13010 SW MORNINGSTAR DRIVE 80 it ISONINHOW MS 01,0£6
v
z
z
O
0
r-
0
M
r
13010 SW MORNINGSTAR DR
CL
Cl. '^ € �e M
tj
g $ 13
Zr
cm
cA � �c1N� � �3�V_ a1ro �
- e9. � Efi
s
iJ O O O N N N N (NNy N N .'77� N 3 N N
C9 0 LD O
7
o� €
ti
0
a V Z x Z ZLLJ J J N J
G> a (rr o a (/) Ov LL CLLLa
r
OD
F" o J O O O N N
O C0 0 Cwt
�°
4i
N a '
L) m � _ Q
L.
0
M-
� m
M
a
a
t roc
o
° ro c
W p a P
' N
c d a a o c c E E }� $ - n E
a p V o M b I�° a c0 LD
c c C a a a ro > a [L A v
QV a ro ro 8 +� 'm
a jQ 3
_ � a C) � � ftp 0 oL k c cEi b c n
fh N 10
O O N N f") O O N f'7 < C`N N N M d N
Ji a g a g a a a a a a a a a
p 'rj m Q l0
m t oG cm
yj
cz
umi
94xe
— o
a w i y 3 z z
cn riri ¢`.r nviv� Gaoai �
J
;Fz22
Tn N Q Q � Q Z Z Z p U N U
CY) o a m <a LL LL 8 8 8 > a
r
m ? p uu!!
o g a a Zab c7 +f
N
EL
(� g g g a$ Ps
N3 g; cg'
y..
a 10 0
r+
Q n � 0 a
L
C
3 L
o m
m 3 r.
0 m a � n '
C C U
'a C LL8 Q 8
d n 0 a y c n
CV) LEi; E iv s_ ' cr
ll U. O LL LL i� _
��p
01,111
�1xt Cm
0Tyn .tom; TT S
®Y � � X41
Y9� g 'c n rid, t (dAr�'5ad $oid1���`� t aia5
m a ico cn U)
ti
En
4 a
Qf o U-"- 11 LL n a a a LL. a a
M c°
d Y 'n co CJ U co Y X X Y
C1 �
1.0
" M
ca d
o
U)
i m a
m fV r
� y a a s 6 O
L cnn
C
r 0)
O f
d c e 8 N
CL a
u c
V.ai LL w � I I
(1) N r- u7 Cl) v in o N
� n n n n n
Ln �
am
Cl)
o
� cn
ti
P
qV• C d IL IL LL a M LL (L a
`P
r C
Y
Q
U $ S 8 S a
N
0 0 0
CL
oc
c O
6 _ 0 !L
d N .E c Iv Igo .3 I
CD
N B a a a s a a a a a
C17Y OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection line: 639.4176 Business Line: 639-4171
BUP _
_ Daae Requested 00 AM
_X BLD
Location_ 1l C� m�Y�1�/�1 �`{' Suite MEC
Contact Person � Ph PLM � Y
Contractor Ph SWR
BUILDING Tenant/Owner _ ELC
Retaining Wall ELR 19 q "0o 2Z?
Footing Access:
Foundation FPS
Fig Drain $QiN
Crawl Drain Inspection Notes: p ---- -
Slab ! SIT
Poss R,Beam
Ext Sheath;Sim..
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall --
Fire Sprinkler 1' 1 4.
Fire Alarm
Susp'd Ceiling �.
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post& Beam
Under Slab
Top Out
Water Service _
Sanitary Sewer
Rem Drains _
Fine!
PASS PART rA.L
MECHANICAL
Post&Beam -- ---
Rough In
Gas Line -
Smoke Dampers
Final ---- - — --- --
PASS PART FAIL
IL §=RICA
2 Service
N Rough In
C UG/Slab
Low Voltage
J Fire Alarm —__—
m
a S PART FAIL
W
J
Backfill/Grading — --- - -- —'
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ _ required bei-)re n spection. ay at City Hall, 13125 SW Hall eivd
Catch Basin
Fire Supply Line [ J Please call for reinspection RE:,—� [ )Unable to Inspect- no access
ADA
Approach/Sidewalk
Other
Date �+O —Inspector Ext
01
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST l9q �.1 7�
24-Hour Inspection Line: 639-4176 Business Line: 639.4171
'UP
Date Requested q2Q D0 AM_ PM BLD
Location O M Qr Suite _ MEC
Contact Person Ph(PZf 0.? PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation �Q �� h 0 k b,"b FPS
Fig Drain L SGN
Crawl Drain Inspection Notes:
Slab _ ��„/.,�— SIT
Post 8 Beam _
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing _
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL — -- ---
LIMBI
Post&Beam
Under Slab
Top Out
Water Service
Sanitary Sewer �— —
Rain Drains
PART FAIL
CHANICAL
Post& Beam — ——
Rough In
Gas Line --- ----—
Smoke Dampers
Final — — --�
PASS PART FAIL
CL ELECTRICAL -� -- -
Service
Rough In
N UG/Slab
Low Voltage
Fire Alarm
m Final
j PASS PART FAIL
W SITE
J
Backfill/Grading
Sanitary Sewer
Storm Drain ( ispection fee of$ _T required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ]Please call for reinspection RE:_ _ _ [ ]Unable to inspect no access
ADA
Approach/Sidewalk Date Inspector i Ext ,
Other
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MS� i'995-6Q1-7
24-Hour Inspection Line: 639-4176 Business Line: 639-4171
BUP
_Date Requested 3131 AM PM BLD
Location Suite _ MEC _
Contact Person _ Ph 7)+ PLM —
Contractor Ph SWR
BUILDING— Tenant/Owner ELC
Retaining V' ELR
Footing ACC@S ��y�1/� 1 ' � VX" ppg
Foundation a4 0(to`r V� '� -
Ftg Brain SGN
Crawl Drain Inspection Notes:
Slab -- - SIT _
Post&Beam
Ext Sheath/Shebr
Int Sheath/Shear
Framing _ -• -
Insulation
Drywall Nailing —-- --
Firewall '
Fire Sprinkler --
Fire Alarm
Susp'd Ceiling ---
Roof
NEC: —..-
Final - T
PASS PART FAIL - --
PLUMBING
Post& Beam — -
Under Slab _
Top Out
Water Service
Service
Sanitary Sewer -
Rain Drains -
Final
PAS i PART FAIL -
MECHANICAL —
Post&Beam
Rough In
Gas Line �-
Smoke Dampers
Final -
PASS PART FAIL
—
r Service --- ---- ----
Rough In
UG/Slab _ - -- -- -- — -
Low Voltage
3 Fire Alarm - -- --- - - --- -
0 �
SS PART FAIL --_ - ------ -
u
Backfill/Grading _
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ]Please call for reinspection RE: _- [ ]Unable to inspect-no access
Fire Supply Lino -
ADA
Approach/Sidewalk late 3)_31 fInspector Ext
Other
Final
PASS PART FAIL DO N04 REMOVE this Inspection record from the job site.
CITY OF T I G A R D CERTIFICATE OF OCCUPANCY
PERMIT 0: MST1996
DEVELOPMENT SERVICES DATE ISSUED: 06/04/119990176
13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 PARCEL: 2S104DD-00500
ZONING;: R-4.5
JURISDICTION: TIG
SITE ADDRESS: 13010 SW MORNINGSTAR DR FILE C
SUBDIVISION: MOUNTAIN HIGHLANDS
BLOCK: LOT:004
CLASS OF WORK: NEW
TYPE OF USE: SF
TYPE OF CONSTR: 5N
OCCUPANCY GRP: R3
TENANT NAME:
REMARKS: PATH I: New single family dwelling w/attached garage.
Owner:
RON POPICK
15395 SW DELINE STREET
BEAVER'TON, OR 97007
Phone:
Contractor:
ARN CONSTRUCTION
16739 SW PLEASANT VALLEY RD
BEAVERTON, OR 97007
Phone:
Reg#: LIC 24324
This Certificate issued 05/23/2000 grants occupancy of the above referenced building or
portion thereof and confirms that the building has been Inspected for compliance with the
State of Oregon Specialty Codes for the group, occupancy, and se under which the
referenced pIt was issued.
W-7 - --- 7iW
BUILDING INSPECTOR BUILDi9d OFFICIAL
POST IN CONSPICUOUS PLACE
ELECTRICAL -
CITY OF TIGARD RESTRICTED NERIGY
DEVELOPMENT SERVICES _ PERMIT 0: ELR1999-00223
13125 SW Hall Blvd.,Tigard. OR 97223 (503) 639-4171 DATE ISSUED: 09/24/1999
SITE ADDRESS: 13010 SW MORNINGSTAR DR PARCEL: 2S104DD-00500
SUBDIVISION: MOUNTAIN HIGHLANDS ZONING: R-4.5
BLOCK: LOT: 004 JURISDICTION: TIG
Proiect Description:All systems
A.RESIDENTIAL B.COMMERCIAL _
AUDIO& STEREO: X AUDIO 6 STEREO: INTERCOM&PAGING:
BURGLAR ALARM: X BOILER: LANDSCAPE/IRRIGAT:
GARAGE OPENER: X CLOCK: MEDICAL:
HVAC: X DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: X FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: X HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL#OF SYST MS:
Owner: Contractor:
RON POPICK GARY'S VACUFLO INC
15395 SW DELINE STREET 9015 SE FLAVEL
BEAVERTON, OR 97007 PORTLAND, OR 97266
Phone: Phone: 775-2042
Reg#: LIC 069047
ELE 985JLE
FEES Required Inspections
_Type By Date Amount Receipt Low Voltage Inspection
PRMT BON 09/241199E $60.00 99-318603 Elect'I Service
5PCT BON 09/24/199E- $4.2.0 99-318603 Elect'l Finel
Total �$64.20
ORIGINAL
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. Ali work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is susr ended for more than 180 days. ATTENTION: Oregon law
CL requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in (JAR
952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246-1987.'"----7 9
Issued by ,C1� Q --- Permittee SignatureI�C ==� �?�
OWNER INSTALLATION ONLY
The installation is being made on property I own which Is not intended for sale. lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY _W
SIGNATURE OF SUPR. ELEC'N: _ DATE:_
LICENSE NO:
Call 639-4175 by 7:00 P.M.for an Inspection needed the next business day
CIO'd _1H1.0i KC%t RNA 11:0 ENERGY ELECTRICAL APPLICATION
r'AL"" Rec'b by- Vim, `
1313x(SW HALL BLVD /e TV•^�`J_
• TIGARD OR 97223 PRINT OR TYPE Do Re.d:
V- 503-639-171 X304 {till �,���
F -503 598-1960 INCOMPLETE OR ILLEGIBLE APPUCATIONS Oust C d:
�---� WILL NOT BE ACCEPTED —�
�....,s...a -,.,.�..
Narse of De sianrlsent protect _TYPE OF WORK INVOLVED. R'ie IDENTIAL ONLY
a "Reim S.d Fee- �_
............... ..................... :tw.00
JOB ts (FOR ALL SYSTEMS)
to M
ADDRESS Check Type of Wook Involved:
Zip Phone a q/'Au ylo and Stereo systems
- Burglar Alarm
OWNER Mallin p Address C_/Garage Door Opener'
_ Cbry/ tate 1 Phone A L� Heating,Ventilation and Air Condkioning System*
Name 5:._'*ouum Systems'
CONTRACTOR It ne M ----..
(Prior to Issuance s
TYPE Or-WORK INVOLVEb-COM�IAERCWL LY
copy of all Iloenses ^e free for each*yawn.........................~ �_ b.���
are required if Orstart Co t.Ord Lic.it (SEE OAR 91 a-200.280)
expired in C.O.T Oa
data base Fie -- O Chaok Type of Werk Involvad!
tt
Can r,Lic.M to
❑ Audio and Stereo Systema
C,0 T�oor.Met, A Ex
—" ' �Z ❑ Polle►Controls
0whers Name
OWNER - Mailing Address — 0 cam systems
APPLICANT ❑ Data Telecommunication Instartrtion
Ciry�e Zip hens�
Fire Alamt installation
This petmlt ls bsued under OA 19.32ti 70.Th applicant agrees to
make only reetrlded energy installations(100 volt amps or less)under this HVAC
perrhh and to do the following:
1- Only use eleclrkal licensed persons to do instanatfons where ❑ Instrumeniation
Certain residential and other tranasetlons am ercempt front licernsing. rr----11
.Theme have asterisks('). All others need Ik ensing; Intercom and Paging Systems
2- Call for Inspections when fristailatlon under this permit are ready for ❑ Landscape f"nfion Control'
Inspection at 903.439.4179; ❑
i Medical
3. Purohnse separate permits for all)nstaHatlons Itiat are not ready for an
inspection when the inspector is out to inspect under this permit; ❑ Nurse Calls
s. Asp vme responsibitity for as3uring that all oorectlons required;v the E] Outdoor Landscape Lighting'
inspector are done,end:
5 Assume responsbIlty for calling for a Anal ins ❑ Protaative Signaling
m
coectioms are completed. �O^when all of the
E Omer
permits are non-transferable and non-refundable and expire if work is not l
started within 180 days of Ikst,erica or it work is suspended for t80 days. i
�Q _Number o/Systems
The person signing for this permit must ion the applicant or a person ' r,
authorized to bind the applicant. N0e^"'see required I.Icenses are nrquired sx ant t%her krshomoons
,'Vww
Signature ENTER FEES
tilt SURCHARGE(.OS X TOTAL AINOVE) f L(•
Authority i Oother than Applicant - TOTAL = Z�
�dsRUonneveirek doe alae
2@'d 917:L0 666T-Z2.-d3S
CITY OF T I G A R D MASTER PERMIT
t
PERMITS: MST1999-00176
DEVELOPMENT SERVICES DATE ISSUED: 6/4/99
13125S" .,all Blvd.,Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 13010 SW MORNINGSTAR DR PARCEL: 2S104DD-00500
SUBDIVISION: MOUNTAIN HIGHLANDS ZONING: R-4.5
BLOCK: LOT:004 JURISDICTION: TIG
REMARKS: PATH I: New single family dwelling w/attached gal age.
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACK$ REQUIRED
CLASS OF WORK: NEW HEIGHT: 26 FIRST. 1,500 of BASEMENT: .1 LEFT: 5 SMOKE DETECTORS: Y
TYPE OF USE: 5f FLOOR LOAD: 40 SECOND: 914 sf GARAGE: 1,038 of FRONT: 31 PARKING SPACES: 2
TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: at RIGHT: 22
VALUE: S 187,158.28
OCCUPANCY GRP: R3 DORM: 3 BATH: 3 TOTAL: of REAR: 41
PLUMBING
SINKS. 1 WATER CLOSETJ: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 $F RA'N DRAINS: 1 CATCH BASINS:
TU131SHOWERS: 4 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: 1 GREASE TRAPS:
OTHER FIXTURES
MECHANICAL
FUEL TYPES FURN�100K: BOILICMP<3HP: VENT FANS: 8 CLOTHES DRYER: 1
GAS FURN>000K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 1
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS _ MISCELLANEOVS_ ADD'L INSPECTIONS_
1000 SF OR LESS: 1 0 200 amp: 0 - 200 amp: WISVC OR FOR, 1 PUMPrIRRIGATION: PER INSPECTION:
EA ADD'L 50081': 5 201 400 amp: 201 - 400 amp: 19t W/O SVCIFDR: 00 SIGNIOUT LIN LT: .'EII HOUR:
LIMITED ENERGY: 401 600 amp: 401 • 400 amp: EA ADDL BR CIR: SIGNALIPANEL: IN PLANT:
MANU HMISVCIFCR: 801 1000 Pmp: 601+4mps•1n00v: MINOR LABEL:
1000 amplvoll
PLAN REVIEW SECTION
Reconnect only:
>-4 RES UNI rs: SVCIFDR,1•225 A.: >600 V NOMINAL: CLS ARBAIIIIIIIIIIII 0001
ELECTRICAL-RESTRICTED ENEROY
A..3F RESICENTIAL S.COMMERCIAL
AUDIO 6 STEREO: VACUUM SYSTEM AUDIO l STEREO: r1RE ALARM: INTERCOMIPAGING: OUTO'30R LNOSC L:,
BURGLAR ALARM: 0TH: BOILER: HVAC: LANDSCAPEARRIG: PROTECTIVE SIGNL:
GARAGE OPENER: x CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATMTF.LE COMM: NURSE CALLS: TOTAL 0 SYSTEMS:
Owner: Contractor: TOTAL PEES: $ 5,061.25
This permit is SUbject to the regulations contained in the
RON POPICK ARN CONSTRUCTION
15395 SW DELINE STREE 1 16739 SW PLEASANT VALLEY RD Tigard Municipal Code,State o k w Specialty Codes and
BEAVERTON,OR 97007 BEAVERTON OR 97007 all ether ce with
bre laws. All work will be done it
accordance with approved plans. This permit will expire k
work is not started within 180 days of issuanall,or If the
work is suspended for more thar,180 days. ATTENTION.
Phone: 643-1202 Plana: 628-0963 Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Rpr: LIC 24324 forth in OAR 952-001-0010 through 952-001-0080. You
may obtain ropins of these rules or direct questinns to
OUNC by calling(503)246-1987.
REQUIRED INSPECTIONS
Erasion 844-8444 Post/Beam MechanicaPlumb Top Out Rain draln Insp Plumb Final ,�R I G l N A h
Grading Inspection Underfloor insulation Low Voltage Water Line Insp Final inspectio
Footing Insp Crawl Drain/Backwater Gas Lin,Insp Appy/Shcalk Insp Building Final
Foundation Insp Footing/Fnundation Dr Gas Fireplace Electrical Final
Post/Beam SL ,tural Mechanical Insp Insulation Insp Mechanical Final
Issued By : Permittee Signatures G -
Call (503)639-4175 by 7:00 p.m.for an inspection needed the next business day
CITYOF TIGARD SEWER CONNECTIOK PERMIT
DEVELOPMENT* SERVICES PERMITS: SWR1999-00097
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 839-4171 DATE ISSUED: 6/4/99
SITE ADDRESS; 13010 SW MORNINGSIAR DR PARCEL: 2S104OD-00500
SUBDIVISION: MOUNTAIN HIGHLANDS ZONING: R-4.5
BLOCK: LOT: 004 JURISDICTION: TIG
TENANT NAME: POPICK, RAIN
USA NO: FIXTURE UNITS:
CLASS OF WORK: NEW DWELLING UNITS: 1
TYPE OF USE: SF NO.OF BUILDINGS: 1
INSTALL TYPE: BUSWR IMPERV SURFACE:
Remarks: Sewer connection for a new single family dwelling.
Owner: ---•
_ FEES _
RON POPICK Type By Date Amount Receipt
15395 SW DF.LINE STREET
BEAVERTON, OR 97007 PRMT GEO 614/99 $2,300.00 99-315891
INSP GEO 6/4/99 $35.00 99-315891
Phone: Total $2,335.00
Contractor:
ANCTIL PLUMBING INC
16900 SW MERLO RD
BEAVERTON, OR 97008
Phone: 503-642-7323
Reg#: LIC 00000241
PLM 26-162PB
Required Inspections
Sewer Inspection
a
ORIGINAL
m
WThis Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit expires
..J 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 loceted 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 952-001-0080.
You may obtain copiesofthese r les or direct questions to OUNC by calling (503) 246-1987 ,
Issued byPermittee Signature
✓(' Call (5011)1'6394175 by 7:00 P.M.for an Inspection needed the next busine -cry
CITY OF TIGARD Residential Building Permit Application Plan check«
43125 SW HALL BLVD. New Construction Date e
y L
TIGARD, OR 97223 Single Family Attached Date Recd?-9 9
'� y Date to P.F.
V 503-639-4171 kNL. Date to DST
F 602 664-7297 S` �j� - Permit#
Print or Type
Incomplete or il',egible applications will not be accepted
2wof gg'j-ooQ 14 _
Name of Project ---rte rr Name
Job � �-
Architect Mailing Address hti,
Addressski ��s –,ems, p _
SCtf City/SlatZip I Phone
Nems , 7 -
Mailing Address �r Name
Owner ,- (- e�ar4 J l��f�UC.
--y –� C '�✓�`��nC
Engineer Mailing Addrebs
late Zi Ph
Ci / one
g _
nA 1lm' `j /,zdZ, CRY/State Zip Phone
General Name _ -7 L," r Z
Contractor . �. r\ ! Describe work New 0 Addition 0 Alteration O Repair O
Mailing Address to be done:
Prior to permit i ? - ! e Additional Description of Work:
issuance,a copy Cit /State Zip Phone
of all lice-Ises - ��:
are required if Oregon Const.Cont.Board xp.Date PROJECT -- -
expired in COT uc.# VALUATION
database
database
TO
Mechanical Name NEW Cl1NSTRUCTION ONLY:
Sub- !- t��_, , Ups Sq. Ft. House: Sq. Ft.Garage
Contr"etor Mailings �� _ L L- — 1 t _3
Prior to permit 0 Indicate the restricteh energy installation by the electrical
issuance,a copy C�y/State Zip Phone subcontractor in the follow' g areas_ —
of all licenses --kt_.f, Restricted Audio/Stereo
are required if Oregon,Const.Cont. Board Exp.Date Energy System Alarms
expired in COT uc.# Installations Vacuum Irrigation
_database r L d System System
Plumbing Name l (check all that Other:
rz ♦.t-
Sub- apply) " _ .�
Contractor Mailing Ad eas w 1",4'A Number of Units In Building Unit Number Designation
d?
Has thea Subdivision Plat recorde — N!A �' E NO
Prior to permit /S,at f</ Zip Phone
issuance,a copy
of all licenses are Oregon Const.Cori. oard Exp.Dat
required if LIa# 41" !� � � I heafiy acknowledge that I have read this application,that the
expired in COT �J
database Plumbing Lic.# Exp.Dalp information given Is correct,that I am the owner or authorized agent
/� z {��1 q of the owner, and that plans submitted are in compiiance with
/ f ) 9 Oregon State laws. _
Name Signature of Owner/Ag
Electrical , �L"I c1�I�le. I�.��c�_'i L .�
Contact Person Name on #
Sub- Mailing Address
Contractor r CO-- '� Y
City/State Zip Phone
Prior to permit 1
issuance,a copy jy't V��. by, V<z� 4 1_ �2�� FOR( E USE ONLY:
of all licenses are Oregon Const.Cont.Board Exp.Date
required if Lic.# PI to rO� MP77 f
expired In CO: � _--- —
database Electrical Lic. ExfD to Se ks: Zone-
rf r- y
Electrical Supervisor Lic.K Exp. ate R
ine�ing Approval: Planning Approval: TIF:
i k1�Mlfrxmalera-new doe 11/20/98'
�-
r / �
10130
t
- - - -- ----
-
.
_
1 4b
- - - - - - - - - - - - - - - - - - -
C
I / • 6 I / / - _ - - - - - - - - - - - - - - - - - -
411
4
r —
pj
ks) 1'n I i
,.�
s ° I