InitiallyGood e
�i
w
0
Itsw
n
z
H
0
I �
Ij
T7
H
C
I
f�
f
1
r
W
rn
r
F�
_ 13043 SW ASCENSION DRIVE
cn cn cn cn L: L7 cn to cn cn cn cn N L7 cn in va cn cn N cn cn v, rr D
•-1 -i --1 - -4 -1
D D D D D D D D D D A D D D D < ul c0
D A D D D -1 V V j j ti v v , 0 0 o v
cD ctl Ql O� (h A W N N N N p V O O) (Oil I"I O N O co U, t'
V Ul O U) C) Ul cm cn Ql A W N N (D
V 7— m DCC x C) G) cn m m U 0 Z7 D T n U c7 $ Cl) CO
'�J S N `G N ::rN lD c s 0 r (A Ln c O 7 j m a R U)
E m Q v o T7 n fD a 3 C o n.
C Q r �; c. :, v nl C CID W
nn
m T ' a m G7 m 3 3 , (n z o
> > > y o m7 O pn <p 4_ N cmc
T 01 N y N n N r j S. cIN
to O Rnn1 ti y t1 O Rl
D
7 � �- � 7 7. Q
— m
o x 3
� 3
c
0
d
1D �I
D
n
v <'
N �
A A A A W W N W (Q)1 Q � W N _• j
Ql l0 A f!b N_ W QD
C Lo
Lo f0 »
:u D 01
m
0 t
Cl
K � v x x K K K CO vi w co � v ai a w o
u) °° v to cn m ao (n � in
m
rT
T v v v v v v o v v v T U v v v v In m rn O
D D D D D D D D FP X vri vDi D Z cn vi p p v O
cn n N � N ccn c cr L7 (n r Ti
� s
� o
A a
c
v
x z v G7 G) G7 v v w m v v v v 4 a
W X v 00 CO ao m m m co -i i 2 = = X <
V1 N N N N Z Z Z Z rD
cn v cn n
A Ql fP -' A W_p (W_p (Wp_ N fN_p (V_p t_1 (-_p4 z1 y
W
V -1 -4 V J J O) Ql O) Off) Q1 Ql Ql C1 C�'� p_
V
(D 3 Q C N � U fD O m m O
C N o R
N o w nl rr m t� Z
or cDa S ao = o c3 � rov q ni m N
c a
9 yo D
a � L? rn QT Y' 2 � � 50 -..�
D ? 3 C73u'a f � ' Ra Dni
of Q p A ^
ate
o m 819 - @ ° , D
a d o cx 9 M W g� w G)
nl Qf < nalloa 3 m
m n w
ti
N � Cf)
D
�pD ��pp Dppi J D D -4 i Cn c0
iu O N U UNi
A d 1) (D
A O C to 7
Q N
a
w
2
4
a
m
D
n
.-a
Q
m �-a
N
-*+
g w O
1-34 �
J V V J
m (q
c^' 4 CD
o � �
w a .•
m m m m w m m w m o
m
� tD
cn
n L A D > -Ti> D r+ O
v) N cn of cn D D cn D in v
v N cn cn cn �_ cn r �
Clt
A =
� o
m a
C
m m W m m 60 u 00 a
C m Oji `G w
G m
CL
J J s J
d
tD
J V J-4 tV -4
V 'J V V VcD
n
a vv CA,0, (D !T @
cm0 cr a ° �!f��> > mat z
o
cw� ow w5 2� �' w < � o
�m � o?iy �$ ° � J2fo .. ° w3
m cu g .. xMcgc� ww > > aa 2ac
� �(a 3IRD ^ c g O� [.v� °mo o nO > > � m � � � ��a
`O ° 5 vc Qc`�o(7�n a a 6 H °' m_ (mp c'.` ° Qa 3 .. � �¢ �w
C N 8 N 7a -3 N O fD 7 f pl a 7 a O 4 ML
aD �+ m
N p�7mn� _ x� < (i7�oommo ° tl1 � �e � �o � �� cR
j 4'7 j ° �. N N d_ v�-[aD 4 N O of �Oi
j m3 ry � 3@ .. mn �? m O wCL) � m
N y a
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 6394171 --
BUP _
Date Requested_, AM —Ch1 `__ _ BLD
Location 1 �si C��7�151 G Suite MEC _
Contact Person _ Ph �—_— ('7h~ -- or,,
Contractor Ph _ SWR
BUILDING Tenant/Owner , _ _ _ ELC
Retaining Wall ELR _
Footing A N07' REQUES'CED
Foundation FOUND DURING RESEARCH FPS
Fig DrainSGN
Crawl Drain In NO INSPECTION(s) IN FILE
Slab _ SIT _
Post&Beam
Ext Sheath/Shear __
Int Sheath/Shear
Framing
Insulation - ----- �_
Drywall Nailing
Firewall
Fire Sprinkler - --__----_----___--
Fire Alarm
Susp'd Ceiling ---------- --
Roof
Misc: - - - -
Final , _
PASS PART FAIL _ -_--- --------�= ------- -
F�LU G _
Post&Beam
Under Slab
Top Out \
Water Service ---------.-
Sanitary Sewer
Rain Drains
PASS PART FAIL —
MECHANICAL
Post&Beam
Rough In
Gas Line -
Smoke Dampers
Final —
PASS rART FAIL
ELECTRICAL. ----
Service
Rough In
UG/Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading -- ----
Sanitary Sewer
Storm Drain ( ]Reinspection fee of S _required before next inspection. Pay at City Hall, 13125 CW Hall Blvd
Catch Basin
Fire Supply Line ( ]Please call for reinspection RE: [ ]Unable to inspect-no access
ADA
Approach/Sidewalk Date Inspector Ext
Other - -- - —
Final
PASS PART FAIL , DO NOT REMOVE this inspection record from the job site.
CITYOF TIGARD
DEVELOPMENT SERVICES
?In— lion 13125 SW Hall Blvd., Tigard, OR 97223 (503)639.4171
CERTIF'ICATE OF
OCCUPANCY
PERMIT #. . . . . . . : MS•T11j6_.04'7,.
DATE. I SSI IE D s 011/11/13,7
I'ARCEI_ s 2510 CC ..IIW0 35
ITE ADDRESS. . . : 13043 SW ASCENSION OR
U1-ADI VISION— . : F- ILL SIA I RE:' WOODS I C I N G P1)
;. . . . . . . . . . . LO'f. . . . . . . . . . . . . v03 JURTSDICTIgNs
LAS�3 OF WORII. s NEW
IYPE OF USE:. . . :SF
I YPE Of' CONSTR s 5IV
)CCUPONCY GRP. &F-3
)C:CUPANCY LUAD s L
i ,>mar ks s Path 1
I
lwners - __.___..._.__...._._..___. .._... .... _... ...___. . .._ .._ ....._._.
1H LBURNr. DEVELOPME=NT
'008 SW NYBE'RG RD
' ' InLATIN OR 97064
--bane #s 692-6383
ontract ors _- -- ...__._._._ .__..___. __._.__.__._ .-•----
,'6-IE3LBURNE DEVELOPMENT
700A `:iW NYBERG RD
I UAE.AT IN UR 97062
-1hone #s 692--6383
42388
Phis Certificate 91-ants occ.upancv of the above referenced building or portion
they eoi• and r.on•f it-mv that the building has haven tnspected for compliance with
tt•ip Sitate of Oregon Specialty Codes for the grog.,, occtipmnt,y, And Uye under
whir.-h the referenced Kermit was is% -ed.
i
RUILDINI3+ IIV�P,E.L'FOR ESU INC, OFT- ICTAL
POST IN CONE'PICUOUr PLACE
rp
CITY OF TIGARD
DEVELOPMENT SERVICESPLUMBING PERMIT
PERMIT #. . . . . . . : PLM97-01 39
13125 SW Fall Blvd., Tigard,OR 9772?3 (503)639-4171 DATE ISSUED: 04/23/97
PARCEL: 2S104CC--HW035
SITE ADDRESS. . . : 1.3043 SW ASCENSION DR
�3UBDIVISION. . . . : HILLSHIRE WOODS ZONING: R-7 PD
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :O35 JURISDICTION:
-...-------------------------------------------------------------------------------------
'-1-A3S OF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
'TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : I
F)CCUPANCY GRP. . : R3 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . : 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
F I LAUNDRY TRAYS. . . . . :, 0 SF RAIN DRAINS. . . . . : 0
5 1 NKS. . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . : 0
LAVATORIES— . : 0 OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 0
WATER CLOSETS. : 0 WATER LINE (ft ) . . . -. 0
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
Remarks : Install residential backflow prevention device
(iwner: FEES ----------------
SHELBURNE DEVELOPMENT type amooAnt by date reept
7008 SW NYBERG RD DRMT $ 15. 00 JST) 04/23/97 97-293625
TUALATIN OR 97062 5Pr1T $ 0. 75 JSD 04/23/97 97-293625
f'ontrartor----------------------------------
11ASTFR9S TOUCH SERVICES INC
DONALD BURTON
1-202 SW MICHAEL DR
WEST LINN OR 97068 ---------------------------------
Phone #: 655--6436 $ 1.5. 75 TOTAL
Reg #. . : 000115 REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the RP/Backflow Prev
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable lam. All work soil] be done in accordance with
approved plans. This permit will expire if work is not started
within IN days of issuance, or if work is suspended tor more
than 180 days.
