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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503) 639-4175 MST•' r,,�� - G, ���°��
INSPECTION DIVISION Business Line: (503)639-4171
// BLIP _ —
Received Date Re uested.L ��� AM_ —_ PM _ ___ __ _ BUP
-3
Location _ Suite MEC
Contact Person _ -___ - - Ph z8 'O PLM __.._-------- —
Contractor_ __-_ ___.--_ _-- __-- Ph(-- ) SWC --
BUILDING Tmant/Owner -- _ _ ELC
For,liog ELC
Foundation Access:
Ftg Drain E:LR
Crawl Drain
Slab Inspection Notes:
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
FramingIL
Insulation
Drywall Nailing - ,< •��1—[r
Firewall
Fire Sprinkler -- - —
Fire Alarm
Susp'd Ceiling -- - — -—---- -----
Roof
Other: --
Firal
PASS PART FAIL —PLUMBING
Post
Post&Beam --- i -- — �_---
Under Slab
Rough-In
Water Service ----- - --- -- — —
Sanitary Sewer
Rain Drains -- -- -- -
Catrh Basin/Manhole
Sto-m Drain --
Shower Pan
Other.
Final
PASS PART FAIL _ - �,.,"
MECHANICAL-�1[� `�� �U��I'l' Z� —�/✓ NlylAl"-
Post& Beam
Rough-In --.- - —
Gas Line
Smoke Dampers -- -------- -
Final
PASS PART FAIL_ -- - --- --- - -ELECTRICAL-
ServiceRough-In _
UG/Slab
Low Voltage
Fire Alarm
AS PART FAIL Reinspection fee of$ —required before next inspection. Pay at City Hall, 13125 SW Hall BIS'1
Please call for reinspection RE:----- -- E] Unable to inspect-no access
Fire Supply Line �7 li i'ADA Date Inspector 164 M r l ` < Wd
Approach/Sidewalk - -
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL l
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CITY OF TiGARD 24-Hour
Line:Inspection Ins 503 639-4175
BUILDING p ( ) IN57
INSPECTION DIVISION Business Line: (503)639-4171
BLIP
Recpived _ Date Requested G — AM _PM BUP
Location _— __ 1�.Ati -. Suite_._ - MEC --
(—
Contact Person —
PLM _
Contractor _ h(_ ) SWR ---- ---- -- --
BUILDING Tenant/Owner _ - �__- __ _- ELC
Footing ELC _—
Foundation Access:
Ftg Drain ELR -----
Crawl Drain — --- — SIT
Slab Inspection Notes: --
Post&Beam ----- - - - ---- ---------- _
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear ���
Framing -�
Insulation
Drywall Nailing
Firewall
Fire SprinklerFire F
Sua
Alarm
Susp'd Ceiling
Roof
Other: T_ -
PASS PART FAI
Post&Beam
Under Slab - --- --- ---_.__ -
Rough-In —_
Water Service --
Sanitary Sewer _
Rain Drains -
Catch Basin/Manhole
Storm Drain -- - - -
Showc•Pan
Other:
Final --
PASS PARTFAIL
MECHANICAL_ —
Post&Brum
Rough-In -- - -- ---- - - --
Gas Line
Smoke Dampers ----
i
AS PART FAIL -- - ---
ECTRICAL
Service_
Rough-in ---
UG/Slab
Low Voltage --------- ---- -- - - -- --
Fire Alarm
Final 0 Reinspection fee of required before next Inspection. Pay at City Hall, 1312 SW Hall Blvd.
PASS PART FAIL.
Please call for rein<ipection RE: _ El Unable to Inspect-no access
Fire Supply Line r---
ADAbate � ' C� — Inspector _ Ext
Approach/Sidewalk -s`'L--= -
Other:
Final DO NOT REMOVE this inspection record from the job site,
PASS PART PAIL
rr.: W
CITY OF i IGA,RD 24-Hour
BUILDING Inspection Line: (503) 639-4175 / _
;.AST
INSPECTION DIVISION Business Line: (503)539-4171
BLIP
Received - Date Requested L-- AM_ ---_ PM BUF
Location Suite MEC
Contact Person �'`�--�,_ __ Ph PLM --
Contractor _ Ph( _._.) SWR
BUILDING TenanVOwner FLC
Footing ELC
Foundation Access:
Ftg Drain ELR - ---- - - --
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
Shear
—__-
Shear Anchors
Ext Sheath/Shear -- -- -- -- -
Int Sheath/Shear ^-
Framing ------_._...-- - -
Insulation
Drywall Nailing
Firewall
Fire Sprinkler V+
Fire Alarm _
Susp'd Ceiling -�
Roof
Other: —- --- i
Final J- -
PA FAIL - -- - —
Beam
Under Slab -- —
Rough-In
Water Service ----�
Sanitary Sewer
Rain Drains -- _-—
Catch Basin/Manhole
Storm Drain --��---
Shower Pan
Other: ---- _ ---------
r
A PART FAIL
CHANICAL _ !—
Post&Beam
Rough-In -- --- _
Gas Line
Smoke Dampers -
Final
_PASS_PART FAIL -- J -
_ELE_C_TRICAL
Service
Rough-In —_._--
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of$._ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE n Please call for reinspection RE A [ 1 Unable to Inspect-no access
Fire Supply Line -7 )//
ADA
Approach/Sidewalk D,�te Inspector _ Ext -
Other:_ _
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAII.
cv" 10F TIGARD 24-Hour
BUILDING Inspection I.ine: (503) 639-4175 MST &A - (61C
INSPECTION DIVISION Business Line: (503)639-4171
/ BLIP
Received Date Requested_ [ - �- AM-- PM _ ______ BLIP
Location 3o --_-_Suite _ _- MEC
Contact Person Ph( )-7�L� PLM
Contractor Ph( )
----- - SWR
BUILDING Tenant/Owner ELC
Footing
Foundation — ELC
Ftg Drain ACCSSB: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation SSS V� � �
Drywall Nailing
Firewall
Fire Sprinkler -- —
Fire Alarm
Susp'd Ceiling - --
Roof
Other. — - — - --
AS*--'PART FAIL - --- -- 00
-
PLUMBING
Post&Beam
Under Slab --- -- � --
Rough-In -
Water Service - ---- - -- --
Sanitary Sewer
Rain Drains - --
Catch Basin/Manhole -' I
Storm Drain - -- -
Shower Pan
Other. ---- -- ------- -_ -- — —
Final
PASS_PART _FAIL —� - - -- — --`-- --
MECHANICAL
Post& Beam
Rough-In
Gas Line
Smoke Dampers ------ - - --
Final
PASS PART FAIL ----
ELECTRICAL —
Service
Rough-In
UG/Slab --— -- -
Low Voltage
Fire Alarm
Final El Reinspection fee of$ __ ___ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd,
PASS PART FAIL
SITE _ Please call for reinspection RE: Unable to inspect-no access
Fire Supply Line
ADA �
r r
Approach/Sidewalk Date.
Other: Inspector .. __ Ext
//�
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24-4, our �,.�..
BUILDING Inspection Line: (503)639-4175 MST
II.SPECTION DIVISION Business Line: (503)639-4171
BLIP
Received __ _ Date Req. AM _PM _.'-�_--- BUP
Location O if 4ej�._t-�-- - -Suite MEC
Contact Person C—'C Ph (___ ) ��_�� — PLM __..---
Contractor Ph ( —) —_ SWR
BUILDING Tenant/Owner --- _ ELC
Footing ELC
Foundation Access:
Fig Drain ELR
Crawl Drain SIT
Slab Inspection Notes:
Post&Beam
Shear Anchors —
Ext Sheath/Shear ----
Int Sheath/Shear /Q .G -� c
Insulation
Framing --
`�
Drywall Nailing -
Firewall
Fire Sprinkler _---
Fire Alarm
Susp'd Ceiling
Roof --
Other.
ASb SART FAIL
PLUMBING - _ __ -- --
Post&Bi,:..n
U ider Slab --- -- -�� -
Rough-In
Water Service -
Sanitary Sewer
Pain Drains
Catch Basin/Manhole _
Storm Drain
Shower Pan _..-
Other:
Final
PASS PART FAIL
MECHANICAL
Post&Beam
Rough-In -- _--
Gas Line
Smoke Dampers --- ---
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 F-1Please call for reinspection RE:—.__ __ 2— rl u Unable to Inspect-no access
Fire Supply Line
� r
A
Ext
ADA
Approach/Sidewalk Dade �/ Inspector _' ——
Other: _-
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL
CITY OF TIOARD
Residential Certificate of Occupancy
r
Permit No.: M S I Zr✓ -00 0 Address:
Owner/Contractor:
Date of Finai Inspection: �? Inspector:
This structure has been found to be in substantial compliance with the provisions of th St e of Oregon One& Two Family Dwelling
Specialty Code and is hereby approved for occupancy.
� CITY O F `r I G A R D MASTER PERMIT
PERMIT#: MST2004-00160
DEVELOPMENT SERVICES DATE ISSUED: 7/6/2004
- 13125 SW Hall Blvd.,Tigard, OR 97223 (503)6394171
SITE ADDRESS: 09303 SW HOME ST PAPCEL: 2S111L)B-KE005
SUBDIVISION: KESSLER ESTATES ZONING: R-0
BLOCK: LOT: ow,, JURISDICTION: IIS;
REMARKS: New SF detached
BUILDING
REISSUE: BVH3070 STORIES: .•_- FLOOR AREAS _REQUIRED SETBACKS _! REQUIRED s_
CLASS OF WORK: NEW HEIGHT. _., FIRST: 1.3:,9 sf PASEMENT. at LEFT: 10 SMOKE DETEC70RS: Y
TYPE OF USE: SF FLOOR LOAD: 4,1 SECOND: I.67i' sr GARAGE: r,58 st FRONT: 20 PARKING SPACES: 2
TYPE OF CONST: 5N DWFLI ING UNITS: I TARO sl RIGHT: 5
VALUE: 31i:-545 9n
OCCUPANCY GRP: R3 aDRM: 4 BATH: 3 TOTAL 3,n;0 sl REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: T WASHING MACH: I LAUNDRY TRAYS: I RAIN DRAIN: 100 TRAPS:
LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAIN'i: 1 CATCH BASING:
TUBISHOWERS: 3 GARBAGE DISP: I WATER HEATERS: i WATER LINES: 100 BCKFLW PREVNTR. GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL y
FUEL TYPES FURN<100K: SOILICMP<AHP: VENT FANS: 5 CLOTHES DRYER: 1
GAS � FURN>-100K: 1 UNIT HEATERS: HOODS: I OTHER UNITS: 2
MAX INP btu FLOOR FURNANCES: VENTS: I WOODSTOVES: 0 GAS OUT[E.TS: 5
ELECTRICAL
RESIDENTIAL UNIT_ SERVICE FEEDER TEMP SRVCIFEEDERS _BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 - 200amp: 0 - 200 amp: WISVC OR FOR PUMPIIRRIGATION: PER INSPECTION:
EA AOD'L 500SF: 6 201 400 snip: 201 400 amp'. 1,t W1 SV C/FDR, SIGN/OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADOL BR CIR. SIGNAL/PANEL: IN PLANT:
MANU HMISVCIFDR: 601 1000 amp: 601+amps-1000v: MINOR LABEL:
1000+amplvoll.
