13099 SW ST JAMES LANE-1 Z
13099 5W St. James Lane
/\
CITY
I�" �� �'���� MASTER PERMIT
PERMIT#: MST2002-00286
DEVELOPMENT SERVICES D." TE ISSUED: 9/5/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
(SITE ADDRESS: 13099 SW ST JAMES LN PARCEL: 2S109AB-07400
SUBDIVISION: RAVEN RIDGE ZONING: R-7
BLOCK: LOT: 003 JURISDICTION: TIG
REMARKS: Construction of new SF detached residence.
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 30 FIRST: 1,690 of BASEMENT: 1 311 at LEFT: 5 SMOKE DETECTORS.
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,033 of GArME: 593 at FRONT: 20 PARKING SPACES
TYPE OF CONST: 5N DWELLING UNITS: 1 TNRO of RIGHT: 5
VALUE: 390.040 70
OCCUPANCY ORP: R3 BORM: a BATH: 4 TOTAL: 2,723 of REAR: 50
PLUMBING
SINKS: I WATER CLOSETS: 4 WASHING MACH: 1 LAUNDRY TRAYS: 0 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 5 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS; I CATCH BASINS:
TUBISHOWERS: 4 GARBAGE DISP: I WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES: 1
N,SCHAIIICAL
FUEL TYPES _ FURN<100K: BOIUCMP<3HP: VENT FANS: 6 CLOTHES DRYER: 1
GAS FURN>000K: 2 UNIT HEATERS HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOUDSTOVES: GAS OUTLETS: I
El ECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: I 0 - 200 amp: �0 -200 amp: WtSVC OR FDR: PUMP/IRRIGATION: PER INSPECTION:
EA ADD L 500SF: 6 201 - 400 amp: 201 400 an,p tat W/O 8VCIFDR: SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 600 nnp EAADDL BR CIR SIGNAUPANEL: IN PLANT:
MANU HWSVCIFOR: 601 1000 amp: 6014anps-1000, MINOR LABEL:
1000+amplvoll
PLAN RFV IEW SECTION _
Reconnect only: > LS ARFAISPC OCC
>:4 RES UNITS: 9VGFUR>=225 A.: 6UU V NOMINAL C
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO&STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OT H: BOILER: HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATAITELE COMM: NURSE CALLS: TOTAL N SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 8,741.87
GEMINI HOMES GEMINI HOMES INC This permit Is subject to the regulation t contained in the
Tigard Municipal Code,State of OR. Specialty Codes and
16995 SW ARBUTUS DR. 16995 SW ARBUTUS DR all other applicable laws. All work will be done in
BEAVERTON,OR 97007 BEAVERTON,OR 970076277 accordance with approved plans. This permit will expire If
work is not started within 180 days of Issuance,or If the
work is suspended for more than 180 days. ATTENTION:
Oregon law requires you to follow rues adopted by the
Phone: 503-648-3512 Phone' 503-642-3512 Oregon Utility Not!ficatlon Center. 1 hose rules areset
forth in OAR 952.001-0010 through 952-001.0080. You
Otto tt HIP 151006 may obtain copies of these rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam Structural Mechanical Insp Shear Wall Insp Low Voltage Rain drain Insp
Sewer Inspection Post/Beam Mechanica Plumb Top Out Shear Wall Insp Gas Line Insp Rain drain Insp
Footing Insp Crawl Draln/Backwatel Electrical Service Shear Wall Insp Gas Fireplace Rain drain Insp
Footing Inap Crawl Drain/Backwste Electrical Rough In Exterior Sheathirg Inst Insula ion Insp ;' Water9-e;--,
a Ins _
Foundation Insp PLM/Underfloor Framing Insp Exterior Sheathing Insl R dr n Ins Rough-In
Issued By Permittee Signature : _
Call (503) 639-4175 by 1:00 p.m. for an inspection needed the next II a meas day
\� CITY OF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2002-00190
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9/5/02
SITE ADDRESS; 13099 SW ST. JAMES LN
PARCEL: 2S 109AB-07400
SUBDIVISION: RAVEN RIDGE ZONING: R-7
_T BLJCK: LOT: 003 _ JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: DWELLING UNITS- 1
TYPE OF USE: SF NO, OF BUIL DINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF residence.
Owner: -- ---- ----- — --
FEES
M.G. ARNETT, INC.
16995 SW ARBUTUS DR. Type BY Date Amount Receipt
EEAVERTON, OR 97007 PRMT CTR 9/5/02 $2,300.00 27200200000
INSP CTR 9/5/02 $35.00 27200200000
Phone: 503-648-3512 Total $2,335.00
Contractor:
Phone:
Rey #:
Requlroed Inspections
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires
180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not
guarantee 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" Pemmit and the Agency will install a lateral ATTENTION: Oregon law requires you to follow rules adopted
by the Oregon Utility Notification Center Those rules are set forth in OAR 952-00 1-0010)trough OAR 952-001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1 7
r
Issued by: �u Permittee Signature: t
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
f-) A -re i.
Building Permit Application
City Of Tigard 1Datercceived:,A,0/ 9 O: Permit no.:4,T-.ayg
Address: 13125 SW all Blvd,Tigard,OR 97223 Projecdappl.no,: Fxpircdate:
Ciry of Tigard
Phone: (503) 639-4171 bate issued: By: Receipt no.:
Fax: (503) 598-1960 Caw file no.: Payment type:
Land use approval: _ — 1&2 family:Simple Complex:
WOR
TYPE OF PERMIT
J I & 2 lainfly dwelling or accessory U Commercial/industrial J Multi-family U New construction U Demolition
U Add ition/alteration/replace men( U Tenant impmoement J Fire sprinkler/alami U Other:
1 ' INFORMATION
Job address: no.; Suite no.:
-J Tax map/tax lot/account no.:
La)l: Block:
Project name:
Description and location of worK on premises/speciai conditions:
OWNER FOR SPECIAL INI-'ORMA'I ION, USL'UHLUKILIST
(Floodolkin,septle capacity,solar4
Mailing address: I:uuil� drielling:
City: _ Slate: IIP: Valuation of work.................................... . $
Phone: I E-mail: No.of bedrooms/haths..
Owner's representative: Total number of floors.................................
Phone: Fax: E-mail: V New dwelling area(sq. Ill.) .......................... _.
Garage/carport area(sq, ft.).........................
--
Name: Covered porch area(sq. ft.) .........................
Mailing address: Deck MCA(sq. 11.) ........................................
City: Slate: ZIP: Other structure area(so. ft.)......................... --
Phone: Fax: E-mail: - — Commerclal/industrial/multi-family:
Valuation of work........................................ $ _
Business name: ; rY ,,.-, Existing bldg.area(sq. ft.) .......................... —
� = t1 ! i
Add re s: (�. �� ( c^- < i i ( TC) 1,(�� New bldg.area(sq.ft.) ................................
_..
city: 0- , , sZ zip: 7�i * 1
Number of stories ........................................
TYI�of construction....................................
Phonr 6_,,r 3 `-trax: •iE-mail: ---
CCB no.: i`r� Occupancy group(s): Existing:
C.�C C. New:
Cityhretm tic.no.: 7juirsdiction
ce:All contractors and subcontractors are required to he
sed with the Oregon Construction Contractors Board under
Name: �ions of ORS 701 and may be required to he licensed in the
Address: — where work is being performed.If the applicant is
Cil Slate: ZII': exempt from licensing,the following reason applies:
Contact person: Plan no.; -- —
Phone: I ax: I E-mail: — ------- ---
Name: lContact person: Fees due upon application ........................... $
Address: _ Date received:
City: State: ZIP: Amount received ......................... ............... $
Phone: Fax: I E-mail: Please refer to fee schedule. _
1 hereby certify I have ad and a amined this application and the Nor.0 Jurisdictions accept cmnr cattle,please call Jurisdiction for mcxe inforrneiinn
attached checklist.All mvisio;'of laws and ordinances governing this U Visa U Mastercard
work will he complie f�'w�h her s red herein or not, credit cod numtvr:
�• } Expires
Authorized sig atu / � •1 t.. Date: �� ? Nuns of cardholder u shown of cmat card
Print name: 6 , C"> l udho�l ern signuuro $ Amount —
Notice:17his permit application expires if a permit is not obtained within 180 days ager it has been accepted as complete. 410-4613 t6r[WOM)
One-and Two-Fainily Dwelling
Building Permit Application Checklist Reference no..
Axamm — ' Associated permits:
City(if Tigard Cit of Tigard City �anU Electrical U Plumbing U Mrchaoucal
Address: 13125 SW I lull Blvd,Tigard,OR 97223 U Other _
Phone: (503) 639.4171 — —
Fax: (501) 598-1960
tREQUIRED40W PLAN REVIEW Yes No NIA
I Land ase actions completed.tier pal IS(Il W11 cl urlia aur cuncuornl 1• •I,
Zoning.flood plain,solar halatwe points,1,rI'll ll( soils designalouu InL,luo, —
I Verification of approsed plat/iol.
4 hire district approval required.
5 Septic ayrtem permit or authorization for remodel. I?xisting system capacity
6 Sewer permit. '--_--- ------� .--_ __
7 Water district approval. ---------�~------ --_ — --
K Solis report. Must carry original applicable stamp and signature on file or with application_
I) Erosion control U plan U permit required. Include drainage-way protection,silt fence design and locallon of
catch-hasin protection,etc.
10 : Complete sets of legible plans. Must he drawn to scale,showing Coll Iormance to apphcahle local and state
building codes. Lateral design details and connrctions must he incorporated into the plans or on it separate full-size
Sheet attached to the plans with cross references hetween plan luc,tllun and del,nls. flan review cannot he completed
it copyright violations exist.
I I Sile/plot plan drawn to scale.The plan must shrnt tut and hulldlnt'scfhaclh dnnensions:pmpk•rt} comer cic�ation,Of
fherr r.Inulr than a 4-I1.elevation LIHICIcnhal.Ilan nnlst shuts culll(Illr Ines of' fl. Iter ah):IIII•alam oteasements and
Ill rt. ,N,I\,footprint of structure(including d('cks);Illeallull Ill ttrlltiw prlc Irniti',llllliIN locallolls;direction indica all 11 lot
arca:buildiog coverage arca;percenlage ofcuverage;uolxirtual�;ur,l.I•trAIl1V sI1I1CIUrCS on site:and surface drain.:Yr.---
Foundation plan.Show dimensions,anchor bolls,any hold soars and II Inil,Ik nllt pads,connection details, tell•
s.Lc and location,
I t floor plans.Show all 11lntensions,room(dent II1,al lull, NI10(m k M.lurill It III 111 'IIII IIT Ilelerlur's, WOW healer,-- --- - ---
furnace,ventilation Inns,plumbing fixtures.balconies and de,k� Ill nlchr`,Il,o .tante,efc.
I 1 Cross section(s)and details.Shaw all framing-member sVes snit k.pacin)' YII,II X,floor FV. headers, Joists. 1111 flour,
tt all cunsouclnm,roof com.uuction. More than oar Criss wdloll nuav he Icquured to clearly portray ronslruclion.Shots
details of all wall and roof .hralhilly roofing,oHt slope,cclhng height,siding material,footings and Inundation,stairs,
Fireplace construction, thl•_Imal m.nl;luun.cn-. _
15 Elevation views.Provide CIO Odor,.fl 11 new construction;minimum ol'two elevations for additions and remodels.
Exterior elevations must tOlcl I Ihr acfu,ll }'lade If the Chill])x Ill}trade is greater than four foot at building envelope.
,
Full-size sheet addendum ,Nm In), I-lul.dauon elct,lhons\cull Crosti references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analyst+plans.Must indicate details and locations;for
nun-prescriptive path analysis provide specifications and calculauonS to engineering standards.
17 Floor/roof framing.Provide plans lilt all IloolVrool assemblies,indicating member sizing,spacing,and hearing
locations.Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rehar. For engineered
systems,see item 22,"Engineer's calculations." -
10 Beam calculations.Provide two sets of calculations using current code design values for all hams and multiple joists
over 10 feet long and/or any team/foist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. _
21 Energy Code compliance. Identify the prescriptive path or provide calculations. 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 he stamped by an engiucer or
architect licensed in Oregon and shall he shown to he applicable to the propeel under review.
23 Five.(5)site plans arc required I'm Item I I above. Site plans must he 8-1/2" x I I"or I I" x 17".
24 Two(2)sets each are required for Items 16, 19,20&l 22 above.
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will he not accepted.
26 "Reversed"building plans must meet criteria outlined in the Permit & System Development Fres document.
27 "Drawn to scale"indicates standard architect or engineer scale.
28 Site plan to include tree size,type 8l location per approved project street tree plan(if applicable),and COT Street Tree List.
Checklist must he completed before plan review start date. Minor changes or notes on submitted plans may he in blue or black ink.
Red ink is reserved for department use only. 4404614 tGMWOM)
Buildi lig Permit Application
Date received: ,- Permit no.:&
City of Tigard
Prgjccdappl.no. Expire date:
City o and
8 T! Address: 13125 SW Hall Blvd,Tigard.OR 972 -f fit..
Phone: (503) 639-4171 Date issued: By: /J Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: I&2 family:Simple Complex-
'
10
bj�I " 1.111 iil I. If n t r :ecce. ly U Commercial/industrial U Multi-family XNew construction U Demolition
U Adclrti li t. I I. 1UJ�Tenant impro% n 111 J Fire sprinkler/.darns J Other:
Job address: 'r L , :;t, r< 13W�. no.: Suite nn.:
Block: - Suhdivisiun: AAL-KE c2 i-TaX map/tax IaUfccOunt no.:
Prujt.�l a me; ���,(; l "" 1 C -LL L..
Description and location of work on promises/special conditions:.
� t
Name: A4 ,G* A NUTT211 C
Mailing address: I&, JU �':+ fes' I &2 family dweilEng:
�j
t City: tom_ �[�NI State: - 71 P:_ ' )� Valuation of work.......
---
Phone: j _ �`I �. 1'ax � :-mail: ._. No,of txdrooms/haths...... _ ..... _-
Owner's representative: i �-_�— Total number of floors... ....... ....................
Fax: E-mail: New dwelling area(sq. ft.t . ... .................. . --sz. �.�_
mum Jarage/carport area(sq. It.) ... ... ...... ......... tea,
Name: -- Covered porch area(sq. ft.) .............. ...... ... -
---- — Deck area(s 11.) 3�.3. ..•
Mailing address: 2'
City: State: l.W: (tther structure arra is . tl.)..rc .�rM.4/
Phunc: F:lx: C mail: ('ommerciallindustrialhnulti-family:
Valuation set work...................... ............... . )'-----Existing bldg.area(sq. I't.)
Business„acne: I�Vyh�GrVt Ll. �sr"� �-j-
New bldg.area(sq.ft.)................................
Address: I S'H�ts Smear ✓ht `t(c�_ Number of stories
Cit Vk tll1•a;t/1 State F ZIP: '77c�t'
.............
—----
Y_ _ Type of construction.......
Phone: "1113 1'a 5'tArrlt: E:mail occupancy group(s): Existing: --
CCB no.: _ �f►Awl New:
City/metro tic.no.: Notice:All contractors and subcontractorsare required to be
licensed with the Oregon Construction Contractors Board under
« provisions of ORS 701 and may he required to he licensed in the
_ •
binme: A N IC'C)0,Q — jurisdiction where work is being performed.If the applicant is
Address: I2)L-
IP
L exempt from licensing,the following reason applies:
City: Stat 'LIP: ,' v
Contact person: flan no.:
Phone: Fax j c_0 E-mail: — --
' :, 3 Contact person: Fees due upon application ........ $ -----
Name: I►o PP ................... -
Address' ;-7 6- ��,2 N5. 1� Ditty received: _ --
City: / 1Stat C 7.I P: l Amount received ................................I........ $
L7 •
Phon 7 Fa ►nail: Please refer to ice schedule.
_
I hereby certify I have read and exam ed this application and the Nd all juns3ictioru xce l cmill cods.Plenae call Jurisdiction for mese information
attached cheLsignatu
t. All p ilio s o ars and o di cc governing this U Visa U MasterCard
t'redit card numtMr, _
work will beplirtt w I • sper' it
or not
Authorized re:__ - Date: - Name of cardh—ober on cmdil card $
Print name: s
Cardholder signature Amount
Notice:Phis pennit application expires if a permit is not obtained is ittnn 180 days after it has been accepted as complete. 4404611(koWOM)
One-and Two-Family Dwelling
Building Permit Application Checklist Reference no.:
Citynf igard Cit of Tigard Ati"" ';Ilicil LJ inti:
Y g _11 I� ulcal U Plumhmg U Mechanical
Address: 13125 SW Ball Blvd,Tigard,OR 971'+ j 111h'.1
Phone: (503) 639-4171 - _-
kix (501) S98 1960
Tilt FOLLOWING 1 1 FOR PLAN REVIEW V-w No N/A
I Land use actions completed.See Ilim(llclion t rlterm lot concurrent Ir.a ,\
Y•oning.flood plam,solar balance points,sei omc rails designation,hit heat dlsulet.etc.
+
I. catlon of approved platllot. _
1 hire district__r - approval required. - -
S Septic system perndl or authorization for remodel. lixisdrig%yslcm capacity
6 Server permit. —
7 Water dl%trlct approval ___ - -�
8 Soils report. Must carry original applicahle s(arnp and signature on file or with applicauon. ---- --- —
9 Erosion control U plan J permit required. Include drainage-WAV prof ectitln•silt fence design and location of — --
C;uch-lt, 'n protection,etc. _
1(1 3 ('061plete 9et9 of legible plans. Must he drawn to scale,showing conformance to applicable local anti --
huilaWi`g codes. I.aaeral design detail~and con11Ct tions must he incorl,olotrd into the plans or on a separ e lull sin'
~heel allacled In dw plalls with cross I00m11cCs hCt\\CC11 plall locill lIll;ultl dcl;llls. 1'It111 reviCw ea1111111 Ilk'et1111pICICd
rFtoll\•Ilghl ,nllallon.exirl r _
1 1 Site/plot plan t rim to lcol0 a plan must slo\v lot and hulldint'sethack diem-Imam.,pn gxvly corner CICva111m(it
Acte IC Ilion•(Ilan;t 4 11.VICVtllioll llllr'ri'Illnd.plait 111(m \flow col Ilolll IIIlC--;ll 2 11 1111e1\.11 );lRllth,ll of C.1WHIC1111 Mid
drivcwav;loolprint of �IIUCIute(includlnt•drJk,J.locntitm of \\ells/segue\\`teals,uu111\ I Kautm.:dnreuo11 Indlc;11411 Iol
area;building coverage arca:percenlap.t1I t 1ylagc.utll,er\hats nIC;c exrstaIt!'AIIIL'IllICs on site;and sIIrlace droinaee.
12 Foundation plats.Show dimensions,anchor bolls,311\ hold-downs and relnfon Ing pails,connection details. \Cal _
size and location.
13 Floor plans.Show all thmew tow, loom idi-imflc,un Ill,\eindo\\ sI/L. It �loon of smoke da tel tors \aatl r heater,
furnace,ventilation ln►r,plumbing llxlttrl s halt omCs and lit-(.ks ;tl Illele,,Shove ga'tltlt etc. - --�
1.1 (Toss section(s)and details.Show a1!flalnlm, 111Cn1lr1 wC.;and spavin}.'such as floor hcallls headers,joists.soh-floor.
\t,Ill,o11sLlurllon. roof conslrucuoll %IOIC 111311 MIC crus,set tion rrla\ bC 1Cyunrd to(Kali\ ptairay colWruclion.Shore
ill-I'll ,of ;III '.\all ;Ind Tool slcmlllnr, roofing,roof slope,erllnlr Ilt'I•e'111,sl,lulg In;uerlal,fuolinps;and IIIIIIldallon.stairs,
I11C11I,I(C runs llik HIM. Ilrrinal Insulation,etc.
15 hleration►fere%. I'lo\Ile VICvations for new Constriction: nnnnnunl of two 00;111011s I'll addilions and IVMOdCI i. — — —
I.\truol CIC\,luons nnlsl ICIICCl the ftlal grade if the change Ill grade IN greatet than 1011t lot)(al building envelope
v
_ Dull sv steel addrndlnns showing foundation elevations eeuh cross r'efe'rences are acceptable. _
I n Wall bracing(prescriptive path)and/or lateral analysis plans. Mort indicate details and locution,; for ---
non-prescriptive path analysis provide specifications and calculations to engineering standards. _
17 Floorlroof framing.Provide plans for all Iloors/root'assemblies,indicating member sizing,spacine,and hearing
i
locations.Show attic ventilation. _
18 Basement and retaining Nall%. Provide cross sections;Ind details showing rlacemenl of rehab. For engineered
systems, we item 22."Fngineer's calculations.,,
19 Beam calculations. Provide two sets of calculations using Current code design values fur till beams and multiple joists
over 10 feet lung and/or tiny bean/joist carrying a nun-uniform load.
20 Manufactured floor/roof truss design detallc.
21 Energy Code compliance, Identify Ihr prV';Cti iI%C path ur provide calculalions. A gals-piping schematic is required
ifor four or more appliances.
I 22 Engineer's ealculatlons. When required or pro\Ided,(i.e.."hear v;all,tool truss)shall be stamped by an engineer or
�\ architect licensed inOregon and shall hV rhos\n to he npplicahlC h,the prujecl under reviece.
23 Dive(5)site pans cire required for hem I I ahmc tide•plans must hC 8 1/2"x I I°or I I" \ 17".
24 'T\\0 i?1 sets each are required for Items Ih, 19,20& 22 above. ----- —'
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans\yell he not accepted
26 "Reversed"building plans must meet criteria outlined in the Pennit&System De\elopmenl fees document.
27 "Drawn to scale" indicates standard architect or engineer scale.
28 Site plan to include tree si/e,type&location per approved project street tree plan(if applicable 1,and COT Street Tice List.
~' 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 liar department use (till). 4411 461416AX)x'0rrl
Mechanical Permit Application
---�-- Datereceived. Pemi:no.:
City of Tigard Projecdappl no Expiredate:
City ofTigard Address: 13125 SW hall Blvd,Tigard,OR 97223
Phone: (503) 6.,9-4171 Date issued: 9y: fteceiptno.:
Fax: (503) 598-1960 Case file no.: _ Payment type:
Land rise approval: Building permit no..
OF
U I &2 family dwellin'v or accessory U Commercial/industrial r)Multi-fantil. J Tenant improvement
U New construction U Addition/alteration/replace ment .1 Other: _
tN COMMkllb_tIAL YALUATIONSCHEDULE
Job address: iC/ Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.; I Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$
Lot: Block: Subdivision: "Sec checklist for important application information and
_Project name: jurisdiction's Ice schedule lin•residential permit feet
City/county:
Description and location of work on premises:_ t � $1
NWA
1 ct,(ca.I IAA
Es(.(laic of completion/inspection: _ Ilkwcrf tion onh He%.onls
Tenant improvement of change of use:
Is existing space healed oi-conditioned'!U Yes U No Air handling unit .—CFM---
Air conditioning(site plan rcyuir�eC 1 �
Is existing space insulaled?U Yes U No Alteration of existing IIVAC system
ui er compressors
Business name: t� - E N� State boiler permit no.:
-�-- __ IIP Tons B•rU/11 _
Address: 1qq1jTi4- -,-wl?R x �i/ Fire/smo c dampers/duct smoke detectors
City: 6 -_ t} 7.IP: an required) —
Phone, 3 Fax: 1?-mail: n1 sta7 rcp ace 'urnace burner f"'
-- Including ductwork/vent liner U Yes U No
CCB no.: 04P iL-r _ nsta rcp ace re ocateheaters-suspendc ,
City/metro lic.no.: — wall,or floor mounted
Name(please.print): - - em for a,p lance oftier than furnace
Absorption units II'f It/Ii
Name; Chillers._ Ili'
Address: --- ('dun rressors— I11'
_. ----- snv ronmcnta exhaust and ventilation:
City: State: ZIP: Apphancevent
Phone: f%ax: 1:-mail: )rycrcx iaust
Hoods,Type res. itc lel-T�nat
hood fire suppression system
Name: Exhaust fan with single duct(hath fans)
Mailing address: %x taust system apart from heating or XC
Cit State: ZIP: Ue piping an t str et non(up to outlets)
Y Type. _ LI'(; NG Oil
Phone: Fax' E-mail: uc piping each additions over 4 outlets
race%%piping(schematic requre )
Number of outlels _
Name: _—_ ter st app ance or equipment:
Address: Decorative fireplace
City: _ State: 'ZIP: Insert-type — -
Phone. I E-mail oo stove pe et stove _
.�_
(it cr.
Applicant's signatt re: — Date: 771 Other: —
Name (Print): — _.--
Not all jurisdictions accept credit cards,please call turixliction for more Inrnrmalim Permit fee.....................$
0 visa O MasterCard Notice: bis permit application Minimum fee................$
/ expires if a permit is not obtained Plan review(at _ 7i) $
Credit card aurid er _— --- — x rcr within ISO days after it has teen
p State surcharge(89h)....$
—F`emr f car�iolder a�i�wn nn c am-1 c�--- $ accepted as complete.
TOTAL .......................$ ------
F older Nsnature �— Amount 4404611(t RDUOA1
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 7 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: PERMIT FEE: Description: Price Total
$1.00 to ,000.0 Minimum fee$72.50 Table 1A Mechanic 'ode Qty (Ea) Amt
$5TU
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,06,]t
$1.52 for each additional$100,00 or Includingducts&vents 14.00
fraction thereof,to and including 2) Furnace 100,000 BTU+
$10,000.00. Includin ducts&vents 17A0
$10,001.00 to$25,000.00 3148.50 for the first$10,000.00 and 3) Floor Furnace
$1,54 for each additional$100.00 or Including vent 14.00
fraction thereof,to and Including 4) Suspended heater,wall heater
_ _$25,000.00. or floor mounted heater _ 14.00 _
$25,001.00 to$50,000.___0 $379.50 for tha first$25,000.00 and 5) Vent not Included in appliance permit 6.80
$1.45 for each additional$100.00 or
fraction thereof,to and including 6) Repair units
$50,000.00. 12'15 -
$50,001.00 and up $142.00 for the first$50,000.00 and rChk all that apply: Boiler Neat Air
$1.20 for each additional$100.00 or ems 7.11,see or Pump Cond
_ fraction thereof. otes below. Comp
Minimum Permit Fee$72.50 SUBTOTAL: $ HP;absorb unit
BTU 14.00
8°/.State Surcharge $ 8)3.15 HP;absorb 25.60
unit 100k to 500k BTU
_____ __ - - --- -- 9)1�-30 HP;absorb
25%Plan Review Fee(of subtotal) $ unit.: 1 mil BTU 35.00
Required,for ALL commercial permits only_ 10)30-50 HP;absorb
TOTAL COMMERCIAL PERMIT FEE: $
unit 1-1.75 mil BTU 52.20
11)>50HP;absorb
--- - - --- ---- unit>1.75 mil BTU 87.20
12)Air handling unit to 10,000 CFM
ASSUMED VALUATIONS PER APPLIANCE: 10.00 _
Value Total 13)Air handling unit 10,000 CFM+
Descrijtlon__, Qty Ea ____Amount 17.20
Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler
ducts&vents _ ____ 10.00
Furnace> 100,000 BTU Including 1,170 15)Vent fan connected to a single duct
ducts&vents 680
Floor furnace including vent _ _955 16)Ventilation system not included In
Suspended heater,wall healer or 955 appliance permit 10.00
floor mounted heater 17)Hood served by mechanical exhaust
Vent not Included In appliance 445 10.00
permit - 18)Domestic incinerators
Repair units 805 17.40
<3 hp;absorb.unit, 955 19)Commercial or Industrial type Incinerator
to 100k BTU _ 69.95
3-15 hp;absorb.unit, 1,700 20)Other units,including wood stoves
101k to 500k BTU 10.00
15-30 hp;absorb.unit,501k to 1J 2.310 21)Gas piping one to four outlets
mll.BTU 5.40
30-50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each)
1.1.75 mll.BTU _ 1.00
>50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $
>1.75 mil.BTU
Air handling unit to 10,000 cfm 656 _ 8°/.State Surcharge $
Air handling unit>10,000 cfm _ _ 1,170
Non-pcrtable evaporate cooler 658 TOTAL RESIDENTIAL PERMIT t•EE: $
Vent fan connected to a single duct 448
Vent system not Included In 656 -
appliance permit pher In�attlF t
Hood served by mechanical exhaust _ _656 1 Inspections outside of normal buf,iness hours(minimum charge-two hours)
Domestic Incinerator _ 1,170 $62 50 per hour.
Commercial or Industrial Incinerator _ 4 590 2 Inspections for which no fee is specifically indicated (minimum charge-half hour)
Other unit,Including wood stoves, 656 $62 50 per hour
Inserts etc. 3 Additional plan review required by changes,additions or revisions to plans(minimum
charge-one-half hour)$82.50 per hour
Gas piping 1-4 outlets 380
Each additional outlet 63 'state Contractor Boiler Certification required for units>200k BTU.
- -
TOTAL COMMERCIAL "Residential A/C requires site plan showing placement of unit.
VALUATION: _ _- _ All New Commercial Buildings require 2 sets of plans.
I:tdsLgUormsvnech-fees.doc 02/11/02
Plumbing Permit Applleation
-- -- Daarealved; ttunlltwCity of Tigard ��QQ'�
Soavrpermftno.: f3utidlaBPermltnn.:
Addrennr 131)+SW hall Blvd,Til"OR 97223 "--
city 0]l7swd Phone: (703) t5'l9-4171 I'ru)wt/.ypl.nu.. �!� tlxyirodatn: --
Fax: (503) 598-19W tate issued; Hy Raolpt no. �,-
Land use appruvttl; -.- - rw lite no.:
big
Cl I &2 family dwr.Illny,or aoee"ory L1(_omintrulal/induxtrlal 0 M�lri•inmily U Tonant impmvcmrnt
U Now consrnx:tiun U AdditkWalteradonlieplecement U Fc:'service U 0111rr
1319AM21111,11 KIJIM 9.1 ELL
e'+ IMWO Uon Fro ea. Total
)ub juhhTM. �lr/ s -
Hldg.no. _ 5trile no.: -sund - � y wa tsts onyt
T �
- (IMIluka1Mlfl.forMttTitllltyein■WIlon)
Tax nu+i+�ta><lot/a000unt no.., -___—-- SFR(1) hnih
lot: 9loclt: Subdivision: FR
—
G� batt)
«dtlUnnl tietlTk�u.Tie(i-
esi-Aption nrul Iln:ation Or work on promises: _ +atultIM
Catch basin/RM drofn
-rwfist date of vom Ictionjow tedon: e . e pc drn(n
drain tu�.lira.
a iawtmvd horre uttlitles
ItuaitMss nnute �� � t
Addrosa: ' 70 Wn a cc wectnr
C'ity: Stat 23P -Mary trewrx no. in-i -- -
"K, Phnnc Part N#4-IWPM H-mail: [anti scwer no.Yr
CCB vu.: Plumb.bas.rcg- - +ti[eCty re no. n.
CI[j/metw lit:.nt,.: Ab an valve
tAdli
$W.A: tativn I apse:_ _ _ _ ac�ow proventei
Printme: Dia+: WA-Wim Volvo--- —
u r ava[bt�-
.nt cow
bt t as intron m_k mall: Mpanrian uta ^--- - —
u[w sewer Ca
ainkan,ub ___ _•�
rm �ia sV
Mali addrm: ctsna, t
City:
"WHO; hart; _ F-matl� ntm pr thin t _
Ownrsr In.tnitutlnnht+x.1dential ma ntmanec only. The actual InVAllatkm ma a
will be made by me n tie+ttlxlntunnnce and m (Wr made by my rtastlK oc;T�firn o rnrnotenr` _
empluyex.rxi the property I awn n+per ORS Chapter 44T l*0' s a sxIn-VIS
<.1Wner'6 nl nntun": Ditte'
Address: r tt�ec oor _
CJS. ---I-Stade-- _`�.. .____ �"_�.ua_+t�irr+► ••
Phone: --
- Minimum fees... .
Not all imt�eroTmm k*4pe ersat rMdI.pv^ n11 1nMWIMM l ax mon In!�++wM Notice Ttde revmit ewioation .. a —
sa r1 MssMtGut F'Inn m.glow(at --- ')
Q Vi
eapins if a pcm,it a tart obaintd 9trVe Au,charl;r
Cmill owd numhrr _—_ -- — within I so dM after it has I cn TOTAL .
_ Weepteci.+,c,mptets
tIQr�Ms♦ _--�---}- AMBM _ 440-4616 IMM 1)MI
zoo/70oIn d"IM, do AID oPOT962COU Yva ti9'8(1 7,UUL tT 'RU
09/26/2000 23:45 397-9022 LG MOBERLY, PAGE 02
PYectrical Permit ApplicatiOn na�tt�•aa: Patttttttea.:
pro)eet/appl,ao.: exptrr lets:H sr
City of 11gard -
sy' ttaoelpw no„
r(ryr+JTidp„t Addtcel: 1,4125 5w xall Blvd,Tleard.oR 'Y32.1Tkle lunadc _
Tvw,,, (503)639-4191 Cue Ella no,:
1.6,t' (503) 599 1960
Land ut:e approval:
CJ Musa I am►1Y 0 Tenant imptaveinut
I 1 St 2 family dwelling,of r,,%cewta)' O Commcreial/indualnal >Partial
�New cuna[rtution L3Arirtiti�n/alrnratioNreplacemOne IJ Other
$fid „- St ite .0. T9x map/tax lot/atxAaM ea.:
i lob Addrot._• '- '"" _ -
I,ol. lock: Sutxllvliltxt -
- Deltcnplion and location of w,otk on prentiseS:
T?{hrnatcd date of Com Ietlonriine COCA,
� rw Max
Job no: _ p«„atM ) ("► rami co dn{p
I — M
Badnus mama: �_�c c LQ fc• .� � '1b or n.ik f.,.xr re
n Add ml: Lf� �_.. e...IW�volt lad .eo.ceede�t+ee.
P. e
d - - 1000
J
Phan Rax: E-mail: h ndditWid 100{ mor ntUon thettof _
-=leo,bus.us.lic.n0: UcnkM ener ,re{IdmJd 3
lJml vuraY•oentra bel
uc,manufeuuro lonxorrtx,nulatdwellinl
V� 2
/naor mgdct
-
toM I alaid.o(i Irar�-- dale
Sarvlu
It
.mow• p � dor�itg e-�M•�1�etiocl
Sap rltunartwlDw+nt> IJtt>twtw! ralhratleneeeelewtton
1001L {of les 1
2
I f 101{n, s m 100 amts _ 2
TJnrttc(tLtlot), 001►m 1106COadn
Matli addreaL jk 9 p /2 1 cacti•to t -- 1
��_
Cil St�' �_ 1i�--.. U.er 1 ua�e of vaso
_ L.-mall: Tlecont>tctonl
Phone, m rt 1 h"'p°nn w canoe
()wncr inatallatten.The Lotallatuon is being:made an P pe Y own y�(W�•algrrelatt,of rdotlti"t i
wtuel)is not Wooded for 110e,10AW,rant.or exchat)!e according to 700 eta
ORS 447,453,4-,9.610,101 X01 th 6001 am
r to 100 amp. - Z
Owner's AI asn"' cb ar.N,jailawmAkni
Of e{Nndkn pee powtt
A rer fat bruwh rlrariu vlitlt puteMo{aof 2
urvlae or feedr fa.took Imurmh dtetdt
Addme: __ Statt: Fn+farb0aaS.iral, wMbotepuraMae 1
�Z --•. otaervwaule.dKtNrfltgtmnct,clrerit,
Phone- Fa,t' r-snail: add,llooalprenohoitauie
( i,ee a War oat t l
l ach pump of ttfluaon dt�
J StrvlCt L"t,77ti an,jd i�r,nrd�d, Q I(nithcrrefeat►a: Ba0Eal ttorooJMen btltt --
Stxvicdwed il0 atnp{<MieRot lthl U Hatrdaa{IooWon nal{ituit(s)or a 11 ew,ow—gw{
terNlydwsUtop ❑ftvlldN�o�er!u.(1,K aquorr trct Mw a 61
'a nYNc'ttreldrr,UN nMNln ntu l,mrt01Y1 Itter'{1rOn�Of aAlatN100� __
0 System over 600 volu nein, a -
5m1dia4ovM Lv-s A- a F4*,un,eW em f{m rerne 4tlbptt.tl._
Q tw Vans I.,M n-90 ptrmru U manufmWed uI%wmrtt or Rv p.re water 1M agottabb In Wm)
O r4mWIlaMuiWan U Ohba" __ -- I* on =1
fitfi�N lata Of Plume"ith WY of 1110 40M Invcatijetion fw o
1(ZH abola art a�aPpllnaYle to teaptrW7 cesairmill"@solea. Ower _ I
_- Prtmit fcc.....................S
Ttor al wnuuotiwr curt dneu eadd,ps{ru wN l�+dw+v.to nww id__W °{' Not(oe This Permll appllt AIQn flab mvlew(At — %) $ -
U V,ta U MuteK:&rd axptret if a patntl it not 0-tAimed
within 130 days filer it hw beat State lntstlule(8�) s
rivow cod so~ -— 1Cl crW as Complrta. TOTM. .......................3 �•••�� ••
- --►.tan..d au3.Aiu v Zee+tr r t c
�� 1 N/r11L'ltYW'Cd"
loop tTlftr9lL d0 Jlt1J 096T96VA4 IVA mho t00b Ai list
-- -- -••- .., .,..... . . �Di 3�6 bPaz v. 01
LOT 3, RAVE',! RIDGE,
e tTr OF TIGA"D,
___
LG2.feIZL 1
sobs 60, FT. .20 • 1
ryr r-+�.a��ar z
2b4,13 80. Pt. UNDER P.A'YVS
aA��aoad • ��x � ! ! A I
MAX ALLOWADL.E W% THEREFORE OK
aErwe�-xgi �: �
Is' (CaARA4E) is ' i t
�t�cERTr �tr+�REAR 19,
II
b0TOACK LINE
I
1 MAOC4:R PLAN '122P
4 MAN FLLPt XEV. P 40'
FImS W CONTC OM '
-SII it
1
i
ITANEr ^ !
• �n MANCHUCK, ARNET i
mage"A n I,» A FR
I-IOt�4E �E$ICsNB
40FY►L 12N MU 11 I6 s DR
L A�+r ,Y ICON61*RUCTIONdL01aA. QI! 1100',4 AIV OV
DAT{lt. %•ry-" t
DAtAl+AM.1*4 f
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST -0 e)2
INSPECTION DIVISION Business Line: (503)639-4171 --
BUP
ReceivedG
t)ate Requested_�—��_`��_y"^ - AM_—_--_ PM_ BUP
Location l ayy� 5' Suite__ MEC
Contact Person — _ — Ph 3 57 Z _ PLM
Contractor Y9 ph(_ ) 3V/ 06)77 SWR
IL Tenant/Owner — ELC
Fooling
Foundation Access: ELC
Ftg Drain LR —.
