12185 SW KELLY LANE v�
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12185 SW KELLY LANE
CITY OF TIGAR® MASTER PERMIT
PERMIT #: MST2003-00200
DEVELOPMENT SERVICES DATE ISSUED: 6/25/03
13125 SW Hall Blvd., Tiy.-rd, OR 97223 (503) 639-4171
SITE ADDRE' t. 12185 SW KELLY LN PARCEL: 2S103CC-09300
SUBDIVISION: WHISTLER'S WALK -ZONING: R-4.5
BLOCK: LOT: 04u -JURISDICTION: I'IG
REMARKS: New SF detached, Path 1.
BUILDING
REISSUE: DM10t STORIES: 2 FLOOR AREAS _REQUIRED SETBAC is 2QUIREU
CLASS OF WORK: NEW HEIGHT: 28 FIRST: 1,742 sf BASEMLNT: at LEFT: 1C1 SMOKE DETECTORS +
TYPL•OF USE: SF FLOOR LOAD: 40 SECONr, 1,736 sf GARAGE a65 of FRONT. 15 PARKING°PACES.
TYPE OF CONST: 5N UWELLING UNITS: 1 THAD at RIGHT: 5
OCCUPANCY ORP: R3 BORM: 5 BATH: 4 TOTAL: 3,478 VALUt 342,5C3 70
78 of REAR: 15
PLUMBING
SINKS: I WATER CLOSETS: 4 WASHING MACH I LAUNDRY TRAYO: i RAIN DRAIN: 100 TRAPS
LAVATORIES: 6 DISHAASHERS: 1 FLOOR LRAINS atn ER LINES: 100 SF RAIN DRAINS: I CATCH BASINS:
TUB/SHOWERS: 4 GARBAGE DISP: 1 WATER HEA'.ERS: 1 WA rER LINES: 100 BCKFLW PREVNTR. GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN<100K: BOIUCMP<3HP: VENT FANS: 4 CLOTHES DRYER: 1
GAS FURN>•100K, I UNIT HEATERS: HOODS: 1 Oi HER UNITS: 1
MAX INP btu FLOOR FUPUANCES: VENTS: I W006STOVES: GAS OUTLETS: 4
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SKVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 -200 amp. 0 -20"an1p: WIB"C OR FDR: PUMPIIRRIGATION: PER INSPECTION.
EA ADD'L 500SF: 1 201 • 400rvnp: 201 00 an1p, lot W/O 8VCIFDR: SIGN/OUT LIN LT PER HOUR:
LIMITED ENERGY: 401 • 500 amp: 401 - eon amp: EAADDL BR CIR: SIGNAUPANEL IN PLANT:
MANUHMISVr/FDR: 601 - 1000 amp: 60l+amps-t000v MINOR LABEI
1000+amp.0I1
PLAN R_EV'L•W 9E1:*ION
Reconnect onlV: >BOD V NOMINAL CLS ARENSPC OCC:
>•4 RES UNITS: SVGFDR>=225 A.:
_ ELECTRICAL•RESTRICTED ENERGY _
A.SF RESIDENTIAL ,_fI.COMMERCIAL
AUDIO 6 STEREO: VACUUM 5.'STEM AUDIO 8 STEREO: FIRE ALARM INTERCOM/PAGING: OUTDOOR I.NDSC LT:
BURGLAR ALARM: OTH BOILER: HVAC: LANDSCAP41IRRIG: PROTECTIVE SIGNL.
GARAGE OPENER: CLOCK: INST JMENTATION' M601611,L: 0111R:
HVAC: DATA/TELE COMM: NURSE C%LLS TOTAL N SYSTEMS:
Contractor: TOTAL FEES: $ 5,939.95
Owner: 1 his permit Is subject to thv9 requot1uns contained in the
DON MORIS3ETTE HOMES INC DON MORISSETTE HOMES ING Tigard A",unicipal Code,State of OR. Specialty Codes an'I
4230 GALEWOOD STE#'100 4230 GALEWOOD ST,STE 100 all other applicable laws. All work will be done in
LAKE OSWEGO,OR 97035 LAKE OSWEGO,OR 97035 accordance with approved plans. This permit will expire If
work is not started within 180 days of Issuance,or if':1e
work is suspended for more than 180 days. ATTENTION.
Oregon law requires you to follow rules adopted by the
Phone: 503-387-7538 Phone: Oregon Utility Notiflration Center. Those rules are set
forth'n OAP c.5.--001.0010 through 952-001-0080. You
Reg w: �:387;7S�,;St may otltain copies of thezp rules or direct questions to
G'.INC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam Mechanica Plumb Top Out Exterior Sheathing Insl Gyp 9oard Insp Electrical Final
Sewer Inspectlnn Under'loor insulation Electrical Service Low Pottage Rain drain Insp Mechanical Final
Footlna Insp Crawl Drain/Backwater Electrical Rough In Gas Line Insp Water Line Insp Plumb Final
Fcundation Insp PLM/Underfloor Framing Insp Gas Fireplace Water Service Insp Building Final
Fost/Beam Structural Mechanlr,dt Insp Shea,Wall Insp Insulation Inan Apr-'Sdwlk Insp
Issued By Permittee Signature — —
Call (501' b39-4175 by 7:00 p.m. for an inspection needed the next business day
CITYY OF I IGARD _SEWERCONNF.CTICN PERMIT
DEVELOPMENT SERVICES f-iISSU #: S25/03 00165
13125 �:" Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUE: 6/25103
PARCEL: 2 S 103CC-09300
SITE ADDRESS; 12185 SW KELLY LN
SUBDIVISION: WHISTLI.II'S WALK ZONING: R-4 5
BLOCK: LOT: 040 .JURISDICTION: Tl(i
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NI-W DWELLING UNITS: 1
TYPE OF USE: SF 110. OF BUII DINGS
INSTALL TYPE: i_TF"WH iMPERV SURFACE:
Remarks. Sewer connection for new SF.
Owner:
DON MORISSETTE HOMES IIJC Description Date Amount
4230 GALEWUUD STE #100 --
LAKE OSWEGO,OR 97035 1SWUSA)Swr Connect 6/25/03 $2,300.00
ISbk'USA]Swr Connect 6/25/03 $0.00
Phone: 503-387-7538 1SWINSPI Swr Inspect 6/25/03 $3E.00
ISWINSP] Swr Inspect 6/25/03 $0.00
Contr actor: _—" — -
� r,tr Total $2,335.00
Phone:
Reg #:
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Clean Water Servic es. The permit expires 180
days from the date issued. The total ..mount paid will be forfeited if the permit expires. The Agency does not gudrdntee
the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect
3 feet In all directions from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer" Perm
Issued by: Permittee Signature:— _�
Call (503) 639-4175 by 7:00 P.M. for 3n Inspection needed the next business day
1c� 6-,A4 -v-3
Building Permit Application
Date received: t' (� 9 Permit �� ?- L
City of Tigard �'0
Address: 13125 SW H Ject/appl.no.: Expire date:
City of Tigard
Phone: (503) 639-4171 . � ,v r r ( ate issued: By: � Receipt no.:
7-7
Fax: (503) 598-1960 1`. Case fileno.:_ Payment type:
Land use approval: MAY '1 ,,j 200 I&2 family:simple Complex:
U I &2 family dwelling or accessory ommemial/industrial CI Multi-family , New construction 0 Demolition
1 Addi;ion/alteration/replacement U Tenant improvement U Firr sprinkler/alarni U Other.
�J SUE r
Job address; '',,� �l IN I_Bldg.no.: ,Suite no.:
Lot. l U Block: Subdivisf n: \� 1`t�_ >) ['E` Tax map/tax lot/account no.:
IL
Project name: ---
Description and location of work on premises/snecial conditions: _
r
Mailing address: L rLIV 1 &2 r,"i dwelling:
City: state l.1 ZIP: ! Valuation of work.......•....... ............. $
Phone: Fax 7 mail _ Nn.of bedrooms!baths.....•.................•...•..... 7�_
Owner's representative: I •Gut V(i LIr Total number of floors.................................
Phone: Fax: IL-mail: New dwelling area(sq.ft.) •..................•......
Garage/carport area(sq.ft.)........................
Name: )%,-, Covered porch area(sq.ft.) •........................
Mailing address: 4— (L V Deck atra(sq, ft.) ....•.................. ................ _
Other structure area(s . ft.)....
City: __ _ _ _ _ State: ZIP: .....................
tax: I E-mail: ConrmercinUlnductrial/multi-family:
ILug Valuation of work............................••.......... $
Business name: ,
Existing bldg.area(sq.ft.) ................•.•......
Address: ti Z -- New bldg.area(sq.ft.) .........•...................... _
Number of stories
........................................
City:
-- State: ZIP: Type of construction...•....................•......•....
Phone: Fax: E-mail:
Occupancy group(s): Existing:
CCB no.: ------
-- — _ New: _
City/mrtn tic tt,d Notice;.'.,:.;ontractors and subcontractors are required to he
., r licen."d with the Oregon Construction Contractors Board under
Name: L3aiAj4CL'- ,Y s provisicns of ORS 701 and may he required to be licensed in the
Address: CL., � jurisdicti:dn where work is being performed. If tt,e applicant is
City: State: 'ZIP: -- exempt from licensing,the following reason applies:
Contact person: I Plan no.: —
Pho:te: Fax: E maiL� --�
RM
Name: Contact pers in: Fees due upon applic .........I................ $_
Address: — Date received:
City: State: ZIP: Amount received .........J............... ............ $ _
Phone: Fax I E-mail: _ Plense refer to fee schedule.
I hereby certify I have read and examined this application and the Na Wt jurisdictions accept cre it cartL,please can jurisdiction for mrxe infmmution.
attached checklist. Alivrovisions of I ws and o dinances governing this U Visa U MasterCard
work will be complwt ,whether qbgcifiead herein L . Credit card number
Authoriz.d SI atU[8' 1 'i Nriuor cardholder v shown on credit card
J 1 _� % _
P .0 name: + 1 f i t ! --- - —
Crndttolder�:gultae� �A mouN
Notice:This permit applica:.ion expires if a permit is not obtained within 190 days aftet it has hren accepted as complete. se0,4613 ayaacOH
One-and Two-Family Dweiiing
�r
Budding Permit Application i tion Checklist Reference no:
Associaked permits-
City of Tigard
ermits:CiryofTigard City of Tigard OElectrical OPlumbing 0Mechanical
Address- 13125 SW Hall Blvd,Tigard,OR 97223 OOther:
Phone: (503) 639-4171
Fax: (501) 599-1960
TIIJE FOLIPWING1 1 FOR.
E4
I Land use actions completed.Ser iunsdictior criteria nt
fou concurrc
2 Zoning.Flood plain,solar balance points,seismic soils designation,historic distn,i -i
3 Verification of approved plat/lot.
Fire district _approval required.
5 Septic system permit_or authorization for remodel. Existing system capacity
6 Sewer permit. -
7 Water district approval.
8 S ills report.Must carry original applicable stamp and signature on File or with.pplicat,on.
9 Ei'•Qlnn control U plan ❑permit required. Include drainage•way protection,silt fFnce design and Ir,,:ation of t/
catch-hasin protection.etc.
IC 3 Complete sets of Ipgible plans. Must be drown to scale, showing confonr:mce to applicable local and state
building codes. Lateral design details and connections must be incorporated:nto the plans or on a separate full-size
sheet attached to the plans with cros.,references between plan location and details Plan review cannot be completed
if copyright violations exist. J�
11 Site/plot plan drawn to scale.The plan must show lot and building setback dimensions;property comer elevations(if
there is more dian a Oft.elevation differential,plan must show contour lines at 24 intervals);location of easements and
drivewav;footprint of st..ucture(including decks);location of yells/-ptic system;utility locations:direction indicator,lot
area;building coverage area;perventag:of coverage.impervious area:existing structures on site;and surface drainage. V
12 Foundation plan.Show dimensions,anchor bolts,any hold downs and reinforcing pads,connection details,vent
size and location. _
13 Floor plans.Show all dimensions,room identification,window size,location of smoke detectors.water heater,
furnace,ventilation f ms,plumhinv fiAtures,balco,.ies and docks 30 inches above grade,etc.
14 Cross sections)and detalls.Slrow all framing-member sizes and spacing such as floor beams,headers,joists.sub-floor.
wall construction,roof ecastriction. More than one cross.section.tray be required to clearly portray construction. v
details of all wall and roof sh:athing,roofine roof slope,ceiling height,siding material,footings and foundation,stairs, Y
fireplace construction, thermal insulativa.etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels.
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing r, Cation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)an: L lateral analysis plans.Must indicate details and locations;for
nor .rescritive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing.Provide plans for all floors/roof assemblies,indicating member sizing spacing,and hearing
locations.Show attic%entilation.
18 Basement and retaining walls.Provide cross sections and details showing placement of rebar. For engineered
systeuts.see item 22."Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists I
over Io feet long and/or any heani/joist carrying a nun-uniform load. _
20 Manufactured fioortroof truss design detaWl.
21 Energy Code compliance. Identify the prescripto a path or provide calcul:unms. A gas-piping schematic is required
for four or more appliances.
22 Engineer's calculations.When required or provided,(i.e..shear wall,roof truss)shall be stamped by an engineer or
architect licensed in Oregon and shall be shown to tw applicable to the project under review.
JUR ISDIC11110NAL
23 Five(5)site plans are required for Item I I above. Site plans must be 8.1/2 x I 1 o 1 I"x 17"
I
24 Two(2)sets each are required for Items 16, 19,20 k 22 above.
25 Building plans shall not contain red lines or tape-ons. _
26 No rolled.reversed or mirrored building plans will be accepted.
27
28
Checklist must be completed before plan review start date, Minor changes or notes on submitted plans may be in blue or black ink
Red ink is reserved for d.parsnent use only. 440"461.AMC JM'
Mechanical 1'crtt><it,Appliicati;on
Date received:4 ! 0 0)5 Permit no.:N°ll�My,voa,c,C
City of Tigard Project/appl.no,: Expiredate:
City ofTigurd Address: 13125 SW Hall Blvd,Tigard,OF, 97223
Date issued: By: Receipt no.:
Phone: (503) 639-4171 _
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: _ _ Budding permit no.. --
TYPE OF PERMIT
❑ 1 &2 family dwellin,,or accessory ❑Commercial/industrial ❑Multi-family U'fenanr improvement
18 1w construction ❑Addition/alteration/replaccinent O 011ier:
t 1N -COMMERCIA VALUAT4,01Nxt
Job audress: N ( 1 ( ! ``l Indicate equipment quantities in boxes below.Indicate the dollar
Bldg,no.:_ Suite value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$ _
Lot: $lock: �.0division: •'.; `r�- (k' tom- 'See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: ZIP: t a
.,n x r
Description and location of work premises: �— i s 1 s1116IN IlIkIfIN1.011111111
_ F0�
Fee a.) 'I ot:d
Est.date of completion/inspection: __ Dem3iptlon Qty' Res.oul} Rcs.md�
Tenant irrnrovement or change of use: VAC:
_
Is.._isdng space heated or conditioned?❑Yes ❑No Air handling unit _ _CFMircon itioning(siteplanrequtr )
Ls existing space in<•c,iated?U Yes ❑No Alteration of existing VACsystem
Boi�compressors
State boiler permit no.:
Business name
_ ___ I__ 1�' '- NP Tons BTI1/11
dre _
Adss: _� 7vrTokedampeructsmo a detectors
City: State ZIP: a cat pump(sue pian reyuu )
Phone: 2 �7 Fax: E-mall: - n,tali/replacefurnac timer
including ductwork/vent liner ❑Yes❑No
CCB no.: C7� _ -_— Fb
replace/re ocateheaters-suspended,
City/metro lic. no.:N/A r floor mounted
Name( lease printf LZ� rap�lianar erthan umace
eration:
IN Nam% tion units _— BTU,HName: �� �1 s HP
�__�. essors— Hp
Address
. v ottmemta a tut an gent tat�:l:
City: Applianceve;it
Phone: rax I nrtil yore gust
-Iloo ,fyj e V iUres. tc erUha+.mat
hood fire suppression system —
Name: r11 Exhaust t:.n with single duct(bath fans)
Mailing address: Exhaust system a dj 1 rrom heaui or C
Clty: State Z►p ) Fuelpiping andistribution(up to outlets)
Ty LPG __ NO Oil
Phone: Fax: Email: ue ting eac a a itiona over 4 outlets
rocessp f,ing(schematicrequired)
Number c,outlets
Name: 0(her!50 appliance or equipment:
Address _ n,!-nrativefireplace
City State: ZIP: n�rt-type
��v o stow etatove _
Phone: nI rax: I-mail: lilmlpllv� Other: _
Applicant's slgnatu �, _ Date:` 7 z t er.
Name(print): (1_L)L'1 1 fa;,ry I�
Permit fee.....................
Na ill jurisdictions accept credit cards,plate till Jutisdicuon for more inforsttation 1! __
Notice:This permit application Minimum fee........... ....$ __—
❑Visa O MasterCard expires If a permit is not obtained
Credit card number ._.,_��_rer Plan rCVICW(at %) E
Expires within ISO days complete.it has been State surcharge(8%) ....$
—Warne o lde
ccardhor u shown on credit card aCCCpled a5 Cpm
s TOTAL .......................S ---
Cardholder sijnature Amount 440.4611�6A7tM:OM
Plumbing Permit Appl•cation
\ Dat received: ()/1 Permit no.:
� '... City Of Tigard Sewer_,,:rill no.: Building permit no.:
Address: 13125 SW Hall Blvd•Tigard,OP. 97 Project/appl.no.: F.xpiredate:
(�'`y"f 7'��°'d Phone: (503) 639-4171 .- -"
Fax: (503) 598-1960 Date issued: ay: Receipt no.: -Y
Case file no.. Payment typo:
Land use approval: -
� a;
O 1 &2 family dwelling or accessory Cl Commercial/industrial ❑Multi-family O Tenant Improvement
ew construcuon O Addiuort/alternuon/replacement t_1 Food service G Usher.
r : •r t , a [:M====T,
lt i r
Description _Qty. Fee(ea) Totnl
Job address: - `• C ( �.t ( \ New l and 2-family dwelling`only:
Bldg. no.: Suite no.. (includes 100 ft.for each utility connection)
Tax ma /tax lot/account no.: SFR(1)bath
Lo- J Block: Subdivision: , SFR(2)bath _
Project name: SFR(3)bath
City/county: ZIP: Each additional bath/kitchen
I)escription and location of work on premises: Site utilities:
Catch basin/area drain
Drywell s/leach lindtrench drain _
Est date of complt:tion/inspection: Fooling drain(no.lin. ft.)
Manufactured home utilities
Business name' Manholes
Address: Rain drain connector
San►tary sewe,Ino.lin.F
City
State* ZIP: --
E-mail: Storm sewer(no.lin. ft.)
Phone: -�' Fax: _ - Water service(no.lin. ft.)
CCB tic.: Plumb.bus. reg.no: - Fixture or Item:
City/metro lic. no.:N/A _ �i Absorption valve _
Contractors representative signature, � A Back clow preventer
l
Backwater valve
Print name: ._
Basins/lavatom
�I — Clothes washer
Name: `- �_ Dishwasher
Address: _ _1 w�G' (�"� ak V Dnrtkina fountain(s)
City State: ZIP: Ejectors/sump --
Phone: F—,—_ E-mail: Expansion tank
Fixture/sewer ca
Floor drainss'floor sinks/hub
Name(print): Garbage disposal
Mailing address: _ Hose bibb _
_City: State P:C? =2 Ice maker
Phon ' - Fac: -)_7(Gi E-mail: Interceptor/grease trap
Owner instal(utionr'residential maintenance only: The actual installation RoofPnmdrain
will be made by me or the maintenance and repair made by my regular Roo!drain(commercial)
"Owners
e property I own as per ORS Chapter 447. Sink(sl.basin(s).lava(s)
ure Date: Sump
Tubs/showec/shower pan
Unnal
Water closet
Address: Water heater
- - -- Other
Phone: ----� ax: E-mail i'olal
- Minimum fee...............$
Na all iunsdreaons weep credit cards,please call lunsdict"'n mare mt xnuuon Notice:This permit application Plan review(at _ %) S ---
Gs Visa O Ma:terCud — expires it a permit is not obtained Stale surchar,
v0thin I8(days after it has been ;
—� e(8^0)
•••.t` -
C.edir card number_�^ Expires TOTAL ... ..........
_ accepted as complete.Name or car r':K+T.kr shown on crealir card $
yI 461616roM1
Cardholdu uRnarure-- 'Amount
Electrical Permit Application �
Datereceived: i, Permit no.:)f riv r
City of TiIn Project/appl.no. Expire date: --
City ojTigard Address: 13125 SW Nall Blvd.Tigard,OR 97223 Date.issued: 11y: Receipt .11
Phone. (503) 639-3171 —----_— --
Fax: (503) 5984960 f•asefileno.: Payment type: _
Land use approval: .. —_
U I &2 family dwelling or accessory U Commerci 'industrial U Multi-funily O Tenant improvement
New construction ❑Addition/alteratior>/replacemcnt U Other. ❑Partial
r t t
Job address: _ v t ' I Bldg-no.: I Suite no.: Tax map/t4, lot/account no.:
Lot: — Block: Subdivision: 1�!, lt. ►_—> — --- _
Project name. _ —�Descripdon and location of work on premises: _ --
Esumated date of completiortins coon:
t
lob no: rj) Fn 11Eax
Business name: L t v- -- - — 11.•},ripiiun Orr_ Tora1 no.Insp .
Nen i ts"-wial-single or multi family pe, I
Address: dwelling unit.Includes attached garage.
