Permit A'" ' CITY OF TIGARD BUILDING'PERMIT
PERMIT #: BUP2000 -00138
ale DEVELOPMENT SERVICES DATE ISSUED: 6/13/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S126C0 -01107
SITE ADDRESS: 09612 SW WASHINGTON SQUARE RD
SUBDIVISION: G -2 ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ALT FIRST: sf N: S: E: W:
TYPE OF USE: COM SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N : sf N: S: E: W:
OCCUPANCY GRP: M TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: 36 BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 31,250.00
Remarks: Interior remodel of existing tenant space.
Owner: Contractor:
PPR WASHINGTON SQUARE LLC ERIC L. SUNDBY
BY THE MACERICH COMPANY 521 NE 17TH AVE
ATTN: JANET FISHER, ASSET MGNT CAMAS, WA 98607
S-Pnone ONICA, CA 90407 Phone: 360 - 833 -8989
Reg #: LIC 133990'
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Electrical Permit Required
PLCK GEO 4/17/00 $201.50 0001495 Sprinkler Permit Required �1 11--
PRM2 DEB 6/13/00 Gyp Board Insp O R v � V
5PCT DEB 6/13/00 $24.80 0002925 Susp Ceilng Insp , `
FIRE DEB 6/13/00 $124.00 0002925 Final Inspection
Total $660.30
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. 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. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -1987.
Pe rm itee
Signature: C 'I
Issued By: .. 1 • • l / ,
Call 639 5 by 7 p.m. for an inspection the next business day
CITli.OF TIGARD Commercial Building Permit
Rec'd By , . ' l..."
,, Date Rec'• �w% � 7 -60
13125 SW HALL BLVD. Tenant Improvement Date co P.E. , - - *o -
TIGARD, OR 97223 Date to DST ?-fo rD
(503) 639.4171 Permit *eV t l O - o5 /39'
Print or Type • Related SWR #
Incomplete or illegible applications will not be accepted Called S - oZ7 - o d
�r /1'� r .: 3C
Name of Development/Project Existing Buildinw Building ❑
Job c!hi IreS liCrpSorieS
Address Areet Address wA Site ^ Building
at
Sw., ,�' a Data
Bldg # City/State Zip Existing Use of Building or Property:
ibatc,A ,cV. 9122 M
N. me C5S
. - �V1/ Proposed Use of Building or Property:
Property
�� 'i - - 1 " t t' � M
Owner Mailing Address - Suite _
"' No. Of Stories: r
City/State Zip Phone 3(0 /
516 Sq. Ft. Of Project: lib
Na
C� ta l ve S tI1 ' C �•„ uG l - Occupancy Class(es)
_ __
Name w
p�J /M
_ __ Contractor _ � Type(s) of Construction `' l __ _ _ __ _ _ _
Prior to permit Mailing Address Suite T
issuance, a copy t ,--,� c 1_ _ Will this project have a Fire Suppression System?
of all licenses �—.. Yes ❑ NO ❑
are required if City/State Zip Pone A with Disabilities Act (ADA) in C.O.T. ('] s ( )
database Ga _ Valuation X 25% = $ Participation
Oregon Const. front. Board Lic.# Exp. Date Complete Accessibility Form
(944‘4444-1-- I a Project $ �\
ame yeSS Valuation 3 1 v
Architect W.k ,1 NYek.k- /0 Pet Wit iS Plans Required: See Matrix for number of sets to submit
Mailing Address Suite on back
i a1 f bsT ve.,) W
City/State Zip Phone 3t G I hereby acknowledge that I have read this application, that the information
intiNA.ce . t a_ aOsoI ' wo , given is correct, that I am the owner or authorized agent of the owner, and
Engineer Name
that plans submitted are in compliance with Oregon State Laws.
ik) A- Siianature of Crier/ e L_ ja -,.....Date
Mailing Address Suite /C C - " ` 1 ` 1 , e 1
Contact erson N 4, Phone
City/State Zip Phone Y kn � - tAckr '' 30 -& 0
FOR OFFICE USE ONLY . l(r 'O.z
Indicate type of work: New 0 Addition 0 Demolition 0 Map/TL# Land Use:
Accessory Structure 0 Foundation Only 0 Alteration
_ Repair 0 Other 0 Notes:
Description of work: /
J j ,, / &,,,#__, C f vs -J r/ TIF:
Parks: Estimated # ' of Employees
- -JA 0 Note: Site Work Permit Application must precede or accompany Bulldin 9 I PP6 I o
Permit Application
I:\COMNEW.DOC (DST) 8/97
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
DISTRIBUTION TO PLANS OUT TO DST
EXAMINERS (Note a.)
TYPE OF SUBMITTAL TOTAL CPE PPE EPE CPE PPE EPE
SITE 1 1 -- -- 3 (j,o,u) -- --
B (New or Add) 1 1 -- -- 3 (j,o,w) -- --
F (New or Add or Alt.) 3 3 -- -- 3 (j,o,f)
M (New or Add. or Alt) 1 1 -- -- 2 (j,o) -- --
B & M (New or Add) 1 1 -- -- 3 (j,o,w) -- --
P (New, Add. or Alt) 2 -- 2 -- -- 2(j,o) --
B & M & P (New or Add.) 2 1 1 -- 3 (j,o,w) 2(j,o) --
B (New, Add, or Alt) 2 -- -- 2 -- -- 2(j,o)
B & M & P & E (New, Add) 3 1 1 1 3 (j,o,w) 2(j,o) 2 (j,o)
B or B & Ivt. - .
2..`. :'; - :: " : ::: : (j,o) - 2{j,o) : : : ,
BA IA & P E ::(AIt) :.; ` .. : : -:' 3,: :. 1 I :. : ..I, : ' .:: 2 (j,o) : 2 `0 Q ?` .. f- -2 G >Q)
NOTES: KEY:
a. Before returning to DST, Plans examiner gets appropriate j = Job B = BUP
number of revised plans from applicant, stamps and completes, o = Office M = MEC
updates and adds actions. f = Fire P = PLM
u = USA E = ELC
IZ. :::.Shaded 4taa$:. C.Isig44*.ALT submit 15'only. w = Wash. County F = FPS
c. FPS is a new permit category set aside for fire sprinklers and fire alarms.
d. Effective August 15, 1997, Tualatin Valley Fire and Rescue no longer requires a set of
approved plans to be forwarded to their office.
Exception, continue to forward a copy of approved fire sprinkler and fire alarm plans with
calculations.
h:\ matnc.Doc
,S -tea- - c7r:,r 3 g-
CITY OF TIGARD
EXPENDITURE REQUEST
This form is a multi -use form. Appropriate receipts and documentation must be attached to this
form. Approved request due Monday 5:00 PM to A/P for checks by Friday (week opposite
payroll only).
VENDOR NO.: DATE: 06 -01 -00
PAYABLE TO : JG ENTERPRISES REQUESTED BY: Kristie Peerman
15632 El Prado Road
Chino, CA 971710
MISCELLANEOUS EXPENDITURES:
Date Description, Invoice No., etc. Account No. Amount
06 -01 -00 Refund due to overpayment. Staff 244.23
error
TOTAL 244.23
Mileage 32.5
APPROPRIATION BALANCE: AS OF: PURCHASING:
APPROVALS:
(IF UNDER $50) Section Manager/Professional Staff �
( ) g � /
(IF UNDER $2500) Division Manager
(IF UNDER $7500) Department Manager
(IF UNDER $25000) City Manager
(IF OVER $25000) Local Contract Review Board
- oo fag'
w. Jew
Customer Receipt
CITY OF TIGARD Printed: 04/17/2000 14:21
User: front
Station: 02
Operator: DEB
Rcpt No: 0001495 Date: 04/17/2000
Customer No: 000000 Amount Due: 201.50
Name: EXPRESS PERMITS Cash: 0.00
Address: PO BOX 4197 Check: 201.50
TORRANCE, CA 90510 N/A 0.00
Change: 0.00
Type Description Amount
BUPPLN Building Plan-Check - - 201:50 •
iLe
'/O7t/
es
94/a &.,0 e c;Q__ —
U
—1- Tekeksi cf C 9
1 ,0 1; „, „ _ 44 W-36 e-
Ar\-e-t-hiL,&<, 6
t62_4.trit 0 _ 0 1 - )1/4)0
• CITY OF TIGARD BUILDING INSPECTION DIVISION . MST •
24-1-lour Inspection Line: 639 -4175 Business Line: 639 -4171
`! . 22, „a 0(// 31r
Date Requested / AM PM BLD
Location c) ' fo! Z S w C s4. S/ Suite C Zi MEC
Contact Person Ph the , Z (oz - 0',9 `/ PLM
Contractor Ph • SWR
LD Tenant/Owner ELC
Retaining Wall EL R
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection.Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof '
- Misc: _
PART FAI
•' - ING / •
- Post & Beam
• Under Slab
Top Out
• Water Service
Sanitary Sewer G
T. Rain Drains ` ,1 � n 4%/2E, ��
f GGC -!�/ i
� vz t a- 4c— le-2
• Final
PASS PART FAIL
MECHANICAL
��U/6/ �� 44/ide/ U� , / �Y � C c9ev, O0 0 Post & Beam ^” T��
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date dd Inspector E
Other x
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line:. 639 -4171
• Date Req�uees-ted _/ 0 AM PM BLD
//aa//
Location ' �Z tA/ / — 5 F P (C(aw..$) Suite MEC •
Contact Person Ph C2-0 -5857 PLM
Contractor Ph SWR
OD I N Tenant/Owner ELC -
Retaining Wall ELR
Footing Access: •
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath/Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof •
Misc: kr c/0
I PART FAIL
PLUMBING
Post & Beam
Under Slab
Top 31
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
. ELECTRICAL (�
Service � 1
Rough In
UG /Slab-
Low Voltage \4OO
Fire Alarm C
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ I Unable to inspect - no cress
ADA -
Approach /Sidewalk
Other D l / �19� Inspector • Ext CJ
�,
Final
PASS PART FAIL DO NOT REMOVE this inspection record rom the job site.
t C OF TIGARD TEMPORARY CERTIFICATE OF
OCCUPANCY
;: ;�I�Y D � E lOPMENT SERVICES
.44 PERMIT #: BUP2000 -00138
131 -I• SW all Blvd., Tigard, O 9 7223 (503) 639 -4171 DATE ISSUED: 6/13/00
11 if 1� PARCEL: 1S126C0 -01107 •
' ZONING: C -G
JURISDICTION: TIG
--
SITE ADDRESS: 09612 SW WASHINGTON SQUARE RD G -2
SUBDIVISION: - -- -
BLOCK: ` ' LOT:
CLASS OF WORK: ALT
TYPE OF USE: COM
OCCUPANCY GRP: M ORIGINAL
OCCUPANCY LOAD: 36
TENANT NAME: CLAIRES ACCESORIES 77 ''ll
REMARKS: TEMPORARY OCCUPANCY FOR 7v DAYS FROM DATE OF ISSUANCE 7 %i f -pv
Interior remodel of existing tenant space. -
Owner:
PPR WASHINGTON SQUARE LLC
BY THE MACERICH COMPANY
ATTN: JANET FISHER, ASSET MGNT
SANTA MONICA, CA 90407 il \
Phone:
Contractor: (--
ERIC L. SUNDBY
521 17TH AVE
CA �'
CAMAS, WA 98607
. / /..... Phone: 360 - 833 -8989
Reg #: LIC 133990
It is understood by the owner/tenant that the issuance of this Temporary Occupancy Permit by the City of Tigard for the use and /or
occupancy of the structure located at the site address listed above (hereinafter "structure "), does not grant or convey to the owner or
tenant any property right or other protectrble property interest in the use and/or occupancy of the structure for any purpose. It is further
understood that this Temporary Occupancy Permit shall only be valid for the number of days from date of issuance listed above and
that the owner /tenant will no longer be authorized to occupy the structure after the period specified, unless and until all the conditions
of approval imposed under the City's or County's Notice of Decision for the projects land use case(s) issued by the City's Development
Services Department or the County's Department of Land Use and Transportation and /or the Unified Sewerage Agency and all
building and related cod - �-- • uirements and any other applicable requirement ave been completely fulfilled and complied with to the
City's or County's a isf . Ql 9 n.
7 414
INSPECTOR INSP ION SUPERVISOR
BUILDING OFFICIAL
POST IN CONSPICUOUS PLACE
CITY OF TIGARD BUILDING INSPECTION DIVISION 66-14-
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP ;d& /3
Date Requested / / AM PM BLD
Location 4 W Z- SW GllA. Sc. Suite MEC
Contact Person Ph ?M- ? Z — PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: •
Slab SIT
Post & Beam
Ext Sheath /Shear
Int ath /Shear
amen
Insulati • . 1 6 /]
irewa 1 0- -oe 77, mil) AP7IF
Fire Sprinkler �" 1
Fire Alarm / .1 •
Susp'd Ceiling � ,..• ;= �l ' VC N6 41' b eAc. /'i
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other
Date 7/6 In spector p� //� — Ext JZ�
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
PAST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUP �d riU -0 4) / 3
Date Requested ■F ( AM PM BLD •
Location 0 9 G / L S w 641 c1 A- - /-I' Suite <J ' MEC
Contact Person Ph L5 9— 5 47- PLM
Contractor Ph SWR
UILDING_ Tenant/Owner ELC
Retaining Wall ELR
Footing
Foundation Access: FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing is
Insulation r ���' �� /�1�/�,
Drywall Nailing /1��7 /� %,' �I.L�� i�. 1�� 'L�4,1A I�i f.1
Firewall ' irlf allEVA [ g„ IF Mir Fire Sprinklers lie ' � IW
Fire Alarm
Susp'd Ceiling -�_ .�� �
Roof _ � / /// i r v'/ //I � L //� /�� � 1 �'-%
Air Apr i ipivorr MP' Misc: .� /�/�� .i /., I i I / J` / � / %� •
'PA PART AIL !�i- ✓,•�-� ✓�
PLUMBING
Post & Beam / c
Under Slab _r I/ /_/
Top Out
Water Service �` /� to lj,/ —
Sanitary Sewer
Rain Drains •
Final e /
PASS PART FAIL � /,� % /- / d C `-4
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
I � � / 1 J 1 1
Approach /Sidewalk D a t e I v �J Inspector �� Ext
Other p
Final
PASS PART FAIL DO NOT REMOVE this inspection reco from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
lilar Avid u /.3r
Date Requested AM / 63 /PM PM BLD
Location 4 �1(r/ 2 Jtv 14. 5 / 1 Suite MEC
Contact Person • Ph 5a3 1- So/3 PLM
• Contractor Ph SWR •
B UILD Tenant/Owner C1 : _ _ 1 - L 5 - ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear %
Framing
Insulation
Drywall Nailing
Firewall -
Fire Sprinkler
Fire •
Susp'd Ceili
Roof
Misc:
Final
PASS R FAIL
PLUMB!
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk 7/1 �/O d Ex 1
Other Date Inspector v"
Final -
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION t MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
2&OW - GU /35
Date Requested 7 PM 3 d BLD
Location 94' /Z 5 L., 6 ski , 5 :, Suite G 2 MEC
Contact Person Ph 5D; - 8' ? - 50/3 PLM
Contractor Ph SWR
T enant/Owner � / d! ✓�— .4.4 - 4 5GY-l. .c 1.L: ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: 'E) / � 20Oo , 00 �-
Slab V+ SIT
Post & Beam .
Ext Sheath /Shear �/� /�/� c l I ` - , F amingth /Shear 641k) V)UV ' OO 2 24 (V v/v��e. ICJ )
Insulation v
Drywall Nailing Z) CA- L_ Q.5 5 .._ - - (..12,
�� i;4 �% lA Q- ►e - l
- S ies— ( k SS A"-e X
ire Sprinkle AA f � (Fire oma, *r0 . 0014 k \ TT
Susp'd Ceiling
! /
Roof VN - g u
Final
P S PART AIL .
PLUMBING 2) 0 6 VS R" ( T =\
Post & Beam 1
Under Slab •Z-. V � J JJ Z� e . () G 1 - 0-
Top Out
Water Service .
Sanitary Sewer ,
Rain Drains k 1 43_C �jtiC�/\�0 Ai)A
Final / _ l
PASS PART FAIL - �� �
Tcr/ SA X
ECHAI L C ) \k".11....‘ u If �^ 4;,..c- k- --
Pos Beam I
Rough In J
Gas Line
e Dampers ei 1 I ,� r /� _ t ��� C—$2. PASS PART in -se .) VI (Il,, ,. V l -; .( 1 ° s \,. A!
lir
ELECTRICAL '
Service 4 "Ll G. C t. �e t
Rough In ?S
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA f� ri
Approach /Sidewalk Date v v Inspector ' �' Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
• CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24'Hour Inspection Line: 639 -4175 Business Line: 639 -4171 4111,00 ^ 00/3e
Date Requested ^ 7 - 2) — 00 AM PM dr) d - QO)- Location L \ 7 � r7 56 ckL _ 7 Suite �Z-- ECC - 6O - 001 9/
Contact C
o
C n t Person -Ph PLM
Contractor Ph SWR
ILDIN Tenant/Owner CA vt..( v prifL 5 ,e S ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation �� ' b Drywall Nailing u i / D . I.: . , 4s69
Firewall 1 0015 —0 0/43 Aid 7 / % a'VlL 4 % •
Fire Sprinkler !/
Fire Alarm
Susp'd Ceiling CAW 1 T T ' r
M scf: (LDU /�'1/ / ') �r4, K^
.7 �i PART 0 0440 e 541-
U NG
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains I/(/° DO ' Dv ( DD'7 ii;rJ°
Final �� , f n
PASS P� RT FAIL M �" C-20 05(/ � — � / ` � I Q1/ 0 -
`/,�� --�.�
ECH L
Post & Beam
Rough In
Gas Line
Smoke Dampers
ASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach/Sidewalk / 7il /U Inspector ," ti
Date Ex
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.