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16772 SW JORDAN WAY w ��y+`'#��p �,�•w+�w'. �+ww�•r•►t�wry�•'+r++•��wt�wv�. '" 'w�ggnu" I t'��,1'15¢ Mf." 4}�, �, ,� } ,.•: v '+. ` �w��� 1� , ,?-iif �, �d� � ,i"��.�V�' 1'% ,�yr Y �, h^T+. I ) I Y ^ i �i I f y t.i i i Cirf OF TI ),,ARD Ct±F:OCCUPANCY OF OCC.URANCY COMMUNITY DEVELOPMENT DEPARTMENT RF.^,MIT *. . . . . . . a MGT93--019:% 1312225 SW Hall Blvd.Tigard,Oregon 97223•8109`�'M03)630.4171 DATE ISSUED a 08/25/93 PARCEL: +2S116AD­-8ED1 � 3I TE ADDRESS. . . e 16772 3W JORDAN WY SUEDIVIS.•ON. , . . a BEDFORD GLEN ZONINOe BLOCK— —« , . . a LOT. . . . . . . . . . . . . a 1 3 MASS�OF„WORK. aNCW____..__w._...____..._._.M__._,.____,..,._w..,...._..__.�...,........___.,_..._.,___._.____._..._...._... � TYPE OF USE. . . a SF OCCUPANCY ORP. a R3 OCCUOANCY LOADel17 4 TENANT NAME— i Remarks : POTH I s Owner-: BEACON HOMES p O BOX 1368 I i DEAVFP',ON OR 9700+7 i Phuue . 11503-524•-1999 fContr^ac:tor e -�... �.__.. . „.... ..._._.__.,.__.._. . ...__.__ DEACON HC AES 9500 SW 1257H BEAVERTON OR 97045 Phone #a 524­1999 99 i leg #. . a 70762 Occupancy of the abuve r-efev�enced building is hereby given, and cc -tifies the complianr:e with 4111p S-k"Ate Of Oregon Spec•iYalty Codes Fur the yrcw.kp, ,ccmpancy, and use under which the referenced permit was ie►cu.rW. r � t -r� FIRE :JEfi T MEiuT zw— Hj,ll DIN© I :TOR POS" IN CONSPICUOUS PLACX Y . kW R01Pl'+diF1 IS Cd t Vti;+7v :{u-0N. A YN:e .,,. w wn. 'tl' m r ��`1 r Uhf P+Yr-,`j( �� J•. y G } . . )Nsgecr o NOTICE city city of Tigard Building r.eparbmsnt 13125 SW Ball Blvd. Tigard, Oregon 972,23 ' Inspection Line (ROC-0-Phone): 639-4175 Business Phone: 639-4171 �tY 4Y„ Inspection:,) Footing Plbq. Dnderslab Mach. Rough-in M1V=� ik 4;, Pound. Plbg. Top Out Gas Lino �'II1f1►Lt� _ Post/Beam Struct. Ban. Sewer Irraming 8 ) ts� � �• ��„ YY ljfh X Post-/seam Hoch. Rain Drain Insulation Plumbs , ��.� Plbg. Underfloor. water Line GYP• Bd. 3 AN PH Data Requested:— Address: 1 -1t�iG�aV� � Permit isl�..�� �)Yf t �'JAXi���, ■ .5�'1/ fill 't C',I( Ar sullders��/1 l(' )� THE FOLLOWING CORRECTIONS ;ryr �'M1y �I tt , , 4NI, , , Inspector: Datet ^� � APPROVED DISAPPROVRD APPROVED SUBJECT TO ABOVE Call For Reinsp. �C �, SLA Nt INSPECTION NOTICE City of Tigard Building Department �J 13125 SW Ball. Blvd. Tigard, Orogon 97223 f•! Inspection Line (Rec-O-Phone: 639-4175 Business Phone: 639„-_Ak71 Inspection: — -------- ----- -— Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk • Found. Plbg. Top Out Gas Lina FINAL. Poet/Seam Struct. San. Sewer Framing Bf la Post./Beam Mech. Rain Drain Insulation lumb. 1 Plbl. Underfloor Wate., Line Gyp. Dd. ech. Date Regvs, .ed: ��T`J r ] —'imes _�AM PM iJ 7 ? Address: 72' ( 72' Builder: THE FOI.LO'AING CORRECTIONS ARE REQUIRED: `j. RC1 InspectoI-APPROVED _ Datoa�� C DISAPPROVED APPROVED SUBJECT TO ABOVE -v_-Call For Reinsp. . ,.. ,.yw+rwapsuHuau,�aMx;Ik A ;' IAft, , a INSPECTION NOTICE City of Tigard Building Department 13125 SN Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phon�rY 6?9-4171 Inspection:_ Footing Plbg. 11 +erelab Mech. Rough-in gppr/Sdwlk � Fou r,d. h Plbg. Top Out Gas Line INAL• Peat/Seam 9tru�t. San. Sewer Framing; g , Post/Fenm ifech. Rain Drain Insulation Plu Plbg. Underfloor (T1� ater Li%q Gyp. Nd. , -Mach. Date Requested: " —_Time: _�AM PM ■ Address:_ �/ � BuildRr:__ / <<ir�� -^------ AAn;tl'. ■ THE FOLLOWING CORRECTIONS ARE REQUIRED: ` /• /fir �— :t IIII ( ! �L� U An - S Inapecter: Dal— -- at e: L { APPROVE[) ROVED APPROVED SUBJECT TO ABOVE Call For Reinsp. r. �r INSPBG ON NOTICE �) Citi of Ttgarvl Buildiog Departs Mt 13125 SW Sall Bl'rrl. Tigard, Orel us 97223 J �. InsI,ection Line (Rec-O-Phone' i 639-4175 Business `hone: 639-4171 Inrpectio`.1 Doting Plbq. ►Tnderelab Mach. Rough-in A � ppr/Sdwlk Found. Plbg. Top Out 4ea bine FiNAI,. � Past/Beam Struct, San. Srrwer framing -Bldg. Post ," ,am Mach. Rain Drain Ina.ration -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Mach. Date Requested, Times ___m -t 1 PM Address: \-1" 1 Z- -ALA 11 iA 1, Permit Ruilder, , THE FOLLOWING OORRECTIONS ARS REQUIRED, G ( r). t is' d Zk V" �r fj r wl .� 1Yt iM1;�it 1 t r• y A. f . 7 r nq.'.. Inspector! -�-�_��.., � Date, l ,IS �_�APPROVED DISAPPROVED ----__—_ APPROVED SUBJECT TO ABOVE iCall For Reinsp. �C o u 1 1; Ir ,,1 M � 1 1� z. IM ZgTION�O��CJ� +� City of Tigard Building Department, , 13135 M Ball Blvd. Tigard, Orogon 9723 d Inspection Line (Rec-O-Phone)s 639-4175 Busineux Phones 639-4171 Inspections_r Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk 5� found. Plbg. Top Out Gas Line FINLLs NEVEMEM Post/Beam Struct. San. Sewer Framing -Bldg. MEN Post/Beam Hoch. Rain Drain Insulation -Plumb. Plbg. Underfloor , Nater Line Gyp. 8d. ) -!loch. -- -::2:f - Data Requesteos_ —/S -� Timet AM _ PH y Address: i Permit is Builders /9�1 . fl�f l THE FOLLOWING CORRECTIONS ARE MUIF.ar,s k r N i I j I r„ 7napecto Oatas APPROVED DISAPPROVED APPROVED SUB.TlCT TO ABOVE f' Call For Reinap. )5 I !'IR• .;p'•"fiY+.yW,M Tt. ^^*gT,rn!t- "Ry'?H�,,.YArl 4l�''�1Y:i{41NNM1r',:"K+1 4f��I W'PIC,H'4 ,�'�I+rT�` .A •R+e-. ', :M'"'f`F" wVMN! �r�d �';r�. q'° R", .,'' �"fiY� l✓.� "T! '4 Y F ``�R'NN__�^ YY1'. *'. � � X' 1 r I i ,I „�' fe r- Y g �y A �.,. JJ1..t�Y' �44�1.,.n' _"(�,•l.�1ii,t -.:IMC ��'.._- ���� `', ISPECTION NCTICE city or Tigard Building Department �V 13125 SO Ball Blvd. Tigard, Oregon 9722:K r.M• Ins/action Itne (Rec-O-Phone)t 639-4175 Business Pho 9-4171 Inspectiont _— Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk • Found. Plbg. Top out Gas Lina FINALt r ( Poet/Beam Strutt. Ban. Sew-or -Bldg. POst/Beam Mach. Rain D:ralrs Inaulation -Plumb, Plbg. Underfloor /water/Line Gyp. 0d. Meeh. Dots Reqs.stedt Time: AM PM • AAdrwst Permit �""'S � (' T8E VOLLOWINO OORPRUTIONS ARE REQUIREDt C Inspectorr_ Dates 1' APPROVED DISAPPROVRD APPROVED SUBJECT TO ____—Call For Re.lnsp, r .."fP}W" ty4�tA,.,u�s.e'rw• r'.' _ ...�w�Iw..� s,I � �1 PAN e .�. INSPECTION NOTICE i City of Tigard Building Depart>wtt 13125 SII Ball Blvd. Tigard, Oregon 97223 U Iaspectlon Line ( -O-Phones 6'3-4175 Business Prone 64417% _ [nepections 'looting Plb6. UnAerelabech. Rough-io�� Appr/Sdwlk Found. Plhg. Top Out _J FINALS Font/Beam Struct. Ban. Sower Framing -r'.ig. 4 Post/Beam Mach. Rain Drain Insulation -Plumb. Plba- Underfloor Water Line Gyp. Bd. -Hoch. Date RequastedsZ'l 3 Times _ AN PH AddresssA& 7�L/ ermit c v Builders- � 9AC�r: �L� ---- TBE FOLLOWING CORRECTIONS RCQ RE 105�4 JIU Inspector s --- Data: _—APPROVED w, DISAPPROVED APPROVED SUBJECT To ADM Call For Reinap. I. 'M�IIY�I� ���. rr+vwi.w..,.,..�.-_.. .. ...,.. ,..+................. ............ ....... ....wNfAlq i I � G NSPECTION NOTICE City of Tigard Building ue%artt=mt �-• . 13125 ON Ball Bled. Tigard, Orson 97223 Inspection Line (Re(-O-Phoneys 639-4175 Business Pho 3: 639-4171 Inspection:_ Tooting Mg. Ontferalab Mech. Roug'i-in Appr/Sdwlk � Pound. pl/ pit Gas Line 4INALs Post/Beam Str�:ct. Ban. Bower Framing -Bldg. t Poet/Beam Hoch. Rain Drain Insulation -Plumb. r Plbg. Underfloor. Water Line Gyp. Rd. _Hoch, Date Req+jested: % TiJetet � �+ J� /A �L Addross:-.Z-. _'.L - � rfait fi1 AullderI__ 4 r� 1}ylrtl� r� of THR FOLLOWING CORRECTf NS ARE REQU.RED: r � d i I{I I • { ��r lel;'� �'l r Inspect Date:- L" L APPROVED DISAPORMED hPPROVRD SURJECT TO ABOVE Call For Reinsp. a's. r F ME—P NOTICE 1 City of Tigard !wilding oepartMMt 13125 SN Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-o-phone): 6:19-4175 Business Phone- 639-4171 Inspection: 'r Footing Plbg. Underelab Koch. Rough-in Appr/Sdwik irk, i� � vx 'res.; a, Found. _ _ Plbg. Top out Gas Lina FINAL: wi et/Wam E gen. sewer naming -Bldg. m,P14 S at/seas Mach Rain Drain Insulation `'?