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Permit CITY OF TIGARD DEVELOPMENT SERVICES MASTER PERMIT PERMIT #: MST2004 -00064 4 At DATE ISSUED: 3/4/2004 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S111AA - 00200 SITE ADDRESS: 14075 SW HALL BLVD ZONING: R -4.5 SUBDIVISION: EDGEWOOD LOT: JURISDICTION: TIG Project Description: 48' x 40' shop attached with breezeway.9 /18/06: PERMIT REINSTATED FOR PURPOSE OF FINAL INSPECTION FOR 30 DAYS. (BLDG /ELC) BUILDING REISSUE: CUSTOM STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ACS HEIGHT: 13 FIRST: sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: N TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: 1,520 sf FRONT: 20 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5 VALUE: OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf 46,656.00 REAR: 15 PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 2 0 - 200 amp: 0 W /SVC OR FDR: 5 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 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: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVC/FDR: 601 . 1000 amp: 601*amps-1000v: MINOR LABEL: 1000+ amp/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: LANDSCAPEARRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL A SYSTEMS: This permit is subject to the regulations contained in the Tigard Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other DANIEL L. BOZICHS OWNER applicable laws. All work will be done in accordance with approved 14075 SW HALL BLVD plans. This permit will expire if work is not started within 180 days TIGARD, OR 97224 of issuance, or if the 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 - 001 -0010 through 952- 001 -0080. You may obtain copies Phone: 503 - 643 - 6390 Contact #: of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344. Reg #: TOTAL FEES: $ 1,271.15 REQUIRED ITEMS AND REPORTS Issued By : r/,,.( Permittee Signatu .�, ..A4 _, Call 503 - 639 -4175 by 7:00 a.m. for an inspecti , n that busines ■ ay. This permit card shall be kept in a conspicuous place on the ob site until co ,_ pletion of the project. Approved plans are required on the job site at the time of each inspection. III CITY OF TIGARD 9/18;-2006 _ 13125 SW Hall Blvd. C ase Activity Listing 12:59:42PM Tigard, OR 97223 (503) 639 -4171 Case #: MST2004 -00064 TIGARD s : a m xs ty , w.,;Code .... Des troq . � ... . , .....Date l ,,.,.,....... � D.ate,2. Date 3� , Hold � Des By By Notes.., �� i ...�� <p :.... ,,.. ..�, .., . ......� ,�...� ......... ........ ..�. ..... ... gyp:,.,., :..,. ,., � -- . .�. ..,............... .... _ .. . .. A080 (F) Ready to issue 3/3/2004 None DONE DEB 3/3/2004 Have owner sign Owner Responsibility Form DEB A092 (F) Issue combination 3/4/2004 None DONE DEB 3/4/2004 permit BLD Al25 PERMIT EXTENSION 9/14/2004 None EXTN HAP 9/14/2004 Per phonecon with owner Daniel Bozich permit extended REQUEST Hpp until March 3, 2005 A700 Ersn Cntrl 681 -4444 None 2/26/2004 MAV f / Footing Insp 10/4/2004 None PASS KBS 10/4/2004 #-l- post holes for pole building. KBS '�I Electrical Service r ���/� L ill No 2 /2 6/2004 MAV i raming Insp None 2/26/2004 MAV t r Exterior Sheathing Insp None 2/26/2004 i MAV I ' I 1 Electrical Final None 2/26/2004 MAV - �r'I• Building Final None 2/26/2004 MAV Page 2 of 2 CaseActivity..rpt CITY OF TIGARD 9/18'2006 1 111 _ ° 13125 SW Hall B lvd. Case Activity Listing Tigard, OR 97223 (503) 639 -4171 Case #: MST2004 -00064 12:59:42FM TIGARD .. _V .. _.. . .. : _ one ated:... , , �. . Code Descri tron. :. ., . e 1 :.:: • .Dat ....Date`12 Date 3 . . . r. . ... Hold Dts - , :,.. : . ° : :.. BY . Notes .. , - • ;: - ;•:;;. .;;�.�... , w 1470 Return to "I" status 9/18/2006 None DONE DER 9/18/2006 BLD 1520 Mail expiration notice 10/10/2005 None DONE JMT 9/1/2005 $125 got bld/elc DON'T CHARGE FOR RAIN DRAINS JMT BUT INSPECT THEM 1530 Permit expired by 8/22/2005 None RB 8/22/2005 limitation RB 1730 Case update (see note) 1/10/2006 None DONE DEB 9/18/2006 Owner, Dan Bozich, wanted to reinstate permit but he is BLD more than 30 days out from being ready for final. Per Hap, ok for Dan to wait to reinstate. When he is ready reinstate for $125.00 (BLD /ELC). Per Paul I, ENG, ok for owner to daylight storm drain to ditch in front. No PFI. / / /Plumbing (rain drains) has been separately permitted. 