Permit Building Permit Application —F X F I F E )) --
Residential FOR OFFICE USE ONLY
City of Tigard RECE N Received Permit No
Date/13 : YAM) . • /tl. '0-00
- • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Q
Phone: 503.639.4171 Fax: 503.598.1960 M Q� 12 2008 L
Date/B : Other Permit: az,7
T I G A R D Inspection Line: 503.639.4175 Dace Ready/By ® See Page 2 for
Internet: www.tigard-or.gov (-VP TIGAR D Notified/Method: Supplemental Information
TYPE OF WORK REQUIRED:DATA:A-AND2-FAMILY DWELLING
®New 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
CATEGORY OF CONSTRUCTION • work indicated on this application.
❑ 1-and 2-family dwelling ❑Commercial/industrial Valuation: $130,000
❑Accessory building ❑Multi-family Number of bedrooms: 2
❑Master builder 0 Other: Number of bathrooms: 2.5
JOB SITE INFORMATION AND LOCATION Total number of floors: 3
Job site address: /'n[(p -iU) fl yt ' New dwelling area: 1329 square feet
City/State/ZIP:Tigard,OR Garage/carport area: 556 square feet
Suite/bldg./apt.no.: Project name:Village at Summer Creek Covered porch area: 25 square feet
Cross street/directions to job site: Deck area: 128 square feet
Other structure area: square feet
REQUIRED DATA:-COMMERCIAL-USE-CHECKLIST
Subdivision: Lot no.: �a Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
Tax map/parcel no.: equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
Existing building area: square feet
New building area: square feet
® PROPERTY-OWNER TENANT Number of stories:
Name:JLS Custom Homes Type of construction:
Address:16280 NW Bethany ct Occupancy groups:
City/State/ZIP:Beaverton,OR 97006 Existing:
Phone:(503)533-4006 Fax:(503)533-4306 New:
®_APPLICANT ❑ CONTACT PERSON
NOTICE -
Business name:JLS Custom Homes All contractors and subcontractors are required to be
Contact name:Nicole Paulsen licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: 16280 NW Bethany et jurisdiction in which work is being performed.If the
City/5tate/ZIP:Beaverton,OR 97006 applicant is exempt from licensing,the following reasons
. apply:
Phone:(503)533-4006 Fax: :(503)533-4306
E-mail:nicole@jlscustomhomes.com
CONTRACTOR
Business name:JLS Custom Homes BUILDING PERMIT FEES*
Address:16280 NW Bethany ct (Please-refer to fee schedule)
Structural plan review fee(or deposit):
City/State/ZIP:Beaverton,OR 97006
FLS plan review fee(if applicable):
Phone:(503)533-4006 Fax:(503)533-4306
CCB lic.:139970
Total fees due upon application: i7 0�
j Amount received: �7�Authorized signature: C Thjj' This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Nicole Paulsen Date: *
Fee methodology set by Tri-County Building Industry
Service Board.
I:1Building\Permits\BUP-RES PermitApp.doc 11/6/07 440-4613T(11/02/COM/WEB)
Mechanical Permit AppIicatio/3ECE1VED
FOR OFFICE USE(MIN A City f Tigard Received 5 /a o `,� '
li ty AMY 12 2008 Re
Date/Sy: • Permit No n G .
• 13125 SW Hall Blvd.,Tigard,OR 97223
p Plan Review
Phone: 503.639.4171 Fax: 503.598.1960
Other Permit: L�3F n
�X
�T1GA RD DateBy Ins
Inspection Line: 503.639.4175 CI �L ❑
T I G A R D Date Ready/By: kris: 63 See Pa ge 2 for Internet: www.tigard-or.gov Bi lLDING VNotifed/Mettod: Supplemental Information
.a ok z titiA arip; itollikookoo*oktoseicog000e.lSln
®New construction ❑Addition/alteration/replacement Mechanical permit fees"are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead.and profit.
E7 E 1 d/ S v❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building ES*
For special information use checklist.
❑Multi-family ❑Master builder ❑Other:
Description Qty. Ea. I Total
L.-7:. (+)B QRl 1B 0;i*C 9f0iON '0_- la, Heating/cooling
Job site address: 1 �1�Q Cj j Air conditioning or heat pump
i Y ►�\`UL� 1 v-1( (requires site plan showing placement) I 14.00
City/State/ZIP:Tigard,OR Furnace 100,000 BTU(ductsiventsl I 14.00 1
Furnace 100,000*BTU(ducts/vents) 17.90
Suite/bldg./apt.no.: Project name:Village at Summer Creek Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler(radiator or
hydronic) 14.00
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 14.00
1 Subdivision: �� Flue/vent for any of above 6.80
Lot no.:
Other: 10.00
Tax map/parcel no.: Other fuel appliances
t t � * a_. -4 Water heater 10.00
Gas fireplace I _ 10.00
Flue vent for water heater or gas
fireplace 2._. 10.00
Log lighter(gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
-- qq$g�.: y y - � � y Chimney/liner/fluervcn; 10.00
Other: 10.00
Name:JLS Custom Homes Environmental exhaust and ventilation
Range hood/other kitchen
Address:16280 NW Bethany ct equipment 1 10.00
City/State/ZIP:Beaverton,OR 97006 Clothes dryer exhaust I 10.00
Single-duct exhaust(bathrooms, i ,
Phone:(503)533-4006 Fax:(503)533-4306 toilet compartments,utility rooms) 6.80
` *.,µ,' - r+ ft �,*„*40 "� " Attic/crawlspace fans 10.00
Business name:JLS Custom HOmes
Other: I 10.00
Fuel piping
Contact name:Nicole Paulsen $5.40 for first four;$1.00 for each additional
Address: 16280 NW Bethany et Furnace,etc.
Gas heat pump 1
City/State/ZIP:Beaverton,OR 97006 Wall/suspended/unit heater
Phone:(503)533-4006 Fax::(503)533-4306 Water heater
Fireplace
E-mail:nicole@jlscustomhomes.com Range
x '-;:-;-.W_ < 754 fix. ii `1IIRAC WR a'` - Barbecue
Business name:TBD
Clothes dryer(gas)
Other:
Address: w�•n141EECsHtA,Ndd+A�IA +E�$ES'
City/State/ZIP: Subtotal
Minimum permit fee($72.50)
Phone:( ) Fax:( ) Plan review(25%of permit fee)
CCB lie.: State surcharge(12%of permit fee)
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: Date: • Fee methodology set by Tri-County Building Industry Service Board
I.1Buildingwermnsu1Ec.Pernot App.doe 01/19/07 440-4617T(11/02/COM/WEa)
Plumbing Permit Application
Building Fixtures RECEIVED
City of Tigard Date By: a Permit No.: KST $ o
Date/By: b 1 7- � _
• 13125 SW Hall Blvd.,Tigard, 3
0 Plan Review , %77c,‘C Phone: 503.639.4171 Fax: 98. 960ZOO8 Date/By: Other Permit No.: g..02_409408.-
_l I I, \I:1, Inspection Line: 503.639.4175 Date Ready/By: 1urh: 65 See Pale 2 for
Internet: www.tigard-or.gwjTY OF TIGARD Notified/Method: Supplemental Information
z, a?R
❑New construction ❑Demolition For special information use checklist
Description I Qtv. I Ea. I Total _
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
.bg_
1 t'o y .. ,I ■ y r *..e
�'f' >.. .a ,....,t� �ni'i"h '�"" SFR(1)bath 249.20
❑ 1-and 2-family dwelling ❑Commercial/industrial SFR(2)bath 350.00
❑Accessory building ❑Multi-family SFR(3)bath 399.00
Each additional bath/kitchen 45.00
❑Master builder ❑Other: Fire sprinkler( sq.ft.) I Page 2•,,,,,e--;-;,,...•... t`:-- .,ea ;w,■: .c.,-w,r+mI SI i,:. F ,,,,,,,.x_� -n.n..,.. 41+ Site utilities
Job site address: I 1 O(.0 W SW C 4 G[A,_)�A-e_,VV Catch basin or area drain 16.60
City/State/ZIP:Tigard,OR Drywell,leach line,or trench drain 16.60
Suite/bldg./apt.no.: I Project name:Village at Summer Creek Footing drain(no.linear ft.:_) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site: Manholes 16.60
Rain drain connector 16.60
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Subdivision: I Lot no.:-7a
Water service(no.linear ft.:_) Page 2
Fixture or item
Tax map/parcel no
v iy ,. .msµ ;, Absorption valve 16.60
,r . ..c. `,•,., n`.t v ,-... `7 Backflow preventer Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
a Drinking fountain 16.60
Ejectors/sump 16.60
Name:JLS Custom Homes
Expansion tank 16.60
Address:16280 NW Bethany ct Fixture/sewer cap 16.60
City/State/ZIP:Beaverton,OR 97006 Floor drain/floor sink/hub I6.60
Phone:(503)533-4006 Fax:(503)533-4306 Garbage disposal 16.60 Hose- .,� � . _ _.�_..._ Icema b 16.60
- - Ice maker 16.60
Business name:JLS Custom Homes Interceptor/grease trap 16.60
Contact name:Nicole Paulsen Medical gas(value:S`) Page 2
Address:16280 NW Bethany et Primer 16.60
City/State/ZIP:Beaverton,OR 97006 Roof drain(commercial) 16.60
Phone:(503)533-4006 Fax::(503)533-4306 Sink/basin/lavatory 16.60
Tub/shower/shower pan 16.60
E-mail:nicolegjlscustomhomes.com _ Urinal 16.60
;Meat _ Water closet 16.60
Business name:TBD Water heater 16.60
Address: Other:
City/State/ZIP: Subtotal
Minimum permit fee: S72.50
Phone:( ) Fax:( ) Residential backflow minimum permit fee: 536.25
CCB Lic.: Plumbing Lic.no.:
Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: Date: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1:1BuildingWamueWLMF•PnmitApp.doc 12/27/06 440-4616T(10/02/COM/WE13)
i3o
Electrical Permit Application RECEIVEI' FOR OFFICE use ONL1
City of Tigard Received Deceive _ ` �M ` �I Permit No.. _6,66 4
" 13125 SW Hall Blvd.,Tigard,OR 97223 MAY 12 2008 Plan Review' C Phone: 503.639.4I71 Fax: 503.598.1960 DateBv: Other Permit: o` K— 7,
TI ei AR I) Inspection Line: 503.639.4175 CITY OF TIGARD Dare KeadyBy. lures ® see Page 2 for
Internet: www tt and-or o3/ Notified/Metho 1 I Supplemental g g , Supp ntal information
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wtitems checked below):
❑Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories
where the available fault current ❑Marinas and boatyards.
r - exceeds 10,000 am ❑Floating buildings.
,. E t.,;a,- e!FS7$Z'U �Dbr Ps at 150 volts or
less to ground,or exceeds 1000 ❑Commercial-use agricultural
❑ I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations buildings.
❑Multi-family ❑ Master builder ❑Other: ❑Fire pump. ❑Installation of 75 KVA or
-? ❑Emergency system larger separately derived system.
- ��. _- '7p C,�-'I IP. ❑Addition of new motor load of ❑"A rate Jeri
Job no.: Job site address: )f( 9(j G j y��� ` j/}�100HPormore occupancy
t t tC/A`(1�(.51. 16 Six or more residential units ❑Recreational vehicle parks
City/State/ZIP:Tigard,OR ❑Health-care facilities ❑Supply voltage for more than
❑Hazardous locations 600 volts nominal.
Suite/bldg./apt.no.: I Project name:Village at Summer Creek ❑Service or feeder 600 amps or more.
Cross street/directions to job site: :t + E t 1P'C3It -4 ifi
1 Description 1 Qt I Fee. I Total I
New residential single-or multi-family dwelling unit
Includes attached garage.
Subdivision: Lot no.:777(2) 1,000
I(2) 1,000 sq.ft.or less I 145.15 4
Ea add']500 sq.ft.or portion I 33.40 I
Tax map/parcel no
Limited energy,residential
_,. i i17$: U181Mit"- it as O (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sc ft.)
