InitiallyGood (2) 12666 SW KATHERINE STREET
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HUILDIN('a PERMIT
CITY OF T'GA RD PE-.PM*UT N(J. : F0jee1452
WYOFTIGARD
%;%)MmuNiTY DEVELOPM -:NT DEPARTMENT DATE. '7/2c3/HCS
13125 S.W.Hall Blvd..P.O.Box 23397.Tigard.Oregon 97223.(503',639A175 P 1:4:1.M PMT' .N(7 (3(31' 52
,.)OF) ADDRESS : 11.r!666 FoW WA'T+*::P1NI--' S T
TAX MAP 11 01' 51.113 L T : BK :
I.-AND USE :
STZf--: : VAI .(.)A'1 10N : g i.:e ,000 SE f BACK$
FPON'r: AEAW :
WORK CLA55 . ALTEPA VON LEFT:
USE TYPE: .54- IAMTLY NO . HF-.:DPO0M5 : EXT . WALI CONS'll
CONST' . 'T'YPE: No . 15 : N: 15 : E: : W.
OCCUP . t.;WP. PREYT .OPENIN(*.;S
(:1C r.UP .I OAD N S W
NO. STOPIES : CONS,T* : F-1PF- RET7
ARL.A SEPAk,'f PAI F!.D:
OCCUI--' SE.PAP7
MEZ ZAN I NE:7 a A!aM, 1,
F-1-00P I OAD; l".."A P 11)GE:: : FZFW SF)PIA-11:47 ALARM*?
F-'I Ow(GPM) DE TEC-11-
I-4k;:A'T 'TYPE . I-IDCP .ACCESS? CORP?
PLAN CHECK BY :
PE.'MAVIKS :
1. WE 'S SUF--: I*J
I. F:' NO.
LAS'T' REISSUE
F'EES :
0 Zukocs Ed PERMI'T 111.92.50
W 1280 mw 185th PLAN REVIEW —41111A0110 01 A
N
E Alaha ()1- 9100") 840
R PHONE-' lttiO311 6'19-37PO STATE 'T'AX
OTHER
DEVELOPMEN'T CHARGES :
C SIX(91,0PI'l)
0
N WELlABLE HOML 1,1PPOVE.MENT I Nit", Soll"11 S,1*RE1;.:,I,
T P0 BOX z1apI P DC
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ApcmtI.aLncI rjl• 91201{ P P E,P A1 U
C PHONE: (503) ','222-1-01-0
0
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t11:I1*AI— : *11.60 1-
0 NO. 4106,'47
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RECEIPT N(J. ;'31":'7:4a
This permit is issued subject to the regulations crotmneo In Tit'd 14
of the TMC, State of Oregon Specialty Coder.zoning regulations INSPE-CUTONS
and at! other applicable codes and ordinances, and i( is is hereby O*I'HF*.P*
agreed that the work will be done In Accordance with the plans and POOV:L NAIA. 1N11
specifications and In compliance %.in all applicable codes and
ordinances The issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have cjjrr2nt city
business tax permits. This permit will expire and become null and
void If work is not started within 180 days.a,if work iti sv9pended or
abandoned for a period of ISO days any time aftel work has
commenced. hall be the responsibility of the permittee to assure
all require actions are requested and approved
tit ta�e Sign n r a
1-sued By I-- OR I NSPI:I- I I(jN 6'
39-41-L,1—
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITYOFTI PLAN CHECK APPLICATION
CITYOFT16ARD PLAN CHECK
312s SW HN
COMMUNvd. DEVELOPMENT DEPARTMENT \ OREGON PERMIT #
all Bwd. P.O.Box 23397,TV-1d-Of-g-Arm(503)639A175 \
DATE ISSUEL _-
1
JOB ADDRESS: jr N((� c, ,., �q,� TAX MAP/1.OT
SUB: _ LOT: I-AND USE:
VALUATION: -( . QyG�_� `— —
OWNER R �T�' -"
SPECIAL NOTES
NAME: 14 REISSUE OF:
ADDRESS: LAST REISSUE: -~ - --_
FLOOD PLAIN/
SENSITIVE LAND:
CONTRACTOR
APPROVALS REQUIRED NAMPLANNING:
E: -_ G I/�F/s[� /�Dh "���L1Et1,�__��k t-.ENGINEERING:
ADDRESS: _Cc/� I FIRE DEPT _
rYi _ .`. - OTHER: _ —.....-PHONE: Via;
f n _3 , ITEMS REQUI_R7D
LIST/SUBCONIKACTORS:
ARCH/ENGINEER NAME: BUS TAX:
ADDR -
CALCULATIONS:��
ADDRESS: -� - TRUSS DETAILS:
PARKING PLAN:
- LANDSCAPE PLAN-
PHONE -- __ _--- OTHER: __--
COMMENTS:
PERMIT # ACCT # DESCR:IPTION AMOUNT AMOUNT PD. BAL. DUE
— _ 10--432 00 Building PermiL- Fees
10-431 00 Plumbing Permit Fees � — -
10-431 01 Mechanical Permit Fees
0-230 01 State Building lax (5%)
Building
Plumbing
Mech --
10-•433 00 Plans Check-Fee
Building
Plumbing _W
Mech
30-7.02. OO Sewer Connection -
30--444 00 Sewer Inspection
51-448 00 00 Street System Dev Charge (SDC)
52-•4 i9 01 Parks I System Dev Charge (PDC)
52-1•49 02 Parks Ii System Dev Charge (PDC) -
31-450 00 Storm Drainage Syst Dev Chr-q (SSDC) -
10--2;1.:1 09 T'RFD
W-230 06 Washington County Fire #1 (95X)
10--220 00 Amart/Wedgewood
TOTAL
;�.� REC #
PPt.fCANl
Received By:
ht/3587P/18P Date Received:
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