Permit t,
A
CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2004 -00122
,,,rl� DEVELOPMENT SERVICES DATE ISSUED: 4/20/04
y' .� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11125 SW TONY CT PARCEL: 1S134CB -05400
SUBDIVISION: ANTON PARK ZONING: R -
BLOCK: LOT: 016 JURISDICTION: TIG
REMARKS: Fire damage repair. Other mechanical work includes duct work.
BUILDING
REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK tia< HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT:
VALUE: 40
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR:
PLUMBING
SINKS: 1 WATER CLOSETS: 2 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: 2 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: 1 WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 5 CLOTHES DRYER:
GAS FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 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 FDR: 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: 9.00 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 6 SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 1,003.77
VANDEBERGHE, DENNIS C + MICHELE OREGON HOME I MPROVEMENT COTga permit is subject to the regulations contained in the
11125 SW TONY CT DBA 0111 CONSTRUCTION Tigard Municipal Code, State of OR. Specialty Codes and
TIGARD, OR 97223 17255 SW PILKINGTON RD all other applicable laws. All work will be done it if LAKE OSWEGO, OR 97035 accordance with approved plans. This permit will expire
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: 635 - 6248 Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
Res a: LIC 34908 may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
PLM /Underfloor Shear Wall Insp Plumb Final
Mechanical Insp Exterior Sheathing Insr Final inspection
Plumb Top Out Insulation Insp
Electrical Rough In Electrical Final 1 f
F Ing Insp Mechanical Final J
Is ued By : _ . _ %.t. �tfi Permittee Signature • , , ....
_ =
.� -,finw.--
Call (51 ) 639 -4175 by 7:00 p.m. for an inspection needed the next b . iness d a
•
Mechanical Permit AppicalEi6hEV E FOR OFFICE USE ONI..Y
• v
City of Tigard Received Date/By: Permit No.: Wordoc - ,
13125 SW Hall Blvd., Tigard, OR 97223 p Z U �A
Uir r�. plan Review
Phone: 503.639.4171 Fax: 503.598.1960 AC .� ;1 D ate /B y: Other Permit:
Inspection Line: 503.639.4175 -rl��° j I1
of Date Ready /By: 3uris: H see Page 2 for
Internet: www.ci.tigard.or.us GIT -�
w' Notified/Method: Supplemental Information
BUILDING D 1
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction IQ Addition /alteration/replacerrtent Mechanical permit fees' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
p- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other:
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: Air conditioning or heat pump
It I 5W - GpLA ► / (requires site plan showing placement) 14.00
City/ State/ZIP: 1 1 / / Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg. /apt. no.: Vl �A l0, n� Project name: Furnace 100,000+ BTU ( ducts/vents) 17.90
Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no.:
Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
YI V--�': 1) jIt4■(st 0 Z . 2f.O d,� Flue vent for water heater or gas
/N1 fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
�ROPERTY OWNER I ❑TENANT
Other: 10.00
Name: D r te_Ait£-- Environmental exhaust and ventilation
L Range hood/other kitchen
Address:
�i o S t 11.-4r= c7 equipment 10.00 ,
City/ State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: co ) �1 , (L � Fax: ( ) toilet compartments, utility rooms) 6.80
APPLICANT APPT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Business me: K J n Other: 10.00
�4 C� Fuel piping
Contact name: c›...4 tA� $5.40 for first four; $1.00 for each additional
Address: �� I 4 u ` Furnace, etc.
7 Gas heat pump
City/State/ZIP: 1, 2.r c i .._ •cx Z t1 1 Wall/suspended/unit heater
Phone: (fh3 ) 2)'3 . 64 rt.. Fax: : (4O'x) . L1j . b41. -5 Water heater
7 � Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: 4.f. Jy - � - / *
A,V ' 1 I er j « '
Address: I V ,5 SIA ' E . 110 Other:
MECHANICAL PERMIT FEES*
City/ State/ZIP: . Ut OIL 1I 7...7.4 Subtotal
tel Minimum permit fee ($72.50)
Phone: (9)) c 1,0 • 13 , i. 3 Fax: (Sb'S) Iv - . 9 0 V o
Plan review (25% of permit fee)
CCB lic.: State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized sign. e' _ This permit application expires if a permit is not obtained within 180
'1 . t days after it has been accepted as complete.