9 /18 /06...hap / /// A005 Application received 2/18/2004 None DONE DEB 2/25/2004 DEB A008 Permit Created 2/18/2004 None DONE DEB 2/25/2004 DEB A010 Check for prcl. restrict. 2/18/2004 None DONE DEB 2/25/2004 DEB A012 Plans routed to Plans 2/18/2004 None DONE DEB 2/25/2004 Examiner DEB A026 Plans checked/approved 3/1/2004 None DONE MAV 3/1/2004 by PE MAV A030 Reviewed plans routed to 3/1/2004 None DONE MAV 3/1/2004 PT MAV A032 Post - review completed 3/3/2004 None DONE DEB 3/3/2004 DEB A035 ELC signature on 3/3/2004 None DONE DEB 3/3/2004 Owner application DEB Page 1 of 2 CaseActivity..rpt ,, C ITY /1,) ___ a v____ 69 ::;. O F TIGARD PERMIT #: MST2004 -00064 4 DEVELOPMENT SERVICES DATE ISSUED: 3/4/04 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 14075 SW HALL BLVD PARCEL: 2S111AA - 00200 SUBDIVISION: EDGEWOOD ZONING: R -4.5 BLOCK: LOT: JURISDICTION: TIG REMARKS: 48' x 40' shop attached to existing house with breezeway. BUILDING REISSUE: CUSTOM �y STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: c HEIGHT: 13 FIRST: sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: N TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: 1.920 sf FRONT: 20 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 THan: sf RIGHT: 5 VALUE: 46 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR: 15 PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN <100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 2 0 - 200 amp: 0 W /SVC OR FDR: 00 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 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+ amp /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: $ 1,146.15 DANIEL L. BOZICHS OWNER This permit is subject to the regulations contained in the DAN DAN E Tigard Municipal Code, State of OR. Specialty Codes and 9860 SW HEATHER H ER LAN LAN E 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 the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: 503 643 - 6390 Phone: Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You Reg #: may obtain copies of these rules or direct questions to • OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Ersn Cntrl 681 -4444 Electrical Final • Footing lnsp Building Final Electrical Service . Framing lnsp Exteri• - - _ ' . • F II . sued By : ' ,.! . , _ � I e , , ,,__! � , • Permittee Signature _ / ... .,"/ _ _ wl Call (503) 639 -4175 by 7:00 p.m. for an inspection n- • • ed the next b , siness'i d I Permit #: \+a-T-9QpLI -- D006 Address: 14 076 44113• NA Issued by: . 9fritt --- Date: 3/ y/O Statement: Information Notice to Property Owners • About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: 1. I own, reside in, or will reside in the completed structure. 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale �� before or upon completion. 3A. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structurezmust be registered with the Construction Contractors Board. OR / 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. (S • s licant) (Date) (White copy to issuing agency permit file, pink copy to applicant) Rnformaltion Notice to Property Owners Abort Construction ResponsibiDit es Note: This .Information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS' 701.055(5). If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYER RESPONSIBILITIES: If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvement ofa residential structure, you will, in most instances, be ruled to be an employer and the people you hire will be employees. As the employer, you must comply with the followin Oregon's withholding tax law: As an employer, you must withhold income taxes from employee wages at thetime employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Oregon Dept. of Revenue at 945 -8091. Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Department at 378 -3524. Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. lfyou fail to obtain workers' compensation insurance, you may be subject to penalties and will be liable for ail claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945 -7888. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax payment even ifyou didn't actually withhold the tax. For more information, call the Internal Revenue Service at 1- 800 - 829 - 1040. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code compliance: As the perm it holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for - accidents and-omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be re -done. Time to supervise employees: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the expertise to act as yourown general contractor, to coordinate the work ofrough -in and finish trades, and to notify building officials at the appropriate times so they can perform the required inspections. If you have additional questions, write or call the Construction Contractors Board (PO Box 14140, Salem, OR 97309 -5052, 503/378-4621). The Board is located at 700 Summer St. NE Suite 300. in Salem. prop -o« n.pm4 1 !94 .. • • • , • I t - _ _. 1 . -.. , ,T ti . F,, , _ • FOR OFFICE USE ONLY a`i c , %: Building Permit Application Received Building / � Date /B •. , /' / Permit No.: t ST��, City of Tigard RECEIVED Planning A.proval Other Date /By: Permit No.: • 13125 SW Hall Blvd. I Plan Review Other Tigard, Oregon 97223 FED 1 2 Date /By ( J X - .. Permit No.: Phone: 503 -639 -4171 Fax: 3 -98 l 60 �, �' ill I Post - Review 1 Land Use - Date /By: i � / - ) Case No. Internet: www.ci.tigard.oCATY OF TIGARD Date/By: �� CO See Page 2 for 24-hour Inspection Regt{i ILPtDEIION Name /Met Su lentental Information I TYPE"OF WORK.. 1' .; ..,.... . , .. , . ' RE Q UIRED ' DAT • - •. I N ,w construction ❑ Demolition 1'& 2 FAMILY W DWELLING, . r edition/alteratiott/replacement ❑ Other: S ! CATEGORY OF CONSTRUCTION. Note: Permit fees* are based on the total value of the work performed. Indicarr n 1 &. 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead and profit for the work indicated on this application. Q. Building ❑ Multi - Family ❑ Master Builder ❑ Other: Valuation 4- - -. - JOB.SITE INFORMATIONand:LOCATION No. of bedrooms: No. of baths: Total number of floors .lob site address: - /hi 0 7 5_c.e:74-iaJ 1 l3 (..A{ . New dwelling area (sq. ft.) _Suite #:_ . 1.7. l t Aet 0 0. ldg. /Apt: #: Garage /carport area (sq. ft.) I _ _____ Project Name: Covered porch area (sq. ft.) Cross street /Directions to site: Deck area (sq. ft.) _ 5 �: • fl G D o w w 10e S 4 I ate P { • Other structure area (sq. ft.) /9O�0 �I 5V /Witt tib 'CC sot , rieut fut F,., r °qREQ.UIRED•':DATA:'; . • .' ONIMER'CIA C � 'L "-'USE CHECKLIST ' Subdivision: Lot #: Tax map /parcel #: 2. S I i 1 4A (jj® .DESCRIPTION'OF. w ORK • • - •. 2 f� P Not Permit are e: Pe mit fees* based on the value of work performed. Indicate r total a the wor r . . • • the value (rounded to the nearest dollar) of all equipment, materials, labor, . overhead and profit for the work indicated on this application. Valuation S — - Existing building area (sq. ft.) _ . New building area (sq. ft.) [91/442. 2/04-6,43-0— Number of stories 'PROPERT•Y•OWNER2' 1 '::; .i II - TENANT Nr > :K:= ':•:::: ;^,: !;•.; :: ti: Type of construction Occupancy group(s): Existing: 'game: �a \ L , ��.ce. ' New: Address_ q 8 ( S pe..), 1-4 X4-1, ,ter- Lo.,tiJ - -- i City /State /Zip: 13.- } , Q 9 � ! , / /_ t � U „ NOTICE: All contractors and subcontractors are required to be flf3 6,y S _( Phone: F ax: �a S licensed with the Oregon Construction Contractors Board under APPLICANT•- •• - • • • CONTACT.PERSON'';,. provisions of ORS 701 and may be required to be licensed in the Business Name: _ _ _ - • ; , ' , jurisdiction where work is being performed. If the applicant is exempt +. Contact Name: r from licensing, the following reason applies: (c i Address: / '- O ' 3 S w H o_.l I R I ,..,a(. ' City /State /7_ip:�� �„ Phone: Fax: . : ,.:, ,, i...;,..; . - ±: : , BULDING PERMITFS E -mail: �: ��� -': A I ,...::.. - :.; �EE* ._... - t `t•'' 1- "•':= SPleas e =refer t`o' fee ?schedu . . •CONTRACTOR . : -- '1) Business Name: 060K) F ees due upon application S r%JO Address: City /State /Zip: ' Amount received S Phone: Fax: Date received: j CCB Il1C. #: • • Authorize �[ Notice: This permit application expires if a permit is not obtained within Siimature: Date:0 /8 — >�7 180 days after it has been accepted as complete. *Fee methodology set by Tri- County Building Industry Service Board. (Please print name) is \Dsts \Permit Forms \BldgPermitApp.doc 01/03 Electrical Per 11 FOo. OFFICE USE ONLY :., ` Received Electrical 'C �q� l i n� Date/B / �� ;�R'�% Permit No.•' /O, City of Tigard Planning Ap. oval Sign Y g F EB 1 8 2004 Date/By: Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 Tyy Date/By: Permit No.: Phone: 503- 639 -4171 Fax:PA - Pg RD Post- Review Land Use UILDIN �V I.SI o- ; j 1(;� Contact Case N .: Internet: www.ci.tigard.or.t _il;. a I I Contact s.' ®See Page 2 for 24 -hour Inspection Request: 503- 639 -4175 ' " '' Name /Method: Supplemental Information. . .':TYPEKOF;WORK1.. ., • •' ,001:REYIEW (Plea`se ctie`eZillUit''aPPIY) • • . ❑ New construction ❑ Demolition El Service over 225 amps- ❑ Health -care facility commercial ❑ Hazardous location I [ ddition/alteration/replacement ❑ Other: ❑ Service over 320 amps- rating of ❑ Building over 10,000 square feet, I 'i CATEGORY OF CONSTRUCTION , - I & 2 family dwellings four or more residential units in ❑ 1 & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts nominal _ op structure El Building over three stories B'l='eeders, 400 amps or more [ cessory Building ❑ Multi- Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park ❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other: Submit _ sets of plans with any of the above. JOB;SITE.INFORIVIATIOIV aad= :)LO;CATION' %: '' The above are not applicable to temporary construction service. Job site address: I y 0 1, s .w 1-1 o.At Q t . 0' ":I' . , .. '. - 'FEE* SCHEDUI E` `'` ` °'::....... . .. , • . Suite #: 4_14 0 Bldg. /Apt. #: Number of inspections per permit allowed Project Name: Description Qty Fee (ea.) Total New residential - single or multi - family per I Cross street/Directions to job site; S+ dwelling unit. Includes attached garage. S,(J - l \ G. , D 0 vo .,1 o ( , Service included: 1000 sq. ft. or less 145.15 t Each additional 500 sq. ft. or portion thereof 33.40 I Limited energy, residential 75.00 2 Subdi'vision': Lot #• , 2g� Limited energy, non residential 75.00 2 'Fax map /parcel #: e a S III 44 00.24230 Each manufactured home or modular dwelling Y .,, :.; �,;;.; r ;. ; - I 2 :: •,: ' ,. DESCRIPI'IOI!I;;OF.';.VYORIC :_.. ....,.. service and/or feeder 90.90 "' Y _ n Services or feeders - Installation, j '"—" rrr �t'1K ,,��p alteration or relocation: 1 I / ^ � 200 amps or less 'l 80.30 /lp .d."' 2 201 amps to 400 amps 106.85 2 401_ amps to 600 amps 160.60 2 .1:YROPE.RTY,`O.WNER`: , .:: 1 a NI TENANT.;'' ':,, ,: `•e: r +=` :; : - . ;:, 601 amps to 1000 amps 240.60 2 Over 1000 amps or volts 454.65 I 21 I Name: Oa,k t� 1 fa 61_ __'(., Reconnect only 66.85 ! 2 1 Address: q g Le 0 S t4 _ K sta.,i'(•t ts..•. i,,,„,,s' Temporary services or feeders - installation, alteration, or relocation: City /State /Zip: (:,, j• 0r, 200 amps or less 66.85 : 1 Phone: s 14 y 3 I, Fax 201 amps to 400 amps 100.30 I 2 3S 401 to 600 amps 133.75 ! 1 2 APPLICANT :.:;" : =_ • '= ®<COIVTACT�PERSO J..- :,. Branch circuits - new, alteration, or r ' / extension per panel: Name: ( �,,, t '� \ y+. .4.- t A. Fee for branch circuits with purchase of Address: 1.4 0 7. % L`) 1-1,. I I (3 I ...J. service or feeder fee, each branch circuit 5- 6.65 , 2 City/State/Zip: -1 4 ,,, De . Fee for branch circuits without purchase of � I ' service or feeder fee, first branch circuit 46 85 2 Phone: Fax: Each additional branch circuit 6.65 2 1 E -mail: Misc.(Service I .(Service or feeder not included): -' I ";;; ,: +; Each pump or irriKation circle 53 4U 2 � i CONTRACTOR';: ;e ;. ' 1; • : <:.•. f . ; Each sign or outline lighting 53.40 i 2 Job No: Signal circuit(s) or a limited energy panel, Business Name: 060.3 E 2 alteration, or extension Page 2 2 Description: Address: 1 Each additional inspection over the allowable in any of the above: City /State /Zip: Per inspection per hour (min. 1 hour) 62.50 1 Phone: Fax: Investigation fee: 1 Other: CCB Lic. #: Lic. #: ' : , :;;:ta, ±:Electrical:'PermitFee's* ±;';?'1 :;_:: ; I Supervising electrician Subtotal $ I signature required: Plan Review (25% of Permit Fee) $ Print Name: Lic. #: State Surcharge (8% of Permit Fee) $ i TOTAL PERMIT FEE S _J uthorized Notice: This permit application expires if a permit is not obtained within ignature: ate: t2t..2'JR - 0 y 180 days after it has been accepted as complete. •Fee methodology set.by TrI -County Building Industry Service Board. • (Please print name) i:\Dsts\Permit Forrns \ElcPermitApp.doc 01/03 CleanWater Services RECEIVED FEB 18 2004 October 23, 2002 CITY OF TIGARD BUILDING DIVISION Dan Bozech 9860 SW Heather Lane Beaverton, OR 97007 RE: Storage shed located at 14075 SW Hall Blvd., Tigard, OR CWS file 2216 (Tax map 2S111AA, Tax lot 00200) Clean Water Services has received your Sensitive Areas Certification Form for the above referenced site. Staff has reviewed the Sensitive Areas Certification Form, site conditions, and the description of your project and concurs that the above referenced project will not significantly impact the potentially sensitive areas found near the site. In light of this result, this document will serve as your Service Provider letter as required by Resolution and Order 00 -7, Section 3.02.1, and your Stormwater Connection authorization from Clean Water Services as required by Ordinance 27, Section 4.B. All required permits and approvals must be obtained and completed under applicable local, state, and federal law. This letter does NOT eliminate the need to protect sensitive areas if they are subsequently identified on your site. If you have any questions, please feel free to call me at 503 - 846 -3553. Sincerely, Chuck Buckallew Environmental Plan Review I. ::'1)evelopment Svcs\SP 00- 7 \Concunencc Letters \2S1 I I A: \00200 - nu impact to %cater qualit)'.doc 155 N First Avenue, Suite 270 • Hillsboro, Oregon 97124 Phone: (503) 846 -8621 • Fax: (503) 846 -3525 • www.cleanwaterservices.org Tidemark Advantage [Jeanne Temple - JMT] `` 1 ''' „” : i;, ,' .r11 ' Start File Edit Options Window Help 4 Novell ... I 11 Exit New open To:k lice QBE GIS ' . Tidem... li © a Bp X — 0 C Clove View Add Delete Sign off PIlAt Document, } (G DOCUm... nY ...... � s. s p , s `. � . ^t1 _ ; Name:DANIEL L BOZICHS Updated: 314/2004 JMT General Address:14075 SW HALL BLVD Jur: IG � ,. 44. � � � Y .,.-',: ;1 '.'' '� � ;. ® Description: Master # 1MST2002 -00446 Project: B � ', � , Pro ect BOZICHS a - 148' x 40' shop attached to existing house with breezeway. _ - , " ; ,i � ` , f; , _ � ; .� . ., Activity for MST2004 00064 ,.7,;:..:,,,7:77-,.. -1012d ,w. nu C< Description Datel Date2 Date3 Disp Done By notes : ` •i9 A092 (F) Issue combination permit 3/4(2004 DONE DEB A080 (F) Ready to issue 3!3/2004 DONE DEB Have owner sign Owner Responsibifrly Form . A005 Application received 2/18(2004 DONE DEB n `�' .p A799 Building Final 4 ' ' . ; i A010 Check for prcl. restrict. 2/18(2004 DONE DEB .:'. A035 ELC signature on application 313/2004 DONE DEB Owner A790 Electrical Final . A723 Electric Service ~ s'= ..` I A700 Ersn Cntrl 681 -4444 A727 Exterior Sheathing lnsp yx: A705 Footing lnsp 10/42004 PASS KBS # -1- post holes for pole building. ` <:a. A725 Framing lnsp .7-..- . A008 Permit Created 2/182004 DONE DEB 1 1530 Permit expired by limitation 822(2005 RB pug PERMIT c tvf1T EXTENSION REQUEST ec 9/14,2004 EXTN HAP P .r h ner - n •wih r• me I, nil :27 h • m _ 1. r until March's �� I .. A026 Plhked /approved by PE 3/12004 DONE MAV : R '• A012 Plans routed to Plans Examiner 2/18/2004 DONE DEB �/ ( ' j24(4/A,/le f 1 4' t.).-1::::..ar,- j A032 Post- review completed 3132004 DONE DEB �, ,n � r � A030 Reviewed plans routed to PT 3/12004 DONE MAV �`}'V '. r . if / \\\ 1 / ..,...:. y. .fr6/Vk-X deift i2 Pe:.;_; .^.' y ', A II I 1 I 1.1 r«. . � . ,,� � ,d x : .;; 4 10:31 AM y�� •a y ', •.s .p . * ' � , _ _ .. h ... 35..kur, _ S, a .. gw' P ...., . -- ,,, _ .� . 1. r R ..: • ;V A .. m *'r .. _ .* r � . rP' ,, .•' " - ,' ', 4t �• �, ,., Tuesday Ready — " � 8130/2005 S a , " .` � - °; � . � °. � �'� ��." r. ° Y_ !. _� 3 _ � Wit' .�na : s � 4 � ` � ,r • 5 _. Tidemar [Rick Bolen ,RB) 4- ;r ^', - J„r ‘'4.q....4.;5-' . p R S File Edit Options Window Help i l] 0 J Exit New Open Task List OBE GIS Close Goto Up Down Attach Detach GIS Cane z g !?: -. E .1. s , ., :' . r: ' rsr ' 1' f E %f > P «9r �= ; , .. t � � � fE :., .. ' x ., .P" p go u. `.'b '� z S�'� j� T ° i <�a -"� n .A� � _ Rra cts ==- PRJZi��4; l38'f7 6 �, E� °� � _ a x � -3..., � : x a �� � � .�,: -" v . .. Case # Descri xtion p General " -;: z� ro , J ame r : MST2002-00446 Construction of 40 x 40 attached sha kBOZICHS� DA NIEL t i, ' ` 4 p .we.- .1 .frf.^&ys} "'- I; ..r( .. Y i ��' T r , Kf{ �, -�I � ...::�a � �:a d ry t �si 'ara .. " q; ,, % $ 'A �. '. < t .;.- da °. '?r�s -� a.., i «� f�, , t`s � wr f r�a��hu° v : ^ r� Yz J . � = .• r , . � .�• E;ts1, 004 r p LL4, „ w: 4 40 �}to ;Attache = E+E yZICH V i r ii X t ,. ANIE � G . _ D - Bulldmg is PLM2006 -00431 Raindr 4 , "4 ns_anly._ BOICH DANIEL l i PRJ2004 -00116 Construction of 40 x 40 attached shapkBOZICHS DANIEL T Mechanical a a r ,_ ; y 3 i 7 ::!,' ' , ' ;' , '; % ' ; ,. , '''''P'': ' E) 7 ^ Plumbing i ,. h. x e i z 4 �. r . Electric I ^gy m . ' ,, ° al 3. " ` . , r r t s' r cy t � tt , „ ” t ` Received . �1 RF 4 Type of Use S Electrical , � ° „, " T arge t : „ � � . :`��.- .�' �. Type of Construction: ,N n ,' ; ' • 1 kq .. .. . .. .," w <, .x � r . r L ,Y� �U� Occupa . gaup. �R3 _ - � �� Restric ' � Ex-p.iretl: 1313 1)200, °.' K. : I ec rical n , a T 1! „ 4 5�.oa " e u .. �:�� Residential ' r � � � -� [ � Finale . . r ;.' Restricted . d " �w r. 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DEB MSTA012 Plans routed to Plans 2/18/2004 None DONE DEB 2/25/2004 Examiner DEB MSTA700 Ersn Cntrl 681 -4444 None 2/26/2004 MAV MSTA705 Footing Insp 10/4/2004 None PASS KBS 10/4/2004 # -l- post holes for pole building. KBS MSTA723 ervic None 4116. 2/26/2004 MAV MSTA725 Fmrring-Insp - --- , -. None 2/26/2004 MAV MSTA727 Exterior SheatEiirig — ...... _ None 2/26/2004 \--Insp MAV MSTA790 Electrical Final None 4100 /0//3/0k 2/26/2004 MAV MSTA799 Building Final None /0/47 2/26/2004 MAV Page 1 of 3 CaseActivity..rpt • 1/23/2008 Case Activity Listing CCEL/ Case #: MST2004 -00064 2:11:21 PM - - ..,;..: ;:e:• � � Assigned " ;Done .. - Updated, Activi De cri :. ... >.., ... F::. •` ty s tion .r ,.. Date 1. Date.l>� .: -: Date -3 = "H Id �. :� ..... , ::.:. By.,:..: "• .�. < By • Notes MSTA030 Reviewed plans 3/1/2004 None DONE MAV 3/1/2004 routed to PT MAV MSTA026 Plans 3/1/2004 None DONE MAV 3/1/2004 checked/approved by MAV PE MSTA032 Post - review 3/3/2004 None DONE DEB 3/3/2004 completed DEB • MSTA035 ELC signature on 3/3/2004 None DONE DEB 3/3/2004 Owner application DEB MSTA080 (F) Ready to issue 3/3/2004 None DONE DEB 3/3/2004 Have owner sign Owner DEB Responsibility Form MSTA092 (F) Issue combination 3/4/2004 None DONE DEB 3/4/2004 permit BLD MSTAl25 PERMIT 9/14/2004 None EXTN HAP 9/14/2004 Per phonecon with owner Daniel EXTENSION HAP Bozich permit extended. until March REQUEST 3, 2005 MST1530 P ermit expired by 1 8/22/2005 None RB 72 /22 005 Itmitatton � f MST1520 Mail expiration notice 10/10/2005 None DONE JMT 9/1/2005 $125 got bld/elc DON'T CHARGE JMT FOR RAIN DRAINS BUT INSPECT THEM Page 2 of 3 • CaseActivity 1/23/2008 Case Activity Listing 2:11.21 PM C CEL// . Case #: MST2004 -00064 Active Description Date l .. , . , ssigne one Updated . .. . t , D ate 2 - � x tY P,.. 5.:; .� Date 3� Hold Disp �°To ., BYE By MST1730 (:'`Case update (see note) 1/10/2006 None DONE EB� 9/18/2006 Owner, Dan Bozich, wanted to BLD instate permit but he is more than 30 days out from being: ready for final. Per Hap, ok for Dan to wait to reinstate. When he is ready reinstate for $125.00 (BLD/ELC). Per Paul 1, ENG, ok for owner to daylight storm drain to ditch in front. No PF1. / //Plumbing (rain drains) has been separately permitted. 9 /18 /06...hap / /// MST1470 Return to "I" status 9/18/2006 None DONE DER 9/18/200 BLD MST1290 Reprint permit 9/18/2006 None DONE DER 9/18/2006 BLD . MST2299 F,tnal' ins a ' ot 10/6/2006 10/9/2006 10/9/2006 None CF O RB 10/9/2006 037865 -01 -- 503-314-6402 VM - STI N —144160 MST 219 -1✓tec rt <cal final 10/10/2006 10/13/2006 10/13/2006 None l GN 10/13/2006 037992 -01 — 503 - 314 - 6402 — VM - STI N --180 Page 3 of 3 CaseActivity..rpi - .4„,., „k, CITY OF TIGARD DEVELOPMENT SERVICES 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -41 ___ ___ __ _ ___ _ _ _ _ _______ _ _ _________________________ SITE ADDRESS: 14075 SW HALL BLVD SUBDIVISION: EDGEWOOD Project Description: 48' x 40' shop attached with breezeway. INSPECTION FOR 30 DAYS. (B BUILDI REI SSUE: CUSTOM STORIES: 1 FLOOR :-.. ' CLASS OF WORK: ACS HEIGHT: 13 FIRST: s : 5 TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: 1,920 5f FRONT: 20 TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5 ' r7 ,. VALUE: 46 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR: 15 PLUMBING • SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TR. LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > -100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS a 1000 SF OR LESS: 0 - 200 amp: 2 0 - 200 amp: 0 W /SVC OR FDR: 5 PUMP /IRRIGATION: PER INSPECTION: [[[///��� EA ADD'L 500SF: 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: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: t 1000+ amp /volt : PLAN REVIEW SECTION O Reconnect only: >=4 RES UNITS: SVCIFDR> =225 A.: > 600 V NOMINAL: CLS AREAISPC OCC: ELECTRICAL - RESTRICTED ENERGY , A SF RESIDENTIAL B. COMMERCIAL AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: O BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: 0 HVAC: DATA/TELE COMM: . NURSE CALLS: TOTAL S SYSTEMS: This permit is subject to the regulations contained in the Tigard ll Owner: Contractor: y� ''[[,,�� Municipal Code, State of OR. Specialty Codes and all other DANIEL L. BOZICHS OWNER applicable applicable laws. All work will be done in accordance with approved 14075 SW HALL BLVD plans. This permit will expire if work is not started within 180 days TIGARD, OR 97224 of issuance, or if the 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 - 001 -0010 through 952 - 001 -0080. You may obtain copies Phone: 503- 643 -6390 Contact #: of these rules or direct questions to OUNC by calling 503- 246 -6699 or 1- 800 - 332 -2344. Reg #: TOTAL FEES: $ 1,271.15 REQUIRED ITEMS AND REPORTS Issued By : ; (i!t r //, %C Permittee Signature.:---/—.04 r ,-) 0 . Call 503 - 639 -4175 by 7:00 a.m. for an inspection that businesr ay. .._E:.__.... This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. `I • � INSPECTL S SIGNATURES ARE NOT REQUIRED ON GREEN INSPECTION CARD. •- By ✓ Code I Inspection Description PASS Date 1 By ELC - Electrical Permit 105 Underground/slab cover 110 Temporary electrical service 115 Electrical service . 120 Electrical rough -in ading/footing 125 Wall cover ails 130 Ceiling cover so ing drain 135 Low voltage _ - 220 Slab 140 Sign installation 310 Crawl drain 145 A/C or heating unit circuit 225 Post/beam structural 150 Hot tub /spa/pool 230 Underfloor insulation 195 Misc. inspection: 235 Shear walls /anchors X 199 Electrical final 240 Exterior sheathing 245 Firewall 250 Roof nailing ELR - Restricted Energy Permit 255 Wtr proofing basement walls 135 Low voltage 260 Tilt -up panel 195 Misc. inspection: 265 Masonry 199 Electrical final 270 Reinforcing steel (rebar) 275 Framing 810 MFG - Structure set -up _ MEC - Mechanical Permit 280 Insulation 605 Post/beam mechanical 285 Drywall nailing 610 Gas line 287 Suspended ceiling 615 Mechanical rough -in 295 Misc. inspection: 620 Hydronic piping 899 MFG - Structure final 625 Duct work 498 Grading final 630 Fire damper X 299 Final inspection 635 Smoke detector shutdown 640 Exhaust hood 695 Misc. inspection: 699 Mechanical final BUP - Fire Protection System Permit 905 Sprinkler underfloor /slab PLM - Plumbing Permit 910 Sprinkler rough -in 305 Plumbing underslab 915 Fire alarm rough -in 310 Crawl drain 920 Suppression trip test 315 Post/beam plumbing 995 Misc. inspection: 320 Plumbing rough -in 998 Alarm final 322 Shower pan 999 Sprinkler final 330 Water service 335 Rain drain 340 Storm drain SIT - Site Work Permit 505 Sanitary sewer 405 Excavation 345 Culvert/catch basin 410 Fill 350 Septic tank 415 Grading 395 Misc. inspection: 205 Footing 399 Plumbing final 210 Foundation walls 215 Footing drain 420 Sprinkler supply lines SWR - Sewer Permit 495 Misc. inspection: 505 , Sanitary sewer 498 Grading final 595 Misc. inspection: 499 Final inspection 599 Final inspection I: \Building \Inspection Cards \Forms \AOP- InspCard- Blank.doc 12/09/2005 7 CITY OF TIGARD — C� S BUILDING DIVISION I PERMIT #: MST2004 -00064 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/4 /2004 Phone: (503) 639 -4171 i Inspection Requests (24 Hrs.): (503) 639 -4175 --..i 47 I �.. INSPECTION WORKSHEET FOR DATE: 10/13/2005 TIME: 7:00AM PAGE: 57 SITE ADDRESS: 14075 SW HALL BLVD CLASS OF WORK: SUBDIVISION: EDGEWOO[) LOT #: TYPE OF USE: PROJECT NAME: BOZICHS DESCRIPTION: 48' x 40' shop attached with breezeway.9118 /06: PERMIT REINSTATED FOR PURPOSE OF FINAL INSPECTION FOR 30 DAYS. (BLDG /ELC) OWNER: BOZICHS, DANIEL PHONE #: 503-643-6390 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10113/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 108 Electrical final 037992 -01 503- 3146402 N Corrections /Comments /Instructions: 2 ? D , Q • �J II Czv I c, iiCI.G.a 6 6 1 8�■ 1. Z VR-0\110a' -- p2A- 1 f 17(Y•. Zo(a f ftSg ,p. L/ — 12:tlYNvgla • O. tom- %' fi F LtzyuL ap Pc ....z4 r C-- F G( ?a-0 0 0 Fts4L ALL ---,/ , cleL,.4 A‘f) r 120 . Q ct:LI•Lcb. Or c) Q t.-04) N) tiogC-ball. 21 1.4 F. ‘6 d(L Zc7 Ra . 40(t1::Ai 1) e=' R1/4) el kA71cLE - ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS - . FAIL 4CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: C7 4 N oC:I L- Date: 101 1 fl10 _ Phone #: (503) 718- 14% CITY OF TIGARD BUILDING DIVISION PERMIT #: MST 004 -00064 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/4/2004 Phone: (503) 639 -4171 -,' w•'�I� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/9/2006 TIME: 7:01AM PAGE: 24 SITE ADDRESS: 14075 SW HALL BLVD CLASS OF WORK: SUBDIVISION: EDGEWOOD LOT #: TYPE OF USE: PROJECT NAME: BOZICHS DESCRIPTION: 48' x 40' shop attached with breezeway.8118 /08_ PERMIT REINSTATED FOR PURPOSE OF FINAL INSPECTION FOR 30 DAYS. (BLDG /ELC) OWNER: BOZICHS, DANIEL PHONE #: 5a03- 643 -6390 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: , Date: 10199/2006 Pour Time: Code # Inspection Description oI�L p ` Confirm # Contact # Message 299 Final ins ection ��' , ` 03786 &01 503 - 314 -6402 N ' Corrections /Comments /Instructions: 41+6 di LA Eezvv ' LA PLH 200 (Q - dd 431 C. ctLv'\ et- (-v\, (' i CI OI - 1 - `4 (1) _ &'D. I , ❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS Fri FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: y Date: 1 6 / Phone #: (503) 718 - 7 -' 7 Z‘/ CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST V"6GO&S INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received / ?te Req a ted / AM PM BUP Location NO 7S u . % Suite MEC Contact Person [,c i /. �e., Ph ( S— lv X17 PLM Contractor Ph ( ) SWR ILDIN Tenant/Owner ELC +o ing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: ,�. SIT Post & Beam . 'tQ Q ?,t-C lP'.e P� Ad Shear Anchors (4 ) Ext Sheath/Shear J � � / a— • Int Sheath/Shear Framing 111 tM ( 7f , ST I -(a alJ)i.:.G , .-E-1-14 \/,'," Insulation , Drywall Nailing A Y .4 uers•s LtA PL i jA L �� 0 2 - rz: t � r-N _ --( r— Firewall t, ; , ✓C'/z�Ta • Fire Sprinkler Fire Alarm Susp'd Ceiling Roof 4 10 PART FAIL " 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 Rough -In Gas Line Smoke Dampers Final PASS PART 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. PASS PART FAIL SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line • ADA Approach/Sidewalk Date 1G — a4-- Inspector � Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL