10223 SW ELISE COURT ADDRESS:
is\records\niicrofl n\targets\building.dcc
CITY OF TIGARD CERTIFICATE Ui-
COMMUNITY DEVELOPMENT DEPARTMENT OCCUPANCY
1.3125 SW Hail Blvd.Tigard,Oregon 97223.8199 (5040294,4171 PERMIT OF. . . . . . . a MST91 -031 E
639-4171 DATE ISSUEDe 08/20/93
PARCE'Le 2S114Bb-19800
9I TE ADDRESS. . . a 10223 SW ELISE CT
SUBDIVISION. . . . a RIVERVIEW ESTATE'S ZONINGoR-7 PD
ALOCK. . . . . . . . . . e LOT. . . . . . . . . . . . . 144
CLASS OF WORK. eNEW
TYPE OF USE. . . t SF
OCCUPANCY GRP. 1 R3
OCCUPANCY LOAD1281 4
TENANT NAME. , . 1
(aemArks e
Owners
511YLIGHT HOME BUILDERS CO
P U BOX 2315
I._ARE: OSWEOO OR 97035
PhO"O Ole 503-636--2994
SKYLIGHT HOME BUILDERS CO
P n BOX 231011
t..11h<,E OF)W`.60 OR 97035
Phone Ma 503--636 -2994
Reg #. . a 14086
Oc_c1.'pa►rrcy of the Above r-eferenced building is hereby given, and certifies
the compliance with the: State Of Oregon Sper.ielty Codes for the group,
occupancy, atld use under which the referenced permit was iss;Apd.
AL
FIRE DEPARTMENT
tz
(3 CTNO_ I
POST IN CONSPICUOUS PLACE
I
INBPBCTIOf NOTICX /
Citi of Tigard Buildi-mg Departtasmt /
13125 8W Ball Blvd. Tigard, Oregon 972
Inspection Line (P.oc-O-_Ihonels 639-4175 Business P 639-4171
Inspection:
Footing Plbg. Underslab Mach. Rough-in Appy//dwlt
Found. Plbg. Top Out Gas Line 1INALt
Post/Roam Struct. San. Bower Framing -Bldg.
Post/Beam Mach. Rain Drain Insulati.... -71umb.
Plbg. Underfloor QWater Line Gyp. Bd. -Koch.
Data Requesteds (p --2t) "1 __Time: _AM � X PH
"..Sdresa t_1�Lz
1 ,25 Sk LA.
I_ --- Permit
Huildert
TBE FOLLOWING CORRECTIONS ARE RE(1DIREDt
7—
Vj fr_r___
—
J
Inspectors_ _ /7
Date:
11 ROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
call For Reinep.
�•�pECTION OTICIC �%
Cit? of Tigard Building aepertment 1.
23125 BW Hall Blvd. Tigard, Oregon 97223
Inspection Line Moc-O-Phone)t 639-4175 Sus�ness Phone: 639-4171
Inspection:
Footing Plbg. Underslab Hoch. Rough-inA r/8dwlk
__
Pound.
Plbg. Top out Gas Line FINALS
Post/Ream Struct, San. Sewer Framing -Bldg.
Post/Beam Meath. Rain Drain Insulation
-Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Hoch.
Date Requested,_—449-113 ____.LT ime t
Ali PM
Address= (02-2-3 E(, a. Permit
Builder: L?� � � ��(ilQ
THE Fp4.LO1IM CONNECTIONS ARE RnWrRROt
InspectoCt__
./ nater
--t2-. b nISAPFROVED APPRUJED S"RJECT To ABOVE
--Call For Reinsp.
'Nr DP=ION NOTICE
City of Tigard Banding Department -
13125 AM Hall Blvd. Tigard, Or"gon 97223
Inspection Line (Rec-o-Phone)s 639-4.175 Businorr Phona: 639-4171
Inspections ------
Rooting Plbg. Undereiab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line RINAU
Poet/Beam Struct. San. Sewer Framing -Bldg.
Past/Beam Mesh. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Mach.
