Case File ADDRESS
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i lrecordslmicroflrnVargetstuilding.doc
Cit' of Tigard Building Department
13125 elf Hall Fled. Tigard, Oregon 97223
.nspoction Lino (Rec-0-10 ne)-r 639-4175 Bunineu Phuna: 639-4171
T r ipect ion t____
rotinq P1 ssdernlab Mwch. Rough-in Appr/8dw1k
Fc4tnd. Plbg. Top out Gas Lino PIRALe
Post/Beam Struct. San. Bower iraminq -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plba. Undorflo�r .*star Line Gyp. Rd. _Meeh.
/ 5
Date Requestadt :Y _Times --AM PN
Addrwees�,.�r_� '�} Lll)t X11 f4) - Permit #t_ Z3
Builders -�� siy�
y —
THR R0LL4_W1Nt. OURARCTIOM8 AR! RBQUIRBDs
Inspector,__ t �(�jyJ/ ----- Dater -
APPROVED DTSAPPROVKD APPROVED SUBJi`.? Ta ABOV2
--Call For Reinsp.
CITY OF TIGARD CERTIFICATE OF
COMMUNITY DEVELOPMENT D,�PARTMENT OCCUPANCY
13125 SW Hall Blvd.Tigard.Oregon 97223*8199 (503)639-4171
PARCEL: IS134CB-17 r 700
SITE ADDRESS— i 12272 SW ANTON DR
CLASS OF WORK. iNEW
'JCCUPANCY GRP. 3 R3
PINNACLE HUMFS
12735 SW GLACIER LILY ("IR
� / Iu*mu OR 9/223
Phone #" 524-4711
�
�
Contrmctoro
PINNACLV HOMES
HOME8 �
12735 SW GLACIER LILY CIRCLE
TI8mN0 OR 9/223
Phone #u 5?4-4711 �
Reg ft. . : 16177
QcCwP&ncy of the above referenced hui ]ding tm hereby given, end ce, tifiem
fhe compliance with the State OF Oregon Specialty Cmdes for the group,
occupancy, and use under which the referenced permit waw, iweutd.
FIRE DEPARTMENT ^/ p
AL
| �338T !N CONSPICUOUS �LPCE y
|
|
' U
INSpe"T,xON RICE
City of Tigard Bu tidies Department
13125 SO Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone)z F,39-4175 Business Phone, 639.4171
Inspections__`_
Footing PYLy. Underelno Mach. Rough.-in Appr/sdwlk
FrNnd. Plbg. Top out Gas Line FINALS
Post/9-am 8truct. Ban. sewer Framing -Bldg.
Peet/8sam Mech. Rain Drain Insulation 1�-pl ,�
Plbry_ Underfloor Water Line Gyp. Bd. -Noah.
Date Requested, / (i -/ /f "�� Tim, AM ___PH
Addresas 11,�77d. ��/lYWYI f Permit 1 1_�7 _ D 21
Builders,_,
THE FOLLOWING CORRECTIONS ARM RXQUIREnt
Is,epectorsT+ �� — Date s1 f. 7
-APPROVED DISAPPROM) APPROVED SUBJECT TO ASM
Call For Reinap.
0 NOTICE
City or Tigard Building Departawmt
131.25 SW Ball Blvd. Tigard, Oregon 97223
Inspe-tion tine (Re4---0-Phone): 639-4175 Business Phone: 639-4171
Inspections__ —.
Footing Plbg. Under& ab Koch. Rough-in Appr/Sdwlk
Pound. Pibg. Top Out Gas Line FINAL:
Poet/Beam struct. San. Sewer Framing Bldg. '
post/Seam Mach. Rain Drain Insulation -Plumb
t
Plbq. Underfloor Nater Line Gyp. ad. Kech l
Date Requeateds7/ ^15 1 Times �PjN
Addre /ta: /�//, Permit #ty
Builder:.
THE FOLLOWING CORRECTIONS ARE REQUIRED:
/y/, A
'
df ad
Inspector: _ — Date:
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
__ Call For Reiner.
City of Tigard Building Department
-312S B/ Hall Blvd. Tigard, Oregon 97223
Inapectlon Line (Rer_-O-Phone)c 639-4175 Business Phones 639-4171
Inspections__
■ootinq Plbg. Undarslab Mach. Rough-in 11 Mr/saw1k
P,7und. Plbg. Top Out Gas Line �P•INALss
Post/Beam Struct. Han. Bower Framing -Bldg.
