11210 SW 84TH AVENUE 1
V
C
�D
11210 SW 84"' Avenue
al ��D MASTER PERMIT'
CITY OF
T PErmlT #: MST2002-00186
DEVELOPMENT SERVICES DATE ISSUED: 4/15/02
- Aill 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 11210 SW 54TH AVE PARCEL: 1 S136Cl3-1040(,
SUBDIVISION: ASH CREEK MEADOWS ZONING: R-7
BLOCK: LOT: 008 JURISDICTION: TIG
REMARKS: New SF detached residence. Path 1
BUILDING _
REISSUE STORIES'. FLOOR AREAS REQUIRED SETBACKS RECUIRED
CI.ASS OF WORK: NEW HEIGHT. .-. FIRST: 83b of BASEMENT: of LEFT: 5 SMOKE DETECTORS. 'r
TYPE Or USE: SF FLOOR LOAD. v SECOND: 1.113 of GARAGE. 460 of FRONT: 20 PARKING SP.CES
TYPE OF CONST5N DWELLING UNITS: I FINBSMENT: at NIGHT: F
VALUE: S 187,436.80
OCCUPANCY GRP: R3 BDRM. t BATH: TOTAL: '.94900 of REAR: 46
PLUMBING
SINKS. I WATER CLOSETS: 7 W,ISHINU MACH: I LAUNDRY TRAYS: RAIN DRAIN: •00 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER,'.ES: Ino SF RAIN DRAINS: 1 CATCH BASINS:
TUBISIIOWERS: Z GAR9AGE')ISP: i WATEI'HEATERS: I WATER LINES: 100 BCKFLW PREVNTR: I GREASE T RAPS.
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN c 100K: 1 BOILICMP,3HP: VENT FANS: 5 CLOTHES DRYER: I
GAS FURN�-100K: UNI1 HEATERS HOODS: i OTHER UNITS: I
MAX iNP hit. FLOOR FURNANCES, VENTS: I WOODSTOVES: GAS OUTLETS: I
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: I 0 200 amp: 0 200 amp. WIS'/C OR FDR: I PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 5005F: 3 201 400 amu 201 400 ani)) tatWlO SVCIFDR: (11! SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 am„ 401 600 amp: EA ADDL SR CIR: SIGNAL/PANEL; IN PLANT:
MANU HMISVCIFDR: 601 • 1000 atilt), 601.ampa•1000v: MINOR LABEL:
1000+amplvolt: PLAN AFVIEW SECTION
Reconnect only: �.4 RES UNITS: SVCIFDRI-225 A.: >600 V NOMINAL: CLS AREAISPC OCC'.
ELECTRICAL.•RESTRICTED ENERGY
A.SF RESIDENTIAL O.t.;UMMERCIAL
AUDIO&STEREO VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOMIPAGINO: OUTDOOR LNDSC LT:
BURGLAR ALARM. OTH: BOILER: HVAC: :ANDSCAPE'IRRtO: PROTECTIVE SIONL:
GARAGE OPENER. CLOCK- INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATAn Et L COMM: NURSE CALLS: OT AL N SYSTEMS:
TOTAL FEES: $ 6,759.33
Owner: Coid,actor: This permit Is subject to the regulations Contained in the
ESLINGER BUILDERS INC ESLINGER BUILDERS INC Tigard Municipal Code,State of OR. Specialty Godes and
11575 SW PACIFIC HWY 11575 SW PACIFIC HWY all other applicable laws. All work will be done In
PMB160 TIGARD,OR 97223 accordance with approved plans. This permit will expire if
TIGARD,OR 97223 work Is not started within 180 days Of Issuance,or If the
work is suspended for more than 180 days. ATTENTION:
Phone: Phone. Oregon!aW requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Reg N: LIC 6236:7 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
Erosion Control In..p 8, Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final
Sewer Inspection Underfloor insulation Plumb Top Out Exterior Sheathing InRf Rain drain Insp Plumb Final
Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Final inspection
Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Line Insp Appr/Sdwlk Insp
Post/Beam btructural PLM/Underfloor Framing Insp Gas Fireplace Electrical Final
Issued By : _�r� ALh Permittee Signature
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next bush dry
__S��RCONNECTIDNPERMIT
CITY OF TIC�ARD _
DEVELOPMENT SERVICES PERMIT#: 515/02 �Ui32
DATE ISSUED: 4/15/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
PARCEL: 1 S136CB-10400
SITE ADDRESS; 11210 SW 84TH AVE
SUBDIVISION: ASH CREEK MEADOWS ZONING: R-7
BLOCK: LOT: 008 JURISDICTION: TIG
"TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL. TYPE: L.TPSWR IMPERV SURFACE:
Rem-irks: Sewer annection permit for new SF detached residence.
Owner: _ �__� FEES
ESLINGER BUILDERS INC Type By Date Amount Receipt
11575 SW PACIFIC HWY,
M6160 PRMT CTR 4115102 $2,300.00 27200200000
IGARDP
TMB,I60 OR 97223 /NSP CTR 4/15/02 $35.00 27200200000
Phone: 503-620-9515 TotalA $2,335.00
Contractor:
Phone:
Reg#:
Required Inspections
This Applicant agrees to comply vJth all the rules and regulations of the Unified Sewage Agency. The permit expires 180
days from the date issuers. The totel amount paid will be forfeited if the permit expires. The Agency does not guarantee
the accuracy of the side sewer laterals. If the sewer Is not located at the measurement given, the Installer shAll prospect
3 feet in all directions from the distance given. If not so located, the Installer shall purchase a"Tap and Side Sewer" Perm
i
,1�?' .1 -
Issued by:, i .z� Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an Inspection needed the next buslne day
City Of Tigard --- I)alereceivcd� y Iler111il11o.p—
' �rV 1'rnjecl/app;.nn: Expire(late:
CiryD(•1811rd Address: 13125 S• 11,111 Illvd,Tigan;,OR 97223
Phone: (503) 639.41'11 Date issued: Ily Receipt n(:.
f'ax: (503) 598-1960 RECEH YV I;Ise life no.: I'aynleullype:
Land Ilse approval: - 1&2 ratnily:siuyric Complex:
U I &.2 famil dwelling�an accessul 1
Y 6 Y ,�sls�'!M t'l,Y�,r►+,u�lh�upal�l�aalf i 1 r.111li. i,�l�u�y ��Ncw cunsuucliun U f)cnmliliun
U Addilion/Sheraliun/replacentenl Il 1nt11rovenlcul to I ttr %pluii,l l/, Inlnl U Other:
Job address: JjZjLj SI,) b4 — u_> 0 rt- ef 1I (31(18.no.: Soile no.:
_Lal: 8 1 Illock: jSubdivision: w �w T'I•ax nlap/lax fol/Ilccoutll no.: 1��3_6cg ,
Prnjcel name: -yam 2 -� 1 �I_ 10`46110
Dascriplion and location of*work on premises/special conditions:
M1101 1 111
N � 1
INS 1101
I I Ill Fill
1011111 AM-0
f _
Moiling oddress:1J� �"� � -.! dw �Y.l:I_lti�s,,._ t & ; Inulily dnvlling:
City: Stau:: 'l.II'
3s^_.r Q1. .�3 vtdn,l !„n ar walk.. ..................................... .1391sLe- --
I'honc: lanx: J=1 i-nlSil: (.� z
No.of bedrooms/baths.................................
Ownel's replesenlSlive: Willb
Q ____W( _ l P r— 'I'ulrll nunlllrr of hours............. ...................
__ _ L. L
/S Ittlx: (, I. 1,i nl:
New dwelling wren(x11. 11.) ................ .
(;Imigc/cmpurl ineil(till. IL).........................
Suva(s(1. I1.) .... .. . . .. . . ... L f�.
NaiIn11,plhhr ', ,r y 1 tach Stun(sy. IL) .. .
I'uY. SISIc: ZIP: OIblrtiuucillreSrvS(sq. I't.).........................
I'llunv: laax: _ ll-nmil: --' Cunlulcrciul/hldnslrisll/undli-fuulilyt
Valuation of work....................................•...
Fxislin,,bldg. ill-ell Oil. ft.) .....................•.... --
Ihtsi11ess neat(: .-.S �n ------.- -- .. --
1.�._ �•I� f� _SCI G.,
Address: Ili-ell, New bld". Ili-ell(sq. fl.)
__ _Y)'►�1�. •,f. I)0 _ •...............................
Oily: tilalr /ISI; -- 1Junllu r of stories . .......................... —�------
_ ypc.1,l cun.ruoctlon........ ...................... . ..
hone: I :x: I I .Ilei'. --------._—
C��l no.: - — Occupancy group(s): FIlisling.
New:
City/ tell;tic. nl' Nolice:All contractors and subcommclors are n•Iluired to he
lit vlv;vd Willi the Oregon C ollmluclion C'Dnum Inls lit ud undo I
II �; l(�"l' J , In,lvl.illus of ORS 701 and Indy be requilvd ID Ill- licvnsvll In III,-
- >< �t_ __ __)_ .�._— L: lltv,dll lion when. work is being performed. II Ili(, nppllcam is
Address: - �,.--�- i
712. 1a1 r�r� ��trt _v__
City: CI � L '� Slii v. l.11': vxcnyrl bunt licensing,the following reason epphvs:
Pta car --
I'In�u
(�nllacl pets""�...dJ.�Z.1C_�_ Vveslluv upon application ..............•....•....... _ --- --
AllJm•, _il 11 _, 1.1 - 0111 (y1.►c It;uvlvcclved.
Illy .I'llr /II'. Auunudllrch ll .. .......... ..... ............•... . 1.
I'hluu' I I .I, I I aunt I'Ic l,r Irli•I lit lvv ;ncvdnll
llvlt'lly(•1.111(y I haVl.• Ivild allll cili1111I1led this appbl'fllioll Ilul(l the Nin all Imimhoowlt llcteln 11011 twill,please 1,111 p1,udu tum Im uwic 10114111-1 noi
11nached checl.Ir;t. All pluvnulrns of laws and uldinnnces gumming Ihiv U vl,n U l"ImIrICold
wank will be complied MtMA
cilled therein ill not. (•ICI1li I lud 11111111M1, --__ __�_._,_.�.___
AnIhorized sl nalme. Date: �210 L h _ __ ___ _._ Nonle/l'IIIII 11;11111.:_ill �_lILt".0 F_'- __ _ __._.�._.('pldholiieriltnoiure_ — S—Amuum
NnlIce•'I his pernlil applicnliau expires iI'll pel ISI 11411 obtained within I NO days Sher it 1111.4 been accepted ns complete I Ia.Int(ltnawl non
I'll 10111 bill ly Permit Application
��lt�' Ol rrl�*7C(�
� -- -Dmercccived: 1'rnniluo.:ry1_T - _ 0
Address: 131:!5 SW hall L;IvJ, I'ignrd,OIZ 9722] Sewerpennitno.: _ Building permit no.:
City oj7igord I'llonc: 503 639A.(71 Project/@ I.no.:
( ) PP Cxpircdatc:
Fax: (503) 598-11960 bnteIssued:
9y: Receipt no.;
Land USC a111)1.ova1: _..,_-_ Case rile no.: Payment type:
r
U 1 &2 family dwelling or acres..ory U C'III- 'elcial oldusltial U Multi-family U•Tenant improvement
r4iNew construction U Addntotl/al(crauull/rcl)lacctllenl U Fo(XI service U Wier: _
INFORMATION
4A#
1 t t t
11011 aJ(h'CSx: 'IZIt7 (�' �y
hSte(_ 71LI _ Total
pIdg.no.: w l - ry dwellings Il only.
Tax mnp/tnx lol/aCCOulll no.: — (IrlcludL4900 ft.for each lit INIyConnect foil)
[AA: IllnCk: subdi SFI((1)bath
S lision: Ittk Mevdaws til;l((2)bath —_.-
Projec:nan1J: lei ,s rhe?(3)bndt
Chy/county- 7.111: Each a ihonal ba ✓kitchen - -
Description and I atlon of wotk on plcrnises: Slfeultlllles:
lU1M1_ S L--'1A 14 ( Catch hasin/area(train
Mt.date of completion/inspection: -3 0 bryweh Iii Iinchtench min
lumillmliell 1 hooting dfaln(no. lin. fl.)
flusi"css oriole: V_(-)(1 K' alt tl�Yll�t- ( anal ufacturc(I home ulilltics
J CF
R Man tole@
Address: 1`)•L H� �C L
Rain drain connector
Cily: Slate:L . ZIRC I-I JAIJ _ Sanitary sewer(no.Ito.fl)
Phone: 4c� 1rax:���, 1�1`�Z H-mail: � Sloan sewer(no.lin. ft.)
CCU no.: �,j (( Plumb.hllx.lLg.nt —� �Vu'cr service(no.ilio. ft.) —
City/nlchu lic.no.: L1 hlxlorc or III-Ill:
U011(m hlr's representative sign_all1re' "` A_11x1»jrlion valor. __
Pliot nnnu: = — --- — Ilnck ow 1f�--icvcn(cr
hall+.1U ? 'x( 11 Ilnckwatervalve
LL
1 Uasins/Inv�alo�_
Name: L1LL�' Clot les wns ted ---
_Address: _ _ _ �— i ►:;allwas leer—
_City: . Slate: — ZI : I ng founla n(s) —
I'llonc:
Pax: E.-Ill1?cctors/sum l
nil: i'z allslon tank -'
1*1>,tur sewer cop
Name(print): E t I i Z u, hoar c ra nNfloor sin mb
Mailing address: 115 5 -/ C)a agc dis-mal —
City: Slate: 7.,11': ose b b 1 —
7ccmn cTt r
1'honc: -q 51 hnx:r�2 CJ-'It F-mail: nlchcc forroa r trail
Owner installaliorllresidenlial nlaintCnancc only: 'The actual installation 1'rimer(s) g �
will be mode by No or the mainlcnanec and repair nlnde by my regular Roof ruin(colnulelcinl)
employee on the property 1 own ns per ORS Chapter 447. Sin a , ln9
Ownces si nature: Date:
Itlwer/showel pall —
Name: �( tlliital —
Addr•:xs: —-- —�
Cal — --___.___ \Valrt Ilt•utt•1 __ -- -
phone:
Na PJ11u1411cUau @Deet,c"t w14,p1tLe C@It 1W411,11(,1 IQ Itumr IntWttuilm Millinllllll fee................
U Vise U MaslerCud Notice:Uls pennil npplicaliun 1 -
expires if n pennil Is tint uhtained I Inn review(at — %)
rinlu ead numlter: _ —.I It/ within 180 days rifler it has been Stole surcharge(11%) ....$ _
--1+st ore ro u Zlown nn e u er I accepted as compiele. '1.O7'AL .......................$
- S
C'@rJf�t r s fie i n�lu►e— —ITm'ounl�_
440 4616(WI COM)
r
Mechanical Permit Application
Ua'.CIeceived: Permit Im.ij))'S
City of Tigard and prgjecUappl.no.: Expiredate: -
['i(yn(Tigurd Address: 1 1125 SW I hall Sllvd,Tigaed,Olt 97221 —
Phune; l`I,1 i) (1 19.417 i L);dc ixxucll ^- hy: Kcccipl nn.
1;;Ix: (50i I Y)X 1900 (':Ise IHe no.: - Payment type:
Itnildinl,pernlil Ito
�._ ►
U i k 2 family dwelling or accessory L! 'u Itnlcr(ial tl; l ,,;,1 U Mulli-I'iunily U Tema+' 'mpruvemenl
�Nrt"lou slrnrtitai IJ ntltlililm/allrl,.Ilunht•Irin�rnu til 1-1011 cr:_
I t e 1 1 1
I'd)addi t k, O? , C)(L `l 7 22,3 Indic;uc cquipnll'nq
t uanlities in cs buxhch)W. Intlicille the dolho
11ldg. no.: Suitelite nvalve of all nle;]Imlical lunletials,cyuipnicIII,Inbar,ovclllcnd,
Tax mall/lax lot/liccounl no.: I profit. Value') - --- --
Block: _�liubdivisioll" �._�x�� 0`;�t- ,h, klisl lar iu�l,tlmmi ;:;Illllr.atiuu illforwalion mill
I'lojeclnanlc: 11-1 r�cy _ julr. li, i nl'; lvc ;I Llilul Ila 11 •id'•nliai pelnlil frc.
Pity/cuunly: �c,'C.l1 YC _ ZIP: �. � 1 �: .fr r 1
DC';C i thou a:Id ht cytlinn 1 I wrrrk on plenljscs: 1 ► ► r 1 1
} 1 J
-_��1.� ��+ 'L.�ti�EU,-[.�3�!'.i:k_� -Y t�• I1., 1 1111;I
I{sl.dale ul•coluplelion inspection • .ate�-3�-b2 Ilrsrriplioo c It .unl ItcS.oul)
Tenant improve/1►cnl or change of use: 11VAir A Udliug unit _ CI'M _
Is existing space located ur rondiliontal7 U Yes l]No iliicoallilion-5fv(sire p on rcgliirciT- —Is existing space inculalvd?U Yes U Nu Xhc--Inllnitn ezlslPF/C syslclu -
' Ir 1 -ll'iiiTit7i•innptcsarns
I11151I1CSV IIi1111C: �� ��./ ��i Shale boiler permit no.;
Address:TP.r -
_� y �Ie smoTuiliainpersh oc1 Kn,o'I�l'ctlicu;lg
C'ily:L,p� _ Slalt %11': I0/3 -Iwl puliiji(s 11 r j,ltui icqu i7j- -'-_ - -
I'hnne: illy- lax: 1 -mail: usla l rcl/T urs nuucr_-_Tl1'iT/11--� -
C:CI) no.: blcludilluduclwotithenl liner U Ye.sU.oa
��_t _____ ____ __Txinlihcp nccT JrciacnieTii:nicis-suspendL<h - ---
Cilyintclrn lie.Ilo.: �3;�. __ wall,or flout momiled
Nan,r
(111vase pllnl): -- �-' 1 C ^471 -WI --
p
�n�►►�jtl__iam:eol ter Iiinn Iwnnce
r r lleralioil:
Ahstnplinu units H'I'lJ/I
Wine: f )(v —
I..-_�_ l'riny,ll .in , III'_
t, w 1D✓@ _-e- :nlltuwurnlal l�hotl�l:old vralilalinu:
CAly: I +I;IIr'
'It►IIC: I-ax. I nl.ul lot yrtcxhatim
1 IIIn,TTyjlcl%iIAI .TCilclr.0 mainal ^- ----
1 baud lits' .ul,l trS$1n118ymelll
Name: ' �I l�l�'E?' ... ( trA� 1 �. lixhnust rnn With single duct(bill,fans)
Mailing address iG r4U0 P i�zri�si s alr.nin lml ram heal n+o1 (-`
Cil , ile pl11ng ttnt t sll ul un pill to oul cls)
City: T r r Stnlc: ZIP-:� _�- Type: _--1.110 NO _ Oil
I'hunc: I I"axbJ Q 417 ?-atail: I t-id-Il15 XTRM-u I ovc�ll-iCh- -
t' recess 1111ug(sc lelnnl c reyuit-
Name.: Number of uutlels
-t � --- -- -- Other floilrd apps ante or egti pn�:
�tllhrss _ _
Decorative
fhr�llncc
Slide: /'.II': ,,,sell IYIiv -- -_-- - -
-__--.-- _. -�__.___.-_—__.___ Wi,uilsiu`vcrilali�lsliivli --
I'hnnl•
' Olhrl:
,11111,1 n1t1 •,I;�n tlult 11n1t 3 vb p� 111 Ire: — -`
Nunn (ptnul r!Q Wt ,,r_ f 4-eI�" - ---- _
Nul all it I.IW.,Ilam"A.ept rlrll1l(VI IIA.IIIc IIIc call loll IM lit dolt 1111 It"I.e IIIto M111111i1II, ('rl1111) Il t .......
Nulicc, s pcuutl apphrnutul
UVIsn UMnsIclClnd Nlnunuun It•c................'(, -_-- _
('Irdll card voider ._--_���_��—_�._ t xltlllx II 11 ltelllld 15 11111
1
oII rq
'I;ul levn w
- 'yilir�
within Igo days nllcr it hasbinim Uc.l, Slate stuchalge(R9f)) .... ._
Nmnr al reilliiu I i ai rTnwll eu eta 1 cull-- -_ Ilceepled a%volnplele TO'1'AI. ......�I
--I ;n�Pn�l Irl Ilr,a1 r Mnowll_ 4 111 4611 1tIANWI IMI)
lJlcctric.a.l PerinitApplicat10I1
/. — Dmercccived: I'cnnil na.:hljT a� - DGl 6
Clay Of "Figard I'rojcct/appl.lim: -- Unpile dale:
r.;ry,l�r;,;herr Address: 13125 SW IIill Itivll,'I igard,()It 97223
Dale issued: l
Phone: (503) 639.4171 _ !1y. —1 ItecclplOo.:
Fax: (501) 598-1960 Case file no.: Payment type:
Lalltl uric approval: — -- — - --
ZKNtvTYPE 1
ly dwelling or accessory U Commercial indusnlal U Mulli-family U'I'ennnl impr venlent
niclion l Ad(Iitionlahrratiouhcpl,uxmrnl C_l 011ier: U Partial
11 .�IITEJNFORMATION
411 address: I I Z.I O St,J $�_ c, ,
DIL ,7t1; Itlrl� nn.: Suile no.: Tnx 11111 tax lol/1lccotlnl on.:
I.ol: 8 filock: S(IIIJivWor�: /.5`L�C SIC rlcwdowl__ — —
�� IL�--. .
projcd nnnlc: A.16 C r s_4'K Description and localion of work on premises: Ne , —"
LstinlntcJ dale of amy,lclion/iuspcclion: gtg= -7_ 3�_0Z
I p 1
Job ale: W7111 I TT 4
3ttsirless rlirtlf": [) , n, ,J p r o gLtt I ] c .r i Description Qly. (en.) I 'thiol uA,his
Address: pQ Box 7J1 New resirknlizl-dnglcormulli-fandlylrl
— dfvcllingunil.InclullesatIndeedgarage.
City: FIi] ] 'r b 0 r 0 Stolle '
Q � 'LII �7 12 Q 5crvicelnrindrd:
Phalle: 6 4 8- 514 4 1'ax: 6 4 9 7 Vit:-n►nil; I WO sq.11.o,less 4
CC13 no.: o(jQ J 1 tilde.bus. lic,no: 3 4-119 Each nddidollal 500 sq.f1.or portion nlcrr.
II.hnited energy, eidenalCIlyJlllcfIf(:.11.: 1Q63 2
.imilyd energy,nnn.resfdcnlinl
� _ I nr 11 wanufachrrcd home or modular dwelling
Slgnnlure of sufpclvisinl c cclricinn(Icquind) _ I)ntr.�- — `:rlvHr and/nr frcder 2
Sup.elect nnnle(plilll). , , I.iCC11rC sci ell rt of(rNICYa—IINIAIlallall
PR
1 OWNER letter anon or relocation:
201 amps Or less 2
Nnmr(pr(nl): t 1. 1,.. I JAI.,„, I,�C 701 strips to 400 amps 2
Mailing address: � �eCl V 1 lM r 1 401 tempo to 600 tempo — — _ 2
--7 2 ---_601 amiss 1n I lith,:vols 2
Cily: � Slate: ZII':q)2 x,"} _ (.ever 1000 amps ur volts 2
I'hon`-;�-•7 e7.eJ51 I'amc.7 U •94175 li roast: Iteccomect only I
Ow:tcr installation- lite installation is being made on properly I own 7•etnporaryaemir"orFeeders-
which is not intended for sale,Icasc,rat,of cxcllnllgc accurdhig lu htslalldlon,allerallau,orreloclellon:
OILS 447,455,479,6.70,701. 201 amps for less 2
201 amps In 4(0 tenq,s — 2
.
Owne''s signllh►rc: hale: _
_201 refills
--- — —_
— '1
Branch cltrUhs-or 11,alter al ion,
Na111C: N/ — oreettenteliell lire
'_---' -- A. Fee Ire 111Nil Ir,it,orfs 1NIl,pul,llacr o1
Address: _ nelvicf•of feeder lee,cold))ranch r r(un
_ _ 1
Oily: --- SUllr --f jll/;--� _ N. pee flet)ranch chcuils svflhnutpurchase — -
('�utte until; Of service of(cr,lei fee,first)tmu•h clrcult: 2
Each addilional)I undh circuli
Mlse.(Service or fredernot included):
U Service Over 225 angfs mlmnclrlsl 1r41111 cnlr.ladlily finch puny,nl inignlion circle 2
U 5etvlcrover 1)onngfs la'ingof lh2 U llnrmdouslucatifln I a,h stento lnnlinr hl,hring 2
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LOT 8 ASH CREEK MEADOWS
WASHINGTON COUNTY
MAP 15136CB-1000
ZONING R7 I.,OT SQ. FT. 5000
11210 SW 84TI-I AVE.
TIGARD;OR
LSLINGER BUILDERS, INC. (503-620-9515)
11575 S W PACIFIC HWY, PMB i JO
TIGARD, Olt 97223
CITY OF T'IGA►RD 24-Hour
BUILDING Inspection Line: (503) 639-4175
INSPECTION DIVISION Busines;Line: (543) 639-417' MST
Q
L--
Received __ Date Requested BLIPP
AM PM
BBLIP- — —_
Location --� Suite_ MEC -
- � _. _ -
- - -
Contact arson __ _ Ph(_ ) _ - _� � PLM
Ph SVIIR
7hh
- _ - —
ING Tenant%Owner -
- ELCation Access: ELC
nin / �Q
rain (� ._- �� ELR Inspection Notes: SITBeam nchorsath/Shearath/Shear
g -
Insulation
Drywall Nailing
Firewall ----------_.—_
Fire Sprinkler —--- _
Fire Alarm -�
Susp'd Ceilinq — —
Roof -- -
Wi
' SSS PART FAIL
Post$ Beam
Under Slab
9ough-In
Vater Service
Sanitary Sewer _--
Rain Drains --
Catch Basin/Me,ihole
Storm Drain ----
Shuwer Pan —
Other:—, -----
Final
P T FAIL
ECHANICAL
Rough-In
Gas Line __.._---.--__-_--
Smoke Dampers —_
PAS PART FAIL
E RICAL
Service ----- _—�— — _ -_--
Rough•In ------- ---- -- _______
Uta/Slab _.. --------- —__
Low Voltage - `--
Fire Alarm —_--- -- ----_-- - --------
Final Reins --
PASS PART FAIL pection fee of$ _--_ required before next inspection. Fay at City Hall, 13125 SW Hall Blvd.
9 - please call for reinspec!;on RE:
Fire Supply Line ------- �_� Unable to Inspect-no access
ADA n
Approach/Sidewalk Date � LI�---__.�.. I11spRctor
Other: EX!
Final DO NOT REMOVE this Inspection record froln the job site.
PASS PART FAIL
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CITY OF TIGARD 24-Hour
8:1 :)ING 4Inspection Line: (503) 639-4175 ,
INSPECTION DIVISION Business Line: (503) 639-4171 MST t_'
BLIPReceived _ / l _- - Date Requested Z /(� _ AM - PM BUP _
Location I Suite - MEC —
Contact Person _ — _ — Ph(-_ -_) -.�'/'-�/ PLM
Contractor — _---- Ph (A_. _-_-) SWR
BUILDING TenanUOwne --_-___. ELC
Footing
Foundation Access:
C --
Ftg Drain L6 ELR
Cr,.vl Drain `--
Slab Inspection Notes: SIT _
Post&Beam
Shear Anchors -
Ext Sheath/Shear
i
Int Sheath/Shear -
Framing
InSL"-lion -
Drj v&d,4;ging
Firew. p
Fire Sprinkler
Fire Alarm
Susp'd Ceiling ���=►-v1G�
Roof
Other:
Final
PASS PART FAIL `
PLUMBING
Post&Beam •--_------- ---- -- .—_ _�--..--
Under Slab
Water Service ��� � ' � ,5
an ,,y Sewer
R
Rain Drains
Catch Basin/Manhole
Storm Drain -- --- _
Shower Pan
Other: --- -- - -
Final Y
PASS PART FA-11L.—
MECHANICAL
AILMECHANICAL
Post&Beam
Rough-In I
Gas Line
Smuke Dampers —
Final
PASS PART FAIL ------ -- -- - ___—�_
ELECTRICAL
Service _ - —
Rough-In
UG/Slab — - --
Low Voltage
tFemReinspection fee of$_____ required before next inspection. Pay at City Hall. 13125 SW Hall Blvd.
PART FAIL
_ Please call for reinspection RE:—.----_ ❑ Unable to inspect -no access
Fire Supply Line
ADA ,
Approach/Sidewalk Date = C C_- Inspect lw" a-`-- Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD 14-Hour
BUILDING Inspection Line: (503) 639-4175 MST _ r �
INSPECTION DIVISION Business Line: (503) 639-4171
B U P
Received --------.--- Date Re :e ted _. - AM _- PM __- - - BLIP
Location - l� ' Suite MEG
Contact Person __ Com — Ph( ) I r PLM - - -
Contractor-_ - -- - -_-- ---- Ph(--) _ SNR - -
BUILDING TenanUOwner _--__ _ ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors - --
Ext Sheath/Shear
Int Sheath/Shear
Framing —_-
Insulation
Drywall Nailing
Firevrail
Fite Sprinkler
Fire Alarm
Susp'd Ceiling
Root
Other:
Final
PASS PART FAIL -
PLUMBING
Post&Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain __.__
Shower Pan
Otber:__._�--- ----- ---
PAS PART FAIL
-NWANICAL —
Post& Beam
Rough-In -- ---- - -- - --- - -
Gas Line
Smoke Dampers -------
Final
PASS PART FAIL
ELECTRICAL
Service ---
Rough-In
UG/Slab
Low Voltage
Fire Alarm - ----------_—._ - - - ---------...----
Final Reins action fee of$_..
PASS PART FAIL [� p ---- required before next inspection. Pay at City Nall, 13125 SW Hall Blvd.
SITE - [ Please call for reinspection RE: --. F� Unable to Inspect-no access
Fire Supply Llne
ADA )
Approach/Sidewalk Onto ta- Inspector
Other:
Final --- DO NOT REMOVE this Inspection record from the jab site.
PASS MART FAIL