9740 SW PEMBROOK STREET E
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MECHANICAL PERMIT
CITY O L T'G /\ R _
DEVELOPMENT SERVICES PERMIT#: MEC2002-00529
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/25/02PARCEL: 2S111BD-0?.000
SITE ADDRESS: 09740 SW PEMBROOK ST
SUBDIVISION: CLOUD CAP ZONING: R-3.5
BLOCK: LOT: 012. JURISDICTION- TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VEN'r FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: _ BOILERS/COMPRESSORS HOODS:
FUEL TYPES 6---3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML.. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU AIR HANDLING UNITS _ OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm:� _ GAS OUTLETS: 2
> 10000 cfm:
Remarks: Install gas line and 2 outlets to 2 gas loci
Owner: FEES _
BARTLETT, JOHN E LAUNA M Description Date Amount
9740 SW PEMBROOK ST %111,111] PC- nit fee 11/25/02 $72.50
TIGARD, OR 97223 i%1LCI II Permit Fee 11/25/02 $0.00
[TAX] 8%,State'rax 11125/02 $5.80
Phone: [TAX] 8%,StateTax 11/25/02 $0.00
Cuntractnr: Total $78.30 j
SHAMBURG HEATING LLC
23975 SW BOONES FERRY RD
TUALATIN, OR 97062 REQUIRED INSPECTIONS _
Gas Line Insp
Phone: 503-692 t pgechanicallnsp
Reg # 126881 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Orr.
Specialty Codes and all other applicable laws. All work will be done on accordance with approved
plans. 'this permit will expire if work is not started within 180 days of issuance, or if work 's suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adoptad ;n the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 though OAR
952-001-0100. You may obtain copies of these rules ordirec,, questions to 1�UNC by calling
(503)246-0699.
Issued By: _ Permittee Signature: \ __�*✓`✓� fes'" "
Call (503) 639.4175 by 7:00 P.M. for inspections needed the next business day
r
Mechanical'Permit Application
_��__— ----- Date received: / ` ,�- ',e- Permit no
City of Tigar.1 Project/appl.no.: Expire date: -
City ofTlgord Address, 13125 SW I fall Blvd,Tigard,OR 97223 Date issued: By&, Receipt no.: _
Phone: (503) 639-4l'i I
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: Building permit no.:
0
=New
ly dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
uction U Addition/alteration/mplacement U Other
rt
Job address: !• 7 IqlnhLa ILIndicate equipment quautiu-,s In boxes below.Indicate the(foliar
Bld .no.: _ Suite no.: —� value of all mechanical materials,equipment,labor,overhead,
Tax map/tan lot/account no.: profit. Value S _
Lot: Black: Subdivision: 'See checklist for important application inform%,ion and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: 1GZt/a!
Description andlocation of work on pd raises: in irla-ZIL -,0'1120__.
only
Est.date of completion/inspection: tka�ri7nr
Tenant improvement or change of use: Air handlin unit CFM
Is existing space heated or conditioned?U Yes U No it con itioning(su—'a tan requir )
Is existing space insulated?U Yes U No Alteration o existing system
Boiler/compressors
State boiler permit no.-
Business name:'./ ,gm L-L L _ HP Tons BTU/H
Address: - 41Fire/smoke ampe uctsmoke detectors _
City: / Stole:/�� 'Lip:j J�l�J eat pump(sue p in iglu ric)
Phone: (� Fax:( ��E-mail: nate rep ace ork/ urne:r
Including ductwork/vent liner U Yes U No
CCB no.: � 'f/ nate rep ac re ocate eaters-suspen
City/metro lie.no.: �%. wall,or floor mounted --
Name(please print): i' �y i , Vent-Torappliance of eer t_mn ornate
e nRernlioa
Absorption units _ BTU/H
Name: / ,i /J6L1 Chillers -- --- _ - HP --
Coin ressors _ . lip
Address: ettlta exhaust and ventilation:
City: 'r/w1 Aeve State: 7.IP: Ap liancevent
I E-mai!: Terex aunt
Roc4s-, yperes. arc er iazmat
hood fire suppression system
Name: J, /i/) r' Exhaust fen with single duct(bath fans)
Mailing address
Exhaust system aea-rarr-0-m-heating or AC
Fed piplinaWrrri►mit (up to out eta
City: State:4� ZIP: t' :9 Type: _LPC;
Phone: C Fax: I E-mail: Fuel pipingeach adaition, over out eta
piplaig(schematic requl-res)
Number of outlets
Name: -------.- - -r 1We_Gppp a or eqn pwent:
Address: Decorativeftreplace
City: State: ZIP: ��-type
_Wood --
E-mail. tov Ix et stove _
Phonc: K:
Appl;cant's signature: _ Date:
Name(print' �i `]f�N� �L. — -- —�
rnv toll furidic•im for mar irdrxrruhinn Permit fee..................... - -�_—
Nd;nrlarlkrbnn�acrrpr cadh card,pi Notice!"thisPermit application Mint
rum fee................S _
01.153 U MasterCard exnims if a permit is not obtained Plan revit.w(at _ %) $
Ordii Card number_ - within 180 days after it has leen
State surcharge(8%) ....$ `
_— N;une -eudkota r �m
-ic- -- $ e ted as complete.
►
Crdhddei dputwu� Amount J 4444617 i60 OM1
CITY OF TIGAPP 24-Hour
BUILDING Inspectien Line: (503) 639-4175
MST
INSPLF"CTI.�N DIVISION Business Line: (503) 639-4171
i BUP - ---
Received — —Date Ranim ted _ AM_---` PM__ __ BLIP -_--_ --_-__— —_
Location SuiteC' MEC
Contact Person —r �� Ph( ) 6 C/ _ 5-SI°-2 PLM
Coni actor - -- Ph(—) , _ SWR _.
13U11_DING Tenant/Owner ELC
—
Footing E L.0
Foundation Access:
Ftg Drain ELF1
Crawl Drain
Slab Inspection Nates: SIT -
Post&Beam ......
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing ! S ,p t rA,tn✓^aj2 42L r- i
Insulation /
Drywall Nailing - �,�- sa/�Z7� 11 i / t:ir t' '°`"K _
Firewall
Fire Sprinkler -- --- -
Fire Alarm
Susp'd Ceiling - - --
Roof
Other: -
Final
PASS PART FAIL - - ----- v---
PLUM_B_INQ --
Post&Beam
Under Slab _-
Rough-In
Water Service - --- ----------- —_--- ------ -
Sanitary Sewer
Rain Drains - - -- ---- -
Catch Basin/Manhole
Storm Drain ---- - - - -__ �__..------------._.
Shower Pan
Other: _ -- -- -- --- ---- ---- --
Final - -
PASS -.PAFTT! FAIL -
I
_._.
Post&Beam ----- _____ .
----.— _---- -_.--
Rough.IroSmke Dampers - -------
-�_-�- ---- ----- -- ----
~AW PART FAIL --� - - --
ECTRICAL
Sr --- ----------
Roug i-In
UG/Slab --- --_---- --
Law Voltage
Fire Alarm ---T-_-=------ - ---
Final Reinspeatbn fee of$— --required before next inspection. Pay at City Flail, 13125 SW Hall Blvd.
FASa PART FAIL
SITE - Please call for reinspection RE: - _ linable to inspect-no access
Fire Supply Line
ADA /
Approach/Sidewalk 7 - C ��---- Inspoc#or --. ___Ext
Other:
Final - — — DO NOT REMOVE this inspection record from the Jeb site.
PASS PART FAIL
OF TIGARD
CEglE-OPMENT SERVICES ELECTRICAL PERMIT
13125 S!Y iall Blvd., Tigard, OR 97223 (503)639.41'1 G'E RM I f #; F LC96-0773
DATE ISSUED: 12'/09/96
PARCEL: 2SiIIBD-O3000
S ITE ADDRESS. . . 09740 SW PE MBROOK S'T
SUBDIVISION. .. . . : (.I-,ICAP
7ONING:R-3. '.3 i
BLOCK,. . . . . . . .. . . . LOT. . . . . . . . . . . . . : 12'
Pt-o.)ect Desr_r'iptio-r : Installing 1 BRANCH CIRCUIT
REF # 62399
c� - -_---M I SCELL_ANEOUS__.--_ .
,RVC_:/FFE:DFRS-----~
1.000 SF OR LE:SS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L- `5009F. ,. . : 0 201. -- 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . - IP
L.TMITED ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/PANEL_. . . . . . .. 4�
MANE. HM/ SVC:/FDR. . : 0 601+rmps--1000 volts. : 0 IhIN0R L..ABE.L. ( 10' . .. .. iC
ICF./FEE<DER----- -_--BRANCH CIRCUITS------- ---ADD' L INSPECTIONS--..-
0 .'00 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PV R INSPECTION. . ,. . . : 0
201 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER. HOUR. . . . . . . . . . . : 0
401 600 amp. . . . •• . . 0 EA ADD' L BRNCH CIRC: 'ih IN PLANT. ., . . . . . . . . . : 0
601 - 1.000 amp. . . . . : 0 -_.__..____.________-PI_.AN REVIEW SECT i ON----____--___
1.000-~ amp/Volt. . . . . . 0 ) =4 RES UNITS. . . . . . . : ) 600 VOLT NOM I NAL_. . :
Reconnect only. . . . . : 0 SVC/FDR > = 225 AMP'S. . : CLASS AFEWSP'EC OCC. :
Ownr�r : FEFS .___.___...._ _..__..._._._.._._.
JOHN BARTLETT type am()'-Ent by date recpt
9740 SW PEMBRCIOK STREET P'RMT $ 3'.j. 00 fAT lc_/O`3/9E; "?f 287396
SPCT $ 1. 75 TAT 12/09/96 96-287396
TIGARD OR
Phone #: 620-0979
Contractor.: .............._..---•----._.____$-------J.-..____._..._.__.__.___._.___.___.____.__.__
TUAI..AT I N ELECTRIC 6. 75 TOTAL_
PO BOX 6`5
RECl1IRFD INSPECTION!!` ---_...- -
WILSONVI.L.I.._E OR 970.70 Ce i. 1. ing Cover Undergr'or_rn•l CnvF3
Phone #: 503-682-2955 Wall Cover^ Elect, I Set-vice
Reg #. . : 655650
This pervit is issued subject to the regulations contained in the .�
Tigard Municipal Code, Statr of Ore. Specialty Codes and all other 17,$.. ee. Sign,atUre
applicable lar's. All work will be done in accordance with 1
approved plans. chis permit will expire i(' work is not started �
within 188 days of issuance, or if wo6 is suspended for sore ------
than 188 days. ns_
r_r e d H OWNER INSTALLATION ONLY
y_--~
' lie installation is being made on proper-ty I own whict-i is not intended for
Ale, lease, nr' r'ent.
'1WNER' S S I GNAT URE: DATE:
-- - CnNTRACTOR INSTAI_.L-ATIOt`I
1!~NATURE OF SUPR. ELEC' N: _��_ DATE:
f CENSE: NO: _—• _______-_--_--
C a;. l for- inspection - 639-4175,
1
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tiger, OR 97223 Planck/Rec. #
Permit # ' 1
Phone (503) 639-4171 pate Issued _
FAX (503) 6647297 Issued
CITY OF TIGARD TDD No. (503) 684-2772
Inspection (503) 539-4175
1. Jab Address: 1 '4. Complete Fee Schedule Below:
Name of Develo Ment ( Number of Inapscdons per permit allowed_-
Address \�C� ��J�—� c� r rn baz ,_. Sarvjv F;j rrfud0dl Items Casson) Sum
• -- -----
r
L 4a. Residential per unit
enia -
City;State2ip___�(, �
X000 1110 00 4
:v '1 or�...
Ear,add I'll
nal 500 W.".or
Name (or name of business) „mon'"mot $2500 '
l.rmaW Energy 325 00
Commercial❑ F�esidential Each Menut'd Home or Modular 2
O«e6ng Sanas or Feeder 86a 00
2a. Contractor installatio only: As). services or Feeders
/� irwtam or l .a Moo
of relegation 2
Electrical ContractOf zoo00 amps Moo 2
201 am.to 400 amps U0 0o 2
Address �;y .� 401 am„to 800 smog $120.00 2
City 1,,1j I �,t1!// — State . Z1p _ so ams to 1000 amps 1180.00 2
Phone No. _ ?r.r lca0 smog or vans 1940.00 z
�, AeeonnatY arty $50 00
Contractor's License No. _
Contractor's rjoard Reg. No. i 4c.Temporary Services or Feeders
gv
ro200 amps`r Is" $5000 2
tatlalton anerstan or relocation2
�/Z—
Signature et Supr. Elec'n __ - 2o1 ammo 400 arrow $7s 00 2
License No. � _.��hone No 401 ar ro Wo amps $100 on
Over 80o amps to 1000 vans
2b. For owner installations: 'aa.5.sone
4d. Branch Circuits
Print Owner's Name `. 4@w anaauon or enenawn per Wel
Address _ a)-*e lot Ion waren orcvds with
_ purems"of servies or feeder lee. 2
City S to Zip Eacr:ranch cimurt !s Co
Phnne N0. b)�@ tae'or oratn ormft wrthour
pureha"of seryies or leader tea. 2
The installation is being made on property I awn which is F;rst orancr.arad � $0500 _ 2
not intended for sale, lease or rent. Eacn am,ddiI Oraam,rt $600
Owner's Signature____ 4e.Miscellaneous
(Servico or feeder not included) 2
Each pump or;rogation Ards $ao 00 2
3. Plan Ret iew section (it required): Earn sign or outllns Iphhng Seo 00
S:;,nr:trt:dl3l or s lamed e 2
Please check appropriate:(am and enter tee in section Se. panel anarIll or eeenaron l 111110000
_ 00
4 or more resider units in ore structure Mincr-absa 00) _
Service and feeder 225 AMPS or more 4f. Each additional inspection over
_ System over 600 wits nominal the allowable in any of the above
I` Classified area or structure containing special occupr.ncy Per rume!wn $35 00
as described in N.E.C.Chapter 5 Par hour $6500 -
In Plant $65 00
rrhmit 2 sets of plans with applir.ri.ion where any of the above
eppiv. "lot required for temporo,y construction services. S5.o Fees:
Ss. Enter total of above fees � r�
NOTICE 5%Surcharge(.05 X total fees) _
Subtotal f
PERMITS BECOME VOID IF WORK OR CONSTRUCTION r
fo
5b.Enter 25°'.of line A
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF plan Review if rA for
(Sse.3) S
CONSTRUCTION OR WORK IS SUSPENDED CF ABAPtDGNF.D FOR subrotil =
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
❑ Trust Account M
COMMENCED. s
Balance Due $
cl-TY OF TIOWIT)
C."WO, 1IMI. MIt,
Cwiti oMUlJNf
11JALATIN ELECIRIC INC 11AYMNI DAIL
PC! BUX 6tirzi I V i S I UN
Wit-SONVILLF-1 OP 9
AMUUN)
` i 4 .. , I -. P
PERMI'l f t
I-OR 9141A _1
,W PABROOK ST
FOR FERMI T it
InTAL AMOUNT PAID
(if Ps 4 YALP41 pf:( 1, 1.
NAMC.. HIONRIDOF
EaC1l, 'FHS r PO BOX 16 '4 POYMV,N1 Of-41t
TUALAI IN FIR
f1UiWCL. 01,10 1N1 PMO
PLUMBING PERMIT
�CITY �
PERMIT #. . . . . . . : PILM96-0251
F TIGARD DATE ISSUED: 06/29/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639-4171 PARCEL:
1:311-E ADDRESS. . . : 001,4-0 SW IDE'11BLOOK ST
SUBD I V I S 1 ON. . . . : CLOUT) CAP ZONING:
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 12
CLASS OF WORK. . :OTR GARBAGE DISPOSALS. : 0 MOBILE-* 1-401YIE SIDACES. : 0
I'YPE OF USE. . . . :Ei F WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : I
(.JCCLJPI(4NCY GRP. . : R3 FLOOR DRAINS. . . . . . : 0 TRPPIS. . . . . . . . . . . . . . : 0
b'roRiEs. . . . . . . . : 0 WATER HEATERS. . . . . : CA CATCH BASINS. . . . . . . : 0
FIXTURES-------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : III
1 -1 RAP5. . . . . . . : 0
.31 NKS. 0 UR I NALS. . . . . . . . . . . 0 bREASE
L A V A TO;R*1 E* S'. , , * , III OTHER FI X1 URES. . . . 171
IUB/SHOWERS. . . . : 0 SEWER LINE (ft ) — : 0
Or'JER CLOSETS. . : III WATER LINE (ft ) . . . C 0
D15HWASHERS. . . . CA RAIN DRAIN (ft ) . . . : 0
Remar-ks : Installinq backflow p),ovention device
()wnet— FEES
f0l-Al\l BARTLETT type amolmit by (Jet e v-ec Pt
74CA SW PEMBROOK PRMJ $ 15. 00 B 06/.:-'9/96 96-283-43171
5PC T $ 0. 75 B 08/29/96 9 6---283,4 13 L,I
1 1u14RD OR I-)72i23
Coritt-actor-.-
HIUHF?IDGE CORPIORATION. THL
,='14140 NW CORNELL RD
HILLSBORO OR 9 7 1
Phone 15. 75 TO I*AL
Peg 62r'1 REOUIRED JNSPECTIUNS
?his pereit is issued sub;ect to the regulations ritained in the RV-1/14ackf low f--Irpv
Aard Municipal Coda, State of Ore. SpeciAty Codes and all other Final Inspection
ipplicabie laws. All work will be done in accordance olth
approved clans. Thi. per-nit will expire if work is not started
within 180 days of issuance, or if work is suspended for moi-p
than 180 days.
I t t;e e i Lill o L 1-1.1
I.Ssfied P.y :
Cell fcr- inspection 639-4175
CITY CSF TIGARD Plumbing Application Recd ey
D2te Recd _
13125 SW HALL BLVD. Commercial and Residential Date to P E.
TIGARD, OR 97223 Date to DST_
(503) 639-4171 Permit 0 F&M'Tc C'zl�I
Print or Type Related SWR r
Incomplete or illegible applications will not be accepted Called
-- Name of DevlopmenVprolect L h1W&_i[Mh-Fd01ily Bgsidencges,Ong..
-01
J o I] / /�/r r f / / /l 5 J p 1 HATH HOUSE$140.00 p 1 BATHHOUSE=191.00
Street Address Suite [3.3 BATH HOUSE$225.00
Address Fee Includes all plumbing fixtures In the dwelling and the first 100 fee4 of''w'.�Mw
Bldg 0 City/State Zip water service,sanitary sewer and stoun sewer. See fees below.
Name FIXTURES(individual) - 01'.1 N1T
PRICE A
N7h 1440 VC' sink -� 9.00
Owner Wiling Address .Suite Lavatory 900
_ rub or TublShower Comb. 900
CitylState Zip Phone — -- 9 00
Shower Only
Name Water Closet —_ 9 n0
Dishwater 900
Marling Address Sudo Garbage Disposal 900
Occupant — —
Washing Machine 900
Cdylstate Zip Phone Floor Dra-n 2" 9.00
_ 9' 9.00
Name _
9.00
Contractor Mailing Address Suite Water Heater 9.00__
'211/ t L\L� C t? _ Laundry Room tray 9.00
CitylState tip Phone urinal 9.00
X14 ` oRU "' W /3 c11,95 —
Other Fixtures(Specify) 9.00
Oregon Const.Cont.Board Lic.# ExDe __ —
Attach Copy of / �-7 ---
9.00
Current Plumbing Lic.4 Exp.Date 9.00
License Sewer-1st 100" Too
COT Business Tax or Metro is Exp.Date Sewer-each additional 100' 30.00
Water Service-1 st 100' 25.00
Name
Water service-each additional 200' 30.00
Mailing Address Suite Storm&Rain Drain-1 st 100' _ 2500
ArchitectMailing
b Rain Drain-each additional 100' 30.00
Or Mobile Home Space 25.00
Engineer City/State Zip Phone
Commercial Back Flow Prevention Device or Antl- 2500
-- Pollution Device _
Describe work New O Addition O Alteration O Repair O Residential Backflow Prevention Devitt' 15.00
y0
$
to be done: Residential '• Non-residential O � - -
Additional description of work Any Trap or Waste Not Connected to a Fixture _ 9.00
,>Rh//K nL� �/v S��!(4 1/O►.J Catch Basin 9.00
Insp.of Existing Plumbing 40.00
__ r hr
Existing use of Specially Requested Inspections 40.00
building or property .-- r hr
Ran Drain single ft,mily dwelling 30.00
Proposed use of Grease traps ---- _ 9.00
buking or property_
�— - - - - QUANTITY TOTAL _
Are you capping any fixtures)^_Yes p No p
. Isometric or riser diagram is required d Ouanity Totals >9 t
I hsreby acknowledge that I have read this application,that the information 'SUBTOTAL o:
given is correct.that I am the owner or authorized agent of the owner,and 1'
that plans submitted are in eompyance with_Oregon Stale laws. 5% SURCHARGE
Signatur6 of OwnerlAgerit Date
y�/9 /V PLAN REVIEW 25% OF SUBTOTAL_61 15 7
^�t /► R used onto R fixture rry trnai is
Contact Person Name j P one --- TOTAL 27,
L ---
•Minimum permit lee is$25- 5%surcharge.except Residential Backflow
Prevr:nitun Device which is S15 �5%surcharge
i i.dsts\plrnapp doc
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST
BUP
— Date Requested 4///#P��- AMPr%A ~�
Location 6(]�yU _ _ BLD
MEC '
Contact Person Ph PLM
Contractor Ph SWR
rBUILDING Tenant/owner ELC _
Retaining Wall ELR
Footing I F
Foundation FP
Ftg Drain [JOT REQUESTED
Crawl DrainI FOUND DURING RESEARCH SGN
-- -
Slab NO INSPECTION(S) FOUND IN FILE SIT
Post 8 Beam
Ext Sheath/Shear
IntSheath/Shear - - - - ---
Framing
Insulation `- - -
Drywall Nailing
Firewall I _
Fire Sprinkler
Fire/Harm l �—
Susp'd Ceiling
Roof -
Misc.
Final ---
PASS PART FAIL
IIIIBI
Post& Beam
Under Slab
Top Out —--
Water Service
Sanitary Sewer —
Riain Drains
PART FAIL
NEVANICAL-
1PO."t& Beam
Rough In
Gas Line
Smuke Dampers
Final
PASS PART FAIL i —
ELECTRICAL —'— — — --- — —.
Service
Rough In ---
UG/Slab —
Low Voltage
Fire Alarm
Final
PASS PART FAIL _
SITE
Backfill/Grading — -- -- — —
Sanitary Sewer
Storm Drain [ J Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ )Please call for reinspection RE: [ J Unable to inspect-no access
ADA "- , -7 _
Approach/Sidewalkq1 �%
Other Date — Inspector i Ext✓
Final —~
PASS PART FAIL O N T REMOVE this inspection record from the job site.