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INSPECTION NOTICE
City of Tigard Building Deptxtzent
13125 SN H311 Blvd. Tigard. oregon 97223 n`
Inspection Line
/((Reec-0-Phone): 639-4175 Business Phone: 639-4'7 .
Inspection:
Footing P1 . Underelab Mach. Rough-in Appr/Sdwlk
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Found. Plbg. Top Out Gas Line _IN1►Lt)
Post/Beam Struct. San. Sewer Frnming
Poet/'Beam mech. Rain Drain Insulation -Plumb.
Plbg. underfloir Water Line GYP• Bid. -Meeh' 1
De.te Requested: __ Time: AM PH
C �! Permit
Addres t:
Builder: — — —THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: _ Date:,
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Far Relnsp.
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INSM-MON NOTICR
City of Tigard Building Depart—nt
13125 B11 Ball Blvd. Tigard, Otegm 97223
Inspoction Line (Rec-4-Phone)t 639-4175 Business Phone: 639-4171
Inspection: --
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Ream Struct. San. Sewer Framing -Bldg.
€ Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Rd. -Rech.
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Date Regttastede Timet �AM
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Addresa t ���1 Permit 1,
�71) _?990
Builders
THE IOLLOWX%o Or1RRECTIONS ARE REQUIRRED-:
Inspector -�1 _ — Date: / -}
APPROVED DISAPPROVED `APPROVED SUBJECT TO ABOVE
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Call For Reinsp.
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CITE' OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171 f L,
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CrffOF 1 Jt."Cl-RD i3iasswti,l,a� PERMIT # j't'I S� f
CnMMUNIFYDC'JELOPMEN'I'DEPARTMENT Tiprd,On bon r�:"'
(50-'1639471 DATE ISSUED
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JOB ADDRESS: 1 , �3 / n SCt� YIU I� // r' TAX MAP/LOT ZS�- 66136, Ul S b0
SUB: -- LOT: LAND USE: _
VALUATION: — �� •��c — `
0_Wt!ERSPEC IAL NOTES
— ) � ' S REISSUE OF:
n�AME: .�r�u��__ { � �
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ADDRESS: �r LAST REISSUE:
�; c �r FLOOD PLAIN/
PHONE: �� f�)3 L----- SENSITIVE LAND: _
CONTRACTOR // APPROVALS REQUIRED
NAME: � � r%�t �(, f PLANNING:
ADDRESS: 13 Jr �2���__/_-'l ENGINEERING: _
FIRE DEPT:
PHONE: C' ,.� / OTHER:
CONTR. BOARD #: EXP DATE:
IIF_MS RE9UIREQ
SUBCONTRACTORS: PLUMB: ,._~ LIST/SUBCONTRACTORS:
MECH: BUS 'TAX:
ARCH ENGINEER J v CALCULATIONS:
NAME: !1 ! TRUSS DETAILS:
ADDRESS: , 2 Ila �� OTHER: —
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PHONE: ��> ' Z � I y� i
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PROPOSED BLDG. UCF:r�' r C�
COMMENTS: —
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APPLICANT SIGNATURE
Received By: Date f;eceived:
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PERMIT # ACCT # DESCRIPTIONAMOUNT AMOUNT PD. BAL. DUE I
h+ �f -032 10.432 00 Building Permit Fees
le-431 00 Plumbing Permit fees
10-431 01 Mechanical NLOnit Fees ---- '
10-230 01 State Building Tax (5%) _ --�-�-
Building _1- 03
Plumbing
Mechanical
10-433 00 Plan. Check fee
Building
Plumbing
Mechanical
10-230 06 Fire
30-202 00 Sewer Connection -
30-444 00 Sewer Inspection _
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees —
25-448-G6 Institutional TIF Fees
25-448-03 Office TIF Fees -
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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) _ —
24-445-0� Water Quantity (Fee in lieu of)
TOTAL
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L;I T Y OFA T I GARD - RECEIPT Or' PAYMENT RECEIPT NO. -93-241111 y
CHECK AMOUNT 147. 53
NAME : W I L.I._I AMS CASH AMOUNT 0. 00 •
ADDRESS : 12390 SW KNOLL. DR PAYMENT DATE 06/09/93 i
SUBDIVISION
TIGARD, OP 972213--
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PURPOSE~ CSE PAYMENT AMOUNT P'F-1 I T) PURPOSE OF' PAYMENT AMOUNT PA 11.1
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L►UIL DING r'E'RM 140. 50 ST. BUILD PER 7. Qi.';
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TOTAL_ AMOUNT PAID — — - - > 1.47. `i3 4
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CITY CIF Ot F'AYMF"NT' RE CE I P V NO. 374
C I,4E e:I-'. AMOUNT 0. Nil.► ,
rvAMF : W I I..l..I AMf3, r-,ORTUI CASH AMIXIN-r 91. :3;.
AI71)FeU" 3E3 a 1,-: '3 Vi SW KNOLL. UR POV1+IE.N'•r r1ATE : i7i"ii;=^1/43
'31.IPr)T.VT IFJhI :
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VILIP OSE C1F' F'(IYME-I\IT AMUwINT V, FIT) F'UP!~'OSr' Or PrIYME'NT f)NO(INT 1='r)iD i
4'L AN C;Nf .`....`........... ....... .... w...._....__...91 . :i:i ....._........._........
___ _... ..... _...... _._._._.. ._ _.._
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G:'L.faIdC:1IF=c:;F; f'1-:k AT Tr)C',wF=c) C-,0WIGL:.
TOTAL AMOIJN r PAID - _ 91
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