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14315 SW 112TH AVENUE-1 14315 SW 112TH AVENUE N Ln 1-4M cT T MEMORANDUM CITY OF TIGARD TO: File Respond By FROM: Brad Roast, Building Official For Your Information DATE: 4-26-89 Sign and Return SUBJECT: 14315 SW 112th Ave On April 25, 1989 Tom Kenyon requested the city inspect cracks in thou foundati )r: of the above residence. George Steels made an i.nsp,_ :tion and found what he believed to be settlement cracks along the f,-ont and left aide of the building, and some shrinkage cracks along the rear. After informing Tom of the findings, he asked if there is any problems with the foundation, and 1.f so what he should do. I informed him that if the building was done settling, there should be no problern. He should grout the crack to: .1. keep water from getting into the crawl space, and 2. to seal the cracks co an inspection can be made in one to two months to See if the cracks are continuing to grow. On April 26, 1989 I spoke with Stacy Buetler and informed her of the above. '`.i `/ •�Y1�}.'•�a�r,lt�•i,A`..,'(j,TTN ��'�y,Y^ .r�„ i1�tDit,z"„�'� "�(`` y4 '•r A �� av .-` �^� "�� ,,y�4 xI r 1r ,1 y h dl '� { �'.: y ,,, i'° �. !r\ � ",L�,.�•,� � �' IIM u, AI' OM �•Q t� I' y � ,' y tirn ;•, e4' •r H rM �{i I r �It �l tll rt � IIIIR q I i ' � � n ► i •+( �`111,' i• {��'+'•'•',�1\Ih �\\11'e"�^>"'••(.:� ..d1t ii1 ��/" �{�1 �'t'' I —� - ��� f��i, � C III�� l► l i'•'i�11{,.� � _tea •' colv, rq 00 Cd 00 1 -08 a+ W O 40 to hH jN'OI t Ji 0 p rNw CIS `^ p'r"1 `v 'C7 '0 q q �y w TT4 `V 0 M , F+ Fri F :nds+cryartdmaatitiitivrtrrtiiati,iuuv.�•da;�cn '\ f t „� � :L,mY.1151u1rL' .._3 :+ a j:tv_e1a,,.d....,:ra-,rr�rr'7 c � �;��1� •r ^� -• y i N�-- '�. ++�,, gyp►- ''� •��s�Z`'�•. � "'* "• -•tib ?., s +„ ,rte. INSPECTION NOTICE City of Tigard Building Departm^nt P.O Box 23397 Tigard, Oregon 97223 Phone: 639-4175 ,L Type of Inspection — i lulyClG t? � Date Requested ig ' Time 2_A.M. P.M. Address �5 �CJ 11,2 IlAae Permit # 8,�A y 1- Owner_ _ Lot # Builder --- The following Building Code deficiencies are required to be corrected: Presented to — 6-4-ps oved Inspector ❑ Disapproved Date CALL FOR REINSPECTION Cl YES 0 NO ■I[ ! u i► w 11111111ff NSPECTION NOTICE City of Tigard Building Oepartrr nt P,O. Box 23397 l igard, Oregon 97223 Phone: 639-4175 Type of Inspection —_— Date Requested Time A.M. P.r1l. Address � `5w��� Permit Owner— -----—--- --- Lot # _— Builder The following Building Codi deficiencies are required to be corrected: Presented to —_.