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' _..._ .•t CITY OF 11
BUILDING DI' WO
NOTICE: IF THE PRINT OR TYPE ON ANY rl �—� � Ir � i � l � l � ilr ( ilc � � l � lili � I � I � ii iilli-CTFFr.tTlF -IT[TF] IIIIiJill 11Itlr � � I � I � � � � I � � ilti � i �ili . � IiIII Ilir� rt� �� III > Ilt � t I � I � ItII � ► � Ilr) II � 1 >—.rtl �rllli Ilt III I II
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IMAGE IS NOT AS CLEAR AS THIS NOTICE, 1 ► 2 3 4 i �17' IS I , � � � •
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No.36
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12763 SW Rocky Mountain Court
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISIONMST
Business Line: (503) 639-4171
BLIP
Received ._ _ Date Requested - _ AM- --__ _-- PM BLIP _----_- _
l-ocation _ J ' quite MEC
Contact Person _ �. 1-1 — Ph _Ll CL PLM
Contractor - ---.._. -- Ph(_ — ) -- — -- SWR
BUILDING Tenant/Owner _ _ _ ELC
Footing ELC __ v
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 �� � 1
Fire Sptinkler -
Fire Alarm
Susp'd Ceiling __-
Roof
Other. �-
Final
-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 8 Beam — —— -------- ----- -----------.
Rough-In
Gas Line
Smoke Dampers - ----- ----- - — -- -
Final
PASS PART FAIL - ------_—^—__ _� — -- -
ELEC_TRICAL --
Service-
Rough-In --- ---- — -- - -- --- ---
UG/Slab
Low Voltage
Fire Alarm
PAS PART FAIL Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinspection RE:___ ____ , T.�-�D Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date -= '�=-�-�L Inspector Ext
Other: ,
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY, OF T'GARD _ MASTER PERMIT
PERMIT #: MST2002-00043
DEVELOPMENT SERVICES DATE ISSUED: 2/8/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 12793 SW ROCKY MOUNTAIN CT PARCEL: 2S109AD-08000
SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7
BLOCK: LOT:024 JURISDICTION: TIG
REMARKS: Construction of new SF detached residence. Path 1
BUILDING _
REISSUE- STORIES 2 FLOOR AREAS_ REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 26 FIRST 877 at BASEMENT: 49000 of LEFT: 11 SMOKE DETECTORS: Y
TYPE OF IISE: SF FLOOR LOAD 40 SECOND: 1.363 of GARAGE: 520 al FRONT: 21 PARKING SPACES: 2
TYPE OF CONST: 5N DWELLING UNITS: I FINBSMENT: of VALUE S 262.047 60 RIGHT: 5
OCCUPANCY GRP: R3 BDRM. .1 BATH: 3 TOTAL: 2.260 00 at REAR: 33
PLUMBING –
SINKS: I WATER CLOSETS: i WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS:
LAVATORIES: 5 DISHWASHERS: I FLOOR DP'INS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
L'BISHOWERS: 3 GARBAGE DISP: 1 WATER V JERS: I WATER LINES: 100 BCKFLW PREVNTR: i GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN<100K: BOILICMp<3HP: VENT FANS 5 CLOTHES DRYER: I
,.,n5 FURN>•10014: I UNIT HEATERS: HOODS. 1 OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS I WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL —
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS_ MISCELLANEOUS ADO'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp: 0 200 arro: WISVC OR FDR: 1 PUMPIIRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 4 201 400 amp: 201 400 amp: tat WIO SVC/FDR: 00 SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 600 amp: EA ADDL OR CIR: SIGNAUPANEL: IN PLANT:
MANU HMISVC/FDR: 601 • 1000 amp: 601-amps-1000v: MINOR LABEL:
1000+amo/volt PLAN REVIEW SECTION
Reconnect only:
>•4 RES UNITS: 9VCIFDR>•225 A.. >800 V NOMINAL: CLS AREAlSPC OCC:
ELECTRICAL-RESTRICTED ENERGY
A.SF RESIDENTIAL B.COMMERCIAL
AUDIO&STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL. OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS TOTAL 0 SYSTEMS:
TOTAL FEES: $ 7,607.74
Owner: Contractor: This permit is subject to the regulations contained in the
LEGACY HOMES LLC Tigard Municipal Code,State of OR. Specialty Codes and
PO BOX 446 all other applicable laws. All work will be done In
SHERWOOD,OR 97140 accordance with approved plans. This permit will expire H
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
Rag a forth in OAR 952-001-0010 through 952-001-0080. You
may obtain copies of th9se rules or direct questions to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erosion Control Insp 81 Wtr Proofing Bsm't Wa Footing/Foundation Dn Electrical Rough In Gas Line Insp Electrical Final
Grading Inspection Post/Beam Structural PLM/Underfloor Framing Insp Insulation Insp Mechanical Final
Sewer Inspection Post/Beam Mechanics Mechanical Insp Shear Wall Insp Rain drain insp Plumb Final
Footing Insp Underfloor Insulation Plumb Top Out Exterior Sheathing Insl Water Line Insp Final inspection
Foundation Insp Crawl Drain/Backwater Electrical Service Low Voltage Appr/Sdwlk Insp
Issued By : �1 Permittee Signature :. �j -_f.
Call (503x619-4175 by 7:00 p.m. for an inspection needed the next business day
CITYOF TIGARD _ SEWER CONNECTION PERMIT
DEVELOPME14T SERVICES PERMIT#: SWR2002-00033
13'125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 2/8/02.
SITE ADDRESS; 12763 SW ROCKY MOUNTAIN CT
PARCEL: 2S109AD-08000
SUBDIVISION: ELK HORN RIDGE ESTATES ZONING: R-7
BLOCK: LOT: 024 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 detached residence.
Owner: -------- -
_
LEGACY HOMES LLC FEES
PO BOX 446 Type By^ Date Amount Receipt
SHERWOOD, OR 97140 PRMT CTR 2/8/02 $2,300.00 27200200000
INSP CTR 2/8/02 $35.00 27200200000
Phone: 503-925-0506 Total $2,335.00
Contractor:
Phone:
Rey #:
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 distance given If not so located, the installer shall purchase a"Tap and
Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted
by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-00 10 through OAR 952-001-0080
You may obtain copies of these rules or direct questions to OUNC by calling(503) 246-1987
Issued by: %1 1L dle 24 Permittee Signature: e,41, ,`i /'i e,,I'i-7CAll
Call (503) 6 9-4175 by 7:00 P.M. for an inspection needed the next business day
Building Permit Application
fi (� Date received:,;y /l'� Permit no.
City of Tigard - _
Address: 13125 SW Hall Blvd,Tigard,IOR 97223 Rojecdappl.no.: Expire date:
CiryojTigurd phone: (503) 639-4171 ` Date issued: By:txl Receiptno.:
Fax: (503)598-1960 Case fileno.: Paymenttype: J
Land use approval: —_ 1&2 family:Simple Complex:
1
❑ I &2 family dwelling or accessory U Commercial/industrial ❑Multi-family /)`a',New construction U Demolition
❑Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alar ❑Other:
1 1 v,
Job address: 1 LitBldg.no.: Suite no.: _
Lor. Block: Subdivt ion:' I p (. --- Tax map/tax lot/account no.: i d ,,_;.)Z (XX)
— —
Project name:
Description and location of work on premises/special conditions:_—_ J _ tI
Name: [-c� r t r --
(Flood t
Mailing :
addressTp' - c c 1, 1 &2 family dwelling: 4
City: IState: ,l Z.IP: I I' ' Valuation of work...........l4Z 0Y L....... $ z f.
Phone:' 'j U'r_ l v Fax: ' `-(Sl'f j E-mail: No.of bedrooms/baths................................. 1 _
Owner's representative: Total number of floors.................................
Phone: Fax: E-mail: New dwelling area(sq.ft. `
Gamge/carport area(q.ft.).........................
Name: r r Covered porch arca(sq.ft.) ......................... _ Z
Mailing address: Deck area(sq. ft.)........................................
City: State: ZIP: Other structure area(sq.ft.)......................... —
Phone: Fax: E-mail: Commercial/IndustriaU7\And'.1,y.ti-f
1 , Valuation of work.......... ......... E
Existing bldg.area(sq.f ........... .... —
Business name: t rYi r (�,t t'r1 t-(,-. New bldg.area(sq.ft.)
Address: Number of stories. .......
State: Z[P:
Crty: Type of construction
Phone: Fax: E-mail: — Occupancy group(s): Exis
CCB no.: t F -- - New-
Cit
ew. _
City/metro lie.no.: Notice:All contractors and subcontractors are required to be
r licensed wide the Oregon Construction Contractors Board under
Name: �'� I ( �_P!` " t t �..G .l provisions of ORS 701 and may be required to be licensed in the
Address: -0 c jurisdiction where work is being performed.If the applicant is
exempt from licensing,the following re*on applies:
Statef,A. JZIP, C-) l. 4
Contact person. -,r(-a r I Plan no.: 7'15 C f;
Phone:rl^, .ser-U U, Fax: '''"•(;f E-mail:
Name: Contact person: Fees due upon application ........................... $_
Address: Date received:
City: State: ZIP: Amount received ......................................... 5 _
Phone: Fax: E-mail: Please refer to fee schedule
I hereby certify I have read and examined this application and the Not all jurisdiction or"credit cards,please call jurisdiction for more information
attached checklist.All provisions of laws and ordinances governing this Ovdsa U MasletCatd
work will be complied with,wheoie_r pe cif d herein or notcrease card number: __ _
Expires
Authorized signature. Upate: `I U Name of cardholder at shown on credit coed
;
Print name: \I l)I ' � Cudholder signature Amount
Notice:This pcmiit application expires if a permit is not obtained within 190 days after it has been accepted as complete. 440.4613(6MCOM)
Elc htrical Permit Application
Datereceived: Permit no.:{VI11 (,' {,r
City of Tigard Pro)ect/appl.no.: _ Expire date:
City ofTigard Address: 13125 SW liall Blvd,Tigard,OR 97223 pate issued: By: Receiptno.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case file no.: Payment type-
Land use approval:
TYPE OF PERN111IT'
O 1 &2 family dwelling or accessory U Comnu71411/111lu"trial U Multi-family O Tenant improvement
New construction O Addition/alteration/replacement O Other: _ U Partial
JOB SUFF INFORM,%
Job address: "y j r I {r Y 1 t Bldg.no.: Suite no.: _ Tax map/tax lot/account no.:
Lot: 1 Block: Subdiv' ion: F.I k l r-)f r;
Project name: I Description and location of work on premises:
Estimated date of completion/inscoon:
ION FEE SUIEDULE
Job no: Fer M1lar
------_---__ llcscription (Xv. (ea.) Total no.insp
BUiness name: (I _- —- -- Nen residential single or multi family per
Address: dwelling unh.lnelurksattached Karage.
City: �(1 L.Q.I State` Z1P:r `o'3 Sveryice included:
Phone: it" ..'' ; Fax: r (-11441 E-mail: 1000 sq.ft.or less
Each additional 500 sq.ft.or portion thereof _
CCB no,: Elec,bus.lie.no: 2 3 (: Limited energy,residential _ _ 2
City/mep tic.no.- Limited energy,non-residential _ 2
r` Each manufactured home or modular dwelling
Signaturd of supervising lectticiati(required) _ Date Service and/or feeder
Sup.elect.name(print) ,.
. l ,, .,,., ;;,� Services or feeders--Installntlon,
alteration or relocation:
111ROPER-11200 amps or less 2
201 amps to 400 amps —T--- 2
Name(print): r (JOCLJ Holil, L .�_ 401 amps to 600 amps 2
Mailing address:'i � I-)t.
601 amps to 1000 amps 2
City: r Stater 1ZIP: Over 1000 amps or volts 2
Phone: .5' 1 I Fax: f E-mail: Reconnect only I
Owner installation:The installation is being made on property I own Tempnrary:ervlces or feeders
whi:h is not intended for sale,lease,rent,or exchange according to installation,alteration,or relocation:
200 ampsor less 2
OR S 447,455,479,670,701. to
--
201 nmps to 400 amps 2
Owner's signature: Date: 401 to 600 amps _ _ 2
Branch circuits-new,alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee,each branch circuit 2
City: $tate: ZIP: ^� B Fee for branch circuits without purchase
of service or feeder fee,first branch circuit: 2
Phone: I ,t E-mail: Each additional branch circuit:
11,11 %N REVII %I (Please check aH that Upply) Mlle.(Service or feeder not included):
U Service over 225 amps-commercial U Health-care facilit) F-ach pump or imgation circle - 2
U Service over 320 amps rating of I&I U Hazardous location Each sign or outline lighting -- — 2
family dwellings U Building over 10,000 square feet four or Signal circuit(s)or a limited energy panel,
U System over 600 volts nominal more residential units in one structure alteration,or extension* _ 2
U Building over three stories U Feeders,400&nips or more sMscri tion:
O Occupant load over 99 persons O Manufactured structures or Rv park Eich additional Inspection over the allowable in any of the above:
O EgressAighdngplan U(thee —.-- Per inspection - —
Submit__sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other
Not all jurisdictions accept credit canis,please call jurisdiction for more infonnatino Notice:This permit application Permit fee.....................$
U visa U MasterCard expires if a permit is not obtained Plan review(at _ 95) $
Credit card number: _ �__- within 180 days after it has been State surcharge(8%)....$
Expires accepted as complete. TOTAL, .......................$
Nanta of--�cardh��'ea shown on credit card
_ S
Cardholder signature_'__ Amount 440.4615(64WOM)
Plumbing Permit,Application
Date received: Permit no.:►Vti,
City of Tigard Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223
CirynfTigarr! Phone: (503) 639-417! ProjecUappl.no.: Expire date:
Fax: (503) 598.1960 Date issued: By: Receipt no.:
Land use approval: _^ Case file no.: Payment type:
U I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant imprnvcrnent
New construction U Addition/alteration/replacentent U Food service U
1i S111 INFORMATION1
Job address: f Ikcrlrtion ()t II Total
Bldg.no.: SUM no.: — - New I-and 2-family dwellings only: ----
Tax map/tax lot/account no.: I0 _-- (includes 100 ft.for each utilityconnetlion)
4 _._-- SFR(1)bath
Lot: .t Block: Subdivision: t c SFR(2)bath - - --�--� -
Project name: _ _ SFR(3)bath
City/county: — _ ZIP: _ Each additional bath/kitchen
Description and location of work on premises: Sheutilities:
Catch basin/area drain
Est.date of completion/inspection: Dr+wells/leach line/trench drain
/iiiiiiii Footing drain(no.lin.ft.) —
Manufactured home utilities _
Business name: f I K. 1r t, _ Manholes
Address: Rain drain connector
City: 11.4 LrOV) StatiI ZIP: - Sanitary sewer(no.lin.ft.) —
Phone: 5rl '34- Fax: ' r t> E-mail: Storm sewer(no.lin.ft.) -
CCB no.: Ll 7 LbL I Plumb.bus.reg.no: Water service(no.lin.ft.)
City/metro lic.no.: 3cl- 1`-)rj Fixture or Item:
Contractor's representative signature: Absorption valve
---z � -�- Ba.k flow reventer _
Print name: I - ^ Date:
� Backwater valve
CONTAft 11"IFIRSON Basins lavatory
Name: t Clothes washer
Dishwasher
Address, _) rj 0 j
Drinking fountain(s) — -
City: 00 4 _ State• ZIP:7` t -
Ejectors/sump
Phone: r3d.5 Uc 6Fax. ' • E-mail Expansion tank
�ixture/sewei cap
Floor drains/floor sinks/hub —
Narne(print): i (✓( (1 uI;i( � � �1-,f
Mailing address: ' f t Garbe disposal
Hose bibb
City State: K ZIP: 'j t 1 Ice maker -
Phone: j 050(v I Fax:rE mail. Interceptor/grease trap
Owner instal lation/r sidential maintenance only: The actual installation Primer(s)
will he made by me or the maintenance and repair made by my regular Roof drain(commercial) _
employee on the property I own a5 per ORS Chapter 447. Sink(s),basin(s),lays(s)
Ownees signature: Date: Sump
Tubs/shower/shower pan
Urinal _
Name: — _ Water close
t
Address: Water heater
_City: State: ZIP: Other:
Phone: Fax: E-mail: Total _
Not all jurisdI accept credit cards,please call jurisdictim for tI inranttatioe. Notice:This permit application Minimum fee................$ _U Visa U MasterCard expires if a permit is not obtained plan review(at — %) $
Credit card numbs: __— —_L_L within 180 days after it has been State surcharge(8%)....$
Expires
Name of cardholdei as shown on credit cordaccepted as camplete. TOTAI. .......................$
' S
Card oldes signature Amount 410-4616(ISM/1 OM)
t
Mechanical Permit Application
Date received: Permit no.: � �� _` /
A City of Tigard Project/appl.no.: Expire date:
City 4Tigard Aderess: 13125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued: By: Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: -- - Iduilding permit nn
U 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
ANew construction ❑Addiutm/allcralicm/rcplarcmrnt U Oflier
Job address: I;�'�(Q�, y.,, i ,,�N I�r j t Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: _ Suite no,. value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: O'� ,roc_, profit.Value$
IL
Lot: Etlock: _ Subdi�isioi i p *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: 1 otihm 01i, ZIP: l
Description and location of Qork on mises: r il6litiLlMKI 0
Fee(ea) Total
Fist.date of completion/inspection: Dewri ion Qty. Res.only Res.only
Tenant improvement or change of use:
Is existing space heated or conditioned?U Yes U No Air handling unit —CFM___ -
Aircon itioning(site plan require )
Is existing space insulated?U Yes U No Alteration of existing FIVAC system -- "
CON1RAt,10111of er compressors -- -- -
Business name: J t A c State boiler permit no.:
_ HP Tons BTU/FI
Address: Z_7 Sr CJ Je• I�r1 '_(' Pirelsmoke dampers/duct smoedetectors -
City: 1J6r• Staled F'- ZIP: per Teat pump(site plan require ) -
Phone: (pU .- Fax:(, A-Lf E-mail: Install/replace urnace/burner__ /
Including ductwork/vent liner U Yes U No
CCB no.: (vU3 Instn rep ac reocate heaters-suspen e
City/metro lie.no.: _ wall,or floor mounted
Name(please print): QUO S,4 Vent forappliance other than furnace
Refrigeration,
Absorption units BTU/FI
Name: I.it 1 t fk I ' C Chillers. FFP
Address: -{ `' u K ' ' ( • Com ressors Hp
City: <l State: }�' Z[P: c i 11 t i v ronmenta ex ust an rent *tion:
�, Appliance vent
Phone: ;� Fax!' Email: [hyere�aust Hoods, -
Type res. rte en/hazmat
�r hood fire suppression system
Name: •/'i(' U r11>ab �- L.C Exhaust fan with single duct(bath fans)
Mailing addr6s: J --& 110 Exhaust s sterna art from heating or AC
City: l i ' State Z[P: (1711q0--
t_ 0 oe piping a d ut on up to out ets) -
City: tj Faz. Type LPG _",_-- NG _-- Oil
E-mail 'tie t m each ad itional overPhonI outlets
rocessp p ng(Umeaticrequired)
Name: Number of outlets
- --- ZSlTrer T{st app ince or equipment:
Address: i L)ecorativefireplace
City: _ State: ZIP: nsert-type T
Phone. v--- Fax: E-mail: -- Woodstovedpellel stove
-
Appli,-ant's signature: Date: Usher.O er:
!dame (print): --
Not all Jurisdictions accept credit carpis,please call Jurisdiction for mom information Permit fee.....................$
U Visa O MasterCard Notice:This permit application Minimum fee................$ _
Credit card number- expires if a permit is not obtained ,
I Ian review(at — 9t^) $
Fsplre� within 180 days after it has been State surcharge(876)....$
Name of c older as Chown on credit card accepted as complete.
s TOTAL. .......................$
rtudholder Nftnatnrc Amount 410-4617(199WOM)
SEE 35MM
ROLL # 20
FOR
OVERSIZED
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175 MSTI' 3
INSPECTION DIVISION Business Line: (503) 639-4171
BLIP
Received ._._ -_ Date Requested__- AM-- PM_ f BLIP
Location —_-_ ,� 1 C i 4 L� � ' _suite MEC -
Contact Person Ph Ph(__ _) _-79 -- ' �. PLM
Contractor --- - Ph( ) -- ---- SWR -- - - - _
BUILDING 7enant/Owner - ELC -
Footing ELC
Foundation Access:
Fig Drain ELR
Crawl Drain ,--- -----�—
Slab Inspection Notes: slT
Post& Beam - - - --
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing - �--
Insulation L
Drywall Nai'ing
Firewall
Fire Sprinkler --
Fire Alarm `
Susp'd Ceiling -
Roof
Other: -
�I'
S PART FAIL
B_IN_G -
Post&Beam
Under Slab - -
Rouqh-In
Water Service -- -- --- - --
Sanitary Sewer
Rain Drains - -- - - -
Catch Basin/Manhole
Storm Drain
Shower Pan
Other:-------
---
-------
Fin n
ASS PART FAIL
_ANICA_L__ --
Post&Beam -
Rough-in -- -- - _ _-_ - --- -
Gas Line
Smoke Dampers
FAAS PART FAIL ---"— ---_---
_CTI ICAL ---
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
Please call for reinspection RE: Unable to inspect-no access
BITE - ---- ❑ __� — L] P
Fire Supply Line �3r
ADA L, Z O Z-.
Approach/Sidewalk Date Inspector
Other _ _
Final - DO NOT REMOVE this inspection record from the Jeb site.
PASS PART FAIL