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16735 SW JORDAN WAY �',t,a ri iU3• 4+� 1 i:\records\micioflm\targ • • •• ,ti � s`""�9�'1• ._. ,?�'warc^.I�yFM""r'�nrhr�t' '"+e�j�• �+ .'a•' ''�t 7�,ip ric�,Y'� Dt61 yY�rM�t,n r��A° .�� a. «:.� btlr ' �7t� ,9, NO LISMUON NOT:CE x,a r city or 71gard Building Departsent 13125 RA Ball Blvd. Tigard, Oregon 9722 Inspection Line (Reo-,O-Phone): 639-4175 Busiress Phodes 639-4191---' d , InepectiontLAIr Footing Plbg. Underelab Hoch. Rough-in Appr/x"lk rY Found. Plbg. Top out Gas L ins Post/Beam Strn,ct. San. Sewer Framihj ,� Post/Beam Hoch. Rain Drain Insulation -Plumb. nn� "I.YYI 1 Plbg. Underfloor Nater Line gyp. Rd. 49sch. Date RaWa tedt_ Addrssse I I�I� � _Ir 'Y r/- '.." -+•� -- Permit tt Builders 1..�?Y� �.�7 L�..-- c)j0q THE FOLLOWING cORRECTIONS ARE REQUIRED: 4 Inepecteri _ Date✓ / C APPROVED DISAPPROVED PPROVXD SUBJECT To ABOVE _--Call. For Relnnp. i ti A � f I q I7 I •' �'' v, a �f 7� t' 1 ♦ Wti • CITY OF1-v.-i-ii:L RECEIPT OF PAY-FNT RF CEiP-C NO. Og3 41 7HC9 CHECK AMO;ANT a 6. 25 al iME. SPECIALTY HEATING & t;nSH AMU( -I" a 0. 00 i)I)RfcL,S : rANRICF;IION, INC. PAYMENT )o•�ll: » of'' `"528 SW TI( ARU ST. Zal . IVIf3IC���1 IGARD, OR 97223-_ -1_iRF'USF= (IF PAYMENT omru,!T r,n I I) PURPOSE OF' PAYMENT AMOUNT V'A I D iIGaNICAL PF ST. BUILD PER 25 � i, n<. I I�f�C X3:3--0142 TOTAL nMOUN T F'A I I) — — , 26. 25 t JIf CITY CSF TIGARD COMMUNITY DEVELOPMENT DEPARTPAF!i T 13125 SW Mall Blvd.Tigard,OrGogan 972Z3•8199 (503)039.4171 E 1 1 I till i i i I t I I I I r' 1 , dl Nr,r �5��1f �A"rti'x1t`r7'yXi:PJ�` bd�'h ..� • 1 CITY OF TIGARD CERTIFICATE OF C®MMUN�TY DRVILQPMENT DIPARTME14T OCCUPANCY 131 Is IW N#A ow.tlknl,or"m "Well" (603)9",+ PERMIT #. . . . . . . II M;3T92-_00 J A I a9. DATE ISSUEDi 01/13/93 i PARCEt_: 2SI16AD LIED54 ,.-'ITE ADDRESS. . ., 1.6735 -SW JORDAN WY GUBD I V I S I ON. . . . i BEDFORD GLEN 7.OP I I NG II P, -OCK. . . . . . . . . . a LOT. i . . . . . . . . . . . e54 r t'.,LASS OF WOPIS. z NEIL 'TYPE OF USE. . . x FV OCCUPONCY ORP. :Rt; QCCUPANCY I..':)F1D i 15 4 TE:.NANI NAME. . . : Remarks : Path 1 Insulation Ownerc __...._._._..__....._...... ._. .__.__.. .._......__ .....__._.,._ E BEACON N014F,F3 PO BOX t"(,s BEAVERTON OR 9775 Phone #m 524--1949 Contractors - _._•___ _. .__._.._...w, ._........ . . . ......___ _..__ BEACON HOMES 9509) SW 125TH BEAVERTON OR 9"i 005 Phone #s 524-..1999 P&q #. . a 7078 Occupancy of the :above referupced bt,ilding is hereby given, ,rid certifies the compliance Wth the State Of' Oregon Specialty Codes For the group, occupancy, and use Vndet-' which the referenced permit w�� ls!ar.ied. FIRE DEPARTMENT IL IINSPECTOR FF ILIAL POST IN CONSPICUOUS PLACE: M =Mair INSPECTION NOTICE City of Tigard Builling Department / 13125 SW Hall Blvd- Tigard, Oregon 97123 Inspection Li.•n (Rec-o-Phone): 639-4175 Business Phone: 639-4171 Inspections Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: +� Poet/Beam St.ruct. San. Sewer Framing Bldg.