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10250 SW GREENBURG ROAD STE 211A i to r• � o r� to m 0 N U� f/ 7 rfr, r I 1 i i i 1 S w 10250 SW GREENBURG ROAD SUITE 211-A CITY Off' TIGARD FLECTRICAL PERMIT DEVELOPMENT SERVICES 13125 S1.7 Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #: ELC96-0714 DA-IF ISSUED: 11/06/96 PIARC.EL: IS135AB04500 SITE ADDRESS. . . : 1.0;250 SW GREE NBURG RD #E-1 1. 1. SUBDIVISION. . . . : ZONING:C--P BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . : Description: Tenant improvement - For,estell - RESIDENTIAL. UNIT------ ----TEMP SRVC/FEEDERS--------- SCEI_L_AI\IEOLJS------- 1000 SF OR LESS. . . . . 0 0 il,0 0 amp. . . . . . . . 0 PUMP/IRRIGATION. . . . : 0 EACH ADDIL 5009F. . . : 0 201 400 amp. . . . . . . : 0 STEN/OUT LINE LIG. . : 0 LIMITED ENERON.. . . . . . 0 401. 600 amp. . . . . . . : 0 SIGHAL/PANEI.. . . . . . . : 0 MANF. HM/ SVC/FDR. . : 0 601-+-amps---1.000 volts. : 0 MINOR L ABEL ( JO) . . . : 0 ---- ---RRANCH CTRCIJII"S--- ------ INSPECTIONS—— 0 200 amp. . . . . . : 0 W/SF,'F,'VICE OR FEEDER: 0 PER INSPECTION. . . . . : 0 400 amp. . . . . . : 0 1st W.10 SRVC OR FDR. - I PER HOUR. . . . . . . . . . . : 0 401 600 amp. . . . . . .. 0 EA ADDIL BRNCH CIRC: 11 IN PLANT. . . . . . . . . . . .. 0 601 1000 amp. . . - . : 0jREVIEW SECTION-...._.___-----__._____ 1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL.. . : Reconnect only. . . . . : 0 SVC/FDR 225 AMPS. . : CLASS AREA/SPEC OCC. owner: FEES NORRIS BEGGS & STEVENF., type amoUnt by date t'ecpt 10220 SW GREENBURG RD PRMT $ 90. 00 .TSD 11/06/96 96-2861"78 5PCT $ 4. 50 JSD J. 1/06/96 96-.2186178 T'IGARD OR 97223 Phone #: 452,5900 Contt-actov-: CHRISTEN SON ELECTRJC INC 94. 50 TOTAL 111 SW COLUMBIA SUITE 480 REQUIRED INSPECTIONS PORTLAND OR 97201 Ceiling Cover Elect' l Final Phone #: Wall Covet, Req #. . : 000004 This permit is issued subject to the regulations contained in the Tigard Mliicipal Code, State of Ore. Specialty Codes and all other Perm ittee Signat fAl-e applicable laws. All work will be done in accordance with approved plane. This permit will expire if work is not started within 188 days of issuance, or if work is suspended for sore 'A- than 180 days. issi-(ed By INSTALLATION The installation is being made on property I own which is not intended fat- sale, lvase, Jr' fent. OWNER' S SIGNATURE- DATE: INSTALLATION ONLY---------------- SIGNATURE OF SLIF-IR. ELECIN: DATE: LICENSE NO: Call for inspection 6394175 Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. r--� Tigard, OR 97223 Permit # ,� �- (� Date Issued _ ! 1 6 Phone (503) 639-4171 FAX (503) 684-7297 CITY OF TICARD TDD No. (503) 684-2772 Inspection (503) 639-4175 1. Job Address; ( r ` 4.^Complete Fee Schedule Below: _ Name of Development LINCOLN CENTER Number of Inspections per permit allowed Address 10250 SW GREENBURG RD SUITE 211 Service included Verne Cost(ea) Surn City/State/Zip TIGARD 4a. Residential -per unit 1000 sq k or less $11000 —__- Name (or name of business) FORESTELL Each additional 500 sq n or portion thereof $2500 Commercial UK Residential ❑ Limited Energy $2500 Each Msnut'r!Home or Modular Dwelling Service or Feeder $6800 2a. Contractor Installation only: 4b. Services or Feeders ROSS CKUS)3YCHRISTENSON ELECTRIC INC Installation alteration,orretncation Electrical Contractor s 200 amps or less $6001 2 Address 111 SW COLUM.3IA SUITE 480 201 amps to 400 amps �— 18000 — 2 City PORTLAND – State_ jig —_ ZiP97j = -88 401 amps to 600 amps $120 00 _ _ 2 601 amps to 1000 amps 5180 00 2 Phone No. '241-48I 2 _ over 1000 amps or volts $340 00 — 2 Job NO. 222-9793 Recnnnectonly --- $5000 _ 2 contractor's license NO. 26-34C 4c, Temporary Services or Feeders Contractor's Board Reg. No. ,slallation.alteration,or relocation - 200 amps or less Y Signature of S�p r. ri'tT c 201 amps to 400 amps $5000 License No.._ 873-S Phone No.241-4812 401 amps to 600 amps $7500 Over 600 amps to 1000 volia $10000 — — 2b. For owner, installations: see"b"above. P4d. Branch Circuits Print Owner's Name New,alteration or extension per pens Addressa)The fee for branch circuits with t` City State__ Zi _ purchase of service or feeder fee. Each branch circuit $500 Phone No. b)The fee for branch circuits without The installation is being made on pruperty I own which is purchase of service or feeder fee. 35 00 not intended for sale, lease or rent. Fbranch circuli �— S35 Faocc h additional bronrh circuit $500 Owner's Signature _ _ _ 4e. Miscellaneous (Service or feeder not included) 2 3. Plan Review section (if required): Each pump or Imigatlon circle $4000 _ 2 Each sign or outline lighting $4000 Signal circult(s)or a limited energy Please check appropriate Item and enter fee in section 5121. panel,afteratlon or extension $4000 4 or;,lore residential units in one structureI Minor Labels(10) $100 00 Service and feeder 225 amps or more System o,,:r 000 volts nominal 4f. Each additional Inspection over _ Clessif,--d area or structure containing special occupancy the allowable in any of the above as described in N E C Chapter 5 Per Inspection —_ $3500 Per hour S5500 In Plant $5500 Submit 2 se►a of plans with application where any of the above "-- apply. Not required for temporary construction services. 5. Fees: 5a Enter total of above fees a 90' N01 ICE 5°h Surcharge (05 X total fees) PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ AUTHORIZED IS NOT COMME14CED WITHIN 180 DAYS OR 11 5u. Enter 25%of line A for required (Sec 3) _ CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if reqS — A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ 94_.50 COMMENCED wn Aocm4M.Nc ❑ Trust Account # prm.pp S 94.50 Balance Due $ --- - — — CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT #. . . . . . . : PLM96-0347 131 q5 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE IBSUED: 11/19/96 PARCEL: 15135AA04500 91TE ADDREE;cb. 10250 SW 6REENBURIa Hu #f'_1. 1. 9UBD I V T SI ON. . . . : ZONING: C—P BLOCK. . . . . . . . . .. . LOT. . . . . . . . . . . . . CA-ASES OF WORK. . :ALT GARBAGE DISPOSALS. 0 MOBILE IAOME SPACES. 0 TYPE OF USE. . . . :COM WriSH ING MACH. . . .-'., . 0 BACKFLOW PREVNT9S. . 0 OCCUPANCY GRP_ :B FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . 0 STOR I ES. . . . . . .. . : 0 WATER HEATERS. . . . . : I CATCH BASINS. . . . . . . : 0 F I X TU RES.—- I-AUNDRY TRAYS. . . . . .. 0 51:7 Rn I 1\1 DRA I NE). . . . . : 0 SINKS. . . . . . . . . . . 1. URINALS. . . . . . . . . . . . 0 GREASE TRAr-,S. . . . . . . . 0 I.-AVATORIES. . .. . . 0 OTHER F1 X TURES. . . . : 0 TUB/SHOWERS. . . . : 0 SI.:'WER LINE (ft ) . . . : 0 WATER CLOSLTS. . 0 WATER LINE (ft ) . . . : 0 DISHWASHERS. . . . J RAIN DRAIN (ft ) . . . : 0 R?mar-ks : Tenant improvement FORESTEL Owner--: FEES NORRIS BEGGS & STEVENS type amount by date r-ecpt i0220 SW GRFENBURG RD PRMT $ 27. 00 JDA 1. 1/12/9ci 96-286392 5PCT $ 1. 35 JDA tl/12/96, 96 286392 TIGARD _)R 97223 1-'hone #: 452-5900 '.:OntTactor,: DETEMPLE CO INC 1951 OW OVERTON r)'T 11OR11 OND OR 97209 Plicine 0.127-2641 $ 28. 35 TOTAL q OO2510 REDUIRED INSPECTIONS 'his peroit is issued subject to the regulations contained in the Rough— in Insp ligard Municipal Code, State. of Ore. Specialty Codes and all other PILM/Undet-f I oar applicable laws. All work will be done in accordance with Top--olit l n s p ,lpproyod plans. This pervit will expire if work is not started Final. Inspection within 180 days of issuance, or if work is suspended for eave than 180 days. 11-i'Mittpe Signati-tv-e : I ssil.ipd By : Call for- 4aspect ion 639-4175 CITY OF TIGARD Plumbing Application I, Recd By IWITV�. rl-l2 13125 SW HALL BLVD. Commercial and Residential ok- Date RecdDate to P E. TIGARD, OR 97223 Slllh Date to DST (503) 639-4171 Permit Print or Type Related SWR 9 �'?y j Incomplete or illegible applications will not be accepted Called ,,`I �c� - -- ,gy p , Name of"Deviopment/proiect f --1 � 1�, 1 Jed L,"1/I C� ��►'�• w�,�� o ATH Ho ! us �,e Street Address uile r= 4+ re. 3 BATH HGUSE 6 d i CA la�ui�. 'ti :s �r; Address ('. S U `�LJ •�� '? �jr(�c (�j Fee Includes ad plumbing fixtures In the'i1we1�ing itrid the}ifz3t 100 feet of 'a","` Bldg itCity/Slat ZI _� water service,sariltary sewer and storm sewer.'^,ee fees belga Na FIXTURES(individual)^ QTY PRICE AMT I T 0 i 111 Sink — 1 goo Owner Mailing Address Suite Lavatory 9.00 Tub or Tub/Shower Comb, 900 City/Slate Zip Phone — Shower Only — 9.00 Name Water Closet 9.00 /(.k; �C Dishwater ' 9.00 Occupant MailingAddressSuite Gar'jage Disposal 900 GL U.) (UU+ �w`� h I ? WashingMaeh,ne 9.00 .j.ity/St�o � Zip Picone Floor Drain ?" I cq-//1 r:f AA Gli -- 9.00 — —— dame / 3" _ 900 —— f�'Vln o b W �GL L 4" 9.00 Contractor /ailing Address Suite Water Heater - 900 TJ V eVIM Laundry Room _+Tray 9.00 on 9 itylState Z,jp Phone — ..y lam- � q--1 U, I I Unnal _ Oregon Const.Cont Board Lic.