT ALL ExrDSED EDGES AND CC HER;
.it�LY WITH ALS S NCS/
WI .JOINTS AND SAND IN FINISHED AREAS. USE VATERr'R;C;-
TS, ASTM A•-3OT 'VITH STAB OM0 PLATE VASN[RS LR+DERALL S L•T TYPE 'X'' IN RESTROOMS,
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1 , h e suspended acoustical ceiling system shall Le anchored to resist lateral
seismic forces (Section 1630.2 and Table 160). Provide suspension wires not --- - Q LaA 5vL-A7tL� bur-ec.,T<r
&mailer than No. 12 gauge spaced at 4' an center, perimeter wires, on terrnina! 6F CLI
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tl 1 �� cnds of cross and main runners at a maximum of 8' from each wall f N'j. ! ` ---- cIAT, FP
our f��. 12 � � /
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gauge wires splayed 10 de frees from each other at an angle not exceeding 45 I i •�`'�
degrees from the plaric of the ceiling witty a strut centered and extending to thts
strUctural members supporling the floor nr roof above and spaced 12' on center
I both directions starting 6' from each wall. All lighting fixtures weighir ig ies�, -
than 56 lbs. shall be positively attached to the suspended ceiling sy stern ASTIM ( I - _-3/4 ' tit-f-c 1 �' !
c(A U U rT 6►,! --- -12 G A
C635-94J. When using an intermediate grade system, No. 12 gauge wires shall a� � C 1�) �.
be attached to the grid members within 3' of each corner of the fixtures, and `f
I•ighting fixtures weighing less than 56 lbs. shall have two No. 12 slack wires �; ;
+ connected from the fixture to the struclure above. Ceiling mounted air terminals ��` .. `�� _ r U1u4 b A:—,
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or � services weighing less than 20 lbs. shall be positively attachud to ceiling
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CITY �� �I��RD BUILDING PERMIT
CI
PERMIT#: BUP1999-00352
^� DEVELOPMENT SERVICESTE ISSUED: 8/13/99
13125 SW Hall Blvd., Ti4ard. OR 97223 (503) 6 IVA N PARCEL: 2S101AD-02900
SITE ADDRESS: 12755 SW 69TH AVE 201 01RI�•J
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT: 031 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: 3.443 sf _ PROJECT OPENINGS?
TYPE OF CONST: 5N sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 31 BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCC:U SEP. RATED:
B` iNT?: MEZZ?: _ REQD SETBACKS _ REQUIRED
FLOOR LOAD: psf LEFT: ft P.GHT: ft FIR SPKL: N SMOK DET:N
DWE=LLING UNITS: FRNT: ft REAR: ft FIR ALRM : N HNDICP ACC:Y
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 51,645.00
Remarks: Commercial TI - Note: No Certificate of Occupancy will be issued until shell permit BUP1999-00105 has received
C of O.
Owner: Contractor:
ROTH J T JR + THERESA A + JT ROTH CONSTRUCTION INC
ZOUCHA, MICHAEL S 12600 SW 72ND AVE STE 200
12600 SW 72ND AVE #200 TIGARD, OR 97223
TI�onD OR 97223 Phone: 639-2639
Reg #: LIC 31700
_ FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Framing Insp
PRMT DEB 8/13/:x9 $289.00 99-317652 Gyp Board Insp
Susp Ceiing Insp
5PCT DEB 8/13/99 $20.23 99-317652 Final Inspection
PLCK DEB 8/13/99 $187.85 99-317652
FIRE DEB 8/13/99 $115.60 99-317652
Total $612.68
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
d 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 days. ATTENTION: Oregon law
N requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503)246-1987
J
•-r
G7
f-
w Pemiitee
-'
Signature: �F-�Z
:ssubd By: 4, _
Call 639-4175 by 7 p.m. for an inspection the next business day
..I OF TIGARD Commercial Building Permit Application Plan Check#
13125 SW HALL BLVD. Tenant Improvement Rec'dBy
TIGARD, OR 97223 Date Recd
Daie to P.E.
(503) 639-4171 Date to DST r
Print or Type Permit#L-'4
Related SWR#
Incomplete of ulegible applications will not be accepted Called
Name of Development/Project �_. Existing Building ❑ New Building
Job 7 Ktn - C - ,
Address Street Address Suite Building
1276-5 5W 4 2 rN C 2p/ Data
Bldg# City/State Zip - Existing Use-of Building or Property.
1-1—IrWD Cf-- '272-23Name � J-9. � --
Property TIM RProposed Use of Building or Property:
Owner Mailing Address Suite D `F
,26Ct7 SIS 2 E ..ZOb No. Of Stories:
City/State Zip Phone Z
T _e_-Ie_ 3 �3 y G3 Sq. Ft. Of Project:
Occupant Name — 3 V
Occupancy Class(es)
Contractor .-7 _ — uC �Type(s) of Construction.
Prior to permit -tN�111ng' ddress Suite ,� .I
issuance,a ropy Will this project have a Fire Suppression System?
of ail licenses 2(�Ov c/ NO A VF_ Ua Yes ❑ No
are required if City/Slate Zip Phone
expired In C.O.T. Americans With Disabilities Act(ADA)
database :!,P— fzg?2 '�O'3r 2L5 Valuation X 25% = $ Participation
Oregon Const.Cont.Board Lic.# exp.Date Complete Accessibility Form
Project $
Name Valuation S/ (SYS•�`c7
Architect ' '�j Ev;/� �/ Plans Required: See Matrix for number of sets to submit,
L��SIGNL�L Mailing Addiess Suite on back
6 SE A r^
City/State Zip Phone I hereby acknowledge that I have read this application,that the information
hT L o. C14- SZ given Is correct,that I am the owner or euthorixed agent of the owner,and
Engineer Name
that plans submitted are in compliance with Oregon State Laws.
Signature of Owner/Agent, Date
Mallin Address Suite
Mailing
Y3 S•�,i AVE Contact Person Narne Phone
City/State Zip Phone
FOR OFFICE USE ONLY
Indicate type of work: New Addition O Demolition O `
Accessory Structure O Foundation Only O Alteration O Map1TL# Land Use
Repair O Other O Notes: ~�
Description of work:
TIF:
Note Site Work Permit Appfication must precw de or accompany Building
Permit Application
I 1COMNEWTI DOC (DST; 5198
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
Plan Review is dependent upon submittal of BOTH plans AND a COMPLETED
application. For an electrical submittal, the application must contain the
signature, of the supervising electrician before plan review will be conducted.
After plan review approval, Plans Examiner will contact the applicant to request
additional plan sets for distribution purposes. (Copy for Contractor, City,
Washington County, Tualatin Valley Fire & Rescue)
Total # of
TYPE OF SUBMITTAL Plans KEY-
Submitted
S (Private) 1 S = Site Wcrk
-6-(-Ne w or Add) 1 B = Building
F (New or Add or Alt) 3 F= = Fire Protection System
M (New or Add or Alt) 1 M = Mechanical
B & M (New or Add) 1 P = Plumbing
P (New, Add, or Alt) 2 E = Electrical
B & M & P (New or Add) 2 New = New Building
-t (New, Add, or Alt) 2 Add = Addition
B & F & M & P & E __ _ 3 Alt = Alternation to Existing
(New , Add) Building
*BorB & M (Alt)
*B & M & P (Alt) 3
*B & M & P & E(Alt) � 3
*B & M & P & E& F(Alt) 3
J
NOTES,
1:
*Shaded areas designate ALT submittals only.
I\dsts\forms\matrxcom doc 10130/98
OVER-THE-COUNTER (OTC) PERMIT PLAN REVIEW
COMMF__RCIAL ( STRUCTURAL) BUILDING PERMIT CHECKLIST
DESCRIPTION OF PROJECT: f
1'0) &:WOL"dC y
CLASS OF WORK: 1-klr FLOOR AREAS EXTERIOR WALL CONSTRUCTION
TYPE OF USE: FIRST SQ. FT. N: S E: W.___
TYPE OF `f
CONSTR. 1 SECOND ','_ SQ. FT. PROTECT OPENINGS?:
OCCUPANCY GRP: THIRD SQ. FT. N: S: E: W:
OCCUPANCY LOAD: TOTAL SQ, FT. ROOF CONSTR. FIRE RET:
STOR: HT: FT BSMNT SQ. FT. AREA SEP. RATED.
BSMNT?: MEZZ? GARAGE: SQ. FT. OCCU.SEP.RATED:
FIRE FIRE SMOKE HANDICAP
SPRINKLER ALARM: � DETECTOR: ;. ACCESS:
COMMERCIAL INSPECTION ACTIONS FEE MENU
rb
Foot/Found Post/Bearn $ Permit Fee
Masonry Framing l $ ... Plan Review
_ Insulation Shear Wall $ 'CV 7% Slate Surcharge
Firewall Gyp Board $ <l5 ma FLS Plan Review
Suspended Ceiling Sprinkler Rough-in $ Add'I Permit Fee
Sprinkler Final Fire Alarm $_ Add'I FLS Pln
Smoke Detector Approach/Sidewalk $ Inspection
Miscellaneous Final $ MIS Fee
FOR OFFICE USE ONLY:
TYPE OS USE OPTIONS(CONI=commercial; CMS=commercial manufactured structure)
CLASS OF WORK OPTIONS FOR ALL PERMITS(NEW=new;Add=addition;ALT=alteration;ACS=accessory;FND-foundation,
OTR=other,DEM=demolition;REP=repair,FPS=fire protection system,NOTE: USE OTR FOR FENCES, RETAINING
WALLS, DETACHED DECKS, SIGNS,AWNINGS, CANOPIES)
I bvrcntr2 doc (DST) 4/97
ELECTRICAL PERMIT-
CITY OF TIGARQ�
' RESTRICTED ENERGY
DEVELOPMENT SERVICEW,RIP
/ PERMIT#: ELR1999-00245
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4 IVA L DATE ISSUED: 10/19/99
SITE ADDRESS: 12755 SW 69TH AVE 201 PARCEL: 2S101AD-02900
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT: 031 JURISDICTION: TIG
Proiect Description: installation of data telecommunication system.
A. RESIDENTIAL _ B.COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X 14URSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
__ TOTAL# OF SYSTEMS: 1
Owner: Contractor
J T. ROTH, JR ALLEN/FALK INC
12600 SW 72ND 9020 SW GEMINI
SUITE 200 BEAVERTON, OR 97008
TIGARD, OR 97223
Phone: Phone: 646-0533
Reg #: LSC 47238
SUP 781JLE
ELE 34258CLE
FEES_ Required Inspections _
Type By Date Amount Receipt _ Low Voltage Inspection
PRMT DEB 10/19/99 $60.00 99-319191 Elect'I Final
5PCT DEB 10/19/99 $4.80 99-319191
Total $64.80
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws All work will be done in accordance with approved plans. This permit will expire if work is
not statted within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
regUires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
9�,2 001 0010 through OAR 9501 0080 You may obtain copies of these rules or direct questions o OUNC at (503)
46-1987. �+ /
Issued by Permittee Signature
i
n �
OWNER INSTALLATION ONLY
The installation is . ging made on property I own which is not intended for sale. lease, or rent.
OWNER'3 SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR ELEC'N DATE:__
LICENSE NO:
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL APRH Rec'd
13125 S1tV HALL BLVD Date Rec'd:
V-5503-639-4171�RD OR X304 23 PRIMT OR TYPE QCr � Permit#: Q �S
F -503-598-1960 INCOMPLETE OR ILLEGIBLE Ae"AT119N&UPMLIr, Cust.Call'd: _
WILL NOT BE ACCEPTED
Name of Development Project TYPE OF WORK INVOLVED-RESIDENTIAL ONLY
Restricted Energy Fee........................................ $60.00
DU a — (FOR ALL SYSTEMS)
JOB Street Address Sle#I
Check Type of Work Involved:
ADDRESS vJ LP +A,.%+A,.% 0
City(StateZip Phone# ❑ Audio and Stereo Systems
T i,qovaO
❑ Burglar Alarm
F-] Garage Door Opener`
OWNER M 'ling Ad rps5 ��O
❑ Heating,Ventilation and Air Conditioning System"
Name Vacuum Systems'
A-01 F-] Other
CONTRACTOR Mailin Address L -
0& Qr . TYPE OF WORK INVOLVED-COMMERCIAL ONLY
(Prior to issuance a ty/State Zip Phone# Fee for each system.............................................. $60.00
copy of all licenses n 001b Vfigp (SEE OAR 918-260-260)
are required if Oregon C,ogf� 01Bld is Exp ate
expired in C.O.T. �-1 _ `t Check Type of Work Igvolved:
data base). Electrical Contr. Lic # Exp pate ❑
CLE 10/00 Audio and Stereo Systems
C.O.T. or Metro Lic # Ex at
1�p 9 1 ❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER- Mailing Address
APPLICANT Data Telecommunication Installation
City/State Zip Phone# ❑
Fire Alarm Installation
This permit Is issued under OAE 918-320-370.This applicant agrees to ❑
make only restricted energy installations(100 volt amps or less)under this HVAC
permit and to do the following:
❑ Instrumentation
1 Only use electrical licensed persons to do installations where required.
Certain residential and other transactions are exempt from licensing. ❑ Intercom and Paging Systems
These have asterisks(') All oihers need licensing;
❑ Landscape Irrigation Control'
2 Call for inspections when installation under this permit are ready for
inspection at 503-639-4175; ❑ Medical
3 Purchase separate permits for all installations that are not ready for an ❑ Nurse Calls
inspection when the inspector is out to inspect under this permit.