Post/Roam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor CWater Line gyp. Rd. -Mesh.
Date Rwquesteds -- ( � Times _AM
>h(
Address at 1 - V� s'\ Permit
nn#t
Ru l.1dar s
Tffit BOLLOWINC, coi DNS ARB RA,QUIRED 2
r7 _
OU f=v4-L---/U'� DePPY 1AJ
i.tJ _
?v /T 15 ;X) 4 w//J G LEa4✓6
Apa/y► Fbtz- A1p4)/ T1oN4/_ 21 " L/,--T
L?F PA vzm zt/r.
3�I1'- PRWA?_E� 7"6 b reCT
Inspectors !—AMOM9 5 Dater
DISAPPROVED ( APPROVND SUBJIMT To ABOVE
G' Por Rainap.
citT Of Tigard Buildiaq Dapart.ent
13125 BW Hail Bird. Titjard, Oregon 97223
Inspaaticn Line (Rec-o-Phone)s 639-4175 Business Phone: 639-4171
InapectIon r
Footing Plbg. Underalak Mach. Rough-in Appr/Sdwlk
Pound. Plbg. Top out Gas W ne /:MAL:
i
Post/e-" struct. Ban. Bawer 1►resinq -Bldg. j
Post/Beam Meeh. Rain Drain Insulation -plumb.
Plbg. Underfloor "star Line gyp. Ed. -Meeh.
Date Requested: CJ 3 Times AM
Addreas:— � � Permit
8uilderr._�ffh _
TRZ POLLOWN13 CORREf'rlod3 AR6 REQUIRED:
_1�>j \ �s
W�� mac", Q_ j
�� N d V_e . A` �e 3
21upHOtok Dates
APPROVED DISAPPRDVED APPROVED SUBJECT TO ASCT//
2 Call For Reinsp.
i
INSPECTION NOTICE
City of Tigard Building Department
13125 SO Ball Blvd. Tigard, Oregon 97.223
Inapection Line (Rec-O-Phone)a 639-4175 Business Phone- 639-•4171
Inapec t ion s ------- --------- ------------ --
Pouting Plbg. Underolab Mor.h. Rough--in Appr/..Awlh
Found. Plbg. Top Out Cas Linc FINAL
Poet/Beam struct. Ban. Sewer G� Framing -Dldq.
Poet/Beam Hoch. Rain Drain s(G ■ulatlog -Pl.umb.
Plbg. Underfloor Nater Line Gyp. Bd. -Koch.
Date Requestedt�7 �,���(y1�_� Timet PH
//�� I1M/`�
Address: I2� `Z Perm1it Ito � rV[��S
Builders
THE FOLLOWING CORRECTIONS ARE RRQUIRFUa
Inr♦1� ror: v /
— rete
�_APPi20VED DISAPPROVED APPROVED SUBJWCT TO ABOVE
I
(c- c-. ( _ _Call For Rrinnp.
INSpZCT.10A-.iLa
City of Tigard Building Department
13125 MT bail Blvd. Tigard, Oregon 97223
Inspection Line (Reu-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mach. Rough-in Appt/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Samar -Bldg.
Post/Ream Meeh. Rain Drain lation\, -Plumb.
Plbp. Underfloor Mater Line oyp. b, _Koch.
—
Date Requaste4t_ /� Timet AK X pN
Addreas: lL1 : Permit
Builder:
THE FOLLOWING CORRECTIONS ARE RQEWIRM
�l V c CLQ t V✓� �c. `�-
3 P 3Z13
lD
ell
- --
Inepaotort Date:
_�APYRtlVED DiNAPPROVED v APPROVED SURJItCT To AWWg
Call Por Rein.p.
INSPECTION NOTICE `
City of Tigard! Building Departaent. ,{)'
13125 BN Ball Blvd. Tigard, Oregon 97223 /
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underalab Nech. Rough-in Appr./Sdwlk
Found. Plbg. Top Out Ola Line FINAL:
Post)'Benm Struct. San. Sewer !raving -Bldg.
Post/Beam Mech. Rain Drain
Inaulati -Plumb.
Plbg. Underfloor water Line gyp. Bd. _Koch.
