Loading...
Permit n CITY OF TIGARD MASTER PERMIT IN COMMUNITY DEVELOPMENT Permit #: MST2009 -00235 13125 S W Hall Blvd., Tigard OR 97223 503.639.41 Date Issued: 10/12/2010 TIGARD 71 Parcel: 2S102DA00800 Jurisdiction: Tigard Site address: 13335 SW HALL BLVD Subdivision: Lot: 0 Project: City of Tigard - Fanno Creek House Project Description: Upgrade existing residence for use as an A -3 occupancy. BUILDING Floor Areas Required Setbacks Reauired Stories: 2 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Yes Total: sf Value: $150,000.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Catch Basins: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Other Fixtures: 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Bckflw Prevntr: 0 MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Furn <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Fum > =100K: 0 ELECTRICAL Residential Unit Service Feeder Temp SrvclFeeders Branch Circuits 1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0 Ea add! 500 sf: 0 20 1-400 amp: 0 201 -400 amp: 0 1st W/O Svc/Fdr: Limited Energy: 401 -600 amp: 0 401 -600 amp: 0 Ea add'I Br Cir: 601 -1000 amp: 0 601 +amp- 1000v: 0 1000 +amp/volt: 0 ELECTRICAL - RESTRICTED ENERGY SF Residential Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr. Occupancy Group: Square Feet: Owner. Contractor: Required Items and Reports (Conditions) TIGARD, CITY OF CENTREX CONSTRUCTION INC 13125 SW HALL BLVD 8250 SW HUNZIKER RD TIGARD, OR 97223 TIGARD, OR 97223 PHONE: 503 - 639 -4171 PHONE: 503 -684 -0443 FAX: 503 -620 -6692 Total Fees: $2,946.81 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of •R. .ecialty Codes - II other app' - ble law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 1:0 day of issuance, or •rk is susp��ded for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utili Noti , -tion Center se rules 3 orth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC b calling 03.246.6699 or 1.82 • 32.2344. Issued — Permittee Signature: 1...1... ■ Building Permit Application Commercial RECEI\IED hOR t,hhlcl: 1[SF ()NIA City of Tigard Date Received O Q d 1 Permit No.: • e ° 13125 SW Hall Blvd., Tigard, OR 97223 DEC 2 3 2009 Plan Review yy �� / C � ^ � / ~ J : 7 Phone: 503.639.4171 Fax: 503.598.1960 Date/By: I ' CAV( 71i//, Other Permit: TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: 1a: ® See Page 2 for Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: 7 /if I , 077 / Supplemental Information Vol mow L . ( q y . , TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ® Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. • 1- and 2- family dwelling of i i ustrial Valuation: $ ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: 'D._ Job site address: /3315 S W /44i _ 13L New dwelling area: square feet City/State /ZIP: "tl6/ J ODZ5Go/V 97Z Z3 Garage /carport area: square feet Suite/bldg. /apt. no.: _ I Project name: rAlk1N 0 e/% L - jfOUSE /1// Covered porch area: square feet Cross street/directions to job site: SW 11,9a- 8(_VL�- varoA '4'17'v Aft') Deck area: 3 a square feet — 15gWif_jv 3W 0/ ST a $W 13 UR'1 /4/y Sr Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKL T Subdivision: Lot no.: ) st Z Permit fees* are based on the value of the work perform d. Tax map /parcel no.: /5/02-DA - 0,g$00 /1/ X700 Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for he DESCRIPTION OF WORK work indicated on this application. I! �}Gtg Valuati $ ¶ ' /4N U,S7.wC S /N6Le - Fes"! / 4 / #4.5446.4/0 q 0DC7 Existing building area: OS 00 square feet New building area: ?/ 5 00 square feet ,PROPERTY OWNER I ❑ TENANT Number of stories: ',-f. 1i0.SEXEAJ Name: CM' of 77 6.1.0 ("N/C14 /V[ •l!) T of construction: V Address: 3777 5 LJ BU/2N/1vi sme - Occupancy groups: it R- City/State /ZIP: 776A44 '/ C' /72 Existing: SINGLE- FAAIIU4 OS/0404Z. Phone: ( 7/3 - 740..S Fax: ( ) New: a 'r A-3 ) APPLICANT 0 CONTACT PERSON NOTICE Business name: £../I5 a1/77 All contractors and subcontractors are required to be Contact name: Ma.- Qx'/DD' licensed with the Oregon Construction Contractors Board under ORS 701 and may be required to be licensed in the Address: 720 IA/ /4 ✓ /f .Sv /1- 3O jurisdiction in which work is being performed. If the City /State /ZIP: 0 /07AA/D 0/14.'N 97205 applicant is exempt from licensing, the following reasons appl Phone: (S•23) 221 110 / I Fax:: (503) 00/ " 2077 E -mail: f130U446 L/ /71clfa„ G4A CONTRACTOR Business name: a lv 1 C X Qn 9J' ( '{ `V\ - Z L Imo) BUILDING PERMIT FEES* Address: y �u1 V \v\b\? e,, t, ��� (Please refer to fee schedule) Structural plan review fee (or deposit): City/State /ZIP:T \ ;ice C��. �C ' r q FLS plan review fee (if applicable): Phone: � ) � j � �0 �• Fax: (2L� . — Cc,,--C- Cc .c 'I� r7 l Jc J • CO CCB lic.: �� C Total fees due upon application: A Amount received: ' Authorized signature:';;_ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: V F • w vr — Date: `Ll 2?j t 0 * Fee methodology set by Tri -County Building Industry Service Board. L I:\Building\Permits\BUP-COM PermitApp.doc 10/01/09 440- 4613T(11 /02 /COM/WEB) P(A.\--CA 1111 a Building Division e Accessibility: Barrier Removal Improvement Plan TIGARD REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241. (1) Every project for renovation, alteration or modification to affected buildings and related facilities shall be made to insure that the path of travel to the altered area and the restroom, telephones and drinking fountains are readily accessible to individuals with disabilities unless such alterations are disproportionate to the overall alterations in terms of cost and scope. • (2) Alterations made to the path of travel to an altered area may be deemed disproportionate to the overall alteration when the cost exceeds twenty-five per -cent (25 %). VALUATION: Total of all renovation, alteration or modification being done, ° excluding painting and wallpapering. [1] $ MULTIPLIER (25% barrier removal requirement): x .25 TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given to those elements that will provide the greatest access. Elements shall be provided in the following order: (a) Parking $ (b) An accessible entrance: $ (c) An accessible route to the altered area: $ (d) At least one accessible restroom for each sex or a single unisex restroom: $ (e) Accessible telephones: $ (f) Accessible drinking fountains: and, $ (g) When possible, additional accessible elements such as storage and alarms: $ TOTAL (shall equal line [2] of Valuation Computation): $ I: \Building \Permits \BUP -COM PermitApp.doc 06/25/08 _ s 4 Electrical Permit Applic FOR r) USE ONLY Cl of Tigard Received `.r b C Date/B : Permit No.: S 7—, ✓ •— • a _ :� 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.51712Di:a 3 2009 Date/B : Other Permit: f I t n It i > Inspection Line: 503.639.4175 Date Ready/By: furls: ® See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information TYPE .; 4 'MING DIVISION PLAN REVIEW ❑ New construction Addition/alteration/replacement Please check all that apply (submit / sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ❑ Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCMON ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: 1 S33 S 5 5 v i At/l, (Q o 100HP or more. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: 'n L A. () 0,0,1,661 /� OR vv$ ❑ Health-care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: 1 Project name: t:l O+l Q M0P, ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: %-.) NO 12_41)' Description 1 Qtr. 1 Fee. 1 Tool 1 • New residential single- or multi- family dwelling unit. Or OrACM • Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Tax map /parcel no.: 1 S ID?" P R — 0 0 la 00 f�srv� -p17 Li Limited ne y, or portion 33.92 I Limited energy, residential idential 67.84 2 DESCRIPTION OF WORK (with above sq. ft.) - ��,,/� n,, Limited energy, multi - family 67.84 2 \ I j vu t 1 "4 hj�, residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less 1 100.70 2 PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2 Name: 011 4 frac. (Nilex- 1550 401 amps to 600 amps 200.34 2 " 601 amps to 1,000 amps 301.04 2 Address: � 11'x' 'w \r6V/2+J VY 0 tr` -. t Over 1,000 amps or volts 552.26 2 City/State /ZIP: /5114) , V ' i j()).„) el'i-223 Temporary services or feeders installation, alteration, and/or relocation Phone: ( 50 5) '11 Q - Z 6 (7 S Fax: ( ) 200 amps or less 59.36 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 _ 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, 6 7.42 2 I ,� each branch circuit 6 Business name: t �' f SIt ' ,, ¶ S B. Fee for branch circuits without service or feeder fee, Contact name: VPs"\) ‘/ ' i ‘ first branch circuit 56.18 2 Address: "" o ‘,4 "DatN c , t 5%)) , 3 00 Each add'I branch circuit 7.42 2 Miscellaneous (service or feeder not included) City/State /ZIP: 04-1.,a1r.po t - t Each manufactured or modular 67.84 2 dwelling, service and/or feeder Phone: (� � � j) 7i ) \ 711 Fax: : ( 5D; ) Z2) - 2,o �� Reconnect only 67.84 2 E -mail: pl7OVY\tJ1 @/ t/v1 / .-L) \n!Z r". core\_.... Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Signal circuit(s) or limited - Business name: .e) energy panel, alteration, or Address: (,1,1- 1l extension. Describe: Page 2 2 City/State /ZIP: j G t / Each additional inspection over allowable in any of the above / Per inspection 66.25 Phone: ( ) Fax: ( Investigation per hour (1 hr min) 66.25 CCB Lic.: I Electrical Lic.: I Suprv. Lic.: Industrial plant per hour 78.18 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: Print name: I Date: Plan review (25% of permit fee): State surcharge (12% of permit fee): Authorized signatur TOTAL PERMIT FEE: ` This permit application expires if a permit is not obtained within 180 Print name: ,(i)AVL. 3 0`x`3 Date: )7,)03) oy days after it has been accepted as complete. • Number of inspections allowed per permit. 1:t Building \Permits\ELC- PermitApp.doc 10/01/09 440-4615T(1l /05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined ... $67.84 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $67.84 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* El Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\ Building \Permits\ELC- PermitApp.doc 10/01/09 Fri Oct 8 17:02:39 2010 503- 281 -7716 P. 1 Perm Appl # , rotz Q FFI(I? US} 0 �1 s 3 c of Tigard RECEIVED llA ° t 13 ' ermit N: , v 13125 sw Fiala' li)vd, i i ;ard, OR 97,'23. Ptan.Reviow - - _ -�� , . l ',.•': ' ' : :::• Phan 503.639.4171 1 a'c: 5 03.598.1.96 ^ T i r ..Date /1Sv: . c:.",:.71'. m l ec.tion.Gine:. 503. 639.497:5 g ' t '- Weit l b e.i'age2fvr 7a1t,A1LD� ns . p F lvouficrl)Method Supple nialInformafion • • Internet www.rtgani- pr.bov t • y� � • { � -•:R f1!1 : �,•.'•••,•.'-'•:::••:.