Permit CITY TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00359
��� DEVELOPMENT SERVICES DATE ISSUED: 6/18/03
' `---' 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 - 4171
PARCEL: 2S105BC -01300
SITE ADDRESS: 16278 SW O'NEILL CT
SUBDIVISION: KERRON'S CREST ZONING: R-25
BLOCK: LOT : 034 JURISDICTION: URB
Project Description: Add (1) branch circuit for A/C. Job No. 431.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS • ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
AYALA, SEMON J JR + JEANNE F HILLSBORO ELECTRIC
16278 SW O'NEILL CT 21185 NW EVERGREEN PARKWAY
TIGARD, OR 97223 HILLSBORO, OR 97124
Phone: Phone: 503 - 439 - 9666
Reg #: ELE 34 -433C
LIC 134481
FEES SUP 4240S
Description Date Amount
Required Inspections
[UELPMT] ELC Permit 6/18/03 $46.85
[UTAX] 8% State Tax 6/18/03 $3.75 Rough -
Elect'I Final
Total $50.60
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
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 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 OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or
1- 800 - 332 -2344. f ,
Issued B : �� \ �. CiC � "�41. Permit Signature: ` — '�c"� i
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
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:OOpm for an inspection the next business day
Fled:deal Pernlit plca ®n ' , i ', 41 1 - 1 11 1 1 -,1 S 1 \I,1 , `" J
4 ® Date received �5 ( Permit no.: Fey, - oe'3
Eapile • 14-''11''1 City of rT d CE'��
irro ecfe t//appl. no.: Permit
Ct o f � Address: 13125 SW Hall Blvd OR 97223 Date E keerept no.;
Phone: (503) 639 -4171 3 2003
Pax: (503) 598 -1960 JUN PIynteat type:
Land use approval: ITY OF TIGARD
i ,i ,..,a d . 1 ,_ . ,, r , , , oo I E 1 (tl f E _ Irlll , l fir . �,. . ,=F .� . ,,;
r4 � � ' 1 t <O'e 1 � �1 � I .,. ..; , . _ __ • , : I'
& 2 family dwelling or accessory ❑ Commercial/industrial 0 Multi - family 0 TO0101t improvement
❑ New construction 0 Addition/alteration/replacement 0 Other: .0 Partial
, y 1t lit ' I11 1V1 It }r \l.Allll \ ._. n i]1; 4 rt
Job address: ` . . ii- Bldg. no.: Suite no.: Tax ti lot/account no.:
Lot: Block Subdivision;
Project name: Me_. tH I Description and location of work on premises: `cf'e ,�� 1
Estimated date of completio inspection:
(,,-„ ,, ,, 4 - ' 6 ,1,;,
a n, ti,,.' k� , r( t (1.A 112\l 1 < 111nr\ 1 f l it ∎I 111A r "+ ;�•i , l , 1 4 ,le 111 .St 1111 /1 11 ,�1 , ,`1'tv "
Job , hula.
Buair►ossaame:Hillsboro Ele t Q. Total aalaap
LLC 'Newem w ndlyper
Address: 21185 NW Ever• reen Pkw Ste Cb dte>lreg,ser,
.. . State: ; ZIP: 97124 sarvIcehm�eds
Phone. .. • _ • 666 Fax6 s 1-36 8 11 E -mail: loos ft or lees 4
Each CCB no -: 134481 Elcc• bus, lie- no: 3 4 — 499
eddNi . son reside ft. or por thereof III gill
ntial
City /metro lie. no.: United mo.re id tial
1 • Decd reanup home • uod hoe or a¢odul� dwelling ■■
9 . 0' of 1S
s"gs .. ec ��� a1C1aa ([equ ate �
Seevie s and/or faadnr 2
:
elect. name a ( t om ) : um= no 4 9 41 S 9eerleeaorteeden— ol(ytt � roMes -om
u.r ...
