9025 SW BURNHAM STREET-1 ADDRESS:
LV r gee ?�
i.\records\microflnniargetstuilding.doc
13M SW Hall M dL PLNCK/RECT
CII',Y 0 �y r�'IARD T��.�, 9Ta21 PERMIT A
CO:IMUNITY DL�ELOPMENT DEPARTMENT
(Al)"¢"" DATE ISSUED
JOB ADDRESS: — ��?> S ,�d1 TAX MAP/LCT
SUB: - - — _ LOT: _ _ LAND USF: _
VALUATION:
OWNER SPECIAL NOTS
NAME: �1, Z u� _�_. REISSUE OF:
ADDRESS: _ �;t-L e o LAST REISSUE: --
�� FLOOD PLAIN/
PHONE: SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME: —. 1 n Lt� L Zo PLANNING:
ADDRESS: �S---T,_l.0 • l�i� .. L,.►.. ENGINEERING: _---
FIRE DEPT:
PHONE: L� �_ OTHER: �
CON TR. BOARD #: �/ 0 1 — EXP DATE:
ITEMS RE UQ IREQ
SUBCONTRACTORS: PLUMB: LIST/SUBCONTRACTOR.S:
MECH: -- -_. BUS TAX: -
ARCH ENGINEER CALCULATIONS:
NAME: _y ___--- _-_ — TRUSS DETAILS: _.--
ADDRESS: w OTHER:
PHONE:
PROPOSED BLDG. USE:
COMMENTS:
c�
APPL I, . I GNATURE -
Received By: ___ - O,t Le Received:
PERMIT k ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAI.. DUE
10-432 00 Building Permit Fee;
10-431 (10 Plumbing Permit Fees
10-431 0, Mechanical Permit Fees _
10-239 01 State Building Tax (5y)
Building
Plumbing
Mechanical
10-433 00 Plans Check Fee _ 2, _
Building
Plumbing
Mechanical
10-230 06 Fire
30-202 00 Sewer Connection
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees
25--448-04 Industrial TIF F--es
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees
52.-449 00 Parks System Oev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) _
24-445-01 Water Quality (Fee in lieu of)
2.4-445-02 Water Quantity (fee in l i,,u of)
TO1 At_
nm/3587P.WPF
To �► H 14, e �
qo z-5 S. to, Bu �h�a�•
i II
cAr
I �
�m��o7re{
LcLAH9e'
I
s �
i
i
her
I
I
T y
I
FUry rice /F•l, r A Y
F 4/r,
F..r+�H� .f.► ��, . ,•�of� , /,, _ \ New
r
�� rr" Ir New wu-1Is
MY OF TIGARD RECEi"'T OF PAYMENT RU.,F71111' NO. 03--P39162
CHt-'.('K AMOLINT s 42. 50
NAME a 70BEIR CONIF.;TRUCTION CASH AMIr.1UNT s IA. 00
ADDRESS s PAYMENT DATE a 04/19/93
SUBDIVISION
PURPOSE OF PAYMENT AMOUNT PAID PURP09E OF r,nymf--!�i\jl AMOUNT PAID
..........---, .
BUILDING PERM ;_1115. 00 PLAN CHECK F'F'. 16.
S'f. BUILD r-*.Ir--'R 1. 85
.kll\ I ,/ b
SW SURNIJI)m /At
TOAL PMOUN-r PAxD 50