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8990 SW Edgewood Street
CITY OF T IG A R D MASTER PERMIT
PERMIT#: MST2001-00395
DEVELOPMENT SERVICES DATE ISSUED: 7/31/01
13125 SW Hail Blvd.,Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 08990 SW EDGEWOOD ST PARCEL: 2S102DC-01400
SUBDIVISION: EDGEWOOD ZONING: R-4.5
BLOCK: LOT 011 JURISDICTION: TIG
REMARKS: Construction of a new 720 sq. ft. garage, attached to residence with a breezeway.
BUILDING
REISSUE: STORIES. I __ FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ACS HEIGHT: 1.' FIRST: sf BASEMENT: sf LEFT. 20 SMOKE DETECTORS: U
TYPE/'I USE: SF FLOOR LOAD. ',u SECOND of GARAGE: 7,10 sf FRONT: PARKING SPACES
TYPE OF CONST: 5N DWELLINC UNITS: FINBSMENT. of RIGHT:
VALUE: $15.744 00
OCCUPANCY GRP: R3 BDRM: BATH: rOTA.L. 000 of REAR.
PLUMBING_
SINKS: WATER CLOSETS: WASHING MACH. LAUNDRY TRAYS: RAIN DRAIN: TRAPS
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES. SF RAIN DRAINS. 1 CATCH BASINS.
TUWSHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES BCKFLW PREVNTR. GREASE TRAPS:
OTHER FIXTURES.
MECHANICAL
FUEL TYPES FURN�10OK: BOIL ICMP�]HP: VENT FANS. CLOTHES DRYER.
FURN>-100K-. UNIT HEATERS HOODS. OTHER UNITS.
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS
ELECTRICAL _
RESIDENT'.AL UNIT SERVICE FEEDER _ TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS _ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp, I 0 - 200 amp: WISVC OR FOR: I PUMPIIRRIGATION. 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 - 800 amp: 401 800 amp'. EA ADDL SR CIR: SIGNAL/PANEL IN PLANT:
MANU HMISVCIFDR: 601 - 1000 amp: 801-ampo•1000v: MINOR LABEL.
10004 amplvolt
PLAN ReVIE N SECTION
Reconnect only:
—4 NES UNITS: SVCIFDR»225 A.: >800 V NOMINAL. CLS AREA/SPC OCC.
_ ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL _ _ B.COMMERCIAL
AUDIO 8 STEREO: VACUUM SYSTEM, AUDIO d STEREO FIRE ALARM: INTERCOMPAGING OUTDOOR LNDSC LT
BURGLAR ALARM: OTH, BOILER- HVAC LANDSCAPEARRIG PROTECTIVE SIGNIL
GARAGE OPENER: CLOCK: INSTRUMENTATION. ML DICAL, OTHR:
HVAC: DATA/TELE COMM. NURSE CALLS: TOTAL 0 SYSTEMS
Owner: Contractor: TOTAL FEES: $ 605.17
This permit is subject to the regulations contained in the
HURLBUTT,WILLIAM M+CHRISTI OWNER Tigard Municipal Code State of OR Specialty Codes and
8990 SW EDGEWOOD ST SIGNED RESPONSIBILITY all other applicable law; All work will be done In
11 BARD,OR 97223 FORM IN FILE accordance with approved plans This permit will expired
work is no: started within 180 days of issuance,or if the
work is suspended for more than 180 days ATTENTION
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center Those rules are set
Rog 0: forth in OAR 952-001-0010 through 952-001-0080 You
may obtain copies of these rules or direct questions to
OUNC by calling(503; 24k .38i
REQUIRED INSPECTIONS
Erosion Control:nsp 8, Electrica'Rough In Electrical Final
Footing Insp Framing Insp Plumb Final
Slab Lisp Shear Wall Insp Final Inspection
Footing/Foundation Dr Low Voltage
Electrical Service Rain draln Insp !�
Issued By : 4" ' _�'. : �/ , —_-- Permittee Signature
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
Building Peri
City of Tigard Permit no/
Address.. 13125 SW Hall Blvd,Tigard,OR 97223 ProjecUappl.no.: Expire date: -
C'in ujTignrd Phone: (503) 639-4171 Date issued: Hy;-. Receipt no.:
Fax: (503)598-1960 Case file no.: Payment type:
Ladd use approval: t&2 family:Simple_ Complex
U I &2..family dwelling or accessory U Commerciaiiindustrial U Multi-family U New construction U Demolition
*Addition/altcration/replaccmcnt U Tenant improvement U Fire sprinkler/alarm U Other:
Job address: VC? sr. Ole. Bldg.no.: Suite no.:
_Lot: Block:_ Subdivision: Tax map/tax lot/account no.:
Project name: WrC VJ ACA&-e - —
Description and location of work on prenlises/special conditions: � Jf�ll f A&_AZF_ T
Name: VOWNER 1.011 %111( IM; INI OICNIA I ION, I M% CIIL( KLIS'l
ILA,VI 41 U9—_- ' UTT
Mailing;address:0990- V--ri-_fL%,\AJQ22 1 &2 family dwelling:
City: State: ZIP: }2 Z Valuation of work........................................ $1519-55 00-
Phone. Fax. ail: _ No.of bedrooms/haths................................. -
Owner's rc resentative: X29- $39Total number of floors.................................
Phone: Fax: I nt,, l — New dwelling area(sq.ft.) ..........................
APPLICANT G
arage/carport area(sq.ft.)......................... :o�
Name: orch area(sq.ft.) ......................... --
-- - - s fl.Mailing address: ( q. ) ........................................cture are{(. fl.)
City: State: •l..II': .........................
Phone: Fax: E-mail: Commerclal/industriallmulti-family:
11101 Valuation of work.... ................................... $_
Existing bldg.area(sq.ft.) .......................... -
Business name _�j�/�J(A New bldg.area(sq.fl.)
__ _ -- __
Address:
---- Number of stories........................................
City: State: ZIP:
—._ - Type of construction.................................... _
Phone: Fax: E-mail: Occupancy group(s): Existing:
CCB no.: _ _ New:
City/metre lie no: Notice:All contractors and subcontractors Pie required to be
licensed with the Oregon Construction Contracwrs Board under
Name: provisions of ORS'101 and may be required to be licensed in the
- - - ---- - — jurisdiction where work is being performed. If the applicant is
A
tJrrss: _
---� - titate: %IP:-- exempt from licensing,the following reason applies:
Cit
Contac►person: Ian no.: ---
Phone: Fax: E-mail:
Name: Contact person: Fees due upon application ........................... $
Address: _ Date received:
City: State: ZIP: Amount received ......................................... $_
Phonc: Fax: E-mail: Please refer to fee schedule.
1 hereby certify 1 have read and examined this application and the Not all iuriddctions rcetx credit cards,pleme call Jurisdiction for more information.
attached checklist. All provisions of laws and ordinances governing this Uviss U MasterCard
work will be complied witlic w er s i e eTin or not.
Credit card numtrer:__�_�__ _..` j e
7 --_ C><plres
Authorized signature: u ' _ Date: ,¢1_ Name 4 eardhoider u dtovvn on credo card
Print name: 8l 1.L C7 U m LH OTT— __-- Cardholder signature — $
Amoum
Notice:This permit application expires if a permit is not obtained within 190 days after it has been accepted as complete. a+r>rnt!(r>"WOM)
One- and Two-Family Dwelling
Building Permit Application Checklist kefcrenceno.:
— _ Associated permas:
Citynjl'igurd City of Tigard �
U Electrical U I'lumhtn� U Mechanical
Address: 13125 SW hall lilvd,'I'igard,OR 97223 UOther:
Phone: (503) 639-4171
Fax: (501) 599-1960
FOLLOWINGTHE 1 1 ' PLAN REVIEW Yes No N/A
I band use actions completed..ticc lim.,fiction criteria for concurrent reviews. Ji v
2 Zoning. I Doul pi m ,Im halance points,seismic soils designation,historic disci ,1 1,
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. -
9 Soils report. Must carry original applicable stump and signature on file or with application.
9 Erosion control U plan U permit required.Include drainage-way protection,silt fence design and l,catioo of
catch-basin protection,etc.
10 -3 Complete sets of legible plans.Must he drawn to scale,showing conformance to applicable local and state
huildtng codes. Lateral design details and connections must he incorporated into the plans or on it separate full-sire
sheet atlachvd to the plans with cross references between plan location and details. Plan review Lannol he cunrpleled
if copyright violations exist. _
1 I Site/plot plan drawn to scale.The plan must show lot and building setback dimensions;property corner elevations(if
Utero is nuae than a4 it.elevation differential,plan must show contour lines at 2-fl.intervals);location of easements and
drivewny;footprint of structure(including decks);location of wells/septic systems;utility locations:direction in,licator:lot
arra;building coverage area;percentage of coverage:impervious area;existing structures un site;and surlace dranutge.
12 Foundation plan.Show dimensions,anchor hulls,any hold-downs and reinforcing pads,connection details,vent
size and locution. --- _
13 Floor plans.Show all dimensnuts, loom hfenttfication,window site,location of smoke detectors,Witter heater.
furnace,ventilation funs,plumhtnp acture,,halcunies and decks 10 inches above grade,etc. _
14 Cross section(s)and details.Show till Itaming-member sizes and spacing such as floor beams,headers,joists,sub-floor,
wall construction,roof cunstrucnon. More than one cross section may he required to clearly portray construction.Show
details of all wall and rnuf'sheathing•roofing,roof slope,ceiling height,siding material,I'txotings and foundation,stairs,
fireplace construction, thermal insulation,etc.
15 Flevation views.Provide elevations for new construction;minimum of two elevations for additions and remodels.
EXICriur elevations must IL-11CCI the actual grade if the change in grade is greater than four fool at building envelope.
Dull sire sheet addendum,showing foundation elevations with cross references are acceptable,
In 11'all bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for
nun prescrtpu,c path analysis provide specificaliuns and cMcnlations to engineering standards.
17 Floor/roof framing, Provide plans for all flaorrs/cool'assemblies,indicating member siring,spacing,and hearing
locations.Show attic ventilation.
19 Basement and retaining Nulls. Provide cross sections anti details showing placement of rehar. For engineered
systems,sec Item 22,"Engineer's calculations." _
19 Beam calculations.Provide Iwo sets of calculations using current axle design values for all beams and multiple joists
over 10 feet lung and/or any beam/joist carrying it non-uniform load. �-
20 Manufactured Moor/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.r.,shear wall,roof truss)shall he stamped by an engineer or
architect licensed in Oregon and shall be shown to he atpl,h(able to the 11WICL t under n•,u•,+.
23 Five(5)site plans are required for Item I I above. Site plans must he 9-1/2" x 1 1 ,1 11" x 17
24 Two(2)sets each are required for Items 16, 19,20&22 above. --�-
25 Building plans shall not contain red lines or tali•-ons.
26 No rolled,reversed or mirrored building plans will be accepted.
27 —_
28
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. 44r14e14ttirtrur•0M,
Electrical Permit Application
Date received: Permit no.: %1'1,9001 -U
City of Tigard Project/appl.no.: Expire date:
(if f718ard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: _-
TVPE OF PERM 11.
I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction U Addltlen/altcrat ion/replacemeIII U O(her: _ U Partial
JOB SITE,INFORMATION
Joh address �_ Ii1d), mr_— -stns• n,,. =Tax map/tax Iot/:tccount no.:
IA: Block~ Sulxlivision:
Project name: _ Description and Icx:ation of work on premises:
Estimated date of completion/ins ction:
Job no: rr� !lits
Business name: Drscriplion IJty. (ea.) rotas no.Insp.
Nen rrsidentfal single or multi famill ix-r
Address: dssellingunit.Includesattachedgarage
City: State: I ZIP_ Servlceinciuded:
Phone: Fax: E-mail: 1000 sq.n nr less '
CCB no.: Elec.bus. lie.no: Each additional 500 sq.ft.or portion thereof
Hurdled energy,residential 2
City/metro lic.no.: Limited energy,non-residenUol 2
Each manufactured home ormodular dwelling —
Si nature ol'suliervising electrician(required) Date -- _s Service and/or feeder 2
Su .elect.name(in Iu0: License no: Services orfeeders-installation,
alteration or relocation:
200 amps or less 2
Name(print): LI. I�U"U`U l T 201 amps to 400 amps 2
401 strips to 61X1 amps _ 2
Mailing address: -- alai Vf, 601 amps to 1(x00 amps 2
City: / Slntc ' LII': ; ,' Over 1000ampsorvolts 2
Phone: e' I'*o%' l r i ;f` E-mall: Reconnect only -- - —-- — I
Owner installation:The installation is b t.ing made on property I awn Temporary services or feeders-
which is not intended for sale,lease,rent,or exchange according to �l+tllation,alteration,orreloation:
ORS 447,455,479,670,,7 201 apps or 400less — 2 _
I 7 201 amps to 4011 amps 2
Owner's si nature: / Date: '' 401 to 600 ams 2
Branch circuits-new,alteration,
or extension per panel:
Name: A. Fee for branch circuits with purcha.e of
Addrti,, service or feeder fee,each -winch circuli 2
Clly: Slate: LIP: B. Fee fur branch circuits without purchase
- of service or feeder fee,first branch circuli 2
Phone: Each addilionalbranch circuit
Misc.(Service or feeder not Included):
tU Service aver 22�amps-commercial U Health-care facility Foch pump or irrigation circle _- 2
U Service over 320 amps-rating of 1&2 U Hazardous location Each sign or outline lighting
familydwellings U Building over 10JI00 square feet four or Signal circuit(s)or a limited energy panel,
U System over 601 volts nominal more residential units in one structure ahewoon,or extension" 2
U Building over three stories U FmIcts,400amps ormore •Iksrn alum
U Occupant load over 91 persons U Manufactured structures or RV park Each addiflonal Inspection over the allowable In any of the above:
U Egremilightingpinn U Other: —_ - Per inspection
Submit sets of plans with any of the above. Investigation fee
Ile above are not applicable to temporary construction service. Other
Nd ail Jurisdictions rcept credit cards,please call jurisdiction for mrxr inf,wrnnnroi Notice:This permit application Permit fee.....................$
U visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $ _
Credit card number: �_ within I80 days after it has been State surcharge(8%) ....$ — —
—_-- Expires accepted as complete. TOTAL ... ...................
Name o r u shown on credh:ard
Crdholder Npruure — At iouri 440.4615(ISW COM)
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
—_ - TYPE OF WORK INVOLVED -RESIDENTIAL ON Y
Complete Fee Schedule Below: —
Restricted Energy Fee...................................................... $75.00
_ Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service Included: Items Cost Total Check Type of Work Involved:
Residential-per unit Y O
1000 sq ft or less $145 15 4 Audio and Stereo Systems'
Each additional 500 sq It or
portion th6mof $33.40 _ 1 Burglar Alarm
Limited Energy $75 00Each Manufd Home or Modular Garage Door Opener'
Dwelling Service or seeder $9090 2
3ervicas or Feeders Healing,Ventilation and Air Conditioning System`
Installation,alteration,or relocation
200 amps or less __ _ $8n.30 _ _ 2
201 amps to 400 amps $106.85 ❑
__ 2 Vacuum Systems'
401 amps to 600 amps $160.60 _ 2 r,
601 amps to 1000 amps $24060 2 Ej Other
Over 1000 amps or volts $45465 2
Reconnect only $66.85 _ 2
Temporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
installation,alteration,or relocation Fee for each system............... ............ .................. ....... .. $75.00
200 amps or less ,_ _ $66.85 7 (SEE OAR 918-260-260)
201 amps to 400 amps _ $100,30 2
401 amps to 600 amps _— $13375 2 Check Type of Work Involved:
Over 600 amps to 1000 volts, a
see"b"above. Audio and Stereo Systems
Branch Circuits F1 Boiler Controls
New,alteration or extension per panel
a)The fee fnr branch circuits
with purchase of service or Clock Systems
feeder fee.
Each branch circuit $6 G:, 2 E] Data Telecommunication Installation
b)The fee for branch circuits
without purchase of service Fire Alarm Installation
or feeder fee.
First branch dreuil _ $46.85 E] HVAC
Each additional branch circuit $665
Miscellaneous Instrumenlabori
(Service or feeder riot included)
Each pump or Irrigation circle _ $5340 Intercom and Paging Systems
Each sign or outline lighting $5340
Signal circuit(s)or a limped energy
panel,alteration or extension $7500 El Landscape Irrigation Control'
Minor Labels(10) _ _ $125 00 r_1
Each additional Inspection over U Medical
the allowable in any of the above Nurse Calls
Per inspection $62.50 _
Per hour $62.50 _
In Plant _ _ $73 75 Outdoor Landscape Lighting'
Fees: Prolective Signaling
Fnter total of above fees $ n Other
8%State Surcharge $ _- Number of Systems
25%Plan Review Fee No licenses are required Licenses are required for all other installations
See"Plan Review'section on $
front of application --
Fees:
Total Balance Due $
�r-11 - �--- - Enter total of above fees s_ —
li Trust Account# 6%Stale Surcharge s
Total Balance Due —
1:\clsts\forms\elc-fee s.doc (W07/01
Permit#:
Address:
Issued by: � _ Date:'��/
Statement: Information Notice to Property owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who tire not registered with the construction Contractors Board to sign the
fi►Iluwing statement hc�1bre a building permit c'an he issued. T his statement is required
fn• residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statetn nt. This statement will he filed►rith the permit.
I ill in the appropriate blanks and initial boxes i and 2,and either box 3A or 313:
1. i own,reside in. or will reside in the completed structure.
2. I understand that I must register as a construction contractor ii'the structure is sold or offered for sale
r up completion.
before c
i on
F]
3A. My general contractor is -_----- -- - —--——--
(Name) Contractor regis. #
will instruct my general contractor that all subcontractors \\ho ark ►►n the structure must be
registered with the Construction Contractors Board.
()R
311. 1 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 \\ill contract with a contractor who is
registered with the CCB and will immediately notitj the ofticr issuing this building permit of the
name ol'the contractor.
herehN certilN that the ahoy a infornratiwl is correct and that I h;r�c read an►I do understand the Information
;Notice to Property (N ners aho t o ruction Responsibilities on the rcN erre side of this form.
(, ignature ofpermit applicant) (Date)
(1111ile cv1�t'to i.k uing agency permit.f le,
pink c opti,to applicant)
Information Notice 'to Property Owners
About Construction Responsibilities
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1 you are actog as YMnI o"n k('Ito, :-)I to con,truct it nc`v horse fir nl:lke a ';llh,lantlal Improvement to an existin,structure.
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EMPLOYER RI~.SPONSIBILITIf~S:
If yoo (tire per',ons not rt' '.t,t, 101 a Ith Il)r ('unsn-110ion i cni actor, Board to du lahe,r in contracting of as!;i.tinng in the
rtln,truetior)ur Irllpr+,aenll•nt('1;t I-C'J,1 111;,1! ,rructure.�('1t n ill, in`nul;t intitanic,. hi,'rt.11ed to he ar►employer and the people
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OTHER RESr"ONSIBILITIFS AND AREA'S OF CONCERN,
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SEE 35MM
ROLL # 20
FOR
OVERSIZED
DOCUMEN
T
CITY OF TIGARD 24-Hour _
BUILDING Line: (503) 639-4175 MST 2Da�L�D �S
INSPECTION DIVISION Business Line: (503)639-4171
BLIP
Received .___ _Date Requested_—_1 Z Z 0 ASM_ PM BLIP _
Location ___ _f<GI -�� -Suite MEC
Y �' `�J. -
Contact Person . ���� Ph( _-) 3 PLM -- -
Contractor _-. _—_-- ---_-- --- Ph(—) SWR _
BUILDING Tenant/Owner _______ _- ELL - - _-
Footing ELC
Ft
Foundation
Access: �.
Draing � 4 r ! 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. _ 1,CLl�, -- - - ---- - -----
-� -
ASS PART FAIL !
IN,G
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
Ei_ECTRICAL _
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: EJ Unable to inspect-no acces,
Fire Supply Line
ADA Approach/Sidewalk Date � - �.� '�Z Inspector Ext
� �
Other:
Final DO NOT RENI01E his Inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639 15 Business Line: 639-41
BLIP
_ Dc'atee Requested l AM PM BLD
Lu ation_—�1�L, Eek-4 Suite -- MEC --_
Contact Person Ph �'�� 3�0�a _ PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Fig Drain
Crawl Draic Inspection Notes. ,, SGN
Slab SIT
Post& Beam - --- --- --- ___ ---
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof c
Misc. - ---
Final
PASS PART FAIL - - - - - -- —- - ---- ---- -
PLUMBING
Post&Beam - ---- --
Under Slab _
Top Out -
Water Service
Sanitary Sewer
Rain Drains
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
rn C
52 PART FAIL
Backfill/Grading
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ( ]Please call for reinspection RE . ( ]Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Gate L-2 -/2-10/ _Inspector �/.,Nr� Ext
Other `J
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.