16661 SW JORDAN WAY w?� a �. MVN:.�yNr M^rM14N':iW4��C'tMM•. „�•M�•'1i �� .�', �"•of"r�i �Tt�+��r7
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INSPECTION N(MCE
City of Tigard Building DerA tmOnt
13125 go Hall Blvd. Tigard, Oregon 97223
7.3spection Line (Roc-O-Phone):`�-6�j39-4175 3uniness Phone: 639-4171 �
a Inrpecti_« L►_C~'f�T
i
Forcing Plbg. Undex:alab Hoch. Rou_41-1r Apps/Sdwlk `
Foun,1• Plbg. Top Out Gas Line FINALE
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pryt/Beam 9truct. San. Sewer Franiog -Bldg.
lfsL/Beam Hoch. Rain Drain Insulatio:: -Plumb.
Mlbg. Underfloor Nater Line Gyp. Bd. -Hoch.
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Date Regnestadf I �• f( '� TieNt AM PN
Address:I I r(�(! �( V1 11�a- Permit
Z 1762
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Builders --
TBE FOLLOWING ODRRECPIU!'3 ARE REpUIRSD:
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Inspectors ' , ? — Dates ��
APPROVED DISAPPROVED APPRCWRD SUBJR,'T TO ABOVE
v
Call For Reinsp.
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INSPECTION NOTICE
City of Tigard Building Depart—t '
13125 SII Hall Blvd. Tigard. Oregon 97223
w Inspection Lina (Rec-O-Phone): 639-4175 Busf.ness Phone: `639-4171
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Ineptction:
Footing Plbg. Underslab Mach. Rough-ir: Appr/Sdwlk
Found. P1Ig. Top Out Gas Line FINAL^
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb. fiW,t4-,
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Data Requested: ��� / J Time: AM _PN
Address: C { Permit tt i r♦ �'�^
Builder:EfACC'Y� I 0 7 I1<< 1
THE FOLI,oWi110 c�7wcrit'AT�"i►n2 RapnlRnD:
?-of V 7 ■
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Inspector: _ Date:
f•�APPROVSD DISAPPROVED APPROVED SURJRCT TO ABOVE
_Call For Reinsp.
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CITY OF TIGARD .
1 CE.k r I F'1 OA rr_ O(
COMMUNITY DEVELOPMENT DEPARTMENT �
13.25 SW HaII Blvd Tlgard,Oregon 97223.8194 (503)839-4171 OCCUPANCY
1 ) XXN F!f-_RM1'r #. . . . . . . ; MST9 3 0i
639-4171 DATE 1GSUEDi r �
{ f"ARCIwi_a 2S 1 16AD--BE;D46
I1 !'31 TE ADDRF S r. . . 0 16661 SW JORDAN WY I
! SUBD I V 1 S I OP'. . . . a BEDFORD GLEN ZON I NO i
BLOCK. . . . . . . . . . e LUT. . . . . . . . . . . . . 946 .
1 C;L.ASa•+QF�WQRI<,. a NEW.,__.____._.._. _.._ _.. _.._._....._. . ._ .___ . .,. _... _..... -
TYNE OF USE. . . a 5r'
OCCUPANCY GRP. a R:lz �
grC'I.1pr4INr'Y : 1:1AD e ] 18 4
TENAAT
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1-'emar•kls s POTH 1
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Ownerr c
SEALON HOMES
}) Pa IlOX 1368
1 BEAVERTON OR 970075 i
Phone #i 5c:4--1999
Cont rAct or tl
BEACON HOME,
{ 9:500 iib+
i!EAJF R'rON OR 9 7005
r
Phom #1 5k!4--1999
'teg #. . e 707f1
Ocr_upwicy of the above referenced building is hereby given, and cortifieG
the compliance with the ",tate Of Oregon Specialty Codes; for the grump,
occupancy, and use undp:r which the referenced permit was issued.
Ir
FIRE DEF"pr'iMENT P 1:1,11CTCira
BU'1'LCIPL
POST IN CONSPICUOUS PLACE.
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City of Tkjard Building Depwrtaent
R 13125 BW (Hall Blvd. Tigard, Oregon 77223 t�
Ir:spaction Line (Ric-4-Phone): 639-4175 Business Phone: 639-4171
C' f Inspection:
Footing Plbg. Dnderslab Mach. Rough-in Appr/Sdwlk A
Found. Plbg. Top Out Gas Line ?INAL: I�
Post/'Beam Btruct. San. Sewer Framing -Bldg.
Post,/Beam Mach. Rain Drain Insulation --Plumb.
Pl)rg. Underilcor Neter Line -Mech.
Drte Reque- ,^it ._.. Tf1Nt __ K
Address ��%W� I •"Y I ' (� _ PRt71t t
Builder: r I rt';V;
THE FOLLOWING CORRIX.TIONS ARE REQUIRED:
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'nspecto�: -- --- — Dates =
` APPROVED -— DISAPPROVED ---- APPROVED SUBJECT TO ABOVE P
r Call For Reinsp.
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MNSPBCT ON NOTICE
City of Tigard Building Departjoeat
13125 SW Hall Blvd. Tigard, Oregon 972?3
Inspw:tion Line (Rea-O-Phone)s b39-4175 Business Ph3na: 639-4171
Inspections V)
Fol Ang Pl. . Underslah
h9 !lash. Ro1fS(h-iff Appr/Sdwlk
Found, Plbg. Top out 4a/ Ling pINALa
�.._�
Post/BOW" Strus_`. San. Sewer 1CaBinQ --Bldg. i
Post/Beano Hach. Rain Drain
Inaulatn -plwoo. ,
Plbg. U.I*rfloor Nater Line tiyP. -Hoch. .
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Date Requested: 4• Tlmef AH pH 46
Address: 'L[(A ( Form,". 6f 3 'UZry
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Builders iLL� ���/1QS Z - ■
THE 1M)LLONINO CORRECTIONS ?RX REQUIPXD t
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Inspectors
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APPROVED DISAPPROVED _ APPROVED SUBJECT TO ABOVE
___C!]i For Reinsp.
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INSPECTION NOTICE
City of Tigard Building Derpartalent V
13125 SH Nall Blvd. Tigard, Oregon 97223 '
Inspects Line (Rec-o-Phone)s 639-4175 Business Phone: 639-4171 _
Inspect ionsf A� 1/-a —
Footl:rg Plbg. Underelab ._ech. Rough-in Appr/Sdw1k 4 tl
Fcund. Plbg. Top Out (;an Line FINALS
Post/Beam struct. inn. sewer !!J taming —Bldg.
Post/team Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
iy dt
Date Requesteds_ C, Times ?K PM `
Address e .1 ^•�vt--3 ' � Permit #t__.
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Builders C4 �r �_L-i—VA \ 74 F+
A a�Yn{J�r f ^N(Y i} 4 i
j TIM FOLLOWING CORRECTIONS PRE REQUIRED: �.,s }('�oyrl��•t :{�(y pk � ,
.�/ +�f{'t+'�.'.
it ��.1 �Q �7 L) O J"•T •. � L..'�!�. �\ �.�sl-� t t`i��'•,F��I4101,t'
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APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
call For Reinap.
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jN&PECTION NC9g D
�
Cit? of Tigard ilai�,zaparlaent
13125 M Hall Blvd. Tigard, Oregon 97223 1
Inspection Line (Roc-O-Phones 639•4175 Buxl.ner• Phones 639-4171
Inspections Y
Footing Plbg. Underslab Hach. Rough-in Appr/Sdwlk � k�
Found. Plbg Top Out Can Lima FINAL:
Post/Beam 8truvt. San. sewer Framing -Bldg. I ,�
Post/Beam Hoch. Rain Drain Insulation -plumb. wr
Plbg. Underfloor Nater Line Gyp. Bd. -Hach, oqa�f`wgki4
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Date Requested: 0 _ Timr: At _PM
� d Mi slayr
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Address:��, C!'l!'( `� c`T`f, �-�\ ��LCG1 hermit Mt�3'..��-�Z-' :� a�� �
Y � t�tlr'
Builder: L o- }ri; t rf���
qty c, ,y Pr k&� y iy�fa a,
THE FOLLOWING OURRECTIONB ARE REQtlIRSD s
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Inspector:
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--APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
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_-Call For Reinsp.
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INSPECTION NOTICE
city of Tigard Building Departwsnt
13155 B11 Ball Blvd. Tigard, Oregon 97223
Inspection Line (Ro -O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
lounA. Plbg. Top Out Gas Line FINAL:
Post/seao Struct. San. Sewer E 1iraming -Bldg.
Yost/Beam Mach. Rain Drain Insula:.ion -Plumb.
P..bg. Unde.�floor Nater Line Gyp. Bd. -Mec1.
�.: '
Date Requested: Times AN _ PM
Address: ( � f �t' I (w , ti� (.1�) Permit is J
Builder:
"HE �'S.t.OWlNa CORRECTIONS ARE REQUIRED:-
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Inspector:--'V/�
APPROVED orsAPPRoNED APP1toVED SURJECT To ABOVE
_call. For Rel.nsp.
'.��psl(RopM rywr.rlW�'v�r.Mll41Fb•if YPpY•F.Nrw;Iu,WYAn+.n'wae,'zt.,,rM`1,wwl#si�iaW 9.IMI�GMW.wIMM'fYWrY'.n..w.xaawn,Mdfe�,(�.,
EMEN
INSPECTICN NOTICE
City of Tigard Building Department// ,,
13125 SO Ball Blvd. Tigard, Oregon 9761
�&_/
Inspection ILne (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
Inspections
Footing Plbg. Underslab Mach. Rough--in Appr./Sdwl.k •
�.
aund. Plbg. Top Cut Gas Lina FINAL: I
./
'st/Beam Struct. San. Sewer Framing -Bldg.
etf8aam Nech. Rain Drain Insulation -Plumb.
'_.._,__.,-_ __
Plbg. Underfloor Water mine oyp. Rd. ` y -Mech.
Date Requested: �� Ti _AM P!l
Addreass � � L -Permit fVf
s �
i
Builder:
} THE FOLLOWING CORRECTIONS ARIL REQUIRED:
i
Inepe,�tors _ � Deter
—_APPROWD - ISAPP D APPROVED SUBJECT TO ABOVE
�,.L_Cell For Rainap.
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'wpm 71
F
MPW29TION NOTICE
City or Tiga-d Building DepartmentJ/
13125 SA Bail Bled. Tigard, Orwgon 97__� �r
Ina.Kion Line (Pec-O-Phone)t 639-4175 Businene Ph 639-4171
Inspectiont
Footing Plbq. Underslab Meeh. qh-3.n Appr/Sdwlk
Found. . Plbg. Top Out Gas Line FINAL: I
�/ - ot• San. Sewer
.---- ` Fraging -Bldg.
Root/atom Mech. .� Rain Drain Insulation -Plumb.
Onderrloor. Fater Line Gyp. Bd. -Mech.
Date Requeotedt _Times _._Am PM
Address: r
Q �� 1 Permit
Builder: tt
TBS FOLLOWING CORRECTIONS ARE REQUIRED: F
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Inspector! __-
_ Dates ��~
`�APPROVRD L DISAPPROVRD T APPROVRD SUBJECT TO ABOVg
Call For Reinsp.
