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15639 SW 82ND AVENUE-1 15639 SW 82ND A;'ENUE +�s ■e �r s W srM rim HISTORY: VIEW UPDATE DELETE ESC Delete selected item 6AMASTER PEItMITaAaaaaaaaAAA@.fifiaaaaaaaaaRaaaa€�a$aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa� • :MST90-0064: PROJECT:LANGTREE STATIJS:F IYPD:11/21/90: :JLH: ° • PERMITTEE:TITAN PROPERTIES PRIM. . :MST90-0064: SITE ADDRESS:15639 SW 82ND AVE ° 66 CASE HISTORY aA&AAaaaaAaAaAAAaaaaaaaaReq/SentaSchd/DueaEnd/DoneAAByAStataaaC A705 Foot/found Insp 04/05/90 TP APS' ° ° A710 Post/Beam Insp 05/03/90 TLT, PASS ° A713 Crawl- Drain A717 PLM/Underfloor 05/03/90 TLP PASS ° A720 N2chanical Insp 07/24/90 TLP PAS: ° A722 Plumb Top Out A725 Framing Insp 07/26/90 TLP FAIL A726 Framing <REINSP> 07/31/90 TLP PAIL y A726 Framing <RF.INSP> 08/07/90 TLP PASS ° A72.6 Framing <REINSP> 08/16/90 TP PASS ° A730 Fireplace Insp A735 Gas Line Insp 08/01/90 TLP PASS ° A740 Insulation Insp 08/16/90 TLP PASS ° A745 Gyp Board In©p 08/31/90 RLT PASS ° ° A755 Rain drain Insp A5aa5aaaaaAAAaAa"iaaaafiaAAAAAAAaaaaaa5aaaaaaaaaaaaAAaaaaSaaAaaaAa3aaaAAaaAaaaa,�i. HISTORY: VIEW UPDATE DELETE ESC Delete selected item 6AMASTER PERMITAAAAAAaAaAAAAAASAaaaaaaaAdaAAaAaaaaAaAaAAAa�+aAa£Aaa�3AAA5€�.� aA�t' :MST90-0064: PROJEM LA. 3TREF. STATUS:F : UPD:11/21/90: :JI.H: PERMITTEE:TITAN PROPERTIES PRIM. . :MST90-0064: SITE ADDRESS:15639 SW 82ND AVE ° 6A CASE HISTORY AAAAAAAAAAAAAAAAAAaaaaaARe,q/SentASchd/DueAEnd/DoneAAByAStatAAAC ° A705 Foot/found Insp 04/05/90 TP APP ° ° A710 Poe`/Beam Insp 05/03/90 TLP PASS " A713 Crawl Drain / / ° A722 Plumb Top Out A725 Framing Insp 07/26/90 TLP FAIL " A726 Framing <REINSP> 07/31/90 TLP FAIL e A726 Framing <REINSP> 08/07/90 TLP PASS A726 Framinq <REINSP> 08/16/90 TP PASS ° A730 Fireplace Insp A735 Gas Line Insp 06/01/90 TLP PASS ° A740 insulation [nap 08/16/90 TLP PASS ° A745 Gyp Board !nap 08/31/90 RLT PASS ° A755 Rair. drain Insp aaAAAAASAAAAAAAAAAAAAAAAAAAAAAA�AAAAAAAA�AAAAaAAAAaaaaaAAAAAAAAAAAAAaAAAAAAAAAi HISTORY: VIEW UPDATE DELETE ESC Update action dates, notes for selected item OAMASTER • :MST90-0064: PROJECT:LANGTRFE ;TATUS:F UPD:11/21/90: :JLH: • PERMITTEE:TITAN PROPERTIES PRIM. . :MST90-0064: ° • SITE ADDRESS:15639 SW bZND AVE ° OA CASE HISTORY AAAAAAAAAAAAAAAA&hh&h."iaaReq/Sent&Schd/Due6End/DoneAAByAStatAAAC A760 Water Line Insp A765 Appr/Sdwlk InBD 08/28/90 MM PASS o A765 Appz/Sdwlk Insp 11/01/90 MM PASS ° A795 Mechanical Final 11/01/90 TLP APP A79'7 Plumb Final 10/09/90 MS PASS ° A799 Building Final 10/31/90 TLP FAIL e A970 Case Finaled 11/01/90 TLP PASS aASAAAAA�.AAAAAAAA�AAAAAAAAAAAAAAaAAAAAAAAAA7iAAAAAaAAAAAAaAAAAAAAAaAAAAAAaAAAAAi CERTIFICATE OF OCCUPANCY CITYOFTIGARD GITYOFTIOARD PERMIT M. . . „ . . n MST99-0064 COMMUNITY DEVELOPMENT DEP AMBhf1' OREGON 13125 SW Hdl surd. P O.sax 23397,Tigard,OrOPM Of (6W)6304175 i DATE: ISSUED: 1 SITE ADpRE85. . . a 1 63' 5W 82ND AVE: PARCELS 2S112CC-108780 SUBDIVISION. . . . E LANGTREE ZONINGS BLOCK -MY. -+--li '.. _w___.._I_-T. -_-__.. _____. a 1g_, _______________. _____. _____ .___.. CLASS -_. OF WORK. eNEW TYPE. OF USE. . . MSF OCCUPANCY ORE'. aR3 OCCUPANCY LOADE220 4 tENANT NAME. . . e Remarks r TITAN PROP'.RTIES p0 BOX 6835 ALOHA OR 97007 Phone #c 64554"7'7 Contractors -•_._._______.__._____.____ ._ .___.__. _. BELL.. HEATING INC 15550 BE PIAZZA AVE CL.ACKMAS OR 97015 Phone Mn 243-1184 Rep *. - 1 447 Occupancy of the abOyl! referenced bui ld i ny given, and certifies the compliarcce with the State Of Oregon �ippci.alty C Odes for the group, occupancyo and llae under' which the referenced pe'r'mit was issued. �— FIRE DEPnRTMENT BUILDING INSPECTOR ILDINO OFFICIAL POST IN CONSPICUOUS PLACE INSPLrCTION NOTICF. City of Tigard Building DepartA"ent 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639--41' 1 Inspection: --- ---- Tooting Plbg. Underslab Mach. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINALS Post/Beam Struct. San. Sewer Framing -Bldg. post/Beam Mech. Rain Drain Insulation -Plumb. 1 Plbg. Underfloor Water Lina Gyp. Bd. -Mech� Date Requested: A �g5�,v Time: 8 Address: x /� I O h Permit L L Builders THE TOLLOWINO CORRECTIONS ARE REQUIRED% Inspectors:: Dates��_ 4;_ APPROVED DISAPPROVED APPROVED bUlMrT All Call For Neinsp. iINSpECfION NOTTC City of Tigard Building Department 13125 SM "fall Blvd. Tigard, regon 97213 46 -/4 Inapection Line (Rec-o-Phone): 639-4175 business Phone: 171 Inspection:__ -- Footing Plhg. Underslab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Poet/Beam Struct. San. Sewer Framing - dg. Post/Beam Mech. Rain Drain lneulation -Plumb. Plbg. underfloor slater Line Gyp. Bd.r-I C -Neth• Date Requesteds ��L—' _-�,I' Z' O __Time: AM —,XIPI( Addrese: _-- Permit dt//!�/J,,/h� Builder:�v THE FOLLOWING CORRECTIONS ARE REQUIRED: AV&_ o IY KIA Inspector: _ __ Date:_ /V _ TSAPPROV$D APPROVED SUMTECP TO ABOVE _Call For Reinep. INSPECTION NOTICE City of Tigard Building Department 33125 BN Heli Blvd. Tigard, Oregon 97223 Inspection Lin (Rec-o-Phone)t 639-4175 Business Phone: 639-4171 �� Inspection• _ --- Footing / Plbg. Underelab Mech. Rough-in `r S wlk Found. Mg. Top Out. Gas Line FINALS Poet/BeAm Struct. San. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Mech. Date 1'equestedt ,Mf' P..it t: �24 Address: �� I:C ---.�. .� �_.�.r—r Builder: THE FOLLOWING CORRECTIONA ARE RRQUIRED: Inspectors fit" DatesZz:�Z APPROVED MAP APPROVED SUEJECT TO ABMN Call For Minep. INSPECTION NOTICE City of Tigaro Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested_ "y Time A.M. P.M. Address Permit -__ h Permit Owner _____ Lot # Builder — The following Building Code deficiencies are required to he corrected: /101 J Oda Presentetd o ___ _. _ Approved Inspector V -__- approved Date CALL FOR REINSPECTION C0Ea 0 NO F FW INSPECTION NOTICE: City of Tigard Building Department P.O Box 23397 Tigard, Oregon 97223 Pho 43 - 75 Type o' In pcetion - _� i r Time_ A.M. [/ .P.M. Date F:,auested_ 1�ZL�--s� �11-'s Permit Address #f>111t�S�>2�r-y Lot Owner Builder — The following Building Code deficiencies Are required to be corrected: Presented to Approved Inspector _ _— Disapproved Date _ CALL FOR REINSPECTION ❑ YES CJ NO INSPECTION NOTICE ` City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection / �• -- Date Requested Time_ A.M. P.M. Address _ L ��d — Permit # �� Owner�. _ Lot # _ Builder v/ The following Building Code deficiencies are required to be corrected: Presented to [• Approved Inspector _ — [.) Disapproved Date CALL FOR REINSPECTION C� YES L'I No INSPECTION NOTICE > City of Tigard Building Department P O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection lb Date Date Requestedy �IL - Time A.M. P.M. Address d h Permit #252) :Z� Lot Owner # Builder The following Building Code deficiencies are required to be corrected: Precented to _ Iff` Approved Inspector `^ Disapproved Date -S!Aa -qo CALL FOR REINSPECTION ❑ VEs f-7 No T f INSPECTION NOTICE .T. City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Q Phone: 639-4175 Type of Inspection ��� Date Requested__�4C_,/._L�L�J��� Time X --- A.M.—P.M. Address _l`: --moo`=" – – -- Permit OwnerLot # Builder —71–Zhn — ----The following Building Code deficiencies are required to be corrected: Presented toApproved Inspector Disapproved Date ---- CALL FOR RF,INSPF,CTION ] YES 1-1 NO '-'I TY OF T T GAPD PECE I PT OF F'AYMENT RECEIPT t,10. z9f-) 2',17-1424 CHEM: AMOUNT a Ito. CR(l NAME t TITAN PRnPPRTlE-l::, CASH AMOUNT C)f . t ADDRESS 3 PAY,mE-.,N,r, CSA r[:7 SUSD I V I So 1 ON ALOHA. OR 9'7()(',"--, PURPOSE PAYMENT AMIXMIT PAID F'UPPOSE rYoYMENT AMOUNT F-Afj.� M I AMIOUS 1.5 FEE 1!*#6'-'-',0 !-'iW O'c"I'll TOTAL AMOUI-1-T PA 1'.D INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Crec _ 97223 Phone: 63a-4175 Type of Inspection _ `I ,/,c Date Requested_ `l �n Time xA.M. �jP.M. Address Permit Owner __ Lot #_ Builder The following Building Code deficiencies are required to be corrected• Presented to __ __ X Approved Inspector __ Disapproved I Date / CALL FOR REINSPECTION yes O NO M AL W w. 1■r uw IR sr INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested _ Time—. A.M._ P.M. Address 3 ZI Permit #l0l®�f Owner_ Lot # Builder The following Building Code deficiencies are required to be corrected: ------------------ — ---------- - - Ce t Duh I Presented t _ F] Approved Inspector ❑ Disapproved Date CALL r,OR REINSPECTION L7 YES ❑ NO tw W WJLW �wJURKt INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone 639-4175 Type of Inspection Date Requested ..___1_—: _G' Time A.M. P.M. Address ___.. _ :-—=-�_-_- -- �� — Permit #/ Lj —:2 ,o C Owner__ Lot # Builder The following Building Code deficiencies/1afe re fired to be corrected: —e—lt And Jaen a4 -4� Presented to -, __—_ __-___ Approved Inspector / _— Disapproved Date 771,,�, CALL POR REINSPECTION El YEt C-1 NO INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection -,�- �— Time r_—A.M. P.M. Date Requested L Address ,j 1 _��(..t/ Permit Lot � --F--- Owner #_ Builder The following Building Code deficiencies are required to be corrected: Presented to Approved Inspectoi-- -4f�- Disapproved Date — 7`�— CALL FOR REINSPECTION YES Cl NO CITY"OF TIGARD cnYOF i;�� M A S)TE."R P ER M 1-1, PI',:'RM I T IIST90 0064 COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd. P.O.Box 23397,Tigard,Oregon 97223 (1503)6394176 MST 90-0064 .iI TE ADDRESS- -' 15639 SW 82ND AVE PARCEL: 2S112CC-..08700 SUBDIVISION. . . . » LONGTREE* ZONING: BLOCK. . . . . . . . . . 9 LOT. . . . . . . . . . . . . .. 19 --------- BUILDING .......----- REISSUE:msT90­0006 DWELLING UNITS'. 1 BASEMENT'.. . .. .. .. .. - . 210 sf CLASS OF* WORK„ :NEW BEDRMS:3 BATHS.-3 GARAGE. . . . . . . . . . :353 s TYPE OF USE. . . :SF' FLOOR REQUIRED TYPE OF CONST. »5N F'IRST. . . . :950 sf LEF--T. . :5 ft RIGHT. :5 ft OCCUPANCY GRP, »R3 SECOND. . . :698 sf FRONT. :20 ft REAR. . :32 ft STORIES. . . . . . . :0 THIRD. . . . ..0 sf HEIGHT. . . . . . . . ..20 ft TOTAL-­­­­: 1648 S-f SMOKE DETECTORS. CY FLOOR LOAD. . . . -40 psf VALUE. . . . . $: 71:515070 PARKING SPACES. . :O Reniarks s PLUMBING SINKS. . . . . .. . . . . : 1 FLOUR DRAINS. . . . :0 BACKFLOW PRFVIA IFS. . .'O LAVATORIES. . . . . :3 WATER HEATERS. . . .' 100 TRAPS. . . . . . . . . . . 'TUB/SHOWERS. . . . t2 LAUNDRY TRAYS. . . -.0 CATCH BASINS. . . . . . . :0 WATER CLOSETS. . .-Ji SEWER LINE (ft) . :0 GREASE TRAPS. . . , . . . :0 DISHWASHERS. . . . .- .1. WATER LINE (ft) . - I.00 OTHER FIXTURES. . . . . ..0 GARBAGE DISPI. . . -. 1, RAIN DRAIN (ft) . :0 WASHING MACH— 91 SF* RAIN DRAINS. . : 1 MECHANICAL FEES FUEL TYPE9 UNIT HTRS. . a0 type a ni 0 U 11 t L)y date -recpt /GAS/ VENTS . . . . . ..0 PAYM $ 40.00 ,1 LH 02/16/90 MAX INPUT:0 P11) VENT F'ANS. . :4 PRMT $ 361. 00 TURN ( 100K . . .- I HOODS. . . . . . il PLCK $ 40. 00 FURN )=100K . . vl?) WOODSTOVES. oO 5PCT $ 18.0ti FLOOR FURN. . . . :0 CLO DRYERS. : 1 STDG $ 600. 00 BOIL/CMP < JHP'-'0 OTHER UNITS:0 SSDC $ i-*!50. 00 GAS OUTLETS: 1 PARK $ 250. 00 Owney,j PRMT $ 39. 00 PLCK $ 9. '75 FITAN FROPERTIES 1..,0 BOX 6835 5PCT $ 1. 95 PRMT $ 132. 50 ALOHA OR 97007 5PCT 1, 6.63 Phone Os 6455477 PAYM $ 1668.88 JLH 04/03/90 (.*,ontracto-r: ... ..... ......------ BELL HEATING INC :15550 SE PIAZZA AVE (1-ACKMAS OR 9*1015 Nione #.. k'eq ". . c 447 $ 1708. 88 TOTAL This permit is issued subject to the rejulations contained in the REQUIRED INSPECTIONS Tilird Municipal Code, State of Ore. Specialty Codes and all other Foot/fot.tnd Insp FJ.replace litsp applicable laws. All work will be done in accordance with approved Plost/Beam Insp Gas Line Insp plans. This permit will expire if wort is not started within 180 Crawl Drain Insulation Insp days of issuance, or if work is susoended f more 9ha I&�@days. Plni/Ltndslab Insp Gyp Board Insp IQ- [1 M/Underfloor Rain drain 1.I-is p Permittee SignAtU'('e: r,hanical Insp Water Line Insp PlUmb Top Out App-r/Solw1k Insp Issued Bys Framing Insp MechanicAl F`i n a 1 Call fc)-I, iris -tinn K39--41 75 ffWJ[1FjWLW1W /� SC.*WER CONNECT.TON PER1111, �� ®� TIFARD CMOFTWARD COMMUNITY DEVELOPMENT F 9% 0"GON A:T ,tf,lg #- -- MS'1­90 0 0 4 ,4 'SUED. 13126 SW Hall BW. P.O.Box 2W97,Tigarel,C"Von E ISSUED 04/03/90 (IlDDRLSS. It-5639 SW i�21,1 F) (IOL: SUBD1VISION. . . . . L 0 N 67'R E E PPRICEL-. 251].2(-,C.-•08700 BLOCK. . . . . . . . . . 1 0 1 ZONING: ............. I'El4f)N'r NP11F*:.*. .. USA NO. . , . . . . .. . . :40641 F*I X rURE UNI T'S. CLASS OF WORK N E.W DWEL-1-ING UN)''US. T.'YPE OF' U(SI. . . SF 110. 01- DWILDINGS.- 1 .1 14S1'Al-L 1-Yl::,[ ., U 9 W 1:k*, IIIF'I*---RV SURFACE. . » ".Sf 11 T 0 N r-,R 0 P ER type a ni 0 U YI t by ' date -reept 1,(j I-.,1OX 6835 PRM'T' ].250.00 0L.C.)HCI Cy ':x'7007':x'7007 ;:3`.1. 00 1:1101-le 0: 645547'� P(MI 10.85. 00 JLH 04/03/90 Gol-It-racto-f': CONFR(WTOR NO'T ON Fj'jj,: U."h c)ii e # Req $ 1285. 00 TO'rAl.- REWHRED I N G P E C I- r n 11 S This Applicant Agrees to comply with all the rules and regulations [r► per tion of the Unified Sewage Agencv. Th, permit eypires 12@ days from Sewer the date issued. The total amount PaiO will he forfeited if the ....... —------ __-_.--_.__._• ....... permit expirks. The Agency does not guarantee the accuracy of the ....... ........... side sever 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, thp installer shall purchase ....... a "Tap and Side Sewe,," Permit and q, c Will I-Ierniittee Si-gllAtLt re ........ Jd ................... Call- rar i1lsPect-101-1 639-41L75 � t • I i i i i CITY OF TIGARD REU IF'T OF F"AYMEyNT RECEIPT NO. 90-0001y:, CHECK, AMOUNT 0. 00 NAME : TITAN Pf'tOPEPT I F::S CASH AMOUN'r 08 ADDRESS : PO FOX 603PAYMENT CIFATE 134,/ .' 0 �u�nlVr.��rclyd : ALOHA. 0R 97007-- 155671"? SW 82ND AVE i I r;I.1Fr-'OSE OF F''AYPIENT Amoma PATO) PURF,013E OF F''AYMENT AMI')UNT F"'AIr) � 1-41JIL.GING PERMIT 61 .01) PI_UMPf.NI:j PEPMIT 1":1. 50 ME.t.HANICAL. PERMIT '39.on ST. BUILD PERMIT 'rAx .-,P% b.6'! FLAN CHECK. FEE 9.75 SEWED W-3A 1250.00 `i WEFT INSPECTION '315.00 STF EE"r SGC: 600.00 F I.IF,Krl soc x°50.00 ST(_')RM DRAIN SOC: 250. Of] I I I 1 1 1 iF(iTAL �WIC'ILINT PAID - x""5."1. HFl, CITY ®F` TIIFA� t � PAN CHECK APPLICATION cmroFn6AND PLAN CHECK N 3.3`t-'— COMMUNITY DEVELOPMENT DEPARTMENT PE kMI-r N M-5 r qv -GU 6 _ 13125 S W Nall Blvd,V 0 Box 23397,Tiflaig Uregon 97223,(503)639"4175 DATE ISSUED I S 3 JOB ADDRESS:f " � - -1 AX MAP/ L OT U SUB: LAND USE: 7�— sl5- -- — 'UALU1IION: " �6 OWNER SPECIAL NOTES NAME: _ jiYn 11'">�'�/i'T i REISSUE OF: ADDRESS: ��c1�.���'t �e�� _ LAST REISSUE: /T -5fFo &L' cl3 FLOOD PLAIN/ SENSIT'IVE LAND: _ PHONE_ ,�,c; �i? 7 ' 3L' ' 916 APPROVALS REQUIRED CONTRACTOR PLANNING: NAME:�..._�_ �.`a�,: .v. _ ENGINELRING: -- ADDI2L-ss: _ _ FIRE DEPT OTHER: PHONr: ITEMS REQU79E0 LIST/SUBCONI-RACTORS: _ A14:11/E_ NGiN_1-FRBUS TAX: NAM[ - CALCULATION:: — ADDItESS: i RUSS DLI-AILS: -"- —'—� -- PARKING PLAN: LANDSCAPE PLAN: NION1 : OTHER: I• c0MML'NTS: (� 3_. e "�.c1_ _ _.. f'C.c' lC� c1 Q -- PERMIT N ACC r H DESCkI P'r]ON AMOUNT AMOIIN I PD. HAL. DUL. h1y1�-v ajz y 10-432 r_u) 13uiIdinq Permit F i —/' .0 _ _ 10 431 uu I11umh,iny Permit lees ,r 10 -431 o Mt!cH,+nicaI llutmit Fees ciJ 10 /A0 (11 State b.ai ldinq Tax (5X) (.3 Dui Moch r� 10 433 CIO Plans Check f"ee �- —AIL.._.-- mach m �/ 30 207 00 Sewer Connect ion ✓ /Z5U �Z SU Su'1�9u "QG l30 .444 00 S1wur• Trispu l ion 11.. 44U OCStreet yslum Dev Charcr (G0C) i ✓`�"v_._ _...,...__._......____ -.G�'�v_.., 1)2.-449 00 Parks System Dev C:hatrge (Pl)t:) 31 4r_•0 0Ci Slur•w Drainage Sys1. Dov ( hrg (;iSUC u __............—..._ _._... 10 -230 Dpi I Rf l) 10 230 U6 Washington County r i t 1, 111 (91)%) 10-220 00 Amok n/Wudgowuud 1 c1 I Al N n11lii trnror .ft,l�itukl Rovoived Uy : � �`. ._._.__ Date Rocelve.d: ._,L.(Q..'. . ..... w w t i w rw I w GRADL GI ?RUSION CU 'l'liQl 1NIDU1 'I�1 TUN GENERAL CONTRACTOR NAME&ADDRESS: 06EFUT NO.: _ P _ PERMIT NO.: - _� — AI'1'LICANT NAME AND ADDRESS: i I XCAVAIIONCONI'RACI'OR riTAN rliC e'r'r►•I NAME& ADDRESS: 11 U, 1. At- I to, [11i9 10 Q "� _ OWNER NAME AND ADDRESS: TTIFPEIONE NUMBERS: APPLICANT: (,�- Co4l`l`7 PROPERTY DESCRIPETON: OWNER` C.•:I I r,. �1-1'7 J _ STREET D REAS AND CR STRE ATED GENERAL CON'!RACIiOR: (, r wII EXCAVATION CONTRACTOR._(ir7 - di 2 U SITE/JOB: _ I LEGAI.DFSCRIPTION: i 24 EIR/AF'TER HOURS EMERGENCY TAX LOT NO.: CO "ACi'PERSON,"ITT.E,TELEPHONE: 1/4 SECTION: S11T. SIZE,ACRES: -- 642- - - DIS'T'LIRBED/WORK AREA,ACRES: i 1 OCATION& ADDRESS WIIERE SPOILS LEAVING SITE WIIA,BE TAKEN SHE R 1JNOEF DRAINS T'O:(CIRCLE ONE) (NOTE:l'IMMITS MAY OF REQUIRED) LI�TCI l-BASIN DI'T'CH PIPE CREEK _ --�— (CIRCI.F ONE) PRIV,%j-9 PjtOPERW -- PU)3T.1f RIGIiTOI_WA a_M,QTI/SEU! _ EEN QTlQN CC�hMIQL, (FSC,) MEASURES MINIMUM ESC REQUIREMENTS MINIMUM ESC REQUIREMENTS DlJI?ING CONSTRUCTION: 1.0I10WING CONSIRUCT'ION: SEDIMENTATION F'ACIL.ITIES STABIIAZE FXPOSED SURFACE S•1'ABil.IZFD CONSTRUCTION EM"RAN('E REMOVE. AND RES'T'ORE TEMPORARY ESC PERiMIi'EER ftIJNOIF CON'ROI. FACILITIES CLEARING AND ORADIN(i RESTR1CI IONS CI.EAN AND REMOVE AI.L SIt.T AND DEBRIS COVER PRA('1'I('I;S ENSURE OPERATION OF PFR►iAN'I'FACILT I'IES ('ONS'IRUCTION SEQUENCE OTIIER _ O'ITIER PIAN FOR EROSION CONTROL.PREPARED AND SUBMITTED IN ACCORDANCE WIT'll" 'ECHNICAL GUIDANCE IIANDROOK". EROSION()ONTROI.PLAN DRAWING,AS REQUIRED,HAS PLAN CONSTRICTION N(YLFS COMPI- FE.INCLUDING EMERGENCY 11IIONE f UMIIER, SCIIEDULF.ISTAGINO FOR INS•T'AI.I.Al ION AND REMOVAL OF EROSION CONTROL MEASORES,AND AI'PHCABLE STANDARD NOTES. I HAVE RF�AD AND WILL COMPLY WITH THE.ABOVE AND WILL CONSTRUCT AND MAINTAIN ESC MEASURES AS NECLSSARY TO CON I AIN SIiDIMI'N1'ON THE CONSTRUCTION SITE. OWNERS AT(1RE APPI 147ANf-1 NATURE OFFICIAL,USE ONI.Y RECEIPT D n I1 ACCEI'TE D Ilii NUMBER RF.I'lil Vlil) BY