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16645 SW JORDAN WAY :., �, 1N .5 ]�„"R trFPe!`tl�”".':'! u,�lr..,.n r..,,,w,.- _..... ....»'>tirt•:Nux�N;n:x.�F,si,ww,».r....., .,.:. FfS .. A ADDRESS. s IY1; ca ifs ;i L SIA 'I 1 i.� f I 1 i:\records\microflm\t,.rgets\building.doc I I A P t 1YY`rr�1�YrIW1 i. I-NSPSCTIUN NOTI(`E , City of Tigard Building Dopartaant y 13125 SN Ball Blvd. Tigard, OragOn 97 3 Inspection Line (Rec-o-Phone': 639--4175 Business ho 2 9-4171 Inss,oction:_-�.—�_i� ' -� �• Footing Plbg. onderelab Mach. Rough-in Appr/Sdwlk Found. ?Lbq. Top out baa Line FINAL: � Post/Beam Struct. Snn. soarer Fram.ng E1aq. Post/Beam Mach. Rain Drain Insulation _Plumb, Plbg. underfloor Nater Line Gyp., Bd. -Hoch. 8 ) Date Rem;,asteds I 2 1 k y 1 Timet e 11 Ad.ress:- Permit t: ` 4 BuildersS!(' L�►1 E�wu�S i7 2- THE !'OLLOWINO CORRECTIONS ARE 'UMUND, � � 51 }(.�,kkt Ali• OAKJ —.— — � }f�lP�i��y�h e 1•� b spy' u 1 Inspector: �� v Dates� �'� - _- APPROVED DISAPPFoVED . - ---.. APPROVED SUBJECT TO ABOVE _Cell For. Reinsp. Wo 00 ' ... •'i ? :i 9r :i 1 _ >u.18a.y..fM`S+..7.!-. '!, a, ,'r,ti.a, .r��MIIRIMI •�.��w �!� t f 1„4'."'h7�'A,P,^ �3, r ' i P f, 6"�lG r.l ........... CITY CSF TIGARD i CERTIFICATE COMMUNITY DEVELOPMENT DEPARTMENT CCUPaNCY OF O 13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)639-4171 OCCUPANCY PERMIT 4#. . . . . . . s MST92—L��413 63'3-4171 DATE 3SSUEDs 10/29/93 PARCELS 2SI16AD—BED42 SITE ADDRESS. . . s 16645 SW JORDAN WY SUET 1 V i S I ON. . . . s BEDFORD GLEN ZONING: BLOLK. . . . . . . . . . s LOT. . . . . . . . . . . . . s42 CLASS OF WORK. s NEW +; TYPE OF USE. . . s 5F OCCUPANCY GRP. s R.B � r' OCCUPANCY LOAD a 1 18 4 � 1� slT[.NANT NAME. . . s Remarks s PATH i Owners I BEACON HOMES PO BOX 1368 BEAVEyRTON Or 97075 Phone ##c 524-1999 Cont race or a DEACON HOMES 9500 SW 125TH BEAVEeRTON OR 47005 Phone #ks 524•-1999 � Reg #. . : 70782 Occupancy of the above referynced h;.ti ldin is-, herebyX given, land c..ertifies the compliance with the State Crf Oregon Specialty Caries for- the 9roUp9 � ocrk.lpancy, and use under which the referenu-ed permit was. issued. I F 1 RF. DE:F'ARTME~NT kT�Y NG ! . SPEXTOR BU LDIN© FICIAL PO57 IN CONSPICUOUS PLACE= i 77",, i i i 1 i i f f ! J VINSPECTION NOTICE City of Tigard Wilding Departaeat or 13:.25 8111 Bal: Olvd. Tigard, Oregon 97223 Inspemlon Line (Rec-O-Phone): 639-4175 Puminess Phone: 639-4171RIf Inspection: Footing Plbg. Underelab Hoch. Rough-in Appr./Sdwlk Found. Plbg. Tap Out Gas Line FINAL: Poet/Bean Struct. San. Bower: Farming -rldg. Poet/Seam Hoch. Raln Drain Insulation Plumb. Plbg. Underfloor wst,.- rine Gyp, Bd. -Meoh. a Data Requested: _ _ Timet Ji i Addrese: ��+I��1, _ Permit 1: Builder! + y�y x, THR FO"OVING COMMONS ARE REQUIREU: OF f .. C toe Inspector: Date: /� r't -__ 4 E i APPROVED ISAPP OINU APPROVRD SUBJECT TCS ABOVE 11 For Reinsp. e�klk 11�. I �� W ? JUPECTION NOT, CSE 4 City of Tigard Building DepartaenY 13125 SB Ball Blum. Tigard, Oregon 97223, r4eo 'l?" Inspection Line (Rec-O-Phone)s 639-4175 Busin•«s Phones 639-4171 Inspections F., Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk Found. Plb,7. Top Out Cass Line FINALS Poet/Beam Struct. San. Sewer Framing Bldq. r Post/Beam Mech. Rain Drain Insulatlon Plumb. Plbq. Underfloor Slater Line Gyp. Bd. -Hech. Date Requested: 1 U 3 Times AK S I Address: / l-- / bl-3� l � y Permit fs ` u3��✓' r ' Builders THE FOLLOWING CORRECTIONS ARE RMQUIREDs r d , Inspectors Dates cS APPROVED DI/ sApPRQ APPROVED BURJECT TO '\ROVE Call For Reinep, I ......- ..._...........,...r wnsxrauwuwr.r,.,.e.,,..w..w,.., .. .. _. i INSPECTION NOTICE City of Tigard Building Department w 13125 SM Ball. Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phon>)i 6.39-4175 Buoiness Phone: 9-4171 7 �4 Inspection:-_-__ -- — - ----- Footing P11)9. Underal.,b Mech. Rough-in Appr/3dwllc . Found. Plbg. lop Out Gas Line PTNALs Poet/seam Struct. San. Sever Framine -Bldg. Poet/Beam Mech. Rain Main '�Ilatian -plumb. Plbg. Underfloor Water 'gine Gyp. Bd. -Mech. DateRequested: .� 1 ^ime: AM f -r- --- -- - Adg ��-rr i0.8Permit : �� f: Builders THE FOLLOWING CORRECTIONS ARE REQUIRED: AW - - j jp�, r 1 Inspector: 't- — - -- --� ..— Detet AP^ROVED DISAPPROVED PPROVED SUBJECT TO ABOVE Call For Reinsp. r, f l M k 77, INSPECTION NOTICE City of Tigard Building Department 13125 SM Ball Blvd. Tigard, Oregon 97223 r Inspection LLne (Rec-O-Phone): 639-4175 BusineeA Phone: 639-4171 inspections___ A � Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk Found. I'lb•. Top Out Gas Line` FINAL: i Poet/Beam Struct. San. Sewer Framing Bldy. Poet/Beam Mech. Rain Drain Insulation -Pluao. Plbg. Underfloor Water Line /Gyp. Bd 1 -Mech. �I Date Requested. Time: AM _.�PM ■ Addzeee:,_� �C/ �') Permit ua i Builder: i fl A THE FOLLOWING CORRECTIONS ARE REQUIRED: g! t. 'R Y •'t � d � I ) J, i 4 Inspector.-IX Dates c:2 _ APPROVED DISAPPROVED APPROVED SUBJPCT TO ABOVE ——Call For Reinep. !h`..'-. idy :MGittP,.k`"•'^ ...•. ,. ......w._r1w.w+MYN�Yti NIYiMW�{.AW1.n'1LLOGdY101NAY�If1�j�yy,5�1 . G,a+ Vi 4 I �. r t. W fX. S( I l INSPECTION NOTICE City of Tigard Building Department 33125 SA Ball Blvd. Tigard, Oregon 97223 Inspection Line (Roc-O-Phone): 639-4175 Business Phone: 639-4.171 Inspections_ Footing Plbg. 7nderslab Mech. Rough-in Appr/Sdwik =� Found. Plbg. Top Out Gas Line FINAL: 1 " Post/Beam Struct. San. Sewer Framing -Bldg. . Poet/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Mech. Date Requested: _ Time: -- AM PM G� i Address:— Permit — Builder:�~1��� - ■ THE FOLLOWING CORRECTIONS ARE REQUIRED: l a f� i i r _ Inspectors/ '/ APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE i Call For Reinsp. t 1 A J 1 1 INSPECTION NCYfICE City of Tiga" Buildi.no Departgsant 13125 Sit Ball Blvd. Tigard, Oregon 97223 f, Inspection Ling (Rec-O-phone): 639-41';5 Buainene Phon • 171 Inspection: Footing Plbg. Underslab ech. Rouqh Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Poet/Beam Struct. San. Sewerraining -Bldg. • Poet/Beam Mach. Rain Drain Insulation ._Ply, Pl.bg. Underfloor WatoL Line Gyp. Bd. -Mach. Date Requested:­��- — Timet AM PM Darmit #: Clic Builders THE FOLLOWING CORRECTIONS ARE REQUIRES: w r zneprctor -- APPROVED DISAPPAOVSD APPROVED SUBJECT TO ABOVE c,pr —_Call For Reinsp. Vi WIN f. I N �l ' d 4I5 '�� 1i'. 'q.} 414 1p�..;p,•. INSPECTION NOTICE City of Tigard Building Department 13125 Bit Rall Blvd. Tigard, Oregon 9722 Inspection Line (Rec-O--P ne): 639-4175 Buainena Ph nn -4171 ' r Inspection• —� ---_ — Footing P1 Underslab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Much. Rain Drain Cnoul.ation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. .-Mach. . Date Requupteds/jTime. ^.M PM Addreeo: [�/ / —_ PArmit /: �3 3 Builder: f"�l�6+►���`-� _ THE FOLLOWING CORRECTIONS ARE REQUIRED: 4 k I InspectorsDate:—� JAPPROVED --- irSAPPROVED APPROVED SUBJECT TO ABOVE I Call For Ruisep �;;;k . _..:.• .,�...,«.J..r�W.�.�w.r•':«d«r1 �l.;u:.. �„r�i:!'�4UiYi59YiAiN!'�irdF�IS9s+rar:�:)�h4,��.a.w:.wMi'ua;a, .. -.. . E ' a' Y �nc'nyy• .w.z. '-. INSPECTION NOTICE City of Tigard Building Department t 13125 Sit Ball Blvd. Tigard, Oregon 97223 Inspection Line (sec-O-Phone): 639-4175 Business Phone: 639-4171 d i Inspections --- - — iw Footing Plbg. Underslau Mecr. Roush-in Appr/Sdwlk Found. P1� bg. Tcp Out Gay Line FINAL: c Poet/Beam StrucL. San. Sewer Framing -Bldg. 'R Post/Beam Mach. Rain Drain Insulation -Plumb. Plbg. Underfloor Watet. Line yyp. Bd. -Hoch. , i Date Requested t_/ Time: CPN Address: } �/ V ' Patmit #-q -36 Builder: THE FOLLOWING CORRECTIONS ARE REQU',' ?D: i' gg i 71 Inspactort Dates APPROVRD DISAPPROVED APPROVED SUP'6CT TO ABOVE �y Call For Relnap. pew - , F p 1P )rly! „yli t� f l{f�4Fll lt�'Ij" ) " t � t 41' {1 i � > M' yin c�a illi_! 