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IMSPECTIOM NOTICE
City #f Tigard Building De mwtsert x
1311b BM Ball Blvd. Tigard, v='agon 97223 15 "
Inspection Line iRec•-O-Phone): 639-4113 Business Phones 639-4171
i
Inspections _ - t,( .Mk'. La D(
Footing Plbg. Underslab IMOh,. Rough-in Appr/Sdwlk
Pound. Plbg. Tap Outi
Oas Line FINAL:
POat/Beam Struct. San. Sewer Framing -Fld
9-
1 /Rego Mo h. Rain Drain Insulation -Ply_
P1'39. Ur',trf l 3or Nater Line Gyp. Rd. -Mech.
Date Re ,%sste/ds �– I Time: _may_ PM
Addresss�(�?t17�f. ' �C:YG1l� (� �� a-L, Permit •t. ��i-L1ZCfZ.
Builder:–L/ rrn - .QY- 7aY O r
TME POI.LOWING Cu,-,itHcTIOMS ARE REQUIRED:
Inspector.: _— (
Dates—
APPROVED DISAPPROVED APPROVED SUBJECT TO AFOVE
_Call For Relnap.
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jNSPECTION -- ICE
City of ?ig.ud Building lle
13125 OW Hall Blvd. Tigard~ Oregon /
Inspection Line (Rec-O-:none): 639-4175 Business P 639-417:
Inspections _- -
Footing Plbg. Underelab Meth. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gai Line FINAL:
Post/Seer /trtf San. Sewer Framing -Bidg.
`PQet/dear Meoh.) Rain Drain Insulation -Plumb.
Plbg. Underfloor Watet Line Gyp. Rd. -Koch.
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Data Requesteds _ 'L _Time: AM _ PM
Address s 1 l.O t FW lk-(/\ I; (')Z 7
- I . l ermit �:
Builders ,G�.4-( � I I�'j��
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inepw.tor: Date: /"U
APPROVED f /_ v DISAPPROVED "PR(7✓3D SUBJECT TO ABOVE
Call For Rainep.
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INS ECTIlj NOTICE F
C.itY of Tigard BL Uding Departaent
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspoctlon Line (Roc-O-Phone)t 639-4175 Business Phone: 639-4171
Inspectiont-
Footing Plbg. onderslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line
FINAL s
iz
Poet/Beam Stru,:t. sA11. Sir; Framing -Bl.dg.
Poet/Beam slosh. `(�#in Ds_aiq Insulation -Plumb.
Plhg. Dndez'lloor Jt4ier Lin Gyp. BA.
-Mech. u h
Date Requested: Times
iMl tit.
x
Address:
Permit
� ��• �_ �_ _ �'S,�,'p ,:t�4r�
-71
Bt tLler,�,' �s
:'ME FOLLOWING CORRECTIONS ARE REQUIRED: p, 5, ,
vw+ ��, J 1�
t : �
71
Inepictor,.
Date:
_. _'APPROVED DISK :'ALMAD APPROVED SUBJECT TO ABOVE F
--Call For Reinnp. al j
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INSPICTION NOTION
City of Tigard Building wsparLaa-
13L2S M! Hall Blvd. Tigard, Oregon 972
Inspection Llne (Pec-O-Phons)s 639-4175 Busina— Pnes 639-4171 t
Inspection: _
�aotin q Plbg. Underalab Mach. Rough-in Appv/Sdwlk
t .k
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Cund. Plbq., Top Out Gas Line FINALS
Post/Beam Stsvct. San. Sewer framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -plumb.
Plbg. Underfl,jor Nater Line Gyp. Rd. -Mach.
4.l�
Date Requested: � / e_7_3 Times AM
Addreras fir / /ham
Permit #45,142
■
THE f0 INGOORRE • S ARE REQUIREDs
Inspectors Date:
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_ APPROVED DISAPPROVBD APPROVED SUBJNCT TO ABOVE
Call for Reinsp.
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CITY OF TIGARD
+ i'E1Mi I }. . . . . . .
COMMUNITf DEVELOPMENT DEPARTMENT �
13126 8W Hal;Blvd.Tigard,Orapon 97223@8199 (603)617,o- 71
DA'T'E I USULD-,
' N
rE.. GTl~ri?(?L`Y C i3W WY
I.lBDIV1131UN. . . . : I)r:.iJ'r t)f21i GL.E:;N
;1..1A !i. . .. . . . . . . . LU'i . . . . . . . . . . . . . ..rlf.
_._._. ._._ ._,.__._.._........__..._._...... _ _.._.,,_.._,. _ ...
BUIL-DING _......,..__,__ _......._..__.. ........__.... .-........_...__. .._.._., . _ ..._._.
IWELLINii !:!!I "S: 1 LAO;EL'[ ar,lY. , . . . . .. . :�+
;L l EiS CJf" WORK. NEW SED ::t )3t�'I'H5:k GR112AGiw. . . . . . . . . . :373
Y,-'L'i Of _i L:. . . ;`; 1'1_i;+ii(� I ri�1::r+�;_ RI.IdIJI f2Ell C:"f" +Fa.�i4ra.,......_
10 C Uri CUNST. :1N 1 I RST. . , .. ; :1913 s f i_E,1.7'. . a 5 fft RIGH"i
ORP. :R3 ;iLC;C CJD. . . :0 t F f•6.N-1 . :8 Qt 1't R 0 R.
TORIES. . . . . . . : 1 THIRD. , . . .►:+ i.ff REL".!lJl tGw�..._....,.._ _._._...._...._._._..._.._..
ILI UH't. . . . . . . . . 1,2�
LOUR LLJAD. . . , .40 p% F VALUE. . . . . s . 9&31F'%iRK-1 NG ::;F'AC:E:'"1. ., :0
._._. .__.._...__ __._.__._...... _.___.___...._. PLUMBING
IPdi1;r. » . « . . « . s 1. 1 L.CI')h I)HPIV`„ia. . . . «4: 1:tPLKi'L(IW �'fiLVI+I
AVATCIr?IES. , . . . i
WA ::fit HEATERS. 1 T'141PS. . . . . . . . . . . . . . z u+
L1U,r 15Fi(:J+,dERS- « . . .s Lr„�I jlii2'Y It 4'C'a. , . :41) r t I CH Bps N;-z. . . .
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qTC:R l,L(?6E` S. 12 SEWF.k' L.INL r f t ; . -.0 6REASE TRAPS
I;A-IW( &l J313. « . . : ? WAILN LIPSL: i ti"t : 1�'+k'+ 11IFiL"R 1='I1.TIFFE'a. .
iA1K8Z1E DISP. . . ai RAIN DRAIN (ft ) . 3 �
Wi.,4 RING MFIC:H. i. SR' RAIN DRA11q;�iC 1
MEC110NICAL _.,..__. _ _.... _,. ......._._.._.....___... ...._. Eu; _........
UEil.. vl L' -..__ ... LNI ( i'•II hJ ar'i type ami,..tr;C by date 4
VENTS .0 BVIRT 430. 00 0 ILL 06 04/9--3
lG;x IN":)UT «►it i,i U VL k. i ra?'!,S. . . DPIJ, $ %10. 00 .JL.1-1 Q15/24J`.73 .
URN ( 100K . . : 1 How),,). . . . . . . ;. BSPU 'a Z,'I. 50 PLL 06104/`);
URN r 1G C:=I; . .4:1 W 0 Q . f,UV:__,. «0 Miss 41 :,a. OVI PILL 4:16 04/`
LOC)R FURN. . . . .0 .::i_G IDRYEIZ:i. u 1 MGI T t 40. 50 TILL 06/04/9:3
U L,,M'= 11E= :k� C]'i 11iV l; .; ;a i':>« s Iw�'I.. 'I 10. 13 PLL. 06/04/13
L. 03 PLL.. 06/04/9 i.
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,,L'AGUN HUMEC; 6. 63 F-ILL r/ri,,04/96 i
i-0 LAOX 1.1614 t
1ri�4E'1�`i C)N U17
'-LALON HOME5 f
CI BOX 1366 �
t E:i,'l'Lt`2TUN f]Ri ')"i417L-
1 horie #.- 524..1991)
e W #. . . 70782
'iis pirlit ii issued subject to, the rey,iat,ans cortart+ed in tnt
i5aro luniciha: i;ude, Stare J '!re. Specidity Cr,des and all otrer Irispr i- it^Llplac:e I'r1sr.
applicable la"s. All wore ":ii to dune in accordaihce with appruvea F'ost:.`lapam ':it v k.tct Las Linc Lnsp
1 .:ians. This pew'ott "iii Expire if "o-> 14 t m+:,;'Ff i«',ir 161, iurl Irl,;p
rays o` issuan;:e, or if «oyk ;s supe^• ray e, PA .t'Ids 1.4h 1711E Gyp Soaar^d InsR
i
ooi ;icitiit tIY'wgiI', II' sp
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131255W Nall ava. PLNCK/RECT #
CITY OF TIGARh
rO[lo`23J97PERMIT # In S f�/3 O A 012,
I:OMMIINI'('YU[sVCLOPMCNTDEPARTMENT Tigara,Oregon�llZ1
(503)639-4171 DATE ISSUED
j JOB ADDRESS: 16661 SW Jordan Way fAX MAP/LOT ,1-5/�(� 4
SUB: Bedford Glen — LOT: 46 LAND USE:
�C
VALUATION: "—q3
OWNER SPECIAL. NOTES
NAME: con licrms_Inc. REISSUE OF: kn
AOORESS: 9500 SW 125th Ave. LAST REISSUE:
j
Beaverton, OR 97005 FLOOD PLAIN/------
PHONE: _ 524-1999 SENSITIVE LANG: 1.
CONTRACTOR APPROVALS REQUIRED
NAME: Beacon Hanes, Inc. PLANNING:
I -
ADDRESS: . 9500 SW 125th Ave. ENGINEERING:
Beaverton, OR 97005 FIRE DEPT:
PHONE: _ 524-1999 OTHER: _
CONTR. BOARD 9: 70782 EXP DATE: _12/93 _ — —
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: Calsby Plumbing LIST/SUBCONTRACTORS: _
MECII: - Muehe Lmality Heg i;La BUS TAX:
ARCH/ENGINEER CALCULATIONS:
NAME: Argo Architect AIA
�— _ TRUSS DETAILS:
ADDRESS: �_ 163:5 SW Boones Ferre Rd. 201 OTHER: _ ^�
Lake OswevoL 97035 —
PHONE: 636-0755
PROPOSED BLDG. USE: Residential*
COMMENTS:
APPLICANT SIGNATURE _
Received oy: /: _ Date Received:
'k hMM'AWRMwe
}`4 r !.!fit`t iP!"NS+ Mh�Y+1pf 1NVF%.K'�M1'd� 1Kld: 1�':;}iut. , .«a,^7.n,. ,. .. _.__ ,• ,w.�, �(
tiCr�a i '
,?;k^I Irk 'M �h�oh' � jr ��+�+» �it.�l:. 7+ ,.,, y.., • , .. :.. � . .u.�:
+
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PERMIT k ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
c�.47, 10-432 00 Building Permit Fees ;/ 0 _ 30' ,
10-431 00 Plumbing Permit Fees f [_3 Z,)'v / 3Z,-,L
10-431 01 Mechanical Permit Fees Wo -5 a
10-230 01 State Building T-.x (5%) 30.1(o 30, lG
Building i S- _
Plumbing
r: ,t
Mechanical
10-433 00 Plans Check Fee So.l3 u lU 1 3
Building �y
Plumbing _
Mechanical �O,1v"
10-230 06 Fire
30-2.02 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
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)
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CITY OF T I GARD — RECEIPT OF P'AYME'NT RECEIPT NO. s 9r L?40958
CHECI'. AMOUNT 67h. a:9
NAME s BEACON HOME 6, INC. CASH AMOUNT s 0. 00
ADDRESS s 1.905 LKNW 169TH PLACE PAYMENT DATE a 06/04/93
SUBDIVISION e `
BEAU RTON, OR 97006— C
v,<RPOSiE OF PAYMENT AMOUNT PAID PURPOSE: OF PAYMENT PMCIUNT r-'A 1 D `
BU I LD i F Q,- Pf"RM M yT93-0-92 4:30. 00 PLUMBING VIERM 132. 50
MF-.l:HANIC'I)L--P . 40. 50 c3T. BUILD PER 316. 16
PLAN CHECK FE 10. 13 SEWER INSPECT :35. 00
TG ;IL AMOUNT Pn I D _ > 6 78. 29
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4 unified SANITARY D MTN
sewerage
agerlElra/ r SURFACE WATER
•155 N.First Ave,Suitt 270,HII eboro,q 87124 .
503 648-6621
CONN► jION PERM I'1 �
ISSUE DATE: Oh04'i•3 ..�., Ex' �rnrt
PIRATI°ON DATE 1,20193- �- -�' -` PERMIT 104329
STQUCTURE ADDRESS 16661. FRUJI CT 1')?i
STRUCTURE STREET SCJ JORDAN WAY-
:3�aiT' tl u L. LOT 46 BLOCK
TYPE CONNECTION-- NEW -- -- _._.-OF DEDrORD GLEN PHASE 2
TYPE INSTALLATION'- (19) IDLD"' WR�'ERD' C()N/ SDC ,r,• w+ ; , i r.,+ yr,r '�i�; ' w
TYPE OCCUPANCY ( 1 ) QINGLE FAMILY PARCEL' tSi 16 nD 28000
QTR,.,SEC. 47.16 NH IB091 r
OWNER DEACON HOMES I I
TkATMF NT F
ADDRESS 9°i00 SW 12.TH�y.,.
1 PLANTLIUF:Hf1M
E
BEAVER'TON �7100t�_
PHONE y524-1999___'.... JUR 3D
(I r'1,N(r131,.4 _.._�.._._�._.. . ,n,. __...__..._......_._,_...._.. ' �I
FIXTURE EQUIVALENT DWELLING RESIDENTIAL
UN1..TS SERVICE UNITS , . O 0 UNITS 1 SERVICE: UNITS 1
CONNECTION FEES SURFACE WATER DEVELOPMENT FEES 5 [
} SEWER CONNECTION x ' 2100.00 WATER QUALITY 180400
LESS CREDIT < 100.00:
WATER QUANTITY 100 .00
LESS CREDIT < 0 .00).
EROS'10N CONTROL
1 INSPECTION 40 .00
j PLAN CHECK 26.00
1
JUE7TO TA 2100.00 SUDT'0'TAL 166. 00
..,ti T 0 AL. 2266 ,00
APPI. NAME PETER KUYS[', PHONE
AFFILLIATIUN VP
REMARKS PF:RJ#1939—TiEDFORJ:1 GI._EN 2—LOT 1 46
*24 HOUR NI.ATI E 70_! EROS CONTROL INSPECTIONS REQUIRE►
SIGNATURE _ ISSUED BY THOMPSONJA
Permit tontt s: The applicant agrees '.o comply with all rules and regulations of the Unified Sewerage Agency. When telling
for an fns action. please refer to the Permit Number. The Permit expires one hundred eighty (180) days from the date of
issuance. The total amount paid (perr.it 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
measurement given, the installer shall prospect three feet in all directions from the distance given. If not so located, the
installer shall purchase a 'Tap and Side Sewer* Permit at the current charge and the Agency will install a lateral.
6/90 WHITE — V;iA, BLUE — Accounting, GREEN —Inspection, YELLOW — customer
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