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Permit CITY OFTIGARD MASTER PERMIT .a,� ll,,�t� DEVELOPMENT R SERVICES PERMIT # MST97 -0089 DATE ISSUED: 05/02/97 I PARCEL: 26104DD -07000 SITE ADDRESS•..:12799 SW RIDGEFIELD LN SUBDIVISION •MOUNTAIN HIGHLANDS NO.3 ZONING: R -4.5 BLOCK LOT •028 JURISDICTION: Remarks: New SFD - Special Note - All footings must have a minimum depth of 4'0° - See Carlson report for this site. BUILDING REISSUE: STORIES • 2 FLOOR AREAS BASEMENT...: 904 sf REQUIRED SETBACKS— REQUIRED CLASS OF WORK.:NEW HEIGHT • 26 FIRST • 1847 sf GARAGE • 638 sf LEFT : 15 SMOKE DETECTRS: Y TYPE OF USE...:SF FLOOR LORD • 48 , SECOND...: 1040 sf FRONT • 20 PARKING SPACES: 2 TYPE OF CONST.:5N DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT : 5 OCCUPANCY GRP. :R3 BDRM: 4 BATH: 4 TOTAL------: 2087 sf VALUE..$: 163189 REAR : 25 — PLUMBING SINKS • 2 WATER CLOSETS.: 4 WASHING MACH..: 1 LAUNDRY TRAYS.: 1 RAIN DRAIN ft: 100 TRAPS : 0 LAVATORIES : 3 DISHWASHERS...: 1 FLOOR DRAINS..: 0 SEWER LINE ft: 1'.0• SF RAIN DRAINS: 0 CATCH BASINS..: 0 TUB /SHOWERS...: 3 GARBAGE DISP..: 1 WATER HEATERS.: 1 WATER LINE ft: 1'.' BCKFLW PREVNTR: 8 GREASE TRAPS..: 0 OTHER FIXTURES: 0 MECHANICAL FUEL TYPES FURN (108K ..: 0 BOIL /CMP ( 3HP: 0 VENT FANS • 4 CLOTHES DRYERS: 1 GAS FURN ) =1084( ..: 1 UNIT HEATERS..: 0 HOODS : 0 OTHER UNITS...: 1 MAX IMP.: 150000 BTU FLOOR FURNACES: 0 VENTS • 1 WOODSTOVES : 0 GAS OUTLETS...: 1 — ELECTRICAL — RESIDENTIAL UNIT— — SERVICE /FEEDER -- —TEMP SRVC /FEEDERS— — BRANCH CIRCUITS— -- MISCELLAN:OUS— - -ADD'L INSPECTIONS - 1'.'.! SF OR LESS: 1 0 - 200 alp..: 8 0 - 208 amp..: 0 W /SVC OR FOR..: 0 /IRRIGATION: 8 PER INSPECTION: 8 EA ADD'L 588SF•: 6 201 - 400 alp..: 8 201 - 4' alp..: 0 1st W/O SVC /FDR: 0 SIGN /OUT LIN LT: 8 PER HOUR • 0 LIMITED ENERGY.: 8 481 - 688 alp..: 0 401 - 600 alp..: 0 EA ADDL BR CIR: 0 SIGNAL /PANEL...: 8 IN PLANT • 0 MANF HM /SVC/FDR: 0 601 - 1080 amp.: 0 601 +asps- 1' v: 0 MIN1R LABEL -10: 0 1888+ amp /volt.: 0 — PLAN REVIEW SECTION Reconnect only.: 0 )=4 RES UNITS..: SVC /FDR) =225 A.: ) 688 V NOMINAL: CLS AREA /SPC OCC: - ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL --- AUDIO I STEREO.: VACUUM SYSTEM..: AUDIO I STEREO.: FIRE ALARM INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM..: 0TH: :: BOILER HVAC LPNDSCAPE /IRRIG: PROTECTIVE SIGNL: GARAGE OPENER..: X CLOCK • INSTRUMENTATION: MEDICAL OTHR: .. HVAC DATA /TELE COMM.: NURSE CALLS • TOTAL if SYSTEMS: 0 Owner: Contractor: TOTAL FEES:$ 4968.41 FOUR D CONSTRUCTION CO FOUR D CONSTRUCTION PO BOX 1577 P0 BOX 1577 BEAVERTON OR 97075 BEAVERTON OR 97875 Phone N1: 590 -8885 Phone (i: 590 -0805 Reg A..: ' This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. 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. REQUIRED INSPECTIONS — Erosion Contol Post /Beam Struct Mechanical Insp Shear Wall Insp Gyp Board Insp Electrical Final Grading Inspecti Post /Beam Meehan Plumb Top Out Low Voltage Rain drain Insp Mechanical Final Footing Insp Underfloor insul Electrical Servi Gas Line Insp Water Line Insp Plumb Final Foundation Insp Ftg Drain Bsm't ectr'cal Rou Gas Fireplace Water Service In Final inspection Wtr Proofing Bsm PLM/Underfloor ,/ g Ins / Insu .tion Insp Appr /Sdwlk Ins - Building Final i Permittee Signature: ri- ,� �, ,� Issued By: (-----, Cal f or in pet ion - 639 -4175 r Plan Check 4- 79 ' ` _ !TY OF TIGARD Residential Building Permit Application Recd By 1,-- *1 25 SW HALL BLVD. New Construction Additions or Alterations Date Recd S_ 7IGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. (I 503- 639 -4171 Date to DST 125147 503 -684 -7297 Permit # MST ci - 7 — OT ?9 Print or Type called `Mg/ Incomplete or illegible applications will not be accepted ' ="` Name of Project . ;S‘ Nam ye t9 Job /7y/nu 37 /,) q.2/L,givdS' "� Mailing d d res� a / Address Site Adddress Architect 7� R. . -/ A 9 l , ->iA ) 2 idf. , 2 .49 � . City/ ta F / Zip Phone Name 7 97 2.23 _ 42f1-92 / ���,� Owner Mailing Address Nam — City/State Zip Phone Engineer ailin Address 9767.5 f -oo�os 5 f .C,'4,) /,.9, 7wu .s City/State Zip Phone Name --- F/4#.11 / 7 nc. 97223 l�2ll 7 s- General F'pce�t:. Describe work New R Addition 0 Alteration 0 Repair 0 Contractor ing Address to be done: Q 2 / 77 Additional Description of Work: CA/State Zip Phone Ra z-ee,". 97v7S ,moo -Dr Oregon Const. Cont. Board Lic.# Exp. Date Attach Copy of 7/o17 /-7 7? PROJECT /l g Current COT Business Tax or Metro* Exp. Date Licenses 9 7- ,5-�� 7 42-3/-77 VALUATION $ 1 Na � NEW CONSTRU TI ONLY: . Mechanical Sub- Malin �� Sq. Ft. House: 2 o d'7 iN Sq. Ft. Garage • Contractor 9s ' S'� bu 7777iy" S/ Corner YES N F Q / Flag o �� YES O City/State Zip Phone �/ �( 0a. 9 7 .2 3 G2 a ---C4/3 Restricted one) (check one) Oregon Const. Cont. Board Lic.# Exp. Date Restricted Auu dio /Stereo Burglar Attach Copy of 4 6S 7 ? S- //- 97 Energy System Alarm Current COT Business Tax Metro Exp. ate Installation Garage Door HVAC Licenses /49 /79? Opener _ Systems 1 Name - (check all that Other. Plumbing - 2 (? w ,,,,i. Jo , apply) Sub- Mailing Address V Will the electrical subcontractor wire for all YES NO Contractor a 2 /2 6 restricted energy installations? 1 Ci /State Zip Pon Has the Subdivision Plat recorded? N/A � Y�s NO /2Z-Os ' 7 / 2 . 6O - , S7 A ) regon Const. Cont. Board Lic.# Exp. Date Reissue of MST #: 1 Solar Compliance Attach Copy of // 907 - 7-2 - 9 , (Calculation Attached) Current Plumbing Lic. # Exp. Date - I hearby acknowledge that I have read this application, that the Licenses 34t- egg G-30 -77 information given is correct, that I am the owner or authorized COT Business Tax or�t i�ietro 9 Exp. D to agent of the owner, and that plans submitted are in compliance ,1)/ 7 /�� with Ore•on State laws. Name Signal e 0 er /A n Date Electrical �L�y,2<c // � 2 �- 32f4S7 Sub- Mailing Address CM Phone # Contractor s 7.57 S; w 4 cre2 Person ame ` R0-9- `la,/ /;-, bk./ „c",o -ogq•r City /State Zip Phone FOR OFFICE US' • � / � t 1 �Z7Z,i�vJ 97-22 / Plat # 6., C /TL #: Q� Oregon Con t nt. Board Lic.# E{� D t I � r s10 yD0- me 3 c� I Attach Copy of 2 d �/7 Setbacks: Zone: ci Solar: Current Electrical Lic. # Exp. Date L ' Licenses 3(L - ,2_3 /0- 77 ring pprov Planning Approval: TIF: COT Business Tax o Metro Exp. Date J Q "3 9s� /2 / �2 — 7 7 - / i:\sfapp.doc (dst) 1/97 T `., Permit # Account Description Amount Amt. Pd. Bal. Due ' - ' /11,579 " 0-(7gf t ST. • Permit (BUILD) 5q3 - - Iv Plumb. Permit (PLUMB) ' 243 -0., 4 Mech. Permit (MECH) A3 6z) ELC /ELR Permit (ELPRMT) Q,� – X9,40 ✓ State Tax (TAX) '508i <ss a Bldg: g•1. Plumb: Ia / ✓ Mech: i� / ELC /ELR: r ' 0 • ..- Plan Check ' - F MST: (BUPPLN) �J� 1 3 �� Plumb: (PLMPLN) Mech: (MECPLN) 10 g 10 a ✓ � - cDCgL-D zc- CDC Review - ,i (LANDUS) G-v CcaLICI zo ' `/ ewer Connection (SWUSA) G � ,p -- ( 3- -- G Reimbursement District ( ) Sewer Inspection (SWINSP) - - S5 .. Parks Dev Charge (PKSDC) 10 ') /o `� Residential TIF (TIF -R) I� '7 D /570 Mass Transit TIF (TIF -MT) / V /Pe) Water Quality (WQUAL) ISO /2D / Water Quantity (WQUANT) i0 /a Erosion Control Permit (ERPRMT) (o / Erosion Planck/USA (ERPLAN) 20 ,° ssa Erosion Planck/COT (EROSN) - g`' �a .e ./- Fire Life Safety (FLS) TOTALS: I' i:\sfapp. oc (dst) 1/97 6/30/99 Activities for Case #: MST97 -00089 1:27:12 PM Assigned Hold Updated' • Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes MSTA005 Application received 3/28/97 3/25/97 JSD PASS JD 3/28/97 MSTA008 Permit Created 3/28/97 3/28/97 , JSD PASS JD 3/28/97 MSTA010 Check for prd. restrict. 3/28/97 3/28/97 JSD PASS JD 3/28/97 The geo-tech report is up in the air as we've received conflicting . information from Dave /Jim/applicant... jsd MSTA012 Plans routed to Plans Examiner 3/28/97 3/28/97 JSD PASS RDP 4/9/97 Application is on hold. We are • waiting for Jim Embrie to give • , us information on the Tie Beams - BobP - 04/09/97 MSTA026 Plans approved by RPE 4/25/97 4/25/97 RDP APPR RDP 4/25/97 MSTA030 Reviewed plans routed to DSTS 4/25/97 4/25/97 RDP RDP 4/25/97 MSTA700 Erosion Contol 4/25/97 • RDP 4/25/97 • MSTA703 Grading Inspection 4/25/97 4/7/98 PI PASS DGW 4/8/98 note: grading permit required with slope greater than 20 %. • note from inspector: prior to grading - looks okay. • MSTA705 Footing lnsp 4/25/97 • 5/9/97 KS A/N KBS 5/9/97 #-1- see inspection notes MSTA706 Foundation lnsp 4/25/97 5/23/97 RC PASS ROC 5/23/97 MSTA710 Post/Beam Structural 4/25/97 3/24/98 KS PASS J *H 3/25/98 MSTA711 Post/Beam Mechanical 4/25/97 3/24/98 KS PASS . J'H 3/25/98 MSTA712 Underfloor insulation 4/25/97 3/24/98 KS PASS J'H 3/25/98 MSTA714 Ftg Drain Bsm't Walls 4/25/97 6/4/97 RAB AP J'H 6/5/97 PERIMETER RAIN DRAIN ONLY MSTA717 PLM /Underfloor 4/25/97 3/24/98 KS PASS J *H 3/25/98 Ken advised that there is an approved slip on job, but not the inspector or date. MSTA720 Mechanical lnsp 4/25/97 8/22/97 KS FAIL J *H 8/25/97 1. Provide 1 1/2" clearance at side of fireplace. 2. Extend insulation shield above insulation line and secure. 3. B -vent touching wood at attic. 4. Provide information regarding max. height of b -vent vertical • with three 45% elbows. 5. Insulate all exposed sections of . heat ducts at attic. 6. Support rds heat ducts at lower level at ten ft. intervals at each change of direction. 7. Fireplace not installed at lower level. 