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9346 SW HOME STREET cb w .�, rn cn z O m J� r a 9346 SW HOME ST CITY OF Ti IGARD 24-Hour / BUILDING Inspection Line: (503) ;39-4175 e-'-? Y'--ed INSPECTION DIVISION Business L ine: 50j) 639-41171 BLIP Received _ / -) .... Date RequRO l PM _--._ _ BLIP Location ___�'" _;� �_'►� --_- Suite . _ - -._- _-- MEC - -- - _ Contact Person ---- Ph(— ) ---____-- ._ PLM _------ Contractor _ Ph( - ) _ -- _-- SWR -- f Q Tenant/Owner _ ELC Footing Foundation Access: ELC Ftg Drain ELP Crawl Drain -- - - Slab Inspection Notes: SIT Post& Beam Shear Anchors - -- -- - Eyt Sheath/Shear Int Sheath/Shear -- Framing C F-ri�/gr Insulation —�- �-�-� Drywall NailingL----� Firewall Fire Sprinkler U L_ — -- Fire Alarm �- ---� / Susp'd Ceiilng / _ Z"Q r L7 Roof Other: PASS PART F L PLUMBING Post&Bearn T" r.- Under Slab _ c l / _ G �� ft/ Rough-In Water Service Sanitary Sewer Rein Dreir, V177- Tit p Catch Basin/Manhole Storm Drain — Shower Panfz Other. -- -- �` � --- Final L)1 PASS_PART FAIL ICAL_ oot& Beam— Rough-In Gas Line S Dampers irta AIL -— — — LECTRICA Seryce — '—�--� Rough-In -----,--- UG/Slab Low Voltage LfP"rm USS iReinspection tce of s—_. required befo next Inspection. Pay at City Hall, 13125 SW Hall Blvd. PART FAIL �- n Please call for reinspection RE:. Unable to inspect-no access Fire Supply Line ADA '^ Approach/Sidewalk Date v'--- Inspector Other: Final DO NOT REMOVE ;il:Is Inspoctlon record ! n the jeb 9R9. PASS PART FAIL e a � NON- a- a ► da a- a ;\� t:drD �° ► a ` O ~ � °, ► a ! �n y I ► aq ! gyp-. ► a ro lob- oil.► ! rD r ► n o o ► a 44 Ob. Pill- a \� h ► a h � ► a � Poo. a ! a ► a ► a ► rvvvevviv�v9�♦ isirV vvV«vwvvN v• .:vvvvvvvvv CITY OF TIGARD 24-Hour BUILDING ,�. Inspection Line: '(F-11639-417 MST INSPECTION DIVISI, .J Business Line: (50 .39-4171 ` BUP — --- Received Date Requostad �� —7 -AM —PM BUP Location ✓ ��--� Suite MEC _ G _ ��{ Contact Person �--�--� _ Ph( —) 7f IS PLM _ — Contractor _ __— Ph( ) SWR — BUILDING Tenant/Owner ELC — Footing ELC -_ Foundation Access: Fig Drain ELR _- Crawl Drain Slab Inspection Notes: SIT — Post&Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing —�- Insulation Drywall Nailing --" Firewall Fire Sprinkler ---- -- Fire Alarm _ Susp'd Ceiling ----'- -- - Roof R-AS" PART FAIL PLUMBING —_ -- -- - - — - --- -- Post& Beam Under Slab ----- — - Rough-In Water Service --- -- - --- -- Sanitary Sewer Rain Drains - -- - — - ----- Catch Basin/Manhole Storm Drain -'------,--� -- ------ Shower Pen Other: Final PASS PART FAIL _ MECHANICAL _ Post&Beam Rough-In Chas Line Smoke Dampers ART FAIL TRICAL Service Rough-in - UG/Slab Low Voltage --- Fire Alarm Final El Reinspection fee of$ required before next Inspection. Pay at City Hail, 13125 SW Hall Blvd. PASS PART FAIL SITE �� Please call for reinspection RE: �_ Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date- ,LJ�?�' ��_ Inspemor Other: Final p DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF T'I�A R D MASTER PERMIT �'�+" PERMIT#: MST2004-00163 DEVELOPMENT SERVICES DATE ISSUED: 6/30/2004 13125 SW Hell b)vd.,Tigard OR 97223 (503)639-x'171 SITE ADDRESS: 09346 SW HOME 3 T PARCEL: 2S111 UB-KE009 SUBDIVISION: KESSLER ESTAT=S ZONING: R-4.5 BLOCK: LOT: 111111 JURISDICTION: TIG REMARKS: New SF detached BUILDING REISSUE. BVH3684 STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 27 FIRST: 1.55; BASEMENT: sl LEFT: S SMOKE DETECTORS: Y TYPE OF USE, SF FLOOR LOAD: 40 SECOND: "W1.1 9f GARAGL 702 9f FRONT: PARKING SPACES: TYPE OF CONST: 5N DWELLING UNITS 1 THP0 at RIGHT: OCCUPANCY GRP: R3 BDRM: 5 VALUE: 361,595 40 BATH: 3 TOTAL: 3.594 et REAR: 1:> PLUMBING SINKS: 1 WATER CLOSETS. 3 WASHING MACH: I LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 1 uu SF RAIN DRAINS: 1 CATCH BASINS: TUB/SHOWERS: 4 GARBAGE DISP: I WATER HEATERS: I WATER,LINES a RCKFLW PREVNTR. GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K: BOIL/CMP<3HP: VENT FANS: 5 CLOTHES DR 'R: I GAS FURN>-t00d: 1 UNIT HEATERS: HOODS: I OTHER UNITS: 2 MAX INP: blo I'LOOR FURNANCES: VENTS: I WOODSTOVES GAS OUTI FTS: 6 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADVL INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp 0 - 200 amp: W/SVC OR FDF. PUMPIIRRIGATION: PER INSPECTION: EA AVU'L 500SF: 7 201 - 400 amp: 201 -400 amp: let W/O SVCJFDR SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 anw 401 •600 amp: EA ADDL aR CIR: SIGNAL/PANEL: IN PLANT: MANU HM/SVC/FDR: 601 1000 amp: 601+ampa 1000v: MINOR LABEL: 1000+amplvolt PLAN RENEW SECTION Reconnect only: >-4 RES UNITS: SVCfFOR>-225 A.: >800 V NOMINAL CLS AREA/SPC OCC. EL2cTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL B.COMMERCIAL AUDIO 8 STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: SOILE4: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATAITELE COIAM: NURSE CALLS: T07AL a SYSTEMS: Ureter: Contractor: TOTAL FEES: $ 8,038.46 This permit is subject to the regulations contained in the BUENA VISTA CUSTOM HOMES BUENA VI��TA HOMES Tigard Municipal Code,State of 69212and all other applicable Taws Alll Specialty Codes 2 SW MACADAM AVE STE C 6932 SW MACADAM SUITE C PORTLAND, OR 97219 PORTLAND, OR 97219 work will done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or H the work Is suspended for more than 180 days Phone: 50.1-443-60.11 Phone: 503-443-6033 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those ReQ 01 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 Mechanica Plumb Top Out Exterior Sheathing Inst Rain drain Insp Electrical Final Sewer Inspection Underfloor Insulation Electrical Service Low Voltage Storm drain Insp Mechanical Final Footing Insp Crawl Drain/Backwater Electrical Rough In Gas Line Insp Water Line Insp Plumb Final Foundation Insp PI-M/Underfloor Framing Insp Gas Fireplace Wat3r Service Ins Bui Ing Final Post/Beam Structural Mechanical Insp Shear Wall Insp Insulation Insp Appr/S wlk In Issued By : t. r °C ; Permittee Signature Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next businass da�r CITYOF T I CSA R D SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2004-00161 DATE ISSUED: 6/30/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S111 DB-KE009 SITE ADDRESS; 09346 SW HOME ST SUBDIVISION: KESSLER FISTA'LS ZONING: R-4.5 BLOCK: !_OT: ow) .JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 1 TYPE OF USE: SF NO. OF BUILDINGS: INSTALL TYPF-: LTPSWP, 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 JSWUSA] Swr Connectit 6/30/2004 $2,400.00 SWUSAI SWrConnecti( 6/30/2004 $0.00 Phoria: 503-443-6033 1SWINS131 Sewer Inspeci 6/30/2004 $35.00 [SWINSP] Sewer Inspeci 6/30/2004 $0.00 Contractor: Total $2,435.00 Phone: Reg#: Required Inspections Th;s 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 sewer is not located at the measurement given, the installer 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 Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through O 952- 01-0100. You may obtain copies of these rules or direct questions to OUNC by calling(503) 246-6699. Issued by: -- _ Permittee Signature: Cali (503) 639-4175 by 7:00 P.M. for an inspection needed the ne usines day- Building Permit Application Received Building Date/By:: Permit No.: (!J City of Tigard Planning A royal Other l 3125 Su! Hall Blvd. Date/By: Permit No.: Plan Review Other Tigard,Oregon 97223 Date/BY: ,",A (- 'I,-("/ Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use Internet: www,ci.tigard.or.us Date/By: Case No 24-hour Inspection Request: 503-639-4175 Contact See Page for Naame/me/Method: Supplemental information TYPE OF WORK REQUIRED DATA: t New construction Demolition 1&2 FAMILY DWELLING Addition/alteration/re lacement Other: _ CATEGORY OF CONSTRUCTION Note. Permit fees*are based on the total value of the work perfnrTncd. Indicate I & 2-Family dwelling Commercial/Industrial the value(rounded to the nearest dollar)of all equipment,materials,labor, AccPssory Building Multi-Family p overhead and profit for the work indicated on this application � . Master Builder Other: Valuation............... .... .................................. S JOB SITE INFORMATION and LOCATION No.of bedrooms: No of baths: 'J Job site address: y(o lif- S'f_ Total number of floors........ New dwelling area(sq. ft.). Suite#: Bld ./A t,#• •• - Garage/carport area(sq.ft.)........... ..1. ......... Project Name: Covered porch area(sq. ft.)............................. Cross streedDirections to job site: Deck area(sq.ft.)..................•......................... !"— Other structure area(sq.ft.)............................ REQUIRED DATA: COMMERCIAL=USE CHECKLIST Subdivision: �, Lot#: Tar ma / arcel #: Note: Permit fees*are based on the total value of the work performed. Indicate DESCRIPTION OF WORK the value(rounded to the nearest dollar)of all equipment,materials,labor, NEW CONSTRUCTION—SINGLE FAMILY RES. overhead and profit for the work indicated on this application. DEATACHED RESIDENCE — Valuation...............•......•...................... ........... S Existing building area(sq.ft.)......................... New building area(sq. fl.)............................... Number of stones............................................ PROPERTY OWNER TENANT Type of construction....................................... Name: Buena Vista Custom Homos Occupancygroup(s): Existing: Address: 6932 SW Macadam Ave. Ste C New; Cit /State/Zip: Portlan , OR 97219 Phone: 503-443-6033 Fax:5 0 3—4 4 3—2 4 4 3 NOTICE: All contractors and subcontractors are required to be APPLICANT W CONTACT PERSON licensed with the Oregon Construction Contractors Board under BUSIneSS Name: SAME AS ABOVE provisions of ORS 701 and may be required to be licensed in the Jurisdiction where work is being performed. If the applicant is exempt Contact Name: E1 i abet h Moore from licensing,the following reason applies: Addre.�s: _ _ Phone: Far; E-mail: BUILDING PERMrr FEGS•.• CONTRACTOR Plein ret'e'Ho ediclimu'le. 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 Fax:503-443-2443 Date received: CCB Lic. #: 152235 Authorized // _ Signature: [i/ Date: Notice: This permit application expires If a permit Is not obtained althin 180 days after It has been accepted as complete. (Please print Warne) v *Fee methodology set by Tri-County Building Industry Service Board. i tDits`Permit Fomu`BldgPermitApp doc 01/03 03/04/2004 16 21 FAX 5036284633 INE MIJUEN UOMNANY BUENNA VISTA Z002/003 Plumbing Permit Application pcCei,� pluntbins �— City of Tigard FlamingArryrava Sswsr Daw ay. Permit No.; 13125 SW Hall Blvd. Plast Review Other Tigard,Oregon 97223 DAWBv; Permit Na.; Phone: 503-6394171 Fix: 303-598-1960 opt-Rry ew tlnd Use Inurnat: v!ww.ci.ttgard.or,us DKK Cur No: contact Juris 1 See Page 2 ror 24-hour Inspecriou Request: 503.639.4175A, k NamelD e ae: uvvlomeoral tntarmatloa. New construction ElDemolition Deaetlition Qty. to w Total Addition/alWation/reptacement Other; ;�^ '• �lEGOR'YtaO>F. ,,! . • .•. ' . .. ,• "I�blle Mr e11?11 tatiIIt .00idedEfo� .::� •t';•:#• y �5I &2-Famil dwellin Commerciai/Indu al S Ft bath Fid 2)bath 350. Acctst;o�Auildin M Sr_R(3)bath 399,00 Master Builder Other: Fach additional battOcitchen 43,03 f H 15 11? 1f:I0t1"�tindJbAi Fuc wnnkl7r-sQ.tt,: Pae 2 Job site address: -Al-) _ 5(*U ria c.. ' ."MY47 . stfirg 0., 1 Bldg./Apt,#: Cet!h ba5in/ercu drain I ti. Prof ect Name: Drfwal euh line/lretteh drain 16.60 Fooling drain W.linrar ft.) Pae 2 Cross stmevDirections to job site: Manufactured home utilities 110.00 Manholes--�^ 16.60 -_- ---- Rain drain igag0otor 16.60 T $a,+ltp sewer no linear it. Pa e 2 division: Stormsewer(no. linear ft.) Pa e 2 Tax map/parcel Water service no.hax ftPae 2 MCRITTION OF FORK - or Item Absotprion valve d0. NF,t,-,CONSTRUCTION -SINGLF FAMILY Aasddlow M cvcntur _ y Pose 2 FAMILY DETACHED RESIDENCE Backwater valve 16.60 Clothcs washer_ 16.60 Dishwasher 16,60 Drinking foumain 16.60 OWNER PENANT ectoralsurr,P 16.60 -- Name: Buena vista Custom Homes Ex anso -- 0 Address: 6932 SW K cudam� lxttrtdlawer cap _ 16,60 Ci lgtate/Zt : Pv r t 1 and OR 9 7 219 Floor drain/floor sinkAnub 16.60 Garbage disposal 6. 0 Phone: 503--443-6033 Fax: 503-443-2,443 Hose bib 16.60 APPi<.LCANT G,py P N Ice mazer Name: RaY Mullen _�- _-_ Interceptor/ geR1y. 16.do Address: Modical-Im-value; S Page 2 "— Primcr 16.60 Phone: drain rAmmerc 16.60 Sir _ - - hone: Fax' WbaeiaAGValo -'o E-trials: Tu / owadthowe►pan 16.60 CONTRACT'OIL Vrui 16.60 i BusinessName; Ep MUil -!-o>en PluWalcr closer 16.60 mbing water heater 16.60 Address: 24470 SW Rainbow Lane Other: City/State/Zip: Hi 1 V,^ 071 71 Other. _ Phone: _fi 1 ax:se�_fi28-d�33 Bluwble 1ect�lt. • y CCB Lic. #: Plumb LICA Subtora.( 5 Authotiz��Zx/ ( Minimum Petmit"cr:S72-50 S Signaturo c: / Pmie.ential Backflow Minima a u ---- Plan Review(25l�of crmir F� S Ray State Sur_cltu a 8X of Pcrmit Ft2 S (plaae print name) _ _ _TOTAL IERMIT P6E Noticei filo perislt■ppllndon esplres Its permit is not obtatoed within AU,w.!commercial bull Ind p rrqu!re 1 tet/o/plant with ometrtc er UA days irter L hat bees seeepted as complete. rlilr d1sWarn fer plait revltw. •Fee mrl\Odalemtet by 11 r County Boitdins Industry Sema teard- i:tpsts\Petrttil FormeVlmhrmltAFP.doc 01101 03/04/2404 16:26 50:,2537693 SUN GLOW INC PAGE 02 Mechanical Hermit AVD1iQd0n R«avein erica,at City of Tigard ?fanning A;,pnw°I Building 13125 SW Hall Blvd. U---` ��_ °F N°.` Tigard,0repi 97223 F12n t•j. _ e amit No.: Phoae: 503.639.4171 Fax 503-598.1960 Post•Ftcw,e� Land Uee DatelB _ LnEeYMt: www,r-i.tigerd.or.tu Cate No.Contact luris. 24-hour Inspection Request: $03.639.4175 IitncMothad: Srepletnental rnfbrmadun. E OFRJIK • s��, ,. -orisee'IAC—'" gvL'1��='.EJBB ct�utCialgi New construction I Demolition Meceanftl pertrrit Cees•arc bailed on the tLUI vaRte of the work Addition/alteration/replacement i U Other: per!btnned. Indicate the value(rounded to the nearest dollar)of all -CATIRMOR QV-()I[STRUC`170&+ mechanical maurialc,equipment,labor,overhead and ptvllt. L41 &2-Funily_dwel_ling CommerciaVIndustrial Valu•: s _ See Paeta for Fee Schedule 6ccessoty Buildir. Multi-Family Ns�ER 1 Master Builder F1 Other: -" �_.��lcripd0n_- 0 V. �otrl J STTE twTION nit ti.Of'1t1t70N — ---- nest9 Cootie furna,te•add-ort air c_ond_tti in " 14,00 Job site aft 6& Ir— Gins heat tM 14,00 Suite 0: — Bldi./Anit.l�: -- Duct work 24.00 Pro ect Name: F dnmic hot watar system 1 1111,00 Cross:ctreet/Dimctions to lob site- --" i Residential boiler fbr radivor w h ronic:+stern) 1 14 M Unit heaters(fuel,not electric) in wall,in•duc su ndedctc) 14.00 F utstvent(for any of above) _ 1000 Subdivision; Lot#: 7 Repair units 12.15 _ Othcz Fud A lbnety Tex / amel IFwaterheatet _ 10.00 tai tt?N F RK ass fitepluc _ 10.00 NCONSTRUCTION—SINGLE FAMILY Flue vent(water haxr/gas(ircpiace) � 10.00 DETACM RESIDENCE Lo lighter _ 10.00 W0067elktstove I 10.00 Wood larA/insert 10.00 (.hitrne unerl u!/vent 10.00_ P AI.,Ctra�+'"'t er, jVaIIle: $ stn C'li�t4m �1fSrrta4' Eaeiroamend,tGtboYst&Vrttl6tCoa Rt Address: mBe oodtother kitchen equipment 10.60 6 2 SW Mae S C trtothes dryer exhaLLst 10.00 Cit;'/State/Zip:Portland QR-9 7 219 Sieh a duct exhaust Phones D3�3�,� Fax: � - e? (Imthroonw,toilet compartments, PL - £ K urili rooms)__..� 80 Name: David Goloba Anis crawl space fan: L 10.00 Address: Oithrr• lo.oa pian ,� Cl /Statf lzi : "(10/10 for first 4,3100 t aoA addidona Phone: Fax: Furnace,ecc - •• — Gas heart .stn • E-mail: Wall/sua eaded/unitbeater •" CTS Water hewer as Business Name: „ _ rjr •• runt c •• Addre9s:2428 8E 105th Ave. � BB •• Ci lState/Zi :Portland OR 97216 Clothes ere1 Phone;503-253-7789 Fa 501,1 SL21 la' outer. u •' CCB Lic.#: 48131 Total: Authorized bllecivalealt"ertnit Pea• — ^ u tal: S Signature: •��;.sn „ Date: �y ininwm Permit Fee V2.10 David Golob yImge+iewFa�LiS6ofFamitFee) S (F Buse Pont ram) Slate Su fir /e T0TAIL oiO fi F •Ef Pcrmic Fen Notlte-. TbIs permft epplicstlon esplres If it pertnit is not obtsiaed within •Fec nKthadetep tet try Tri-rounry Building ladtutry Sery ee Sord. 180 drtyo aRerit has been wepted as entnplete. •"41te ptan rtquirrd for rtt.rier Ax'units. is�Dsts�f'ermitPatn,MlesPentiitllpp.doc ntrCl 93'/04/2004 15:11 5036425815 ROSS ELECTRIC INC PAGE 02 E lectr. ica! Permit Application Received F.lectt;tal Date Pertntt ' City 0f Tigard Sign Date/By: Permit No.: 13125 SW Nall$lvd. Pian Ravic,H Other - Tigard Oregon 97223Date/B • I Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Lane Ute Internet: www,ei.tigard.or.us 211"Y: Cue 110„ 74-hour Inspection Request; 503 63S1i17.s Contact Juris.: Sae Page 2 for Norm/Method: Sunsilernsintal inrermation. TYPE OF WORK ' lealec,�ta�f4a�f:eWAllibn New construction __ Demolition Service over tis amps- UHe■lth-care fa:ility Addition/alteration/r lacement Other: C01r"t,er`tat I f]Hvvdous location ❑service over 310 amps-rating of (]Building over 10,000 square feet, CATEOC11FtYOF'CC1t?PSFIiIJCTIOtif 1 &2 rarn0ydweilinp four or more residential unix in & -Famil dwelling__ Commercial/Industt al ❑System over 600 volts nominal onc,tru,o re Accessory Buildiri Multi-FamilyBuilding over three stone- L Faders,400 amps or mors -- Occupant load over 99 persona lanuhetured stmctures or RV park Master Builder Other: 13 Egres0ightingplan I �ptacr: _ JOB SITE UVEO 'TION atl L!1CXnO- I subtnit as of plana with any at the above. Job site address: ti e above r,re not anplieable to temperan construction gar-vice. Suite#: Bld ./Apt,#: Number of iaa ections per It allowed Project Name: Description --- Qty Fcc(ea T■W Cross street/Directions to,Job site: New rng unit.l t{nRle or Mcbed sort. par dwelling colt.tarl■ACt attacbrd Range. Service lnel■ded; 1000 Sit, or lets 145.1` 4 Each additioaa )nig R or rdon thereof 33.40 I Subdivision: `� r Lot#: Gaited eMf 'resid`","'l 75• 2 Limited tnerary.r,onresidential 75, 2 Tax map/parcel#: finch manufactured home or modus v dwellins DE NOF WQRK - srvme and/or feeder Gras 90.90 2 F L.V mit Services r rrioc -Imfallatlae, u� v { "�/� C �/jl l alteration or relocarbn: t It/1 200 am or leu -- . 0 - 2 amps to 400 amod _ 106.85 2 401 un . to 600 am 160,60 2 RO1PEEtTY OWNER 'EEPD 601 2MV to 122(!14 140.60 Name: i C a- -�z4. Over loon amo7 pr volts 454.65 2 Reconnect oral 66.8 J Address: 51V 9, ac oc,loln - �� Temlxcrsry servicer or feeders-instillation. Ci /State/Zi C p •-7,;I— .Iterat;aa,or relocation: Phan , 200 am or tca� _ - 66,85 y 3-(exi Fax 3 �O1 am to AM amps 100.30 C PIT CT PE ON 40110 600 amus ,.,75 2 Branch Circuits-pew,alteration.or Name: 6V,ii-, SS estentlnnper panel: Address: A.Fee for brarceh citcuit,with purchase of urvirx or feeder fee,each branch circuit 6.63 2 city/state/zip: B Fee forbranc circuit,without purchase of Phone: - service or feeder fee,iiia broneh circuit 46, 2 Fes' _-- Each eaditional bract h circuit - - - ,65 2 E-mail: Misc.(Serv;ce or feeder teat 115tided), J CONI ACTUR h or" cation circle _ 5].40 2 " --_ -- Each si or outline lighting_ 57.40 2 Job No. 5ip,al circuit(,)or a limited energy pastel. - Business Name: 05, � L_ 1i.ru;og.of cxtcaclon - Pa 2 Address.Q S'70 Sk? 'c- "T n;tit;en: #' �C•3 Cl /State/Ztn' Q b o p ri ��i 7 Eath add_ldnnal(papection over the allowable Ind of the alcove, •r' �� /C °`'•7 Per In n hour(min• I hotel 62. 0 Phone: to Z$O<- Fax:6rJ ,'jj S invests tion ter CCB Lic.#: 15-7a� Lic.#: GG oncc Suptrrvisingelectricia Lf tilelfit�lPekialCFee!(' �,.• ,`.'.,, silgaturere uire ^ Subtotal -S Plan Review 251/1 of Pcrtnit Fee S Print Name: VeieOSSI Lic.#:_`� — Statc Surchar c 81/1 o(pemtit Fee) S _ .. Authorized TOTAL PERNn'FEE S Signature Date: 'ibtiec: This permit application en Ire%If a perndt is not ahteiaml"Ith{ct 180 days after it has been accepted r complete. •Foe methedoingy set by Tri"C:nunty Building fndntrry$Crisco Hrca1. (Please print name) - (ADaWPerrnir For%n%'•ElePermitApp.doe 01 10) 9346 HC"JE ST., TIGARD, OR LOT 9 OF KESSLER ESTATES SUBDIVISION, PHASE I HOM , 1,,r , wm °C own UJ f 1 Z 06 (X C, 7_ 24 CL l I V V) Icy ►1 i „ j I_QT9 11 La A SF 'V U a I4 3E38�9-L j Iy I� u ul I_ f' syl cjlLT FENCE nS �. ^9' .6 I i LOT 9 - SITE PLAN jJ .-+vC BUENA VISTA CUSTOM HOMES SWVISTA STE84 KESSLER ESTATES, PHASE I — CITY OF TIGARD — WASHINGTON COUNTY PORTLAND,446, QR 97219 1 , 43-QI033 `,'►gP; F'l Mi TAX: 18031 443-2443 CITY(►h TIC.,t . BUILDING PERMIT Nsift- P�'A v1EVV PLANNING [),W.`►10N: REquired Sethacks: p q v e Side: $ 'al Approved 0 Not Approved Street Side 1S From. — Visual Cl (garage.: trance: Kean �s Maximum iiuild . Hei tAPPpoved ❑ Not Approved "urS Service Provider Letter Reyuieed: ❑ Y'es � No H /! Receive LNC.INEI Date: - �; DLPARTMFNT- Act�ai Sl() Y.,o Site PI 'b ApIN"ved Not A g Appruvrci Ppri�vrii ❑�O, pprovtld Notes: Dale: e!� -e,-VI Gt a Q