III 4c� l { l 111 i ♦ I, r,...,
r 1sa � , ya � a '. ti� � t.,. � .n ` - y , �� i - °+ ... 2(b BtOpa Or leas 2
Name , • t ): 201 to 400 MEM_ 2
Marlin address: 601 am. to 600 . � MMII
601 amps to 1000 amp - ME MI
StatE: ZIP: Over 1000. or volts
Phone: Pax: E -mail: Reconnect .. ��
Owner inatallstioa: The installation is being made on property 1 own T�°rarg services orf -
hatilladealtarill
which is not intended for sale, lease, tent, or exchange according to °
201 ^ • or leis 2
ORS 447, 455, 479, 670, 701.
2(1l em• : m400 :., ,,. ��� 7
Owner's si:•t • Date: 401 to 600:., . It rIIM IIIIIIMI
�,, l ieacbtlrcta - new alteratio
', 1 \( \I � , K n : - 0.
f, GJ' �' ,ed t , .JA t a .
.ti �: .t er _ . � Jc " 4 _,I :. ..
Or extension per pawl:
Name: _ A. Fe for branch circuits with pwvlmo of
Address: service or feeder the, each brunch ctrcatt
City: State: ZIP: B. Fee for blench drone without putohoae
Phone: ran: E-mail: of service or feeder foe first broach chant . i
Each additional bra ch circuit
- /J. q , 1.- . 1( f,1 (I 1 1'1 1.4 4, ii 1 ;1 11 Ih 41'. Alp I 1 �,, i ' ��� 2
0 Service over 225 amprcomoeaial Q Ilalthwe flldllty+ 2
Q Service over 320 amortising of 2&2 O Ha�rdara location Each sign or mltlnle lighting
fealty dwellings t3 Building over 10,000 scam feel fiver or Signal eltCldt(t) or a 16nited energy panel,
Q System over 600 volts wailed more residential units is one at aisle attention. or extension° 2
O Building over three stories 0 Seeders, 400 amps err Mere 'Desert. • on: _
❑ Ocruseat load over 99 persona 0 Matrtlscturvd own tutee or RV pads diets adddlkaat bipedal] war then3owoble to any arias sharer
0 Egrcavlightiag plan 0 Other: Pa oa
Sebltldt _____ aide of pl ins wtth any of the above. investigation fee
The above ere not apps to temporary conitrvetioo service. Other
N all jurisdictions accept milt cads, ptesm Doll Puiedicdoa for more iatbawtioa Notice: This pint application Permit f00 $ p s
milt
ss Q MasterCard expires if' a pt is not oblaitted pla»< revitaw at 9 �s} $ '-`° �—
matt cord two pewit
180 days after it has b� State surcharge ( $ 4 —tI-
.Gt. i accepted ,._. _• Expires as complete. TOTAL $ 91.51
5
I lr. o oasdeolderr o shown ea . ■ end
. •
Amnn e , 44114015 (6, wcOM)
Z0 3917d 0I610313 OdOg11IH 089E109E0S Z0 :i2I E00Z /E1/90
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 G -
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested -fin AM PM BUP
Location 1 (e 9 g l�' 0 Q. ct Suite MEC
Contact Person A U Ph ( ) '1 �� -- '744 , PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC ,3 -
Footing •
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
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
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
SASS —PART FAIL
:ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
� �591 PART FAIL
SITE ►: 'lease call for reinspection RE: nable to inspect – no access
��
Fire Supply Line 'C `v I CY, }F}-
ADA Approach /Sidewalk Date — 22 _ 0 3 Inspector \ ■ y S xfikk
\' \
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
07/23/03 WED 08:27 FAX 503 846 3993 WASH CO, BLDG SERVICES 001
WASHINGTON COUNTY
q �z
Building Services
u a iIM t V,
FAX 'I'RANSIVII'I'I"AI.
Send Fax To: I,u
/ f f 6fl Fax # �3 - 1002 `- <3C�/
Attn: 0
Fax Transmitted From:
Name: G 4
Phone: 5 3 - 8 9 / 9 ' Ext:
Total number of pages (including cover) Co
Date: '7 - -a3
Notes or Comments:
a .. � , 7"
G - $ _
Washington County ,
Land Use and Transportation
Building Services
155 N. 1st Av. 350 -12 FILE C
Hillsboro, OR 97124
Fax Number 503
Note: To avoid loss or misplacement, the Project number must be included
on all additional information sent to us for plan review.
If we have sent a fax and all pages do not arrive in legible form, please
contact our staff at (503) 846 -3470.
07/23/03 WED 08:28 FAX 503 846 3993 WASH CO. BLDG SERVICES Z002
DEPARTMENT OF LAND USE & TRANSPORTATION
BUILDING SERVICES DIVISION #350 -12
�. ,a WASHINGT 155 NORTH FIRST AV HILLSBORO OR 97124
Vt; COUNTY PHONE: 503 - 846 -3470
'1 40 OREGON
INSPECTION REQUESTS (24 HOURS) 503- 846 -3699
RECEIPT NUMBER : Project # : P0112835
E ='c:rt 1tl:i. i.: Type RL `;r1E::C :1 -1 Permit # . 05167851
;; A 1 1:-'Rf::IVI:_D A 1::›ID :L :i. e:ad u CI <5 I :14 -;/ 2 I:: :ICI:::i
J. 1 t.1t : :i Ac:ica:, e E ° ss r :1. '7 8 6A jr'1E ::IL...I.... t. :: r T1: 1: :3t;k.t.r:cl /
/I�:I;; `_I i (:1::`,
11 F. � `,
r•:Il.i(P1b t Y _ a-• : 2. .::::1...._L.,I'. C ..... I_I'.1. ' I :; L ' : . 'r.'.I::> :L :C' f i i ;; 0 6 / 1 : 1 4 . / 2 0
0 : AY AL... A , E::r5(:Ira ._7 .._1Ei ' ,JE :A1''d1''.1E: :: .•
•
r-1 p :I... : tI RE.::G0N HE:AT:I:r1c & A,!t::: :1:1''4
1 c:i d :,. . ;: I:°' ., t ) . B 1 I X 3 9 _( A p l _,1 . 1 I -, <_, n r:: . ,
97 11::: V<:t 1 i. c.:iia t d I1 y r HIE IA
Permit•Descr. : SFR — A/C — APPROVED SITE PLAN IN FILE
;: I:::1<5/ I::I:>/ 'i11.1:> ACCOUNT STATUS
r1 iia<:_ I..., 11m f- : L..t r 24 A 5 C<1.l... t.1 :tf::r I
I n :i. {: :i. a ]. s; 1 : : 6 . J A <::I <:i i. t :i. 0 n is :I. 1::: ,:_, F => ; i ,: 110 • ,111::1
F F°'f:' I; t..tf ,. *64 ,. I31:::1
yfl E: n t`i:+ '1: 0 [) •I :t :: > ;)4. ., f3(l
ACCOUNT BALANCE : $0.00
TRUST ACCOUNT LIST:
TRANSACTION LIST:
Type r'1 e t: I c (.::) :i 0 r'1 A m tin 'L
a y rn c : : ri t C V I S A :34.4.4. 64.80
TOTAL: 64.80
ACCOUNT ITEM LIST:
Fee ID lie5c:,:'•a.1::)t'a.on ,...,c<_'(::L!ni: t.. c: >c:I t: li:r: ., .. , t „ I"1 '1 1
1006 Mechanical Fee .:. /'r ,, til...l.:':l..lL..`.`.:? ,. `t•2I.IC`:•'.:] • f) I. I
. 7X e.) 4. ID . 21:3 i lc.. 6 0 20 1. 1. t •, 1)
t.i rt ty ..Lax l.X 6 4. 0 .:;'CI1.10 .. 6I: 1,:'01.1.
TOTAL: 64.80
flLE copy
Important Notice:
The fees listed above should be considered incomplete until the permit and any required plans are approved and issued. The balance shown may change as
additional fees are entered and verified. Per Washington County Uniform Building Code, once issued, permit(s) becomes null and void if the work authorized
is not begun within 180 days, or is suspended/abandoned for more than 180 days. Once issued, permits) shall expire 24 months from the date of issuance,
• provided the work remains in progress. For limited exceptions, see Washington County Code, Chapter 14. It shall be the duty of the person of record doing
the work to request arid have the work inspected and approved by Washington County Building services. Expired permits, with no approved final
inspection(s), will have a notice placed in the property record of the possible building code violation. If the Building Code requirements for occupancy of this
property have not been met, there may be a delay to the issuance of further permits.
I acknowledge these provisions :
Authorized Signature •
THIS PERMIT RECORD MUST BE AVAILABLE FOR INSPECTION AT THE JOBSITE
07/23/03 WED 08:28 FAX 503 846 3993 WASH CO. BLDG SERVICES I J 003
try DEPARTMENT OF LAND USE & TRANSPORTATION
, WASHINGTON BUILDING SERVICES DIVISION #350 -12 .
�.,
155 NORTH FIRST AV, HILLSBORO, OR 97124
COUNTY PHONE: 503- 846 -3470
1 ryd �H .r
OREGON INSPECTION REQUESTS (24 HOURS) 503 -846 -3699
RECEIPT NUMBER : ?? Project #
Permit Type ;; FBI :SP'11:::C1•{• Permit # : 05167851
Permit Status : f I:'I:'h(iV1:-:D +i.:i : (:{
I- •11:1 :. . I:.:I C> /I::I / i'2( :)I..I ::`.i
-. _x a:•s f, �' Issued
-,.1. .l.a., Address :
I'_ar< is l Number :
„ �• c. a Expire :; 06/04/2005
t.:16'Jr1r':I. ( I'1s1: ,. Ty � t::
. G�
r1 r I::) 1 .i :a n tF „ ,
F1Ci(:;IJ:'(':)`P:i`_i f"' ()„ F),(lY :i 9 "7
9 '7
(... call t: I' °'I' I <::1 {.. 5 CI...)........).3 ::.. 9...i
Valuation : `:>0.00
Validated By :, I<E6'J
Permit Descr. : ??
Conditions ;; Cord: 1
ORS 4.55.355, the disposal of thermostats that c o n t a i n
...
mercury F.iil''lct.t .. :: >(-i1 .1.1 "1 accordance with programs established t:>y
thermostat manufacturers, their representative OP
distributor, or by delivery to sites tI"ia 1' will en:st.a:r'e that
the mercury does not become part C3 1' the solid waste stream
L'4 8 `:i •l': €.•:! 6'J :, {:
(::: I..t r:i :.
follow rules
Attention: Oregon law requires you to adopted
by the Oregon utility N o t i f i c a t i o n Center. Those ::3: t''t.t .I. r- .• are
set forth in OAR 952 001.....0010 through OAR 952-001-0090. 1- ..I_II_90.. You
I I....a J. "1 copies a 1:7 a. (f:' I the I (_ a i €: ;s I::)1y calling :L f'1 C:I t :1 ' center.
may Ia::;'.._ is .-
(Note: the telephone number . I: . , - ,:r' the Oregon Utility
f
: r:.. r . 232-1987)
Notification Center t..:; ._) L.I :.�)
• FILE COPY
Important Notice:
The fees listed above should be considered incomplete until the permit and any required plans are approved and issued. The balance shown may change as
additional fees are entered and verified. Per Washington County Uniform Building Code, once issued, permits) becomes null and void if the work authorized
is not begun within 180 days, or is suspended/abandoned for more than 180 days. Once issued, permits) shall expire 24 months from the date of issuance.
provided the work remains in progress. For limited exceptions, see Washington County Code, Chapter 14. 1t ,.hall be the duty of the person of record doing
the work to request and have the work inspected and approved by Washington County Building services, Expired permits, with no approved final
inspection(s), will have a notice placed in the property record of the possible building code violation. If the Building Code requirements for occupancy of this
property have not been met, there may be a delay to the issuance of further permits.
I acknowledge these provisions :
Authorized Signature
THIS PERMIT RECORD MUST BE AVAILABLE FOR INSPECTION AT THE JOBSITE
07/23/03 WED 08:29 FAX 503 846_3_993 WASH CO. BLDG SERVICES E 004
..____.. a,,.. , .,ir JUizi., -2 172
P -
` ,TON Mechanical r
i� an i ca1 Permit APP ��+ , � �
�� Application r ' � o r lc r
3 • ` WASHINGTON COUNTY Dale iectivgl:
c
Permit no.:
u Address: 155 N. Ist AV, Suite }SU_]Z Hillsboro, OR 97124 YroJrcVappl, no.: — DJ, /
OREGO Phone: 50 3 -846-3470 Fax: 503 -R46 -]993 Expire date:
Internet Address: www.co.washington.or_us n a'� issued: �Y= Reccipr no.: \413 Cast tilt no.:
Land use approval Building Payment lype:
ldm
8 Pc m ut no
�rae eT15- '« 4n . < �I, C dr 0�T � : ?' n r r_ _ i. , + ' 5 ..d +
i" _.C'���1a ��. +����� °��r ri a I� obi ,1 iv.. i-r , r +rg -Ht� � �' f
7 s I & Z familydwelling � ``' a ' 4 �M � ' "`�'t't a *tom + mss
t7 New2 famdydan accessory Commercial/induct n n ,i a r i� v en ! ,:
a 0 Addition/alleratton/replacement Mult m y U Tenant 0 i fa it
�e 0 Otlfet ntimprovemcnt
i d. �^f� A iVA �r i 'rr� `,,x: ' Bryn I t. r�F. ? h Y 7n , w -ter i . — L r .�. f l " I;,
Job address: ¢: :�. 41 : •` i 7 " q T
� i-iP � 2..ra u w
a-7� �� r1 � � �o- r' YEC i rr� r�s.` A•
Bldg, no.: Indicate equipment uanttties in boxes below. Indicate the dollar
value ofall mechanical materials, equipment, labor, overhead,
" rofit. Value
IIM See checklist jot .nrporfont app /rcauon information a nd
Ciry/county: /�� G Jurudrer s fee s hedu /e for reaiden /ml permit fee
s' *,'dt� %mig ZIP: q7
De cnonon .nd1. anonofw• u3 + I r ` y ` r r�L L �
• • CmISCS: �r , ...ii• � Fr= ] Nv � �c _
■ E4 r!
Fee (ea.) Total
Tenant improvement or change of use: Description Res only Res. oil
li r ri II 8
Airhandlin unit CFM
Is existing s ins ulated? 0 Yes CINo
Air condition 8.50 Mil
Is existing space heated or conditioned? 0 Yes 0 N
� g (mitt plan required) ., 8.50 _!__a'
a +tY .r(J r p _ :a' 4 ._ . Alm-noon RYAC s slam _ am :.50
ro xw
a WC- r? ( t 1 j 0 ',1 n lye ` r . ' Bat er/co ressors g Y
Business name: h
a GON a _ Slate boilerpermilno.:
Address: & AIR CONDITIONING IN . Tons BTU/H N/A
City: P.U. Box 397, Dund; e .0 c• - duct
req ecinrs
�it� 971 ' EIP:
Phone: -- g_ • as cal • • r snc plan required)
tliiTItl- bl E - mail: lima Ureplaee furnace/burner B
Including ductwork/vein liner 0 Ycs 0 No .
Ciry /metro lie no N/q InmrotVrcplacc/relixate heaters - suspend 8.50 III
CCB no.: 5
wall, or floor mounte
rygl qn ii Vern forappliance ut r an u— 8.50 - •
"� mace
n� +, Iw; ,!4r t �! " t ��';$ 5. arya� r1 • Ih r _ i, +��a wc+ t1 r - Rtfrigcrillon_ I.St)
aa,..+ .! . Abaotptionumis III N/A
Chillers ---- Address: N/A
City: Campraaors HP N/A
Stale ZIP: Environmental ex4aust and ventilation:
Appliance real
i�}x r 8.50
r 1� � ,:�%'A4�Y, +(t 'r 1,v� . r i v' ?, r G ; . r �. r r Dryer e . usl � '
,',r Mle "+u ,'. ( � , u .Ir r ,,; Floods, 0
:atn S r YPe r6. kiichc at
Name: &C.- - r et-, J hood fire suppression system --
:
I / t
Mailss: 6 SA./ 0 ' e - , ' LfL Exhaust fail wish single duct (bath fo A g.5 _
VVLLG6�jL TT �[ Exhaust sysit art rom heatin, or A
/ rl('� Fuel pIprh and C fup in a Gulletr) 8.5 i
s , i r�eee� -
-�',,� 8.50
Type: LPG
���r.a"rrY�Mrr� � 4C 4 ;;�,� c � • � 2.--r S,IF ? E-mail: E mall r Fad Piping each sddiuonal over 4 O
Name: vrrr, • . ., Praeess piping (schematic required) 1.00 —
Number of outlets III Address: Other listed a ptianee or equipment: N/A
City:
State ZIP: Dccorariwc ireplaf � ee - 8.50 ""
Phone Insert - type _ MilliMMI
F E -mail: w. • • star d stove -
Applicant's signor `�1j Date: tr - - -- ME
. Name(print): �� other: — 8.50
L� / - - _
-
Notice: This permit appliroriow Permit fee S
Minimum fee Y
expires if a permit is net obtained - QD —
within 180 days after ir Alai hems Commercial Plan review
occepiedos reepleex. (at 95 %) ....._.... $
State surcharge ($ ° /,) g a
tan -as" ( "vCuFt) TOTAL
/FILE copy
..
07/23/03 WED 08:30 FAX 503 846 3993 WASH CO . BLDG SERVICES Z005
, ES . c c
. — — ..., 1 _ 1 1 P - 3
•
•
. ,
' .
OREGON HEATING & MR CONDITIONING, INC.
CCO #125815
.... -... : • -
992 HIGHWAY 99W
DUNDEE, OREGON 97115
• (503) 538-2953 FAX (503) 537-2172
. . .
•
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FILE Ctipy
7 7a_aa
07/20/03 WED 08:30 FAX 503 846 3993 WASH CO. BLDG SERVICES Zons
.
•
OF LAND USE & TRANSPORTATION
WASHINGTON BUILDING SERVICES DIVISION #350-12
0 ���� 155 N��RTHPURS�HYLLS���������R 97124
,� - - -- --'
PHONE: 503/846-3470
� OREGON INSPECTION REQUESTS (24 hours): 503/846-3699
F'� z` ill i1•.• :It � OE? • i d78 51 F`z'o '1.t !:F'C1l2835 Statu 5: APF`R(}VE[`
1 su.'?d�6 � 5/O3 Expiz`es 6 /4;0 5 R�q' ['ate::7/22/O:::;.;
till om posi.tion Tyoe:RESMECH Const ruc�ion Type:
Permit Title::Re Mechanic Applie Date:: 6 /4�O1.1
Description: SFR — A/C — APPROVED SITE PIAN IN FILE
Addz'�ss:', ld� S [/'NElLL CT T . IG�RD
Location::
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