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13400 SW 128TH PLACE 13400 SW 128"' Place CITU' OF TIGARD DUII DING INSPECTION DIVISION Ms1 ��; _&0 6 � 24-Hour Inspection Line: 63� 75 Business Line: 639-4% =—f- BUP Date Requested !_AM F,M BLD Location c, Suite MEC Contact Person Ph CJ.S PLMr Contractor Ph _ SWR _ — �blJILDING Tenant/Owner _ _ - ELC _ Il Retaining Wall _ ELIR _ Footing ACC.ss: R Foundation FPS Ftg Drain - SGN — Crawl Drain Inspection Notes- Slab SIT -- -------- -- ----- Post&Beam — —"�- kxt Sheath/Shear Int Sheath/Shear Framing ------- -_._ —.. ------------------ — Insulation ,�/1 cely' Drywall Nailing � Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc.------ — -- -—— PASS_ PART FAIL - - - ---- -- LU1Wk31NG Post& ajearn — Un'er Slab O�►"; Top ft -- Water Service' _ Sanit"Sewe Rain Drains r �j PASS PART FAIL MECHANICAL \ Post&Beam — -- - ---- Rough In ' Gas Line - - - - - -- - - -- --- Smoke Dampers I 1 — PART FAIL -_— Service Rough In `�-- UG/Slap Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill/Grading - — ------ Sanitary Sewer £form Drain [ j Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fare Supply Line I j Please call for reinspection RE: ( J Unable!o Inspect-no access ADA Approach/Sidewalk Date _ Inspector _-_ -_ — Ext Other - Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. i i CITY OF TIGARD BUII DING INSPECTION DIVISION MST 24.,Hour Inspection Line: 63, 175 Business Line: 639-4. �- BUP —gate Requested L p AM__,___PM BLD _ Location 1 3 VOL Suite MEC _ Contact Person Ph 13-S 5 PLM Contractor Ph — — SWR BLIILIgING Tenant/Owner ELC — Retaining Wall �— ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: -- Slab _- ____ _____ - SIT Post&Beam ,�'� Y ri �� ► ; I Ext Sheath/Shear Int Sheath/Shear Framing -- - ------- —-- --- — Insulation Drywall Nailing _ -- Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling — Roof ,.— SS PART FAIL -- PLUMBING Post&Beam Under Slab Top Out Water Service Sanr!ary Sewer - Rain Drains _ Pinel PASS _PART FAIL T MECHANICAL Post& F,eam — Rough In Gas Lire Smoke Dampers Final — ---- A_ FAIL ELECTRICAL — Fough In UG/Slab Low Voltage Fir -- -- ----- --- — ---- na PART FAIL ------- -------- --- - - ---- - -- _--SITE Barkfill/Grading ----- --_—_ ----- ------------ -- jnitary Sewer Storm Drain [ J Reinspection fee of$ required before next inspection y at City Hall, 13125 SW Hall Blvd Catch Basin [ ]Pleas all for reinspection RE: — i Unable to inspect - no access Fire Supply Line ADA Approach/Sidewalk Other Date -- _ Inspector T_ f� /�� -Ext _ Final PASS PART FAIL DO NOT REMOTE this inspection record from the job site. CITY OF TIGARD PIALDING INSPECTION DMS'-N 24-Hour Inspection Line: .f9-4175 Business Line: 63x4171 MST _—Date RequestedCBLIP — AM --PM Location�� Z C� i�- �� — "� --- BLD A Suite MEC Contact Person -- �� Fh f ] "" PLM Contracior Ph SWR — BUILCING YenanUOwner EL3 Retaining Wall `- Footing ELR Foundation Access: ,,\\ -- - Ftg Drain r-- V FPS - — Crawl r ain Inspection Notes: .� � SCA Slab -- --- Post& Bearr _ —�"�-, - SIT Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Ai3rm - - Susp'd Ceiling __ T Roof Mi3c: Final - - — --- �� :RainDrains ART FAIL - --- --.---___-- �" m -- --- -.. -- _ 7- ce wer - ART FAILAL Post& Beam -- .- Rough In Gas Line Smoke Dampers Final - PASS PART GAILELECTRICAL - Service - Rough In --" — UG/Slab Low Voltage Fire Alarm —_ Final -- - --- __ PASS PARTF"AIL. SITE _ _-- ------_ -------- Backfill/Grading Sanitary Sewer -' Storm Drain ( J Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ J Please call for reinspection RE: _ ( J Unable to inspect nn Access ADA — Approach/Sidewalk I Other _- Date _inspecto, ext Final — —__ PASS PART FAIL DO NU REMOVE this 'nspectlon record from the job site. AAAAAAAAA.AAAAAAA.AAAAAAAAA AAAAAAAAAAAAAA AAA s O0. .. d ► Ut 4 y � � ► I d r cn br 0 Poo. CLUIQ-+ � t� b o � J � ► H ° p t ► 0 4 Irl+ ► ► N ► N � + ► � (� I v I► ril i pool 4 ► 1 ► 4 ► y � � • a � o a �- R W a �. a A r � I � O N n 4 r CITY OF TIGARD BUII DING INSPECTION DIVISION � - 24-Hour Inspection Line: 63:. .175 Business Line: 639-4 BUP Date Requested l C� > D E AM Q/ PM BLD Location .� TSuite �_1 MEC jcl �" Ph 31 r Contact Person -L._ Contractor --- — Ph SWR ELC _ BUILD_ING Tenant/Owner ,_ - --� Retaining Wall CLR Footing Access: FPS Foundation Fig Drain SGN _ (Crawl Drain Inspection Notes: SIT Slab -- Post&Beam Ext Sheath/Shear Int Sheath/Shear V� .-f e Framing Insulation � �1/\q�C Drywall Nriling Firewall Fire Sprinkler �— Fire Alar o Susp'd Ceiling - J Roc( �1 Misc. Final - — PASS PART FAIT. 1 PLUMBIN 1 Post& Beam Under Slab _ t Top Out +� Water Service G( Sanitary Sew �I Rain ins ,/�% - , Fin - � ASS ,,PART FAIL M ANICAL Post&Beam Rough In Gas Line Smoke Dampers ' --- Final --- PASS PART FAIL _ ELECTRICAL r Service - - Rough In UG/Slab -- �— Low Voltage Fire Alarm Final — PASS PART FAIL -' SITE Backfill/Grading Sanitary Sewer Storm Drain [ I Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ )Please call for reinspection RE: _ __ [ ]Unable to Inspect-no access Fire Supply Line ADA Approach/SidewalkEXt Other r Date Y�i416 ( Inspector Final - PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITE' OF TIGARD PLUMBING PERMIT DEVELOPMFNT SERVICES PERMIT#' PL.M2001.00459 13125 SW Hall Blvd , I i('"rd, OR 97223 (503) 639-4171 DATE ISSUED 9/26/01 SITE ADDRESS: 13400 SIN 128TH PL PARCEL: 2S104DA-02000 SUBDIVISION: QUAIL HOLLOW - WEST ZONING: P-4.5 BLOCK: LOT: 006 JURISDICTION: TIG CLASS OF WORK: AL1' GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFL OW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES _ _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER. FIXTURES: TUB/SHOWERS: SEWER LII` r": ft WATER CLOSETS: WATER LINE: ft D!SH'NASHERS: RAIN DRAIN: ft Remarks: Irrigation backflow prevention device. _ FEES Owner: ---- -- — Type By Date Amount Receipt NORTHWEST CONSTRUCTION PRMT CTR 9/26/01 $56.25 27200100000 296 NW PACIFIC GROVE DR BEAVERTON, OR 97006 SPOT CTR 9/26/01 $2.90 27200100000 Total v $39.15— — Phone 1: 201-9850 Contractor: ANCTIL PLUMBING INC 16900 SW MERLO RD BEAVERTON, OR 97008 REQUIRED INSPECTIONS Phone 1: 503-642-7323 RP/Backflow Preventer Reg #: LIC 24184 Final Inspection PLM 26-162PB This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Cosies and all other applicable laws. 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 requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. Yui- r y obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issursd By: /11r'i _ Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day Plumbing Permit Application Date received: Permit no.:� City of TigardIECR/Fr) P� raIVNW6 Address: 13125 SW Hall Blvd,Tigard,OR 97223 Sewer permit no,: Building permit no.: City of Tigard Phone: (503) 639-4171 S Project/appl.no.: Expire date: Fax: (503) 598-1960 °�� 2 2001 Date issued: By eceiptno.: Land use approval: Ci[TY()F TN(-'iE' Q,- Case file no.: Payment type: &2 family dwelling or accessory U Coramercial/industrial !J A11116-Gunily U•tenant intprovernenl ew construction U Adtfition/alteration/replacement U I-oo l wrvice U Other. 1 1 ' 1N 'FtE'SUIEDUL�06rspecW Inforilifili Job address: �(�Oc t /fi AGE Description _ Qty. 1-ce(ea.) 1,0ta1 —`-'�---�- New I-and 2-family dwellings only: n Bldg.no.: Suite no.: - - � f Tax /tax lot/?ecotrnt no.: (includes t00 ft.for each utility connectimsp p SFR(1)bath Lot: Block: Subdivision: SFR(2)bath _-- Project name: . (,t;1 U6v, L^� _ SFR(3)hath City/county: I ZIP: Each additional bath/kitchen Description and location of work on premises: _ Sitentilities: -//'i p bel- CSC AT Catch basin/area drain — Est.dale of completion/inspection: Drywells/leach line/trench drain Footing drain(no.lin.ft.) PLUMBING CONTRACTOR Manufactured home utilities _ Business name: .0 L (//77 V>t ;qc _ Manholes _ Address: 6 9 dd (Aa, Rain drain connt ctor City: ejoy • Statc:(f/( ZIP: tv� Sanitary sewer(no.lin. ft.) Phone: Fax. $S E-mall: Storm sewer(no. lin.ft.) —_ CCB no.: _q j L Plumb.bus.reg.no M Water service(no,lin.ft.) City/metro lic.no.: Fixture or item: Absorption valve Contractor's representative signature:_ ,u �lu - ---� vBack flow prcv5_ter Print creme: GL i L Date: ./?-11 Backwater valve 1 Basins/lavatory _� Name: Clothes washer —-- - ---- - -- Dishwasher Address: punkin fountain(s) City: _ State: ZIP: Ejectors/sump Phone: I E-mail: Ex ransion tank 1 Fixture/sewer cap _ Name(print): Garbage dmins/noor sinks/hub - ----- - - Garbage disposal Mailing address: - ------- — — _— - -- Hose bibb City: State. ZI I' Ice maker _ Phone: I•ax: E-mail: Interco tor/ cease tm _ Owner installation/residential maintr.tance only: The actual installation Primers) _ will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the property I own as per ORS Chapter 447. Sin (s),basin(s),lays(s) _ Ownces si nature: Date: _ Sump Tubs/shower/shower pan Urinal Name: Water closet _ Address: -Water heater City: State: LIP: j Other: Phone: Fax: I E-mail: I fo-rar— Not all Jurisdictlotu accept credit tarda,please call iuriuhdaan rot mmwr infomollon. Notice:This permit application Minimum fee...... .........$ __ U Visa U MasterCard expires if a permit is not obtained Plan review(at ___ %,) $ _ Credit card numtwu _� _ ��L within 190 days afte-it has been State surcharge(SNF,) ....$ �aplma TOTAL .......................$ � �-�ime anr carcYwTr as shown on credit cord — accepted as complete. - _ f Car Idea a gnuure Amount 410 MSIb I�arCOMI PLUMBING PERMIT FEES: r= PRICE TOTAL New 1 and 2•family dwelling3 only: FIXTURE-S (individual) UTY 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 utilit connoction _ 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 id.60 _ 8%STATE SURCHARGE Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL Garbage Disposal - 16.60 Y _ TOTAL Laundry Tray 16.60 Washing Machine 16.60 Floor Drain/Floor Sink 2" 1R 60 3" 16.60 - PLEASE COMPLETE: 4" 16.60 _ Water Heater O conversion O like kind 16.60 quantit b Work Performed -_ Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ permit. __ Capped MFG Home New Wates Service 46.40 Sink MFG Home New S3rUStorm Sewer 46.40 Lavatory Tub or Tub/Shower Hose Bibs 16.60 Combination Root Drains 16.60 ihower Cy Drinking I ountain 16.60 I Water Closet Other Fixtures(Specify) 16.E0 Urinal Dishwasher Garbage Disposal Laundry Room Tray Washing Machine _ Floor Drain/Sink: 2" Sower-1st 100' 55.00 3" Sewer-each additional 100' 46.40 4" Water Service-1st 100' 55.00 Water Heater _ Water Service-each additional 200' 46.40 - Other Fixtures (Specify) Storm&Fain Drain-Is(100' 55.00 Storm&Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention De,:,;e 46.40 - Residential Backflow Prevention Devic r' 27.55 - Catch Basin 16.60 T - Inspection of Existing Plumbing or Specially 72.50 Requested Inspections _ per/hr COMMENTS RECARDING ABOVE: Rain Drain,single family dwelling 65.25 Grease Traps 1660 -- QUANTITY TOTAL Isometric or riser diagram Is required If -- Quantity Total Is >9 ---- *SUBTOTAL •J_/ •ZS 8%STATE SURCHARGE JW - .10 "PLAN REVIEW 25%OF SUBTOTAL Required only If fixture gly total h a 9 _ TOTAL *Mlnimum permit fee Is$72'50•8%state surcharpe,except Residential Backnow 1 Prevention Device,which Is$36 25•89L state surcharge "All New Commercial eu!!rlings require plans with Isometric or riser diagram and plan resew i:ldstslforms\plm-fees.doc 10;10100 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE BEAR ELECTRIC P O BOX 389 DONALD, OR 97020 Electrical Signature Form Permit #- MST2000-00364 Date Issued: 1217;00 Parcel: 2 S 104DA-02000 Site Address- 13400 SW 128TH PL Subdivision: QUAIL HOLLOW - WEST Block: Lot: 006 ,Jurisdiction: TIG Zoning: R-4.5 Remarks: Construct single family residence. Path 1 Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Dept. No electrical inspections will be authorized until this completed form is received OWNLR: ELECTRICAL CONTRACTOR: NORTHWEST CONSTRUCTION BEAR F_LECTRiC 296 NW PACIFIC GROVE DR P O BOX 389 BEAVERTON, OR 97006 DONALD, OR 97020 Phone #. 201-9850 Phone #: 503-678-1355 Req #: Lac 29919 ELE 24-1070 SUP 3162-S AN INK SIGNATURE IS REQUIRED ON THIS FORP.1 X Signature of Supervising Electrician If you have any questions, please call (503) 63c1-4171, ext. # 310 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE CHESHIER PLUMBING INC 34798 SE COUPLAND RD ESTACADA, OR 97023 Plumbing Signature (Form Permit #. MST2000-00364 Date Issued: 1217100 Parcel. 2 S 104DA-02000 Site Address: 13400 SW 128TI! PL Subdivision: QUAIL HOLLOW - WEST Block: Lot: 006 Jurisdiction: TIG Zoning: R-4.5 Remarks: Construct single family residence. Path 1 Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, A1_TN: Building Dept. No plumbing inspections will be authorized until this completed form is received 0W1,1FR PLUMBING CONTRACTOR: NOR"rHWEST CONSTRUCTION CHESHIER PLUMBING, INC. 296 NW PACIFIC GROVE DR 34798 SE COUPLAND RD BEAVERTON, OR 97 006 ESTACADA, OR 97023 Phone 11 201-9850 Phone #: 201-1856 Rep �: 1 Ir 140381 P1 M 3-439PB AN INK SIGNATURE IS REQUIRED ON THIS FORM Sianature of Authorized Plumber If you have any questions, please call (503) 639-4171, ext. # 310 CITYOF TIGAIRD MASTER PERMIT PERMIT#: MST2000-00364 DEVELOPMENT SERVICES LATE ISSUED: '?/7/00 13125 SW hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 13400 SW 128TH rL PARCEL: 2S104DA-02000 SUBDIVISION: QUAIL HOLLOW-WEST ZONING: R-4.5 BLOCK: LOT: 006 JURISDICTION: TIG REMARKS: Construct single family residence. Path 1 BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED _ CLASS OF WORK: NEW HEIGHT: 24 FIP.ST: 1,799 of BASEMENT: at LEFT: 5 SMOKE DETECTORS: Y f TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 973 of GARAGE: 'AG of FRONT: 38 PARKING SPACES: 2 TYPE OF CONS'i. 5N DWELLING UNITS: 1 FINBSMENT: of RIGHT: 5 . S zne.=.'a I; OCCUPANCY GRP: R3 BDRM: 'f BATH' ] TOTAL: 2,77:00 of VALUEREAR: 71 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: i LAUNDRY TRAYS: I RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: IQ., SF RAIN DRAINS: 1 CATCH BASINS: TUBISHOWERS: 3 GARBAGE.DISP: 1 WATER HEATERS I WATER LINES: nn, BCKFLW PREVNTR: 1 GREASE TRAPS: MECHANICAL OTHER FIXTURES: FUEL TYPES FURN c 100K: BOIL/CMP<3HP: VENT FANS: CLOTHES DRYER: 1 `IAS TURN>•100K: 1 UNIT HEATERS: HOODS: I OTHER UNITS: I MAX IN!: Ulu FLOOR FURNANCES: VENTS: I WOOCSTOVES GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE.FEEDER TEMP SRVCIFEELERS BRANCH CIRCUITS MISCELLANEOUS _ AUD'L INSPECTIONS 1000 SF OR LESS. 1 0 200 amp: 0 200 amp: WISVC OR FDR: I PUMPIIRR;GATIOW PER INSPECTION: EA ADD'L 500SF: 5 201 400 amp: 201 400 amp: let W/O SVC/FOR: 00 SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 000 amp: EA AOOL BR CIR: SIGNALIPANEL IN PLANT: MANU HMISVC/FDR: 601 • 1000 amp: 601•ampr1000r MINOR LABEL 1000•amp/volt Reconnect only: — PLAN REVIEW SECTION >•4 RES UNITS: SVC/FDR>.223 A.: >$00 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL. B.COMME_RCIAI AUDIO 6 STEREO VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM INTFRCOMIPAGING: OUTDOOR LNDSC LT: BURGLAR ALARM 0TH: BOILER: HVAC: LANDSCAPFARRIG PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL OTHR: 14VAC: OATAITELE COMM: NURSE CALLS. TOTAL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 3,745.25 NORTHWEST CONSTRUCTION NORTHWEST CONSTRUCTION This permit is subject to the reguha6ons contained in the 296 NW PACIFIC GROVE DR 296 NW PACIFIC GROVE DRIVE Tigard Municipal Code,State of OR Specialty Codes and BEAVERTON, OR 97006 BEAVERTON,OR 97006 all other applicable laws. All work will be done in scoordFnce with approved plans This permit will expire If work Is not started within 160 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 Rep N: LIC 141600 forth in OAR 952-Gol-0010 through 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSP--CT,nNS Erosion Control Insp 8, Post/Beam Structural PLM/Underfloor Electrical Rough In Gas Line Insp Appr/SdwlK:nsp Grading Inspection PosUBeam,dechanica Mechanical Insp Framina Insp Gas Fireplace Electrical,=1-Lal Sewer Inspection Underfloor insulation Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Footing Insp Crawl Drain/Backwater Plumb Top Out Exterior Sheathing Insl Rain draln Insp Plumb Final Foundation Insp Footing/Foundation Dr; Electrical Service Low Voltage Water Line Insp Final Inspection Issued By Permittee Signature Call (503) 639-4175 by 7:00 p.m. for an inspection ^eeded the next business day CITYOF TIGARD SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2000-00249 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/7/00 SITE ADDRESS; 13400 SW 128TH PL PARCEL: 2S104DA-0000 SUBDIVISION: QUAIL. HOLLOW-V'1--ST ZONING: R-4.5 __ BLOCK: _ LOT: 006 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Single family residence Owner: - NORTHWEST CONSTRUCTION --- FEES-- 296 NVVv PACIFIC GROVE DR Type By Date Amount Receipt BEAVERTON, OR 97006 PRMT CTR 12/7;00 $2,300 00 27200000J00 INSP CTR_ 177/00 $35.00 27200000000 Phone: 201-9850 Total $2,335.00 Contractor: Phone: Reg #: Required Inspections [Sewer Inspection Inspection 1 his Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency The permit expires 180 days from the date issued The total 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 dl�ections from the distance given If not so located, the installer shall purchase a"Tap and Side Sewer" Permit and the agency will install 3 lateral. ATF ENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notifrr•ation Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987 Issued by: _ Permittee S;r,,nature: Call (503 639-4175 by 7:00 P.M. for an inspection needed the next business day (.!'fY OF TIGARD Residential Building Per►nit Application Plan Che 13125 SW HALL BLVD. New Construction Dat Recd TIF;ARD,"OR 97223 Single Family Detached Date to P.E. Vd;L!5 V 503-639-4171 j I C� Date to DST F 503-684-7297 Pe,"it 5� L Print or Type Called-/--�' Incomplete or illegible applications will not be accepted Name of Project Name l I Job i �'G�-i Gv� - Mailing Address Address slj�A�idress, �, t� Architect �`. . CRY/State Zip Phone Name L• L/ — Name Owner Mailing Ad6ress City/State Zip Phcne Engineer Mailing Address g e ,Z / nd amt -, y _��_____ CRY/St zip Phone General Name 1 — Contractor Describe work NevkO Addition O Alteration O Repair O Mainp Addr ss to be done y _ Prior to permit /h6t} r/f/( Additional Description of Work: issuance,a copy City/State Zip Phone of all licenses f, -Ari . ',of �a�� ,' - L. are required If Oregon Const.Cont.Board Exp.Dae PROJECT expired in COT Lic.# `� 41W �. VALUATlJN database - ---- Mechanical Name NEW CONSTRUCTION ONLY: Sub- �� mar, f",, ('-(r Sq Ft. House: Sq. Ft. Gc,rage ---� �� Contractor Mailing A dress --- - Prior to permit /"l��' ,lL) - Indicate the restricted energy installation by the electrical issuance,a copy City/Stet Zip Phone _ P"bcontractor in the,ollowin areas 0l all licenses -. �� /4) -7.�1J jJ`; 4'x)} Restricted Audio/Stereo are required if Oregon Const.Cont.Board Exp.Date Energy System Alarms _ expired in COT Llc.# InstallationF VacllUm Irrigation database C �� ' �' _ System T S stem_ Plumbing Name (check all that Other: Sub- C E' Z%�i �� a pl - - ContractL r Mailing Address Number of Units in Building UniI Number Designation 7 -sie' �� """ n Has the Subdivision Plat recorded? I'l/A YES NO Prior to permit i;&1$t a Zip Ph ne issuance,a copy C- 4 � '� J G� ��G of all licenses are Oregon Const.Cont.8 and Exp Date required if L'-..# r.•,,rred in COT f4��1Fer - — database Plumbing Lic.# Exp. Date I hearby acknowledge that I have read this application,that the information given is correct,that I am the owner or authorized agent of the owner, and that plans submitted are In compliance with Name v Ore on State la s. Electrical '" ' t .c �n[ — I Signature of Ow r/ -,� Da v Sub- Mailing Address 1 -- [Contrt Person me Phone# Contractor ) c'`�1f lam!;l�P �,�, ` pi. /.;) _ �o City/State Zip Phone —��- Prior to permit .,/c� i�v) d ex'%v /,j�S issuance.a copy f FOR OFFICE USE ONLY: of all licenses are Oregon Const.Cont. Board Exp. Date Plat#: required If Lick / / expired In COT � � ;� ' .-`L► n 1.30., 0 7`� "- � Gr , U�Jlq - CSO database Electrical Lic.# Y xp Date Set ayccks' Zone: J7 r /C el-- --1 ) "J Electrical Supervisor tic.# Exp. Date Eng l e g pproval: Planning Approval: TIF: I\fists\forms\sfd-new doc 11/20/98 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 GS INSPECTION DIVISION Business Line: (503)639-4171 BUP Received _ ��- —� Date Requested_ L Zq�L�-AM__—_— PM __—_�_ SUP Location 4 Qy ?�_ _� Suite MEC Contact Person _ _ _ —_ Ph (_ —) __ PLM Contra --��__-- --- Ph (--- ) --- ------- SWR ------ UILDIN Tenant/Owner —� _._ ELC Foundation ELC Ftg Drain Access: ELR Crawl Drain Slab Inspection Motes: SIT Post&Beam Shear Anchors --- - --- ------- Ext Sheath/Sherr Int Sheath/Shear Framing Insulation Insulation - --� -- - -- - --_ Drywall Nailing - --- Firewall Fire Sprinkler - - - - -- - -- ----- Fire Alarm �1 Susp'd Ceiling -- Roof Other: ine ' _TASS PART FAIL_ / 1A11F -'-� PLUMBING Post& Beam Under Slab -- --- Rough-In J Water Service - -- -- -- -- - J------ -- Sanitary Sewer Rain Drains - -- - Catch Basin/Manhole Storm Drain -- - -- - Shower Pan Other- Final ther Final PASS PART FAIL -- - - --- -- - MEC_HA N-1CA_L Post& Beam Rough-In - Gas Line Smoke Dampers Final PASS PART FAIL ELECTRI SAL _- Service Rough-In UG/Slab - - _ - - -- --- --- Low Voltage _ Fire Alarm Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. _PASS PART FAIL 81TE [:] Please call for reinspection RE:_ J Unable to inspect-no access Fire Supply Line �1 ADA Z Z 0 �L--- Inspector -- Approach/Sidewalk Rate Other: Final DO NOT PEMOVE this Inspection record from the Job site. PASS PART FAIL. NOVEMBER 22, 2002 CITY OF TIGARD BUILDING INSPECTION DIVISION TIGARD, OREGON DEAR SIR: IN REFERENCE TO LOT 6 QUAIL HOLLOW WEST. NORTHWEST CONSTRUCTION HAS DONE THE TESTING ON THE MASTER SHOWER AND IT DOES NOT LEAK. THEY WILL GUARANTEE THAT THE SHOWER WILL, NOT LEAK. BEST REGARDS NORTHWEST CONSTRUCTION