Flermittep Signat'
T s s iA e d -Ca.1. 1. for inspection 639-4175
Read By
TY OF TIGARD Plumbing Application `-
125 SW HALL BLVD. Commercial and Residential Date Rec%,
Date tc P E.CARD, OR 97223 Date to DST.T
j3) 639-4171 Permit a(L Hcr 3
Print or T pe Related SWR a
Incomplete or illegigle applications will not be accepted Called- ►'�
Name of Cevelapment/0ro1Rat
FUJURES (individual) QTY PRICE AMT
` ot 9.00
Job ////ISGG��,K" Si �-"
Address `rtrset Address Suite Lav,tory 9.00
S — _
—L3 i= 5 c-64 S r d t " r J S— Tub or i uu:Shower Comb. 9.00
dldg a C tyiState Zip Shower Only 9.00
> k•/ Water Closet i 9.00
+11
������j.r�r,� t' J� ✓r (/
(Dishwasher _-� 9.00
a�ktq Add s — Suite Garbage Disposal 9.00
m
Owner '/
L'(l rijVY-<C'.'( 1i Washing Machine 9.00
CMylstate Zip I Phone Floor Drain 2' 9.00
GC Oc u Y2 '?O Y 9.00
Nenie -
V 9.00
Occupant Me"Address surto Water Heater 9.00
_ Laundry Room Tray 9.00
City/State Zip Phone Unnal 9.00
- -
Naar! Other Fixtures(Specify) 9.00
_
900
Ontractor `nail a as a V.1-iiTowl, MiT 9.00
8202 SW Whatll rive 9.00
CityrState Westl4nn, one --
S6 y3 6 __ 9. -
Oregon Const.Cont.Board Lica ftp Date 9.0000
ANsch copy of U r -.3 v ` (S — 900
I cal"W" Plumbing Lic.a. Exp.Date Sewer-1st 100' 30.00
Lke+ew Newer-each additional 100' Y I 25.00
COT Business Tax or Metro a Exp.Date Water Service• 1 s! 100' — -30.00 j
Nsn4 Water Service-each additional 200' 25.00
Architect Storm d Rain Oram- 1st 100' 30.00
Or Mailing Address Sr.,ce
- Storm 6 Rain Crain-each additional 100' 2500
Mobile Home Space X5.00
Engineer C.tyiSlate Zip Phone Commercial Back Flow Prevention Device or Anti- 25.00
Pollutnon Cevice _
+scar a wort New O Addition O Alteration O Repair O Residential Backflow Prevention Devine' 1500
5e dons: Residential O Von-residential O Any Trap or Waste Not Connected to a Fixture 900
la tonal description of wort Catch Basin
t'�9-0
Insp,of Fxustirg Plumbing 0
:sting Lae of - Specialty Requested Inspections 4000
_ penhr
«*q -pmPMY --- -- Rain Crain.single family dwelling 30,00
,Dosed use of Grease Traps 9,00
Jdinq or property— — ----
___ QUANTITY TOTAL
re yogi capping, moving or replacing any fixtures? Yes❑ No C] Isometnr or neer augram is reuuw"d Cuandy rout is >9 -
tf ey s see back of form) _ _ 'SUBTOTAL
erebv acknowleage that I ha•,e read this application that the information
sn s correct.!nat I am Me owner or authorized agent of the owner.and 5% SURCHARGE
iitrrt3 su6711M? d re in compliance with Cregon State Laws. _.
