Permit . PLUMBING PERMIT
� CITY OF TIGA 11P
Ik DEVELOPMENT SERVIC `11A� PERMIT #: PLM1999 -00375
r � l II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 02/09/2000
SITE ADDRESS: 13939 SW PACIFIC HY ""' PARCEL: 2S103DD -01000
W
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: COM WASHING MACH: BACKFLOW PREVNTRS: 3
OCCUPANCY GRP: FLOOR DRAINS: 8 TRAPS:
STORIES: WATER HEATERS: 3 CATCH BASINS:
FIXTURES LAUNDRY TRAYS: 1 SF RAIN DRAINS:
SINKS: 3 URINALS: 1 GREASE TRAPS:
LAVATORIES: 3 OTHER FIXTURES: 6
TUB /SHOWERS: SEWER LINE: 100 ft
WATER CLOSETS: 3 WATER LINE: 300 ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Plumbing for a new Walgreens. SWR1999 -00242
FEES
Owner:
Type By Date Amount Receipt
VILLAGE PROPERTIES PRMT DST 02/09/200C $526.00 00- 321652
562 MISSION STREET PLCK DST 02/09/200C $131.50 00- 321652
SUITE 201
SAN FRANCISCO, CA 94105 5PCT DST 02/09/200C $42.08 00- 321652
Phone 1: 415 - 546 -9373 Total $699.58
Contractor:
EAGLE PLUMBING
13801 S FORSYTHE RD
OREGON CITY, OR 97008 REQUIRED INSPECTIONS
Phone 1: 503 - 650 -8703 Sewer Inspection
Water Service Insp
Reg #: LIC 47914
P Top -out Insp
LM 3 -154PB
Storm Drain Insp
Crawl Drain
Rain Drain Insp
RP /Backflow Preventer
RP /Backflow Preventer
Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952 - 0001 -0010 through OAR 952 - 0001 -0080.
You y o Iopies of these rules or direct questions to OUNC by calling (503) 246 -1987.
Is ed By: l , 4,1 , i • Permittee Signature:y
Call (503) . 9-4175 by 7:00 P.M. for an inspection needed the next business day
CITY OF TIGARD Plumbing Permit Application Plan Check : ADC
13125 SW HALL BLVD. Commercial and Residential Rec'd By :*7
TIGARD, OR 97223 Date Rec'd I -' kf '
(503) 639 -4171 Date to P.E. I" f f
Print or Type Date to DST
Incomplete or illegible applications will not be accepted R s WR 09 fry 0R '2
Related f - ex , R
Called
Name of Development/Project FIXTURES (individual) QTY PRICE AMT
Job tiMCOGgralSd Sink 3 11.50 3■ I/
Address Street Address Suite Lavatory ® , 11.50 3y q` I/
131 31 s..r A 4 : . , , c t " ? Tub or Tub /Shower Comb. 11.50
Bldg # C i ty/State Zip Shower Only 11.50
Name
t 4.10 -0 Water Closet/Urinal (Specify) am ' 11.50 3y 5Ci i/
V 11 -4Acto C Q4.�Pe0. -TICS Dishwasher 11.50
Owner Mailing Address Suite Urinal 1 11.50 )f 5/ l /
St.2 IA. AOA64 ST ZA t Garbage Disposal 11.50
City/State Zip Phone
Laundry Tray M04 3.►l,� 1 11.50 if y 1 - . A
f+l fitdw CAt..F 9 9l i 511, 4373
Name Washing Machine /Laundry Tray (Specify) 11.50
• W AL-t. st ell4 cowpt404 Y Floor Drain/Floor Sink 2" 7 11.50 gds
Occupant Mailing Address Suite 3° -- ll 11.50 v'
��O y
200 1N It_woi d. 4" 11.50
City/State Zip Phone •
ocea.F104) t tx Gco IS 647 _ 4 i N ' b34 a Water Heater 0 conversion 0 like kind 11.50 �/ 76
Name Gas piping requires a separate mechanical p �/�
MFG Home New Water Service 28.00
C aL PLAIA4AmX' MFG Home New San/Storm Sewer 28.00
Contractor Mailing Address Suite
1.3 Sot 3 i�tSQ 114t' R O Hose Bibs 5 11.50 5 Z5
Prior to permit City/State Zip Phone Roof Drains •Y 11.50
