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12762 SW Rocky Mountain Court
MASTE
ERMIT
CITY OF TIGARD PERMIT
: MST2
PERMIT#: MST2001-00537
DEVELOPMENT SERVICES DATE ISSUED: 12/4/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 12762 SW ROCKY MOUNTAIN CT PARCEL: 2S109AD-08600
SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7
BLOCK: LOT: 029 JURISDICTION. TIG
REMARKS: New SF detached. path 1
BUILDING
REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 'I FIRST. 1 SOr' sl BASEMENT sl LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 4n SECOND 'aA7 sl GARAGE. 460 sf FRONT: 20 PARKING SPACES
TYPE OF CONST: 5N DWELLING UNITS. I FINBSMENT of RIGHT: 11
VALUE. S 237.382 00
OCCUPANCY GRP: R3 BDRM 4 BATH. 3 TOTAL. •I H7`n sf REAR' 29
Pt UMBING
SINKS. WATER C-OSETS'. 3 WASHING MACH LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS
LAVATORIES. 4 DISHWASHERS: I FLUOR DRAINS: SEWER LINES: vu, SF RAIN DRAINS. I CATCH BASINS
TUB/SHOWERS. 1 GARTIAGE DISPWATER HEATERS: WATER LINES- 100 BCKFLW PREVNTR I GREASE TRAPS.
OTHER FIXTURES
MECHANICAL _
_ FUEL TYPES FURN,100K. BOILICMP c 3HP: VENT FANS CLOTHES DRYER: I
FURN>-100K: I UNIT HEATERS: HOODS. OTHER UNITS: I
MAXINP: LAU FLOORFURNANCES'. VENTS, t WOODSTOVES'. GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADO'L INSPECTIONS
1000 SF OR LESS. 1 0 200 amu: 0 200 amp: WISVC OR FDR: 1 PUMMIRRIGATION' PER INSPECTION:
EA ADO'L 600SF: 4 201 400 amp: 201 400 amp: 1st WIO SVCIFDR: i1 SIGNIOUT LIN LT PER HOUR.
LIMITED ENERGY: 401 600 amp. 401 600 amp: EA ADDL SR CIR: SIGNALIPANEL: IN PLANT.
MANU HMISVCIFDR: 601 1000 amp: 601-amps•to00v: MINOR LABEL:
III amplvoll
PLAN REVIEW SECTION
Reconnect only:
>•4 RES UNITS', $VCIFDR>=226 A.: >800 V NOMINAL CLS AREA/SPC OCC.
ELECTRICAL•RESTRICTED ENERGY
A,SF RESIDENTIAL 6.COMMERCIAL
AUDIO&STEREO. VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM INTERCOMIPAGING: OUTDOOR LNOSC LT:
BURGLAR ALARM OTH BOILER: HVAC LANDSCAPEIIRRIG PROTECTIVE SIGNL
GARAGE OPENER. CLOCK: INSTRUMENTATION-. MEDICAL. OTHR:
HVAC DATA7TELE COMM: NURSE CALLS TOTAL N SYSTEMS
Owner Contractor: TOTAL FEES: $ 7,411.99
This permit is subject to the regulations contained in the
LEGACY HOMES LEGACY HOMES LLC Tigard Municipal Code,State of OR. Specialty Codes and
PO BOX 446 PO BOX 446 all other applicable laws. All work will be done in
SHERWOOD,OR 97140 SHERWOOD,OR 97140 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:
Phone: Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Rep N: [W 64.1H, 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)246-1987
REQUIRED INSPECTIONS
Erosion Control Insp 8, POSt/Bearn Structural PLM/Underfloor Framing Insp Gas Fireplace Appr/Sdwlk Insp
Grading Inspection PosUBeam Mechanlca Mechanical Insp Shear Wall Insp Insulation Insp Electrical Final
Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Ins{ Gyp Board Insp Mechanical Final
Footing Insp Crawl Drain/Backwater Electrical Service Low Voltage Rain drain Insp Plumb Final
Foundation Insp Footing/Foundatioo Dr; Electrical Rough In Gas Line Insp Water Line Insp Final inspection
Issued By m_ ' Permittee Signature . _ ,�1
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the text business day
CITYOF TIGARD SEWE R CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2001-00293
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/4/01
SITE ADDRESS; 12762 SW ROCKY MOUNTAIN CT PARCEL: 2S109AD-08500
SUBDIVISION: ELK HORN RIDGE ES FATES ZONING: R-7
BLOCK: LOT: 029 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS: 1
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection permit for new SF residence.
Owner: _ FEES
LEGACY HOMES Type By Date Amount Receipt
PO BOX 446
SHERWOOD, OR 97140 PRMT CTR 1214/01 $2,300.00 27200100000
INSP CTR 12/4/01 $35.00 27200100000
Phone: 509-9+25-0506 Total $2,335.00
Contractor:
Phone:
Reg#:
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires 180
days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does not guarantee
the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect
3 feet in all directions from the distanoe given. If not so located, the installer shall purchase a "Tap and Side Sewer" Perm
f '
Issued by: _ _ ccs . . ' Permittee Signature.�' � � �• J, i
;,all (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Building Permit Application
1 Datr received: I'�y. �•? Permit no4sw DU J 7
City of Tigard ?
ProjecNappl.no.: Expire date:
CiryojTigurd Address: 13125 SW IlalI Blvd,Tigard,OR 97.223 .1
Phone: (503) 639-4171 Date issued: By• V Receipt no.: r�
Fax: (503) 598-1960 Case file no.: Payment type:
1&2 family:Simple Complex:
Land use approval'
TYPE OF PFRN11Tr+
U I &2 family dwelling or accessory U f'rnnincrcial/industrial U Multi-family New construction ❑Demolition
❑Addition/alteraiion/replaLcment U"I cn;rnl Inylr rvrnn nl ❑Fire sprinkler/alarm ❑Other.
JOIR SIIE INFORNIA11ON �l
r Bldg.no.: Suite no.:
Job address:
Loc: Block: Subdivision: F
r ; 1 L r. Tax map/tax lot/account no.: '
Project name: I:1`5 4Cr 4I U"J-J t F-
c• ,
Description and location er work on premises/special conditions:
soil Name: F(IAMailin address: VO rx-)%• �` 1 &2 family dwelling:State: i. Valuation of work.. ..... . �7
City: G �.• / - ..�'..
... ........
Phonc:' ��t� Fax:rl j`, i)1`i E-mail: No.of bedrooms/baths........ ... ..............
Total number of floors.........' ......... ....
Owner's representative: k-,,,' 1 7 It_l-VA _ •r "
hone: IFax: E-mail: New dwelling area(sq.ft.) .....
Garage/carport area(sq.ft.)...... G
Covered porch area(sq.ft.) .........................
-- Deck arca(sq.ft.)........................................ _
utrng address: Other structure area(sq.ft.
City: State: ZIP. --
Fax: Email: CommerclaUindustrinUmulti-family:
Phone: Valuation of work
1 1 '
Existing bldg.arca(sq. ft.) ..........................
Business name: ME `�`� (�It�h. E- New bldg.arca(sq.ft.)
Address. - --- Number of stories............ :.........:........I...... _
City: State: ZIP: Type of construction.. •••••
Phone: ��—�
Fax: E-mail: Occupancy group(s): Existing:
CCB no.: I ( --- ---,-- --- New:
City/metro lic.no.: Notice:All contractors and subcontractors arc required to be
a licensed with the Orsgon Construction Contractors Board under
provisions of ORS 701 and may be required to be licensed in the
jurisdiction where work is being performed.If the applicant is
r...r fa tJ A �_V. ►J �_)
Address: exempt from licensing,the following reason applies:
O7ity: Starr:(_;� ZIP: -
Contact person: J.Gll Plan no.:
Phone: Fax: I E-mail:
Contact person: Fees due upon application ...........................$
Name: Date received:
Address: $
E-mail::
.� - State: ZIP: Amount received ..................'......................
Please refs to fee schedule.
Phone: Fax: --
Not ail Jurisdictions accept credit canis,pleave call jurisdiction for more Information.
1 hereby certify I have read and examined this application and the p visa o MasterCard
attached checklist.All provisions of laws and ordinances governing this creak card n0 Ma
bel
work will be complied with,whether specified herein or not. !spires
1 / f f Nuns of catdholdrt as shown on credit cam
Authorized sigilature. x711 + /. }Daft: _ _ g _
Print name:_� F1�11111 l'• r i I��� E Cudholder signature Amount
Notice:This permit application expires if a permit is not obtained within ISO days alter it has been accepted as complete. W4613(&W/CgMI
1
Mechanical Permit Application
Date received: Permit no.:
City of Tigard Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 ---
Phone: (503) 6394171 Date issued: By: Receipt no.:
Fax: (503)598-1960 Case file no.: Payment type:
Land use approval: Building permit no.:
0 1 &2 family dwelling or accessory 0 Commercial/industrial U Multifamily U Tenant improvement
0 New construction U Addition/alteration/replacement U Other:
.1011 SITI' t 0 'RUIAL VAUI AI ION
Job address: ., (r - AC , Indicate egoipntent 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.: f r.oCj - rofit.Value !�
Lot: I Block: Subdivision: Et.K.N(URl-1 P C_. *See checklist i,)r important application information and
Project name: -c jurisdiction's fee ` ' ! r rr residential permit fee.
City/county: t ZIP: t t
Description and location of work on premises: t t f t t
Fee(ea.) Total
Est.date of completion/inspection: Description Qty. Res.only Res.only
Tenant improvement or change of use:
Is existing space heated or conditioned?0 Yes O No Air handling unit CFM _
Air conditioning(site plan required)
Is existing space insulated?U Yes U No I Alteration of existing FIVAC system
o er compressors -
State toiler permit no.:
Business name: (.H _ �_ l HP Tons BTU/H
Address: `r' r K. I i 1Fire/smoke ampers c uctsmo aeta ectors -
City: State: ZIP: cat pump(site plan require )
Phone: E-mail: nsta rep ace unace/buner
/7
Including ductwork/vent liner U Yes O No
CCB no.: ( nsta rep ac re ovate heaters-auspen -e ,
City/metro tic.no.: _ wall,or floor mounted
Name(please print): (>t 1�t F. • ;TVent forappliance o er than furnace
Oe ent on:
CONTACT Pt�RS �,
Absorption units�_ BTU/}I
Name: ''>fe_AU iL-.(-rL- LE( C 1 ,L „ Chillers.-- _ HP -_
Address: Lit-ICO Com ressors HP
Environmental exhaust an rent al on:
City: ` ) State: ZIP: ' i ? Appliance vent
Phone: r- Fax:r`►^r; E-mail: ryerex gust —__
s,Type V Wres, itc a azmat
hood fire suppression system
Name: E J 1 UE 1Tp r TExhaust fan with single duct(bath fans)
Mailing address: .r a�gnat apart from heating or AC
Fuelpiping a distribution up to outlets)
City: State: ZIP: Type: LPG __ NO Oil
Phone: Fax: E-mail; 'vel piping each a itiona over 4 outlets
Process piping(s-- c t�ematic req—Mr—R—)
Name: rNumber of outlets
i ` j )E �i -> j teracT ppTiance or equipment:—
Address: r c '1 L Decorative fireplace
14
City: }1 F T State:-"� ZIP: l iinsert-type
Phone: 1 r ax: E-mail: stov pc et stove
Applicant's sign Lure: i Ilatx Other:
_ _ ter:
Name(print): ENj/� _ I_
Not all jurisdiction rxept credit cards,please call jurisdiction for more inrotmation Notice:This permit application Perl,lit fee.-..................$
J Visa G MastetCard Minimum fee................$
tledu card number:
expires if a permit is not obtained
_ been within I80 days aPlan review(at ._ -') $
aplrc, after it has State surcharge(8%) ....$
Name of cardholder u a own on credit cad accepted as complete.
_ _$ TOTAI. .......................$ -
-----—Cardholder dgnalurc vJ Amount 41p 4617(rwvorr0e)
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Electrical Permit Application
Date received: Permit no.:
City Of Tigard Project/appl.no.: Expire date:
City,ofTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receiptno.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case rile no.: Payment type:
L and use approval:
O 1 &2 family dwelling or accessory O Commercial/industrial O Multi-family O Tenant improvement
New construction O Addition/alteration/replacement O Other: U Partial
JOB SITE INFORMSTION
Job address_ " W ,('1-I Bldg.no.: I Suite no.: Tax map/tax lot/account no.:
Lot: j- Block: Subdivision: HQ J 1 �J i0. _ -
Project name: Description and location of work on premises: r
IL
Estimated date of cornpletion/inspection:
CONTRAC70111 APPLICATIONSCHEDULE
Job no: I y Max
Business name: ��` F1 E zC'(�IC. Description ) p
Qt-r. (ca. lural no.ins
--
Address: New residential-single or tmdti-famill per
U 3 2-
dncllinRunit.In(holes attached Karage.
City: AL F 1[ State:- y'. ZIservice included:
Phone: Y15 Z227 Fax:Y13 " 7 E-mail: 1000 sq.ft or less 4
Each additional 500 s ft.or onion thereof
CCB n .: - Elec.bus.lie.no: e •� r�
City/rrtrlie.n . Limited ener y,residential 2
. _..
Limited energy,non-residential
Acr Each manufactured home or modular dwelling
rat t o u tying rcian(required) Datef I Service and/or feeder
Su elect.name rind Serrates or feeder-Inslallallon,
P (P License no
Alteration or relocation:
11"'Will"ERTYOWNER
200 amps or less _ 2
Name(print): L tj fH L t f 1 L .L .l- . 201 amps to 400 amps 2 —
401 amps to 600 amps Mailing address: '1 rCln 601 amps to I000 00amstrips 2 --
_City: �J E P_vq n State: ZIP: �1 l) Over 1000 amps or volts 2
Phone:r 2 Fax: rJ E-mail: Reconnect only
1
Owner installation:The installation is being made on property 1 own Temporary ser-0cm or feeders-
which is not intended for sale,lease,rent,or exchange according to Installation,alteration,or relocation:
ORS 447,455,479,670,701. 200 amps or less 2
201&nips to 400 amps 2
Owner's si mature: Date: 401 to 60()amps — ____2
1111111111111WL"1101 Branch circuits-new,alteration,
or extension per panel:
Name: :° �j A. Fee for branch circuits with purchase of
C C -
Address: J service or feeder fee,each branch circuit 2
City: I Sc.tal7.1 P: (1 e B Fee for branch circuits without purchase
p of service or feeder fee,first branch circuit: _ 2
Phone:"' e -f t : ) Fax: E-mail:
Each additional branch circuit.
Misc.(Service or feeder not Included):
U Service over 22.5 amps-commercial U Health-care facility Each pump or irrigation circle 2
U Service over 320 amps-rating of I&2 U Hazardous location Each signor outline lighting 2
familydwellings U Building over 10,000 square feet rout or Signal circuit(s)or a limited energy panel.
U System over 600 volts nominal more residential units in one structure alteration,or extension" 2
U Puilding over three stories U Feeders,400 amps or more "Description:
Cl Uccupant load over 99 persona U Manufactured structures or Rv parte Fisch additional Inspection o.er the allowable In any of the above:
Q EgressAighdngplan U Other Perinspection
Submit—sets of plans with any of the above. Investigation fee —The above are not applicable to temporary construction service. Other --- -
Not all jurisdictions wcept cr,dit cards,please call jurisdiction for more Information Notice:This permit application Permit fee.....................$ -
U Visa U MasterCard expires if n permit is not obtained Plan review(at _ %) $
Credit cud number _ -__ L _ within 190 days after it has bccn State surcharge(8%)....$
Name of cardholder as Shawn on credit caul Expires accepted as complete. TOTAL
$
Caidholde'rsignature Amount 4404615(&A=-ONt)
Plumbing Permit Application
City of Tigard Date received. Permit no.:
Address: 13125 SW Hall lilvd,Tigard,OR 97': i Sewer permit no.: Building permit no.:
City of Tigard Phone: (503) 639-4171 Project/appl.trm Expiredatc:
Fax: (503)598-1960 Date issued: By: Receipt no
Land use approval: Case file no.: Payment type:
U 1 &2 family dwelling or accessory O Commercial/industrial U Muni family l7 Tenant improvement
W New construction U Adchlion/alter,,tion/rcplacxnumt U i;xNl "deice U Other:
10 11 11i'llulli 7
Job address: Z'�(r� ;�{nJ (<.i�C KY tJ. C.T. Description 0q. Fee(ea.) Total
Bldg,no.: Suite no.: New I-and 2-family dwellings only:
Taxmap/taxlot/accountno.: )_` 'tom _ - (includes 100 ft.foreachutilityconnection)
SFR(1)bath
Lot: Block: I Subdivision: F L KNcJVJ.
SFR(2)bath --- - - -
Project name: r TH SFR(3)bath
City/county: -r - 7_.IP: Each additional bath/kitchen _
Description and location of work on premises: SiteutWties:
_ Catch basin/area drain
Est.date of completionlinspection: Drywells/leach line/trench drain
PLUMBING 1 Footing drain(no.lin. ft.)
Manufactured home utilities
Business name: F'l V r-1 E5 (y Manholes
Address: "' `;� 'L 1, C ;q
Rain drain connector --
City: < j State: ZIP: 1 is_ Sanitary sewer(no.lin.ft.)
Phone: Fax:'r)q E-mail: Storm sewer(no.lin. ft.)
CCB no,: �_ . )(�, Plumb.bus.reg.no: ' Water service(no.lin.ft.)
City/metro lie.no.: �- Fixture or Item:
Contractor's representative signature: Absorption valve
Print name:
Back flow reventer
i r .} r 1 bate: % i Backwater valve
CONTUTPURSON Basins/lavatory
Nance: L.E.CIAC..Y H T5 , L .L .r - bVIAUMlUF 'Clothes washer
Adiress: PCU boy. `Ay(r. Dishwasher
Cit `T -��----
Drinking
fountain(s)
city: OC) State: : i 71P:
•:,r, )r O Faz:� r.-- Ejectors/sump
Phone: 1_, OrY ;E-mail: Expansion tank
Fixturc/sewer ca
Name(print): 71 it".i Floor drains/floor sinksthub
Mailing address: — -- Garbage dis sal
Nose Bibb
City: State: ZIP: Ice maker
Phone: I E-mail: Intercept ase trap
Owner installation/residential maintenance only: The actual installation Primer(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:
Tubs/shower/shower pan
Name: 1 KE(aUrinal
Lr�K:�1t�1 L.>E51Cjt l Watercloset
Acidtes J 7 LEtia I.V. f��Ll.� Water heater
('ity: _ Stater>� ZIP: ` - Other:
Phone: Fax: E-mail: Total
Not all)udsdictions acceo credit cards,pimse call lui:Octlon for mom Informnem Minimum fee................$
Notice:This permit application
❑visa U MasterCard Plan review(a( _ %) $
credit cad number- expires if a pemlit is not obtained -
------- �-Fr i�-- within 180 days aRcr it has been State surcharge(85h) ....$ _
p TOTAI.
-- - — - ecce tcd as com lett. $
Nan*of cardholder to shown on cmdit card P P
' S
'-- ...�.. Cardholder sigtahtre Amount 1404616(NOOICObt)
1
SE- , E 35MM
ROLL # 20
FOR
OVERSIZED
DOCUMENT
CITY O TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 x.00 jj X537
INSPECTION DIVISION Business Line: (503) 639-4171 MST
� BUP - --- —
Received __ Date Requested __ __ AM � . PM -_.________ BUP
Location _-_ �—� �v 2-- ,,���r,, Suite MEG
Contact Person _ �-rye _ Ph (�_.....) ._'Z�y"-�LO PLM
Contractor --- - Ph ( -- ) - - - - - SWR
BUILDING Tenant/Owner -___- ELC
Footing
Foundation ELC
Access:
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:
Final i
PASS PART FAIL
PLUMBING
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
PA RTS FAIL
TRIC
Rough-In
UG/Slab
Low Voltage
Fire Atarm
Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
[� Please call for reinspection RE. —_ Unable to inspect-no access
Fire Supply Line
ADA )_I—'
I.-'
Approach/Sidewalk Date _ Inspector
Other
Final DO NOT REMOVE this Inspection record from the job site,
PASS PART FAIL
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175 MST o`00( 00 S^,3
INSPECTION DIVISION Business Line: (503) 639-4171 l" r� .
BUP
Received __ Date Requested �3`•5___ -__ AM l PM -__ - BUP
Location ----------- - --Suite - MEC
dl U 0A
Contact Person ____- r_,.�,aq Ph(—) -79 __ PLM
Contractor _ -. _ Ph(_ ) - SWR
BUILDING Tenant/Owner
_r.------___ -- ELC _- ------ -
Footing ELC -
Foundation Access:
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
Othar;
- --- _
in
PART FAII —�--k4JMBING
Post& Beam
Under Slab
Rough-In
Water Service -- --
Sanitary Sewer
Rain Drains - - - -- --
Catch Basin/Manhole
Storm Drain - -
Shower Pan
WCHA
PART FAIL_NICAL
Post& Beam -
Rough-In
teas Line
Smoke Dampers --- --
PART FAILEtOTRICAL _
Service V --- ------- -
Rough-In
UG/Slab --__—,_-
Low Voltage ---___--
Fire Alarm
Final Reinspection fee of s required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS _PART FAIL
SITE - L] Please call for reinspection RE: —_ Unable to inspect-no access
Fire Supply Line _
Approach/Sidewalk Date f" 2 _ Inspector Ext `
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL