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CITY OF TIGARD BUILDING INSPECTION DIVISION T
24-Hour Inspection Line: 539-4175 Business Line: 639-4171
-7 BUP
li 7�4 I Date Requested � - �- AM PM _JF'BL�p C
Location_ `y'.� �"�3�/Sr' A � Suite (M
Contact Person Ph 62 94 if f76- PLM
Contractor—_ (C � Ph _ SWR
BUILDING enarf rJw/ner 7J ELG _
Retaining Wall s ELR _
Footing Access:
Foundation FPG
Ftg Drain _
Crawl Drain Inspection Notes: SGN - ---
31ab __— SIT
Post& Beam —
Ext Sheath/Shear
Int Sheath/Shear —
Framing a0s t-i►%I S TLS: -7-
Insulation Insulation
Drywall Nailing --__.�aGz /.4!!;-
Firewall Firewall
Fire Sprinkler _—
Fire Alarm
Susp'd Ceiling
Roof
Misc: _ — —
Final
PASS PART FAIL -- --- ----- --
PLUMBING
Post&Beam -i ---- —`—
Under Slab
Top Out ---------_ __ ___— -- --
Water Service
Sanitary Sewer ---_ ---- �� _ '--- ----- ---`--
Rain Drains
Final -- -- ---- — --- ---
PA FAIL _
ECHANICAL _
Ro2RLRL-
Smoke Dampers
SSJ PART IL
ECTRICAL --- --- --__._ —
Service
Rough In ------------- --- -- - -------- — ----
`A UG/Slab
� I_ow Voltage ----------- ----- -- ----- --
Fire Alarm
Final
`' PASS PART FAIL —_____—.--- — _—._ —_—_�_ _.___ —
�i' SITE
J
Backfill/Grading -- — - - --�
Sanitary Sewer
Stoim Drain [ ]Reinspection fee of$ _iequired 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 =.�/ �� Inspector Ext
Other --
Final
PASS PART FAIL DO NOT REMOVE this Inspection rp Wird from the job site.
li.
CITY GF TIGARD
MECHANICAL
-.
DEVELOPMENT SERVICES F'E
PERMIT #. . .. .. .. .. . MEC98-0537
13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 DATE: I C'SUED: 11/30/98
PARCEL: ES102CC-08600
SITE ADDRESS. . . : 13845 SW 104TH AVE
SUBDIVISION. . . . : JO SQUARL ONINC• R-1
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . ..006 JURISDICTION: TIG
(,LASS OF WORK. . :OTR FLOOR FURN. . . . : 0 EVAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FAN`:;. . . : 0 �
OCCUPANCY GRP. . :R3 VENTS W/O APPL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . . 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL_ TYPES--- --- ---- 0-3 HP. . . . : 0 DOMES. I NC I rel: 0
3-15 HF'. . . . . 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR UNITS: 0
FIRE DAMPERS?. . : 30-50 HP. . . . 0 WOODSTOVES. . : 1
GAS PRESSURE. . . : 50+ I-1F'. . . . : 0 CLU DRYERS_ :: 0
NO. OF 11NITS--_.._,_______. AIR HANDLING UNITS OTHER UNITS. : Q1
FURN ( 100K BTU: 0 (= 10000 cfm : 0 GAS OUTL.ETS. : 1
FURN ) =100K BTU: 0 > 10000 cfm : 0
Remarks : Add gas fireplace and gas piping.
Owner: -------------------------------------------------------- FEES --------------
MICHAEL R TIFTZ type amoi_tnt by date recpt
13845 SW 1.04TH AVE PRMT $ 25. 00 GEO 11 /30/98 98—•311125
TIGARD OR 97223 5PCT $ 1w25 GEO 11/30/98 98--311125
Phone #: 684-8976
Contr'actor': ---------------•-------------•--
OWNER
$ 26. :5 TOTAL
Phone #:
Req
----_-- REQUIRED INSPECTIONS ---- ---
Thus permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Wo od st o v e I n s p
applicable laws. All work will be done in accordance with Final Inspection _
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
than 100 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952-001-0018 through OAR 952-0014080. You may
obtsin copies of these rules or direct questions to OUNC by calling _
(583)246-9187.