issuance, a copy flfl et tY Ott_ 9 70`ii (5"o - 8 703 g // I/
Drinkin Fountain 11.50
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date
required if 9 ?91 y q - L3 _ V t Other Fixtures (Specify) 15.00
expired in COT 1 Plumbing Lic. # Exp. Date
datah2-7 3 -15 P8 _ 9 -30 -oe
Name
Architect T A t-k
KO &C ere GTv Sewer- 1st 100' I 38.00 --
or Maiiing Address Suite Sewer - each additional 100' 32.00
SUL Hh , St'0.9 Sr 203 Water Service - 1st 100' i 38.00
Engineer City/State Zip Phone
JAN FAA CA 9 t t DS its -sic. - 13 7J Water Service each additional 200' I 32.00 5
Describe work to be done: Storm & Rain Drain - 1st 100' 38.00
New R Repair 0 Replace with like kind: Yes 0 No 0 Storm & Rain Drain - each additional 100' 32.00
Residential 0 Commercial Si j Commercial Back Flow Prevention Device /3 3 9G . -
Additional description of work:
• Residential Backflow Prevention Device' 19.00
Catch Basin 11.50
Are you capping, moving or replacing any fixtures? Insp. of Existing Plumbing or Specially Requested 50.00
Yes fit No 0 Inspections per/hr
If yes, see back of form to indicate work performed by Rain Drain, single family dwelling 45.00
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50
•
WORK COULD RESULT IN INCREASED SEWER FEES. QUANTITY TOTAL
•
I hereby acknowledge that I have read this application, that the information Isometric or riser diagram is required if Quantity Total is > 9
given is correct, that I am the owner or authorized agent of the owner, and *SUBTOTAL that plans submitted are in compliance with Oregon State Laws. 5( 7,----
Signature of Owner /Agent Date
C--. C._._ I I- 7 59 SURCHARGE �� 4. .
Contact Person !p me 0 Phone
CskAA_ L4' 6Y WO **PLAN REVIEW 25% OF SUBTOTAL /3/ 5°
1 BATH HOUSE $178.00 Required only if fixture qty. total is > 9
2 BATH HOUSE $250.00 TOTAL Y+� � 0
3 BATH HOUSE $285.00 - - Y
(This fee includes all plumbing fixtures in the dwelling and the first *Minimum permit fee is $50 + 7% surcharge, except Residential Backflow Prevention
_100 feet of sanitary, sewer storm sewer and water service) Device, which is $25 + 7% surcharge
All New Commercial Buildings require plans with isometric or riser diagram and
plan review.
I:tdstsVorms'plumapp.doc 9/20/99 - - -
- I
/35 5. Phc4 r —rc :y
/3933 -3 ) Qom -.r tc,
PLEASE COMPLETE:
Fixture Type Quantity by Work Performed
New Moved I Replaced Removed /Capped
1
Sink
Lavatory
Tub or Tub /Shower Combination
Shower Only
Water Closet 7
Dishwasher cow• otu
Urinal
Garbage Disposal TD t-k4;
Laundry Room Tray —
Washing Machine
Floor Drain /Floor Sink 2" ► o
3"
4"
Water Heater z.
Other Fixtures (Specify)
•
COMMENTS REGARDING ABOVE:
•
I:tdststformstplumapp.doc 9/20/99 — -,
O Accumulative Sewer Tally
•
Tenant Name: arc - io4 /C1f r.b-r'r This SWR# •
Address: ,s Sv.! ?ecsFix-A y This PLM#: .
- Fixture Value Previous Previous . Credits . Capped Fixtures Fixtures New total New
• # • . Value Capped off value added # added #s ` total
Count off #s count value values
•
Baptistry/Font 4 .
Bath - Tub/Shower 4 • • • • '
- Jacuzzi/1Nhirlpool 4 • • • . •
Car Wash Each Stall . 6 '
- - Drive Through 16 . •
•
Cuspidor/Water Aspirator 1 .
Dishwasher - Commercial 4 I zi •
- Domestic - 2 • •
Drinking Fountain 1 1 /
Eye Wash " 1 '
. Floor Drain/sink - 2 inch 2 ID • AO ,
3 inch 5 • • •
- 4 inch 6 •w •
- Car Wash Dm 6 •
Garbage Disposal 16 • .
- Domestic (to 3/4 HP)
- Commercial (to 5 HP) 32 3 9 6
•
- Industrial (over 5 HP) 48 •
Ice Machine/Refrigerator Drains 1 I - . I .
Oil Sep (Gas Station) 6 .
Rec. Vehicle Dump Station 16
Shower - Gang (Per Head) 1
- Stall 2 • • .
Sink - Bar/Lavatory • 2 3 4/ • •
- Bradley 5 -
- Commercial 3 J5..
-
- Service - • .3 .
Swimming Pool Filter 1 -
Washer - Clothes • 6 •
Water Extractor : 6
Water Closet - Toilet • 6 T „V • •
Urinal 6 -I - fp
•
TOTALS ! V .
Total fixture values: divided by 16 = • EDU
HISTORY •
PLM# EDU# • SWR# ' PLM# - EDU# SWR#
PLM# EDU# SWR# PLM# . EDU# • SWR#
. PLM# EDU# .• SWR# PLM# • EDU# SWR# •
PLM# EDU# SWR# PLM# EDU# . SWR#
i:'asrslswrtaly.doc
C--9■— . •
�6�4 C►4e,c +t.�5. —
D
, .
1.4 ) ,14 P.; '
• Accumulative Sewer Tally C)
T
•
enant Name: eykeSSTS� ' riAIRiatEC This SWR#
Address w1 TS This PLM#: -
Fixture - • Value Previous Previous Credits Capped Fixtures Fixtures New total New
• # Value Capped off value added # added - #s total
Count off #s count value values
• Baptistry/Font 4 -
Bath - Tub/Shower 4 -
- Jacuzzi/Whirlpool 4
Car Wash - Each Stall 6
. - Drive.Through 16 `
CuspidorNVater Aspirator • 1 -
Dishwasher.- Commercial 4 .
- Domestic • • 2 - •
Drinking Fountain 1 1 -, - • .
Eye Wash 1 - •
Floor Drain/sink - 2 inch 2
- 3inch. 5 •
• -4inch 6 • `*
- Car Wash Dm 6 •
Garbage Disposal 16
- Domestic (to 3/4 HP) •
- Commercial (to 5 HP) 32
- Industrial (over 5 HP) - 4$ - -
Ice Machine/Refrigerator Drains 1 -
Oil Sep (Gas Station) 6 •
Rec. Vehicle Dump Station 16
Shower - Gang (Per Head) 1
- Stall 2 -
Sink - Bar/Lavatory 2 / C) -
• - Bradley 5 '
- Commercial 3
- Service 3
•
Swimming Pool Filter 1
Washer - Clothes .6 • • •
Water Extractor 6
Water Closet - Toilet 6 3 V •
•
Urinal - 6
TOTALS , Aq -
Total fixture values: divided by 16 = EDU
HISTORY •
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# • EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# SWR#
PLM# EDU# SWR# PLM# EDU# - SWR#
• t 4sts\swrtay.doc
5'
c.
REQUIREMENTS. ALL RELKCNC.CV c.v1..0E-.2 rM - .. - • • - --
ADOPTED BY THE STATE. IF ANY CODE LISTED 15 OUT OF DATE, THE MOST
REGENT ADDITION WILL SUPERSEDE.
...__._.".__
PROJECT DIRECTORY L I
VILLAGE PROPERTIES MECHANICAL i MACDONALD MILLER CO. INC.
562 Mission Street, Suite 201
OWNER: 1111 Detroit Avenue S.W. ae San Francisco, CA 44105 ENGINEER: Seattle, WA 48106-1403
Tel: (415) 546 -4313 Tel: (206) 163-4400
Fax: (415) 546 -0564 Fax: (206) 161 -6Ti3
Jim Helfrich Carol Uchneot
TENANT: WAL6REEN COMPANY LANDSCAPE MACDONALD ENVIRONMENTAL
200 Wilmot Rood ARCHITECT: PLANNING
DeerPbld, IL 60015 510 NJN. Third Avenue, Suite 101
Tel: (841) 414 -2342 Portland, OR 41204
Fax: (841) 414 -3400 Tel: (503) 224 -1225
Leslye Winslow, Protect Architect Fax: (503) 245 -6406
Laurel Macdonald - Sorrell
ARCHITECT: -IMP A RCHITECTURE PROJECT DESIGN CONSULTANTS
Af 562 Mission Street, Suite 203 CIVIL PROJECT
Skyline Blvd. Suite 224
San Francisco, Ca 44105 EN&INEER: Portland, a Bl vd .
Tel: (415) 546 -4313 Tel: (503) 246 -6100
3r1 Fax: (415) 405 -5514 Fax: (503) 246-6200
if m
y Brandy Yaoroto , Project Manager Dick 6rave, P.E.
' BERRY- NOROLIN6 ENGINEERS, INC.
STRUCTURAL PBS ENVIRONMENTAL
order' ENGINEER: 3601 nd, Corbett Avenue E SOILS
N iGi: 1220 5W Morrison Street Suite 600
Tel:
Portland, 2 2 41201
21 --T111 83 Portland, OR 41205
( (50 Tel: (503) 248-1439
Fax: (503) 221-1184 Fax: (503) 248 -0223
e Bill Berry, SE.
o Garrett Koster
on oP ELECTRICAL CeMAI•IONY $ MYER
ENGINEER: 4340 Redwood H1glway, Suite 245 CONTRACTOR YORKE $ CURTIS
Son Rafael, GA 44 10125 5W Beaverton HI
'r Ti: e (415) 442 -0420 Beaverton, OR 4/005 -es. Fax: (415) 414 -4662 Tel: (503) 646-2123
,Janette Kushner Fox: (503) 645 -5531
Dave Curtis
TESTING i To be determined
SPECIAL
INSPECTION
10 I
A In 5 R6<a. i3 �'t3 S w a cc. y
a Ideas,
' ever
ever VICINIT Y MAP
GTURE.
al and
•
5W GARDEN 0� •
PARK PL.
ved as a
F oundation W / I .
,,
:or. Q I
I ItIon ~ O Q
vi
07/11/2000 Activities for Case #: PLM1999 -00375
2:14:02 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
PLMC008 Plans Approved /Routed to DST 11/29/1999 11/29/1999 11/29/1999 MS SENT No Hold MRS 11/29/1999 received only one set of plans
PLMC120 Plumbing Undersl 11/29/1999 11/29/1999 02/11/2000 MRS PASS No Hold AKJ 02/13/2000 foam around penetrations
PLMC705 Sewer Inspection 11/29/1999 11/29/1999 No Hold HAP 07/05/2000 See sewer PART inspection
1/6/00 by MRS hap
PLMC711 Water Service Insp 11/29/1999 11/29/1999 03/02/2000 TLP PASS No Hold AKJ 03/02/2000
PLMC725 Top -out Insp 11/29/1999 11/29/1999 04/19/2000 TLP PASS No Hold AKJ 04/19/2000
PLMC734 Crawl Drain 11/29/1999 MRS No Hold • MRS 11/29/1999
PLMC735 Rain Drain Insp 11/29/1999 11/29/1999 06/27/2000 MRS PASS No Hold MRS 06/27/2000
i
PLMC750 RP /Backflow Preventer 11/29/1999 11/29/1999 06/27/2000 MRS PASS No Hold MRS 06/27/2000 •
PLMC799 Final Inspection 11/29/1999 11/29/1999 06/23/2000 MRS FAIL No Hold MRS 06/23/2000 need contractor to walk thru
PLMC003 Application received 11/09/1999 BON RECD No Hold GEO 11/18/1999
PLMC005 Permit Created 11/16/1999 GEO DONE No Hold GEO 11/18/1999
PLMC007 Plans routed to Plans Examiner 11/16/1999 GEO SENT No Hold GEO 11/18/1999
PLMCO20 Hold for 12/14/1999 GEO HOLD No Hold GEO 12/14/1999 Hold pending issuance of SIT
and BUP permits.