8. Remove insulation touching • fireplace at main level and secure F.S. paper. 7. Page 1 of 7 • • 6/30/99 Activities for Case #: MST97 -00089 1:27:12 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated. Notes MSTA722 Plumb Top Out 4/25/97 7/31/97 RAB PASS J *H 8/20/97 MSTA723 Electrical Service 4/25/97 8/20/97 BRP PASS B`P 8/20/97 MSTA724 Electrical Rough In 4/25/97 8/20/97 BRP PASS B *P 8/20/97 • Rear receptacle to be installed in accordance with article 250 -52 NEC. Verify amount of wires that can be under one wire nut. Check setback allowance for all outlet boxes. • • • • • Page2of7 • 6/30/99 Activities for Case #: • MST97 -00089 1:27:12 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes MSTA725 Framing Insp 4/25/97 8/22/97 KS . FAIL J *H 8/25/97 1. Positive connection trimmers to header at garage. 2. Strap plates to glulam at garage also • post to glulams. 3. Nail king • studs to glulam at garage. 4. • Block floor joist at garage as shown. 5. Add stud at off wall at garage adjacent to half -bath, extend double top plate. 6. Support under hips at garage. • 7. Add nailers at mechanical soffits at garage. for attachment of gypsum. 8. Wall around mechanical at garage. 9. Nail each of triple floor joist at utility • room. 10. Add stud under • • double joist at utility room and • • strap across notch at plate/waste. 11. Provide hanger at double header at storage rim . • • adjacent to stairs. 12. Strap each end of glulam to post at kitchen. 13. Plans (show) 6 3/4 x 13 1/2 glus lam at dining room. 14. Add studs each side • of fireplace header to carry roof • load. 15. Post connection glulam beam at great room & studs each side. 16. Strap post to post same location. 17. Add ledger under (notched rafters at great room). 18. Strap plates to header at den and add trimmers right side. 19. Add nailers at bay den. 20. Fireblock • at jacuai. 21. Full bearing under 4" x10" beam suOporting roof load and positive • connection #4 x 6 post supporting suspended garage at each end, provide full bearing. 22. Post caps and post brackets not installed. 23. Stud • missed at lower garage wall. • 24. 25% of stud at bearing wall allowed /recover plywood • interior side of load bearing suspended garage floor. 25. Tie plates together exterior/interior wall at garage. 26. Block • subfloor at suspended garage floor per detail at #13. 27. Firahlnrk at Inwar huh nn NOT Page3of7 6/30/99 Activities for Case #: MST97 -00089 1:27:12 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes REMOVE HARD CARD. .� MSTA726 Shear Wall Insp 4/25/97 7/29/97 RB FAIL J *H 7/30/97 1. Nail shear panels where - missed. 2. Straps missing MST48 - requires 17 -16d nails in each. 3. HDSA's sub'd for HTT22's - ok. 4. Upstairs gyp shear 4/4 nailing. 5. Rim connection needed at "E" wall locations. MSTA727 Low Voltage 4/25/97 RDP 4/25/97 MSTA735 Gas Line Insp 4/25/97 8/22/97 KS PASS J'H 8/25/97 Gas piping pt = 25 psi MSTA740 Insulation Insp 4/25/97 9/10/97 KS PASS _ J`H 9/15/97 Approved as noted: 1. Underfloor not insulated at this time. 2. Insulate mechanical return supply. MSTA745 Gyp Board Insp 4/25/97 9/16/97 TB FAIL J *H 9/17/97 1. Install drywall shear walls per approved plans. All edges are required to be blocked and nailed. At bedroom #3 on 2nd floor. DO NOT MUD & TAPE. NOTE: BASEMENT UNFINISHED. CALL FOR REINSPECTION. MSTA761 Water Service Insp 4/25/97 11/10/97 MS FAIL J *H 11/11/97 MSTA765 Appr/Sdwlk Insp 4/25/97 3/24/98 PI PASS J *H 3/27/98 MSTA790 Electrical Final 4/25/97 12/19/97 BRP FAIL B *P 12/19/97 No receptacle in kitchen island. Cover plate missing. Kitchen plugs dead. MSTA795 Mechanical Final 4/25/97 3/11/98 KS FAIL J*H 3/11/98 See bldg final this date. MSTA797 Plumb Final 4/25/97 12/19/97 MS FAIL MRS 12/19/97 no hot water no underfloor plumbing insp. • Page 4 of 7 • 6/30/99 Activities for Case #: MST97 -00089 1 1:27:12 PM • Assigned Hold Updated Activity Description • Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes I MSTA799 Building Final 4/25/97 3/11/98 KS FAIL J *H 3/11/98 1. Need final erosion control approval. 2. Seal (void) above furnace at ceiling line. 3. Support gas piping adjacent to water heater at horizontal section. 4. Post insulation certificate. 5. Kitchen range not • • functional. 6. Support gas pipe at range cabinet. 7. Provide guardrail at front entry. 8. AC - Unit not installed at this time. 9. • _ Basement unfinished at this time. 10. Need to locate low point drain at garage. 11. Provide access to crawl, too tall. 12. Seal unused rain drain • at side of structure. 13. Slope finished grade away from structure at side and rear. 14. Seal around penetrations at exterior. MSTA032 DST Post - Review Completed 4/29/97 B PASS BON 4/29/97 MSTA080 (F) Ready to issue 4/29/97 B MEMO BON 4/29/97 Need copy of electrical supervisors license in database before issuing. MSTA092 (F) Issue combination permit 5/2/97 JSD PASS DST 5/2/97 MSTA095 Issue plumbing signature form 5/2/97 JT RECD - JT 1/5/98 • MSTA097 Issue electric signature form 5/2/97 JMT RECD JT 5/4/98 MSTA713 Crawl Drain 6/5/97 6/4/97 RAB AP J *H 6/5/97 MSTA755 Rain drain Insp 6/5/97 6/4/97 f RAB AP J *H 6/5/97 PERIMITER RAINDRAIN ONLY MSTA726 Shear Wall Insp 8/19/97 KS APP - KBS 8/19/97 MSTA755 Rain drain Insp • 7/29/97 MS PASS J *H 8/20/97 MSTA713 Crawl Drain 7/31/97 RAB PASS J *H 8/20/97 MSTA720 Mechanical Insp 8/25/97 KS FAIL . J *H 8/25/97 Corrections incomplete at this - time. MSTA725 Framing Insp 8/25/97 KS • FAIL J *H 8/25/97 Corrections not complete at this time. 1. Need to provide letter from structural engineer eliminating blocking at suspended garage floor (subfloor), also letter indicating what ( ?) size of glulams are required at main floor. Page5of7 • 6/30/99 Activities for Case #: MST97 -00089 \ I s 1:27:12 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes MSTA725 Framing Insp 8/27/97 KS FAIL J *H 8/27/97 Received approved engineering. Okay to insulate, call for reframingfinsulation inspections. 1. Add studs at each side of fireplace and nail to adjacent studs. 2. Positive • connection at 4 "x10" beam supporting partial roof load. 3. Strap plates at bay /den. 4. Add studs at lower level wall supporting partial suspende'd garage floor. 