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14296 SW LUKAR CT .-
CITY OF TIG,ARD
DEVELOPMENT SERVICES
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171
CEPTIFTCATE. OF
OCCUPANCY
PERMIT #. . . . . . . 3
DATE V-'�SUEI)c 055/0L,/�47
PPRCEL- P5104BC-04700
f TE AIWESS. . . v 1.4296 SW LUKAR CT
I)SDI VISION. . . . : HIL LSH IRE' WOODS Z ON I IVO: P 7 Fr)
.00"
. . . . . . . . . . LOT. . . . . . . . . . . . . :58 JURISDICTION:
C'-A39 OF WORK. tNEW
TYPE OF USE. . . sGF
TYPE OF CONSTR:5N
OOP. sR3
1,J.'UPANCY LOAD:is
I Path I
14INDWOOD HOMES INC
14076 SW DENCHVIEW TERRACE
1*IGAP0 OR 97,224
Phone #.- 590-4700
VINF)WOOD HOMES
14076 '3W FAENCHVIFW I'ERRACIZ.
TIr',ARD OR 9'72 '4
Phono #s 590-4'.100
Req #. . : 000501
This UerftFicAte r
.4-ants occupancy of the above r,i-ferencpcl bl.ii1ding or portion
thei-eoF and confirms thiat the building his bee r n . n 9 ps-c I ed for c o m p I i Aric e w J.t h
the Stakte of Oregon 5pectiilty Codes for the 4r-r and Lisp under
o t 0 c c u p ER n C,'Y9
which the referenced per # WOS iSSUO.md.
MIT
I-DING INSPECtOR eu(T�L INO. ICIAL
POST IN CONSPICUOUS PLAC"C'.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line 639-4115 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing -Mech.
Plbg Und/Flr/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd. (
BId
San. Sewer Gas Line Appr/Sdwlk Reins
Other:
Date: A.M.
Address
Tenant: - - _- Ste MST: �i.r G Z-1�
Con/Own: ff BUP:
`._L—� _�_ ____ MEC:
n PLM:
n/
ELC:
THE FOLLOW14 CORFrECTIONS ARE REQUIRED: ELR: —
Inspector -� - LG - //_ ---- Date:5:
_�APPROVD _DISFKPPROVED/CALL FOR REINSP. CF CO
was
P!4.e No. 1 CASE HISTORY FOR rASE NO.: MST96-0407
WINOWOOD HOMES
14296 SW LUKAR CT
08/01/97
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Dat( By
------- ---------------------------- - -------- -------- -------- -------------------- ------------------- ---- --- -------- ---
MSTA005 Application received / / / / 00/16/96 PASS JMH 08/26/96 JDA
MSTAO08 Permit Created / / / / 08/26/96 PASS JDA 08/26/96 JDA
MSTA010 Check for prct. restrict. / / / / 08/26/96 PASS JDA 08/26/96 JDA
MSTA012 Plans routed to Plans Examiner / / / / 08/26/96 PASS JDA 08/26/96 JOA
MSTA026 Plans approved by Plans Exmr / / / / 09/05/96 PASS RT 09/05/96 BT2
MSTA030 Reviewed plans routed to DSTS / / / / 09/05/96 PASS RT 09/05/96 BT2
MSTA080 (F) Ready to issue / / / / 09/07/96 AePR TAT X9/07/96 TAT
MSTA092 (F) Issue combination permit / / / / 09/24/96 PASS DRA 0,1/24/96 DRA
MSTA097 Issue plumbing signature form / / / / 09/24/96 PASS DRA 0S/24/96 DRA
MSTA098 Issue electric signature form / / / / 09/24/96 ; SS DRA 09/?4/06 DRA
MFTA705 Footing Insp / / ! / 10/14/96 APP GS 10/'4/96 GES
MSTA706 Foundation Insp / / / / 10/30/96 APP ua 3j31/Y6 GES
MSTA710 Post/Ream Structural / / / / 11/08/96 APP GS 11/08/96 GFS
MSTA711 Post/Beam Mechanical / / / / 11/08/96 APP GS 11/08/96 GES
MSTA713 Crawl Drain / / / / 12/2.7/96 APA GS 12/27/96 GES
MSTA717 PI.M/Underfloor / / / / 11/08/96 APP GS 11/13/96 GES
MSTA720 Mechanical Insp / / 1 / 02/24/97 p-1- see framing notes this date DIS KS 02/25/97 KBS
MSIA720 Mechanical Insp / / / / 02/18/97 qas pressure 0#19; exterld dryer vent FAIL RB 02/18/97 RB
inward; insulate heat duct w/in soffit;
cover stud w/ftame spread Win fireplace
cavity; exhaust vent
disconnected-upstairs bath R make
tighter seat at master bath.
MS1;720 Mechanical Insp / / / / 02/27/97 pending- make tighter seat at master PASS RR 02/27/97 RB
bath exhaust vent; insulate heat duct at
garage soffit;
MSTA720 Mechanical Insp / / / / 03/03/47 damaged wall duct stairs/kitchen PEND RB 03/03/97 RB
do not drywall over this section.
MSTA722 Plumb Trip Out / / / / 01109/97 trap r-;n exceeded develop( length FAIL MS 01/10/97 MRS
MSTA722 Plumb Top Out / / / / 01/13/97 PASS MS 01/14/97 MRS
MSTA723 Electrical Service / / / / 01/23/97 s'gn label APP GS 01/23/97 GES
MSTA724 Electrical Rough In / / / / 01/23/97 APP GS 01/2 /97 GES
MSTA724 Electrical Rough In / / / / 01/7x/97 CALLED FOR COVER AND SERVICE [ALREADY DIS GS 01/30/97 GES
DONE 1 WET CONC FLOOR, 1 COULPNIT SFE IF
PANEL WAS SiGNFD
MSTA724 Electrical Rough In / / / / 02/25/97 APP GS 02/25/97 GES
gage No. 2 CASE HISTORY FOR CASE NO.: MST96-0407
WINDWOOD HOMES
08/01;97 14296 SW LUKAR CT
Action Description Req/ Schd/ End/ Action Notes
Code Disp By Update Upd
Sent Done Done Date By
----------------- --------------- ---- --- -------- ---
MSTA725 Framir,l insp / / 02/24/97 #-1- stra
p glu/lam to plates at carege DIS KS 02/25/97 KBS
#-2- insulate heat ducts at garage
#-3- support micro/lam hip at garage
#-4- fireblock soffit adjacent to
furnace
#-5- add support under lvl header
hallway
0-6- support rafters at rear ba/
0-7- provide clearance at firepla.:e
#-8- strap notched plates at oval duct
# 9- provide complete roof framing
detail
#-10- Strnp trimmers to garage header
MSTA725 Framing Insp / / / / 02/27/97
pending- meth issues; cover suds w/ n PASS RB 02i?7/97 HA
fireplace cavity w/ flame spread.
MSTA725 Frominq Insp / / / / 03/03/97 Mech issue
r_iAD RB 03/03/97 RB
Also noted: planting is in the crawl
ac,:ess holF and needs to be protected;
allow for 18 x 24 clearance w/in opening
of access.
MSTA726 Shear Wall Insp / / / 01/09/97 nail floor sheath;ng above garnge; nail FAIL RB 01/09/97 RB
garage wings 2/8; OTT-22's missed at
living room wings. nail sheathing 6/12;
FTA's missed upstairs- sheathing req'mts
!1/4/12 nailing; exterior sheathing- nail
6-inch o.c. if side wall of garage and
fireplace chase.
MSTA726 Shear Wall Insp / / / / 11/06/97 #-1- no approved plans on site DIS KS 01/06/97 KBS
MSTA726 Shear Wall Insp / / / / 02/18/97
MSTA735 Gas Line fns PASS R8 02/18/97 RB
P / n7/24/97 # 25 psi for 15 minutes APP KS J2/25/97 KBS
MSTA735 Gas Line Insp / / / / 02/18/97 0#
FAIL RB 02/18/97 RB
MSTA740 insulation Insp / / / / 03/03/97
MSTA745 Gyp Board inspPASS RB 03/03/97 RR
03/10/97 ponding- missed nailing- marked! PASS RB 03/10/97 RB
MSTA755 Rain drain Insp / / / / 12/27/96
MSTA761 Water Service Ins APP GS 12/27/96 GES
P / 1 / / 12/27/96 APP GS 12/27/96 GES
MSIA765 Appr/3dwlk Insp / / / / 05/01/97 SIDE 8 ADPROACH FINAL
PASS PI 05/01/97 KAS
r
Page No. 3 CASE HISTORY FOR CASE IV -: MST96-0407
WINDWOOD HOMES
14296 SW LUKAR CT
08/01/97
Action Description req/ Schd/ End/ Action Notes Disp By Update Upd
Code Ser, Done Done Date By
------- ------------------------------- -------- -------- -•------ --------------------------------------- ---- -
MSTA790 Electrical Final / / / / 04/30/97 secure grounding cc.uuctor for- phone FAIL DD 05/01/97 RB
Lines & cable grounding service;
grounding conductors req'd to go to
-eparate grounding lugs in service;
panel labeling; smoke detector not
interconnected in bednn upstairs.
MSTA790 Electrical Final / / / / 05/01/97 PASS TLP 05/05/97 TLP
MSTA795 Mechanical Final / / / / 05/01/97 see building final th s date FAIL Ria 05/01/97 RB
MSTA795 Mechanical Final / / / ! 05/02/97 PASS DD 05/02/97 RB
MSTA797 Plumb Final / / / / 04/30/97 not ready FAIL MS 04/30/97 MRS
MSTA797 Plumb Final / / / / 05/02/97 PASS MS 05/02/97 MRS
MSTA799 Building Final / / / / 05/01/97 seal siding at meter location; FAIL RB 05/01/97 RB
usa erosion approval;
electrical final;
fwd bedrm Smoke detector not
interconnected;
handrail needs to be extended to nosing
of tread at base of stairs;
UNDER-FLOOR-
support flex 4" off ground/4'
intervals
insulate bare meal of duct
MSTA799 Building Final / / / / 05/02/97 electrical not approved FAIL DD 05/02/97 RB
exterior grading 4% dope
6" clearance from siding-to-earth
MSTA799 Building Final 05/07/97 / 1 05/06/97 PASS GL 05/07/97 JT
MSTA960 (F) Issue Cert. of Occupancy / / / / 05/06/YT mail•;d 8-1.97 08/01/97 S"W
MASI'ER P,EF01I'T
PE:R1111' #. . . . . . . : 119 T,6 l7j,i
CITY OF TIGARD i)(11TE 11.;SUE-.D: 09/24/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Otagon 97".3*1119l) (503)639-4171 F-1(I R C E!-
t41LL13FI19E WOUDE, �ON119G: R-7 P'l,
Jli_*[�,. . . . . . . . . . ., .. . . . . . . . .. . . . .
-.,iarks: Path I
--------------------------------------------------------------- BUILDING ---------------------------—--------------------------------
15SUE; STORIES.......: 2 FLOOR AREAS---------- BASEMENT.,,: 0 sf REOUIRED SETBACKS---- REOUIRED------------
PSS OF WORK.-NEW HEIGHT,,,.....: 26 FIRST....: 931 sf GARAGE....,,: 440 sf LEFT.. ......s c SMOKE DETECTRS: Y
�E OF USE...:SF FLOOR. LOAD....; 40 SECOND...: 73i sf FRONT.........: 20 PARKING SPACES: I
.-f OF CONST.:5N DWELLING UNITS, I FINBSMENT- 0 sf RIGHT.......,.: 13
i:UPANCY ',,PP.:R3 BDPM: 3 BATH: 3 TOTAL--------: 1663 sf VkUE..1: 115034 REAR......,...: 35
------ ------------------------------------------------------- PLUMBING ---—----------------------—--—---------------—--------------
'NKS......... I WATCR CLOSETS.: 3 WASHING Mk,H..: I LAUNDRY TRAYS.- 0 RAIN DRAIN ft: 0 TRAPS.......,.: 0
oATORIES,... 4 DISHWASHERS...: I FLOOR DRAINS.,: 0 SEWER LINE ft, 0 9' RAIN DRAINS: I CATCH BASINS.., 0
SIR64GE DISP, I WATER HEATERS,: I WATER LINE ft: 100 ECKFLW PPEVNTP: 1 GPEASE TRAPS-: @
OTHER FIXTURES: @
----------------------------------------------.------ ------ MECHANICAL --------------------------------------------------- -_---
.EL
------------------------------------------------------------
.EL TYPES----------- FURN S IM I BOIL/CNP ( Xl: 0 VENT FANS..,..: 4 CLOT4FS CRYERS: I
4/ .' / FUP.N I OOK 0 UNIT HEATERS..: 0 HOODS......... I OTHER UNITS,.,: I
INP.: 0 BTU FLOOR FURNACES: 0 VENTS........,: @ WOODSTOVES.... 0 GAS OUTLETS..,: I
---------------------------------------------------------____ ELECTRICAL —----------------------------------------------------------
-+ESIDENTIAL UNIT--- ---SERVICE/FEEDER ---- --TEMP SRVC/FEEDERS-- BRANCH CIRCUITS--- ----MISCELLANEOLr„---- --ADD'L INSPECTIONS—
010 SF OR LESS: I @ - I@@ alp..: 0 0 - 2k) alp..: @ W/SVC OR FDR..- 0 PORP/IRRIGATION: 0 PER INSPECTION: 0
ADDIL 5M.i 3 211 - 4@0 alp..: 0 201 - 4#0 amp..: 0 1st WID SVC/FDR: 0 SIGN/OUT LIN LT: @ PER HOUR,....,: 0
^I ED ENERGY.: 0 401 - 600 amp..: @ 401 - 600 alp,., 0 EA PDDL PR CIP: 0 SIGNAL/PANEL, .: 0 IN PLANT.,,,.,; 0
"iF 4M/SVC/FDR: 0 601 - ION amp.: ? 6Ql1+aRps-lW y: a MINOR LABEL -1111! @
'W+ alp/volt.- @ ----------------------------------- PLAN REVIEW SECTION -----------------------.------- ---
Reconnect only.: 0 )-4 :*5 UNITS.,: SVC/FDR)u225 A.: > 600 V NUMINk. CLS APEr,/SEC OCC!
-------------------------------- ELECTRICAL - RESTRICTED ENERGY
SFRESIDENTIAL--------------------------- B. COMVPCIk------------------------------------------------------------------------------
�10 9 STEREO.: VACUUM SYSTEM-: AUDIO 3 STEREO.: FIRE ALARM,....: INTERCOMiPAC-INGi OUTDOOR LNDSC Ll;
�SLAR ALAPM..,- OTH: y BOILER........,,: HVAC......,,... : LAND3CAPE/IPRIG: PROTECTIVE SlrjNL:
,AGE DPENER.. : CLOCK........... INSTRUMENTATION: MEDICAL........ . OTHR: 1:
+C.........,. : DATA/TELE COMM.: NURSE CALLS....: TOTAL 0 SYSTEMS:
LOTIM -____..—..---------------------------Contractor: ---------- -- ---------------- TOTAL FLEE:$ 4056.06
WINDWOOD HOMES INC WINDWOOD HOMES
14076 SW BENCHVID' TERP4CE 14076 SW BENCHVIEW TERRACE
TIGARD OR 97224 TIGARD OR 9722-4
Phone 0! 59@-470@ Phone 0: 9111-47ft
Reg N..: 05@196
This permit is issued subject to the regulation, contained in the Tigard Municipal Code, State of Ore. SDecialty Codes and all oth.L
313olicabir iaws. All work will be done i:. accordance with approved plans. This permit will expire if work is not started within 180
days of issaance, or If work is suspt;iced for more than 180 days.
------------------------------------------------- REDUIRED :4SPEC-IONS --------------------------------- -------------------------
rooting Inst/ PLM/Underfloor Framing Insp Gas Fireplace Water Servicq In Building Final
ro,jrldaticr Insp Mechanical Insp S:i,ar Wall Insp Insulation IrSD Appr/Sdwlk Irsp Erosion Control
Post/Beat Strvc! Plumb Tou Out L w Voltage Gyp Board Insp rl-1-i-al Final
dost/Beam merh2r Electrical Sevi Fireclace Insp Rain drain Insp
Crawl Drain Electrical Rio Gas tine ';nSp Water Line Insp
r t1 r; f: .. a._-.�,,� //' G�•G'L.�, I k ._�_t rt + ; �SCE ��` '_ /
o i- i,n E pec_,t i. o ii
P 17 R lyl 1-1
CITY OF T I GARD PERMIT #. . . . . . . SWR96-0415
DATE. ISSUED: 09/24/96
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.T19ard,Orepn 97223*8199 (503)639-4171 PARCEL-
IL PDDREc3l.3. . - i4 1 �3W LIJI<AR CT
113DIVI5ION. . . . : HIL.L.SHIRE WOOD(.; ZONING: R-7 PD
01 CI jk. . . . . . . . . . . L01.. . . . . . . . . . . . . .58
114AN T NAME. . . . .
'A NO. . . . . . . . . . : FIXTURE UNIT13. 0
.OGS OF W1,jRK. . . :NEW DWE'LL11`1133 UNI I'3. . , I
PE OF USE. . . . . :SFNO. OF LAUIL.EINGS- I
c.1"A L L T Y P,E. . . .b L)1-3 W R IMF-IEPV SURFACE" 'a s f
PAth I
NDWOOD HOMES type Am 0'-m t by date r'ecpt
SW SENCHVIEW TERRACE PRMT $ 2,200. 00 DRA 09/24/96 96-L-64.1120
INSP $ 35. 00 DRA 09/24/96 96
GORD OR 97224
one #- 5590-.4700
11\1TRACTOR 1\101' ON FILE
P-2353. 00 -1-0TAL,
Req
-------- REQUIRED INSPECTIONG
This Applicant agreeF to amply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. T4 pewit expires 180 days frop .......
the date issued. The total avotint paid will be forfeited if the
persit expires. The Agency does not guarantee the accuracy of the
rice sewer laterals. If the sewer is not located at the aeasurevent
,en, the installer shall prcspect 3 feet in all directions f-em
P distance given. If net so located, the installer shall purchase
tap Pnd Side Sewer" Perot and the ftc" will install 1 lateral. .... ....
r �- ;
for" inspection 639-4175
Plan Check# [J Z a
0. TY OF TIGARD Residential Building Permit Application Recd By
3125 SW HALL BLVD. New Construction Additiol,s or Alterations DateRoc'd �� ��d f(,, `f`b
GARD, OR 97223 Single Family Detached orAttached Date to P E
13) 639-4171 Date to DST j S'
Print or Type Permit# n
Called /
Incomplete or illegible applications will not be acceptt
Name of Subdivision Lot# Name
Job / I (L :: _•� 0 ` r,r, s c .`p —-
Architect Mailing Address
Address Site Address J 3,d
14 :)-f LUk-tA a <
- City/State Zip Phone
Name .- t�jO c;n -Ti :� :1J �1rvt
l �Cdf�YwN_% C --'— Name
Owner Mailing Address
City/State 4 Zip Phone Engineer Fading Address
-------------- n. `" City/State Zip Phone
Name
General -J1,ti2 Describe work new addition alteratio10 repair
.OntraCtUr, Mailing Address ^� to be done.
Additional Description of ork:
CityrSiate �J Zip Phone
Oregon Const.Cont.Board Lic# Exp.Dat9
^[tach Copy of _, r -: .� I `' ' Project ,
Current COT Business Tax or Metro# Exp.Date Valuation — J
— Ucense5k
Name NEW CONSTRUCTION ONLY:
_
Mechanical G Sq.Ft. House Sq.Ft.Ga/rage:
I Sub- Mailing Address
Contractor '" - 5C 4 �'I o 'l Corner Lot Yes No Flag Lot Yes No
city/State Zip Phone (check cne) - (check one)
I _'al'-a -'0. un- `t �• �4`f -�1�'i Restricted Audio/Stereo Burglar
Oregon Const.Cont. Board Lic.# Exp.Dee Energy System Alarm
Attach Copy of ' � `ii t , t 2 ,1 . � r' _ f vara P. Door HVAC
Current COT Bus ass Tax or Metro# Exp.Date Installation g
o Opener Systems
Licenses �- ���� � I'7 r� ;
Name (check all that Other:
Plumbing aPPIY)
Sub- Mailing Address — -- ---- Will the electrical subcontractor wire for all Yes No
restricted energy installations
"-)ntractor t tla'te / 6?-,6?-,CityHas the Subdivision Plat recorded? N/A Yes
int f�, No
, Zip Phone �
. , �'.� c. >'r._ � Irl" t{03y -- — ---
Oregon Const.Cant.Board Lic.# Exp. Date Reissue of MST# Solar Compliance
Attach Copy Of r / _y 4, �, j _ (Calculation Attached) ^�
Current Plumbing Lic.# Exp Date I hereby acknowledge that I have read this appliration, that the
Licenses information given is correct. that I am the owner )r authorized agent of
COT Business Tax or Metro# Exp.Date the owner and that plans submitted are in compliance with Oregon
State laws
Name i - Signature of Owner/Agent Jate
Electrical f` c_ r. c ( \ Contact Person Name —� Phone --
Sub- Mailing Address
Contractor FOR OFFICE USE ONLY:
City/State Zip Phone Plat# Map/TL#
Oregon Const.Cort.Board Lic.# Exp D
Attach Copy of I "L —� ----
Setbacks Zone: Fol
Current Electrical Lid.N Exp.0
Licenses J. t , `a c_ /�. rtE, 1 I
COT Business Tax or Metro# Exp Date Engineering Approval: Planning Approval: -
asvnstapp doe
r
Permit# Account Descrir)tion Amount Amt, Pd. Bal. Due
MST. Permit (BUILD)
Plumb. Permit (PLUMB) ew
Mech. Permit (MECH) q 3, )_V
ELC/ELR Permit (ELPRM-r) - _pk�
State Tax (TAX)
Bldg
Plumb: /� y
Mech:
ELC/ELR:
Plan Check A� 2
M�', �5 �! 4 Ir'A (BUPPLN) I►1.� �3�J�
Plumb: (PLMPLN) U SD
Mech. (MECPLN) y, SYY /U,
CDC Review (LANDUS) e
r• �!i 1 ff Sewer Connection (SWUSA) v u o�-e�✓U
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC) /6 ;
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Water Quality (WQUAL)
Water Quantity (WQUANT) _ ,'O 0
Erosion Control Permit (ERPRMT) 6_ 1 4
Erosion Planck/YSA (PPPLAN) ,!�fl _ _'9v j
Erosion Planck/COT (EROSN)
Fire Life Safety (FLS)
TOTALS:
i 1,dslslmstapp doc
Rev 7/96 qYU4—
CITY OF TIGARC
13125 S.*W H<LL BLVD.
TIGARD, OR 9/223
IMPORTANT PERMIT NOTICE
MT HOOD ELECTRIC INC
8900 SW BURNHAM #F-7
TIGARD OR 97223
Electrical Signature Form
Permit ## . . . . : MST96-0407
Date Issued. : 09i241'%6
Parcel . . . . . . : 2S104BC-HW058
Site Address : 14296 SW LUKAR CT
Subdivision . : HILLSHIRE WOODS
Block. . . . . . . . Lor- . 58
Zoning. . . . . . . R.-7 PD
Remarks :
Path I
Your company has been indicated as the electrical contractor for the permit indicated above. In
order for the electrical permit to be valid, the signature of the supervising electrician
is required.
Please have the appropriate individual from your company sign below and return this Electrical
Signature Form prior to the start of work. No electrical inspections will be authorized until
this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
rrWNRP : ELECTRICAL CONTRACTOR:
WINDWOOD HOMES INC MT HOOD ELECTRIC INC
14076 SW BENCHVIEW TERRACE 8900 SW BURNH_t1M #F-7
TIGARD OR 97224 TIGARD OR 97223
Phor_rF� tt : 590-4700 Phone # :
Reg # . . : 113641
SrgnatUr/ upeivisin - E ectrcian
Please return this completed form to the address above.
ATTN: Building Dept.
If you have any questions, please call 639-4171 , ext. #310
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT Fd ]TICE
JIMS PLUMBING
P O BOX 7160
ALOHA. OR 97007
Plumbing Signature Form
Permit # . . . . : MST96-0407
Date Issued. : 09/24/9.,
Parcel . . . . . . : 2S104BC-H1q058
Site Address : 14296 SW LUKAR CT
Subdivision. : HILLSHIRE WOODS
Block . . . . . . . : h(d : 58
Zon.ing . . . . . . : R-7 PD
Remarks :
Path I
Your company has been indicated _.s the plumbing contractor for the permit indicated above. In order
for the plumbing permit to be valid, please have the appropriate individual from your company sign
below and return this Plumbing Signature Form prior to the start of work. No plumbing inspections
will be authorized until this completed form is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
C!AtJFR : PIAJI IBING CONTRACTOR:
WINTDWOOD HOMES INC JIMS PLUMBING
14076 SW BENCHVIEW TERRACE P O BOX 7160
TIGARD OR 97224 ALOHA OR. 97007
Phf )ii 4 : 590--4700 Phone # :
Reg # • • : 71860
X
Signature of Authorized Plumber
Please return this completed form to the add;ess above.
ATTN: Building Dept.
It you have any questions, pleEse call 639-1171 , ext. ##310