1 .k_te F'ermitteP Si not�_tr
g -6-7
1 ++++++++++++++++++++++-++••+-1-+++-4-++++++-+++++f++++++.++++++++++++++++. +.++++++
Call 639-4175 by 7:00 p. m. for• inspections needed the next business day
++++++++++++++++-+++++++++++++++++-++++++++++++++++++1-+++•++++l +++++++++++++++++++
Permit#:
Address:
Issued by: — Dater -
1859
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Coastruction Contractors Board to sign the
following statement befere a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 313:
1. I own, reside in, or will reside in the completed structure.
�2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
L_1 3A. My general contractor is
L�1 (Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
E*], B. I will be my own general contractor.
-t
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Ln Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above information is correct and that I have rend and do understand the Information
Notice to Property O ners About on ruction Responsibilities on the reverse side of this form.
------ ll Lge
;Sig ature of pe nit applicant) (Date)
(White copy to issuing agency perrtit file,
pink copy to applicant)
Plan Check#
CITY OF TIGARD Mechanical Permit Application Recd By.
13125 SW HALL BLVD. Commercial and Residential Date Recd _
TIGARD, OR 97223 Date to P.-E.
(503) 639-4171. x,304 Date to DST_
Print or Type `�/ Permit#1`14 F
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
Table 1A Mechanical Code Q Price Amt
Job Street Address — Suite# A) Permit Fee 10.00
Address +�y�/ pylu14f 1) Furnace to 100,000 BTU
including ducts&vents 6.00
Bldg# ?Favl"�21'. Zip 2) Furnace 100,000 BTU+
T/6,*,o oe gTzZ including ducts a vents 7.50
Name(or name of business) 3) Flooi Furnace
Owner ,- including vent 6.00 —
—1—�-[ 4) Suspended heater,wall heater
Mailing Address
or floor mowoted heater 6.00
S / (/ 5) Vent not included in appliance permit
City/State Zip Phonr 3.00
1&A"eD 7L31 coo e CHECK ALL 'Boiler Heat Air
Name(or name ref business, THAT APPLY: or Pump Cond Qt,, Price Amt
S - Comp
6)<3HP;absorb unit to
Occupant Mailing Address 100K Bl u 5.00_
7)3-15 HP;absorb unit
City/State Zip Phone 100k to 500k BTU 11.00
8)15-30 HP;absorb
-- unit.5-1 mil BTU _ _ 15.00
Contactor Name 9)30-50 HP,absorb
unit 1-1.75 mil BTU 22.50
Prior to permit Melling A idress 10)>50HP;absorb unit
issuance,a copy >1.75 mil BTU _ 37.50 _
of all licenses City/State Zip Phone 11)Air handling unit to 10,000 CFM
are required if 4.50
expired in COT Oregon Const Cont.Boare Lk#� Exp Date 12)Air handling unit 1u,000 CFM+
database _ 7.50
Architect Name 13).Ion-portable evapora a cooler
4.50
or Mailing Address ---- — 14)Vent fan connected to a single duct
3.00
_. 15)Ventilation system not included in
Engineer CRY/State Zip Ph—one— appliance permit 4.50
16)Hood served by mechanical exhaust
Describe work to be done 4.50
17)Domestic incinerators
New-4kRepair O Replace with like kind: Yes O No O 7.50
Residenti� Commercial O 18)Commercial or Industrial type incinerator
30.00
Additional information or description of work: 19)Repair units
/4 t.7 H� fi Ev4S F/Aux PLf}G' . Ex)"k-Ail) 20)
—
1 20)Wood stave
> 4/-
TI Al 6t�S /N L44J f a E P, Nc�t 4.50_
21)Clothes dryer,etc.
4.50
Type of fuel: oil O natural gasY! LPG O electric O 22)Other units
4.50
I hereby acknowledge that I have read this application,that the information 23)Gas piping one to four outlR is
given is correct,that I am the owner or authorized agent of 2JOO __
the owner,that plans submitted are in compliance with Oregon State laws. 24)More than 4-per outlet(each)
Signature of er/A nt Date
!
Minimum Permit Fee$26.00 SUBTOTAL
5%SURCHARGE
Contact Person Name Phone PLAN REVIEW 25%OF SUBTOTAL
r' p v
Required for ALL commercial Permits only
/1/11 K / 1 eT- UG?7 �' L TOTAL
�r
'State Contractor Boiler Cirtification required
"Residential A/C requires site plan showing placement of unit
I VTtechperm doc rev 07/20198
CITY OF TIGARD MASTER F='ERMIT
1-f RMI T #. . . . . . . : MST96-0347
COMMUNITY :)"VELOP'MENT DEPARTMENT I)A•FE ISSUED: 07/03/96
13125 SW Heli Blvd. ..,,ard,Oregon 97223.8199 (503)639-4171
IDARCEL: S 102'CC:•-08600
3I TE gDDRESf3. . . : 13,845 SW 114141'H AVIS
-)UPD I V I S I ON. . . . : .TO SQUARE. 'ZONING: R-12
13L'IC K. . . . . . . .. . . . LO-1. . . .. . . . . . . . „ .
Remarks: ?40 SQ FT ADDITION PATH I
-------------------------------------------------------- BUILDING
REISSUE: STORIES.......: I F!OOR AREAS------- -- BASEMENT...: 0 sf REQUIRED SETBACKS---- REQUIRED-------------
CLASS OF WORK.:ADD HLIGHT........: 13 FIRST....: 240 sf GARAGE.....: 0 sf LEFT.......... : 10 SMOKE DETECTRS: Y
TYPE OF USE...:SF FLOOR LOAD....: 40 SECOND...: 0 sf FRONT......... : 0 PARKING SPACES: 1
TYPE OF CONST..-5N DWELT_ING UNITS: 1 FINBSMFNT: 0 sf RIGHT.........: 5
OCCUPANCY GRP,:R3 BDRM: 0 BATH: 1 TOTA!-------: 240 sf VALUE..$: 15518 REAS..........: 39
--------------------------------------------------------------- PLUMBING ---------------------------- --------------------- --------------
SINKS......... 0 WATER CLOSETS.: 1 WASHING MACu..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.,.......: 0
LA7ATORIES....: 1 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0
TUB/SHOWERS...: l GARBAGE D1SP,.: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GRE;SE TRAPS..: 0
OTHER FIXTURES: 0
-------------------------------------------------------------- MECHANICAL --------------------------------------------------------------
FUEL TYPES----------- FURN ( 1F0K ..: 0 BOIL/Chi' ( 3HP: 0 VENT FANS.....: I CLOTHES DRYERS: 0
/GAS/ I / FURN )=100K ..: 0 UNIT HEATERS..: 0 HOODS.........: 0 OTHER UNITS...: 0
MAX INP.: 0 BTU FLOOR FURNACES- 0 VENTS.........: 1 WOODSTOVES....: 0 GAS OUTLETS...: 0
------------—----------------------------------------------•-- ELECTRICAL ---------------------------------------------------��._-----
--RESIDENTIAL UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ----MISCELLANEOUS----• --ADD'L INSPECTIONS--
1000 SF OR LESS: 0 0 - 2* 21p,,: 0 0 - 200 alp,.: 0 W/SVC OR FDR..: 1 PUMP/!RRIGATIUN: 0 PER INSPEC+ION: 0
EA ADD'L 50VISF,: 0 201 - 400 amp..: 0 201 - 400 amp..: 0 1st W/0 SVC/FDR: I SIGN/OUT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 .. 600 amp..: 0 EA ADDL BR CIR: 0 SIGNAL/PANEL...: 0 IN PLA14T........ 0
MANF HM/SVC/FDR: 0 601 - .e@@ Amp.: 0 601+amps-1000 v: 0 MINOR LABEL -10: 0
1000+ amp/volt.: 0 ----------------------------------- PLAN REVIEW SECTION ----------------------------------
Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)=225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC:
------------------------------•----------------------- ELECTRICAL - RESTRICTED ENERGY ----------------------------------------------------
A. SF REilDENTIAL--------------------------- B. CCMMERCIAL-------------------------------------------------------------------------------
AUDIO 6 STFREO.: VACUUM SYSTEM..: AUDIO b STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALA9M..: 0TH: :: BOILER.........: HVAC...........s LANDSCAPE/IRRIG. PROTECTIVE 519k:
GARAGE OPEN%.: CLOCK..........: INSTRUMENTATION: MEDICAL........: OTHR:
HVAC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL # SYSTEMS: 0
Owner: --------------------------------Contractor: ---------------------------- TOTAL FEES:$ 294.66
MICHAEL ROLAND TIETZ OWNER
13845 SW 104TH AVE
TIGARD OR 97223
Phone N: 624-'247 Phone M:
Reg k..: 13125
Ln
This permit is issued :Object to the regulations contained :n the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All 'vork will be done in accordance with approved plans. This permit will expire if work is not started within 188
On days of issuance, or if work is suspended for more than 180 days.