5. Support post at garage (lateral). MSTA720 Mechanical Insp - 8/27/97 KS FAIL J *H 8/27/97 See framing notes (3rd inspection) this date. MSTA720 Mechanical Insp 9/3/97 GS PASS J *H 9/3/97 1. Protection posts for equipment in garage required. 2. Gyp boar nailers needed at garage soffet around front and side of fumace ducts and b -vent. Previous corrections approved. MSTA707 Slab Insp 9/3/97 GS PASS J *H 9/3/97 MSTA725 Framing Insp 9/3/97 GS PASS J*H 9/3/97 Previous corrections approved. MSTA740 Insulation Insp 9/17/97 KS FAIL J *H 9/17/97 1. Lower level unfinished. 2. Seal void behind fumace at ceiling either with gypsum or sheet metal. 3. Nail shear wall at great room and bedroom #3. Nailing applies to both sides of • wall. Where 1/2 sheathing is not applied to wall it needs to be blocked as indicated at bedroom #3 side. NAIL PER SCHEDULE. MSTA745 Gyp Board Insp 9/19/97 KS PASS J'H 9/21/97 1. Basement unfinished at this time. 2. Seal (void) at ceiling behind furnace (WILL CHECK AT FINAL). 3. Extend gypsum to garage floor slab to provide complete separation between garage and crawl space. 4. • Adjust insulation at b -vent (no contact). MSTA760 Water Line Insp 11/10/97 MS PASS J *H 11/12/97 MSTA797 Plumb Final 12/30/97 TLP FAIL J'H 12/31/97 Key missing from lock box, unable to inspect. MSTA790 Electrical Final 12/30/97 BRP PASS J'H 1/1/98 Page 6 of 7 6/30/99 Activities for Case #: MST97 -00089 1:27:12 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes MSTA797 Plumb Final 1/6/98 MS PASS MRS 1/6/98 down spouts in front of house need to be hooked up MSTA799 Building Final 3/24/98 KS PASS J *H 3/25/98 Approved subject to: 1. Need final grading approval. 2. Install nuts & washers missed at pony wall at crawl space. 3. Stuff insulation (tight) at void above fumace. MSTA795 Mechanical Final 3/24/98 KS PASS J *H 3/25/98 See bldg final this date. MSTA799 Building Final 4/15/98 KS PASS J *H 4/16/98 MSTA960 (F) Issue Cert. of Occupancy • 4/15/98 VN • MAIL VLN 6/11/98 MAILED 6/11/98 • • • Page7of7 / 635: CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 Date Requested: 'V — i '_ 7 O A. M P.M. MST: 9 7 av /9 Location: i'2 ! 7 9 ,,j-t,0 sc� i ' �/, ? L/ BUP: Tenant: / Suite: Bldg: MEC: Var. Contractor: . V � , Phone: PLM: fa i : Phone: ELC: /I IL .L � / //t API _/ 4-i / ! . /.. ' / R: R: J /,:■ iii .ILEA! / SIT: BUILDING BLDG 1 n't) PLUMBING MEC • • (• C • ELEC • . 'AL SITE Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm Footing Roof UndFl/Slab Rough -In Ceiling Water Line Slab Framing Top Out Gas Line Rough -In UG Sprinkler Foundation Insulation Sewer Hood/Duct Reconnect Vault Bsmt Damp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Drain A/C UG Slab Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt O K— 3M 9/1' I . • .. ov Approved Approved Approved Approved Appr /Sdwlk . • _ • . oved Not Approved I � lqr Not Approved " / Not Approved 2 fq 7 Not Approved Qt FIN • . FINAL D 4 — l FINAL 6 91.' FINAL MCI FINAL ,e-� —' ni,/ -& 3 V 6.-P P RO v &n 7 • O Call for reinspecti Cl Reinspection fee of $ required before next inspection Cl Unable to inspect Inspector: i Date: y--/.5 Page of