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6930 SW Locust Street
1
/ CITY OF T I G A R D _ _ MASTER PERMIT
PERMIT#: MST2002-00155
DEVELOPMENT SERVICES DATE ISSUED: 3/12/02
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 06930 SW LOCUST ST PARCEL: 1S136AA-09500
SUBDIVISION: VENTURA ESTATES ZONING: R-4.5
BLOCK: LOT: 017 JURISDICTION: TIG
REMARKS: New SF Path 1
BUILDING _
REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 23 FIRST- 1.322 of BASEMENT: of LEFT: 10 SMOKE DETECT'1RS 'I
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1 306 at GARAGE: 729 o1 FRONT: 20 PARKING SPACES: 2
TYPE OF CONST: 5N DWELLING UNITS: I FINDSMENT of RIGHT: 15
VALUE. $258,91k90
OCCUPANCY GRP: R3 BORM: 3 BATH: 3 TOTAL: 2,6'18 O0 of REAR: 28
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH. I LAUNDRY TRAYS: 1 RAIN DRAIN 100 TRAPS:
LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS, SEWER LINES•. 100 Sf RAIN DRAINS. i CATCH BASINS:
TUBISHOWERS: 3 GARBAGE DISP 1 WATER HEATERS: I WATER LINES: 100 BCKF LW PPEVNTR 1 GREASE TRAPS-
OTHER FIXTURES:
MECHANICAL
_ FUEL TYPES FURN-K TOOK: BOILICMP<3HP: VENT FANS: CLOTHES DRYER: 1
GAS FURN:--1o0K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 2
MAX INP: btu FLOOR FURNANCES: VENTS: I WOODSTOVES: GAS OUTLETS: 1
_ ELECTRICAL.
RESIDENTIAL UNIT SERVICE FEEDER _ TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp: 0 200 amp: WISVC OR FDR, 1 PUMPIIR RIGA(ION: PER INSPECTION:
EA ADD'L 500SF: 5 201 400 amp: 201 -400 amp: 101 WIO RVCIFDR: 00 SIGNIOUT LIN LT: PER HOUR:
LIMITED EfIEROY: 401 800 amp: 401 600 amp: EA ADDL RR CIR: SIGNALIPANEL: IN PLANT:
MANU HM/SVC/FDR: 601 • 10on amp: 601+ampe•t000v: MINOR LABEL:
1000+amplvolt
PLAN REVIEW SECTION
Reconnect mdv:
�•4 RFS UNITS: SVCIFUR>+225 A.: >600 V NOMINAL: CLS AREA/SPC OE.C+
ELECTRICAL•RESTRICTED ENERGY
A SF RESIDENTIAL _ B.COMMERCIAL _
AUDIO 6 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: rIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM 0TH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC DATA7rEl.E COMM: NURSE CALLS. TOTAL N SYSTEMS.
Owner: ContreJor: TOTAL FEES: $ 7,659.77
This permit is subject to the regulations contained in the
WINGATE CORP WINGATE CORPORATION Tigard Municipal Code,State of OR. Specialty Codes and
15840 S POPE LANE 15840 S POPE LANE all other applicable laws. All work will be done In
OREGON CITY, OR 97045 OREGON CITY, OR 97045 accordance with approved plans. This permit will expire if
work is not started within 180 days of Issuance,or if the
work Is suspo•Iried for more than 180 days. ATTENTION.
Phone Phone: Oregon law re,4uires ycl:to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Rep 6: LIC 94680 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/Beam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final
Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Inst Rain dre n Insp Plumb Final
Footing Insp Crawl Draln/Backwater Electrical Service Low Voltage Water Line Insp Final Inspection
Foundatlon Insp Footing/Foundation Dr, Electrical Rough In Gas Line Insp Appr/Sdwlk Insp
Post/Beam Structural PLM/Underfloor Framing Insp Gas Fireplace Electrical Final
Issued By : Pert11;!tee Signature
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next bus;ness day
1
CITYOF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2002-00111
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 GATE ISSUED: 3/12/02
SITE ADDRESS; 06930 SW LOCUST ST PARCEL: 1S136AA-09500
SUBDIVISION: VENTURA ESTATES ZONING: R-4.5
BLOCK: LOT: 017 JURISDICTION: TIG
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS. 1
TYPL OF USE: SF NO. OF BUILDINGS: 1
INSTALL. TYPE: I_I PSWR IMPERV SURFACE:
Remarks: Sewer connection for new SF
Owner FEES
WINGATE CORP
15840 S POPE LANE Type By date Amount Receipt
OREGON CITY,OR 97045 PRMT CTR 3/12/02 $2,300.00 27200200000
INSP CTR 3/12/02 $35.00 27200200000
Phone: 503-657-3300 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 dWe 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" Perm
Is cued by: Permittee Signature: 4'AZ
Call (503) 639-4175 by 7:00 P.M. for an Inspection needed the next business �ay
Building Permit Application
Dale received: Permit ao.:lySj.ZN.4 w 15r
City of Ti r�
•'✓ •g �,,L.� Project/appl.no.: 4pim date:
Cit u Tigard Address: 13125 SW H I ,tiMtttl, t1A
Y f 8 ^ Date issued: fiy / Receipt no.:
Phone: (503) 639-4171 `
Fax: (503) 598-1960 /\� Case file no.: Payment type: -�
Land use approval- 1 J t&2 family:Simple Complex.
