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Permit k. RECEIVED OCT 2 1 2004 V Building Division j4 _����JI \ Applicant Request for Permit Action City of Tigard TO: CITY OF TIGARD, BUILDING OFFICIAL 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.598.1960 FROM: Applicant Name: Cu Q� L32 r\c S ,v. s Mailing Address: 3 k 5L) n )S (2 , S1-e 1 50 � ,' - �1/A/E City /State /Zip: \___0. \4_ (.)SLoecy fig C j�(�3S Phone No.: ( 503) C- { Li 3 � V O I D Fax No.: C5(5) y L i 3- a L/ y3 /a/.:2-707 , PLEASE TAKE ACTION CHECKED (1) FOR THE FOLLOWING PERMIT: CANCEL PERMIT APPLICATION. R( REFUND PERMIT FEES. Permit No.: rr\ ST )L CC) a 1 Type of Permit: ( U r Site Address: C)(o 5 Sfj % A Subdivision: V-,e l e r Lot No.: co EXPLANATION: IN C s �-\-- O t , (c, I � c;, r� wc� Cec / fer\ -v)vc,L o '�re, f-ve w P\ rN a \\ ow v-c) Signature: Date: Q-1 0 C i-O Print Name: `JQ("1,r\G. ijr. cell 7/6 — 0.6P94 FOR OFFICE USE ONLY Route to Admin.: Date: /o /ai o V By: !J� Permit Canceled: Date: iofa A By: , of Refund Processed: Date: /o 05/ By: ' , ..S.f Cashier Receipt: Date: / ' #: 02ao y -3723 Amnt: $,P�Q .sS C eir(m' Payment Type: Per: /96 p� .-ss i . \BuildingWorms\Re 09- 27- 04.doc r,. k CITY OF TIGARD MASTER PERMIT PERMIT #: MST2004 -00218 uar �l1j DEVELOPMENT SERVICES DATE ISSUED: 8/25/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 15065 SW 94TH AVE PARCEL: 2S111 DB -KE222 SUBDIVISION: KESSLER ESTATES NO. 2 ZONING: R - 4.5 BLOCK: LOT: 022 JURISDICTION: TIG REMARKS: New SF detached. BUILDING REISSUE: BVH2116 STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 23 FIRST: 882 sf BASEMENT: sf LEFT: 15 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,234 sf GARAGE: 352 sf FRONT: 20 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THRD: sf RIGHT: 5 VALUE: 205,134.40 OCCUPANCY GRP: R3 BDRM: 4 BATH: 3 TOTAL: 2,116 sf REAR: 15 PLUMBING SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 0 RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: 4 CLOTHES DRYER: 1 GAS FURN > =100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 2 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 5 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 3 201 - 400 amp: 201 - 400 amp: 1st W/O SVC'FCR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: . 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 7,537.55 This permit is subject to the regulations contained in the BUENA VISTA HOMES BUENA VISTA HOMES Tigard Municipal Code, State of OR. Specialty Codes 6932 SW MACADAM #C 6932 SW MACADAM SUITE C and all other applicable laws. All work will be done in PORTLAND, OR 97219 PORTLAND, OR 97219 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. Phone: 503 443 - 6033 Phone: 503 443 - 6033 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those Reg #: LIC 152235 rules are set 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 Ersn Cntrl 681 -4444 Post/Beam Mechanical Plumb Top Out Low Voltage Storm drain Insp Mechanical Final Sewer Inspection Underfloor insulation Electrical Service Gas Line Insp Water Line Insp Plumb Final Footing Insp Crawl Drain /Backwater Framing Insp Gas Fireplace Water Service Insp Building Final Foundation lnsp PLM /Underfloor Shear Wall lnsp Insulation lnsp Appr /Sdwlk Insp Post/Beam Structural Mechanical lnsp Exterior Sheathing Insr Rain drain Insp Electrical Final Issued By :.1) Permittee Signature : ....3—€-: C>s\pN Call (503) 639 -4175 by 7 :00 p.m. for an inspection needed the next business day ' fir •�` � FOR OFFICE USE O \Lti' <<„ Building P A *li n V [ Re ceived # / Building Date/B : , D &OP Permit No.: 1y ,t I —Q(7, • • City of Tigard 'JUL 2 ) 200i' Planning A :I Other `����� Date/B Permit"No .. 