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Permit C ITY OF T I G A R D MASTER PERMIT PERMIT #: MST2002 -00419 -�I�� DEVELOPMENT SERVICES DATE ISSUED: 10/16/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 13420 SW SANDRIDGE DR PARCEL: 2S105DD -03800 SUBDIVISION: ZONING: R - BLOCK: LOT: 014 JURISDICTION: TIG REMARKS: Construction of new SF detached residence. Path 1 BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 23 FIRST: 1,454 sf BASEMENT: sf LEFT: 15 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,133 sf GARAGE: 744 sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: sf RIGHT: 5 VALUE: 257,118.00 OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2,587 sf REAR: 37 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS: LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 5 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1 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: 1 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 5 201 - 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: EA ADDL 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: X VACUUM SYSTEM: X AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: X OTH: ALL ENCOMP BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: X CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: X DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 7,832.31 This permit is subject to the regulations contained in the D R HORTON D.R. HORTON INC Tigard Municipal Code, State of OR. Specialty Codes and 5125 SW MACADAM #145 4386 SW MACADAM all other applicable laws. All work will be done in PORTLAND, OR 97201 SUITE #102 accordance with approved plans. This permit will expire if PORTLAND, OR 97201 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: 244 - 5322 Phone: 503 222 - 4151 Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You Res #: LIC 130859 may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Erosion Control lnsp 84 Post/Beam Structural PLM /Underfloor Framing lnsp Gas Fireplace Electrical Final Grading Inspection Post/Beam Mechanical Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final Sewer Inspection Underfloor insulation Plumb Top Out Exterior Sheathing Ins[ Rain drain Insp Plumb Final Footing lnsp Crawl Drain /Backwater Electrical Service Low Voltage Water Line Insp Final inspection Foundation Insp Footing /Foundation Drs Electrical Rough In Gas Line Insp Appr /Sdwlk Insp r Issued By : Permittee Signature : . � TYL Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day FROM :CRAFTIJORK PLUMB FAX NO. :5036445989 Nov. 01 2002 08:34AM P2 Plum - bing Permit Application 014.14.1.. Cit o T ,— Date re c eived: / Permit no.; 2—oz / ' .'� - "' Address: 13125 SW Hall Blvd, Tigard, OR 97223 Sewer permit no.: Building permit no.: City of Tigard Phone: (503) 639 -4171 Project/appl. no.: Expire date: Fax: (503) 598 - 1960 Date issued: By: Receipt no.: Laud use approval: Case file no.: Payment type: 0 1 & 2 family dwelling or accessory 0 Commercial /industrial 0 New construction O Multi - family 0 Tenant improvement D Addition /alteration/replacement 0 Food service 0 Other: .1(111SI INI.010I. PION I EU .`( 711 1 11, 1? (for Sptu •ial iufue'uIaliun ttst' chcchlia) Job address: r2 r I �� �f), M Defier' don Vee(en.) Total Bldg. no.: Suite no.: New l- and 2 -fam y dwellings only: Tax map /tax lot /account no.: (Inelodea.10011. for each utility connection) Lot: 14 IBlock: I Subdivision. `�� % _ SFR (I) bath Project name: SFR (2) bath SFR (3) bath -- City /county: 1 : Each additional bath/kitchcn Description and location of work on premises: Site utilides: Catch basin/area drain Est. date of completion /inspection: ' D wells/leach line/trench drain 1'1.1111111 N'(: ('1111' 1'I( AI '101t Footing drain (no. lin ft.) �r � �' Manufactured home utilities Business name: I W Me. Manholes Address: 1 S NiM b I K R a i n drain connector City: d en State :0 4 ZIP: ' r Sanitary sewer (no. lin, ft.) Phone: et*. r Fax' em-.q - E- mail: Storm sewer (no. lin. ft.) - CCB no.: 7466 Plumb. bus. no: AO % /yr 1 00 Water service (no. lin. ft,) City /metro lie. no,:/ Fixture or item: Contractor's representative signature:1 Absorption valve Print name: / ,,.. / -71fr� Hack flow prcvcnter Date: Backwater valve CON 1'At 'I PENS/)N Basins /lavatory Name: Clothes washer Address: Dishwasher City: State: �I ZIP: Drinking fountain(s) Phone: Fax: E -mail: Gjectors /sump Expansion tank • Fixture/sewer cap T — Name (print): Floor drains/floor sinks/hub Mailing address: Garbage disposal : Hose bibb , City: Stare: ZIP: Ice maker Phone: I Fax: I B -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 OILS Chapter 447. Sink(s), basin(s), lays(s) Owner's signature: Date: Sump • ENGINEER Tubs/shower /shower pan Name: Urinal • Address: Water closet Water heater City: I State: I ZIP: Otter: ' Phone: I Fax: I E -mail: Total Not all judidictiona accept credit °fires, please call juriedictinn kw more information Minimum fee $ N 0 ot 0 MaaterC uH Notice: This permit application , expires if a permit is not obtained I Ian review (at _ %) $ ttntber: —. --I---I---- within (R %) .... $ Credit cord n Expire. within 180 days slier it has been State a N o cardholder np ahewn an credit cord — accepted as complete. $ mlle S cardholder de awro -` Amount 440.4616 WOO/COM) r P e lfr if' -"7- A r au1220oa -Goa- 5 ,. Building Permit Application D id A atereceve: 6 -1 e y Permit ,l call City of Tigard rlVls r a�a -�x�t� - Project/appl. no.: Expire date: CirynfTigard Address: 13125 SW Hall Blvd, Tiat_d, O1 97223 _ • Phone: (503) 639 -4171 t _E I i] V „ t / Date issued: By:Z5 Receipt no.: Fax: (503) 598 -1960 g �/ Case file no.: Payment type: Land use approval: SEP 3 n 2017 1 &2 family: Simple Complex: j„-c " TYPE Of PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Cormiterdih indi tial' --.❑ • IJlti- family , 1s1ew construction ❑ Demolition ❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other: JOB SITE INFORMATION Job address: if/ ?%!�a,/.c i Bldg. no.: Suite no.: Lot: 1t- Block: Subdivision: 'fie r v t i t, t Tax map /tax lot/account no.: Project name: / G A O •f ( / ( / v e t - 1 • - V - IOS pp - / 0 - ? ) / 6 , Description and location of work on premises/special conditions: • OWNER FOR SPECIAL INFORMATION, USE CHECKLIST Name: 'p..'- • N14 h 1-1/ha •7 (Flood plain, septic capacity, solar, etc.) Mailing address: 125 ►i/L.,, /A /, AA f,` . t • 1 & 2 family dwelling: City: / y a / State: Of- ZIP: 'T1 i I Valuation of work $ 20 ill, Phone: fpy,- ZZ2 -416 ( IFax: 502 4 0711 -mail: No. of bedrooms/baths 4 d Owner's representative: i t a F( li j Total number of floors . Phone: '( , I Fax: E -mail: New dwelling area (sq. ft.) 'ji' -;1 APPLICANT Garage/carport area (sq. ft.) 1 Name: p • i r t'b Covered porch area (sq. ft.) Mailing address: 6A yvve at S 6( 1.7 0 V -fi Deck area (sq. ft.) City: I , I State: I ZIP: Other structure area (sq. ft.) Phone: \V Fax: E -mail: Commercial/industrial/multi- family: CONTRACTOR Valuation of work $ Existing bldg. area (sq. ft.) Business name: D . , if-1-6 h New bldg. area (sq. ft.) Address: ,, S A i J / i /, 4• Ad Number of stories liniwj i . t ra State: p ' ZIP: Type of construe Phone:t - LU -[f151 Fax: - 3717 E -mail: CCB no.: /? DRS Occupancy •up(s): Existing: City/metro lie. no.: Notice: All contractors and subcontractors are required to be ARCI IITECT /DESIGNER licensed with the Oregon Construction Contractors Board under Name: p. f , 1-171.-1- i . provisions of ORS 701 and may be required to be licensed in the Address: Gffj( jet," -c... AS Q i, , re...---" jurisdiction where work is being performed. If the applicant is City: State: I ZIP: exempt from licensing, the following reason applies: Contact person: / , lc Plan no.: ' A i Phone: - / j . 1 Fax: E -mail: ENGINEER /� , ; ontact person: 4 ar Fees due upon application $ Address : Lf S /y(p?Ph ' / Date received: City: / �i 74 , State:Q/_ ZIP: / Of Amount received $ Phone: �j- &.947,26.3-. Fax: V4(4yy 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. All provisions of laws and ordinances governing this 0 Visa ❑ MasterCard work will be complied with whether specified herein or not. Credit card number: _ / / q Expires Authorized signature: Date: g 02..— Name of cardholder as shown on credit card Print name: N /GQ/ /1'D .0'7 $ 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 (6/0tICOtr) • Mechanical Permit Application Date received: Perntitno.:/� �, m.w. � ul'(O��- -OU�/% all • �� lL City of Tigard Projecdappl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Phone: (503) 639 -4171 Date issued: By: Receipt no.: Fax: (503) 598 - 1960 Case file no.: Payment type: Land use approval: Building permit no.: TYPE OF PERMIT 0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family 0 Tenant improvement • 0 New construction 0 Addition/alteration /replacement ❑ Other: JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE . Job address: / / % Neo / 1-7f /" n `, Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: - I - Suite no.: f - value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot/account no.: profit. Value $ . Lot: fp jBlock: I Subdivision: 0 tre t- 'See checklist for important application information and Project name: au.f c_. Gre -- jurisdiction's fee schedule for residential permit fee. City /county: 774 a j r(, t> I ZIP: 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE Description andYocation of work on premises: AND COMMERIGUJINDUSTRIAL EQUIPMENTSCHEDULE 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 0 No Air handling unit CFM Air conditioning (site plan required) Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system MECHANICAL CONTRACTOR Boiler /compressors Business name: V t 'r,P State boiler permit no.: Address: (pi o h HP Tons BTU/H V IA) 1 Fire/smoke dampers/duct smoke detectors City: A InVto`, State: ql✓ I ZIP: 41001 Heat pump (site plan required) Phone: wp(,ti . v.isx I Fax: I E -mail: Install/replace furnace/burner BTU /H CCB no.: Q Including ductwork/vent liner CI Yes ❑ No Install/replace/relocate heaters— suspended, City /metro lic. no.: wall, or floor mounted Name (please print): AA', d i / , . Vent for appliance other than furnace CONTACT PERSON Refrigeration: Absorption units BTU/H Name: NI co (G t- z 1s p/ Chillers HP Address: y jjq 40 Aid 1 zda _•1.t- ./V5- Compressors HP Environmental exhaust and ventilation: City: /0/9/Pril I State: I ZIP: 47--d/ Appliance vent . • Phone - j . -y/ / Fax. i - 19/ E -mail: Dryer exhaust OWNER Hoods, Type U II/res. kitchen/hazmat t� p hood fire suppression system Name: P. . A • )r -- 0/.7 ti Exhaust fan with single duct (bath fans) Mailing address: 5j !W k d7m' 4-7 Exhaust system apart from heating or AC City: firi m tate: Q_ I ZIP: .ft.0 Fuel piping and distribution (up to 4 outlets) Type: LPG NG Oil Phone: .• /,r Fax: / I E - mail: Fuel tying each additional over 4 outlets Process piping (schematic required) Name: go #0 �'� /,lj Number of outlets � — Other listed appliance or equipment: Address: 13y5y 5E JLU A-ve Decorative fireplace City: el State:pg I ZIP: 41,p/fr Insert- Phone: ,4f- >psi I Fax: (/j9 WA I E -mail: Woodstove/pellet stove Other: Applicant's signature: /7 , Date: 41-4-01.-0, ther: Name (print): Aj 40 (e c Not all jurisdictions accept credit cards. please call jurisdiction for more information. Permit fee $ Notice: This permit application ❑ Visa t] MasterCard Minimum fee $ expires if a permit is not obtained Credit card number: / 1 Plan review (at _ %) $ Expires within 180 days after it has been State surcharge (8 %) .... $ Name of cardholder as shown on credit card accepted as complete. $ TOTAL $ Cardholder signature Amount 440 -4617 (6/00/COM) Electrical Permit Application Date received: Permit no. ± 0)__ 00414 4:41, 1 City of Tigard Project/appl. no.: Expire date: i Address: 13125 SW Hall Blvd, Tigard OR 97223 S and Phone: (503) 639-4171 Date issued: By: City of T I Receipt no.: Fax: (503) 598 - 1960 Case file no.: Payment type: Land use approval: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi - family ❑ Tenant improvement in New construction Cl Addition/alteration/replacement ❑ Other: ❑ Partial • • JOB SITE INFORMATION • • Job address: Y ,cill y //7 ,., prk Bldg. no.: Suite no.: Tax map /tax lot/account no.: • Lot: 54 Block: Subdivision:. ( -nU (jre. -- Project name: Rci ezc, G ff' � f 'Description and location of work on premises: Estimated date of completion/inspection: • CONTRACTOR APPLICATION \ — ' '""'r, FEE SCHEDULE Job no: Fee Max Business name: k1/2 e i. l ! ( ' j t y , (� Description Qty. (ea.) Total no. insp / L .2 � New residential - single or multi- family per Address: $ % `L y I / dwelling unit.Includesattachedgarage. • : City ` 1 1T State: yr Z IP:t ' 11 23 • Serviceincluded: Phone: OD `Fax: 4441() E -mail: 1000 sq. ft. or less 4 0 CCB no.: I f Elec. bus. lic. no: ?� - y7-,lo(J Each additional 500 sq. ft. or portion thereof Limited energy, residential 2 City /metro lic. no.: 5 — Limited energy, non- residential 2 _ —r _ • Each manufactured home or modular dwelling Signatu of supervising electrician (required) Date Service and/or feeder 2 Sup. elect. name (print): License no: Services or feeders – installation, alteration or relocation: • • PROPERTY OWNER 200 amps or less 2 Name (print): D 1 R , /- � h zs. 201 amps to 400 amps • 2 • in^7 401 amps to 600 amps . 2 Mailing address: rji <SiN Ql 4- / 601 amps to 1000 amps 2 // City: ry-m M a State: to/( (ZIP: • / Over 1000 amps or volts • 2 p Phone: pa- rf f I Fax: 0 , Z- 5-7111E-mail: 1 Reconnect only 1 Owner installation: The installation is being made on property I own Temporary services or feeders - . which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocadon: • ORS 447, 455, 479, 670, 701. 200 amps or less 2 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 ' Branch circuits - new, alteration, or extension per panel: Name: � ?i/ eons VH7n A . Fee for branch circuits with purchase of • Address: �2/ f5! f i � l j e/ service or feeder fee, each branch circuit 2 City: e/At liLlma, 'State: OK 'ZIP: TINT B. Fee for branch circuits without purchase Phone: Fax E • of service or feeder fee, first branch circuit: 2 r . _ �g� rr Each additional branch circuit: PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included): O Service over 225 amps-commercial 0 Health -care facility Each pump or irrigation circle 2 O Service over 320 amps - rating of 1&2 0 Hazardous location Each sign or outline lighting 2 family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, O System over 600 volts nominal more residential units in one structure alteration, or extension' _ 2 0 Building over three stories 0 Feeders, 400 amps or more *Description: O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above: O Egress/lightingplan 0 Other. Per inspection I I I I Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $ O Visa 0 MasterCard expires if a permit is not obtaine Plan review (at _ %) $ Credit card number: / / within 180 days after it has been State surcharge (8 %) .... $ Expires accepted as complete. TOTAL $ Name of cardholder as shown on credit card $ Cardholder signature Amount . moum 440.4615 (6/00/COM) \ • ' 1 kikAAAAAAAAAAAA♦AAAA AAA® aA AAAAA AAAAAAAAAAAAAAAAAAs®AAAAAAAAAAA ■ TREE CS ,„. It- .. ® ,i', 1 4. I, 5 't E )t 4 tl* , ,Owner /I gent for ' ® (PLEASE PRINT) J (PERMIT HOLDER) t ` \ ® -. ,r , i ' � . 1 a Do hereby cethfy that e: fo'1!lowing location • < ,. '-. th �.: , i 1 " meets ,� ty : /XTashngt 'County 0. • land use and development standards for street tree installation. 0. • 0. 1 0. ® ADDRESS: MISO `ASV. 14VDte1 Del E- Ptu VE. • Pi- t 1 1 LOT: Ik SUBDIVISION PAS Ft C , 1 BY DATE: 3 / PS i RECEIVED BY: DATE: CITY OF TIGARD 24 -Hour BUILDING 0 Inspection Line: (503) 639 -4175 MST ° 6 1( 7 INSPECTION DIVISION Business Line: (503) 639 -4171 � BUP p Received Date Request- • 3 — ° o AM PM BUP , Location MEC I Contact Person Ph (_ ) 57/ —q 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 Susp'd Ceiling Roof Other: Final PASS RT FAIL BI eam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan SS ART FAIL M ANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL Service .w ::1L1J7L> UG a . w o a Fire Alarm Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL ' 0 Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line ADA C� /� ? Approach/Sidewalk Date ° Inspeeto Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour LeZ BUILDING Inspection Line: (503) 639 -4175 MS INSPECTION DIVISION `' Business Line: (503) 639 -4171 BUP Received Received Date Requested '7 r AM PM BUP Location /3 y u a Suite 2'o3 -6e/67 Contact Person Ph ( ) S' -q 36 4 PLM Contractor Ph ( ) SWR tt:ITEDING Tenant/Owner ELC Foundation - ob3- DUl9z 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 Oth: : in I(AZ PART FAIL BING Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final P• = - • -T FAIL - os : :earn Rough -In Gas Line S moke Dampers 4.). PART FAIL CTRICAL 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 y /y�U 3 inspector Ext Approach/Sidewalk Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL