14807 SW KENTON DRIVE dl
44
1
tl
y�
1480' sw KENTON DRIVE —
'CION NOTLCE
City of Tigard Building pepartanent
13125 SN hall Blvd. Ti Orerton 97223
Inspectio �4tfe (Re!c-O-Phoneys 6395 Bua.nesn Phi ie: 639;3;71 \
Inspection:
Footing l Plbg. UnderslrW N - - n ->Appr/ wlk
s ` t
Found. Plbg. Tcp.eut t a yasr- PINAL:
Post/Beam 3trurt. San. Ser Framing -Bldg.
Poet/Beam llech. Rain Dr:LR Insulation -P1umb
Plbg. Underfloor Water Lin* ` G]Cp,-Bd__:_- Neck
Date Requented: r / `" Time: �AM PM
i
Address: / 7- /9 L Permit
Builder:--
J.%. FOLL04INO C(RRLCTLONS ARE REQUIRED:
I
Inspectorr� - ---- - ---- Datnt
APPROVED DISAPPROVED APPROVED SUBJRCr TO ADM
Call For Reinep.
CER*TIF'ICATE OF
CI1"YOFTIFARD OCCUPANCY
COMMUNITY DEVELOPMENT DEVA CClMVY!0FT7W4ki. i PPRMIT #. . . . . . . c MST91 -02'44
9=
4t OR16ft
13125 SW HWI Blvd. P.O.Bm 23M.TlpM,OmWn OW 1 F6 WIT 19SUED- 07/22/921
c:')ITE ADDRESS. . . A 14807 S14 KF:,',WJ ON DR PARCEL 2SI12CB-00146
SUBDIVISION. . . . : A%IFORD OAV,''S 3 :'ONINGi R- 7'
BLOCK. . . . . . . . . . s LOT. .. . . . . . . . . . . . . 148
CLASS OF WORK. vNEW
TYPE OF* USE. . . i fT
OCCUPANCY GRP. iHJ
occur-Am.—
TENANT
Owner,i
ME,' VIN WAYMIRF"
PO BOX 231164
�
,IOARD#?11634f--
Clone
Contractori
MELVIN WAYMIRE
PO BOX 23IJ64
TIOARD OR
Whanta #c 639-674�--
Rog 1 35976
Occ,l.i(jancy of the above building is her-eby given, anc.1 eprtifies
the complianre with t!ie Stato Gf Oregovi Specialty Codes for the gt-,olApq
11f. c-upency, Pncl use oxidev, which the permit was issuecl.
Z�
FIRE l)FPAAriT'MEN*V W1 INC INS)PECTO17-
Fill I L D I NG I
POST T CONSPICI)OUS PLACE
j1g..-Fd Jbu I:CT I CE C
City of. Siq...�d Iluildlrrq DepMri�rnt [/
13125 SM Ball Rlvd. Tigard, Oregon 47223
irepecti.on Line (Rec-O-Phone): 639-4175 Burmese Phone: 639-4171
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
P..end. Plbg. Top Out Gan Line (\—FINALt)
Poet/Beam Strjet. San. Sewer Framing Hl.d
Post/Be:vn ?tech. pain Drain Insulation -ltlusnb
Plbq. Underfloor Water Line Q Gyp. Bd. -Meeh.
Date ,q, stedsI Time: AM -7 RM
Address: - ��C�T� s q�Pe-r-,m�ilt)
I Builders_ `
THE FOLLOWING CORRECTIONS ARE REQUIRED:
i
Inspector r nater
APPROVED DISAPPROVED APPROVED 5119JFVV TO ABOVE
Ce11 For Reinsp.
AS-PI:T�ON NOTICE J
:ity of Tigard Bulldino Department
13125 S'` Hell Blvd. Tige_d, -regon 97223
Inspection Line (Re,!-i)-Phone): 639• .175 Business Pho�a: 639- 1
Inspection:_
- "4nq Plbg. Underelab Mach. Rough-in Appr/Sdwlk
OVA.-d. Pll,g. Top Out Gae Line FINALt
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulstion -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
DatP Requested: r 7� �, _Timet AM _ _PM
Address: 14y' G 7Permit
i.der: /
THE FOLLOWINGCTIONS ARE REQUIRED:
Inspector: _ Date:1
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_—Call For Reinsp,
INSPECTION NOTICE
City of Tigard WeildLng Department -�
131.25 Sit Ball Blvd. Tigard. Oregon 9722
Inspection Line (Roc-O-Phone): 639-4175 Business Phone: 639-4171 i
Tnupecti.on: ---
Footing Plbg. ,inderulah Mech. Rough }nApp,/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Bean Struct. San. Sewer Framing -Bldg.
Post/Beaui Mach. Rain Drain Insulation -Plumb.
Plbg. Unlerfloor Water Line Gyp. Bd. -Hoch.
�jJ i
Dale Requested: �� Time n' PH
Address: '1111d2K*FU
Permit
Bui hers_
117
THE POLW41NO CORRECTIONS ARE REQUIRED-
Mew OR-
LIC S 04V X01ELIE
e2 a`P
ti -
Inspectors_ ' �.�f-��Lc% _ Dotes _
APPROV"� —! DISAPPROVRD 'PPROVED SU&=CT To ABOVR
---Call For Reinsp.
L'ssssssssi
IN _Z9_T ON NOTICE
City Of Tignrd Building Departtient
1.3125 RW Ball Blvd. T
Inepectign-b" -0- --� r`i�-__�a 9.2223_---------_
S Phone) brJ�-4175 Bueineaa—Wtonet 639�-417'L\
Wooting —_
APP�Sdwlk
Pound.
klbg. Top Out Gas Line
FINAL:
Poet/Beam Struct. San. Sewer raming -Bldg.
Poet/Ream Hach. Rain Drain
-�
Ineulatlon _plumb,
P1bq, Underfloc Water Line
J Gyp. Bd. ,-Mach.
Uate Reluesteds
/
AM PM
;O --
Address:
Permit
Builder. lam{.
THE FOLLOWING CORRS ONS ARE R4 UT
U/Y f —
Inspector=
-- - Date:
APPROVED _--_ DISAPPROVED APPROVED CsUR.1SCT TO ABOVE
___,__Call Ic:r Reinsp.
INSPi t;xION_"O IC$
City of Tigaz+l Building Departjent `
13125 SW Ball Blvd. Tigard, Oregon 9722.3
Inspection Line (Rec-O- one): 639-4175 Businean Phon 639-4171
Inspection:_
Footing Pl Undere.lab Lech. Rough-in Appr/Sdwl.k
Found. Plbg. Top Out Can Line FINAL:
Post/Beam Struct. Man. Sewar Framing -Bldg.
Poet/Boam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. 61. -Hoch.
Date R9queatedt Ae Time ]_ �PM
Addreno: _1 .! Permit #I
Builder.: '
THE FOLIAIWING CORRECTIONS ARE REQUIREDt
i
1
r'
l;'
-- - ---
Inspector: ! Datw• .L
APPROVED D1£APPROVED APPROVED SUBJECT TO ARO-M
gall For Reinsp.
NSP- ECTION NOTICE
City of Tigard Building DepartAwnt
131:5 BM Hall Bled. Tigard, Oregon 97
Inspection Line (Rec-O-Phone): 639-4175 Bunine
0 9-4171
Inspections
Footing Plbg. Us:dorslab
Mech. Rough- n Appr/Sdwlk
Found. Plbq. Top Out C l.isse
� F]:NAL s
Poet/B6am Struct. San. Sewer Praminq 1 -Bldg.
Poet/Beam Mech. Rain Drain
nnulatton _pis,
Plbg, Underfloor Nater Line Gyp.
-Neth.
Date Requaeteds
Times AM PN
l.do�eee: J
Permit 1s
Buildnr: .cf/'y�
'ME FOLLOWING CORRi TONS ARE REQUIRED:
Inspectoq:_ D
_ __ -a
J ate:=
—_-APPROVED DISAPPROVEL` APPROVED SUBJECT 1t ABCVE
11 For Reined.
I
IN .pjc_TL0j!_p_a-'-1-0
City of Tigard Baild�,��997423
7.3125 BW Ball Blvd. 19
inspection Line (Rer-o-Phone): 639-4175 Business Phonr: 639-4171
I nspect ion t.
tooting Plbg. Underslab
Mech. Rough-in Appr./Sdwlk
FINAL%
Pound. _
Plbg. Zop Out\ Gas Line
Bldg.
post/Beam St:ruct.
Sen. Sewer traminq
Post/Beam mach. Rain Drain
insulation -Plumb.
py_pq. Underfloor Nater Line
Gyp. Pd. --mech.
_3
Date Requestedc_ - 7
Permit f
Address:��(�
eu i ider: .._1...
i
THE T'0LLMIl10 CARRE ONS ARE REQUIRT 11 _
Inspector
U
APPRO✓ED
ISAPPROVPD APPReV47) SUBJECT TO ABOVE
Call For ReinsP.
�N8PB4'T1C!�7.SIOTICE � � i
City of Tigard Building Departsent
13125 SM Ball Blvd. Tigard, Oregon 97223 i
nepectior Line (Rec--O-Phone): 639--4175 Business Phone: 63
7:nepect ions_
Footing Plbg. Underalab Hoch. Rouoh-in Appr/Sdwlk
Found. Plbg. Top Out Gas Lins FINAL:
et/Beam Struclt. l San. Sewer Framing -Bldg.
■t Beam Hoch. '., Rain Drain Insulation --Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
_ y
Date Requested: 1� �- Times �C PM
POL-mit
Builder: 17tt ,L
THE FOLL/0WING f]D IONS ARE REQUIRED:
e.
Date: / t
` APPROVED DISAPPROVED APPROVED SUBJECT To ABOVE
_,Call For Reinsp.
i
r
INSPECTIO (�Y um
City of Tigard Building Depart-sec
13125 BM Ball Blvd. Tigard, Oregon 9'.A23
Inspection Line (pec.-o-•Phone): 639-4175 Bua:nese Phones 639-4171
Inspections_---------------
nspectiont -- --_.---- --_.
Footin.g Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Fou-id. Plbg. Top Out Gas Line FINALt
Framing --Bldg.
Post/Ream Struct. San. Sewer g
Insulation -Plumb.
Poet/Beam Hoch. Rain Drain
.......... ` -Mech.
lbq, Underf1 Water Line Gyp. Bd. -
+.� --- —1r M PM
Date Requested:� Tliis±:
Permit
Address:
Bu 11 der:
THE FOLLCYWING CORREMONS ARREQ.UlRED:
1
f
Inspector:---?
APPROVED DISAPPROVED APPROVED SURJP,CT TO ABOVE
Call For Reinsp.
INSPRCTION NOTIq l' 1'
City of Tigard Building Departmen
13125 SW Ball Blvd. Tigard, Oregon 9'/223
Inspection Line (Ree-O-Phone): 639-4175 Business Phone: 639-4171
7
Inspection: '7 4f_ 00-
Footing PI-i. Underslab Ne.h. Rough-in Appr./Sdwlk
Pound. Pllx. Top Out Gas Line FINAL=
Poet/Beam Struct, en. Sewer �'
i Praming -Bldg.
Post/Beam Hoch. /Ratn Drain Insulation -Plumb.
Plbg. Underfloor &ter Line Gyp, Bd. -Nech•
Date Requ.:ste/d: - Time:
Address•
_ Permit #:.�
Builder:, �L•
TNS FOLLOWING CORRE ONS ARE REQUIRED:
//f'!
Inr,lectoc:-7`c�- �y l -�
/ !late:-
J APPROVED _
DISAPPROVED APPROVED SUBJECT TO ABOVE
JJJ���"• "- --_-Call For Reinsp.
r
IF
i
INSPECTION N(271-9
City of Tigard Building DOPartnent
13125 SM Ball Blvd. Tigard, OrHgo'a 97223
Inspection Line (Rec-o-Phone): 639-4175 Busi-aess Phone: 39-41:1
Inspection:
Footing Plby.
Underslab Mech. Rough--in Appr/Sdwlk
plbq. Tap Out Gas Line FINALt
Found. �
Poet/Beam Struct• San. Sewer
Post/Beam Mech. Rain Drain
Insulation -Plumb'
Framing -Bldg.
-Mech.
Plbq. Underfloor water Line Gyp. Bd. /
/' Z.r TimesAM PN
Date Reg„ested: �� / —""-- ��
Permit �I_L
Rddreas:
THE FOLLOWING CORRE OMS ARE REQUIRED= -
Dates L,L�
Inspector:_ --
APPROVED DISAPPROVgD APFROVED SUBJECT To ABOVE
call For R'inMP.
C1 T1FARD � �� S ,_ -
(1A.�TEF+ FERhI I
COMMUNITY DEVELOPMENT DEPARTMENT oftem VDD RM I T #. . . . . . . . MST'?1--0244
13126$W►:Wl dWd.P.O.u roc 23397,Tlpmd,Ckgpl 117223(SCO)6304176
--- - 6.39 -4171 --- DA'Tc :aSUED: O5/01/92
f�i 4RCEL: 2a 1 18CS--0014(3
SITE ADDRESS. . . 1.4807 SW KINTC)hJ DR ZONING: R--'7
SURD I V I S)I CIN. . . . : ASHFORD OAKS 3
BL(OCK. . . . . . . . . . : L..OT.. . . . . . . . . . . . . s 14E3
BUILDING
REISSUE: DWELLING-IJNITS: 1 BASEMENT. . . . . . • . s0 sfi
CLASS OF WORK. :NEW BEDRh'IS:4 PATHS: 3 GARAGE. . . . . . . . . . s430 s
1 YPE OF I.JSE. . . :GF FLOOR fiRT_1►r�._..___-__.___.._- REQUIRED SETBAC:KS.---__-.__ -
I'YF-V OF GUNa f. :5N F I RL;T. . . . :945 s f L_E�F'T. . :5 ft RIGHT. .-
ft
COCCUPANLY GRP. :R:a aF;(:010. . . :877 f f F=RONT. . 26 ft REC►R. . :Z�+ ft
STCIRIEE. . . . . . . :2 THIRD. . . . :O S REQU1REi)--
HE16HT. . . . . . . . .L ft r101"Fi1._- _ -- .: 1A2;:. _52 SMOKE PARKIN'13 SPACES.7. :0
FLOOR LOAD. . . . :40 psf VALUE:. . , . . $ : 91�,ai�
PLUMBING
INK:i. . . . u. . . . : 1 FLOOR URAIN`;'a. . . . :Q' BAC:KFI....CIW PREVNTRS.
._AVATORIES. . . .. . :4 WPTE:R HEATERS. . . : 1 TRAPS• • • . . • . • . • • . . . ..
TUB/SHOWERS. . . . :2 LFiLINL R,,' r F;AYS. . . ; 1. CATCH BAS I IVa. . . . . . .
I(iTER CL_GCiE::JE. . :3 ; E.`WEV LINE (ft ) . 10 GREASE: TRAPS. . . . . . . .Q)
DIGHWAT: HEPi» . . . : 1 WI:aTER i..I1%!E (ft) . : tOO OTHE=R FIXTURES. . . . . .VI
LiPRBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :0
WASHING MAC:H. . . : 1 E,F POIN DRAINS. . : 1 FEES;
ME LHANIC;AL
UNII HTRS. , sO type amnunt lay date ►--er_pt
r= GAS TYf=E:_,_.._._-___.._____.._ )ENTS . . • + , :0 TIF' k .1380. 00 JLH 05/01/92:
/GAS/ / / -
MP�X 1 Nr"jT :0 PTU VENT FANG. . -4 BPR1 s 409. 00 JLH 05/01./92
i=URN HOODS. . . . . . : 1 BPL.0 'b 265. 85 JLH 1._'/2:3/91. 221O9c
F=IJRN ) =liil�L►F4 . . : WCOf_lt)al'fJVE5. :0 BFJPC; t i.'O. 4 5 JLH 0`3/01/92
F-LOOR FURNVL ��
CLO DRYERS. : 1 SSDC. c'E1O. O�h JLH 05/01/92 -
U'Ull_/GI,�; OTHFEi I..1h•IITS:O N'ARVx $ :�joo. 00 JL_H
fill- I E=�Tc: 1 MPRT $ 39. 00 JLH 05/01/92 -
gwne i/ 11PLC 1• 1). Y5 TL{1 O5/O1/1)E M`PC w 1. 95 JLH 05/01/92 --
p() BOX .:.a 1 164 PP'R'i 14. 1,4 7. 50 JL.H 05/01/92 ;
FISPC $ 7. 38 JLH 05/01/92 -
T I GARD 014 972P"
1-1harle #: 639_. /7
MELVIN WAYMIF�E
�i NUX
1IrARn UR
Phone #:
F';nca #. . 35976
88 TOTAL
. --._...-- -.---..-----
mis oerait is issued sutiect to the regulations contained to the RE:%IUIRED INSPECT
ire lace Ins
Tigard Municipal Code, State of Ore. Specialty Codes and all otner Foot/fol.lnd Insp p p
applicable laws. All work will be done in accordance with approved pc,st/Bean Strict Gas Line Insp
plans. This Pei-sit will expire if work is nut r► . "ed within 180 Post/Bpsm Mer:�han Irso.► iation Insp
days of issuance, or if work is ad fc" Ir-0 dans. Pim/tindslab Ings) C=yp Board Insp
PLM/Underi'loor Rail, drain lIl'ip
Permittee 5ictnal:�.1rE �� -.. hie►_htanis•a1 InS�, Water I._.�ne Inst
Plumb "fop Out Appr/Sdwlk Insp
�]� Fr mina InspMe► hAniraI 1=i.na7
Lal l for i ngE7pc t i on - -�►17`
L-
SEWER CONNECTION
CITYOFTIFARD cffy TMID PERMI1
COMMUNITY DEVELOPMENT DEPARTMENT MIND �-,ERMIT #. . . . . . . : SWRI)r'-001c)
13125 SW HWI BNd P.O.Box 23397,TOW,Onqw,V/ (SM)8304175 7
617L ADDRE.5,13 14607 SW KLN-IUN DR P"RGEL-
SURD IVISION. . . . ASHFORD OAKS 3 ZONING: R7
. . . . . . . . . . a LOT. . . . . . . • . . . . . : 148
TENANT NAME.
USA NO. . . . . . . . . . . FIXTURE UNITS. . .
CLASS OF' WORK. . . :NEW DWELL INC, UN ITS. . - I
TYPE OF USE. SF* NO. OF BUILDINGS: 1
INSTALL, TY1 P IMPERV SURFACE. f
Owner-, -------- FEES
MELVP AY'1 type Anol�(n t by date rec-
Pt
0 BOX 231164 PRMT $ 1900. 00 JLH 05/01/92
—
INSP $ 35. Olt JLIA 05/01/92
I I GA RID OR '37`E
6 C4
39
Cunt r-actot--. /
CONTRACTOR 1,401
Phone #: 1035. 00 TOTAL
Reg #. . . REQUIRED INSPECTIONS
This Applicant aoree5 to comply with all the rules and regulations Sewer- ln5c)eutiran
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. Ine total amount paid will be f^rfeited xf the
permit expires. The 'qencv does not guarantee the accuracy of the
ride tester laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given, If not so locatev,, tha tt;11Pr shill purchase
a "Tap and Side Sewer' Permit and th-,4t lateral,d t 1,A�, �
d0 . ......
(".All for, inspection 639-4175
TI
CITYOFM �TNG PERMVT
BAFCA PERMIT MST91-0244
(CA RD
COMMUNM DEVELOPMENT DEPARTMENT C0124M
13126 BW HWI Blvd PA Oft 23397,TOM,ONODn UM(6W)W94 i 76 DATE Tc,;SLJF-D.-. 05/01/92
SITE ADDRESS. . . : 14807 `::W KENTON DR 17'PRCEL I 2S I I,'-:'CB,-00 1 'in
5UBDIVISTON. . . . : A9HRqRDOPK9 3"""" 7 1 NG- P-- 7
BLOCK. .
. . . . . . .
17-LASS 13 RK. oNCW GARBAGE DISPOSALS. . : 1
TYt'-"E OF USE. . . . :5F" WASHING MACH. . . . . . . it B0CV.FLOW PRrVNTR9. . SO
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . .0 TRAPS* . . . . . .
STORIES. . . . . . . . 12 WATE*R HEATERS. . . . .. . : 1 CATCH BASINS. . .
F
LAUNDRY TRAYS. . . . . . : 1 SF RAIN DRAINS. . . . . : 1
1 NKS. . . . . . . . . . .. I GREASE TRAPS. . . . . . . !0
LAVATORIES. . . . . 14 OTHER FIXTURES. . . . . SO
ruB/SHOWERS,. . . . : SEWER LINE (f t) 0
WATER CLOSETS. . c3 WATER LINE
PISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . . « 10
OWNERS
(,IELVIN WAYMIRE TIF $ 1380. 00 JLH 05/01/92
T'O BOX 231164 BPRT $ 409. 00 JLH 05/01/91"
BPLr, i P05 JLH 12/23/91 22 1 Oq:.
I OARD OR 972;'3 B5PC $ ;00. 45 JLil 05/01/9;? -
Obone #t 639-4742 SSDc $ 280, 00 JLH 05/01/92 -
PARK $ 500. 00 JLH 05/01/92 -
F,1 umbing
V)lumbing Cant ract at,i MPPT t 39. 00 JLH 05/01/92
MPLC t 9. 75 JLH 05/01/92
m5pc $ 1. 95 JL'A 05/01/9E
a M e r
PP,R1 % 147. 50 JLH 05/01 /92
; A t y - at e I P5P[; $ 7. 38 JLH 05/01/92
!Req
REDO IRED INSPECTIONS
rhis permit is issued subject to the recl-
,!latioris contained in the Tipard MuriicipAl Foot/found Insp Rain drain Insp
,-.ode, State of Ore. CO(jjs At-,.;J all Font/Beam Struct Water Line Inge
1
(ithor .applicable laws. All work will be dome Post/Spam MeehanAript /S3dw k Tr1sP
tri accordance with approved plans. This Plm/undslab Insp Mechanical Final
-t ed PLM/Un cl v t-f I a a t- PlkAfflb Final
)t-v-mit will expire it work ir, 110 StAl
" . thin 160 days of. issuavlcP, or if w0l'k is Mechanical Insp Building Final
jw0nded for more than 180 days. Plumb Top Out F v,osi(an Control
Framing Insp crawl Drain
Fireplace Insp
bas Line Tnsp
lnsl.11aticin Insp
11 Gyp Board Tnsp
In At
nu 441 Pd mbi _ c3ignature
Call for inspection 6�9-4175
f-ontrac:tor
17
M T OFCF�IPT
c V" TIGARD �IpT r)F PAYM- cv*-c"K pt,10UNT 4745- 88
cprH I-AmouN*1 0. 00
p-r.IYMF--,N*T MITE 05/01142
TRE M6'l I-ODD I
WAY M
r;I,,DFtEr:fa�c; � !,
PURPOSE CIF PlO
� YMENT polOUNT PWD
-MJRPOSE OF PAYMEN'. (.4MOUNT PAI ------ 147—
E fti
401 pjjjMP I NG
mill-DING)~ f> 3"-J. 00 SIT. sull-1) J-FE 00
MECHANICAl- PF in.60 SEWER I J�"WA F r-.E.9 00
pl- C,1
AN F4F-C-K F-E:
"a"5. Oki RF.t-;jDFNl'.lAL TRAFF 280- 00
SEWER INSPEC' 500. OVI slTripm DRAIN GDC
PARKS SOCI ovk. 00
MAqq URMS IT Tlr,
LOT 148 ASHFORD OAKS #3
1480-7 $-;W KENION DP
4 745. 88
pMOUNT' t,
i
I
J
ICITY OF TIGARD -- RECEIPT OF PAYMENT RECEIPT
i
NOME,
NO. 1 _c;l Q1i
x WAYM I R , MEL.W I N G. —Ji2« C:Nr'C`K AMOUNT Q ��
I
Fil:wUf�F'fd"a P CASH AMOUNT y :�.�0.0P. U. E�C7X c;P 31 1,Ca/� kJ« II0
PAYMENT DATE x 1;:='/23191
TIC3"D, OR 9-1223-- 3UBDIvIs1(161
P'!.(RPOSE OF r`�AYMEN'T
I _ AMC)UM"C PAID GUF2PC3:3E:: C►F �gYh1f fJ"1.
A!_AN CHECK F"F'Y '�N _ ., . ..._...,� � ,..__.... _.... ._._.._ ...._...._ _._ ►'IMCaI)NT r='AIE7
p
I
{
ASHFORD IJAKL #F3, ()T tRa (KENION UF2zVE)
i
00
I
1