Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Permit
w o 6 • , -„ 9d dea- CITY OF TIGARD BUILDING ERMIT PERMIT #: BUP2005 -00268 �, ii DEVELOPMENT SERVICES DATE ISSUED: 6/23/2005 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S 110 BA -03700 SITE ADDRESS: 11645 SW CLOUD CT ZONING: R -2 SUBDIVISION: SHADOW HILLS LOT: 028 JURISDICTION: TIG Project Description: 730 sf. deck replacement. 7/6/05 adding 900sf new deck. REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: OTR FIRST: sf N: S: E: W: TYPE OF USE: SF SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 5N : sf N: S: E: W: OCCUPANCY GRP: R3 TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: 5 ft RGHT: 5 ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: 25 ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 12,000.00 Owner: Contractor: VAN HOOPER DECKS BYJRW 11645 SW CLOUD CT. 16540 SW 72ND AVE., #7 TIGARD, OR 97224 PORTLAND, OR 97224 Phone: 503 - 957 -7427 Phone: 503 - 620 -2333 FEES Reg #: LIC 57769 Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 6/23/2005 $158.50 [TAX] 8% State Surchari 6/23/2005 $12.68 [BUPPLN] Pln Rv 6/23/2005 $103.03 • [CDCPLN] CDC Pln Rey 6/23/2005 $42.00 (additional fees not listed here) Total $646.24 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 -33 -2344. Issued By: .01 ! _ , • ` Permittee Signature: s Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. . adifA -- t jitt)OM " 0 1 91jVin7( i Building Permit Application FOR OFFICE USE ONLY City of Tigard Received -7 Q P ennit No -.1.1.- �' ����® Date/By. (7 09 � �Y C,a —Oaf -� 13125 SW Hall Blvd., Tigard, Ei ' `, Plan Revie Phone: 503.639.4171 Fa 5 03.598.196 0 ��na;t4'�I' p��B Other Permit: Inspection Line: SOg .639.4175 JUL 0 6 2005 D Ready/By: ® Pee Attached Checklist for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information riTY OF TIGARD RUILOM OW6NN REQUIRED DATA: 1- AND 2-FAMILY DWELLING New construction ❑ Demolition Permit fees' are based on the value of the work performed. ( Indicate the value (rounded to the nearest dollar) of all ❑ Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF. CONSTRUCTION work indicated on this application. �{, Valuation: $ L \ c p - 1- and 2- family dwelling ❑ Commercial /industrial El Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: / / (e 7 S 3/A) Ca.)vi C 7 New dwelling area: square feet City /State /ZIP: '7-')6 D O(L 77 Z Z C4 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: )_/, ).-/00eFVZ Covered porch area j square feet ' Cross street /directions to job site: Deck area: eW square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: Permit fees' are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. V; (__ .l Piecuvi) D Valuation: $ � I (v L Existing building area: square feet New building area: square feet • , fi r PROPERTY OWNER ❑ TENANT - . Number of stories: v Name: '(1 Type of construction: Address: Mn( l:c >l,.J e ()(/D C`7 Occupancy groups: City /State /ZIP:' h Q \� 012 2Z Existing: Phone: ) 15 - -1 ��71 Fax: ( ) New: APPLICANT ❑ CONTACT PERSON NOTICE Business name: (ZLJ Cot .5772 L'c -rl DZ All contractors and subcontractors are required to be Contact name: v USTI )\J licensed with the Oregon Construction Contractors Board Q under ORS 701 and may be required to be licensed in the Address: r 1 2 Z J SC 82`' jurisdiction in which work is being performed. If the City /State /ZIP: 6( D&Tb 66?-- applicant is exempt om licensing, the following reasons apply: nt✓� i, 7• 3 O Phone:( (9 ?� 33 Fax: :EQ c —alp Z330 6..v• /a- f. 75 ,i E -mail: TX / `r - c l CONTRACTOR a, \ " • Address: name: I� e 1 ? / BUILDING PERMIT FEES* Adres: Please refer to fee schedule. City /State /ZIP: Fees due upon application Phone: ( ) Fax: ( ) Amount received CCB lic.: 51 Icook Date received: Authorized signature: c_.----- This permit application expires if a permit is not obtained /.(9..' / within 180 days after it has been accepted as complete. Print name: i (`ht ( ��-- i - \ Date: " 6 ' Fee methodology set by Tri- County Building Industry Service Board. i.\ Building \Permits\BUP- PennitApp.doc 12/03 440 -4613T(11 /02/COM/WEB) One- and Two - Family Dwelling • Building Permit Application Checklist FOR OFFICE USE ONLY City of Tigard Received ty g Permit No.: 13125 SW Hall Blvd., Tigard, OR 97223 Dated t Phone: 503.639.4171 Fax: 503.598.1960 &tamp Associated permits: 24- Hour Inspection Line: 503.639.4175 ,'t'� CI Electrical ❑ Plumbing ❑ Mechanical Internet: www.ci.tigard.or.us Cl Other. • THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Ves No N/A I 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. Name of district: ❑ ❑ ❑ 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. 1 I 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 Enginee'r's calculations. When required or provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑ architect licensed in Ore:on and shall be shown to be applicable to the .ro'ect 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 and 22 above. ❑ ❑ ❑ 25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be 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 and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include tree protection measures as required by conditions of approval. ❑ ❑ ❑ 30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. L:\ Building \Permits\BUP- RES- PermitApp.doc 2 I ` CITY OF TIGARD BUILDING PERMIT PERMIT #: BUP2005 -00268 411 DEVEL R I CES -639 -4171 DATE ISSUED: 6/23/2005 - 13125 SW PARCEL: 2S 110BA -03700 SITE ADDRESS: 11645 SW CLOUD CT ZONING: R -2 SUBDIVISION: SHADOW HILLS LOT: 028 JURISDICTION: TIG Project Description: 730 sf. deck replacement. REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: OTR FIRST: sf N: S: E: W: TYPE OF USE: SF SECOND: sf PROJECT OPENINGS? TYPE OF CONST: 5N : sf N: S: E: W: OCCUPANCY GRP: R3 TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 12,000.00 Owner: Contractor: VAN HOOPER DECKS BYJRW 11645 SW CLOUD CT. 16540 SW 72ND AVE., #7 TIGARD, OR 97224 PORTLAND, OR 97224 Phone: 503 - 957 -7427 Phone: 503 - 620 -2333 FEES Reg #: LIC 57769 Description Date Amount REQUIRED ITEMS AND REPORTS [BUILD] Permit Fee 6/23/2005 $158.50 [TAX] 8% State Surchari 6/23/2005 $12.68 [BUPPLN] Pin Rv 6/23/2005 $103.03 . [CDCPLN] CDC Pln Re` 6/23/2005 $42.00 (additional fees not listed here) Total $322.21 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of these rut- • or . r; t questions to OUNC by calling 503 -24 9 0 1- 800 -332- 4. Issued ByA ,e" �,, Permittee Signature: Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Building , Application H V E ® FOR OFFICE USE ONLY CI Received Of Tigard Permit No.: City g Date/By: G a 3 a5 6 0 13125 SW Hall Blvd., Tigard, OR 97223 JUN 2 3 200 Plan Revie Phone: 503.639.4171 Fax: 503.598.1960 4 "` " m cm:�m)'I I { f � Date/By: Other Permit. o? by Inspection Line: 503.639.4175 CITY OF T IG 1 Date Ready/By: JApW El See Attached Checklist for Internet: www.ci.tigard.or.us BUILDING DIVISION Notified/Method: V t Supplemental Information TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all 'Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. Valuation: $ / Z v a o 1- and 2- family dwelling ❑ Commercial/industrial i ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floers: Job site address: (I ( S 5 vo ( t,D J 0 C"- New dwelling area: square feet City/State/ZIP: ---\-- \ 1, A IZ,> ©a q-i-izi.4 Garage/carport area: square feet Suite/bldgiapt. no.: Project name: }}(f P "ER_ Covered porch area: square feet Cross street/directions to job site: ti ��"* Deck area: '"1 3 D square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST. . Subdivision: Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK - work indicated on this application. gE � \( E — \ , K Valuation: $ Y4 a Existing building area: square feet New building area: square feet PROPERTY OWNER ❑ TENANT Number of stories: Name: VA NI N 0t _ Type of construction: Address: m y W cum) C')i Occupancy groups: City/State/ZIP: Existing: G In ( . O a t. �1l1 0 1,1, Lk Phone: 5C)3) 1 c — 1 t4 1,1 Fax: ( ) New: APPLICANT ❑ CONTACT PERSON NOTICE • Business name: j k XY (4 (( 1 () /, All contractors and subcontractors are required to be �U 57-' f� T licensed with the Oregon Construction Contractors Board Contact name: under ORS 701 and may be required to be licensed in the Address: n 8 2s- g2,,t4P ok jurisdiction in which work is being performed. If the City/State/ZIP: ott S N V.J me" otL on ®t applicant is exempt from licensing, the following reasons ` �_ ' � \ � aa 2 �/, 22 ry ,, 7 apply: Phone: (az) (pZO Z33 Fax: 60,3) ((4 — 3 0 E -mail: CONTRACTOR Business name: Address: /1/p /T 5 �p :5 , =%‘v(&---- BUILDING PERMIT FEES* Please refer to fee schedule. City/State/ZIP; Fees due upon application Phone: ( ) Fax: ( ) Amount received ' -' CCB lic.: 5�] (09 p � vo 1 1 7 �;� • Date received: 4 ' • Authorized signature: / . gn This permit application eapires if a permit is no obtained � within 180 days after it has been accepted as complete. Print name: l) S� ( l 12to'� Date: 612.3 * Fee methodology set by Tri-County Building Industry "t Service Board. Jun.23. 2005 9:43AM - CLEAN WATER SERVICES 503 6814439 7ptd No.7616 P• 1- 0 ......, .. . . d2 W1= (,■-,; ■t!‘ 1 - \\ . \.\\ AIN i 7 M _) CleanWater S - -- .. _._ - File Number . D0 _ Our commitment (a cleat. Sensitive Area Pre - Screening Site As :essment Jurisdiction , a4—.. 04 • 1 Date n l t'1 I a s Map a Tax Lot .251 / p 134 4 3 9 Owner VA, n H ao p e• • sivk a,+ M■ ‘‘s lick* Applicant w . (re - r5 Site Address U 4t1 S s,.•.) c.■006. �4, Company Pecwti by , rhzw - rig ^elk, o Q et 11_1-y Address C'1 ,Z S W _ Proposed Activity • City State Zip ..A, c wk- 9707_7 e.s'Ft±_-, 6..t . Phone Su& -5 (.f!:4 Fax 3b -tie° - 2. 33 0 • Wide/ um only below title ane Y N NA Y N NA ❑ ❑ • Sensitive Area Composite Map rmrtfri structure maps Map # . 23(4.0. ._.__ E] ❑ Stowater I QS # v V? . ❑ ❑ � EA . Locally adopted studies or maps 'e.' ❑ ❑ Other fY SPOCKy .Qo'l , . • Based on a review of the above information and the requirements of Clean Watt tr Services Design and Construction Standards Resolution and Order No. 04.9: El Sensitive areas potentially exist on site or within 200' of the site. THE Al'PLICANT MUST PERFORM A SITE CERTIFICATION PRIOR TO ISSUANCE OF A SE RVICE PROVIDER. if Sensitive Afeas exist on the site or within 200 feet on adja ;ent • properties, a Natural Resources Assessment Report may also be require f: 112 Sensitive areas do not appear to exist on site or within 200' of the site. This pre- . screening site assessment doei NOT eliminate the need to evaluate and orotect water quality sensitive areas If they are subsequently discovered. This, d acument will serve as your Service Provider letter as required by Resolution and Order 04-9, Section 3.02.1. All required permits and approvals must be obtaine I and , completed under applicable locat, state, and federal law. ❑ . The proposed activity does not meet the definition of development. NO ; ITE ASSESSMENT OR SERVICE PROVIDER LETTER (S REQUIRED. Reviewer Comments: A 4e4 at i'eYJ W of A.CicRI a..r/+a./ 4e re. vie . r4 ea r W. a k/7 .170:11 Q..pa c �P . r•.r h j a y . 4.0101 ..7;ir 4.ra • .7411x k ,ewe ot^ ; � r_ /Z a 11 ' Reviewod By: _ c C j - ,-�' - _.� Date: G/2 310 5 . . • Post -it" Fax Note 7671 Date 3 aj Aes► if O Cla use only • To r•1 From ` J 4 vt c / 3 1 / 4 1/4 " I ! Relurtt to Applicant co. /Dept. co. C . I ! Mail Fax )' Con iter — ii Pn000 x Promo # 5 , 6 $/ - S/GO A I i Date � 3/U S B , : H Fnx H t` / �I FOX 5�3� - ... --. _1" ■ i , , . . . . , D eck k Permit Plot Plan Page 1 1 /\ Property owners: VAN HOOPER 30 Home Phone: 503 957 -7427 SCALE: 1" = -O�� Property address: 11645 SW CLOUD CT TIGARD OR 97224 • Legal Description: 143 Contractor: JRW Construction Inc. \`° 17825 SE 82ND DR GLADSTONE OR. 97027 a5 OCB # 57769 \ - -- - Metro # 001175 Contact: DUSTIN �` 90 503 519 -6549 `� \ \ 1 % ' A Component Summary /] O U5 5" / I Ledger: 2x8 pt. attached with 5" LEADER LOCKS 12" oc. hi /low Joists: 2x8 pt. 16" oc. Joist hangers: Simpson LUS26Z . _ CITY OF TIGARD - SITE PLAN REVIEW Blocking: 2x8 pt on or near mid beam run BLAILDING PERMIT NO.: Beams: 4x8 pt PLANNING DIVISION: , I \ Column caps: 2x4 pt. sistered each side of post/beam connection Required Setbacks: [proved ❑ Not Approved w /4ea. 16p GIV. Side: S _ Street Side: " t Fron. Posts: 4x4 pt -_ Garay - 2� Rear: ~ - Visual Clearance: proved ❑ Not Approved - Post bases: Simpson EPB44HDG Maximum Building Height•l v feet y i i Rack bracing: 2x4 pt. diaphram at 45 degree attached with CWS Service: ovider Letter Required: ErYes ❑ No tea. 16p HD box per joist. a„../eived B oa B : X Date: S \ ENGINEERING DEPARTMEN ` T. rit. Actual Slope: _% ❑ Approved 0 Not Approved Site PI �: nn ❑ Approved N t Approved HOOPER B 0I Date: 7 to c Note : 1 J I 4 CITY OF TIGARD BUILDING DIVISION PERMIT #: BUP2005.00268 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/23/2005 Phone: (503) 639 -4171 %Ao�li�u�� +� Inspection Requests (24 Hrs.): (503) 639 -4175 ' j l� .. INSPECTION WORKSHEET FOR DATE: 9/2/2005 TIME: 7:07AM PAGE: 78 SITE ADDRESS: 116455 SW CLOUD CT CLASS OF WORK: SUBDIVISION: SHADOW HILLS LOT #: 028 TYPE OF USE: PROJECT NAME: HOOPER DESCRIPTION: 730 sf. deck replacement. 7 /6/05 adding 900sf new deck. . OWNER: HOOPER, VAN PHONE #: 503 -957 -7427 CONTRACTOR: DECKS BY �JRW PHONE #: 503- 620 -2333 Inspection Request Scheduled For: Date: 9/2/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 014837 -01 503-519-6549 Y Corrections /Comments /Instructions: f / < Po L. L 5 5 ;..emu ,,.., a .. C Vr4-7C,�7 < -- . 7--- c-1 4 --- / 4 LC -555 ---7-0 - ., —6 a L_. At-v� 6 'Z �' c3S I -•-e - Ld4- '//(A. • - PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: D a t e : ne #: (503) 718-