PLMC015 DST Post Review Complete 01/11/2000 DEB DONE No Hold DEB 01/11/2000
PLMCO34 Hold Release to Ready Status 01/11/2000 DEB DONE No Hold DEB 01/11/2000 Okay to release all permits per
PLN & ENG, SIT has already
been issued. There are still 9
EDU credits from the demo, so
no sewer assessment fee.
PLMCO50 (F) Issue permit 02/09/2000 DEB DONE No Hold DST 02/09/2000
PLMC799 Final Inspection 06/27/2000 MRS PASS No Hold MRS 06/27/2000
PLMC800 Case Finaled 07/05/2000 HAP DONE No Hold HAP 07/05/2000 •
Pagel oft
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 3/2 0 AM PM BLD
Location I 3 31 PaC Suite MEC n
Contact Person 0x O � vt Ph CQSD - 0 .3 PLM [ q'1 - c37 S
Contractor rte; /�, � Ph SWR
BUILDING Tenant/Owne tiJ I V� e ' v� ! ELC
Retaining Wall ✓ ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
4:PLUMBINQ
Post 4 Beam
Under Slab
Top Out
Sanitary Sewer
Rain Drains
'nal
PART FAIL
111M4ICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date Inspector Ext
Other
Final
PASS PART FAIL DO N REMOVE this inspe ion record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested d? /� 1 rn AM PM BLD
Location I � 9 � 9 rA, '�'f( q Suite MEC
Contact Person 91 0 Ph tPSn r7 PLM /' ' 1 XD T 7S
Contractor Ph SWR
BUILDING Tenant/OwnerC j I t 7 ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall , -
Fire Sprinkler _ Il�� ALL �L� iiil _ / /LW,1 1 1 �
Fire Alarm /
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
ctLUMBI
Post &Beam
nder Sla
Top ut
Water Service
Sanitary Sewer
Rain Drains
Final
_ PART FAIL
`IT
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Othe�ach /Sidewalk Date Inspector 9re Ex
Final
PASS PART FAIL DO NO REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested d1/1 I/ AM PM BLD
Location 9 31 Pot-e Suit e MEC
Contact Person alL2.-- Ph ( " SD —C C1O3 PLM iggq "rib 3?
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
I�CUMBING )
Post & Beam
Under Slab
op 0
er Service
Sanitary Sewer
Rain Drains
Fi A%
PART FAIL
M? • NICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk D ate (�0 •
Other 1 W Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
1
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
�
BUP
Date Requested 3-7(3 / (3 AM PM /1 / BLD
Location I ' I i r a • Suite MEC
Contact Person 1 Ph COS - 7O 3 PLM - r D
Contractor Ph SWR
BUILDING Tenant/Owner
(.4) i ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
R.•1 Drains
• AS - PART FAIL
CHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Dat / • Inspector Ext�
Final
PASS PART FAIL ' 0 NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested ID( ?;3/ AM PM _ <" BLD
Location 1 J Pot( ).J 1 Suite MEC
Contact Person 40,g U Ph CO S " $"703 PLM / 99q Oo 37S
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling _ _ yy`� �! j
Roof /'
Misc:
Final
PASS PART FAIL
Under Slab
Top Out
Water Service
Sanitary Sewer
R._D rains
• S PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
•
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA ^h�/
Approach /Sidewalk Date I) Inspector 4r/A Ext c�
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.