�7
U I &2 family dwelling or accessory U Commerciai/industntd U Multi-tatnily New construction U Demolition
U Addition/alteration/replacement U Tenant impswemcnt U Fix sprinkler;alarm U Other: _-
Job address: (� .xJ 1` Bldg. no.: Suite no.:
(,«: 1�_ Blcx k: Sutxlivision: N Tax ma tax lot/account no.:____
Project name: --�
Description and location of work on premises/special conditions:
=Raw
Name:"%�
Mailing address: j N�,S, fbpel I &2 Gundy drrelUng:
City: C.I — StareO ZIP: =tpL4 r _ Valuation of work........................................ $
Phone: (05'V--6'A00 Fax: E-mail: No.of bedrooms/baths.................................
Owner's representative: cx" Total number of floors................................. 21
Phone: 3 Fax: Frmail: New dwelling rma(sq.ft.) ......... ..�,.. -'--4 -i
Garage/carport area(sq. ft.)...........�....,.:.�. _
Nance: �" _ Covered porch area(sq.ft.) .........................
Mailing address: _ -` Deck area(sq.ft.) ........................................ _
City: !� State: ZIP: Other structure area(sq.ft.).........................
Phone: - I ax E-mail: CommerelallindtulrW/mulll-fvmlly:
Valuation of work...................................... $
Existing bldg.area(sq.R) .... y:...... __
Business name:TMLNew bldg.area(sq.tt)
Address: Number of stories................. •.... �,........
City: State: ZIPr Type of construction.......
Phone: Fax: E-mail: — OccutNotice:
ancy group(s): Existing:
CCB no.: New:
City/metro lic.no.: All contractors and subcontractors are rtquimd to be
al ilium IF11310 Lw� with the Oregon Consttucuon Contractors Board under
Name: ns of RS 701 and may be required to be licensed in the
Address: - jurisdit,ttt.n where work is being performed.If the applicant is
City: -- State: ZIP:_
exempt from licensing,the following reason applies:
•W
Contact person: _ Plan no.:
Phone: Fax: E-snail:
Nance: Contactperson: Fees due upon application .......... .......I.. ..... $
Wilm
Address: Date received: -
City: State: ZIP Amount received .....................................sch.dule.
...$
Phone: Fax: Email: Please refer to fee e
I hereby certify I have read and examined this application and the Na YI patblaion WOW aeric aadr.0—cail*W&1—f"" iYdarmom
attached checklist.All provisiont;of laws mid ordinances governing this U Viu U Mutercard
work will be complied with,whether specified herein or not. c,.ar►err ter :
Authorized signature: <tki �a _ Date: I i — N. u Au"on cxrda and
_ � 3
Print name: AMD" -
Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted a complete. 440-4613 HMK-X)M)
Mechanical Permit Application
-- Datereceived: if ilS G% " Pernu�no.: r to
City of Tigard Projectaappl.no.: Expuc date
CitynfTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: Hy: Receipt no.:
Phone: (503) 639-4171
Fax: (503) 598-1960 Case rile no.: Payment type:
Land use approval: fiuilding permit no.:
U I &2 family dwelling or accessory U Commerc:iaUindustrial U Multi-family U Tenant improvement
XN.:w construction U Addition/a::eration/replacement U Other:
Jot;address: c< Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: I Suite no.: value of all mechanical materials,equipment,labor,ovenccad,
Tax map/tax lot/account no.: profit. Value$
Lot: Block: ISubdivisiow Ey.ltUE,L See checklist for important application information wit]
Project name: jurisdiction's fee schedule for residential permit fee.
City/county, t I p ZIP: Z l
Description and locatioff of work on premises:
Feelm) Total
Est.date of completion/inspection: Desai "y. Res urrl Res.ont
Tenant improvement or change of use:
Is existing space heated or conditioned?U Yes U No Air handling unit CFM
Air conditioning(site planrequired)
Is existing space insulated?U Yes U No Alteration of existing HVAC
o er compressors
Business name: State boiler permit no.:
HF TonsBTU/H _
Address: 6000 S EV�I.. Fir•amu c damper 4.tsmo a detectors _
City: C A,0*C_V-Pti'`rltAs I State:64LZI Heat pump site plan required) -_
Phonc:65b--5pFax: E-mail: InstaIVreplace turnacelburner
Including ductwork/vent liner U Yes U No _
CCB no.: nate rep ac re orate heaters-suspen ,
City/metro lic.no.: wall,or floor mounted
Name(please print): EPLi V_A I p[T2 t C� Vent fora iince other than furnace
FINE e
Absorption units BTU/H
Name: Chillers- HP l
Address: Com ressors
State: ZIP: r ntttte� ex oat veal tun:
Appliance vent _
I'llone: Fax: E-mail: Dryerexhaust ^_
loods,Type res. tc a azmat
hood fire suppression system _
Name: y �_- Exhaust fan with single duct(bath fans) -
Mailing address: x aunts atemm-a—art from heating
City: State: ZIP: P p og ant up to 4 ou eU)
Type: LI'U NO Oil _
Phone. I a E-mail: Fuel pipingeach additional over 4 outlets
trocem piping(schematicrequl )
_Name: Number of outlets
Otliii Rated app a or equipment:
Address: Decorative fireplace
City: State: ZIP: Insen-t
Fux: I E-mail: stov etsto••e
Applicant's signature: � ':!- �' pate: ?, L � et:
Name ( Tint):
Na as puiedicaom keep cram cans,plea¢call jurisdiction Int mire infarroatlon. Permit fee.....................$
U visa U MuierCard Notice:This permit application Minimum fee................$
credit card number ��_ expires if a permit is not obtained Plan review(at __ %) $
[lapis within 180 days after it has been Sade surcharge(8%) ....$
'�rVr>r
of rxtrioloer 2 drown on credit card accepted as complete. TOTAL
Cardtatdrn dyoiture —' Amoun 4464617(6003COM)
Plumbing Permit Application
Date received: Permit no.: IIS�"�b0p•00�.
City of Tigard Sewer permit no.: Building permit no.:
Address: 13125 SW Hall Blvd,Tigard,OR 97223
c;ry of rigors Projec
Picone: (503) 639-4171 Uappl.no.: F.xpirodate:
Fax: (503) 598-1960 Date issued: By: Receiptno.:
Land use approval: _ Case file no.: Paymenttype:
P
U 1 &2 family dwelling or accessory U Commemial/industnal 0 Multi-family U Tenant improvement
%1CNew construction U Addibon/alteratiotUreplacement U Food service U Other.
Job address: f ;.J Description (tt . Fee ea. Total
c`": New t-tad 2-funny dwellings only:
Bldg.no.: Suite no.: (Includes 100 A.for eachVdIityconwc-0ua)
Tax map/tax lot/account no.: SFR(1)bath
Lot: Block: Subdivision: T FR(2)bath
Project name: SFR(3)bath _ -
City/county: ZIP: C1 I-LL3 Each additional bath/kitchen
Description and location of work on premises: G Siteutllillks:
Catch hasin/area drain
Est date of completion/inspection: D wells/leach lin trench drain
mi-Footingdrain(no.lin.ft.)
Manufactured home utilities _
Businessname c..J_�a1 ll� _ Manholes _
Address: H1 E v3pfq Rain drain connector
Cit J State. A Z1P:q Sani sewer(no.lin.R.)
City:
��
Phone: E-mail:
Storm sewer(no.lin.ft.)
-(, - Fax:
CCB no.: Plumb.bus.reg.no: - Water service(no.lin.R.)
City/metro lie.no.: Fixture or Item:
Absorption valve
Contractor's representative signature: Back flow reventcr <
Print name: Date: Backwater valve
Basins/Iavato
Name:
Clothes washer —
-
Dishwasher
Address: Drinking fountains) _
City: State: L1P: E'ertoll Phone: Frx: E-mail: ---- Ex ans, tank _
FixturUsewer cap
Name(print): Floor drains/flour sinks/hub _
p sal
Mailing address: Hose bibb _
City: - State: ZIP: ice mrker
Phone: I Fax: E-mail: Intern for/grease 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),6as-in(s),lays(s) _
Owner's signature: _ Date: Sump
Tubs/shower/shower
Urinal _
Name: Water closet
Address: —_ v __ Water heater
City: _ State: _ ZlF':---- Other. M--
Pfione: nutil MSI
Minimum fee................$ .
Not ail jzluscbm amep uedit cards,peace call iurbdicuan for nun Worumion Nulla:This pennil application
0 vita U MuterCard expirms if a permit is not obtained Plan review(et 8 96) -
Credit card sambr: _— -.- —L—L— within 180 days after it has been State surcharge((896)....$
S --
E.pms accepted as complete. TOTAL .......................$
Nosed crdwldn r sbown oa crodif cud =
Crdldder ore Asowr 440-4616(69000M)
Electrical Permit Application
"DatereNceived: ' Permit no..
City of Tigard Projecdappl.no.: Expire date:
0 i„a ltgurd Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639-4171 —
Fax: (503) 599-1960 Case file no.: Payment type:
Land use approval:
t
U I &2 fantily dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
>(New construction U Addition/alteration/replacclucni U Other: U Partial
Job address: (� w�,J — Bldg.no.: I Suite no.: Tax map/tax lot/account no.:
Lot: Block: Subdivision: e ---
Project name: _ Description and location of work on premises: J
Estimated date of cam letion/intirwction:
Job no: _ _ lee MAX
Business name: MeJIL ELL=L1'f�I C.� Description _r Qlv- (ea.) 7olal no.insp
New residentLl-single or multi-family per
Address: (� _i dweWr4lwdLInclYdesattached garW.
City: _ �� Statc:p ZIP: C{'�ZZ'L SerNnxYnchded
Phone: -{5 Fax: 1. marl: la)o$y.rt.or less t
CCB no.: �3q 3S Elec,bus. tic.no: L� Each additwnal 5W s ft,or portion thereof
--- -
Cit /metro tic.no.: Limited energy,residential -2
_ Y Limited energy,non-residential 2
Fach manufactured horn or modular dwelling
Si nature ofu ry t g selccuician Ire aired) `3 Dale _ Service and/or feeder 2
License no: Services or feeders-Installation,
6Sup.elect nano(prim), Qqy�►, �� f M alteration or relocation:
200 amps or less
Name(print): 201
an
to 400 amps 2
Mailing address: ------ - --- — 401 amps to 61x1 amps 2
-- 601 amps to 1000 amps 2
City: State: Z:�: Over 1000 amps or vols 2
Phone: lax: I E-mail: Reconnect onlyI
Owner installation:•Ilse installation is being made en property I own Itmporary services or feeders-
which is not intended for sale,lease,rent,or exchange according to Installation,alteration.orrelocation:
ORS 447,455,479,670,701. 200 amps or less 2
201 amps to 4011 amps 2
Oaces sI nature: Date: 1 401 to 600 ams 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: I Slate: ZIP: B. Fee for branch circuits without purchase
-_--_--�-__.-- - of service or feeder fee,first branch circuit 2
1:-mail: -
Lath idditional branch circuit,
PLAN RE'VIEW 011efl%e check-all that japply) Mlsc.(Service or feeder not included):
•Service over 225 amps cunmrlclai U Health-carr(actin} Each pump or imgauon circle 2
U Service over 320 amps-rating of I&2 U Hazardous location Each sign or outline lighting 2
family dwellings U Building over WSW syuarc feet four or Signal circul(s)or a limited energy panel,
U System over 6W volts nominal more residential units in one structure alteraliun,or extension• 2
U Building over three stories U Feeders,4W amps or more •lcsrn uot: .!p
LJ occupant load over 99 persons U Manufactured structures or kV pork Fjch additional Inspection over the allohable In any of the above:
U Egress/lightingplan U Udur. - - Per inspection
Submit_seta of plans with any of the above. [Investigation fee _
71w above are not applicable to temporary construction service. I Other
Not all Jurisdictions accept credit cards,pleaw can)omda ion for carr inheowillm Notice:this permit application Permit fee........... . ._... $ _ -
U Visa U MasterCard expires if a permit is not obtained Plan review(at __ %) S
Credit cud numbef: _.�_-_—_ .__L__ / within 190 days after it has been State surcharge(E96) ....
r{Ap11TA accepted as complete.
_ TOTAL .......................$
Name of cardholder w shownon ciei t card
Cardholder signature - Amouni 4144615(M UCOM)
RECEIVED
N
C!1 Y U ' I I OAKU
BUILDING DIVISION
lI E
S.W. LOCUST STREET �
aM se S
SCALE: 1• - 20' ���q- Sv �„ Q.f doo VA p.�L
,s �•� zo' , L T 17 Z��
'j�W W W I`h �Q 7,747 so. 4��
� i II I
Z I I
w FVE:� NI
31� I yL- � 31$ --i 5•
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C6 (L M 45' _
15
51.62'
WINGATE CORPORATION
15840 S.HOPE LANE
OREGON CITY,OREGON 97045
503$57-3300 '_c z. U 6'L12
"
COMPASS ENGINEERING LOT 17, "LNTURA ESTATES°
-- CITY OF TIGARD
ENGINEERING SURVEYING PLANNING
GSM&E.LAKE ROAD 1�1 br39097 PHONE WASHINGTON COUNTY, OREGON
s waWAME,ORE"9= (sm)653-M FAX
.2J,ff„7,M
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST .21 -60
INSPECTION
—DDINSPECTION DIVISION Business Line: (503)639-4171
BUP _
Received — Date R ested -3�( � AM PM—____— BUP
Location (D [G 3 O 40 _ Suite MEC
Contact Person —___ Ph(—) -7 PLM
Contra ___— Ph(—__) SWR — —_
UILDI _ Tenantlowner ___—._ _—._— — _____ ELC
noting ELC
Fbwdation Access: V
Ftg Drain L 6Qx `j f ELR
Crawl Drain
Slab inspection Notes: SIT —�
Post&Beam _..--- ---__.--- _ -- T- ---- __
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing ---- --- -- _-_ -.- --- --
Insulation
Drywall Nailing -- - -- — ----
Firewall
Fire Sprinkler ---- --- --- -
Fire Alarm
Susp'd Ceiling - --- --
Roo!
�&__
PART FAIL ---
PLUMBING �_.--.-- — ------- - --_g
Post& Beam -
Under Slab - --- - --- --- ----- ----
Rough-In
Water Service -- --- --- -`
Sanitary Sewer
Rain Drains --- --
Catch Basin/Manhole
S,,-, ,n Drain -- — ---- - —�
Shower Pan
Other:__ -------.-- -- - - -
Final
_ PASS ?ART FAIL ------ _ -- -�----
MECHANICAL ------------- - __ --- -- ------- ---
Post&Beam
Rough-In -- -- - --- - _
Gas Line
Smoke Dampers -----._- -- ---- - -- - -- --- --
Final
_PAR FAIL ---- ____- --- — '-"' --- --
LECTRICAL
Se -.— _ _ -- ---------.—
Rough-In _—
UG/Slab
Low Voltage
Fire Alarm r�
PART FAIL Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hell Blvd,
SITU— -- ❑ Please call for reinspection RE: _ Unable to Inspect-no access
Fire Supply Line
ADA pats Inspector ----
Approach/Sidewalk
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
INSPECTION DIVISION
Business Line: (603) 639-4171
�r BUP
Received Date Requeste $L l— AM— PM BLIP
Location rJ f C-l1 "d'"f Suite - MEC
Contact Person -T - Ph(-)
Contractor -- -- - -- ------ - -- Ph ——) SWR
BUILDING _ Tenant/OwnerELC
Footing
Foundation Access: ESC
Ftg Drain L Z/ ELR
Crawl Drain _ ly
Slab Inspection Notes: SIT
Post&Benm
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler -
Fire Alarm
Susp'd Ceiling ---- -- - - _
Root
Other:-- - - — -
Final
PASS T FAIL -
PLUMBIN
am
Under Slab
Rough-In
Water Service _T-
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain - - - - -- -_ ...-------
Shower Pan
Ot
in
A. PART FAIL
Post&Beam
Rough-in
Gas Line
Smoke Dampers
Final
PA S P AT FAIL
CTRI
Roug . Irf
UG/S -
Lo n I gO _
Fir I rm i — -- -- .
Reinspection fee of$ - requirod before next inspection. Pay at City Hall, 13125 SW Hall Blvd,
RT FAIL
F] Please call for rainspectlon RE: Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk ptttlb 2' --�-�- - Inspector
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS _ PART FAIL _�
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