City: Sla'C: ZIP---- p Senir.hhcluded:
Phone: ,j- I Fax: E-mail: 1000 N.it or less 4
Foch additional 500 sq.R or portion thereof _
CCB no.. Elec. bus. lac. no: r Umnedenergy,residential 2
/C' > l-rnitedenergy,non-residenual _ _ 2
/� Foch manufactured home or modular dwelling
`dir�iafurr of supenrnng decrrlcjan_(requbed) - Date Service And/or feeder 2
yup erect namciprirn 1-icensen.s /�. Serrlcaorfeeden-Installation,
alteration or relocation:
200 amps ur less _ 2
- 201 amps to 400 amps 2
Name (print): ` � �� ---
401 amps to 600 anhps 2
Mailing address: ����� 11x� Sot ,n z ,: rMi imps _ Z--
City: t St1te /I P:1_. Over IOU_)amps or volts 2 ,_
Phone: -- Fix:
:•mail: Reconnert only
Owner in.sm!/adon:The installation is being made on property I own Temporary services or feeders-
which is not intended tin sale, lease,rent,or exchange according to insUll'tion.alteration.orrelocaton:
200 amps
ORS 447 455.479,670, 701. m less 2
-01 amps to 4011 amps
Owner'% signature: Date: 401 to rot .asps 2
Branch cimiits•new,Alteration,
or extension;ter panel:
Nance: — A Fee for brar,ch circuits with purchase or
Address: __service or feeder fee,each branch circuit 2
Cit - State: ZIP: B Fee for'.rrancn cucunts without purchase
City: — of service or fmder fee,first branch circuit: 2
Phone: Fes: E-mail: Eochaddidonalbrsnchcircuit:
PLAN REVIEW41"llease E Mise.(Service or ieedernot Included):
O Service over 225 amps-commercial O Heal 'mare facility Each pump or trngauon ci_tle
-3 Service over 320 amps rating of I dc2 O Harardous location Each signor outline iigh-ing _ 2
familydwellings O Building over 10,000 square feet four or Signal circuits)or a limited energy panel,
17System over 600vrdunonunal more residential units in one structure alterahon•orextension' 2___
•Building over three stories O Feeder,400 amps or mor! •Descn!unn _ --- -
O Occupant load over 99 persons O Mam.factured structures or RV park Each additional hupeetlon over the Alto wable b any r•rthe above:
•Egress/lightingplan 0 Other- _ - Perinspecuon _ r
Submit,•ets of p!,itts with any of the above. Investigation fee �-
The above are not applicable to temporary construction service. Other
Na all jurbdctiom Accept credit cards,please call jurisdiction for more mformauon Notice:This permit application Per nit fee.....................$
O Visa O MasterCard expires if a permit is not obtained Plan review(at __ %) $
Cmdlt card number ,.. _ _ within 180 days after it has been State surcharge(8%) ....$
aprres accepted as complete. TOTAL .......................S
Name of evdho,der As shown on credit cant
_ S
Cardholder utnatute Amour, 440-4615("Wd or,)
TION • MORISSETTE OBE : 2810
s0a9S IN C0 RP 09ATED LOT: 40
4 2 9 0 G A L n if O 0 D S T R E E T'
LAr2 Akt0SW , 00, 0Rsa0r 97036 DATE: 4/26/09
�5 0 s) 3 e 7 - 7 5 3 6 VAX (603) 367 - 7 6 1 6 PROPERTY: WHISTLER'S—WALK j
CITY: TIGARD '
SCALE: 1"=20'
PLAN No.: 191
OPTION 2 ELEVATION
_ I
328' 01
on r
t'1m38'
-Iof s
0 09 (J ,
e '-
15' I--
I }
FUl
3,425 6q. ft. I _ I 'n
5 bbrm. _ sIlor;
31/2 bath T
FF E. 3365' �� o
ll ,
r- :E I �
665 6q. ft.
3 Gar gar.
FFF_. 336'
- %
I 10.13' PL.E.
.r, 2D' LAND-
30' SITE
D16rANCC TRIANGLE
`-
3 z
3038'
II
l_EGEND _ A
--2' ACER RUBRUM
oM
P.ED ML.PLE' LOT COVERAGE
LOT AREA: 1,662 50 FT.
---2' PtRJS CALLER?ANA BUILDING AREA 2,554 5Q FT LOT 040 ,
'CUANTICLEER PEAR' PERCENTAGE: 33.3% 1,662 eq. ft.
CITY OF TiGAR.D•SITE PLAN REVIEW
11IJIIA)INCi PERM{U NO.:
PLANNIN(i DIVISION:
Rcquircd Settc-ks: a Approved ❑ Not Approved
tilde: Street Side: ,,(l-
1=runt. �? (parare. --As. Rear
V isua1 l::Iearanet: 0 Approved_ ❑ Not Approved
Maxin-111111 Building Height. feet
(:W'S 5crviee Provider l,ettcr Rrquired: ❑ Yrs No
❑ Rccei d
Cate: (, 7- 3 7o 3
1'11 tt 1 nII:N f:
\ 111,11 Slu)e:&—,yu 1 Appruv'ed (3 Not Approved
tiilc I'Iatr./ Approved Not ppruvcd
Dow 7 of-
N, t.,.
CITY' OF TIG,ARD -- ELECTRICAL PERMIT ENERGY/ RESTR'CTED ENERGY
DEVELOPMENT SERVICES PERMIT#: ELR2003-00234
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 8/4/03
SITE ADDRESS: 12185 SW KELLY I_N PARCEL: 2S103CC-09300
SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5
BLOCK: LOT: 040 JURISDICTION: TIG
Proiect Description: Dishwasher&audio
A REC!DENTIAL� _ B.COMMERCIAL
AUDIO & S rEREO: X� AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE-RRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDS(: LITE:
OTHER: ALL ENCOMP X HVAC: PROTECTIVE SIGNAL:
I INSTRUMENTATION: OTHER:
TOTAL#OF SYSTEMS:
Owner: Contractor:
DON MORISSETTE HOMES INC QUADRANT SYSTEMS
4230 GALEWOOD STE #100 PO BOX 14833
LAKE OSWEGO OR 97035 PORTLAND, OR 972.93
Phone: -�03-3137-7539 Phone: 234-5559
Reg #: 1111.1' 00002406
Still 121111,E
LIC 96806
F FEES -- 11.1.1'. 146460btf Inspections
Description Date Amount_ Elect'I Final
I:I'V I'rrmit 8/4/03 $75.00
1:� ti" Statc Tux 8/4/03 $6.00
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other anolicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance,or if vork 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 952-001-0010 throu�
Issued by _r Permittee Signature _
OWNER INSTALLATION ONLY
T he installation is being made on properiy I owc which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE
—_ CONTRACTOR INSTALLATION ONLY�_T _
SIGNATURE OF SI)PR. EL EC'N � DATE:
LICENSE NO:
Call 639-4175 by 7:00 P.M. for an inspection needed the next business day
07/31/2003 13:56 5032352322 QUADRANT SYS 1 l F l,GE 11:
Deiztrieal Permit ArtIvilication Receive
--- -- -- R=v , herrnit No.r °�3-an e?3 '
City of Tigard Planning pproval � Sigc
DOWRY; _ ?emit No.:
I-125 SW Hall Blvd. Plan Review `'�--
Tigard,Oregon 97223 3 Other
Date/BY: OtherPennit
Phone: 503-639-4171 Fax: 503-598.1960 Pov-Review Urnd Linc
Intemet: w.v:v.ci.ti9Ard.or.u8 Da_cBy; _- Case Nn.
24-hOur Inspection Request: 503-639-4175 Contact lu��. -M See Page 2 for ��-
NAmuMethod: ,-, l SitIcrnentai information.
!tr�� I'N9�6 �)ll:,L � ria'��'Jl1AA1"alI7Kl�.y 'i�l'�NMy;,• y' ,n. � �.�.' r + —
v New constmaionL-
Service over 225 amps-
DemolitionHealth-care facility
Addition/alterati,pin/re lacement I Other': °sir'' al [J 11nzardous locaHan
r ,v al,,h ,r,, - - ; T ❑'iervfce over 320 amps-rating of [)Building over 10,000 square feet,
I At 2 famil dwcilin
7 gi four or mrn•e resid-tiol units In
_ 1 & 2-Famil dwt-Mintr Commercial/Industrial _ ❑System over 600 volta nominal OTIC structure
J
Accessoa Building Multi-F'attllly-:- ❑Building over three Ptories L1 Feeder?,400 ahtpa or more
❑Occupant lot.d nver 99 persons O b,snur,ctured structures nr RV pork
IN-astc:guilder L Otl_ler
. ❑E(ttess/ItKhting plan Other: _
< I Submit___sate o(pinnv with any of the above.
Job site address: / lr .1 I The above are not snplirwhir to Mm 10x'8 construction Orr vicc.
Suite# �,_B1 /Apt.
_ Nurr,bcr of ins actions er crndl Allowed
Project Name: - Desct'ft+(nn _ ---' Qty to ea.) Total
Cross street/Directions to job site: Nrw reildentla14Inpic
nr mufti-family per
Jrvellluq unit.lneludrq Warhed garage.
tD %rrvice Incir:ded:
1000 s .it or less
r'r1 c+
Each mdditienal SOO aq.1L pr yartion thereof 3,40 j
Subdivision: umited en rtt+dentisl _ 75.00
Lob,S _Fc-S W Cwt W Lot#: Limited�ever, ,non ra,tdent;al
75.00 2
TAX Tt1a /)flrCcl #' f dch mettu(s,.cured Mame or mo ular dwelling
w„
_ service and/or freder 90.90 2
Jam, pJ�, Y•'i yy t ��lt 3eryor(ia installation,
alterAllatlan or relocation:
200 am ya or lase 30 2
-— 201 an:ri to 400 attnn' -85 2
401 am s to 600 arra s -~ 60,tio
601 am to 1000 ami 2 .60
Name: Over 1000 ,g of vola 54.65
R,ctmnetl only 66.85
Address: Tom,•orary merwlees or feeders-tnstatiatlot" `
-- -- dtera bin.or relocation:
mit /State✓�i 1
_ '�.�_—�-_. � .— � 200 am err le.
201 am ---" '
1�hone: r��. -- pimaoo� �o —0 — z
{� 401 to 6(4)amt I 75 2
Branch elrevits-ntw,alteration,or `
Name: - - - exten,lon per panel:
Address: - A.rer fat tannch cirruitt with prarhme of
scrvtce ur feeder fee,each branch cimft 6.65 2
Cit /Stat-e/zil - S.Fee for-6 ranch circuits without pmchale of
- stt+tice or freder fee,fit,t brutclt circuit i 2
Phone: Fax:_ each addit I branch circus! I
---
FS-mail: - Mi+c.(Servire or fnnJer not included),
kuh punts err i&Hon circle 53.
Fath+i or outline l-aW Mg 53. 0 2
Job NO: Smut eirtuit(s)0 limited enrtgv panel,
Business Name: Q���-�} ��c ahergaon.a�><tc",+a"� PAM 2 I 2
Address: �
-� � Ea.h additional Ins cellon ever the at able In Ott'of the above:
Ci /State/Zip: S - __
Phone:�.IVJ- 1114- PDX Pa i Non per hour(mina I�our�: 62.50
-�..���3!��_
CCB Lic.#: 9-- .x� Lic. #_ Zto O Opp
Supervising electrician." i _----- subtotal s
15i
stunt ra uired: fes, �i(,e� _ Plan Review(25°ie of Permit Fee) S _
Print Name: Lie.#: L2,11 j CA-- state surcharge(8°/m of Permit Fee
TOTAL-PEMT FEE
Autl!txltcd -7/51 Notice- This rtnit a ileatlon t ire,if a
Si natarc: DsM: � � pP YP permit Is not obtained within
- 180 days after it ham hecn steepled as complete.
*Fee methodology met by Trl-County Building Industry Servlet Board.
(Please print name)
i\DsvlPcrmit Fom,;NFlcPcrmltApp.doC 01/03
CITYOF T I GAR D PLUMBING PERMIT _
DEVELOPMENT SERVICES PERMIT#: PLM2003-00373
1312.5 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 07/30/2003
317E ADDRESS: 12185 SW KELLY LN PARCEL: 2S103CC-09300
SUBDIVISION: WHISTLER'S WALK ZONING: R-4.5
BLOCK: LOT: 040 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSAi-S: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: 1
OCCUPANCY GRP: FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: CATCH BASINS:
FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS:
SINKS: URINALS: GREASE TRAPS.
LAVATORIES: OTHER FIXTURES:
TUB/SHOWER. SEWER LINE: ft
WATER CLOSETS: WATER !_INE: ft
DISHWASHERS: RA114 DRAIN: ft
Remarks: back flow rreventor _____
FEES
Owner: -- -------- —--
Description Date Amount
DON MORISSETTE HOMES INC — – -- -
4230 GALEWOOD STE #100 IP11,M131 Permit I�cc 07/30/200: $36.25
LAKE OSWEGO, �,R 97035 11AX18"i,State Tax 07/30/290: $2.90
Total $39.15
Phone : 503-387-7538
Contractor:
LANDSCAPE OREGON, INC.
12200 SW MYSLONY RD.
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone : �i1 t-b�t2- ens RP/Backflow Preventer
Reg #: IIIAl 7804
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicab a laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. 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 CAR 952-0001-0100.
You may obtain. copies of these rules or direct questions to OUNC by calling (503) 246-6690.
Permittee Signature:
Cc.-�� flt_•
Issued By: � -- -----_ g
Cali (503) 639.4175 by 7:00 P.M. for an inspection needed the next business day
Jul 29 03 02: 36)p dan edmonds 503-692-0768 p. 4
E ONLY
Plumh:ngx ermit Application Received FOR OFFICE P,umbSg PQM
Pemet No.: a0 D��_� 3 7
Planning Appro I scvmr
City of Tigard DaWL3yr. PermitNo.: _
13125 SW Hall Blvd. Plan Review other
Tigard,Oregn.. 97223 D'tcM ___ Permit No.:
Phone- 503-639-4171 Fax. 503-598-1960 Post-Review [and Use
rase No.
Intc:nct. www.ci.tigard-onus Cuntart Juri:.: Sec Pagc 2 for
24 hour Inspection Request. 503-639-4175 Nanr/Mcthod: Sapplcmental Infarmatlon.
TYPE U�WORK _ FEE"SCHEDIJI,I's for spet�l'utforro>ation use checklist)
�cw construction _ Demolition - _—_`Description j.lily. Fec(ea.) -7 otnl --
Addition/altemtionhcplacement Other: New 1-&z-family dwellings -�
_
(includes CATEGORY OF.CONSTRUCTIOry . 180(L fr etaeh otili coancetion
_ _SFR(1)lratl► __ ____ ^ _ _ 249.20
1 &2- dwelling ComnnerciaUlndustrial ( SFR 2 bath - 35o.c►r�
Accessory I3uildi &_ _ Multi-Farni� SFR 3 tyath - 399.00
J Master Builder _ Other: F-ach additional bath/kitchen 45.00
JOB SITE INFORIV[A rION and t.00ATION Fire sprinkler-sq_t� Pae 2 —
Job site address: / S (t` � -f Lu/I E', Site UtiUiiat
Suite#: F31dglApte �� catch basin/atea drain — 16.60
— -L D welVicach line/trench drain_ , - 16.60
Proicct Name:x'11 S//c,/ 5 U)C_LQX_ Lir /
-.-�-- - - -- -- Footin drain net._linear R
Cross strect/Directions to jobsite: nu fact cal home ---�—
J Manufxtured horse utilities 110.00
Manholes - _16-60
} Rain drain connector 16.60
Sani sewrr ino�linear ft.)� - _ Page 2
sewer uolinear[t) g ?
Subdivision:W Pae
Storm
- --
T—__—- Water service(nc.
Tax map/paccel#: C"��—z5 nature or ltetn�
— _ DliSCRIPTION.OFWORK Absorption valve 16.60 _
- 1, C ?rr/z-1 Lr-f7()7t: Backflowpmvcmcr _L2M2 —�
13e-,,C fK Backwater valve _- - -- 16.60
Clutha;washer16-60
------- Urinkinp fountain --____-- 16.60 _
OPERTV'OWNER TENANT'
_-- �— --- E'ecturslsump 16.60 --
_Nam._e: �j�_�, �Yl�'�'i s.5 r t fc� �f^rn>~SExpansion rank � 1x.60 -- -
_Address:� 30 ,St u Gc�6e_I-V S�rr�t Fioo rdrstwu�--- 16-61) _
City/Stat%(tt/c e_ 6SttrC n O R970.3y Floor dratnlilnor sink/hub - 16.60
Garbage disposal i6.60
Ph ne:� _ - Fax: _ rinse bib — - 16.60
_ PPLICANT __ CONTACT PERSON Ice inaket 16.60
Name:&Jle, e,) o -ry-ct� [nt odgr P 16.60
Addre_ts: Cr) %S Ltd hi 14S`JiYn Li Medical has_valuc�S Pagr 7
Cily/StatPJZ1�1 �1 (.lL�1/i -�)/�- Y JU_ e], Printer ofdrnin oonunelcial) 16.60 -
Phone:5iti3 1,9j�-517 y- Fax: Lo 9A- QW, sittk/bas;t�ila�at�t� _ 16.60
E-Mail: Tuh/shower/shower -_ 16.60
_ CONTRACTOR Urinal - —16.60 -
Busirless Name: �/S C br "dam Water closet — _16.60
-� �- ! 2�l Water heater 16_60
Address:I.Da C .SW /h c S/tr" kb other. - -
Ci /State/'Zi rt �v_�Z '7U(vim. _ cam,. ---- -- _
a 4 v#I . _ _ -
Phone:563 LeQ.. - 5741 Fax:S63 t.i9a - 07(e - Plombing Permit Fees* —
CCB L.ic. #: lea - Plumb. Lica Subtotal S
� - --- _ �_ _-Minimum Permit Fee 572.50 S -^- -
Authorized Residential Backflow Minimum F � •�� 5
Signature:----,'_:1 L'----1_.e:e1 � ��J� �!!T�1Data_7 C33 --_
--T"_-- Plan Review(7-1%otPermit Fcc) S
r-r ct L►J Stutc Sum a 8%of Permit Fee S !G
(Pleam print name) -- TOTAL PERmr FFF.
Notice: nis permit application expires Its pi it is not obtal.ed""hie All nrn m_mm"d&I:in idietp reagnire 2 sets of plans with Isometric or
180 days after it has been accepted as completeriser dtagr aru for plan review.
'Frlr rnrthudology sct by Tri Count, Dulldinc Industry Service unard.
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
BUP
Received' Z
` _.Date Requested-_-_.J__-2 . AM _- PM_ BLIP -
Location � ,.�_ � �`�� Lk, Suite -_ MEC -
Contact Person —__ _ Ph( ) 16 67. - PLM ' _ >
Contractor _.--------- -- — Ph ---) ----------------- SWR —
BUIL01ING Tenant/Owner -_-_-_ _._. ------- ____ _-- ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain —
Slab Inspection Notes: SIT
Post& Beam _-
---.-------
ShearAnchors ------- _-�-- ---
Ext Sheath/Shear
Int Sheath/Shear
Framing - - --_ ---- - ------ -
Insulation
Drywall Nailing --------- -- ---- ----- ------ - -
Firewall
Fire Sprinkler ----- -- -- -- -- _
Fire Alarm �
Susp'd Ceiling -
Hoof !J
Other __._--- - ----- ----_--
--- -
Final
PASS PART FAIL
ALS MEIN _ __ ------ ---- -- -----__.
Post& Beam
Under Slab _ ___------------ --- .
Rough-In
Water Service --
Sanitary Sewer
Rain Drains
Catch Fasin/Manhole
Storm Drain -- - - - - -- ----- - --_------ _-- - -
Shower Pan
A S PART FAIL ___.� - - ------- ----__ ---- - --_. _.
--
CHANICAL - --- - -- ------_-.__ --- - - - - --- - -
Post& Beam
Rough-In ----- -- - -- _._. - -- --- -
Gas Line
Smoke Dampers - - - - ---- - - --- - - -- ---Final
PASS PART FAIL - - ---- - - - - - - - - - --- --- - --
ELECTRICAL _
Service
Rough-In
IJG/Slab
Low Voltage _
Fire Alarm
Final -� Re nspection fen of$ __- -___ required before next i ispection. Pay at City Hall, 13125 SW Hall B'✓d
_PASS PART -AIL
SITE _ PI ,ase cal)for roiw;oection RF --_---- _-_ _._..._. ❑ Unable to inspect--no access
Fire Supply Line - X,
ADA Ll
i .� _- Inspector ` „�'
Approach/Sidewalk Date -{ - Itr � Ext
Other.---. ----- l
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGA,RD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
BUP
Received _____ _ Date Re uested_ �,`�g AM___ PM BUP
Location —�� �C "/ 4 !1__-- _Suite MEC
Contact Person __ —_ ____—.___—_ Ph(___^) _ — PLM
Contractor ,. ___ Ph SWR
ILbINQy TenantlOwner _ —___ 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 - ---- - - - -- - --- _.- -_- —-
Irsulation
Drywall Nailing ---- --- - - - - ------ - ---- --------
Firewai
Fire Sprinkler
Fire Alarm
Svsp'd Ceilirnt --- - - - -- - -- - --------- ---- ---- —
Ro.n
thW
9 PAFIT FAIL ------- ----- - _ - _ -------------- - --
_ _MBING
Post& Beam------ -- -- - --
Under Slab - ---- - - - - - ---------- - - -- -— - ------- -- —
Rough-In
Water Service --- -- - -
Sanitary Sewer
Rain Drains --- -- - - -- - ---- - -
Catch Basin/Manhole
Storm Drain -- - --- - -
Shower Pan
Other: -- -- -
Final -
PASS PART FAIL -
-HANI AL
Rough-In - -- -- - _
Gas Line
Srn ke Dampers _-._
In X t
AS PART FAIL -
E CTRICAL
Service - -- - - -
Rough-In
UG/Slab
-----
ire larm
�' "' Reinspection fee of$� ___ required before next inspection Pay st City Hall, 13125 SW Hall Blvd.
AS PA7T FAIL
--
$ Please call for reinspection RE:_____ - - __- -__,__ Unable to inspect-no access
Fire Supply Linn
ADA
Approarh/S�dewalk Date ___ �-j Inspector �_ - Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
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CITY OF TIOARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503) 039-4171 �J' —
/� BLIP _.
Received —. �' r'`�_Date Requested_ AMPM BLIP
I...ocation --Suite _ _ MEC — — - ---
- � __-..it�`�S
Contact Ferson —pill-5------__.._ _ Ph(_- ___--) �-�- ---- --- -
Contractor — -- --- ---- -— Ph -- --) — — — SWR -- - --------
BUILDI Tenant/Owner _--._--___ _ ELC
u mg ELC ----
Foundation FInspection
ess:
Ftg Drain ELR —.. -----
Crawl Drain
Slab Notes: SIT
Post R Pearn - -- - - -- -
Shear Anchors
Ext Sheath/Shear �.� — --- ----
Int Sheath/Shear
Framing --- ---__.� _ _ -- - ---
Insulation
Drywall Naili ig
Firewall
Fire Sprinkler -�L �-��-�— (� �T
Fire Alarm L� �` A `I��- �/O1C.-t
T #1 -
Susp'd Ceiling - — ----
Roof
Othel �(Z
NVA _
-PASS PART
II _
LUM —
Post& Beam
Under Slab -� ----
Hough-In _
Water Service ------_ _._ -
Sanitary Sewer
Rain Drains
Catch Basin i Manhole
Storm Drain - ---
Shower Pan --
Ot r: - -
inal
_ SS r�ART FAIL
M_E_C_HAN_I_ - --- —
Post a Beam
F+ough-In - - --------
Gas Line
Smoke Dampers -- - - - - — - -
Final
PASS PART FAIL -- - - — -
14 ECTR
Service
Rough-In _—
UG/Slab
--
Fr arm
rn E] Reinspection fee of required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
--
SITE _ [l Pleas a call for reinspection RE: Unable to inspect-no access
—.___- ---
Fire Supply Line - n
ADA Orb v �- Q�j Inspector
A pproach/Sidewalk
Olher:-._--_--
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL