9735 SW NACIRA LANE r
9735 S1M. Nacira Place
CITY OF TIGARD 24-Hour
BUILDING Inspection ' ;e: (503)639-4175 -G v�
MST _..
INSPECTION DIVISION Business Line: (503) 639-4171
A-Ze-
BLIP _--.-- _
Received _ _Date Requested -- AM _—._ _ PM BUP
Location _� _ _- _Suited - MEC
Contact Person ,,,1� __ -._ Ph(__ _) ��' PLM
Contractor�1��5-�L/ �=��� - Ph(-- ) - - SWR
BUILDING TenanUOwner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR - -- -
Crawl Drain --Slat) Inspection Inspection Notes: SIT
Post&Beam
Shear Anchors - - -
Ext Sheath/Sh m --
Int Sheath/Shear
Framing - -- - - -
Insulation
Drywall Nailir - - - -- - — ------Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceilinb _ -
Roof
Other: - - - ---- ---- --- ----_.._ _
Final
PASS PART_ FAIL
Post&Beam
Under Slab - —
Rough-In
Water Service - - - - - --
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain
Shower Pan
Other:
Final
PAS.11 PART FAIL
MECHANICAL --- ---
Post&Beam —
Rough-Ir — - ---- - - --- ---- -.. -- -
GNs Line
Smoke Dampers �—
Final
PASS PART FAIL -- --- - - ---- --- ----_ -_ —
ELECTRICAL
Service
Rough-In -- — --- -.._ --- -_--
UG/Slab
Low Voltage
Firq Alarm
iri$b n Reinspection fee of required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
l$1w PART FAIL
Please call for reinspection HE:_ _ -__. —_ _— Unable to inspect- no access
Fire Supply Line
ADA
Date Inspector � -
Ext
Approach/Sidewalk ✓ l
Other:
Final -- DO NOT REMOVE this Inspect!on record from the job site.
PASS PART FAIL
CITY" OF TIG,ARD 24-Hour
BUILDING Inspection Line: (503) 639-4175 MST _-
INSPECTION DIVISION Business Line: (503)639-417'1 —�—
BUP _
Received —__ ____.Date Requested — AM__ __ PM __-__ _ BUP
Location _ �_�.___— � T Yl suite- . ____ MEC
Contact Person _____ --- Ph(--) —__ __..__ _ PLM
Contractor _ __ Ph( _i _ SWR —
BUILDING _ Tenant/Owner LLC
Footing E LC
Foundation cc:ess:
Fig Drain ELR
Crawl Drain
Slab Inspection Notes: SIT --
Post&Beam ---.---
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear 7T�
Framing +
Insulation /Lt
Drywall Nailing --
Firewall
Fire Sprinkler
Fire Alarm �� f
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAV_
PLUMBING
Post&Beam
Under Slab
Rough-In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Dain
Shower Pan
Other:
ASSPART FAIL
ANIC_AL
Post& Beam
Rough-In
Gas Line
Smoke Damp rs —
Final
PASS PART FAIL -- - --- -
ELECTRICAL —
Service
Rough-In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART _FAIL
❑
SITE u Please call for reinspection RE _ _ Fj Unable to inspect-no access
Fire Supply LineADA
61
Approach/Sirtowalk Daft L�-° inspector - — —�—.�axt
Other; -
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 630-4175 MST c,-5162
INSPECTION DIVISION Business Line: (503)635-4171
BUP _
Received _Date Requested _ �G"� 3 AM PM BLIP
Location 't-,---_ - - Suite_ -------- MEC -.
Contact Person — _ Ph(_ ) y�1-�. y Z- _ pl_M
Contractor—_ Ph(___— ) - SWR
TenanliOwnpr - ELC --
- - ---
ooting
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain _ -
Slab Inspection Notes: ~-- -~----- - --- - SIT
Post&Beam ---
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear --
Framing r �'►_".� '� C
Insulation
Drywall Nailing _�-_ �
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roofi <
Other:
Fin
AS PARI' FAIL -
P ING - - -
Post&Beam
Under Slab _
Rough-In
Water Service
Sanitary Sewer —
Rain Drains -------
r
Catch Basin/Manhole
Storm Drain --- _
Shower Pan _
Other. ----
Final
i
PASS PART FAIL ,
ECH�1C _-- ------ -- - �.