Date Requested: /[p - l� Tip= /�AM fM
Addreeo s ,Z C Permit #s
Builder ,
TH6 TOLLONI OOR IONS ARN REQUIREDs
l!'lam-rte
---
Tnepectors � _'� � 1 � Dates�_Y / Y�
APPROVED DISAPPROVED APPROVED SUBJECT To ABOVE
---Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 Sit Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-0-Phone): 639-41 Bisiness Phone: 639-41.71
Inspect lon:__
Focting PJ.bg. Underalab Mech. Rough-.in C Appr/Sdwlk
I
Found. Plbg. Top Out Can Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Y ..
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor meter Line Gyp. Sd. -Hach.
Date Ragveeted: Time: AN PH
hdo�eBs:�si_L_ ti2__�Lcr Permit /:.(! / a31L2
ul 147-
T --- [--
—HE—FOLUMTNG MRRECTIONS ARE REQUIRED:
A C i_ Z Q
°-� — D�CIa kJ L /S E S To
Inspector: }L,ry1,C� Date: -�.�- J
APPROVED DISAPPRMFD APPROVED SUBJECT TO ABOVE
Call For Relnsp.
k?kSPECPION NOTICE
City of Tigard Building Department,,'
13125 9W Ball Blvd. Tigard, Oregon 9�2
Inepection Line (Rec-C-Phone): 639-4175 Bueines e: 639-4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Fond. Plbg. Top Out Can Line PINAL:
Poet/Bean: Struct. San. ,,ewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp.
Bd. 1 -Mech.
Date *mq:ested:__���-y _�r 'fime: _ AM PN
Address: / Permit f: U
Builder: ---- —- —
L
THE FOLLOWING CORRECIIONN ARE REQUIRED:
_ Date r
Inspectors _
PROVE DISAPPROVED APPROVED SUBJECT TO ABOVE
^-Call For Reinsp.
INSPECTION NOTICE.
City of 11gard Building Department
!.3125 SM Rall `rlvd. Tigard, Orogon IJ7223
Inspection Line (Rec-O-Phone;; 63y-1175 Dusiraea Phone: 639-417:
Inspect Lon:_
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Fovnd. r �p�l rg Top Out 1 Gas Line FINAL:
Poet/Beam Struct. ` Ban. Bower Framing -Bldg.
Pont/Beam Mech. Rain Drain Insulation _plumb.
Plbg. Underfloor Nslter Line Gyp. Rd. -Koch.
Date Hequenttedd)s_ 1�L-�"���?, Tom: /, �t / PM
s
Address: _1 11��3 � �is! C� Permit �'fj/
Builder:
TME FOLLOWING CORRECTIONS AM RLQUIRLOf
Inspector:
_APPROVED OISAPPROVED APPROVED SUBJECT TO ABUVH
--Call For Reinsp.
R(SPBCTION NOTICE v
City of Tigard Building Departasent
13125 6N gall Blvd_ Tigard, Oregon 97223
Inspection Line (Rec-O-Pho::e): 639-4175 Rosiness Phone: 639-4171
Inepection:
Footing Plby. Underelab Mach. Rough-in Appr/Sdwlk
Pound. Plbg. Top out Caw Line
FINAL:
Poet/Roam Struet. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Dr�tn Insulation
-Plumb.
Dndorfloor Water Line Gyp. Bd. -Meth.
Date Requested
AM _pm
lddress: Permit f: _
)
Builder:
17TE FOLLOWING Cp CPRS ARS RSQOIRSD,
i
i
Inepectorc--�/�-: /�
— — Date: �---
APPRc)VRD IISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinnp.
IaSPECTION NOTICP,'
City of Tigard Building Department
13125 fM Ball Bltd. Tigard, Oregon 9722
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing P1. Underalab - - ----`- --r
Plbg. Mech. Rough-in Appr/Sdwlk
Found.
Plbg. Top Out Cas Line
FINALS
st/Beam 8truat. Sen. Sewer Framing --Bldg.
et/Bea♦ Koch. Rain Drain Insulation
-Plumb.
Plbg. Underfloor Water Line
aYP• Bd. -Hach.