� x, Poet/Beam Mach. Rain Drain Insulation -Plumb. Plbg. Underfloor ater Linn_et,]� Gyp. Bd• -Hoch. rr ' PM Date Re�g+eet, ds ���Jc'�' --Time i -- i' Address: P Z � _ Permit Builder: -- Y THE i'OLLOWING CORRECTIONS ARE RF(?TIIRED: i. ' - { Inupector: !—APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE i Call For Reinep. i i p ` INSP£C."fION NOTICE City of Tigard Building Depart:aent A 13125 SM Ball Blvd. Tigard, oreyon 97223 Inspection Line (RF°c-O-Phon°e): 639-4175 Business Phone- 639-4171 Inopec tIon:�_ _�----- �.� ------ For-Ling Plbg. Underalab Mech. Rough-in Appr/Sdwlk ; pp r P. l Found. Plbr. Top Out GAS Line FINALS Post/Beam Strict. San. Sewer Framing -Bldg Past/Bear., Mech. Rain D;cain Insulation -plumb.l �—-- Plog. Underfloor Water Line Gyp. Bd. Mech._ Date Requested: �„�-_. ^_ Time: _.__PM ! AdArean•-- �� � ( it 1s,1>� Ql��° Builder:_— - f-•.��iUt c� (/�' -- __ J THE FOLLOWING CORRECTIONS /1RE REQUIRED: �L �--r -1-1-i _ c�6u-•-�/ ar t - l�- �w1_ _ __ -- i r inspector:, APPROV<D /�` DISAPPY&M APPROs1CD SUBJWT TO ABMT call For ReLnep. ti Yi5 . n A ,r� 4 , 1 � : e, a INSPECTION NOTICE / City of Tigard Building Department- L ' 13125 Sit Ball Blvd. Tigard, Oregon 97223 s { Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection•__ —_ ---� Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk • Found. Plbg. Top Out Gas Line FINAL: Poet/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain Insulation Tlumb.� Plbg. Underfloor Water Line Gyp. Bd. -Mech. }, `G Date Requested: Times __)].AN �-� PM Address: / Permit #s(7r�— Builder:_. ■ THE FOLLOWING CORRECTIONS ARE REQUIRED: i Inepector:_,-11!7 4:2 Dets: APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE ,. Call For Reinep. i 1 A �1 fig' INSPECTION NOTICE a City of Tiga+-d Building Department h 13125 STI 9e:11 Blvd. Tigard, Oregon 97223 Inapsction Line (Rec-O-Phone): 639-4175 Buainea© Phone; 639-4171 i r Inspection:_ — Footing Plbg. U.:deraleb Mach. Rough-in Appr/Slwlk 1. Found. Plbg. Top Out Gan Line FINAL: Poet/Beam Struct. San. Sower Framing -Bldg. 9 P:dc/Beam Hoch. Rain Drain Insulation -Plumb. Pl.bg. Undarfloor Water Dine^ _Gyp.:Bd::) -Mach. Date Reque ted: -6 �'� Timet _AM / PM Addceees '� Permit �Yl.�-� .����[�- • ^� Builders THE FOLLOWINr CORRECTIONS A?L+ PEQUIRED: 1 z r � Tnapectort F r _ ___ Date:_—_ frYV � �APPROVZD DISAPPROVED APPROVED SUBJECT TO ABOVR Call For Reinap. i I°1 C INSPECTION NOTICE City of Tigard Building Department 13125 SN Ball Blvd. Tigard, Oregon 97223 InaPection Line (Rec-0-Phone1 639-4175 Businens Phone: 639-4171 MInspection-___ "s Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk ' Found. Plbg. Top Out Gas Line FINAL: Poet/Beam Stract. San. Sewer Framing -Bldg. Post/Beam Mach. Rain Drain nsulation Plbg. Underfloor Water Line Gyp, Bd. -Meeh. Date Rec�sated-: _���(!� Times ��Ah PH Adi,rean: +� _ Permit 1: Builders — `��THE FOLLOWING CORRECTIONS ARE RE(lUIRED: r. ji r. - j j - - '6 Inspector:-- Dates 7 •/ Z� ' t � APPROVED -` DISAPPROVED APPAOVBD SUBJECT TOABOVE .y t Call For Reinsp. �n ;l a ! i� A ,aa+lwrai.rcwn�......,......,.... ,.r..+..,w..,...w.......w..�..........._.......,-.....++..+xv�Nl(� '. , 1i i A(,��n„ , Alt 1,' 9 tt �•`� �A�1, i rl 'a f, INSPECTION NpTICR City of Tigard Building Department f 13125 SH Ball Blvd. Tigard, Oregon 97223 ?' Inspecti.or Line (Rec-O-Phone): 639-4175 Business Phone: 6:39-4171 Inspections^ Footing Plbg. UndecelabMeoh. Rough-in Appr�Sdwlk rY Found. Plbg. Top Out Gas Line FINAL: Poet/Beam Struct. San. Sewer �nq -Bldg. a. Poet/Beam Mech. Rain Drain Insulation -Plumb. r Plbg. Underfloor Mater Line Gyp. Bd. -Nech. Date Regyestad s "�r�` Time i ..._ AM P14 Address . Permit # a wyI/ Builder: ) C -- l ■ THE FOLLOWING CORRECTIONS ARE REQUIIRRED: 4, �L Lam+'' ✓��":'I ,�R/��+^� .f T Inspector: Date: l ry 4J if .Y. u' APPROVED _ /DISAPPROVED APPRtOVED SUBJECT TO ABOVE _Call For Reinap. s I l i � +' ggIJRrY F�ii; yea '�h Its YF s 1'��a:y I � INSPECTU)V NOTICE City of. Tigard Building Depa / /� /J • 13125 SW Hall Blvd. Tigard. Oregon 97 f3Gl� Inspection Line (Roc-O-Phone): 639-4175 Business P nss 639- Inspections Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk Found. Top Out Gas Line FINAL: plbq. Poet/Beam Struct. Sar, Sewer Framing -Bldg. Post/Beam Mech. Rain Drair: Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Mech. , Date Re�est r'%Y's"' PM Address•_ _33 _Ue&111j_ Permlt 1f Builder: _ '� _ !6 'v— THE FOLLOWING CORRECTIONS ARE REQUIRED: r!, •— r` I' # tnepact Dttes s I, APPROVED DISAPPIIOVRD APPROVED SUBJECT TO ABOVE rd --Call, For Reinsp. yyry b� 1 •elver Mw•+ - r 4 II{I 4'� � 'rl•'' ^ Ir I 1. ..... _ : 4 zNSPECTION NOTICF. 'nT_ City Tigard BuildL�g DepartateoL 13125 SW Hall Blvf. Tigard, Oregon 107223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 i} In9pection:_ Footing Plbg. Underelab\\ Mech. Rough-in Appr/Sdwlk Pound. �� Out . Top / Gas Line FINAL: Post/Bezw, Struct. San. Sewer vraming -Bldg. Poet/Beam Mech. Ra.n Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. 9d. -Hoch. Date Aequesteds � p� / Timet _�AM PN r Addresse it fs_ Builder: THE FOLLOWING CORRECTIONS AIR 1,EQUIRED: i AA/1 .14 1) \J 7 'I t' Inspectors.��/� _ t.PFROVFD bliAPPAOVF.D APPROVED SUBJECT TO ABOVE b Call For Reinap. rmrm:nl4::,�r.�xa�mrcrr.,..- k' ,fir . ^.1.{• it lel 5. i tS' • INSPECTION NOTICE City of Tigard Building Dedartmant 0 13125 Sw Ball Blvd. Tigard, Oregon 97223 „ Inspection Lille (Rec-o-Phone)s 639-4175 Business Phone: 639-4171 Inspections_ Q� • 'R r Sdwlk Footing Plbg. Unde.slab Meth. Rough-in l App / Pound. Plbg. Top Ou`. Gas 1.ne F'.AALs poet/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Hoch. Rain Drain Insulation --plumb. i 5fi PLM Underfloor Water Line Gyp. Bd. -Mech. PM w Date Requ at'eds --TSO — Address:` n Permi.; „ Bu i lder: THE FOLLOWING CORRECTIONS ARE REQUIRED: is; 4� l'. too t i )ii fi r 1 I/ r (yy! a Inspectors - Dates _' APPROVBn DISAPPRC•►RD APPROVND BULINCT TO ABOVS } r _Call For FPinsp. rV �Pa„aw tirJs r r F y � 'r INSPECTION NOTICE City of Tigard Building DeFartoent 13125 811 maljavd. Tigard. Oregon 97223 Inspection Lina (Rec-o-P no)% 639-4175 Business Phon 9-4171 In.paction: Footing Pi Underslab Mech. Rough-in Appr/sdwlk Found. Pi Top Out Gas Line FINAL: Post/Beam Struct. San. Sewer Framing Bldg. Post/Beam Mach. Rain Drain Insulation -Plumb. t, Plog. Underfloor water Line Gyp. Bd. -Koch. Date Raques"d: - Timm : AM P A/ � � � Permit i Address: Builders — �t �f..� ar':.:, ■ TBE FOLLOWING CORRRCTIONS ARE REQUIRED: •^-/ ..�... — 1 :r� al C r:�r�'lt/ICGtJ r ; 17 IvyInepecior — •,_ Dater —_APPROVED DISAPPROVED A' •ROVED SUBJECT TO ABOVF. ___Call For Reinan. f " . t � �'?.fel-iry+ra„Fs�i•.,,,. ... INSPECTION NOTICE /j/)' �r w° city of Tigard Building Departaent 13125 an Ball Blvd. Tigard, Oregon 97223 Inspertion Line (Rec•-O-Phone)s 639-4175 Bu—neee Phone: 639-4171 it Inspection:__ — M Footing Plbg. Und4irelab Hech. Rough-in Appr/Sdwlk q' dp Found. Plbg. Top Out Gan Line FINALS !" Poet/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Hoch. RaLn Drain Insulation --Plumb. ,Flb Underfloor Nater Line Gyp. Bd. -Meeh. r) l4�'Z. Time: AM Date Regygsed: - ((��� 11 AddressPermit i_ �=�Sri+- Builders_� S' 1 Yri4i flf I Ily,ip t' { THE FOLLOWING COIUUECTIONS ARE REQUIRED: B ;� ��.1. Inspector:_// Date:- �� --- -- A^PR'OVED UISAPPROVftD APPROVED SUBJECT TO ABOVE 3 —Call For Reinep. +.,, fh. R P ¢, INSPECTION NOTICE City of Tigard Building Department 13125 811 Ball Blvd. Tigard. Oregon 97223 Inspection Line (Ren,-O-Phone): 639-4175 Business Phones 639-4171 Inspections__ Footing Plbg. Underslab Meca. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas L_ne FINALS st%am st San. Sewer Framing -Bldg. `oat/Beam Mech Rain Urain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Hoch. Data Re aetedt J �� Times AM _ j,PM • <t�3-� � Adareu s �:� G Z rmit ;:�� � /C�Builders �•i1>Z - ��'��j% - ■ THE FOLLOLLNG CORRECTIONS ARE REQUIRED: I i� nn/' rL /i•�1 1 I u fi Inspector: i"1L � Date: Z APPROVED DISAPPROVED �_ APPROVED SUBJECT TO ABOVE !_Call For Reinap. N { 4 INSPECTION NOTICE City of Tigard Building Department i 13125 SW Ball Blvd. Tigard. uregon 97223 Inspection Line (Roc-O-Phone)t 639-4175 business Phone: 639-4t7l Inspection: — Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk x Found. Plbg. Top Out Can Line FINAL: Poet/Beam Struct. San. 8ewec Framing -Bldy. Post/Beam Hoch. n Drain Insulation -Plumb. Plbg. Underfloor �ter Gyp. Bd. -Hoch. Data R!q/`/q��uest _ T / ) _ _PH rmit Address$ - '- Pel�U/� guilder: �;. THE FOLLOWING CORRECTIONS ARE REQUIRED: Tn• I p All 7 n r tt ' Inepectov! Dater __— — APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Cell For Reinep. y AWA ,a _ INNS?ECTION NOTICE L� City of Tigard Building Departaent ` 13125 SN Ball. Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone); 639-4175 business Phone: 639-4171 o� i` y Inspection:_ _ Tootia ! Plbq. Underelab Hach. Rough-in hppr/Sdwlk 41 Round. Plbg. Top Out Can Line ?INAL: n :r Post/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Hach. Rain Drain Insulation _P1un,GF' Plbg. Underfloor WaterLine Gyp. Bd. -Rech. Data Re sated;_ /y Times AN PM • 7 js Address; L `� "� w Permit 1: C L Uul l.der: THE FOLLOWING CORRECTIONS ARE RIQUIRED: R I — — ; 'i Inspector: Ina p# �° — Date:_ y. y' APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Y i _ Call For Reinap. H ..a :... 6.� J CITYOFTIVARD CflY TIAIRLJ MAS�f F:R PERMIT COMMUNITY DEVELOPMENT DEPARTMENT 0016" r E RM L T #. . . . . , . . MST9 2- 01ii x O 13126 SW l Wl Bhd.P.O.Bm 23387,TOW,UmWn 97223(603)&19.4176 lar r• E, -14171 ADDRE SS. . . CW .JORDAN WY /r cj C� �'� 1='ARCFI- : L2':31 16AD•-BGD34 >A 1 SURD I V 13 ION. . . . BEDFORD GLEN 7 O i NG: ' . . . . . . . . . . . . . .. BUILDING RE I SSUE: DWE'1_L I til UNITS: 1 BASEMENT. . . . . . . . :0 s f CLASS OF' WORK. NEW BEDRMS:.3 BATHS:.:-` GARAGE. . . . . . . . . . :555 S TYPE OF USE.. . . :`�f' FI-00R ARL AS _....._..--__....._...__ REQUIRED SC"fL►ACI;a-__._____.-.._._ > TYPE OF CONST. :'IN FIRST. . . . : 1600 s f LEFT.'. :5 ft R I GHT. :5 F t r OCCUPANCY GRP- :R3 SECOND. , . :0 sf FRDNT. :�_0 ft REAR. . s 18 ft. STOF41 ES. . . E. . . . : 1 TH I RD. . . . :0 s f RQU I RED--_ HES I GH1.. . . . : 15 ft TOTAL.--_._..._....-.: 1600 ,f SI 1O1•(E DETECTORS. .Y FLOOR LOAD. . . . :40 psf VA1_UE:. . . . . $ : 83590 PARKING SPACES. . :0 � Remarks : Fath 1. Ins'-tlation _.._... PLUMBING SINKS. . . . . . . . . . : 1 FLOOR DRAINS;. . . . :0 DCit-KFL.OW F''REVNTR5. . :0 I.WVATORIES. . . . . :3 WATER HE_AT'ER S. . . : 1 rRAVIS. . . . . . . . . . . . . . :0 TL1B/SHOWERS. . . . : ? LAUNDRY TRAYS. . . :0 CATCH 13ASIIUS, .. . . . . . :0 WATER CLOSETS. . : _: SEWER LINE:. (ft) . :0 GREASE TRAPS. . . . . . . :0 i DISHWA5HERS. . . . : 1. WATER LINE (ft ) . : I01A OTHER FIXTURES. . . . . ..0 GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :0 WASHING I11ACH. . . : 1 S)F RAIN D RA I NE3. . : I - MECHANICAL -- __.__._.___.........._._._ ______-.---____..-- FEES F-UEL. "TYPES-_ -_._.._._._...._._..... UNIT HTRS. . °O type, nmol-tnt by date recpt /GAS/ / ! VENTS . . . . . :0 BPRT 1; 385. 00 BI...T 02/18/92 MAX INPUT:O B-rU VEI`JT FANS. ::3 BF'I._C $ ;.:7517.1. ;:5 JL.H 1,?!10/91 F-URN ( 10011, .. . : 1 HOODS. . . . . . . 1 B5P(: b 19. 25 BL. f 1712:/18/ 9..: IFURN ) ==IOVIR . :0 WOODS TOVES. -0 MPRT $ 36. 00 BI-T' 0 10/92 ,. FLOOR FURN. . . . :0 CLO DRYERS. . 1 MP1_C 91 9. 00 BL'f 02/18/92 BOIL/CMF' ( 314P.0 OTHER L11\IITS:il M5PC 9. 1. 8171 nl—.T 0;_/18/'32 GAS OUTLETS: 1 PPRT $ 132:. 50 BLT 02.'/18192 OWTIer': __.....__.___._.____.-_---.___. _._____.._._._.._ P5PC $ 6. 6x3 131_1 01— E xE BEACON HOMES PO BnX 1368 BEAVERTON OR 97075 t Phone #: 5214- 1999 (;ontractor: a BEACON HOMEf:3 PO BOX 1.368 i BEAVERTON OR 97075 Phone #: 5: 4--1999 Reg #. . 70782: $ 840. 43 TOTAL. Tnis periit is issued subject to the regulations contained in the ---- -- - REDUIRE:.D INSF'E:CTIONS - ---- Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/fol.md Insp Fireplace Insp applicable laws. Ali work will be done in accordance with approved Post/Beam StrI.tc..t Cas Line Insp plans. This persit will erpirF if work is not star ed within 160 Post/RpAm Mechan Inst.tlat i.on Insp days of issuance, or if work is suspended fcr eor than 160 days. Plm/1-tndslab Insp Gyp Board Insp / PLM/Underfloor, Rain drain Insp Permittee Si.rinatr.trp �l Ilechanical Insp Water Line Insp t' Pll_tmb Top OLtt Appr/Sdwlk Insp Issf.ted Nv: ._.._M_. ...__ _..__. f ram i.Trrf T n s p Mechanical Final Call for inspection - 6.`339-417`'; Ag .,.._. �- .�...11P:p4rti:-7r•r;.rc...._. -..'...�gp�„..ermna.:• .,n.w.v..,...... .......... .... ..:.urc'� .. 13125 sw lull 311. PLUCK/RECT # Cf [ f OF TIGARD fOf3ox7JJ97 PERMIT # < r 'GQ COMMUNITY Tigard,Oregon 97W (503)639A171 DATE ISSUED _ JOB ADDRESS:/%1 S s'6 S,�[w� C, — TA); MAP/LOT / o 4 SUB: LOT: _ -_f:l LAND USE: _ VALUATION: OWNER SPECIAL NOTES � NAME. C&Wa., e_. /C - REISSUE OF: ADDRESS: � �, x /�3L8� LAST REISSUE. 70 FLOOD PLAIN/ PHONE: y �T9a _ SENSITIVE LAND: CONTRACTOR APPROVALS REQUIRED NAME: _ � _ PLANNING: _ ADDRESS: ENGINEERING: — FIRE DEPT: PHONE: OTHERr CONTR. BOARD #: �_ EXP DATE: ITEMS IUIEcEO SUBCONTRACTORS: PLUMB: 1 _ LIST/SUBCONTRACTORS: _ MECH: BUS TAX: ARCH/ENGINEER CALCULATION`;: i NAME: TRUSS DETAILS: ADDRESS: OTHER: PHONE: 36 --D 2 6S PROPOSED BLDG. USE: COMMENTS: I 1�4 F z-/.. �. PL CAN r7NATURE Received By: `--------------__.__------__--- Date Received: _/•� '/(�-9/ C,; PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAE. DUE 1.ut+0 10-432 00 by ilding Permit Fees —— — 10-431 00 Plumbing Permit Fees _ 10-431 01 Mechanical Permit Fees Lw_ 10-230 01 State Building Tax (5%) �2S '6•Y Building Plumbing 4�'"3 Mechanical "0" ■ 10-433 00 Plans Check Fee .5 Building .��ZL•� '� Plumbing Mechanical 10-230 06 Fire 30-202 00 Sewer Connection — 30-444 00 Sewer Inspcction 25-448-U2 Commercial TIF Fees — — 25-448-04 Industrial TIF Fees -- 25-448-06 Institutional TIF Fees _ I 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) —_-- ° I TOTAL nm/3581P.WPF ,I a ' e E. ^t oil CITY OF- 'I'I CSARD - RF.UE I PT OF PAYMENI RECEIPT NO. 191•-220303-`3 ';HECK AMOUNT a 1000. 00 NAME. PE=::AC::(1N HOMES I NC L:A431-4 AMOUNT 0. 00 ElU1 FtFF;rt t 19051 NW 169 rH PL PAYMENT DATE 12 I0;'91. SUBDIVISIll.N M—AVE RTON, OR " 717.10 ,-- i-,URPOSE* OF PAYMENT AMC)UN`f POID PURPOSE OF PAYMf::NT faMnLINT PAIL) � P-1 AN-CHECK_F .. _ i _. ._... _250,...00 PLAN CHECK F'E'. _12-�2. "R _ c:�k�, 0 ` PL_AN CHECK f'"E. 12--,'3R 2.50. ►A0 PLAN CIAE(.,K FE:: IP---•24R 00 11� ,I i) i 1._(71'0 r'V►, '1, r:E', 23 RE:DFORD GL.H:NN, KING CITY I T OTAL. AMOUNT PA I D ~> 1000. 00 i q r'Y:r .:WARN yI KING CITY r.rrrw IUSW ti1�.I Pith Aceime.Xing City.Oregon 97224 •y . ,i, Building Permit No. COUNTYWIDE TRAFFIC IMPACT FEE Planning File No. PAYMENT OPTION FORM �� S / / L o �; Tax Map & Lot No. 41 Date Pro,ect Name realizo that I roust make a docis c,! on payment of the Traffic Impact Foe O'lig at this time. T"tert:�-.pro I request the following (Choose'Nhichcver option or options are appiicaUie): Cash or Check L� Grcdi't Voucher I� Bancroft or Installment Payments 1 a, and/or .,i The Ordinance allows for deferral of payment of tho TIF until issuance of tho occupancy , crmit if the 71r= is greater than$5,000.00. if the TIF meets this requirement, I also request this optio. . I �.nd:�r stand the TIF roust be paid prior to issuance of an occupancy permit. I also understand t'rat the TIF wi g be recalculated based on tlIe prevailing rates at time of payment. Please be advised tl at I'= rates r;;uy increase up to six percent each July 1 st. This rate incre2.GC is not subject to appeal OWNER-APPLICANIV NC- i� PPLICANT— i J .r . G ^ I CC: i3uilding Permit rile 4` Payment Option No;eba�k '.ml tifC2 t' i • t 'Q'1 f77 Mr.7., WON Vq{MmY"+ria�r'rdAw.,.pmw.r :... ,. .r^.....,.4...nswlw..vv. ..e .y4rfk4.91At ';Iji79Nr'71d4vitiNl,bsYtwnwo-.M•... l ; ' 1y �N�'7tA«.'.�•'IN'4�11'M?rr.....,. ..Jun..r.ww•u. _�"__ _._.._.. _._ ... 111 flunified sewerac,,e SANITARY D a 270agency N. First Ave.,Suite ,Hillsboro,Or.,97124SURFACE WATER eaa-sell • CONNEL'. f 10 N F'E F;rf! h ' ISSUE UA I E U21492 kxP 1RAl ION ISH l t U>31: 9: P LRM1 T 1U2U95 '1 RUC [URE ADDRESS --ya3fs x(055- F RllJkl: t 1 y06 I STRUCTURE STRLE. I 5W JORUAN WAl l LU 1 54 SL0t;K 1 y TYPE L:UNNLLTIUN- NEW OF E1tL1hORL1 IiLLN NU. 1 c 4W 11F'E INSTALLAIION— ( 18) EROS CUN/SDC 1 ! YPE OCCUPANCY— ( 1 ) S1NGLk FAM1L1 PARL'LL 251 16 AL1 3800 ufR SEI, 4/16 MH 1HU26 � WNE1`; BEACON HOMES INC DURESS 1905 NW 1 6Y T H PL 1'REA I r!LN1 PLAN I 11UI:HAM j BFAVLRTON OR 97006 SUNLRG MST t HONE 524-1999 - Jl%jliiISri -__.-_,.-_---------------------_..-•------ ___ _ _-------------- IX PURE EL7UIVALEN 1 [1WELL1rJ , REb111LN 1'1AL JN1TS SLRVILE UNI1b Q UNIT + 1 StkVICE. UNI15 1 L.ONNECi ION FEES URF�)t.b WH ; E:R 11LVLl_UF"iLN f FEES WATLR LUAU i l' 1SU.VU 1 LLSS CREDIT WATER UtJANTLTY 100.00 �. LESS C'RE:DI i E.k0U,IUN CUN'1R0L. i I.NSPE.uiION 04 .00 i FLAN EHL(.+ 41 .60 SUBTO1AL U .Oo SUB1UTAL 325.60 TOTAL 325. 60 PPL 14AME: PETER KUSYK P14ONE '--)_-.:& 22?-- FFILt-IATION OWNER �1 J � REMARKS �QEDrT �r,,� C „�1N. FE_E FPe r j ��:.�/lA/��7.til�D L v/lli�c7 24 HOUR NOTICE FOR EROO ON CONTROL INSPELiIUNS RLUUIRLD SIGNATU _ _ ll C --------_ 1SSUL I -- f i Peirmit Conditions: The applicant agrees to comply with all rules and regulations of the Unified Sere ge 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. Thi total aeourt 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 measurement given, the installer shall p,ospect 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 — USA, BLUE — Ar_countin,„ GREEN —Inspection, YELLOW — customer jkqgj I