9217 SW Martha St - DENIED Tigard High School Area Parking Permit Application
Permit Period. September 2014—June 2016
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1. Applicant name:
Address:
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Tigard, OR 97224 Phone# of)C I
2. For proof of residency,attach a copy of a utility bill,real estate title or rental contract including
name&address.
3. Attach a copy of the vehicle registration for each parking permit requested. Each household will
receive a guest parking permit.
How many total guest parking permits would you like?
I agree to use any parking permit(s) assigned to my vehicle(s) only on the specific vehicle it is
assigned by the City of Tigard Police Department, for the purpose it was issued. Any parking
permit(s) remain the property of the City of Tigard and may be revoked if improper use is
demonstrated. I agree to assign guest parking permit(s) to people only while visiting my home and
surrender any rights if I move. Violation of any of these understandings may result in cancellation
of the parking permit(s). After cancellation, any vehicle(s) found parked in the permit area bearing
said parking permit(s) shah be cited.
Signature--'-- Date
Mail completed application with proof of residency and vehicle registration(s) to:
Tigard Police Department
Attn. THS Parking Permits
13125 SW Hall Blvd.
Tigard, OR 97223
PLATE NUMBER PASSENGER REGISTRATION CARD
71TLE NU BER FUEL :TYPE
CK74581 1225818816 GASOLINE FARM ID NO.
NEW EXPIRATION DATE
YEAR MAKE STYLE MODEL VEHICLE IDENTIFICATION NUMBER AUG 13, 2018
2007 TOYT UT AV JTMBK32V475014770 HVUT DATE
EQUIPMENT NO. EIGHT/LENGTH
TITLE BRAN05 - *r FEE
ODOMETER READING
ODOMETER DATE ODOMETER MESSAGE
iY ONE
$124.00
••1 �O�.IYON 1
*ROUSSEAU
SCOTT DAVID c
025 SW SLAVIN RDAPT 5
PORTLAND OR 97239-3013 COUNTY OF RESIDENCE
COUNTY OF USE
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Quick Reference Information
Account Number 3409979-6
Bill Date 12/12/2016 Customer Statement For Service At:
Bill Inquiries 800-422-4012 SCOTT ROUSSEAU
9217 SW Martha St
Current Charges Due 12/28/2016 Portland, OR 97224-5577
AMOUNT DUE $103.93
USAGE SUMMARY NW NATURAL
ACCOUNT SUMMARY
Meter 981616 Previous Balance $ . 00
Actual Read 5390 12/12/16 Payment(s)Received . 00
Estimated Read - 5301 11/14/16
Units of gas 89 28 days Subtotal Balance Forward $ .00
Billing Factor x 1.093
Therms 97.3 Current Charges
Monthly Service Charge Rate 02R 8 . 00
Gas Usage 97.3 @ .92984 90 . 47
2%City Franchise Fee 1 . 97
Public Purpose Charge 3 . 49
Subtotal Current Charges $103 . 93
New Balance $103 . 93
A late charge of 1.8%with a minimum of$3.00 may be
assessed on past due balance of$50.00 or more.
You are participating in the WARM program, which adjusts
_ bills if weather between Dec.and mid-May is colder or warmer
LOCAL DAYS IN AVG than normal.
BILLING AVG DAILY BILLING THERMS
PERIOD TEMP PERIOD THERMS PER DAY
DEC 16 45.1 28 97 3.5
DEC 15 N/A N/A N/A N/A
} 5.7
Q
4.6
W
v7
3.4
g
W 2.3
F Under normal operating conditions,natural gas burns cleanly. But if
> 1.1 the appliance has a mechanical problem,it could create a hazard.
If you or other members of the household feel out of breath,dizzy,
D J F M A M J J A S 0 N D nauseous,and have headaches,you could be suffering from
15 is carbon monoxide poisoning-leave your home,then call 911.
Please detach and return this portion with your payment. 09 7,032
ACCOUNT BER
3409979-6
DUE DATE FOR PLEASE PAY
CURRENT BILL THIS AMOUNT
12/28/2016 $103.93
SCOTT ROUSSEAU
9217 SW MARTHA ST NW NATURAL
PORTLAND OR 97224-5577
11111
000000003409979600000000000103930000000000000103930008
City of Tigard,Oregon Page 1 of 1
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Property
I Summary I Permits I Community I Businesses I Liauor Licenses I Hazards I Plats I Benchmarks I x l r I
9217 SW MARTHA ST, TIGARD
Property SummaryDURHAM RD
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Property Owner Info G
Tax ID Number: 2S114AB10100
Tax Account Number: R1238734
Owner: ROUSSEAU,SCOTT
Owner 2: MILLAR,CAITLIN
9217 SW MARTHA ST
Owner Address:
Owner City: TIGARD
Owner State: OR
Owner ZIP: 97224
Acres: 0.14
Sq Ft: 6,098.4
Bldg SF: 1,426
Bldg Value: $134,750
Land Value: $181,390
Total Value: $316,140
Taxable Ass'd Value: $187,610
Sale Price: $325,000
Sale Date: 11/09/2016
Year Built: 1988
City I Tigard 1 13125 SW Hall Blvd., g. • OR I ■
CITY DEPARTMENTS I DIRECTIONS i LOCATION AND HOURS OF OPERATION TIGARD
http://www.tigardmaps.com/mox6_multimap/index.cfin?fuseaction=property.summary 3/9/2017