--• -Plumb. Plbq:Ondariloo Nater Line GYP. Bd. -Koch. Da`�Rwqueeted���L��_ Time: X___AM PK Address 7 __. L■L��G� Permit Builder: THE POLIAMINU CORRECTIONS ARE REQUIRED: . F Inspector: --_ Y - Date:_ _ PROVED DISAPPROVED APPROVED SUBJECT To AgM —Call For Reinsp. I INSPE 7TION NOTICE IF M11 w. Citg of Tigard Bui-1dlag Depw tent 13125 811 Ball Blvd. Tigard, Ororpn 97223 Inspection Line (Ilse-O-Phone): 639-4li5 BuAiness Phones 639-4171 iY �lY Inspection:_,_ _ ' yt� +rr �f• Footing PI-bg. Underslab Mach. Rough-in Appe/Sdwlk tin e 4'lound. Plbg. Top Out cine Line FINAL: Poet/Beam stnact, an. Sewer j Framing -Bldg. .t+,9fi� rJl� Post/Beam Mech. in Drain Insulation -Plumb Plbq. Underfloor Nater Line ) Oyp, Bd, "°' "I".., 'p.". � / -Meeh. iM ���r, - /Oats Requastarl: Time: AM _ pM _ 4dc Address: ormit Builder: - r < ���`1p��,���+t`Sy ', ■ 4i -y THE FOLLOWING OORAECTIONS ARE F6 EQUIRBDs � �� � o E �'����� t f h y�+ b o� yrf', 61 Wi Inspectors Date: APPROVED DISAPIROVED APPROVED SUBJECT TO ABOVE ___Call For Reinsp. �seis�s�� INSPECTION NOT= City of Tigard Bull4ing Depnrteeot t 13125 BW Hall Blwu. Tigard, Oregon 97223 In►pection Line (Rec-O-Phone)t 639-4175 dusinsas Phone: 639-4171 e Inspection: Footingn' Ploy. Underelab Hoch. Rough-in AErpr/Sdwl.k �. nd: Plbg. Top Out Gas Line FINAL: Post/Bean Struct. San. Sewer Framing -Bldg. il t Post/' dam Hoch. Rain Drain Insulation -Pl:unb. Plbg. Underfloor Na or Line Gyp. Bd. -Hoch. Date Requested:— C i Times Address:l � _ 11 (�� �T - Permit 9 V 1 Builder: ` l t - , i I I' I 1� TRE FOLLOWING CORRECPIOvs ARE REQUIRED! : - L Inspector: ✓ '�-Data: z z -- --- ._ APPROVED — DISAPPROVED APPROVED SUBJECT1 ABOVE ----Call For Reinsp. I t' J,JN-44-'93 FRI 14:07 ID:CITY OF kir, CITY FAX NO:503 639-3771 4800 P17 LKING CITY as�.a.•e 15300 SW.116th Avenue,King City,Oregor.97224 Phnne:649.4082 COMMUNITY DEVELOPMENT APPLICATIO0 FOR BUILDING PERMIT (Instructions a -►verse) DATE 1. NAME OF APPLIC,; NW - -a- _ ' &&,zxNnPhai1e No. ADDRESS: I �O :t- 15-1 - — ADDRESS OF PROPOSED IMPFnVFMT .f 116 -7 -2 — U r 2. TYPE OF CHIHNGE, IMPROMENT OR CONSTRUCTION FOR WHIG" PERMIT IS REQUE.S'IED- DESCRIBE BRIEFLY - ATTACH TWO COPIES OF PLANS OR DRAWI11GS OF PROPOSED PROJECT: r 3. NAME XID ADDRESS OF CONTRACTOR-11,L", /41 --Vz _. PHONE NO. 1,":�1SE NO. 4, NEIGHBOR WHO MAY BE AFP'!:L'TED BY THIS PROJECT WILL BE NOTIFIED BY THE CITY. t I 5. APPLIC.'ANT OR IHER/HIS REPRESENTATIVE MUST BE PRESENT AT THE PLANNING CAINISSION � M=IN'," NEXT MELD ON REPRESFNTATIV.?S NAMF NONE NO, ..� (The Ring City Plauniog Coati ian hill consider only those applications received at least five (5) days prior to a see . SIGWATURE, g APPLICATION RECEIVED E1Y T1 APPLICABLE FF— RECEIVED �._ �� . TOTAL_ - PLANNING C)CMISS DECISION: Approv _ _ Deni 00— CONDITIONS !-� .� C-�' e -��' _�;prou a ications are valid for sit months only Si gnatu� Date 10TB: egan Basebuilders Law requires that all persons who contract for work on their residence be a. registered with the Builders Board which aeaos the contractor is bonded and insured on the job site. For your protection, be certain your contractor is registered by calling City Ball Ph: 639-1082. 1, a } NOTE: A permit must also be obtained �,ZLhe City of Tigard Department of ctrmi lity Development Yes_ No CITY OF TIGARU INSPECTION VZPORT The above listeca project has been a.nnpected and Apprcvect_Deniesd Date C,arlsnents Signature (Bwi,t Ana -inAper, L peaa,&z nzAuvn one- (1) copy #n King CLU) co 2-17 as ,rlip i­ CITY OF TIGARD COMMUNITY DEVELOPMENT DEPWITMENT 13125 BW Hall Blvd.Tigard,Oregon 97223.61 is 9 (503)8311111-44 it I 1 iaMF2l.:SS. . . - 1 o i 7." 6 ,i; F'ARC;E.L. G 1. 16+1La.. i:,=_ ■ * .iS BD 1 V 1.61 ON. . . . : EtLA)r ORD GL, c CI �`� ZONING.- LA l: LMr.iq i . . . . . . . :ie.+ 1' � ;Lil OF WU�tK. : a1.� BEL) cawTt�;a:w: GAr��aUti_. . . . , . . : ,r y . . . f;. Y(''E. OF (JUL. ,. . :.>i I I_IJL1 2 PR( i i'; RE:.UU I RED Fill.. OF" GONE;'(. :`ail F I R2) i. . . . . 1 t c7 t;t i.& "r. . n l L f t Ft I C7ii i rC y F F'itiJl 1 i . : i�'t 1''1: iiti,' ,.;L;L:LiF°i=iNL"Y Kai'ZF'. . '1'CIRIL'). . . . . . . o .t roIi-N_ . 1',� ar:lJi;lL. ( ' lJ�i�:C:1' JI�'':.i. t ;..,(JL1H K_J€�l). . . . .4Z it.,f VAL4.)L.. . . . . f � 7'rJW`�i3 PPRK I NLiSPOCE S. . a I IDING __ _ __ _.........__._.... _ tiK . . . . . . . . ; i F)UR Dl-'W! i' ,.. . .VJ LZAC:K{ t. F'L. W I"f"EViVTR5. . :4ti PVAT0N1EGS . . :L WATER HEAT-LR'... . . . 1 7'F44-1). . . . . . . . . . . . . :Qi ,: 1.4:14UNDVl r' A is"I":R GLC►;iE "t'Li. . ; 1i 9LW1l LINE' (ft ) . :0 GRL,PGE TRAPS , . :1Z+ 1.:aiiWHI ,iiE !'� i. . . : J 4'Jk1tlfr' i..,Iivk. fi iO4: f.)' File I% I:IA"RJREI,i. . . . . .�'. ;A'RBAGE I'i:6P. . , e 4 Rf41N DR;t IN t ft ) , ;0 t 1.. t l"ff-�LH. . . : 1 agdilJT I" 1/trhiJ �iI'.'i• r : l t ,, _ ..........,_... ._.._..�.......... 1''IEGHHNICtaL FEET .. ...._......�� ..... ...... .. UNA,I IIfRs. . ;+ type ainL,tAilt by data ,.`pw,p'. fJiili/ / % V�..iV rS . . . . . :0 B F,R T 370. 00 JH 04/20/9 tial Ii'4i"`i.l' :rZ` ?:l'TU 'v(1 ,.' f 11:Ha; . . :3 144—L $ 250. 00 JL_11 0.°;,%311 P :a ':33--i'.;,11,i. URN ( 100K . . ; .t 14001:•`". . . . . . . 1 kl`pc' 16. 50 JH 04/20 93 -- URN ) =I(W . . z0 WG':U'.-�TCJVE;... ';'.1 rel IEtC i T5, 'Lo J" 0/tfi='lzi/'),*,'. LOUR TURN. . . . ;0 CLU iJRYERL,, I i VIRT � 40- `50 :" 04/c0 /9: UTHL.F, UN175 i 11PLE 4 1Q. 1,,, ,111 04ir'41�'19 3 UAS li K'L.L T r : I M115pc 1 '.. ILi,; JH 114/21li ; iit',CJi+r 'i17Ml:a i15PL v f_+. r_'5 JH 04/,10/93 1) l3UX 1ai��a :� wV TUN ill 9700';' 1363 i 11U t+1L t:; ,i ..aaVLIiILIN LJ I% 1�70i;:j i11r:e? #: bi:4•-•1999 ago« . rOJEic _.. _.– .__.._... _.__...._.._ ......� ..._ ..... 7; 4a �ers.t ;s issued satject to toe regu,ations container; in the F21,:.',LJIRLU INS1'EL;'I1UNG Mapicipal Coder State of Jre, 5Pe_1aiiy Lodes anal all 'ji, er Cuot/resi.tnd Inai•; F�ir^ap1.nCe Triai Y ;. ,cadle iays. All worn w.li de done in accuroance w;tn approved F''ost/beeam Llt;r^uct tax Lis'tv? lnsp an,. This pti',rit will er.pire if stark is not started within ldati Mer_i'7an 1ns;..+1tation Inw•;., s :t iss'janre or if work is = ';r..�.: In F, f3yiy Board insl3 y r i m/�_iriciei Liricic+; 'i ; i,,ar 'r?cii1 d r-+airr 1. n it'All 'ttt.e 1.11 , _... I'ir � IEl "�,;x l "It E; f�lat.vr, L] rie Jn ir.1 kmb lop ti..lt Appr/53dwlk in: Lir r rr;,. i01 i1 051, NoclrAT,Ic:.dl. Fir A A IB['1.�'� 1,M7YWr m..r.. ...... ...v.erH..:JIUIV.V.k':XtlGI �.l�'4+'.�IEpP➢I:.M7YNP/tWt1hJ17NW.4'KMr•.:-.:..., -..`e '.. -• a`. f 13175 SW Hall Blv4 PLNC RECT # 7-2 CITY OF TIGARD rd. "OMMUNM DEVELOPMENT DEPARTMENT rc�"3n97� PERMIT # Tip("3) 6�39""" DATE ISSUED ■ JOB ADDRESS: _� _� I .� C7PMI ` �,"r'1 — TAX MAP/LOT SUB: T54el>'R'pio GLAI*j LOT: � LAND USE: _ VALUATION: B, _ OWNER SPECIAL NOTES � NAME: VeP6 C-ew`J �AOOIE'S REISSUE OF: _ ADDRESS: -'P". 0 - :L�-ik 13(0 _ LAST REISSUE: — • Ve?4yF�a-t� ��L `'1''lba� _ FLOOD PLAIN/ PHONE: "" �9G1`I _ ___ SENSITIVE LAND: CONTRACTOR APPROVALS REQUIRFQ NAME: '� `' UOM PLANNING: ADDRESS: PU. 3o?s 13(0P-.) ENGINEERING: — cv . 'l'l00-1 FIRE DEPT: i PHONE: — '524=ICLekCi OTHER: CONTR. BOARD #: =ly"tY�Z _ EXP DATE: / ITEMS _REQUIRED SUBCONTRACTORS: PLUMB: _ y � � --� _ LIST/SUBCONTRACTORS: 41-1-PC's MECH: I I l�G(0 BUS TAX: _ ARCH ENCINFcR CALCULATIONS: NAME: TRUSS DETAILS: ADDRESS: 1 U—l'rs--j OTHER: PHONE: 5"z`}' PROPOSED BLDG. USE: Cr-- COMMENTS: __�_ 1__� t•�__ _ i i I I _. APPLIVAI'f [GNAf 1 Received By: _� ��:� _ Date Received: 7 I I ...t•r.Y1wnMIra Y•:e/✓X�'VMY".«MMyMYA�MF '�"�'�Ml��/AMIYItlYTON'MnM'�!V;v......:. ...-...... 'r11•...._..- r f PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE �f5afy -a/4J 10-432 00 Building Permit Fees ' `37U _ 10-431 00 Plumbing Permit Fees 10-431 01 Mechanical Permit Fees — 10-230 01 State Building Tax (5%) �6 7� -- ' 7Y i Building Plumbing ♦6L� Mechanical 07 G-3 0. (3 ' 2SD - U.lc3 j 10-433 00 Plans Check fee �S — I i ■ Building 2 v w Plumbing Mechanical /0•/3 / i 10-230 06 Fire — --- I 30-202 00 Sewer Connection — 30-444 00 Sewer Inspection 25-448-02 Commercial TIF Fees I 25-448-04 Industrial TIF Fees - 25-448-06 Institutional TIF Fees - 25-448-03 Office TIF Fees - 25-448-01 Residential Traffic Fees �— — 15-448-05 Mass Transit TIF Fees — 52-449 00 Parks System Dev Charge (PDC) 31-450 00 Storm Drainage Syst Dev Chrg (SSOC) - 24-445-01 Water Quality (Fee in lieu of) 24-445-02 Water Quantity (Fee in lieu cf) TOTAL �� nm/3587P.WP{ i 1 ( ' y P a CITY OF TIGARD - HFC. IP'T OF PAYMENT RECEIPT 1140. CHECK AMOUNT NAME; a BEACON HCME S CASH AMOUNT I ADDRESS PO 80X 1368 PAYMENT DATE:: BE AVERTON, OR SUBDIVISION I r#URE,oSE" OF' PAYMENT AMOUNT PA I P PURPOSE: OF PAYMENT AMOUNT PA I D IftUIL DINCa�_>~EF�M...._ MEiT93_.019lP.S. 00 MECHANICAL PE 40. ON ST. BUILD PER 26. 78 F`L_AN CHE=CK FE 0. 63 SEWER INSPECT 35. 00 '.I i it �I LOT 1. SEDFCIRI7 (3L<EN 16772 SW JORDAN WAY �I TOTAL. AMOUNT PAID > 1'19'7. 91 'I AAA I ,mw li r ,4 a i 1 ,rwHM1�M '�'��•.. dJl ', tis_' }t, unified SANITAffio 0 a� sewerage ��,e"may SURFACE WATER f Uf N. First Ave.,Suite 270,Hillsboro, Or.,97124 I 503 648.8621 1 C:CItlPlL [1 1014 rTRh T T IS 5111;: GAVE: 01',1093 E:(L'II�r1T [0N 1)ATF 1.01.'/93 F'Ef�l4IF 104010STRUCTURE ADDRESS i,6-172 FRCIJECT 1906 STRUCTURE STRUT SW JORDAN WAY � LOT i Ti I..Oct", 1'YF'I:: CUMNEI"1'T:Qt! PlIi:W ql" 6r DFflRD ')LF'N N0 1 TYPE INGJALI-ATiON_. ( 19) TILD SOR/E'RCl (';1.N/! JIC t7! TYPI: OCCUPANCY ( 1. ) !'iI!'IE.;I.f.': rAi-11.1 Y I'r1r;l';[:I_ ;.'.Cil. 1.h AD 1.31500 QTR 1,"TC 471 f., IiH 1 1.Z 9 r OWNER I+f't1CON imir`' ADDRE1•30 PTJ L40X 13LO TF'FATMF'NT ri.an, i'luralAM BEAVT"R rON OR 9/075 PHONE 524- 1999 jURISU KING CITY F I XTURE E01.11VAI..F"!!'T IIWE1.L INC, R E S I DVNITTA L UNITS (iERVICI U14T I'f3 0.0 UNITS 1 9FRVICE UNITS) I C04NECT1,014 f FF:S SUf'F'AIT 41f1 i l R ri[ VZ+ i l'.TNT FE:FS WATER Cl11;1I.. E T Y 1.4I0. 00 LESS CRF)IIT 100. 00:`• WA1 ER QUAN 1'T TY 100 .00 LESS CRFPII* 0.00::: ERC)SION CONTROL. a INSPECTIO14 40 : 00 FLAN C111-CK 26. 00 f SUBTOTAL 0100 SUDTOT AL 166.00 ( d TOTAL 166 .00 APDL. NAMC: PETER Kl1Y K P110Mf AFFILLIATION VP REMARKS PROJ#190[.1•-f1EPrnRri GU N-•LlIT I 1 *24 HOUR NOTICE 1= R ST'f1N CONTROL INSPECTIONS REQUIRED Flyn Permit rond tions: The applicant agr s to cor,.ply with all rule- and rem-lations of the Unified Sewerage Agency. When calling for ar inspection, please refer to the Permit Number. The Permit expires one hundred eighty (190) days from the date of issuance. The total amount paid (permit fee, connection charge, line t.p fee and/or other charge) will be forfeited if the permit expires. The Agency does not guarantee the accuracy or the location of side sewer laterals. If the sewer is not located at the 1 measurement given, the installer shall prospect three feet in all directions from the distance given. If not so located, the iinstaller shall purchase a "Tap and Side Sewer" Permit at the current charge and the Agency will install a lateral. 6/90 WHITE - USA, BLUE - Accounting, GREEN -Inspection, YELLOW - customer I .t