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InitiallyGood .:.�b�a�l«„,•N..,w.:,:.+w!Y*r•,»......N-wriMi:W/A„T:..—.-•M1•M....,.wv.rn.wa.rw.,.�,,.ww..W..w• wW.............wM.....�.�'. . 12566 SW Bridgevie;. ^c. I i f i AV i I� I v v m 3 Lo 'Ln cv I i r� i I CERTIFICATE OF CITYOFTIGARD OCCUPANCY CfPi'JFTI�RD COMMUNITY DEVELOPMENT DKP PERMIT #. . . . . . . i 1413T90-0315«tenon 13126 SW HWI BNd P.O.Boor 23371,7pud,(roar 71$23(603; 176 DATE I S:3 )F D i 0311/13/91 SITE ADDRESS. . . ; 12566 SW DR I DGEV I E W Cl ',PARCEL.i 1 S 133DD--•0;3700 SUBDIVISION. . . . i VILLAGE AT SUMMER LAKE.' PARK 3 ZONING: R--4. S BL_OCK. . . . . . . . . . i LOT. . . . . . . . . . . . . t76 CLASS OF WORK. =NEW I'YPF OF USS:. . . i'CF• OCCUPANCY GRP. i R3 OCC I.JI,'ANCY 4 7'F.NANT INIAME . . . Owner. DON MORISGETTF' 2! DERS, INC. . P 0 LAOY 1952/f PORTI..AND OR 97211) '-'hone #: 503-•-620-7538 C ontrac:t or i DON MORISS;ETTF BUILDERS, INC. 15555 SW BANDY RD. 0;!V11 LAKE O SWEGO OR 97035 I='honer #i GPO-7530 Rep #. . '35-"Z4. Occupancy of the abr.vr referenced bkttilding i % hereby given, and certifiers 1-he compliance with the State Of Oregon Specialty Codes for tha group, occ'r, ppr►cy, and L1Fe tinder which the referenced Frerm.it was i6sr!eci. .d 0 /4 FIRE DEPARTMENT BUILDING INSPECTOR F;C?7'1_DI-5-1140 F F I C I A'. POST IN COINISPI!:UOUS PLACE 1 I " xNcPE�C�'IOtI NO'A� yAr/( city of rigara Building Departrent 7V 13125 Sw Bell Blvd. Tiynrd, Ore9o� 97223 Inspection Line (Roc-o-Phone): 639-4175 Business Phone: 639-4171 Inspection: -` A r/Sdwlk � Tooting plbg. Underslab Mech. Rough-in pp round. plbq. Top Out Gag Line iT�t ng �_Hl q. Post/Seam Dtruct. ban. Sewer Tram , Poet/Roam Mech. Rain Dram. Insulation -Plumb. Gyp. Bd. -Neeh� Plbg. Underfloor hater Lino - - Timet _ A14 PN Date Requestedt Permit Address: C Builder: TELE TOLJ,OWIN(i CORRECTIONS .IRR REQUIRED: �'7lTPR[WEII Inspectort / DISAPPROVED APPROVED SUn.tEi(T TO ABOVE � Call Tor Reinsp. MMMLO NOTICE City of Tigard Building Departmmt 13125 Blt/ Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rea-Q-Phons): 639-4175 Business Phone: 639-4171 Inspection: --- Footing Plbg. Undurelab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line �`lIN1►L: .) Post/Beam Struct. San. Saws Framing -Bldg. i Post/Beam Mech. Rain Drain Insulation -Plnm� Plbg. Underrloor stater Line Gyp. Bd. -Noah. Date Requent:ed: _Time: _ ARI PM Q Address:. ,� ��� .6y 4�t_U 1 Lo � Permit #i� d��J Builder: l� Z `l �3 TBE FOLLOWING CORRECTIONS ARE REQUIRED: i Inspector: _ Date: /-APPROVED DISAPPROVIlD APPROVED SUBJECT TO ABOVE u Call For Ra!nsp. City of Tigard Buildi..og pepartaent'223 1312S 811 Nall Blvd- Tigard. Oregon Inspection Line (Roo-o-Phone): 639-4175 Business Phone: 639 . Inspection: , J Undo lsb M pough-in kppr/Sdwlk Footing Pf, Found. Plbg. Top Out Can Line FINAL: Poet/Beam 9•:ruct. San. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain Insulation -plumb. -Nech. Oyp. Bd.� Plbg. Underfloor Nater Line `J Time: AM PM Date Requcated:_ Permit #s Address: BuildersT__� THE FOLLOWING CORRECTIONS ARIL REQUIREDs Dates Ingpootors AppnMo r_ DISAPPROVED D 9118JECT TO ABOVE Call For Reinsp. esa w INSPECTION NOTICE City of Tigkrd ButldLaq Department - 13125 " Ball Blvd. Tigard, Oregon 97223 Inspection Line Voc-O-Phone): 639-4175 Business Phones 639-417 Inspection:_ �" _ 11 f Footing Plbg. Underslab M061 Ro::gh-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINALS Post/Beam Struct. San. SAwer Framing -Bldg. Post/Beam Mach. Rain Drain Insulation -Plumb. Plbg. Underfloor water Line <=CG;yp. Bd -Hoch. Date Requested: —31 'Time: _X_AM PM Address:�c7 Builder:_- THE FOLLOWING CORRECTIONS ARE REQUIRED: Inspector:_ � Datot L—� APPROVED _ DISAPPROVED SUBJECT TO ABOVE —.__CalI For RPJnep. I1! P�ion poricg Ny city of Tigard Building DepartAlOnt 13125 ON Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phoney 639-4171 Inspection: -- l `1 Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk Lound. Plbg. Tap Out Gas Line VINAL: Poet/Beam Struct, Sen. Sewer Framing -Bldg. Poet/Beam Mech. Lain Drain Insulation -Plumb. -Koch. Plbg. Underfloor Nater Line Gyp. Bd. Date Requested:— �/- / Time Address: THE FOLLOWING CORAECTIONS ARB REQUIRED: cy � ►r : Cp h �l c , �1 L' _C1 v Iv w� e 5 0 i 1 Inspector: Date: APPPDVSD DISAP k PPROVRD SUFvFcT To Asm Call For Reinsp. INSgZCTlgk NOTICY City of. Tigard Building Depa:tsient 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171 Inspection: Footing Plbg. Underslab Mach. Pough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Poet/Beam Struct. San. Sewer ramigq -Bldg. Prat/Beam Mech. Rain Drair Insulation -Plumb. Plbq. Underfloor Water Line / Gyp. Bd. -Mach. Date Requeated:_ ` _ ��/ - Tom= -PM Address:_ � j,� 'ermit : , Builder:THE FOLLOWING CORRECTIONS ARE REQUIRED: Inspectors Date: V `r y APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Ref.nsp. (2SUSkJ VA1iAX- vw-pv c-r. lt'10- 03157- SEAM ANALYSIS PREPARED BY ; TRI -CITY DRAFTING GLADSTONE, OREGON !)7027 ( 503) 559 3445 Client : DON MORISSETTE BUILDERS ProJect : . PLAN NO, 51 opTION # 2 L o c a t I o n F LOOR J 0 1 ST OVER GARAG1%„A4W 701%-VS OYER ICITCWW Date ; 0I - 07- 1991 Comment USE 2 X 12 0 12” U.C. ENDS CAN BE CUT DOWN TO 5 1/4" BEAM AND LOAD DIAGRAM HIIIIIIIIIIHIIIIIIIIIIIIIIIIJI1111i I HHH1111HIII 111111 Ikill fill]11"4111111 If J##W#########A#####W#######r, h,###########K J J R2 Ri Reaction 111 = 500. 