Date Requested:
Timet AM PH
Address: �� � �� i• /
l`- Permit /:
Builders
THE FOLLOWING CORRE O�MSARMZ REQUIRED:
— I
I
Inep actor _ /O `
-- --�_•— Date:_
APPROVED DISAPPROVED APPROVED SUBJECT To AqM
__Call For Reinsp.
INSPECTION NOTICE
City of Tigard B:silding Department j)
13125 BW Hall Blvd. Tigard, Orogon 97223
L:apection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections
'footing } Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Can Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drair Insulation -Plumb.
Plbg. Underfloor Water Line / Gyp. Bd. -Mech.
Date Requested:'/ ,�i� ��� Time: AM PM
Address: Permit lt:a,-ll e13 4"
r
Builders
TBE FOLLOWING CTIONS ARE REQUIRED:
yIV,( w
Inspector: Date:
,__� APPROVED DISAPPROVHD _ _ APPROVED SUBJECT TO AROVE
__Call For Reinap.
CITYOF TIF
C1TY' 7MR01 PI_IJMB T 1V(; PF RM I T
COMMUNITY DEVELOPMENT DEPARTMENT 001e0N PERMIT a. . . a MS rel a �,>
13126 SW�i BMd. P.O.Bas 2ZW,7*4 ori 07=(stem)d3�N 75
DATE ISSUED s 09/2t/9,1'
1 T S ADL►RUE:;L-,. . . % 102P3 SW El.CSE C1 PARCEL: 2S 1 1 4BB- 196140
.iutu[V1'SION. . . . a RIVERVIE:W ESTATES 70NINGs R•-7 PD
RI.CICK. . . . . . . . . . I LOT. . . . . . . . . . . . .. 44
------------------
CLASS
_--___._.__--_ — _.
CLASS OF WORK. . !NEW GARBAGE DISPOSALS. . 11
TYPE OF USE. . . . ISF WASHING MACH. . . . . . . 21 BACKFLOW PREVNTRS. . a0
OC6UPANCY URP. . I R3 FLOOR DRAIN5. . . . . . . :0 TRAPS. . . . . . . . . . . . . . IO
57'('JR1Era'. . . . . . . . _ WATER HEATERS;. . . ,• . . . 1 CATCH BASINS. . . . . . . 30
F'TX1"URES--- ---- ----_ -- LAUNWY TRAYS. . . , . . .0 SF RAIN DRAINS. . . . . s 1
SINKS. . . . . . . . . . al GREASE TRAPS. . . . . . . :0
LAVATORIES. . . . . 14 OTHER FIXTURES. . . . . :0
IUB/SHOWERS. . . . I ;SEWER LINE (ft) . . . . i@
WATER C;LUSUB t... 13t WATER LINE (ft) . . . . a 100
L I bHW#4bHLRE. . ,. . a 1 PAIN DRAIN (ft) . . . . s O
k!raoarke a
UWNERe _________.__________..----_.___..__..._ _._._._______._ ____-_____
SKYLIGHT HOME BUILDERS CO TIF $ 1.380. 00 .JH 09/18/92 -
P 0 BOX 2315 BPRT $ 433. 00 JH 09/16/92 -
Bp _,. $ 40. 00 JLH 12/31/91
L.HKE OSWEGO OR 97035 B5PC $ 21.65 JH 09/18/42 -
Phone Ila 50.a--6,36-2994 SSDC $ :.'.80. 00 JH 09/18/99
PARK $ 500. 00 JH 09/18/9P
Plumbing Contr.srtora ----________-__._._ MORT i 39. 00 JH 09/18/92
_�+� MNL J 9. 75', JH 09/18/92 —
Name: fe Cc ..t� _._ h15pC $ 1. 95 JH 09/18/92' _
Addressl PPRT $ 147. 50 JH 09/18/92 --
C i t y I_ St at e I _ _ p5PC; $ ;,, 7. 38 JH OW/18/9P_ —
'ipa --PhonP)1a !
Reg M a __- _ _. _ 44..•
lip
REQUIRED IiJF.►Y�EGITf7N�' -- -�
Th i'i Permit is issued subject to the rag--
Meation,% 'ci►ntained . in ith• ,Tigard Municipal . Font/found In%r -Raih drain Insp
Code, Stats of Ure. Specialty Coders and all Post,iDeam Strur_t Water Line In
othor applicable laws. All work will be done Frost;/Beam Mechan Appy-/Sdwlk in Aar
.,l.n vecordanr-e with approved plans. This Plm/undslab Insp Mechanical Final
Hermit will expire if • work is not started P .11/Underfloor $Iamb Final
viith n 180 days of is,,uance, or if work is Nechaniral Insp Building Final
s�ispenr-1ed for more than .1110 rlays. Plumb 'fop Uut t"`ro!sion Control
Framing Insp Crawl Drain
I=ir'epl acre Inmp
Gas Line Insp
.�._ , _.____.... I n s u 1 a t i o n I+>i s p ._ .....W..__......__
>� OV0 Hoard Insp
w.
Outhorixed Plumbing C'.ontrartor Signa._ture
Call for ingper_tion - 6�9-4173
Lontroctor Notes:
CITYOFTIFARD
COMMUNrrY DEVELOPMENT DEPARTMENT T01ooi:�j MASTER PERMIT v
13125 SW HWI Blvd. 2339'7
d. P.U.B .TWIM.orsoon 972? (5W)436.4175 PERMIT #. . . . . . . : MS T91-0316
639-4171 DATE ISSUEDc 09/21/92
SI'TF_ ADDRESS. . . : 10223 SW ELISE• CT PARCEL: 2S114BB--RV44
SUBDIVISION. . . . : RIVERVIEW :STATES ZONING: R-7 PD
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :44
-•-------------._______.___-_._----.._--- BUILDING
REISSUE:MST91-0310 DWELLING UNI•TS: 1 BASEMENT. . . . . . . . c 0 s f`
CLASS OF WORD. :NEW BEDRMS:4 BATHS:3 GARAGE. . . . . . . . . . :456 - i
TYPE OF USE. . . :SF FLOOR AREAS---------- REQUIRED SETBACKS--------
TYPE OF CONST. :5N FIRST. . . . :914 s f LEFT. . : 10 ft RIGHT. :20 -it
OCCUPANCY GRP. :R3 SECOND. . . s1068 sf FRONT. s20 ft REAR. . .-55 ft
STORIES. . . . . . . :2 THIRD. . . . :0 s f RFQU I RED-----_--_-_-_-_--.-.__
HLIGH1 . . . . . . . . c21 ft TOTAL------a1982 sf SAOKE DETECTORS. aY
FLOOR LOAD. . . . :40 psf VALUE. . . . . $ : 99380 PGRKING SPACES. . a0
kemarksc
____________._.______._____._._--•-____-- PLUMBING ---------------------------------------
SINKS. . . . . . . . . . cl
---_-------------------------------_._SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . c0 BACKFLOW PREVNTRS. . :O
LAVATORIES. . . . . c4 WATER HEATERS. . . ai TRAPS. . . . . . . . . . . . . . sO
IUB/SHOWERS. . . . :3 LAUNDRY 'TRAYS. . . :O CATCH BASINS. . . . . . . :0
WATER CLOSETS. . :3 SEWER LINE (ft) . sO GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . el WATER LINE (ft ) . : 100 OTHER FIXTURES. . . . . :0
GARBAGE DISP. . . : 1 RAIN DRAIN (ft) . :O
WASHING MACH. . . cl SF RAIN DKA1NS. . : i
----------------- MECHANICAL -------------- - ---•------------- FEES __-
FUEL TYPES----------- UNIT HTRS. . :O type amount by date recpt
/GAS/ / / VENTS . . . . . :0 TIF $ 1380. 00 .iH 09/18/92 -
MAX INPUT:O B VENT FANS. . :4 BPRT $ 433. 00 JH 09/18/92
FURN ( 100K . . sl HOODS. . . . . . : 1 BPLC f 40. 00 JLH 12/31/91 .
FURN )=100K -0 WOODSI-OVES. c 0 B5PC $ 21. 65 JH 09/18/92
FLOOR FURN. , : CLO DRYERS. : 1 SSDC $ 280. 00 JH 09/18/92 -
DOIL/ChIP ( 3HW- 0118 UNITSa0 PARK $ 500. 00 JH 09/18/92 -
_AS-OUTLETS: 1 - MPRT $ 39. 00 JH 09/18/92 -
Owner: ------ -•- � __ MPLC $ 9. 75 JH 09/18/92 -
SKYL.IGHT HUM" UILDERS 0 Ih5FIL $ 1. 95 JH 09/18/92 -
P O BOX 2315 PPRT $ 147. 50 JH 09/18/92 -
PSPC f 7. 38 JH 09/18/92 -
LAKE OSWEGO OR 970•
Phone #: 503•.-636-
Contractor: ---_ � ___ _........__._... - -----
SKYLiGHT HOME B LUER5 C,O
P O BOX 2315
I
LHKE USWEGO OR 970:35
Phone #: 503-636-2994
Reg #. . : 34086 _--_-------.-----------------------------.
f 2860. 23 TOTAL
This permit is issued subject to the repda ions contained in the - ------ REQUIRED INSPECTIONS - - ---
Tigard Municipal Code, State of Ore. S eci ty Codes and all other Foot/found Insp Fireplace Insp
applicable laws. All Morkwill be d i accordance with approved Past/Beam St r uc t CRs Line Insp
plans. This permit will expire if s not started within 180 Post/Beam Mechan Insulation Insp
days of issusnce, or if work is so for more than 189--days. Film/undslab Insp Gyp Board Insp
PLM/Underfloor Rain drain Insp
Permittee Signature �^� Mechanical Insp Water Line Insp
Plumb Top Out Appr/Sdwli( Insp
Issued By : Framing Insp Mechanical Final
Call for inspection - 639-4175
C'TY OF TIFA RD SEWER CONNECTION
MY PERMIT
COMMUNITY DEVELOPMENT DEPARTMENTonsom PERMIT #. . . . . . . : SWR9L--Q)173
13126 SW FW 6Jvd P.O.Bar 23307,Tigwd,Orepm 97 (500)6304175
-- bZ39 4i7i BATE fSSHEE),
SITE ADDRESS. . . : 10223 SW ELISE LT PARCELS 2SI14ii6—RV44
SUBDIVISION. . . . : RIVERVIEW ESTATES ZONING: R--7 PD
BLOCK— . . . . . . . . . LOT. . . . . . . . . . . . . 944
-----------------------------------------------------------------------------------------
TENANT NAME. . . . . s
USA IVO. . . . . . . . . .
. FIXTURE UNITS. . .
CLASS OF WORK. : . DWELLING UNITS. 1
A�iE
TYPE OF USE. . . . A 5 NO. OF BUILDINGS: 1
I THLL TYPE. /.
NS ,USWR IMPERV SURFACE. . : Isf
Owner: ------------------------ FEES
SKYLIGHT ME BUILDERS CO type Amount by date recpt
P 0 BOX 2315 PRMT � 2100. 00 JH 09/18/92 —
)YP
111 E
5) INSP $ 35. 00 JH 09/18/92 —
LAKE OS1,k1EG0 0 035
3
Phone #s 503 P-Y9 4
Contractor-
t
L014TRACTOR "T ON FILE
Rhone #: $ 2135. 00 TOTAL
Reg #. . -
------- REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Linitied Sewage Agency. The permit expires 180 days from
the date issued. The total amount paid will be forf6ited if the
permit PNpires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not Icd at the measurement
given, the installer shall prospect 3 44 i all directions from
nr
the distance given. If not so located, stthe nstaller shall purrha--e
a "Tap and Side Sewer" Permit and th Ag cy will install a lateral.
I pi in ittee Skgriati-trp :
4SS,-kPd By :
Call for inspection 639-4175
- 0
--3
C I l Y OF TIGARD RECEIPT OF PAYMENT RECEIPT NO. o92-231890
CHECK AMOUNT t 345515. 23
NAME SIERRA PACIFIC DEVELOP CASH AMOUNT v 0. 00
ADDRESS PAYMENT DATE i 09/22/9C'
SUBDIVISION v
I-"IJRPO,gF-'. OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
433. 00 PLUMBING PERM 147. 50
MECHANICAL PE 39. 00 ST. BUILD PER 30. 98
I-"I..AN CHECK FE 9. 75 SEWER USA 2100. 04
SEWER INSPECT 35. 00 PARKS SDC 500. 00
s,roRM DRAIN SDC 280. 00
I-OT 44 RIVERVIEW ESTATES
10ii?23 SW ELISE CT
TOTAL AMOUNT PAID 3575. 4'_3
INSPECTION NOTICE
City of Tigard Building Department
13125 Bw Ball Blvd. Tigard. Oregon 97223
Inspection Line (Rec-O--phone): 639-4175 Buciness Phones 6 -4171
Inspection:
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain r Insulation _Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Date Requnatedt r—�'�� __ Time: AM PM
:
Address e =� _� Permit
Builder:
TBE FOLLOWING CTIONS ARE REQUIRED:
Inspector Date: _____/ 5
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
---Call For Rei.nap.
INSPECTION NOTICE
City of Tigard Building Departaent
13125 Ow Ball Blvd. Tigard, Cragon 97223
i
Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Cee Line
FINAL:
k Poet/Beam Struct. Sail. Sewer main -Bldg.
i
Poet/Beam Nech. Rain Drain Insulation -plumb.
F
Plbg. Underfloor Water Lire Gyp. Dd. -Mach.
Date Requested: Time: _ AM
___pH
Address: Permit W—
� 7-
Buildert_
TRE FOLLOWING CORRECTIONS ARE REQUIRED:
7
7T_ - I
Inspectors\ ( Date:_
APPRrVI;D DISAPPROVED APPROVED SUBJECT TO ABOVF
--call. For Reinep.
urns__
13123 SW 11yu Blvd. PLNCK/RECT # /,� / 7 Gam_✓
CITY Y O T I GARD 1O 13-ox23397
COMMUNITY DEVELOPMENT DEPARTMENT Tigard.Oregon 972n PERMIT N lb IL 91- 0 •3/�
(503)63"171 DATE ISSUED
JOB ADDRESS: Z_. TAX MAP/LOT U `I
SUB: K1✓E0tviekl LOT: yy LAND USE:
VALUATION:
OWNER SPECIAL NOTES
NAME: 1401LE 9L,"COF-JES C'(?. REISSUE OF: --
ADDRESS: Q O f3ux t3is" LAST REISSUE:
C.AKe O-TW060, O,2 7-701 S— FLOOD PLAIN/
PHONE: (570?) 636-Z99y SENSITIVE LAND: _
CONTRACTOR APPROVALS REQUIRED
NAME: Hom>r iSwc Off-y CO. PLANNING: 61,+e
ADDRESS: f O Loi 'Z5,1 r- ENGINEERING:
(4)1(e osl—,r6o, an 97v3s - FIRE DEPT:
PHONE: - 3.j.. 36-799Y OTHER: 7iF •-n&=
CONTR. BOARD : _ Q86 EXP DATE: Ii Z. q Z
ITEMS REQUIRED
MKOONTRACTORS: PLUMB: Jit/e L 0'TT AmTI LIST/SUBCONTRACTORS:
MECH: fhvCNC N-I'6 Coep. BUS TAX:
IRCHANGINEER CALCULATIONS:
NAME: SK V CI II HT h►omC TRUSS DETAILS:
ADDRESS: ---eO gy,c ?T-1r _ _ OTHER:
(-OqK - 0Ju-V60, oz 9713 f _
PHONE: SO3 636 Z99`I
PROPOSED BLDG. USE: Sf2 _
COMMENTS: I rfc c l",7 ,tt- 3 ,atx b uti so4elo-Awf cD,v�S A sg�sFse�J
APPLI SIG ATURE
Rece ved By: �� — Date Received:
• • r
PERMIT : ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
lI'igi-v310 10-432 00 Building Permit Fees
10-431 00 Plumbing Permit Fees ./'/7.
10-431 01 Mechanical Permit Fees 3`i ✓ `I -
10-230 01 State Building Tax (5%)
Building
Plumbing
Mechanical
10-433 00 Plans Check Fee _ �� _ L)
Building 41)
Plumbing
Mechanical _� 71
10-230 06 Fire
}.• "y� o!13 30-202 00 Sewer Connection
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees _
25-448-04 Industrial TIF Fees
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 l+�
52-449 00 Parks System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC)
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water, Quantity (Fee in lieu of) _
TOTAL `��i Zr.3�"�;'
nm/3581P.WPf