Print name: , _ _ C. - Date: _ tab • Fee methodology set by Tri-County Building Industry Service Board
w
i:\ Building \Permits\MEC- PermitApp.doc I 03 440-4617T(11/02/CO B)
Plfimbing Permit Application,\ �D FOR OFFICE USE ONLY
City of Tigard U 1 Received
Permit No.: ( 00lP9'
13125 SW Hall Blvd., Tigard, OR 97223 Date/By:
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 0i;`, . 0 // rnNilr I1h Date/By: I./1,v b�- ,2j - ti1 Other Permit No.:
24 - Hour Inspection Line: 503.639.4175 F - -w Notified/Method: Supplem ental c Date Read /B I Jam ® : See Page 2 for
Internet: www.ci.tigard.or.us �,� Q�� ental Information
TYPE t ot' , FEE* SCHEDULE
❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
V Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection)
CATEGORY OF CONSTRUCTION SFR (1) bath 249.20
F rl - and 2- family dwelling ❑ Commercial/industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi- family SFR (3) bath 399.00
❑ Master builder Each additional bath /kitchen 45.00
❑ Other: Fire sprinkler (_ sq. ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: Ai A Catch basin or area drain 16.60
City/ State/ZIP: `LI A PA i O C' Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: Project name: Footing drain (no. linear ft.: ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
DESCRIPTION OF WORK Backflow preventer Page 2
/ • , i i • _ Backwater valve 16.60
Clothes washer 16.60
Dishwasher / 16.60
Drinking fountain 16.60
PROPERTY OWNER I ❑ TENANT
Ejectors/sump 16.60
Name k�� 2�j.. 2Ls Expansion tank 16.60
Address: ki .•: a Fixture/sewer cap 16.60 is City/ State/ZIP: Floor drain/floor sink/hub 16.60
Phone: (fp) ) si.41 , (1 Fax: ( ) Garbage disposal / 16.60
pf APPLIC ❑ CONTACT PERSON Hose bib 16.60
Ice maker 16.60
Business name: _ .. (... Interceptor /grease trap 16.60
Contact name: imi e.„ ' icc -e Medical gas (value: $ ) Page 2
NI Address: ?3 AL..) i 1y hge. ST .1.4-)g Primer 16.60
City/State/ZIP: c O /11.01 Roof drain (commercial) 16.60
p ) Fax: ( ) Si in/lavatory 1-5 1-04',5 �3' 16.60
Phone: (
3 Z'1'3 , a 1 Z 501 "1-1.A - Tub /shower /shower pan ( 16.60
E -mail: Urinal 16.60
CONTRACTOR Water closet A 16.60
Business name: r - L Water heater 16.60
Address: *0 1.16 l:),6, W 1.+ J f, _ Other:
Subtotal
City/ State/ZIP: 4.11 Llf, a 1/.0 O L I �' 1 7.
g t Minimum permit fee: $72.50
Phone: (50) is 9 • 8 Fax: (51) G 3 9 . 7 /_ Residential backflow minimum permit fee: $36.25
1 5.0 9� /l � p1 Plan review (25% of permit fee)
CCB Lic.: M( Plumbing Lic. no.: �� p I
I
Authorized signa - • I
-./ 6/1/ Al State surcharge (8% of permit fee)
�1 _ _ TOTAL PERMIT FEE
17 .5, / / 27, Date: IMEMI This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
i:\ Buildng \Pefmits\PLM- PermitApp.doe 12/03 4404616T(10/02/CO :1 :)
FROM : JEFF PARSON PLUMBING PHONE N0. : 503 693 1766 ` Apr. 07 2004 03:57PM P1
Jeff Parson Plumbing Est imate
706 NE Baldwin Drive •
Hillsboro, Oregon 97124 Number: E138
ph: 503939 -8294 bc: 903. 639 -1766 Date: '10S, 20
Bill To: _ f
- -- —
Gary B Cody E138 4 -
OHl 1125 SW Toney C1
17255 Pilldngton Rd. Tigard.
Lake Oswego. OR
Date Description _.._-- - -.__. r..._...... ...._.__. _ __ ....,...� T .... Amount
04/0E44 Re -vent upstairs hall Bathroom.
Re-set existing fixtures.
fixtures include :
(1) Kitchen sink vv /Dishwasher
(2) Lays.
(2) Toilets.
Man hrs & Material = 800.00
.,- ..........__.., - -- .__...._._..._.^
Total $800.00
E'd CBTL- 9E9 -EOS bIHO TadaIN RJe9 13 02:II b0 ST -Idl
Building Permit Application FOR OFFICE USE ONLY
Cl of Tigard ' ° t C E " V A Received permit No.: 13125 S W Hal Blvd., Tigard, OR 97223 Plan Review �/ ' Q 5 � /per Phone: 503.639.4171 Fax: 503.598.1960 A ,t"s`r '4 0 4 t.1` tty14f)i� t� Date/B : Other Permit:
Inspection Line: 503.639.4175 ._i_11 el I Date Ready/By: ® See Attached Checklist for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: Supplemental Information
RI Ill flING DIVISION
TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the ne est dollar) of all
Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhe , d the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
,Vi- and 2- family dwelling ❑ Commercial/industrial Valuation: $ • 00' as
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: I It 2 S s tit) -inL g c o u e New dwelling area: square feet
City/State/ZIP: -1- d Garage/carport-area: square feet
Suite/bldg. /apt. no.: 3 j ect name: Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL-USE CHECKLIST
Subdivision: 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
equipment, materials, labor, overhead, and the profit for the
• DESCRIPTION OF WORK work indicated on this application.
