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16704 SW JORDAN WAY-1 . g�,y� j �•• ��" ,,•�II�I�YMWryI�h(II�MMM•'rMa11M w�_anra A1 LP I , r I i. y r; r i 0 i � l � I i ;I f pA P r WAN � -, • ,�1M1IiylY���..., Fr CITY' I J. 11"!IFV' I ! IGARD I i I lyl 1 1 14 1)f-. .J[444C y COMIMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd.Tigard,Orogom 97223se190 (503)639-4171 1W ukLti W1 A I ION. . . T W. OCK. T' OAD r.--IN f A N I N fl lyl I k I: F4:111 I '.500 ':1114 t I WHY 10i !�300 �A4 f he comp). i,;Ivi- f- It 1 7'1 j I INSPECTION NOTICE City of Tigard Building Departs:ent 13125 SW Ball. Blvd. Tigard, Oregon 97223 IneFealJon Line (Rec-O-Phone): 639-4175 Bueir-eee Phone: 9-4171 r, Footing Plbg. Underslab Mech. Rough-in I.ppr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain Insulation .PLuo:li• Plbg. Underfloor Water Line Gyp. Bd. -Meeh. r y Data. Requested:-- � .� Times _ _AMPN Ad r�ee1: _ _ 1LPPermit is �-f� Builders THE FOLLOWING CORRECTIONS ARE REQUIRED: L/ i q ''• r.. IM1 1 Inspector: DAte: � APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reina . P rr' { �= T". y� IYjy}4 oil rIlk W PIN. ' -, Ail ff r 7 tlrr' i M i � tf� ff f t j f • n r '1 f I t S "fie � I � � r"��...,�...-, S•���tf �ff y'".}r f ff j f ��7 �y��r � f u y _ i �" i 111 t. •� 1 n ' f � f ems---- IN6FRrfION NOTICE City of Tigl-.d Building Departmr_nt l� 13125 SM Bail nl.vd. Tigard, Oregon 972231 f ■ inspection Line (Rec-O-Phona): U19-4175 Business P-,one: 639-4171 Inspection: --- - — —.�- ----- ---- -- Pouting Plixl. Undgrnlab Mech. Rough-in Appr/Sdwlk j Pound. Plbg. Top Out Oa:i Line FINAL: t Post/Beam Strutt. San. Sewer Framing -Bldg- Poet/Beam Mach. Rain Drain Innulatlon -Plumb. Pibg. Underfloor Water Line P. Bd. J -Hoch. Date F.equtrt Time: -_—AM _ _PM Address:..- ' / % permit 1:-4�:� Builder.: L LjLC ! �_ !i ■ TBS FOLLOWING CORRECTIONS ARE REQUIRED: t _ f Inspector: �___--- -- _ Dates. APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE CnII For Reinep. .;ray:'. j �a INSPECTIQN NOTICE City of Tigard Building Department t � 13125 SW Hail Blvd. Tigard, Oregon 97223 __� Inspection Line (Pecn -O-Phoa): 639-4175 Business Pho 639-4171 Inspection' I ii Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: i f Post/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain Insul.ation , -Plumb. i, i Plbg. Underfloor Water Line Gyp. Bd. -Mech. �/7 J • Date RequentedJi �/ 7 / Time. AM PMAddreest ' Permit Builder:. G L f L 6 Tl]8 FOLLOWING CORRECTIONS ARE REQUIRED: Y. ? ti 1 rq���eTs�a u+�i�li�rlmti i4- i L l X13% Inspectors Uates 1 APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinsp. t r T' INSPECTION NOTICE City of Tigan! Building Departoen 13125 SW Hall Blvd. Tigard, Oregon 972V� ?' Inspection Line (Rec-O-Phone). 