Permit CITY OF T I G A R D MASTER PERMIT
PERMIT #: MST2003 -00297
L ''ill' DEVEL d OR 3CES 639 -4171 DATE ISSUED: 7/24/03
1 13125 SW
SITE ADDRESS: 13545 SW 122ND AVE PARCEL: 2S103CC - 10500
SUBDIVISION: WHISTLER'S WALK ZONING: R -4.5
BLOCK: LOT: 052 JURISDICTION: TIG
REMARKS: New SF detached, Path 1.
BUILDING
REISSUE: DM178 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 23 FIRST: 1,476 sf BASEMENT: sf LEFT: S SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,574 sf GARAGE: 460 sf FRONT: 15 PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD. sf RIGHT: 5
VALUE: 295,604.20
OCCUPANCY GRP: R3 BDRM: 5 BATH: 3 TOTAL: 3,050 sf REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOILJCMP < 3HP: VENT FANS: 3 CLOTHES DRYER: 1
GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 6 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EAADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amo /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 5,495.28
DON MORISSETTE HOMES DON MORISSETTE HOMES INC This permit is subject to the regulations contained in the
4230 GALEWOOD STE #100 4230 GALEWOOD ST, STE 100
Tigard other r applicable w
Code, State work k w Specialty Codes and
all other applicable l ro v. All work will be done i
LAKE OSWEGO, OR 97035 LAKE OSWEGO, OR 97035 t
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 rules adopted by the
Phone: 503 387 - 3875 Phone: Oregon Utility Notification Center. Those rules are set
S forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
Reg #: Lk- 387 may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Erosion Control lnsp 8 Post/Beam Mechanical Plumb Top Out Exterior Sheathing Insf Gyp Board lnsp Water Service lnsp
Sewer Inspection Underfloor insulation Electrical Service Low Voltage Rain drain Insp Appr /Sdwlk Insp
Footing Insp Crawl Drain /Backwater Electrical Rough In Gas Line Insp Storm drain Insp Electrical Final
Foundation Insp PLM /Underfloor Framing Insp Gas Fireplace Roof Nailing Mechanical Final
Post/Bea • - r • -I Mechanical lnsp Shear Wall Insp Insulation lnsp Water Line Insp Plumb Final
Issued By : ■ : ::.&511111k ' Permittee Signature : c
Call (503)- •39 -4175 by 7:00 p.m. for an inspection needed the next business day
-To �-t-: 7 -)y - 0 3 eiA✓
. u�12 aoa
Building Permit Application
Date received: 7 / 63 Permit no.: !`/5f?a3raf,7
"i'� i City of Tigard �y1 C n C lM D Project/appl. no.: Expire date:
- 4F
CirvojTigard Address: 13125 SW Hall B1
P.l..c...: (503) 639-4171 Date.ssued: , By I Receipt no.:
Fax: (503) 598 -1960 J I IL 1 2003 — Case file no.: Payment type:
Land use approval: CITY OF TIGA > al &2 family: Simple Complex:
• . • • H li1t
Tv ::1F P rrc11 ►r " '"' ' • 'sue - '''''''P. '
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi- family ; 'New construction ❑ Demolition
❑ Addition/alteration/replacement ❑ Tenant improvement ❑ Fire sprinkler /alarm ❑ Other:
JOB SITE INFORMATION
Job address: (, 7 ‘,..21 i` & Bldg. no.: Suite no.:
Lot: �� I Block: Subdivision: w ` \{efe k � I Tax map /tax lot/account no.:
Project name:
Description and location of work on premises/special conditions:
OWNER FOR SPECIAL INFORMATION, USE CHECKLIST
mva; (Floodplain, septic capacity, solar, etc.)
Mailing address: ler t 6i ai a ja 1 & 2 family dwelling:
EMINIM ZIP: '2 . WI Valuation of work $
Phone:. T` ////2 =Allreria , -mail: No. of bedrooms/baths
Owner's re -- , '7tative: k+ r `.. ; - C C Imo Total number of floors
Phone: '? .t: '1: -mail: :<..s' ,:wetting area (sq. ft) —
APPLICANT Garage/m, .c.i ksq. it.)
EMINWIL
& A Covered porch area (sq. ft.)
Mailing address: 'i'Yle y S ce Deck area (sq. ft.)
City: I State: I ZIP: Other structure area (sq. ft.)
Phone: Fax: E -mail: Commercial/industrial /multi - family:
CONTRACTOR Valuation of work $
Existing bldg. area (sq. ft.)
r I g 4i New bldg. area (sq. ft.)
Address: _ &v`i �I
Number of stories
City: State: ZIP:
Phone: I Fax: I E -mail: Type of construction
CCB no.: .j ?j Occupancy group(s): Existing:
New:
City /metro lie. no.:
Notice: All contractors ...bent, :u, , al ... : .;yiaied to be
ARCHITECT /DESIGNER licensed with the Oregon Construction Contractors Board under
11 provisions of ORS 701 and may be required to be licensed in the
Address: G � - �� C - I - -r3N 'w. jurisdiction where work is being performed. If the applicant is
City: State: I ZIP: exempt from licensing, the following reason applies:
Contact person: Plan no.:
Phone: Fax: E -mail:
ENGINEER
Name: Contact person: Fees due upon application $
Address: Date received:
City: (State: (ZIP: Amount received $
Phone: I Fax: (E -mail: Please refer to fee schedule.
I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards, please call jurisdiction for mote information.
attached checklist. A . rovisions of 1 ws and o dinances governing this 0 visa 0 MasterCard
work will be compl - • wi.•, whether ifie�diIerei�t r�tot. Credit card number. / /
J
Authorized si a •z. i Name of cardholder as shown on credit card Expires
$
Print name: •!L ' f t ( ,K_ Cardholder signature Amount
Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4613 (6roWCOM)
One- and Two - Family Dwelling
' ' Permit Application Checklist
1 = :,_y Building Permit Application Checklist
City ofTigard Associated permits:
Ci
City of Tigard ❑ Electrical O Plumbing O Mechanical
Address: 13125 SW Hall Blvd, Tigard, O13 97223 O Other:
Phone: (503) 639 -4171
Fax: (503) 598 -1960
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews.
2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc.
3 Verification of approved plat/lot.
4 Fire district approval required.
5 Septic system permit or authorization for remodel. Existing system capacity
6 Sewer permit.
7 Water district approval. )(
8 Soils report. Must carry original applicable stamp and signature on file or with application.
9 Erosion control CI plan ❑ permit required. Include drainage -way protection, silt fence design and location of , f
catch -basin protection, etc. J�
10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full -size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed t/
if copyright violations exist. J�
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if
there is more than a 4-ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements and
driveway; footprint of structure (including decks); location of wells/septic systems; utility locations; direction indicator, lot x
area; building coverage area; percentage of coverage; impervious area existing structures on site; and surface drainage.
12 Foundation plan. Show dimensions, anchor bolts, any hold -downs and reinforcing pads, connection details, vent
size and location. ,}(\
13 Floor plans. Show all dimensions, room identification, window size, location of smoke detectors, water heater,
furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc.
14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub -floor,
wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show
details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs,
fireplace construction, thermal insulation, etc.
15 Elevation views. Provide elevations for new construction; minimum of two elevations for additions and remodels.
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full -size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing (prescriptive path) and/or lateral analysis plans. Must indicate details and locations; for
non - prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor /roof framing. Provide plans for all floors/roof assemblies, indicating member sizing, spacing, and bearing
locations. Show attic ventilation. ' X \
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered
systems, see item 22, "Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists
over 10 feet long and/or any beam/joist 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 be stamped by an engineer or
architect licensed in Oregon and shall be shown to be applicable to the project under review.
JURISDICTIONAL SPECIFICS
23 Five (5) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". k
24 Two (2) sets each are required for Items 16, 19, 20 & 22 above.
25 Building plans shall not contain red lines or tape -ons.
26 No rolled, reversed or mirrored building plans will be accepted.
27
28 •
Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may be in blue or black ink.
Red ink is reserved for department use only. 440-4614 (6l00/COM)
Mechanical Permit Application
4
Date received: 7/, //3 Permit no.: tir OD, 7
�`"` 41 City of Tigard �I,j, •: _. ty g Projtxt/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639 Date issued: By: I Receipt no.: _
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT .
CI 1 & 2 family dwelling or accessory CI Commercial/industrial ❑ Multi - family CI Tenant improvement •
,few construction CI Addition/alteration /replacement ❑ Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
. Job address: I ?y C3 ,C - - PC Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ .
Lot: C ,D - JBlock: 'Subdivision: V, A.^, 'See checklist for important application information and
Project name: WA A jurisdiction's fee schedule for residential permit fee.
City/county: 1 ZIP: I & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: AND COMMERICAL/INDUSTRIAL EQUIPMENTSCHEDULE
Fee(ea.) Total
Est. date of completion /inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: Ii r handling •
Is existing space heated or conditioned? ❑ Yes ❑ No
Air rcondit unit CFM
g P Air conditioning (site plan required)
Is existing space insulated? O Yes CI No _ Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
State boiler permit no.:
Business name: 14 /,I / _ HP Tons BTU/H
Address:M Fire/smoke dampers/duct smoke detectors
ENUK4. Li State• - ZIP: - Heat pump (site plan required)
Install/replace furnace /burner BTU /H
Phone:,A0 _ 'Fax: E -mail: Including ductwork/vent liner ❑ Yes ❑ No
CCB no.: '?jr9�(°) Instail/replace relocateheaters- suspended,
City/metro lic. no.: N/A wall, or floor mounted
(please print): 1,17 1 Ve for appliance o ther than furnace
Name lease riot : N.�� lianc —
CONTACT PERSON Refrigeration:
Absorption units BTU/H
Name: 0 E - L Chillers HP
Compressors HP
Address:
- &a`_ 1 4. (' 4j Environmental exhaust and ventilation:
i City: State: ZIP: Appliance vent
Phone: Fax: - 1E-mail: Dryer exhaust ,
OWNER ��; N F R Hoods, Type U II/res. kitchen/hazmat
hood fire suppression system
1 221k1 .in ivitwa Exhaust fan with single duct (bath fans) .
Mailing address: 74/Ziri / �'.�ar��rll Exhaust system apart from heating or AC
��
.� Fuel piping and distribut (up to 4 outlets)
�r•��� Type: LPG NG Oil
Phone: • 2��i Fax: E - mail: Fuel piping each additional over 4 outlets ,
ENGINEER Process piping (schematic required) —
Name:
Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace .
City: I State: [ZIP: Insert - type
Woodstove/pellet stove
Phone: / Fax: E - mail: — -
g 1�' 1IT Other 1.11 Applicant's si Haver Date:
Name (print): , * . . f
T
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ _
Not Th permit application Minimum fee $
❑ Visa 0 MasterCard expires if a permit is not obtained
Credit card number: / / Plan review (at %) $ •
Expires within 180 days after it has been State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete.
$ TOTAL $
Cardholder signature Amount 4404617 (6430lCOM)
Plumbing Permit Application
Datereceived: / D 3 Permit no.: d r . 6._
oe
�_ _'' ;• Tigard Building _� �'+►�1� City of Tigar Sewer pe rmit no S Pin it no.:
ct"� Address: 13125 SW Hall Blvd. Tigard, OR 97223 Expire City ojTigar d Phone: (503) 639 -4171
Fax: (503) 598 -1960 Date issued: By: I Receipt no.:
Land use approval: Case file no.: Payment type:
TYPE OF PERMIT
0 I & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
•: New construction 0 Addition/alteration/replacement 0 Food service 0 Other.
JOB SITE INFORMATION FEE SCHEDULE (for special information use checklist)
Job address: W I a Description Qty. Fee (ea.) Total
New 1- and 2- family dwellings only:
Bldg. no.: Suite no.: (includes 100 ft. for each utility connection)
Tax map /tax lot/account no.: SFR (1) bath
Lot: 'VIM Block: Subdivision: nita 7 SFR (2) bath I__ �� Project name: L t. " SFR (3) bath
City /county: ZIP: Each additional bath/kitchen
Description and location of work on premises: Site utilities:
Catch basin/area drain Est. date of completion/iinspection: Drywels/leach line/trench drain
Footing drain (no. lin. ft.) I'LL (RING CON I It CTOR Manufactured home utilities Business name: ...jp L i Manholes EMI
Address: R 2 • Rain drain connector IIIIII
ZIP: Sanitary sewer (no. ln. ft) hone: torm sewer (no. tin. ft) Mill
—
y �.�� Fax: E-mail: E mai: _ n Water service (no. lin. ft.
CCB no.: I a — 1 L P lumb. bus. reg. no: - s Fixture or item:
City/metro tic. no.: NSA �// Absorption valve
Contractors representative signature ......../ „..--------\ •�(.� —.dr Back flow preventer
— Print name: , • r , 1 ua
• . Backwater valve
CON•I - AC t' PERSON Basins/lavatory IIIIII=
Clothes washer
Name:- (� E Dishwasher
Address: aak 1 go f , .N Drinking fountains)
City: State: Ejectors/sump
Phone: F Fax: Expansion tank
OWNER Fixture/sewer cap Mil-
Floor drains/floor sinks/hub
Name (print): :�i� t '�^ Garbage disposal
Mailing address: ea `b Hose bibb a
City: . ' IM: �'M rle��il Ice maker _
Phone: "7 -'�- I Fax: 57 , E -mail: Interceptor /grease trap ,
Owner installation/residential maintenance only: The actual installation Primeri's)
will be made by me or the maintenance and repair made by my regular Roof drain (commercial)
employee on the property I own as per ORS Chapter 447. Sink(s), basin(s), lays(s) _
Owner's signature: Date: Sump _—
ENGINEER Tubs/shower /shower pan
Urinal
Name: Water closet
Address: Water heater
City: State: ZIP: Other. _
Phone: Fax: E -mail: Total
Minimum fee $
Notice: This permit application
Not all hunsdicu,u o accept credit cards, please call )unsdicuon for information. morinformation. Thii $
Plan review (at _ %)
C Visa ❑ MasterCard / / expires if a pe mit is not obtained State surcharge (8 %) • . $
C.edit card nu mber. _ w ithin 1 80 d ays after it has been $
Expires accepted as complete. TOTAL •..-- --
Name of cardholder as shown oo credit cant
_ S
Cardholder signature Amount 440 -4616 (6. »COM)
Electrical Permit Application
Date received: / / o3 Permit no.:Ho r � i 9
-�'�.}' 411 City of Tigard Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: By:- I Receiptno.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
. ,. TYPE OF PERMIT
0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
L New construction 0 Addition/alteration/replacement 0 Other. 0 Partial
JOB SITE INFORMATION
Job address: - C J T� � Bldg. no.: Suite no.: Tax map /tax lot/account no.:
Lot: a Block: Subdivision: n
Project name: I Description and location of work on premises:
Estimated date of completion/inspection:
CON I RAc i OR :AI'I'l.lc :A 1 ION FEE SCHEDULE
Job no: ; % ir Fee Max
Business name: .. ‘ Description Qty. (ea.) Total no. insp
_ `/ �� New residential -single or multi- family per
Address: TIrl _ �_ ��` .. dwelling unit Includes attached garage.
-, . eA ZIP: • Semi« included
Phone: a . ...3 - l jJ Fax: E -mail: 1000 sq. ft. or less 4
Each additional 500 sq. f . or portion thereof
CCB no.: Elec. bus. lic. no: i Limited energy, residential 2
C' Limited energy, non- residential 2
Each manufactured home or modular dwelling
, nature ojsupervtsing eledrician (required) Date /
Service and/or feeder 2
9 a`
��p License no -1 Services -. installation,
Sup. elect. name (print) .....a 1 r F— _ Ahn I alteration or relocation:
PROPERTY OWNER 200 amps or less 2
►_.t r 201 amps to 400 amps 2
Name (print): � II etat 2
�� 401 amps to 600 amps
Mailing address: �. ear _ i � \ t it � I 601 amps to 1000 amps 2
City: .a, State Ilr ZIP: ?Q Over 1000 amps or volts 2
Phone: ,/7 -h Fax: - - x, -mail: Reconnect only 1 ,
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation:
200 amps or less 2
ORS 447, 455, 479, 670, 7 01. 201 amps to 400 amps 2
Owner's signature: Date: 401 to 600 amps 2
... N:: FN6INEER a Branch circuits - new, alteration,
or extension per panel:
Name: A Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: f State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E-mail: .
Each additional branch circuit:
PLAN REVIEW (Please check all that apply) Misc. (Service or feeder not included):
0 Service over 225 amps-commercial ❑ Health-care facility Each pump or irrigation circle 2
0 Service over 320 amps - rating of 1842 ❑ Hazardous location Each signor outline lighting 2
family dwellings ❑ Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
❑ System over 600 volts nominal more residential units in one structure alteration, or extension* 2
❑ Building over three stories ❑ Feeders, 400 amps or more *Description:
0 Occupant load over 99 persons ❑ Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
❑ Egress/lighting plan ❑ Other. Per inspection I I I I
Submit _ sets of plans with any of the above. Investigation fee .
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Notice: This permit application Permit fee $
❑ Visa ❑ MasterCard expires if a permit is not obtained Plan review (at _ %) $
Credit card numbs: / / within 180 days after it has been State surcharge (8%) .... $
Expires accepted as complete. TOTAL $
Name of cardholder as shown on credit card
$
Cardholder signature Amount 4404615 (6603/COM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST 3 00 7
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested ! c - AM PM BUP
Location / 3 5 /-1 5 / AV'e— Suite / / MEC
Contact Person Ph ( ) „2e 7 - ` a37 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
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:
ART FAIL
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Ott ',C
PASS' PART FAIL
1dF�CH ANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
PASS PART FAIL
- 1S3.y i AL _
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
''ASS PART FAIL
Please call for reinspection RE: I I Unable to inspect — no access
Fire Supply Line
ADA /O /? q/ �
Approach /Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL