Permit ,,.
^' F ' CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2002 -00350
���Iil DEVELOPMENT SERVICES R9 I (503) 639-4171
DATE ISSUED: 7/25/02
13125 SW Hall Blvd.,
SITE ADDRESS: 15033 SW 81ST AVE PARCEL: 2S112CB -12500
SUBDIVISION: PP1990 -012 ZONING: R -4.5
BLOCK: • LOT: 003 JURISDICTION: TIG
REMARKS: Convert 143 square feet of garage space to bedroom.
BUILDING
REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ALT HEIGHT: FIRST: 143 sf BASEMENT: sf LEFT: SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT:
VALUE: $ 12,000.00
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 143.00 sf REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 600 amp: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT:
MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVESIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 324.81
This permit is subject to the regulations contained in the
CUTTER, STEPHAN G + STEPHEN G KARL CONSTRUCTION
Tigard Municipal Code, State of OR. Specialty Codes and
KELLIE S 21550 SW MCINNIS LN all other applicable laws. All work will be done in
15033 SW 81ST AVE ALOHA, OR 97007 accordance with approved plans. This permit will expire if
PORTLAND, OR 97224 work is not started with in 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 Notification Center. Those rules are set
Reg #: LIC 47160 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
Post/Beam Structural Electrical Final
Mechanical lnsp Mechanical Final
Electrical Rough In Final inspection
Framing lnsp
Insulation p—�
1 7
Issue By : / � , i . /�/ : Permi ttee Signature : •
Call (503) • 9 -4175 by 7:00 p.m. for an inspection needed tie next business day
`'- Building'PermitApplication
� Date received: 7 01-5" 01-5" Permit no.: /lT l j -ap p ?
7
X 1 1 11 City of Tigard
Project/appl. no.: Expire date:
CiryofTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 -4171 Date issued: By: Receipt no.:
Fax: (503) 598-1960 \ 0 Case file no.: Payment type:
Land use approval: 11( I &2 family: Simple Complex:
- TYPE OF PERMIT .
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ New construction • ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
• JOB SITE INFORMATION
Job address: I .5 033 5 tom) Q i tt A- V Bldg. no.: Suite no.:
Lot: Block: (Subdivision: I Tax map /tax lot/account no.:
Project name: /� /� //
Description and location oof rrk on premises /special conditions: C.(I A) V �T /'/3, �J
4 /1�46 G ry
6 S-r-, aocti
,- , , : " OWNER , FOR ,;, :„ .,,. . FOR SPECIAL INFORMATION; USE CHECKLIST , , •
Name: S S'€ t+p�N s y,, E., L L L V - T T E ., . (Floodplain, septic capacity, solar, etc.),
Mailing address: I So • 3 S W $1 5 t' p �.. , 1 & 2 family dwelling:
City: TA Ca p �-' I State: b ej ZIP: q-I Z Z c4.. Valuation of work $ /2 000
Phone: (p Zt./- 104( o (Fax: . IE -mail: No. of bedrooms/baths -
Owner's representative: Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.)
APPLICANT - Garage /carport area (sq. ft.)
Name: Covered porch area (sq. ft.)
Mailing address: Deck area (sq. ft.)
City: I State: I ZIP: Other structure area (sq. ft.) l'7
Phone: Fax: E -mail: Commercial/industrial /multi- family:
i `' s CONTRACTOR • Valuation of work $
Existing bldg. area (sq. ft.)
Business name: K q, ?...L eats v , Co . New bldg. area (sq. ft.)
Address: &(S., O Su pet c. -1..v1v∎;S L 1 • Number of stories
City: N. 1 I I State:O2 I ZIP: 97007
Type of construction
Phone: s q 1- S! Z/ I Fax: s N, f - , I E -mail:
Occupancy group(s): Existing:
CCB no.:
47t6,0 New:
City /metro lic. no.: Notice: All contractors and subcontractors are required to be
ARCHITECT/DESIGNER - licensed with the Oregon Construction Contractors Board under
Name: provisions of ORS 701 and may be required to be licensed in the
Address: jurisdiction where work is being performed. If the applicant is
State: I ZIP:
exempt from licensing, the following reason applies:
City
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: State: ZIP: Amount received $
Phone: Fax: I E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this 0 Visa ❑ MasterCard
work will be complied with, w Cher specifie herein or not. Credit card number: / /
Expires
Authorized signature: Date: 7-2 3 --OZ— Name of cardholder as shown on credit card
$
Print name: Sac, E, 1� 4 L Cardholder signature
) Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440 -4613 (6ro0/COM)
A tio One- and Two - Family Dwelling
ryre > Building Permit Application Checklist Reference no.:
Associated permits:
City of Tigard City of Tigard Y b ❑Electrical ❑Plumbing ❑Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR 97223 ❑ Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
• ' THE FOLLOWING' ITEMS ARE REQUIRED FOR PLAN,REVIEW Yes No • N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews.
2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc.
3 Verification of approved plat/lot.
4 Fire district approval required.
5 Septic system permit or authorization for remodel. Existing 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 ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of
catch -basin protection, etc.
10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed
if copyright violations exist.
11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if
there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and
driveway; footprint of structure (including decks); location of wells/septic systems; utility locations; direction indicator; lot
area; building coverage area; percentage of coverage; impervious area; existing structures on site; and surface drainage.
12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent
size and location.
13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater,
furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc.
14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub - floor, .
wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show
details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs,
fireplace construction, thermal insulation, etc.
15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels.
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full -size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing (prescriptive path) and /or lateral analysis plans. Must indicate details and locations; for
non - prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered
systems, see item 22, "Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams 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 Code compliance. Identify the prescriptive path or provide calculations. A gas - piping schematic is required
for four or more appliances.
22 Engineer's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or
architect licensed in Oregon and shall be shown to be applicable to the project under review.
• JURISDICTIONAL SPECIFICS
23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ".
24 Two (2) sets each are required for Items 16, 19, 20 & 22 above.
25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will be not accepted.
26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document.
27 "Drawn to scale" indicates standard architect or engineer scale.
28 Site plan to include tree size, type & location per approved project street tree plan (if applicable), and COT Street Tree List.
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 440 -4614 (6 /00 /COM)
.. K ` Electrical Permit Application `'
Date received: 7 / /&-.. Permit no.: d rlecps-r 0
n l (' City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction Addition /alteration/replacement ❑ Other: ❑ Partial
_ JOB SITE INFORMATION
Job address: rj 0 W • 's--1 - ` . Bldg. no.: Suite no.: Tax map /tax lot/account no.:
' Lot: Block: Subdivision:
Project name: Description and location of work on premises: 3.eJ To . • rk -
Estimated date of completion/inspection:
, C ONTRACTOR; APPLICATION, • -, :, FEE SCHEDULE : , •
•IVE r ',G ,_.43 ..._/1.-62 fLY✓ e-Otur , .4.1-e. Fee Max
Business name: A a O - \A , Description Qty. (ea.) Total no. insp
New residential - single or multi- family per
Address: • IA a • PL . dwelling unit Includes attached garage.
a ME= State: v oe_ ZIP: • 6 5''' Service included:
Phone: eg —1., _ E -mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof _—
CCB no.: ($O 2_' - ii - . 61at.�nh1 ,tt� S Limit edener
/o �_ gy, residential ___ 2
City/metro lic. no.: / ohs 2' Limited energy, non - residential ___ 2
Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date to ,, Service and/or feeder 2
Sup. elect. name (print). - -1 - c kik O License no. • _ Services or feeders — installation,
alteration or relocation:
. , , PROPERTY OWNER 2 00 amps or less 2
Name (print): f 201 amps to 400 amps ___ 2
�' 1 _ 401 amps to 600 amps ___ 2
Mailing address: a S g 5 t V 'e—.. 601 amps to 1000 amps ___ 2
• ZIP: q Over Over 1000 amps or volts ___ 2
Phone: Fax: E -mail: Reconnect only ___ 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration
200 amps or less 2
ORS 447, 455, 479, 670, 701.
201 amps to 400 amps ___ 2
Owner's signature: Date: 401 to 600 amps ___ 2
., i ';,r' ,ENGINEER Branch circuits - new alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: State: ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: ■■ 2
Phone: Fax: E-mail: Each additional branch circuit: ___—
PLAN REVIEW (Please check all that apply) ` Misc. (Service or feeder not included):
❑ Service over 225 amps - commercial ❑ Health -care facility Each pump or irrigation circle ■■ ■ 2
❑ Service over 320 amps- rating of 1 &2 ❑ Hazardous location Each sign or outline lighting ___ 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal ' more residential units in one structure alteration, or extension* ■■ 2
❑ Building over three stories ❑ Feeders, 400 amps or more *Descri .non:
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lighting plan ❑ Other. Per inspection __
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card
$
Cardholder signature Amount 440 -4615 (6/00 /COM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES
Complete Fee Schedule 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. ft. or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof $33.40 1 Fl Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular El Service or Feeder $90.90 2 Garage Door 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 Vacuum Systems
401 amps to 600 amps $160.60 2 ,
601 amps to 1000 amps $240.60 2 ❑ Other
Over 1000 amps or volts $454.65 2
•
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $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. ❑ Audio and Stereo Systems
Branch Circuits
New, alteration or extension per panel n Boiler Controls .
a) The fee for branch circuits •
with purchase of service or n Clock Systems
feeder fee.
Each branch circuit $6.65 2 I Data Telecommunication Installation
b) The fee for branch circuits
without purchase of service n Fire Alarm Installation
or feeder fee.
First branch circuit $46.85
Each additional branch circuit $6.65 ❑ HVAC
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40
Each sign or outline lighting $53.40 n Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00 n Landscape Irrigation Control
Minor Labels (10) $125.00 l �� I
Each additional inspection over I I Medical
the allowable in any of the above
Per inspection $62.50 n Nurse Calls
Per hour $62.50
In Plant $73.75 ❑ Outdoor Landscape Lighting
Fees: ❑ Protective Signaling
Enter total of above fees $ ' n 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 Balance Due $
Enter total of above fees $
❑ Trust Account # 8% State Surcharge $
Total Balance Due $
All New Commercial Buildings require 2 sets of plans.
•
i:\dsts \forms \elc- fees.doc 08/30/01
CITY OF TIGARD, ,
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
OREGON INTEGRATED CONTRACTING
19239 MECHANT PL
OREGON CITY, OR 97045 AUG (1 4 2fl117
cIl A kUi ki/i1 W
Electrical Signature Form BUILDING' MNIMON
Permit #: MST2002 -00350
Date Issued: 7/25/02
Parcel: 2S112CB -12500
Site Address: 15033 SW 81ST AVE
Subdivision: PP1990 -012
Block: Lot: 003
Jurisdiction: TIG
Zoning: R-4.5
Remarks: Convert 143 square feet of garage space to bedroom.
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
OWNER: ELECTRICAL CONTRACTOR:
LUTTER, STEPHAN G + OREGON INTEGRATED CONTRACTING
KELLIE S 19239 MECHANT PL
15033 SW 81ST AVE OREGON CITY, OR 97045
pO Lk ND, OR 97224
Ph Phone #: 503 - 880 -8649
Reg #: LIC 150266
SUP 3853S
AN INK SIGNATURE IS REQUIRED ON THIS FORM
''
Signature of _ pervising Electrician
If you have any questions, please call (503) 639 -4171, ext. # 310
CITY OF TIGARD 24 -Hour
BUILDING • Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP '
•
Received Date Requested V") AM PM BUP •
Location `CD 33 ? 1 Suite MEC
Contact Person _D _ Ph ( ) 2 (— STS :57c, PLM
Contractor Ph ( ) SWR
ILDING� Tenant/Owner ELC
ELC
Fou Access: /
Ftg Drain / ( ( i-. /71) ELR
Crawl Drain l`
Slab Inspection Notes: Q S SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
- T FAIL
Under Slab
Water S
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
P _ T FAIL
a�i'ANIC
- m
Rough -In
Gas Line
S•• • .e Dampers
hm-
taD ;! �
4 PART FAIL
='= RICAj
Rough -In
UG /Slab
Low Voltage
Fire Alarm
PART FAIL
❑ Reinspection 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 7 l Approach /Sidewalk Date 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 411 Business Line: (503) 639 -4171 MST
BUP
Received Date Requested 7 /P' AM PM BUP
Location / 33 '/ - — Suite v MEC
•
Contact Person v ` = Ph ( ) o (el PLM
Co Ph ( ) SWR
Tenant/Owner ELC
Footing?
Foundation J , ELC
Access:
Ft Drain
9", 5 S ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Shear
�1 '•�� ailing /
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
F FAIL PL
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
•
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
P RT FAIL
,ELL
Service
Low Voltage
Fire Alarm
El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
4P) PART FAIL Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Dat (� �/ I U Zi Inspector ti 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 MST OL — G D 35
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested 7--3e) AM PM BUP •
Location / 5 3_3 Set) 9 / S/ I Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
UG Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab . Inspection Notes: . SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear �) r
Framin • ,( ° f `ee / c/7--c77.5-/L- /f o .`J @
ation Al sa JOGC
rywa Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: (/ate—
Fi
ASS ART FAIL
P MBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: Unable to inspect – no access
Fire Supply Line
ADA -7 – Q — � Inspector c Ext
Approach/Sidewalk Date p
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
•