4 Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting'
a inspector are done,and, ❑
.� Protective Signaling
5 Assume responsibility for calling for a final inspection when all of the
N corrections are completed ❑ Other
�- Permits are non-transferable and non-refundable and expire if work Is not
r started within 180 days of issuance or if work is suspended for 180 days. Number of Systems
m
The person signing for thin permit must be the applicant or a person No licenses are required Licenses are reyulred for all other Installations
au ed to bind the applicant
J
FEES: II __
ENTER FEES $ 1pD.oO
Signature o(a
SURCHARGE(.05 X TOTAL ABOVE) $ LA . BO
Authority if other than Applicant TOTAL $ to Li. 80 —
i Wstslforms\resele doc 3/98
CITYOF TIGARD _ CERTIFICATE OF OCCUPANCY
DEVELOPMENT SERVICES PERMIT#: BUP1999-00352
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED• 08/13/1999
PARCEL: 2S101 AD-02900
ZONING: MUE
JURISDICTION: TIG
SITE ADDRESS: 12755 SW 69TH AVE 201
SUBDIVISION: WEST PORTLAND HEIGHTS
BLOCK: LOT:031
CLASS OF WORK: ALT
TYPE OF USE: COM
TYPE OF CONSTR: 5N
OCCUPANCY GRP: B
OCCUPANCY LOAD: 31
TENANT NAME: DUNCAN HONN, PC
REMARKS: Tenant Improvement
Final Building Inspection and Certificate of Occupancy
Approved 2/8/00 by Tom Plescher, Building Inspector
Owner:
ROTH, J T JR + THERESA A +
ZOUCHA, MICHAE=L S
12600 SW 72ND AVE #200
TIGARD, OR 97223
Phone: 639-2639
Contractor:
JT ROTH CONSTRUCTION INC
12600 SW 72ND AVE STE 200
TIGARD, OR 97223
Phone: 639-2639
Reg #: LIC 31700
This Certificate grants occupancy of the above referenced building or portion thereof and
confirms that the building has been inspected for compliance with the State of Oregon
Specialty Codes for the group, occupancy, and use under which the referenced permit was
issue
BUIL ING INSPECTOR BUILDINh, OFFICIAL
POST IN CONSPICUOUS PLACE
moi.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BUP !JP- 00-06/4'
Date Requested /Z A _PM
Location��12 7)�� Oji,,/ G Suite _ Mt
Contact Person ,/ T Ro Ph PLM —
Contractor__ Ph SWR
BUILDING-_)' Tenant/Owner EI_C
e aining 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 ! fj �/ T
Roo
p'd Ceiling --
Roof
FaST ---
PART FAIL ---
MBING
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
n_ Low Voltage
N Fire Alarm -_ - - - --- --- --- -
Final
PASS PART FAIL
SITE
ca Backfill/Grading -- ---_� --
i Sanitary Sewer
I1' Storm Drain ( )Reinspection fee of$_ _required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd
.J
Catch Basin Please call for reins ection RE:
Fire Supply Line p )Unable to inspect-no access
ADA
Approach/Sidewalk Other Date _ spector7J- I Ext
Final
PASS PART FAIL DO NOT REM-VE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4'175 Business Line: 639-4171
BUP
Date Requested /00 AM.-_ PM BD
L
Location 12.- J (o Suite MEC
Contact Person �� �?� – Ph � �� �� 7 PLM r
Contractor Ph SWR
UILDIN Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: — ---
Slab _ SIT
Post& Beam - ---
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Firs Sprinkler
Fire Alarm
Susp'd Ceiling _ --
Roof —
Mi c.
i
Ap PART FAIL ----RttMBING
Post& Beam -
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final —
PASS PART FAIL
MECHANICAL
Post& Beam
Rough In
Gas Line - ---- --------
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL_ - -- _ - -
Service
Rough In
UG/Slab
Low Voltage —
i Fire Alarm
Final
PASS PART FAIL -_---
SITE
c�
Backfill/Grading
Sanitary Sewer
Storm Drain [ ) Reinspection fee of$— _ required before next inspection Pqy at City Hall, 13125 SW Hall Blvd
Catch Basin [ )Please call for reinspection RE: [ 1 Unable to inspect-no access
Fire Supply Line
ADA /
Approach/Sidewalk DateIII) Inspector +� Ext
Other
Final
PASS _PART FAIL DO NOT REMOVE this inspection record from the job site.
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