Crawl Drain
Slab Inspection NotE /S � SI - --
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear ��
Framing
Insulation
Drywall Nailing �� r, '�'`� �'✓fes
Firewall
ol
Fire Sprinkler -
Fire Alarm
Susp'd Ceiling - --
Root ✓�_ y 0.0
Other: -- ----- - 44 V �
PASS PART -
PLUMBING
Post
Underr Slab
__ )il.U-•-+��T"'�� 1r� _
Rough-In �,.�. I :51
Water Service �'--�" ---- —_-`-� T'�-,-••--�+Y
Sanitary Sewer �
Rain Drains --
Catch Basin/Manhole
Storm Drain > �_rlsa v �-�'� - -_ 1. V , f 1,^,�• "� _+ �
--- -- '
Shower Pan
Other: --- ------------ _ .- _ .� - ^—_
Final
PA' --R4RT_ FAIL - -- - -- ------
�tIfEC _AL_- --
Post&Beam
Rough-In ------ ----
Ga s Line
Smoke Dampers
-final
S ART FAIL - ----- - —_
RICAL —
S9NICe
Rough-In ------ - — -- ---
UG/Slab
Low Voltage —
Fire Alarm
FinalReins ction fee of$ required before next ins
PASS __PART FAIL � � - 4 pection. Pay at City Hall, 13125 SW Hall B10
SITE _ __— - Please call for reinspection RE: Unable to inspect-no access
-ire Supply LineADA
Approach/Sidewalk Date.- __!� Inspector
Other:
Final DO NOT REMOVE this Inspection record from the fob site.
PASS PART FAIL
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 63UJ 75
INSPECTION DIVISION Busint. Line: (503 1 ST
¢ Z��a3
BLIP
Received -_ - _ Date R., este AM_ PM._ -_ BLIP
Locationl Suite MEC
Contact Person _ - Ph(— ) — PLM
ContWc10lt ._._- Ph(--) -- SWR
I DINNG•�– Tenant/Ownpr
Footing
---- - - - -- - ELC
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: A,, -� '' SIT
Post 8 Beam - ,6./y ,��i•�
Shear
Anchors L� ---
Ext Sheath/Shear �(
Int Sheath/Shear
Framing
Insulation -
Drywall Nailing _--
Firewall - ---
Fire Sprinkler -_-
Fire Alarm
Susp'd Ceiling
Roof '
Other
inal •
"'.S
PART FAIL - -- ------
P
- BING
—-- -
Post&Beam - -- ---- —---
Under Slab
Rough-In - -----
Water Service
Sanitary Sewer ---
Rain Drains
Catch Basin/Manhole - --
Storm Drain
Shower Pan
Other:
Final
_PASS PART FAIL
MECHANICAL
Post&Beam -- - —
Haugh-In _--_--- ..- -
Gas Line -- --- - --- --- -
Smoke Dampers -- -_----_----_----_--_.-
Finai
PASS PART FAIL --- ----- -- -- ------ -- --------
ELECTRICAL — —
Service — --- ----- -- --- --- --- --- ----- -
Rough-In
UG/Slab - -- --
Low Voltage -
Fire Alarm - --- ---
Final n Reinspec•tinn too of$ - required before next inspCon. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE L I Please call for reinspection HE Unable to inspect-no access
Fire Supply Line
ADADaftApproach/Sidewalk � Inspector �'�---
Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171 - - - —
�� BUP - - ---- - -
Received Date Requested__ t - 5 AM PM _ BUP _
Location -suite-. _ _
MEC - -- - - -
Contact Person Ph(--) G 42-- 3s �� _ PLM _
Contractor ---_-----_"�_-- Ph( ) _ SWR
BUILDING Tenant/Owner - ELC
Footing
Foundation ELC - -
Ftg Drain Access:
L,13 Q ELR - - - -
Crawl Drain _
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors -- --
Ext Sheath/Shear
Int Sheath/Shear ��}
Framing �_ r.
Insulation
Drywall Nailing
Firewall
Fire Sprinkler ---•- ��
Fire Alarm
Susp'd Ceiling - / - - --- ---
Roof
Other: - - _ -- --- - ---
Final
PASS PART FAIL
PLUMBING -
Post&Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain
Shower Pan
Other:
_PA_
PART FAIL -
CHANICAL
- - -- - -
Post& Beam
Rough-In
Gas Line
Smoke Dampers _—
Final
PASS PAr. FAIL ---- - ---- ----
ELECTRICAL
Service
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of$_. _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
LASS PART FAIL
Please call for reinspection RE: _ Fj Unable to inspect-no access
Fire Supply Line
ADA L/,
Approach/Sidewalk Date Inspector
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171 -
BUP
Received ___ Date Requested SirA _-__ PM _—___-_ SUP
_ - -_
Location —_-- 3 D Suite -- MEC
Contact Person --- --- --�Y�-� � — Ph( ) _ t a� -- 5 (
a PLM -- -
Contractor_ _ -.. _ _ Ph(—) - _ _ SWR
BUILDING Tenant/Owner _-----_- - - ELC
Footing E!_C
Foundation Access: - (�
Ftg Drain / �� I t" ELF!
Crawl Drain [--
Slab Inspection Notes: SIT - -
Post&Beam _
Shear Anchors
Ext Sheath/Shear _
Int Sheath/Shear
Framing - - -
Insulation
Drywall Nailing —
Firewall
Fire Sprinkler ------
Fire Alarm \ ��
Susp'd Ceiling ---- --- — -- ---- --"
Roof
Other: --___ -- -------- -------
Final
PASS PART FAIL � -----------_— �.__----_ -_ --- _
0LUM9ING ----- ----- --- ---- ----.. --- --
Post&Beam
Under Slab - --- - --- ------- -- -- -
Rough-In
Water Service - ------- — --
Sanitary Sewer
Rain Drains - --
Catch Basin/Manhole
Storm Drain --
Shower Pan _
Other: - --
Final
PASS _PART FAIL
MECHANICAL -
Post&Beam
Rough-In -- ---------- —
Gas Line
Smoke Dampers -- — ----- -
Final
PASS PART FAIL -----— -
ELECTRICAL
Service -�--- ------ - —
Rough-In
Vol
Fire Alarm
Reinspection fee of$__. required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE E] Please call for reinspection RE:-_ _ - Unable to Inspect-no access
Fire Supply Line f
ADA Daft car j Insp or '-"
Approach/Sidewalk
Other: _
Final DO NOT REMOVE this inspection (record from the Job site.
PASS PART FAIL