16676 SW 88TH PLACE•
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FF-11-UMBING PERMIT
CITY OF TIGARD PERMIT #. . . . . . . MST96-0141
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 04/04/96
13125 SW Hall B!vd.Tioard,Oregon 97223.9199 (503)639-4171
FARCE!-: 2S 1 14AU -02 1 00
;MTI_ ADDRESS. . . : 16676 SW 88TH F'L
SUBDIVISION. . . . : WPVERLY ESTATES ZONING: R--12
BLOCK. . . . . . . . . . . LOT.. . . . . . . . . . . . . :020
CLOGS OF WORK. . : GARBAGE DISPOSALS. . : 1
TYPE OF' USE. . . . :NEW WASHING MACH. . . . . . . : 1 BACKFLOW G'REVNTRS. . : 1
OCCUPANCY GRF,. . :SF FLOOR DRAINS. . . . . . . : 0 TRAPS. . . . . . . . . . . . . . : 0
STORIES. . . . . . . . :2 WATER HEATERS. . . . . . . 1 CATCH BASINS. . . . . . . . 0
F I X'TURES------•----------- LAUNDRY TRAYS. . . . . . : 1 SF RAIN DRAINS. . . . . : 1
S1NKS. . . . . .. . . . . . 1 GREASE TRAPS. . . . . . . :0
LAVATORIES. . . . . : 6 OTHER FIXTURES. . . . . : 0
TUB/SHOWE=RS', . . . : 4 SEWER LINE (Ft ) . . : 0
WATER CLOSETS. . : 4 WATER L INL (ft ) . . : 100
DISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . : 0
Remarks : PATH I
OWIVEf2: _ ___ _ ___.__.____._..__.______FEES---•__.____.----...__.
MICHAEL-G. �7.DUCHA CONST. CO- _ TIF $ 1470. w0 JSD 04/04/96 96-2778:36
18585 SW ROSA RD TIFh1 $ 1=0. 00 JSD 04/04/96 96-277836
SWIh $ 180. 00 JSD 04/04/96 96--27783C,
nl nHA OR 97-0007 SWM $ 100. 00 JSD 04/04/96 96-•277836
Phone #: 6:39--2639 ELCF $ 285. 00 JSD 04/04/96 96 -277836
ELC5 $ 14. 25 JSD 04/04/96 96--277836
F'1+_cmbing Contr�ar+or- _---_____..____....____ EL.RP $ 40. 00 JSD 04/04/96 96--277836
nn /� ELR5 $ 2. 00 JSD 04/04/96 96-277836
Flame : 1!' !_. 1 r ► `�G�aX�� _- DART $ 638. 00 JSD 04/04/96 96-27783C,
Address :_._. ]Z O __.._�....4_..� ___._ BPLC 1, 414. 70 JD 03/ 19/96 96-27715E'.
City :,___ _ �State :.__.O(t- _ R5PC $ 31. 90 JSD 04/04/96 96_27783(_
Zip:_-_--�� r'hone#:_.L"$_-_ _�-.�5� PARK $ 500. 00 JSD 04/04/96 96-277836
Reg #Q: -� .�. /--._..._....__ Additional. fees net shown here. . . . . . . . .
P:
DF3_ � 7J r - ------ REQUIRED INSPECTIONS
-- - -- -
This permit is issued subject to the rey--
,..clations contained in the Tigard Municipal Footing Insp Gas Line Insp
Code, State of Ore. Specialty Codes and all Foundation Insp Gas F-ireplace
other applicable laws.. All work will be done post/Beam Struct Insulation Insp
in acc:oi-dance with approved plans. This Post/Beam M�c_han Gyp Board Insp
ermit will expire if work is not started Crawl Drain Rain drain Insp
i hin 180 days of issI_canc_e, or iF work is FILM/Underfloor Water Line ltiisp
suspended for more than 180 days. Mechanical Insp Water Service In
F= Plumb Top Out Appr/Sdwlk Insp
N Electrical Ser-vi. Electrical Final
Framing Insp Mechanical Final
Low Voltage Plumb Final
c,> >< � •- _—�_.�_ __..._._.�x'_'L' __._....__._ Fireplace I n tp Building F=ina1
Authorized c.lmbing Contractor Si at�_cr
;' Call for inspection - 639-4175
(_:ontrac_tor Notes :--_. ---- -
CITY OF TIGARD
_ DEVELOPMENT SERVICES
13125 SW Hall Blvd,, Tigard,OR 97223 (503)6394171
CERTIFICATE OF
OCCUPANCY
PERMIT #. . . . . . . r MST96--0141
DATE ISSUED: 10/23/96
PARCEL: c:.S 1 1 4Ar)-02100
iI'VE ADDRESS. . . : 16676 SW 88TH PL
,;UHDIVISION. . . . : WAVERLY ESTATES ZONING.-R-12
2LC..)CK. . . . . . . . . . e LOT. . . . . . . . . . . . . 020
----------------------
CLASS OF WORK. :NEW
YFE OF USE. . . :8F
1-YPE OF CONSTR:5N
uCCUPANCY GRP. :R3
'.)C:CUI'-'ANCY LOAD:
,temarks s PATH I
,11CHAE:L S. MUCHA CONST. CO
18585 5W ROSA RD
ALOFIA OR 97•-02117.17
I='hone 0., 639-2639
:ontractor- .
