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Permit C I MASTER PERMIT CITY OF TIGARD PERMIT #: MST2004 -00052 AIII DEVELOPMENT SERVICES DATE ISSUED: 4/1/04 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 15875 SW AVON PL PARCEL: 2S11200 -19000 SUBDIVISION: DURHAM OAKS ZONING: R -12 BLOCK: LOT: 026 JURISDICTION: TIG REMARKS: New SF Detached BUILDING REISSUE: BVH1605 - STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: NEW HEIGHT: 22 FIRST: 616 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 989 sf GARAGE: 307 sf FRONT: 15 PARKING SPACES : 2 TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: sf RIGHT: 5 VALUE: 156 OCCUPANCY GRP: R3 BDRM: 3 BATH: 3 TOTAL: 1,605 sf REAR: 15 PLUMBING . SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: RAIN DRAIN: 100 TRAPS: LAVATORIES: 5 DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 2 GARBAGE DISP: 1 WATER HEATERS: 1 WATER LINES: 100 BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: 1 BOIL /CMP < 3HP: VENT FANS: 4 CLOTHES DRYER: 1 GAS FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 4 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 1 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 2 201 - 400 amp: 201 - 400 amp: 1 st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EAADDL BR CIR: SIGNAL /PANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC/FOR>=225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE /IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 7,228.18 BUENA VISTA HOMES BUENA VISTA HOMES This permit is subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and 6932 SW MACADAM #C 6932 SW MACADAM HOMES all other applicable laws. All work will be done in PORTLAND, OR 97219 PORTLAND, OR 97219 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if the work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Phone: 503 443 - 6033 Phone: 503 443 - 6033 Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You Reg #: LIC 152235 may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -1987. REQUIRED INSPECTIONS Ersn Cntrl 681 -4444 Post/Beam Mechanical Plumb Top Out Low Voltage Storm drain Insp Mechanical Final Sewer Inspection Underfloor insulation Electrical Service Gas Line Insp Water Line Insp Plumb Final Footing Insp Crawl Drain /Backwater Framing Insp Gas Fireplace Water Service Insp Building Final Foundation lnsp PLM /Underfloor Shear Wall lnsp Insulation Insp Appr /Sdwlk Insp Post/Beam Structural Mechanical Insp Exterior Sheathing Insf Rain drain lnsp Electrical Final Issued By : A / Permittee Signature : Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the n t bu / ne day / /3 Building Permit A 1•cation FOR OFFICE: U SE O N L Y E 1 Received ©� Building C Permit NoMS t24)°"/"O°05-2_. E Date/ ' � City of TigarR Planning A,provil Other Si. ✓ (e Zooy "060 y Date/By: Permit No.: 13123 SW Hall Blvd. F EB 6 'to Plan Review ,/ Other Tigard, Oregon 97223 to Date/B : M /1v — 3-.27 Permit No.: Phone: 503-639-4171 Fax: 3 gggg,,960 ..x�,, A I ` Post - Review n � [and Use Internet: www.ci.tigar i ts�F �AFt� � :� Date/13y: g'24 b�( / Case No. t AI 3 $40N Contact • l Supplemental Information uris.: Su See Page 2 for 24-hour Inspection R Name/Method: J . ..jot. TYPE OF WORK .REQUIRED DATA: ,.^ ``-: ";; .N New construction ❑ Demolition 1 & 2 FAMILY DWELLING ❑ Addition/alteration/replacement ❑ Other: — CATEGORY OF CONSTRUCTION Note: Permit fees* are based on the total value of the work performed. Indicate gi 1 & 2- Family dwelling El Commercial/Industrial the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead and profit for the work indicated on this application. ❑ Accessory Building ❑ Multi - Family ❑ Master Builder ❑ Other: Valuation g . JOB SITE INFORMATION and LOCATION No. of bedrooms: j No. of baths: B Job site address: 15t /S . Sw A-10, eiacL Total number of floors New dwelling area (sq. ft.) / Suite #: Bldg. /A t. #: Garage /carport area (sq. ft.) Project Name: VVANY\ U& \<5 Covered porch area (sq. ft.) Se Cross street/Directions to job site: Deck area (sq. ft.) ''-\,\J , ` r;�1 �`� D ��� 1^ G' 'nn �� Other structure area (sq. ft.) Y �'j ` I �f' I REQUIRED DATA:.:. :. . - Subdivision: ow Oat <S Lot #: , CohiMERCIAL •=USE CHECKLIST . Tax map /parcel #: Note: Permit fees• are based on the total value of the work performed. Indicate •DESCRIPTION OF WORK the value (rounded to the nearest dollar) of all equipment, materials, labor, ev 1 c DTI `,) C-1-1 t overhead and profit for the work indicated on this application. IA I - - . ° i t , ° Valuation S Existing building area (sq. ft.) New building area (sq. ft.) Number of stories U} PROPERTY OWNER - , I ❑ TENANT • . - . • Type of construction Vl Name: A')( \f \ a \--'�m 5 Occupancy group(s): Existing: Address: 1 QO1 7, J M Va n ik New: City /St.to /Zi•: ? YA i 12 g32-ic 2 Phone: ej� / p ,, Fax: NOTICE: All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under El APPLICA 12 CONTACT PERSON provisions of ORS 701 and may be required to be licensed in the Business Name: iii f (M jurisdiction where work is being performed. If the applicant is exempt Contact Name: M\ m exss from licensing, the following reason applies: Address: :oJ yle a tu we, City /State /Zip: Phone: I Fax: - E -mail: :BIIILDING:PERMIT FEES; = • : - y� p�/ ��� .,:�:.,.. .�-•... 1 1' j�m �� ll/1 v i s in -um e D _ � . -,-. Please "refer to-fee schedule: ., -, . _ - CONTRACTOR - �.. Business Name: r Wel V 15jj i Fees due upon application S Address: , ► .I /, G k ,_,/g 14-6... Cit /State /Zi s : , 0412MEWilvKarilra Amount received S Phone: .li 1.1 4103 1f, .. J Date received: CCB Lic. #: Authorized ti Signature: V � Date: 1 Notice: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. rr► tic( tit 04 ,•-S • Fee methodology set by Tri- County Building Industry Service Board. (Please print name) is \Dsts\Permit Forms \BldgPermitApp.doc 01/03 01/20/2004 16:22 5032537693 SUN GLOW INC PAGE 02 Mec Permit A.pphc.a Received Mechanical ' hates . Permit loo.: i' — aZ G E planning Approval k)atts City of Tigard �e `� BEEMMIIIIIIMI 1M25 SW Hall Blvd a f,'1 Plan Review otter Tigard, Oregon 07223 c bate/13 , - molt No.: Phone: 503- 439 -4171 Fax: 503 -5980 ptul.Rsvlew Land the : _ " ll Date/8 : Case 14o.: tg Internet: Www.ci,t ar d.or_ us F �. ' - i C 6tttaet Jur1S.: :� 24 -hour Inspection Request: 503 - 639-0 0 N '' Name/Method: , '..- - N.I: 1 1 7:1 N:7.-. d':•. 1, ►i New construction S Demolition m permit (bee are based the total value of the work .la cement Ili Addition/alteration/re • c t ■Other: perfbrrned. Indicate the value (rounded to the =rest dollar) of all mec ma equipment, labor, overhead arid profit_ ' CATEGORT a :CONSTRUCTION 4 - • .31:1 & 2 Fami'ly dwellin_ `■ Commercial/Industrial . `Ill J H . 1 1' .. . 7 1. �. 'M ^:1:DUL, • 110 Accesso Buildin:, Ill Multi -Famil Descri :on . r Total I. Master Builder t Other; II- : .1. Cool'la: JOBSI'I'E E FORMATEON.aiid '' Furnace - addAon air cenditionln - " 14 -00 Job site address: ( S N ' / 14,00 . , NM 14.00 Suite #: = • Pro'ect Name: J, / ,/I ,DIS 14.00 Residential boiler Cross street/Directions to job site: (fbr radiator orhydronia system) 10 D , Q �L/r 1/ ` ` l� / /� �1 � Link in- not otelecuic) V itll in wall, induct, no esi electric) etc) 14.00 Flue/vent for an of above 10.00 ai r units 12.15 SulxliVi11011 'J''i �I `.I /I /. '� Lot #: / Other Fuel Ap • Humes Tax map /parcel #: Water heater _ 10.00 1 ESCRIPTIO'N OF WO • Gas fireplace 10,00 / / I l _ AMMAN Flue vent (water ecntcrlbas fireplace) 10.00 Lo- li: er :as 10.00 MI A di ' 0 .AI ... 10.04 I.11'MIT IM Wood - 10.00 Chimneyillner/fluc /vent 10.00 �1 MEN- Other: 10.00 ;e3tOPLRCY'OWliER' :'; ,:: :. , t Environmental Exhaust Ventilation . �.! /I�r�►�l�l�.t�iII� � w R ange hood/other kitchen equipment 10.00 - Address: UM I► NIA /R IM ' Clothes dryer exhaust 10 -00 • I MI TI Wi TSM Single duct exhaust Phone'mie.� Ms M ieora3 ii; (bathrooms toilet compartments. (M ,A- PLIC NT I� a • c i, a' ` utility rooms) 6.80 Name: V /arw /7/l D $ ANN Attie/crawl Space fans 10 00 . . A,ddress: O O %, Other: �I1 Pbon D ,, Fes' Gas heat ;i y l • ■ •" E- mail: • -. ! .'J!. ,V. II P110.1 • PI Wall /suspettdcd/unit •• - ' ' '' CONTRACTOR . . • ; Water heater Business Name: , : A 4 r . ._ i , Fireplace A IIIE ddress: ' L 6 3 r - t - tf Rael es• • • O . / it r Z ,b Clothes. ;as " IN Phone 5 - Z55-- ITN Fauc',936- 233=7 Other. Total: CCB I.i # : E3) ,yech toi4u F •• t us" Authorized Subtotal: Signature: X10 Date: I l z Ol DI Minimum Permit Fee $72.50 ill_ - Platt Review Fee (25% of Permit_ Fee) `i In (Please c name) State • SurCh T P ERM FE S pP . *Fcc etetbodolo y set by Tli- County Bultdmg Wintry Service B. Notice: This permit a Leption rspirea tea permit is eat obtained within "Site plait required for exterior A/C oohs. 180 days alter k has been seslayted as complete. i :t,DstO rmit!omts\McePermitAPP•d 01/03 01/20/2004 16:03 FAX 5036284633 THE MULLEN COMPANY a 002/002 , Plumbing Permit Application Recei ved Plumbing }..), ...- , Dry: . Permit No/f7/ - Ou6S City of Tigard Planning Aprovat Sewer 13125 SW Hall Blvd. RECEN 4. D Dale/g,: Plan Review , Permit No.: Other Tigard. Oregon 97223 Datealy: • Permit No.: Phone; 503-639-4171 Fax: 503.598. kro i l ■ 0 .• post-F.eview Land Use ........- interact: www.ei.tigarior.us ALL' Al Contact heti.: P.1 See Page 2 f 24 Inspection Request: 503-6394 OF 1 175. ':"-::' , - .---' Name/Method: SU . , !mental taforasetion. GM , • ' • TYPE OP. WORK 7117 • . ' FEE* sallow= gar'spetriTtaiititiiittiirearelitlajust 1 4.- Id New construction • I Demolition Description T Qtr. LL) I Total ' • Addition/alteration/r. • lacement I. Other; ''' .1 ' I 0 ON ''':::2,.'iP-tVIreSY1,114-fath20.,gdahrP.,j7•:•.0,1-;:;',.:, . , 7'. .. e . p‘.' ,,,,,, .'.. , ..:v' -.-- = . '••• . ' • • ' go 1 & 2-Farnil dwellin: la Commercial/Induarial 5111.0 t NL11:11 __2KgO SFR (2) bath 350.00 Accessory Building •I Multi-Family 5FR (1) bath 399.00 • Master Builder 0 Other: Each additional bathlkitchen . 45,00 JOB SITE INFORMATION. aildtOCATION Fire sprinkler - 3q. ft.: Page 2 Job site address: KVC SI....) Ava Pik<- , •• --' *.• - • 'Sat usitia 1. 'i . tV4i• " . ' '-. . Suite #: B1d 1./A.t.#: Catch basin/area dram 16.60 Pro'ect Name: • 4 , 'a L Diarai■ Drywellileach line/trench drain 15.60 Footing drain (no. linear ft.) Page 2 Cross street/Directions to job site: Manufactured home utilities 110,00 . NO Nin - a 4- i1-all VD1 va - Manholes 16.60 Rain drain connector Sanitary sewer (no. linear ft.) Page 2 Subdivision: INAITArmini, Lot #: -__ ■ Storm sewer no. linear ft.) Pa:e 2 Water service (no. linear ft.) Page 2 Tax map/parcel #: -' , • . ' - • -:. : • FixturiciiItem:' ' ., ..' -, ','"•? " • '-:-. • .' DESCRIPTION OF WO ' 1 Absorption valve 16.60 CAt Ili A /A I ' , Backflow preventer Page 2 . Ingiolneralliallib 0)1 Backwater valve 16.60 Clothes washer 16.60 Dishwasher 16.60 Drinking fountain 16.60 ?3 -PROPERTYCIWNER ' -''.' ' ..':, ';115' TEXAM • :,-' , : E 60 jectors/sump 16. Name: I szrawrimarimmignir Er.,_iiii. Expansion tartk 1640 Address: / f I YAROMIERIMMINIVrit 0 Fixture/sewer cap 16.60 " IMIEMMI•AUSITAIM111101=Griia. Floor drain/floor sink/hub 16.60 'Garbage disposal 16.40 Phone: Z4 - 110. EMIUMEAMLIN Hose bib 16.60 ,11 K4 (�, _ „., . • ERSON ', lee maker 16.60 Name: Sri ,A A 7/111 1 ificer,eptoe I6.ss Address: A ,, ea / A diA e-- Medical gas -value; $ Page 2 Primer 16.60 Cl% iState./Zi• ; Roof drain (commercial) 16.60 . Phone: 51)3 - i - 10 UOZ2- 1 Fax: SD3 4L) 744 s.Injoinsin/lavatery 16.60 E-mail: rn" t / MA ... AI 4 lir • *Li '• . D Tub/shower/shower pan 16.60 i ...";" . ';' ' •• • . comntAewrort . . - C ''. , • . Urinal 16.60 Water closet 16.60 Business Name: 7 Ze _ - 4 „' Water M., ' Water heater .60 Address: .,_ AO , re -. .4/4 ... 4 ..i. "• Other: , CitYiStEgeilP: 045 h.ro,DR 9/ A-3 ocher: Phon- Co' , :- , jr Fat 5 . • I, .4 ..,...- ';-,.:1-..,altinablit'eteriiiRjfelia.f.L' ,. •.:: ':,:': •. - . Subtotal 5 Ca Lic. fillprigli :3 ti: - , , . lumb. L'e.#: -20 to; multrnum Permit Fee $72,50 $ Au orizcd '' .41 - Residential Backflow Minimum Fee S36.23 gnature; / ‘-- Date:/ z-` c: Si Plan Roview 2.5% of Permit Fee $ ,r4 , - State Surebas30 MK of Permit Fee) S (Pleas print name) TOTAL PERMIT FEZ 5 Nutlet: This penults application ospirci if a permit is not obtained within ' All tiew commit:retail buildings require 2 seta of plans with isometric or 180 days after it has been letiepiod u complete- riser di ignite Or plan riviow. *Fee methodology set by Tri-County Building Industry Service Board. i:\Ds\Permit ForrnsTimPermitApp.aoe 01/03 01/20/2004 16:08 5036425815 ROSS ELECTRIC INC PAGE 01 ' Elect Per • Vfilu F012 OFFICE: USE ()NIA Received Electrical 4 Date/8 : Permit No.: j' % — COO 5 City of Tigard F 6 1° Planning Approvat Sign 13125 SW Hall Blvd- LD Plan RC P : Permit No.; Plan Review Other • Tigard, Oregon 97223 F TICAR� Datc/BY: Permit No.: Phone: 503- 639 -4171 Fax: 50 ��1 0DIVIS • Post - Review Land Use Internet: www.ci.tigard.or.us g1) .1 r t Case No.: 24 -hour Inspection Request: 503 -639 -4175 " - " Supplemental ltQis. See Page information. r Name/Method: � l nformation. :.TYPE 0 WORK ' . ::..• .. -... • :5' • .PL N'REV EW ' li`ase ctiecR,a7E;t : ' '`1 New construction r facility • Addition/alteration/r- •lacement ❑ p e ❑ p Hazardous location cttmtnetcial ❑ Service over 320 amps - rating of Building over 10,000 square feet, CAi'I E 1Jt'k OFCO1VSTRUC ION.. '' I & 2 family dwellings four or more residential units in Kg 1 & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 601) volts nominal one structure ❑ Building over three stories ❑Feeders, 400 amps or more El Accesso Buildin . • Multi -Famil ■ Master Builder ❑ Occupant load over 99 persons 0 Manufactured structures or RV park Other: ❑ Egress/lighting plan ❑ Other: :.'.`. 10B5fTE I 'ORMAT•IO1t li ittLOCAiION•' -:' Submit sets of plans with any of the above. _ Job site address: 15 ?S 5 A..t P/Prc - The above are not applicable to temporary construction service. Suite' #: B1c1 ./A • t. #: ItEL+"' b'4 UI,E.: ,:. <. j .it . "' .. Pro act Name: Number of ins . actions . er • ermit allowed �i ♦ I �i �� �/ Deserl . lion Qty Foe (ea.) Total Cross street/Directions to job site: New residential-single or multi - family per ■ _� ��/ j v dwelling unit. Includes Attached garage. t� / "' Rot v }- I /d , servicC included: v �-o ° 1C/ 1000 so, R, or less 145.15 4 Each additional 500. • . ft. or • • rtion thereof En 33 I Subdivision: ���/,1A,�D► Lot #: _rill Limited energ_tnsidettrial 75 2 Tax map /parcel #: Each :• .non res idential 95 2 Each manufactured home or modula dwelling ■ • ' •DRSCRtPTION Og WORK • :: 5 . .. .. service and/or feeder 2 . #jt I 0 V I I 'I N A IN ' i Se alteration or r ee l o c s - (actallatioo, I ���t� �1 ■��lt, OratMa orrelae IIII•Idl , O w I 200 am•s or less 80.30 2 201 am. • to 400 am. in 106.85 - 2 ]b'4 :.'•• • lI '.. r ..; '. t.. 601 a ... to 600a •s ] � i T 1 i - ' .' 601 am •: t ° 1 ° ° ° arts .. 24060 IMI 1 60.60 2 Name: ti '�� � ■'A��/ Re • or votes 5 4 54,65 2 � fi6.85 Address: �J . u �. # ,,I , e, Temporary services or feeders - installation, 2 P �, I � ► p alteration, or relocation: 1 200 am•s or less 66.85 1 Phone .'D wr ' i ii r mEtamtiii 1 40201 1 am., to 400 am to 600 am • s 100.30 2 � NM 133.75 2 e 1 Branch i- new. alteration. nr extension per per panel: Address: v��t A LI/1 A Fee for branch circuits with purchase of City/State/Zip: service or feeder branch circuit I 1.65 2 B. Fee for branch circuits without purchase of Phone: ig, /0 Fax: .-L I DTI-) service t Or o nal branfeeder fe e, first branch circuit 44.55 2 E-mail: ig ' I c `Y h add circuit 6.65 2 �1; 1 I j , MIS . C Qfl ' • Misc.(,Servicc or feeder not included); :.CQ1A Pp$':_ Each • rrm . or irri: ' on circle ■ 53.40 2 Job No: Each sign or o inc li• hying 53,40 2 Signal circuit( or a limited energy panel, Business Name: Ross etapezz. '7 "y� � • alteration, or extension _ 2 Address: Q 370 .50 ice,) : _ lf1 aescriptinn: MI „r Cl /State/Zi • : i}t S 60 Or t - Each additional ins. • ion over the allowable in an of the above: CCB Li #: 5" Od - r Z� tnvesti .:lion fee: 62.50 = Other: MI Supervising electrician Elittri l.:Peil itEfetall f r. `:. . si ± afore re•uired Subtotal S Plan Review 25 %, of Permit Fee S Print Name: ' V - 1 , OSS Lic. #: +123 RS State Surcharge (S% of Permit Fee) S Authorized ^ • / i / TOTAL PERMIT FEE S Authorized — C l ` Notice: This permit application expires If a permit is not obtained within Date: �C- / 7 IBA day alter it has been accepted as complete. 41 t� (-it r .r, *Fee methodology set by TM-County Building Industry Service Board. (Please print name) i:\bsts1Permit Forms 1 Elc rermi tApp,doc 01/03 CITY OF TIGARD Credit No.: 200q - 0003 Date Issued: 2/24/04 Engineering u�� �� Authorization _La = i Date: 2/2404 TRAFFIC IMPACT FEE CREDIT VOUCHER Land Use Casefile No.: SUB2002 -00009 In accordance with Ordinance 379 (Washington County Traffic Impact Fee Ordinance) ECF Durham Oaks, LLC developer) (name of is entitled to $ 37.332 in Traffic Impact Fee Credits that can be applied to TIF charges for development on lot(s) 1 -27 of the Durham Oaks Development. The use of TIF credits are subject to the rules and limitations of the TIF Ordinance which are listed on the back of this voucher. WARNING: This voucher must be presented at the time of issuance of the building permit, or if deferral was granted, issuance of an Occupancy Permit. P. Direct Date Permit Numbers Lot Numbers Credit Used Balance Beginning Balance $ 37,332 AV Balance carried forward to TIF Credit No. • Ordinance 379 provides for an expiration 10 years from authorization. login \viola ■tif09.1 kAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA Pr 1 Var. STREET TREE CERTIFICATION .. .. ..- / .. k .. ,,.w Yr�:, I, I k Vt� , O wner / .gent for mill 1-10(2. es .... (P AS E PRINT) i (PERMIT HOLDER) / ". p Do hereb 76,,, = y a ` 11,- zoll location o. meets �� o�f :.. / XT h County 0. si sr, > 3 p L"wti cYfiYYk ,,, '*A•+": as #, ' ; LY4P$ � ,, ',,,,��l$R l and use and development standards for street tree installation. t 5 X15 5(4'' �m ADDRESS: n F LOT: b SUBDIVISION: j 0 k5 04. BY: Xik 0,04; DATE: 11,(01 1 --"./ , - ) 0. RECEIVED BY: DATE: ` ` - • 0 7 0._ CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 " MST BUD 4/-00 a INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received / Date Requested — 3i' AM PM BUP Location l 5 .`? Suite MEC Contact Person .� Ph ( ) to 4 1 Z ' -FDD PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC \ Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT - Post & Beam MOW Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation PP � Nailing I — / K� 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 PASS PART FAIL ELECTRICAL - Service Rough -In UG /Slab Low Voltage Fire Alarm f diet, PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SI Please call for reinspection RE: h)(Eattii 0 Unable to inspect — no access Fire Supply Line ADA r 3 1 / t/ `�q` Approach /Sidewalk Date Inspector �� —� ". Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 ' MST ° O (7(''&J45' INSPECTION DIVISION Business Line: (503) 639 -4171 BUP Received Date Re uested 7 -g AM PM BUP Location 1 S 3 3 1 'L CY \ Suite MEC Contact Person Ph ( ) - 7) d — /C 7 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear ; Framing / d / e i i S 4 l c , ti/ o< '7 2 z =w = —d' Insulation Drywall Nailing �T �as _ �'� a B _ Firewall _ a� Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: 4 4:1I RT FAIL MBING 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 'ART FAIL TRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE 0 Please call for reinspection RE: Unable to inspect – no access Fire Supply Line ADA C • Approach /Sidewalk Date 9 Q Inspector Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL