Permit CITY OF TIGARD PERMIT #: MST2003-00391
MASTER PERMIT
�
� DEVELOPMENT SERVICES DATE ISSUED: 8/22/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 10677 SW LADY MARION DR PARCEL: 2S110DA -08100
SUBDIVISION: ERICKSON HEIGHTS ZONING: R -3.5
BLOCK: LOT: 042 JURISDICTION: TIG
REMARKS: 315 square foot 2nd story bonus room addition.
BUILDING
REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 315 sf GARAGE: sf FRONT: PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT:
VALUE: 34
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 315 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: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: 1 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 FD R: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: 00 SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EAADDL BR CIR: too 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:
Owner: Contractor: TOTAL FEES: $ 742.96
This permit is subject to the regulations contained in the
DAVID BROWN WELLINGTON WORLEY INC Tigard Municipal Code, State of OR. Specialty Codes and
10677 SW LADY MARION DR 18151 S UPPER HIGHLAND RD all other applicable laws. All work will be done in
TIGARD, OR 97224 BEAVERCREEK, OR 97004 accordance with approved plans. This permit will expire if
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: 503 968 - 5222 Phone: 503 637 - 1145 Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through 952 -001 -0080. You
Rey #: LIC 151769 may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Mechanical Insp Electrical Final
Electrical Rough In Mechanical Final
Framing Insp Final inspection
Insulation Insp
Rain drain Insp ��
_mil
Issued By : / / .. , Permittee Sig . v=t'R (.vci.uN6zyo 07,e
Call (503 639 -4175 by 7:00 p.m. for an inspection need /ed"t/- 6Ax _ ‹' he next business day
FOR OFFICE USE ONLY
Building Permit A,,pp on, l a� Date /By: e d a 0 3 ' Build r
Oa s ]- J5--e-.439/ t _,
y of Planning Approval Other
City of Tigard Date /By: Permit No.:
13125 SW Hall Blvd. JUL 23 2A r Plan Review Other
Tigard, Oregon 97223 Date /By: r 4 V 7-a / -° 3 Permit No.: w
T � '/yew1 • v Post- Review Land Use , \
Phone: 503-639-4171 Fax: 503 59 _ J _ a �k7�lh �II Date/By: Case No.
Internet: www.ci.tigard.or.us BUILDING �� ✓' ` ---� Contact i : ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name /Method: I «' Supplemental Information
., : ,m t st:m.TYPEOFWWORK , . °.:;.. x ; .' `6,..z W UIRED DAT °A �„f s F
10 New construction ❑ Demolition _ 1& 2 FA . g ' ���
Addition/alteration/replacement ❑ Other. "`` ' "' ° ' ". �.. �::
t
., ,,,,;; , ,..iCATEGORY ;OF,CONSTRUC°"TIONE ;,. _.. Note: Permit fees* are based on the total value of the work performed. Indicate
1 & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor, \ \\
overhead and profit for the work indicated on this application.
Accessory Building ❑ Multi Family 0
❑ Master Builder El Other: Valuation -- $ `� / OOQ,
.� No. of bedrooms: No. of baths:
�,,� ;`�JOB)SITEI and„IQGATION��� .,� ,� 5 K�
Job site address: / O C f,(,(), IAAY / 412( Or O2. Total number of floors Z
New dwelling area (sq. ft.) � c
Suite #: Bldg. /Apt. #: Garage /carport area (sq. ft.)
Project Name: 3 4(.0 N.( Covered porch area (sq. ft.)
Cross street/Directions to job site: Deck area (sq. ft.)
•
Other structure area (sq. ft.)
g ` REQU
;fi
- ' COMMERCIAL DSE CHE61<t1ST "
Subdivision: EA/ C.K.SON. (-T3', Lot #: 1/ i
Tax map /parcel #: Note: Permit fees* are based on the total value of the work performed. Indicate
i:VEZMI:.„NriA: °DESCRIPTION tiO , WORK , . _ _p the value (rounded tof dollar) of eq, materi als, labor,
o verhead and profit for the the work indicated on all this application. uipment
[3 (Z- 4 D P C11 ON
Valuation $
Existing building area (sq. ft.)
New building area (sq. ft.)
Number of stories
<,i ® = i's'PROPERIVOWNER ( Y i° t » TENANTt >, , ; . `` `. Type of construction
Name: 0/10( o 0, O u) (\l Occupancy group(s): Existing:
New:
Address: (O 77 sc0. LAD 4 1A2i004 OK.
