Case File ADDRESS :
120---mac i.A2kn b r-iac
records`niicroflm\targets\building doc
CITY OF TIGARD CERT CUPATE OF
[1Cl1F'>AiVC'(
COMMUNITY DEVELOP ENT D P,�� ',��, �h1T PERMIT #. . . . . . . s MST9:3--021 c
13125 SW Hall Blvd.Tigard,Orrgon 87223*81 `(603)'�d-4171 KATE I E31riUED r 10/19/93
RARC,6:L.s 151.7,4CB�-•1;3100
��I TE AUDftf�88. . „ s 1811:.5 SW ANT'GN UR
SUBDIVISION. . . . i ANTON PARK II ZONING;
€11.oCK. . . . . . . . . . s LOT. . . . . . . . . . . . . 1064
CL.'ISS OF WORK. s NEW
TYPE OF USE. . , t SF
UCCU'ANCY GRP. s R3
OCCUPANCY LOAD; 12.t. 4
TENANT NAME'. . » s
Remarks PA71-1 I
Owner`
F70UR D CONSTRUCTION
P O BOX 1577
BEAVERTON OR 9700
Phone #s 641•-0935
Contractors _.__...,_. .._...._.._ ...._._ __ _.____... _...._.___._ ._..
FOUR D CONSTRUCTION
PO BOX 157:
BEAVF13TON OR 97075
Phone #. 64.1-09305
Peg #. . : 7tO37
(nrcupanc•y of the above referenced building is hereby given, anti ertifi%-
+ 1-e compliance with the c;tate Of Oregon Specialty Codes for, the group,
!,erupanr..y, and 118& under which the referenced permit wa,1 issued.
FIRE: DEPARTMENT 41AULPING 1 'CTOR
1 D I C i F
POST IN CONSPICUOUS PLACE
I
1
city of Tigard Building Departarmt
1__1125 aw Ball Blvd. Tigard. Orogon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phonat 539-4171
Inspections —
looting Plbq. Underalab Mach. Rough-in Appr/Bdwlk
Pound. Plbg. Tvp Out Gas Line ��tI`MALe
Prost/Beam Dtruct. Ban. Sewer Framing
Post/Seam Mach. Rain Drain Insulation -Plumb.
Plbq.
Plbq. Underfloor Nater Line Gyp. Rd. C-IWO
Date Requwated:_ C�} (/I__ 13 -`Time PM
Addressey 11 A+, " ,7 Permit #e12
-7
Builders ` t lM _ !y'(S
TER FOLLOWING CORR=CTIONS ARE REQUIRED:
Inspector:
y APPIPOM1fED DIs1►PlRovED APPROVED SUPJEC'r TO ABOVR
Call For Reinsp.
INIREcTJ NOTIca
City of Tigard Building Deportment
13125 RM Ball Blvd. TLWd, Oregon 97223
Insp•.ction Line (Rr-0-(Phh�on.)t 6:9-4175 Business Phones 639-4171
lnspectior
Footing Plbg. Underslab Mach. Rouqh-ir. Appr/Sdwlk
Found. Plbg. Top Out Gas Lin. PIMALe
Pcat/Beam 3truct. San. sewn Framing '-oldg.
00'-
Post/Beam Hoch. Rain Drain Insolation -Plumb. /
Plbg. Underfloor Water Lin. Gyp. Bd.
Dates q.stedt / `3
L
Address$ Z-( � 3 /f�t m 1-C.
Build.rs ?w - 7V q
TBE FOLLOWING MRPACTIONS ARE RXQUIREDS
-t-Lr
Inspectore� '/ y�
APPROVZD V DI6AT%P1e0VRD APPFATM SUBJECT TO ABOVE
�l GSC V Gll
For Ileinsp.
ti
atA Ue t - KA r -Fvo,�.� dctir
�BPBC'Ixo�Li�CIS�
city or Tigard Building Depaelannt
23128 BW Ball. Bl.td. Tigard. orwgon 97223
Inspection Line (Roc-6-Phone)+ 639-4175 Business Phones 639-4171
Inspection-----_—.--- --. --- - — ---
footing Ploy. Undorslab Hoch. Rough-in Appr/Sdwlk
Found. PIN. Top Out Gas Line IINALt
Post/Ream Struct. San. Sewer Framingldq.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
PIN. Underfloor water Line Gyp. Bd. -Hoch.