0 lbs . Re ac tion X2 S00 . 0 lbs . Total load 1, 000 . 0 lbs - 7 ..) DimelkSions ; Clear ipan &0. 0 deet , no ov,urhang . ,No point loads . No triangular- loads . No uniform beam weight Uniform loads : ul = 50 . 0 lbs, l £ at 0. 0 feet tt) 20 - 0 feet ' Beam spacing = 1 2 . 0 1 IiL lit'S - opflrctloll limit (live load plus dead load ) : t/240- BEAM TYPE: WOOD: MULTIPLE JOISTS #2 COM.PUTLD STRESS/STRAIN DESIGN VAL . PROPERTILS REQUIRED ACTUAL Shear ( I-bs ) 500. 0 FV 45 . 0 Area (Sq . til . ) 14 22 Moment ( £t -lbs ) 2, 500 . 0 FB 1 , 450. 0 Sect .Modulus Deflection ( ill) 1 . 00 E I - 70E6 Mum. lnertla 106 106* Actual Maximum Deflection 1 - 00 !11u11 c . Maximum 0*1 f I I-C t 10 11 0 L!t U I'S At 10- 0 fk"('t Maximum Moment Occul's at 10 . 0 Beam size (W K H) : 1. 5 0 0 tb -Y 4 5 9 BEAM AREA : 14 . 19 II II Z DETERMINING FACTOR -7, A N A L, Y S I S - - - _ • . M PREPARED BY : 7'R1 CITY DRAFTING GLADSTONE, OREGON 97027 (50:1) 659-3445 Ciient : DON MORISSETTE BUILDERS project : NO. 51 OPTION 4 2mo LocatLon : SARA©B 60OR HEADER ® 18' -0" 000 Dal (. : 01 01, 1991 Comment : USE 5 1/8 X 12 CLU -LAM BEAM BEAM AN6 1.0iD 1)1 ,WHAM H[II:HHiiHHHIIIIHHfiltHH1111111IHiiiI11HH111liiHHII IlJlIIH11H1111Jill Jill IIHHHHHIIHHH/)11111111111I11HH11 J�pNppppw�pppA'rlpp�lwllrttt:l#wp#AMwNq� 1 R R1 2 React i urc R1 = 4, 7 60. 0 lbs . RLac t 1 un R2 = 4, 760 . 0 lbs . 'Total loud = 9, 520 . 0 lbs . Dimensions : Clear span - 16 . 0 feet , no ove.r. hang .No point loads . No triangular loads . Uniform beam we- fight - tri lbs,/ If l 11,40 lbs . total ) . Uul term loads : U2 = 80 . 0 lbL,%1 f at 0. 0 felct to 16 . 0 teat . Ul z 500. 0 lbs/If at 0. 0 feet to 16 . 0 feet . Beam spacing - 12 . 0 inches . Ueflec•t iou limit (live luad plus dual load ) : 1/240. - - BEAM TYPE : LAM 24 F GL.ULAM COMPUTL'D STRESS/STRAIN DEN I(aN VAL . PROPERTIES REQUIRED ACTUAL. Shear ( Lbs ) 4, 760. 0 FV -- 1G5 . 0 Arra (Sy. ln . ) 43 58 MumErtl' (ft -lbs ) 19, 040 . 0 FB 2, 400 - 0 sect .Niod"l us 95 108 Uetluullun ( in) (.► , 80 E I . 80E6 Mum- Inertia h08 608* ActualMaximumDeflection = 0. 80 inches . Maxinluln Deflection owuurs at S . 0 (c k"t . MaXiUlu In Muwc•nL %)ccurs al S . 0 feet , Boom sfi~sal (w x 11) 1 i 2 � i •J BEAM AREA: 57 . 66 « = DG1'EIIMI N 1 NU FACTOR BEAM ANAL Y S I S PREPARED BY . TRI --CITY DRAFTING GLADSTONE, OREGON 97027 (503#1 659-3445 Cl tent ; DUN MORIS:SETTE BUIL00S Project : PLAN NO. 5t OPTION # Z Luta! I ion : GARAGE DOCIR Hl-.'AVER 0 8 ' -0" 'f. Date. 01 07 1891 Cumine nl : USE 4 X 12 BEAM BEAM AND LOAD DIAGRAM HHHHHHHHHHHH1111Hhn 1111.• NHH1111111111HHH11//H J###############h J J . g 4 R1 H2 Reaction 1(1 - 2, 380 lbs . Reaction U2 2, 380. 0 143 . Total loud = 4, 760. 0 lbs . Dimensions : Clear span - 8 . 0 feet , nu uvesrhang . ----- - --- ---- No Int Ioads . No lrlangular loads . Uniform beam we. lght - 15 lbs/lf ( 120 lbs . total ) . Uniform loads : U2 = 80. 0 ll,a,'If• at 0. 0 Peet to 8 . 0 feet . U1 = 800. 0 lbs/if at 0. 0 fret to 8 . 0 fL►et . i VA111 sial ing . 12 . 0 111e hes . Deflectiun 11mit (live load plus dead load ) : 1/240. BEAM 'f YPE : WOOD: FIR/LAIICII 4X #1 COMPUTED STHLSS/STRAIN DESIGN VAL. PROPERTIES REQUIRED ACTUAL Shear (lbs ) 2, 380. 0 FV 95 . 0 Arca (Sy. ln. ) 38 38* Moment (ft --lbs ) 40760. 0 FB 1, 500. 0 'Sect .Mudulus 38 67 Deflection ( in) 0. 40 E 1 . 80LO Mom. Inertia 7G 361 At.,tuaI MaxLmum DefIcc:llun : 0. 08 iimlies . Maximum Def ►.,Iul ►un uuLurs at 1- 0 fL'ul. . Maximum Mome:;L occurs at 4. 0 feet Aft BEAM * t Uls'!'ERMI N I NG FACTOR 4 �racTIGN NoSICL city of Tigard Building Depsrterat 13125 SB Ball Blvd. Tigard, Oregon '17223 Inspection Line (Rec-O-Phone)s 634-4175 Business Phone: 639-4171 Inspection:_ f' Footing Plbg. Underslab Mech. Rough-in Appr/Sdalk found. Plbg. Top Out Gas Line.) FTNALt post/Beam Struct. San. Sewer Framing -B1'(9• Post/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Nater Line Gyp. Bd. -Much. Date tt"ieyted: �- Cf -- Timet AM PM Address:_, / �~ permit Builder: jLs _. THE FOI.I.OWING CORR$CTIONS ARE REQUIRED: + � R5i I'V /J '//t/L/ i Inspaetort r _ Dates �r APPRMD DISAPPROVED A/'RPPRZIVED SUBJECT TO ABOVE Call For Reinsp. INSPETION NOTICE City of. Tigard Builditeg DpparttrJbeti 13125 an Ball Blvd. Tigard, Aragon Inspection Line (Rec-O-Phone)t 639-4: 15 Nus+^ .� ^u. at 639-417 Inspections Footing Plbg. Onderalab Mex.' Rough-.'.n Appr/rdwlk Found. Plbq. Top Out Gas Line FINALt Post/Bean 5rrvcr. Ban. Bever Framing _ql,d 9• Post/Beam Koch. Rain Drain Insulation -Plumb. Plbg. Underfloor Nater Line Gyp. ad. -Rech. Dater Requestedt me -ID Tit V AN C M Addreset �L J L Permit 11 Builders THE FOLLOWING CORRECTIONS ARE REQUIRED: Itinpuctort a -- --- — Datas��/ p DISAPPROVED -- APPROVED 6tlBJRCf TO ARM Call For Reinsp. 1NEECTION NOTICE City or Tigard Building Department 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Pone: 639-4171 Inspection: Footing P1 .. Ond Mech. Rough-in Appr/Sdwlk Found. bg, pa�i Cas Line FINAL: Post/Beam Struct. Sen. Sewer Framing -Bldg. Post/Beam Mech. Rain Drain Insulation -plumb, Plbg. Underfloor Water Line Cyr), Bd. -Nech Dete Requested: ..j 3 `^�0 Times __AM pM Address ��L 7 G ^-�CGG-14ermit #: Builders THE FOILOWINC CORRECTIONS ARE REQUIRED: 1 i Inspector: Date t ?j 7 APPROVED DTSAPPROVED _- APPROVED SUBTSCT TO ABOVE JJ�� Call For Reinsp. INSPECTION NOTICE City of Tigard Building Department , 11.0. Box 23397 Tigard. Oregon 9722 417 Type of Inspection Date Requested ,1,!Q — "r— Time A.M. P.M. Address Permit # Owner Lot # Builder lu _ The following Building Code deficiencies are required to be corrected: Presented to _ �ll Approved Ll Inspector —__--/ Disapproved 1 Date CALL FOR REINSPECTION CJ YES 0 NO INSPECTION NOTICE City of Tigard Building Department N.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection r„t�y�iG;�.• �-c_�� fJOZi Date Requested D dd Time_ A.M._1� P.M. Address a_ �1�5 la to Permit *`a,17 Owner_ _ Lot # Builder The following Building Code deficiencies are required to be corrected: Presented to ---__- ----_--------_—_�— Approved _i- Inspector i __- [ Disapproved Date — !( CALL FOR REINSPECTION YES ❑ NO INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspections Date Requested�1L.J� ' �O Time A.M.__P.M. Address �_l,` LTJ Permit # r Ownerf Lot # k Builder _. The following Building Code deficiencies are required to be corrected: i Presented to - --.— —_ —_. —�pproved lei Inspector _�— Disapproved Date CALL FOR REINSPECTION (� YES [.] NO s INSPECTION NOTICE City of Tigard Building Department , P.O. Box 23397 Tigard, Oregon 972.23 Phone: 639-4175 Type of Inspection -�-- Date Requested_ Timely?) A.M. P.M. Address Z.2'�G G _ Permit Owner____— —_ Lot # Builder —1k2j-1P1—_ -- The following Building Code deficiencies are required to be corrected: �� �lr-_t_`7� �!�vSi v.�i l c•,.i7�'c l .��.bes�-�� r��'cA'�y'�).,; cr`1Tv Ctrl _I? _aoe4 14.2 az { Presented to 7�pproved Inspector LI Disapproved Date CALL FOR REINSPECTION ❑ YEA 0 No F �- CITYOFTIFARD CffYOFTMRD pq�- MOSIL:.N FIERMIT RIIIII OFTMRD� i fel COMMUNITY DEVELOPMENT DEPARTMENT 0119m FIRIII., VIERIT111' 0 - IIST90-031.5 13126 SW HWI Blvd, P.O.Box 2W97.TOud.OrOW 97M(OW),6994`1 76 ;7 ADDRESS. . . - J.2566 SW l?R.1D6LVIEW C*r PIARCEL: 151133DD--03*7011-i . . . .. . VIIJ AGE (YT, SUIIIIE'RI-OKE Z C)H I N 6 14-OCK. . . 76 B U I I...DI N G --- .................-.......-- REISSUE:: DWEL.L.ING UNITS.- J. BASEMENT. . . . . . . . :o -*f (:I.-()SS OF WORK. h I Fi*W DEDRNS.-7 BOTIAS.- 3 GARAGE. . . . .. .. . . -. 742 si f T'YP'E=: OF' USE. 1:3 F F L 0 0 R AREAS REOUIRED S T Yl'-"[--- OF C 0 N S 1'. N 1:RST.. . .. . : 159,­3 S f E F*T.. G ft R I[-i H 1'. 2 -Ft 'OND. 947 -f t L)C;CIJI':'(4I%1CY GRP,. -R3 SEC, I �if F R 0 NT. 2 0 ft REAR- . 16 510 R 1.1-",S. . . . . . . »r' THIRD. . . . ;0 ssf R EQU I RED--- HE I GHT. . . . . . . . .20 ft TOT�)L._._.._._.._.._..:1-3'-140 f SI1IOKE DETECTORS. Y P 1...00R 1.-0 01). . . . ..414 -r 176196 F, 6 S V,fl C E S. 0 m a-r k s g PIL-UNDING SINKS. , . . . . . . . . » I DRAIN G. . . . -0 DACKF"I-OW 1:1REVNTRS. . -.0 1--.OVATORIEF' 1-:1 WATER HEATIERE). :1. TRPP,13 . . . . . . . .0 TCH B(ISINC511 J UP/SHOW0 3 L..AUNDRY TROYS. -0 CI1() 14014:'R CL.OSETS. -3 SEWER L..INE (ft) 0 GREASE. ASE TRAP'S. -0 DISHWOSHERS. 1. WATER I-INK (ft) 100 OTIAER I.."IXTUP.IES. 0 Cif-1RBP(3E DIST-1. J. RF.1JN DROIN (ft) .. -.0 WASHING IIA(".;H. I SF RAIN DROI.NS. .1. ........ MLCFI(4NICAI- F'E'ES FUEL- U N I F H T*R G. 0 type amount: 1:)y date -re pt; /(.7A S VENTS . . . . -.0 VIAYM $ 40. 00 JI-.H 09/12/90 204671 Ilf)X INI-1UJiO IR T U V I-"NT F 0 N S. . :4 JHPIRT 111 625. 50 f.7 URN < LOOK - ::0 HOODS. . . . . . C I 14P,L C $ 406. 58 TURN >::--1.001; WOODSTOVE-S. :0 1.4 5 171 C ;3].. 08 F'L-0 0 R F'U R N. . . . »0 CLO DRYERS. - 1. SPDC 600. 00 B 01'I /CI1PI < 3HP-0 OTHER UNITScO SSDC, 111 :17`:1. 00 GAS OU1'L-ETS- 1 11PIRI $ 40. 50 0 w vi P r III V.,L.C $ 1.(7. 1.3 DON Pltll!�ISSETTE YL-DERS, INC. 115ptl $ 2. 0;3 P, 0 K 19524 P,I."R T $ 1.40. 00 P,5 P,C $ 7. 00 PIURTI IND OR 97219 1--, y 11 � 100. '50 J1-'. :1.0/0'x!`:30 1711-1c)ile fic 503-620-7536 1:'FIYITI h 2097. 52 JL-H 10/09/90 Col-It-ractorc D011 VIORIG)SE.TTE EIL.DERS. INC. 11 0 11OX 19524 I I0TF TA ()ND OR 97219 ;l1lic)vie 14:: 503--rI20-7538 F%,eq V. . . 3553,! ........ ............ $ Pp,"314. Oi7 JOIAI This Derpit is issued sub'iect to the regulations contained in the E REQUIRED INGV, CTIONS Tigard Municipal Code, State of Ore. Specialty Codes and all other Fact/f cmricl 311sp F*-r a m:i il q I ri c3 p Applicable laws. All Work Will be done in accardanct, With approved F�'Dst/IRPAM Strl-lct F'i-repl.ace Infip olans. This pervit pill rypire if work is not started within 181 P'Cist/DeAm Ilechail Gas; IJ.rje Irish days of issuance, or if work is suspended for oqre than 18P d s. Cr A w I D r ai.n Inso'lati,all Illsp Illsp Gyp Bc)ay,cl Ivii;p PF,Irnlittee Si.1 -ide-rf 1.cmv, RAi.vi drain Irler) Ilectiallica.1 Ills[) Water Line Iii-;p By: F*11.c.tmt) Tt:)r) (3Ut Appr/St1w1k Iii-sp C'011 Fc)r j.ilspectimi 639 4175 .TTY OF TIOW RECEIPT OF PAYMENT RECEIPT NO, :90 20M86 (WCk AMOUNT : 2097.52 NAME MORISSETtE, DON CAaH ►MOUNT 0.00 ADDRESS PAYMENI DATE : 10/09/90 SUBDIVISION ; LAKE OSWOO, OR 91/g5- `-)E 7035`-)E OF PAYMENT OXINT PAID PUPPM OF PAYMENT AMW PAID ,ING FTPM M5T90-0311. 57`.,.110 PLOPING PEPM _ 140.00 ,NICAL PE 40.50 ST. WILD PEP. 40,31 :NECK. FE 376.71 STREET SDC 500,00 DRAIN SDC 375.(K) I TOTAL AMOUNT PAID - - - 207.52 77 ''r11�ti -7 F I L I T'y of TI GARD - RECEIPT OP' PAYMUNT• RLCE:I PT NO. -90-.204671 CHECK AMOUNT s 30o.(:;C> NAME s 11OR I SSC'T'TEv. DON CASH AMOUNT a 0.oQ CMDRESS PAYMENT DATE a 09/12/90 SUBDIVISION a PORTLAND. OR 97035- i i f=-POSE OF PAYMEN"C AMOUNT PAID PURPOSE OF F'AYME"NT AMOUNT PAID CHE'Ck: FE ...w ....._..._._ fir:►`:►.C!t' _..._.,._._.__._....._"...._._........__.._...__. .._._._.._. I I I 1 TE:1'f oaL AMOUNT PAID 300.00 i SEWER CONNECTION w RD PERM 1"T C17YOF716A CnYOFIM V,I"'.R M I J SWR90 0 18 COMMUNITY DEVELOPMENT DEPARTMENT 0111100" PRIM. P 1:-R 111 rl IS T 9 0-0 1Y 0 L 13125 BIN Holl Blvd. P.O.B.23307,TOW,Or%. 4 76 DATE 113SUED: 06/29/90 ;7,A qj t V C�14—' c31111* ADDRESS. . . .. 6W 410144RI AKT.--ftR,- I--'ARCEL-- SM.'IDIVISION. . . . : VILLAGE AT SUMMERLOKE #3 ZUNING- BLOCK. . . . . . . . . . s L 01.. . . . . . . . . . . . . : 1.18 T'F-"N A N T NA 11E:. . . . . .. USA NO. . . . . . . . . . :41665 F1 X T IJ R E U N I TS. . (:A.-ASS OF WORK. . . .-NEW 1)W E L L.I N G U NTTS. 1. TYPE OF USE. . . . . -031' NO. OF BUILDINGSil I N S T A I-L TY PE. . . - '.1.1 LJ S W R 1MI."'ERV SURFACE. :Sf N e In a r k.Is ()wner: FEES DON PIORISSETTE BLDERS, INC. type a In a 1.t 11 t, by date rer-1ii; V) 0 BOX 19524 PRITIT $ 1.2',50. 00 TNG1::1 35. 00 P 0 R TI AND OR 97219 V,1 4Y 11 1.285.00 JLH 06/29/90 Ptioi-ip H.- 503-620-7538 Corltractor: CONTR( CTOR NOT ON FTLE .............. t 1.285. 00 TOTAL REQUIRED INSPLUT IONS ihis Applicant agrees to comply with all the rules and regulations Sewer 11-)5pec�tiol-1 of the Unified Sewage Agency. The permit expires 120 days from ...... the date issued. The total amount paid will be forfeited if the .................... permit expires. The Agency dies not guarantee the accuracy of the side sewer lateral=_. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase 4 "Tap and Side Sewer" Permit and the Aiency will install a lateral. is e IF S i g 11 a t U r E? .......... d Icy. ....... ...... ........... C;A.1. 1 -f c)r i ri s p e c,t:i a r) 639 -41'15