••••• l` Please ch'eck,•ill that aPP1Y (submit T sets Df plans w /iteir4v checked fiotoiv): `• r ID NOY.' constriction diiitiUti ; .4lleratiolitr;:p 1:3Sarviccorfeedt 'r400attiptormure' CI-Wilding over Chree:sRirica. [] Deirinlition Critter : boatyards. ,., : . :..: . .:. : . .:::. ... ., .. ,.: ':.' :. , , � ;: , - ... . . , .. , .: .:' exceeds 10 (t0(1 available-fault nrpx a 1' p v ar Cl • h4ildj�nF� ..... :......, Gn1 .I'. .. C�fUI)C; c: i ;:;;: >s ^' - > : < ' f :: : ; : : ' : .:>.x : o::',.:.,:-: c...::. . . .::::. �; :° : �;; ..::.,.:...::. � �':::<.......;..... .... , , ►esste © useag>aculhxlrl 1- and 2- family d. welli 0 Co!ntnercia tiadustrial D Accessory building a.nps f g11 Ut)1M installations. bultd ng ; • CI lytu it:i- family - • • 0 Master builder 0 Other: } irep p- .lus allatirm 75 1:VE1'nr .:. -- . - system, �-- r- , - .--- ,-= -:: ©Emergency s ystcm. 'lunar •aepsratelY cttl'ived . ,..... :,.: >...• >.;: '_ :: .. 'b MATIUN >''' SID >'T UCi[�'��1� :` i'`'.i ;'- :'r'::`' = Adtli 'on.of ncnv motor load of 0 1-1". "1 -? ". .. j: " oceop:mcy . ,, . •H 11rP oc mars. S .•J .'3 Si, FALL ISi..VI C3Snor attire- reidenualsnits. 0 l tcereational • T ❑13eallh care facilities. 0 Supply voltage fa:mttre than C.1 1SMte -� � 1 s!*! 042,..., 600 Volts marina 1' i ._ - • -. ' ilarai locations Suite/bid '.1 t. no:. Prnie ctname: ,.� C7'3 or feed.. bU0 amps or'raort • vs ( ...:.:.. ... •• Cross street/directions to job site n 1 • Qt 1 1d►. 1 wow 1 . • . - . New'I e.sidcntial ; singl e - or inulti-fainily dwelling unit.. .).nclndes attached garage. . . SubdivisialK. .. Lot PO:: I,000sq. ft or less ^ 1613, >d 4 • . • • • . • a. add'I 500 sq.. ft- or portion _, -- • 33.92 - ._- 1' tax maplpilrcel no,: .. nt��,.r 1 . 75 -0(1 • - • • 2 rmi n gsl .r ::..: . = -.::: .., '# ..':'4. ? + v+ pRTt ;..:.::::;:.;::;.;:;:::::.:,.: :.. ' :' (w ith aba sy. t 3.) - m Cd ait},.mulu Fnmil} 75.00 2 tesidential (with above 511:0) ,_ - . . • . -' • Services: or feeder tinstalliriion, alteration, and/or relocation • • 200' amps oz1ess • . i00.70 . ' 2 ::....:: _ < _Ol.a to 400 5 .. :.T " i2�'-• �' traps amps . ::......:._ :.. ... .: • 4i) amps . 6tn1 s traps . 20034 2 . . Name: 601. amps to 1.000 amps • . 301 • g •Address: - O ver -1,000 amps or Volts . 5 52.26 . 2 . • Temporal'.' services ot.feedera instaiiati6u, altetatiga,.andlor. C :ity/State/T1P: � ' • ' rcloeatiun . 20o:drips nr less 5936 • . 1 him: ( ) Fax: ( ) ■ _ - • 201 Imips.to400•amps 125.08 .. 2. • Owner installCition This inst31lation•iS being .made on''property th.at'1 ow.n which i diot •4 :amps to 599 amps 168.54 2 intetided for salc..l e,.rent;'or exchange, according to ORS.447, 449, 670, and 701: B raach circuits- new, a[teratioa; or:eitt> asirin, eer.pauel . • Owner signature Date: A. Fee: for hrmch.cireutta wit < , ...a,... ..,:. 2 ,. above service ur faedc ' isz :43 • M r;'o nor. iii 1 •, 11YP111('A:N! ;:. eadh branch circuit • 134siness name: *Iv llo tis. .. 7t1? f .. . . .. .. 13. se rvice or feeder w } _ t = t�i` I. • 56.18 • 64.4 ...2. Contact. nam ...� .branch circuit. _ 1 1 1 ) L Each.tnifii. branch. circuit 7.42 q'. 1 Address: • rar2 S3.( M. 444r .. &-y am t3 Miscellaoenus (service or feeder ttot iitelaAed) _ _ . . 'Each - manufactured or modular 67.114 .2 City / 14 U;b. e) ' 0 ...dials ' dwelling taerviCe and/or.fceder -* - =-•- { ' -- -1 -. -- - - - - Rt cor9recf only 67.84 .. 2 Phone: (L 3 . ) f,04 ' K � 4'3. . � f Fax:: (5D 3 ) 't.$ i - 7 . 7! _ .. ... 67. • ` 2. Fatrip or irrigmion.'circle vh t- nisi!:: 4s'2 11 R r+ se e C:- •' o^ 'F'Y?' . g n:tirouuino lighting' .......... ..:..: :...... ...:...:.:- .::. , ......::. <,,... , .. Sigtal city -tar. js j or Lrnitcd- ctierty. panel, alteration, or extension. . age. 2 .. . . ,'.2 . [3USInC5s118rr1C . l ., ;• • a ''C: . . 'Each additional insj�iectinn overellnwable in. any of.the above -Addnnss: :5 3 1 . I& ' . 4biti )t)6. Additinnal•in spection (1 hr min) • 66.251hr City/Statef7IP: �q• L 4 . 40 q r. . (3 _ .. investigation (.1 hr. min) (6.251.hr . { i i. �! a C - F ns : q Phti '� (�✓ ) �.� .�• �IG.t1iZ (� � �.*�� /" ®b!� ; lnd plant (hr min) 71r.igPhr �. • CFi. ic.: t F lectrical Lie.:. Supra': L lnspr ctions for which no fee is: `s 4A � � �tccdicalh fisted (n hr mm) '10 00i hr Suprv, Electric. . - e . ir rsq u . cl `� //� � j �`� b l EC • ti lt' f.T, 1' Rl11tT FL S - - . - ✓" Sub total: Q 'Print name: ,. bate: /t7.�;- ,1( ,,ye ( „ ' ) •--- �: y � , � �� r •-'ti . Plan � �o of fee): _ Autht>rized signalil } �' j ; r T ri: r �8 //i. State surcirarge (12 % cif permit fe : j:. . 1 A- _ t. (' • --- 11 - _ 1Q1 1CR 11' FE1 1 Print name,: . t E1.t { bate: t • 10/08/2010 12:35 5036849015 WESTERN PLUMBING INC PAGE 01/01 10/88/2010 10:14 %_ 9960 _ r CITY OF TIGARD PAGE 01/01 Y _ , .1 " C !(fl.:: I*1.141 f■; ;:,%!.', .:— Building Fixtures OCT 8 t : 1` o Clty` of Tigard $ 3'0Qg A. N ., 13125 S , G s i 1';. .4 u;; ! C J�Q ! _ ... 7 l••a q � •_ _ _ EntCttlRt: www.figardia.gov • A , 1 SON we JjMetlrod: I ® floe Pop 2for Doe Ready/Br W cc Eickhottsfruction 0 Dcntolkloe For aascaI4 &ilea ■ .- .... (UOe/alteratioa placement 0 tic: , -, 'u: Ea. Tote! New J- LflastlhlY d.rq :' � �: .. 1 � R far emit utiti t connection :r "r.;'l '4;r , ; ;; t: ' SfR (1) baths um 31x.10 — 1- and 2•Ponsi ty dwelling .. Q �thpn SFR (2) bads 437.78 IIIIIIII Q Accessory building El Multi- family SIR. (3) bah ,00.32 Etrab ❑ Master builder Q ter- etddit ( b.,ah 25.02 .. ; , . 'r', ',JQtIE' w -.. Tr _ Pips o , 1 I d o: (_ _: ' Job site eddrr 13315 3 44 ) jpl�lf -11_41 Q Catch basin cc eh,:e dra6a 18.9b Cieyl3zate/Z�: � � O t �1 #1,- 27. Footing drain Om tt: r Drywall, bwh ,, , • of hatch chain NM 18-74 ` - Ma__) Page 2 Sttlialdtl.�aPt 1+4.: 1 P?O mum 4Jr C %- F * x`641' Mt red home utilities 51f,03 BIM Cross stint/directions tujob : 1/(rf a f , • Manholes gm 18.76 d Mtrk,A. -i • Rein Ott catnaetra 18.76 IIII Sanitary sewer (no. linear R: _.) Page 2 Storm sewer (n0.11near IL _ ___) mourni wesgr ataviGe (ao. line X; ,. ) 1.1111M111.1111 Sebdivision: Lot hw.: ; j,.t„ Or • A, . Mxtnepiptvdd no.: 1 Z PA •• 00e100 p 641 3 L27 1 — h BaOlswatcr valve IIIIIIIIMI C1othos washes 2542 IIIIIIIII 25.011 Etifiti Drinking Oxman 111 25.02 Ejectorslaurep 25,02 ` .. . . 1z� .... 25.02 B11,3- F3vRA.sf Peer 25'02 a• r / costa 25 City/State/ZIP: 1 d ' a1''�L 2.3 Hose bib 25'02 MEM i Pbo is ( 5 ) .- $ ~ ?.G t7 Fax: ( ) th e maker ,�•, 1251 Bueinrss name: e5 '. r 5 Medical gas (value 5 — — 1185o 2 ri COrtaet wane: "PAW—, �. Jar)© Primor t251 reia (o0lmncrcieR 12.51 N Addrr aa: y. h) R a 330 ' ctg•/stardzlr: � , , u. a* ii ii., -. stlntaa�ary �� 2s,a2 Ch t o Solar units (.•. . k water) • E rail: , OVri� —. LV-S,flrp.t e1 -5, L O Urinal 25.02 r t , : <�i.4. 7 .;w ..'.'.''':.;. e ,,� 'x =a'C 1 Weterck. ct 25.02 /1" 1lt�.� BIN lig noftsts; /,. (-1 — 1 name: . i f:I�. ii.a • ♦ • 4/, Water heater 37.52 Wow ' - r. � _ 25.02 C /9tsderaP :— _ .. .2 l . -4 Sr btotal r► .- n I� i ,,.,, , L Minim= permit fee: 872 50 IIII "` my - _,,,Ifm-rifrfflINSII Phobias Lie, no " Ar pi, • J Authorized si r r. l 7 // _ ' E. I. = rrnrn[ PERMIT FEE l71:±�ty Feint nine, i s t + V r/ 1=11620 M 7146 permit appitentiort Whet it a permit is not a_ Baled within NO days law it has beam accepted MI e Poo eathedrM ' set by Tsi.county 5lobar/ Owwioo Boart p. 1t>rdmamalva+otulnsa[aennuAOaa ttwoaaa veo.rbsst(tamatLbbv+vae)