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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP
Date Requested AM PM BLD
Location �i1 -Suite MEC
Contact Person Ph — PLM
Contractor Ph _ — SWR
C3!IIL6IMG —^- Tenant/Owner ELC
Retaining Wall ELR _--
Fjotng
� iA.ceess: FPS
Foundation c' �� t �v�J`�(I i
Ftg Drain SCGN
Crawl Drain "'ot Requested - -
Slab Found During Research - SIT
Post& Beam
Ext Sheath/Shear No Inki cectinn(s) in File — ---In,Sheath/Shear
Fr sming --------
Inculation i
Dryw,Il Nailing I -- - ----- -- - — -- --__- ----- -
Fireviall
Fire Sprinkler —_-----_____.- ------- .____.._.._-_-.------_.-_-- —
Fire Alarm
Susp'd Ceiling I --- ---- -- -— -_.... - -- ----- _ — --.- — — -----
Roof
Misc:_ ----- ---- ---- ---- --- --- -- -----_
Final _ --
PASS PART FAIL ----- __ _--- - ---------- --- - - --- ------ -
PLUMBING ,
Post& Beam _'.'_-� _..----------..-..-------_._- -------- --___ -------
Under Slab
Top Out
Watar Service
Sanitary Sewer
Rain Drains
-------- ------- .__-______ - -----
Final
PASS PART _FAIL __ ------ -------------- ----- --- - ---
MECHAMICAL
Post& Beam — - ----- --------- --- --- —
In
Gas Li
Gas Line - -_ _------- -
Smoke Dampers
Final -------------
PASS PART FAIL
ELECTRICAL -- ----__ _ _ _ - _ —--------- — -- - --
R Service ---- - —
Rough In
UG/Slab
Low Voltage
J Fire Alarm - - -- - _-__---- — - —.—
r� Final
co PASS PART FAIL --
`�' SITE
.J
Bacn`i!I/Grading --
Sanitary .'ewer
Storm Dram [ J Reinspection fee of$_- —required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Besin
Fire Sur)ply Line [ J Please call for reinspection RIF: _ — _ _-__- - [ J Unable to inspect-no access
ADA
Approach/Sidewalk Date Inspector_ Ext
Other _ - ---- -
Final
PASS PART FAL.. DO W)T REMOVE this inspection record from the job site.
s
BUILDING PERMIT
#. . . . . . : -
CITY OFTIGARD DMEPERMIT ISSUED; . 02/27/96BUP9F, -0075
COMMUNITY DEVELOPMENT DEPARTMEN7 Pi7iRCE'_: 2S110AD-000*73
13125 SW Hall Blvd.Tigard,Oregon 97223*6199 (503)639.4171
i ;-. Ii 'ij i 6-:J .;. . . . I,+ ; Lt. j � . I i! w I . -
SUBDIVISION. . . . :
-SUBDIVISION. . . . CANTERBURY WOODS CONDOMINIUM ZONING: R-12
LOI.. . . . . . . . . . . . . ....7,
RE15GUE: FLOOR AREAS—- EXTERIOR WALL C0N5TI`%L1r , IOI`1
CLASS OF WORK. -.RE ' FIRST. . . . 0 Sf N: S:: E: W-
TYPE OF USE. . . :MF -IECOND. 0 Sf PROTECT OPENINGS?——
TYPE OF CONST. :5N . . . 0 Sf N.- S: E W:
OCCUPANLY GRP. :R3 TOTAL--_.__.I
IZI Sf ROOF CONST: FIRE RET? :
OCCUPANCY LOAD: 0 BASEMENT. : 0 Sf AREA SEP. RATED:
STOR. : 0 HT ; 0 I:t GARAGE— : 0 Sf OCCU SEP. RATED:
Bpm" MEZZ?6 REVD SETBACKS--
FLOOR LOAD. . . . : 0 p s f L1-FI": 0 ft RMAT., 0 ft FIR SPI.L : SIYIO'1 DET. . .
DWELLING UNITS: la FENT: 0 ft REAR: 0 ft FIR ALRM: HNDICPI PIC-
BEURMS: lil BATI-16: 0 IMP, 5URFr4Cl[.z*.,,, 0 -'RO CORP: PARKING . 0
VAw-UL-. $ : :SLIOO
Rem.xks : Rppa.ii- dtte to stur-m ciamage. No fee assessed. Condo 1OWel' unit.
3WT)El " : ---...._.__...._1- . ...-..... -- ---_.1...._.--..- -----.- ---------------- rEEG
EVF.*.SETT HEWLAND type .111OUnt by date recpf
1 .988 SW 1MTH PrLmT t o. i-210 JSD 012.,/115/96 STORI-0
TIGARD OR 97223
pt-lt.mq 4:
HORIZON RESTORAI'lONG
161-/b SW 72ND AVLNUE
T'IG"RD OR $7224
Phone #; 503--6,:0- 2215 $ 0. 00 l'OT(IL
Hey #. . . 46081
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Fi-miiig Irisp
1,gard MUNCIPA! Lode, State o' Ore. Specialty Lodes and all other lns,.t.iatiun Ititip
applicable fats. All work will be Joni in accordance with Gyp Doat,d Iiisp
approved plays. This pew-sit will expire if work is not started Firial Inspec:tic)n
within 160 pays of issuance, or if work is suspended for sort
thar 180 days.
li7lLued By :
Lai I fut, inspectii t) 6.39--4175
OCW
ggrftmeircial Building Permit Application
City uk' Tigard
'13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address: i Ct cJ Lt J 10-1
Tenant: _ Suite# Office Use Only
— Planck/Rec# A
Val��ation: _ �� 1(�
Permit# _
�49r. v L _) '%u '� u �.r I Map & TL#
Address: ) 1A, { 9 U `� L) _i �� C� _—. Approvals Required
1 y cl 12 2-
�''
�' -- Planning _ _
Phone: _ Engineering
Other
�� --
Contractor: l "ZOO �P)C C, CL'�r 0�
Address: CD
�
j Cq Type of const:
� 77Z�l
Occupancy class:
Phone: ._�Q�._`: �—_2-� e--, _.�y
Sprinklered? es No
Contractor's License j ;`. --
(attach(( copy, off curren.' Oreg.)n license) Sq ft. of project:
Contact name & phone: �n-CS, y` �,1�1(� r.c_� _ Story ('ist, 2nd, etc.)
Arch itect/EngineEr: Proposed use: —_--.- —
�.� iy�t'EC l !'�!r�i��,5
Prwious use:
Address
1 �, Note: Plumbing & mechanical pla�is
Ln P-+ (6, C), -T 1 Z o_Q must be submitted at time of
v building p, nit application.
Phone.
J
CO
L JOB DESCRIPTION: .I'M rai 1J t (
(A'1�_)X r(
Applicant Signature Phone number
Received by: _ Date Received:
permit Account Description Amount Amt. Pd. Bal. Due
Bldg. Permit (BUILD) -
Plumb. Permit (PLUMB) _
Mech. Permit (MECN)
State Tax (TAX) _--
Bldq:
Plumb:
Mech:
Plan Check (PLANCK)
Bldg: _
Plumb:
Mech:
Server Connection (SWUSA)
Sewer Inspection (SWINSP)
Park- Dev Charge (PKSDC) _
Residential TIF (TIF-R)
Marr. Tiansit TIF (TIF-M-r)
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF ;TIF-IS)
Office TIF (TIF-0)
Water Ouaiity (WQUAL) _
Water Quantity (WQUANT) [/
h
:. Fire Life Safety (FLS)
Erosion Cntrl Permit (ERPRMT)
Erosion PlanckJUSA (ERPLAN) S
Liosion Planck/COT (EROSN)
TOTALS:
CITY OF TIGAF 0 BUILDING IWSPEC T ION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 [[B``ullsiiness Phone. 639-4171
Inspection-
Footing Susp. Coiling
� Sprink. Fough-in r,r/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough in FINAL:
Post/seam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Rd. Elect.
Date Requested;_ - Time: AM PM
Address: 09{ _
Builder: Permit q:
THE FOLLOWING CORREC– -)NS ARE REQUIRED:
Civ v4 L
LAA-
.J
T '
lnspector. �'�---�'"""� Date:_kL _ —�
y
APPROVcD DISAPPROVE) APPRObED SUBJECT TO AEOVE
/'� J� _Ca:! For Reinsp.
N 4k
• N
City of Tigard, Oregon
Detailed. Damage Assessment Form
BUILDING DESCRIPTION: OVERALL RATING: (Check one)
INSPECTED(Green) ❑
Name: -__-- LIMITED ENTRY (Yellozo) -'Cr
LiNSAFE (Red) ❑
Address: _—� 45 Svc
No.of Stories.__ DATE _ 1 _TIME am
pm
Basement: Yes` No ❑ Unknown ❑
Approximate.Age: years REPORTED BY
Approximate Area: square feet INSPECTION TEAM MEMBERS
Structrral Sy tem:
Wood Frame � Unreinforced masonry L
Reinforced tvlasonry ❑ Tilt-up U - —
Concrete Frame ❑ Concrete Shear Wall U --
Steel Frame ❑ Other
Primary�Occupa�c
Dwellini ,&Other Residential U Commerciai U Notified occupants to vacate
Office O Industrial U Public Assembly U premises U
Occupants indicate temporary Nous:ng
School ❑ Government ❑ Emer.Serv. U is required U
Hospital U Other—
Instructions: Complete building aluation and checklist on next page and then summarize results below.
Posting Exish,ig Recommended—
None U Posted at this Assessment:
Inspected(Green) ❑ U Yes U No
Limited Entry(Yellmo) ❑ � 'IV"6� Existing posting by:
Unsafe(Red) ❑ ❑
Area Unsafe U ❑
l:rcommendations: � — --� �--- _------_ _-- -
- ❑ No further action required
;- ❑ Engineering Evaluation regaired (circle one) Structural Geotechnical Other
;7 Barricades needed in the following areas:
U Other(falling hazard removal,shoring/bracing required,etc.): _
Comments(Why posted Unsafe,etc.): — �'`\- 1
.(C-
C'r O,w.Z'�1 � \art������ ��\ ' "'�A�(i1. � �Q14��• �\'nA� Wet --of
ELECTRICAL PERMIT
-%m,ITY CSF TIGARD DATEIISSUED: 02/09//96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Dragon 07223.8199 (503)839.41%' PARCEL: c:S 1 10AD-901073
Ti
_.. � ` iil.'iJI�:L.a4��. . . 1=1`J�_ii.5 .r�•J 1��'.' i s ♦•-i'Ji.:.
UBDIVISION. . . . : CANT:RE-URY WOOnS CONDOMINIUM ZONlNG: R-1
LOCK. . . . . . . . . . . LOT. . . . , , . . . . . . . : 73
,ro,)ect De scr-i pt i on . INSTAL TWO BRANCH CIRCUITS.
---RE.SIDENTTAI- UNIT----- ---TEMP SRVC/FEEDERS----- -------MISCELLANEOUS---- -
10001 SF OR LESS. . . . : 12) 0 200 Lamp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH AD.)' L_ 500SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 - 600 ramp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 01
MANF. HM/ S:l:/FUR. . : 0 601+anps-10110 volts. : 1h MINOR LABEL ( 10) , . . : 0
....--.---;3ERV10E/FEEDER.__.__._ -___.__BRC'4NCH CIRCUITG--------- --.---ADD' L INSPECTIONS —
0 -- 200 amp. . . . . . : 0 W/SERV:iCE OR FEEDER: 0 PER INSPECTION. . . . . : 0
201 �-- 1,0,0 'amp. . . . . . : 0 1st W/0 SR JC OR FDI;. : 1 PER HOUR. . . . . . . . . . . . 0
401 1,00 amp. . . . . . : 0 EA ADn' L BRNCH CIR:: 1 IN PLANT. . . . . . . . . . . : 0
011. 101100 nmp. . . . . . 0 -- -__. ...__._.._._.____._._FLAid REVIEW bECT,.OKl1 -._ .._.. _._.....___...__._......
L0001+ amp/vVlt. . . . . : 0 ) �4 RES UNITS. . . . . . . . : > E001 VOLT NOMINAL. . :
Rer.:onrect only. . . . . : 0 SV(,/FDPA > = 225 AMPS. . : CLASS AREA/SPEC UCC. :
Uwnpr. --------------------------- ----------------------------- FEES
CANTERBURY WOODS type amol.tnt by date r-ecpt
PRMT $ 401. 00 CJS 02/09/96 96-275792
5P C.T $ a. 00 CJS 0-/09/96 96-27579.:
Phene #:
Cont r^act or:
ROSE-: '_`I TY LLEC TR l C CO INC $ 4C1'. 00 TOTAL
4012 NE CULLY BLVD
------ RE ,1RED INSPECTIONS --- ---
POIRTLOND DIR 97213 E1 ect' 1 Ser-v v �N
Phone #: E 1 t±ct' 1 Final
I?t-g . .
This permit is issued subject to the reg,a ations contained in time _i
Tigard Municipal Ccde, State of Ure. Specialty Coees and all otr.er Permittee Signature
applicable laws. All work will bp done in acca&m� d with
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more -CA12tzar__..,2aCJ�JtttLeY.�
than 160 days. Iss1_ted By
INSTALLATION ONLY __ ......._. .._. ..._
theinstallation is being made on property I own which is not intended
ft
rL .ale, lease, or rent.
Ln ANERIS SIGNATURE:
C0NTRACT0R INSTAL.L 'ATI0N ONLY -_.._...__.._.......__.....__...._.____.._._.__..._____._
J
fGNAT UPE. 0K. SUP R. ELL.0N: Il�A�/�� DATES � _ 9' Sib'
LO
W
Call for- inssppct .lon - 1,39--4175
49t
WA P., I fill P JI'l I
!4 1 0 it 11 I 11 0.100 1.V 1 1.1-01
II v it it 1111 I '� ; il i1{ 11 11 1 1 1 1 1
N 0 1/1111 i
ca
LLJ
ilf-d NMI LION 1 G44111 OV.
Community Development ELECTRICAL PERMIT APPLICAT ION
13125 SW Hall Blvd.
Tigard, OR 9,_23 Planck/Rec. # 96. 2,25 9.
Permit # 01,f9,- -oo yy
Phone (503) 639-4171 Date Issued = y 46
CITY OF TIGARD FAX (503) 684-7297 Issued by _ Shu i-r
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development_ Jai, _ Number of Inspection, "r Fdrmil allowed
Address � r �• � Service included: Items Cost1•a) Sum
City'State/Zip QA 4s. Residential-per unit 4
1000 sq It or leas $110.00 i
Each additional 500 sq It or
Name (or name of bu ' ss) ,
�y�, portion Thereof 1p25 00
CommerciaNL L_ Residential❑ Limded Energy $2500 2
Each Manul'd Home or Modular
Dwelling Service or Feeder $6800
2a. Contractor i stallation only:
4b.Services or Feeders
inatalialwn,elterahon,or relocation 2
Electrical ntractor 200 amps,or lase __ $60 00 2
Addie 201 imps to 4C0 amps $8000
2
Cilfi� Stat ZI ( 401 amps to 600 rvnpe $12000 _ 2
r1 Zip,_j 601 amps to 1000 amps $180.00 2
Phone No. L Over 1000 amps or volts $34000 — 2
Contractor's License No. �R Reconnect only $5000
Contractor's Board Reg. N0. 4c.Temporary Services or Feeders
Inetallation,allegation,or relocation 2
Signature of Si r. Elec'n 200 amps or lase $5000 !_ 2
License No Phone No. 201 amps to 400 amps $7500 2
401 amps to 600 amps $100 00
Over 600 amps io 1010 volts
2b. For owner installations: rise'b'above
4d. Branch Circuits
Print Owner's Name New,niteradon or nxlension per panel
Address at The Ion for branch rarcuits with
City State Zip! purchase of servke or feeder Ars. 2
Each branch cncud $500
Phone No. b)The lee for branch circuits wi"houf
The installation is being made on property I own which is purchase or service or feeder Are. 2
not intended for sale, lease or rent. First branch nmol $35 n0 � 2
Each additional branch olrmit $500 _
Owner's Signature_ _ _ 4e. Miscellaneous
(Service or feeder not included)
3. Flan Review section (if required): Each pump or irrigation crrde $40 00 2
Each sign or outline lighting $4000
Signal cucuil(s)or n limited energy 2
Please check appropriate item and enter fee in section 56. panel alteration it extension $4000 _
4 or more residential units in one structure M-nri Labels(10) $10000
Service and feeder 225 amps or more
System over 600 volts nominal 41. Each additional inspection ovw
N Classified arca or structure containing special occupancy I the allowable in any of the above
�- �
F- as described in h c.C. Chanter 5 Per rtst>w'f,n,i $35 00
Pnr hour $5500
J In i'lanf $5500
Submit 2 sets of plans with application where any of th-
°Oapply. Not required for temporary construction ti l $. Fees:
1.0 NOTICE 5s. Enter total of above fees g _
-- 5%Surcharge(05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSIRUC'ION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DA 'S, OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WORT(IS SUSPENDED OR ARANDOt4�0 FOR Plan Review if reci fired(Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal g
COMMENCED ❑ Tnist Account 0 �
Balance Due $ yL-
.w&e.ed.,s1w-P- r