Services or feeders installation,alteration,and/or relocation
200 amps or less 80.30 2
4-* _e 11EIAIN 201 amps to 400 amps dQ ? � , 106.85 2
Name:JLS Custom Homes 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address:16280 NW Bethany ct Over 1,000 amps or volts 454.65 2
City/State/ZIP:Beaverton,OR 97006 Temporary services or feeders installation,alteration,and/or
relocation
Phone:(503)533-4006 Fax:(503)533-4306 200 amps or less 66.85 1
Owner installation:This installation is being made on property that 1 own which is not 201 amps to 400 amps 100.30 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 1 401 amps to 599 amps 133.75 2
Branch circuits—new,alteration,or extension,per panel
Owner signature: Date: A.Fee for branch circuits with
g `' *ice Of81t1:**#rdR' CA above service or feeder fee,
6.65 2
Business name:JLS Custom Homes
each orbrancirci circuit
B.Fee for branch circuits
without service or feeder fee,
Contact name:Nicole Pauisenq first branch circuit 46.85 2
Address: 16280 NW Bethany ct Each add'1 branch circuit 6.65 2
Miscellaneous(service or feeder not included)
City/State/ZIP:Beaverton,OR 97006 Each manufactured or modular 90.90 2
dwelling,service and/or feeder
Phone:(503)533-4006 Fax: :(503)533-4306 Reconnect only 66.85 2
E-mail: nicole @jlscustomhomes.com Pump or irrigation circle 53.40 2
'0, I0"`x a'i( 40t Nra-RACNddt 4:4W45 ,,- s Sign or outline lighting 53.40 2,
Business name:TBD Signal circuit(s)or limited-
energy panel,alteration,or
Address: extension.Describe: Page 2 2
City/State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50 I
Phone:( ) Fax:( ) investigation per hour(1 hr min) 62.50
CCB Lie.: Electrical Lie.: Suprv.Lie.: Industrial plant per hour 73.75
'u ,7,.: e,_,, DE+'COERIOAL ERMITilEES °µ
Suprv.Electrician signature,required: Subtotal:
Plan review(25%of permit fee).
Print name: Date: State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires If a permit is not obtained within lab
Print name: Date:
days after it has been accepted as complete.
• Number of inspections allowed per permit.
1,113uildmgiPermhs'ELC-Permit App.doc 05/23/06 440.46!5T(I I/OS/COM/WEB
;i s II Building Division
f:1 One & Two-Family Dwelling
Fees Checklist
PERMIT INFORMATION: .
Permit#: Plan #: C u M Date: 6• 29 .CB
Site Address: 1 1() re 5\,1,) Mak\ow T e rrc ce_ Parcel#:
Subdivision: Vt. \\4O�C.. co �u - rv1 e r C r e( Lot#: —2 Z Zoning:
Jurisdiction: rick Front: Rear: Left: Right:
Class of Work: N 2to Stories: 3 First Floor: -]y-`°
Type of Use: rn Height: ‘ Second Floor: S Z3 3 �`
Construction: 515 Floor Load: 50 Third Floor: to 9 $ at
Occupancy Group: 3 Dwelling Units: L Bonus Room:
Valuation: Z !bedrooms: a Total Floors: 13 55?
Bathrooms: 3 Basement: QS
Decks: 12s cl. Garage: 542 f
Porches: 20 cl° Other:
FEES: Description: Fee Amount: Amount Paid: Balance Due:
Plan Check: Building: (o—Z _--$ 10,00
Extra Set: 10
Permit: Building: I .T7
Tax: 244 32..
Metro CET: 1 Millob
School CET: 112,_
Mechanical 0.k
Tax: J 3. 0(0
Plumbing: 34,4 . CO
Tax:
Electrical: ' \ .9
2 3 •
Tax: 2_5-14-
Low Voltage: 2s
Tax: QS
CDC: CDC Ping. Rev.: 4A
CDC LRP Fee: mike, •
SDC: Parks: •
TIF Res.:
WI `•
TIF MT: 4
Erosion Permit: 1,
Erosion CWS: _ ` ,
Erosion COT: • •. r`
• Water Quality:
.Water Quantity: _ _
SUB-TOTAL: 13 y, l a,-1 30. La—
Sewer: Permit:
Inspection:
SUB-TOTAL:
TOTAL MST & SWR:
I:\Building\Forms\ResPlanCheckFees.doc 01/19/07 Page 1
PLUMBING FEES (for special information use checklist) MECHANICAL FEES (residential equipment/systems)
Description I Qty. 1 Fee(ea.) 1 Total Description Qty Fee(ea.) I Total
New 1-&2-family dwellings Heating/Cooling
(includes 100 ft.for each utility connection) Air conditioning or heat pump* 14.00
SFR(1)bath 249.20 Furnace 100,000 BTU(ducts/vents) 14.00
SFR(2)bath 350.00 Furnace 100,000+BTU(ducts/vents) 1 17.90
SFR(3)bath ( 399.00 Gas heat pump 14.00
Each additional bath/kitchen 45.00 Duct work 10.00
Rain Drain,single famil dwelling 65.25 Hydronic hot water system 14.00
Fire sprinkler-sq.ft. 0 to 2,000 115.00 Residential boiler
Fire sprinkler-sq.ft. 2,001 to 3,600 160.00 (for radiator or hydronic system) 14.00
Fire sprinkler-sq.ft. 3,601 to 7,200 220.00 Unit heaters(fuel,not electric)
Fire sprinkler-sq.ft. 7,200 and greater 309.00 (in wall,in-duct,suspended,etc.) 14.00
Site Utilities Flue/vent(for any of above) 6.80
Catch basin/area drain 16.60 Repair units 12.15
Drywell/leach line/trench drain 16.60 Other Fuel Appliances
Footing drain- 151 100' 55.00 Water heater 10.00
Footing drain-each additional 100' 46.40 Gas fireplace 10.00
Manufactured home utilities 110.00 Flue vent(water heater/gas fireplace) 10.00
Log lighter(gas) 10.00
Manholes 16.60 Wood/Pellet stove 10.00
Rain drain connector 16.60 Wood fireplace/insert 10.00
Sanitary sewer- 1 100' i 55.00
Sanitary sewer-each additional 100' 46.40 Chimney/liner/flue/vent 10.00
Storm sewer- 1u 100' __� 55.00 Other: 10.00
Environmental Exhaust&Ventilation
Storm sewer-each additional 100' 46.40 Range hood/other kitchen equipment 1 10.00
Water service- 15` 100' t 55.00 Clothes dryer exhaust 1 10.00
Water service-each additional 100' 46.40
Fixture or Item Single duct exhaust
Absorption valve 16.60 (bathrooms,toilet compartments,
Backflow preventer 27.55 utility rooms) 6.80
Backwater valve ) 16.60 Attic/crawl space fans 10.00
Clothes washer 16.60 Other: 10.00
Dishwasher I 16.60 _ Fuel Piping
Drinking fountain 16.60 **($5.40 for first 4,$1.00 each additional)
Furnace,etc. l **
Ejectors/sump 16.60 Gas heat pump **
Expansion tank 16.60 Wall/suspended/unit heater **
Fixture/sewer cap 16.60 Water heater 1 **
Floor drain/floor sink/hub 16.60 Fireplace 1 **
Garbage disposal 1 16.60 Range 1 **
Hose bib `.,) 16.60 BBQ **
Ice maker ‘ 16.60 Clothes dryer(gas) **
Interceptor/grease trap 16.60 Other: **
Primer 16.60 Total:
Roof drain(commercial) 16.60 Mechanical Permit Fees
Sink/basin/lavatory %/c /4 16.60 Subtotal: $ 9.0.cam
Tub/shower/shower pan 16.60 Minimum Permit Fee$72.50 $
Urinal 16.60 Plan Review Fee(25%of Permit Fee) $
Water closet 3 16.60 State Surcharge(12%of Permit Fee) $ I U.$6
Water heater I 16.60 TOTAL PERMIT FEE $
Other:
Other:
Plumbing Permit Fees ELECTRICAL FEES (residential single-or multi-family)
Subtotal $ 3994 Qtj Description Qty. Fee Total Insp
Minimum Permit Fee$72.50 $ 1,000 sq.ft.or less l 145.15 4
Plan Review(25%of Permit Fee) $ Ea.add'1500 sq.ft.or portion Z 33.40 1
State Surcharge(12%of Permit Fee) $ 4-]. R Limited energy,residential 75.00 2
TOTAL PERMIT FEE $ Each manufactured or modular
dwelling,service and/or feeder 90.90 2
Electrical Permit Fees
Subtotal: $ Q ( l - �
Plan review(25%of permit fee) $ 2 S - 1j
State surcharge(12%of permit fee) $
TOTAL PERMIT FEE $
I:\Building\Forms\ResPlanCheckFees.doc 01/19/07 Page 2
1111 CITY OF TIGARD FEE AND PAYMENT HISTORY
i -,47 7 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
MST2008-00064 - 11066 SW MALLOW TER
Revenue Payment
Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due
[BUPPLN] Pln Rv Deposit 245-0000-433000 $750.00 $750.00 $750.00 5/13/08 Check 2720080000 $0.00
0000001630
[CDCPLN] CDC Pln Rev 100-0000-433060 $46.00 $46.00 $46.00
[LRPF]LR Planning Surcharge 100-0000-438050 $6.00 $6.00 $6.00
[BUPPLN] Pln Rv Balance 245-0000-433000 $673.38 $673.38 $673.38 6/19/08 Check 2720080000 $0.00
0000002168
[BUILD] Bldg Permit 245-0000-432000 $1,035.97 $1,035.97 $76.62 6/19/08 Check 2720080000 $959.35
0000002168
[TAX] Build 12%State Surchrge 100-0000-207020 $124.32 $124.32 $124.32
[METCET]Metro Const Excise Tx 245-0000-229202 $183.55 $183.55 $183.55
[BEACET] Beaverton School CET 245-0000-229204 $1,355.00 $1,355.00 $1,355.00
[MECH] MEC Permit 245-0000-431010 $90.50 $90.50 $90.50
[TAX] MEC 12% State Surcharge 100-0000-207020 $10.86 $10.86 $10.86
[PLUMB] PLM Prmt 3Bth 245-0000-431000 $399.00 $399.00 $399.00
[TAX] PLM 12%State Surcharge 100-0000-207020 $47.88 $47.88 $47.88
[ELPRMT] ELC Permit 220-0000-431510 $211.95 $211.95 $211.95
[TAX] ELC 12% State Surcharge 100-0000-207020 $25.43 $25.43 $25.43
[PKSDC]SF Park SDC 270-0000-450000 $5,215.00 $5,215.00 $5,215.00
[TIF-R]TIF Resident 210-0000-448001 $2,960.00 $2,960.00 $2,960.00
[TIF-MT]TIF Mass Tr 210-0000-448005 $240.00 $240.00 $240.00
[ERPRMT] Erosion Control 100-0000-207307 $64.00 $64.00 $64.00
[ERPLN] Erosn Pln Rv CWS 100-0000-207308 $20.80 $20.80 $20.80
[EROSN] Erosn Pln Rv COT 245-0000-433010 $20.80 $20.80 $20.80
Refund-[BUPPLN] Pln Rv Depos 245-0000-433000 $-750.00 $-750.00 $-750.00 6/19/08 Check Refund 2720080000 $0.00
0000002167
Totals for Fees $12,730.44 $12,730.44 $750.00 $11,980.44
Revenue Payment
Fee Description Account Number Fee Amount Invoiced Paid Date Paid Method Receipt# Due
Receipt# Payment Method Check# Payor: Receipt Date Receipt Amount
27200800000000002167 Check Refund 06/19/2008 $-750.00
27200800000000002168 Check 912156 JLS CUSTOME 06/19/2008 $750.00
HOMES
27200800000000001630 Check 912156 05/13/2008 $750.00
Total Payments: $750.00
Balance Due: $11,980.44
.� 4" STORMLINE. WATER METER e At uming reek IVll N, '
`,..) 4,..:A„,b, 2" Paper Birch Tree
MAY 12 2008 4" SANITARY SEWER. C ,
/ r
u1 cn Pan: 9 CITY OF TIGARD ' k �''
y
BUILDING DIVISION '
L 2. ' PUE
f
4" SANITARY SEWER. /� e'
Zats ' 69, 70, 1i 72, 73 : ` 2" Paper Birch Tree
•�" �` Unit B
((,�, •
4" SANITARY SEWER. /�� D) �r �� ���
i k ,_, Unit E , ,. •
/ / �r \ ' ,
1. PROVIDE A MINIMUM 8" DEEP GRAVEL BASE FOR ALL 4" SANITARY SEWER. .Q , ' a'. 2" Paper Birch Tree
DRIVEWAY AREAS. • �� .. .
2. MAXIMUM DRIVEWAY SLOPE SHOULD BE VERIFIED WITH v 0 :•` ■� Unit E ? =,
THE BUILDING DEPARTMENT PRIOR TO CONSTRUCTION. Q- 411rii.. '� � r m
3. PROVIDE A MINIMUM 4" DEEP GRAVEL BASE FOR ALL /� l is
SIDEWALK AND PATIO AREAS.
IP ''° < \� / �` c�Gj .`/ Unit E ., ' J w 4. PIPE ALL STORM DRAINAGE FROM THE BUILDING TO A 4" SANITARY SEWER. a \ ,,DISPOSAL POINT APPROVED BY THE BUILDING '` �: ,ji �? 2" Pa er Birch Tree z DEPARTMENT. , . p g f
4 STORMLINE. L� M §5. PROVIDE AND MAINTAIN POSITIVE DRAINAGE AWAY 1` �r ��
FROM BUILDING ON ALL SIDES. y
10 Water line 0
Unit B 6
6. NON—STABILIZED FILL MUST NOT EXCEED 2:1 SLOPE rI \ 9 2" Paper Birch Tree
. / F- •
` ��� II
7. NO CUTTING OR FILLING SHALL TAKE PLACE WITHIN ►D • N! \ .� j '4 __ 1
THE DRIP LINE OF AN EXISTING TREE UNLESS THE --- ,O ♦ ••
EXCEPTION IS APPROVED BY THE BUILDING DEPT. ________________ _ ___ _� • •
8. AFTER COMPLETION OF CONSTRUCTION, THE CONTRACTOR as - _ CITY OF TIGARD- SITE PLAN REVIEW no•
MUST EITHER LANDSCAPE THE SOILS, MULCH THE SOIL OR 4 .--�` O m `' MG PERMIT NO.. �.�• • ��`�''�•SEED THE EXPOSED SOILS.
_ ; ' 4--,. —�*---�•. :1 PLANNING DIVISION:
4 - A roved ❑ Not Appro d
9. PROTECT STOCK PILES FROM OCTOBER 1st THRU 2" Eastern Redbud __: . Y. Required Setbacks: pP 5e 4 hay`s
APRIL 30th PER THE EROSION CONTROL HANDBOOK. Street Side:
S'�' Rear:
SVv ROSE Front. Garage: — Not Approved
�VIEw MARY LANE ,,i; t cteara,mo Islip( ❑ Ap roved ❑ PP
pF TIGARD-SITE PLAIT 5' Side 4446.x.� „ B�ri�MtEiatg Height. feet 45
CITY 4����.� •
BUILDING PERMIT NO: + t vrt�cei, -e P1a�ier Letter Rtquirtd: ❑❑ R�eived
it No
Approved ❑ Not Approved p It . Date:
Street Trees: Approved ❑ of Apps
,, �• ,� �, : ���kN�I�PA�'FI�fENT:
Protecte� s. Date` - ) - I 0 'V" . % proved ( N't A, , oved
B o ■, .VI , (7 q Approved a C . �, . -.-
Notes: NORTH V � " _ _ s
1 20 A a;/a8
ocs:: G /
DATE 4/8/08