Permit CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2003 -00397
41 0 , 04,1110 , DEVELOPMENT SERVICES DATE ISSUED: 8/29/03
" r 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 12330 SW KELLY LN PARCEL: 2S103CC -08300
SUBDIVISION: WHISTLER'S WALK ZONING: R -4.5
BLOCK: LOT: 030 JURISDICTION: TIG
REMARKS: Const. new SF detached residence.
BUILDING
REISSUE: DM194 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 2,272 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,048 sf GARAGE: 578 sf FRONT: 20 PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5
VALUE: 321, 626.80
OCCUPANCY GRP: R3 BDRM: 5 BATH: 3 TOTAL: 3,320 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL /CMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1
GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 6 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /F DR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EAADDL BR CIR: SIGNAL /PANEL: 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: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
TOTAL FEES: $ 5,708.06
Owner: Contractor: This permit is subject to the regulations contained in the
DON MORRISETTE HOMES DON MORISSETTE HOMES INC Tigard Municipal Code, State of OR. Specialty Codes and
5000 SW MEADOWS RD 4230 GALEWOOD ST, STE 100 all other applicable laws. All work will be done in
SUITE 151 LAKE OSWEGO, OR 97035 accordance with approved plans. This permit will expire if
LAKE OSWEGO, OR 97035 work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days. ATTENTION:
Oregon law requires you to follow rules adopted by the
Phone: Phone: Oregon Utility Notification Center. Those rules are set
p forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
Reg #: LIk 3877 may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Erosion Control Insp 84 PosUBeam Mechanical Plumb Top Out Exterior Sheathing Ins[ Gyp Board Insp Appr /Sdwlk Insp
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Rain drain Insp Electrical Final
Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Storm drain Insp Mechanical Final
Foundation Insp PLM /Underfloor Framing Insp Gas Fireplace Water Line Insp Plumb Final
Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Water Service Insp Building Final
Issued By : Permittee Signature iLl
Call (50 639 -4175 by 7:00 p.m. for an inspection needed the next business day
1
g- '3,1 a . A....4 Buildin . Pe ,:r plication
,....---
m "i'�i City of I . sill'-'! Date received :7 -36 -O-3 Permit no.: 467:,20,../):',-; -0030
. . _ ,
''- Project/appl. no.: Expire date:
Addres: all d, g, OR 97223
�,
City of Tigard
�� �`� D ate i ssued: B
Phone
; (503) 1 125 034 y: j Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment
CITY OF TIGARD y
Land use appitlai NG DIVISION -/c 1 &2 family: Simple Complex: °Q
TYPE OF PERMIT
CA
❑ 1 & 2 family dwelling or accessory Cl Commercial/industrial ❑ Multi - family ,New construction ❑ Demolition
❑ Addition/alteration/replacement Cl Tenant improvement ❑ Fire sprinkler /alarm Cl Other. \
JOB SITE INFORMATION
Job address:
Bldg. no.: I Suite no.:
Lot: I Block: Subdivision. \j) e�j 1 I Tax map /tax lot/account no.: $i0� a• >, do * -,
Project name: /h/_ r (°
Description and location of work on premises/special conditions: �t,;(/ r.()/US j
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
Name: ,M p rk / ' (Floodplain, septic capacity, solar, etc.)
Mailing address: 'rZatai ia art 1 & 2 family dwelling:
City: > , State { '41 ZIP: 1 'T). Valuation of work $ _ (
Phone:. - llipip Fax -. )-7 4 0, -mail: No. of bedrooms/baths
Owner's representative: s '11 i i r Ca {j Ly___ Total number of floors
Phone: Fax: E -mail: New dwelling area (sq. ft.) M
APPLICANT Garage/carport area (sq. ft.)
Name: � ' ^i.a• &:—. Covered porch area (sq. ft.) l �
Mailing address: 'rY1e__.- a rt, Deck area (sq. ft.)
City: I State: I ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/industrial /multi- family:
CONTRACTOR Valuation of work $
• Existing bldg. area (sq. ft.)
Business name: 1 , d g fig((] iii 'a New bldg. area (sq. ft.)
Address: , & v �< Number of stories
City: State: ZIP: Type of construction
Phone: I Fax: I E -mail:
CCB no.: 2) S �j �j' Occupancy group(s): Existing:
New:
Cityrmetro 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: c--t'lks.,) 1'‘P C. (`tom jurisdiction where work is being performed. If the applicant is
City: State: I ZIP:
exempt from licensing, the following reason applies:
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: I 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. • , rovisions of I ws and o dinances governing this 0 Visa ID MasterCard
work will be complt - , WI , , , whether cified kerei t. ] Credit card number: / /
�j � • ( � � l 7 Name of cardholder as shown on credit card Expires
Authorized si atu . , i l A ' l' :tC:
Print name: m!>, "1M 4 [ 1 (. 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)
■
1
ss
One- and Two - Family Dwelling
44= :, Building Permit Application Checklist " `ti „Referenceno.:
City of Tigard City of Tigard As�u�iatedpermits:
g U Electrial ❑ Plumbing ❑ Mechanical
Address: 13125 SW Hall Blvd, Tigard, 04 97223 D Other:
Phone: (503) 639 - 4171
Fax: (503) 598 -1960
TILE 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. 4
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 t/
if copyright violations exist. J�
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 x
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. ,X
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, X
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. /X\
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. x
•
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.
26 No rolled, reversed or mirrored building plans will be accepted. _
27
28 •
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)
Mechanical Permit Application
Date received: Permit no.: I) ) * - 09 ' 1
1" "I City of Tigard R EC E
Vg) n Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, R 47Z2�
Phone: (503) 639 Date issued: By: I Receipt no.: _
Fax: (503) 598 - 1960 JUL 2003 Case file no.: Payment type:
Building permit no.:
Land use approval: CITY OF TIGARD
x, - <, ' f , TVA: E OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ❑ Tenant improvement •
few construction 0 Addition/alteration /replacement 0 Other.
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: L J � ' 16 /lA, ( 1,//'L . Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no. value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ .
Lot: ( 'Block: Subdivision: \A ,, , *See checklist for important application information and
Project name: 1 �a �( jurisdiction's fee schedule for residential permit fee.
City/county: f ZIP: b�- n �"'�' 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: • I COMMERICAL/INDUSTRIAL EQUIPMENTSCIIEDULE
Fee(ea.) Total
Est. date of completion /inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC: •
Is existing space heated or conditioned? 0 Yes ❑ No Air handling unit CFM
g P Air conditioning (site plan required)
Is existing space insulated? ❑ Yes ❑ No Alteration of existing HVAC system
MECHANICAL CONTRAC "[OR Boiler /compressors
State boiler permit no.:
Business name: t 5 -J c 4 •,/ IQy‘z.�- HP Tons BTU/H
Address: i tl•& Fire/smoke dampers/duct smoke detectors
City: - Li■ State vEria O1. Heat pump (site plan required)
Phone, ). / )J Fax: E -mail: Install/replacefurnace/burner BTU /H
Including ductwork/vent liner 0 Yes 0 No
CCB no.: 'F).9 Install/replace/relocate heaters -suspended,
City/metro lic. no.: N/A wall, or floor mounted
Name (please print): ' / 1 d PAim' (■LE�t__ Vent for appliance other than furnace
Refrigeration:
CONTACT PERSON
Absorption units BTU/H
Name: # a -c IEU Chillers HP
`��,.�� Compressors HP
Address: CIA 4 -1-21v �. Environmental exhaust and ventilation:
City: State: ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
OWNER Hoods, Type U II/res. kjtchen/hazmat
hood fire suppression system
Name: q � R` Exhaust fan with single duct (bath fans)
Mailing address: / V1,1 WAIL �'1r Exhaust system apart from heating or AC
City: " ZIPq te)5 Fuel piping and distribut (up to 4 outlets)
Type: LPG NG Oil
Phone:. � Fax: E -mail: Fuel piping each additional over 4 outlets ,
ENGINEER Process piping (schematic required)
Number of outlets
Name: Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: (ZIP: Insert - type
Phone: Fax: E -mail: _ Woodstove/pelletstove
Applicant's signatu
'r, Other:
:� ��� D ate: � ���J� ' Other.
Name (print): lei. i ri f 1n / r' i 1 --- .
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $
Notice: This permit application Minimum fee $
0 Credit Visa O edit card number: MasterCard expires if a permit is not obtained
r Expires within 180 d after it has been Plan review (at — %) $ •
p State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete. TOTAL $
Cardholder signature Amount 440 -4617 (6MU0/COM)
Plumbing Permit Application
RECEIVED Date received: Permit no.: ��jf�y) 3 317
,t,' City of Tigard Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd, Tigard, OR 97223 Project /appl.no.: Expire date:
Ciry ofTigard Phone: (503) 639 - 4171 JUL .i U 2003
Fax: (503) 598 -1960 Date issued: By: Receiptno.:
Land use approval: CITY OF TIGARD Case file no.: Payment type:
I3UILDING ' • ■
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ❑ Tenant improvement
b: New construction ❑ Addition/alteration/replacement ❑ Food service ❑ Other.
JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist)
Job address: -32JJ '3W Description Qty Fee (ea.) Total
New 1- and 2- family dwellings only:
Bldg. no.: Suite no (includes 100 ft. foreach utility connection)
Tax map /tax lot/account no.: SFR (1) bath
Lot: 7 r' Block: Subdivision: IV1� i�tMi� SFR (2) bath
Project name: / SFR (3) bath
City /county: ZIP: Each additional bath/kitchen
_ Description and location of work on premises: Site utilities:
Catch basin/area drain
Est_ date of completion/inspection: Drywells/leach line/trench drain
Footing drain (no. lin. ft.)
PLUNIBING CONTRACTOR Manufactured home utilities
Business name: .__7 L ft Manholes
Address:
�s7 Rain drain connector
Sanitary sewer (no. lin. ft.)
City: i7 .�1O State' ..� ZIP: �Y
Phone: " Fax: E -mail: Storm sewer (no. lin. ft.) —
7I -< -� ax: } ter Water sewer (no. lin. ft_)
CCB no.: [ C9! L ( -] I Plumb. bus. reg . no: -' Fixture or item:
City/metro lie. no.: N/A ' Absorption valve
Contractors representative signature Back flow preventer
r Print name: uag J , Backwater valve
Basins/lavatory
\ Clothes washer
Name: l {�- SN -) E Dishwasher
Address &as / b E 4 ,V - Drinking fountain(s)
City: I State: ZIP: Ejectors/sump
_City:
Fax: E -mail: ' Expansion tank
Fixture/sewer cap
�,� Floor drains/floor sinks/hub
Name (print): \ ;� �V`�i5 it t'v` Garbage disposal
Mailing address: _ • . • S Hose bibb
City: _ (" . State ZIP: / Ice maker
Phone: j , - ,,, 1 •,7 -70 E -mail: Interceptor /grease trap
Owner installation /residential maintenance only: The actual installation Primer(s)
will be made by me or the maintenance and repair made by my regular Roof drain (commercial)
employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), iays(s) _
Owners signature: Date: Sump
Tubs/shower /shower pan
Urinal
Name: .
Water closet
Address: Water heater
City: State: I ZIP: Other.
Phone: I Fax: I E -mail: Total
Minimum fee $
'Not all lurisdicuo s accept credit cards. please call lurisdicuon for more informauon� Notice: This permit application
Plan review (at %) $
0
Visa ❑ MasterCard if a permit is not obtained State surcharge (8%) .... $
C.edit card number. Ea
Expires w ithin 180 days after it has been $ �_
p TOTAL
accepted as complete.
Name of cardholder as shown oa credit card
S
Cacdhotder signature Amount , 440- 4616 (60C COM)
CITY OF TIGARD 24 -Hour
BUILDING Inspecti 'ne: (503) 639 -4175 MST ? 3?
INSPECTION DIVISION Busing E; (503)639 -4171
BUP
Received Date Requested /c / � 03 AM PM BUP
2
Location / -� 3 0J k (c y L._ �+/. Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
UILDI Tenant/Owner ELC
Foo ng
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: 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:
•11gi‘
4 PART FAIL
P UMBING
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 Date /-2/ 0 Inspector Ext
Approach /Sidewalk
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) 639.4171 MST
BUP ,F
Received Date Requested /" // Z4 9 AM PM BUP
Location / 2 330 k //,►/ L.-, • Suite MEC
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
UILDING Tenant/Owner ELC
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Fi rewal I
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
0 . -r:
i
taitt PART FAIL
BING
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 ( / j
Approach /Sidewalk Date J f� 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(593)t639-4175 , it 0 9 7
INSPECTION DIVISION - Business Line: (503) 639 -4171 4' �� '
BUP
Received ' ` b 2 43c/Date Requested / i'/ AM • PM BUP
Location 2.33
C� /ez / Suite MEC
Contact Person ; /_ G%�c -e Ph ( ) O ' f3 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation •
Drywall Nailing
Firewall
Fire Sprinkler _
Fire Alarm ( c` t I I � S 16 £ 6 \ \
Susp'd Ceiling
Roof 111
Other:
Final
PASS PART FAIL 4 A
PLUMBING
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 /V h'/ U
UG /Slab (/v Ll
Low Voltage
0- Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
S 'ART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line /
ADA
Approach /Sidewalk Date/ � �/ O3 inspector _ I . /a ` • .44ir Ext
Other:
Final DO NOT REMOVE this inspection record rom the • b site.
PASS PART FAIL