13581 SW LIDEN DRIVE U�
On
m
W
c�
H
d
Z
H
1
I
fi
I
f"
I�
fs7 {
� 11
13581 SW LIDEN DRIVE
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line CeilinguM
Post/Beam P.1ech. Shear/Sheath Framing -Mech.
Plbg.Und/Flr/Slab Plbg.Top Out Insul-ition -Elect.
Post/Beam Struct, Mech. Rough-in Gyp. Bd, -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: —
Date: _1,-r ( _ A.M. —P.M.�,(_ Entry:
Address: _27Lr ,__
Tenant: _—__-- Ste:— MST:
t3UP• —
Con/Own: _ _ MEC:
PLM:
ELC _
THE FOLLOWING CORRECTIONS ARE REQUIRED ELR: _
Inspector __ Dater
APPROVED _DISAPPROVE D/CAL L FOR REI NSP. CF CO
r CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Framing ec
Pibg Und/Flr/Slab Plbg. Top Out Insulation Elect.
PosUBeam Struct. Mech. Rough-in Gyp. Bd. (E3Idy;�
,an. Sewer Gas Line Appr/Sdwlkeirt
Other: -- e? - -
Date: ,.- l A-1 49_ A.M. ^P.% Entry.
Ad-tress:
Tenant - _ Ste:__.. PAST: _q_r_0 � j
BLIP:
C.m/Own: .,L �.-- ' --- IAEC:�_
—_- ---- ----- - PLM:E:LC: _
THE FOLLOWING CORRECTIONS AHE REQUIRED ELR:
Inspe for �C -------.. - Date: 2-1 INo -b
-_APPROVED _DISAPPROVE D/CALLFOHREINSP. CF
CITY OF TIGARD
DEVELOPMENT SER110ES
13125 SW Hall Blvd., Tigard,OR 97223 (5(3)639.4171
L.L.RCIF'ICATE OF
OCCUPANCY
PERMIT 16. . . . . . . t MST96 02-,
DATE. I SSUED s 12/18/96
PARCf:L.s ea104BA-112-00
SITE ADDRESS.. . . t 1358t SW L.I.DEN DR
aLISD I V I G I ON. . . . a CAST LE. H I L L IVO. 3 20N T NG s R--1 P fats
BLOCK. . . . . . . . . . t LOT. . . . . . . . . . . . . t 14r"_'
CLASS OF WORK. a NEW
T'Yr-" OF USE. . . t 5F
TYPE OF CONST R:5N
CICCUPANCY GRP. s R3
OCCUPANCY L LAD t c
Romairwe % path i
Owners _.__...__....._..-_____.....w_._...._..__.. ..._. _.._....._,_.___
D014 MOP I SSETTE
5000 ,W MEADOWS RD
GUITE 1`i1
LAPSE. OSWEGO OR 976.35
Phane #s 620--7538
C'r.►nt rac•t ar s ___._..._...__._.......---..__.._.__._. _...___._.._... ..... _.
DON MOPISSETTL HOME:
5000 aW MEADOW;; RD
51JITr 151
I-AKE OSWEGO OF? 97035
Phone *% 6%'20-7538
Rep tt. . . 35533
Thi q C;et-t: i icatt e grants occupancy of the above referenced bui ldintl or r+art ac►n
thereof atnd confirmf that the butes ing has been inspected for comp lance with
the Gtate of Oregon Specialty Cndes for the group, occupai -y. and Mme undo
which the r e f e v er epi p 9 r m i t w.as J.gv�uwH. /
I I L 1 I Nf3 , NS,F'�.I:l O R F?lJ
v
POc r IN CONSPICUOUS FIL_ACE
STER 1',
-1
CITY
M0 OF FERM #ERMITIT . . . . . . . "IST96-0291
✓
COMMUNITY DEVELOPMENT DEPARTMENT DATE 1S1.*1LJED: 08/01 /96
131125 SIN Hall Blvd.Tigard,Oregon 97223e8199 (503)539.4171 0413A--1 .L:::i1:1
ADDRESS. I '...)W L.IDEN DR
GLIBDIVISION . CASTLE HILL 190. 3 ZONINCi: rt PD
SLOCJ�.. . . . . . . . . . L01.. . . . .
Remarks: path i
--------------------------------------------------------------- BUILDING ------•----------------------------------------
REISSUE:
--------------------------------------------REISSUE: STORIES..,.,,.: " FLOOP AREAS---------- BASEMENT...: 0 sf REQUIRED SETBACKS---- PErAJIRED--------------
CLASS OF WORK..-NLW HEIGHT........: 25 FIRLT....- 850 sf GARAGE,....: W sf LEFT..........: 9 5'I0KE DETECTRS: Y
TYPE OF USE... :SF FLOOR LOAD.,,.: 48 SECOND...: 945 sf FRONT.......... 21 PARKING SPACES: I
TYPE Or CONST.:5k DWELLING jNITS: I FINOSMENT: 0 5f RIGHT.........: 5
OCCUPANCY GRP..R3 BDRM: 4 BATH: 3 TOTAL------: 1795 sf VALUE.Ai 124615 REAR..........: 30
------------------------------------------------------------------ PLUMBING ------------------------------------ -------------------- ----
SINKS......,.,:
---
SIWS.........: I WATER CLOSETS.: 3 WASHING MACH..: I LAUNDRY TRAYS,: 0 RAIN DRAIN 't: 0 TRAPS.........: 0
LAVATORIES....- 2 DISHWASHERS...: I FLOOR DRAINS..: 0 SEWER LINE, ft: 0 SF RAIN DRAINS: I CATCH BASINS.. 0
TWSHOWF.Rs...- 2 GARBAGE DISP..: I WATER HEATERS.- I WATER LINE ft: 100 K9FLW PREVNTR: I GREASE TRAPS_ 0
OTHER FIXTURES: 0
--------—-----------—--------------------------------------- MECHANICAL ----------------------------------------------------------------
FLIEL TYPES----------- FURN ( WK I BOIL/CNP ( 3►P; 0 VFNI FAN'S..... : 4 CLOTHES DRYERS: I
/GAS/ FURN )=I@@K 0 UNIT HEATERS.. : HOODS......,..: I OTHER UNITS.,.: I
MAX INP 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES.... 9 GAS OUTLErS... I
--------------------------------------- ------------------------- ELECTRICAL ----------------------------------------------- --------------
--RESIDENTIAL. UNIT--- --SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS--- ---MISCELLANEDtJS---- --ADD'L INSPECTIONS—
1000 SF OR LESS: I @ - 200 alp.,: 0 0 - 40 alp..: 0 W/54C OR FDR..; 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADDIL 5005F.: 3 2"'01 - 400 asp..: @ 201 - 490 amp..: 0 1st W/O SVr/FDR: @ SIGN/OUT LIN LT: I PER HOUR......: 0
LIMITED ENERGY., 0 401 - 600 amp.,: 0 401 - 600 asp,.: a EA ADC)_ BP CIR: 0 SIGNAL/P(AEL,..: 0 IN PLANT...... : @
MW HM/S)C/FDR: @ 41 - 1000 amp.: @ E0I+am.cs-1000 V! @ MINOR LABEL -10: 0
I@@@# amp/volt.: 0 ----------------------------------- PL* REVIEW SECTION ----------------------------------
Reconnect only.: @ )=4 RES UNITS..: SVC/FDR)=225 A.. ) 600 V iOINAL: CLS AREA/SPC OCC:
-------------------------------------------------- ELEC-11CAL - RErTRI7ED ENERGY -1----------------------------------------------------
A. SF RESIDENTIAL------------------------ B. COWRCIAL----------------------------------------------------------------
AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO I STEREO.: FIRE ALARM-- : INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM-: OrH: BOILER.........: HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE jIGNL:
GARAGE OFTENER,.: CLOCK..........: INSTRUMENTATION: MEDICAL........: OTHR:
HVAC...........: DATA/TELE C".: NURSE CALLS,...: TnTPI I SYSTEMS: @
Owner; -----------------------------------Contractor: ------------------------ TOTAL FEES:$ 2815,02
DON MURISSETTE DON MORISSETTE HOMES
5000 SW MEADOWS RD 3000 Sid MEADOWS RD
SUITE I)l SUITE 151
LAKE OSWEGO OR 97035 LAVE OSWEGO OR 97035
Phone #: 620-7538 Phone 4: 620-7538
Reg C.: 35533
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of ure. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is nt started within 180
days of issuance, or if work is suspended for more than IN days.
------•-------------------------------------------------- REPUIRED INSPECTIONS ------------------------------------------------------------
Footinn li,sp PLM/Underfloor Framing Insp Gas Fireplace Water Service In Building Final
Foundation Insp Mechanical Insp Shear Wall Insp Insulation Insp Appt,/Sdwlk Insp Erosion Control
Post/Seam Struct Plumb Top Out Low Voltage Gyp Board Insp Electrical Final
Post/Beam Mechan Fiectrical Servi Fireplace Insp Rain drain Insp Nechanicai Filial
Crawl Drain Electrical Rough Gas Line Insp Water Line Insp Plumb Final
Flev 1a L t,e e 1 1.1 e cl D
.4 11 ia t 1-1 r'E, Ix—
Call foir, inspection 639 4175
i
SE=WE k C LINNEL'T I ON
CITY OF TIGARD PERMIT #. .. .l1.T. : SWR90--0276
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: OB/01/96
13125 SW Hell Blvd.Tigu 1,Oregon 97223.819a (503)636-4171
PARCEL: cS 104BA-1 1200
SITE ADDRE(,35. . . : 12,581 SW L I DEN DR
SUBDIVISION. . . . : CASTLE HILL_ NO. S ZONING: R-12 PD
BLOC;. . . . . . . . . . . LOT. . . . . . . . . . . . . : 14c:
TENANT NC411E. . . . . ..
USA NO. . . . . . . . . . : FIXTURE UNITS. . . : 0
CLASS 01--' WORK. ., . :NEW DWELLING UNITS— : 1
TYPE OF USE. . . . . ..aF NO. OF BUILDINGS: 1
IN STALL TYPE7. . . . :BUSWR I M1='I:RV SURFACE: 0 s f
Remark B : PATH I
Owner-: _______.__________...___________.___ ____.__._____.___ _._____._- FEES _..........._____._.__.._.._..__..
DON MCRISSETTE type am%)1.rnt by date recpt
5000 SW MEADOWS RD PRMT' $ 2200. 00 .,SD 08/01/96 96--262408
SU I TE 151 .1 NSID $ 35. 00 ..SD 08/01/96/96 96 _8:_4o0
LAKE: OSWEBO OR 97035
Plhone #: 620--7538
Contractor: —
CONTRACTOR NOT ON FILE:
E bone #: $ 2235. 00 TOTAL
Flet' #. .
_ ....._..._ REt;U I RED I NSPECT I ONS
This Applicant agrees to comply with all the rules and regulations Sewer-, Inspection _
of the Unified Sewage Agency. The permit expires IN 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 1n all directions from
the di.tance given. if not so located, the installer shall purchase
A "lap and Side Sewer" Permit and the Agency will install a lateral,
,r mittee 5i gnat1_rre
'a S tl a c1 ,B Y: �:/., ��. r 4,:4.' _..,c.i
Ca 11 for inspection — 639--4175
I
Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 9,7223
(503) 639-4171
Jubsite Address:
Subdivision: L CxK`3} �� �� Lot# Office use Only
// Contact Date c'" f,: f _Initials
Valuation: /�- `,y [c ) . — Result f t'r)ti
New Construction Only: (Square Footage) Planck/Rec #
House: �/ - __— Garage: _ ! '"' Permit # h1 S f S� - U = /
Reissue of .k,//
Corner Lot? Y N Fla Lot? Y N Map & TL #
9 Zone
Owner: �� �Jf=
)� l �r�l�l� Plat
Address: Approvals RE_qutred _
Planning Setbacks Solar
Engineering .
t
Phone: Other
L��L�Si�,% ' � J ------"
Contractor: 5P*__-1 C �`Z Items Required
Subcontractors
Address: _ _ _ _._ Truss Details
Other
--^--�.__ Notes
Phone:
Contractor's License # q D_
,. attach copy of current Oregon license)
Contact Name: _L"
Contact Phone:
Subcontractors: /� Arch itectlEngineer� -)-V
k .
Plumbing , F�LI>��t �� �U Address: — — —
Mechanical:' `
(attach copy of current OR Contractor's license)
(j D i. Phone: LIL( )�
r
JOB DESCP;PTION:
Applicant Signatu e 1� Applicant Phone number — 4—J--�
Received by: ,��► V� �` Date Received:
N- _M
H Yopnhn:•uoD
v
Permit At Account Description Amount Amt. Pd. Bal. Du
IriS (V l/ Bldg. Permit (BUILD)
Plumb. Permit (PLUMB) 1� $"—
Mach. Pemiit (MECH) v ?,i
State Tax (TAX)
Bldg:
Plumb: _
Mech: %
Plan Check (PLANCK) ' 7?•U
Bldg: -522- n
Plumb:
Mech: ��'. t� �i►, ff `
U [ Sewer Connection (SWUSA) o a o1yu_
Sewer Inspection (SWINSP) 3 3; ---
Parks Dev Charge (PKSDC) USS a 'y
Residential TIF (TIF-R) 2 0 �...-
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
...duntrfal TIF (TIF-1)
Institu;conal TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WQUAL) --
Water Quantity (WQUANT) /o o
Fire Life Safety (FLS)
Erosion Cnirl Permit (ERPRMT)
Erosion Flancl•JUSA (ERPLAN) Cq%- go
Erosion Planck/COT (EROSN)
TOTALS: G Vo, -L
_-,-�• :F:asr -!-E�:i:.�v rct•+�rs�r, � �r7?.6�v"•+as _:.......=-.3 .. :r7 �:'?: �.J3• :.'
.L f1�•a . w•• ht::7 .i•Sri I � •'•'' Q•'• i7 i' f•'�if1• •7i' T.•.;.
�}'jy:'��i�, �i�j!'�' t �S� �,�tj•. ••.�!r'' r ••,;• ,s; ,t.��,t4.z. y.y. ,. \;• ;;�%y s•' i /• .. 4s. t;
71Ji:. t i ��'+'.:�{::Z.;.j; +t\T.Ot;.. {O6S41;r1: (\�!!•tlw.y:•'•S.�/ � :t\A 7; { �_�!!:' +;_���'� v
y f.' ,; tt rr•y rr1 � •r f •.r •��� t t�•',is�• 'S�'. ,•,,• s i _
'���y.(�,�L �; ,.:ti 4• 7t r;•;,�,s; :�. � u;•1 �sem, ,,,. ;�, , s' �t j s.s�.s• ••;•
,':^''�l ,S J.•�yt,.4 :'�/ �.�7 'i �':' :.�� J.1.,S, fY+1�•'; :�2� ��;".ri•� �1� �,f:;•• .�.�'t ••
•. "'' .'•.�j.�.
•��.•��• SII:�•I.
••l�rr: Cate Issued.'
::tit;'' �'� � (J� �'� �•"!;'tt..
7rZ4A-_lC'!Mr'.4C7 FEE � � C r` � '``, r�'••'
�" Cn.�:7�VOUC��� � •:: itr
7 :!y !n is ^rdan e x
c ;r7L7 L a ;rs e�.r:loc,TPrt Cor:etatic,r
iRCa'c:'S3 Cr8(1115 ""at=r..;e F.Ccrled tC i it c173ry^eS
Ed-lZ7 Of »:gaits
i«•'•' , a,'4 SL,+'BC::0 "e I
rtd:Ors Cf.�. C r •• '"l.� : ::'.
:•1 •-% .., .J•aS 2r'(1 ibT, ' B i;r
:::;iia. l R!S VCUG~�r�T,u.Si vP "'.'aSe`r's�:a:.'f'8 Jr c<;c•, ••r � C i:�•�:
was;ramed issuarres coda'
M.iin;i::.c'%=_^,rr1�l�'VT .SFr;(+ir'r+ilrrrV t'?./555',"Sd'l;'rSriCl';,
��•:�`
t;,,'6 Ile '07,•c:ea,:ein7,,7{(1.(1'!"c8?:=PG
uccr ;�7! ,'ssL'c.,cr :f 3 bu:7c..'+ :ar,-ri,' J L : r
CA.57% '7,r. 2 3LCCivis;Cr, Wasr
iters ass, rs -,t -�`;C 7,-'-c. r!! o'c',7 s.racy ar,C
fA4Eiii CCnr,-'p'
;;CN, ,•
•SSS'• }, ,��. l7,,+�..' ,i •.q ! �(��.- f{•. .., �:• "�ti;• ''r}s �•�:d:�: S�i�. .��i••fi•:i
`tj•',, 7 � 'Si fr \17,'/+• ,'t' S.S',' . ,t '. ,��t•},S3 1S,lj x'77: ' .� .' •;i1��4.!;• •. •1,�I' ! •'• •••
:;��. 17�� ;r�'"2{S�....r �, '�t: �%'iSf S{. ..p1::7� �•�: :�.� 53'•.1" d.�� ��`• :'�r, S.{�t!' [.. ''7,•f r.•�{.. +a2•.N1'• '.�/ K;:�,,
• a• ', !f 1 yj •• t • 1'�,(7::. i?:. ''•�j= � rC,•:I,'� ",�sst;�'Yt ,.,, i:)' �:. ..>}r: t;_ ' f 5'l'y:
'e,'•,�•:��t�=t ''�3,$;+A� t+�ii"j i i�,.S�! 7 ..��i.' �7��'�•,"•I:•�i�. •1.�••r:SSr..1��\��,ai�,• �;i�i'i�,ii'•7i�•{'''\,•Z.\7,.,i '.�;���41.
DON • MORISSETTE
H a H E a I N C 0 2 P 0 A A T Z D
6000 e. w. YEADO • e ROAD IBITI 101
L Z Z 0 a • E 0 0, 0 Z Z 0 0 N a 7 0 a 5
(eo3) eao •• 7e36 FAX (e03) e30 - 74e6
OBE : 1. 433
LOT: 142
DATE: 05-23-1996
PROPERTY: Castle hill 9
CITY: Tii and
SCALE: 1 =20'-0`
PLAN No.: 105
J " I
71.19' •': '��: .
3.
A b• 119D&M.FT. \
]b MATH \
FFL 1911 20,
V
t / \
\ \ = I*>R� \
Fvno
ue
\ � 5081 FT.
\ D142T
\ YY^ti
\ 9761'
\ T
1J'
J
Solar Balance Point Standard Worksheet
Address 1 �r'�' 1 ,�- ') ( , r`r . 4
Box A calculations: North-South dimension for the lot. Box A:
This dimension is determined by finding the midpoint of the North lot line and drawing
an intersecting line perpendicular to that point.
First, determine which property line is the North lot line. The North lot line is the line
with the smallest angle from a line drawn east-west and intersecting the northern most
point of the lot.
'15°
X—+
\
NOG RN t NORTHERN
nor ur+E \ tot uNE
— N \ North-youth
Dimension for Lot:
Measure the distance from the midpoint of the North lot line to the South lot line along
the described line.
fret
NORTH-SMTH DIMENSIONC�'.�
V
Box B calculations: Shade point height for your residence.
Box B:
1. Determine whether measurements will be based on the peak or eave of your Which describes
structure. The orientation of the ridge is also important. your residence?
1 a: If the roof line runs North-South, measurements will (circle one)
be based on the peak of the roof. To a o o ax"
1A IB 'C
I
1 b: If the roof line runs East-West and the roof pitch is
less than 5/12, measurements will be based on the
eave. -
SHACE Z:'NT EAA
I 1 c: If the roof line runs East-West and the roof pitch is
50 2 or steeper, measurements will be based on the �y,l
peak.
Box B. continued Box B.
?. Measure change in elevation from front property line to finished floor elevation. If
the lot slopes up from the front lot line to the foundation, the figure is positive If
the lot slopes down from the front lot line to the for. dation, the figure is negative.
3. Measure distance from finished Floor elevation to th, affected peak/eave. ft
4. If the roof line runs North-South, deduct three feet. If the roof line runs East-West, - —___ ft
deduct nothing.
5. Subtrzct one foot for each foot of difference in elevation from the front property
line to the rear property line, if the lot slopes up from the front to the rear. If the
lot has no slope or slopes up from the rear to the front, deduct nothing. ft
6. Total figure for box B: ',
jr
Box C. Distance to the shade reduction line. BOX C.-
1. Mea,..,rc the distance from the North property line to the foundation near the ft
affected peak/eave. J
2. Measure the distance from the foundation to the affected peak or eave. + fI
3. Total figure for box C:
ft
It is most useful to draw a vertical line to represent the appropriate figure found in box"A"and a horizontal line to represent the
appropriate figure found in box"C". The intersection of the vertical and horizontal lines determines the value found in box"D".The value
in box "D"should be compared to the value in box"B"; if the value in box"B"is less than or equal to the value found in box"D", then
the building is in compliance with the solar balance code. If you have any questions, please contact us at 679.4171, x304 or at the
Community Development Counter.
MAXIMUM PERMITTED SHADE POINT HEIGHT (In Feet)
Distance to North-south lot dimension(in feet)
shade 100+ 9 5 90 85 80 75 70 65 0 55 50 45 40
reduction line l
from northern
lot line(in feet)__
70 40 40 40 41 42 43 44
65 38 38 38 39 40 41 42 43
60 36 36 36 37 38 39 40 41 �2
55 34 34 34 35 36 37 38 39 40 41
50 32 32 32 33 34 35 36 37 30 39 40
45 30 30 30 31 32 33 34 35 3'6 37 38 39
40 28 28 28 29 30 31 32 33 34 35 36 37 38
35 26 26 26 27 28 29 30 31 32 33 34 35 36
30 24 24 24 25 26 27 28 29 30 31 32 33 34
25 22 22 22 23 24 25 26 27 28 29 30 31 32
20 20 20 20 21 22 23 24 25 26 27 28 29 30
15 18 18 18 19 20 21 22 23 24 25 26 27 28
10 16 16 16 17 _1$... 19 20 21 22 23 24 25 26
5 14 14 14 15 1fi 1" 18 19 20 21 22 23 24
Box D. Maximum allowed shade point height: feet
h:'doct,nancv\ventura\solar.chp E _
Revised:'2696 / ' '�
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
DICKS ELECTRIC
8907 SW HILLSBORO HWY
HILLSBORO OR 97123
Electrical Signature Form
Permit # . . . . : MST96-0291
Date Issued. : 12/10/96
Parcel . . . . . . : 2S104BA--- 200
Site Address : 13561 SW LIDEN DR
Subdivision. : CASTLE HILL NO. 3
Block . . . . . . . . Icr . 142
Zoning. . . . . . : R-12 PD
Remarks :
path i
Your company has been indicated as the electrical contractor for the permit indicated above. In
order for the electrical perrnit to be valid, the signature of the supervising electrician
is required.
Please have the appropriate individual from your company sign below and return this Electrical
Signature Form prior to the start of work. No electrical inspections will be authorized until
this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FOi-,M
( 'WNII'P . ELE.CTRICAL CnNTRACT'OR:
DON MORISSETTE DICKS ELECTRIC
5000 SW MEADOWS RD 8907 SW HILLSBORO HWY
SUITE 151
LAKE OSWEGO OR 97035 ii-LiuSBORO OR 97123
Phone # : 620-7538 Phone # :
Reg # . . : 030474
X l e �_C��
Signature of Supervising Electrician
Please return this completed form to the address above.
ATTN: BL ilding Dept.
If you have any questions, please call 639-417 1 , ext. #310
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
BEAR ELECTRIC
PO BOX 389
28085 BUTTEVILLE RD NE
DONALD OR 97020
Electrical Signature Form
Permit # . . . . : MST96-02.91
Date Issued. : 08/01/96
Parcel . . . . . . : 2S104BA-13200
Site Address : 13581 SW LIDEN DR
Subdivision. : CASTLE HILL NO.3
Block . . . . . . L-A : 142
Zoning. . . . . . . R-12 PD
Rernarks :
path i.
Your company has been indicated as the electrical contractor for the permit indicated above. In
order for the electrical permit to be valid, the signature of the supervising electrician
is required.
Please have the appropriate individual from your company sign below and return this Electrical
Signature Form prior to the start of work. No electrical inspections will be authorized until
this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
)WNER : ELECTRICAL CONTRACTOR:
DON MORISSETTE BEAR ELECTRIC
5000 SW MEADOWS RD PO BOX 389
SUITS 151 28085 BUTTEVILLE RD NE
LAFr OSWEGO OR 97035 DONALD OR 97020
11. ft : 620-7538 Phone # : FAX-687-1108
Reg # . 20 19
i Pure o pervising Electrician
Please return this completed form to the address above. 3 k S
ATTN: Building Dept.
If you have any questions, please call 639-4171 , ext. #310