R Beam - l
Rough-In
Gas Line --
Smoke Dampers
- ASS-PART FAIL
ELECTRICAL
Service --
Rough-In
UG/Slab ---
Low Voltage
Fire Alarm -
Final
PASSPARTPART rAlt_ RGIon tee of$-, --- •equired before next Inspection. Pay at C:it+/Hall, 13125 SW Hall Blvd.
SITE - [I Please call for reinspec ion RE - C� Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk [fate- =� � � � Inspector � � utt
Other:_
Final DO 140T REMOVE this: Inspection record from the Job site.
PASS PART FAIL
CITY O F T I G A R D MASTER PERMIT
PERMIT#1: MST2002-00245
DEVELOPMENT SERVICES DATE ISSUED- 5/24/02
13125 SW Hail Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 09735 SW NACIRA LN PARCEL: 1S135CD-NP009
SUBDIVISION: NACIRA PARK, ZONING: R-4.5
BLOCK: LOT:009 JURISDICTION: TIG
REMARKS: Construction of new SF detached residence. Path 1
NUILDING
REISSUE: STORIES: 2 FLOUR AREAS REQUIRED SETBACKS REQUIRED _
CLASS OF WORK: NEW HEIGHT: 25 FIRST: 1,402 of BASEMENT: of LEFT: 15 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1,600 at GARAGE: 462 111 FRONT: 30 PARS<ING SPACES: 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: of RIGHT: 5
VALUE: $285,082.60
OCCUPANCY GRP: R3 BORM: 4 BATH: 3 TOTAL: :,002 00 of REAR: 52
PLUMBING
SINKS: I WATER CLOSETS: 3 WASHING MACH, 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 5 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: I CATCH BASINS:
TUBISHOWERS: 3 GARBAGE DIXP: 1 WATER HEATERA + WATER LINES +00 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES_ FURN v 100K: dOIL/Cf W<3HP: VENT FANS: 5 CLOTHES DRYER: 1
GAS FURN>•10014: 1 UNIT F,EATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT _ SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADO'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp: 0 200 amp: WISVC OR FDR: I PUMPARRIGATION: PER INSPECTION:
EA ADn'L SOOSF: 5 201 400 amp: 201 400 amp: tet W/O SVCIFDR: 00 SIGNIOUT LIN LT: f EN HOUR:
LIMITED ENERGY: 401 •$00 amp: 401 600 amp: EA ADDL BR CIA: SIGNALIPANEL: IN PLANT:
MANU HMISVCIFDR: 801 • 1000 amp: EO1+8mpp1000V: MINOR LABEL:
10004 amolvolt
PLAN REVIEW SECTION
Reconnect only:
>•4 RES UNITS: SVCIFDR>=225 A.: >600 V NOMINAL: CLS AREA/SPC OCC:
_ ELECTRICAL•RESTRICTED ENERGY
A SF RESIDENTIAL S.COMMERCIAL
AUDIO B STEREO: VACUUM SYSTEM:_ AUDIO&STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT
BURGLAR ALARM: OTH BOILER: HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM. NURSE CALLS: TOTAL N SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 7,532.80
This permit Is subject to the regulations contained in the
INTERCOASTAL DEV GROUP LLC JLS CUSTOM HOMES Tigard Municipal Code,State of OR Specialty Codes and
PO BOX 91185 17200 NW CORRIDOR CT #110 all other applicable laws All work will be done In
PORTLAND,OR 97291 BEAVERTON,OR 97006 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 ATTENTION
Phone: Phone. Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules areset
Reg#: LIC 1391170 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)248.1987.
REQUIRED INSPECTIONS
Erosion Control Insp 8& PosUBeam Mechanica Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final
Sewer Inspection Underfloor Insulation Plumb Top Out Exterior Sheathing Inaf RDIn drain Insp Plumb Final
Footing insp Crawl Drain/Backwater Electrical Service Low Voltage Water Line Insp Final inspection
Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Line Insp Appr/Sdwlk In;
Post/Beam Structural PLMiUnderfloor Framing Insp Gas Fireplace Electrical F al
Issued By : Permittee Signature
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next bu!.•Iness day
CITYOF TI G ^ R D _ SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#. SWR2002-00161
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/24/02
PARCEL: 1 S135CD-NP009
SITE ADDRESS; 09735 SW NACIRA LN
SUBDIVISION: NACIRA PARK ZONING: R-4.5
BLOCK. LOT: 001) JURISDICTION: TIG___
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: LTPSWR IMPERV SURFACE:
Remarks: Sewer connection permit for new SF detached residence.
Owners _ FEES
INTERCOASTAL DEV. GROUP LLC Type By Date Amount Receipt
PO BOX 91185
PORTLAND, OR 97291 PRMT CTR 5/24/02 $2,300.00 27200200000
INSP CTR 5/24/02 $35.00 27200200000
Phone: 503-209-8940 Total $2,335.00
Contractor:
Phone:
Reg #:
Required lnspection. _
This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit Expires
180 days from the date issuer'. 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 ,nstaller
shall prospect 3 feet In all directions from the distance given. If not so located, the installer shall purchase a 'Tap and
Side Sewer" Permit and the Agency will install a lateral. ATTENTION: Oregon law requires you to follow rules adopted
by the Oregon Utiliiy Notificatior Center. Those rules are set forth in OAR 952-001-0010 through tiAR 952-301-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987 -
Issued by: _ '1 _ Permittee Signature:
Call (503) 63V-4175 by 7:00 P.M. for an inspection needed the next business day
p-Z. l
1;uiidi ig Permit Application
I)atereceived: � Permit nogI
City of Tigard �� Project/appl.no.: Expiredat
Address: 13125 SW hall Blvd,ligard_OR 97221 l3 ccipt nu.
City u(Tigard Uatcissucd: Y'
Phone: (50.1) 639-4171 Pa men t e
(503) 598-1960 Case file no.: Y YP —_
&2 family:Simple Complex:
Land use approval: {
s
U I &2 family&A-0111119 or acrrssory U Commercial/industrial U ".' lii I ,,i l> Wew construction U Demolition
U Adclitionat
/ tention/replacement U'1'enant improvement I � t I ,/alarnt U Other:
It t t
I31dg.no.: Suite no..
3J 1oh address�{ -a` I�� �Vt - --
4� Tax map/tax I t/account no.: J Si 3.5 __.
L_ot: r lilt) k: - 5utxlivision: - t i 1_.��� -�----
-Project name: a---
Descr•iption and location of work on premiscs/sixcial condition"-:_ - - - ----- — — _
N:►ntr:Zrl: F�' :S tea !__11��L1
1 R 2 fatnil) dwelling: ;4
Mailin: addles' A
„I work........ 7
--- titatr �l.II . J
L T-LyN � - - 1 ttt;lll: Nn.of bed,0011"/paths....
....
ame
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Owner's trint^:rnlalivr IZ�3E. U�� ------- - Nt.�t dwelhn4!arca(�yMAIL
II
{'hone' 4.1 L"CeLitt I ,I,
Lj
Gatucr/uulwtl:ora(sy. It.l
('oveu'd porch area(syIII
L I
Name: -- --
I
• Deck arra Ia 1.
Mailin!addrLss: �
other suucturc,
Cit
it 7,11 -- (orntnercial/industrial molt,--fa diY
Y I: nl•ul:
1•ax:
{'hone: Valuation of work......... ..............
1 '
Existing bldg.arca(sq. ft ) ...�,....�... .
i �.� __ New bldg.area(sq.fl.) ..... ... -
Business name: \ X7.1_
Numtx t of,torics.............
Address:
_ State lll', •
City: s. fypr of cunsttucuon... ..... .
Phone: .Fax. •� mail: Orvupancy vroup(s): I:rte+
Ne
('03 no
CityInco ,II n".: Notice: All contractors and sutx:ontraciors arc required to he
I Iicenwd with the Oregon Construction Contractors Board under
` provisions of OILS 701 and ntay h,•re(Im.rd to Ix licensed in the
Name: \AA-C-, t C_ �� 4 ' t jurtsdtclion where work is beim Ix rft,nmr,f. if the applicant is
� ! exempt from licensing,the foll-AA119 reason aPPlir.
Address � See_� - .�� I _—. ---- ---- - -
State
Ci Y: " ai� - — --
Contact flan nu.:- -�1 -- _-- — - _— —
PltonrZ Z. •` will
C_ N - V� ��, t,'ontart p_ess ott-4�-0
lI�)t•.u,Isr drpotr runpo'dn applica
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�, 1U-�L' ly .. I'lease refer In Ice schedule -- -_ -_-
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Mechanical Permit Application
ltatcreceived: Permit no.: )f)e/l.'�-(��,.r,;
City of Tigard lRoject/appl.no.: Expire date:
City(if Tigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.:
Phone: (503) 639-4171
hax: (503) 598-1960 Case file no.: Payment type:
Land use approval:
Building permit no.:
---
=Newconstnict
dwelling or accessory U Commercial/industri;ll O Multi-family U Tenant improvement
wt1 U Add ition/al teration/replace inent U Other:
I Lei
Job address:-.H r j w 1 rex L✓s Indicate equipment quantities In boxes below. Indicate the dollar
Suite no.: value of ail mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.:
' + - profit. Value$
S
wt; Block: Subdivision:- •Sec checklist for important application information and
jurisdiction's fee Schedule for residential permit fee.
Project nantc: �_
City/count IP: ME I � I
1 kA I I r al to-11
Description an ation of work on premises:---
Fce(ca.) Iblal
Description Qly. Res.only R--onl)
l /inspection: j st.dote ofcoptionn _ 11AU:
'tenant intplovement or change of use Air handling unit -
Is existinf!space hralyd ur conduioncd?U Yes U No Airconditioning(site oin required) —
Is existing space 111su1;111'd'?U 1'es U No A lex/oexisung AC system _
l ei I ioicr commpp ressors
Stale boiler permit no.:
Business nanlc v'(rtivS�r'.�J HI' Tuns--_nl-U/11 _ ---
_C'IIdyr:essf: • _�1jsi--�` ' - MaJuc
t Bno a erectors7
Ad1Un to uirc(T) — _
_ ----
-_-
usla I Ureplacefurnac• wrner—__ 1 Will
Faxes - mall:
f hone: _�) -��-' Including ductwork/vent liner U Yes C]No - —_
CCI; Ito.: 8r,-7 _ nsta Vrep ace/rc ocatc tcaters-suspen c
T.
City/metro hc.no.: � wall,of floor mounted _
cot fora iancc of cr than furnace
Name(please print) f l 1 7 of gerol on:
I I Absorption units- -- RT11/11 _
Chillers _-. III'
Name: _-_-- ----- - Com ressors ----
— til'
-—
Address: --- - - :n ronmenta exhaust an ventilation:
.
City. rSWtC. Appliance vent
-- - - - -�
Phone: - 11 I -- I n„II )rycrex gust -
1 Ito s, •ype / /res. 'huhu tazmat
hood fire suppression system
_Nantc:� _ i �_ 1'.xhausi fan with single duct(bath fans)
ix aust s stem a tart from beating or AC
Mailing ad ress'" � �i t.� •ue piping an st ton(up to 4 out ct )
f.�nc - Statc:��' �1” ���� , type: .-
Piton -F �, 1,, 3 2-✓ I In l i :Ucl LmEing each additional over 4 out ets
'romsp p ng(schematic required)
Nomlxr of outlets
Numc'� '� + _ ter it�app�ifince or equ pmenf: -- //a�rt
Address' x - Decorative fucplace ,--_- -_ 'x✓
Stat 7.IP:C "' �TTseit iypc
City: — — — —_�- � l nVl/Ile el Stove �.
1,ax tnall: Ul tcTr. ------ --__ -
Applicant's signature -
Nante (prin(j
Permit fee . .....1
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e,tcpled as complete •1 OTA1,
Narnr nl,udhal,►•,;r,sh�,wn un t,rgil i ant t -
A nun .. a 41 a,,l'u,o..0�nd
Electrical permit Application
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PlumbingPelrmit Apq lication
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-- - Valtteceival: J Q% -
City of TigardSewer pcnnil aur Building Perrot'no:
Addrem: 13125 SW Ball blvd. liprd.0 9T221 IM k:
Cit)r{/rlaan( Phone: (.03)6394171
Ita)ect/sppc•tn: —� p -- —
Fax:(50.1) 598 1960 Uete{alum_ b _ Itxelpt no, _
t lee file nv.: F'eymentry{+e:
1.tutu use approval. ._ — ----
U 1 &1 fainily dwelling or accesltxy 13 Cornnlemia Industtitd O Multi-famlly U Tenant improvement
jVew catstructlrnt U Addition/nli ,r-ttionfreplaccnrent U rood tervice U(?cher.
D"t-FijtMn . re! lea. Total
lob add CIA: }.rr 1 —__w IC4 .!-_✓ — N,n, •'text 1-Ltrdly d�IlnXaonlyt
81A .no., _ Suitt no. (Includes 110
Tax t tan lovau runt otm 5 3� a — Sl.t(1)�bnlh --
Loi: Block: Subdivision: 14c)-j, 5FR(2)Witt---
P cct -
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Cltylcuunly� T
Dewnptk ll end location of work on ptltttisea ___� Catch basin/aten drain
:f - t L . uryive�ItJIOAOr�utQ'�rcticli dtaill - --.
tial.date of cwn Irdunlint;• � rt L
�3mtufet.W ttc�lwme utiliuts —_ _
_Dus{nass nnmr_ Suctta 'Pan o es
Adders,: Knin in conncctut -_ ..•---
_?Y ?�}�'�— 2 c• �xnle
City: 1 Geri C? State:b_t! IJi� -i1/�
( mail: Ston,l sewer(min. 7�
Fax: —
P►conr.: !�3" (n �=--- seer strvico(no. In. .•
— - r I lurch.bu,.
CCB no.: ],�t✓o.��_ _ L. �—_._�___.3 .' � Ftxiare or Ilenu
CYt er Ila.nu.: �
'3 —tz- - Abso tion valve
Contractor's Mpteattttative sieneWre: r �� lsc to wale'
Print name: G Natc: 0 j)��water valve
'tesla evtdu
-Ci eawas r
Name: __-- - - Jiro washer — _
n Ing ounta n s)
State: —�'llP t cctow --
Phone: t'ax: Flrtwil: MpRilsiolllaA —
—
xtuWM rc erwor ca _ —
t"drWnWiloc,,aiuk,/Itu t
Name(mint): fir ne�po
Mnifin aAditsi: jl_ ._ __ ),e b16b
Gt:: w 11 IV L''tat j ZIP: tx ms�r
Pltonc f'-. mail: nter.e�tto: 'eau ern
Owner installati(nhrsidential maintenance only: 'the actu installation 4 mer(s) ---will he trtade by me or the mairder,ance and repair made b) my tcgulm 'hrf �lncomms acyrtltlnyeaextliteptv{tuty i ran n,t.r a11t.0 rl"ptcr 441. res
UatrtSum --—.. -
Uaw,m'e si wee` u owe shower an -
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Nantr. �ialercioset
Addteae: t1 11 Wacerh:al;r
su
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Minimum fax... ... S _
N,a rl)rlrtruar Wtf "Sal :ds,peer■e11Noiine:11111 perM11 application plat)review(at %) -_�--
O N11 O hUuetCuA e■pins it a permit is nm nbtalnad $talc,urrtuirge(11%)....S
"milt e.d mmbe• . ._ .—._ .w' within Igo days allre it bas been
accepted a,tnmplett
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Main Floor c,i
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rl
Garage
ca•e,etP O
D.on �
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60 SW Naci LN
(Tract B Private ST.)
Scale V = 20'
9735 SW Nadra LN Applicant:
Tigard, OR IDG LLC
PO Box 91185
Lot 9 Nacira Park Subdivision Portland, OR 97291