City /State /Zip: A /LD 6 /Z
e i NOTICE: All contractors and subcontractors are required to be
Phone
5 03) 96� S 2-22.1 Fax licensed with the Oregon Construction Contractors Board under
ci 'AP ICANT MnitWar ❑ CANT A C T PER:S °Win provisions of ORS 701 and may be required to be licensed in the
Business Name: LO E L. L.( lq 6 Tor'( (,vog, LE le /NC jurisdiction where work is being performed. If the applicant is exempt
d Contact Name: j I N I SL rZ.tJ..- - 0 hl from licensing, the following reason applies:
Address: ((S7 S _ q Pi'Jo2 f-4 ( 6 (-f &AND tO.
City /State /Zip: f(4offLoes_f_C G (2. Cf 70 o Se
Phon 503) A 3 2, -/(lf.51 Fax (a 6 U, (l Li 6 # { , BU>zn rrc PE> II T> ES* p� ;
eas ee s e
"`
� . `_ t _ ' Pl prefer to f : c h dd a 1C P: . , .. : { d
� f
E mal
�....t _. ..., 10610- RACT® a ,..ice, ,, .,:�
Business Name: (,Jca., a/OR(,,,€,Y (iv C • Fees due upon application $
Address:
Rn City /State /Zip: S (� & 05 r ` , 3 O d L. Amount received $
1 O ) Phone: Fax: Date received:
r CCB Lic. #•
Author. • • Notice: This permit application expires if a permit is not obtained within .
Si gn. ure: Date:7= 2 2 = u3 180 days after it has been accepted as complete.
q- M £, S A . SG R- Lk..TT U h-/ *Fee methodology set by Tri- County Building Industry Service Board.
(Please print name) c - �
i:\Dsts\Permit Forms\BldgPermitApp.doc 01/03 # % 9 P V , DO
One- and Two - Family Dwelling
R�bp Building Permit Application Checklist Reference no.:
Associated permits:
City ofTigard City of Tigard .. .
g • D Electrical Plumbing 0 Mechanical
Address: 13125 SW Hall Blvd, Tigard, OR' 97223 ❑ Other:
Phone: (503) 639 -4171
Fax: (503) 598;060
• 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.•Mast indicate details 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 • • s
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." } t
,
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 revi • . .
• 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)
07/22/2003 08:54 5036502933 OCH PAGE 01
JUL -E2- 08: 09R FROM: 4 ja.- t I Lk b - TO: 50.36502933 P : 1' 1 •
• IIl �.�GA Cllr � r''s�R.�f'1 =l<�Lr l:`r: ()NIA •
.
+ „ed Meclnnicel, i
eC D II u�te B . Permit No. :11 P -G29 �/
JUL 23 2003 Mitring Approval
City of Tigard t& y t
C ITY OF TIGARD Plan Wow
13125 SW Hall Blvd. Permit +„
Timed, Oregon 972 C' r1I IO�I Dose:ttsvicw land tote
Photo: 503•439 lYA1e • 1 :, . I ` ". Dntellir _ cam tea.:
}} :< so Page 2 air
24-ho spectii_ Request t r I NwnetNief l: no v . tealettallnteeft►odo
24 hater tnxpetr�tlnii Request 503..6 9 -1175
_ .1117SV :WORK ," (,ogiutstam.:Fue sC NE i)[JJ,E �391L
t4T' '
New Ct)TtStrUCtlbn il1 Demo Titan Mechanical permit ffeee` are based on the total value ort a walk •
Addition/alters
eA�Ei
perform)._ Indicate the value (rounded to the nearest darter) of all
0 01 t r rsplsltCet Cb y �_ . C7 ,VA Otter_ ,nechanieai materials, equipment, labor, overhead Red prufil-
G
Ste Page fur lies Schedule
1�} - l~tLt1711�+{1Wl�lltil_ ('e)IItm4'etC18l/ttl(ltt8 trial Value: 9 — ,A 7.,.1,1 1 .it AtsP. !•.l iJ.r� i f` 5�'l- LElU ..
M.0111 X'$Illl U eeaription )J ° 0111 T arn)
A l3uxltifn gyaWiteicooli�
❑ M, Builder uilder I O ther" 14.00
jog . , Cr r.: i 1' 1. )N ' , • L o T1OPl fr uraace - �,t1rl -on air : ooditioniol;•°
GaS lrtatt tL>s 14,00
_ Job sits addre j�J - t` t au I L 1A.00 / q. (1_0 _ Bldg. / Duet work 1a.
SU1LC H • .rile hot:water system
,voject NomC: ( . 0th) - Residential holler 14 Ov -
Cross s#ractlDireetiota to jots site: for radiator at hydrotnt System
Unit herders ((L net ekctrie) 14.t1U
(be w induct, suspended, !do.) -
trlUelvent (litr qiv of abovo 10.00 .
_ r2
R tor titters - ..
l ulxliv siom �Qicisonr f T"S , X of /t: ' ' c�tttcr nP lances
W ater ktetcr 10.f
• Tax Ina • l #, l O.Ae
. 1 . . >a ." e to , • It Wt11KlL:. ..._. Gas hi pines
14.04
Floe V t'3it (water hgter h*C _ ..,
1 Iwo: ii y:.;) 10.0 )0.00 alli
/ J p, A Woe:moiler stow:
�` Wood rinepleeorioaett - i D "Oil
— chiral / ltaer/fti1n vt nt ions
a aer: 10.00 IIMMI
® lttt ; ' ' A, `" - oments1 Arhus; & Yentllatien
iR 1PR '. aJi ro lU.t1t1
Name: t? , j � 1114) lunge hoadlothlr kit r rctu ltrnertt
Address: j D? _, t., ' 1. 4I : , / -' ' acmes dryer exhaust 10.00
Cit /State / ,l 1 ! 0 g. Singic duct ax
..ax: (badlreoms, tvitel compertmonle,
Phan. . '- ' - .., .. ;'i uti„h ��) _ 6 ,tia
g •. H 10.00
�,�it� r!. �� • ` -, ; ' �� tS,. - �
Auks/Crawl space tat±a • ,•.
di]lC: �OI .4 ♦ r 1 ... . p 10.00 Addres , r , ` y ktiralPi(fling I �• . _ .. • � —MAO Der first 4, $1.90 eraL additional)
—'
�r
!/S_ �IP� Edlc F>�acd ere ••
a - 4 ') flan heat . ••
` J Wallis - endcxlhtnitheater
Frtxlai . s•
• ` [.•' , Fin lace .»
Business Name: _ _ v . _ Rand — _
AddreSS7 4 . Claim tit 'r �/ •s . .. 3
City/ .. •• MI
Phone: Fax; (?the: Total:
CCB Lie. #: _ .. Me et! , r .1 ,
C7 S
Authorized
slgttan•se: '. e nact". /r3l,a' 3 M fnimu n P rdt Ft a $72.30 $
Plan Review Mine {25'1' of Penni; Fee $ -
!% �5 State 5 , , ; I: 894 of Penult Fee $ —
(Irltarsa print name) TOTAL P PMIT Vint $
Gmtlon swims If a permit It not obtained militia *Lies impludata le[ by 'M -County handing Ind i iry 9crt9 t Ward.
1BO d a: s f kr ii b•+ boo et "Sire Soo required for exterior A/t :
1B9 Or aticr It boo boon aceq:ttd as complete. i ;t sWennii vdeeParmi+App.due OM
JUL -22 -2003 TUE 08:39AM ID: PAGE :1
07 -22 -2003 08:46 FROM-Dryer Electric Contractors, Inc +5037741046 T -763 P.001 /001 F -411
Electrical Per i 1 . ls jI.4 = - Daterecerved: Per nu.- 1 - P 5 •• 3- 00,
: ��s �• City a = Expire date:
� 11 . City of Tigard JUL 2 3 , PraJect! pP 1_ao
GryvfTlyasd Address: 13125 SW Hal! Blvd. Tigard. OR Date issued: By: Receiptao.:
Phone: (503) 639 -4171 CITY OF TIGARD .
cagefllelto.: Payment type:
Fax: (503) 598 -1960 BUILDING DIVISION
Land use approval: .
' TYPE OF IPERMJ
1 & 2 family dwolling or se.ccssory U '' merciaUsndustrial 0 Multi - family C1 Tenant improvement
0 New construction M' Add '+Lion /alteration /replacement U Other: . 0 Partial
.)O B 51'1'E INFORMATION
Job addrass: o • 7 ..SCt) LR , he, /. - Pi' Bldg. no_: Suite no.: Tax map/tax lot/account no.:
Lot: Block: Subdiv Sion: -
Project name: Dcscri•tion and location of work on premises: awl< f/;,m ',, // t/
Estimated date of completion/inspection.:
or.r� Ra� �.
( rlusv
FFE $CIIII)ll F
Job na: — harm don
�REI_
Business names: 7 .940e L [ C, cc, - c orms n- tmtutyper
Address: x.11, ;• � ,
a dialltttgrmis. wactdde, wo
atlacboevara
City: ro I an, S tnm: D cimbi ud..* 4
I i 23P; 72 ' � $..
Phone: 503 77 5 Fax: 77 - /D ,„. E-mail: Moo sq. ft- or less Each additional 500 sq. ft, or portion thereof 1.1111111.1.111111111.111=1 CC8 no.: /5 w Elec, bus. lie. no: _ - — / C Limited energy, residential r_1•1•
City /mrtzo ltc, no.; mited energy, ron t home or �■�
-
-- / - • Earn manufactured homm or modular dwelling
Signature of superrviisin . aired) Date iFflarilv Servicemtd0ot feeder 2.
♦ , • ' e, Seevic s orf i0u or —Installation. 111111 ahetat relocation!
lion
oca
"'ROPER1 OWNER 200 amps or less 2
Name (pant) 201 amps to 400 , . •s
4 0 1 amps to 400 amps � IIIILIN
Mailing address: r 601 amps to 1000 atop; __ M
City; Suite: ZIP: Oyer 1000ampsor __
Phone; F. 'mill' A.ecanneetonl . I♦MINIMMli 1
Owner installation: The installation is being made on property I own TomperstyseMcesor[cadent
installa
Which is not intanded for sale, lease, rent, or exthan a according to °n' alteration, °r relocation:
200 amps or less z
ORS 447, 455, 479, 670, 701. 201 , . • to 400amps ■IIII 2
Owners S9: - Dare: 401 to • 01 am. 2
r Branch cirwits -nvw,a eraiiott,
Fl r
or extension per panel:
Name: A. Pee forbmnch circuits with purchase of
Address: f eervlec or feeder fee, each branch circuit 2
City: state: aP: E. Feemr branch circuits without purchase
ofwrvioaorfeadv foe, 4 ustbryrreh circuits nil,
III EngllIllMllirIaMIMIIIIMII Phone: PLAN Iiht ILtiI (P1e i' ) }'tt all that apply) F�chndditionalbtae )♦����
5 - r . a t n ) ; ,. Misc .(5erviceor'feedernotincludod): rill Q svrvloo ovor 225,,10 - ooiumerclal 0 Flea lth-4 facility Each pump or lrt'i argon circle
tT t] f tuover320amps- ratingaFl &2 0 uil ov Eathsi•rtoron melig ti 2
fstuisttilydwd B lings Q uildinsover 1 1 000 gquarcfcet feu: o- Si g naltireut s) oreliraltedenergypanel, � 0 System over 600 volts nominal more rrsidrntiel units in one scrum re attcro:lon,or -
0 Building overtnrceslories '` 0 Focdee,,400 amps cr snore -Deccdpdon: • -
0 Occupant load over 99 porton; 0 Mnnufsewred structure; or RV park
o Egtess/l ghdngplan 0 Othen.
Sall nit, sets of plans with any ante above. laves on et
TI•e :hove are not plicable to ,, i , construction service. Other
'Not a
ot all Jri- d n ct
ictio accept edit casts, picare eau jurbdlctien for more tomnotaloo. Notice: This permit application Permit fee $
0 Visa 0 Mastercard expires if a permit is not obtained Plan review (at r , -- . 90 $
caea l card cue / / within 180 days after It has been Slate surcharge ( .... $
B"P"°" accepted as complete.
TOTAL . $
MU= or =disorder as shown an cm& card
ca dholdts elpuature Amount aa0 -4619 (60(100OM)
JUL -22 -2003 TUE 08:33AM ID: PAGE:1
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: .(O3) 639 -4175 " , 0C)39 I
INSPECTION DIVISION Business -Line: (503) 639 -41.71
BUP
Received Date Requested AM PM BUP
Location 1 0 CP 7 7 - t,ct s- - Suite MEC
- ,pD 3? - 0-5 7
Contact Person Ph ( ) PL M
Contractor ww Ph ( ) SWR
BUILDING Tenant/Owner. ELC
•. ,
Foundation ELC
Access:
Ftg Drain �,_ ELR
Crawl Drain
Slab Inspection Notes: ; SIT
Post & Beam V\-, Kt ea-V -- Oki./ ✓, , )
Shear Anchors f
Ext Sheath /Shear
Int Sheath /Shear
Framing .
Insulation
•
• Drywall Nailing
Firewall
Fire Sprinkler ' V
Fire Alarm
Susp'd Ceiling
Roof
PART FAIL
PLUMBING.'; ""
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other: r
Final
PASS PART FAIL .
MECHANICAL e
Post• & Beam
Rough -In
Gas Line
Smoke Dampers
Final
FAIL •
ELECTRICAL
5rvice
Rough -In
UG /Slab •
Low Voltage
-- larm •
Reinspection fee of $ V required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
11 7, PART FAIL
SITE El Please call for reins.ection RE: 0 Unable to inspect - no access
- Fire Supply Line
APP DAoach /Sidewalk Date - Inspe r � // Ext
Other:
Final V DO NOT REMOVE this inspection record , om the J site.
PASS PART FAIL