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9397 S`J1l HOME ST
TY OF
T, ^ A♦R D __ MASTER PERMIT
�J"��• PERMIT#: MST2004-00208
DEVELOPMENT SERVICES DATE ISSUED: 8/18/2004
13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171
SITE ADDRESS: 09397 SW HOME ST PARCEL: 2311 1[)[3-KI— 20
SUBDIVISION: KF_SSLER ESTATES NO. 'l 70NIN�: It-•I
BL(_ K: LOT: U?(I JURISDICTION: I III
REMARKS: New SF detached.
BUILDING
REISSUE: BVH3070 STORIES: 2� FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: NEW HEIGHT: 25 FIRST: '."UP st BASEMENT, 5f� LEFT: 5 SMOKE DETECTORS.
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 1.672 at GARAGE: 656 sf FRONT: z0 PANKING SPACES:
TYPE C F CONST: 5N DWELLING UNITS: 1 THIRD. at RIGHT: ,
54560 `
OCCUPI,NCY GRP: R3 BORM: 4 BATH: 3 TOTAL: 3,070 sl VALUE 302. REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH I _"UNORY TRAYS: 1 RAIN DRAIN, 100 TRAPS
LAVATORIFS: DISHWASHERS: 1 FI OOR DRAINS. SEWER LINES: 100 SF RA'N DRAINS: 1 CATCH BASINS:
TUnISHOWERS: 3 GARBAGE DISP: i WATER HEATERS: I WATER LINES: 10, BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN<10OK: SOILICMP s AHP: + VENr FANS: 5 CLOTHES DRYER: I
;AS FURN>-100K: t UNIT HEATERS: H001S: 1 OTHER UNITS: 7
MAX INP: hW FLOOR FURNANCES: VENTS: I WOODSTOVE': GAS QUTLFTS: 7
ELECTRICAL
_ Rr 51DENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDER5 BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
loot.SF OR LESS: 1 0 200 amp: 0 200amp: WISVC OR FDR. PLIMPIIRRIGATION• PER INSPECTION:
EA ADD'I-5008F: 6 201 •400 amp: 201 -400 amp: ta4 WIO SVOFr1R SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 •000 amp: 401 600 amp: EA ADOL OR CIR: SIGNALIPANEL: IN PLANT.
MANUHMISVCIFDR. 601 1000 amp: F^1+amos•1000v: M,NORLABEL:
loon+amp/Volt:
PLAN REVI E W S EC TION
Reconnect only: --`
>•4 RES UNITS: SVCIFDr.>•225 A.: >600 V NOMINAL: CLS AREAISPC OCC:
ELECTRICAL •RESTRICTED ENERGY
A.SF RESIDENTIAL _ S.COMMERCIAL
"'^6 STEREO: VACUUM SYSTEM: AUDIO 6 STEREO: FIRE A.LAPIv INTERCOM/PAGING: OUTDOOR LNDSC LT:
BUR3LAR ALARM: OTH: BOILER: HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CIOCK: INSTRUMEMTATIO!1 MEDICAI: CTHR:
HVAC. DATAITELE COMM: NURSE CALLS: TO IAL N e/STEMS:
Cwner: Contractor TOTAL FEES: $ 7,844.23
BUENA VISTA HOMES BUENA VISTA HOMES This permit 15 s'Abject to the regulations contained in the
6932 SW MACADAM#C 6932 SW MACADAM SUITE C Tigard Municipal Code. State of OR SDecialty Codes
PORTLAND, OR 97219 PORTLAND, OR 97219 and all other applicable laws All work will be done in
accordance with approved plans This per-nit will expire
if work is not started within 180 days of issuance,or if the
w)rk is suspended for more than 180 days.