PLAN REVIEW SECTION
Reconnect only:
>�4 RES UNITS: SVCIFDR>-225 A.: >6011 V NOMINAL CLS AREA/SPC OCC:
_ ELECTRICAL•RESTRICTED ENERGY
A.SF RESIDENTIAL. B.COMMERCIA'_
AUDIO 6 STERr0: VACUUM SYSTEM. AUDIO&STEREO: FIRE ALARM INTEPCOM/PAGING: OUTDOOR I.NDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPEIIRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL. OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS TOTAL N SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 7,683.23
This permit is subject to the regulations contained in the
BUENA VISTA CUSTOM HOMES l3UElAA VISTA HOMES
Tigard Municipal Code, State of
6932 SW MACADAM AVE STE C 6932 SW MACADAM SUITE C
PORTLAND, OR 97219 PORTLAND, OR 97219 and all other applicable laws. Alll work will Speciabe lty Codes done In
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 N: 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 Exterior She:thing Ins; Gyp Board Insp Appr/Sdwlk Insp
Sewer Inspe-tion Underfloor Insulation Electrical Service Low Voltage Rain drain Insp Electrical Final
Footing Insp Crawl Drain/Backwater Electrical Rough In Gas Line Insp Storm drain Insp Mechanical Final
Foundat;an Insp PL;vl/Underfloor Framing Insp Gas Fireplace Water Line Insp Plumb Final
Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Wate: rv'ce In1p Building Final
Issued By Permittee Signature
Call (503) b39-4175 by 7.00 p.m. for an inspection needed the nex� usi ess ay
�\ CITY
OF TIGARD SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2004-00158
13125 SW Hall Blvd., Tigard, OR 97223 1,503) 639-4171 DATE ISSUED: 7/6/2004
PARCEL: 25111 DB-KE005
Sll E ADDRESS; 09303 SW HOME ST
SUBDIVISION: KFSSLI'.R I STATES ZONING: R-4.5
BLOCK: LOT: 005 JURISDICTION: I'IG
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 for new SF detached
Owner: _ --------------- FEES -
BUENA VISTA CUSTOM HOMES Description Date Amount
6932 SW MACADAM AVE STE C -- — ---
PORTLAND, OR 97219 ;WINSPJ Sewer Inpeci 7/6/2004 $35.00
SWINSP) Sewer Inspect 7/6/2004 $0.00
Phone: 503-443-6033 1SWUSASwr C'onnecti( 7/6/2004 $2,.500.00
�SWUSA) S,.vrConnectii 7/6/2004 $0.00
Contractor:
.�-_� Total $2,535.00
Phone:
Rett#:
Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. The permit expires 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• ,wer is not located at the measurement giv,n, the installer shall prospect
3 feet in all directions from the distance given. If riot 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 `he
Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 throw OA 952-001-0100. You
may obtain copies of these rules or direct questions to OUNC by calling(503) 246-6
Issued by: /C_7z.cat Permittae Signature:
Call (503) 639-4175 by 7:00 P.M.for an inspection needed the nod bu Ines day
Building Permft AV Lk Lion '
Received ,/ mi
DatelB � 17`J Permit
No
City of Tigard Planning A proval Other
Date/By: Permit No.: "1Z7/
13125 SW Hall Blvd. Plan Review Other
Tigard,Oregon 97223 Date/By: 1J r.- t,,q Permit No.:
Phone: 503-639-4171 Far: 503-5984960 Post•Revie Land Use
Intemet: www.ci•tigard.or.us Date/By: G4 r Case
Contact rs See Page 2 for
24-hour Inspection Request: 503-639-4175 Name/Method t t) Supplemental Information
TYPE OF WORK REQUIRED DATA:
New construction Demolition
I&2 FAMILY DWELLING
Addition/alteration/re lacement Other: — ---
CATEGORY OF CONSTRUCTION Note: Permit fees'are based on the total value of the work performed. Indicate
1 & 2-Famil dwelling CommerciaVIndustrial the value(rounded to the nearest dollar` )fall equipment,materials,latmr,
overhead and profit for the work indi, on this application.
LJ Accesso Buildin Multi-Family
Master Builder I F1 Other: Valuation.................:•.. .........•........................ 5
JOB SITE INFORMATION and OCATION No.of bedrooms'-
edrooms No.of a1.hs:�
Job Site address: Total number of floors.... .......
New dwelling area(sq.
Suite#: $ld ./A L'�: Garage/carport
area(sq. ft.).. ....�'_..1.�......
Project Name: Covered porch area(sq. ft.)....•.•...................... _
Cross street/Directions to job site: Der k area(sq.ft.)...........................I................
Other structure area(sq. ft.)............................
REQUIRED DATA:
CONI[MERCIAL=USE CHECKLIST
Subdivision. �✓ Lot#:
Tax map/parcel #: Note. Permit rets*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......................................................... 5
Existing building area(s+ft.).........................
New building area(sq. ft.)...............................
Nurrber of stories............................................
PROPERTY OWNER TEI TENANT Type of construction.......................................
Name: Buena Vista Custom Homes Occupancygroup(s): Existing:
Address: 6932 SW Macadam Ave. Ste C New
Cit /State/Zip: orEland, --
Phone, 503-443-6033 Fax:5 0 3—4 4 3—2 4 4 3 NOTICE: All cootractors and subcontractors are required to be
APPLICANTCONTACT PERSON licensed with the Oregon Construction Contractors Board under
provisions of ORS 701 and may be required to be licensed in the
Business' Name: SAME AS ABOVE jurisdiction where work is being performed. If the applicant is exempt
COnuxt Name: E1 iabeth Moore from licensing,the following reason applies:
Address: i
Cit /Sta'e/Zip: _ --
Phone: Fax_ ----- --- -�
E-mail: _ ---- BUILDING PERMIT FEES
CONTRACTOR -Ple"ase refe'r'tu felt retie"duly
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.............................................
Phone: 503-443-6033 1 Fa :503-443-2443 Date received:
CCB Lic. #: 152235
Authorized
Signature: G pate: Notice: Ibis permit application espires if a permit Is not obtained within
Y180 days after It has been atcepted as complete.
(Please print name) —� "Fee methodology set by Tri-County Building Industry Service Boar
i:\Dsts`Pcrmit Fornu\BldgPermitApp doe 01/03
03/04/2004 16 21 FAX 5036264633 THE MULLEN COMPANY BUENNA VISTA 1a002/003
P uanbing Fernait AD]RUC4 ian RCC i,�d „
;TWt N -�
atr/B ms
i•�rtft Na.:
City of Tigard Plamting Approval Saw
Dawav: Permit No.;
13125 SW Hall Blvd. Plan Review Other
Tigard,Oregon 97223 2&14my:
Phone: 503.639.4111 lr•K: 303.59$-19W Post-Roview se
Inwrnst: www.ci.dgari•or.us oawBY: _ cue No.:
24-hour Inspecrioo Requert; 503.639-4173 ^^itaa lulu; Sa Page 2 hr
Uam►Mst�1�4t1; _ 9v loma9RUAf4rmatro,.
w4r -T , ; 'r"-_ $Td&`SC�:LUI.7f:(taterlil infohaittollYit
New construction _ Demolition Descti tion t1100(—) � x
_ Lp r• ) Total
Addition/i�l0etati0n/re�iacement �OtheT. _ i 16;���tim�'ihv' ,.? '�''4
�IEGOkwo .CONS iW�C.'7fDOQ�1.^�- tt;.' 0 «:1dDll�ta'r't��
SFR(1)both
1 &2-Famil dwellin �Co,nryerciiUIndu__:_trial ------- 149.00
SFR 2)beth 50.00
cc story Building Multi-Fa SFR{3q 39900
�.�-_, -_
Master Builder _ _ Othei Each additional buhlkituhen 41.06
'JOBS= P T1GXib JE OP( Fbe surinkir. -Eq. Pae 2
Job Pity addmii Stu Utiniia:
Suits 0, _ Bld ./.A t,#: Catch basiW*rra dmio - — 16.66
Project Name: --- clWituh line/imch drain 16.60
— I FoaNng drain t'na.lincar ti.) _ Pae 2
CIO+JS Strett/l){1CCti0C1S IO job Site: Manufactured home utilities 110.00
Manhulcs _� 16.60
Rain drain c0 ector 16.60
Sat+lt sewer no, linear ft. Page 2
division: _ Lot#: Storm sewer(nolinear ft.) Pee 2
tax map/parcel#: water cervica no, i itj Pae 2
t)FSCAfl — .: �•.
_ _ 06 tit•'ORor Jim
K Ab •
14K_CONSTRUCTION -SINGLE FAMI wftoe valve
Snso valveckflow previcntur_- Pa c 2
F'ARILY DETACHED RESIDENCE Backwater valve 16.60
Clothes washer 16.60
'-'- DishwuhR --� 16.60 _
Drinkin f'otult;!it� 16.60
• � •.�;• .••�.:,: TEIYlL�IT�: g'eLor�rfum�_ ^_ _ l6.!0 ----
Nau�e: Buena Vista Custom Homes E>c wino can: 16.60
Address: 6932 SW ha ccadam -Ave- st,�_ c Fixture,'sawer cap 16.60
Ci /Statelzi : Portland.and OR 9 7 21 9 Floor drain/Door stnk/hub 16,60
Garbage disposal 16.60
'hone: 503--443-6033TFtX: 503-4413-2443 Hose bib 16.60
APPLICANT ACTT N , ' I ice maker 16,60
Name: R&Y Mullen lntam tod e c 16.60
Address: MAiiew SU-value; S !Pante 2
city/state/zip:: nmor 16.60
-T—Fax—: - Roordrsln cotrvtterc 16.60
Phone: - SiddbasiM_avatory 16.60
E-mail: I TubJ owsNlhower pan 16.60
_ CONTRACTOR Ur1na1 --- 16.60
BusincssNamc: ED Mullen Flufr. ing__ Wuttcloset _ 16.60
Water e l t3.60
Address; 24470 SW Rainbow Lane —
city/State/zip: i11nV'nrr%_ UR 97121 Othm --
Phone: o3-6_2.8-16M Fax' II -fi28-4611 _ - :Plambla ?*fie.
CCB Lic. #: - 3'lumb Lic.# - __ _. Subtotal s
- ��iB9 - N initnum Penrtit Fcc S72.50 S
Authorized v _ Resident al Baddlow Minium Fee$36.25 _
Signature: c: - -
�__-�-• Plut�c+�iaw2S7S of Prnnir Fad Sr _
Ray Mu t_-n. -�� State w5h_arge;8%ofPcrntitFee S
-- (Plow print tunrne) L_ TOTAL PERMIT'IFEE 1 S
Notices This pertelt appllesdae esplees Ira pertWt is oot obtained within vl i%w commsrclal buUdlep roqulre 2 leu or posm with come,it or
110 slays srtep U hat baa ueapted u eotnpatte. r,sa,ditirem Tor plan rcricw.
-rrr nethndn1nV tet by 1 ri (`nunry Baltdine lnduct.y Se .ica ga_rd.
I:�Dsu�Petmitlotme�lltnlarmlNpp•sac
0Iro3
i
03/04/2004 16:26 5032537693 SUN GLOW INC
PAGE 02
Mechanical Per"At Application Rived eehanicat
k•u_ dames _ _ Perm,e No;
City Of Tigard Planning Approval- J � Building
1312.5 SW Hall Blvd. ti IN
Plan FttViCW I� �othet —_�••••
Tigard,Gregon 97223 pa" . Pc�vt140.; _—
Phone: 503-639-41"r: Fax: 503.598-1960 Port•Rcv,e u [and USW
Intemet: www.ci.tigara.cmuf Cut No.-
Contact Juns J E see Pace the
24-hour Inspection Requet: 503-639-4175 Namc/ldethod: tttep a.hfl+rmatBon.
TYIPEUFWORK CbRi!-,_t7t�RCAL- ILtE .BCli1EUL7Lr-Ek°f[Se :a.
New Conanction -_ _ Demolition Mechanioal pernut fees'are ba+cd on the totsl value of the work 1
Addition/alteration/replacentent Othrr: Performed. Indicate lhfr value(rounded to the rimest dollar)of all
l AlLGO>rt U1tTCONSFRfPCTI int ="�<' mechanical roatrralc,equipnxnt;labor,overhead and profit.
Family dwellingConunerciaVIndtlstrial Va1ut S :— ....See page 2 for Fee 9ehedule
Acccsrnry BuildingMulti-Fami1Y RESLDVM 4 sI�EB� tom;
Mnstel Builder Other; 7--Z— Fe ea. Total _
l0ealtatlCoulia
JO STTE R�"ORMwT[OR and OC.(1)<ON -- "' «.
$ L furnace•add-on air condi i _ 14.00
Job site address:_ Gas heat tri� � 1e.00
S+titer: - — SidJul A.pt.f�: Dnctwortc t4.Q0
Project Name; _. H drop'l hot snratcr s sttan 14.00
Cross street/Directions to job sue Residential boiier
for radiator or hydromic n5tam
Unit heaters(fuel,not electric)
lin w2l:,in-ducsusIvneed,ctc.) 14.00
Flut/vent for any of above) 10.01J
Subdivision: -! Lo;#: R air units--
1<97t / #: [ith:r Fuel A tbrarm
� ArcCl arccl Water hew:t t O,JO
DOCRyallQN 4f WORK Gas fietplacc _ -
NewW�C.t51�P-fJC.—OPV 3T GL,.. F C I
_ Flue vent(water he2t r/ tirepiace) 10.00
DETACHED R> SIDENC"E Loz li hter lo.oc
- Wood(pellet stove II J_00
Wood$ lace/insert 10.00 _
Chimne llincrl uelyenti 10,00
-- Ptd X nWNl11R• NA1r�T',ra:T' Other. - 10.00
Name: :' `�- Ea�iro'ao�cx»auat&veaetletsoa
BupA yi a -C,�ustDm Hail Les Purge hoodlother eitchart equiptnalr 10.00
Address: 6� 2 S Ma c a8attnV _ _G Clothes dryer exhaust I o.00
City/state/zip- ortland OR--9721 9 Single duM«haust
Phoma _4Q 3_6.3.-- , FBX: ~s-_ (bathivoms,toilet Crimpalmrrnts,
X>E'PLICKPi'i CinA� SIDhi_' udli rooms_) 6.80
N& MC: David Golobay r Ame;rawl Spice fans -� 10.00
Address, Other;
_city/state/zip: 1011SAU for nrxe 4.SIM lath addidonal
Phone: Fax: Furnace.etc. -- -- -
Qm
at pmv
E `lai1: wal�ti9 tudedlurtitheater •• — —
-- ----CUNTRAC"TQR �- _� Water heater
_Business Name, s�tGl�s�w Sry. Fire �•�"�C' "
Addre94:2428 9E 105th Ave. --
Cit IStatc2i Pc zr :l nd, OR 9721 6 °�- --
1'!__.� Ciorhes dryer�assj •' _
LPho�lme: 5p3-i
03/04/2004 15:11 5036425815 ROSS ELECTRIC INC NAGE 02
Electrical Permit Application Received >rlectria,,
nst�gy Pcrmtt 4j
City of Tigard Planning Approval Sign
Date/ L Permit No
13125 SW Ball Blvd, Plan Review Other
Tigard, Oregon 97223 DaD te/By oenrdt No.
Phone: 503-639-4171 Fax: 5(13-5981960 Post-Revicw land Use
Intrmet: www.ci•tigard.or.us Dzx/B Cue No,:
Contact Juns: See Pa t 2 far
24-hour inspection Request: 503 639-4175 NantelMethod: Supplemental Inrormation.
TYPE OF WORK PLAN 1REVIEWlegate chez k iat`ilta_- apIty)
New construction Demolition Service ovcr 2.25 amps• Flcdth-care facility
mm crcial
AddttiotUalteratioNr lacl:ment Other; ❑Nasardous loation
O-- - �— ❑Service over 320 amps-rating of ❑Building aver 10,00 square feet,
CATZGMYOF'C0NSER,UCITC3lf 1 &2 family dwellings four or more residenAl units in
&2-Familydwellin [ Commerciat ndustt ial ❑Syttcm over 600 volts nominal one structure
Accessory Builditt Multi-Family ❑Building ovcr Ihree stories ❑Fecdcrs,400 amps or morin
-_ Q Occupant load over 99 persona ❑Manufactured structures or RV park
Master Builder Ulher: A C7 Fgr!%0iShting plan ❑Other-
JOU SITE INFORM UON cud LOCATION Submit__,sets of plans with Inv of the above.
n �- rue above ate not applicable to cemDnrtry construction service.
Job site address: moi _ L Fw SCBE me
Suite
—.-� Numberoiial tions ler Mit allowed
Project Name- Description _ Qq Fee(ea.) Tatal
Ncw mIdenttat-sinelt or mratti-family per
Cross street/Direal0`1S to job SitC dwelling atilt.lafledes attached garage.
Service loeladed:
h�1000 ft.or kss _
_ 14515 4
---_W _ ��E-Le a_ddiitiioonaat Son 9 R,or portion thereof 31,40
Lienal ed ener residential
Subdivision: L) -���Z�� �-�� Lot#• -x'�, _-� 75.00z
Limited energy,m-,residential 75.00 2
Tax map/ arcel k -- Each manufammed home or module dv:clling
DE ON OF WOK service antllor feeder 90.90 2
Services or feeders-Installe✓on, V—
l� ahenllon or relocation
200 am or IN" 80.30
---— 201 amp!Fo 400 amps 10615 2
_ 401 am ro 600 arn� -- 160 Get 2
EiOR1gEtX X OWNER TF "- 60!am to IVANT 1000 un s� - _ 240.60
7� Over IPT am r volts 454.65 1
Dante.-_: I e �- iLL-I-u, Il(,!�"1 --- --
Rcwnntctonly _ 66.85 2
Address: UC(/ �', Trmporary servim nr feeders-instillation.
] — dteratioo,or relocation:— —
Cit stat!=l�1 t; C 0/l C �� 200 amps orins 66.85 1
Phon ( � �3�(,op Fax q_ z I y 20l ampa 1n 400 amps-, -- 100.70 2
�hP CA:� _NTAC C P5905 401 to Eno amps 1,,,•75 - 2
Branch rirruits•Uew.alteration.cr
Name: �_ L- _ l�Cis _ i cttendnn per panel:
Address: A.Fcr.ror branch circuits with purchase of
-- —---- .-wrvicc or Feeder fee,each branch circuit 6.65 2
Ct /statf/Zl : --- -A R Fct for brar.h circuits without{uchare of
-— —� _service nr feeder fee,t nt brinch circa t 46.85 2
Phone: Each additional branch circuit -- 665 2
E-mail: �_ Mnvc.(Smice or feede not irxludedl, ��
('E)N 1CRACI OR Each np or trngatton circlr 53 40 2
---
J ---- —_— --_- E uh sign arovtlinc l�htlnR-- 53.40 2
Oh 110: _ _ - Signal circuige)of a limited energy panel.
BuSlne59 Name: 055 ��C' �-�/ .1" M pittcrcmion Past 2 2
Address:;?3-70 5k) Rat.! t1ye 3 _
Clt�tate/ZtP��.t Its 6,0� / g7i a 7 Lech addltinnal its estinu ov_ er the all.,wable In an of the above: _
-'! _ �``7 Pn in%cation ser hour(min. I_haa) 62.30
Phone:�5iL3 !0 74d Fax: J3 4�7Sl I�vestt�aeion fee, =
CCB Lic. #: i S7b l — Lic.
___ rNtlHl�l Pe1rmKlt4ies".
SltjlervjSUlg C,l'CA iCia Subtotal
sl atuIe required _ _ Plan Revizw 25%of Pcrmit LFee S
urchPnntName,T Ue� ► .DSS Lic. > : --B`/ Perri-di::Fee S
Sari;cSofPerri-di:Fn S _
Authorized -_ TOTAL PERMIT FEE S
permit application expires Ir a permit is not abtsined v.ilhin
Si)tnaturr I)utr 180 days after it has been accepted as complete.
"Fre menhodoingv set by Tri-rnunty&aildina fndustry Srrvice 8nard
—-- (PICase print names
f:\Dst,Tmrnh Fnrny�ElcPcrmitApp.doc 011W
r
9303 HCME ST, TIGARD, OR RECEIVED
LOT 5 OF KESSLER ESTATES SUBDIVISION, PHASE I
1LJN 7 2001f
3 S
211
SiLT
FENCE
I IV
rr��-,L-8 MT�5' f) 11 11
Lu 9076 SF
BVH3070-R
to
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z
'4
fill
fy
fiII ll].
Q
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(y
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if
IZ
7N
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LOT 5 SITE PLAN NCR4
BLIENA VISTA CUSTOM HOMES KEPI-LOTS
BUENA VISTA CUSTOM HOMEkS 6932 SW MACADAM AVE, STF
KESSLER ESTATES, PHASE I - CITY OF TIGARD - WASHINGTON COUNTY PORTLAND, OR 07219
1503) 443-6033
Pi A,' "•AX: (6031 443-2443
CITV OF TIOARD-SITE PLAN REVIEW
1,01JILIJINUPERMITNt .:
PLANNING DIVISION:
Required Setbacks: +0 Approved 01 Not Approved
Side: Street Side• /'-'
Front. : ,..,_. ORrage: = Rear: /S
Visual clearance: 13 Approved ❑ Not Approved
Maximum Nuilding Height sfeet
CWS Servic rovider Letter Required: ❑ Yes No
t3 ❑ Receve?
'
Date: 0
FNOINLERIN DEPARTMENT:
Actual SI pe: % 14 Approved ❑ Not Approved
Site Plar ['Approved Q t ved
li Date: L �b
Notes;
I