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C11Y OF TIGARD CERTIFICATE OF
COMMUNITY DEVELOPMENT DEPARTMENT OCCUPANCY �
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (603p8894171 PERMIT $. . . . . . . a MST93•-0207
E,39-4171 BATE I SSUE'D a 09/07/93
PARCEL: 1 S 134AL-r-0',36@0
SITE ADDRESS. . . c 107:30 SW MARY PL
3UBD I V I S I ON. . . . c HART" S LANDING i ON I NG c R--4. 5 Plo
BLOCK o LOT. . . . . . . . . . . . . c 007 e
' f.LWSFi OF WORK. cNEW
TYPE OF USE:. . . a SF"
OCCUPANCY ORP. 03 t
OCCUPANCY L.OAD a 30 is
TENANT NAME. . . -
Remar•kse PATH I
I
RENAISSANCE DEVELOPMENT CORP
j 1672 SW WILLAMETTE FALLS UR
WEST !_INN OR 9717168
phone #: X57--8000
OZENAISEANCC DEVELOPMENT 1
167c_' SW WIL!,AMF T-TE;
INSPEC4�ION NOTICE
City of Tigard Building Department
Ball.
13125 SN all Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Uueineee Phone: 639-4171
Inspection:__----
Footing — -
Plbg. Underslab Hach. Rough-in Appr/Sdwlk
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Founts.
Plb Top Out Cas Line �FIN»s
Bld J
Poet/Beam Struct. San. Sewer Framing < i
Poet/Beam Mach. Rain Drain
Insulation :Plumb.
Mech
Pltb.a. Undo.-floor Water Line OYP• Bd' y
yL?�� , Times �_ —PH
Duce Regueeted:--7
Address:
Builder:
THE FOLLOWING CORREGTSANS ARE REQUIRED: --
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Inspectors
---- Date:
DISAPPROVED APPROVED SUBJECT TO ABOVE
APPROVED
Call )'or Reinsp. t
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INSPECTION NOTICE
City of Tigard Building Depaztaent
13125 611 Ball Blvd. Tigard, Orego•4 97223
Inspection Line (Rec-O-Phone)s 639-4175 Bt.siness Phones 639-4171
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Inspections
Footing Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Post/beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulatiio�on -Plumb.
Plbg. Underfloor water Line Oyp. 8d. 1 -Hoch.
Date Requwcte�s 1) M� Pu l Times AM PH
Address: A )Q 1" '��. 4 1 � r C Permit ft
Builders G'v etl L
THE FOLLOWING OORRECTIONS ARE REQUIRED:►
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Inspectors �_� (/-/ - — Dates �_U 7 3
APPROVED DISAPPROVED APPROVED SUBJECT To ABOVE
Call For Rsinap.
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INBPIcTION NOTICE ( '
city of Tigard Building oepartamot
13125 8+11 Ball Blued. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone)t 639-4175 Business Phones 639-4171 ;
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Inspections s
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line I/NALs
Post/Beam Struct. San. Sewer Framinq -Bldg.
Post/Beam Hoch. Rain Drain �Insulation\ -Pl-umb.
Plbg. Underfloor Nater Line 0". Bd. -Hoch. l/1
Date Requ�essteds/ Times AM 7- _ FM
Addreses; I _'-/ �� / 1 CtG'L/f��_.)�_ Fermis. #t�� �JJ U 7
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Builder:
TBE FOLLOWING CORRECTIONS ARE REQUIREUt
Inspectors Dates
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APPROVED DISAPPROVED APFROV7l;D SUBJECT TO ABOVE
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Call For Reinap.
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INSPECTION NOTICE
City of Tigard Building DOPartaeot
13125 811 Ball Blvd. Tigard, Orogor 97223 I
Inspection Line (ROC-O-Phone): 639-4175 Business Phones 639-4171
In►', -ctions
ruot: .7 Plbg. Underalab eCh. Rough-in hppr/Sdwlk
Found. Plbg. Top Out .AAs Lino FINALS
Post/Bee Struct. San. Sewer __F,raminq �� -Bldg.
Post/Beam ech. Rain Drain Insulation -Plumb.
Plbg. Underf.00r Nater Line Gyp. Rd. -Neth. I +
lI
Data Requestede � 7 Times IIM416,_4_PM
Address: o Permit #:��
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Builders 617
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TRE FOLLOWING CORRECTIONS An REQUIREDs
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Inspectors _ _ Date: IeF_/2
kPPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
' Call For Reinap.
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INSPECTION NOTICE
City of Tigard Building Depnl
13125 SM Ball Blvd. Tigard, o:r] o � 3 r
Inspection Line (Ree-O-Phone): 639-4175 Busirler Phode'S 639-4171
Inspection•
Footing /
Plbq. Undsrelab Mech. Rough-in Appr/sdwlk ,
I
Found. Plbg. Top Out Gas Line
FINAL:
Poet/Bean Struct. San. Sewer Framing -Bldg.
Poet/Ream Mech. Rain Drain Insr:atlon -Plumb.
Plbg. Underfloor �L, Gyp. Bd. --Mech.
Date Requested:_
Time: PM
Address: C_ / _
3 t Permit
Builder:_
THE FOLLOWING CORRECTIQNS ARE RE U
Inapertnr: � �"
— � Dates f,J
APPROVED _^ DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Aeinep.
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jg$$,CCPION NOTIC�B
City of Tigard Building Department � : ......._.
13125 SM Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phoae)s 639-4175 Business Phone: 639-4171
Inspection=___—�
Foo*=119 Plbg. Underslab Aech. Rough-in Appr/Sdwlk
L
Pound. 4Plbq. Top out Cas Lina FINALt
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Lien Gyp. Bd. -Hoch.
Date Requee'.edc� �� L Time: AN PM
Address:� (,J �i l/ J�1�,�C/ J Permit #,4--3 ' y'1 c,7
Build-►r: �'�;�:'7j�/_ c,
THE FOLLOWING OCRRECTIONS ARE REQUIRED,
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inepsctors Dat
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/_APPROVED DISAPPROVED APPROVED SUBJtCP To ABOVE
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-Call For Reinsp.
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INIPECTION NOTICE
City of Tigard Building Department µ
13125 89 Ball Blvd. Tigard, Oregon 97223 1,
Inspection Line (Rec-O--Phone): 639-4175 Business Phone: 639-4171
Inspection:
M
Footing Plbg. Unders.lab Mach. Rough--in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
ce
Post/Beam St.ziuct. Ban, Aaaer' Frnming -Bldg.
Post/Beam Her_h. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. ,l
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Date Re3quested: �—Time: AN _PH �
Address: i`lj �/.�� - � Permit f: �
Builder:_
THE FOLLOOiING ODRRECTION3 ARE REQUIRED:
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ori Inspector �� Dater _ y
d 7+ ?APPROVED DISAPPROVED APPROVED SUBJECT TO ABcri/E
Call For Reinsp.
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PLUMBING PERMIT
CITY OF TIGARD PrF(IhIT . . . . . . . : MST931X1~0
COMMUNITY DEVELOPMENT DEPARTMENT DATE. :ISSUED- 04/27/93
13125 SW Hall Blvd.Tigard,Oregon 07223.8109 (503)630-4171
I TIH ADDRE S. -.). . . : 1.07-1,10 �-:W MARY F'I._ PARCEL: 131.74AC--1-fI. O07
SURD I V 191 ON. . . . : i TART" 5 LAND I NG ZON I NG a R-4. 5 PD
BLOCK. . . . . . . . . . . L01 . . . . . . . . . . . .. . ;007
1;LASS OF WORK. . y NEW GARBAGE_' DISPOSALS. , : 1
TYPE: CIF' LIGE. . . . :SF WASHING MACH. . . . . . . : .1 BACKFLOW PRCVNTRS. . 3o
OCCUPANCY GRP. . :R3 F'LGOR DRAING. . . . . . . ..0 TRAPS. . . . . . . . . . . . . . :0
!.-.,TORTES. . . . . . . . :"r? WATER HE PTERG. . . . . , 3 :1. CATCH SAS)I N:'.-i. . . . . . . :0
FI X T U RES...... _,..,...._.._.... I AUNL'iRY TMIY5. . . . . . p 1 ;Sf:-' RAIN DRAINEL3. . . . . : I
;1NK5. . . . . . . . . . . J. GRE:AE�E MAPS. . . . . . . :1T1
I-.AVATORIES. . . . . :4 UTHEt� r iXTURES. . . . . :0
I`UH/SHOWERS. . . . : '..:)EWE'R LINE (ft ) . . . . :0
WA'TI• R C[J]SI-TS. . :3 WATE12 LINE (ft ) . .— -. 100
RAIN DRPIN (ft ) . . . . :0
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I��+m r•Ics ., PA1`LL,,; _ .t
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OWNER. _ _ _ - -- _.. . -F E7E'.C...__ .._
RENt.1193GANCCE DL.VE.LUF='ME:NT C:Clr2r-1 TTr: t 1460. 00 JIi 04/c7/93
1672 f=;W WIL..L.AME'TT'l:: FALLS DR, 13PRT fi 510 5, 50 .JH 04/L7/9.3 r
BPI._.C; 1; :.328. 58 .71..•1.1 1714/07/9 .
WEST I-.l NN OR 97168 B51`1, $ a5. c:f.:1 JI-F 04/x:'7/93
I:'hornp #3 557-11000 SC3DC: $ 280. 00 ,.7H 04/c:'7/9,j� -
*5_ 15`1 P8 PARK $ 5,17117.1. 00 ,TIA 04/x'7/' .:3
1='11.1mbinw C.ontr,actor : MF:'rZT" $ 45. 00 JH 04/27/'J3
1
"111_.(: $I 11. 25 ,.JFi 04/c:'7/93 _
Name ^ M5ir=C $ ..« w'S JFK 1714/ '7/93
s.
Add e .::.. TZ .�E._.H t G7�T[...�x ' 1� . _...1.._. r'1-,RT $ 155. 00 „7H 04/27/93 w
�--RV _...._..__. _ _.. t i, f> : ��/ I� r�5PC S i« I!.i JI-I 17.14/27/93 -
Zi(7; .? .1 C: C LPh1one#;: '1 (n CJ._..�_� �caJ_...._.
. _..._ ...._..... Rr�aF�ir°r�FWc) l;vr.��'rt:;T:r.r_1N� _._._......•.. �
rhi y; ppr,mit is issued v-tb ject to the r,oq
I 1.l.ations corita:inFd in the Tigal-d M1.1niCir)t-t1 Font/found Tnsp Rein di-ain IriFp
1-ode, State of (11^e. Gpecim[ty Coda,; and ml. ). Post/Deem Str^uu•l: Watnt' L111e 11.1-,p
other, app 3. icatrle laws, 01 J. wov,k w I I he doI-)Ea Post•/Eleam Mechem Pppv,/(5dwIk Inep
in ac cor,danc,p with appi-,nved plants. This I-Ilm/4vidsl�-Ab Trisp Mechanic.-al {"i.n
r:ler,mit wi11. expir-e if• wog o is nut -•9ttarted r'ILM/I.Indpr-floor p11.1nit) I i.I1ia.l
within 18171 clays of issuance, or, if wo i is IHpr:hanical Insp Bui. ldinrl F 1via 1
sunpe;tded for, mut-o thaari 180 days. Plumb Top Out L:ro,; i on Contro t
I r a.nling Jngp
r { i 1,epl.ace Insp
Ga., Line Tnsp
I n w u l e t i.a r s I n s p _..-_...._.......�...._..._� ..
�•x .... Gyp Deard Insp _ .._-._.._ _........
Outhni-izer_I F'lclmtal:ly c..anl1 y.ic_tur tsi`gnatf.0-le _
Call f"or inspection 65'? 4171
Cani;r^a._1tor N n t e s
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CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hall Blvd.Tigard,Oregon 07223.8199 (603)839-4171 {)H;G, I O:3UED:
aI 'f f 1�Ia1JF7Lr: �"a. . ,. i OY :VI SW 110 1Y V"L. F='Al2t:E:.f...s 1Gi 3�+FiC. I1l..IflII1l
3USDIVI:SIUN. . . , HARTI S LANVINi ZON1NU: k--4. 5 PIT)
l;t t:)fWh<. . . . . . . . . .
w _. _ . ....__ ... BUILDING
OWE Li...1 NO iJj%l I Vs. 1 BASE MV91 . . .
