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Permit Vii: ;. 2:::. r J 1 • . / -/ - O 7 ' � BUILDING PERMIT P A �� ' ERMIT #: BUP2005 -00017 � ; *'y D k D EVELOPMENT SERVICES DATE ISSUED: 1/1t /2005 13 125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102CB 02800 SITE ADDRESS: 09963 SW FREWING ST SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: C -G BLOCK: LOT: 021 JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: DEM FIRST: sf N: S: E: W: TYPE OF USE: SF SECOND: sf PROJECT OPENINGS? TYPE OF CONST: : sf N: S: E: W: OCCUPANCY GRP: TOTAL AREA: 0 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: B'!MT ?: 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: Remarks: Demo house: Sewer to be capped. DEMO CREDITS FOR SEWER, TIF AND PARKS. US Owner: Contractor: EXPIRED � KAMELIA MASSIH GDI DESIGN BUILDER, INC. PO 1831 SW DICKINSON LANE 3300 NW 185TH AVE. PORTLAND, OR 97219 PORTLAND, OR 97229, OR 97229 a Phone: /' / q yz/V �I /y y l Phone: 503-789-2345 Reg #: LIC 160884 o FEES REQUIRED INSPECTIONS _ 0 Description Date Amount Ersn Cntrl 681 -4444 0 - [BUILD] Permit Fee 1/19/2005 $62.50 Final Inspection r r,. U � ' � r [TAX] 8% State Surcharl 1/19/2005 $5.00 , � . J [ERPRMT] Erosion 1/19/2005 $26.00 [ERPLN] Ero Plck -CWS 1/19/2005 $8.45 rr nl r ( 1 foC (additional fees not listed here) v. V is 1 �,� lam _" Total $110.40 ______A.... 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 - 332 -2344. issued By: / , 1 " .; !. %. !.l ', ; -�, Pe rm ittee r--• Signature: ) 7.? /i f . _ - - Call 639 -4175 by 7 p.m. for an inspection the next business day BUP - Building Permit ELC - Electrical Permit \I Inspection Description Date Passed By _ Inspection Description _ Date Passed 1 By Footing /Setback Underground cover Foundation walls Wall cover Footing drain Ceiling cover _ Waterproof bsmt walls Electrical rough -in Slab Electrical service Crawl drain Electrical final Underfloor insulation Post /beam structural _ Shear walls /anchors ELR - Restricted Ener Permit _ Roof nailing - 4 Inspection Description Date Passed By Firewall Low voltage Tilt up panel Electrical final Masonry /Reinforcement — J Framing • MFG Structure set -up MEC - Mechanical Permit Insulation Drywall nailing 4 Inspection Description Date Passed By Suspended ceiling Post /beam mechanical • . - Engineered soils _Gas line Welding Lab Final _ Mechanical rough -in Concrete Lab Final Fire damper _ Duct work Bolting Lab Final Smoke detector Structural observation Mechanical final Fireproofing Lab Final — — Final inspection PLM - Plumbing Permit BUP — Fire Protection System Permit Inspection Description Date Passed By Plumbing underslab - NI Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab — Post /beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler final RP /backflow preventer Fire alarm final Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer - 4 Inspection Description Date Passed By Culvert /catch basin Footings Pump /fill septic tank Foundation walls Plumbing final Sprinkler supply lines Sprinkler underfloor /slab Catch basin /Manhole _ _ SWR - Sewer Permit Engineered soils 4 Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits is \dsts \ forms \InspRecordBUP.doc 04/17/01 Mb �.,A �� BUILDING