j. "f. ROTH LONSTRUCTION INC
12540 SW 68TH PARKWAY
F I GPRD OF 9 72;?,
-'hone #4 6:39-2639
� ey #. . I 0ElOri'70
phis CertificAte grants occupant-y of thw abcve rpf�-renved building or portion
her%of and confirms that the building has been inspected for compliance 1-ith
,:he ;tate of Oregon S ecialty Cucles for the group, ,gc_cupanc: , and Use ander
t,,hir_h t_h ire f-evenc d errs .t was issued. � /J
OU i !)ING~ 1NS^ I,TOR '~ BUILDING OFFICIAL
J
Cil
POST IN C( WN P I CUOLIS GLACE
J
F,EHMIT #. . . . . . . : MST-)6--0141
CITY OF TIGARD DATE ISSUED: 04/1-714/96
COMMUNITY DEVELOPMENT DEPARTMENT E=ARCEL: 2S 1 14AD- 02100
]31 Ivd.Tlgerd,O e 07 8 ( 3 99.4171
SITE fl�Y#L@�. . . 1�,r�°96GW ��1 � L
SUBDIVISION. : t4AVERLY ESTATES ZONING: R-ic
DL.00:. . . . . . . . . . . I_OT. . . . . . . . . . . . . . alr
Remarks: PATH I
----------•----------- BUILDING --------------------- ---•-------------------------------------
REISSUE: STORIES..... 2 FLOOR AREAS---------- BASEMENT...: 921 sf REQUIRED SETBACKS---- REQUIRED-------------
CLASS OF WOR9.:NEW HFIEHT........: 28 FIRST....: 1138 sf GARAGE.....: 704 sf LEFT..........: 60 SMOKE DETECT RS: Y
TYPE OF USE..-:SF FLOOR LOAD....: 40 SECaID...: 1218 sf FRONT.........: 20 PARFING SPACES: 1
TYPE OF CONST.:5N DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT.........: 7
OCCUPANCY GRP.:R3 BDRM: 4 BATH: 4 TOTAL-- 2356 sf VALUE..$: 181839 REAR..........: 20
-------------------------------------------------------------- PLUMBING ---------------------------------
-----------•------------------
--
SINKS.........: 1 WATER CLOSETS.• WA5H:46 MNA..: 1 LAUNDRif TRAvS.: 1 RAIN DRAIN ft: d TRAPS.........: 0
LAVATORIES....: 6 DISHWAS6ERS...: 1 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 1 CATCH BASINS..: 0
TUB/SHOWERS...: 4 GARBAGE DISP..: 1 WATER. HEATERS.: 1 DATER LINE ft: 100 BCKFLW PREVNTR: 1 GREASE TPAP5..: 0
OTHER FIXTURES: 0
--------- -- ----------------------- MECHANICAL -------------------------------------------------------------------
FUEL
------------------- ------------..------------------------------
FUEL TYPES----------- FURN ( 100K ..: 0 DOIL/CMP ( 3HP: 0 VENT FANS.....: 5 L'•_OTHES DRYERS: I
/GAArS / / FURN )=1009 ..: 1 UNIT HEATERS..: 0 HOODS.........: 1 01HER UNITS...:
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES..... 0 GAS OUTLETS...: I
----- ELECTRICAL ---------------------------------------------------------------
_-RESIDENTIAL UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- .---MISCELLANEOUS---- --ADD`L INSDECTIONS--
I000 5F OR LESS: 1 0 - 200 amp..: 0 0 - 200 amp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 7 201 - 400 amp.,: 0 201 - 480 amp..: 0 1st W/O SVC/F►)R: 0 SIGN/OUT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 401 - 600 amp..: S 401 - 600 amp..: 0 EA ADDL. B9 CIR: 0 SIGNAL/PANEL...: 0 IN PLANT......: 0
MANF HM/SVC/FDA: 0 601 - 1000 amp.: 0 601+81ps-1000 v: 0 MINOR LABEL -10: 0
1000+ amp/volt.: 0 ---------------------------------- PLAN RLv1LW ZECTION ------------•----------------------
Reconnect oily.: 0 )=4 RES UNITS..: SVCiFDR)=225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC:
--- ELECTRICAL - RESTRICTED ENERGY --------------------.-------------------------------_
A. 5F RESIDENTIAL------------------- ----'-- B. COMMERCIAL---------------------------
--------------------------------------------------
AUDIO 9 STEREO.: VACUUM SYSTEM..: AUDIO I STEREO.: FIRE ALARM..... : INTERCOM/PAGING: OUTDOOR LNDSC LT:
AURGLAR ALARM..: 0TH: :: X BOILER.........: HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK..........: INSTRUMENTATION: MEDICAL........ : OTHP: :.
HVAC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL N SYSTEMS: 0
Owner: -----------------------------------Contractor: ------------------------------ TOTAL FEES:$ 4231.60
MICHAEL S. ZOUCHA CONST. CO J.T. ROTH CONSTRUCTION INC
18585 5W ROSA RD
12540 SW 68TH PARKWAY
ALOHA OR 97-0007 TIGARD OR 97223
hone t: 639-2639 Phone 1: 639-2639
Reg 1-: 080970
n
`r' This permit is issued subject to the regulations contained in the Tigard N ,icipal 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 180
J days of issuance, or if wirk is suspended for more than 180 days.
-------- REQUIRED INSPEC ------------------------------------------------- -
CO
Footing Insp PLM/Underfloor Low Voltage Gyp Board Insp Electrical Final —
''' Foundation Ir-,p Mechanical Insp Fireplace Insp Rain drain Insp Mechanical Final
Post/Beam Struct Plumb Top Out Gas Line Insp Water Line Insp Plumb Final
post/Beam Meehan Electrical Servi Gas Fireplace Water Service In Building Final
Crawl Drain Framing Insp Ins 1 ION-1 sp Appr,ldwlk Insp Erosion_ Control r
c
e� lnittee 5ign.At�.ire : �.� n� L __ Issi-ied )ly
Call for in_ pection .- 639--4175
qpupp rnmNFrTTnN
PERMIT
PE #. . . . . . : SWR9r ,'.
crimly OF T S GARD DOTERMIT ISSUED:. 04/04/96,-O 24
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Orogon 97223*8199 (503)639-4171 PARCEL: 2SI14AD-02100
SITE ADDRESS. . . : 16676 SW 88TH PL
SUBDIVISION. . . . : WAVERLY ESTATES ZONING: R—I '
BLOCK. . . . . . . . . . L01.. . . . . . . . . . . . . 020
TENANT NAME. . . . . :
USA NO. . . . . . . . . . : FIXTURE- UNITS. 0
CLASS OF WORK. . . :NEW DWELLING UNITS. . :
TYPE OF USE. . . . . ;SF NO. OF BUILDINGS: i
INSTALL TYPE. . . . :BUSWR 1MPIUI1V S' IRFACE: 0 s
Remarks :
PATH I
Owner-: FEES
MTCHAEL S. ZOUCHA CONST. CO type amol-Int tly date t,pcpt
1j585 SW ROSA RD PIRMT $ 2200. 00 31) 04/04/96 96-277636
INSP $ 35. 00 JSD 04/04/96 1)1� 7836
ALOHA OR 97-0007
Rhone #: 639--2639
CONTPnCTOR NOT ON FILE
Phone it: s 2235. 00 TOTAL
Reg
------- REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer- Inspection
of the Unified Sewage Agency. The Dermit expi-es 180 days from
the date 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 frog
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" Permit and the Agency will inalml� a lateral.
[let-mittee Signe i1. W"A
ty r e
115, "T47
s 1-t e d R61
_T Call for- inspection 639-4175
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{
Residential Building Permit Application
City of Tigard
13925 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address:
Subdivision: 14-V13,,CW � i�5
Lot# ZU Office Use Only
�
Valuation: -J L� Conta:t Date / / —Initials
Result _
New Construction Only: (Square Footage) Planck/Rec #_ ,&
House: �= Garc,ge: Permit # il_ 7�' _. Reissue of _
Corner Lot? Y Flag Lot? Y Map & T,� '�
Zone 1'�
rF1� Platy ! -� ��r v�TY: ;T,
Owner: 1x 1�� 3�', zatl evict , )�I, —
_�p �5� =�— Approvals Required
,address: Q,
Planning Setbacks( �,�Solar C�\
r-ngineering —
Phone: �O`-C 'rr,3.9 Other_
Contractor:
;terns Required
_ �,.� �U �5� ,��(�, Subcontractors
Address:
--1�--- Truss Details
11 Lz 2z Other
Phone: �39 Notes 2S'
Contractor's License # _ .9 7L
attach copy of current Oregon license)
Contact Fame: _—
Contact Phone:
Subcontractors: rci V�tL Y FI�4 c r 1, Architect/Engineer:
CLE LIT0((AL '
Ale
Plumbing: _ .d•.0 . l Address'
`L --
Mechanical: -5Cr C4:411N r r'
(attach copy of current OR Contractors License)
Phone: >— )
JOB DESCRIPTION. tii(�La- tCQkl L�� '( jVf w' CjV%,Y<7'0ek C 7-t,,,
LL) - —
Applicant Signature Applicant Phone number
Received by: Date Received: (�
wba,whv-•w
YES NO N/A
9. [ ] ["] [ ] ROOF TRUSSES (engineering, details and layouts)
10. M [ ] ( ] COMPLETE CROSS SECTION(S)
11 . ] [ ] ( ] ALL -I ELEVATIONS ARE SHOWN - 3 ELEVATIONS FOR
NDDITIONS AND REMODELS
12. BASEMENT WALL, FOUNDATION AND RETAINING WALL
SECTIONS (will need engineering if walls are 8 ft. high or
higher).
13. lr] ( ] [ ] 'WALL BRACING (structure gnu„ nieet table R-402.10, revised
alternate method n3-7, or a lateral design shall be provided).
1.4. ] ALL DETAILS REQUIRED BY NO. 13 ABOVE SHALL BE
INCORPORATED INTO THE PLANS. (Attachments must be
clearly legible and fully referenced in the plans).
15. [. J [ ] [ ] BEAM CALCULATIONS (all beams over 10 ft. in length or anti
beam that supports a point load).
16. ENERGY CODE PATH IDENTIFIED
DO NOT MAKE CORRECTIONS IN RED
RED WILL ONLY CAUSE DELAYS
J -
Permit,#_ Account Descrlptlon Amount Amt.. Pd. Hal. Dub � 4'
Bldg. Permit (BUILD)
Plumb. Permit (PLUMB) •�S X 55
Vech. Permit (MECH)
Bldg: �. 30
Plumb:
McCh: .2
E*( L
Plan Check (PLANCK) 1 7 VZ( 4'
Bldg: / " U
Plumb:
Mech: 12 12
1
Serer Connection (SWUSA) -zJ AUL'
I J
Sewer Inspection (SWINSP)
I Parks Dev Charge (PKSDC)
t Residential TIF (TIF-R) 1 s/ 7 y / (Z 70
Mr,wa Transit TIF (TIF-MT)
Commercial TIF (TIF-C) _
Ind,ledrial TIF (TIF-1) _
Inst4ldlonal TIF (TIF-IS)
IF (TIF-0)
Waiter :)uaitty (WOLIAL)
n Water Quantity (WOUANT) i �'0—
Fire Life Sa!ety (FLS)
Erosion Cntri Permit (ERPRMT) _ G"
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN)
TOTALS: / 5� I(c• "U
i - I e• r
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 3usiness Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Meth.
Plbg.Und/Flr,'Slah Pibq. Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. 8d. -Bldg.
San. Sewer Gas LineAppr/Sd Reins.
Other: _
Date: A.M. P.M. Entry: _
Address: _t� 'q —�
Tenant: _ _ Sf9:_` MST:
BUP: _
Con/Own• _ MEC:
PLM: _
ELC:
THE FOU.OWING CORRECTIONS ARE REQUIRED ELR
F-
ur
Inspector. "—"' Date:_ 9
-_APPROVED —DISAPPROVED/CALL FOR REINSP. _ CF CO
CITY OF TIGARD BUILDING INSPE,,'TION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL,
Foundation Water Line Ceiling -P+umb.
Post/Beam Mech. Shear/Sheath Framing ec .
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: /� 1 Z1- l`-'�(� A.M.`P.Me. _ Ent -
Address:
Tenant: _ Ste:__ MST:
Con/Own: 7-S�3 1 �k.� o BUP:MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
ee
CID
LO
L0
Inspector: _. _ Date:LL_
APPROVED C✓QrSAPPROVED/CALL FOR REINSP, CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phune: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Mech.
Plbg.Und/Fir/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdw Reins,
Other:
Date: �Z P..M. p.M. E _ 4
Address: ��/1Q2 �
Tenant: _ Ste:---- MST: LO
BLIP:
Con/Own: MEC:
PLM:
ELC:
THE "OLLOWING CORRECTIONS ARE REGUIRED: ELR:
,r
7`_
C7
111
JInspector: Date:r j Date: _ 'Aa
APPROVED __ DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPFCI'�N W,TICE
Inspection Line: 639-4175 Business Phone:639-4171
Footing Rain Drain Cover/Service FI1L:
Foundation Wal x Line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Framing -Me
Plbg.Und/Fir/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct, Mach. Rough-In Gyp. Bd. (ng.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: _
Date: C
f _ A.M. P.M. Entry: G� _
Address:
Tenant:i ^ Ste: _ MST:
l3UP:
Con/Own: _ MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
c^
Ye
ctor: Date:PROVED _DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling Plumb.
Post/Beam Mech. Shear/Sheath Framing -Mec .
Plbg.Und/Flr/Slab Pibg.Top Out Insulation -Elect.
Post/Beam Struct. Mech, Rough-in Gyp. Bd. -Rldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: //
Date: �'N����/` - f!! A.M. P Ent :
1�
Address: 7 b s t
Tenant:_ Ste.__ MST:7�' T�
,
'' /I / BUP:
Con/Own:.Auk' Zdu c Gt/¢ MEC:_
PLM: _
ELC: _
THE FOLLOWING CORRECTIONS AAft REQUIRED: ELR:
�L
r
v.
F-
LD
J
Irp//eFtor 14P
__ PROVED —DISAPPROVE FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-41 71
Footing Rain Drain Cover/Service F AL`
Foundation Water Line CeiNng - lum
Post/Beam Mech. Shear/Sheath Framing -Meeh.
PIbg.Und/Flr/,lab Pibg. Top Our Insulation Elect,
Post/Beam Struct. Mach. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwik Runs.
Other:
Date: ��//S A.M. —P.M.
— Entry:
Address: 1 6e(.e �� 1C `(L
Tenant: Ste:
MST:f&
BLIP:
Con/Own: MEC:
PLM:
ELC: —- ---
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: —_.-_— _
V
Inspector: Date: Id
_APPROVEDISAPPROVED/CALL FOR REINSP. rqF CO
CITY OF TIGARD BUILUING INSPECTION NOTIC '
6is;)ection Line: 639-4175 Business Phone. 633-4
t Footing Rain Drain Cover/Service AL\
Foundation Water Line Ceiling Plu
Post/Beam Mech. Shear/Sheath Framing Mech.
Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Stri lo. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other
Date: — v/ 9 A.M. �-P,VI. E
Address: 6
Tenant:----- _ Ste: MST:
BUP:
Cori/Own: — -L 11� S g � MEC:
PLM: F
THE FC OWING CORRECTIONS A�D: 1:
i
Ln
K
O]
r.
W
Inspector:
_APPROVED SAPPROVEC),CALL FOR REINSP CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Seam Mech. Shear/Sheath Framing -Mech.
Plbg.Und/Flr/Slab Plbg, Top Out Insulation CEIe
Oost/Beam Struct, Mech. Rough-n Gyp. Bd. -Bldg.
Sen. Sewer Gas Line Appr/Sdwlk Reins.
Other --
Date: D t! 1 A.M.Q P.M. J Entry,)_
Address: --L tv 71 10 5,60 ...-/
Tenant: -- _ Ste:__ MST: 1 60
Con/Own: T l 7 '----5F31 BUP:
— MEC:--- —
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED ELR:
Spector, 4e- Date:
Y APPROVED —DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639.417
Footing Rain Drain Cover/Service NA
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Mech.
Plbg.Und/Fir/Slab Plbg. Top Out Insulation -rlec
Post/Beam Struct. Mec i. Rough-in Gyp. Bd. Bldg,
San. Sevver Gas Line Appr/Sdwlk Reins.
Other: f_
Date: -, A.M. P.M. Entry- rn Z
Address: 4
Tenant:_ _ Ste: MST: �=
n ' 1 /� BUP: -
Con/Own _1_uMEC: _
PLM:
ELC: —
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
46 ols�6�cot LZ
D%?1�R G✓O�/L 1
w
Inspector:
_APPROVED —DISAPPROVED/C FOR REINS CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain rover/Service FINAL:
Foundation Water Line Ceiling -Plunib.
Post/Beam Mech. Shear/Sheath Framing cls.
Plbg.Und/Flr/Slab Plbg. Top Out Insulation Elec
Post/Beam Struct. Mech, Rough-in Gyp. Bd. Bldg.
San. S?wer Gas Line Appr/Sdwik Reins.
Other:
Date: Z 3 _ A.M. -__P.M.___ Entry:—
Address: S — —
Tenant: _ -- Ste: MST: 94, 0,/
BLIP:
Con/Own: _ MEC:_
ELC
THE 9a,_tW_ ING CCRRECTIONS ARE REQUIRED: ELR:
---- --- -
a
14F 1
J
Lk!
J
Inspector:
Date:?77� Y�
__APPROVED ADISAPPROVED./CAL OR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Ream Mech. Shear/Sheath Framing -Meth.
Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect.
Post/Boam Struct, Mech, Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/idwlk Reins.
! -
Other:. 1�---`�G `-_._�.._ �ait[dZ?l i
-
Date: A.M. P.M. Entry:
Address: �� _.S�i4" _ ..
Tenant: Ste:___ MST: y6 O�yL
BUP: —_
Con/Own: MEG:
Y97- F3� PLM _
TI4E FOLLOWING CORRECTIONS ARE REOUiRED: ELR:
d
f.Y
F-
Uj
N
I-
J
.J
Inspector: Date:
__APPROVED ^DISAPPROVED/CALL FOR REINSP. CF
CITY OF TIGARD BUILDING IN3Pl :TION ICE ,
Inspection Line: 639-4175 Business Phone: 3 7
Footing Rain Drain Covar/Service FINAL
Foundation Water Line Cailing -Plumb.
Post/Beam Mach. Shear/Shea!li Framing -Mech.
Plbg.Und/Flr/Slab Plbg.Top Jut Insu�lat11o�n -Elect.
Post/Beam Struct. . ech. Rough-i yp. Bd. -Bldg.
ti
San. 'b!ler �j,� Gas Line Appr/Sdwlk Reins.
Other: �► - -- ----
Date: / — �6 A.M. _P.M. try: --
�� G 7 G —E-A --�–`t",�..`-
Address:
Tenant: Ste:__ MST: rL�---1�1_
Con/Own: MEC:
�1 PLM:
7 7- 51 S� ��`"��'� ELC:
THE FOLLOWING CORREC rIONS ARE�REQUIRED: ELR: _
CC
LD
LL /Illy
.— Date: 00,
OVED _ PPROVED/GALL FOR REINSP. CFLLIP
7-V Irl"re
CO
/vU 2 ''-QisT- /rt
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech, Shear/Sheath Framing -Mech.
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Posl/Beam Struct. Mech. Rough-in Gyp. Bd. '�� -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: l- ///y� A,M.—P.M.^- 4--
Tenant:
�J Entry: ^�
Address: _�fo to 2 f, M.
s&2 Fey 4-
Tenant:_ Ste:____i MST:
Con/Own. EC
M
MEC:
�
�JL Atic Ct c.tC, _LCi
ORRECT
THF FOLLOWING IONS ARE REQUIRED ELR:
J
00,
LL! -
J
Inspector: _ Date: 1
--APPROVED Of 04APRO✓ED/CA,LL FOR REINSP, CF CO
r CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspe• tion Line:639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Framing -Mach.
Plbg.Und/Flr,'Slab Plbg.Top Out Insulation -Elect.
Post/Beam 3truct, Mach. Rough-in _y 6 -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: _ ,�� A.M. _P.ly1. _ Entry
Address: __16L__ p76 7 —
Tenant: _ __ Ste: MST qL o/q/
// BLIP:
Con/Own:�L 0 - MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED ELR: _......
-ob w
—
J
J r
�oTu�� -
Inspector: Date
_APPROVED — PROVED/CALL FOR REINSP. CF CO
r-------- - - — - -- - ..
CITY OF TIGAPD BUILDING INSPECTION NOTICE
Inspection Line, 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FI L
Foundation Water Line Ceiling _Plu
Post/Beam Mech, Shear/Sheath Framing -Mech.
Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sew as Line Appr/Sdwlk Reins.
Othe ��- _— ---— ---
Date: (o A.M. P.M. — Entry:
Address:
Tenant: Ste:__ MST: 5_4 -0 1y1 _
Con/Own: MEC:
_5-2 3 SSU F j ELM:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
c�
Inspector: Date:
— VE _DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
inspection Line: 639-4175 Business Pho 71
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line
-Plumb.
Post/Beam Mach. Shear/Sheath Framing -Mach.
Plbg.Und/Fir/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mach. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: —
Date: �— A.M._PM. _ Entry: __---
Addriss:
_—_ _— Ste: MST:
Tenant:
BLIP: _—
Con/Own: — MEC:_— —
PLM:
ELC:
THE FOLLOWING FOLLOWING.CORRRECTIONS ARE REQUIRED: ELR: _
cc
w
_ ��r-
Date-:&
Inspector: � 4
APPROVED _DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639.4175 Business Phone: 639-4171
Footing Rain Dram Cover/Service F AL:
Foundation ater Line Ceiling -PI b.
P h. Shear/Sheath Framing -M
PIbg.Und/FIr/Sr+ib y.Top Or Insulation Elec .
tict. Mech. Rough-in Gyp Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: _
Date: �/�_ ___ A.M �cvP.M.__ — t�'y/, —
Address: I�.{2 T k _. A'`�.
Tenant: _u.-- ---------- Ste:_ MST:
BLIP:
Con/Own: _ MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
J
w
c�
J
Ins ector. _ _ Dater/
APPROVFD DISAPPROVED/CALL FOR RNSP. /CF
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service F;NA Lk;-- /
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. hear/Sheath Framing -Mech.
Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect.
Post/Beam StfUCt. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: - �;p A.M. P.M. _ Entry:
r
Address: `� 6p 1 Gi---�j _— —
Tenant: _ - _- _ - Ste:_ MST: 96, o/o
BUP:
Con/Own. _ MEC:
FILM:
ELC:THE FCU-OWING CORRECTIONS ARE REQUIRED. ELR.
Ins ector: _ _ Date:
APPROVED DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TI ARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Meeh.
Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect.
(post/Bean) Struc Mech, Rough-in Gyp. Bd. Bldg.
San. ewer Gas Line Appr/Sdwlk Reins.
Other: ._
Date: .+
- —�/O� A.M.
PZ„S
O.M.1ntry: �u
Address: _� --4� r ' 't
Tenant: _ Ste:_-_-_ MST: (p_p.�
Con/Own:_`lrt7— S��/ ��s�— MEC:
PLM: _
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
Vit L .��7L'�[...( �A� T27 �•Si^" _ .�
J
V) -
ti
CA
C7
LL1
ms;FPROVED
40r- Date:.,�1--p
__ DISAPPROVED/CALL FOR REINS P. CF CO
CITY OF TIGF RD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Mech.
Plbg.Und/Flr/Slab Plbg, Top Out Insulation -Elect.
eam Struct. Mech, Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Othei _
Date: _ A.M. e P M._.-- Entry:
Address:
Tenant: Ste:---- - MST:
------ — BUP:
Con/Own:— __-- _-- MEC: --
PLM:
ELC: _ ---_—_
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
Inspector: Date:
_APPROVED
41410MIPMVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-',175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL
F ndati (%o Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Meeh.
Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: -- – -- -- __--
Date: A.M. P.M. Ent :
Address: 4 L9
Ste:-- --- MST: qVi lot.*
B U P.
-.
Con/Own:_ MEC:
PLM:
ELC: – - —THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:Ln
h-
1-
J
r-�
In ector: - -- Date`��-s'T
APPROVED DISAPPROVED/GALL FOR REINSR / CF
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
FootingRain r Cover/Service FIN l
Foundation �Vate7 Ceiling -Plu
Post/Beam Mech. Shear/Sheath Framing -Mech.
Plbg Und/Flr/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyi.. Bd. -Bldg.
an. Sewe Gas Line App�rr/Sdwlk Reins.
Other: -
Date: A.M. _- Entry:_
r -7 4o
l � 1�Z1
Address: � t`D ��=� , �
Tenant:_ _ Ste:__ MST �-�
BUP:
Con/Own: — _ MEC: _—
PI_M:
ELC: - -THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
M
V)
H
02
C.7
W
Inspector: _ Date
Ret7ED _DISAPPROVED/CALL FOP. REINSP. CF cy
CITY OF TIGARD BUILDIN 1 INSPECTION NOTICE
Inspection Line: 639-4175 Bus',ness Phone: 639-4171
Footing Rain Drain Covet'Gc,,vlL;e FINAL:
Foundation Water Line Ceiling -Plumb.
PosUBeam Mech. Shear/Sheath Framing -Meeh.
Plbg Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in C- yam, -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other. —
Date- A.M. p_.P.M.__ Entry:
Address: .,2ce
—�Tc
Tenant: _ -- __ Ste: MST:
BLIP:
Con/Own: _ — __ MEC:—
PLM:
ELC: — ---
T E FOLLOWING ORRECTIO S ARE REOUIRED EL _
rr
N —
r..
J
cc
C7 - - --
W
J
___— —
Inspe r: __ _ Date:
APPROVED —DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line. 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Pluinb
Post/Beam Mech. Shear/Sheath Framing -Meeh.
Plbg.Und/Fir/Slab Plbg.lop Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in CypB� -Bldg.
San. Sewer Gas Line Appr/Sdwlk
Other: -- -- — .--.��----
Date: l_1 L_pl-l_ _ A.M. P.M._ Entry: _
Address: Ce
Tenant:
Tenant: _ -_ Ste:_ _.. MST: G[
Con/Own: p , MEC
��_-_�—��- MEC:
9(
- MEC
PLM:
ELC
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: -
_ � 7 l L �.. - -- -- ---
LD
4!
inspector: _J'� Dater
_,.,.APPROVED ISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Q2tingl Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech, Shear/Sheath Framii ig -Meth.
PIbg.Und/Fir/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Strutt. Mech, Rough-in Gyp. Bd. -Bldg.
San Sewer Gas Line Appr/Sdwik Reins.
Other: ------- — --
Date: � ^ A.M. _ P.M. _ Ent
Address:
Tenant: - --_ - _ Ste:---. MST: `
BLIP:
Con/Own:_.._- — _-- _-_---__-- MEC:—.- —
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
r,
Ill
7 Ins ctor: Dat
APPROVED __DISAPPROVED/CALL FOR RE.INSP, CF
Solar Balance Point Standard Worksheet
Address (io" l i ( I ('f.1 1 1.
j'`
Box A calculations: North-South dimension for the lot. Box A:
This dimension is determi ied by finding the midpoint of the North lot line and drawing
an intersecting line perpendicular to that point.
First, determine which property line is the North lot line. The North lot line is the line
with the smallest angle from a line drawn east-west and intersecting the northern most
point of the lot.
.0 450--o —
t
NC�MFRN
t
\ NCRMEON
lel UNE 101 UNE
--- — N I North-South
Dimension for tot:
Measure the distance from the midpoint of the North lot line to the South lot line along
the described line.
feet
ElN >
NORM-SOUTH DI1VFN510Nh7-y�
Box B calculations: Shade point height for your residence. Box B:
1. Determine whether measurements will be based on the peak or eave of your Which describes
structure. The orientation of the ridge is also important.. your residence?
vqN Y_:N G{v:I
1a: If-' e roof line runs North-S,Mth, meiEsurements will (circle one)
be used on the peak of the roof. o 0 0 0 ,:4
h: If the roof line rYins East-West and the roof pitch is
" less than 5/12, measurements v.ill be based on the
Y
1 F 1 9Hi r•
�- ease.
J SNaL)E FCMi FAbf
G7
l Gl
1 c: If the roof line runs East-West and the roof pitch is
5/12 or steeper, measurements Jll be based on the
peak.
514ACW Y nmcE
Box B. continued Box B:
2. Measure change in elevation from front property line to finish,-d floor elevation. If
the lot slopes up from the front lot line to the foundation, the figure is positive. If
the lot slopes down from the front lot line to the foundation, the figure is negative. —(D ft
3. Measure distance from finished floor elevation to the affected peak/eave. + _.�' _ ft
4. if the roof line runs North-South, deduct three feet. If the ruof line runs East-West, ft
deduct nothing.
5. Subtract one foot for each foot of difference in elevation from the front property
line to the rear property line, if the lot slopes up from the frontr to the rear. If the
lot has no slope or slopes up from the rear to the front, deduct nothing. - (✓ _ ft
6. Total figure for box B: _ ft
Box C. Distance to the shade reduction line. Box C:
1. Measure the distance f im the North property line to the foundation near the ft
affectea peak/eave.
2. Measure the distance from the foundation to the affected peak or eave. + ) ft
3. Total figure for box C: 7 ft
It is most useful to draw a vertical line to represent the appropriate figure found in box"A"and a horizontal line to represent the
appropriate figure found in box "C". The intersection of the vertical and hog izontal lines determines the value found in box"D". The value
in box "D"shoule be compared to the value in box"B"; if the value in box "B"is less than or equal to the value found in box"D", then
the building is in compliance with the solar balance code. If you have any questions, please contact us at 639-4171,x304 or at the
Community Development Counter.
MAXIMUM PERMITTED SHADE POINT HEIGHT �:n Feet)
Distance to North-south lot dimension (in feet)
shade 100+ 95 90 85 80 75 70 65 60 55 50 45 40
reduction line
from northern
lot line tin feet)
70 40 x0 40 41 42 43 44
6; 38 38 38 39 40 41 42 43
60 3E 36 36 37 38 39 40 41 42
3 34 34 34 35 36 37 38 39 40 41
50 32 32 32 33 34 35 36 37 38 39 40
a; 30 30 30 31 32 33 34 35 36 37 38 39
l'— 40 28 28 28 29 30 31 32 33 34 35 j6 37 38
35 26 26 26 27 28 29 30 31 32 33 34 35 36
30 24 24 24 25 26 27 28 29 30 31 32 33 34
25 22 22 22 23 24 25 26 27 28 29 30 31 32
20 20 20 20 21 22 23 24 25 26 27 28 29 30
15 18 18 18 19 20 21 22 23 24 25 26 27 28
10 16 16 16 17 18 19 ; 20 21 22 23 24 25 26
5 14 14 14 15 16 17 18 19 20 21 22 23 24
Box D. Maximum allowed shade point height: Z� feet
95 Oct 25 17:24:16 R:\LT\LT20WE 7 Alen Mescord Design 15031 2269161
2220D
BY :
J.T, ROTH CONST.
CITY OF TIGARD
WAVERLY ESTATES
LOT 20
44 142 X S 89'58'48" W_
)<X,108 06' � �_ .� � x IG��K x�\0�`42.
SEWER AND STORM �300•,.� W
1 v DRAINAGE MAINTENANCE 1
146E- _ 1 AND ACCESS EASEMENT
�h. ....... ..``\..... '.. .......................... ......... i w
NJ
148
PIC)- _ ................
.. I�� N
U) I LOWER FLOOR
150 - -- I EL..143:0..... 149
1 `f•--_�� — li
1
MAIN AIN FLOOR 144
1521 _ _ I �� EL:�,153.0' to
GARAGE•
li o
I .. EL:152.0'•
aft" ( i.
73.10 SB' Y? .. ......... .
L
8328.�.` ` ` (n3 4" CONC.' 146
••''' �+ DRIVEWAY - 1- - '"
w 1.3400 PSI) 148
r' .1. 150
1D15 2
o -
o -
N 5000'
11r 77l A 4a.:
2Z4-
10/25/95 MRR
ORIGINAL
A L A M f1Af ( 0DD DIf100 AIIoCIATF / In
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CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
ACI MECHANICAL
12300 SW 69TH
TIGARD OR 97223
Plumbing signature Form
Permit #. . . . : MOT96-0141
Date Issued. : 11/15/96
Parcel. . . . . . : 2S114AD-02100
Site Address: 16676 SW 88TH PL
Subdivision. : WAVERLY ESTATES
Block. . . . . . . . Lot: 020
Zoning. . . . . . R-12
Remarks:
PATH I
Your company has been indicated as the plumbing contractor for the permit indica
for the plumbing permit to be valid, please have the appropriate individual From
below and return this Plumbing Signature Form prior to the start of work. No pl
will be authorized until this completed form is received.
AN IN) SIGNATURE IS REQUIRED ON THIS FORM
OWNER: PLUMBING CONTRACTOR:
MICHAEL S. ZOUCHA CONST. CO ACI MECHANICAL
18585 SW ROSA RD 12300 SW 69TH
ALOHA OR 97-0007 TIGARD OR 97223
Phone #: 639-2639 Phone #:
Reg #. . : 68338
V)
m
LD .. . gnature of Authorized Plumber
Please return this completed form to the address above.
ATTN: Building Dept.
If you have any questions, please call 639-4171, ext. #110
CITY OF TIGARD
13125 B.N. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
NORTH VALLEY ELECTRIC INC
PO BOX 222
WOODBURN OR 97071
Electrical Signature Form
Permit #. . . . : MST96-0141
Date Issued. : 11/15/96
Parcel. . . . . . : 2S114AD-02100
Site Address: 16676 SN 88TH PL
Subdivision. : WAVERLY ESTATES
Block. . . . . . . . Lot: 020
Zoning. . . . . . . R-12
Remarks:
PATH I
Your company has been indicated as the electrical contractor for the permit indi
order for the electrical permit to be valid, the signature of the supervising el
is required.
Please have the appropriate individual from your company sign below and return t
Signature Form prior to the start of work. No electrical inspections will be au
this completed form is received.
AN INK SIGNATURE IB REQUIRED ON THIS FORM
OWNER: ELECTRICAL CONTRACTOR:
MICHAEL S. ZOUCHA CONST. CO NORTH VALLEY ELECTRIC INC
18585 SN R08A RD PO BOX 222
ALOHA OR 97-0007 WOODBURN OR 97071
Phone #: 639-2639 Phone #:
-' Reg #. . : 88302
m
Signat re of Supervis ng Electrician
Please return this completed form t0 the address above.
ATTN: Building Dept.
if' you have any questions, please call 639-4171, ext. #310