Phone: 503-443-6033 Phone: 503-443.6033 A17ENTION Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those
ria III: IAC 152235 rules are set forth in OAR 952.00'-0010 through
952-001-0080. You may obtain jopies of these rules or
direct questions to OUNC by calling (503)246-1987
REQUIRED INSPEC11ONS
Ersn Cntrl b81.4444 POst/Bearn Mechanica Plumb Top Out Exterior Sheathing Inst Gyp Board Insp Appr/Sdwlk Insp
Sewer Insnection Underfloor Insulation El,,ctrical Service Low Voltage Rain drain Insp Electrical Final
Footing Insp Crawl Drain/Backwater ectrical Rough In Gas Line Insp Storm drain Insp Mechanical Final
Foundatior Insp PLM/Underfloor I aming Insp Gas Fireplace Water Line Insp Plumb Final
Post/Beam Structural Mechanical I;sp -hear Wall Insp Insulation Insp Water Service Insp Building Final
ISSlled By : _ _ Permittee Signature
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITYOF T I GSA R D ---SEWER CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2.004-00207
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/18/2004
SITE ADDRESS; 09397 SW HOME ST PARCEL: 25111 DB-KE2.20
SUBDIVISION: KESSLE.R ESTATES NO.2 ZONING: R-4.5
_ _BLOCK: LOT: 020 JURISDICTION: IIt
TENANT NAME:
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: IMPERV SURFACE:
Remarks: New SF detached.
Owner: ---- — -- --
__ FEES
BUENA VISTA HOMES Description Date Amount
E332 SW MACADAM #C _
PORTLAND, OR 97219 1SWI'SAI SwrConnectic 8/18/2004 $2,500.00
1SWUSA]SwrConnecti( 818/2004 $0.00
Phony: 503,443-6033 [SWINSP]Sewer Inspeci p/18/2004 $35.00
[SWINSP]Sewer Inspec, 8/18/2004 $0.00
Contractor:
Total $2,535.00
Phone:
Reg #:
Required Inspections
J
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 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 OAR 952-001-0100. You
may obtain copies of these rules or direct questions to OUNC by calling(503) 246-6699.
Issued hy:Z_ 4,,je ' _ Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day
Buildiu JPermit Application rXON,ed Building yy
Latt/B �SU.j �; Permit No
o:►/p� �Y� (>O
City of Tigard PlanningApprdval Other
Date1Ry: Permit No.: �1(4=0Do?
13125 SM Hall Blvd. Plan Review Other
Tigard,Oregon 97223 Date/By: .Aj r ' Permit No:
Phone: 303-639-=1171 Fax: 503-598-1960 Post-Review - Land Use -
Date/B
Internet: www,ci.tigarci.or.us Case No.
Conta t lug.1 See Page rfor
2J-hour Inspection Request: 503-639-4175 Name/Method: -//L1 Sup2leniental Information
_ TYPE OF WORK ----_ _
REQUIRED DATA:
New constiyction — _ Demolition 1 &2 FAMILY DWELLING
Addition/al teration,'replacement Other: -CATEGORY OF CON_STRUCT'ON Note. Permit fees*are basrd on the total value of the wcrk per formed. Indicate
M I & 2-Family dwelling Comin_erciaMndustnal the value(rounded to the nearest dollar)of all equipment,materials,labor,
-- --cad and profit for the work indicated on this application.
Accessot _ Building Multi-Fanifl
LJMaster Builder C Other: _ valuation ................. ..............I—................. S _
JOB SITE IFORMATION,and LOCATIO No. of bedroomsNo.of baths:
Job site address: r Total number of floors............7 .........I.........
• - t New dwelling area(sq. R.).,...
Suite r`� Bld ./A t.#: """"' --- -- -
� .L_ Garage/carpon area(sq. ft.).... ...........
Project Name. Covered porch area(sq. ft.)........ ... .............
Cross tteet/Directions to job site: Deck arca(sq ft.)............................................
Other structure area(sq. ft )_...................
REQUIRED DATA:
-- - CONII`IERCIAL-USE CHECKLIST
Subdivision: _ . Lot#: V7.5 -
Tax map/parcel #' _ 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 indict,ted on this application.
DEATACHED RESIDENCE Valuation......................................................... $
Existing building area(sq.ft,).........................
- -- - -- - New building area(sq. ft.)...............................
_ Number of stories............................................
EMPROPERTY OWNER! — TENANT Type of construction.......................................
Name: Buena Vista Custom Homes Occupancygroup(s): Existing. _ ^
Address: 6932 SW Macadam Ave. Ste C New: _
C_ ity/State/Zig or an , OR
—_
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 _ CONTACT PERSON licensed with the Oregon Construction Contractors Board under
provisions of ORS 701 and may befequired to be licensed in the
Business Name: SAME AS ABOVE jurisdiction where work is being performed. If the applicant is exempt
Contact Natne: E1 iabeth Moore from licensing,the following reason applies
Address: -------- -.—
Cit /State'Zip: --- - — ---- _� ----
Phone: Fa`x: ---- --
— BUILDING PERMIT.FEES"
E-mail: _ _
-- Please i>siiF6 ie!2'i��u1e.
