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13750 SW MISTLETOE DRIVE Na g013'11SIW MS OSLib w oc w 0 I- w J F- N IL E-- N N O ti M r _m U! J 13750 sW MISTLETOE DR CERTIFICATE OF OCCUPANCY CITY OF T I C;A R D PERMIT M MST99-00010 DEVELOPMENT SERV;%E,S DATE ISSUED: 1/26/99 13125 SW Hall Blvd.,Tigard,OR 97223 (303)639-4171 PARCEL: 2S109BA-05700 ZONING: R-7 JURISDICTION: TIG SITE ADDRESS: 13750 SW MISTLETOE DR SUBDIVISION: HILLSHIRE SUMMIT NO. 2 BLOCK: LOT:041 CLASS OF WORK: NEW TYPE OF USE: SF TYPE OF CONSTR: 5N OCCUPANCY GRP: R3 TENANT NAME: REMARKS: PATH I: New single family dwell;ng w/attached garage. Final Inspection Approved 7/26199 by Ke i Srhriendl, Building Inspector Owner: J P CONSTRUCTION LLC 10275 SW GULL PLACE BEAVERTON, OR 97007 Phone: 524-3295 Contractor: J P CONSTRUCTION 10275 SW GULL PL BEAVERTON, OR 97007 Phone: 524-3295 Reg#: IL x H N t>0 (9 W This Certificate grants occupancy of the above referenced building or portion thereof anv! confirms that the building has been Inspected for compliance with the State of Oregon Specialty Codes r the gro p, occupancy, and use unsiller which the referenced permit was Issued. 1A 1 BUILDING INSPECTOR BUILDIN FFICIAL POST IN CONSPICUOUS PLACE CITY OF TIGARD BUILDING INSPECTION DIVISION 119ST 24-Hour Inspection Line: 639-4175 Business Lina: 639-4171 SUP Date Requested -7!t k- (c�1 AM _PM BLD _ �M Location ) '3 !S D L11'2�t.X � Suite _ MEC Contact Person 1J6 Y) Ph PLM -_- Contractor Ph SWR 18JULD11f[a> Tenant/Owner ELC -- Retaining Wall ELR Footing Access: / ftW FPS ��p Foundation y n co C'f��✓ Fig Drain 1•�, SIGN Crawl Drain Inspection Notes: Slab _ _.— _ SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alam Susp'd Ceiling Roof Misc: - r PASS PART FAIL - --- ---- ----. --PtMBING Post 6 Beam Under Slab Top Out Water Service Sanitary Sewer _— Rain Brains Final -------- ------__- _ PASS PART FAIL Post&Beam Rough In GasLine --__-.- ----- -_--_—__ _ __------- _-_�_ Smoke Dampers ASS PART FAIL RICAL n' Service � Rough In - -�-- -- N UG/Slab Low Voltage J Fire Alarm Final PASS PART FAIL W SITE Backfill/Gran!, g Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next inspection. Ray ai City Hall, 13125 SW Hall Blvd Catch Basin I ]Please call for reinspection RE: I — I ]Un3ble to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date 7-26- 99 —inspector Ext Other _ ----- Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. w -b lu Ii J sC O 'f. �i9�i ui 11. L 5� W c 0.O _ (1�'Qo n at�iii 2 °Dt�i �! N� :` cam GO O O N N O 0 0 cq U LL U) v ro w w w w m m cw7 cwa co _1 vm o *� =J r G d o 2 Z !n Z "r N cA N r N N N J a uwi � a i � a a ¢ c m (L n n. CL' CL a LL ro H m as D N C O U yN„� m0 CL 4 N AN W N Q U re Q IL IK c J m o d E m ll! 2 V! m C R D L° W O _ c �Q(yjj _ c m N 4 a L G c > $ c [o v Z 6 c n Q S n ani N c Fa ' a m 1 O� 75 ro m a a U a s rz e w L rL a a C) a a 1u IL NCY) C41A O N f0 O 'V M 1A app O r M h O �d 1A OD S O O rJ O O c, - - — h 1'4 a a a a a Q a h h h h h h h h h h h h h h h h h h h F !- F- FA to in to to (n to N !A N N N !A N U) N 'm n r� V N N N C � m OL E Nov A € g IL C aO C G) 3 8 C G d -F. T L u i17 c �• Gam. G1 V U Y C N lD c (D 13 G 1 y Af. v g o _ .20rN i elnc CL �i In a r3 n n a c3 a vii u��S i� n� a 1 O 0 Q a Qd a a LL !3. w w Q a Qa Q Q� Q C 4 O f` m cn (ri.3 !n V) to WW Cl) (n (n cn Q to 0 (n � � C7 Y Y X an Y Y Y N O Cn n m a oc W 13 N CL C vai c s� c C Y IL C_ U .Q C G .0 Cn C U CM N C1 �i C c Q ¢ E 32W �' ro CL ' t�/p� ('0 LL LLCC..II 1N(� — f]� It 11�� CJ IGLU 1� C LL�7 MN N (O tD 01 O� Qni 0 a6 Ql Oi a n N cV t� T Oi O' (D ap aj n n n n n h• n r- G OO 0 o n n n n n r- n Of Q Q Q d Q 4 Q Q Q Q Q Q Q Q 4 Q Q Q Q Q h !- h h !-• F- h h CITY OF TIGARD BUILDING INSPECTION DIVISIONt 24-Hour Inspection Line: 639-x175 Business Line: 639-4171 MST BUP J Date Requested L _AM PM BLD Location r ?�_ C)��1 ( Suite ME _ - Contact Person ( kV) Ph a PL Contractor Ph SWR e,UILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundatin,. , FPS Ftg Drain " � SGNcrawl Drain — _ Inspection Notes:2 I ,�� „/ 1 �Y -- Slab ,�I(� �V SIT Post&Beam Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm r+- Susp'd Ceiling __ AV Rc of Misc: _ — - ------ Final PASS PART FAIL — - --- - — -- --— — -..--_ Post&Beam --�— -- ----- -- ------__-- _ _— Under blab Top Out Water Service Sanitary Sewer Rain Drains PART_FAIL. _�— MECHANICAL Post&Beam Rough In Gas Line — Smoke Dampers Final -- PASS PART FAIL CL ELECTRICAL _..------.--___.. _—_ --- — --------------- -- _- aC Service N- Rough In UG/Slab Low Voltage Fire Alarm m Final PASS PART FAIL W SITE Backfill/Grading - --- �- - — Sanitary Sewer Storm Drain [ ]Rein,per-tion fee of;_- _required before next inspection. Pay at City Hall, 13125 SW Hail Blvd Catch Basin Cat Supply Line [ ]Please call for reinspection RE: __-__. _-__._ _ __ ! ]Unable to inspect -no access FireADA '� Approach/Sidewalk Uate EXt 32 Other Inspector ,,�/ — Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD PLUMBING PERMIT DEVELOPMENT SERVICE PERMIT#: PLM1999-00211 13125 SW Hall Blvd.,Tigard, OR 97223 (50RPJ 1 A ATE ISSUED: 2SI0 9 PARCEL: lS109BA-05700 SITE ADDRESS: 13750 SW MIS I .ETOE DR SUBDIVISION: HILLSHIRE SUMMIT NO. 2 ZONING: R-7 BLOCK: LOT: 043 JURISDICTION: TIG _ CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFI-OW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURESLAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: It WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Installation of residential back flow prevention device. FEES Owner: _ _ Type By Date Amount Receipt SHARAYFIA, EYAD & CHANEL PRMT DEB 7/13/99 $25.00 £9-316807 13750 SW MISTLETOE DR MISC DEB 7/13/99 $1.2.5 99-3'3807 TIGARD, OR 97224 Total $26.25 Phone 1: Contractor: CANBY PLUMBING 805 NE ATH AVE '" CCB EXPIRES 8/2/200 REQUIRED INSPECTIONS CANBY, OR 97013 — — ----- RP/Backflow Preventer Phone 1: 266-2091 Reg#: LIC 00033572 Final Inspection PLM 3-7PB i I i This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. i Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. I ' This permit will expire if work is not started within 180 days of issuance, or if work is suspender] for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notificat;on Center. Those rules are set forth in OAR 952-0001-0010 throw h OAR 952-0001-0080. Yo Main copies of these rules or direct questions to OUNC by calk g 503) 246-1987. I sued By: V � LPermittee Signature: ---- Call (503)639-47119 by 7:00 P.M.for an inspection needed the nA business day CITY,OF TIGARD Plumbing permit Application Ulan Chs • 13125 SW HALL BLVD. Commercial and Residential Recd B , c,4)- TIGARD, OR 97223 Date Recd 7-15 (503) 639-4171 Date to P.E. Print or Type Date to D T Incomplete or illegible applications will not be accepted Permits zH 1999-c;oAll Related SWR 0 Called Name of Development/Project FIXTURES (individual) - QTY PRICE AMY Job I Sink 11.50 - Address Street Address 15uite Lavatory 11.50 aT L r. U 7�/� Tub or Tub/Shower Comb. 11.50 Bldg 0 �IIY/Slate ?ip - V Shower Only 11.50 N Water Closet 11.50 l -L( Dishwasher 11.50 Ownerlir'Address suite Garbage Disposal 11.50 Of M I TLE Washing Machine 11.50 C' /Slate Zip Phone -7Z� Floor Drain/Floor Sink 2" 11.50 r Name 3" 11.50 4" 11.50 OCCL:-%ant Mailing Address Suite Water Heater O conversion O like kind 11.50 Gas piping requires a separate mechanical permit. City/State Zip Phone Laundry Room Tray 11.50 -- Urinal 11.50 Name Other Fixtures(Specify) 15.00 Contractor Mailing A dress i. ite 3('`S n1 C ti� A 1J t_ _ - Prior to permit City/State Z� Phone - - issuance.atopy 0t),)-,7,1 1 C<< l�r l .il(tie-1�Ql of all licenses are Oregon Const.Cont.Board Lic.0 Epate - required if -, iI'll)f' , t pl _c d expired in COT PlWnbing lAc0 E p.9ate databaSewer-1st 100' - - _ 39.00 Name Sewer-each additional 100' 32.00 Architect Water Service-1st 100' 38,00 o. Mailing Address Suite Waier Service-each additional 200' 32.00 Engineer City/State Zip Phene Storm R Rain Drain-1st 100' 3800 9 Stone&Rain Dmin-each additional 100' 32.00 Describe work to be done: Mobile Homc 6pace _ 32.00 New O Repair O Replace with like kind Yes O No O Commercial Back Flow Prevention Device 32.00 Residential O Commercial O Additional description of work: Residential Backflow Prevention Device' 19.00 jg.601 Catch Basin 11.50 Insp.of Existing Plumbing 50.00 Are you capping,moving or replacing any fixtures? per/hr Yes O No O Specially Requested Inspections 50.00 If yes, see back of form to indicate•.4ork performed by r/hr fixture. FAILURE TO ACCURATELY REPORT FIXTURE Rain Drain,single family dwelling 45.00 WORK COULD RESULT IN INCREASED SEWER FEES. Grease Traps 11.50 1 hereby acknowledge that I have read this application,that ttie information QUANTITY TOTAL given is coTect,that I am the owner or authorized, of the owner,and isometric a riser diagram is required N Quantity Total is that n submitte in com li with Oreo State Laws. g u of Own rt A en Date qq 'SUBTOTAL rl 7%SURCHARGE Contact rerann Name Phone •R "PLAN REVIEW 27%OF SUBTOTAL - .11 BATH HOUSE$178.0C Required anty H fixture qty,total h>9 2 BATH HOUSE$250.00 - TOTAL 3 BATH HOUSE$285.00 (This fee Includes all plumbing fixtures In the dwelling and the first 100 feet of sanftary newer storm sewer and water service) permit fee is$50+7%surcharge,except Residential Backrlaw Pmventlon Oevke,which Is$25 4 7%surcharge "All New Commercial Buildings require plans with Isometric or riser diagram and plan review PLEASE COMPLETE: Fixture Type Quantity by Work Perf rmed New Moved Replaced emoved/Capped Sink — — —_ --.----.-._ Lavatory Tub or Tub/Shower Combination Shower Only Water Closet Dishwasher — Garbage Disposal Washing Machine Floor Drain/Floor Sink 2" 411 Water Heater _ — Laundry Room Tray Urinal Other Fixtures (Specify) COMMENT'S REGARDING ABOVE- 1 WstA%formMphnnepp doc 7/9199 CITY CF TIGARD DEVELOPMENT SERVICES MASTER PERMIT F'L`RMIT # . , . . . . : MST99-..001 13125 SW Hall Blvd., Tigard,OR 97223(50.2)639-0171 DATE ISSUED: 01 /26/99 PARCEL: LS 10914A-P.5700 TTE ADDRESS. . . : 1.3750 SW MISTI-ETOE DR 'JSDIUISIIN. . . . :FIIL_L.SI)7R S1IMMIT NO. 2 T.ONINJ: k-7 PD DL.00I;. . . . . . . . . LUT. . . . . . . . . . . . . .0A7,, JURISDICTION: TIG Remarks: PATH I: New singe family dwelling w/attached garage. -------------------------- --------------- - - - -- BUILDING ---------------------------------------- RE I T_tE: ------------_ - REISS!E: STORIES.......: 2 FLOOR ARFAS----------- BASEMENT...: 0 sf REQUIRED SETBACKS_--- REQUIRED------------- CLAS" OF WORN.:NEW HEIGHT........: 26 FIRST....: 1794 sf GARAGE.....: 672 sf LEFT........... 9 SMOKE DETECTRS: Y TYPE 7r U`51...:SF FLOOR LOAD....: 40 SECOND...: 1706 sf FRONT.........: 35 PARKING SPACES: 2 TYPE OF CONST.:5N DWELLING UNITS: 1 FINBOW: 0 sf RIGHT.........; B OCCUPANCY GRP.*R3 BDRM: 4 BATH: 3 TOTAL------t 3500 sf VALUE..f: 256071 kEAR..........: 68 ------------------------------------------------------------ PLUMBING --- ----- ---- - ---------------- ---- SINE'S.........: 2 WATER CLOSETS.: 3 WASHING MACH..: 1 LAUNDRY TRiYS.: 1 RAIN DRAIN ft: 100 TRAPS......... : 0 LAVATORIES....: 5 DISHWASHERS...: 1 FLOOR DRAINS..: 0 SEWER LINE ft: 100 SF RAIN DRAINS: I CATCH BASINS.. : 0 TUB/SHOWERS...: 3 GARBAGE DISP..: 1 WATER HEATERS. : 1 WATER LINE ft: 120 BCKFLW PREVNTR: i GREASE TRAPS_: 0 OTHER FIXTURES: b MFCHMUCAL ------------------------------------------------------ FUEL TYPES----------- FURN ( IM ..: 0 BOIL/CMP ( 3HP: 0 VENT FANS.....s 4 CLOTHES DRYERS: 1 GAS FURN )=loom ..: 1 UNIT HEATERS., : 0 HOODS....... .: 1 OTHER UNITS...: 1 MAX TNP.: o BTU FLOOR FUPNACES: 0 VENTS......... : 0 WOODSTOVES....s 0 GAS OUTLETS...: 1 —------------------------------------------------------------- ELECTRICAL --------------------- --RESIDENTIAL UNIT--- ---SERVICF/FEEDER--- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS-- ----MISCELI.t E0U5---- --ADD'L INSPECTIONS- 1000 SF OR LESS: 1 0 - W. alp..: 0 0 - 200 alp..: 0 W/SVC OR FDO .: 0 W/IRRISATION; 0 PER INSPECTION: 0 EA ADD", 5005F.: 7 201 - 400 alp..: 0 201 - 400 alp.,: 0 1st W/O SVC TDR: 0 SIGN/OUT LIN LTi 0 PER HOUR......: 0 LTMTTED ENERGY.: 0 401 - 60P amp..: 0 401 - 600 amp..: 0 EA AODL PR CIR: 0 St[iHAf.iPANEI...: 0 IN PLANT....... 0 MANE HM/SVC/FDR: 0 601 - 1000 amp.: 0 C81+88ps-1000 v: 0 MINOR LABEL -10: 0 ;000+ amp/volt.: 0 --------------------------------- PLAN REVIEW SECTION ----------_�_� -----_----- Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)=225 A.: ) 600 V NOMINAL: CLS AREA/SPC OCC: -------------------------------------------- ELECTRICAL - RESTP,ICTED ENERGY ..Y--------- ----- -------------- A. qr RESIDSNTIAL—------------—---------- B. COMMERCIAL-----------------------___-_—.---------------- --_____ ----- AUDIO 6 STEREO.: X VACUUM SYSTEM..: X AUDIO t STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT: BUIPMPR ALARM..: 0TH: :: BOILER.......... HVA:............: LANDSCAPE/TRRIG: PROTECTIVE SIM: GARAGE OPENER..: CLOCK..........: INSTRLMIENTATION: MFDICAJ........ 'MR: HVAC...........: DATA/TELE COMM.: NURSE CALLS....: PJTAL L) SYSTEMS: P Owner: -----------------------------------Contractor: -- ------------------------ TOTAL FEESO 5495.06 I D CONSTRUCTION LLC J P CONSTRUCTION This permit is subject to the regulations contained :,i the 10275 SW GUL_I- PIAT 10275 SW GULL FL Tigard Municipal Code, State of Ore. Specialty Codes and all BEAVERTON OR 9700? BEAVERTON OR 97007 other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is Phone li: 524-3295 Phone 1: 5^4 3295 not started within 180 days of issuance, or if the work is Reg R..: 120868 suspended for more than 180 days. ATTENTION: Oregon law ---------—-------------------------......_-----------—---------.- requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAq 952-001-0010 through CAR 952 fl01-00BA. You may obtain copies of these rules or direct questions to UUWC by calling (503)246-1907. ------------------------------------ - RE011TRED INSPECTIONS --------------------- ------- --- ------- -- Erosion 8444444 Post/Bear Mechan Electrical Servi Gas Line Insp Electrical Final Grading Inspecti Crawl Drain/Back Electrical Rough Insulation Insp Mechanical Final Foo+irg Insp PLM/Underfloor Framing Insp Rain drain Insp Plumb Final _ Fnurda+ion Insp Mechanical Insp Shear Wall Insp Water Service In Paildin Final - 41Brae St rt ukb Topp 00 Low Voltagp AppriSdwlk Insp ' , .:ed y' : � �11 R'ermittee Sigriaturee . + + 1 , , .V s + r +.+ , , ., + r , 1 A +4 + r +++4++++-s+++4..+..+.+4 ,,.4.+++f 4 + + 1 o ,.+.+ +_4+4-4-+,+++ Call 6-39--4175 by 7 00 p. m. far an inspection needed t e next husiness day CITY OF TIGARD AL�aDEVELOPMENT SERVICES SEWER CONNECTION 13125 SW Hall Blvd., liyard,OR 97223(503)6394171 PERMIT PERMIT #. . . . . . . .. SWR99-0003 DATE ISSUED: 0I /26/99 PARCEL: 25109BA-05700 ITE ADDhESS. . . : 13750 SW MI GTLETOE OR 7URDIVTSION. . . . :I-1TI-LSHIRE` SUMMIT NO. 2 ZONING: R-7 PD r1-OCK. . . . . . . . . . LOT. . . . . . . . . . . . . :043 JURISDICTION: TIG ---------------------------------------------------------------------------------------- TENANT NAME. . . . . :J P CONSTRUCTION LLC: ISF,% NO. . . . . . . . . . : FIXTURE UNITS. . . a 0 "LAGG nr WORK. . . :NEW DWELLING UNITS. . s 1 TYPE OF USE. . . . . :SF NO. OF SLIT LD I WrS: 1 "'hISTAI..L_ TYPE. . . . :LTPSWR I MPERV SURFACE: 0 5 f '2ema1^ks : Sewer connection for, a new single family dwelling. Owner-. _ _._. _...._....__....._....._... . . ......_.._.....____.__.__ __.__.._...__.___..___.__._._. . _ FEES _.__.—_—__—__.__ J P CONSTRUCTION type amlolAnt by date rerpt 102175 SW GULL Pl-nrE r RMT t 2300. 00 DEB 01/26/99 99--312439 BEAVFRTON OR 97007 TNSP $ 35. 00 DFB 01/26/99 99-312439 Phone #: Conti-actor: nwNCR Phone+ #: ! 2335. 001 TOTAL_, Reg it. . . - ---- REOUIRED INSPECTIONS --- This Applicant agrees to comply with all the rules eid regulations Sewer, Inspection of +he Unified Sewage Agency. The permit expires IN days from the date iSSqed. The total amount paid will be forfeited if the permit expires. The Agency does net guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement _ given, the installer shall p-obpect 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. P7FNTION: Oregon law requires you to follow rules adopted by the Oregon Utility Nctification Center. Those rules are set forth in CZAR 9152401-OO1P through OAR 952-8081-0P88. Vou may obtain copies of _ +hese rCby t questions to Off by calling (503)246-1487.--) _. _ F'ermi.ttee Si gnat tn-e:_ i 1 4 4-+•4-++4.+--4•++++4.4-+++-+-+4-++++++++4++++--++++4•++•+++++++++4-+4-4-4-+4-+++++++4..+++++++ Call. 639- 417n by 7:00 p. m. for an inspelction needed the next bkASiness day i-++++++..++++++++++.4.4-++++++++++4-+++•++4-4•++++++++++++++++++.4-4.+++++++++.4-++++++•+++ CITY.OF TIGARD Residential Building Permit Application Plan Chock# t I- C 13125 SW HALL BLVD. New Construction Recd By-`- byte Recd L7/ / 7_ IGARD, OR 87223 Single Family Detached 503-639-4171 Date to P.E._ t-/3 � slate to DST-E! -1-9 f— F 503-684-7297 ourm"t 0 rte- Print or TypeL,f Incomplete or illegible applicat'-me will not be accepted _ 150 >�9-•o o a Name of Project � � - — Name J,bb ? �a l.rf 3 ;Ils�,�t SvrNMi�' '`� 4!� 13 °�' vor Address Site Address Architect Mailing Addroos 13 ,-SO 5 )1 N S Fl e o` - City/State Zip Phone Name Name A Owner Moiling Address / I' ,,t_ ^E�iC nl Cnh/St TRti (&) En ineev Meiling Ad $a C /State ZIP Phone !-TW N It 1.1 t r177 " -P4-3 x9 S" C y/state Zo I Phone General Name __ ?�907 399- Contractor �D IA� A VII Desciibework NewOk Addition Alteration Repair Mailing Addrosa to be done: Prior to permit /077 W &WI p( Additional Description of Work: 'rsuance,a copy CRY/State ZIP Phone of all licenses lout► o N c/ 47r1c'7 are required If Oregon const.Cont.Board Exp.Date PROJECT 2-0 expired In COT L c�pVALUATION ;2,_57(, 07l __.. ustsbase /s�G'E3(v , -AJ 3-,l "' 1 1 Mechanical Name NEW CONSTRUCTION ONLY: Sub- r-� {,a G� Me la1 Sq. Ft. House: - Sq. Ft.Garage Contractor Mailing Address JI ____ __� �:t• Prior to permit N I,} 3 Indicate the restricted energy installation by the electrical Issuance,a copy CRY/State �Z�IP� � Phone subcontrarior;n the followingareas ! of all licenses fS c„ rr [ �,� _l=,l._ &49 sl I Restricted Audlo/Stereo are required If Oregon Const.Cont.Board Exp. 'Note Energy System Alarms a expired In COT Lic.A �„ Installations i Vacuum Irrigation database 438b-S " V System System Plumbing Name (check all that Other: -- appl Sub- C`el 0ing Address r)wic (�. Numyber of Units In BuildingUnit Number Designation C JntraCtOr Melling Address � 9 �� UC 4 Has the Subdivision Plat recorded? N/A YTS I NO Prior to permit City/State zip Phone issuance,a copy q.,�) O•' 7013of all licenses are Oregon Const.Cont.Board Exp.date required if LicA expired In COT i Shc1 A database Plumbing Lio.# Exp.Date I hearby acknowledge that 1 have read this application,that the /� information given Is correct,that 1 am the owner or authorized agent 7 �1� H �' of the owner,and that plans submitte a n complianr a with Name Oregon State laws. Electrical L G, Irri a vL Op L.T,r Signature of Owner/Age Date Sub- Mailing Address VqA� /42-94 tar Contact Person Na Phone# Contractor 9,4x1 se T✓ q4S _ Jokes �l�ps Saa-��95" City/State Zip Phone -- Prior to permit Issuance,a copy Ni 14 o C 01 1-171,X3 19*. . —L--- FOR OFFICE USE ONLY: of all licenses are are Oren locust.Cont.Boa xp.Daterequiplat#: Map/TL#: expired In COT ( 36i5 _ �y-K� - _ i�' T _ �� r 7KD database Electrical Llc.0 Exp.Date et s: Zone: 1- 373 t:- /0-1- f r�E. _ .e-2 E rival Supervisor Lic.* Exp.Date Engln ring Approval: Planning Approval: TIF u �- �� '� 5 �d/ Fklstslformsbfd-new doc 1100/98 -+� sw�g9—noa9 `` p 01 w 15 �3 1 i I Iz Q94 � 1 °� Ln VIt Qvi ci 1A cj- I � � ?^ cli ct } ---- i