• Exp.Date Other Fixtures(Specify) 9.00 Attach Copy of (�Jl-S( C-) N I —_ 900 Current Plumbing Lic.0 . rJ Ex D to 900 Licenser 1� S 17�� 6 t{1 -- Sewer-1 st 100" g 0"1 COT Business'rpZ or Met A Epp.Qafe _ — — r �L Sewer-each additional 100' 30.00 Name Water Service-1st 100' 25.00 Water Service each additional 200' 30.00 Architect Mailing Address Suit., Storm&Rain Drain.1st 100' 25.00 Or Storm&Rain Drain-each additional 100' 3000 Engineer City/State Zip Phone Mobile Home Space — 25.00 Commercial Rack Flow Prevention Device or Anti- 25.00 Describe h nic New O Addition O Alleration ffi Repair O Pollution Device _ to be done: Residential O Non-residential KResidential Backflow Prevention Device' 15 00 Additional description of work _LL .II — Any Trap or Wase Not Connectel to a Fixture 900 5+ 5i,-Ic_ i ttJ� �0-6 i 4 i 1.�.-,,,. , tis L Catch Basin — — 9.00 Insp.of Existing Plumbing 4000 i per hr Existing use of Specially Requested Inspections 40.00 building or property P_ er hr — _ Proposed use of Rain Drain,single family dwelling 3000 building or property — _ _ Grease Traps 9.00 QUANTITY TOTAL ;Ks Are you capping any fixtures? Yes❑ No ..,. Isometric or riser diagrams required if Ouandy Total is >9 I hereby acknowledge that I have read this apnlicition,that the information *SUBTOTAL given is correct.that I am the owner or authorized agent of the owner,and that plans submitted are in compliance with Oregon State Laws. 5%SURCHARGE / Sig ture of Owner/Agent Date F(atit{(1' *' �OQv>�tj i '�Z I�f(c PLAN REVIEW 25% OF SUBTOTAL Contact Person Name -- Phone Required ontyn fixture qty ictal-s>9 _ + TOTAL 1�.3 — Minimum permit fee is S25+5%surcharge,except Residential Backllow < i ldstslplmapp.doc lrevention Device,which is S15+5%surcharge Tenant Name:_A 'N f 0rtle, Accurnulative Sewer Tally This SWR#: C'Y _ Address: (; - r., b, r ~� _I 1 ' 7— <" This PLM#: '�C �`> -- Fixture Valuo Previous # Previous Credits Capped Fixtures Fixtures New New Value Capped off value added# added total #s total Count off #s count value values Baptistry/Font 4 — ! Bath- Tub/Shower 4 Jacuz/Whpl 4 Car Wash - Each Stall 6 -Drive Through 16 Cuspidof/Water Aspirator 1 Dishwasher - Commer 4 Domest 2 Drinking Fountain 1 Eye Wash 1 Floor Drain/sink 2 inch 2 3 inch 5 _ 4 inch _ 6 _ •Car Wash Drain 6 Garbage Disposal ) 16 Dom(to 3/4 HF) Comm Ito 5 H?) 32 Ind lover 5 HPI 48 Ice Machine/Refrigerator Drain-, 1 _Oil Sep(Gas Station) 6 Recreational Vehicle Dump Station 16 Shower Gang (Per Head) 1 . Stall 2 Sink - Bar/Lavatory 2 Bradley 5 Commercial Service 3 S vimming Pool Filter 1 Washer, Clothes 6 Water Extractor 6 Water Closet, Toilet 6 Urinal 6 TOTALS Total fixture values:,_----__ divided by 19 = / r- ��_ EDU HISTORY PLM# EDU# i 'r' SWR#( li 1(F ( PLM# EDU# SWR# PLM# EDU# SWR# �'�r Y, PLM# EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR I ht# FDU# SWR# f PI M# EDU# SWR# CITY OF T'GARD MITCHAN I CAL. DEVELOPMENT SERVICES PE Rt,'I I T 13125 SW Hall Blvd., Tigard,OR 97223 (503)639-41/'1 F-'`-R111 T it. . . . . . .DATE.* ISSUED, PARCEL_: IS135AB-04-500 f. TE ADDRI'-'-SS. 1.0250 SW GREENBURG RD #211 SUBD T V 1.S 1011. . ZONTNG- C-P BI-Ocv. . . . . . . . . . 'J-ASS OF WORK. . :AL-T Fl.-OOR FURN. . . . . o EVnP r-001-ERS: 0 -TYPE OF." USE. . . . :COM UNIT HEATERS— : 0 VENT FANS. . : 0 OCCUPANCY GRp. . B;:, VENTS W/O APDL: 0 VENT sys'l-EMS: QA 5TORIES. . . . . . . . o BOIL-FRE;/COMPIRESSORS FlOODS : 0 FUEL 0-3 lad',. . D 0 M r S *I NCI. . . . : 'I 1*,.l: 0 4-15 IAP. . . . .- 0 COMML. INCIN: 0 MAX TNPHT. 0 BTU 1 3-30 HP. REPAfk UNITS: 0 PIRE DAMPERS?. . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0 r )AS FIRESSURE. . . : 50r* HP. . . . : 0 CLO DRYERS. . : 0 NO. OF LINITS-- -__._._.._ AIR HANDL.ING UN I T F OTHER UNITS. : I rURN ! 100K BTU: 0 1001110 c..f-'m : 0 GAS OUTLETS. : 0 TURN ) =J.q.otN BTU: 0 1.0000 c-fM: 0 Remarks : Instal lat- i()n of IfL gri. 11 COVP)--, for air d1ACt system after 1-1 work done. Owner': FEES MORRIS BEGOV3. A. STEVENS type amol.111t by date V-eCpt 10220 SW GREENBURG RD PRMT $ 25. 