11495 SW LAUREL GLEN COURT I
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11'•95 SW Laurel Glen Court
-_MASTER PERMIT
CITY
OF TIGaRD +
PERMIT#: MST2002-00161
DEVELOPMENT SERVICES DATE ISSUED: 3/18%02
13115 SW Hall Blvd., Tigard, OR 97223 (503) 639-41'71
SITE ADDRESS- 11495 SW LAUREL GLEN CT PARCEL: 2S110AC-02200
SUBDIVISION: LAUREL GLEN ZONING: R-4 5
BLOCK: LOT: 005 JURISDICTION: TIG
REMARKS: Construction of new SF detached residence.
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 20 FIRST: 1925 it BASEMENT: at LEFT 11 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1.064 at GARAGE: 623 sf FRONT: 23 PARKING SPACES: 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: of VALUE: S 285.993 20 RIGHT 5
OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2,99300 at REAR: 55
PLUMBING
SINKS: 2 WATER CLOSETS. 3 WASHING MACH: I LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS,
LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: I CATCH BASINS
TUSISHOWERS: 3 GARBAGE DISP: I WATER HEATERS: I WATER LINES: 100 BCKFLw PRE.VNTR: I GREASE TRAPS
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN<TOOK: BOIL/CMP<3HP: VENT FANS: 5 CLOTHES DRYER: I
GAS FURN-=TOOK I UNIT HEATERS: HOODS: I OTHER UNITS: 1
MAX WV: hill FLOOR FURNANCFS: VENTS: I WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT _ SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp, r 200 amp: WISVC OR FDR: 1 PUMPIIRRIGATION PER INSPECTION:
EA ADD'L OOOSF: 6 201 400 amp: 201 •400 amp: 1st WIO SVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL SR CIR' SIGNAUPANEL: IN PLANT.
MANU HMISVCIFDR: 601 • 1000 amp: 601-amps-1000v: MINOR LABEL:
10004 amolvplt
PLAN REVIEW SECTION
Reconnect only: >*4 RES UNITS: SVCIFDR>•225 A ,600 V NOMINAL: CLS AREA/SPC OCC.
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDFNTIAL _ B.COMMERCIAL
AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMlPAGING: OUT DOOR LIJDSC LT:
BURGLAR ALARM: OTH BOILER: HVAC LANDSCAPEIIP.RIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL a SYSTEMS:
TOTAL FEES: $ 7,793.58
Owner: Contractor: This permit is sublet%to the regulations cont3lned in the
ALPENGLOW HOMES ALPENG1.()W HOMES Tigard Municipal Code,State of OR. Specialty Codes and
5620 SW KELLY AVE. 5620 SW KELL Y AVE all other applicable laws. All work will be done In
PORTLAND,OR 97201 aconrdance with approved plans. This permit will expire H
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 NotltuJation Center. Those rules are set
Rap N: LIC 131932 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 Insp 8, Post/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final
Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Insl 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 Ralgh In Gas Line Insp Appr/Sdwlk Insp
Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical Final
Y :�da�
Issued B � Permittee Signa ire :�-
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITYOF TIGARD SEWER CONNECT1ONPERMIT
DEVELOPMENT SERVICES PERMIT#: S 00119
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/18/02
8/rJ2
PARCEL: 2S110AG02200
SITE ADDRESS; 114115 SW LAUREL GLEN CT
SUBDIVISION: LAUREL GLEN ZONING. R-4.5
BLOCK: LOT: 005 — _ JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS: 0
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE- SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF residence.
Owner: - �- _FEES
ALPENGLOW HOMES Type By Date Amount Receipt
5620 SW KELLY AVE.
PORTLAND, OR 97201 PRMT CTR 3/18/02 $2,300.00 27200200000
INSP CTR 3/18/02 $35.00 27200200000
Phone: 503-793-3866 Total $2,335.00
Contractor:
Phone:
Reg#:
Required Inspections
This Applicant agrees to compl% with all the rules and regulations of the 'Jnified Sewage Agency. The permit expires 180
days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee
the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect
3 feet in all directions from the distance given, If not so located,the installer shall purchase a"Tap and Side Sewer" Perm
Issued by: �� ,� ,L�:� �t z' c ���^ Permittee Signature:,c/
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
J
Building Permit Application
I)alclet.11YCd: of Perr$it O�De)
City of Tigard ,,' /�
-
f
Address: 13125 SW Hall Blvd,"1•igard,OR 972'23 Projecl/appl.no.: Expire date:
City oTigard
Phone: (503) 639-4171 Date issued: dy: Receipt no.:
Fax: (503) 59R-1960 �` Case file no.: Payment type:
Land use approval: IR2 family:Simple Complex: t.
e
0 1 Pic 2 family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition
U Addition/alt -ttion/rcplacenu nt U Tenant improvrnn•nl 'J hit-tiprinkler/alarm U Ocher
JOB SITE INFORMATION
Joh address: L�'.��w Lqursf w r _j�_` 7717 no.: Suitc no.:
I.ot:- S --�Ilhkk: Subdivision: (1 we _-(/tom_ fax ma /tax lot/account no.: _
Project name: --
Description and location of work on premises/special condition:. - _ ,,
OWNER FOR e
Name:
Mailing address: if Ll(> tyW _ FNo.
2 family d»elling-
City: ,- IStaattc: ZIP: q yz/O ation of v;ork....�. ............... $
Phone: ♦1 9'F- 7 Fax: qfy E-mail: tedrooms/baths.................................
Owner's representative: Fri k' 0,5 mo - Total number of floors................................. Z _
Phone: 9J-3 r&Y' Pax: p(,-401/ E-mail__ New dwelling area.(sq. ft.) .......................... 2943
0arage/carport area(sq. ft.)..7111 lia�.......... &7-3
Name: r, Covered porch area(sq.ft.) ......................... - (25
Mailing address: Sligo 6w .r• Iheck area(sq.ft.) ........................................ 6 _
City: Ppk" State: 6W I ZIP: f 720/ Other structure area(sgIft lam_ ...............
Phone: Pax: yet, (,ozi E-mail: CommerciaUandustrial/mnitI-family:
r Valuation of work................... .................... $- ----
Existing bldg.area(sq.ft.) ..........................
Business name: New bldg.area(sq.ft.}
Address: s ................................ _
ILve
City:
Stnte: ZIP: Number of stories.....................................
Type of construction.................................... --�
Phone: I'll X: - - E-mail: Occupancy group(s): xisting:
CCB no.: 11�q� cw:
City/metro lic.no.: 7No11rr-.AII contractors andsubcontractoro are required to be
ed with the Oregon Construction Contractors Board under
Narne: /�raS�Grr ions of ORS 701 aril may be required to be licensed in the
Address: ction where work is being performed. If the applicant is
Cit State: ZIP: exempt from licensing,the following reason applies:
Contact person: Plan no.:
Phone: --- -
F,-mail: — - —�-- --
Name: Contact person: Pees due ulxm application ........................... $�.
Address: -� _ �_ -- Date received: -
City: _ State: ZIP: - Amount received ......................................... $
Phone: I'ax - E-mail - - Please refer to fee schedule.
hereby certify I W!-.e read and examined this application and the Not dl Jurisdictions oc"cm(il cardr,please call Jurisdiction►m rtxKe information,
attached checklist. All provisions of laws and ordinances govcrninp this uvisa a Muter('ard
work will be complied with,wheth s ified herein or not. Credit earn"amber --- -
Autho,ized signature: "�' �� "T . DatC: G Oz- Name d cardholder aR shown on c t erd —"
k OJ/1010 __._ _-- $
Print name: tri Crdholder d�rtattue Arrwror
Notice:Phis permit application expires if n permit is not obtained within I RO days efler it has been accepted as complete. 4404613(GM/coM)
One-and Two-Family Dwelling
;6 A\ Building Permit Application Checklist Referencrno.
c rn l7r),ud (;It Of Tigard - Associated permits:
City g U Electrical U Plumbing U Mechanical
Address: 13125 SW Hall Blvd,T:gard,OR 97223 U Other:
Phone: (503) 639-4171
Fax: (503) 598-1960
1 1 FOR PLAN,RPIEW.
I (Land use actions completed.Scelurv,,I - , i iit-ria for concim, nI reviews.
7,oming. Flood plain,solar balance pow, s oils designation,historic district,etc.
t Verification of approved plat/lot._
I Fire district___approval required._ T
Septlr system permit or authorization for remodel. Exis,ing system capacity
6 Sewer permit. -- --___--
7 Water district approval.
8 Soils report.Must carry original applicable stamp and signature on file or with application.
9 Erosion control U plan U permit required. Include drainage-way protection,silt fence design and location of
catch-basin protection,etc. _
10 3 Complete sets of legible plans.Must he drawn to scale,showing conformance to applicable local and stair
building codes. Lateral design details and connections must he incorporated into the plans or on it separate full-sire
sheet attached to the plans with cross references betwc-n plan location and details. Plan review cannot be completed /
if copyright violations exist. __ V
I I Site/plot plan drawn to seale.'rhe plan roust show lot and building setback dimensions;property corner elevcrions(it'
there is more than a 4-It dei,auun ditIL-rential,plan mint shokt contour lines at 2 11 intend,).It k atiun of casem:•nis and
driveway;footprint of structure(including decks);location of wclls/septic systems;utility to tmtions:direction indicator;tut ✓'
area;building coverage arva;1wicentage of co,.rage;impervious area;existing strttclures on site-,and surface drainage.
12 Foundation plan.Show dimensions,anchor volts,any hold-downs and reinforcing pads,connection details,vent /
size and location. _ V
I 1 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors,water heater. V/_furnace,ventilation Ia.is, plumbing fixtures,balconies and decks 30 inches abowe grade,etc.
14 Cross;sections)and details.Show all fr•,umng-member sves and spacing such as floor beams,headers,joists,sob-floor.
wall construction,rout construction. More than one cross ,•cUon may he required to clearly portray construction.Show
details of all wall and roodsheathing,roofing,roof slope.t,•thng height,siding material,footings and foundation,stairs, /
fireplace construction, thermal insulation,cur J
15 Elevation views.Provide elevations for new cumouciwn. imminum of two elevations for additions and remodels.
Exterior elevations must reflect the actual grade if the t:hmwc in grade is greater than four foot at building envelope. /
Full-size sheet addendums showing foundation elevations wu!i i cuss it-ferences are acceptable.
�- In Wall bracing(prescriptive path)and/or lateral analysis plan%. must indicate details and locations;for /
non-prescriptive path analysis provide specifications and calculau,ms to engineering standards. ✓
lJ•, .7 Floor/roof framing.Provide plans fior all floors/red assemblies,indicating member sizing,spacing,and hearing /
`r locations.Show attic ventilation. _ — V
18 Basement and retaining walls. Provide cross sections and details showing placement of rehar. For engineered
systems,see item 22,"Engineer's calculations."
1 y Beam calculations.Provide two%cis of calculations u%ing current code design values for all heams and multiple joists
over 10 feet long and/or any beam/joist carrying a non-uniform load. ✓
20 Manufactured floor/roof truss design details.
21 Energy(ode compliance.Identify the prescriptive path or provide calculations. A gas-piping schematic is required j
for four Or mare appliances. V
22 Engineer's calculations.When required or provided 11 (-. shear wall,ru if irtssl shall he stamped by an engineer or
architect licensed in Oregon and shall he shown to by ap li.al+lc to the piolrci under review.
23 Give(5)site plans are required for Item I I above. Site plans must tw 8-1/2" x 11"or I I" 17 ✓
24 Two(2)sets each are required for hems 16, 19,20&22 above.
25 Building plans shall not contain red lines or tape-ons.
26No rolled,reversed or mirrored building plans will be accepted. _- ✓ -
�1
28
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may he in blue or black ink.
Red ink is reserved for department use only. tan-4M4(60M'OM)
Electrical Permit Application
I late received: Permit no.:
City of Tigard Project/appl.no. Expiredate:
tn/1i�ur,l Address: 13125 SW Nall Blvd,'figard.OR 97223 Date issued: - By: Receipt no.:
Phone: (503) 639-4171 -
Fax: (501) 598-1960 Case file no Payment type:
Land use approval: -
bd 1 &21'amily dwelling or accessory U Commercial/industrial U Multi-fami',, U'fenant improvement
U New construction U A(ldition/alteration/rcplaccntcnt U Other: _ U Pat tial
!oh address: ,, BWg.no,: Suite no.: T'„x map/tax lot/account no.:
Lot: Block: jr
O-ous,e-1
--- ---- -------
Project name: Dellription and 1,wation of work on premises:
Estimated date ol'com letitni/nr.Jn t u n -
CONTRAC70111
Job no: t`r
D"c•ription Qt . (ca) total no.htsp
Business name:
New residential-shrklr(ir nndti family per
Address: / -t
&K J ( dwelling unit.lncludry all it bed rarage.
City: r Slate: l/II' Service included:
Photic: Fax: E-mail IWK)sq.lt otless 4
it'.) . Each additional 50O sq.ft.or portion thereof -
CCB no,: Elec.bus.tic.no: Limited energy,residential 2
City/metro lic.no.: Urniledenergy,non-residential 2 —
Each manufactured home or modular dwelling
Signature of supervising electrician(required) 4uc Service and/or feeder _ '- _
Sup elect nalnctpnnt) ctttcno; Setvicesorfeeders-Installation,
Alteration or relocation:
1
200 amps or less
201 amps to 4(x1 amps
Name(print): 0 Oil q 160 2
401 amps to 6110 amps
Mailing address: 4ti11 fV►'t'_ 14,,11jap 601 amps to IWOamps 2
City; Stale: ZIP: 17-7 7 10 Over 1000 amps or volts _ 2
Phone: 2 1--ax I E-mail: Reconnect,ml
Owner installation:The installation is being made on property I own Temporaryservicesorfeedem-
Installation,alteration,or relocation:n l
which isnot intended for sale,lease,rent,or exchange according l0 2t91 l lest 2
ORS 447,455,479,670,701. -'O 1 amps to 4txl amps 2
Owner's si nature: Vail': lol t(,
Branch c n uity-new,alteration,
or extension per panel:
Name: ___ A_ I•ee for branch circuits with purchase of
Address: nmatl service or feeder fee,each branch circuit 2
City: Slate: 7.1 P: B. Fee rot branch circuits without purchase
-1 of service or feeder fee,first branch circuit: = _
Phone: I ax I', Each additional branch circuit:
Mbc.(Service or feeder not Included):
U Service over 225 amps commercial U Health-Late fat ahty Each pump or irrigation circle 2
O Service over 320 amps:-rating of 1&2 U Hazardous location Each sign or outline lighting 2
family dwellings U Building civet 10AX)square Iret four or Signal circuit(s)or a limited energy panel,
USystem over600volts nominal ninre residential units in one truoure alteration.or extension* _ 2
U Building over three stories U Feeders,4tx)amps or more "Description._
U Occupant load over 99 persons U Manufactur(d struor-es or RV park F'ach additional Inspection over the allowable In any of the above:
U F.gress/lightingplan U Other. __, __. Per inspection
Submit_sets of plans with wty ufthe above. Investigation Ire ^,
The above are not applicable to lempomry condrnetion service. Other
Not oil Juriadktiorn acceptcauls,
credit please call Jurisdiction for snare inkmnaaion Notice:This permit application Permit fee...... .............$
U Visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $
Credit card number . __—_ ___-..-_-_ ___-_L_ _ / within 180 days after it has leen State surcharge(8%)....$
accepted as complete. TOTAL $
---Name of cardhol r u shown on credit card
Cadholder elpsture�^ Amour 44114615(ISWCOM)
ELECTRICAL PERMIT FEES:
LIMITED ENERGY PERMIT FEES:
-- ---- -- -�` I TYPE= OF WORK INVOLVED -RESIDENTIAL ONLY
------ .................... $75.00
Complete Fee Schedule Below: Restricted Energy, Fee.....................
............
Number of Inspections per permit allowed- (FOR ALL SYSTEMS)
�—
service included: Items COSI Tctal check Type of cNork Involved.
rEach
idential-per unit $145.15_-_ Audio and Stereo Systems'
0 sq It or less �-
h additional 500 sq it or $33.40 Burglar Alarm
ortion iii®root ---- �_�
ited Energy $75.00 _
Manufd Home or Modular $9U 90 2 Cl Garage Door Op9ner'
Dwelling Service or Feeder _--
F-1 Heating,Ventilation and Air Conditioning System'
Services or Feeders
Installation,alteration,or relocation $80.30 2 I-I
200 amps or less - $106.85 7 l J Vacuum Systems'
201 amps to 400 amps $160.60 2
401 amps to 600 amps — $740.60 2 ❑ Other -
601 amps to 1000 amps ----- $454.65 2
Over 1000 amps or volts $66,85__
68 85— 2
Rerbnnectonly --- TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Temporary Services or Feeders Fee for each system................. ........................................ $75.00
Installation,alteration,or ieloralion $68.85 2 (SEE OAR 918-260-260)
200 amps or less ---- $100.30 2
201 amps to 400 amps $133.75 2 Check Type of Work Involved:
401 amps to 600 amps _ ------
0%er 600 amps to 1000 volts, Audio and Stereo Systems
see"b"above.
Branch Circuits ❑ Boller Controls
Now,alteration or extension per panel
a)Tim fee for branch circuits ❑ Clock Systems
with purchase of service or
feeder fee.
Each branch circuit $6.65 _._ Data Telecommunication Installation
b)The lee for hianch circuilS
without purchase of service Fire FJarm Installation
or feeder fee. $48.85 _
First branch circuit - HVAC
Each additional branch circuit $6.65
Miscellaneous Instrumentation
(Service or feeder not Included) I'"�
Each pump or Irrigation circle _ $53.40 - LJ Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(s)or a limited energy $75.00 Landscape Irrigation Control'
panel,alteration or extension - ---
Minor I abels(16) __ $125.00 ❑
Medical
Each additional;nspection uvef
the allowable in any of the above Nurse Calls
Per inspection - $62.50_----
Per hour $82.50 Outdoor Landscape Lighting'
In Plant $73.75 _
Fees: ❑ Protective Signaling
Enter total of above tees $ -_- F-1 Other.__--- ---- ---
9%state Surcharge $- __Number of Systems
25%Plan Review Fee No licenses are required Licenses are required hr all othrr installati .s-
See"Plan Review"snciirm nn _
front of application Fees:
Total Balance Due $ ------ Enter total of above fees :
[El Trust Account p _- _ 8`/.State Surcharge $
- -- --- -- -- - Total Balar::e Due --
i\rlsL-\fiirnu\cic fees doc MA)7101
r
Plumbing Permit Application
Datereceived: Perron no.:
City �+of Tigard - ---
Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223 -- — — --
('ilv,d Io,,ard Phone: (503) 639-4171 Project/appl.no.: Expire date:
Fax: (503) 598-1960 Datc issued: By: Receipt no.:
Land use approval: Case fife no.: Payment tvpe.
I &2 family dwelling or accessory U Commercial/Industrial U Multi-family U Tenant improven)ent
U New construction U Addition/alteration/rcplacemenl U Food service U()cher:
.301111 Sill,"INFOlININTION FEL SCIIIIEDULE(for special Informatloil uwcheckllst)
Jobaddress: /�,I', I)esrription (1tv. hec(ea.) 'lotal
-��" -----
Bldg. no.: Suite no.:
New I-and 2-family d»ellings only:
I
Tax map/lax lot/account no,: (Include~10011.for each ulllil y conneclion)
SFR(I)bash
Lot: Block: Subdivision: SFR(2)bath
Project name: SFR(3)bath _
City/county: ZIP: Each additional hath/kitchen
Description and location of work on premises: SiteutillNes:
_ Catch basin/area drain
Est.date of completion/inspection: Drywells/Icach line/trench drain
t Ftxtling drain(no.lin, ft.) _
Manufactured home utilities
Business name: , r�re Manholes
Address: r o.�f,_ Rain drain connector
City: ;i,, State: , l ZIP: (1 Sanitary sewer(no. lin.ft.)
Phone: Fax: E-mail: Storm Sewer(no.lin. ft.) _
CCB no.: !11 $t Plumb.bus.reg.no: Fater service(no.lin. ft.)
City/metro tic.no.: F 8/i o 6 7 h Z Fixture or Item:
Contractor's representative signature: Absorption valve Print name: Date: - Back flow prcventer
Backwater valve
Basins/lavatory _
Name: /%r) -
Clothes washer
�__ � Dishwasher
Address: 5j,2 - lE'-t� r — -
City: Stale: �► ZIP: >P72h/ Drinkin fountain(s)
Ejectors/sum
Phone: 9 - b8 Fax: Z 2 E-until Expansion tank
Fixture/sewer cap
Name(print): bbonolalu3 Floor drains/floor sinks/hub
Mailing address: I✓ - -- - Garbage disposal
— -�— Hose bibb
City: Slate ZIP: f771 Ice,maker
Phone: 3 Fax: E-mail: _ Interceptor/grease tray_ _
Owner installation/residential maintenance only: The actaal mst:.11ation Primer(s) _
will be made by me or the maintenance and repair made by my regullr Roof drain(commercial)
employee on the property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s)
Owner's si nature: Date: Sump
Tubs/shower/shower pan
Name: Urinal
—. - - - Water closet
Address: _ _ Water heater
City: Other.
Phone: Fax: E•mnil: _ Cots,
Not all Jurisdicaona rcepl credit cards,please call Jurisdiction for more inforrnatlon. Notice:l•his permit application Minimurn fee................$ __-
U Visa U MasterCardPlan review(at — %) $
expires if a permit is not obtained
Credit card number within ISO days after it has been State surcharge(8%) ....$
Expire
-- --- accept rd as complete. TOTAL .......................$
Name of cardholder as shown on credit card
_ f
Cardholder signage Anwtrn 4404616(6MCOM)
PLUMBING PERMIT FEES:
PRICE TOTAL -We-w-1 and 2-famlly dwellings only:
FIXTURES (indivldu & QTY (ea) AMOUNT (includes all plumbing fixtures in Ppir` TOTAL
Sink 16.60 the dwelling and tho first100 ft. QTv (ea) AMOUNT
for each utility connection
Lavatory -- 16.60 "One 1 $350.-u
bath _ $241.2.0
_ � _
Tub or Tub/Shower _a Comber 16.80 Two 2 bath _
- 16.60 Three 3 bath $399,00 _
Shower Only -�-"-
Water Closet - 16.60 - _SUBTOTAL
Urinal -^ 16.60 8%STATE SURCHARGE
Dishwasher 16.60 PLAN REVIEW 25%OF SUBTOTAL
---- TOTAL
Garbage Disposal 16.60 -- _
Laundry Tray - 18.60
Washing Machine 16.60
FloorDraln/Floor Sink 2" _ 16.80 PLEASE COMPLETE:
3^ 16.60
q^ 16.60 -
- Ouantit b Work Performed
Water Heater O conversion O like kind 16.40 Fixture Type: New Moved Replaced Removed/
Gas piping requires a separate mechanical Capped-
permit.
MFG Horne New Water Service- 48.40 Sink -
Lavato
MFG N 46.40 ome New San/Sloan Sewer Tub or Tub/Shower
Hose Bibs 16.60 Combination
Roof Drains 16.60 Shower Only --
Drinking Fountain 16.60 Water Closet
Jrinal � _
Other Fixtures(Specify) 16.60 Dishwasher
Garba e Disposal _ -
Laundry Room Tray
_Aashinu Machine
Floor Drain/Sink: 2" -
Sewer-1st 100' 55.00 3"
Sewer-each additional 100' 48.40 - 4"
Water Service-1st 100' 55.00 Water Healer _
Wl 200' u 48.40 --- Other Fixtures
ater Service-each additional
Storm 8 Rain Drain-1st 100' 55.00 __ r
Storm b Rain Drain-each additional 100' 46.40 - --
Commerclal Back Flow Prevention Device 46.40 - -- --
Residential Backflow Prevention Device27.55 -
Catch Basin 16.60
Inspection of Existing Plumbing or Specially 7250
Re nested Inspections erlhr COMMENTS REGARDING ABOVE:
Rain Drain,single family dwelling 65.25 -____ ------- -
Grease Traps 16.60 -- - -�-
QUANTITY TOTAL - -- --
Isometric or riser diagram is required II -.--
OuantRy Total is >9
'SUBTOTAL -
8i STATE SURCHARGE
''•PLAN REVIEW 25°/.OF SUBTOTAL-
Required only II fixture qty total is,6
TOTAL a
Minimum permit fee Is$72 50+8%state surcharge,extent Residential Packllow
Prevention Device,which is S36 25 t A%state surcharge
"All New Commercial Buildings require plans with Isometric or riser diagram and
t'an review
I:\dsts\forms\plrn-fees.doc 10/10/00
Mechanical Permit Application
Date received: Permit no.:
City of Tigard Project/appl.no.: Expire date: —
(yry(,/Tiger i Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Recegri nu.:
Phone: (503) 639-4171 — — ---
Fax: (503) 598-1960 Case file no.: Payment type:
[nand use approval: _ Building permit not.:
61 W Will 11111161LI
lff I &2 family dwellinp or accessory U Commercial/industral U Multi-family U Tenani improvement
U New construction U Addition/alteration/replacement U Other: _-
Job address: lfpv / er Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical mater;-Is,equipment,labor,overhead,
Tax map/tax lot/account no.: profit. Value$ —_
Lot: 5 Block: Subdivision: 4 *See checklist for important application information and
Project name: jurisdiction's fee m liedulr for re,Jdcntial permit Ice
City/county: ZIP: 1
Description and location of work on premises: 0111111AL Oil
—_
_ Fee(ea.) 'Iotal
Est.date of completion/inspection: --_— Description "y. Res.only Res.only
Tenant improvement or change of use: Air handling unit _ CFM
Is existing space heated or conditioned?U Yes U No Air conditioning(site plan required)
Is existing space in mulated?U Yes U No Alteration of existing 11 V A('system
01 cr compressors
Business name: State boiler permit no.:
- - HI --Tons-BTU/14
_Address: 0, U X •1r smo a amper. uct smoke detectors
City: r,n State: R 71P: Q y-- eat pump(site plan require ) —
Phone:' 3 - 29 Fax: E-mail_ nsta I rep ace urnace turner
Including duetwork/vent liner U Yes U No -
CCB no.: 5'7 nsta 'rep ac relocate eaters-suspended.
City/metro lic.no.: _ __- wall,or floor mounted
Name(pleaseprint): �yie tf., Vent for Ianceother r an furnace
e gest on:
Absrnption units
Name: k os1 v /6I_
Chillers— --
Comressors
----- III'
Address: 5b?vEnvironmental
III'
nv ronmenta ex ort and vent at nn:
City: Stater"I� 7_,IP_6i 7 Appliance vent_ --
Phone: - G Fax: I mail Drycrcx gust
Hoods,Type res. itc a azmat
hood fire suppression system
Name: Op — Exhaust fan with single duct(bath fans)
Mailing address: y yy Ary, r -_ :x hosts stem a art rom Cann or C
Cit _ State: " ' LIP: q sue piping an ri tut on(up to out eta)
Y: P _ ?2!(7 1 ypc. LPG -- NG Oil
Phone: 2 ciWibs
E-mail: Fueln nn eachadditional over outlets
rocerr p ping(sc nmatfc required)
Number tit outlets
Name: ter Wed app atnte or equipment:
Address: _ _ Decorative f ssepiace
City: tate: 7.1 P: nsen-type _
Phone: Fax: Email: oo stov pe etstnve
Ul er:
Applicant's signature: "' 1 Date: j S d 7_ t rix
Name (print): Er (. __--_--
Not all Jurisdicth+m accept credit cordo,please call Juriwliaion Im mum Information. Permit fee.....................$
UVisa UMasterCard Notice:This,iermit application Minimum fee................$
expires if a permit is not obtained Pian review(at _ °ti) $
Cmdit rand number within ISO days after it has been
Explmr y State surcharge(89G) ....$ _
Name of cardholder u r nn credo card accepted as complete. TOTAL .......................$
S
Cardholder signature A;ZW - 410-4617(bOQK'OM)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
Description: _ Price Total
TOTAL VALUATION: FEE: --.- Table 1A Mechanical Code _ Qty (Ea) Amt
$1.00 to$5,000,00 Minimum fee$72.50 - 1) Furnace to 100,000 BTU
$5,001.00 to$10,000.00 $72.50 for th-,first$5,000.00 and Includin ducts 8 vents - 1400
$1.52 foi each additional$100.00 or 2) Furnace 100,000 BTU+
friction thereof,to and including including ducts 0 vents _ 17.40
_ $10 000.00. 3) Floor Furnace
$10,001.00 to 525,000.00 $148.50 for the first$10,000.00 and including vent _ 1400
$1.54 for each additional$100.00 or 4) Suspended heater,wall heater
fraction thereof,to and including4)
floor mounted heater 14 00
$25,000.00. g Vent not included in appliance permit
$25,001.00 to$50,000.00 J $379.50 for the first$25,000.00 and ) s eo _-
$1.45 for each additional$100.00 or 6) Repair units
fraction thereof,to and including 12 15
$50,000.00. - --- -
$50,001.00 and up
$742.00 for the first$50,000.00 and Check all that ap,-ly: Boller Heat Air
$1.20 for each additional$100.00 or For footitems 7-11,snotes below.__ee Com • Pump Co:
or
fraction thereof^_ -
7)<311P;absorb unit 14 Ou
__ to 100K BTU
ASSUMED VALUATIONS PER APPLIANCE: 8)3-15 HP;absorb 25.60
'- Value Total unit 100k to 500k BTU -
Description: oty a Amount g)15-30 HP;absorb
Furnace to 100,000 BTU,including 955 unit.5-1 mil BTU 35.00
du is&vents 10)30-50 HP;absorb 52.20
Fu,,lace>100,000 BTU Including 1,170 unit 1-1.75 mil BTU -
ducts&vents 11)>50HP:absorb 87.20
Floor furnace including vent 955 unit>1.75-nil BTU
Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM
floor mounted heater 10.00
Vent not Included in applicance 445 13)Air handling unit 10,000 CFM+
17.20
ermit - - 805
Re air units 955 14)Non-portable evaporate cooler 1000
<3 hp,absorb.unit, -
to 100k BTU - 15)Vent fan connected to a single duct 6.80
3-15 hp;absorb.unit, 1,700
101k to 500k BTU ----- 16)Ventilation system not Included In 10.00
15-30 lip;absorb.unit,501k to 1 2,310 ____a /lance ermit
mil.BTU _- - 17)Hood served by mechanical exhaust 1000
30-50 hp;absorb.unit, 3,400
1-1.75 mil.BTU _ _ _ -- 18)Domestic incinerators 17.40
>50 hp;absorb.unit, 5,725
>1.75 mil.BTU - ----- 19)Commercial or Industrial type incinerator
Air handlin unit to 10 000 cfm 656 69'95
Air handling unit>10,000 cfm 1 170 - 20)Other units,including wood stoves
Nonce-ortable eva ratecooler
- 656 - 10.00
Vent fan connected to a sin Is ouct 446 21)Gas piping one to four outlets
Vent syslem not included In 656 5.40
a Ilan_ce permit -- 22)More than 4-per outlet(each) 1.00
Hood served b mechanical exhaust 670 -_ $
1
Domestic incinerator -- Minimum Permit Fee$72.50 SUBTOTAL:
Commercial or Industrial Incinerator 4
Other unit,including wood stoves, 656 8%Stats Surcharge $ ✓
Inserts,etc. 360 $ Jt
Gas piping 1-4 outlets --- 25•/.Plan Review Fee(of subtotal)
Each additional outlet 63 Required for ALL commercial permits only
TOTAL COMMERdWA- $ TOTAL RESIDENTIAL PERMIT FEE: $
VALUATION: -_ -- -- -
Q1,her Ineoectio(tj and Feu:
1 Inspections outside of normal business hours(minimum charge-two hours)
$72 50 per hour
2 Inspections for which no lee is specifically Indicated (minimum charge-half hour)
$72 50 per hour
3 Additional plan review required by changes,additions or revisions to plans(minimum
charge-one-helf hour)$72 50 per hour
State Contra-tor Br,ller Certification required for units>2001,BTU.
"Residential A/C requires site plan showing placement of unit.
i\dsts\forms\rnech-fee3 doc 10111/00
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CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
PLUMBING SYSTI`MS CONTRACTORS
5067 S SCONCE RD
HUBBARD, OR 97032
Plumbing Signature Form
Permit #: MST2002-00167
Date IS^,UG(1: 3;18102
Parcel, 2S11 OAC-02200
Site Address. 11495 SW LAUREL GLEN CT
Subdivision: LAUREL. GLEN
Block: Lot: 005
Jurisdiction: TIG
Zoning: R-4.5
Remarks: Construction of new SF detached residence.
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, ATTN: Building Dept.
No plumbing inspections will be authorized until this completed form is received
OWNLR. PLUMBING CONTRACTOR:
ALPENGLOW HOMES PLUMBING SYSTEMS CONTRACTORS
5620 SW KELLY AVE. 5067 S SCONCE RD
PORTLAND, OR 97201 HUBBARD, OR 97032
Phone #: 503-793-3866 Phone #: 503-804-5281
Reg #: 1 it 112518
PI M 3-466PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
Signature of Authorized Plumber
If you have any questions, please call (503) 639-4171, ext. # 310
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
WEBER ELEC (SEE 44087)
14524 SW CHARDONNAY AVE
TIGARD, OR 97224
Electrical Signature Form
Permit #: MST2002-00167
Date Issued: 3/18/02
Parcel: 2S110AC-02200
Site Address: 11495 SW LAUREL GLEN CT
Subdivision: LAUREL GLEN
Block: Lot: 005
Jurisdiction: TIG
Zoning: R-4.5
Remarks: Construction of new SF detached residence.
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 tc the
start of the work to the address above, ATTN: Building Dept.
No electrical inspections will be authorized until this completed form if eceived
OWNER: ELECTRICAL CONTRACTOR:
ALPENGLOW HOMES WEBER ELEC (SEE 44087)
5620 SW KELLY AVE. 14524 SW CHARDONNAY AVE
PORTLAND, OR 9-1201 TIGARD, OR 97224
Phone #: 503-793-3866 Phone #: 579-5168
Req #: LIC 0044087
SUP 4028S
ELE 34442C
AN INK SIGNATURE IS REQUIRED ON THIS FORM
X �
Signature of Supervising Electnci�n
If you have any questions, please call (503) 639-4171, ext. # 310
CITY OF TIGARD ELECTRICAL -
ENER
RESTRICTED ENERGY
DEVELOPMENT SERVICES PERMIT M ELR2002-00081
13125 SW Hall Blvd.,Tiqard. OR 97223 (503) 639-4171 DATE ISSUED: 5/14/02
PARCEL: 2S 110AC-02.20k
SITE ADDRESS: 11495 SW LAUREL GLEN CT
SUBDIVISION: LAUREL- GLEN ZONING: R 4.5
BLOCK: LOT: 005 JURISDICTION: TIG
Prosect Description: All encompassing low voltage for new SF.
A. RESIDENTIAL B.COW MERCIAL
AUDIO & STEREO: A0DI0 & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: ALL ENCOMP : X FIVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL#OF SYSTEMS:
Owner: Contractor:
ALPENGLOW HOMES T & L COMMUNICATIONS INC
5620 SW KELLY AVE. PO BOX 87387
F=ORTLAND, OR 97201 VANCOUVER, WA 98687-7387
Phone: 503-793-3866 Phone: 360-731-9725
Reg #: uc 677x7
FLE 37-428CLE
FEES _ Required Inspections
Type By Date Amount Receipt Low Voltage Inspection
PRMT GTR 5/14/02 $-1'5 00 2720020000 Elect'I Final
5PCT CTR 5/14/02 $6.00 2720020000
Total $81.00
This Pen-nit 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 started wits n 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 Censer. Those rules are set forth in OAR
952-001-0010 thmgh OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC at (503)
246-1987. �� '1/1 /� /
Issuedlby l'- aLL�l� Permittee Signature -
-
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale. lease, or rent.
OWNER'S SIGNATURE: __ _—— DATE:
_`CUNTR4CTOR INSTALLATION ONLY —
SIGNATURE OF SUPR. ELEC'N _—_ __. — _ DATE: _
LICENSE N O: --- — _ ---- ---— ----- ---—_—_
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
Electrical Permit Application
— Date received: Permit no.: "M
City Of Tigard Project/appl.no.: date:
vgIi);nrrI Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: Hy Receipt no:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U Ncw constnicticm U Addition/alteration/replacemrnl ®Other: U Partial
Job address: _ l f� �5 L r y C—t BWg.no.: Site no.: ITax map/tax lot/account no.:
Lot: Block: Subdivision: -
Project name: 9001,0 , Oz., Description and location of work on premises: f{(arw" _' so'Ak 5
Estimated date of com lelion/ins ction:
Maw
Job no: _ vee Mn r
Business name: 1-ft~L corrnwtr rtk h.9 s 47,,,,_ Description Qt1. (ea.) total nn.insp
Address: V,e_c 0,-- New rsldenttal-singi-or murtl-family per
I"1 Lpl•.tn.b.t.
dwelllnr,unit.Includes attached garage.
City: .t, r / State:(.M1 I ZIP: h (��/ Senicrlaclarkvl:
Phone: k.,r,13 7 8715 Fax: v�7�79GNH E-mail: 1000 sq.ft.or less a
CCB no.: (�, —7Else,bus.lie.no:U/rte g ./ y-(s� Each additional 500sq.ft.or onion thereof
Limited energy,residential +
City/metro Ilc.no.: .,ZXI -U'L Limiledencrgy,non-residential 1
Each manufactured home or modular dwelling
Signature of supervising electrician(required)' moi y-�;L- Service and/or feeder 2
Sup.elect.name(print):�/ref ii i•c:t-' I,icenseno:C,B/SLC Servitesorfeeders-Installation, _
alteration or relocation:
200 amps or less 2
Nance(print). 201 amps to 400 amps 2
Mailing address - - --- 401 amps In6(K)amps 2
60 1 amps to 10(x1 amps 2
state: Zi P: Over If")amps or-Volts -- — 2
Phone: Fax: I E-mail: Reconnectonly — I
Owner installation:The installation is being made on property I own Temporary services orfeeders-
which is not intended for sale,lease,rent,or exchange according to Installation,alteration,orrelocation:
ORS 447,455,479,670,701. 20()amps or less 2
201 amps to CH)amps 2
Owner's si nature: Dale: 401 to 600 amps — 2
10114 101 N 0 Branch circuits-new,alteration,
or extension per panel:
Name: A. -cc for branch circuits with purchase of
Address: service or feeder fee,each branch circuit
City: Slate: 2.1P: B. Fee for branch circuits without purchase
Phone: ;rx {. rn,ril - of service or feeder fee,first branch circuit: Z
t ach additional branch circuit:
1'L%N 1(LV1FW0'len%e check sillMlie.(Service or feeder not Included):
U Serviur over 225:rips-comnwrcial U Health cmc facrhh Eat 11 pump or irrigation clrcle l
U Service over 320 amps.toting of I&2 U Hazanlouslocation EachsignorouilineIighting — 2
family dwellings U Building over I0.000 square feet four or Signal circuit(s)or a limited energy panel.
U System over 60f)volts nominal more residential units in one structure alleration,or extension* 2
U Building over three stories U Feeders,400 amps or more 'Description:
U Occupant toad over IN persons U Manufacture*]structures or RV park Each additional inspection over floe allowable In any of the above:
U Egress/Iightingplan U Other: _ _ Perinspection ��--
Submit.__sets of plana with any of the above. Investigation h•c
The above above are not applicable to temporary construction service. other �— --"
Ncs all jurisdictions acre"co:stil cants,please call jurisdiction fa more infomralion. Notice:'Mis permit application Permit fee.....................$
U Viso U MasterCard expires if a permit is not obtained Plan review(al — %) $
Credo yard number: - within 180 days alter it nas leen State surcharge(9%)...,$
xMtes accepted its complete. TOTAL . $ l
Name of cardholder u own on ore It card—
Cardhotdersiipoature Amount 44114615(641atCOM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
Complete Fee Sc��dule Below: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
p Restricted Energy Fee...................................................... $75.00
Number of Inspections per permit allowed) (FOR ALL SYSTEMS)
Service included: Items Cost Total I Check Type of Work Involved:
Residential-per unit
1000 sq it or less $145.15 ` _ 4 Audio and Stereo Systems'
L.ach additional 500 sq It or
portion thereof __— $33.40 1 ❑ Burglar Alarm
Limited Energy — $7500 _
Each Manurd Home or Modular ❑
Dwelling Service or Feeder _ $90.90 2 Garage Dour Opener'
Services or Feeders ❑ Heating,Ventilation and Air Conditioning System'
Installation,alteration,or relocation
200 amps or less $80.30 2 ❑
201 amps to 400 amps _ $106.85 _ 2 L Vacuum Systems'
401 amps to 600 amps _ $160.60 _ 2 ❑
601 amps to 1000 amps —`_ $24060 _ 2 Other
Over 1000 amps or volts $45465 2
Reconnect only $6685 2
TYPE OF WORK INVOLVES -COMMERCIAL ONLY
Temporary Services or Feeders
Installation,alteration,or relocation Fee for each system.......................................................... $75.00
200 amps or less Y� $66.85 _ 2 (SEE OAR 918-260-260)
201 amps to 400 amps $100.30 2
401 amps to 600 amps $133.75 _ 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see"b"above. I`J Audio and Stereo Systems
Branch Circuits ❑ Boiler Controls
New,alteration or extension per panel
a)The foe for branch circuits
with purchase of service or ❑ Clock Systems
feeder fee.
Each branch circuit — $6(35 2 CJ Data Telecommunication Installation
b)1 he fee for branch circuits
without purchase of service LJ Fire Alarm Installation
or feeder lee.
First branch circuit _ $40 85 ❑
Each additional branch circuit $665 _ HVAC
Miscellaneous ❑ Instrumentation
(Service or feeder not Included)
Each pump or irrigation circle _ $5340 ❑ Intercom and Paging Systems
Each sign or outline lighting $53.40
Signal circuit(e)or a limited enargy
panel,alteration or extension $7500 __ C� Landscape Irrigation Con!rol'
Minor Labels(10) ;.125 00 _
Each additional Inspection over F] Medical
the allowable In any of the above L I Nurse Calls
Per inspection $6250
Per hour $6250
In Plant $73 75 EI Outdoor Landscape Lighting'
Fees: ❑ Protective Signaling
Enter total of above fees $ �_� ❑ Other
8%State Surcharge $ Number of Systems
25%Plan Review Fee
See"Plan Review"section on $ No licenses are required Licenses are required for all other installations
front of application — - --
Fees:
Total Balaace Due $
-�— Enter total of above fees $—
Trust Account# _ _ 81,:State Surcharge $
Total Balance Due
All New Commercial BuFldings require 2 sets of plans.
i Astsworm\eIc-fees.doc 08/30/01
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 633-4175
INSPECTION 171VISION Business Line: (503)639-4171 MST
I BUP
Received Date Requested
_--__--�-
rs AM_ �/ _ PM - 8UP
Location l--L-L1�_ uite`_ MEC
Contact Person ph �__---) --�!?�-�- PLM
Contractor -_
- - - - - - - - .- - - I'h ----) -------- SWR
BUILDING Tenant/Owner ELC -
Footing — _ _ —_ -_ __._---.-__--
Foundation ELC
Ftg Drain Access:
Crawl Dr iin ELR
Slab Inspection Notes: SIT
Post& Bearr,
Shear Anchors
Ext Sheath/Shear -
Int Sheath/Shear
Framing -- -_-- --- -
Insulation
Drywall Nailing
---- ----------------
firewall - - ----.
Fire Sprinkler -- --- - -
ire Alarm ----
Susp'd Ceiling --- --_
Roof
Other: -
-
. ^ �>PART FAIL - - -- -
PLUMBIN(i�—`-
Post& Beam
Under Slab I
Rough-in
- -
Water Service
--- - --
Sanitary Sewer --------
Rain Drains
Catch assn i Manhole
Storm Drain - - ------
aower Pan
Other: ----- -
Final --- -
PASS PART FALL
HA -- — -- -
MECNICAL
Post 8 Beam ---— - - -
Holigh-In -
-----------------
Gas Line - --_.--_
Smoke Dampers
PASS PART FAIL - - —-
- - -- --
ELECTRICAL:- -
-- —
------
Rough-In
UG/Slab ------ — -— _ --- - -----
Low Voltage
Fire Alarm
Final 1
PASS PART FAIL 1 Reinspection fee of$-_ - required before next inspection. Pay at City (fall, 13125 SW Hall Blvd,
Fire
SITE __ I I Please call for reinspection HE: _-__ Unable to in -no access Supply Line — -
ADA
Approach/Sidewalk Date [� /_" Inspector
_ - --
OtheExt
r. --
Final DO NOT REMOVE this InKpection record from the Job site.
PASS PART FAIL
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CITY OF TICARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 cmsi
C-A/ BUP
Received _ _ /Date Req ested �_. — AM __�_—_ PM _-_ BUP —
Location __---� j •� 1 A/ — : 2_/fuite�__..-..___.____._---- EC ;�CI_L�Z4C(
Contact Person --___ Ph ___ PLM
Contractor -_ Ph SWR _
BUILDING Tenant/Owner —__ ELC --_-�.
Footing �ELC �'�'_, j
Foundation Access: 371,,2f2j
Ftg DrainL' G�Crawl Drain
Slab Inspection Notes. SIT
Post& Beam
Shear Anchors -
Ext Sheath/Shear
Int Sheatri/Shear
Framing
Insulation
Drywall Nailing -- -----
Firewall
Fire Sprinkler - --- ------ — --- ------------- _- -... --- -
Fire Alarm
Susp'd Ceiling -
Hoof
Other: - �----
Final
PASS PART_ FAIL
PLUMBING
Post& Beam
Under Slab - --
Rough-In _
Water Service -
Sanitary Sewer
Rain Drains - -- -- ---
Catch Basin/Manhole
Storm Drain ---- - - - - - - - - -
Shower Pan
Other -- --
Final
PFAIL
ECHANIC
eam
Rough-In ----_- ------
Gas Line
Smoke Dampers ----
na
FAIL --------- ------
- - ---------- ----- -- - - --- ---- - -----------------------
Service
Rou h
a lab
Lo_w_Toltage _
Fire Alarm
n ART FAIL Reinspo ctio ,fee of$__ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
Please call for reinspection RE: _ _._ Unable to inspect-no access
Fire Supply Line
ADA ,
Approach/Sidewalk Date ( l_`_�-_� __ Inspector __ __- Ext -_- --
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL.
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)539-4171 MST
�� 11 BUP _
Received __�_ Date Requested 'W _ AM PM . ✓_ BUP
Location ' °l --Suite--- MEC
Contact Person Ph( ___1 _ _7 1122 — < PLM
Contractor------------------------- — -_— Ph
SWR
BUILDING Tenant/Owner -_ __ _ ELC
Footing ELC
Foundation Access: �^
Ftg Drain �� I �` 1` >ELR ------ - -- .
Crawl Drain
Slab Inspection Notes: SIT
Post& Beam - -- - -- --- ___
Shear Anchors j
Ext Sheath/Shear
Int Sheath/Shear
Framing -
Insulation
Drywall Nailing -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling --
Roof
Other
Final
PASS PAR' FAIL
UMB G - -
Pest&Beam-
Under
eamUnder Slab --- —_.�------ - - ---
Rough-In
Water Service --
Sanitary Sewer .�
Rain Drains
Catch Basin/Manhole �-
Storm Drain —
Shower Pan
Other:
Fin
SS I PART FAIL
MS-_ NICAL -- - -- _ _..---- --—
Post& Beam
Rough-In ---. -- - - -
Gas Line
Smoke Dampers _ - ---_- _
Final
P RT FAIL - - - - --
RICA -
ice
Rough-In --
UG/Slab
Low Voltage -------- - — ---
Fire Alarm _
Reinspection rce of$__ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART _FAIL
— -- n Please call'or reinspection RE: .._- Unable to inspect-no access
'apply Line
ADA `-� / , _ Ext -_
Date
Approach/Sidewalk (� (1_ V Inlp•Ctor -
Other.
Final DID NOT REMOVE this Inspection record from the,fob site.
PASS PARI FAIL
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