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9281 SW LOCUST STREET to N 00 J 5n I- 0 n N .+ N r+ N I i 9281 SW Locust Street CITY OF TIGABD BUILDING INSPECTION DIVISION MST 4Wb 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP —Date Requested-- � , AM PM BLD Location _ 7115 v GSC 5 — —_ Suite _ _ MEC _— Contact Person —_-- — _-- Ph 00 1( _ PLM - Contractor --- ---- ------- Ph _— — SWR -- ------ BUILDING --✓� Tenant/Owner _ ELC Retaining Wall — ELR — Footing ------_-•-- Foundatiun ACCESS: --�(/G/� VGx �� FPS Ftg Drain �--�--------- Crawl Drain Inspection Notes: SGN Slab Post& Beam --- ---_ ------ - SIT --__-- Ext Sheath/Shear Int Sheath/Shear ------ -- Framing Insulation --- — -_ --_-- _-__-_ Drywall Nailing - Firewall - - - --- --------- - ------- -- Fire Sprinkler - Fire Alarm Sasp'd Ceiling ---- ---------- - - - Roof --- ---- -- Misc: — -_ _ _------------ - ---- --------- --- ---- ----- Final PASS PART FAIL --- --------------- ----- -—-- - L Fost&Bean i - - ---- ---- ----- ---------- ---- -_ - - ------- Under Slab Top Out - - - ---- __- -- - - - --- - - Water Service Sanitary Sewer - --- - ---- ------------.- ---- -- RajQ Drains PA. C1 PART FAIL A_NICAL - iPost& Beam - -- - ----- - Rough In ------1--- Gas,Line -- - -------._...--- -— _ omoke Dampers Final -- -- PASS PART FAIL. --_------_-_-__ ELECTRICAL_ _ ---- ------ - --- —. —-- ------- --------- ---- _.— — Service Rough In - UG/Slab Low Voltage Fire Alarm Final ---_----------- --- __-------------- ---__------------ PASS PART FAIL - -- --- ----- -- - ---------- ,--- ------ SITE Backfill/Grading --_-- ---- --------- -----_--. Sanitary Sewer Storm Drain [ )Reinspection fee of$ required before next inspection. Pay at City Hall. 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ]Please call for reinspection RF:_- _ v- [ ] Unable to inspect -no access ADA Approach/Sidewalk Date Other _ _-.i_ /_Inspector_-- �/�' _\ __ Ext —r Final _ PASS PART_ FAIL DO Nt T REMOVE this inspection record from the job site. CITY OF TIIGARD BUILDING INSPECTION DIVISION MST 26,va ra�Z 24-Hour Inspection Line: 539-417F Business Line: 639-4171 BUP --�__ .Date Requested_ LI �� --AM—.--PM — BLD _ Location FLS'/ Sc..� �C�s f _ Suite _ PEG —_ Contact Person _ _-- Ph ,.SS..`r—�� __— PLM Contractor � f}2NE1�_ __-- Ph SWR .--__�—�-- BIJILDING -Tenant/Owner EL(: _ -- Retaining Wall ---- EL.R FootingAccess, FPS Foundation G-G� �CL�C ��CJJ - - Ftg Drain - SGN Crawl Drain Inspection Notes: -- - Slab _ - ---- --- c,T Post& Beam Ext Sheath/Shear --_—_ - Int Sheath/Shear Framing - - -- - - -- -- - -- -- --- Insulation Drywall Nailing _-- _ -- --------—- --- --_- --- Firewall r: Fire Sprinkler s `v-- `� �✓ Fire Alarm ------- --- - -- �--------------- Susp'd Ceiling - - - - -----. ��1. let _ Roof Misr,, -- - - -- - -- - ---- - ------ --- - ------ - Final PASS !'ART FAIT_ --- - ---- --- --- --- -------- - _ ._..-- PLUMBING Post& Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains F,;lal PASS PART FAIL - - -- --- --- ... ---- --- - ----- - ---------- -- MECHANICAL _ Post& Rem -- -.._.._ --------- ----- Rough In GasLine ---- -__ _ --_ . _- - ----- _ ---------_--- ---- ------------_ __ Smoke Dampers Final ------ -. - --- -- - - _ . ___------------- - -- ----- - _.. PASS PART FAIL r -- - __ - -- ---- --- _. _- ------- ------.._.�- __.._ ----------._._.._--- Service Rough In UG/Slab -- --- - ------ -- - - -------- Low Voltage �*FireAlHrrn PART FAIL -- --- ------------- ------ - --- `fE Backfill/Grading � ----- - --- --------- ------------ —_-- -----.-- Sanitary Sewer Storm Drain I J Reinspection fee of$ -___--_required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin (Fire Supply Line f Please call for reinspection RE- Fire — �-_ -� Unable to inspect-no access ADA /;..- Approach/Sidewalk 7 Other _— nate — �' Inppector— C-t�� =- Ext -- Final PASS PART FAIL. DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 6394175 Business Line: 639-4171 �— — B U P ---_--- _-- Z� —_Date Requt;sted AM —_PM BLD Location —f y� 5(c , 6-6 C�` 5 r Suite MEC Contact Person _ - /9.0 r _ Ph 61}3r PLM Contractor _— -_—_ Ph .—__— SWR C UI —��_— Tenantiowner -- — ELG _� 4 Retaining Wail ELR --------- -- Footing Access 4-✓c C a - FPS Foundation S'(pS, �� rst �/ Fig Drain - SGN _----�_—_-- Crawl Drain Inspection Notes: Slab ___— -------- ----- _ ---_ SIT ---_—__ Post R Beam Ext Sheath/Shear - — -- -- Int Sheath/Shear Framing — -- -- ------ — --- -- — — — Insulation R Drywall Nailing -- Firewall Fire Sprinkler -------- -- -�^-- __"-- Fire Alarm Susp'd Ceiling ----- Roof Mise - --- 15 S8. PART FAIT_ ---- --- -- --- PLUMBING --_—_ -_ I lost& Beam Under'Slab — Top Ou! i Water Service --.__—_— Sanitary Sewer I _—�— Rain Drains — � --- -------- -- Final PASS PART FAIL _--_— — — MECHANICAL) — --- —_ __— Post& Beam - -- — Rough Ir; — ------ _ --- _— Gas Line -- Smoke Dampers ' Final.r� -- - —--------- f,ASS- PART FAIL ELEGTRrGAL -_-----------._—____.--_-------------------- _-- Service --------- Rough In UG/Slab _ ----------- -------_—_ —--- ---- Low Voltage Fire Alarm -- - _— ------- — --- ----- -- Final PASS PART FAIL —._-_- --__--_" __--_----- __ — --- ----i SITE -- Backfill/Grading - — — — Sanitary Sewer Storm Drain [ ]Reinspection fee of$ _required before next inspection. Psy at City Hall, 13125 SW KA Blvd Catch Basin [ ]Please call for reinspection RE:__ [ ] Unable to inspect no access Fire Supply Line ADA Approach/Sidewalk -------- - --�-- _ �_�---- Ext Ina Inspector OtherDate (incl PASS PART FAIL 00 VOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business tine: 639-4171 BUP — — __—Date Requested__ AM_ _--PM ---- BLD Location�= �� s i~> "�� ~S� Suite _— MEC Contact Person PhS_5=- l�U PLM Contractor _ Ph - SWR _-- BUILDING— Tenant/Owner ELC - Retaining Wall ---~ ELR _... .....Footing Access Foundation FPS - Ftg Drain SGN Crawl Drain Inspection Notes. Slab I ---_----__ -- SIT Past 8 Beam ----------- __.-- — Ext Sheath/Shear Int Sheath/Shear Framing -__.—_ �.- ---- - --- - Insulation Drywall Nailing Firewallc^ `/ ��--L� Fire Sprinkler t r _ /V/ 'N4, / — --- - Fire Alarm l�� r Susp'd Ceiling ! Roof Misc. _ - -- L/- - --- Final PART FAIL -- ��(� PLUMBING Post& Beam --- -- - --- ----- --- Under Slab I op Out Water Se,-vice Sanitary Sewer -^ Rain Drains Final PASS PART FAIL MECHANICAL�� Post& Beam --- --- - Rough In Gas Line - Smoke Dampers Final -- - -- - - - PASS PART FAIL Service RoLrgh In UG/Slab I-ow Voltage F 1 I;,rm — - ----- ---- - ------ -- ASS PART FAIL -- --. ___------- --- ----- --- -- --- ,B H:ackfilllGrading ----- .----- ------ ---------------- --- -- -- ---_ --- Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply I ire [ j Please call for reinspection RE:_-_--_-__- zo [ j Unable to inspect no access ADA /Approach/Sidewalk �� -Q Ins eclat _!! Ext r finerlate p _� __— _— _— �.--- FinnI PASS_ PART FAIL] DO NOT REMOVE this inspection record from the job site. � � F o 0 �. a s - � N CL C. CA y j t oIrk, r z 4 �e x __J CITY OF TIGARD •13125 S.W. HALL BLVD. TIGARD, OR ! 7223 IMPORTANT PERMI ' .4'OTICP�E GARNER ELECTRIC 21785 SW TUALf.,TIN VALLEY HWY S ALOHA, OR 97006-1248 Eloctrical Signature Form Permit #: MST2000-00248 Date Issued: 8111100 Parcel: 1 S126DC-06700 Site .Address: 09281 SW LOCUST ST Subdivision: MLP96-0014 PP1997-124 Block: Lot: 003 Jurisdiction: TIG Zoning: R-12 Remarks: New SF - Path 1. Duplex for 92.81 and 9283 SW Locust. 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 bele,,j and return this Electrical Signature Form prior to the start of the work to the address above. ATTN: Building Dept. No electrical inspections will be authorized until this completed form is received OWNER. ELECTRICAL CONTRACTOR: L.UNDMARK HOMES LLC GARNER ELECTRIC 3381 COEUR D'ALENE DR 21785 SW TUALATIN VALLEY HWY S WEST LINN, OR 97038 ALOHA, OR 97006-1248 Phone #: Phone #: 591 .1320 Recd #: LIC 121159 SUP 3707S FLE 34-3050 AN INK SIGNATURE IS REQUIRED WT HP F RM X —--- Signature of S p ising Electrician If you have any questions, please call (503) 639-41'1, ext. # 310 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE J + R PLUMBING(SEE 72680) ALIri h ^ 2000 3430 SW 209TH AVE ALOHA, OR 97007 Plumbing Signature Form Permit #: MST2000-00248 Date Issued: 8/11/00 Parcel: 1 S126DC-06700 Site Address: 09281 SW LOCUST ST Subdivision: MLP96-0014 PP1997-124 Block: Lot: 003 Jurisdiction: TIG Zoning: R-12 Remarks: New SF - Path 1. Duplex for 9281 and 9283 SW Locust. Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Form prior to the start of the work to the address above, ATTN: Building Dept. No plumbing inspections will be authorized until this completed form is received OWNER. PI_IJMBING CONTRACTOR. LUNDMARK HOMES LLC J + R iPLUMBING(SEE 72680) 3381 COEUR D'ALENE UR 3430 SW 209TH AVE WEST LINN, OR 97033 ALOHA, OR 97007 Phone #: Phone #: 642-7776 Reg #: I Ir '12680 P1 M 34-21 '1PB AN INK SIGNATURE IS REQUIRED ON THIS FORM \ ` X i Sig lure of Author' Plumber If you have any questions, please call (503) 639-4171, ext. # 310 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour-Inspection Line: 639-4175 Business Line: 639-4171 BUP _ _.._.._ "Date Requested_ _PM — DLD — — - Location Suite _ —_ MEC — ------ Contact Person Ph LJ PLM Contractor_ Ph _ SWR _ _ BUILDING Tenant/Owner ELC Retaining Wall _ - v- ELR Footing Accacc -- ----- ---- FoundationS /�,`� `� /G FPS _- Fig Drain !� S G N Crawl Drain Inspection Notes ---- -- ---- Slab ----- ---- -�..--- - - ---- - Sir Post&Beam -- -- ------ Ext Sheath/Shear Int Sheath/Shear - - Framing _--------- - --- --- --- -- -- Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof --.�----_ Misc: -- V-------- - ------------------ ------- Final PASS PART FAIL -- ---------------- ---IN Post Post R Beam -- — — - --- Under Slab Top Out Water Service Sanitary Sewer ------N -L Dialns �/,— � ZU Fi ' . q AS,' PART FAIL Post& Beam --- - - - --- - -_____ Rough In Gas Line -- -- --- Smoke Dampers Final ------- - -- PASS PART FAIL ELECTRICAL -- -- -- Service Rough In T UG/Slab Low Voltage Fire Alarm Final PASS PASS PART FAIL - ---____----_- __--------_-_-- SITE Backfill/Grading Sanitary Sewer Storm Drain [ ]Reinspection fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hall ?! + Catch Basin ( ] Please call for reinspection RE:_________—_�.---__ ( ) Unable to inspect- no access Fire Supply Line ADA Approacti/Sidewalk �' Other Date ICS - -,-- Inspector �� ~��cra-ti_ _ Ext �— Final PASS PART FAIL DO NOT REMOVE this inspection record from the jab site. CITYOF T I G A R D MASTER PERMIT PERMIT#: MS12000-00248 DEVELOPMENT SERVICES DATE ISSUED: 8/11/00 1312.5 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 09281 SW LOCUST ST PARCEL: 1E' ;2FDC-06700 SUBDIVISION: MLP96-0014 PP1997-124 ZONING: R-12 BLOCK: LOT: 003 JURISDICTION: TIj REMARKS: New SF Path 1. Duplex for 9281 and 9283 SW locust. BUILDING REISSUE S1OP.IES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 21 FIRST: 1 406 of BASEMENT. of LEFT 5 SMOKE DETECTORS: 1 TYPE OF USE: MF FLOOR LOAD 40 SECOND: 1.66.1 sf GARAGE: 61r, of FRONT: 20 PARKING SPACES: 4 TYPE OF CONST: 5N DWELLING UNITS: 2 FINBSMENT: sf RIGHT': > VALUE. 5 775,Ifb 7; OCCUPANCY GRP: H3 BDRMBATH: 5 TOTAL: 2 97200 of REAR. 1!, PLUMBING SINKS: 2 WATER CLOSETS: 6 WASHING MACH: , LAUNDRY TRAYS: RAIN DRAIN: 200 TRAPS: LAVATO,. S: 5 DISHWASHERS: 7 FLOOR DRAINS: SEWER LINES:200 SF RAIN DRAINS: 2 CATCH BASINS TUBISHOWERS 4 G4RBAGF DISP WATFR HEATERS: 2 WATER LINES:200 BCKFLW PREVN'TR. GREASE TPAPS: OTHER FIXTURES: MECHANICAL. FUEL TYPES FURN<100K: BOILICMP<3HP: VENT FANS: 6 CLOTHES DRYER: CTAS FURN-100K 2 UNI"HEATERS: HOODS: 2 01 HER UNITS: 2 MAX INP: btu FLOOR FURNANCES: VENTS: WOCUSTOVES: GAS OUTLETS. 2 ELECTRICAL RESIDENTIAL UNII SERVICE FEFnER TEMP SRVC/FEEDERS BRANCH CIRCUITS MISCEI.LANEOLIS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 200 amp: 0 200 amp: WISVC OR FDR: 2 PUMPIIRRIGATION: PER INSPFCTION EA ADD'L 506SF: R 201 46,,amp: 201 400 amplet W'O SVCIFDR: no SIGNIOUT LIN LT: PER HOUR: LIMITED F AERGY. 401 600 amp: 401 600 amp: EA ADDL SR CIR: SIGNALIPANEL: IN PLANT: VIAND HM SVCIFDR: 601 1000 amp: 601+amps•1000V, MINOR LABEL 10004 amp/volt: PLAN REVIEW SECT'7N Reconnect only: —'-"—� ' '�------' -4 RFS UNITS: SVCIFDR> 225 A.: >600 V NOMINAL CLS AREAISPC OCC: ELECTRICAL•RESTRICTED ENERGY A.SF RESIDRNTIAL B.COMMERCIAL AUDIO 6 STr_RFO. VACUUM SYSTEM: AUDIO 6 STEREO: FIRE.ALARM- INTERCTIMIP'.GING: OUTDOOR LNOSC LT: BURGLAR ALARM OTH: POILER: HVAC. LANDSCAPEIIRRIG: PROTECTIVE SIGNL GARAGE OPENER: CLOCK. INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL M SYSTEMS: Owner: contractor. TOTAL_ FEES: $ 7,493.80 This permit is sutgect to the regulations contained in the LUNDMARK HOMES LLC LUNDMARK HOMES LLC Tgard Municipal Code.State of OR Specialty Godes and 33F1 COEUR D'ALENE DR ALBERT C'_UNDMARK all other applicab:e laws All wolk will be done in 'NEST LINN,OR 97038 3381 COEUr: D'ALENE UR accordance with llpproved plans This permitwill expire if WEST LINN,OR 97068 work is not starlet'within 180 days of issuance cr if the work is suspendec for more than 180 days. ATTENTION Phone: Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Noti'ication Center Those rules are set Reg# I IC 1;1499 L;rth 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 Erosion 8448444 Post/Beam Mechanica Mechanical Insp Framing Insp Gas Fireplace Water Line Insp Sewer Inspection Underfloor insulation Mechanical Insp Shear Wall Insp Insulation Insp Appr/Sdwlk Insp Footing Insp Crawl Drain/Backwater Plumh Top Out Exterior Sheathing Ins( Gyp 2jard Insp Electrical Final Foundation Insp Fooling/Foundation Dr Electrical Service Low Voltage Fim,/atl Insp Mechanical Final PosUBeam Structural PLM/Underfloor Electrical Rough In Gas Line Insp Rain drain Insp Plumb Final / Issued By : _ Permittee Signature Call ( 03) 639-4175 by 7:00 p.m. for an inspection needed tthq next business clay CITYOF TIGARD _ SEWER CONNECTION PERMIT DEVELOPMENT SERVICES PERMIT#: SWR2000-00197 13125 SW Hal' Blvd., Tigard, OF: 97223 (503) 639-4171 DATE ISSUED: 8/i 1/00 PARCEL: 1 S1 26DC-0r3700 SITE ADDRESS; 09281 SW LOCUST ST SUBDIVISION: MLP96-0014 PP1997-124 ZONING: R-12 BLOCK: LOT: 003 JURISDICTION: TIG TENANT NAME: USA NO: FIXTURE UNITS: CLASS OF WORK: NEW DWELLING UNITS: 2 TYPE OF USE: SF NO. OF BUILDINGS- 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: Remarks: Duplex address inclu.tes 9281 & 9283 SW Locust. Sewer connection credits for or.e connection were given to this permit as the previous house on this lot vvas demolished. Owner: _ _ - — - — FEES LUNDMARK HOMES LLC Type By Date Arnowit Rere;pt� 3381 COEUR D'ALENE DR = - -- -- WEST LINN, CR 97038 PRMT RCP 8/11/00 $2,300 r0 0004429 INSP RCP 8/ 1/00 $35.00 0004429 Phone: INSP RCP 8/11/00 $35.00 0004429 +— Total $2,370.00 Contractor: -- Phone: Reg #: Required Inspections Sewer Inspection This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. 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 Crynter. Those rules are set forth in OAR 952-001-0010 through OAR 952001-0080. You may obtain copies of these rules or direct questio!rs to OUNC by calling (503) 2.46-1987 r Is:-.ued by: _1��--��r�' Permittee Signature: Call (. 3) 639-4175 by 7:00 P.M for an inspection needed the next business day Y OF TIGARD Resi - -�-r� O �S ication Plan Check# 1312.5 SW HALL BL'v D. (� 2.i� Recd By �_,, �i-n Date Rec'd_ 7( � �, TIGARD, OR 97223 !t/�Q U�f"`L" Date to P.E. -2,11- G7 V 503-639-4171 Date to DST 1 / �'> F 503-684-7297 /r I Permit# ZZ-o®O-.�20 Z Print or Type /� Called b- Z -DU Incomplete or illegible applications will not be accepteds��(�`�,� c��fk7 Name of Project vime Architect Mailin Address --Address - SiteAddress I l To ty/ to \yr — - —_ 2r�1 Phone- Oh cCi 16 r�Q"1��jtM� amc: Owner Mailing ,di ress En ineer Mailing Address City/State Zi Phon 9 l NN �7�6� Clty/Stale Zip Phone General Name Contractor LU r..1 yy� � Describe work News Addition O Alteration O Repair O Mailing Add rf ss to be done: Prior to permit t6 k i uyL 1 Nky.-J,ti - Additional Description of Work: issuance,a copy City/ tat Zip Fan _ of all licenses \60 /,��_�`JOL�� _j� _66pt are required If Oregon Const Cont.BoardExp Date PROJECT database expired In COT Lic ►. c# � / VALUATION d� Mechanical Name — , r e,=r NEW CONSTRUCTION ONLY: Sub- W!�A - 164\ILSq. Ft. House: Sq. Ft. Garage - Contractor Mailing Address �- 2--T`T 7 ;-7D".�L�1_i1r\ 406 x Z9 11. _ Prior to permit 5 �rr1� Indicate the restricted energy installation by the electrical issuance,a copy Ci /Sta Zip Ph ng' subcontractor in the following areas of all licenses b�Z b z_ 23� `'I O 1 3 Restricted — j Audio/Stereo i _ire required It Oregon Const Cont.Board Exp.Date Energy System — _ Alarms expired in COT Li-# D Oct-0 2- InFtallations Vacuum Irrigation database astem System Plumbing Name (check all that Other: Sub- 4 12- ap I v) Contractor Mailing Address --� Number of Units in Building Unit Number Designation Has the Subdivision Plat recorded?_ N/A I YES, NO Prior to permitCit /State Zip Phone issuance,a copy gq 9 cZ �7�';o _ - of all licenses are Oregon Consl.Cont Board Exp. Date required if Lic# expired in COT 7 24T- SO3 " database Plumbing I-ir # - Exp Vete I hearby acknowledge that I have read this application,that the r j q information given is correct,that I am the owner or authorized agent 3`�`t_�___ -a/ of the owner,and that plans submitted are in compliance with Name Ore on State laws _ Elec!rical _ s' at a Ow t - Date QW�ft °` �cL Sub- Mailing Address Contractor JJw #G Co act Person Name Phone# - PL7k L-v'► City/State Zip Phone —` Prior to permit issuance,a copy 970 P' _F_OR OFFICE USE ONLY: of all licenses are Oregon Cont Cont.Board Exp.Date --- --- -- required if Lic.# 1I l �1 Plat#: r 7 I Map/TL#: expired In COT y ' dr)� -o if _ database Electrical Lic # 1� Exp Date Setbacks: Zone: 4166il Supervisor Lic.# Exp.Date Engineering Apprgval: Planning Approval: IF: 00 1.\dsts\forms\sfd-,ew.doc 11/20/98