10932 SW GENEVA STREET •�AN�:#w"WN :. �iMaA6M��+•+M�M�11k1� ., j .J "11MlM'N�k1�A1MMf+6•'iM pdwDl� �r.,{mr!»�n�m7- •7. .°a+�.n��a� '
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City of Tigard Building Depurtaent
13125 811 Hall Blvd. Tigard, Magon 9722'4
':nspection Line (Rec-O-Phone) 63,9-41755 Business Phone: 639-4171
Inspections_— -L
Footinq Plbq. Ii 2.1ab Mach. Rough-in (Appr/8dwlk _
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round. Plbq. Top Out Lias Line IINALs
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Post/Seam 5truct. San. Stwer framing -Bldq. y
Post/Beam Hoch. Rain Drain Insulation -Plr/mb.
Plbg. Dnderflot.` star Une Oyp. Bd. -Meeh.
Date RoquestedtTime:
„-„
ilddresa:��'Z C�'L.g�IJ-�� Permit 1t
Builder:THE roLI.OWINO CORREt.'TONS 11RZ REQOIREDt
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Inspector: _"T�QArl7�� -- ------ --- DLte:-X'--� (�-�
APPROVED `-- DIS"PRo461) — APPROVRD SUBJECT TO ABOVE
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call. For [.ninsp.
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CITY' CSF TIGARD
COMMUN17Y DEVELOPMENT W,PARTMENT
t 13126/W HSU 614.Tigard,span 97129011,11 (50)SJO.4171
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CERTIFICATE OF
} OCCUPANCY
xxxx PCRi! T #. . . . . . . : MST�3a -006t'
639-4171
DATE ISSUED: 06/15/93
3
SITE ADE)RE:aS. . . : 1093P SW GFNEVA ST PARCEL: 19134AC•44LO1 �
( `:iUBDIVISION. . . . . WART' 9 LAN ►INC, ZONINGS
. . . . . . . . . . c LO'T. . . . . . . . . . . . .
CLASSOF'WOREt. aIVEW-._...._.___.._.. ....._______._.____---___...._._.._.__.�w_..._.__._.____._.______.._.___..___...___ �
rYPE OF USE. . . :SF*
OCCUPANCY GRP. :R3
OCCUPANCY LOAL):r'_26 4 m
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t -rE:NANT NAME:.. . . :
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+tenta�r^kis: PATH I
O%nera
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RE NA I SSEwNCF_ DE VF L-OPME N'T^
Phone #i
Contracture
RENAISSANCE DEVELOPMENT
1672 SW WILLAMETTE: FALLS DR
WEST LINN OR 910613
Phone #: 557-8000
Reg #. . : 49955
Occttpunr_y of the r�bove r•efere±rnced building im hereby given, and r_artifies
the compl.im-c a w0-h•s the Sta+.e Of Ovegon Speciality Codes for- the group,
occupancy, and use undv wr�ich the referenced permit was, i%%ued.
FI RE DE PnRTMLNT'� -I t_D I NSPEMCTOR
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UIij_ L7FFIC_IA L
POST IN CONSPICUOUS PLACE
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Cit' of Tigard Building Department 1
13125 811 Hall Blvd. Tigard, Oregon 972
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Inepection Line (Rec-U-Phone)s 639-4175 Business Phona: 639-4171
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Inspection:__
Fwting Plbg. Underelab Koch. Rough-in Appr/adwlk
Found. Plbg. Top Out Gap Line FINAL1
1 Post/Beam Struct, San. Serer rraming
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Rd.
Date Requestedr Timm/ PN
Addreea:�v Permit #e -
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Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector.:
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APPROVED —_ DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Poinep..
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cij y of Tiqud Building Department ,,-
13125 aN Ball Blvd. Tigard„ Oregon 9722 {
Inspection Line (Rec-O-Phones 639-4175 Business Phones 639-4171
Inspections -
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Footing Plbg. Onderslab Koch. F+ough-in Appr/Sdwlk
Found. ir ✓'_ -Aa■ Line FIHAI•t j
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Post/Beam Struct_ San. Bower Framing -Bldg.
Point./Beam Mech. Rain Drain Insulati-n -Plumb. j
Plbg. Underfloor Witiar Un. Gyp. Rd. -Koch. B)
Date Requested: _ Time: AM _PM i
Address: U Permit 1:� '�Y, Z
Builder:
THE FOLLItMING OORRBCTIONS ARE REQUIRED: M
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Inspectors _ Dates
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Rainnp.
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City of Tigard Building Depertaesnt
1.3125 Sw Ball Blvd. Tigard, oregon 97223 •
Inspection Line (Ruc-O--Phono)e 639-4.175 Business Phone: 639-4171
Inspection: - _
Footing Plbg. Underelab Mech. Rough-in Appr./Sdwllr.
Found. Plbg. Top Out Gas Line FINAL:
-Bld -
Post/Beau Struct. San. Sewer Framing 4•
Post/Basan Mach. iin Drain Insulation -plumb.
Plbg. Underfloor Mater Line Gyp. Bd. -Nech.
,piss' [�t pM s
Date Requutedt j
i Address:
�.. Permit
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Builder:
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THE FGiS.OWjNG CORRECTIONS ARE RRQTIIRED= -—
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Inspector: try-fin _rHr a Dates
APPROVED DISAPPROVED _J,/ APPROVED 80BJEGT TO ABOVE
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Call For Reinep.
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INSPECTION NOTICE
City of Tigard Building Department
13125 SM Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk 1
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Found. Plbg. Top Out Gas Line FINAL: ; '
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Poet/Beam Struct. San. Sewer /Framing l/ -Bldg. t
I Post/Beam Hoch. Rain Drain `C��Bulatlon,/ -Plumb. +�
Plbg. Underfloor Water Line Gyp. Bd. -Hoch
Date Requested:
et— Timet AN PH
Addrees:.� �,��� / Pecmlt
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Builder-
THE FOLLOWING eA-IAECTIONS AAF REQUIRED:
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Inspector: ky' — Dateev 3
APPROVED DISAPPROVED _` APPROVED SUBJECT TO ABOVE
—_—Call For Reinsp.
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INSPFSC _ ON NOTICE
city of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec�O-/P/ho�nee): 639-4175 Business Phone: (.39-4171 �
Inspection:
Footing Plbg. Undeselab
Rough-i Appr/Sdwlk
Pound. Plbg. Top Out Gae Line FINAL:
Fust/Asara Stcuct. San. Sewer -Bldg.
F aIDinq
Poet/Beam Meeh. Rain Drain Inoulation
-Plumb.
Plbg. Underfloor water Line �+ Gyp. Bd.
-Mech.
1)ate Requested: /7 Time: _—AM ----PM -
3
Address: 10 �7/7� � Z,Q c_ Permit i s /�
Builder-.y'Gi//✓� • 6L�V �+ 7 -�
1. TBE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector.•i_ , -— _ Date: 3
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Cell For Reinap.
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fINSPECTION NOTICE
l City of Tign-d Building Department
J 13125 SW Hall Blvd. Tigard, Oregon 97223 r" �
2 Ir..,pection bine (Rec-O-Phone): 639-4175 Business Phone: 639-•4171 ;
Inspections— --------_-------- —
I �
Q Footing Plbg. Undoralab Mech. Rough-in Appr/Sdwlk
i
J Found. lbg. Top Out/ Cas Line FINALS
Poet/Ream Struct. San. Sewer Framing -Bldg.
Poet/Be • Mech. Rain Drain Insulation -Plumb. }
E111111 Plbg. Underfloor Water Line Gyp. Bd. -Mech.
73
Date Requested: Times -AM ---_PM
Address: �_ --� — Permit
Builders --- -- ---- —
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110 FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors_
APPROVED -- DISAPPROVED APPROV4D SUBSEC'.' TO ABOVE ,
--Cell For Reinep. :�;
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INSPECTION NOTICE
City of Tigard Building Department �-- 7 /" •
13125 SW W 1 Blvd. Tigard, Oregon 97::23
Inspection Line (Rec-O-Phone): 639-4175 Business Phone! 639-4171
Irepection:
Footing Plbg. Undarslab Mech Rough-in Appr/Sdwlk e S
Found. Plbg. Top Out Gas Line FINALS
Post/Beam Struct. Lan. Sewer Framing -Bldg. �
Post/Beau !tech. Rain Drain �t Insulation -ply_
bg. 'Underfloor Water LineGyp. Bd. _ ech•
Date Requested: c� !Timet AM PM
Address: Permit �s
Builder• � -- —
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector:! --_�-- _ Date:
APPROVED D[SAPPP.OVED _..� APPROVED SUBJECT TO ABOVE
Call For Reinnp.
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INSPECTION NOTICE
City of Tigard Building Departsvent
13125 SW Hall Blvd. Tigard, Oregon 97223
Inapection Ll.ne (Rec-O-•Phone): 639-4175 Buo.iness Phone: 631-4171
9 �
Inspection:---.... -- ------- - --
Footing Plbq. Underslab Hach. Rough-in Appr./Sdwlk
Found. Plbg. Top Out Gas Line FINALt
set/Beata Strt,7L.) San. Sewer Framing -Bldg.
ot/Beam Hech. Rain Drain Insulation --Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Mach.
Date Requested.
--.:j Times V" AM — PH
Address:2 C/ Permit �:��~U✓W
Builders
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THE FOLLOWING CORRECTIONS ARE REQUIREDs
1 _
Inspector t i � - _- �Dates- L_,g
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APPROVED DISAPPROVED -A,/APPROVED SUBJECT TO ABOVE
--Call For Reinsp.
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INSPECTION NOTICE � ^' ••
City of Tigard Building Department
131.25 BW Ball Blvd. Tigard, Oregon 97223
Inspection Line (P.ec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
i
j Footing Ping. Underslab Moch. Rough-in Appr/Sdwlk
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Found. Plbg. Top Out Cas _.ine FINAL:
Poet/Beam Struct. Sar:. Sewer Framing -Bl.dg.
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Poet//Beeam Hoch. Rain Drain Insulation -Plumb.
�Plbq. Undar� Water Line Gyp. Bd. '.ech.
Date P3questedt, Time: AN _ PH
Address: Permit f: ��
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Builder:
k' THE FOLLOWING,' CORRECTIONS ARE REQUIRED:
Y�
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Inspectors
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APPROVED —� DISAPPROVED _ APPROVED StIBJECr TO ABOVE
Call For Reinsp.
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i C I'T'Y OF l I(jAkr) k:L Ul;- I PT (JF K,IAYMI~.N I RLC:E I PT NO. :93-2'36518
CIAEC:F<, AIIUIJNT 4983. 06
4 NAM:. a RF'IVA I SILIN- 4;E Dr-V E:L.1JPMIl'H T CAI-'?H AI II)LIN f 0. 00
(�CJ',.�RLtiti F'AYME•.NT DATE: x 02/1.0/93 i
GI. SE)I V 15 I ON a
URl='UFa t.)F PAYMENT AMOUNT PATI) PIJF2POI.-if Or PAYMENT AMUI-.INT X011)
5
LSU I Lo I NC3 f»'Ft♦M 38-3. 00 PLUMBING 1='F=FIM 140. 00
I IC C."HAN I CAL. F1= 4.5. 50 ,-;T. BUILD PER c'8. 413
1.--LAN CHCICK FF 11. 13 %iEWIR USA 2100. OIA "G
i I`WER I N6PEUT 25. 00 PARKS IX* 00
ORM DRF41N SDC 28171. 00 RESIDENTIAL. TRAFFIC FF,f-;5 1. 161.1
1�1i 1K:��i TRANb I I TIF. F C,.E.!i 110. 00
y
I_UT 273 HARTS I_ANl)INO r
10932 U-1 OF:.NL:W4
f(ITAI. AMOUNT PAID > 4903, 06
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INSPECTION NOTICE /
City of Tigard Building Department
13125 SN Hall. Blvd. llgacd, Oregon 97223 4
Inspection Line (Rec-O-Phone)t 639-4175 Business Phone: 639-4171
Inspections
Toot Plbg. Unddrelab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Float/Beam Struct. San. Sewer Framing -Bldg.
I
Post/Beam Hoch. Rain Drain Insulation -Plumb. -
0
Pl.bg. Underfloor Water Line Gyp. Bd. -Hoch.
Date Requested: Ti�AH PH
Address- ��' ` Permit I t ? ---
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Builds -----^ — — M
THE FOLLOWING CORRECTIONS ARE RRQt.IRED:
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,tib S APPROVED - DISAPPROVED APPROVED SUBJECT TO ABOVE
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--Call For Reinsp.
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TYOF TI ARD
COMMUNITY DEVELOPMENT DEPARTMENTMY(4-7 PLUMBING PERMIT �
13126 SWHWIBN �,o►.00„sa7213 sem+►�-��76
d. P.O.B=23397, PERMIT #. . . . . . . a MST93�-0061` ,
_ �—�
SI IE ADDRESS. . . = 10932 SW GENEVA ;;'1' S •
i ',1RCF:.L:. 1G1
., :34AC:-'Fll_klc',r
SUAD I V 1 310N. . . . a Hf1R'F' L AND I NG I.CIPI I IyF.i a
BLOCK. . . . .. . . . . . a L[lT. . . . . '"5
_......... _..___ .__.._._ .___._.,_..__. . _.....___r.._....,.,....
CLASS OF WORK„ . :NE:W GARBAGE bI5PnSALS. . : 1
TYPE OF: USE. . . . 39F WASI•II NV MACH. . . . . . . a 1 bACKFi_OW PRE:VNTRS. „ .0
OCCUPANCY GRP. . IRS FLOOR DRAINS. . . . , . . a0 TRAPS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . ac:' WATER HEATERS. . . . . . 11 CATCH . . . . . . . . f w
FIXTURES---_-_-._.._-_.._..._.... LAUNDRY TRAYS. . . . . . a0 SF RAIN DRAIN;. . . . . : i !
SINKS. . . . . . . . . . 11 GREASF _(RAPS. . . . ,. . . :
LAVATORIES. . . . . :4 OTHER FIXTURES. . . . . .0
TUB/SHOWERS. . . . a SEWER
WAT'EP CLOSE'TS. . :. WATE=R LINE ( f s: ) . . . . : 100
DISHWASHERS.
,
1 Re!mar ks a PATH t
;a
OWNFRI
4 „ F2(rN(l ISSENC.'E DE:VPL�PMF'N"C TIF" $ 14bO. 00 JH 02/08/93 _ _._.._
SPRT $ 3£5. 00 1';1 02/08/93 --'
BPI..'. $ 259t. 25 JLH 01/x_8/93 9,3 3F0,? �
H'3F'C $ 19- 25 JH 0c'/VIS/93
Phone lF. 657-5739 SSDC $ 8130. 00 JH 02/08/93
3-154PS .$ . .I.500- 00 JH 02/08/93
Pl,amhi.np Cantrectar :-
- _..__.__.__ _.... MPRT $ 4:3. 50 .1H 02/L.8/9-3 �
Q MPLC $ 10. 8A JH QrR/06,193 E
NamR: r� .22. _ __ IV15PC 2. la JH 08/68/93
Flcirlr�*ss;_ JOW.6 _R� ; t,G11TF;�HV7, _ Pr 1441. 00 JH 08/08/93
C i t y a_ PORTLAND _S t wA t eF Pr)
$ 7- 00 .7H 0R i OL�I i 02/093
xiEaa.. vT ��.._ _. PFlonedl• _760-59155 _._ _.
Rey #a�_ _ �!' .514 --
.
_.__.__.. ..._.. --
r15 permit isi.4.—''.led subject to the reg- RFL�LIIRE:D IMISPEC"IICIN6
_...
��1ulions contpinpo in the Tigard Mun.iC�ip,al F'uat;fuk_in(I InE;p Rain drain Insp
od 6, State of Ore. Speci&%Ity Codes ani, all F-'c,stiApam '�tre,rtl`t Water Line 7nss�l
other appl i.tsal3,l a l Awq. til l wor.lt will hp (lane.i'ost�$e��+ t+I�S �r - AF,F,riit1Nl k Insp
in accordance with appr'ovted pt nss. Tt,ia C�.tm/urrdslab Insp Mechanical F's.nal
rpa 'Wit will empire if Wp►^li' f*% not started r't_.I+1/Onder,fIaor 911trmb Filial
wthin 190 day,; of lv: ,.sance Orif wt)rlt i.4 Mechanical Insp Building rine '
iitlum ,ended for More than J80 days;, Plumb Top Out F_rnsion Cant
Frarmiiip Insp Crawl Drain �
Firep.l,acce Insp
1 G a y I-_i n e Insp
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Instoation Insp _
Gyp Board tnap
1 Authorized Plumbing Contractor, SignatUrleCall For tnspel_'t ion - F,39-4175
Luntractor NotesF
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t.ITY OF T I GA RD ® /
CO?AMUNrTY DEVELOPMENT DEPARTMENT Darvon
OFTWARD MASTER
13125 SW HWI Blvd. P.O.Baa Mgt.T*td.Or"m OrM(500)8194175 1-*,F-'RIYIIT #. . . . . . . : IvIST93-0062
639-4171 DATE ISSUED: 02/08/93
0
SITE ADDRESS. . . : 10932 SW GENEVA ST PARCEL: 1S134AC—HLO25
SUBDIVISION. . . . .- HART LANDING ZONING., v
BLOCK. . . . . . . . . . : LOT. . . . . . :25
BLJ_' _DING
REISSUE: DWELLING UN I T'S 1 1 BASEMENT. . . . . . . . 20 sf
CLASS OF' WORk. :NEW BLDRIYIS:3 BATHSc3 GARAGE. . . . . . . . . . 1441 sf
TYPE OFUSC . . :SF' FLOOR AREAS---------- REQUIRED SETBACKS ----------
TYPE OF' CONS,-. :51\1 FIRST. . . . :904 sf LEFT. . : 17 ft RIGHT. : 17 ft
OCCUPANCY GRP. :R3 SECOND. . . x732 sf FRONT. c20 ft REAR. . *.32 ft
STORIES. . . . . . . ;2 THIRD. . . . -0 sf REQUIRED---------------- -
HE I
EQUIHE'I GH'l . . . . . . . . C-6 tt TOTAL-------: 1636 sf SMOKE DETECTORS. :Y
FLOOR LOAD. . . . 4 ILI psf ivit)LUE. . . . . $ : 83104 PARKING SPACES. . - 1
Remarks : PATH I
--------------------------------- PLUMBING -----------------------------------------
SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :vA
LAvA,rORILS. . . . . 14 WATER HEATERS. . . ol TRAPS. . . . . . . . . . . . . . :Q1
TUB/SHOWERS. . , . :2 LAUNDRY TRAYS. . . 90 CATCH BASINS. . . . . . . :Q1
WATER CLOSET6. . c3 SEWER LINE (ft) . :O GREASE TRAPS. . . . . . . :V1
DISHWASHEPS. . . . : 1 WATER LINE ( ft) . : 1.00 OTHER F I X TLJ RES. . . . .
GARBAGE DISP. . . : l RAIN DRAIN ( Ft) . :0
WASHING MACH. . . : 1 SF RAIN DRAINS. . : l
------------------- MECHANICAL ------------------------------------- FEES
FUEL T'YPES----- -.--- UNIT' HTRS. . :0 type amount by nate r e u p t
/GAFj/ VENTS . . . . . :0 TIF $ 1460. 00 JH 02/08/93 —
Mrx INPUT:0 BTU VENT FANS. . :4 BPRT $ ;385. 00 JH 02/08/93 —
FJRN ( 100K . . : I HOODS. . . . . . : 1 BPLC $ 250. 25 JLH 01/28,193 93-236093
FURN )=100K . . :0 WOODSTOVES. -0 B5PC $ 19. 25 JI-1 02/08/93 —
FLOOR FURN. . . . :0 CLO DRYERS. : I SSDC $ 280. 00 JH 02/08/93 —
BOIL/CMP ( 3HP:0 OTHER UNITS: l PARK s 500. 00 JH 02/08/93 —
GAS OUTLETs: i MPRT $ 43. 50 JH 02/08/93 —
Owner: $ 10. 88 JH 02/08/93 —
RENAISSENCE DEVELOPMENT M5PU $ 2. 18 JH 02/08/93
PPPT $ 140. 00 JH 02108193
P5PC $ 7. 00 JH 02/08/93
F11--ione #:
Contractor: ---------------------------------
RENAISSANCE DEVELOPMENT tot
1672 SW WILLAMETTE FPLLS DR
WEST LINN OR 97068
Phone #c 557-8000
Reg #. . - 49955 -----------------------------------------------
$ 3098. 06 TOTAL
This pewit is issued subjec'. to the regulations contained in the REQUIRED INSPECT10NG
Tigard Municipal Code, State 0 Ore. Sperialtv Codes and aY other Foot/found Insp Fireplace Insp
applicable laws. All work will be done in accordance wit Vapproved Post/Beam Struct Gas Line Insp
plans. This peroit will expire if work is not started OtLin 18@ Post/Beam Meehan Insulation Insp
days of issuance, or if work is suspended fW'Iore the g@ days Plm/mndslab Inap Pyp Board Insp
f
r-'Llyl/Underfloor �ain drain Insp
Per,mita ee Signatii, Pc
...... Insp Water Line Insp
Plumb Top Out Apl:)r/Sdwlk Insp
lssue(J i:iyc Framing Insp Mechanical Final
6 e5—h 149
....... ........
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TICITYOF GRD
SEWER CONNEC;TIOIV
COMMUNITY DEVELOPMENT DEPARTMENT Osseo" PERMIT
131:5 BW FWI Blvd. P.O.Boer 23307,TOW,O"Wn 07223(603)8314176
PE1.'IhI .I #. . . . . . . : SWR93-0057
DOTE ISSUED: 02/08/93
•
SITE ADDRESS. . . : 1169., c' SW GENEVi-1 ;i PARCEL: IS134AC—IAL025
SURDIVI SIO1V. . . . : HAIRT LANDING Z(.-NIN6:
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :2.t.
TENANT' NAME. . . . . : k;
USA IVO. . . . . . . , . . FIXTURE: UMTS. . .
CLASS OF WORK. . . ,iVEW ►)WELL 1IV6 UN I'T'S. . : 1 •
IYPE_ OF USE. . . . . :SF IVU. OF PUILDI"165: 1
IIVSTAL.L_ T YPE. . . . :NUSWR IhIPEF'.V SURFACE. . : : s f
Remarkst PATH 1
Owner. ---_.____________.__________---______
---____.___._._._._________._. FEES
RENAISSENCE DEVELOPMENT' tvpe amor_rnt by date recpt
F-'RI+1T $ 2100. 00 JI-1 02/08/93 —
INSP 4 35. 00 JH 02/01.3/93 -
F�hone #: �
Con+--act or: ------ '
CONTRACTOR NOT' ONI LE
f
Phone #: 11 2135. 0Q1 TOTAL
Reg #. . :
------ REUU 1 RED I NSF 'EC'. ' 1 ONS - -
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. [he permit expires 180 days from
the date issued. The total amount paid will be forfeited if ►.he
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all dire ns from
the distance given. If not so located, the installer s all purchase
a "Tap and Side Sewer" permit and :he Ag� will i all alateral.
F rr mii;CPs? Siynat�..rr e :
I s s r_r e r-1 H v
Call for inspection — 639-4175
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1..1125 Sw 11au nwd. PLNCK/RECT
CITY OF TIGARD PERMIT #
COMMUN1W DEVELOPMENT'DEPARTMENT Tigard.Oregon 97M
��
(503)6394m DAZE ISSUED
JOB ADDRESS: / �57 TAX MAP/LOT /5/ J VAC -14C y 1.)�
SUB: �YS LOT: f e7 LAND USE: i •
VALUATION: S•3 /9y. �=
OWNER SPECIAL NOTES
NAME: -i2r' �IM�'an�o l :v ��� REISSUE OF:
ADDRESS: .'L Sit C��i/lc... r,�/�� 1-r:�� i�r __ LAST REISSUE:
(1/! _ FLOOD PLAIN/ i
?HONE: SENSITIVE _AND: _
CONTRACTOR APPROVALS REQUIRED
NAME PLANNING: _
ADDRESS: _ _ _ _ ENGINEERING: _
FIRE DEPT:
PHONE. __ OTHER-
CONTR. BOARD #: _ EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: r Z��e- LIST/SUBCONTRACTORS: ----
MECH: ", / (rte v- z '�;PS TAX:
ARCH/ENGINEER / CALCULATIONS:
NAME: TRUSS DETAILS:
ADDRESS: _ OTHER: _
PHONE:
PROPOSED BLDG. USE:
COMMENTS:
APPLICANT SIGNATURE t
Received By: Date Received:
—� - - — ---
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PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
�Z 10-432 00 Building Permit Fees
_ 10-431 00 Plumbing Permit Fees U /#0
10-431 01 Mechanical Permit Fees .-v _r%3, �U
10-230 01 State Building Tax (5%) } 3 Y. q,
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Building
Plumbing �v
Mechanical
10-433 00 Plans Check Fee
Building 2,5u,
Plumbing
Mechanical
10-230 06 Fire
Sui _Uv 7 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 _/,3 5T 3s ;/
'55-448-05 Mass Transit TIF Fees _-�/ -/l—0 --
52-449
__52-449 00 Parks System Oev Charge (PDC)
�
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) / tl
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL.
nm/3587P.WPF
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