16668 SW JORDAN WAY rA4,
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INSPECTION NOTICE /
j� ' / City of Tigard BLflding i�epart'ent 'S l
t •Y/ `�
3-3125 SK SBall Blvd. Tigard, Oregon 9722
�nsp4ti Line (Rec-O-Phone): 639-4175 Business Ph a 639-4171
Inspection: '— --- --
p. fk A
+'A{ Footing Plbg. Underelab Mach. Rouqh-in App
r./Sdwlk
` Found. Plbg. Top Out Gas Line PINALs�
Post/Beam Struct. snn. Sewer Framing �
1 >r Post/Beam Mech. Rain Drain Insulation -P-Bldqlumb
Plbg. Underfloor Water LLne Gyp. Bd. -Mach.
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Data Hequented:--�� — Timet _AM _PM
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Address-
Builders
ddress: �r��i]�I1 t� J Vr�1A�- ' ermit �s ..� S 1iLL2� ■
I 4"; T—
Buildars_� _- --
TRE FOLLOWING OORRF.CTIONS AR1. REQUIRED;
-`yam is 7D --
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Inspector: nate: �T
PPROVED DISAPPROVED APPROVED SUBJE:.7' TO ABOVE
" Call -oi Reinap.
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FW= NOW
CERTIFICATE OF
CITY OF TIGARD PERMIT #. ..,. . . . I MST93—OOSE
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUEDs 07/27/94
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)639.4171
PAR(.:r-.:L s 2,1 16All-BED27
SITE f1U1)REz'6. . . 1t+f:.b8 SW JURDrwN WY
SURD I V 1 X3ION. . . . ; BEDFORD GLEN 70hi T NCti s
. . . . . . . . . . . . . . . .
nE..oCE;. . . . E..oT. . . . e27
CLASS OF W7RK. sNEW
TYPE OF USE— CSF"
OCCUPANCY ORP. sR3
OCCUPANCY LOADs115 4
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TENANT NAME. . . : I
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Remarks , PATH 1 CONSTRUCTION f
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Owners - .- - _...._.._,..__.__._...._..._.._._.._.__ �._..._.._._____ i
K.,I)CON HOMES
P 0 BOX 1368
6EAVr'R'roN ON 97075
Phane #t 321a ...i999
} Cont r•act ar s . - . .-_.._....._..._.,_._.... ........__.__._._.___,_._
III, LAEOCON HOMES
9500 SW 125TH
BE PiVERTON OR 97005 `
Phone 524-I`!'" 9
Reg #. . s 707SE
Occupancy of I:he above referenced building is; hereby given, at.cI r_:ertifie"
the c:tampl,ianc::e with i;he Statim Of ()rlegon peCiAlty CLfJwS for the group,
i►ccuEranry, and uxe under which the referent:.,ed L,srrmit wiis : slued.
i l . 1 N F'E:CTUR ^�
BUII.DINca FICIAL`
Pl.K;'1 IN CONOP I CUOU a PLACE
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IMSpECTIDN NOOTICE
City of Tigard 'ant!!ding Deparbsent
13125 811 Ball I.lvd. Tigard, Oregon 97223
Inspect'_on Line (Rec--O-Phone)t 639-4175 Buaineas Phone: 63y-4171
I nstoct ions __ �—
Footing Plbq. Underalab !loch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Lino IINALt
Post./Sean Struct. San. Sewer sratainq -Hldq �.
Post/Veam Mech. Rain Drain Insulation C-Pluab. J
Plbg. Underfloor Rstc- Line Gyp. Bd. Merh.
Date Raquestedt `�D c7 --Time: 11M PN
address:iCc Lf G<: �t ,� c C, l Permit it
.�`' / "
Buildex: ✓- f- Cl%/7t
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THE FOLLOWING CORRECTIONS ARE REQUIRED: , f
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Inspecto : — _ Dater L�
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APPROVED DISAPPROVED APPROVED SV CT TO ABOVE
Call For Rainap.
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INSPECTION NOTICE
City of Tigard Building Department
13125 BR Nall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phona)i 639-4175 Business Phones 639-4171
Ins�act,on s
Footing Plbg. Underslab Mach. Hough-in Appr/Sdwlk
Found. Plbg. Top Out CI 4 Line FINALS
Post./Bears Struc+. San. Sewer Frewing -Bldg.
Poet/Beam Macf,. Rain Drain Insulr.cion -^lumb.
Plbg. Underfloor Mater Line Gyp. Bd. --Hoch.
Date RequestedsF�.� Times _—__AM PM
Addresss ` V G Permit is % ZZ o �-
Builcsers ��.A t6( _
THE FOLLOWING CORRECTIONS ARE REQUIPAD.
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Inspectors_ ---- ------- ------ Dates_
APPROVED DISAPPROVED � ._ APPROVED SUBJECT TO ABOVE
---Call For Reinsp.
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INt,PECT O� N riarICE Y '
City or 'i tgard Building Departwt �-
73125 BW Ball Blvd. Tigard, Oregon 979
Inspection Lint, (Roc-O-Phcne)s 639-4175 Business Phones 6:.9-4171
Inspection:__ _ }'
Footing P'.bg. Underslah Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Une IINALs
Poet/Ream Struct. San. Sewer !:..airy _P_dg,
Post/Beam Mach. Rain Drain Insulation -Plu-.b.
Plbg. Underfloor Water Line Gyp. Bd _ h.
Date Regvesteds 61 '�� Times ) ��AM __PM
ikidrau s Permit ft O I
Builders-
THE FOLLOWING CORRECTIONS ARE REQUIREDs
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inspectors ^_ Qatar
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`rAPPROM DISAPPROVED APPAOVED SUBJECT To ABOVE
Call. For Rei.nsp. "r
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INSPECTION NOTICE
City of Yi9ard Building Departanat
1317h BW Ball Blvd. Tigan ,, Orgx 97223
Inspa,.tion Line (Rec-O-Phone)s 639, .;.,o :.rminese Phones .34171
Inspectioc s—
Footing Plb9• Underalab Mitch. Rough-in %Ppr/Sdwlk I d,
Found. Plbq. Top Out Gas Line 1'INALs ;'� ,� M1' •`�'�fR `��,F .
Post/Beam Struct. Sari. Sewer Framing -Bldg. r °? f"41F¢p;'j..
Post/Beam Meeh. Rain Drain Insulation Plumb. f
Plbg. Underfloor slater Line `-`Cyp. Bd. -Koch.
Date Requestsds� 7�� Times AM
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Address: , le!!/,� � 'C _ Permit ri —p > 2- Gro "1�. ,ult
Builder:
TRE FOLLOWING CORRECTIONS AIM REQUIRED: �w ,;r'P�w
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-- - �- 14ri
InNpectors Dates
__APPROVED _-- DISAPPROVED APPR(IVRD SUBJECT TO ABOVE Y
' —Call For Reinsp, �r �y�
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155PECTION NOTICE
City of Tigard Building Departsbent
13125 6R Ball blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phons): 639-4175 Business Phone: 639-4171
Inspection: —
Tooting ?lbq. Underelab --. bough-in Appr/sdwlk "l
Pound. PLbg. Top Out Gas Line FINAL: 1
Post/Beam Struct. San. newer -Bldg.
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Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor "iter Line yp. Bd. -Neck.
Date RequestedTime: AM __PM w
Address: L�j4'4X Permit 1eBuilders .4 t7 L
TBE FOLLOWING CORRECTIONS ARE REQUIRED:
41.;
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Ire ector:
p / — Date:.-�_��_,L'�
APPROVED —_ DISAPPROVED APPROVED SUBJ!.t_T TO ABOVE
Call For Reinsp.
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- 771W.,
JUN-04-'93 FRI 14:06 Il):C17Y OF KfN CITY FAX NO:503 E39-3771 4800 P16
2/7
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KING CITY es
-� IM SW. 116th Avenue,Kinif City,Oregon 97229 Phone:6394)82
COMMUNITY DEVELOPMENT
APPLICATION FOR BUILJINO PERMIT
(IDatructions on reverse)
UATF,ey-Z2-9
1. NAME OF AP ICANT: - . fie No. S
Z�- 222
ADDRESS:
ADDRESS OF PROPOSED g
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2. TYPE ')F (WNGF, IMPROVEMENT Iii OONSTRUCTION FOR W1110i PHF44IT IS REQLIEST®• i
DESCRIBE HF.IEFLY - ATTACH TWO COPIES OF PLANS OR DRAWINGS OF
PItOPOSF.D PR��JEyG°T: 11 R a RMOI n —
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3. NAME
AND ADDRESS OF OONTRACPOR2o�Ct 1�bmo�J
PHONE NO. LICEIdSE X10. IV _71 f�
4. YFTaMORS WHO MAY BE AFF>h' ) BY THIS PROJECT WILL BE NOTIFIED BY :'HE CITY.
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S. APPLiC2VT OR HEFt/HIS REPF'ESEN'TATTVy MUST BE PRESENT AT THE PLANNING OCHMISSION
MEE'Tlrw NEXT HELD ON
REPRESERFATIVES NAMX _ PHCNE NO. _
(the Ring City planiag C mmission ill consider only those applications received at least fire (5) days
,c prior to a Beet'
f` SIC�IA
APPLICATION RE=VVED BY— - — DATE j 7 �
APPLIC'SLE FIE RECEIVED $,
TOTAL—
PLANNING CCNMISSION DECISION: prc/ed Denied ---
CONDITIONS—4L
pp ted apps' tions are valid for sir months only i
[C�;� `deJQd �Date__.
Signature � �
110TE: 0 on Ruabuilders Lae requires that all ieisaos ebo contra.t for Nork on their residence be
registered eith the Builders Board which means the cantractor is bonded and insured on the job site,
par your protection, be certain your contractor is registered by calling City Sall Ph: 639-+0821 1
NOTE: A permit rrv.Lst also be obtainerl ft-an the City of Tigard Departrnent of
Cartnnmity 'bevel opnti nt Yes No
C,Ln.._OE_TlgARL) INF„�ON.-REPQ
The above listed project has been irmpectod and Approve k,___-._)enied
Date Carmlent,s—
Signature
Jftb d,in,g #nR.. pIM.W- AntUA . one- (I copy to King City) ;
9",w1viOUS �� $
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4F, T, nY-.-w11tr K�►'k'+'f�' SY9�e1�11 �F"'
IF-
INSPECTION NOTICE
City of Tigard Building Depo.rtinent
13125 SW Hall Blvd. Tigard, Oregon 97113
i Inspection Line (Rec-O-Pt.one)= 639-4175 Business Phore: 639-4171
Inspect ton: ._. --`
Footing Plbg. Underelab Mech. R,.tgh-ir Appr/Sdwlk
Found. q. TopOu Can Line FINAL:
Poet/Bebe; Struct. San. Sewdr Framing -Bldg.
Post/Beam Me-h. Rain Drain Ins.lation -Plumb.
P1bq. Underfloor Wate[rf Line J Gyp. Bd. .-Mech. i
Date Requested: / 7/ —Timet AM �^ PM 7
Ad�-ass: C' `c/ _— Permit #=_1
Builder:
nX FOLLOWING CORRECTIONS ARE REQUIRED:
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71 pr�.Yi
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Inspector: Dates 7
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( -APPROM DISAPPROVED APPROVED SUBJECT TC ABOVE
V� Call For Reins/. 1
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INSPECTTON NOTICE
City of ' "gard Building Depariakent ;4
{ 13125 SW Ball Blvd. Tigard, Oregon 9722
Inspection Line (Rec-O-P:,nne): 639-4175 Businese Pho es 639-4171
Inspections _ -- --
Footing Plbg. Underelab Mach R agh-in AFPr/Sdwlk
Found. Plbg. Top Out Can L.'-no FINAL:
Past/Bar_4 Stru San. Sewer Framing -Bldg.
�OLt/Peam McCbyi Rain Drain Insulation -Plumb.
Underfloor Water L.1 no Gyp. Bd. -Mer',.
g, Da::s Requested: LZTime: _ AM PM
Address s-�/4� l PermV. #:
r Builders % __- Z.1 ■
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THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector
d ApiRMD DISAPPROVED APPROVED SUBJECT TO ABOVE
N� Call For Reinep.
Y�fri i;
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INSPECTION_NOTICE
City of Tigard Building Departanent
13125 SM Hall Blvd. Tigard, Oregon 97223 vl
Inspection Lin^ (Rec-:I-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Int Gas Line FINAL:
Pont/Beam b`.ruct. San. Sewer Framing -Bldg.
f
^ Poet/Beam Hoch. Rain Drain Insulation -P1 mt-
sPlbg Underfloor 1 water Line Garp. Bd. -Hoch
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Data R�eqieated:✓ J Time: _--AM PM
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Address:�CP' emit is
Builders_ ,.�GS21�-t �
THE FOLLOWING CORRECT ONI S An REgI;LlED:
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Inspector: — — —� Datat �✓��'��
�-APPROVED DI^APPROVED APPROVED SUBJRCT To ABOVE
_—Call Far ReinaP.
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INSPECTION_NOTICE
City of Tigard Building Department "
13125 SK Ball Bled. Tigard, Oregon 97223
Inspection Line (Ree-O-Phone): 639-4175 hup:,mess Phone: 639-4171
1
Inspection: —_ - ----- i'
Footing 111bg. Underslab Mech. Rough-in Appr/Sdclic
Found. ?lbg. Top Out Gas Line FINAL: +'
Post/Beam Struct. San Sewer Frami-ng _Bldg.
:f
Poet/Beam Mech. nin Drnin Insulation -Plumb.
c_
Plbg. Underfloor Water. Lina Gyp. Bd. -Mech.
��)) ti
�� Time: /0 —AM •
Date Requested: � _ — P`�
Address: C)Is"
�CP4r� / ermit 1:1y� __
Builder: A —
THE -OLLOWING CORRECTIONS ARE REQUIRED:
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Inepectoc�j�
y � P ' ------ — Date:- S'
/- ' PPROVED W SAPPROVED APPROVED SUBJE r TO ABOVE J
Call Fcr Reinsp.
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INSPECTION NOTICE
City of Tigazd Building Department
133.25 SM Hall 81-44. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-41.71
Inspection:_
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Poon�� Pibg. Top Out Gas Line FINAL:
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Post/Beam Struct. Sar. Sewer Framing -Bldg.
}
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Poet/Beam Mech. Rain brain Insulation -Plumb.
Pibg. Underfloor Wnter Line ? Gyp. Bd. -Much.
Date Requested s - / - `, Time: AM PM
Address W !3 -Permit
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Builders----: �_ �dY�-� {'t �Paj ��a f
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THE FOLLOWING CORRECTIONS ARS REQUIREDs
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Inehector: Dato�
APPROVED DTSAPPROVED _ APPROVP.D SUBJECT TO ABOVE
Call. For Reinep. yr. MI
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CITYOFTIGARD
C"
COMMUNITY DEVELOPMENT DEPARTMENT .w. MASTER PERMIT
'3126 sw►wi Blvd P.O.ee«23W,Tipud,onpon o7?23(�>e�c-a, OFWWRD
�s f-�E-�F<IYt I T' #. . ,. . . . . : hf S F t3�;--Qr 08;
OOTL ISSUED: 03/01/93
S'cm ADDRESS. . . : 16668 SW JORDAN WY _/ PARCEL: 25.1, 16AD--EiED27
SUBDIVISION. . . . : BEDFORD GLEN - 1"'n Ci T/ ZONING:
P�.00K. . . . . . . . . . . LOT. . . . . . . . .. . . . :27 S,
----------------
._-.._--__-_--_------_.-. BUILuING __._._.._._ __ .....---__..__............_....._.___...._._._..____.___.________.
nEI;.;SUE:11ST92-00Qr` DWE=LLING UNITS: 1 B(ISEMENT. . . . . . . . .0 S
CLASS OF WORE'.. :NEW BE'DRIvIS:3 BA FHS:� GARAGE. . . . . . . . . . :556 s f
TYPE OF USE.. . . :SF FLOOR ARkf?5----- -- -_ REUUI RED SETBACKS--__-___----
TYPE OF CONST. :5N F I RST. . . . : 181j4 C LEFT. . :5 ft RIGHT. :5 ft
OC'CUPANCY IRF='. :R3 SECOND. . . :0 5 f FRONT. 120 ft REAR. . : 15 ft
STORIES. . . . . . . : 1 THIRD. . . . -0 ., F REUU.IRED----------------------
HEIGHT. . . . . . . .
--..----------------------
HEIGHT. . . . . . . . e15 ft TOTAL-------: 1894 S1 SMOKE: DETECTORS. :Y m
FLOOR LOAD. . . . :40 ps f VALUE:. . . . . $ a 9 7 J.32' PARKING SPACES—:1
Remarlis a PATH 1 CONSTRUCTION
------------------------------------ PLUMBING
SINKS. . . . . . . . . . : 1 FLUOR DRAINS. . . . :0 BACKFLOW PREVNT-RS. . :0
LAVATORIES. 13 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . ear
TUB/SHOWERS. . . . -3 LAUNDRY TRAYS. :0 CATCH BASINS. . . . . . . ..0
WPTER CLOSETS. . :2 SEWER LINE (ft ) . 10 GREASE_ TRAPS. . . . . . . :kr
DISHWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXTURES. . . . . arch
GARBAGL DIS►!. . . : 1 RAIN DRAIN (ft ) . :0
WASHING MACH. . . : 1 SE= RAIN DRAINS. . : 1
FEES
FUEL T'Y'RES _._._._....__-_......____ UNIT' HTRS. . :0 type ani ar.rnt by date recpt
/GAS/ / / VENTS . . . . . :0 13 V,RT h 427. 00 FILL 03/01/93 --
111IAX 1NPUT :0 BTU VENT FANS. . -3 BF-'I._I $ 40. QQ JLH 02/03/93 93-236298
TURN ( 100K . . -. 1 HOODS. . . . . . : 1 BSPC 4, 21. 35 FILL 03/01/93 —
FURN ) =:100K . . :0 WOOD5TOVES. :0 BPLC $ 15. 00 PILL 03/01/93 —
F=LOOR FURN. . . . :0 CLU DRYERS. : 1 MFIRT 0 40. 50 PILL 03/01/93 —
BUIL/GlYIF' ( 3HP:O OTHER UNITS: 1 IvIPLC s 10. 1.3 PILL 03/01/93 —
GAS OU"FLETS: 1 M5DC $ 2. 03 PILL !r3/01/93 -
Owner: $ 1,32. 50 RLL 03/01/93 -
BEACON HOMES F=5PIC $ 6. 63 PILL 03/01/93 -
P 0 BOX 1368 MISC $ 35. 00 PLI... LA3/01/93 -
BE:AVERTON OR 97075
Phone #: 524-1999
BEACON HOMES
PO BOX 1368
BE'AVERTON OR 97075
Phone #: 524-1999
Reg 0- 1 70782
K 730. 14 TOTAL
This permit is issued sub iect to the regulation, contarr,ed in the -- --- REUUI RED INSPECT IONS ---- - -
Tigard Municipal Code, btate of Ure. 5pecialiv vies and aJ uther Foot/found Insp Fireplace Insp
applicable laws. A11 work will to done in ar.•cordance with approved Prost/Beam Str•r_rct Gas Line Insp
plans. This permit wril expire if wcrk is not started within i80 Post/Beam Mechan Inssr_rlation Insp
days of issuance, or it work is susnended for more than 0 days. F'lmlundslab Insp Gyp Board Insp
f-ILM/Underfloor Rain drain Insp
F rJr m.. ttp �,iyn�rtr_rr r� e4� i*iechan.ir:a1 Insp Water Line Insp
F-'Ir_rmb Top Out Appr/Sdwlk Insp
_.__...............__._-- _._�_. __ __.._-...__ Framing Insp Mechanical Final
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11125 SW lieu atid. P`LNCK/RECT #
CITY OFTIGARD ��2J�97
COMMUNITYDCVEL-WAENTDEPARTMENT Tigard.Oregon 97Z23
PERMIT #
(503)6J94171 DATE ISSUED
1 �y
JOB ADDRESS: _ TAX MAP/LOT �! J J 1�14 - �' 1 z 7
SUB: LOT: — LAND USE:
VALUATION: J��
OWNER SPECIAL NOTES
■
NAME: REISSUE OF:MM" I - A
DRESS:?20LAST REISSUE:
d O S_ FLOOD PLAIN/
PHONE: • •Iff r SENSITIVE LAND: _
i
I CONTRACTOR APPROVALS REQUIRED
NAME: Or _ PLANNING:
ADDRESS: _ ENGINEERING:
FIRE DEPT:
PHONE: OTHER:
CONTR. BOARD #: EXP DATE 12q 7 — — --
ITEMS—REQUIRED
SUBCONTRACTORS: PLUMB: AW41NALIST/SUBCONTRACTORS:
MECli: BUS TAX:
ARCHIENGINEER • CALCULATIONS:
AA'NAME: TRUSS DETAILS:Iftmaba All
_
ADDRESS: WmWft JWOTHER:
'A die 124wave'a, t. u-
PHONE:
PROPOSED BI W. USF•: PCs1 • _
COMMENTS: Me W
9 •
APPLICANT SIGNATURE
Received By: 4tl— _ Date Received:
All .
7P`E,
RMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DOE"
NIST 3.60,32 10-432 00 Building Permit Fees, _ `/ 7, '
_ 10-431 00 Plumbing Permit Fees A3z
10-431 01 Mechanical Permit Fees ���, ?� _ z/0.
1 10-230 01 State Building Tax (5q) 3 0 ,0 L % _ .3� rel
Building
i
Plumbing
Mechanical � D 3
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j 13-433 00 Plans Check Fee
Building t �7
Plumbing
Mechanical 10.1-3 /
– --- {
10-230 06 Fire ;R
I
30-202 00 Sewer Connection _
30-444 00 Sewer Inspection _ ��'/ _3��
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) —
j31-450 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
nm/3587P.WPF
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OF TIGAR PERMI RECT #13123 SW Hall Blvd. /CITY
1'OOox?J97 PERMIT #
COMMUNITY DEVELOPMENT DEPARTMENT 'Sprd,Oregon 97W
(503)639.4171 DATE ISSutD
JOB ADDRESS: _ TAX MAP/LOT _
SUB: i LOT: _ LAND USE: —
VALUATION:
OWNER SPECIAL NOTES i
NAME: REISSUE OF:
ADDRESS: — LAST REISSUE:
■
FLOOD PLAIN/
PHONE: _ SENSITIVE LAND: _
CONTRACTOR APPROVAL) REQUIRED
NAME: — _ PLANNING:
ADDRESS: ENGINEERING:
FIRE DEPT: _
PHONE: — OTHER: —_
CONTR. BOARD 1: _ EXP DATE:
ITEMS REOUIREO
SU CONTRACTOR-: PLUMB: — LIST/SUBCONTRACTORS:
MECH: BUS TAX:
ARCH/ENGINEER CALCULATIONS: _
NAME: _ — _ TRUSS DETAILS:
ADDRESS: _ OTHER: _
PHONE:
PROPOSED BLDG. USE: ----
COMMENTS:
I
APPLICANT SIGNATURE T
Received By: _ ,._ Date Received:
..��L�4;�..�.` _ •1.
Lit
To
lIOIMNIIN AM:NM,'•RNN,IW.' iTn + . ,. S,rwW ..
�PF` 'J �
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CITY OV T'il:ARD — RECEIPT (IF PAYMENT RECEIPT NO. s93—Z:VP72
CHECK AMOUNT 690. 14
NAME s BFACUN HOME$ CASH AVOUNT s Ia. 0Q
ADDRESS s FI® Bay 1:168 PAYMLN 1 DATE s 0" /01/93
BEAVE ETON, OR SIJBD1 V ISION s
t� J0715.._
PURPOSE OF PAYMLNT• AMCIUNI PAID PURPOSE UE PAYMENT AMOUNT PAID
11UIl..UING PERM 213 427. 00 PLUMSINU PERM 1:32'. `50 �
MECHAN I CAL Pt" 40. 50 :'3T. BUILD PER 30. 01
FLAN L IEC:ht FE 5. 13 SLWF-R IIS SPE_C,T
1 �
16666 TORDAN WAY
i '10TOL, AMOUNT PAID 4
I
C I VY IIF- T I I 1IND - tTC'F=I PI' OF PAYMC.N'1 RECEIPT Nu. s 93-oR3A62,9A
CHECK r;aI+IOUNT s 60. 010
NAMt:: s +xF:.ACON WUMt'"; CASH AMOUNT
ADDRF-bb PAYMENT DATE
SUSDTVI':SILIN s
PURPOSE IiF F'i4'11ll-JV AMI'SUNT VIATD C=URF'OSL Ur 1=rr'iY1*,1ENT AMOUNT PAID
PLAN EAEK rF 4171. 00 PLON CHECK FE 41A. 00
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I
/L_UT c E� t288,05 W ,JI:IRUNIy WA
L OT 27 1c'897 tilJ JIIRDAN WAY
TtlTAL AMOUNT Ara l rl _ ._ , , . 00
i
F.
.....ice
:
1�.+C...� , '�, �,.... .,� „ ,>"- �: .,... ^++'iafl'a',h ,r-,Y¢.1.'e1)r+<+!T,stf:�' •r.. +.41... vkyju2.q,.. .r,:-. .aN,ry,+r.s2YMAeYuaM,!'ti'dl:h''f"q".''�'.'nh.
I
unifiei:id,
Uf155 sewerage SANITARY•agencySURFACE WATER N. First Ave.,Sults 270,hlllaboro, 7r.,97124
503 648-8621
CC1tJNl' i:'l I:UW F''F�F;MIT'
I ':' ? L ;i�l:"'011f]0 J!AI C 00')rin3 1'f.i;'011 10;i:
STRUG f1.)F:F �',D RFS' (3 +7-t�'�:-T //c-e PR0_Il.l':I 19 9
hrr�I)ClfRL1'.1 1"Y 10R0AN
LU'I :7 Et 1. 0C K I
TYPF Cnt'M.F.i' f T.0M ?!r W n., 1:;'' Cir•Ci :•Li ni,ri'l f'11(+^E
i T'YP'E IN'.,I A1,LAT T 0 M ( 1 q) Iii ii f.;wr2/E r'.n C'UtJ!r;DC w
2
TYT-`l:' Qf';(:III'(1Nt;'( ( 1 1 IT.t'Ilil_.I�: r'fat41:1..Y I''Af;C:Y..I_ ....11 16 (lU ".6100 +
j 0 F: 15E C .171 C, MN I ?;i' Y:1.
UWNI I'. L+r ACi1i! Ni'IFif��'
maicvEat:, Pn E.nx 136FT TRFA1 Mr Ni F'I A141 1*1IJ131 M
E+EA1)UR TnN OR 97075
PHONE 5219-1455' JURISD
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FIXTURE' EQUIVAL I-NT LIWI 1.I_ INC RE'aIIIE'N'T IAL
UNTT6 '�t,*RV T.CE 11NTT5 010 ON rs 1 Sr.. iVII;C 0NII':' t
C:UN14 F'C'1 10111 IFF '3Ctr;r'ACE WATER DEVELOPMENT Fk:E 5
SENE!"; CONNFC, rl'`"! '1.00 ; U0 WAT R (1IJAI.. I:I Y 1.001 00 q
LENS CREDIT 180 , 00;.
WATE FR 0IJAN I' I: r 100.U0
L.FS, CFTItTT 0 : n0::
7
j ERn'.;Ti')il C(INfPCII_
f
INSPECTION .10 40
FLAN CHI:TK 261 OCA
I
.4 IS(JJ{1*(17ri1_ 1-100 . 00 S11DT0TAL 1.66 ,00
TO'Ly�oL 2266 a 00
iaF'f'I Il;at11 I T..T'1.1i, h;IIY'31 I'I40N17.
F'IFF IL.I._1.A110N VP
,t
PLMAF:K+S riiu .11 1:F L11 01'.L+ bi t-f4 C11 r
*24 Ii0im Mi11 Trr r'(:1R i_i')3Z11tI CON'T'F:C.11_. INSPUTTOWI. PC01JIPED
51:0NATtI E
Permit Conditi,,ns: The applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency. When calling `
for an inspec',ion, please refer to the Permit Number. The Permit expires one hundred eighty (180) days from the date of
issuance. Tie total erount paid (permit fee, connection charge, line tap fee and/or other charge) will be forfeited if the
permit expire.
The Agency coos not guarantee the accuracy of the location of side sewer laterals. if the sew^r 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 shell purchase a "Tap and Side Sewer" Permit at the current charge and t-e Agency will instal a lateral.
6/90 WHITE — USA, BLUE — Accounting, GREEN —Inspection, YELLOW — Customer