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Permit
GA;RDY City of Tigard May 13, 2013 Westland Industries, Inc. >,A Attn: Jim Standring 12670 SW 68 Ave. Tigard, OR 97223 Re: Permit No. MST2012 -00169 Dear Mr. Standring: The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the following: Site Address: 11052 SW Legacy Oak Way Project Name: White Oak Village, Lot 6 Job No.: N/A Refund Method: ® Check #210166 in the amount of $523.00. ❑ Credit card "return" receipt in the amount of $ Note: Please allow 2 -5 days for this refund transaction to be credited to your account by the company that issued your card. ❑ Trust account "deposit" receipt in the amount of $ Comment(s): Per applicant's request as a different house plan was resubmitted under MST2013- 00029. Plan review was incomplete, therefore refund 80% of plan review fees paid, less development code review fees due. If you have any questions please contact me at 503.718.2430. Sincerely, • Dianna Howse Building Division Services Supervisor Enc. 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard- or.gov III CITY OF TIGARD FEE AND PAYMENT HISTORY I1 1 3125 SW Hall Blvd., Tigard OR 97223 • 503.639.4171 TIGARD MST2012 -00169 - 11052 SW LEGACY OAK WAY, TIGARD, OR 97223 Revenue Payment Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt # Due DC Provision Review, SF - Ping 100- 0000 -43112 $67.00 $67.00 $67.00 6/28/12 Check 187381 $0.00 DC Provision Review, SF - LRP 100 - 0000 -43117 $10.00 $10.00 $10.00 6/28/12 Check 187381 $0.00 Plan Review - Building 230 - 0000 -43106 $150.00 $150.00 $150.00 6/28/12 Check 187381 $0.00 Totals for Fees $227.00 $227.00 $227.00 $0.00 Receipt # Payment Method Check # Payor: Receipt Date Receipt Amount 187381 Check 10210 Westland Industries Inc 06/28/2012 $750.00 191350 Check 210166 Westland Industries Inc. 05/13/2013 $- 523.00 Total Payments: $227.00 Balance Due: $0.00 City of Tigard TIGARD Accela Refund Request This form is used for refund requests of land use, development engineering and building permit application fees. Receipts, documentation and the Request for Permit Action form (if applicable) must be attached to this request form. Refund requests are due to Accela System Administrator by each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to applicant. PAYABLE TO: Westland Industries Inc. DATE: 5/6/2013 Attn: Jim Standring 12670 SW 68 Ave. REQUESTED BY: Dianna Howse Tigard, OR 97223 TRANSACTION INFORMATION: Receipt #: 187381 Case #: MST2012 -00169 Date: 6/28/2012 Address /Parcel: 11052 SW Legacy Oak Way Pay Method: Check Project Name: White Oak Village, Lot 6 EXPLANATION: Per applicant's request as a different house plan was resubmitted (see MST2013- 00029). Plan review incomplete, refund 80% of plan review fees paid less development code review fees due. REFUND INFORMATION: - Fee Description From Receipt Revenue Account No. • Refund Example: Building Permit Fee - Example: 2300000 -43104 $ Amount Plan Review 230- 0000 -43106 $523.00 TOTAL REFUND: $523.00 APPROVALS: SIGNA• RE'S DATE: If under $5,000 Professional Staff P / Lr�� If under $12,500 Division Manager If under $25,500 Department Manager If under $50,000 City Manager If over $50,000 Local Contract Review Board FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY • Case Refund Processed: I Date: -- By: W I: \Building\ Refunds \RefundRequesr.doc x 09/01/2010 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT C III = , Request Permit Action q TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov TO: CITY OF TIGARD Building Division Services Supervisor 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.718.2430 Fax: 503.598.1960 www.tigard - or.gov