PERMIT CITY OF TIGARD PERMIT #: BUP2005 -00017 ll DEVELOPMENT SERVICES DATE ISSUED: 1/19/2005 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 09965 SW FREWING ST PARCEL: 2S102CB 02800 SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: C -G BLOCK: LOT: 021 JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: DEM FIRST: sf N: S: E: W: TYPE OF USE: SF SECOND: sf PROJECT OPENINGS? TYPE OF CONST: : sf N: S: E: W: OCCUPANCY GRP: 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: Remarks: Demo house: Sewer to be capped. DEMO CREDITS FOR SEWER, TIF AND PARKS. Owner: Contractor: KAMELIA MASSIH GDI DESIGN BUILDER, INC. 1831 SW DICKINSON LANE 3300 NW 185TH AVE. PORTLAND, OR 97219 PORTLAND, OR 97229, OR 97229 Phone: Phone: 503 - 789 -2345 Reg #: LIC 160884 FEES REQUIRED INSPECTIONS Description Date Amount Ersn Cntrl 681 -4444 [BUILD] Permit Fee 1/19/2005 $62.50 Final Inspection [TAX] 8% State Surchan 1/19/2005 $5.00 p [ERPRMT] Erosion 1/19/2005 $26.00 [ERPLN] Ero Plck -CWS 1/19/2005 $8.45 (additional fees not listed here) Total $110.40 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 - 332 -2344. i Issued By: /0,A.,Z4A4_, 0 I Permittee r — Signature: f)7 /' ,,(/),�, r6/�/( ( - Call 639-4175 by 7 p.m. for an inspection the next business day P . M P 0 . ' . , , . Building Permit Applica I!' °:� u' , - FOR - OFFICE USE ONLY '. City of.Ti ,;rd Date/By: / — I "/ — 0.5 8./. PernutNo.:: • , G . 000/ 7 13125 §`4V Hall Blvd., Tigard, OR 97223 // Plan Review Phone: 503.639.4171 Fax: 503.598.1960 . JAN 19 Iii i DateBy: Other Permit: Inspection Line: 503.639.4175 E' i� Date Ready/By: 0 See Attached Checklist for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method Supplemental Information �uR,.,. t.> � , ..,..- „.-: »”" �x "fit .` .., ., -,. ,. �: BUILDING A:z � ��„�., -� ��:- - ,�,_ .. ., �gx- • s�,�.�.T;`w3'�w°�::.r: {�,. •�.�s:.:. ^a. > ».. x ?:�, ,,. < .,9 r` : Q r a"k - " .s' *:tea?; ,'" ' ' TA " -'A 2 F. t;MILXp LUNG 1 .: %z•- :, : t :TaYPE O oV.ORK ` `l . is . ~ tri -e1 ` t - ;; $t , :3 .,f RE e, IRE:D A- ND. �A?E r • �'�.- �.- ' �. �;L� :�C. ..�. �.'��`'.�'.`:.��a a^�uA., a- n..�£�s.- a•.��.+ sesk. . azd e��'�z:wR�'. °,::' �.,, A�, < ,., ..e�S's.�'�' .- ;�., » ,-.•: - . ❑ 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 " ^_ .:K : work indicated on this application. � T4 1 " i CA t;EGORY OF .GONST Wg IOi`f: 4 ms . µ = °'1' �.°` '.z.5 {. :nit.'�„""Y^. .,.xf �a''."<<�ea'i�f .�., 'vsU. 3'saf�';. - .:E��ato .�id5':. W �'+�e6 -a a ...',.',htF Valuation: $ ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑ Multi- family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: a i A i r. ,rs * ':re= _ ^-:�,. - i;.„a ±�. - - , .. , ' °:t'' ' 1 ''``'' Total number of floors: _r` ' , ft ;.�'�'°, JOB ; =TE' :INFORMATiI4 LOCATI,it „ ��'3�:�.�w,�;_:,;€�. -_� ri ,x��s,.�, r�::.:��3 ,t-3 <:�ss�rs;. -.�.� �, . n , �: - . - ., - , Job site address: (ij 6 60 (Z "Z,e.)/ Ai q, New dwelling area: square feet City /State/ZIP: I . i l i Garage /carport area: square feet Suite/bldg. /apt. no.: 4 Project name: Arg 1► � iffig % Covered porch area: square feet Cross street/directions to job site: : at y ^� „ � cm _ JJ II Deck area:, square feet �"�' l• Other structure area: square feet ef1REQU`IRED°D`O \COMMERCIAL.'USEiCHECKLIST. Subdivision: I 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 „ Y +�. ,zu p ?3^ DES,G3t.�taa�I2TP IZON ,� :,� � -e. s aax 5 � s1t , }„ equipment, materials, labor, overhead, and the profit for the K " 1: �"'za ?��` a vim». fi # QF; WORK ' ' '` "'_' «y' Y work indicated on this application. `'��+ * 1 s � r°ahr ��•cr; >. o. _ ..:. , €`..r �^ >41410 Valuation: $ O n M .i—e-V t_ 5(A V C� LCY� ! � „—L Existing building area: square feet New building area: square feet ''$''.�`x ,. ,`,a" . .�:ii. ° ��r a,-- . '�'s . "�:.. »,fi r'; "' �,s: ,4'F�a"` , ,�. � . :�,�� - kva ��."":.:i`#?,'Y,''� "^ 1 �' - . , KP OW,NE J t .., rt_ TEN'ANT ., a' , Number of stories: Name: I Al/ I , Type of construction: Address: 1 1 / 4 - C1- r) I O 8 Occupancy groups: City/State /ZIP: lv�r / n 6 /70 7 S Existing: Phone: 3) qt. " - �, ( 't I Fax: (56Q la q L1 y3 6 New: c r,� ,:a f fr .; < .?i�._ y: -;;>z• - a ':; "'s ^;.�rrr::gy. .�i<zs:.:::°: ) acr; ".;ti. ?.: ,;fie , , a^ w : $ - a• •.�t >7' 'se:, �: s ; ; G ON<TA CTIE P ER SON t ., ,:��Sr• ° "'< � ;� _.� �•�� .r ` Business name: (D � ✓ l v (n �. Alt contractors and subcontractors are required to be Contact name: licensed with the Oregon Construction Contractors Board DAN/ �Y O�� under ORS 701 and may be required to be licensed in the Address: 3 / - t ( a/ ,) /� �-- / S � 7 r b apply: • Phone: (0 P -7 7 1 jurisdiction in which work is being performed. If the City/State /ZIP: J�cA , , n I ( 1 I C` " W _( - 7 /_ 2- q applicant is exempt from licensing, the following reasons � 1' � I Fax: (go � 3 � /; & �tJ j C� - �3 `4 / i 3I °� E -mail: ''iW "'� �.a rte z '`r kr° ' .atx ` e� . °' -"am'" ` 'r r :' , . t ,.. . .Ig,It . * C 6/r >R, 40" 4i- . 4.` . ? ' . ,' Business name: C V T I' ! ' d ',xw �, . ,...'. . ..'1;g,° • „= , ..,,'„,t, -- = . 4 .,,- .• , - : � /�� f BUIL DTiG ERIYIIT {;FEES .. Address: ' J '!/ L r : ».2 s ~�s _�` Please refer to fee schedule. City/ State/ZIP: Oi 1j( - �4 ( CZ 1' 7 2 "7 '7 Fees due upon application Phone: L A - Fax - ) (i3.____76.766 6 ,. � ' Amount received �� CCB lic.: — _ • — 0 ! — Date received: Authorized signature: • This permit application expires if a permit is not obtained ✓ - e within 180 days after it has been accepted as complete. Print name: ,� / Illh4 , 4 Date: (_ l -QA * Fee methodology set by Tri- County Building Industry Service Board. i:\ Building \Permits \BUP- PermitApp doc 12/03 440- 4613T(I l /02 /COM/WEB) 1 s k_ ..sr 'a. s : One- and Two - Family Dwelling 4 =7 Building Permit Application Checklist .FOR- OFFICE USEONL . , '_ City of Tigard Received Permit No.: - 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: Associated•permifs: ' Phone: 503.639.4171 Fax: 503.598.1960 / /piNl v , <3� 24- Hour Inspection Line: 503.639.4175 .i�� ❑ Electrical ❑ Plumbing ❑ Mechanical Internet: www.ci.tigard.or.us ❑ • Other: 3 • 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. 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 1 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 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. i:\Building\Permits \One - Two - FamilyChecklist.doc 12/03 - A • 1 ui . A } , \ \j ,.. / 0.\ , • i _._. . ,, c• .. ,, . . , . , c . .. - --.., -... \ ( ,, j v. 1 30. 0 c;1,41 PA - co SI - S 1 t' NI 6 01 N • /_' --- , .1.-■,. - i 1 ., Z .." ' \/ 1 : \ , \ \ f! ' ' --/C/) I (74 1-..... / F • > / / .rl 4 !... . , LAJ 7---- ....'.•' \ ,..11- ' 73 1 - ''. '4 CITY OF TIGARD 24 -Hour BUILDING Inspection 4 ine:'i503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 - 4171 MST BUP Received Date Requested ./- `+ AM PM BUP Location ' 9 7 �rz Lj L--./.. Gs Suite MEC Contact Person Ph ( ) • -'j (-LS PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner \ v q 1 -55 \ At 4 4 ` C_ 3 L ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: - Lj ‹: v IT) , 0 L . " 60 o — I Post & Beam Shear Anchors // A/v 7 o/v Si T / .T ,L;r- L - , '! 'o 4.A Ext Sheath/Shear Int Sheath/Shear _/� -�.-� (),71. S2 ' :, � - 2 v' ,-N : --J rj . k v-- 2 p.,? . Y,\' ± Framing T'�` 4 Insulation k-�� *- VLS (l` e 5 > V■ Q- Drywall Nailing Firewall Ai / P u-. r -1 r n /' L Fire Sprinkler l Zv y ' U v ��I / - > �' F-' C >� �Z / �� , b� Fire Alarm ( ,'-) S Z.-COY-006C) 1 // it /OS: 00 Susp'd Ceiling `� / _ Roof - L. - - - 7\i/6 2.-o D y C1 U U� U f : e,,-) vn G� - Other: / Final ( _ ) S 7-7" Zo Q L-/ - 0062,1 " –E7 PASS PART FAIL - / PLUMBING ) lj 1_4 ,J 2 O U - U D D / S i) - -> 4 v - )•�t sc= u Ll -' -& Post &Beam ( T Under Slab 1 l� ��v S - U U C, � / ‘ // v ' • Rough-In -Inrvice C / ✓j Zi - �' - v 0 - - 06 u 1 7 /i r ,Ty` 4-- Sanitary Sewer (X) L- - j o 00 t f / Z C; ) l ` Rain Drains f / r �' Gl�l � ' 7 S ��0' Z/ Catch Basin / Manhole Storm Drain Shower Pan / J ] ,!� ` Other: // S"---/--d �' L" 0j 7C `( d-) D e r-z< PASS PART FAIL r / (-2 Ci // MECHANICAL j� Ct Post & Beam % ` Rough -In Gas Line Smoke Dampers f Final -e 2 / ' j L-1,-"L 4; L " 1 .,)-(10 - DO c //)---• PASS PART FAIL �,c� ELECTRICAL �N' /`� G: L- l� /' 5 6iC f L( /?' / 0 / 0 . Z 7 /) LC.e/ , Service Rough -In UG/Slab Low Voltage C: , -- 77' , , , // Li U Fire Alarm '� Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL (SIT Li Please call for reinspection RE: 1111 Unable to inspect - no access Fire Supply Line ADA �� - ---�� Approach /Sidewalk Date ' Inspector �`" Ext Other: �jc(-L) - 0 -. -.rz---__ Fi9al ; DO NOT REMOVE this inspection record from the j . b site. ti,;(0 V CITY OF TIGARD /� BUILDING DIVISION #:IJ0/�e1 -(2d d /7 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: V/ l /6 e Phone: (503) 639 -4171 I Inspection Requests (24 Hrs.): (503) 639 -4175 'f �� INSPECTION WORKSHEET FOR DATE: , 2/7 /i 6 TIME: PAGE: SITE ADDRESS: 1/0 fr €/(),,ig 5 /- CLASS OF WORK: Y 9a SUBDIVISION: '� f LOT #: TYPE OF USE: PROJECT NAME: 4 #; I f, D44, P( DESCRIPTION: ((U OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date:. Pour Time: Code # Inspection Descriptionm # Contact # Message 21i / / , 2..-3 Corrections/Comments/Instructions: � r r "fr 6 1,(); 41, h `' J�` iv, -11 4 ae J /21 1 / .- -L a- ti%CG;_v i 40-. y/I / -1 //t /.4 irfpi,/1,/, �.z - e 4 4 4 A ,q1 /11 ,4 44 - % /V i- t -�e�e- i A-4 7 - / / ‘ "760 - Ile /fp ` ' r � � i ;� �r�xd- , 4-- , -et} -2-i--- /d4--e' / A ittl, /-4e/r.,44 h--eed-7 ing-i-- a6 , / 5/ 74Z/ fr e,,, a ,,,', / C--C' iiI I I PARTIAL APPROVAL Il CANCEL I I NO ACCESS n FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED /,7 1/Y6 Inspector: Date: `w 6 " Phone #: (503) 718 -