00 DRA 1211P196 96-c"87660 SPC 1 25 DRP q6,--287G(.',0 TIGARD OR 9712,23 Phone #: 452-5900 Cont)-actor: NORTi-I v-,nCTFIC HEATING ,7700 SE DUIJS RD .. C:)'TACAI)n OR 97023 Phone #: 2 *25 T 0 T A L Peg #. . : 63746 REOUIRED TNSPECTJONS 'hos permit is issued subject to the regulations contained in the Final. Inspection Tigard Municipal Lode, State of Ore. Specialty Codes and i!1 other applicable laws. All work w;I1 be done in accordance with approved plans. This pervit will expire if w!:-i- is not started Within 180 days of issuance, or if worn is suspended for sore than im days. tee gna SS LIP. Call fov- inspection 639--41.75 e o.Q5,g na. City of Tigard MECHANICAL PERMIT P;anck/Rec. # _ 13125 sw Hall Blvd. APPLICATION Permit # v. Tigard, OR 97223 (503) 639-4171 7escnpUon — -- —� Table 3A Mechanical Coda QTY PRICE AMT Job > 1) Permit Fee -U- -U- 1000 Address _ 2) Supplemental Permit 300 1) incl, d.,cts &vents 6,00 Owner I T•r 2) incl. ducts &vents T 50 - JFloor urnance 3) incl vent 600 - !Yn' "T ��••� � Suspended eater, wall heater 4) or floor mounted heater 600 Occupant ""• Vent not nc. in p r / 5) appliance permit 3.00 . • ALJ Repair of heating, re ng. • / _ 6) cooling, absorption unit 600 •n• Q�Lboiler or comp, heat pumpcon, air con/._ 7) to 3 HPabsorp unit to 100K BTU 6.00 • u• •• Boiler or comp, heat pump, air sono - .) - 3) 3-15 HP, absorp unit to 500K BTU 11 00 Contractor „•. t� `mow" w� -offer or co heat pump, air con 9) 15-30 HP. absorp unit 5-1 mi; BTU 1500 • • .,a� 13-der or(,omp, heat pump, air cond. e/ � G'h�J 10) 357e FIor absorp unit 1-1 75 mi! BTU 22.50 ereby acknowledge a have readthis—application, that the �o her or comp, eat pump, au con information arven is correct. that I am the owner or authorized 11) , 50 HP, absoro unit 1 75 and BTU 37 50 agent of the owner, that pians submitted are in compliance with Air handling unit to State ,aws. that I am registered with the Construction Contractor s 12) 10.000 GFM 450 Boaro that the number given is correct. (If exempt from State Air an ung unit _ registration. please give reason below.) 13) 10,000 CTM + 7 50 -- on portable 14) evaporate cooler 4.50 Vent fan connected 15) to a single duct 300 �— Ventilation system not 15) included in appliance permit 450 moo served by _ 17) mechanical exhaust 4 50 scribe work hew lj add' n 3 tera,ion repair'U Commercialor industrial to be done residential O on-residential 18) type incinerator 2000 _x sting use of Other u e woo stove, water building or property ZJJ�n191 heater solar, clothes dryers. etc 4 50 -- -- OF Proposed use of 201 Gas pipir cne to four outlets 200 building or property _ 21) More than 4-per outlet teach) 200 Type of fuel -oil O natural gas L LPG Q electric i) NOTICE Minimum Fee $2500 SUBTOTAL PERMITS BECOME VOID If- WORK OR CONSTRUCTICN AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR 5°o SURCHARGE IF CONSTRUCTION OR WORK IS SUSPENDED OR — — —� ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25'o OF SUBTOTAL AFTER WORK IS COMMENCED ---- —` rO TA L _^�r Srecial Conditions —_ -- _— Date issued by A kLOOiMOBMME(PW..T CITY f) F TIGARD DEVELOPMENT SERVICES BUTLDING 'rFRMTT 13125 S W Hall Blvd., Tigard,OR 97223 (503)639-4171 PERMIT #. . . . . . . : BUP')7- !7117�7' DATE ISE.-)UED- 02/18/97 I I TF ADDRES3. . . 10250 SW OREH-ENSURG RD W21 PARCEL: IS13-35AB-0430Q) JBD I V J q I,N. . . . : ZONING:C--P -OCK. . . . . LOT. . . . . .. . . . . . . . 1S)SUE. FLOOR EXTERIOR. WALL CONSTRUCTION (�'LASS OF WORK. :FPS F I R s'r. . 3L'::'O 4 s f N: S. E: W I .P OF UqE. . . :COM SECOND. . . 0 s f PROTECT OPENINGS?--._....-.- - TYPE OF CONS T. ;2N . . . 0 s N: S. E: W: nrCUPANCY GOP. :D 3112,0 it s ROOF CONST: FIRE RET?: OCCUPANCY LOAD: IZI BASEMENT. : 0 Sf AREA SEP. RATED: !3 TO R. . 0 IAT: 171 ft or,)RnGE. . . : 0 S f OCCU SEP. RATED: SSMT" : MF. ZZ": REQJ GETBACKS---------------- F I.- OOR LOAD. . . . : 0 ps f LEFT: 0 ft RGHT: 0 ft FIR SPIfl -Y )110S DWELLING UNITS: 1T t�' OET. . : FRNT: 0 ft REAR: 0 ft FIR ALRM:Y HNDICP ACC: IBEDRMS: 0 SATI IS: 1r IMP SURFACE: 0 F,P 0 C 0 R I PARKING: 0 VALUE=. $ . 4787 R(tema04s : Fir-e sl.ipp)--essian system Owner,: FEES NORRIS PEGGS & STEVENS typ(-., amm-trit by (I o t P r'err.)t 10220 SW GREENBURG RD FIRE $ 0-- 00 JDA 1211 /29/97 97-289629 PRMT 1, 50. 50 1.1 02/10/137 97-29041337 TIGARD OR 97'"-'23 FIRE $ 20. 20 B 02/:113/97 97--290483 fah ime 4: 452-591210 5PCIT $ 53 B 02/18/97 97-2904B3 Contr-actor: A1,.OHn FIRE. PR0Tr.-.CTTON 18935 SW WRIGHT CT N—OHA OR 97007 Ffimie 0. 50,*3--r-.,4;-' 437B $ 7:?. 23 TOTAL Reg" 65221 REDUIRED TNSPECTIONS this pervit is issued subject to tl,e reg!ilation- contained in the Sprinkler Ral.tgh— ' ard Nun'cipal Code, State of Om Specialty Codes and all other Spt-inklev, Final applicable laws. All work will be done in accordance with approved plans, This peroit will eypire if 1400' is not started within 188 days of issuance, or if work is suspended for core than 188 days, Pei'mitte" Call for inspection 639--4175 it Protection Permit Application PIan Check 0 ,TY OF TIGARD Commercial or Residential Redd By t lv6 U"— "GARD, OR 97223 Print or Type Date to P E. %{ 41 - 503) 639-4171 Ext 304 Incomplete or illegible applications will not ba accepted Date to DST Permit 0 6( Called Z i - ITI— Name of Dave lopmenuProject — Type of System (Complete A or B as applicable) Job A+=Ms F.'P_- Tir L Address Address A.) Sprinkler Wet Dry ❑ 7`i. ��, .�K k r• ,; S' 2 i Standpipes Name�n Hazard Group Owner Mailing Address u I _v Additional t , c ,-4 T CitylSIfte O Zip Phone Information Density Il` I Design Area Name I rf`i t1 F 1�if, 1 �1— K. Factor Occupant Mailing Address _ '! Sprinkler Project Valuation $ Cltylstate Zip Phone COT Business Tax or Metro N Exp.Date B. Firc AlarmAA Submittal Shall Include Battery Calculatior ss YES Q contractor Name _ \-r-I Iiopk_ f'o'al:( .-_ k' t : 6 Individual Component YES C1 (Sprinkler or Mailing Address Cut Sheets _ Alarm I „..; t-19 I(,f 1 Fire Alarm Project Valuation $ Company) CitylState Zip Phone 1r 6 ,- , Pi `I 1( ` 6-"1 ( `f i ! Project Valuation Subtotal (A or B) $ liv Attach Copy State Const.Cont_Board Lic it Exp. Date of / '� ' ie i /I ! $ ` 3� Current COT Business Tax or Metro N Exp. Dale � Permit fee based on valuation Licenses e 1 fl U-73 _ � _(s"chart or back) _ 3 Name 5% Surcharge $ S Makin-Address FLS Plan Review 40% of Subtotal $ . Architect g I C tyiState Z p Phone TOTAL $ L_ �r. l escnbe work A.)New O� Addition O Alteration 0" Repair O Fu�S MUST 9F_SUBMITTED pan approver aro a peeq ed wr poor to 2bon owrl:- Thea sets of plans aro srte p.an land vianf�map)required wtucn snows brabon of to be done: _ I nearest hydi)nL B.) Basement O HoodNeot O Spray Booth O i her"acxnowwage mat I have read-pis appiication,that the informaoor,given is Complete O Pdrtial O Exrt way O correct.7,a,i am dpi owner or autrwnrea agent of tMw,owner.and that oians subrrrned am in m4notiance*nidi Oregon State laws Additional Descnpaon of Work: — i Si�tyttun 9t rlAgent Date A.)In Exlsbng Buildingp New Building ❑ Tondat f'4 n Name Phone l Building .___ I..�r' ;��,�.J 'J0'V 6'!'_.J 4,4.7 rr I — — Data B.) Commercial [7 Residential FOR OFFICE USE ONLY: Ptat 0 -- MapnL* No.of stones. f ' I R, ! SQ.Ft: ` Notes C:cupancy Class Type of Construction sts\firesupr doc C rrY CE T7 r„A R Q TCTAJ, PLAN STAi c BUILDING VA L'-'A 7t CN PSRh1Ci FLS REVIEW TAX PER FL. =S �.5PERMITt' FE :S �5.Ca SO.CO 16.25 . 1.25 52.50 1,5J'-1,5L0 25.5a 10.x'0 17.23 1.33 5- 1,Gg1-1,7Cq �.6a z3.Co 11._7 18.20 1.40 !'p.,130 1.701-1,SCO ::9.!J 11.90 19,18 1.48 61.9b' 1,901-1,SC0 31.Co 12.40 20.1 5 1.!a 65.10 1,901-2,200 32.60 13.Co 21.13 1.63 5a.26 2.CO1-3,CCo 28.50 15.-to 25.03 1.93 80.86 3,C01-4,CCO 44.50 17.90 28.93 2-23 911./46 4.001-S.CCO 5< <0 20.::0 0.83 2.53 1(06,C1F 5,001-6,CCo Sts.50 22.50 36.'a 2.°3 118.66 6,CO1-7,CCO 62.SJ 25.CO 40.53 3.13 1;11.2:] 7,001-a,CCO ea.-CO 27.40 44.53 3.43 14 3.8 6 8,001-9,000 74.,0 29.00 48.43 3.73 156 46 9.001-10,CC0 80.!0 32.20 52.33 4.03 169'aG 10,Co1-11,CCo S6.-co 34._o !6.=3 4.33 181.66 11,CC1-12.CCO 92.SJ 37.CO 60.13 4.53 194.25 12.CO1-13, .0 98.SG 39.410 64.03 4.93 206.66 13,001-14 ,0 1CA.^0 41.80 67.93 5.23 219.46 14,001-1S,t:CO 110.!0 44.:0 71.83 S.53 232.06 15,f u t-10,;00 11 a'.?J 46.:'0 75.73 5 a3 24-t.!'6 'S.CC1-17,CC0 1^? .0 s9.�3 79.53 6.13 257.25 1 i,C01-18,CCO 1:9.;0 51.-,0 83._93 6.53 259.86 13,001-19,CCO 124.50 =3.30 87.43 6.73 282,4B 1e,C(11-2o,CCO 1AC._0 55.20 91.33 7.03 2SS.C6 -0 C0"-_,,C. O .. 0 5 3..0 . . 7.11'3 307.50 a01-�?,CCJ 51.:0 99.13 i.53 320.25 -_.001-23.0 :0 153._J 63.-0 103.03 7 =3 332.�F .Zj 106._3 8.13 '4a.4& _'.cc1-__. :C 1i0.5J 53.=0 1 '0.8.3 8._93 358.CE CJ 110.7: 8.74 2c'i._9Q i_.:0 7',.!0 113.c-8 9.53 2i 6,96 - 2. ,0 7:.10 Sq . 920 �. 3EEj.4U 2.8.^.01- 9,r a0 ;Sg.50 i 0.40 1.C?!3 9.+3 395.85 .Co'-:C. -=7 ;c3.:0 Trr. 5.415 g.:::: 20,001-.31, 0 197._J 79.00 '39.38 ?Q5.3C� -?8 414.73 . 1,:01-.2, �0 2'22._0 c0.c7 11.20 1G.i0 424.20 r01-23. _0 _rc: :0 ?2.=J 12'.23 1 .33 433 23.001-3»,CCO .11.00 8-!.-!o 127.15 J._� 453.10 2 '. 01-:5,000 ='3 aE.20 140.u9 10.73 452."6 CITY OF TIGARD November 5, 1996 OREGON Smith Space Planning 10130 SW Nimb !s Avenue, D-4 Tigard, OR 97223 RE: FORESTV. Building Plan Review 10250 SW Creenburg Road PC#: 10-62c BUP#: 96-0560 Submittal documents for the above referenced project have been reviewed for conformance with the applicable 1996 Oregon Specialty Codes and other applicable ..,-pies and standards. The following comments are noted: 1. An amount equal to 25% of the remodeling cost shall be budgeted for removal of architectural barriers within the site and tenant space. A. Barrier removal is determined in accordance with OSSC, Section 1 113.1.1., ORS 447.241 (4). B. The barrier removal plan shall include exterior improvements. 