PLAN REVIEW 25% OF SUBTOTAL
nature of Owrt n r Date secured�h, .,um"aW totals>9 _ 1
L i. f t( • y 7 _.-�—�.- -- TOTAL ow7
,tact Perso
'M
Name I Phone —.
inimum permit fa.is$25•5%surcharge.except Residential Back
Prevpnnon Cevice.which is S15-594 surcharge
i'dsistplmaop doc 8/913
PLEASE CUMPI,��E ASAEp£4PRIATE TQPROJECT:
Fixtures to be capped, moved or replaced Qty
Sink _
Lavatory
Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal _
Washing Machine
Floor Drain 2"
3"
4
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
1
CITY OF TIGARD
DEVELOPMENT SERVICES ")4TER PERMIT
L. 13125 6W Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . : MST96- 0O 9',DATE
DATE ISSUED. 11 /04/96
PARCEI_: 2-'S 1 O4CC—HWO35
SITE ADDRESS. . . : ,.3041 SW ASCENSION DR
SUBDIVISION. . . . : H I L.L.SH I RE WOODS ZONING: R-7 P1)
HI-OCK. . . . . . . . . . . I-.OT. . . . . . . . . . . . . :039
Remarks: Path 1
_— --------------------------------------------------- BUILDING ---------------------------------------------------—--------
REISSUE:
------------- ---------------
REISSUE: STORIES.......: 2 FLOOR AREAS---------- BASEMENT,..: 0 sf REQUIRED SETBACKS---- REQUIRED-------- -
CLASS OF WORK.-,NEW DIGHT........: 17 FIRST....: 2607 sf GARAGE.....: 713 sf LEFT..........: 9 SMOKE DETECTRS: Y
TYPE OF USE...:SF FLOOR LOAD....: 40 SECOND...: 475 sf FRONT.........: 28 PARKING SPACES: '
TYPE OF CONST.:SN DWELLING UNITS: 1 FINBSNENT: 0 sf RIGHT.........: 15
OCCUPANCY GRP.:R3 BDRM: 3 BATH: 4 TOTAL------: 3082 sf VALUE..$: 218792 REAR..........: 65
PLUMBING -- —----------------------------------------------
SINKS.........: 1 WATER CLOSETS.: 4 WASHING MACH..: 1 LAUNDRY TRAYS.: 1 RAIN DRAIN ft: 0 TRAPS.........: 0
LAVATORIES....: 6 DISHWASHERS...: 1 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: I CATCH BASINS..: 0
TUB/SHOWERS...: 4 GARBAGE DISP..: 1 WATER HEATERS.: I WATER LINE ft: 100 BCKFLW PREVNTR: 1 GREASE TRAPS..: 0
OTHER FIMRES: 0
----------------------------------------------------------- MECHANICAL --------------------------------------------------
FUEL TYPES---------- FURN ( 10 ..: 0 BOIL/CMP l 3HP: 0 VENT FANS.....: 5 CLOTHES DRYERS: 1
/GAS/ / / FURN 1=188K ..: 1 UNIT HEATERS..: 0 HOODS.........: 1 OTHER UNITS...: 1
MAX INP.: 8 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOGDSTOVES....: 8 GAS OUTLETS...: I.
--------------------------------------------------------------- ELECTRICAL -----------------------------------------------------------
--RESIDENTIAL UJNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS-- -----MISCELLANEOUS---- --ADD'L INSPECTIONS--
1880 SF OR LESS: 1 0 - 208 amp..: 0 0 - 280 alp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
FA ADD'L 5809F.: 6 201 - 400 amp..: 0 ,1-01 488 amp..: 0 1st W/O SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - G80 amp..: 0 EA ADDL BR CIR: 0 SIGNALIPPNEL...: B IN PLANT......: 0
MANF HM/SVC/FDR: 0 601 - 1080 amp.: 0 601+amps-1888 v: 8 MINOR LABEL -10: 0
1008+ amp/volt.: 0 ----------------------------------- PLAN REVIEW SECTION --------------------------- ----
Reconnect only.: 0 1=4 RES UNITS..: SVC/FDR1=225 A.: 1 688 V NOMINAL- CLS AREA/SPC OCC:
--------------------w------------------------- ELECTRICAL - RESTRICTED ENERGY ---------------------------------------
A. SF RESIDENTIAL—— ------------- B. COMMERCIAL---------------------------------------------------- .--------------
AUDIO I STEREO.: VACUUM SYSTEM..: AUDIO 6 STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: OTH: :: ii BOILER.........: HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE SIX:
GARAGE OPENER..: CLOCK........... INSTRUMENTATION: MEDICAI.........: OTHR:
HVAC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL t SYSTFMS: 0
Owner: -------------------------- ----Contractor: ------------------------------ TOTAL FEES:$ 4985.91
SHELBURNE DEVELOPMENT SHELBURNE DEVELOPMENT
7008 SW NYBERG RD 7888 SW NYPERG RD
TUALATIN OR 97862 TUALATIN OR 97062
Phone 4: 692-6383 Phone UM: 692-6383
Reg A..: 42388
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 188
days of issuance, or if work :s suspended for more than 180 days.
------------------------------------------------ ---- REQUIRED IN9PECTIONS ------------------------------------------------
Footing Insp PLM/Underfloor Framing Insp Gas Fireplace Water Service In Building Final
Foundation Insp Mechanical Insp Shear Wall Insp Insulation Insp Appr/Sdwlk Insp Erosion Control
Post/Beam Struct Plumb Top Out Low Voltage Gyp Board Insp Electrical Final
Post/Beam Meehan Electrical Servi ireplace sp Rain drain Insp Mechanical Final
Crawl Drain Electrical Ro Gas Lin Water Line Insp Plumb Final
Permittee Si.gnati_u-eIssued
(_aI I for- iris pection 6;.39--4175
CITY O F TI G A R D SEWER CONNECTION
DEVELOPMENT SERVICES PERMIT
13125 SIN Hall Blvd,, Tigard,OR 97223 (5PERMIT #. . . . . . . : 6WR96-049C:03)639-4171 DATE aSSUED.- 11/04/96
PARCEL: 2S104CC—HW035
SITE (iDDRESS. . . -- 13043 SW ASCENSION DR
SUBDIVISION. . . . : HILLSHIRE WOODS ZONING: R-7 PD
BLOCK,. . . . . . . . . . . LOT. . . . . . . . . . . . . :035
-----------------------------------------------------------------------------------------
TENANT NAME. . . . . :SHELBURNE DEVELOPMENT
t'JSA NO. . . . . .. . . . . : FIXTURE UNITS. . . .- 0
CLASS OF WORK. . . :NEW DWELLING UNITS. . : I
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: I
INSTALL TYPE. . . . :BUSWR IMPERV SURFACE: 0 sf
Remarks : Path I
Owns": ----------------------------------------------------- FEES ---------------
SHELBURNE DEVELOPMENT type amount by date r-ecpt
7008 SW NYBERG RD PRMT $ 2200. 00 BON 11/04/96 96-286041
INSP $ 35. 00 BON 11/04/96 96-286041
TUALATIN OR 97062
[."hone #- 692-6383
Contt-actov•:
CONTRACTOR NOT ON FILE
Phone #: $ 22'35. 00 TOTAL
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer- Inspection
of the Unified Sewage Agency. The permit expires 180 days from
the date issurd. The total amount paid will be forfeited if the
pervit expires. The Agency does not guarantee the act---acy of the
side sewer laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all 4,..tections from
the diitancp given, If not so located, the installer shall urchase
a "Tao and Side Sewer" Permit and the Agency vifl instal a lateral.
Permittee Signatui-e
Issued 0—
/7tA
Call for inspection 639-4175
Plan Check# ;---
'ITY OF TIGARD Residential Building Permit Application Redd Ey 9, ,
v .
1312.5 SW HALL BLVD. New Construction Additions or Alteration. Date Recd 10--16- U
IGARD, OR 97223 Single Family Detached or Attached Date to P E.
03 a39-4171 Date to DST 0- d L-
Permit# h b >7' '1'� U*
Print or Type Called nut
Incomplete or illegible applications will not be :cepted_
Name of Subdivision Lot# Name
Jona Hillshire Woods JS— ST L o^/
Architect Mailing Address
Address Site Address Z LJ
0
4/3 S[.J A City/State Zip I Phone
Name -1--aAG47-11YT42/1 10 —12Sr
Shelburne Development -- — Name/ �—
Owner Mailing Address _CL
Engineer Mailing Address
Cit /State Zi Phone g JZ y Tk
ri'ual.atin 9062 692-6383 -date
_ 'itylState ZipPhone
Name 7- t�7 Lpl� g
Genaral Shelburne Development Describe work new addition O alteration O repair O
Contractor Mailing Address to be done:
7008 S.W. N ber Rd. Additional Description of Work:
City/State Zip Phone
Tualatin 97062 692-6383
Oregon Const.Cont.Board Lic.# Exp. Date - -
AttachCopyof 042388 _ 11-8-96 Project
Current COT Business Tax or Metro# Exp.Date Valuation $ 2,1Z
Licenses 00003412 17/l/97 NEW CONSTRUCTI N ONLY: —TY
Name ---- —
Mechanical Oregon Comfort Heating Sq.Ft. House: Sq.Ft.Garage:
Sub- Mailing Address r
Contractor P.O. Box 355 Corner Lot Yes No Flag Lot Yes No
City/State zip Phone (check one) (check one) X _
Eagle Creek 97022 655-0221 Restricted v' Audio/Stereo Burglar
Qregon Const.Cont. Board Lrc# Exp.Date Energy X System X Alarm
Attach Copy of 042519 2-24-97 Gara iaDoor HVAC
Current COT Busings ax or Metro# Exp. a Installation g
Licenses - 000
00 01313 3/T>y 7 X Opener X Systems
Name (check all that Other:
central vacuum
Plumbing C & K Contracting, Inc. ply
Will the electrical subcontractor wire for all Yes No
Sub- Mailing Address X
536 6 N.E. 63rd restricted energy installations? _
Contractor Has the Subdivision Plat recorded? N/A Yes No
cSryalem 91T01 P3QT1-3539 X
Oregnn Const.Cont.Board Lic.N Exp.Date Reissue of MST# Solar Compliance
Attach Copy of , 065015 3-15-97 (Calculation Attached)
Current Plumbin L # xp Qat I hereby acknowledge that I have read this application,that the
Licenses 2T--�9 PB l- 1-�7 information iven Is correct, that I am the owner or authorized agent of
COT BusinessTax or Metro# Exp,Da te97 the ow r, an hat plans s miffed are in compliance with Oregon
MCI 13-2C�/ 5 77 StA laws _
Name gnatu f Owner/A Date
Electrical Dryer & Sons Electric
i Cginfact Person yoe Phune 7�
Sub- Melling AddressLCT
Contractor 5536 SE Woodstock FOR OFFICE USE ONLY:
City/State Zip Phone Plat# Map/TL#:
Portland 97206 774-1606 C/C( -I JUJ6 3J�
Oregon Const.Cont.Board Lic.# Exp. Dale �' 1 /
Attach Copy of, 001114 11-23-9b Setbacks Zone: Solar:
Current Electrical Llc.# Exp.Date
Licenses 26-43C , '�-
COT Business Tax or Metro A Exp.Date Engineering proval: Planning Approval: TIF:
00003046 _ 12-1-96 -' IF Fir
l' �r
dstslmstapp.doc - t
Permit # Ac oust Description Arno nt AML?- L Bal. Due
�►', �( S'J MST. Permit (BUILD)
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
FLC/ELR Permit (ELPRMT) JGV- `� (�0�✓I
State Tax (TAX) `• G �' rD
Bldg: --
Plumb:
Mech: o� U
ELC/ELR: /J 1GY
Plan Check
MST: (BUPPLN) , . �� �-�--
Plumb: (Pt-MPLN)
Mech: (MECPLN) 12,
CDCReview (LANDUS)
%L Sewer Connection (SWUSA)
Sewer Inspection (SWINSP) — 3 � _ .3j
Parks Dev Charge (OKSDC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Water Quality (WQUAL)
Water Quantity (WQUANT) /G _ - / L
Erosion Control permit (ERPRMT)
Erosion Planck/USA (ERPLAN) 21,
Erosion Planck/COT (EROSN)
Fire Life Safety (FLS)
TOTALS: L ���U. y1 ,,2 j-V
i\dstslmstapp doc
Rev 7196
W, ,.y I+;•, I .,
MIST
IR .
0V a
,w
iiil��iiwiwi�r��► �.', �n,�
R R� I bo
F'Dt14"11
1
bf mu-Nal
r Am VAN "on
W 11A."114
'r��yRlkkWFaa�f'�+"i..rr.xx„
' i� i �gar ` ����;�► �ir'�r�
��■■Nr i r s+� pN�::� err
RR■■ M �rr !■MIMIGIII�>IWRI I`r�
04
Ole ► 9Dh1' I
r M � ■� 1
�j Ifc► ■ /bre A
A RL Mt MN NMi R
y I - ok
�1 molls a *■n Ito N.
psM i
owl
h saw W, "41411
N, r
1.�4+�`.: r -1 f MR NR/wI11wUMv. i�iN'
lam%II lift 41 v� � �1 ��1PR ■R11!��16wS � !R;Rp'
►IM ��r �� �•AMNMI IiFAi ����
NRflib�Mkr111Rnow 1 11On ■
•■s . N ■■ M ■IrgIIM R w
• �� s� gall as� a IN
12
t► M � s '+ a;�IJt
� �* !
News MfI
a onU
:
own
�*; i
• �.
AMA * I