CONTRACTOR
Business Name: Buena VIsta Custom Homes
. ---- Fees due upon application.... ...... ............... .
Address: 6932 SW Macadam Ave. Ste C ---
City/State/Zi Portland, OR 97219 Amount received. _ .., S__-___- -_-
Phone: 503-443-6033 Fax:503-443-2443 Date received _
CCB Lic. #: 1 52235 L_--- ------ -- ------- --
AuthoAutho!i ---
zed /�t �-
ure: (A Date: Notice- Thh permit application expires If a permit is not obtained within
Signat -- -- --- IRO days after It hat been accepted as complete.
*Fee methodology set by Tri-County Building Industry Ser%Ire tloart
(Please print name)
I:\Dsu\Permit Forms\BldgPermitApp doc 01/03
03/04,/2004 16:26 5032537693 SUN GLOW INC
PAGE 02
Mechanical Permit Application
Received MMechanical.�....--..
gate/�y: iee"A No,;
Cit), of TigardPlanning Approval 1lultding ---
13125 Soy Hall Blvd. Dt1e -
Phm P.criew --
�,� 1,Oregon 9722-3 i�att/8 Ptrr,itNo.:
Plane: ;03.639-4171 Fax: 503-598-1960 Past• eu - Land use `- -- `--�
Dat�e/6Y: _ Cue o.•
lrtterRrt: www,ci.tigard.or.us Contut Juris.: Ste Paae for
24-hour Inspection Request: 5)3-639-1175 `tatttcMothod: ietrleet,rl fnfbrrttadoa.
�• r OM1►701OR' fdEE+
Ncw comtruetion Demolition Mech,mioat perrrut rbcs-arc hued on the taW value of the work
Addition/altetation/L_ Iacement 'Mer: performed. Indicate the value(rounded to the r,rluest dollar)of tit
XATIGOR Otr.00 ST 1TCT1k + ;':'''' ';,' '.. mechanical rrntrtials,equipment ichor,overhead arid pcoftt.
1 &2-Family dwelling Conn rrvalAndust ial Value: 4 _ Ser.21W 3 for Fee Schedule
Accessor�Buildin 4- qL
Multi-Farnfly a3S6b F g� V ULF
Mwner Builder yOttu r: R Darr don tre w Fatal
_ 8eadayC�oiia _ _
JQJ1 SM UMORMATION sAd LOC14TTON Furnace•add on>lir condilrvuin " 14.00 Jv
Job site addrtss: O Gas heat
a.
Suite 0: BidjUdAptA Ltucc woti, 14,00
Project Name: HAM 4-hot water eyste14.00
Cross streeMrcc6ons to job site: Reside, ::1 boiler
fbr radiator or h roni.c CVy* l 14.00
Unit heaters(fuel,not elecnic)
in wall,induct ous4enderi ctr 1 _ 14,Op
Flue/vent for an�af 4bave 10 J0 7
Subdivision: _ Lot#:2c� R air units - - 12.15
110c Fud Appiteacm
Tax-_ / arcel# ater isnut��-' 10.00
230 intoN of Ak _GAA fir�lacc 10.00
NEw L'61791in-UT -S1 -.—TA il, Flue vent(ware tx*ttrlgss preplsc:> 10.00
DETACHED RESIDENCE Log li ter ss) _ 10.00
—- — wood/Pellct stove 10.00
Woad&glace/insert 10,00
t:hitratey/lincr/flue vent 10.00
OP61�1'Y' APIF itu,+'':. Other _ _ 10.00 _-- -
Ewiroammen WlWat&VeaN q
Name: Bueaa i�,G >•om_J3s�mA-s-. .. —
Rartge hood/other kitchen equipment 10.00
Addresa: 6 6W MagaLIA
StEl C Clothes dryer exhaust — 10.00
Ci /Sttate/Ztp:Pcrtl�and1O_R 97219 -
Phone . . Si�6edarwtwun —:ii_
kr - 3 (bathrrocns,toilet eempamrcnrt,
PLIC�1'R _
L.WqOr%A unlit rootns) 6,80 _
Name: David Golobay Anidcrawl space fans I I0.00
Address: Other; -- 10-00
Ci Ratr./Zlp --�— — eA 1p for first ce raddidond
Phone.: � Fax; Furnaceas ,mtt. ••
-- - Gheat _n►
••
E-mail:
�pecded/un it heater •«
CONTRACTOR Water heater ••~ —
BusinessNarrte. 5tt�1 U! Z.nC_ Fireplw •• -1
Addres3:2428 SE 105th Ave. Ra`lRS �• - ----
_
CitylStatCg1L.Port1ar;d, OR 97216 Clothes d2er(aas)
Phone-,5U3-253-7789 Fax:503- 5 Oaf other
CCB Lic.*;43131
_ Total;
Authorizedai-°-s`l rorm_tc Fee'
Signature:• -4 „ Date: r.i
Subtotal: S ,
'7"" lan Revih4initnum 5%of t
F4
David Goloby
Ptnv ec ofd ZSSt _ _ea)
5
r (P est.Pint name) _miStitt Suu_��8:�peetrt�t'rae
TOTAI. _rT _
?SaUr.- Thli pefftt appal- cion expires if a pert if not shtsinM within •Fee metlwdelep set try-1 H-Ceueq f-*Rdlrtx adustry Servile board.
100 dqs after it h"Me* etom ai rnrnplete. •-lite plan required rar n1e*1or.UC uniq.
i;1Lw"trmit FnmssrAtrcFennitApp.doc: OVOJ
03/04/2004 15: 11 5036425815 ROSS ELECTRIC INC PAGE 02
Electrical Permit Application R«e;Kd Electrical
DawB : Pcrmlt V •;
City of Tigard � Planning Approval Sign
1J125 SW Halt Blvd, DAte/B : PermitNo__
Plan Rcvicw Other
Tigard, Oregon 97223 Date/B • Permit No
Phone: 503-639-4171 Fax; 503-598-1960 Post-Review land use -'
Internet: www,ci,tigard.or.us Cuss No.:
24-hour inspection Request: 503-6394175 Centacl tuns.: See PAgo 2 for
Natne/Method: Su lemantal[nformatlon.
OF WORK - � _REVMW lea to eeo�rt,Ilarnmt taicb
f New Construction Demolition Service nvcr 223 amps. 14eallb ary raciiiry
r ❑Addition/alteration/r iaCemt;nt Other; covmvrcial ❑HNa'dow IopHon
.'CX'iL►" YOP'COPiSTRT1C"tICgP ❑Service over 320 amps.ratinr of ❑Building over 10.000 square feet,
1 do 2 ramily dwellings four or more residential unit-in
&2-Family dwelling_ Comimercial/Industtial ❑Systtm nvcr 600 volts nominal one strucrtlre
❑Buildingovcr three stories ❑Feeders,4C0 a
jAccessory$uildin Multi-Famil �Oee mps or mon~Y— uiwt load ovcr 99 persons ❑Manuraetured structures or RV park
aster Builder Ll tither: M Egre%Vlighting plan o Usher
J >a9CI'B
INFORMATION anti LOCKnUI Submit^ads of piens with any of the above.
Job site address: p The above are not Applicable to tem
(,e eoodructl a pry{Ae.
Suite#:
Bldg./Apt.#;
Project Name: _ Number of las tions per tmIt allowed
_ flcscri Hon
_ Pct(ea.) Total
Cross street/Directions to,lob sitc: New reeldeattal stnClc ar maltl hmlly per
dwelling putt.tonedes attacbed garage.
Ser vire leeluded:
1000 sq.R.or leas 145.1 4
_ ~E•1ch zd�itiorul 500 aQ.It or portion thereof 33.40 i
Subdivision: -_- T�#-_, Lhni cd__�re,i&-ntial _ __ 75.00
2
limited etterBy non midenNal 73. ,
Tax ma / azcel#: _ Each manufsM. red horns or modular dwcl ins
R NOrw se-ke_ars9or(Ceder 90^0 2
P�A.) Ons V Scwhn ar beden•InslAliat.. ,
C I Y aherallon or relocr-bn:
D•t' L e e _-!" n c -- 20n amps or lass Ar 0 2
-- 201 sm ---[I Iran --- 1U6. s ,
401 am . to SM naps 160.6(1 2
g0)E` EITY OVITIER �$ AOI to 1000 a --
240, 2
Over I OOn am t vo is �- -_-
Narne: i Cn l� /,, — 454.65 _ ,
� Lr�"�.-� t1C��' Rccomxct on-� 66.85 2
Address: q(fiC��j e. Temporary service,or feeders.instaliatlon.
Cltt/State/Zi : C (2 )yf_ / alteration,or relocation:
--���.9 200 AMPS or Im 66,85 I
Phon 3- Fax 3 2oi.mks ro mO n„ - 1 0 — 2
_UUMC t Nt CT Vb (iK 4o I to 600 enps —-- 2
Name: • Branch rlrru!b-new,alteration,or
�� o5S etten-lonper panrl:
Address: A.Fee rot bratrch circuits with purchase of
Cl /$tatf/Zl : mvicc or render ree,each Manch eit-it•s 6.65 2
Fac roc branch OrMia without pu=nt of
Phone: Fls service or reedsr feefirst branch ehwh 2
--_ Each- o�ditinmi branch circuit 6.6S2
E-mail: _ Mise.(Snviee or fader not metudad),
CMTRALdA h or hti -tion,'rele 53 est 2
Job N0: -'-�`+ Each si or ouHtnc II ht!n 13 40 2
Sips- circult(s)a a limited trerg y patkl,
Business Name. Ross ,p�Z_ = alterul oreateMion pa 2 2
Address: S+/ .$KJ ��J —
City/State/Zip '� I6()� D � EAch addltlnnAI i 1SPectioo ever the allowable In an of the stave:
Phone: (, zgpa Fax:�� intron pa hour(min. I hotel - -6 . 0
_ In.rosti�aHon feed—--
CCB Lic.#: I S 7a / [ic.#: ----
v Supervising elecbiclanm
/� si -lure re uircd .�•`� — -�— S��E
Print Name: 0 Lic. - plan Review 25%of Permit Fac $
_ ,�_ State Str::har %Of Parfait Fix s
Authorized TO T A L PEiRMrTFES S
SiEtttttturc: NAHect This permit appheation empire+If a permit h not obtained within
days ager It has bean gerent,.d ss complete.
•Fes methodology s;4 by Tri-C riunty Building fndtntry Service R.tard.
- �- (Please print Mme) -
ialktn 15c mit FnmtttElePermitApp.doe 01103
1r, 71 FAX 5o362i)a633 THE MULLEN COMPANY BUEW +VISTA ®002/003
Plumbing Permit Application , cti
DateiHj Permit No
City of Tigard
Planning Approval SOVAIr
tdmli
DaBy• p
_ Permit No.. _
13125 SW Hall Blvd. Plan Review Other
Tigard,Oregon 9722..3 Oallmy: _ orrAil No•_�_v
14
Phone: 503-639-4111 Fax: 303-598-IW Paie,By:itw CuLant
o
Daie�: rate No' _
Internet: vrww,ci.tigard.or.us Centact luris; M See Page 2 far
24-hour Inspecriun Request: 503.639.4175 1 9upplaindaml linformatlo■.
-TYPE OF.Winfs• C�DLxE [oc 'FWW9d_
'
NCW construction Demolition _Description Qa• r a'- - Taw
Addlt3vn/I1Wf1ti0n/r tacement C�tr ; ,�,P ��ii x; .1.faUi�YtM'e]IW 9
' �OR1E('t0 '>pk34tF' . • n�%1'tlrs•tr f►t elFeio`iitlicl!<oi9 •..L r+�'•s','�''
SFR I bath 249
- ---- "
1 &2-Famll dwelling ComricrciaVIndustrial SFR 2)bath 330.00
ildi� Mta
Accessory Bu ;f• Y �_-_�— SFR(3)bath 399.00
Master Builder Other: Ea-n aMibonal badViritchen 49.00
n Mm 11%i1P^ TLONiAd&V TI0@( _ gCat
inklar• ,!t.' Pae 2
Job site address: `I > _ Stteutwtta: ��•
Suite M: Bid ./ - h bt in(aru drain 16.60
cll each lineltTCtt4it dram f 6.60
Project Name: ----- ts drain ne.lines ft.) _I Pa e
Cress 9t-ceVDirgctlors t0 job Site: 1 Manu acturedanrrie utilities 110.00 —
M ariholc:t „^ _ __ 16.60
Rain drain comrtor _ _ '6.60
Sartlt :♦ewer no. linea'ft) P..18 2
Subdivision:
Storm sewer Pa no.linear ft.) e 2
— -- Water service(no,Itng Pae 2
Tax ma / arccl#: t Fhttttre or stern ,:
DESCRIYHOR O WWW Abse tion valve'
N9• ,,CONSTRUCTION —SINGLE FAMILY Backflow ptevcntcr Pe c 2
FMMILY DETACHED RESIDENCE Backwater valve 16.60
— — ��•� C1o:hcs washer 16.60
16.60
Dlti l;L' fount3ln 16.60
}� p p 173cYKlIT : eCtOrelitlnlD 16.60
Plaine: Buena Vista^Custom Homes Ex ttnso -ane 16.60
Address: g 3 2 SW 1� 4�am — F1�iewi r ca9 --- 16.60
Floor drelNtloor sink/hub lb•d0 —
Ci /,Q,tate/Zip: Poxt1.and OR 97219 rbage disposal 16.60
'hone: 503-443-6033 Fax: 503w443-2443 Hose bib 16.60
APPLLCA14T ;�OlY7J C>P)P�RSOr1 Ice maker 16.60
Name: Ra Mullen _ _ lnrerc tor/ e a
%tadiew`u- glue; S __ Pa do I'
c 2
Ad&eas: — - -- Ptimcr 16.:0
Ci /swu/Zip: __ _ Roordrain commetctnl) - 16.60
Phone; Fax: SinWbostn/lavatory _
�_TuVjboworllhowef Pan _ 16.60
CUD£L RAtCTOR - Urinal 16.60
-- Watcr closer _ 16.60
pAddress:
ineas Nam; ED MU 1911 Plu ing ___ Waterhtatcr 16.60
24470 SIP Rainbow Lane ___ Othor y/Statc/ZiP: Ili --- Other._— — T
Phone; -528-•1_� ZF!X:Rnt=62R�.63i __. Subtotal s
CB Lic. tt: 6H4 Plumb Lio.#: X60 `'-- Mini,-tum Permit I'm S77_.50 5
Authorized / Residential Bu ow MV1i
gi9nature: 6 �4�t€ ! itw 2S o amit Fa S
Roy u1 an i - _State satchuyr 9%ofPamir Fee .•_...
(Plow print rune) �__ _ TUICAL
Notices Ther pe►telr applteallon esptres If a pertWt is oat obtained»ithin All rmw eoinlneretal buff ihp►egvlrs 3 tett of p*ns wish Isemttrie nr
la0 days iRer L tw baa uerpted a earaplete. ;iar dlay►am for plan rtvicw.
•pre matladnlnQy s:et by Tri- County Ballding Industry Serrles•card•
1:tDita\Pemit Fom"\?1,mtermltApto-doe 01103
9397 HOME ST., TICARD, OR
LOT 20 OF KESSLER ESTATES SUBDIVISION, PHASE II
jk 252'
133.16' �.
Cy rn Ul � v
1 v-tom D� .,� "1'_-v.�// �•.�,
Lq n
_, - --- -- -- -I I -- PRI
s\ \
TOr
LOT 20
o
8744 S.F. -
ti
BVH307 '
250B, r n
-- ---- --
UTILITf KEY: ?�� \\ 250' Z
\ GAR - --
reYMBOL,: UTILITY: n
-- --!
1F'�
o�
C,G
�vIL1�IN ��,�,•�I
PLANNI"1G DIVISIU';"C- `,.1•,. J_l,- �r•• -LS
��yrcics:
Requited NlIpv'`ved
Side: -xi--
�►,,r,,,r:a No
H Ce: icy � Yes
V isual Clewan He,L1i� ---' u+red'. e1"cd
MaX;mum Build►nt� �C�t�r Itr�1 0 Kee
Provide+ ,o'�0,0
`w5 Service
0 .ENKI '; +t► � • 01 ppprOved
13 G rovcd
pri,yNof
(
1 rOye Slop,; .�
App
pct as � vale:
Site
B .• ,� A JIB&S
Notes: 7'!u ,�e� o� 71
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TIGARD 24-Hour �
BUILDING Inspection Line: (503)539-4175 MST s_M`4 -L2311„ _,—e
INSPECTION DIVISION Business Line: (50r6 -4171BUPReceived ��/_ D�a�te_Re uested IdAMPM BUPLocation . 939 -7 11__ � MEC _
Contact Person — _ k0. Pte) L k1'` Ph(— ) •� u`("I PLM --_
Contractor —— Ph( SWR
B iL
Tenant/Owner ELC _
Footing ---- ELC _
Foundation Access:
Ftg Drain ELR -
C ewl Dram;
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
i
S13' PART FAIL
PLUMBING --
Post&Beam
Under Slab ---
Rough-In
Water Service -- ------ - - -”
Sanitary Sewer
Rain Drains - —�— --
Catch Basin/Manhole
Storm Drain —— - —
Shower Pan
Other.—_ _ --- --- --
Final
P RT FAIL
_M CHA AL
Post&Beam
Rough-In -----
Gas Line
7Dampers
Fin
S PART FAIL
ELECTRICAL
Service --- -- - ------_---
Holigh-in ---
UG/Slab
Low Voltage --
Fire Alarm
Final U Reinspection fee of$ requ!red before next insnectlon. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE F-1 Please call for reinspection RE:___ _ Ej Unable to inspect-no access
Fire Supply Line
ADA Approach/Sidewalk
Date._I 2 67 _�, Inspector _ __� ---Ext
Other: _
Final DO NOT 11100[DVE this Inspection record ft the Jab site.
PASS PART FAIL
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CITY OF TIGARD 24 Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171 BUP
Received Date Re uested /-I)- - (1 AM-_ _ PM ________ Bt1P - -
1 -- Su�te.....� -- - - ME'
Location ��� �'' - , - -- --
Contact Person Ph(-- - --- - - PLM - -- -- --
Contractor Ph(----) — _---.__ 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 Sprinkler ---- - -----
Fire Xarm
Susp'd Ceiling
Roof
Other.------- _. -_ - - - — -
Final
PASS PART FAIL
PLUMBING
Post
--
Post&Beram
Under Slab -- -- --- - - -
Rough-In
Water Service -- — -- ---- _.
Sanitary Sewer
Rain Drains -- -- -- —,-- -
Catch Basin/Manhole
Storm Drain
Shower Pan -
Other: - - --- - —
QS PART FAIL --- ------- -� - -
HANI_C_AL -
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: ._. E] Unable to Inspect-no access
Firo Supply Line } )
ADA -�Date Inspector% b// �
Approach/Sidewalk -- -_ - —
Other:_
Final DO NOT REMOVE this Inspection record from the jab sitba
PASS PART FAIL
CITY OF TIGARD 24-Hour `
BUILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Line: ( )639-4171 —'
BUP _
Received __Date Requested_ AM PM �-'" _ BUP
Location — -7 &en'YL� Suite MEC
Contact Person ��� Ph( —) ��D �y/� PLM
Contractor _ — Ph _ _) SWR
ILDI Tgnanl/Owner _ _ ELC
Footing
FoundationWC-7.7ELC
_ - -
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int /Shear
Framing ming L� ��/U�.A C p O 5/o _ /
,j -------- -
DrywInsulall
tion � [ ' G�
Drywall Nailing � � �. [ -' -
Firewe l f\I S V L-A 7—=� r✓
Fire Sprinkler
Fire Alarm lJ ---�' ��V 6-'—
Susp'd Ceiling --
Roof L T/49 t
r S ��
Other:
PASS PART A(L .
PLUMBING ' Lof��7 Ni G^/�✓f-l�� �� r M i-yL�(?�--r�'z�
Post&Beam � l r 0
Under Slab •N ��r ST-
Rough-In
Water Service io L41 LA 7 _L/C1G
Sanitary Sewer
Rain Drains --
Catch Basin/Manhole
Storm Drain
—
Shower Pen
Other:
Final �(��~/ L � vWy� m!� ✓/`f L l�f Ado%
PASS PART FAIL
Posi Beam
Rough-In
Gas Line
Smoke Dampers --
nal � &I-
� —
L
--
L
Service ----- __
Rough-In
UG/Slab
Low Voltage
FireAlarrn ---------__---------
( _) [] Reinspection tee of$_ ___ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE Fj Please call for reinspection RE: Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspeetor Ext
Other: _
Final DO NOT REMOVE this Inspection record 4n the job site.
PASS PART FAIL