2. The lunchroom sink shall be accessible in accordance with OSSC, Section 1109.11.3. Provide a detail and specifications. Please submit three cnri�c ;; revised submittal documents and a letter indicating your response to the ah.ove comments for review. Please call me at (503) 639-4171 if you have any questior s. Sin�, ely, i m F `✓tis�'�_-+-.-_'"' PLANS EXAMINER U,\PRMS\'S\DOCUMEN'�BUPBE; OS.60\PC10-62CDOC 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639-4171 TDD (503) 684-2772 CITY OF' TIGARD DEVELOPMENT SERVICES BUILDING PERMIT 13125 SW Hall Blvd,, Tigard, OR 97223 (503)639.4171 PERMIT #. . . . . . . : BLIP96-0560 DATE ISSUED: 12/06/96 PARCEL: 1S135AB-04500 ITE ADDRESS. . . 10250 SW GREFNSURG RD #211 _.UBD I V I S I ON. . . ZONING:C.—P BLOCK. . . . . . , . . . •• LOT. . . . . . .. . . .. . . . REISSUE; FLOOR AREAS-----.---.---.-- —EXTERIOR—WALLCONSTRUCTION- CLASS OF WORK. .-ALT FIRST. . . . : 3219 sf Ns S: E: W. 1 TYPE OF USE. . . :COM SECOND. . . : 0 Sf PROTECT OPENINGS?------------ TYPE OF CONST. :2FR 0 sf N.- S.- E: W: OCCUPANCY GRP. :B2 3219 sf ROOF CONST: FIRE RET? : OCCUPANCY LOAD: 37 BAGEMENT. : 0 sf AREA SEP. RATED: STOR. : 2 HT: 0 ft GARAGE. . . : 0 3f OCCU SEP. RATED: BSMT?.- MEZZ?-. REUD SETBACKS-------- REQUIRED--------------- FLOOR LOAD. . . . : 0 psf LEFT: 0 ft RGHT: 0 ft FIR SPKL:Y SMOK DET. . :N DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM:Y HNDICP ACC:Y BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORRIN PARKING: 0 VALUE. $ : 19798 Remarks : 'Tenant improvement Owner: --------- FEES ---------------- NORRIS BEGGS & STEVENS type amount by date recut 10220 SW GREENBURG RD PLCK $ 91. 33 JH 10/23/96 96-285591 FIRF $ 56- 20 JH 10/'2'3/96 96-1-285591 TIGARD OR 97223 IDRMT $ 140. 50 JSD 12/06/96 96-287355 Phone #: 452--5900 `=PCT $ 7. 03 JSD 12/06/96 96-287355 Contractor: MALIBU PACIFIC 735 NE JACKSON SCHOOL. ROAD HILLSBORO OR 97124 ------------------------------- Phone #: 693--9797 $ 295. 06 TOTAL Reg #. . : 059045 REQUIRED INSPECTIONS This perett is issued subject to the regulations contained in the Framing Insp Tigard Municipal Code, State of Dre. Specialty Codes and all other Gyp Boara Insp applicable laws. All work will be done in accordance with Susp Ceilng Insp approved plans. This persit will expire if ark is not started within IN days of issuance, or if work is suspended for wore than IN days. Permittee Signatime: Co Issued BY. Call for inspection 639- 4175 ID.Z3•`��0 1� 7. 5�J Commercial Building Permit Application City of Tigard I 13125 SW Hall Blvd. Tigard, OR 97223 �✓ (503) 639-4171 Jobslte Address: 1D'G.So._�11 �UI1L. Qo .. '' 40 _ Office Use Only Tenant: -ST�(r _ Suite # PlanWRec # t 2- Valuation: Valuation:_19 19A Permit — Owner: �j' -� +- _, Map & TL# Address: O,21 S.YV, C-7(er-)u6 atzL -_C_ Approvals Required -- - - -5 ---- Planning - --- --- ---- Phone: _ 2012..—__ Engineering _ Other Contractor: AL 11644 Addre s 7391 LILS Type of const:__,._ _ C� Occupancy class: Phone n�-1- — -- Spy inklered? (les No Contractor's License # SL._'"t _ V(attach copy of current Oregon license) Sq. ft. of project: -7 .7 Story (1 st, 2nd, etc.) (c6tdiess. itect/Engineer: -,mr4�OA� tyLj Ip,l[� Proposed use: Ply -aw4oUL f2 N. N 1m& .4vPrevious use, G&I.Lt r-FL16 P- , Note: Plumbing & mechanical plans must be submitted at time of e, Phone: � O . _— building pernA appication. � (,�_-jLAMENTS: -- — - - —�--. - t ADplican signature & P ne number Received bv: ., _ Date Received: ( Permit # Account Description Amount Amt. Pd. Bal. Due Bldg. Permit (BUILD) �— Plumb. Permit (PLUMB) Mech. Permit (MECH) s --- State Tax (TAX) Bldg: Plumb: Mech: Plan Check (PLANCK) t3. I33 Bldg: Plumb: Mech: Sewer Connection (SWUSA) ewer uispec-tion (SWINSP) Farl•.s Dev Charge (PKSDC) Storm Drainage Chg (SDSDC) Residential TIF (TIF-R) Mass Transi' TIF (TIF-MT) Commercial TIF (TIF-C) — Industrial TIF Institutional TIF (TIF-IS) Office IiF (TIF-0) Water Quality (WQUAL) _ Water Quantity (WQUA" Fire District (FIRE) /x{7 ,3 TOTALS: o(o _ f�� I— CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639-4175 Business Phone: 639-4171 Footing Rain Drain Cover/Service FINAL: Foundation Water Line Ceiling -Plumb. Post/Beam Mcch Shear/Sheath Framing e'recR Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect. Post/Beam Struct. Mech. Rough-in Gyp. Bd Id San Sewer Gas Line Appr/Sdwlk Reins. Other: Date: A.M. P.M. Entry: Address � � �� n Tenant: '=f--� 1 te:" ��#I�T: !i� _ – BUP: Con/Own: MEC PLM: ELC: THE FOLLOWING CORRECTIONS ARE REOUIRED: ELR Inspector !"APPROVED — DISAPPROVED/CALL FOR REINSP CF , CO CITY OF TIGARD DEVELOPMENT SERVICES 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639.4171 CERTIFICATE_ OF OCCUPANCY PERMIT' #. . . . . . . a PUP96•-•0560 DATE=. ISSUED: 03/06/97 PARCEL.r 1 S 1,35A£+-fav 500 iITE;' ADDRESS. . . s 10250 SW BREENSURG RD #211 3UHDIVISION. . . . t ZONING%C--P lll._OCK. . . . . . . . . . t I.-OT. . . . . . . . . . . . . . k":LAGS OF WORK. GALT tYPE OF' Ul.'Z:. . . r COM fYVE OF CONSTR:2F"R _7CCUPANCY GRE'. a Pg OCCUPANCY LOAD- 37 T1-Nr?t\►T' NAME. . . nFORESTEL i%timar-ks : TVpant improvement Owner- 1 ____._.__. _.__ _..__._..__.__..._. _._....._._ _..- -_-- r_.. ;;NICKERDOCKER PROPERTIES INC C/0 NORR I S, BE:GOG it S I MPSON 10300 SW GRE'ENDURG RD #i?00 PORTLAND OR 97223 Phane #n Contractors ___._ _._. _._ ._._ .._.._....-.... ..._ __. ._ _ .. ._.._ MAL.1.BU ECAC I F"I C 735, NE JACK90N SCHOOL. ROAD I 1 i LL.SBORO OR 97124 Phone #r 693-9797 Req 11. . a 1000590 This Ger^t i f irate gr art s ocr. upanc•V of the ahove refer,enced bui ldinq or port ion thereof and confirms that the bu.ildiog iras been inspected for- compliance with the State. of Orgc.n cperialty Codes for, the group, C-- upas , and �s�e under• whiLh the refevenced permit was issued. 1 &U I L.Ci I NG I Nr� f:Tf]R E;U I L.D OFFICIAL POST IN CONSPICUOUS PLACE I CITYOF TIGA R D PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM1999-00268 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/20199 SITE ADDRESS: 10250 SW GREENBURG RD 211 PARCEL: 1 S135AB-04500 SUBDIVISION: LINCOLN BUILDING PP1991-055 ZONING: C-P BLOCK: LOT: 001 JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: M061LE HOME SPACES: TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: 1 CATCH BASINS: _FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: 1 URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Relocate one sink and one water heater. Dummy sewer permit SWR1999 00176. Owner: _ FEES —�— KNICKERBOCKER PROPERTIES INC Type By Date Amount Receipt— BY NORRIS BEGGS & SIMPSON PRMT GEO 8/20/99 $50.00 99-317815 10300 SW GREENBURG RD STE 200 5PCT GEO 8/20/99 $3.50 99-317815 PORTLAND, OR 97223 Total $53.50 Phone 1: Contractor: DETEMPLE CO INC 1951 NW OVERTON ST P PORTLAND, OR 97209 REQUIRED INSPECTIONS t — a Phone 1: 227-2641 Rough-in Insp Underfloor/Underslab Reg #: I-IC 00002.510 Insp existing/capped fixtures PLM 26 25PB Final Ins, action This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR. 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 issuan.;e, or if work is suspended for more than 180 days. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OU, 'C by calling (503) 246.1987. Issued By: Permittee Signature.,Call (503439-4175(50 39-4175 by 7:00 P.M. for an inspection needed the next business day CITY OF TIGARD Plumbing Permit Application Plan Check 13125 SW HALL BLVD. RECEIVEDPlumbing and Residential Recd By TIGARD, OR 97223 /, Date Recd q (503) 639-4171 AUS i l 199�' Date to P.E. COMMUNITY UFVE.LOi M, 1N1 or Print T Date io DST Permit Incomplete or illegible applications will not be accepted PeRer Related rem/�l� /5 G F f r- M f4ys�9 .;� Name of Development/Project FIXTURES (individual) UT1( PRICE AMT Job Sink _ 11.50 j y0 Address Street Address // Suite Lavatory 11.50 5l("6116('IhL'rte � Tub or Tub/Shower Comb 11.50 Bldg# City/Slate 11ZIP Shower Only 11.50 --- � Lr 7��}3 Water Closet 11 50 Name T-Ji C K Ei'l [k i'1 �12` ori I c's Dishwasher 11.50 Owner Mailing Address Suite Garbage Disposal 11.50 Washing Machine 11.50 City/State ZIpp Phone i-le,o'7 Cry G/� Z 3 Floor Drain/Floor Sink 2' 11.50 '- Nome 3" 11.50 4- 11.50 Oce upant Mallinq Address Suite Water Heater O conversion ® like kind 11 50 Gas piping requires a separate mechanical permit City/State Zip Phone Laundry Room Tray 11.50 Urinal 11.50 Nm er T�141ple f ll `wc - Other Fixtures(Specify) 15.00 Contractor Mailing Addre,s Suite Prior to permit City/StateZ1' Phone Sewer-1 st 100' 38.00 issuance,a copy P'.,if' T �� d f,)e I ' Q �// Sewer-each additional 100' 32.00 of all licenses are Oregon Const.Cont.Board Lia# Ex Date - --- required if r,)<�/7 6, 1cre Z- Water Service- 1st 100' 38.00 expired in COT Plumbing Lic.# Exp.Date Water Service-each additional 200' 32.00 �database (, S W SLY- b Storm&Rain Drain-1st 100' 38.00 Name Storm 8 Rain Drain-each additional 100' 32.00 Architect Mobile Home Space 32.00 or Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 32.00 Pollution Device _ Engineer City/State Zip Phone Residential Backflow Prevention Device' 19.00 (Irrigation liming devices require a separate Describe work to be done: restricted energy permit.) New O Repair n Replace with like kind Yes O No O Any I rap or Waste Not Connected to a Fixture 11.50 -^ Residential O Commercial^J Catch Basin 11.50 Additional description of work Insp of Existing Plumbing 50.00 Y�FIQCct S1sby LL<l1 Cr 1c'av/-f'- per/hr Are you capping,moving or replacing any fixtures? Specially Requested inspections per/hr Yes Ar No O Rain Drain,single family dwelling 45.00 If ycs, see back of form to indicate work performed by Grease Traps 11.50 fixture. FAILURE TO ACCURATELY REPORT FIXTURE WORK COULD RESULT IN INCREASED SEWER FEES. ^QUANTITY TOTAL 1n I hereby acknowledge that I have read this application,that the information Isometrir,or riser diagram is required H Quanllty Total is >9 �l given is correct,that I am the owner or authorized agent of the owner,and 'SUBTOTAL it tans submitted are in cpm fiance with Oregon State Laws S 911 ere of Owne fAgont Lleto 7% SURCHARGE Yf r '1 LC ntact Penton N ma ono "PLAN REVIEW 25%OF SUBTOTAL Required only K fixture qty total is>9 1 BATHHOUSE$178.00 ', ' TOTAL c<� 2 BATH HOUSE$250.00 3 BATH HOUSE$28b.00 'Minimum permit fee is$50+5%surcharge,except Residential Backflow (Thla fee Includes all plumbing fixtures In the dwelling and the first Prevention Device,which is$25+5%surcharge 100 feet of sanitary sewer storm sewer and water service) - "'All Now Commercial Buildings require plans with isometric or riser diagram and plan review i vs*-rnstplurnapp doc 611609 PLEASE COMPLETE: Fixture Type Quantity by Work Performed New Moved Replaced Removed/Capped Sink _ - Lavatory -- Tub or Tub/Shower Combination Shower Only Water Closet Dishwasher Garbage Disposal______ ----- Washing Machine — Floor Drain/Floor Sink 2" 411 Water Heater Laundry Room Tray _ — Urinal — Other Fixtures (Specify) COMMENTS REGARDING ABOVE: Accumulative Sewer Tally tenant Name: F�r ��> y� This SWIG# bD 1-7� 4ddress: / OaSv s�J *,,4-1,)af This PLM# j94q -00 ;t&6 fixture Value Previous Previous Credits Capped Fixtures Fixtures New total New # Value Capped off value added# added #s total Count off#s count _value values 3aptistry/Font 4 3ath -Tub/Shower _ 4 - -Jacuzzi/Whirlpool 4 ;ar'Nash - Each Stall 6 _ Dnve Through 16 :uspidorNVater Aspirator 1 _ Dishwasher- Commercial 4 _ Domestic 2 Drinking Fountain 1 Eye'Nash 1 Floor Drain/sink -2 inch 2 _ 3 inch 5 4 inch 6 Car'Nash Drn 6 Garbage Disposal 16 -Domestic(to 3/4 HP) -Commercial (to 5 HP) 32 - - Industrial (over 5 HP) _ 48 Ice Machine/Refrigerator Drains 1 _ Oil Sep (Gas Station) 6 Rec.Vehicle Dumn Station 16 Shower- Gang (Per -iead) 1 _! - Stall _ 2 Sink- Bar/Lavatory 2 Bradley _— 5 —v— — —� Commercial —_ 3 _ Service 3 _ Swimming Pool Filter _ 1 Washer- Clothes 6 Water Extractor _ 6 _ — N- Water Closet - Toilet g Urinal 6 — � - --- -- - - — TOTALS Total fixture values by 16 = '� EDU = vr� /(�<► (1 fM, l(±. v ; HISTORY EDU# SW_R# -C�l`5� /' PLM# EDU# SWR# ' PLM# EDU# _SWR# PLM# EDU# S_WR# _ PLM# _ EDU# SWR# _ PLM# _EDU# SWR# PLM# EDU# SWR# PLM# EDU# SWR# dsisuwcaly do'' —� — CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST — — _ Date Requested to 's (� AMBUP^ PM BLD Location 10 ZSD G� >I /� Suite 1 1 MEC o Contact Person 5?�4 Ph -] _S7�l-�S PLM r�o Contractor _ Ph SWR BUILDING Tenant/Owner _ _ ELC Retaining Wall ELR Footing _ - Foundation Access: SPS Fig Drain --- Crawl Drain Inspection Notes: SIGN Slab ---�- Post& Beam - --_-_ -_------------ --- SIT _ Fxt Sheath/Shear Int Sheath/Shear - ------ - Fra.ning Insulation --- --- -- Drywall Nailing - Firewall Fire Sprinkler Fire Alarm -- - - Susp'd Culling ---- -- - - ------ Roof Misc. -- -- -- ------- --- --- --- -- -- - - - Final PASS PART FAIL �. PLU191SfN Post& Beam -- ----- - -- -- Under Slab Top Out Water Service Sanitary Sewer - -------- - -- -- - --- Rain Drains CRAZe PART FAIL_ MECHANICAL Post& Beam Rough In Gas Line - - - - Smoke Dampers Final PASS PART FAIL P ELECTRICAL - - -- Service Rough In - _ ---- UG/Slab Law 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 OtheroachlSidewalk Date C / - Inspector_ Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.