1. -- ------------------------------------------------------
REQUIRED INSPECTIONS --------------------------------------------------------
Q)
LL) Footing Insp PLM/Underfloor Framing Insp Electrical Final
Folinaation Insp Mechanical Insp Low Voltage Mechanical Final
Post/Beam Struct Plumb lop Out Insulation Insp Plumb Final _
Pest/Beat Mechan Electrical Servi Gyp Board Insp Building Final
Crawl Drain Electrical Rough ad in Insp Erosion Control
Permittee Signat1-ir,e: IsS'.Aed--
Call
-'Call f of inspection - 639-4175
Residential Building Permit Applit= -:`,on
,ty of Tigard
3125 SW Hall Blvd.
. ard, OR 97223
(503) 639-4171
Jobs'te Address: 1.36-Il -, 'SYV h_nV�6 AZf
Office Use Only
sr:odivision: �,l[`_` ��G%[�i4f�f Lot #
valuation: Contact Date 42 12 f Iniyals C-1'S
Result GcI'�
New Construction Only: (Square Footage) APPIrIEW Planck/Rec #
Permit # 021 G-y 3 N Z
House: cf(_/0 Garage: Reissue of_
Map & T # X01
Corner Lot? Y C Flag Lot? Y N Zone _1"L
Plat #
Owner: MQ f&A -:L k'G'L,' &I2 %�f
Approvals Reguircad
Address , 1r j 1 0 i
Planning Setbacksn+ Solar 0
,E'L� ����- y'� — Engineering —
Phone: —
Other
( SC'3 1 ��� ��y�
Items Required
Contractor: _
�ddr :
Subcontractors �r
= ---- Truss Details _
Other —
_
Phone: LLNotes_
Contractor's License # ---�
(attach copy of currant Oregon license)
Contact Name:
Contact Phone: L_`�_ _.
Subcontractors: Arch itect/Engineer:
Plumbing _. Addc
Mechanical.
(attach copy of current OR Contractor's Licensel
Phone
J06 DES T N: _1 O �541 rCT F 1C .`. )f7 A
App nt i na re Applicant Phone number
Received by: i Date Received:
H'bant A{MUl�Op
Permit# Account Description Amount Amt. Pd. Bal. G
li6- 3Y, Bldg. Permit (RUILD) _//4.. )-7% //( I_:�C)
Plumb. Permit (PLUMB) 7,u✓
Mech. Permit (MECH) 7-5,uU j
__ Urcv
Bldg: Y�3
Plumb:
Mech:
Plan Check
(PLANCK) 7S� �.j �,73 �
Bldg:
Plumb:
Mech:
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC) _ ^
:upside;,:al TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF (TIFF-C)
Indt---trial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WQUAL)
Water Qua^tity (WQUANT)
Fire Life Safety (FLS)
Erosion Cntrl Permit (ERPRMT)
Erosion Planck/USA (ERPLAN)
i
Erosion Planck/COT (EROSN)
TOTALS: -�= '� J• 73 y'
Ilennit #: �/t / �' _ � ,7;�Z
Address:-L . :)4-1(� _`� �G��_ ✓� -
Issue,d nv: _. _�� Date:
Statement: Information Notice to Property owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential const-uclion permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can he issuer This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit Misstatement. This statement will he filed with the permit.
Fill in the appropriate blanks and initial boxes I and 2,and either box 3A or 313:
l. I own, reside in, Or \\Ili residc in tile, completed structure,
M7-
r'71 I
I understand that I must register as a construction contractor if the structure is sold or offered for sale
ref hctore or upon completion.
(� 3A. My general contractor is
U (Name) Contractor regis. #
1 will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
3B. i will be my own general contractor.
or If i hire subcontractors. I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor Aho is
Gn
registered with the CCB and will immediately notify the office issuing this building permit ofthe
name of the contractor.
u I herebp certify that the above information is correct and tiu►t I lip%a real and do understand the Information
Notice to Proper 0 %ners h ut C-onstruction Responsibilities on the res crsc side of this form.
_ _
(Sign ore of permit applicant) (Bate)
(!While copi,m issuing agency permit file+,
pink copy to applicant)
Solar Balance Point Standard WorkshQet
Address _
IBox A calculations: North-South dimension for the lot. `
Box A:
i his dimension is determined by finding the midpoint of the North lot line and drawing
an intersec'ing line perpendicular to that poirt.
