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Permit
15 SW Hall Blvd. PLNCK/RECT # CITY OF T 131 Box 23397 PERMIT # Xi/ COMMUNITY DEVELOPMENT DEPARTMENT Tigard' Oregon97223 (503)6394171 DAT ISSUED JOB ADDRESS: St,() 1`�C 'i ` � 5� � TAX MAP/LOT l' / 2 C C 7G 70Q SUB: LOT: U LAND USE: C VALUATION: OWNER T � - i 2� .5-00,00 �\ SPECIAL NOTES NAME: C r P nmi c�-►� l C n k c rT \ i offt .�L \ V 2 , REISSUE OF: ADDRESS: 135"cicj SULD `?c5LO , (� LAST REISSUE: AA A A n C I Z� FLOOD PLAIN/ PHONE: (sU) C�$U -- 3 \ SENSITIVE LAND: 1SceTt l3 k fie. COQ) CONTRACTO APPROVALS REQUIRED C43-82- NAME: C C (.le .LXOCJY7Q/7 PLANNING: a'-?4 - ADDRESS: ENGINEERING: FIRE DEPT: PHONE: OTHER: NI) T/F — W — CONTR. BOARD #: EXP DATE: ITEMS REQUIRED SUBCONTRACTORS: PLUMB:. LIST /SUBCONTRACTORS: MECH: BUS TAX: ARCH /ENGINEER CALCULATIONS: NAME: TRUSS DETAILS: ADDRESS: OTHER: PHONE: PROPOSED BLDG. USE: COMMENTS: 3552 OA• - 36� ,3Z 1 . 7V /,24 C�/lI s�/.h APPLICANT SIGNATURE Received By: Date Received: 7 9 �� 1 PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE 10 -432 00 Building Permit Fees —/95 aU /95, 2O 10 -431 00 Plumbing Permit Fees q0,67) 10 -431 01.. Mechanical Permit Fees 10 -230 01 State Building Tax (5 %) /9, Building Otgn46 Plumbing 4.50 Mechanical 10 -433 00 Plans Check Fee /,z3 ez Building /2..s,45' Plumbing 22,56 Mechanical 10 -230 06 Fire /77,zO - 77,20 30 -202 00 Sewer Connection 30 -444 00 Sewer Inspection 25- 448 -02 Commercial TIF Fees 25- 448 -04 Industrial TIF Fees 25- 448 -06 Institutional TIF Fees 25- 448 -03 Office TIF Fees 25- 448 -01. Residential Traffic Fees 25- 448 -05 Mass Transit TIF Fees 52 -449 00 Parks System Dev Charge (PDC) 31 -450 00 Storm Drainage Syst Dev Chrg (SSDC) 24- 445 -01. Water Quality (Fee in lieu of) 24- 445 -02 Water Quantity (Fee in lieu of) TOTAL 746 3)1. /S nm /3587P.WPF