FROM: ❑ Owner ❑ Applicant ❑ Contractor Er City Staff (check one) REFUND OR Name: ) -� �__J INVOICE TO: (Business or Individual) l �,,r LA. tSb / 01) u- I E5 /Ag---' Mailing Address: I of 4 7 o .W (4 U t " eloo City /State /Zip: - A 2 1 012- Ct l 2 - 2 - 3 Phone No.: SS C.,3 - 6 / (,o PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED ( ✓): ,j CANCEL /VOID PERMIT APPLICATION. ❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). ❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). ❑ REMOVE /REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit #: M aTa1O / o'). - 00 [ (2 9 O / - - 15 Site Address or Parcel #: (tOSP (..o Li-Co ke. CDAl''' UD AI Project Name: ii..Dt.-f t Tt b it v. I V L� t s1- C. 1— Subdivision Name: 1- 3 1- - r _ bi t K J t Lt_AQ E- Lot #: (0 EXPLANATION: ( P P L C Ar +J - fi b H l Tr £1") ---- i F tit C ,J i 1 -£. NA N 0 S £.t I I Sr ,9.o t 3— 000 a e t °` ‘- w2 2,ot3 —000 7 , 0 Lt. L o.. p - £J t Co H ALE-TC1 Signature: ' _ , C-4..-S Date: i ® . Print Name: )E , b, t. Z_ Po.41Mbl`,1 Refund Policy 1. The Director or Building Official may authorize the refund of: a) any fee which was erroneously paid or collected. b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended. c) not more than 80% of the land use application fee for issued permits. d) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended. e) not more than 80% of the building permit fee for issued permits prior to any inspection requests. 2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 2 -4 weeks for processing refunds. FOR OFFICE USE ONLY Rte to Sys Admin: Date $ 13 : [ eir m Rte to Bld: Admin: Date - A 4SKgMI:i7P r ic Refund Processed: Date //_?/3 By i Invoice Processed: Date By Permit Canceled: Date 4/j By,( Parcel Tag Added: Date By Receipt # Date Method Amount $ I: \Building \Forms \RegPermitAction.doc Rev 05/25/2012 Building Permit Application U Residential RECEIVED FOR OFFICE USE ONLY Receivd ... City of Tigard JUN 2 8 2012 Date /Be: Permit No.: r ,0_, l 1, m q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.196 s ; Date /By: Other Permit: 50)4000 "inn /5 Inspection Line: 503.639.4175 ( � • DIVISION A tit f y ap Date Ready /By: luris: ® See Page 2 for TI GA RD Internet: www.tigard- or.gov BUILDING BUIL Notified /Method: Supplemental Information TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ® ]ew construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the work indicated on this application. CATEGORY OF CONSTRUCTION ,% Valuation: $ 10 1- and 2- family dwelling ❑ Commercial /industrial Number of bedrooms: ❑ Accessory building ❑ Multi - family Number of bathrooms: d l ❑Master builder ❑Other: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: i(Osy 1 try a afft-t/ New dwelling area: '{J1 g square feet City/State /ZIP: -wit`.- Xl�' / Q� V 7 233 Garage /carport area: �k� square feet Suite/bldg. /apt. no.: Project name: /04 the `//c E_ Covered porch area: square feet Cross street/directions to job site: Deck area: square feet Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: /ay f7 0,4-__ /4�c4 f I Lot no.: b Permit fees* are based on the value of the work performed. /� / 3b 0 Indicate the value (rounded to the nearest dollar) of all Tax map /parcel no.: C equipment, materials, labor, overhead, and the profit for the DESCRIPTION OF WORK work indicated on this application. , 114/1///4/ `/ Valuation: $ Existing building area: square feet New building area: square feet ❑ PROPERTY OWNER ❑ TENANT Number of stories: Name: Type of construction: Address: Occupancy groups: City/State /ZIP: Existing: Phone: ( ) Fax: ( ) New: rffr APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: 97 7 i 5 itrL �� ( Structural plan review fee (or deposit): Contact name: R0/3 /1 e50,2 / . 5-�vOek ((( — 71 FLS plan review fee (if applicable): Address: /36 ?0 50 a= X,4 v Total fees due upon application: City/State /ZIP: , /� 7 Z 2-3 Amount received: 750 CO Phone: (S D3) 5 72 - -0 76 Fax: : (j pj ) 5 ,e( /-�,� PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* E -mail: ` � J��6� � U .E /L ,C0ty Commerc al and residential prescriptive installati CONTRACTOR roof -top . nted PhotoVoltaic Solar Pan stem. Business name: 1,06 26 74 3) Submit two ( ets of roof plan w' • the 2010 details and fire departure access, a • g with the 2010 Oregon Address: i 7 3, G�(da L Solar Installation Spe '• d Code checklist. r ' C� Permit Fee c udes . :. review $180.00 City/State /ZIP. ( i� �77a� d administrative Phone: '`?),, ) •- Fax: ( 5)9 M`qa 1 Stat - rcharge (12% of permit fee): $21.60 CCB lie.: , 2267 Total fee due upon application: $201.60 Authorize. ' _wt.. This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. + r . / . * Fee methodology set by Tri-County Building Industry •rint Dan . t lip, S G � 4q Date: !w Service Board. "t 1: \Building \Penni . \BUP- RESPennitApp.doc 02/24/2011 440- 4613T(1 1 /02 /COM /WEB) [s.l Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard RECEIVE Date/By: id sg is \.3/ PermitNo.: h c14F 11114 . ' 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit: L � t'S 3 Phone: 503.718.2439 Fax: 503.598.1960 JUN 2 8 2012 DateBy: TI GARD. Inspection Line: 503.639 Date Ready/By: Juris: H See Page 2 for Internet: www.tigard Notified/Method: y Notified/Method: Supplemental Information CITR 05 .i Y o5ARD r ; :'r.C,7:_,r rCr �I- =� =\ 1 �i0N COMMERCIAL FEE* SCHEDULE — USE CHECKLIST TYPE OF WORK - Mechanical permit fees* are based on the value of the work New construction ❑ Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. Value: $ CATEGORY OF CONSTRUCTION - RESIDENTIAL EQUIPMENT / SYSTEMS FEES* • land 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. Ea I Total JOB SI INFORMATION AND LOCATION Heating/cooling: qt Air conditioning Job site address: (/'a S J_/ /l ( / (requires site plan showing placement) 46.75 Furnace 100,000 BTU ( ducts/vents) ` 46.75 City /State /ZIP: �l d 17 2.2 Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: C V i �- Heat pump b71 t (requires site plan showing placement) 61.06 Cross street/directions to job site: "" -Ty Duct work I 23.32 4N Hydronic hot water system 23.32 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 Subdivision: A ` , l Lot no.: rw Flue /vent for any of above 23.32 �! V 1/ "� �G.J Other: 23.32 Tax map /parcel no.: i 5 1 3 ( C,(} Other fuel appliances: ` 23.32 DESCRIPTION OF WORK Water heater F(/'^ t,^2 L f j 6 Gas fireplace 33.39 Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 Chimney /liner /flue /vent 23.32 ❑ PROPERTY OWNER . ❑ TENANT 23.32 Other: Name: Environmental exhaust and ventilation: Address: Range hood/other kitchen equipment I 33.39 City/State /ZIP: Clothes dryer exhaust I 33.39 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32 Ef ❑ CONTACT PERSON Attic /crawlspace fans 111 23.32 Other: 23.32 Business name: 1 05- 1 -7,44-7 3 � +� • Fuel piping: Contact namev�` - / `0, ^ �" t � '[ $14.15 for first four; $4.03 for each additional lam Address: ��ll '� ' ru - D , � � b 4 t/'-6 Furnace, etc. Gas heat pump City/State /ZIP: Ti(Q� C c ) Wall /suspended/unit heater Phone: `-L.�3 )S72_011 ` (c ` eobb*.. : ( c vg cis 1� P, , 9 Water heater "G�Q�� �p �^ /� � ,Q�/ Fireplace I E- mail: ?.. LC IAtL .(�. I ��1 "y(1... m(6) Range I ✓ i�` �4 CONTRACTOR Barbecue Business name: j\ .I IGr t J ' Clothes dryer (gas) //)) f f' 1 , 1 Other: Address: Y. b• T � � I MECHANICAL PERMIT FEES* City/State /ZIP: / C6,9 Subtotal C> Minimum permit fee ($90.00) Phone: ( t.,02 , Sig S'�� Fax: ( ) Plan review (25% of permit fee) CCB lic.: i �'�, ' - ('7 State surcharge (12% of permit fee) f TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signature: days after it has been accepted as complete. Print name: 'f2' {C e c...._ (I Date: Gj +' i ■ tip/ * Fee methodology set by Tri -County Building Industry Service Board \ I:Building\Permits'I4EC- PermitApp.doc 09/ 09/10 440- 4617T /02/COM/WEB) Electrical Permit Application RECEIVED FOR OFFICE USE ONLY City of Tigard Received (F as / z , / Permit No.: �/5rb /a .. f 13125 SW Hall Blvd., Tigard, OR 97223 JUN 2 8 2 012 Plan Rev Other Permit: A2,�ia�a� (t l 5 3 ' _ Phone: 503.718.2439 Fax: 503.598.1960 Date illy: 4175 639 503 Line: ne: .. n � T , AA n Date ll;eadyBy: Atria H See Page 2 for 7 1 G r\ R Cl_ I �f 1 OF (1 111�� Internet www.tigard- or.gov = .� . Notified/Method: Supplemental Information BUTT i TYPE OF WORK : i . PEAN REVIEVh, ?: ;_: • • t w construction Addition/alteration/re placement ` Please check all that apply (submit 2 sets of plans w /terns checked below): ❑ P ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. • • • CATE6QRY OF. CONSTRUCTION . • exceeds 10,000 amps at 150 volts or ❑ Floating buildings. • less to ground, or exceeds 14,000 ❑ Commercial -use agricultural and 2- family dwelling ❑ Commercial/mdustrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ❑ Emergency system- larger separately derived system. JOB SITE INFORMATION AND LOCATION • ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", address://6 Le — Sla or oo more. Re Job no.: • Job site on _ � � F ❑ Six or more residential units. ❑ Recreational vehicle parks. / it ❑Health -care facilities. ❑ Supply voltage for more than City/State/ZIP: C �7� 600 volts nominal. 6�� ❑ Hazardous locations. Suite/bldg. /apt no.: Project name: 4 r i ieA L t ��� ❑ Service or feeder 600 amps or more. • FEE SCHEDULE Cross street/directions to job site: Description I Pty. I Fee. I Tot I • New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: W jt/rc n_ 1414 Lot no.: 1,000 sq. R or less 168.54 4 Ea. add'! 500 sq. ft or portion 33.92 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK. (with above sq. ft.) /} N Limited energy, multi -family 75.00 2 / � � rCr /I/ v ! ►� �, W / /A 5 ,c� residential (with above sq. ft.) C fJ t �w V Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 20034 2 Name: • 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and/or City/State/ZIP: - relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with APPL ❑ CONTACT PERSON above service or feeder fee, 7 42 2 each branch circuit Business name: Ak57(N T,✓0U5 - ri./E, s B. Fee for branch circuits without �^ service or feeder fee, fast 56.18 2 Contact name: TZo6 4N f A$a() /Tim 77715/40/L/ - branch circuit Each add'! branch circuit 7.42 2 Address: g 610 5v 6 / 5a ire- 7W) Miscellaneous (service or feeder not included) ty / ©� q 7 2- 3 Each manufactured seie and/or d/ r modular feeder er 67.84 2 City/State/ZIP: �/ ! 7 dwelling, service and/or feed Phone: (7 . . . 0 - N )572_ I Fax: : (Cp 3 )5qe - /0 g / Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E -mail: • Si gnor mane lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited -energy • Business name: E £ cne / / /Lo(//'F 77ti15 panel, alteration, or extension. Page 2 2 Each additional inspection over allowable in any of the above Address: c 14 eig3 5 Additional inspection (1 hr min) 66.25/ hr Investigation (1 hr min) 66.25/ hr City/ State/ZIP: aq .$CUS ' L )701 ` Industrial plant (1 br min) 78.18/ hr Phone: (53_5 ) 3,5 j - 6 I Fax: ( 671 ) / b- 01.80 IniPections for which no fee is 90.00 / hr specifically listed (16 hr min) CCB Lic.: , (((2..... Electrical Lic.: • • . n j J � Suprv. Lic.:=V ELECTRICAL PERMIT FEES Subtotal: Suprv. Electrician signature, required: Plan review (25 %of permit fee): Print name: .--1-1eigy l [ IU 111 Date: .t ., r 10/ State surcharge (12% of permit fee): t t t� �� TOTAL PERMIT FEE: Authorized signature` This permit application expires if a permit is not obtained within 180 • days after it has been accepted as complete. Print name: 1 Date: = Number of inspections allowed per permit. • I:\ Building \PermitsSELC- PermitApp.doc oirolno 440 - 4615T(11 /05 /COMJWEB Plumbing Permit Application l2 v r Building Fixtures RECj ,TE 1 1 City of Tigard JUN 2 8 2012 Datea G A 8 ' frcalla Permit No.: t/yrao is - daf6 Y • IN 0 13125 SW Hall Blvd., Tigard,OR 97223 plan Review C Phone: 503.7182439 Fax 503.598.196tk, Other Pe®itNo• :W Q aQ/ j'eiplrj''S Inspection Line: 50(1.639.4175 r t i � 'fi 1 1 �A RrD 1) R �r rims: Ef See Page 2 for Tf G �RD Intemet www.tigard-or.gov BUIL 1-i'�f'`3 DIVIS[Q ithed/Methad: Supplemental Information T OF WORK _ - . construction ❑ Demolition For special information use checklist Description I Qty. I Ea- I Total ❑ Addition/alteration/replacement ❑ Other: New 1- 2- family dwellings (includes 100 ft. for each utility connection) CATEGORY -OF' .CONSTRUCTION:.. - :- - •• SFR (1) bath r 312.70 • 1111.--- 2- family dwelling ❑ ' - S C bath 437.78 SFR (3) bath l 500.32 ❑ Accessory building ❑ Multi- family Each additional bath/kitchen 25.02 ❑ Master builder - ❑ Other: Fire sprinkler L._ sq. ft) Page 2 JOB SITE INFORIf TION•• AND LOCAT N . Site utilities: Job site address: iroS �• f ' Catch basin or area drain 18.76 L l City/State /ZIP: ' �i � � ,. � 2., // Drywell, leach line, a rft.: drain Page 2 Footing drain (no. linear $: _� Page 2 Suite/bldg. /apt. no.: Project name: 6/116. /II ` M anufachued home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer (no. linear ft.: _) ( Page 2 Storm sewer (no. linear ft: -) / Page 2 a`lr Water service (no. linear II: ____3 t Page 2 Subdivision.: j/f Lot no.: k Fixture or item: Tax map /parcel no.: r 7 G� Back low preventer 3127 Backwater valve 12.51 DESCRIPTION OF WORK ,� Clothes washer 25.02 _,I I _ "-_/ � "f ivG i�) " i & i %/if �G , If t" % Dishwasher �/ 25.02 Drinking fountain 25.02 . Ejectors/sump 25.02 ❑ PROPERTY OWNER I d TENANT Expansion tank 12.51 Name: Fixture/sewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal / 25.02 City/State /ZIP: Hose bib 7- 25.02 Phone: ( ) z I Fax: ( ) Ice maker ( 12.51 LL ❑ CONTACT PERSON Interceptor /grease trap 25.02 Business name: ifeoti y A fit Medical gas (value: $ ) Page 2 Contact name: / �� p Roof drain (commercial) 12.51 12.51 Address: e - i 9) � ) 7 g Sink/basin/lavatory , 25.02 City/State /ZIP: � `e _ � OIL' q7 -2 Solar units (potable water) 62.54 p�QA Tub /shower /shower pan � 12.51 Phone: (t� 'VII - o��� Fax:: ( () l/� E -mail: 5 u3ar @ Urinal 25.02 - yr °T Water closet 2 5.02 CONTRACTOR r9 /' Water heater I 37.52 Business name: /Ij I^n (-- Pc4 0 Al 6' (P (_ Water piping/DWV 5629 Address: • t2sx a n Other. , 25.02 City/State/ZIP: / jo if� V Subtotal lvfin Phone: ( ) Fax: ( ) / imum permit fee: $72.50 qt; Plan review (25% of permit fee) CCB Lic.: 3 ` jj Plumbing Lic. no.:' 4 - A sy State surcharge (12% of permit fee) Authorized signalize: TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days Print name - ( y\ e ` Date: cp • • ri after it has been accepted as complete l *Fee methodology set by Tri- County Building Industry Service Board. r:\ BuildingtPermiiPLMU- PermitApp.doc 10ro1109 440-4616r(10/07JCOMnvm)