Valuation: $
TC PA l 0 -- T i g DA MAk.V0 •DF I- LA AN.1 CY
9+-_--1-/IA- Existing building area: square feet
New building area: square feet
7 PROPERTY OWNER l ❑ TENANT Number of stories:
Name: Q ,I� Q4 Type of construction:
Address: r jc* 4 t 1.E 0 Occupancy groups:
City/State/ZIP: Existing:
Phone: (5,) II , 4, Fax: ( ) New:
AP PLICANT ❑ CONTACT PERSON NOTICE
Business n 0.t. � (jG E tZ_( � J-C All contractors and subcontractors are required to be
Contact name: T licensed with the Oregon Construction Contractors Board
.4 - A� under ORS 701 and may be required to be licensed in the
Address: '�—), _ is t ri iyhr 4. A fr. _ S LL c T .e. Lot jurisdiction in which work is being performed. If the
� ] 9'rt —y applicant is exempt from licensing, the following reasons
City/ State/ZIP:
�p/ TLI... I 1 ) 9 apply:
Phone: ( y0; ) Z2 . n t 't o ( P _ Fax :: (Col) Z1, _ niz z
E -mail: f
IONTRACIGR
Business name: 0 i IM pto T Co • BUILDING PERMIT FEES'
Address: 1
25 11 L � ei o t 4 p.zb . Please refer to fee schedule.
City/ State/ZIP:
W " i QQ. Fees due upon application
Phone: (9 ) & IA . 11 t Fax: ([ , // 11 S 3
f"' Amount received
2 /
CCB lic.: gg
/ Date received:
Authorized signature , MI o This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Milli Date: /r • Fee methodology set by Tri County Building Industry
• Service Board.
i:\Building \Permits \BUP- PermitApp.doc I 3 440-46I3T( I I /02/COM/WEB)
APR -20 -04 09:56AM FROM- Oregon Electric 5032313587 T - 858 P.002/002 F - 888
rlpr cu u, -.-- �l ��
� (�� FOR rJi rice u� (l ;�l.l' �
,
Electrical Permit Ap>p atio�u=
City of T rd �o �' ' - /e 2 •
125 SW Ha11131vd. OR 97223 n�,� (. l: 1004 e}Mr Permie
13 Tigard, r..
Phone. 503.639.4171 Pas: 503.598.1960 sh ' ' ' Yon: El See Pagesfor
Internet Lint: 503.639.4175 CITY OF T I G a� v !M•- . _ .. Data Rea4!s, s, „�,�I l,ro..aat Internet arww.ei- tilardor.us ION NmiGed/Mettad: .
null r)IN DIVIS ::. PLAN tt w
.:. _
Q New construction �Additiott/altertttiOnhI pincemertt Please cheek all that apply:
['Service ovcr 225 amps, comet DHaucduus location
❑ Demolition ❑ Other.
Osesvice over 320 amps - rating OBuildng over 10,000 sq. a.
' ` of 1 - and 2 family dwdliags 4 or more new residential
CpT8G0]8 Y 00, COiilbT tDC2TOPL ;:' = . .-° - OW= over 600 volts nominal units in one s ructure
01- El and 2- family dwelling ❑ Commas iaUlndttsaial ❑ Accessory building
°Building over three stories P�eR, 400 amps or more
Multi-family ❑ Master builder Q loa over 99 pascals ❑ Oceupaot Mme suucmrcs or
. JOB N: AND,ILOC� Y.. LV. 8.V park
. .: St![?. IKFOC�NIA7XO
.�:. g ghl
Qt�e:tlth -care fnelity pOC:
Job no.: I lob site address: II i I j5 10 G Submit 1, seen of plena with any of the above.
City/State-LIP: f 5.' (�AV d bQ- The above are not applicable to temporary construction service.
._ ` FEE* SCBESIOLE
Suite/bldg. /apt no.: J Project name: _ tsewsotoa Lou. I Feb _I Toad j ^ -
New residmti■1 single- or multi - fnmly dwelling unit.
Cross street/directions to job site includes attached garage.
1.000 sq. ft: or less 11 145.15 4
Subdivision: l Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 I Limited ma 4 , rtsidmtial 75.00 2
-
Tax map/pateel no.: Limited maw, , ma- residential 75.00 2
• =SCR/En ON OF"WORK -7 Each manufacturod or modular 2
dwelling, service and/or Ibeda
*I C . TA Al. A( past ti — _ Services or feeders instaiiation, alteration. and/or relocation .
200 mops or less 80.30 2
:.:.: 201 amps to 400 auras
106.85 2
-. 106
L FER1'tf OV1TiEIt -"::•:. ; I7iNIftT1T - ? -: 160.60 2
�I�r 401 amps to 600 amps
Na . V tr ki De p�G•eroe[� 601 amps to 1,000 amps 240.60 2
Ova 1.000 amps or volts 2
Address: jo�S1 �• II�M Pa - Reconnect only 66.85 2
City/Sate/MP:
`` installation,
Phone (60'h) rj3..4 1� 1 T Fax: ( ) � I ' loadign
Owner installation: This installation is being made on property that 1 own which is not .:.
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps ® U
Owner signature: , Date: _ Branch circuits - new, oat or extension, per panel
= A . pa for branch citetats with
Cd' APtLtCI►I4r . ' I' .. - : :. .'Q -.dD1�'ACT ::PERSON
. " service or feeder foe catch • Butin 6.65 2
tss name: l�.�. ��,,� ` branch chef it
i1r'a'r�a"`� B Fee for branch circuits
i Contact name: l I n� p� widaut service or feeder fee. , 1 46.85 'lb. U 2
^tea " each branch circuit
Address l . ^. _ - r Eacb midi branth circuit _ ° t 6.65 FiKLZq 2
Arisedlaneom OEcrvke or feeder not included)
Cily /Stand �, �._ / . ♦ 7.09 P or irrigation circle 53.40 2
Phone: (16 ) r , , LA 1111111111 Fart:: ( r ) 14$ . b - Sign or otcline lighting 53.40 2
irma7
14.4 . Cr lL Signal eiralit(s) or /imbed
CONTRACl10R ,
- . tartly pastel. eheratioa. or
txtmsion. Describe: Page 2 2
Business name: Otte /16..1 E.1,&--rd sS ( re. 0
Each additional inspection over allowable in any of the above
Address: t7 b 5� 1 l •1' �' A Y,� Pet inspection 62.50
, ,i,v .. p. 4 Investigation hour p hr oda) 62.50
City/statuZlP: 1 ^ ,,�,� 1 • Q �'� ation per
lndusOial plant per hour 73.75 _ •
Phone: ( SB ) _ Fax: ( , j ) .. ELECTRICAL PERNAT BUS' '" -
CCB Lic.: --L 0 3 Electrical Lie: Cs � C Su • . Lie.: Subtotal I 0 (.,, ;70
Suprv. Electrician signature, rrguircdi / '
■ Print name: jai 1Z� WF ` Plan review (25%of permit fee)
�� _ - r I a Due: •. ta � i
1 State surcharge (8% of permit foe) .
r I )li / f3EM
..,_=, TOTAL PERMIT FEE ,1151 • ),(.1. Authorized signature: ■ J 4 / 1 1 14 C--) . r Ibis Permit appeases expires if o permit Is not abtaoned within lee L - day. after It has born aeeeptod as maple: Print rtasec /� (1l f . -J 1 ( a r D.. /96 • Fee nay MdobO' sel by Tri-Court Buildin Indootry Service Board
7
•• Naaiber d inspections ter OM* allowed.
iltaoidlarremdst5LGPemesto .doe ilea 4404M11strta1vrnsnwca
CITY OF TIGARD' 24-Hour - ?/
BUILDING Inspection Line: (503), 639 -4175 MST � G `T dQ / a �--
INSPECTION onnsroN Business Line: (503) 639 -4171
F� BUP
Received S - Z 2 abate Requested l d .7 AM PM BUP
Location 1 I / a- d Suite MEC
Contact Person Ph (q 7 / ) a l ` 7 68 7 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Crawl ELR
Dr ain 1 y � „ D . '
Crl Dr L /c=.
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing L.: r i , �. i � �s 'Al- 6/".z- _ . L C ' /S* C ) / • •- - 6 -
Insulation
Drywall Nailing
Firewall . e G
Fire Sprinkler C /
Fire Alarm
Susp'd Ceiling
Roof
Other:
( IV PART FAIL
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
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
Approach/Sidewalk Date /e'- S(-- Inspector A Ext
7 — v
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL