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13011 SW BROADMOOR PLACE TTFMCAL MRL BUILDING SETBACK LINE& AROUND THF F'%JPEKTY AS SMOuN FFR CITY PLANNING STANDARDS -- --- 7 (~' l• `, TYPICAL. PROPERTY LME � ADJUSTED 0,W c1RADE LINES A/,GkOU l . � 60PA01=SLOPE AT ANY FVJIN t ' "WO)VIDEE A 36'MEAL SILT Sr�EN FENCE arRY.: PMOF'ERTY LME EN061M CONTROL 8APIRIEIR AROUNIO TI-! 7 O4E CI Y 6T.V ATED STTE AS REOUIIRE D AY THE CITY BT.�NDARDB- EWOblC11 C43NTROL BAfftER AROUND THE PROVIDEt A 3b'MRL MLT 6CiRI�N P7Nti \ LOWR kXCAVATP.D 61TE A6 REQUIRED BY 47 TM G"T` STANDARDS — PROPOem EUILD10 PERK 1lSZIt �� RLIEV. ELEV. 140,64' - N. 89D35' 3b' E. -IA' " tism � ELEV. MILEV. -IU' �C qt --- — —SILT FES IGNG , Gr .../ �' ' Q - -_ - r o down Ono ump mm"aftmb qmftb GINA 4R \ d�% STAIR ' . d .3 \ TO aRADE— — �. X ELEV. \ - - ........... .................... ... X11 EXISTING 24'IRDCKERY \ '� d) ELEV. X ELEV. T \ WALLA TWE NEIclaofalr, I HOLLba 0 , V. ........................... ... . f ........................... .. ............ . . ........ . ...... ........................ . 6' fV ............:. + w. a . .. CA, ' . ... .. ... . ... .... ::. .". .. . ................ •C \ :: :: - \\ : TTrICAL MRL MUILDIM2 497BACX LIMW FACE of rooT:�,' - .0 L'LEv� :.......::.......... CITY RaNNMG 6TAfOARD6 F� . .. ..... ... .. . ................ ....... . ..... . .:: .�r� Tri, \ ........... ...... . ...... :.. :::: 1 .zt I �� � � Ae e+.folw 70F OF&-Oft F�ROF'EIRTY LME ,AS \ \ , f di --FACE OF eTf%X-,TURff _;� ��, \ ►4� : S?. ELEV. HA BUT NEED NOT FLA \ \ t :.: PROWDE N"WIDE ENTRY WALK EKTENDMG E)(GEED 4D'MAX ' -03' \ :' WOU M TAS FRONT ENTRY DRIVE �O THE HOU!! SNOW OVER FI 6TURBl9 \ j I SOIL BASE FOR AF'F'IOOVEL`CC71 IPAGTED JJ TOE OF SLOPEGRANULAR –4-0 BUT NEED EKCLM B MAX T \ -3O' WE PU —TYTIGAL DR7VEWA'f -4'MM 96010 r CCNCp IZ�- EXT1'1dD TI-6 74'ROCKERY WALL \ \ x b' / S.I. aTE PROM THE T 6 G NEIGI BOR AS / /' SLAB WITH DROCM MN16W OVER 4'MIN.3/4'M%* SNIOUN AT THE DE PROPE]QTY LINE C MPACTF.D CJk4YLLAR FILL 6L.OPED TO DRAM b TOWARD STREET EDC3E T1TIC.AL FRDPoeE±D BUILDING PETRR'IETER AS SWOUN ADAOTFD NEW GRADF LINES AS S AOUN - I 7d MAK.a ADE SLOPE:AT ANY PONT ON slit FROVIDE 4'A016 STORM DRAM LME FROM TFE PERII"lWRAIN Cs DRAMCS BHE TO T STREET STOW, DRAM A6 RSY THE CITY STANDARDS AND CODER PIOVIDE 4'ABS SANITARY SEWER CONNECTION \ TO E06TING SANITARY SEWER STUB •THE FILTER FAE9RIG SNMLL BE f VRC"ASf J N A C ONTIN000S PROYMI! STREET TRi.FE6 AS REGI MM BY PROWDE A C NCJWM GIDFAIALK AT ROLL GUT TO THE NECLPNCiTH a=EC BARRIER TO AVOID USE OF JOINTS.. WHEN PLANNING AND STVI6ION ,MIDAwo ANO J THE STREET EDGE INSTALLED F'ER THE WHEN JOINTS ARE NECESSARY,POW UEiO6TREQ qv CRY 6TAMPAMG ANp RI:'GUMM-EKTIS DMIGIID 4 DRAWN BY, 36'CONTINUOUS APPROVED PIOST WTH A MNMJM 6-Nc;; OvERJ�,AND 60TH ENDS �—FILTER PADRLC ROLL WTTH 6EC0FFIY FA6TE7 TO THE FYJ6T. "!OR TO 16 TO VERIFI ALL FIELD CGNDTTIq�S r`R;oR To CCJNBTRUCTION .4e ' r'EXISTING aTR�r G1IRpnIG RI ft 61001 L. WHITE vLIRTIGAL STAKES AT b'-O' p�wllfE weodlwnoo E a«Ign O� 0 T1-E FILTER FABR';FENCE %4Al„L ee INSTALLED TO FOLLOW CONTRACTOR 16 TO VE*ItlFT ALL F%i4_ STORM AND �\ 11-E CONTOUIRS WHE!`R FEASIBLE_ THE PENCE POSTS 64.4ALL SANITARY INVERT ELEVATION 6TUB6 FOR PROPER M(I6TING GRADE BE OPAC4D A MAXII• -1 Op b FEET APART AND DRIVEN DRAINAGE PRIOR TO ESTABLISHNO FNAL BUILUNm 6EGU1l1T" INTO THE CA VU D A MINRIL11 OF 3V NGFE6. ELEVATION TRENCH R'LO FREDCCNTIAB •CONTRACTOR 16 TO VERIFY LOCATION CF ALL P'a pox BASE FOR LOWERED FABRIC •A TREJVC.H 8N1ALL DE lDof„AVA A D,ROJ ACE O O T14E WIDE OM0E1ly�p UTILITIES PRIOR TO EKCAVATION ��cwrea o�N=y� ROLL. AIS) EWGKFILL FOR pY D INC""pEEp•DOPE AND ADJACENT 70 TtiE UIOOD 6TABILITY F06TS TO ALLOW T4 FILTER FA9R1C TO ESC BURIED. •CONT UCTOR 16 TO VERIFY THE LOCATION OP ALL / �W-Dr*-W''FfNCE5 SPA"MF Imo+WHEN THEY HAV`E WRVCD F"OMRTY LNE6 AND BUILDING 6ETElACKS TO VERIFY FILTER FABRIC MATERIAL THEIR UdER1 MOPE ]BUT NOT BEFORE THE UF'l4L0FM=ANSA TkAT TWE HOUSE MEETS ALL TFE CURREWT CITY STA*CARD6 "AS e�FERMAI•IENTLY STABILIZED. AND�'=IRE!'E►JT6 •6EDR'ENT tEN•I=S 614ALL BE N6PEGTED ESY Af'PL.ICANT/c'o ITRAG'G4S V♦>'!R•TICAL STAKES "MIEDIATELY A"R MAC44 RAINFALL ,yam AT LEAST DAILY DURING !INTO TIE E>(MTNG GROUNDIR POOi M RA"ALL. ANY IRE6 AW.D RLFPAIRS SHALL BE MADP. AT 6'-O'O.G. E'*'ELUATELY. •AT NO TD 64+au.MOMLA THAN A ONE FOOT DEP'TN aE,61EDP E3E AME SBURY }-}E IC=HTS ALLOIIED TO AC:GtI''4JL.�TE DEHNp A 6EDA'ENT FQ�LGE.SE"TS�'ENT SED" T REMOVED OR REGRADED INTO a-iswm AND rD �� SED'?'tE►'R FEtNGL'a REPAIRlD AND RE-ESTAElI_IS1�!D AS NEEIOED. — ■ qC ' Al FM 8053 SQUARE FEET -- -- SHEET NO. NOTICE- IF THE PRINT OR TYPE ON ANY -( �-1 ► I � � I � I � I � il � fili Iili � ! � I � li ilili� rTT�r�-� ..r r� rl �1_r �tlilili ililili r� ►-�rli ililili hili i ililili li ilililril � liltli1iltli ; lilil � ililrli ililili ililili ililili f IMAGE IS NOT AS CLEAR AS THIS NOTI(,E, �. 4 F) _ _ 8 9 - 10 _ 1_l 12� IT IS DUE TO THE QUALITY OF THE __ — - No.36 �� •, �� ��. _ ORIGINAL DOCUMENT � -- - 67 8Z LZ 9Z � Z fi+ ZTH1114 Z TZ OZ 6T gT LT 9i STT1�1111 C11111,111111 l TI ,,, i1 T 6 8 L IIIIIIIII IIIc 1111 1111 IIIIIIIII Ilii 1111 ILII ILII Illi Ilii 1111- lU ILII Llll I I i Illi Illi 11 l Illi II! IIII ILII Iiil 1111 1111 Illi 1111 lillli �lll 11 Ilii l lll1 IIII 111 .1111 11111111. 1111 l 11 Jll 1>J IIIIf1�il I 0 cn W 0 D O O r A n m I I t I 1 13011 SIN BROADMOOR PLACE CITYOF T I G A R D CERTIFICATE OF OCCUPANCY PERMIT#: MST90-00072 DEVELOPMENT SERVICES DATE ISSUED: 03/02/1999 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S104DB-01000 ZONING: R-4 5 JURISDICTION: TIG SITE ADDRESS: 13011 SW BROADMOOR PL FILE � SUBDIVISION: AMESBURY HEIGHTS BLOCK: LOT:010 CLASS OF WORK: NEW TYPE OF USE: SF TYPE OF CONSTR: 5N OCCIIPANCY GRP: R3 TENANT NAME: REMARKS: PATH I: New single family dwelling w/attached garage & deck. Final Building Inspection and Certificate of Occupancy Approved 10/19/99 by Ken Schriendl, Building Inspector Owner: CASCADE WEST CONSTRUCTION CORP 10445 SV\1 CANYON ROAD SUITE 103 BEAVERTON, OR 97005 Phone: 641-7424 Contractor: CASCADE WEST CONSTRUCTION CORP 10445 SW CANYON RD STE 103 BEAVERTON OR 97005 Phone: 641-7424 Reg #: This Certificate grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliance with the State of Oregon Specialty Codes for the group, occupancy, and use under which they referenced permit was issued. BUILDING INSPECTOR BUILDINd OFFICIAL w POST IN CONSPICUOUS PLACE CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 / BUP .--Date Requested /t� f � AM PM _ Location_ (36 1 �W + '�C��J YriMV 7 Suite MEC Contact Person od d Cdy. e"-sL Ph S�9-5-,3=3� PLM Contractor Ph SWR 160-110-1467�— Tenant/Owner _ ELC Retaining Wall ELR Footing Access: --- Foundation FPS Ftg Drain 5T / 4K`' SGN Crawl Drain Inspection Notes: — Slab ---- -----.__�.—__..- ------ --- SIT Post&Beam - Ext Sheath/Shear Int Sheath/Shear Framing insulation Drywall Nailing Firewall - - -- --- Fire Sprinkler -- - --- - -- - Fire Alarm - - -- Susp'd Ceiling Roof I - --- - - ASS ART FAIL PL NG Post&Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post& Beam - - Rough In Gas Line - - Smoke Dampers i -- PART FAIL EL TRIAL -- Service Rough to _. ---—-- ----- -- _— UG/Slab Low Voltage I -- ----- _ --- _-- 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 RE. I ]Unable to inspect-no access ADA Approach/Sidewalk Date f�- Q - Other �' _ Inspector�� - ----- -- Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD MASTER F,ERMIT ' F ERM I T #. . . . . . . : MST99-007;, DEVELOPMENT SERVICES 13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 DATE ISSUED: 03/02/99 PARCEL: 2S104DB-01000 SITE ADDRESS. . . : 13011 SW BROADMOOR PL SUBDIVISION. . . . :AMESBURY HEIGHTS ZONING: R-4. 5 BI...00K. . . . . . . — LOT. . . . . . . . . . . . :01.0 JURISDICTION: TIG Remarks: PATH 1: New single family dwelling w/attached garage I dee:: This is a special design SFD - There will be no portal frame - Insp ect and approve according to approved plans -------------------------------- --------------------------------- BUILDING --------------------------------------------------------------------- REISSUE: STORIES.......: 2 FLOOR A-------•---- BASEMENT...: 0 sf REQUIRED SETBACKS—— RE(?UIRED-------------- CLASS OF WORK.:NFW HEIGHT........: 30 FIRST....: 2171 sf GARAGE.....: 718 sf LEFT..........: S SMOKE DETECTRS: Y TYPE OF USE...:SF FLOOR LOAD....: 40 SECOND...: %3 sf FRONT.........: 30 PARKING SPACES: 2 TYPE OF CONST.:SN DWELLING UNITS: I FINBSMENT: 0 sf RIGHT....,....; 5 OCCUPANCY GRP.:R3 BDRM: 3 BATH: 3 TOTAL-------: 3134 sf VALUE..1:: 234067 REAR..........: 16 ------------------------------------------------------------------ PLUMBING ----- --------------- -- SINKS.........: I WATER CLOSETS.: 3 WASHING MACH..: 1 LAUNDRY TRAYS.: I RAIN DRAIN ft: 100 TRAPS.........: 0 LAVATORIES....: 5 DISHWASHERS...: 1 FLOOR DRAINS..: 0 SEWER LINE ft: 100 SF RAIN DRAINS: 1 CATCH BASINS..: 0 TUB/SHOWERS...: 3 GARBAGE DISP..: 1 WATLR HEATERS.: 1 WATER LINE ft: 100 BCKFLW PREVNTR: 1 GREASE TRAPS.. : 0 OTHER FIXTURES: 0 ---------------------•---- -------------------- ------ MECHANICAL- --------------------------------------------------------------- - FUJEL TYPES-------- FURN ( 100K ..: 0 BOIL/CMP 13HP: 0 VENT FANS...,.: 4 CLOTHES DRYERS: I GAS FURN )=100K ..: l UNIT HEATERS..: 0 HOODS.........: I OTHER UNITS...: I MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WCX1nSTOVES...... 0 AS OUTLETS...: I ----------------------------------- - -- ------ - -- - -.._ ELECTRICAL ----------------- --RERTDENTIAL UNIT--- --SERVICE/FEFDER---- --TEMP SRVC/FEEDERS-- ---BRANCH CIRCUITS---- ----MISCELLANEOUS---- --ADD'L INSPECTION.- I000 SF OR LESS: 1 0 r00 asp..: 0 0 - 200 asp.. : 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0 EA ADD'L `*SF.: 6 201 400 amp..: 0 201 - 400 asp..: 0 1st W/O SVC/FDR: 0 SIGN/OU1T LIN LT: 0 PER HOUR...... : 0 LIMITED ENERGY.: 8 401 600 amp..: 0 401 - 600 asp.. : 0 EA ADDL BR CIR: 0 SIGNAL!PANEL...: 0 IN PLANT...... : 0 MANE HM/SVC/FDR: 0 601 - 1000 amp.: 0 601+amps-1000 v: 0 MINOR LABEL_ 10: 0 1000+ amp/volt.: 0 -----._.__________.-.--.____---_----_•-_-- PLAN REVIEW SECTION --------- ------------------------ Reconnect only. : 0 )=4 RES UNIT,',.. SVC/FDR)=225 A.: ) 600 V NOMINAL-: CLS AREA/SPC OCC: ----------------------------..---------------------- ELECTRICAL - REST,ICTED ENERGY ------- A. SF RESIDENTIAL--------------------------- B. COMMELTCIAI. -- - -- -------- -- ------- ---- ------- - --- - ------------------------- AMID d STEREO,: X VACUUM SYSTEM..: X AUDIO 6 STEREO.: FIRE ALARM.....: INTERCOM/PAGIN3: OUTDOOR LNDSC LT: BURGLAR ALARM..: X 0TH: :: BOILER.,.......: HVAC...........: LANDSCAPE/IRRIG: X PROTECTIVE SIM: GARAGE OPENER.. X CLOC:K.......... . INSTRUMENTATION: MEDICAL......,. . OTHR: HVAC...........: X DATA/TELE COMM. : NURRT CALLS..,, : TOTAL # SYSTEMS: I Owner: -------------------------- -Contractor: --- -- --- - - ---- - - 10TAL FEES:f 5585.31 CASCADE WEST CONSTRUCTION CORP CASCADE WEST CONSTRUCTION CORP This permit is sub)ect to the regulations contained to the 10445 SW CANYON ROAD 10445 % CANYON RD Tigard Municipal Code, State of Ore. Specialty Codes and all SUITE 103 STE 103 other applicable laws. All work will be done in accordance BEAVERTON OR 97005 BEAVERTON UP 97005 with approved plars. This permit will Pxpire if work is Phone #: 641-7424 Phone #: 641-1424 not started within 180 days of rssuanc or if the work is Reg C.: 62678 suspended for more than 180 days. ATTENTION; Oregon law ------------ — --- --- ---- --------------------------------- requires ynu to follow rules adopted by the Oregnn Utility Notification Center. Those rules are set forth in OAP, 952-001 0010 through OAR 'Fic-001-0080, ynu may obtain copies of these ruiPs nr UNG direct questions to Dby calling (503)246-1987. --------------------------------------------------•-- REQUIRED INSPECTIONS ------------------------- Erosion 844-8444 Crawl Drsin/Back Electrical Rough Insulation Insp Mechanical Final Footing Insp PLM/Underfloor Framing Insp Rain drain Insp Plumb Final Foundation Insp Mechanical Insp Shear Wall Insp Water Service In Building Final _ Post/Beam Struct Plumb Top Out Low Voltage Appr/Sdwlk Insp _ Post/Beam Meehan , ectri i 0ervi /Bas Line Insp Electrical Final _ Issr_ied ByPermittee Signatr-ir-e • ++'4•+++++4-+++++++++++44 +++++++++++++++++++++++++++ ++++++++++.++.++++++ Call 639-4175; by 7:0 p, m. for- an inspection needed the next business day CITY OF TIGARD DEVELOPMENT SERVICES SEWER CONNECTION ' P'ERMZT 13125 SW Nall Blvd„ Tigard,OR 97223(503)639-4171 PERMIT #. . . . . . . : SWR99-0039 DATE ISSUED: 03/02/99 PARCEL: 2S104DB-01000 5ITE ADDRESS. . . : 13011 SW PROADMOOR P'L SUBDIVISION. . . . :AMESBURY HEIGHTS ZONING: R-4. 5 PLOCI.. . . . . . . . . . LOT. . . . . . . . . . . . . :010 JURISDICTION: TIG TENANT NAME. . . . . :CASCADE WEST CONSTRUCTION CORP USA NO. . . . . . . . . . : FIXTURE UNITS. . . : 0 CLASS OF WORT!. . . :;NEW DWELLING UNITS. . 1 TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1 INSTALL TYP'E. . . . :LTP'SWP. IMP'ERV SURFACE: 0 sf Remarks : Sewer connection for a new single Family dwelling. Owner: __..____.__.______.___.___._____._____________.____._..----_--_ .__-- FEES CASCADE WEST CONSTRUCTION CORP' type amol_int by date recpt 10445 SW CANYON ROAD P'RMT $ 2300. 00 GEO 03!0/99 99-313389 SUITE 103 I NSF' f 35. 00 GEO 03/02/99 99—:313389 BEAVERTON OR 97005 Phone #: Contractor: OWNER Phone #: $ ?.:5 X710 TOTAL Reg #. . ------- REQUIRED I NSPECT I DNS — - -- --This Applicant agrees to comply with all the rules and regulations Sewer Inspection of the Unified Sewage Agency. The permit expires 188 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 Fide sewer laterals. If the sewe, k not located at the measurement given, the installer shall Prospect 3 feet in all directions from the distance given, if not 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 Center. Those rules are set forth in OAR 952--001-0818 through OAR 952-8801-MAA. You may obtain copies of these rules or direct questions to OK by calling 15031246-1987. _ Is�;lled h —_C -� i�'�—, F'ermi.ttee SignatUre • +++-F+++4++++++4++++++++++++++++++++++4-+t+1111+4-+++++++++++++1111+++++.4-+++++4++++ Call 639-4175 by 7:00 p. m. for- an inspection needed the next bkisiness day ++++++++++++++++++++-'4++A-++*+;-+++++++++++++++++f-++++++++i•+++++++++++++++++++++++ CITY OF TIGARD Residential Building Permit Application Plan Check#c)� 13125 SW HALL BLVD. New Consti Liction Recd By 97 TIGARD, OR 97223 Single Family Detached t+ Date Recd !C� Date to P E V 503-639-4171 ,I Date to DST F 503-684-7297 Permit# /lys�i 9�GlD7;2 Print or Type Called <a--w Incomplete or illegible applications will not be accepted 1,PT.cF P` V-61>,C> FA Name of Project Na e .lob LA 10 Architect Mailing Address Address Site Address - ;, t y - - -- 1 304-%,JCit 11 4 ( f�c,��c�w�Gt QL . yS y/State Z��Ipp Phone CAWADE WL'S'T CON!lltttlC'CION �AIName Owner M3E �VERTON,OR 97006 K t k Lv h I City/State ZipPhone Engineer Mailing Address �`'l 1 --7y1`� City/State Zip Phone General Name — +I Contractor D�.acribe work New CASCADE WNW CONINMUCTION '100 ' � Addition O Alteration O Repair O io 01CA&Mbi RDI sum#I" Mailing Aldft to be done — Prior to permit _ N,OR 17= Additional Description of Work: issuance,a copy City/State Zip Phone of all licenses ( y/-7,4 Zy are required if Oregon Const Cont Board Exp Date PROJECT - - -' expired in COT Lic.# 11 ) VALUATION " database w7Lt Mechanical Name — NEW CONSTRUCTION ONLY. Sub- W J �e" E SkA. kA ON4-{O'1 Sq. Ft. /Ho� I Sq. Ft Gar ge Contractor -�Mailing Address �.[ � _ 7F'/ Prior to permit y � o N w 2- -�, 5 + Indicate the restricted energy installation by the electrical subcontractor in the followin areas issuance,a copy City/St to Zip Phone -- -- - - -of all licenses `� i 1 )Ot1•{� I_1_ _� �(f� 1`�(_I Restricted Audio/Stereo are required if Oregon Const.Cont.Board Exp Date Energy __System Alarms expired in COT Llc.# Z %7 �; Installations .Vacuumrigation database 4 ��� I System System Plumbing Name n (check all that Other: Sub- ?Q (. VJ t S 1' J apply) - r g Contractor --- Mallin Address 'Number f UnIn Building Unit Nurhber Designation u _ -2-110 NE '�� I Qd Has the Subdivision PIt/t recorded? N!A Y S NO Prior to permit City/State tip Phone i issuance,a copy N ('��•a r a 714-4 �,�t a `lY( -- —�- -of all licenses ar Oregon Const.Cont.Board Exp.Date required if Lic# v n expired in CO - database Plumbing L.1c.# Exp Date I hearby acknowledge that I have read this application,that the �3; 3I , I information given is correct, that I am the owner or authorized agent of the owner, and that plans submitted are in compliance with Name Uron State laws. Flectrical �''-�['t'r e k4C't2,1 L — Sign4"e of 0' ner/A ent , ' , D to rj Mailing Address Ii 7 I Sub Contact Person Name Phone# Contractor �,�� -3`8q _ T04 A �a� �.qI--IgZq City/State tip Phone Prior to permit issuance,a copy FOR OFFICE USE ONLY: of all licenses are Oregon Const.Cont.Board Exp.DateMa #: required if Lic# 7-U 1 19 -Z' 2,)l'o r• _ }"' p qlLC! expired in COT _T --- database Electrical Lic.# Exp.pqate S acks Zone. 2y - IUIC l//`t Electrical Supervisor Lic.# Exp Date Engi Bring Ap roval Planning Approval. TIF i\fists\forms\sfd-new doc 11/20/98 SEE 35MM ROLLJ 22 FOR LARGE DOC UMENT I