639-4175 Business Phone: 639-4171 I Ins.,ection: Footing Pibg. Undere .ab Mech. Rough-in Appr/Sdwlk Pound. Plbg. Top out Cas Line FINAL: POnI./Beam Struct. San. Sewer Framing -Fldg. Poet/Beam Rech. Rain Drain Insulation -Plumb. Plbe. Underfloor Nater Line gyp. Bd. THoch. �- / -x7 Datil flequestede Z Z Time: AN PM _ r � Addreve: Permit #: •. It��7 J5€� k Pailder: ~ THE FOLLOWING CORRECTIONS ARF. rcnUIR.ED: I ' MI tt l Inspector: —--- —- Date• APPROVED -- DISAPPROVED APPROVEDSUBJECT TO ABOVE "y a. Call -- For Rei-nap. Tq �!'#�j ,tY� N..i r .i t y, r � rr• r 1 y : t, t � �� .. '�14y14i�y ily4°t'if.Ai j31A•Y, 7. , i•.`V( � 1. ,.. ... ... .. .,... .. _,,.„.. 71 INSPECTION NOTICE City of Tigard Building Department 131.25 SW Nall Blvd. Tigard, Oregon 22ak�� Inspection Line (Rec-O-Phone)i 639-4175 Business Phone: 639•-4171 l• � Inspect ion: Foo: ng Plbg. Underslab Mech. Rough-in Apr/Sdwlk Found. Plbg. Tup Out Cas Line FIVALt Poet/.seam Struct. San. Sewer 'Pi;ming -Bldg. Poet/Beam Hoch. Rain Drain Insulation _Plumb. Plbg, Underfloor Weter Lino' _] Gyp. Bd. -Hach. Date Requested: / !�/!T� _Time° / AN PN Address: W mit 1 L VLL Bullder:__�K {� THE FOLLOWING CORRECTIONS ARE REQUIRED: Leo �O �' •tea �c is,�- �- �l�� _o v�—.__ z2 c e Inspector _ Date: �• APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinep. r ;d , k+/ w.wwr:�«,r�Hv.r,.✓+.:+wva4� 7�+ 4,MOMW 3! t � v INSPECTION NOTICE ?_/yam_ S �°) ��r`. ty • City of Tigard Building Departatent 13125 SW Ball Blvd. Tigard, Oregon 97223 ?} ^ 't+• Inspection Line (Rec-O-Phone): 639-4175 BustnetiB Phones: 639-4171 v �r21 SAA �� �fh - ✓� Inepectlon: Footin Plby. underslab Mech. Rough-in ApIrSdwlk / I •fw '"hs 9 Found. Plbg. Top Out Baa Line FINALS (Saj Framin -81dy• t t' + Poet/Beam struct. San. Sewer 9 Insulation -Plumb. Post/Beam Moch. Rain Dtain !!l Plbg. underfloor I WattorLyine Gyp. Bd. -Hoch. Dote Roque fedi I l - J ' -I r�i Time= �cNl�d��n1 G� ■7 �}�Js2�-� Permit i= -oil — Address: Builder: THE FOLLOWING l`ORR:yCTION4 AAE REQUIRED= i 1 r __ I. 1 Dates Ins cto�rs6 __.----- — - —� X -APPROVED DISAPPROVED APPP.OVEU SUBJECT TO ABOVE �[ Call For Reinsp. INSPECTION NOTICE City of Tigard Building Department 13125 SN Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-1171 y a Inspection• --- i Footing Plbg. Underelab Hoch. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: d Post/Seam Struct. San. Sewer -Bldg. Poet/Beam Mech. Rain Drain �Ineu ion + -Plumb. Plbg. Underfloor Water Line Gyp. Rd. -Rech. Date Requested: -� �i / �?+1 -/ Z Times _.AH PH t' Addreees ��� Permit f: ' Builder: — _ -fir e THE FOLLOWING CORRECTIONS ARE REQUIRFD: Ir 'I 4 I" i Y fli '4 i r r.. _ Lnspectors Cate: APPkOVRD DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinsp. 1. 0 Y li 1 ( �i 1 � INSPECTIOP NOTICE w City of Tigard Building Departw-t ' 31125 Sw Hall Blvd. Tigard, Oregon 9.1223 t. Insp,action Liu(- (Rec-o-Phone): 639-4175 Dueineee Phone: 639-4171 , Inspections M FootingPlbg. Underelab Mach. sough-in Appr/Sdwlk y+' Found. Plbg. Top Out Gas Line FINAL: oat/Beam Struct. San. Sew or Framing -Bldg. ie Boam Mech. Ra+.� Drain Insulation -Plumb. - Plbg. Underfloor Water LJ_ne Gyp. Bd. -Koch. i Dote Reque ,tS a- ! M PM Times `AK Address: 'T��� Pn•-mit 1t�/ Builder:__ y- -- THE FOLLOWING CORRECTIONS ARE REQUIRED: Indpeator:- -Dater APPROVED DISAPPROVED !/ APP VSD SUBJSf'T TQO�ABOVE Call For'Re nap. �✓�-'" S � � }r �a t .., r '.. r.,........ .. ... v. ,. :_,::. ."';','. ,..•i :, is -'. i I„ i .� "�(. r u I , , IKE9 PION_NOTICE City of Tigard Building Department . 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Busineas Phone: 639-4171 1 1 � ' f.nepection:— Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk i Found. Plbg. Top Out Gas Line FINAL. Poet/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain Insulation -Plumb. Plbq. UnderfloorWater Line Gyp. Bd. -Mech. , DSte Requested: j _Tlmtr ,w rose: Permitt iAdd4h Y�. Builder. 'duh' TME FOLLOWING CORRECTIONS ARE REQUIRED: fl i9'Cy II, 7u — J Inspector:_ /�---- ,APPROVED DISAPPROVED APPROVED ST1B:,RCT TO ABOVB t Call For Reinep. it k�J liAlti +��: ' ti.l,.,•...�� Ys'�„.� , .-5,.. .cd.. ;,r". .. "P"f'...,'.. '�"�".-.. :�y� '•�' •-vt5iP1 �[f fl' u fJ I Nor. 4 ^ '7 INSPR. ION NOTICE t r City of Tigard Bui-ding Department 13125 Sit Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: 1.. Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk Found. Plbg. ,np Out Gas Line FINALS Poet/Beam Struct. San. Sewer Framing -Bldg. Poet/Bwt•.0 Mech. Rain Drain Insulation -Plumb. ' Plbg UnderYloo /Water Line Gyp. Bd. -Mech. Date Requested:• Time: AM —__PN p� Address: Permit Builder: THE FOLLOWING CORRRCTION3 ARE REQUIRED: 41 1: 5 --� 9 Qf:i Inspector u! Dater — —APPROVED DISAPPROVED - 7 APPROVED SUBJECT TO ABOVE 77-- Call For Re.inap. 0. ilk d I 1 C i .r i INSPECT?ON NOTICE T� City of Tigard Buildi.nS, Department 13125 SW Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Itepection:_ Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk ` I F0 un3. P1'n. Top Out Gas Line FTNAL: Poet/Beam Struct San. Sewer Framing -Bldg. i Poet/Peam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Mech. i Date Requsnted:_ Time: Address: Permit Builder:--r'^�� THE FOLLOWING CORRECTIONS ARE REQUIRED: r .9. i r' Inspector: Date• iG Z �,CJ APPROVED — DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Relns l P• d r i 4 /��1►wK!'7GWYh�J�ryw°«.:a+_ ll DD ...... r..,... a..a 4 CITYOFTIFARD ji�,, MASTER PERMITCrTYO / COMMUNITY DEVELOPMENT DEPARTMENT 019 o�� PERMIT #• • • • • • • ; M5T92- 195 13126 BW Hrl Blvd P.O.Ba 23307,TWwd,Or"M 07223(603)630.4176 ' ISSUED: SITE ADDRESS. . . : ? 'T,SW JORDAN WY PARCEL: 26:11SAD.-HE'.L'18 SUBDIVISION. . . . : BEDFORD GLEN ZONING: BLOCK. . . . . . . . . . . LOT.. . . . . . . . . . . . . : 18 r -------_-•----._.------_-----.__.____._.._____ BUILDING REISSUE: DWELLING UNITS: 1 BASEMENT. . . . . . . . ;L71 sf CLASS OF WORK. ;NEW BEDRMS:3 BAT1 i ;.3 GARAGE. . . . . . . . . . .440 5 f TYPE OF USE:. . . :SF FLOOR AREAS--•-___.__.__.._. REUUI RLD SETBACKS---_____..___ Y TYPE OF CONST. :5N F I RST. . . . :894 sf L.E:FT. . :6 ft RIGHT, .-5 ft OCCUPANCY URP. ;R.3 SECOND. . . -.830 s f F RONT. :20 ft REAR. . :30 ft 4 STORIES. . . . . . . :2 'THIRD. . . . :0 sf REG►UIRED ----- ____...___.._._---.--..___._ HEIGHT. . . . . . . . :24 ft TOTAL-------: 1724 sf SMOKE:. DETECTORS. :Y FLOOR I-OAD. . . . :40 psf VAL.UE. . . . . 8•7224 PARK IING SPOCES. . : I Remarks: PATH I m PLUMBING e SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :141 BACKFLOW PREVNTRS. . :0 LAVATORIES. . . . . ..4 WATER HEATERS. . . - 1 TRAP'S. . . . . . . . . . . . . . . 'I"UB/SHOWERS. . . . :2 LAUNDRY 'TRAYS. . . :0 CATCH BASINS. . . . . . . :0 WATER CLOSET S. . :3 SEWE=R L.INL:. (ft ) :0 GREASE TRAVIS. . . . . . . :0 � DISHWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXT'URES. . . . . :0 GARBAGE DISP. . . : 1 RAIN DRAIN (ft) . ;0 WASHING MACH. . . : 1 SF' RAIN DRAINS. . - 1 -------------- MECHANICAL _._____.______-- -______._._._._.______- FEE=S FUEL TYPES------------ UNIT, HTRS. . :0 type amol_tnt 1i date reept /GAS/ / / VENTS . :0 BPRT• $ ;.97. 00 JH 09/04/92 - MAX 1NPIJT:0 E1-fU VENT FANS. . :4 BPLC 'b 258. 05 .JLH 0'1/01/92 FURN ( 100K . . : 1 HOODS. . . . . . .. 1 B`JPC• s 19. 85 JH 09/04/92 - FURN ) =100K . . :0 WOODSTOVES. :0 MF'RT $ 43. 50 JH 09/04/92 _• ) FLOOR FURN. . . . .0 CLO DRYERS. : 1 MPLC $ 10. 88 JH 09/04/92 - p BOI1_/ClyJP ( 3HP:0 OTHER UNITS: 1 M5PC $ 2. 16 JH 09/04/92 - GAS OUTLETS: 1 F-"PRT t 140. 00 .TH 09/04/92 - t Owner: -.-___._____________._____._.__.______._.______.. P5F'C: $ 7. 00 JH 09/04/92 OAKWOOD CONSTRUCTION CO INC' MISC $ 35. 00 JH 09/04/92 - l 4500 SW KTUSE WAY #100 LAKE OSWE GO OR Pl-inne #: 635-973: Cor,trac_tor OAKWOOD (-.0N STRUC T I ON 4500 SW KRUSE: WAY #100 LAkL OSWE GO OR 970:35 P,t-)one fFe 635-9'7�s3 Reg #. . : 32734 $ 913. 46 TOTAL "w This permit is issued subject to the regulations contained in the - ---- RLUUI RED INSPECT I ONS -- -- - Tigard Municipal Cad�State of 11re. Specialty Codes and all other Foot,' feund Insp Fireplar_e Insp applicable laws. All r+or�k ill be done ' ccardance with approved Post/Beam Strk(ct Gas Line Insp plans. This permit will expir work 1 started within 188 Post/Beam Meclran Insulation Insp days of issuance, or if work is cusp a or mar_ han 180 days. Plm/t.mdslab Insp Gyp Boa-d Insp P'I_h1/Underfloor Rain drain Insp 1=ermi.tt;ee C�ignat�..lrp : — ___ hlectianical Insp Water- Line Insp Plumb Top Out Appr/Sdwlk Insp [ss1..1ed By : ---_ Framing Insp hlecl-rani•-al Final Call fClr` inspection - 639--4175 r"Y...r.r.Www+w.+aww.-mrahwMYWI�!hl.r:;kWi"Jro'..r,nWy-�... . 131)-%swHalliiwa. PLNCK/RECT NCTTi OF TIGARD PO Box 2.3307COMMUNITY DEVEILOPMENT DETARTM ;NT Tigard,Oregon'7123 PERM IT # 10 i; � �Z l (503)639-4171 DATE ISSUED JOB ADDRESS: ;L�.y^ ("�' t >�r�� ,�Cl.t1 TAX MAP/LOT 7�, SUB: b. CQ 1'6/1 �l!.U.ti __ LOT: LAND USE• _ VALUATION: OWNE& SPECIAL NOTES NAME: (_) K-LOLN V� _ �4�yVl fLld �C I,L�y�.. ��`, ���� REISSUE OF: ADDRESS: �\ �i� �Cfl�v�?_ 1, � li�� LAST REISSUE: ■ AT-) ( AFL000 NLAIN/ PHONE: SENSITIVE LAND: CONTRACTOR APPROVALS RE UO IREO NAME: — 'S►'1---u-- PLANNING: ADDRESS: ENGINEERING: � � 7 Z' FIRE DEPT: PHONE: - OTHER: _ CONTR. BOARD I': - l L L� EXP) DATE: '10 2 3 1 ITEMS REQUIRED SUBCONTRACTORS: PLUMB: 60— n--� ., i1. c' LIST/SUBCONTRACTORS: MECH: .��. �-r`-Q c ,�. r' BUS TAX: ARCH ENGINEER ---� N (� CALCULATIONS: NAME: TRUSS DETAILS: ADDRESS: OTHER: _ PHONE. PROPOSED BLDG. USE: COMMENTS: APPLICANT SIGNATURE Received By: � Date Received: I'- 1 r .ry IIA'i�4�a,1'4\.'j�a1.,Mhi01�3}!f„yM 1 4• ...�s.{iUn—,n, v.. 4 r...�'1',+..u..,"T ,.... ...:L.._. . • PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE 12-�1�$ 10-432 00 Building Permit Fees ✓� t/'� G� y 10-431 00 Plumbinq Permit Fees C 10-431 01 Mechanical Permit Fees 10-230 01 State Building Tax (5%) -0-, Building 13•�s - ,� Plumbing -/ oy Mechanical 10-433 00 Pans Check Fee Building Plumbing _ — Mechanical 10-230 06 Fire i I 30-202 00 Sewer Connection i 30-444 00 Sewer Inspection ' . 25-448-02 Commercial TIF Fees _ 25-448-04 Indrstrial TIF Fees 25-448-06 Institutional TIF Fees tv i 25-448-03 Offic- TIF Fees i 25-448-01 Residential Traffic Fees 25-448-0q Mass Transit TIF Fees 52-449 00 Parks System Dev Charge (PDC) 31-450 00 Storm Drainage Syst Dev Chrg (SSDC) 24-445-01 w'a'ter Quality (Fee in lieu of) 24-445-02 Water Quantity (Fee in lieu of) t TOTAL 6 I nm/3587P.WPF �, '1 CITY C)F T I GAFtD ._. RE'l::C':I r'T C1F PAYMENT RECEIPT M1IC7. a 9 P3 14:<<=1 CHLCK AMOUNT a 46 NAME Of 0WOOD C;ONSTRUCI TON CASH HHOUNT a 0. 00 � F1i7C)Rt= ;S PAYMENT DATE.: a 0911 /W.' p SUBDIVISION a �I C✓URP(r-W 13F 1''(- YME.N'!" AMOUNT P(711L) PURPOSE OF PAYMENT AMOUNT PAID F)1_ ILDING PERM 397. 00 PLUM✓RIN©�PE_RM 140. 00 MECHAN I C:AI.. PE 43. 50 ST. BUILD PFR 29. 03 r'i_.AN C f4F--:CK F F..-. 1 A. q3 SEWER INSPECT 00 LOT IS Hk D1=ORD GLIFN 1a7;31 SW .JORDAN WY TOTAL AMOUNT" 'AID - -> 663. 4(, I�i 1 t h�uy fi'h4 °NI 1 KING CITY �,.. -.W 15300 SK.116th Avenue.King C(ty,Oregon 97224 Building Permit No. COUNTYWIDE TRAFFIC IMPACT FEE Planning File No. PAYMENT OPTION FORM 4Z-3 i / �141-� Tax Map&Lot No. 2-A— Date Project me I realize that I must make a decision on payment of the Traffic Impact Fee (TIF) at this time. Therefore I request the following (Choose whichever option or options are applicable): , LA Cash or Check Credit Voucher CBancroft or Installment Pay,nents and/or L� The Ordinance allows for deferral of payment of the TIF until Issuance of the occupancy permit if the L-1 TIF Is greater than$5,000.00. If the TIF mee`:s this requirement, I also request this option. I under stand the TIF must be paid prior to issuance of an occupanc ermit. I also understand that the TIF will be recalculated based on the prevailing rates at a of payme . lease be advised that TIF rates d may Increase up to six percent each July 1 st, This i ate an Is no subject to appeal. 4 t� i OWNER-APPLICANT ._ OW A LICANT °. f 4. CC: Building Permit File Payment Option Notebook form tIf02 e = �4�a� NLlrr 1 ra. � 1 DATE: PLANS CHECK O.: P ROJECT TITLE: y COUNTYWIDEe TRAFFIC IMPACT FEE AP CAN WORKSHEET (FOR NON-SINGLE FAMILY USES) MAILING AD DRE S /o fly : IP/P ON -7 ff RATE PER --LAND U E QATEQQRY TRIP TAX MAP NO.: / a LLLRESIDENTIAL $146.00 1 S / _MINESSAND COMMERCIA 37.00 SITUS NO.ICEADDR 1 1 4 .. --INDUSTRIAL 141.00 f��pc�l INSTITUTIONAL $60.00 PAYMENT METHOD: CASH/CHECK CREDIT INSTITUTIONAL ONLY: BANCROFT PROMISSORY NOT► IAND USE CATEGORY DESCRIPTION Or USE EEKDAY AYfi�TRIP R4T WEEKEND AVE TRIP RAT BASIS: DEFER TO OCCUPANCY C) Aki �Z�2Q l/ 1 1�.C/ ✓ `/ i �i _ X i CALCULATIONS: alx PROJECT TRIP GENERATION: f FEE: Cf n ADDITIONAL_NOTES: FOR ACCOUNTING PURPOSES ONLY: r- PREPARED BY: CC: WASHINGTON COUNTY I IF NOTEBOOK e form till Yo a o .1prr S E ITER: phi � :�� ,' X503 848.8921; t ,.,,� r'i"!' � •; ' ,;. ''��• ' `'x'v�. PERMIT I 4.,,; . r �G"� �1Jt 1 TE,. Q i�.S9. ,• 'PERMIT 163 i efi P$RJECT 1,939 .any 1 1'n a �r r ;a �'t t4" »+n' r, �AF'l,F; �► 1 A BLOCK TY ." w,B' EDFOND GLEN PHASE 2 TYP, ,'- T' ' .1LA'r,x'o it, ", w '�I��;n'`coN/gnc ge ' + TYf; GCCUTA �� < 1 ) lIYNt3L' FAMILY PARCEL 281 16 'AG 25200 Q' R .8EG 4716 MH 18089 ■ OWt� R iAKW dry TRUCTIiN�t.Y�'"fir; } ;r AO ' .�i , Y,�Or 1,00 ?i, �. TREATMENT PLANT DURHAM PHONE 'b �S�l3 ;, r n JURISD KING CITY--------------- FIXTURE ' _ .__.. ___.FIXTURE '. EQUIVALENT DWELLING FEStIIEN T IAL uN :Y$ ' , +. SERVICE uN.,' s oto UNIiS 1 SERVICE UNITS a FEES ON:I i, &URF A4E WATER DEVELOPMENT FILLS WATER 064"LITY' 180.00 �. r : LESS Ck�:DIT { 180.00> 4 rr r4ti ;� t " i WATER QU'�NTITY.• 100.00 ►'l' 'l l I p Jf IJ I 1` LES S CACDI T \ 0.00?• 1, y 1<rr ut r r � ER06014 CONTROL ' �e°`�jw �M ;R� •i �' { INSf"El:tp 40.00 {� PLAN C E K 26.00 $U�$1 r7L � ! ' b�00 SUBTOTAL 166. 00 TOTAL 166.00 APp� R; ki0 PHONE -------- AF —_—__ry rAl �' { + ►u E 18 R. C N�'RLi 'INSPECTIONS Rt:QUIRED .a tiif' 'I. kI � .� .art .1• I 1eri�! to'ndltibnfY `Theepplicent agrees to comply th all rules and regulations g f the Unified Sewerage Agency. When calling for an inspectldn, please refer to the Permit 1,umber. The Permit expires ons hundred eighty (180) days from the date of lfsuer0. , The Rotel Amount paid (permit fee, connection charge, line tap fee end/or other charge) will be forfeited if the permit explres )V'.5 t"he Agency doer"not quer'bntee the eccurlcy:of the location of side sewer lateral:. !f the sewer is not located at the aMdurefernt ylverf, the.inAtaller shell prbspOtt three feet in all directions frau the distance Ivan !f not so located, the installer shall pUr;hase b<�!Tip,dnd Side Sewer" Permit at the current charge and the Agency will iIvan. a lateral. WRtT8 08A, BLUE — Accounting, GREEN —inspection, YELLOW customer h I r, �J , FI ,fix, 5F'T KING CITY 15309 SW. 116th Avenue,King City,Oregon 9722.1 Phone:639.4092 COMMUNITY DEVELOPMENT APPLICATION FOR BUILDING PERMIT I (Instructions on reverse) DATE 1�1 �Z-- ' 3 1. NAME OF ADPL I CANT:�`��G`�% 0`2G�' "`-`" Phone No. 93 - - C,l 0 3 ADDRESS: cro -3-U-2 4 1 vv 1_Q,L6 C-47 %-j Gc o 0--� -C ADDRESS OF PROPOSED IMPROVEMENT - 0 2. TYPE OF CHANGE, IMPROVEHENT OR CONSTRU ION FOR WHICH P RMIT IS REWESTED. DESCM1 BE BRIEFLY - ATTACH TWO COPIES OF PLA1�S OR DRAW!NGS OF PROPOSED PROJECT: I 3. NAME AND ADDRESS OF CONTRACTOR- PHONE ONTRACTO PHONE NO. 3y-2733 LICENSE NO. 3,2--73-1 4. NEIGHBORS WHO MAY BE AFFECI'FD BY THIS PROJECT WILL BE NOTIFIED BY THE CITY- 5. ITY.5. APPL I CANT OR 1iER I)RESIMTAT I VE MUST BE PRESENT AT THE PLANNING OCNM I SS I ON MEETING PIEXT H D ON _ REPRESS TATI N PH,7TE NO. e i gill consider only those applications received at least five (5) days prior to a meeting, i SIGNATURE APPLICATION RECEIVED APPLICABLE FEE RECEIVED PLANNING CCrMISSION DECISION: Approved Danied CONDITIONS Approve ications are valid for sit months only Signature Date 7 ROTE: Oregon Romebuilders Law requires that all persons who contract for work an their residence be registered with the Builders Board which means the contractor is banded and Insured on the job site, Por-your protection, be certain your contractor is registered by calling City Ball Ph: 639-4082, NOTE: A permit must also be obtaineran the City of Tigard Department of Corrmtmity Development Yes _ No _ CITY OF TIGARD INSPECTION REPORT The above listed project has been inspected and Approved_. enie� Date Cowmen c s - Signature WO-ding do pec-to,t, ptwAe ",turn one- ( t) copy U King Uty) � '