10245 SW SERENA WAY-1 • "' �rA
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CITY OF TIGARD BUILDINP INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171 •
FootingRain Drain Cover/Service Fly A
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Foundation Water Line Ceiling -Pial
Post/B-iam Mach. Shear/Sheath Framing -Mech.
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -F_lect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg. .
San. Sewer Gas Line Appr/Sdwlk Reins.
I Other: --
Date: ( C A.M. P.M. Entry:
Address:
Tenant: Ste: MST:
BLIP:
Con/Own:G � MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: _
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In pectur: v�p Dat9l
— O D —DISAPPROVED/CALL FUR REINSP. CF O
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6
i January 2, 1997
CITY OF TIGARD
OIREGOV.
10245 SW Serena Way '
RE: 1995/1996 Storm Damage
i
We hope:hat you have recovered from the storm and that you are not experiencing any
difficulties related to storm damage. As you will recall, following the 1995/1996 Storm, a j
staff member of the City of Tigard Building Division performed an inspection at the abo'-e
noted address, to assess storm damage. At that time you were left a notice regarding the f
need for a permit to cover the necessary repairs.
i Our records indicate that a Building Permit has not been obtained for the repair. Permits f
and inspections required by the Tigard Municipal Code are an important part of your
repair project. Permits help to ensure that work is done in compliance with minimum code
requirements. Inspections are intended to protect the occupants of buildings and wilding !
owners. If the work has already been done, we can still inspect it for compliance with the
code.
ALL FEES WILL BE WAIVED FOR BUIILDING PERMITS TO REPAIR STORM
DAMAGE.
Enclosed are the necess vy permit applications along with supplemental
information1im tructions.
Please submit, in person, the necessary application materials to DEVELOPMENT
SERVICES, 13125 SW Hall Blvd. Or, if you have questions regarding the permit
process, contact DEVELOPMENT SERVICES at 6394171 ext, 304.
Thank You.
.fill Aldrich, Customer Service Manager E
Development Services
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13125 SW Hall Blvd., Tigard, OR 97;23 (503) 639-4171 TDD (5503) 684-2772
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in -'NAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: \ �7 C —Time: AM —_PM
Address: U L,�� ��,y f�►'e-*-j
Builder: Permit ft:
THE FOLLOWING CJRRFCTIONS ARE REQUIRED:
J
Inspector: f.. y Date:iii
APPROVED DISAPPROVED APPROVES SUBJECT TO ABOVE
��� _Call For Reinsp.
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Community Development tiLECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. ?I
Permit # _ :L.0 5— Q 7-5
Phone (503) 639-4171 Date Issued 4 _
CITY OF TIdAR� FAX (503) 684-7297 Issued by
TDD No. (503) 684-2772
— Inspection (503) 639.4175
1. Job Address: 4. Complete Fee ,Schedule Below:
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Name of-BevtbpmSht Fl C1 41✓► Number of Inspections psi permit allowed
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Address !l _�� 1 —' �V :"e-Y L1) Service,ncludod Items Cost(oa) Sum
City/State/Zip�T( /r(4,j �3 tf — Os. Residential-per unit 4
1000 wl It or bee $11000
Name (or name of business)- _.__, Each a here 500 eq D or -- "-`
podron thereboo
$2500 1 I
Commercial❑ Residential Limned Energy $2500
Ead1 Manut'd Home or Modular 2
Dwsllmp Service or Feeder __ $NB 00 _
2a. Contractor Installation only: 4b.Servirses or Feeders — `^
Installallon.alteration,or relocation 2
Flectrical Contractor 6 r 1 e c��-L C.• 200 amps or less $e0 00 _ 2
Address 1 2Ll G 61 51 l�!�r cl_�`�,[_ 201 amps to 400 asps $80 00 -- 2
City t.t ► ,- f State 4� Zip7 401 amps to 600 amps $12000 __�
..-" r'/ )L'{S. 601 amps to 1000 amps $180 Dr 2
Phone No. . 7.CI` 4 / f/, Over 1000 amps or volts $340 00 2
Contractor's License No. ,Z IV ;, '7 Recooned only $6000
Contractor's Board Reg. No. 61/
9 40. Temporary Services or Feeders
Installation,alteiallon or relocntio- 2
Signature of Supr. Elec'n 200 amps or less $5000 2
License No._,, -S q -y , /_ 201 amps to 400 amps ;'1500 _ 2
Phone o. �'� 401 amps to 600 amq $11000 _
Over 600 amps to 1000 volts
2b. For owner Installations. see•b•above
4d. Pranch Circuh.r
Print Owner's Name New,allsrat,on or extension per panel
Address_ e)The lee for branch circuds with
City_ State_ Zip_ purchase of saryke or Feder Ne. 2
Phone No. — Each branch circus S:r of yf,
h)The tea for branch circuits witho-rt
The installation is being r.tade on property I own which is purrhesa of service or!sada ale.runt branch circuit $3500 2_ 2
3 l '
not intended for sale, lease or rent. E;,,,,additional brand,circuit $500
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $4000 V 2
Each sign or outline lighting $40 00 ___
Signal circud(s)or a limited energy 2
Please check appropriate item and infer fee In section 5B. panel,alteration or extension !Ao 00
4 or more reaidonNal units in ore structure Minor t,bete(10) $100 DD
Service and header 225 amps or more
System over 600 volts nominal ! 4f. Each additional inspection over
_Classified area or structure containing special occupancy :,re allowable In any of the above
as described in N E.0 Chapter 5 I Per Inspection $1500
Per hour $5500
Submit 2 sets of plans with application where any of the above In Plaid $55 00
apply. Not required for temporally construction oar%Ictre. 5. Fees: _
NOTICE 5e. Enter total of above fees $
--- 5%Surcharge(05 X total fees) s
PERMITS BECOME VOID IF WORK OR CONSTRL;Cl ION Subto►sl $
AUTHORIZED IS NOT COMMENCED W;T'=fN 180 DAYS,OR IF 5b•Enter 259',,of line A for
r.ONSTRUC TION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required(Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $
COMMENCED. ❑ Trust Account M s
Balonre Due $75
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O Phone)- 639-4175 Business Phone: 639-4171 �
Inspec'ion: f4 J_
I Footing Susp. Ceiling Sprink, Hough-in Appr/Sd
Foundation Plbg. Underslab Mech. Rough-in Fircpiace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation rMech.)
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: %1/ `7 f -z— Time ) PM
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Address. f G'i .7 C �1r tc
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Builder: -'�� C�G' ( � Permit
THE FOLLOWING CORRECTIONS ARE REQUIRED,
Inspector:_ Date: I
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PROVED �-DISAPPROVED APPROVED SUBJECT TO ABOVE
—Call For Reinsp.
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CITY OF TOi�Ri� MECHANICAL L4
PC RM 11'
FIERMIT #. . . . . . . s MEC95-0225
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 07/13/05
13125+SW Hail Blvd.Tigard Oregon 07223•@190 (503)639.4171
Fit-1RCk�. : �Si 14RP--01300
: ITE ADDRESS. . . : 10,245 5W SI:REW WAY
>UBDIVISION. . . . : PICKS LANDING NO. 1 ZONING: R-4. 5
I ;'CLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . ...
-LAOS OF WORK—ODD FLOOR FURN. . . ,. : EVAP COOLERS:
TYPE OF USE. . . . :OF UNIT HEATE=RS. . : VENT F='ANG. . . :
JCCUPANCY GRP. . :P3 VENT'S W/O APDL: VENT SYSTEMS. �
STORIES. . . . . . . . : 1 BOILERS/COMPRESSORS HOODS. . . . . . . :
FUE'_ TYPES ______._.__..__..._ .. 0-:3 HP. . . . : 1 DOMES. INC11V:
1/ 1 / / 3-15 HP. . . COMML. 1NCIN:
MA) INPUT: BTU 15 30 HP. . , . . REPAIR UNI 1 (.i:
FIR,: DAMPEwRS?. . s 30--50 HP. . . . : WOODSTOVES. . :
GAS PRESSURE-'. . . : 504- HP. . . . : CLO DRYERS. . :
NO. OF UNI 7S --- ---- - - AIR HANDLING UN I TD OTHER UNITS. ;
Fi.,RN ( 1001. ITU: ( 10000 cfm : GAS OU'TLE-T:`�.
FURN > =100K BTU: > 10000 c•fm :
remarks : INSTALL REC,IOCNTIAL CARRIER l-1IR--CONDITIONING UNIT.
FEES
C HOLLAND type amol.knt by ' date recpt
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5 SW SERLNA WAY PRMT f 25. 00 SW 07/13/95 -
75PCT f 1. L5 5W 07/13/15 _
1'IGARD OR
Phone #:
SUNSET FUEL CO 415'J y
PO BOX 42267
PORTLANDOR 97M,yC __....-.__.____......_......_._.__._.._._..______._.._._..__._.___.__
Phone #: 234• VI 11 3 26. ."`; TOTAL
Rey #. . . 002 074
__._._.._..__ REQUIRED INSPC.CTIONS
This permit is issued subject to the regulations contained in the Mechanical l n sE)
Tigard Municipal Code, State of Ore. Specialt, Codes and all other Final Inspection
applicable laws. All work will be done in accordance with
Approved plans. This permit will expire if work is not started
within 186 days of iss�iarce, or if work is suspended for more
tt!an 186 Gays.
171e)-m:i t t e e 5 i gnat a r-e! :
I a s+.led fly : !
Call for` inspect i%,n - 639-4175
MECHANICAL PERMIT Planck/Rec. #
City of Tiga,d _
13125 SW Han Blvd. APPLICATION Pet-mit #
7gard, OR 97223
(503) 639-4171 _
-- escnpuon
Table 3A Mechanical Coda CITY PRICE AMT
Job �,S���-(,Q( rA 1) Permit Fee -0- -0_ 10.00
Address r-
2) Supplemental Permit 3.00 V I
Furnace to 1
1) incl.duds b vents _ 6.00
•,,v,a,,,, Furnace iC0,000 +
I C� y�_�G r 2) incl.duds b vents 7.50
Owner
,•,, oor umance
3) incl. vent 6.00
H.•,> ,,.. ,.,
Suspended eater,wall heater
4) or floor mounted heater 6.00
--- �• —went not m7in .
Occupant 5) appliance permit 3.00
epair of heating,re ng.
6) cooling,absorption unit 6.00
Boiler or absorp
unit pump,air cond.
7) to 3 HP absorp unit to 100K BTU 6.00 I
,,,o,,,•,. �• oder or comp,heat pump,air Gond-
,tosi,l '_ ��0 0 C1 8) 3-15 HP absorp unit to 500K BTU 11.00
Contractor �z ., —'—T— Boiler or comp, oat pump, air cond.
(J (1VVA� 9) 15-30 HP absorp unit.5.1 mil BTU 15.00
.• ,, w. -�ryLa.T. Boder or comp,heat pump,air Gond.
10) 30-50 HP absorp unit 1-1.75 mil BTU 22.50
hereby ac. ow ge that I have road t is application,that the er or comp,heat pump,air r.ond.
information given is correct,that I am the owner or authorized L•;ent 11) >50 HP absorp unit 1.75 mil BTU 31-50
of the owner,that plans submittrd are in compliance with State Air handling unit to
I;-,ws,that I am registered with the Construction Contractor's Board, 12) 10,000 CFM 4.50
that the number given is correct (If w,ompt from State registraticn, Air handling unit
please give reason bolo v) 13) 10,000 CTM r 7.50
Non portable
14) evaporate cooler 4.50
ent tan connected
15) to a single dud 3.00 i
Venn ation system not
� / I 16) included in appliance permit 4.50 It
....... "' 0 sarved by C
17) mochanic:al exhaust 4.50
srxl w new a non alteration repair mmeraal or industrial
o be done residential. nen-residential Q 18) type incinerator 30.00
Existing use oT— — er i.e.,w stove,water
btsldng or pre,porry_ _ 19) heater,solar,clothes dryers,etc. 4.50
.1—
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Propcied use cl 20) Gas piping one to four outlets 2.00
building or property _
21) More than 4-per outlet _
Typ9 of fuel-oil Q netural gas Q LPG() alo&Ac Q
--~ "
NOTICE
Minimum Fee$25.00 SUBTOTAL
PEPIMITS BECOME VOID IF WORK OR CONSTRUCTION I
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE
IF COKSTnUCTION OR WORK IS SJSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT At'Y TIME PLAN REVIEW 25%OF SUBTOTAL
�\FTER WORK IS COMMENCED. FF
TOTAL C
Special Cori-5do —
cit Date issued ALL,'` i�A.� —by
�waoou*
,
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639.4175 B.siness Phone 639-4171
Inspection:c, L i.• ? C`L' - 1
Footing Susp. Ceiling Sprink, Rough-in Appr/Sdwlk
Foundation Plbg. Underslab (V=K�W� Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer ,as Line -Bldg.
Plbg. Underfloor Rair Drain Framing -Plumb.
Alarm Water Line Insulationec
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
c
Date Requested:_ C' Time: AM XPM
Address:_ -
Builder: Permit 9:�i� _�/S C)6c"7
THE FOLLOV ING CORRECTIONS ARE REQUIRED:
Inspector: Date:
/--APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For ReinsD.
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MECHANICAL
CITY OF TIGARD PE RMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT T M. . . . . . . : MEC95 0091
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)830.1171 DATE ISSUED: 0 4/1 1/95
PARCEL: 2S 1 14 BS--lZl 1300
`ITC ADDREG). . . : 10t_45 SW SERENA WAY
UBDIVISION. . . . : PICKS LrINDING NO. 1 ZONING: R- 4. S
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :.;"�
CLASS OF WOnK. . :PLT FLOOp FURN. . . . EVAP COOLERS:
TYPE OF USE. . . . :SF UNIT HEATERS. . - VENT FANS. . , e
OCCUPANCY GPP. . :R 3 VENTS W/O Ar-'PL: 1 VENT Y DTI.MS:
STORIES. . . . . . . . : 1 POILERC/COMPRE:SaDR^ . . . . -
HOODSC
FULL TYPES. HP. : OOMEG. I NC I N: I
3-15 NIP. . . . : COMML.. INCIN:
MAX INPUT: STU 15...30 1-1P. . . . : REPO I R UNITS:
FIRE DAMPF"7S . : ,30--50 HP. . . . : WOODSTOVCS. . :
GAS PRESSURE.. . . : 50+ 1IP. . . . : CLO DRYERS— :
NO. OF UNITS----------- AIF HANDLING UNITS OTHER UNITS. : 1 r
FURN ( 10011, PTU: i 10000 cfm : GAS OUTLETS.
FURN )=100K PTU: > 10000 cfm :
Ramat-ks : Install one "othet•" w/pipiny and V(Int
Ijwnpr•t ___.__. __.._....___.__.___...___—___.___._.._._..__._.____...__...___._.__.__..__-- FEES
DEBBIE HOLLAND type amount t)y date recpt
10245 GW OCRENA WAY PRMT t 25. 00 JD 04/1 1/95 95--26412125
PLCR $ G. ILJD 04/11/95 95-, 640a5
TIGARD OR ;F'CT t 1. 6x., JD 04/11 /95 95--264024
hone #:
!RESIDE CONTRACTOR
18383 SW BOONCO FERRY RD
PORTLAND OR 97224 .._—_--- --_--.—
p'honn. #. 684 ..85313 4 32. 50 TOTAL
Rey N, . : 40979
REOUIRED INrPECTIONS
This pewit is issued subject to the regulations contained in the Final Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all oii,ar
applicable Iaws. All work will be done in accordance with
approved plans. This permit will expire if work is ^;t started
within IN days of issuance, or if work is suspended for more
than ±;,; days.
M ATt-C
ss�.sed I:
Call for inspection 639- 4175
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StCd'�r��•n•,e a;nir�x l"AliMiwM.tlt'WO4w$;°a>�iA7 ="!v,ro-, .i,nt ..n.�Na�r.n. , a ,., .. r,reNN"" y;+ '!r,t.p,•.rr..wydialMloNrrF'�IL Il1.IMi�'MN
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City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 sw Hall Blvd. APPLICATION Permit # ,,HC
Tigard, OR 97223
(503) .739-4171
oscn i n
iY_J i 1 Table 3A Mechanical Code QTY PRICE AMT
Job 'Cj2gS 5>j S --��� 1) Permit Fee -0. -0- 10.00
Address
P- re— 2) Supplemental Permit 3.00
I 1-umace
OEE& r- H(--,ZAtj 1) incl. ducts 6 vents 6.00
vumace loo.ow F3 10 +
Owner ate^ Q CA-0AC\'E 2) incl. ducts&vents 7.50
Floor 1-umance
;i) incl. vent 6.00
Suspended heater,wall heatsm
4) or floor mounted heater 6.00
Vent nar incl.in
Occupant 5) appliance permit / 3.00
—W Repair of heating,re ng.
6) cooling,absorption unit 6.00
" — Boiler or comp, aatpummp;sirsu con .
t 'T C) 2- 7) to 3 HP abaorp unit to 1ooK BTU8.00
»� i er or comp,heat pump,air co
Contractor J 6) 3-15 HP absorp unit to 500K BTU 11.00
�y ter or comp,heat pump,au co
9) 15.30 HP absorp unit.5-1 mil BTU 15.00
ter or comp, eat pump,air co
4(Q— 1�i5 10) 3050 HP absorp unit 1-1.75 mil BTU 22.50
hereby r,c ow ge a tnave rea is application,thaEIie— ter or comp,heat pump,air con .
information given is correct,that I am the owner or authorized agent 11) >50 HP absorp unit 1.75 mil BTU 37.50 `
of the owner,that plans submitted are In compliance with State Air handling unit
laws,that I am registered with the Construction Contractor's Board, 12) 10,000 CFM 4.50
that the number given is correct. (If oxempt from State registration, - r handling unit -
please give reason below.) 13) 10,0:,3 CTM+ 7.50
Fon po(table
14) vaporate cooler 4.50
— — Vent fan connec
15) to a single duct 3.00
eV nblanon system not
tol� y—�j 16) included in appliance permit 4.50
qu•• .w , —�JTia O
Served by
17) mechanical exhaust 4 F�
assn wo new a i ton a aeration repair Commercialor industrial — —
to be done residential non-residential O 18) type Incinerator 30.00
Existing use o c� er i.e.,wo_ s ove,water
building or property Q 19) heater,solar,clothes dryers,etc. �1 4.50
Proposed use of20) Gas pipingone to four outlets / 2.00
building or property S F\�
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Type of fuel-oil O natural gasAl LPG O electric O 21) More then 4-per outlet
Minimum Feb$25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE r
IF CONSTRUCTION OR WORK IS SUSPENDED OR — p
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL
AFTER WORK IS COMMENCED.
TOTAL
5
Special Conditions — 1
Date issued
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FUEL.COMPANYk
2944 S.E. POWELL BLVD. P.O. BOX 42287 PORTLAND,OR 97242-0287 TELEPHONE 234-0611 FAX N 503-234-0380 I_
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City of Tigard, Oregon
Detailed Damage Assessment Form
';UIz DING DESCRIPTION: OVERALL RATING: (Checf:ore)
INSPECTED(Green)
Name: _—. LIMITED ENTRY (Yellow) ❑
UNSAFE, (Red) ❑
Address:
No.of Stories: DATE TIME , �� ar pm
Basement: Yes ❑ No�4 Unknown ❑
`� REPORTED BY _
Approximate Age: _years
Approximate.Area: square feet INSPECTION TEAM MEMBERS `
Structural System:
i Wood Frame Unreinforced masonry ❑ —
j I
Reinforced Masonry ❑ Tilt-up ❑ --— — —
Concrete Frame ❑ Concrete Shear Wall ❑ --- - — -- -
Steel Frame ❑ Otber
Primary Occupancy:
a
DwellineV Other Residential LJ Commercial 0 Notified occupants to vacate
premises LlOffice ❑ Industrial LJ Public Assembly ❑
Occupants indicate temporary housing
School ❑ Government ❑ Emer.Serv. ❑ is required ❑
Hospital ❑ Other _ _ L _! ^-
Instructions: Complete building evaluation and checklist on next page and then summarize results below.
Posting Existing RE:ommended
None ❑ Posted at this Assessment:
i Inspected(Green) ❑ \ ❑ Yes No
Limited Entry(Yellow) ❑ ❑ Existing posting b
i
a Unsafe(Red) ❑ ❑
Area Unsafe ❑ ❑
Recommendations:
❑ Nc further action required
❑ Engineering Evaluation required(circle one) Structural Geotechnical Other
❑ Barricades neoded in the following areas: —
i
❑ Other(falling hazard removal,shoring/bracing required,etc.): —
Comments(Why posted Unsafe,etc.): Q�j(.Q t d� ----
�� A,�,�t„r Sheet of_ I