Date Roquestods-__.L� Time+ L� AM --PH
Address s1(� _T_ Permit
Bu:.lder i
TAR FOLLOWING OORR=CTIORS ARE REVIREDf
/ l 1�� /1
� �j��•s 1 r� ���1u�✓ l�� t'S 5
� 7✓� �. ,� ,� l r . I'1 l�/ ice.
/,
Inspector Date r�j
____-
APPROVED DISAPPROVED �__ APPROVRD SUBJ>tCP TO ABOVE
call For 'ceinsp.
cit! or Tigard Building Department
13125 s11 Ball Blvd. Tigard, Oregon 97223
Inspection Lina (Rec-O-Phone): 639-4175 Busineas Phones 639-4171
i .epsctl-on:
!r""ting Plbg. Underslab Meeh. Rough-in `Appr/sdwlk
Pou«h- Plbb,. Top out Gas Line lIIp1L1
Post/Renm Struct. ban. Sewer Framing -Bldg.
Post/Ream Mach. Rain Drain Insulation -Plumb.
Plbg. Underrloor Nater Lim gyp. Bd. -Koch.
-_�
Data Requested:„ -A Imo=
_. /__AK
P
Address: A1�
1kon� Permit 01_r
guilder:�y
TOM FOLLOWING CORRRC'TI.. " RRQUIREDt
64
TQ-arm L_'r
Inspectors72 __�_ `_ Detet �
APPROvtD DIBAPPROVED _LZ/AppRMRD SUBJECT To ABM
Call For Reinep.
IIIBPICTI NOTICE
�( -"'Ly of Tigard Building tepee-tasnt
lbl tS B,R,Aa]1 Bled. Tigard, Or"MI 97223
Inspovtion Tina, (Rec-O--N.one)t 639-4175 Business Phonac 639-4171
Inspection,_ yam'
footing P1 . Underwlsb
� Hach. Rough-in Appr/Sdwlk
Found.
Plbg. Top Out Gas Ll.nw
lINALt
Poet/Beam srruct. Ban. Sewer
Framing -Bldg.
Post/Bion M.eh. Rain Drain
Insulation -Plumb.
PIN,. Underfloor Nater Lina
-Koch.
Drt.e Requestedt d'L�3
TLa►et __AM PM
Aadrwret 12113 ' try\ P.r.it f t '
Au i l.dert f-�lJ�.� S� /j
(V y�^-9r cioO
�D
THC YOUIOUINtl CORRCCTIONS AM RRQUIRROt
-----------------
_ �=�:
a nrSAPPAOVRD i� APPRO j) SUBJECT To ABOVg
_ _Call For Reinsp.
City of Tigard Building Departaesrt
13125 811 Roll Blvd. Tigard, Oregon 97223 4
IINPOQtLon Use (Roc-O-Phona)e 639-4175 Business Phones 639-4171
Inspections --}7i'^3
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
round. Plbg. Top Out Can Lina P1NALs
Post/Beam btruct. San. anwer rrawlnq -Bldg.
Post/Beam Koch. Rain DrainInaulation> -Plumb.
Plbq. Underfloor Nater Lina Z Gyp. Bd.
Data Requentode /� lt" J Time: �M .X,_pM
Address: ' AyJ Iy. ,� Permit #s�7 Z
Builder.:.
THE rOIJAMING CORRECTIONS ARE REQUIREDs
()LAJ 9 ✓�r' / �1_ V1
Inspectors.
APPAMID _ DIdAPPROVBD APPROVED SUBJECT TO ABOVE
\-<" C C, Call Per Relnep.
Cit! Or Tigard EhtildLng Depert wA nt
13125 SN Nall Blvd. Tigard, Oregon 97223
Inspection Lina (Roc-O-Phone)s 639-4175 Business Phonac 639-4171
Inspeceiont
Footing Plbg. Underslab Hach. Stough-in Appr/Sdwlk
r--
Found. bg• Top Out Can Lina IENALi
l
Post/ream Ptruct. San. Sower Framing -Bldg.
Post/89am Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Rd. -Hoch.
Date Requeetedl ___
�
Time: v pH
AdOresoe /.-�C / "7 Parmit
Builders— — L
THE FOLLOWIND- CORRZCTIONS An nsMIR1SDt
Data,
v�APPR,7VXD DISAPPROVED APPROIIRD SUBJECT TO ABOVE
Call For Rainap.
INSPECTION-NOTIQ4
City of Tigssd Building Deparfaeat
13125 9W Hall Blvd. Tigard, Oregon 97223
inspection (Line (Roc-0-Phone)r 639-1175 Business Fhone: 639-11
InspectionrljL.cs.c�"_� �tjZ
Footing Plbg. 6nderslab Ileoh. Plough-in App /Bdwlk
Found. Plbg. Top Out Gas Line fINALr
Poet/Baan Struct.. San. Sower ttasLLng -Bldg.
Post/Baam 14wch. Rain Drain Insulation -Plumb.
Plbq. Underfloor Nater Lim Gyp. Rd. _Koch.
Date Re7uestedr / i-:2 TLms _,L.AM PM
Acldre►a e r� � `/��jZjt/ . Permit
Bull.derr
THE FOLLOWING CORRECTIONS ARE REQUIRED%
SIM
1A
C'. T-S I )�.1 Y}n �Yy� Z►. 1 _` AA JQ -"j 9-M
_L)C_ L w S
2.c f — ____� ► -� 4
1
w
Inspectors Dabs 7
APPROVED DISAPPROVED Pg1oVED BVs ve? To ABO !
���, Call For Reinsp.
INSr_gCTIQt NOTLCE
City of Tigard Building Department
13125 BII Ball Blvd. Tigard, OrrAjon 97223
Inspectton Line (Rec-O-Phone): 639-4175 Rusinean Phone: 639-4171
Inspection:_
Footing Plbg. Underslab h. Rough-in; a Apor.,I.'idwlk
�r
Found. Pll:q. Top Out Gas Line FINAL:
Poet/Beam Ptruct. San. S, -sr Frasinq -Bldg.
Past/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Date Requ1entod: , Y Timet AM PM
Addreae: \ l /' �►`�TL�/� /� �— Permit 02 ` �
V
THE FOI.LOWINfl COpncrIONS ARE REQUIRED: ` J
Lkj
Inspector.---- ------_ L7 2 ,
� � Dates � .
APPROVED _- DISAPPROVED PROVED SUBJECT 1U ABJVE
Q, LA Call Por Reinap.
INBPISCT
City of Tigard Building Depari;=ftnt
13125 811 gall Blvd. Tigard, Or.goo 97223
IBepBtttion Line (ROC-O-Phone)e 639-4175 Buninona Phone: 639-4171
=�Dbti011t
ft*tL&0 Plbg. Underalab !tech. Rough-in Appr/S&sIk
�• Plbg. Top out Gas Line PINALt
/Nr Btl110t San. Rower Framing -Bldg.
Oman. Rain Drain Insulation
Plbg.zt-d
Nater Litre gyp. Rd. h.
t —/ 7-
Date Tutu
Address:
L- P.rn,lt #�
Builder:___
THS POLLONING OORRRCTIONS APR ";)UIRRD3
Inspector^
--- ----- Date 1
APPROVlD DISAPPROVED AppwpyBD SUBJRM TO
ABOVB
Call For Rei-nap.
---W-'i.r 1 r•.L i•r•s•,I..+Mww` MvM,K'W
).MpT1C1.QE N(7I1Q9
CitT Of T19".4 Bn:lding Department
17125 89 Halt slvtl. Tigard. Orwyoo 97223
Inap x ion Lina (Rar_ •1�.P, ,n*)t 639-4175 Business Phonal 639-4171
I '^�wcLLon,
1bttl .,r Plbr. Vndor-lab Koch. Rough-in Appr/8dwlk
`round° ' 'by. Top Out Gas Liao FINALt
�Oe�/Mei Btt�c. Ban. Rower Framing -Bldg.
rpft/loam Moen. Rain Drain Insulation -Plumb.
. onder'.1oor J Mater Line Gyp. Bd. -Koch.
Data waqpeftedg Tiast
h
1lddrerr e A) !M
Permit fi. n< Z
Builders
ii1E FOLLOWING ^'1'IONB ARE REQUIRED1
Inspector:
Dates 75'2?
���' -
APPROV= DIBAPPROVRD APPROVED SUNjNCT TO ARMN
Call !or Reinsp.