__________ ___ [_� Approved Inspector Date CALL FOR REINSPECTION CY€8 I� NO i Jnr II1• �' � wo � ae d INSPECTION NOTICE City of Tigard Building Departrment P O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection ------- -- --- ----- Date Requested _ -� tl .,� d� TimeA.M. � P.M Address y ��UC ���l�� - Permit Owner _ __ __. Lot # Builder -- _— ----- The following Building Code deficiencies are required to be corrected: •l - d Presented to - I_1 A,iproved Inspector Disapproved Date, CALL POR REINSPECTION NES 1�11 NO I INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested—_. Time A.M. P.M. Address A/3 15 _ zZ22 _ Permit Owner Lot # Builder - C rnn� The following Building Code deficiencies are required to be corrected: Presented to pproved Inspector ❑ Disapproved Date CALL FOR REINSPECTION U YES I=1 NO INSPECTION NOTICE City of Tigard Euilding Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection �� Date Requested,_—� Time A.M. P.M. 4// �/�1 Address /13/5 ; r Permit Owner ,/J_r_ Lot # Builder — ':'L– The :1'L–_� _ The following Building Code deficiencies are required to be corrected: Presented to pproved Inspector [ Disapproved Date CALL FOR REINSPECTION `1 L_] YES 0 NO INSPECTION NOTICE City of Tigard Building department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested 7 Time A.M. I P.M. Address k-1 2 '"1 Permit #G ale" Lot Builder The following Building Code deficiencies are required to be corrected: Presented to F1 Approved Inspector Disapproved Date CALL WR REINSIECTION -3 No INSPECTION NOTICE City of Tigard Building r)epartr�ent P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection -- Dare Requested �'��f Time A.M.—P.M. Address 3�5 �- �� - Permit # l� Owner - ---- Lot #k Builder — TI- following Building Code deficiencies are required to be corrected: 07 Presented to � � Approved Inspector — _.,.... L1 Disapproved Date _- CALL FOR REINSPECTION ❑ YES L_7 NO MF.-'A'.'l-1AN1CAl.,. PEPM*I.*'T' l---1EPMYT' NO . . ME-801-046 CRYOFTIGARD ClIFY40'LAIND ;F COMMUNITY DEVELOPMENT -)EPARTMENT6/27 13125 S.W.Hall Blvd..P O.Box 23397,Tigard,Oregon 97223,(503)639-4175 DATE ISSUED: 1211 T M InmT-Wn OW3 Olet-'I JOF.", ADI)PESS : IA*ZI5 sw iiprm AVE TAX MAP/1...O T' RG1.10ADRIP00 SUB : LT : BK : LAND USE. : 1 OT SIZE: ITEM: NO : NO: WORK CLASS : NEW FURNACE <100K I ATP HANDLA <10 tJSr.-: TYPE: SINGLE 11:'AM11 Y P't.JPNACr--" 100K4- AIP HANDLA 10K CONST .TYPE : VN FLOOR FURNACE L'VAP .COOLER OCCUP .GII. P. : P3 1--lEATER Vii"N'T' FAN 2 VENT VENT . SYSTEM BLIVCOMP <31-IP HOOD I NO. S1'0RIl:::S : I BLR/LOMP 3-15HI" INCINERATOR(DOM DWELL.UNITS : 1. HI-11/113OMP 1.5-30HP INC I NERATUk(CUM FUE1... TYPE 8LQ/CUMP '30-50HP REI PAP UNITS MAX . INPUT B1 R/COMP 50+1--lp OTHER I FIPE DMPPSI? GAS PINING OUTLETS i I-1,1('A-1 VIPESSI? 6010.1 1'4466r"'? 1i;rii, ---- REMARKS : 0 W 1<1'-"NYON 'T'0M PE.RMIT 11111.0 . 00 N E $8.PINS 2547'c'! SWIFTSHOPE. PLAN REVIEW R womt 1A.1-11-1 c)1- Y70611 FIXTUPES 11111123. 00 PI--IUNE-. (530) 650-050y STATE TAX $1 OTHER C "j0 ND T P2% R A C (A c t: v- I yk- T 0 R TOTAL.. : 1 This permit 19 i991.1od subject to the regulations contained in Title 14 PECEIPT NO . of the TMC. Stale of Oregon Specialty Codes.zoning regulations and all other applicable codes and ordinances, and it is hereby REQUIJIED INSPECTIONS agreed that the work will be done in accordance with the plans and GAS LINE specifications t Ions c POST Ti 81:::AM and in compliance with all applicable codes and ordinances The issuance of this permit does not waive restrictive. covenants. Contractor and subcontractors shall have Current city N business tax permits This permit will expire and become null And I' I NAL void if work Is not started within 180 days or if work is suspenaeu or Abandoned for a period of 180 days any time after work has commenced It shall be the responsibility of the permittee to assure all required inspections are requested and approved 'ke P-A 4- Permittee SpAntule Issued By (':AI I i PP:'TTON 639---/Il 15 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE ciEWE'P P"EAMIT C11Y OF T167A RD i�_ RD FIERMI'T NO . : GE88joe4,7 COMMUNITY DEVELOPMENT DEPARTMENT 1*.)A'T'F..: ISSUEI): 6/27/88 13125 S.W.Hall Blvd..P.O.Box 23397.Tigard,Oregon 97223.(503)6394175 Pvum . Pm*r .NO. 13010412 JOB ADOPESS : 14315 SW 11.2TH AVE USA NUMBER : 35902 MAI:)II...01, 2S1.10A8(R200 SUB LAND P-41 , :3 1_01, 5.1.ZE : SECIAMN: to rwp: fa PNG : w WUPIK NEW USE 'TYPE: STNOI-E FAMILY appl.iciarit agi-eem t(:j wi.th vii.13. r-t.C.Lem curl el c)4' theUrij.ftiP_(1 fiewri#I-agre Agellc.y .. The pee-1hit expil,eill 1.P.0 dirkyla fl,oln thce clatte :1.1lifill.led . 'rilie tc)ta:i. pilkid Wi1j. I-)e .111:11­foraJ.ted If thea per,irtit . '11-ie Acjv-.�tlr.?y cloeiit ricit gmitki—­ iAllt00 th*11) flt('�XNAI"UCY (:).F thiv'I 1c)c�1R.tiall cif the 1"icle motwel, L4L,LeI*,IILJ.%I . 14, th6l., Viewel- :Lfil ricit lclr.:ilktecl illit the gi.voAll , I.hivii irivitaL:I.Ier� whial:k 3 :1 1-1 al 3. di r-ectionm froin the d i iu (i i.veil . T.11 11 c)t, me) A.0 CAL t e d , the Inmt,aii.]Jer- mhat.11 ilk "1'okI:) ill.rid Side 5c.-twer" Pei,in:i. t, mod the Agericy w:11.1. :hitutia.1.1. 4it Jiittwr�vt]. . INSTALL. . TYPE BUIL.MINU SEWER IMPERVIOUS APEA: F:r.XT1Jr.1I-_: UNITS TENANT IMPAUVEME.N'T NO DWEI I ING' LJNJ­T*!; I NO. OF* 81.J.)GSi . I -1 F o KENYON 'TOM PF14MIT Oi 3!,.� 00 W 25472 SWI FTSHOPE ("C)INNEXTION s 1. o o N E wimitt, ).inn ri I., 97066 L-INE TAP INSI'AL.A., . R PHONE (330) 650---0509 11THEP KENYON 1,01011 N NOS3TAI...GTA 140MI:---S T 25417 P_GW I FT SI-W)MR. R A wen itit, 1ir1n C PHUNE. 11503) 650-- 0309 T 0 REGIG'TPATION NO. 53633 101 AL.. $1 , 135.00 RECEIPT NO. This permit IS Issued Subject to the regulations contained in Title 14 )f the TMC. State of Oregon Specialty Codes,zoning regulations PP'.QUIPED INSPECTIONS ind all other applicable codes and ordinances, and it is hereby POLIGH­-IN agreed that the work will be done in accordance with the plans and qpecifications anu in compliance with all applicable codes and (irdinances The Issuance of this permit does not waive restrictive covenants Contractir and subcontractors snall have current city inisiness tax pc!rm,:,- This permit will expire and become null and void it work Is not started within 180 days,or It work ir,suspended or .ibandoned for a period of 180 days any time after work has I ji tim—iced It shall be the responsibility of the per-tifflee to assure all r6clutred Inspections are requested and approved Permittee Issued 13y CAl. I.. FOR I Wir"F-It."T''r(IN 63"7 --4t7! SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE MWIEF - WAWIII�P-P PLUMBIN(a PF'14M I C'WOFTIGARD PERMIT NO. : P11_081.04115 CITY01FTWAM COMMUNITY DEVELOPMENT DEPARTMENT ORIGON DA'T*F' ISSUED: 6127108 13125 S W Hall Blvd P C) Box 23397,Tigard.Oregon 97223,(503)6394175 PPI M- F)M T .NO . (:)a 1.().e42 ,.JOB ADDPIESS : 1431.5 SW :Lie*rH AVE MAP,/L.GT 25110ABF200 SUB: BK : LAND USE: R4.5 LOT !.IZE : I'TEM: NO: NO: WORK Cl.ASS : NEW WA*Y'I--':P CLOSET 2 "TRAP USE 'TYPE: SINGLE FAMTl..-*Y LIPINAI BKFLOW PRVN'rR CONST . I'YPE: VN l...AVORA1*OAY TRAP PRIMER (:)(N".UI_) .GPP. : P3 *rU8 SHOWER 142 GPL-KASILK 'TRAPS DISHWASHER I GARSAC'i:: DISPOSAL.. 1. NO. WASHING NAGMINE I DWELL . t.JNT*T'S ; I LAUNDRY BLOC .DRAIN (01A FLOOR CIPAIN r 5INK 1. SEWEP (FT) WA'TEP I S'T()RM/RAIN (F*T 100 REMARKS . 0 KENYON PERMIT $117 , 50 W 254112 SWTFTSHOPF. N E weiist linn 97064 FIX"tURC.'.5.) R PHONE (530) 6,10 STATE: 'TAX $3 .88 �01 C a11. N T R 94 A T 0 T(YTAL.. : $123.38 R REC'EIP'T NO. This permit Is issued subject to the regulations contained in Title 14 of the TMC, State of Oregon Specialty Codes, zoning regulations INSPEC'TIONS and all other applicable codes and ordinances and It is hereby PLB .UNDERY.-AB :agreed that the work will be done in accordance with the plans and POSY & 0KAM specifications and in compliance with All applicable codes and Ainances The issuance of this permit does not waive restrictive WA11:11 J.-INE avenants Contractor and subcontractors shall have current city P:. R "TOPOUT tiusiness tax permits This permit will expire and become null and nAIN DRAINS vaid if work is not started within 180 days,or it work is suspended or FT.NAI Abandoned for a period of 180 days any time after work has ornmenced It shall be the responsibility of the permittee to assure required inspections are requested and approved PermittepAnature lg!Ljed By CAI I.- FOR INSF)EC.I'TON 639-411'7.15 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE Cl CITY OF TIGARD (IYOFTI PIF.'PM'. T* NO. : Bl'PEPMIT P COMMUNITY DEVELOPMENT DEPARTMENT 0 'I 'ISULD ; 6/27/80 13125 SW Hall Blvd,P 0 Box 23397 T.Bard.Oregon 97223.(503)639-4175 D0'1 F, . 1,1 A I M. PM F-;040. 1141131101q2 JOR ADDPFESS : 1.41315 SW 1.121+1 AVE I AX MAP/LOT 25 A.1.006220 0 SUB: LT : HK . LAND USK I ptz.l . .`.5 I-OT 9IZE. : VAI...UATION: 11; 56,Z11,21 SETBACKS FRONT : 25 PEAP : 9 WOPK CLASS : NEW DWEI.A-.UNIT'S : I LEF'T: 5 PIGHT . 69 USE TYPE: SINGLE'. F'AMILY NO. BEDPOOMS : 3 L-*:X*Y* . WALL CONST : CONST' . T YPF:.' : VN NO. BATHS : 2 N : S : I*-- W OCCUP .GAP. : R3 PRO T . OPENINGS : UCCUP .LOAD N S W TOTAL AREA 1.200 NO. STORIES : 1. 1ST : 1.200 POOF CONST : C F TPE PET'? HE I GI-411, : :1.2 2ND: AREA SEPAP7 PATED: BASEMF:NT'? 3PD: OCCUP. SEPAR7 PATEO : MEZ Z AN 1:NE 7E1A!iCi:M 'T F'1-00P LOAD : 40 ZI40 FIRE. SPRKLR? ALAPM7 FLOW((*.,PM) DET1-*:CT7 YES Wii.;AT TYPF—L i VIA16- 1 Q6113 PLAN CHECK BY: bo.l` REISSUE OF' NO. LAST RI=ISSUE: 0 FTKES : W KENYON TOM PERMIT $304. 00 N 25472 SWIF Y'SHOPE. PLAN PEVIEW $197 . 60 E R west linn 13r 9,7064 FrIPF-K DEPT PHONI-i (530) 690---0509 STATF.: TO X $15 , PO OTHER C DF-.:VFJ...0PMENT CHARGES : 0 N KENYON I OM So(',( STURM) *e50 .00 T NOSTALGIA HOMItAs SUC(STRFX.T) $600 . 00 R A PDC(O2 11 $290 .00 C wiliewt linri n ir� 97064 PREPAID $100 . 001 T 0 FIHONE 11-503) 650 0509 R REGISTRATION NO . 55633 TOTAL : 1111111. 316 .EIO This permit in issued Subject to the regulations contained in Title 14 NO. of the TMC. State of Oregon Specialty Codes.zoning regulations and all other applicable codes and ordinances, and it is hereby nEQUIPED INSPECTIONS agreed that the work will be done in accordance with the plans and 1:!'U()T:rNG SF:WE*,11 specifications and in compliance with all applicable codes and FOUNDA'T'ION WALL PAIN DRAINS ordinances The issuance of this permit does not waive restrictive POST & 0F'.Af4 WATER I I N L' covenants Contractor and subcontractors shall have current city busiress tax permits this permit will expire and become null and Pl..14 . UNDEPSI AB ('TT'Y APPRCH/SW vold If work Is not started within 180 days.or If work Issuspended or 1-1 L.A F.4 IINAL abandoned for r, period of 180 days any time after work has PI B . 'I OPOUT (,ommenced It Fhall be the responsibility of the permittee to assure F PAM ING all required Inspections a!e requested and approved F 111 Er.)1—A C F.' GAS 1. I:Nr.,*' INSULATION Permitt./ ature GYP. DOAPD Issued Ry t L-- --.. -- ---- CAI I. 1 OP INSF.11 (JION !s39-4175 SEPAr-AlE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE -C • PLAN CHECK APPLICATION CITYOF TIGARD PLAN CHECK # COMMUNITY DEVELOPMENT' DEPARTMENT ORM PERM11111 # 13 125 SW Hall Jjjvd. P.O.6 Jx 23397,Tigard,Oregon 97223(503)6394175 DATE iSSUFD A)B ADDRESS: -.7) /,-.5 N�, -"./ :--I I —------ I-AX MAP/LOT SUB: LOT: LAND USE OWNL R VALUATION: ------------------ iv oed OJI SPECIAL NOTES REISSU NAME: ADDRFSS. 7,;z 7; E OF:LASI REISSUE: FLOOD PLAIN/ PHONE: SLNSITIVE LAND: CONTRACTOR APPROVALS REQUI-RED W PLANNING: INC,INCERIN6 ADDRESS: FIRE DEPT 01 HLR: ITEMS REQUIRED ARCIVENGINEER LIST/SUBCONTRACTORS: NAME: BUS TAX: ADDRESi-'.--' CALCULATIONS: TRUSS DETAILS: PARKING PLAN: LANDSCAPE PLAN: PHONE OTHER: COMMj-'N T', PERM:11 !r ACCT # DESCRIPTION AMOUNT AMOUNT PD. DAL. DUE 10-432 00 Building Permit Fees 10-431 00 Plumbing Permit Fees 10-431 01 Mechanical Permit Foes 10-230 01 State Building Tax Building _.Z�". Plumbing 5, Moch "' 10-433 00 Plans Check Fee Building Plumbing Mech 30-443 00 Sewer Connection (20%) 30-202 00 Sewer Connection (80%) Sn-444 00 Sewer Inspection 51-448 00 Street System Dev Charge (SIC) 52-449 01 Parks I System Dev Chargo (POC) 52--449 02 Parks 11 System Dov Charge (PDC) 31-450 00 Storm Drainage Sys( D(,,v Chrg (SSDC) 10-230 09 TRFD (95%) -a-�5—C, 10-451 00 TRI'D (5%) 10-230 06 Washington County Fire #1 (95%) 10--451 00 Washingtt-.)n County I-ire. #1 (5%) 10-220 00 Amar-L/Wodgewood TOTAL REC N APPLICANT SIGNATURE Porvived By: Dat.! Received: CITYOFT167ARD PLAN CHECK APPLICATION CffYOFT COM,MUNRY DEVELOPMENT DEPARTMENT '4� PLAN CHECK I 13:25 S%v HeN elwi P.O.Sm�,TigeK OMw rrrn(M)M4175 PERMIT I --- DATE ISSUED ),JOB ADDRESS: 1 ' _ TAX MAP/L0T 25 / -/6 4 43 7L 110 U j •SUB* _ LOT: _ LAND USE: X,,VALUATION: SETBACKS: FRONT: REAR: LEFT: RIGHT: WORK CLASS: HEIGHT: TOTAL AREA: USE TYPE: _ FLOOR LOAD: _ 1ST: CONSTR TYPE: HEAT TYPE: v 2ND: _ OCCUP GROUP: DWELT,/UNITS:- 3RD: OCs' LOAD: NO BEDROOMS: BASFXENT: N) STORIES: NO BATHS: GAP GE: I14P SURFACE: APPROVALS REQ'D SPECIAL NOTES ITEMS REQUL—'.D PLANNING: REISSUE OF: LIST SUBCONTIACTORS: ENGINEERING: LAST REISSUE: BUS TAX: FIRE RPT.: _ FLOOD PLAIN/ CALCULATIONS: OTRER' SEN IND.: TRUSS DETAILS: PARKING PLAN: LANDSCAPE PIAN: PLAN CHECK BY: OTHER: COMMENTS: i nom. �12r, N. !r b�<ra� l. 4 t .UZ°.: - Vv, L 777 UE-S PTION AMOUNT OWNER 10-432 00 Building Permit Fees NAME: � vP,. _ 10-431 00 Plumbing Permit Fees S /,DDRE.SS:�_ %_ � �� s� �e 10-43101 Mechanical. Permit Fees � �. i,•��,_(1 _ y?v y 10-23001 State Building Tax (5%) -- 10-433 00 Plans Check Fee PHONE: - s 30-443 00 Sewer Connection (20x) 30-202 00 Sewer Connection (80X) CONTRACTOR 30-444 00 Sewer Inspection t-- jW.1 t .51-448 00 Street System Dev. Charge (SDG) $ ADDRESS: %52-449 01 Parks I System Dev. Charge (PDC) 52-449 02 Parks II System Dev. Charge (PDC) 31-450 00 Storm Drainage Syst Dev Chrg(SSDC) PHONE: 10-230 09 TRFD (95x) t� 10-435 00 TRFD (52) ARCH/ENr1,tEER `S 6.35 2 Z z.- 9 10-230 06 Washington County Fire 01 (95X) NAME.: _c ,`,��i �tvr� 10-435 00 Washington County Fire it (52) ADDRESS:�� �� ; . e(- 10-220 00 Amart/Wedgewood TOTAL, $ PHONE: .. - PREPAID PEC A IIAIANCE DUE PPLICANT L E / Received By: _ L Date Received:_- // -2 ZiLl- INSPECTION NOTICE 1,)(,.4 r 1,UdL---)4C(� . City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4176 Type of Inspection �_ �' i� ` / : �' -- P — -- Date Requested_-_ 1.t Time A.M. P.M. Address ;' ` J� / ��` � _- Permit Owner f Lot — Builder / `t~A i�(14 e, [ [C The followinq Building Code deficiencies are required to be corrected: r' Presented to _ Ll Approved U Inspector _ _. _— -—_- Disapproved Date _ _ --- CALL FOR REINSPECTION 0 YES ❑ NO INSPECTION NOTICE Cit,, of Tigard Builo ig Department /O P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection ----—__ I t12 -- Date Requested / y Time_ A.M. P.M. Address 4/ 3 r / 7 2 f� Permit V2-' Owner N 0 1 C •� _ y_ T,�u'� _. Lot # Builder _ The following Building Code deficiencies are required to be corrected: Presented to _ _ _ ❑ Approved Inspector _ ___ ElDisapproved Date CALL FOR REINSPECTION Cl YES I ] NO