Date Requesteds Timm
Address: !shit ;e_L3" UZ3 1
Builders
'fRE FOLLYWING CORRECTIONS ARE REQUJREDt
- -v _J� ¢✓tS t_�t1� .vim
SC
r2._ 7,d
_ �' C--�.,` l-.�� •-7 —x/1,1-z� -.�-�...;,,, L2 ��,� ' i
'v1_
�.% f � .cam ��-- -a \
��
�Z� ✓c- 5-x'7,.0 t ��. �.` _.0,0„-\
y
2 LS c4- �i►-�n 7�'��e �- `�'Uv
Tad rA �:N&\_Amjak1I.
-� �--
Inspector: Dates j12--71 '3
APPROVED DISIMPROVED PROVED BUBO CT TO ADM
` �-�- Call For Reinsp.
INSPSCTIOM NpP_ICE
City of Tigard Building Department
13125 M Hall Blvd. 'Tigard, Oregon 97223
Inspact:on Line (Rec-O-Phone): 639-4175 Business Phone! 639-4171
Inspect ton
Footing Plug. Underel.ab Mach. Rough-in Appr/sdwlk
Found. Plbo. Top Out Can Line FINAL#
Post/seam Strutt. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain DraJn Insulation -Plumb.
Plbg. Underfloor Water Line: Gyp. Bd. -Mach.
Date Requested:_„_ 2 3
Address! 2 -2 Z__ ��; ftrOit #t9 5 — Z3
BUI ldeC:
THt FOI.LfMINr. CORR?CTIONS ARF RtQUMni
3 PrCV \ �; \1� \c,\ l� T`.•yam `A
— Y-V\ 2.�-,.�� 2-�–,.1 cam/ .� Q c 7A t
re
Inepwtort --- Date: z 53
11PPilOVRD _ DISAPPROVED APPROVED SUBJMT 'Co ABOVE
Z' c_ __Call For Reinnp.
IMSPECfION NOTICE
City of Tigard Building bepartm me
13125 BM Ball Blvd. Tigard. Crr 97223
inspection Line (Roc-O-Phone)s 639-4175 Business Phone: 639-4171
Inspections__ —
aoot i.ng Plbq. Underelab Mach. Rough-.in Appr/Sdsalk
Pound. Mg. Top Out/ Gas Line FINAL:
Post/Beam Strvct. Ban. isaer \` Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Lim Gyp. Bd. -Hoch.
Date Requested:____- � Times AM PN
/r .- /�
Address � �� (��/,..,1,,/�, � Permit r:_�_C/2-3�
Builder:__.___
THE POLIONING CORRECTIONS ARE REQUIREDt
Inspector: _ Dater_
_APPROVED —�— DISAPPROVVD APPROVED SUBJECT TO ABOVE
--Call For Relnsp.
iNSPECTIONT No')'� 1,�
Citi 6.' Tigard Building Departzrani:
11725 an Ball Blvd. Tigard, Orwgon 9722,
Inspection Line k"ac-O-Phons)t 639-4175 Business Phones 639-4171
r
Foot .,y F lbg. Undersrl ah 4�� o'h Rough-in !►ppr/adalk
loured. Plbg. .'cp out ��s Line / IINALs
Post/Boam at ,ct. San. Sewer lren.ing -Bldg.
Post/Beam Mach. Rain Drain Irsulat.ion -Plumb.
Pllg. Underfloor Nater Line/� oyp. Rd. -Hoch.
Jate Requestods Z - l Z l Ls AH PM
Address: 1-2- 2 -1/2 1/JQVI �( ' Permit #t �'✓ y LJ 14
BuLldors
TM F'OLLQMINO ODRRECTIONS ARE REQUIRED:
C.
' Nf—
�' _
z) (fir u-Fe� t
Inspectors`���
__APPROVED DISAPPROVED ROVED SUBJECT TO ABOVE
y_-Call Por Reinsp.
�ns�crlDn noxrce
city or Tigard Bukldimg Depertmout
1312!, ON Hall Bled., Tigard, Oregon 97223
Inspection Line (Per_-O one)t 639-4175 Business Phones 639-4171
Inspections_
Footing P?.bg. ^nderslab Nwh. hough-in Appr/Sdwlk
Pound. Plbg. Ton Out gas Line FINALS
Post/Bo-am Str-ict. Can. Sewer ,raolgg� -Bldg.
Post/Beam Hoch. .kaln Drain Insulation -Plumb.
Pl.bq. finderlloor Mater Lina g". b. -Nech.
Data Requested. 2'(j 3 Timet G�-3
I1l1 pN
Address. 17-2--7 L ^ Permit #s'l-3- _
Builders T IVIV ch I I�►t'�L� _v( � IG
THE FOLLOWING COPtXCTIOtls ARE RRQUIRED%
J,2 12 -3 19
i (•tnj L. 4P �-i S vJ�(
s J
r� TvV t/
W.
ww•
�L�"1/t Cl�- Yl Z-�� L - I Q C
Inspector: Dates
APPROVED DISAMOM APPROVED SUBJECT TO ABOVE
Call For Reinap.
ait*f of Tigard BallAimq Dapartasmt
13125 SII Nall Blvd. !lysed• Orsysm 9712.1
Inspsotioonn Line (IMso-tPhons)s 619-4175 Business Phones 639-4171
Inepeotlone �'�'�
Footing Plbq. Onders ab Meeh. Rasgh-in Appr/Bdwlk
i'm'j• Plbq. !op Out Ws Line PINA(.s
Post/seem Strut. Ban. fester Pressing
Pest/Besss Meeh. Rain Drain Insulation -Plumb.
P14. Qnderlla,)r Yater Line
Opp• Bd. -Koch.
Cate Requested s_ �^ AM PM
Address I ' .l /_V_lltArn'k, (Permit 6s_'
Builders
`-18 POId.ONINO OORRNMIONS An RBOOIRMs
`SGV i .E
\ 2 \ z L�
r
+ -✓e �o ova-,r' -�
Ca
\ LS
kA
Inspsators Dates V 2
APPRUVBD DIfI1tPRD APPRDIIBD fOBJBO! 4b ABOYB
X11 Por Rsinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 on Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)t 639-4175 Bus ineas Phone: 639-417-
Inspect ton t_
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Past/Beam Mech. Rain Drain Insulation -Plumb.
Pibg. Underfloor Nater Lina Gyp. Bd. -!tach.
Date Requested: Time: _--AM PM
Address= � `�'�� i i^" Permit f:
Builders---
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Lam/ /�������1 \ j• \ �.
� `,l✓L� c7' L./�/� `�'�C. ���---- C--� � � Vim`r`QC
77 5
Ck
l
1�-
vt
�G� �- 2 �r� S v ✓�.C.fZ�S S' C'aSTw.
Inspectors _ Date:
APPROVED DISAPPRQVED L/APPROVED SUBJECT TO h9M
T` Call For Reinsp,
I BPZCTIQN NOTICE
City of Tigard Badding Department
13125 BW Hall Bled. Tigard, Oregon 97223
Inspection Line (Reo-O-Phone): 639-4175 Business Phones 639-4171
Inspections
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Post/Beam Struct. Ban. fiewor Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Urderfloor Mater Line Q q gyp. Rd. _Nech.
Date Requesteds �I f/- /� Time -AM PH
Addreaa s _ c: %21 Permit #1
Builder:r _ .�Gs do�d ) s > r
THE FOIJ ONINQ ODRRECTIO*f ARE REQUIREDs
> - r
InepectQ, Bates _yi'-�5",>
APPRMTD ROVED APPROVED SUBJECT To ABOVE
Call For Reinsp.
I!QFLC-U +Q"2TLCs
Git7 of Tigard Bulldlny Departsaent
L1125 9p 3a.11 Bled. Tigardr orogon 97223
Inspection Line (Roo-o-�--p��h77one)s 639-441M1755 Business Phones 63,9^-4171
Inspections_ -_ . -I,- 6—L=: (•b l ` �I
Tooting Plbg. Underelab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top out Gas Lina FINALt
Post/Beam Strum. San. Sower Framing -Bldg.
Pant/Beam Mach. Rain Drain Insulation -Ply.
Plbg. Undoz-floor Nater Lite Gyp. Bd. -Mach.
Date R.oyuestods - Times _ AM pM
Address L -77-- (
r h
Builders
TB= FOLLOWING OORRIcrIoms ARE REQUIREus
Inapectors GL l - ,
Dote:
APPROVED DISAPPRnVED APPROVED sunTRrT TO ABOVE
Call For Reinsp.
jN&FBCTION NMICi �R
City of Tigard Building Department
13125 ON Ball Blvd. Tigard, Oregm 97223
Inapeation Lino (Rec-O-Phone)t 639-4175 Business Phone: 639-4171
Inspectionc_Z
Footing Plbg. Dnderslab Koch. Rsugh-in Appr/Sdwlk
ForBd. Plbg. Top Out Cas Line FINALt
`- /Nam ` San. Sewer Framing -Bldg.
t//ser Keob>` Rain Drain Insulation -Plumb.
Plbq. Onderiloos Nater Line Oyp. Bd. -Koch.
Date Requesteds " =� _Timet AN B11
Address s/cmc /oZ. G-tr�, - Permit --
/7 L? /
Builders-t jJ�.,L.a -� u '2-,
TNM IMLONINO OORRRCTI ARE RBWIREDt
Inspectors1��.Q
1�PPROVID v DISAPPROVED APPRtYVED BUBJ ^T TO ABOVE
Call For Reinep.
INSPECT IQR NOTI-0 ..
City of Tigard Building Department
1312sS SW Ball Blvd. Tigard, Oregon 97223
Inspection Lina (Rec-O--Phones 639-4175 Business Phones 639-4171
Inayaations_ I
Footing Plbg. Dnderalab Mach. Rough-in Appr/Sd.lk
Found. Plbg. Top Out Gas Lina FINALS
Post/Baan Struct. San, /ewer Framing -.Bldg.
Post/Bean Mach. in Dratwl" Insulation -Plumb.
Plbg. Underfloor Nater_j.! ` Gyp. ad. -Koch.
Date Regventeds (r, ��]��7` _/Vines
Addresses / f r'Porrit
Builders
Tia :OLL0hING OORRECTIONS ARE PZQDIREDs
Inspectors
APPMOVED DISAPPROVED APPROVRD SOBJECT TO ABOVE '
-_Call For Rainap.
i
I,NBPECTIOji=ry�7�A0 I,—
City of Tigard B 11MIL g Departannt
13125 M Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
Inspection:_
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gas Line FIFAL:
Post/Seam Struct. Jan. Bower_�� Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Mater LineGyp.Gyp. Bd. %*ch.
Date Psquested: '_ z ��� Time: AM _ PH
(�
Permit 1:�
Builder:
'i'NE FOLLOWING OORRECTIONS ARE REQUIRED:
i
i
inspector: Date:. - -
/
APPIADVSb -� UISAPPROV=D APPROVED SUBJECT M AgwR
—Cal l For Reinsp.
XKMCTIOM NOTICE
City of T4MxA Building Departsmant
13129 BW Ball Blvd. Tigard, Oregon 97223
Inopeation Line (Rec-O-Phune)c 639-4175 Business Phonal 639-4171
ItupeatLoat _
Plbg. Underelab !Rech. Rough-in Appr/Sdklk--
POend. Plbg. Top Out Gas Lina FINAL:
Post/Beam etruct. San. Saaar Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. h.
Data Roqumetedt__ !' _L y! AN
// /' / Time:
Address: /
POMLt
Builder:_- 'y. .e'- z"
THE FOLLOMING CDRRSCTIo"8 ARE REQUIRED:
t
i
i
Y
Inspector:_ - Date
1►PPROVED ---- DI81lPPROVED APPwNffD HURJECT TO ABOVE
____Call For Rainap.
.CITY CSF TIGARD hiAGIT 4.. PLRiNill
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Ht11 6ivd.TIQar.i,Onpon 97223.9199 (503)639-4171
_._. l:' �4W ANTON DR 1='faFi(. t: i-. i 1 34Cllk
v ; ANTON PORK 1 .1 Z(at,.i,`4G: R--7 F':-,
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LAF- ; � t
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riPL Ur r.(jN61 . :`KI F I RST. . . . :c)84 s f LEVI - . :5 ft R1614T. ;t�
1F'A14L:Y Lmp. : ,LI--GND. . . s ' 61 1 F F=RUN i . 120 V L R
'.�. . . . . . . TF-11 RD. . . . :I0 5f rpt:Glad t ilE�(l:?_., �..._._....
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J 14 LUPD. . . , ..40 psf 041L. r . . . $ : 91Z 76L MARKING
�emark�o l=1ia1"t; I '
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rN ( 100K : 1(.'Gi1.1: . . . . , . c 1 Ni={l (, $ X69. 75 ,;i.F� +l �6/ _.
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JUR FLJR;\1. . . . :0 L LU 1JWIE:R6. . L>;,J; $ ; f3+1. 00 ;11
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l'llYr•ti_.VC'. !"t(.:1�;�.7t.;h•IL • 1G1 .l ; 4 .:,�41[.!
i _L.ARD 13R 57
his peh+tit is issued subject to the reg,iativ.s clntai-ed 1-1 ttr 1id-i.1) A'3PEL I .t'AL,
ffgar-d*111cipal Code, State �f iie. 5pec161ty Lodes ann all ,z'er Fcroi;ifaurtict iT-, it-Op1SLe In
4zpHcAb.e ism, Gi; wat w1_1 E: done in ar.cer lnre wit? apprr;ved Post "Beaty, `it' ,+ '. .-it; Line I r111R
flip pewit will e•pir•e if vmi-, ,s riot =tartea witrzn 1Ba Po t/I_leAm Me -' T:'_rlat I Q f I I1,s<
Jay$ tbsianCe, ovii :s for p 1 mi ;1d . , A+:; 1 y1_1 F To- cl :Fl
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cirf ovrIGARD iyJ I T . . . . . . . iWR93-0:205
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregcn 07223981199 (503)639-4171 D071 E. I SL)Lj1;-*-L) Ob 01--.
L. ,. �.
1.e72 SW AN i UN
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1-;T 1,4 L-L s DO-ieiR L R V 6-jhF ACE..
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CITY' OF 1 ��1�D 1:�vsswt�,N� PLNCK/RECT # ----
CoMMUNrrYDEVELOPMENT DEPARTMENT TpiAOmaw,97M PERMIT a
(503)639 4171 DATE ISSUED
JOB ADDRESS: 12 7Z j A/U7y� L ��'_ TAX MAP/LOT lS/ 3yG8 7 foo
SUB: _ �� Al -41-- _ — LOT: -_ I 6 L1 LAND USE:
VALUATION:
OWNER SPEC IAL NOTES
NAME: REISSUE OF:
ADDRESS: —_ L2 j �. j z../ <�'aST REISSUE: _
FLOOD PLAIN/
PHONE:— _� '7/./ _ _ SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME: y0/` '1 c _ ___-- PLANNING: t�f fOACV S 4r f Sr�GA12 mit
ADDRESS: v ENGINEERING:
FIRE DEPT: _
PHONE: -- _-- OTHER: --
CONTR. BOARD : l G l EXP Dv-: - 9
/ ITEMS REQUIRED
SUBCONTRACTORS: P B ��,� �e�r�t �E' LIST/SUBCONTRACTORS:
M e� / cam / --� _ BUS TAX:
ARCH ENGINEER CALCULATIONS:
NAME: G� ;�rZ `� i � '= �' �� TRUSS DETAILS:
ADDRtSS: OTHER:
PHONE:
PROPOSED BLDG. USF:
COMMENTS:
AFVLICANT SIGNATURE
Received By: _Or Date Received:
1
i
PERMIT N ACCT # DESCRIPTION AMOUNT f AMOUNT PD. SAL. DUE
10-432 00 Building Permit FeesU��l .Ir, &V
10-431 00 Plumbing Permit Fees L b
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%) .3U -3--- -�3 L
Buildingo,�_
Plumbing
Mechanical
10-433 00 Plans Check Fee '0• ( ? 2-
Building ,g(el—. 4—'
'
Plumbing
MechanicalS'�
I
10-230 06 Fire
30 -202 00 Sewer ConnectionLau
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees
25-448-06 Institutional TII= Fees
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees
25-448•-05 Mass Transit TIF Fees _!/ �) / o
52-449 00 Parks System Dev Charge (PDC) sco
31-450 00 Storm Drainage Syst Oev Chrg /
(SSDC)
24-445-01 Water quality (fee in iieis of)
?4-445-02 Water quantity (Fee in lieu of)
TOTAL
nm%35f?11' lJl'� '
�
' ` |
CITY OF TI8#RD - RECEIPT OF PAYMENT RECEIPT NO. m93 24
CHECK AMOUNT t 5041. 9
NnMp � PINNACLE HOMES CASH AMOUNT v 0.
PAYMENT DATE � 06/02/9�
ADDRESS � �
SUBDIVISION :
PURPOSE OF PAYwi-11T AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
-- - -- 415 �� PLUMBING PERM � 4�7
BUIL�%NB PERM . ~ 50
MECHANICAL PE 43. 50 GT. BUILD PER 30. 31
PLAN CHECK FE 30. 63 SEWER USA 2100. 0N
SEWER INSPECT 35, 00 PARKS SDC 500. k.0
STORM DRAIN SDC 280. 00 RESIDENTIAL TRAFFIC FEES 1350. 00
MASS TRANSIT TIF FEES 110. 00
LOT 104 ANTON PARK II
� te272 SW ANTOM DR
�
TOTAL AMOUNT PAID - - - -) 5041. 94