IN?M(TION_IOT cz
city of Tigard Building Dopert,,mot
I312S OW Ball Blvd_ Tigard, Oregon 47223
Inspection Lina (Rsc:-O-.Phone)r 631-4175 Bual.naom Phone: 639-4171
Inepection�
Footing Plbg. Underslab Hoch. Rough-1n Appr/Sdwlk
Found. Plbg. Top out Gas Line
FINALt
Poet/swam Struct. /N, Newer Framing -Bldg. i
Post/Roam Mach. �_-
n Insulation -PliMti,
Plbg. Underfloor etBr L1AB� ' Gyp. ad. -Hoch. A
Date Requested,
_Times —.-AM �
Addreaef / 3
YL� l PArait 0 i 7_� 6 Z j Z.
Builder
— I
THR FOLLONIN OOl1=rZONS ARE F.EQUIRRD:
_ I
I
Inepwctoc
' —APPROVED DISAPPROVRU
APPROVED BUB.J1iCT 1'O Aepy=
---Call For Reinep.
City or Tigard BulAdloy Department
13125 BW Hall Blvd. Tigard, Oregon 97223
Inspection Line Ree-O-Phone)t 639.4175 Business Fhone: 639-4171
Inspect ion v_
Footing Plbg. Underslab Mach. Rough-in APer/Sdwlk
Found. Plbg. Top out Gas Line CPIIp1Lt
Post/Berm Struct. San. Sewer Framing -Bldg.
Post/Boom Much. Rain Drain Insulation C-PI-ab.
Plbg. Underfloor Nater Line Gyp. Rd. -Mech.
Data Requestedsy- Sialet �L AM PH
1 i
Address t (21 13 � PeroLt t t`l 'DZf L I
TAE FOLLOWING CORRECTIONS ARE REMIREDt
i
Inspecttorrs Dates.
Y APPROVED DISAPPROVRTI _ APPROVED SUBJECT TO ABOVE
For Reinsp.
city of Tigard Building Department-
13125 dw Ball Blvd. Tigard, Organ 97223
Inspection Line (Rec-o-Phonw)s 639-41.75 Businese Phone: 639-4171
ing Plbg. Undereleb Hoch. Rough-in Appr/Bdwlk
Plbq. Top out Gas Line FINALS
Post/Beam struct. Ban. Sewer Framing -Bldg.
Poet/Deem Hoch. Rain Drain Inaul.ation -Plumb.
Plbg. Undertlour Nater Line Gyp. ad. _Hoch.
Data Reslupteds �� i/}',,,, �i��11H PM
Addresses/,�f/ Permit #s
Builders LI-D
TBE FOLLOWING ODRRECTIMS ARE RRMIREDs
aC1,17s'—__ --
Inspector: _
ter
__
APPROVED - DISAPPROVED �APpRO� DaSUBJECT Tin Anove
—_,Call Por Reinsp.
PLUMBING PERMIT
C.TOY OF TIG�,R® PER1411 #. . . . . . . : MST93--i&.
COMMUNITY DEVELOPMENT DEPARTMENT DA'TE ISSUED: 05/29/93
13125 SW HO Blvd.Tigard.Oregon 9722398100 (503)839-4171
SiHE i_' il-a UW A.NIL-,,,; �jk
SUBD I V I S 1 ON. . . . ; ANION PARK 11 1�4 ZONINO; R-7 PI)
14LdCK. . . . . . . . . . S LOT. . . . . . . . . . . . . .�j
MOSS OF WORK. . :NEW GARBAGE D I CGPO'SALS. i
TYPE OF USE. . . . -.SF WASHING MACH. . . . . . . 91 13ACKFLOW PREVNI RS. . .0
OCCUPANCY LIRP. - t R3 FLUOR DRAINS. . . . . . . :0 TRAVIS. . . . . . . . . . . . . . z0
s 1(3R I ES. . . . . . . . 51 WATEP HEATERr. . . . . . il CATCH BASINS. . . . . . . :ka
f'J.KTURL5----- - LAUNDRY TnAYi. . . . . . : 1 3F RAIN URAING. . . . . .. I
I NKS. . 0 . . . . . . GREASE: TRAPS. . . . . . . :0
:_.�AvwruRms. . . . . ..4 OTHER r I XTURES. . . . . :10
IUB/SHOWERS. . . . . !jEWLR LINE ( 1t) . . . . :M
WATER CL0i')ET6. . :2 WATER LINE (ft) . . . . : 100
D1$f,*4ASHERG. . . . 21 RAIN DRAIN (ft). . . . :0
R,arkst f"44TH I
'JONERs
iOUR D CONSTRUCTION 1IF $ 1460. 00 PLL 05/28/93
P 0 BOX 1517 8PRT $ 376. 00 PLL e3/28/93
BPLL $ 244. 40 JL.14 t?4/0 8/9":; 1L-L_ u
DEAVLRtON OR '31001 B5PC 11 8. 80 PLL Otj/26/93
Phone #: 641-0935 SSDC -11 260. 00 PLL 05/26/93
PARK 0 500. 00 PLL 05/28/93
51L
uxibin6 Centract , MPRT $ 40. 510A PLL- 0. "S/13
MPLL 4 10. 13 PLL 05/213/93
m5pc f i:..@3 PLL 05/e8/93
PPRT t 147. 50 PLL 165.'28/93
t y Is)j,)r o e"v P5PL $ 7. 38 ;-LL 05/28/93
11P3__ 1t712_,3 --.-.,-Phone# ,.
REUIJIRED INSPECTIONS
This permit is i -.sus�d subject to the -eg
UlAtions contained in the Tigard Municipal i<Uot/found Insp Rain drain Ins[.
Cod'el State of Or*,. Speciaity Codes and all Post/beam Gtruct Watet Line Ins,,
othor applicable laws. Ail work will be done PostlBeam Nechan Rppr/Sdw&' k Ins;
ir, acit-ordance with approved plaits, Thi % Ple/undslab Insp Mechanical Fit,
pr.-roit will expire if woy-k is not started PLM/Underfloor Plumb Final
withii-. 160 u*vy%, of issuance, or if work is Mechafnical Iner, Buildirig Final
-urspe )ded for more than 180 days. Plumb Top Out Erosion Lontro ,
Uraming Insp Crawl Drair
Fireplace Insp
GasLine Insp
Insul.ttion lni�p
lk4/ 14'yp 80-lrd 11vir.,
L': -i :+Ctor Notes:
CITY OF TIGARD MAISTER PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PLRI41 T it. . . . . . . . M15 T9 3 a
I4125&W Hell Blvd.Tigard,Oregon 97223*9599 (503)639.4171 DATE ISSUED: 05/28/'93
if
1P.1 13 SW ANTON DR PARCULt IS134Lo
SUBDIVISION. . . . t ANTON PARK 11 ZONING: R---7 F)
BLOCK. . . . . . . . . . : LOT. . . . . . . , . . . . . _
REI AGUE: DWELLING UNITS. 1 . . . . . . . . :0 s
OF WORK. -.NEW BEDRMS;3 SATHS-2 GARAUE. . . . . . . . . . :40e 5
OF USE. . . :SF FLOOR REUUIRED SETBACKS--------._-
TYPL OV CONST. :5N FIQST. . . . t 1598LEFT. . z5 ft RIGHT. t5 ft
OCCUPANCY GRP. tR3 SECOND. . . 10 sf FRONT. =20 ft REAR. . .-26 ft
'.."rQRIL3. . . . . . . .. I THIRD. . . . .121 S f' REQUIRED-
HEIGH1.. . . . . . . . .LiZ: f t TOTAL----.- 1598 s f SMOKE DETECTORS. :Y
I LOUR LOAD. :40 Visf VALUL. . . . . 4 -- a@ 70s PARKING SPACEZ3. - : 1
Romarkst PA",11 '11
PLUMBING
SINKS. . . . . . . . . . . I FLUOR DRAINS. . . . %Q BACKFLOW PRLYNTR5. . %0
LAVATORIES. . . . . :4 WATER HEATERS— : 1 TRAPS. . . . . . . . . . . . . . ..0
IJB/SHOWERS. . . . t3 LAUNDRY T RAYS. . . : I CATCH BASINS. . . . . . . :0
64ATER GLUSETS. . t2 SEWER LINE (ft ) . jO GREASE IRAPS. . . . . . . ..0
DlSliWASHERS. . . . . I WATER LINO Cft ) - : 100 OTHER FIXTURES. . . . . ..0
GARBAGE DISP— : 1 PAIN DRAIN (ft) . :0
WA51 I ING MAci i. I SF RPIN DFAINS. . z I
MECHANICAL F1 LS
FUEL TYPES UN I t H I RS. - -.0 type amouitt. by date r rcpt
/3qs/ VENTS . . . . . :0 TIF $ 1460- 00 PLL 05/2e/93
OAX INPUl' -.0 BTU VENT rANG. . z3 UPRT $ 376. 00 PLL 05/k(8/93 31
URN C 1001', . . .- 1 HCOUS. . . . . . .. 1 HPLC $ 244. 40 JLH 04/06/93 93-F.
-A txONAK WOUT)STOVLS. 0 35PC 't I U. 80 PLL 05/i-`8/93 -
�_JOR FURN. . . . %0 CLU DRYERS. I SSDC .$ 280. 00 PLL 05/20/93 -
L U 1+_/CM4 < 314P:O OTI ILR UN I TS i I PARK S 51210.00 PLL 05/28/13 -
GAS OUTLETS: 1 MPRT $ 40. 50 PLL 05128/93
C t 10. 13 PLL 05i28/9-3
FOUR D CONSTRUCTION M5PG # 2.03 PLL 05/28/93
W, 17-o COX PPR T S 147. 59 PLL 05/2!3")3
p5pc 7. 38 PLL 05/a8/93
DLO"Ji-PTION Uri 9-iQ10?
Phone #. 641-0935
,-0,'JR 1) LONSTRUCTION
Cl BOX 1577
F'AVERTON OR '370'7t3
# hone 1k : 641--0935
71037
3086. 74 TOTAL
ptmit is issued subject to the regulatious contained in the RLQUIRED INSPECII(INS'
ija-d Municipel Code, State Of OrF. Specialty Codes and all othet Foot/found Insp Fireplace Insp
j1pplicabl; liras, All, wo-k will lit don in accordance with approved poqt/Deam Struct Gas Line Insp
plans. ?his plirlit will expire if worts is not started within IN post/Seam Mechan Insulation Ins,
days of issuance, or if work is suss-Pr'-' !r, Plin/undslab Insp Gyp BoArd Insp
E'L M/Utiderf I oor Rain drain insp
it t L3e 9 i gnat Lit-4 Mechanical Insp Water Lltnq litsp
Plumb lop Out Appr/SdWlk Insp
- m F_
B F, Aminy c:iiianir_aki Final
639-41 75
CaIL for inspection
CITYCSF (77IGARD SEWER PER14l 'i CONNE '71-
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . .. . kalci
,13125 SW Hall Blvd.Tigard,Oregon 97223s@199 (503)639-4171
AuRES5. . 12113 SW ANTON DR Ica PC1k4_c_&_. A j1,a,+Lf%
I V I S I ON. . . AWON PARK 11 ZONING: R 7 Pi
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . .
TENANT NAME.
USA NU. . . . . . . . . . : FIXTURE UNITS. . .
C,L(ISS OF WOPK. . . xNLW )14LLLINLs UNITS. I
IvPE OF USE. . . . . sSF m3. OF BUT-LDINGS21
I ASTALL TYPE.. . . . i BLISWR IMPERV SURFACE. . sof
RF-Naf^kSZ PATI"-j I
Owner: ____._.____—._..._._. .__......._.___.___-__ .._._____._ ..-.._ --------------- FLE3
FOUR D CONSTRUCTION type amount by date reci;-.
P 0 BOX 1577 PRMT $ 2100. 00 PLL 05/28/93
1NGF- $ 35. 00 PLL 05,120/13
ALAVLRIUN UP, 3",007
lcinp #& 641--10935
Lontractors
LUNTRACTOR NOT ON FILE
lt 21135. 00 TOTAL
RLQUIRED INSPECrIONS
:cis Applicant agrees to comply with all the rulot and ir%_Iationt Sewer, Inspect inn
of the Unified Sewage Agency. The pervit expires 180 days froo
the dale issovd. The total amount paid will W forfeited if the
peroit expires. The Agency does no-, guarantee the accuracy of the
side sewer laterals. if the sewer is not located at the measurement
liveli, the installer shall prospect .3 feet in all directions frac
the distance given. If not so located, the installer shall mmhase
a 'Imp and Side Sewer` Perait and th- Agency in Attral.
0el-mittee
Issued by:
Call for inspection 639--4175
cj ItIO 6,76-
ARD
CITY
yT(�� A j� u1i5 S%V IfAN qwd PLNCK/RLCI # Z 0, .,>.,SOF 1 I PERMIT # _'-
COMMUNITY DEVELOPMEN"I'DEPARTMENT To"cvtO` gm9TDJ
(50')6-14"171 DATE ISSUED
JOB ADDRESS:--•• A YOZ4 S4,) o4gn�On Or, _ TAX MAP/LOT /5/ lYeld - /36tO --_
SUB: �zJ �P gy-- LOT: G��----- LAND USE:
VAl-UATION:
OWNER SPECIAL NOTES
NAME: ol-A R - N 5ct7e-uc�l a REISSUE OF:
ADDRESS: , c X 1 !&:7"7 IAST REISSUE:
=L _ � ��J�b L FLOOD PLAIN/
PHONE: �Y1 - o y --s; __. SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED s,46q,'-tJDG'X
NAME: _SfiAn __/IS _ _jagZL,1 _..--- - PLANN IVG: - —
ADDRESS: _--_ -__-- - ----.----�_.--- ENGINEERING:
FIRE DEPT:
PHONE: OTHER:
CONTR. BOARD #: _ EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: Com _ j !UMC3�`� LIST/SUBCONTRACTORS:
MECH: � L eq--tLo" BUS TAX: _
ARCH/ENGINEER CALCULATIONS: _
NAME: c7 L l� � ' }� 0 m A tz, TRUSS DETAILS:
ADDRESS: �Scii _11Zz_��z.:30 -57,1 e>,O HER:
PHONE: --
PROPOSED BLDG. USE: G6--
COMMENTS: -- -- — — -- _ ----__--�.
PLICANT NATURE
Received By: _ _-_ -- — Date Received: _
I -
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL, DUE
17l5 dr 10-432 00 Building Permit Fees 3 7(a, uy
10-431 00 Plumbing Permit Fees ��
10-431 01 Mechanical Permit Fees Al() ,sD
10-230 01 State Building Tax (5x) l; --
7`� �2 8, 21
Building
Plumbing 3� _ ,✓
Mechanical
10-433 00 Plans Check. Fees
Building'
Plumbing
Mechanical /0
10-230 06 Fire
.0 30-202 00 Sewer Connection VIoo 'Ploo
30-444 00 Sewer Inspection
25-448--02 Commercial TIF Fees
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-443-03 Office TIF Fees
25-448-01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees
52--449 00 Parks System Dev Charge (POC)
31-450 00 Storm Drainage Syst Dev Chrg
(SSOC)
24-445- 01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL ? LLL 1-'IJ_'' _Y.
Q_
nnV3581P.WPF
CITY OF TIeARD - RECEIPT OF PAYMENT RECEIPT NO. 193+240675
, CHECV. AMOUNT : 4971. 74
NAME x FOUR QtONSTRUCTIOW CASH AMOUNT 0. 00
ADDRESS o PAYMENT DATE : o5/28/93
SUBDIVISION :
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMFNT AMOUNT PAID
| ' ____---_____- ___-
! BU�LDJNM PERM '-f �»L��-�IWT PERM 147. 540
|
MECHANICAL PE 40. 50 ST. BUILD PFR 28. Pt �
/ PLAN CHECK FF 4. 5:3 SEWER USA ;?1408,. 00 /
EEWER INGPFCT 35. 00 PARKS SDC 500. 00 '
5TO�M
DRAIN SDC 280. 00 RESIDENTIAL TRAFFTC FEES 13-50.00
MA3G TRAN5IT TIF FEES 110. 00 |
}
`
i�
|�
t2113 8W ANTON !
|
TOTAL AMOUNT PAID 4971. 74 |
|
'
_ _ _
CITY OV 'TIGARD RECFIVIT OF' PA*YMENT RECE IPT NO. 03-0,38830
C14ECK AMOUNT 2,50. ola
NAME FOUR r, CON91-RUCTION CASH AMOUNT lb. 00
ADDRF�iS PAYMENI DATE 04/08/93
SUBDIVISION
PURF-109F." OF PAYMENT AMOUNT PAID PURPOSE OF PAYMEN, PMOLINT P"ID
p 850. 00
1-0T ## ANTON PORK Il
VOTAL AMOUNT PAID 250. elef