-L OSS OF WORK. :NE W 1:+LUIRMS e 4 �1(i?' i�;t ti i�clh�i•3U"t::. . . . . . . a 481? 4 f
i''Ix'F:. 1:)F J�f :ai' k t_(J(li t�l�i 1{<.., . RE:Ul:I fiC:.i',
rYP E C)F CONS *bN F I RST» . . , : 1 167 cif i-EFT'. . :7 Ft HIGH) . :b f r;
1\ L Uw'F�i�tC Y
131-4 a :1;,: )!.'LUNI.). . . 1 4..;(3 S f FF,ON T. f E iti:-AR. . G4r`. fi,
iTORIE::,ci. . . . . . . ;c. I,.! F 13 . . . s f' RF`UU1 -
iEIUHT. . ., . . . . . e3;0 1 GI AL :c:60b f ,!"1(Jiil. DE T EG TO RE,.: :Y
!'L,OUR LOAD. . . . -.40 fraf "1i4LUL,. . . , . $ : 128470 k'raRKIN6 ''iP14CE:''S. . a I
lC•rrl4ae !c y : POTH
r-'LUMSINIG
,'INKS. . . . . .
AVW1 RIES. . . . . z4 WWTLRFIL!'-1'fE:'R'Li. . . I FiAk=':i. . . . , . . . +
• Y i • • p •
UD/1131 U1JL1i r. . . . .;a ;_(4UNia� `, ! 17fi r , :I. CAI I U l BA"DIE,. . . . . . „ ,Iii
�aA it R GLUGLTE1r. . : SLWER L INL (1"1. ) . 0 c,r,r€�,� TFNAPS. . . . . . . :�
WHTLP.. I_INE r{l ) . cikli f-rllir=:►a � Ii iUkrt'1:.:::>. . . . . Rk)
N1 F7 FaGf L11SP. . . : l RAIN DRAIN ( ft) . :I!I
16-11N IikF'+3.ivfi. :. L
_... . _ ._ MEf::FaAN I C(-4L _.._ .. _. . .. . . _....._ FEES
...
UN i I H f RG. .0 t
�Ypp t by rlatrr e ,•r171
-I+II ; . . . . . siih Tl P' 9, 1f+60. 00 JH 04/27/93
1F'�1.11 : i`iJ i..:.iaa I..I.•lilW:. . ,• i)t'If 'I b Jj1;:, ::0 JI-, 0/1ii: .: '"i3
0 111100 . , ; a' HUUV:J. . . . . „ c :s DPL.0 $ :3216. 56 ,.Tl.H 1114j0r'/93 93--
:.:i.001' . , 1 r.,;l:)f ti:::3"f G.fVf�:;. :1)1 LI.:iP ',' i L5. 20 JH 04/2.7/9 i
TURN. . . . CII i l+C1 DRYE f?:i. 1 '366':: 4 k?I. 4°10 ,J1..1 4.'14/`'7/13.3
(.1. ik-:N \.UNIT,:;: ! PkRi'ti I .1500. Owl .tit 04/27/9Z
+.awa`3
OUT i..Ui`a'. ,1 MVIRT 'G 415. 00 ,.a!-! 4',14/,x'7/93
i 014/
�NfitEifaF-iN�:� 1)L 4'E:.1 UJ 'h'!r�N'i CORP
(.42 Sw i 1- f('i l I` :,. tr'Iut .ihi 0r+r;;'i;'L',
: �;i'I L.a!"�llyi '1:)fi '� r 41:4 i., • F.'.
hone
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,ENA ISBANCE U:)t:.1.'6. l.i1F'hrl, i,1
EkT L..INN OR
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_.fir('. (_�1. 1 1..`..i OL
is pergit is issued sublot3 to the rlegulatms costa;net' :n the RF-G01Rl::1) 1!4' t'e::(,:'1 ;.ONE.i _... ...._.....-.
yar; ,Minicifai Lade, eta"@ Of 3r�e. 4f0aity %Odor and ail Othf1° i \7 r;t, ,`fcr+..�nrJ 1. ie,Op,! Ace beep
e:lcafrif :"aws, A1141 work oil; be dare It,, accordance with approv?,, ='c. r r ���m r C r 1_\r..t ;,;- f,..i rre I r s w
41111. This pfrait will pxpire if Quark iq sat ;11ar'tfd within 10 1''cr,t �'1r1N�rtr t11�charn Intihl -ln �r 1n�F�
,is of issuance, or ,t tivrirk ;s zuspfnrr. than ;ill day 1> trn,'"-rrl,a GYp BQaI-, i irrwp
p r aor k atrr �lr r ir1 Ir13p,
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._......., __._.._......__.....___—. 6 t.a{r1..I�o„) 1 -+eM1 r Pet P�!'!cF•; i C.fd:i ,. ��t��
iuY
�..'a• �'' R'q�,,'" 'ewj. Or M'r�,�'q�g'..e"i�„'�`ow w+rn„"M'i} x'v '� 7+ ta�:aim•.ra :pry +' •_ A.,+ Ir
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CITY ®F TIGARD
„ '�'`;„ UN
COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hall Blvd.Tlgard,Oregon 07223+6100 (603)630-4171
.';tT! F1CxI,ft t::; '.. . , a 10;730 5W !MARY PL PARCELS
,UkIJSfI!"�,il(Jsa. d_ti'dI)lig(G ZONING- i, _tr,
. . . . .. . . . . , , LOT T. . . . . . . . . . . . . f }t:
'':NPN'i Nf31+'L. .
rY
. . . . . . . . . IFI X TURF. UN i I•t.i. . .
I
,,.i ,�a i.a' WOki vNE,
W 1JMilwh.l li'd9:i JIJ,i 7 d
YPL tJi' USE.. . . . . OF N'Cj, OF" BU I LD'A NGS a 1
LAW:WR
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l`.i,tl=iIS:3NWl"F_ 1:)F VLLUf••'f,1Lr; CORI- t YNO =Ertl+�l.tt;1, �,y lost;e
f,74 OW W I I..;_.FWIL: f'r# fA ALL41 W f-'fthl'C $ x:100. 00 JH 04/27
-,, 41111 JH 1'`:
T—T LINN OR 91'060
1)Iv'fl"fIOC('111.1 NUT UN f Ii.I:
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This Applicant agrees to ,:01ply with a.1 the r'4es and i r,i.,i,ec
! the boif zed Sewage Agen,:y. the permit expires 166 aala `r as i.
e date issued. The tutai aoo,.Qt pais will ue fa-feil ee it the G
rviA expires. The Agency does not guarantee the accsrv,, of tkrE
,de sewer lateral:,. if the saver is not locatea at tie reasipeaer{
:.vers the installer shall prospect 3 feet in all directim fr•oo Y
e distance given. If not so located, tte installer shall
"TAp and Side Sewer' +Perut and ah= agency w::i
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CITY ®r TIGARD r1l�fQ3 -c)���
COMMUNI'IYDL-VELOPMENTDEPARTMENT Tigard Oregon MD PERMIT #
(sol)639-4n' DATE ISSUED ■
� ,✓1'lG ry �� I
JOB ADDRESS: 10730 SW N0ttrrf--f;t. _ TAX MAP/LOT /5/UAC-NL eC, 7 —
SUB: Harts Landing LOT; 7 LAND USE:
VALUATION:
_OWNER SPECIAL NOTES
NAME: Renaissance Development Corp. REISSUE OF:
ADDRESS: 1672 SW Willamett, Falls Drive LAST REISSUE:
i
West Linn Or. 97068 FLOOD PLAIN/
PHONE: 557-8000 SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME: Renaissance Development Corp._ . PLANOING:
ADDRESS: 1672 SW Willamette Falls Drive ENGINEERING:
West Linn Or. 97068 _ FIRE DEPT:
PHONE: .557-8000 __ _ OTHER:
CONTR. BCARD #: 49955 EXP DATE:
ITEMSREUIRED
SUBCONTRACTORS: PLUMB: Eagle Plumbing LIST/SUBCONTRACTORS:
MEW Tri-County Temp. BUS TAX:
ARCH/ENGINEER CALCULATIONS:
NAME: Alan Mascord TRUSS DETAILS: _
ADDRESS: 1515 NW 23rd. Ave. OTHER:
i
Portland, OR. 97210
PHONE:
PROPOSED BLDG. USE: Now Home
COMMENTS: Wood Frame
APPI_I C NT ATURE __ I
Received By: Date Received:
_—
9 5
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' PERMIT N ACCT N DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
hs+ -0201 10-432 00 B,;ilding Permit Fees v.,.iU - SoS . 5o
E �
_ 10-431 00 Plumbing Permit Fees /S•S .�d /SS
10-431 01 Mechanical Permit Fees ` � �✓ ' �r'�� `''
10-230 01 State Building Tax (5%) -3� -Zy 35;.28 �
Y � I
BuildingS,�b
Plumbing
Mechanical
10-433 00 Plans Check Fee
Building X,S'��
Plumbing _
Mechanical _1�z_-
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10-230 06 Fire
,-,,,A 3 -v/27 30-202. 00 Sewer Connection cZv0
30-444 00 Sewer Inspection -3�� 3j'
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees
25--448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees 1350 /36 U_
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25-448-05 Mass Transit TIF Fees J/U _ _ ,
52-449 00 Parks System Dev Charge (PDC) 500 — �5
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) �
24-445-01 Water Quality (Fee in lieu of) —
24-445-02 Water Quantity (Fee in lieu of)
TOTAL S S5_�L .�L �
nm/3587P.WP1-
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CITY OF' TICARD REC:E:IVIT OF PAYMENT RECFIPT NO. :43--
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43-•
{ 1 CHECK AMOUNT �]20"J.. Ei
NAME = RENAISSANCE DI�VEL_pC'MENT CASH it ADDRESS s 0. 00
PAYMENT DATE 04/27 rg 3
SUBDIVISION �
PURPCTSE OF PAYMENT AMOUNT PA I I) PURPOSE OF PAYMENT AMOUNT PAID
.. �. . »..._._ ..__...._._..
12UIL.DINC3 f�1=:FSM
IWECHAN 1 C.'.ALPIF
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S05. 51a PLI.JM8 J Nf.7 r1 5
1."5.r. 0�t
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45. OC. ST. 1AUiLP PFR :ti: . ��A
PLAN CHECK FC, l�� SEWER USA
G L-WE:: 4 INSPECT 100. 00
.�5. 00 PARKS, SDC 1 r50 h. 00
'STORM DRAIN SDr 2181a. 0a RESIDENTIAL TRAFFIC FF-F-i 13;;4). 0(A
MASS TRANF;IT TIF' F.-FES 1Ila. 00
HAFT+ S I-AND I NG
10-130 :W MARY PL,
TOTAL ()MOUNT PAID - _.) 5c'05. 61
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INSPECTION NOTICE
City of Tigard Building Departaeat
13125 BA Hall Rlvd. Tigard, n 97223 /
� , Orargo
Inspection Line (Ree-O-Phones 639-4175 Business Phone: 6 -4171 I
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Inspection:
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Can Line FINAL,
Pc(fam struct.) San. Sewer Framing -Bldg.
sem Haa s) Rain Drainl Insulation -Plumb.
. underfloor water Line Oy?. Bd. -Meeh.
Date Requerted:_ L/ i,�I I_� Tine: AN PN
Address: �/J / l -;� 2�1 /Oormit 1: T 3–bl-tJ 7
Builder:
TBE FOLLONiN.-I CORRECTIONS ARE REQUIRED:
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Inspectors. Date: l"
APPROVED DISAPPROVED APPROVED RUBJECT To ABOVE
Call For Reinsp.
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