4 � rr7�h1` l�+ - i a Y�der t e)� a t 4 , trot �a, w c � ,p._.. .t n..I.liB .rt1. per•�.�LW pld),i :.... ��1,X,.t�e n r,.fa't. ..:aYa�i FJ'1.,,,? I)" Ill z t "Rwl a,::: INSPECTION NOTICE City of Tigard Building Uepartmint` 13125 Sit Rall Blvd. Tigard, Oregon 9722 Inupection Linc. (Reu-O-Phone): 639-4175 Business Phone: 639-4171 Tnepecstion: `— Foot'.ng Plbg. Underslab Mech. Rough in Appr/Sdwlk e i Found. Plbg. Top s.-It Gas Line FINAL: /Be S4-S•�ct San. Sewer Framing -Bldg. 2 ost/Beam Mech. ,' Rain Drain Insulation -Plumb. �Mg. Underfloor Water Line Gyp. Bd. -Meeh. Date Reqs ted _7�( —Time: _--_`AM PM r Address:_= V JAY_�L[�4�I Permit Builders --- ■ THE FOLLOWING CORRECT ONS ARE FEQUIRED: t Ar ti _ f j > Inspector —_-- _------- Dr,tes APPROVED DISAPPROVED APPPOVED cs:BJECT TJ ABOVE { i Call For Reinsp. 1 I. t L _�J y � � NSPECTION NOTICE City of Tigard Building Department 1.3125 M Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: Footing Pltxxl. Underela6 Mech. Rough--4n Appr/Sdwlk w tOtt d' D t'" Found. Pl.bg. Top Out Gas Line FINAL: Poet/Beam Struct. San. Slwar Framing -Bldg. Poet/Beam Mech. / -in Drain Insulatl-on -Plumb. k ar`vF r' 'rr Plbg. Underfloor Nattx Lina Gyp. Bd. -Mech. t Data Roqusetedi —� �` —_,Time: I��.11M — PN Addresai "FC �' L _ Permit #: Builder: _ -- THS FOLLOWING OORRECTIONS ARE REQUIRED: _� - -- i h 1 Inspector:_-`//�JF/ �� --- _ Date:-12 f 'XIAPPROVED DISAPPROVED APPROVED SUBTECT TO ABOVE —Call For Reinap. rar�aai INSPECTION NOTICE City u° Tigard Building Department 13125 SW R.,11 Blvd. Tigard, Oregon 9722 lnapection Line (Rec-O-Phone): 639-4175 Busi..eae Phone: 639-4171 Inspection• : Footing Plbg. Underslab Hoch. Rough--in Appr/Sdwlk i Found. Plbg. Top Out Gas Line FINAL: Poet/Beam Struct. San. Sewer Framing -Bldg. Paat/Beam Hoch. Rair Drain Insulation -Plumb. 1 i Plbg. Underfloor 1 Water Line Gyp. Rd. -Rech. �sts•� ,I Date Re -( U C� — _Time: —LYS`�IAH - I ` PH que teds 7 Addraeef V �( A l'v� Permit .w ti - Builder: -- (` ► THE FOLLOWING CORRECTIONS ARE REQUIRED: f h t 1 'd t ' Y,11 w 11 — ot MEL Inspector: Datt e: APPROVED _ DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinnp. r a `v d' ,1. -.... ...... : III I� ti �•. .. � '� 1 PLUMBING PERMIT > 17YOFTIGARDPERMIT #. . . . . . . : MST92-0303 C11YOF 11iri0RD '`� C'OMMUNTV DEVELOPMENT DEPARTMENT DATE ISSUED: 12/17/92 13126 SW NO BNd.P.O.Bac 23307 TlOvd,Orpon G7Z23(600)630 4176 SI"i'E ADDRESS. SW JORDANWY PARCEL: �S116AD-PED ► ZONING: 5 JBD I V I S I OiV. . . . : BEDFORD GLEN BLOCK. . . . . . . LOT. . . . . . . . . . . . . :42 _____-_.-__-__._----___.______.______-___-__ ------ __--_ CLASS OF r � _ WORK. . :NEW GARBAGE D I SPOSAL.S. . : 1 i OF USE. . . . SF' WASH I NG MACH. . . . . . . : 1 BACKFLOW PREVNT RS. . .0 YF'Er � 9 OCCUPANCY GRP. . : R3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . STORIE:S. . . . . . . . : 1 WA'11R HEPTER�). . . . . . : 1 CATCH PASIIVS. . . . . . . :0 FIXTURES-------___-.----.__. LAUNDRY TRAYS. . . . . . :ILi SF RAIN DRAINS. . . . . : 1 SINKS. . . . . . . . . . : i GRE=ASE TRAPS. . . . . . . :0 p � LAVATORIES. . . . . :3 O1 HER F I X•TURES. . . . . :0 , TUB/SHOWE=RS. . . . : SEWER LIIVF. (ft ) . . . . :0 r` WATER CLOSETS. . : WATER LINE: (ft ) . . . . : 100 i DISHWASHE:.RS. . . . : 1 RAIN DRAIN (ft ) . . . . :0 �f ■ Remark, : PATH I OWNER: --_.-----•--_._.____._..______.__._.__..._.-___ ___.__..________._._.______F=EES--____--__.______.__ BEACON HOMES BPRT $ 385. 00 SCR 1 ,/17/92 - PO BOX 1368 BF'LG $ 40. 00 Jl_H 12/ 1-0/92 92- B5PC 'F 19. '25 BCR 12/17/92 -- BEAVERTON OR 970'75 MISC $ 3`x. 00 PCR 12/17/92 - Phone #: 524--1999 Mf'-,RT 1, 40. 50 BCR 12/17/92 - MPLC $ 10. 1.3 BCR 12/17/92 - �- // 1+15F-C $ c'_. 0,3 BCR 12/'17/92 - F'l�_uubiny Contr•�ctar, : -���_...._. ._l�T�__ PPRT $ 132. 50 BCR 12/17/9-'_ - .•�_ �! '. _______.____.._ P5F'-'C b 6. 63 PCR 12/17/92 Name: - Address • b �✓.4T� ] _. �..__� r__ BI'LC 15. 00 BCR 12/17/92 - C i t y . � _ _S t o A,e Zip: Req RE UU I RED INSPECTIONS ------ 4 This Hermit is issued subject to the reg- ulations contained in the Tigard Municipal Foot/found Insp Rain drain Insp �. Code, State of Ore. Specialty Codes And all Post/Beam L-'. -uct Water Line Insp other applicable laws. All work will be done Post./Beam Merhan Appr/Sdwlk Insp i,i accordance with approved plans. ]'his pim/s_rrrc:Jsl.ah Insp lYleclranical Final pet-mit will expir-e if work is not started I'11_.11/UncierfIoor Plumb Final Within 180 - of issuance, or if work is 11echanical Insp Builcliny Final suspended For more than 180 days. F"'lumb Top 01..rt Erosion Control Framing Insp Crrawl Drain f�ireplare Insp Gas Line Insp - lnsulation Insp _ x- - _. L� ' '�' ..-___ _.____ _�_ (3 y p Board Insp �- AUthorized plumbing (-,ontractor Signature Call for inspection - 539-4175 Contr�rctor Notes:-.__....T__ i. I Y' i CITYOFTIGARD �®N� MASTER PERMIT " � COMMUNITY DEVE XPMENT OEPAR'>,'MENT 011114M011114ME�ERIrI PERMIT #•. , . . . . . : 1�I5T'92-0303 13126 SW Holt Blvd P.O.Bo A TOW,dragon 07223(609)6344176 6.39-4171 _ DATE. ISSUED: 1:9/17/9G SITE ADDRESS. . . : a +#��+ SW .10FtDA!\1 WY PARCEL : 'Si 16AD--BE:.D42 SUBDIVISION. . . . : BEDFORD GLEN ZONING: s BLOCK, . . . . . . . . . . Lo-r. . . . . . . . . . . . . :4: _____________.__._____...______-•—__-._— BIJILDING —____.____._________.._..__.__...__..._- { RE I SSiJE:MS'T92-0059 DWELLING UN i TS: 1 BASEMENT. . . . . . . . :0 s f CLASS OF WORK. :NEW BE:DiRMS: E-ATHS:2 GARAGE. . . . . . . . . . :555 s f TYPE OF USF'. . . :SF FLOOR AREAS----•--'--•---- REQU1 RED 5ETBACKS•---"-------- TYPE OF CONST. :5N FIRST. . . . : 16VIO s f LEFT. . :5 ft R I GHT'. :5 ft OCCUPANCY GRF='. : RS SE:'COND. . . :0 S FRONT. :20 ft REAR. . :20 ft � STORIES. . . . . . . : 1 TH I RD. . . . :0 s f REGIU 1 HEIGHJ.. . . . . . . . : 18 ft TOTAL--•----: 1600 sf SMOKE DETECTORS. :Y FLOOR LOAD. . . . t40 psf VALUE. . . . . $ : 13590 PARKING SPACES. . :0 Remarks : PATH I PLUMBING 1 SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :0 ' LAVATORI.E :i. . . . . .3 WilTER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0 TUB/SHOWF_ IS. . . . : 3 LAUNDRY TRAYS. . . :0 CATCH BOSINS. . . . . . . .0 WATER CL,.,3ETS. . :c SEWER LINE (ft) . :O CREASE TRAPS. . . . . . . :0 DISHWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXTURES. . . . . :0 GARBAGE D I SF'. . . : 1 RAIN DRF=1 I IV (f t ) . :0 WASHING MACH. . . : 1 BF RAIN DRAINS. . : 1 j MEL;HANICAL ---- ----- — ____.--_---__.-.---_—___--- FEES -------------.- FUEL TYPE:S---___-______ UNIT HTRa. . .01 type amol.rnt by date recpt /GAS/ / / VE.NT'S . . . . . :0 BF'RT $ 385. 00 BCR 12117/92 — Q MAX INPUT:O BJU VENT FANS. . :3 BPL_C $ 40. 00 JLH 12/10/92 92— FURN ( 100K . . .- I HOODS. . . . . . : 1 B5PC $ 19. 25 BCR 12/17/92 — r FURN ) =100K . . :0 WOODSTOVES. :0 I+IISC $ 35. 00 BCR 12/ 17/92 -- I FLOOR F URN. . . . :0 (',LO DRYERS. : 1 MPRT s 40. 50 BCR 12/.17/92 — BOIL/CMF' ( 3, 1F-0 O'THF_R UNITS: 1 HPLC $ 10. 13 Brr,t :.:/ 17/9 2 - GAS OUTLETS: 1 M5PC $ 2. 03 BCR 12/17/92 — Owner: --_____.._____________._.__.__._ _.____.___...__..._-F'F'R`F $ 132. 50 50 BCR 12/ 1'7/92 BEALON HOMES F-15F'C $ 6. 63 BCR 12/17/92 - PO BOX 136B 11PL-C $ 15. 00 BCR 12/17/92 - BEAVERTON OR 9707; Phone #: 524•--1999 E Contractor: -----------------------_-----__— BEACON HOME PO BOX 1366 BEAVERTON OR 97075 Phone #F: 524-1999 Reg #., . : 70782 4 666. 04 TOTAL This permit is issued subject to the regulations contained in the -- ----- - RFUUIRED INSPECTIONS - - --'-•-- Tigard Municipal Code, State of Ore. Specialty Codes acd a'.1 other Font/found Insp Fireplace Insp applicable laws. All work Hill b�! done in accordance with approved Post/Deem Struct Gas Lane Insp plans. This permit will expire is Hork is not started within 1B8 Post/Beam Meehan Insi_rlation Insp days of issuance, or if work is sispended for mor tha days. P.lm/t_rncislab Insp Gyp Board 'Insp PL.M/Underfloot- Rain drain Crisp s r'ermittee SMec_hanir.al Insp Water Line Insp Pl1_rmb Top Otrt Appr/Sdwll< Insp Issi_red By : _ _ Framing Insp Irlec:haniraI Final Call for insper.tion - f,39-4175 r I J r r y `,;.. � {.n:,�MN�a+t�,n+,b:FMS''��RI'MmyY'rnNYvn,mII11MfYdKT-q•,+aW6rtlwe+awn•,.,..,......-..�,..wvr.+.*.M�1RIpW1�1 !,;, I� RECT # �?.5 131755W Hall Blvd. PLNCK/ � .. CITY OF TIGI- RD PO Box 23397 PERMIT # COMMUNITY DEVELOPMENT DEPARTMENT Tigard,Oregon 97M (503)639-4171 DATA ISSUED JOB ADDRESS: ��( ' (, _ I ,��3G'CC �(t'1 LAJ C� _ TAX MAP;LOT �. LAND USE: SUB: _ VALUATION: Z-� OWN R SPECIAL NOTES ! NAME: t'C�CCY1 1'►�! lToREISSUE OF: _ I ADDRESS: L, LAST REISSUE: FLOOD PLAIN/ PHONE: ���"L�"� SENSITIVE LAND: CONTRACTOR AE'RGVALS RE UIRED NAME: _ C,--A VN _ _ _ PLANNING: ADDRESS: _— _ _ ENGINEERING: FIRE DEPT: PHONE: OTHER: — i � � Z-- L`-`l ��'— CONTR. BOARD #: �r�— EXP DATE: � I ITEMS REOUIREO SUBCONTRACTORS: PLUMB: \J tvc ' I� LIST/SUBCONTRACTORS: MECH: �� �a'�� � BUS TAX: — ARCH ENGINEER CALCULATIONS: NAME: l- � tur�' �� ' .� TRUSS DETAILS: _ ADDRESS: 1����� WY�f�� t-tY4'L �_ OTHER: — t,i(yi cswequ Grp- U � PHONE: _ ��? -- 1 ROPOSLD BLDG. USE: af AJ COMMENTS: 2. I I APPLICANT SIGNATURE u ' / Date Receive : Received By: d �.____. _— --�-� i L� PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE 41 3o3 10-432 00 Building Permi' Fees 38 _ '�FPJ �� 10-431 00 Plumbing Permit Fees /3z,,v 3 Lvv J 10-431 01 Mechanical Permit Fees Uu Zvi _11o, so 10-230 01 State Building Tax (57-� 7. fl Building / .z � I Plumbing 3 J. Mechanical .2 v 3 10-433 00 Plans Check Fee /� - i 3 Building Plumbing Mechanical 10-230 06 Fire i 30-202 00 Sewer Connection i 30-444 00 Sewer Inspection -3 _ 25-448-02 Commercial TIF Fees _ �r 11-5-448-04 Industrial TIF Feer i25-448-06 Institutional TIF Fees 25-448-03 Office TIF Fees i 25-448-01 Residential Traffic Fees 25.448-05 Mass Transit TIF Fees _ 52-449 00 Parks System Dev Charge (PDC) 31-450 00 Storm Drainage Syst Dev Chrg i (SSDC) 24-445-01 Water Quality (Fee in lieu of) 24-445-02 Water Quantity (Fee in lieu of) TOTAL nm/3587P.WPF r II �Y k CITY OF T I rARL) — RECEIPT Or PAYME^NT RECEIPT NO. e 1)("--2.14799 a CHECK AMOUNT a 646. 04 NAME s BEOCON HOME".S INC C(I yN AMOUNT 0. 00 ODDRESS a 1905 NW i6g,rii PLACE PAYMENT DATE s 12../17/98 B AVERTON, OR SUSOI V I S ION � PURPOSE OF: PAYMENT AMOUNT PA I D PURPOSE OF PAYMENT AMOUNT PA 11) E:1U I L D I Np PERM MST 92--0;034 85.-00 PLUMBING PERM 13P. 50 MECHANICAL P'1= 40. 50 ST. BUILD PER E7. 91 FLAN CHEC i FF 27s. 1::3 SEWER INSPECT .35. 00 =F (� 13010 5W JORDAN WAY T'OT'AL AMOUNT PA 1 D _ - > 646. 04 P �' V •JPMrP:.xry,.,,+p.q". , ,�•rr�.��p. +^N�pp'ria,RlrI,�NYMIp1l�pM!'e .4:m-,a..,crai: '.t'' .. -_ .. y1 ,�}y�,' l "� unified ` . . . SA�II�'ARY� D o y 1� r' sewerac.�e� ;' s t l p4j . agelncy fQ, ;185 N..First Ave.,Suite 270,Hillsboro,rr.,97;34' '� SURFACE WATER s 503 648.8621 � tJ ■.......�.�,�,_���.� - -_._ - ter. C0NNE.0 J ION F'VRMIT ~ + ISSUr-"DAT. X-1'2 1792 w »;CXPIRATION-J)ATE 061'593 " PERMIT 103576 STRUCTURE; ADDFtES5,-130101 (Ct'-1 STR.UCT "IS . �,..i.R,' E1ET'-404031,W.�.,.JO1R,D;AN .WAY ,.nLO`p�Ci ;s42 BLOCK' LOC'(1� Ally ':2 .L., TYPE—GKCTIONS-N=W .... 'OLEN PHAS . 19 ;BL.11rWR/ERTYPE IN3TRLA7IONr-`" O COIJ/ ,F'C I , � "11000 J '! <' T1�PE. C�C1 UF'ANLY. ( 1 ) 1;xNGLk FFtMILY'r PARCk:L $i,' ��1'6" An 1!8300" QT ' hEG 97iG n,- , N 1Q0dj vi 91 r► OWNCI< '1 11 . >rr• ; ;rxt° t, u , �, ;,of �,: :�r+s ° , ADLR $ 7, AMT ''tuuRNAM AVE9/07+ ,Ys�� �. j, yk PHONE 6_26r9029 �r JIIFt,I,SD FIXTURE EQUIVALENT DWi::Li..INfaf' ~RESTDENTTALw., + UNITS '-%x r l I SE RVICIr. UNI TO 0.0 UNITS SERV ICC. UNITS .1 ' CONNECTION FEES ;'' SURFACE WATERr DEVELOPMENT FEES SEW , CpNA1EClI.­ ^.100.00 ++, WATER QUALITY ` 180.00 LESS CREDIT < 1.x0,04?� DATER QUANTITY 100.00 ,a LESS CREDIT < of 4.9 ERQ Iq N S CONTROL t r' <,,,: INSPECTION 40.00 PLAN CHOCK 26.00 r. `R y SUD'TO rAL : 2100 ,00 SUBTOTAL 166.00 pgqTOTAL. 2266. 00 AF'PL .NA1iE1 PETER KU'f;;K PWONC:52L/ 1.11J_ ....__ AFFILLIATION VP REMARK9'.•QNOJ#, 1939••HEDFORD GLEN 2-LUT 4 42 "r v *24. II< UR NOTA" FOR E ' 3I11N CONTROL . INGVEC ,*IONS REQUIREp'� NLI V11 I MA:M[LC�*-v__ -�� rr r Permlt`Condttlonss The app ant agrees to comply with al rules and regulations of the Unified Sewerage Agency. When telling ? for an inspection. please refer to the Permit Number. The Permit expires one hundred eighty (180) days from the date of issuance. " The total amount paid (permit fee, connection charge, line tap fee and/or other charge) will be forfeited If the permit expires. The Agency does not guarantee the accuracy of the location of side sewer laterals. if the sewer is not located at the I measurement ggi,,en, the installer shall prospect three feet in all directions from the distance given. If not so located. the inst411or Permit shn11 purchase A "Tap and Side Sewer" at,the current charge and the Agency will install a lateral. 6/goy WHITE - USA, BLUE Aecounting, GREET: -Inspectlon, YELLOW Customer r� j