0 ^00 13125 SW Hall Blvd. Plan Review Other Tigard, Oregon 97223 CITY OF TIGArA Date/B : n ° < 1=2 3 -0 y Permit No.:' 1{;" 1 /�+!r,t t; ' Post - Review Land Use Phone: 503 - 639 -4171 Fax: 503 - 598- 1I960DIVI �h; Jl�` ` Internet: www.ci.tigard.or.us Date/B : Case No. . Contact �u See Page 2 r 24 -hour Inspection Request: 503- 639 -4175 Namme/Method: Su . . lemental Information • TYPE OF WORK. ....:.:: < : . ,•: LTIRE : . :... A ._. ..: - fr New construction emolition ❑ Demolition .1 2 FAMILY DWELLING ":., ; '. °, ° . ' ... ❑ Addition/alteration/replacement ❑ Other: CATEGORY OF CONSTRUCTION • . . Note: Permit fees* are based on the total value of the work performed. Indicate © 1 & 2- Family dwelling ❑ Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor. overhead and profit for the work indicated on this application. ❑ Accessory Building ❑ Multi- Family ❑ Master Builder ❑ Other: Valuation S JOB SITE INFORMATION and OCATION No. of bedrooms: / No .f baths:2 5 Job site address: • Total number of Fors . 1 I� New dwelling area (sq. ft.).... Suite #: Bldg. /Apt. #: Garage/carport area (sq. ft.) Project Name: Covered porch area (sq. ft.) Cross street/Directions to job site: Deck area (sq. ft.) Other structure area (sq. ft.) ":REQUIRED DATA: :.. _: .. _. i. COMMERCLAL =USE CHECKLIST. : Subdivision: AX) Lot #: Tax map /pa cel #: Note: Permit fees' are based on the total value of the work performed. Indicate 'DESCRIPTION OF WORK • . the value (rounded to the nearest dollar) of all equipment, materials, labor, NEW CONSTRUCTION — SINGLE FAMILY RES , overhead and profit for the work indicated on this application. DEATACHED RESIDENCE Valuation S Existing building area (sq. ft.) New building area (sq. ft.) Number of stories ® PROPERTY OWNER • . I ❑ TENANT . . • •- . Type of construction Name: Buena Vista Custom Homes Occupancy group(s): Existing: Address: 6932 SW Macadam Ave. Ste C New 'City /State /Zip: Portland, OR 97219 - Phone: 503-443-6033 Fax: 5 0 3- 4 4 3 - 2 4 4 3 NOTICE: All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under APPLICANT ❑ 0 CONTACT PERSON provisions of ORS 701 and may beiequired to be licensed in the • Business Name: SAME AS ABOVE jurisdiction where work is being performed. If the applicant is exempt Contact Name: Eli abeth Moore from licensing, the following reason applies: Address: City /State /Zip: Phone: Fax: . E -mail: • . ':BUILDING CONTRACTOR p : lease r e to . ee. s u a :.. - • . . . _. • . Business Name: Buena VIsta Custom Homes Fees due upon application S Address: 6932 SW Macadam Ave. Ste C City /State /Zip: Portland, OR 97219 Amount received . S Phone: 503- 443 -6033 Fax:503 443 - 2443 Date received: CCB Lic. #: 152235 Authorized dtbki) • Signature: (mil• _ ` Date: - Notice: This permit application expires If a permit is not obtained within J 180 days after it has been accepted as complete. •Fee methodology set by Tri- County Building Industry Service Board. (Please print name) i:\DstsTermit Fomts \BldgPermitApp.doc 01/03 (^ 03/04/2004 16 :26 5032537693 SUN GLOW INC PAGE 02 Mechanical Permit AVigication FO 01:1 k: l..f r Received Mechanical `� ° •L.-.7 Datell3 : Permit New aDO COD . D City of Tigard Planning Approval Building JUL 2 3 2001' Dat = . Pe rnit 13125 SW Hall Blvd. Peat Review Tigard, Oregon 97223 Dateft , Pcrmi(No.: r"' Y ?c IGP Poet - Review Land Use phone: 503-6394171 l: ax: 503 - 598 -196 p ; Case No.: BUILDING DIV a . ; • --' i t Internet: : www,ci.rigard.or.us ��, -•� Contact Juris.: ∎ 4 See page 2 for 24 -hour Inspection Request: 503- 639 -4175 Catrtc/Mathod; Supplemental folbrmatio • •i•...1,.,.. QFW l'.:... ; .::;::.:'.. ,'? .:^;.COM:505IRCIL1i.T ..•PEE+:BC UAE ; I? New construction • Demolition Mechanical permit fees' are based on the total value of the work ■U Addition /alteration/re •laccment • Other: performed. Indicate the value (rounded to the nearest dollar) of all • ■ • ' `dY�:C41!ISTB1E .:CATEGOR _ " L ; ,t, �;:.r ::�,.i _ . • . mechanical materials, equipment, labor, overhead and profit. : L 1 & 2- axnil dwellin:. U Commercial/Industrial Vatut S _ See Page 2 for Fee Schedule - IM Accessory Building Q Multi-Pamil Ri�sio�>!mla t Total 1 Descr • lion la Master Builder Other: aeat➢nrJCoorag ,,JQp SITE I?4rORMAT[ON and LOCATION • • • furnace • add-on air conditionin • *• 1 4.07) r Job site address: Gas heat • •• 11111 14.00 D uct work � 14.00 Suite 4: Sid _ JA. t.#?: 14.00 IIIIMMI H tironic hot waters tern Project Name: Residential boiler Cross Street/Directions to job site: (for radiator or h system) . 14.00 IIM Unit heaters (fuel, not electric) in wall, in•duc su • nded. etc.) 14.00 Flue/vent for an of above 10.00 Lot #: R •air units 12.15 Subdivision: Lot Fuel Ap • tl*Qees IllErIMMEMIIIIIMINIIIIIMMIIIIIM Water heater _ 10.00 . • ' . '• DES u h' [ON * sF WORK „ ' •••• ' • • Gas fireplace _ 10,00 NEW CONSTtRU TION – SI GL" P" I ' Flue vent (water heater/ass firepiacti 10.00 DETACHED RESIDENCE Lo.li•• ter 10.00 -- Wood/Pellet stove • 10.00 - Wood .: • lace/insert 10.04 IIIIIIMI Chitrateincrlllue(vent 10.00 - x « , Other. 10.00 �6F OPERIE'SG O' "t . =- : TNAFiX tir . Environtocetal exhaust & Vesielta eo Nagle: B _ = .t- . V i s - . .. . n • • ii - Range hood /other kitchen equipment 10.00 Address: 6932 SW Mac - ' _ . v - S . - C Clothes dryer exhaust 10.00 Ci /State /Zi•:Portland OR 97219 Single duet exhaust Phone s _ • _ . e Fax: 1 - . . - ' . (bathrooms, toilet compartments, SE APPLICANT ... .. OP .CONT • PERSON '' utili rooms • 6.80 N Attm/crawl space fans _ 10.00 :i e: D - + d Gol • • - Other; 10.00 Address: Fuel :t..I .: Ci /State/Zi * *(SSA° for first 4; S1.00 nth zdditional) Furnace, etc. •• Phone: Fax Crds pump •• E-mail: W all/suipended/unit heater • • . CONTRACTOR Water heater • • Business Name: . ._ G • w .. Fireplace . Address :2428 SE 105th Ave. Sege •• BBQ Ci /State/ZZi•:Portland, OR 97216 Clothes dryer (gss) II Phone; 5D3 -253 -7789 Fax:503 -- 253 -1 73 Other:. CCB Lie. #: 81 31 Total:' Penult Fees' _ Authorized . Subtotal: S Signature: Date: '7" k Minittttun Permit Fee S 7150 S David Goiob2 y plan Review Fee (25% of Permit Fee) 5 State Sureller . : % of Permit Fee S (P ease print name) TOTAL PA 1 - E S Notice: This permit application expires if a permit is not obtained within • Pee methodology set by Tr<- Conary Building tudastry Service Board. *•Site ptan required for exterior A/C units. 180 days after it has been accepted as complete. i:‘Pst\Permit Penns UvteePer mitApp.doc 0103 • • 03/04/2004 15:11 5036425815E ROSS ELECTRIC INC PAGE 02 119. Q. 9f�li : I FOR OFEIC USE ()NIA Permit Applic Received Electrical Cate,By: Permit No.: 06 `>!-- 0o i CITY OF TIGARD T� O City of Tigard Planning Approval S; BUILDING DIMS 7iV Date/Ely: re 13125 SW Hall Blvd. Plan Review Other Tigard Oregon 97223 Date/By: Permit No.: Phone: 503- 639 -4171 Fax: 503 - 598 - 1960 Post - Review Land Use Internet: www.ci.tigard.or.us Contac : Case No.: 24 -hour Inspection Request: 503 -639 -4175 Contact Juris.: f S See Page 2 for Name/Method: I Supplemental Information. TYPE;OF VVORII( .... ; .: . •...: • le.EVIEW: • Iease•t to rAil itlnit:a ■ Service over 225 a ,� :: -.:: NCW construction Demolition amps- � Health-care facility El Addition/alteration/replaeement Other: commercial 0 Hazardous location . El Service over 320 amp$.rating of ❑ Building over 10.000 square feet. C.ATEGC Y<�F'CON$) 1E)ir F] T. I & 2 family dwellings four or more residential units in & 2- Family dwelling Cori]rf1CTClal/Indtisttial ❑ System over 600 volts nominal one structure A oceSSO Bllildin ❑ Buildin over three stories amps m . more ry ❑ Multi- Family g ❑ Feeders, 400 a (('�� Master Builder ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park _ ] U Other: 0 Er/est./lighting plan ❑ Other: . ': t , .: '. JO1 SITE i LOCH 'IOr " ' Submit Sets of plans with any of the above. Job site address: The above are not applicable to temporary d onetruetlon service. Suite #: .. 'FE1�'":SCHROT :Ek .i. " : :; i• ' .' .:;i;;Ii: ;',: • Bldg. /Apt. #: Numbe r r of ins dons er permit allowed Project Name: Description P Qty Fee (ea.) Total Cross Stt•eet/D1reotiOns to job site: New residential - single or mold-family per dwelling unit. Includes attached garage. Service Included: 1000 sq. ft. or less 145.15 4 Each additional 500 sq. ft. or portion thereof J3 1 Subdivision: r Lot #: Limited cne ,residential 75.00 2 Limited energy, non residential 75,00 j Tax map /parcel #: Each manufactured home or modular dwelling . ••C '. ' •• DE ' • I' Oil :OF - WORK > . • :: service and/or feeder 90.90 2 EA-- Go n s t...1(...... (� S alteration or reloeatbService, or feeders - Installation, , /� . - "/h 1 / I n: De.: Lh e c fin,' e n ems— 200 amps or less 80,30 2 201 amps to 400 amps 106.85 2 401 amps to 600 am ..; 1'A. OW1r1ER :: • ' ' .TEN .. • +': >.:'. 6°1 amps to 1000 amps 240.60 2 Name: at en a I S 1 t /- ti S. m it Ger 1000 ect amps or volts 454.65 2 Address: rr <� con --ti 66.85 lO y • l j t ' j1 &(. 11 6fc ` Temporary services or feeders • installation. 2 Ci /State /Zia ; wo o - - alteration, i re{aatien: 200 amps or less 66.85 I Phon -. �o 5 ily3T � 3 . Fax 41Z 9 3 201 amps to 400 amps 100.30 2 e 401 to 600 amps 133,75 2 _ _' ' B ranch circuits - new, alteration. or Name: ' ' 4e. ✓E'- / • $ S extension per panel: Address: A. Fee for branch circuits with purchase of service or feeder fete, each branch circuit • 6.65 2 City /State/Zip: B. Fee for branch circuits withour rehace of Phone: service or feeder fee, first branch circuit 46.85 2 Fes: Each additional branch circuit 1 6,65 2 E -mail: Misc.(Service or feeder not included); 'l : .:. ''COPURACTE)R. ` • •, • 7-7 Each pump or irrigation circle 53.40 2 Job No: Each Si or outline li htin: 53.40 2 Signal circuits) or a limited energy panel, Business Name: O53 EZ...C; alteration, or extension Page 2 2 Address: Q S 5 k) OW .#' • !'3 Desrnpt'on: Ci /State/Z. : �t -p t' 117123 Each additional inspection over the allowable In any of the alwve: PhOne:5 (o 2- .454 Per tnsgeetion per hour (min. 1 hour) 62.50 � Dd Fax: SO Z ' J investigation fee: CCB Lic. #: 1 $788 / Lic. #: &e Other Supervising elect ici • �p tota S . is X sgtlature re uired; Plan Review 25% of Permit Fee �, t�`- Subtotal $ S Print Name: j--€-0t ROSSI Li #: 5/23,2.,$ State Surcha Pe rmit Fee 5 Authorized TOTAL PERMIT FEE S Signature: Notice: This permit application expires Ifa permit is not obtained within Date: 180 days after it has been accepted as complete. ' Fee methodology set by Tri- County Baildioo fndnatry Service Board. (Please print name) - i :\Dsts \Permit Fnnrts'.E1cPermitApp.doc 01/03 ` 03/04/2004 16:21 FAX 5036284633 THE MULLEN COMPANY a BUENNA VISTA 1002/003 t. Plurnbing•Pelrmit Application sD FC>'ROFFI - r_ I 'tit ONLY j� 1L Dote P er m it N �%SC�O`1 &�•L� � �� � V Datr/9Y: Permit Na.: Planning Approval Sever City Of Tigard e'lUI Dau/gv, permit No.: 13125 SW Hall Blvd. JUL Plan Review Other Tigard, Oregon 97223 Date/By: Permit No.: Phone: 503- 639 -4171 Fax: 503- 59S- 196QTY OF.TU - Port- Review Lind Use `, I Date/By: Cote No.: Internet: www.ci.tigard•ar.us BULLDIP' a�; Contact lurs: �® SeePage2for ��� 24 -hOUr Inspection Request: 503.639.4175 "" Namc /Method: _ _ Sepplaonennt tntbrrnotioe. . ...: cr: -i PgOFwORR,T1•. .'.o.•� • . .. . 1 - C U.1R.'ifor peentl'infO abltal1C •••x.• 1117 New construction t Demolition Description I Qtr. I Pee(ea4 Total • Addition/alteration/replacement 7�,.. • ;E' Other • • . ' Y F1;A : Xt &g 4 i tit, : 54 k' •: . , , ...c ; �a n + i'br t� btalif aifitt - ..'.4:.. 't$IECAR'SC�11�' 1 � y N: D f� f ` SFR 1 bat 2 h 2 • )' 1 & 2- Family_dwelling ■ Conimercialllndus �xal SFR (2 b ath 350.00 ' ■ Accesso Buildin: ■ Multi- Farllil SFR (3) bath 399.00 lr Master Builder • Other: Each additional bath/kitchen 4100 OB SrFE INPQR1ctTlt iuitiLE1CA:S'FIORr ' Fire sprinkler • sq• et.: Page 2 _ Job site address: ' • • • .... Site litU (ties ; .: ,..> :,� 'lM: , • ... _ . Suite #: Bldg. /Apt. #: Catch basin/atza drain 16.60 Project Name: Drywall /leach line/warn drain 16.60 Footit &drain (no. linear ft.) Pa?e 2 Cross street/Directions to job site: Manufactured home utilities 110.00 Manholes ' 16.60' Rain drain connector 16.60 Sanitary sewer (no. linear ft.) Page 2 Subdivision: I Lot #: Storrn sewer (no. linear ft.) Page 2 Tax map /parcel #: Waxer service (no, linear ft) Page 2 DESCRIPTION OF WORK Fixture or Item , Absorption valve 16.60 NFL(, • CONSTRUCTION — SINGLE FAMILY _ Basiclow prevcntcr _-- Page 2 ' FAMILY DETACHED RESIDENCE Backwater valve _ 16.60 Clothes washer 16.60 Dishwasher 16.60 - NI 'IPROPERFY'QwNp :- • 'EN I•ATIT : 5_.. _ Dte fountain 16.60 •� = � , 6Ejectors/sump _ 16.60 _ Name: Buena Vista Custom Homes Expansion tank 16.60 , Address: 6 9 3 2 Sw Macadam AvP . sra_ c , Fixture/18*er cap 16.60 . City /State/Zip: Portland, OR 97219 Floordrain/tloorsinklhub _ 16 Garbage disposal 16.60. Phone: 503-443-6033 Fax: 503,6+443-2443 Hose bib • 16.60 EN APPLICANT • . ••'>. ' . CQNT� 'TE5QN • Ice maker 1 6,60 Name: Ray Mullen Interceptor /grease trap 16.60 Address: Medical Rae • value: S Page 2 Primer _ 16.60 City /State/Zip: Roof drain (commercial) 16.60 Phone: I Fax: _ Sink/basin/lavatory 16.60 E -mail: Tub /shower /shower pan 16.60 , • - . CONTRACTOR . • • Urinal 16-60 Water closet 16.60 Business Name: ED MUlaen Plumbing Wattrheatcr _ 16.60 Address: 24470 Sw Rainbow Lane • Other: City /State/Zip: 1•Ti labor • . QE 9 71 ?3 Other. Phone: 503 - 628 - 163 Pax : 51 —6 - -46 .,.,:FlttsnblastPacmlel Subtotal CCB L #: Lic. #: _ . _ ' S e . Plumb. • 0 - ' ' Minimum Permit Fee S72-50 Authorized - ?#L(''' / Residential Bacidlow Minimum Fee $34.25 Signature: ✓ A -4/ • • c Plan Review (,2SS4 of Pcrmu Fee) S Ray ul en State Surcharge (8% of Permit Fee) , S (Please print name) TOTAL PERMIT FEE S plotless Tbls permit application *vim, Ira permit is not obtained within - All now cocntnerdat bulldlep regalre 2 Leis or plaes with isometric or 180 drys after L has been accepted u complete. riser diagram for plan miry. - Pee methodntoty set by Tri -County &sliding Industry Serrico Board. 1ADSts\?ettnil Pot s\PlmPermltApv.doc 01/03 15065 94TH AVE., TIGARD, OR PLANT LIST LOT '22-0F KESSLER ESTATES SUBDIVISION, PHASE II = PROPOSED STREET TREE OREGON WHITE OAK UTILITY KEY: SYMBOL: UTILITY: o —0 STORM LATERAL - EXISTING TREE WITH CLEANOUT t0 BE SAVED — - DI WATER LATERAL WITH METER = MITIGATION TREE - SEWER AND PAPERBARK MAPLE SANITATION 2 "co (MEASURED AT BASE) (2 PER LOT) EIRE HYDRANT = MITIGATION TREE PROPOSED PROVIDE TREE I ° PROTECTION FENCING AROUND a L r . X ALL TREES t0 j •.. � .... . . f i 20' BE SAVED 20' n ° Z J — � " " ` / N 77:3771-- 8" - _ tn . � � _ • .... . w - --5 . T FENCE �, i w 44 ' ., ` ° _ . ° o LOT 22 GAR- 24a a / / / °iY - 24S_5 I a . ' • FFE__ ] dII / 44' -6" � ,m TB • i ` J CK , 1 • SILT 1, m 7 cu 1 � , - �� FENCE 8 I jib � I 1 •—.E.,— — (— f 24S' — A 4 214' TILLIE LN I J ---4 _ TRACT "B" 3360 SF I ,41- 2 fl•2 i ■ NORTH SCALE: I" = 20' - 0' 0' 10' 20' 40' �0' 100' KEP2 -LOT22 0 BUENA VISTA CUSTOM HOMES KESSIeER ESTATES, � ®RTLARJD,AR BUENA VISTA CUSTOM A PHASE II - CiTY OF TIGARD - WASHIW TON COUNTY (603) 443 -443-6033 3 FAX f5 031 443-2443 07.14.4 LOT 2� SITE PLAN CITY OF TIGARD - SITE PLAN REVIEW BUILDING PERMIT NO.: - ov. / 7;0 PLANNING DIVISION: " `( .5 Not Approved Required Setbacks: �J Approved ❑ Side: S Street Side: / .tee - �S- a o Garage: .' Front. Rear: Visual Clearance: f Approved ❑ N ot Approved Maximum Building Height feet CWS Service Provider Letter Required: ❑ Yes l No ❑ Received B ' a • (- Date: '7 -0113 -occ EN Actual SI p e: IN.DEPARTMENT : ved ❑ Not Approved Site Pla SI p_ roved IN No Approved • Site Pla App Date: Notes: U . f .i J .P (/Loa