First. determine which property line is the 's orth lot line. The worth lot line is the i
ne
with the smailest angle from a line drawn east-west and intersecting the northern most
point of the Ict.
1K*"t
Jt ,ryp ' 1�OT UM
N Nor* -South
Dimension for Lot-
Measure the distance from the midpoint of the worth lot line to the South lot line along
the described line. 1
1 tee°:
��
N el
`4CRU-9CU14 CZ*MC?4
Box B calculations: Shade point height far your residen-e.
1. neterrnine whether measurements will be based on the peak or eave of your Box B:
structure. The orientation of the ridge is also important. Which describes
your residence?
1a: If the roof line runs North-South, measurements will (circle one)
be based on the peak of the roof.
CCCC
Ty
I A 13 1 C
R 1 b: if the roof lire runs East-Nest and the roof pitch is
less than 3,11 measurements %vill be based on the
C.7
LL!
ic: If . .e roof line ru. 3t-West and the roof pitch is
I or steeper, mEasurenlents will be based on the
peal:. -...e.
Box B. continued Box 8:
r. Measure chonge in elevation from front property line to finished floor elevation. If
the lot slope!7 up from the front lot line tn the foundation, the figure is positive. If It
the lot slopes down from the front lot line to the foundation, the figure is ne-e itive.
3. Measure distance ttnm Fnished floor elevation to the atfected peak,'eave. + — — ft
If t`1e roof line n-ns North-South, deduct three feet If the roof line runs East-West, ft
deduct nothing.
S. Subtract one foot for each foot of difference in elevation from the front property
line to the rear property lire, if the lot slopes up frorr, the front to the rear. If the
lot has no slope or slopes up from the rear to the front, deduct rothing. - It
6. Total figure for box %: (p .5 ft
Box C. Distance to the shade reduction line. Box C:
1. Ivleasu;e the distance from the worth property line to the foundation near the ft
affected peak/eave. �-
2. ilvleasure the distance from the foundation to the affected peak or eave. + tt
3. Total figure for box C: ft
it is most useful to draw a vertical line to represent the appropriate figure c,,cd in bcx'.A'and a horizontal line to represent the
appropriate figure found in oox'C-. The intersection of the vertical and cririzontal lines determines the value found in box'D'.The value
in box 'D'should lie compared to the value in box'8'; if the value in box '8'is less than or equal to the value found in box 'D', then
the building is in compliance with the solar balance rode. If you have any que-dons, please contact us at 639-4171, x304 or at the
Community Development Counter.
MAXIMUM PERMITTED SHADE POINT HEIGHT (In Feet)
Distance to North-sout, lot dimension(in feet)
shade 100+ 95 90 85 80 75 70 65 60 55 50 45 40
reductinn line
from ,orthem
70 40 40 40 41 42 43 44
65 33 38 38 39 40 41 42 43 j
60 36 36 36 3" 38 39 40 41 4'-
55 34 34 34 35 36 37 38 39 40 41
50 32 32 32 33 34 >> 36 37 33 39 40
15 30 30 30 31 32 33 31 33 36 37 38 39
10 '_3 _3 23 29 30 31 32 33 3-4 35 36 37 31;
33 25 25 25 27 28 29 30 31 31 33 34 35 3�
30 21 _ _ 2: 26 17 23 29 30 31 32 33 3
25 '2 22 22 23 24 , 26 27 28 29 30 31 3
20 20 =0 20 21 2 23 24 :3 26 27 .8 29 3
15 13 19 18 19 10 21 22 23 24 25 25 27 1$
10 16 16 16 17 18 19 20 21 22 23 24 ?3 26
3 1-1 14 14 1; 16 1, 18 19 20 21 12 23 24
Box D. Maximum allowed Shade point height: feet
h:ducs,nanco"nrura,sciar c.o
Rev,3ed J;6,96
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 9-4171
Footing Rain Drain Cover/Serv' e} FINAL:
Foundation Water Line Ceiling �l�l Plum
Post/Beam Mech. Shear/Sheath Frami -Mach
Plbg lend/Flr/Slab Plbg. Top Out Insulation -E� lett.
PostJBeam Sfruc, Mech. Rough-in Gyp. Bd. E�ldg�
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: A.M.- P.M. f Entry:
Address:
Tenant: Ste: MST:
Con/Own: MEC:_
PLM: _—
ELC:THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR�:
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Insp r Dat
_APPROVED DISAPPROVE WCALL FOR REINSP. CF CO
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