9415 SW HOME STREET .LS 31NOH MS S lb6
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9411 SW HOME ST
MAST
CITY OF TIGARD PERMIT ERMIT PERMIT
#: MST2004-0020d
DEVELOPMENT SERVICES DATE ISSUED: 8/25/2004
13125 SW Hall Blvd.,•1 i9ard, OR 97223 (503)639-4171
SITE ADDRESS: 09415 SW HOME ST PARCEL: 25111 DB-KE221
SUBDIVISION: KESSL.ER ESTATES NC. 2 ZONING: R-4.5
BLOCK: LOT: 021 JURISDICTION: TIG
REMARKS: New SF detached.
BUILDING
REISSUE: BVH3303 STORIES. FLOOR AREAS ,_ REQUIRED SETBACKS REQUIRED -
CLASS OF WORK: NEW HEIGHT: 73 FIRST: 1,45+ of BASEMENT: of LEFT. 11 SMOKE OETECT'JRS Y
TYPE OF USE: SF FLOOR LOAD. 4n SECOND: 1,641 of GARAGE: 631 of FRONT: 11b PARKING SPACES
TYPE.OF CONST: 5N DWELLING UNITS. I THIRD of RIGHT:
n14 10
OCCUPANCY ORP: k3 BDRM. 5 BATH 3 TLITAL: J 3114 of VALUE: 377. REAR: 1
_ F-UMRING
SINKS: 1 WATER CLOSETS. 3 WASHING MACH. I LAUNDRY TRAYS: i RAIN DRAIN: 100 TRAPS:
LAVATORIES: DISHWASHERS: 1 FLOOR DRAINS: SEWER LINES: 100 SF RAI-:ORAIN?: 1 ^.ATCH BASINS:
TUSISHOWERS: .I GARBAGE DISP: 1 WATER HEATERS, 1 WATER LINES: 100 BCKFCV PRF-1ATR: GREASE TRAPS:
C THER FIXTURES.
MECHANICAL_
FUEL TYPES FURN<10OK: BOIL/CMP 9 3HP: 1 VENT FANS: 5 CLOTHES CRYER: I
GAS FURN> 100K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: 2
MAX INP: btu FLOOR FURNANCES: VFNTS: WOODSTOVES: GAS OUTLETS: 5
ELECTRICAL
RESIDENTIAL UNIT _ SERVICE FEEDER _T£MP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS _ADD'L,NSPECTIONB-
1000 SF OR LESS: 1 0 200 amu: 0 - 100 amp: WISVC OR FDP: "JMPIIRRIGATION: PER INSPECTION.
EA ADD'L 500SF: 6 101 400 amp•, 201 400 amp: tet WO SV7FOR. SIGNIOUT LIN LT: PER HOUR:
LIMITED ENERGY: 40. 600 amp: 401 600 amp: EA ADDL BIR CIR: SIGNALIPANEL: IN PLANT:
MANU HMICVr.IFOR. 601 Ingo amp: W1+2mp5-.000v: MINOR LABEL:
1000+amolvolt
PLAN REVIEWSECTION
Reconnect only:
>•4 RES UNITS: SVCIFOR>•116 A.: >600 V NOMINAL: CLS AREA/SPC UCC.
El•'.CTRICAL•RESTRICTED ENERGY
A.JF RESIDENTIAL S.COMMERCIA.1 .
0 j010 6 STEREO: VACUUM SvSTI AUDIO 6 STEREO: FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNOSC LT.
BURGLAR ALARM: C11 H BOILER: HVAC: LANDSCAPEIIRRIG: 'ROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATAJELE COMM: NLASE CALLS: TOTAL a SYS TEMS•.
Owner: Contractor: TOTAL FEES: $ 7,952.42
This nit Is subject to the regulations contained in the
BUENA VISTA CUSTOM HOMES BUENA VISTA HOMES Tigard Municipal Code,State of OR Specialty Codes
6932 SW MACADAM AVE STE C 6932 SW MACADAM SUITE and 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 with,n 180 days of issuance,or if the
work is suspended for more than 180 days.
Phone: 503-443-603-1 Ph 503-443-6033 ATTENTION: Oregon law require.,yo,l to follow rules
adopted by the Oregon Utility Notifinatl,)n Center. Those
Reg 0: LIC 152235 rules are set forth 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
Ersn Cntrl 6814444 Underfloor Insulation Electrical Service Gas Line Insp Water Service Insp Building Final
Sewer Inspection Crawl Drain/Backwater Electrical Rough In Insulation Insp Appr/Sdwik Insp
Foundation Insp PLM/Underfloor Shear Wall Insp Gyp Bo^- .nqp Electrical Final
Post/Beam Structural Mechanical Insp Exterior Sheathing Inst Rain dri n Insp Mechanical Final
Post/Beam Mechanl..a Plumb Top Out Low Voltage Water Li - Insp Plumb Final
n
Is5Jed Ry ' .� ,'C>!1_,��L�_ Permittee Signat ire
Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day
CITYOF T I G A R D __SEWFR CONNECTION PERMIT
DEVELOPMENT SERVICES PERMIT#: SWR2004-00208
'10125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/25/2004
SITE ADDRESS; 09415 SW HOME ST PARCEL: 2S111DP4Kc ?21
SUBDIVISION: KESSLER ESTATES NO.2 ZONING: it--i s
-�— BLOCK: LOT: 021 _ JURISDICTION: I'll
TENANT NAME: —+
USA NO: FIXTURE UNITS:
CLASS OF WORK: NFW DWELLING UNITS: 1
TYPE OF USE: SF NO. OF BUILDINGS:
INSTALL TYPE: 1_TPSVVR IMPERV SURFACE:
Remarks: Sewer connection for new SF
Owner: [�----------- —
FEES
BUENA VISTA CUSTOM HOMES - - --
6932 SW MACADAM AVE STE C Description Date Amount
PORTLAND, OR 972'3
[SWUSAJ Swr Connccti( 8/25/2004 $2,500.00
[SWUSAJ Swr Conncctii 8/25/2004 $0.00
Phone: 503-443-6033 [SWINSP]Sewcr Inspect 8/25/2004 $35.00
Contractor:
[SWINSP] Sewer Inspect 8/25/2004 $Q.00
_
'--- - -- -- Total 535.00 --
Phone:
Reg #:
_- Required Inspections
This Applicant agrees to comply with all the rules and regulations of the Clean Water Services. 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 '--�ctions 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 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 by calling (503) .246-5699.
Issued by: _,� s, Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next buaine— ss d
BuildinisT Permit Application ReceivedBuildrming
—� --—
Date/By:: ? /y J Peit No.: `Ji
City of Tigard Planning Approve other ��''���
Date(B Permit No�r=pp doo
13125 SW Hall Blvd. Plan Review other -
Tigard,Oregon 97223 Date a•:M n v Permit No.:
Phone: 503-639-4171 Fax: 503-598-1960 Post-Review — Land Use —
Internet: www.ci.tigard.or.us DateMy: Case No.
-ontact 0 See Page 2 for
24-hour Inspection Request: 503-639-4175lyome/Method; �( Su plem;ntal Information
TYPE OF WORK REQUIRED DATA:
New construction Dt:mohtion 1&2 FORLY DWELLING
Addition/alteration/replacement Other.
CATEGORY OF CONSTRUCTION Note: Permit fees'are based on the total value of the work performed. Indicate
1 &2-Family dwelling Cornmercial/Industrial the value(rounded to the nearest dollar)of all equipment,materials,labor,
Accessory Building Multi-Family
overhead and profit for the work indicated on this application.
Master Builder Other: Valuation............Ao��rs '
.................,............... S
JOB SITE FORMAI s 4ad LOCATION No. of bedroomsNo.o baths:
Job site address: Total number of ............
New dwelling area(so. ft.)....... n
Suite #: BI /A t.#: /'"""' —
Garage/carport area(sq.R.).........��„..:
I Project Name: Covered porch area(sq. ft.).........,.t�
...............
Cross street/Directions to job site: Deck area(sq.ft.)..................... ........ ............ _
Other structure area(sq. ft.)... ........................
REQUIRED DATA:
COMMERCIAL=USE CUECKLIiST
Subdivision: Lol -
I ax map/parcel r#: Note: Permit fees'are hasea on the total value of the work performed. Indicate
DESCRIPTION OF WORK the value(rounded to tht:near est dollar)of all equipment,materials,labor,
NEW CONSTRUCTION-SINGLE FAMILY RES . overhead and profit for the work indicated on this application
DEATACHED RESIDENCE Valuation......................................................... $
Existing building area(sq. ft.).........................
New building area(sq. ft.)............................... �-
Number of stories............................................
PROPERTY OWNER TENANT Type of construction.....................................-
Name: Buena Vista Custom Homes Occupancygroup(s): Existing:
Address: 6932 SW Macadam Ave. Ste C New:
City/State/Zip: Portland, OR 97219
Phone: 5 0 3-4 4 3-6 0 3 3 Far:5 0 3-4 4 3-2 4 4 3 NOTICE: All contractors and subcontractors are required to be
APPLICANT CONTACT PERSON licensed with the Oregon Construction Contractors Board under
provisions of ORS 701 and may befequired to be licensed in the
Business Name: SAME AS ABOVE — jurisdiction where work is being performed. If the applicant is exempt
Contact Name: E1 iabeth Moore from licensing,the follawing reason applies:
Address: _
City/State/Zip: --
Phone: Fax:
E-mail: BUILDING PERMIT FEES•.'
Please refeF 6 ied�ieli;dule'-
CONTRACTOR
Business Name: Buena Vista Custom Homes Fees due upon applicatic:........................ ...... 5 _
Address: 6932 SW Macadam Ave. Ste C
City/State/Zip: Portland, OR 97219 Amount received............................................. S _
Phone: 503-443-6033 1 FSx:503-443-2443 Date received:
CCB Lic. 0: -152235
Authorizednn _
Signature: U• Date Notice: This permit application esplres If a permit is not obtained within
1 R0 days ager it has been accepted as complete.
'Fee methodology set by Tri•Couniv Building Industry Service Board.
(Please print name)
i:\Mts\PermitFomrj\BldgPcrmiLAppdoc 01'03
03/04/2004 15: 11 5036425815 ROSS ELECTRIC INC: PAGE 02
tumwmlklw
Electrical Peirce„'~ Q application Rocc„ed Electrical
Permtt i ODa�l�q
City of Tigard Planning Approval Sign
Dawrjy Permit No
13125 SW Hall Blvd. Plan Rcvicw Other
Tigard, Oregon 97223 Da1dH Permit No:
Phone; 503-639-4171 Fax: 503-598-1960 Pt>SLRrvicw land use
Da _
Intctt- s+(
rt: ww,ci,tigard.oGMMY; Care No.:u9 Contact luras Sar Page 2 fer
1.4•hour Insprction Request: 503-6394175 NamelMethod: Su�rpl.mental[nRrmatlan.
- 1'YYE OF WOkOC nAN REVIEW /sere elStai tt it7l,ibat• I :;J
New construction Demolition service over 225 amps. Hcalth-caro facility
— ❑
_ AdditioN'CAT tinn/replac'CON commercial Hvardow location
Other: ❑;Service over 320 amps-rating of (]Building over 10.000 square feet.
CAT8fiC1StY OP'CO@iSTR OK 1 alt 2 ramily dy cilings Ibur or more residential units in
&2-Family dwellin CommciciaUindustrial sYnmm over 600 volts nominal one ewcture
Building over three stories ❑Fecdera,400 amps or more
Accessory$uildin Multi-Familyoccupant load over 99 persons r• vlanufkctumd structures or RV park
HMaster Builder Other: Egreudlightin`plan LJ uthe --
'109 tt 9fi E INF'ORMA'TION'and LOCAMON Submit_tats or plans with any of the above.
Jo 17 site address: Y %5 - above are not applicable
to tt�e�moorlry�*_�construe 1 A service.F'Elti'e J1.Q151aJ{/ijt. ' .• �. .�• �.L�+` -
Suite#: N -amber of Ina Hoas tr it alicv ed
Project Name: _ Description oty Ftt(e L) Tstal
Neff midectrrttaintit cr malt{-hmily per
Cross street/Dlrection3 to]ol'1 S1tc dwellint ask.lorladep Attached garage.
Service Included;
1000 sq.h.or less _ 14515 _ 4
E.ch additional 500 ig.N or portion thertor 31.40
Subdivision:
Lot : Lim ited crier ,residential 15.1 2
Limited U non real af�I- 75 00 2
Tax map/parcel#; _ Fach manufactured home nr modular dwelling --__ _
DESCUrMN.OF WORK Rervice ad/or rerdnr 90.90 2
Srrvtcea feeders ders-Instanstion.
Ql� Ons L� I�GII C _J IV aherarion r rsiocubn:
t•c ��, e En e --� 201 am tit lean �__ — Bo,�o
201 vn to 401 a 106.35 2
401 Lmp%tel 6%amps _ 16060 2
R'OIPERTY OWXZR 'EEttiP 601 arnpl to 1000 arm 140,60 2
Over 1001 Amos or volts 454.65 _ 1
Name: t e. a 'f w ()t Reconnect only
Address: 51V jL1aC,0Cj(1M_,4Y(. 5te,e Temporary servien or(eeder#-insi alivion.
City/State/Zip: Vcr4jond. G 61-79/q alteration,or relocation:
200 am )r teav 66.85 1
Phott . y 3� Fax 3 2o1 amps to waw __ .100.30
IC C,I' OK 411 to 600 am _ 113.775 2
Branch circuits-new,alteration,or
Nalne: S ✓� SS ertmslnn per penrl:
Address: A.Fee rot branch circults with purctusc or
service or reede�roe,each Manch circuit ` 6.65 2
CI /State/Zip:_ _ B Fee for branch orcuin without ptacha_a of
— $m ice or reed”foe,fine branch chwh 46. _ 2
Phone: Fax: FAChadditional Manch circuit 6. S 2
E-mail: _ Mise.(Service or reedcr not Included)
_ .a C C1N TRACtIOFt _
jach Eop or" Anion circle 51.40 2
-- -- u- --- -- Each ai or outline 11 htln 57,40 2
Job No: _ Signal circuit(s)or a Ilm ted energy panel.
Business Name: pay t ��rui ,CT eAtenslen Pan 2 :
Deserrgtien:
Address:Q 870. 5 c�_ cka 1 1W #��3
Cl /StSttj/z►p: 1 �Q► G` r-21�s 7 F,ach additional iespectioo ever the allowable In 411 of the above:
1 �J PetI_n �cr hou(min. I haa)� 6 .SO
Phone: (a tig
2800 Fax:St7 S invosdon fer -- _
CCB Lic.#: IS7d Lic.#: GG Other°N' -- — —
Supervising electrics ).f inlnl -•� ' -
X
Si /.��Q Subtotal S
/� ature re uired• _ __ Plan Revitw 2Le/r of Permit Fee S _
Print Name: �Ule0 Lic.#: _ 3eZ� State Surrhatg—a(85�,o—hcrnnt Fen S
Authorized TOTAL PERHrf FEE S
Sittnalurr. —_ Date: r4atic130 de a his fit has been tion eiplrrt If Permit b not obtained+ithin
Y etpted as complete.
.Fc.;r"AhedolnRy set by Tri-Cnunty Balldloa industry Serrate ISoard
(Plr_tc print none) —
i:\Dstt\Pcrmh Fotmv`.E'cPtrmitApp.doc 01 r0?
03/04/2004 16:26 5032537693 SUN GLOW INC: PAGE 02
Mechanical Permit ,A.pplicationReceiveQ
- _
0%W8Y: Permit Ne,; ►' i_ , �,, ,4
City of Tigard Planning Apprrvai y Aultding
Det hrtnit Na.:
13125 SW Hall Blvd. pan Review after
Tigard,Oregon 97223 c te/41 ecrmltNo.;
Phone: 503-639-4171 F3.-: 503-598.1960 poet' ew Land use
Dam/Sy: Cue No.•
Im)err*c www,ci.tigard.or.us Connct Juns �T ra 3rePaee Y for
7.1 hour Instnction Request: 503.639-4175 Vatttelytathod; 19rpPlettteet>sJ Infurnatioo.
n� r+:P=r �t:rrCOrih►7cC�/tJ 1►11�+.114DU—�'r-F47�11r�CC ;_ �1
New construction i Li Demolition Mechanioal pemut fees"arc based on the total value of the work
Addition/alteration/replacemEritOther: performed• Indicate the value(rounded to tht newt dollar)of all
CA G41tz t1Hr.CONs�RUETI �+ ':' i".':.:: meehanicat materials,eq,sip pent,labor,overhead and profit.
1 &2-Fatnily dwelling C0=1C ciaVlndustrial Value: 5 See Page a for Fee 9cledule
U
Accesso Buildin Multi-Family RFSED"M `—>EN >e pig -
-- J cri�rlaa O�tSyFe ea-1 I 'Total
Master Builder _ Other: Elead c�1ia _
J STtE_ MAT[ON aid LOf..u•'TI<ON furnace-add-on aircmditigl LLL 14.00
Job site address: /S Hf 2L Gus heat purnp - 14.00
Suite 0: Duce work 14.00
Project Name: Hydronic hot water system 1400
C kesidential boiler
Cross street/Dircetions to jot,site: I f5r tad' or or h ronie r4wm 14.00
Unit heater!:(fuel,not electric)
U,wall,ln.duc su M4 ccc.) 14,00
E 'vent Cor anof 4bo 10.0
Subdivision: _ Lot N; "lrt�''' z.ts
E'ud Appilmagg
Tax /pattcl# _ Water heam 10.
r o.r.WrIONOF W01r qac f, lace 0.00
N STCT IN-4--S I-1i GX'-'.-FTR1 LY I Flue vent(water he*wr! +a us) 10.00
DETACHED RESIDENCE ^� Lo li h r(gu) 10.00
— -- WoodRellet stove (0.00
Woad dMlaWirtsert 12,22
G".:mm eyllincrifluely tO.OD
Ola Oi_ ;ra: Other: 10.00
,r• .t tinim_`ttteaea ti hauu&Vmtsniatiaa
Name: BSiPi1��Yist:a.CsuSS. M $a!t1' [ RautgehootUothe kitcbeftequiprttestc 10.00
Address. 6932 Stn Mac&A Ctotha dryer exha est 10.00 --
Cl /State/Zi :Portland' OR 97219 Single duct ochaust
Phone _ _r,n 14 1 I Fax;SD--3- (bathrooms,toilet eettt>xtttmcnts,
L GKri? �Ol�PFA,t;T P1�RSOI't L• i1r rootM --
Name: David GO_lobay 4ttic)Crtwl ace fin: 10.00
Other; - 10.00 _
Address: _ --�PW
ity/Statel 'p: '" _AO for first 4;514 eAth additional _
Furnace etc "
Phone: Fax, Gas hot�tm _ -
E-mail: waillsua tudal!unit heater ••
ti~QA(_�R�1 :. -. Arai"heater -- ••
B1lsiness Name: F,3313 GL rw Tnc_ — Fl laae •"
Addros1:2428 SE 105t:h Ave. _ B e ..
C: /State/Z�Oxtlanci�OR 97216 Cloches er as meme
PhOte: 03-253-7789 Fax:503-253-"7 t
CCB Lic.*: 48131Total: �"
Moel,aela.�sdt Pea"
Authorized - Sub tal: S
9igttatut+: .� i Date ►� in"i➢&tori rec 90 S --
David Golob y !art Kav(eiw Fteee xof dt Fee) 5
(p ease print name) _State uS rc .sis Pettnit Rae _�
TOTAL. IT
rsoUw. Thli permit appileatlon expires if a permii if oet abtaiaed within •F^c siethedetep set tw Trileunty Bunding ladust-ry Scr bard.
I$r!days after it has beet!*"0014111016 cotnpietr.. •'Site ptan rcquircd for raterior A/C unitg.
i:V7sMPrrntit PocntsWtrOpamtitApp•doc
(WO)
03/04/2004 16 21 FAX 5036284633 THE MULLEN COMPANY + BUENNA VISTA (aJ002/003
Plumb—ing Permit Application RxCt„W leu
Date/13Y 9 PrmmOitln
s >(r O C y
City of Tigard P:amins Awro%oal
a —
13125 SVS'Hall Blvd. Plann ltcPLPermit No..
Plan ether
riearcl,Oregon 972.23 all/By: Psrmlt No..
T'hooe: 503-6394171 Pax: 303-598-19W Post-Rtview tend it
1rlietTlet: wvvw.Cl.tigard,o[.us 2iL"1 _ Cut No:Contact Jury:& See Pace 2 ror-
24-hour Inspection Request: 503.639.4175 Name/Mc 0: I 79�ovI'M Cat inebrmttioa-
_i' •-j';Q�w ,- -r.�_ ”' $*SCIMULZ((or i Ctrl intoY'mitio eye
New construction I M Demolition Dacri tion =Qty. F aa. TOW
Addition/wit W$,'n/r 1RCLIM (filter:
i8,G0 k'MCM=Tcrci�""
1 &t-Fanul &welliesal sl 1t 1 bat SFR 21 bath 350.60AcCeSilo Buildin SFR 3' bath _ 399.00
Matter Builder Other: Each mtit itiortal badJkitchen 43.00
tOB ME . Ti dL-W_-^77QK Fire wnsikin-sq,M:
Job site address: /y ~s�tc UculHsv a 1
Suite#: B1dz./AytA _�� Catch basin/uta&twin - - 16.60
Project tinme Drywall/leach line/mch draloT 16.60
--
FoadDs drain(W. lincru ft.) _ Pane 2
Cro73 9"eVDirecuors[o job Site- Manufactured home utilities - 110.0_0 _
Manholes 16.60
Rain drain connector 16.60 -
$anitary fewer Cno. linear!l. Pa a 2
Subdivisfow Lot>M; Storm sewer(no,linear ft. Pa s 1
Tax map/pareel ff. - - water WACO no.!inset page 2
Fbaun CRII"TIO U6 VH�RiC. or Item
Abso tion valve
N1 ,,,CONSTRUCTION -SINGLE FAMILY Backflow prcvcntcr Page 2
FAMILY DETACHED RESIDENC Baokwatervalve 16.60
Clothes washer 16.60
- Dishwasher 16.60
Drinkins founia(n _ 16.60 —--
--- 'iectort/sump - 16.60
Name: Buena Vista Custom HOMON Ex tutstontank _ 16.60
Address: 6932 SW 1�,O¢ m -- 1xUw18wor ca - 16.60
Ci /State/Zi : Portland OR 97219 Floor drain/poorsink/hub 16.60
Garba a dig 16.60
Phone: 503-443-6033 Fax $03-443-2.443 Hose bib 16.60
APPLICAM' N lee maker �— _ 16.60
Name: Ray Mullen Inters or/ exec oaf 16.60
Address: Modlew Ede.value: S —- Page 2 1 `
Ct /5tate/Zip: Prima _ 16.60
- ----- Roordraln commerclnl 1560
Phone: Fax: _ Sink/basidlavato -- 0
E.[riajl: T ./showe�dlhoower pan 16.60 _
�.COPEIRACTOR 16-60 _
Elti.iitlless Name; EID MuJlari Plumhim wan -het 16,60
waterffeaeater 16,60 _
Address: 244"D SW Rainbow Lame
C1 /Statc/'i y Ilia 97� -_-- lhhcr.
Phone: 0 -028 X32__ SD3_ _ ambli * •+ _—.
CCB Lic. #; Plumb. Lic.# _ Pe mit��s foal s
6 H 9 Minimum T .50 S
Authorized Residential Backflow MtAiMW E19$34.2.5
signature: - � �� PI i�23SS o is 05 _SY -
—
Raiyul en _ State �rchat eS85�.ofPC.-, ec S
— (Plow print rwna) TOTAL P rr FL 1r 5 _.
Nallat 1"016 Pern11 appllentlae aspires Ira penwt is not obtafoed within Atl new eomM4rdal bu Imp squirt I tits o p.n+With ioometrtc s
tip lays sRo U Yat been areapted as ootaPlete. rlaar diagram for plan rrA-.
•rte rnttleAoleQy ut by Tri-Couutr Baltdinz todusery Service Soar&.
I:�DsuUertttit PortnllFlmterntl4lpc.doe 011!11
9415 HOME ST., TIGARD, OR PLAN_ T LIST
LOT 21 OF KESSLER ESTATES SUBDIVISION, PHASE II
2053 Ah 252' PROPOSED STREET TREE
OREGON WHITE OAK
4
EX15TING TREE
TO BE SAVED
\S�: \ MITIGATION TREE -
e\ PAPERBARK MAPLE
i
\ 2"0 (MEASURED At BASE)
(2 PER LOT)
= MITIGATION TREE
ILII I / PROPOSED
252' \
FENGE
2r Q� �• •4
ftft_N 81'33
ft
o '18 W ,. ° `SL
.2 ---SU T FENCE
UTILITY KEY: _ _-
i
SYMBOL: UTILITY: SYMBOL: UTILITY: \
-- -(� STORM LATERAL - - - - SEWER AND
WITH CLEANOUT SANITATION LATERAL
- ---� WATER LATERAL FIRE HYDRANT
WITH METER
--- NORTH
SCALE: P . 20'-0'
0' 10' 20' 40' 60' IEC'
1 T BUENA VISTA CUSTOM HOMED K�P2-LOT21
BUENA VI��OT , CUSTOM STOM HOMES 0932 9W MACADAM AVE, 8TE C
-
PORTLAND, OR 97219 1 • t
US= Ir.ATM, MOB U - CITY OP TIGAfifl �►AtIGrON COl1NTY 16031 443••0033
LOT 21 - SITE PLAN VAX- 16031 443-2443
07,14.04
RECENED
CITY OF TI(.;Altl) - ITF. PLAti REVIEW
'il_IILI)ING PERMIT No ... 5
PI_ANNIN(i DIVISION ed
Required Setbacks' fil Not A Approved ❑ pprov
Side: ,._ Street Side: —Ar
Garage: .. ._ Rear:
Front. �v�.-
Visual Cleatance- '0 Approved [3 Not Approved
Maximum Building Height- Y-Q— feet M
Yes
CWS Service Provider Letter Required: a Received No
R �^«rne. Date' 7-.�w -Q
ENGINES NQG DEPA�LNT: d [3 Not Approved
Actual Slope:f�... % 0 APP nveef
Site Plrt: / / Qj Approved ❑ Not Pp
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639- 175
MST
INSPECTION DIVISION Business Line: (503)63 4171
�
1}11BLIP _
Received I` Date Request! _ � __ --- AM PM BUP _
Location ___7 �tl_5 S .�-� MEC
Contact Person ___ ka ct PM 17b\ ph( 0- (A-1)0 l _ PLM _..-...___
Contractor _____ Ph( SWR
B ILDIOW Tenant/Owner - ELC _
Footing IL
ELC - ---- --
Foundation Access:
Ftg Drain ELF!
Crawl Drain
Slab Inspection Notes: SIT _ _--_--
Post&Beam —
Shear Anchors -
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulatioi
Drywall Nailing
Firewall
Fire Sprinklerrf � L- �_�- °�-�' •�
Fire Alarm
Susp'd Ceiling I - —
Roof
Other.
IS /PART FAIL - -- -----__ __ -- --PUMBING _
Post&Beam iiiiiiiiiiiijllllllll
Under Slab -- --- - -- - - --- ---
Rough-In
Water Service - - _------ -- --- -__-_ --
Sanitary Sewer
Rain Drains _--
Catch Basin/Manhole
E'orm Drain
Shower Pan
Other: - - -- ------------ — -----
Final -----_-----
PA a--_-P-AffT FAIL_ - - —_-- -—-- -- _- _- -_
ECHANIC - --- -- -- --- -- - ---
Post&Veam - -
Rough-In — -- --------- --- - ---- --
Gas Line
Smoke Dampers
i
PART FAIL -- — ---- - - — ---
IVAL
Service - ------ --- -- ------
Rough-In
LIG/Slab — -- �-_----
Low Voltage
Fire Alarm - - --- -- ----------
A�SS _PART FAIL Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE U Please call for reinspection RE: _ Unable to Inspect-no access
Fire Supply Line
ADA /Zz-
Approach/Sidewalk
Date __ -._ Inspector Ext
Other: `-
Final -- DO NOT RE OVE this Inspection record Jr '�n the job site.
PASS PART FAIL
1
CITY OF TIOARD
Residential certificate of Occupancy
Permit No.: MS7 Z.",) —UOL-7o? Address: _1411 ,>
Owner/Contractor:
Date of Final Inspection: l U� Inspector:
This structure has been found to be in substantial compliance with the provisions of thQSr e of Oregon One& Two Family Dwelling
Perialty Code and is hereby approved for occu ap ncy.
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