15196 SW KENTON DRIVE ..iwnww.�rwrwawww.w.w.rr.wvw-»u.r.w«�,r� Y�+ uw+uw.w..wwwMw'w..wa.+w�rw�w.wwnuu au YW":ihtiYW�dwtla�Y�N4eilOd61�W�►(H#LYWNiY9g5Wk+Nu
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L5196 SW KENTON PRIV(_
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Citg Tigard Building INepart ment//
13125 SW 6t-]. Blvd. Tigard, Oregon 9 �
I.,apection Line pec--o-Phone):
639-4175 Business Ph(wro: 7�
Inspects unt _--.--
Frot ing P 11=g.
Undarelab Mech. Rough-).n Aper/Sdwlk
Found. F .bg. '='op Out
Gas -ine FINAL=
Post/Beam 3truct. San. Sealer
Framing -aldg.
,,at/Beam Mech. Rain Drain
I"Julation -Plumb'
'
plbq. Undo tfloor Nater Line Gyp. .
Date Requested= Bd -�-�f--'---�
t AN PM
_ Time
P'rMTt -
1lddreea=_ _
•u i lder=—
THE FOLLOWING CORRSCIIONB ARE RSQUIRLA= _
----------
_—^ - _____—— �i•.--°raj� [/
Date:--.-
APPROVRU
p13APMROVED APPROV£.D SUBJECT II ABOVE
� �F ----
Call For Aeinsp.
CITY OF TIGARD
September 29P 1992 OREGON
Edith Emmons
15196 SW Kenton Drive
Tigard, OR 97224
Re: 1.5196 Sin' Kenton Drive
Permit # MEC 91-0124
] �91 a permit. was issued for the above, project . As of
un July 16, i�lspecton having been
this date, there is no record of any
recorded.
Please advise the Building Division of the statusofproject
as soon as possible so that the file may
be kep_
pe without activity for over 1130 days
Please not-_e that any pproject ,
becomes void. If you needadditional
time
x ens onomcpan betdiscussed.
pease contact this department
Sincerely,
Robert Thompson
Building Department
Noticeb. r.ev
1312.5 SW Nall Blvd., Tigard, OR 97223 (503) 639.4171 Ti , (503) 684-2772 - - —— —
C17YOFTIFARD MECHANIGAk
CITYOFT164 PERM11'
COMMUNITY DEVELOPMENT DEPARTIAIE!T7 004141001 FERMI 1' #. . . . . . . . W
13125 SW HWI BW P.O.Box 23397,TOW,Orqpn 97223 ISM)639-4176 (--A
SITE ADDRESS. . . 15196 SW KENTON DR PARCEL 2SI 10'
SULAD[V I G T ON. . . . ZONIN6:
SLOCK. . . . . . . . . . .. LOT. . . . . . . . . . . . .
CLASS OF' WOW. :ADD F'LOCIR T=URN. . . . : EVAP COOLERS:
TYP[ OF' UGE. . . 'SF U1411" HEATERS. . a VENT FANS. . ., -,
IJUL'Ut-1PINLY (wHP. R3 VENTS W/O APPLi VEN'r SYSTEMS:
STORIES. . . . . , B0'JA.EI?S/C0MPREGS0P,5 I+,)OW
)OW . . . . . . . :
FUEL 0-3 HP. . . . : 1 DOMES. INCINz
-. /ELF- 3—15, J-4P., . . . - COMMI... INC'IN-
MAX 1 NPUT: BTL! HP. . . . : REPAIR UNITS:
I"=114E PAMV`"-'R5?. « 30-50 Hp. . . . : W001Y3TOk)I7-9. . :
GAS 1-*,RF-SSURE. 50+ HP. . . . . CLO DRYERS. . t
Nt"j., oi.- 0.1 R HANIDL I NG UN 1'rs nTHER UNTTS. .-
F-UHN (OWK B'[U.' 10000 cfm2 [-,AS OUTk,-ETS. c
FIJVO,� I OOK W U: 10000 cfm,
Rpmav,kst Install too air c-,,onclitionei,
OWJ'je7- , -—--- -.1- ---- - --, —-....... FEES
EDITH EMMONS t-,�pe amount by elate recpt
15196 SW KENTON W4 PRMT $ 6. 00 JLH 07/16/91
LA. tits JL.H 0//16/91
FG)A14D UH
BELL 1-+IATING INC:
15550 SE PIAZ70 AVL-
CLACKMWi OR 97015
Phone #z 243- 11;1`i 16. no TOTAL
447
——————-- REOU I H(-11 1 NSPEUI .1 ONS
This permit i,i isvied subject to the replations contained in the Vinal Inspection
Tioard Mvicijal Code, State of Ore, Specialty Codes and all other
aoolicahi# laws. Ali mark will be done in accoreance with
avoroved plans, This verwit will oxvire if wore is rat started
IA# dans of issuarce, or if ww* is suspender; for more
,1.v 180 days,
Tall f'(3 t ins nect i o n 639 - 417 i
CITY Or TIGARD .MECHANICALPERM -
13125 SW HALL BLVD.
I7` Receipt# —
P. .O. BOX 23397 Permit#
TIGARD, OR 9'7223Descriptlon - �- -_
(503)6.39-4175 -Table 3A Mechanical code -'
----- ---- CITY PRICE AM_T
1) Permit Fee
- Name of Development �e -0- -0- 10.00
_ 2) Supplemental Permit - -
�``- n.c _ ---- ---_ _
Job Address 3.00
Address % Furnace to 100,003 BTU
Tax Lot ^='� v _,��s___ incl ducts 8 vents _ 6.00
Map No. � Fumaco 100,000 BTU +------
tof Block 2) incl.duras&vents
Subdivision 7.50
Name(or name of business) -
3) Floor Furnace
�` L�i C✓?�ic�v �� V. incl.vent
,iringAdd =-- r1' --.-
I Ownr Address 6.00
P1Ona - 4) Susperoed heater,wall heater -
,7)- or floor mounted heater 6.00
��tare -
, zip 1 '/en_-._-�not incl.in
`^ -tr 5)
appliance permit 3.00
�'2c" < Y
Na (or name of business)
6) Repairof heating,refrig., ---
1='�-__.__ cooling,absorp+ion unit 6.00
Lpant r�ailingAddress --- -___ -
t'hone 7) Boiler or cutup to 3 KP
City/State ---
absorp.unit to 100,000 BTU 6.00
--.---�-'-'--_-� _
_ Zip 8) Boiler or comp to 3 HP-15 HP - --
absorp.unit to 500,000 BTU 11.00
Name ----
9) Boiler or comp 15-30 HP -
' %�r
ailtngAddress absorp.unit'/z 1 million_ - 15.00
M
Phone 10) Boiler or comp to 30 50 HF
Contractor !5 L 5. % ;tom _ absorp.unit 1-1.75 million 22.50
City/State ` _. _
Zip 11) Boiler or comp to 50 HP
���/ absorp.unit 1,750,000 BTU_- 31.50
Slate Registration Nn � --'-
City Bus.Tax No. 12) Air handling unit to -
' __ ,
10000 CFM
1 herehy acknowledge that 1 have read this application that the information given is 13) - �_ 4.50
coned,'hat I am the owner or authorized agoni of the owner,that phns submitted are in Air handling unit
complian,f with State laws,that I am registered with the State Builders' 10,000 CFM + 7.50
n" fiber gn'a,i is rx7ned (If exempt from slate registration pinase give reason below). 14) Non portable ----
-�� evaperate cooler4.50
/r
Vent fan connected 15) to a single duct
_ 3.00
- - 16) Ventilation system not - -
- --- included in appliance permit 4.50
17) Hood served by —
Signafuro r or agent) Ate'-- ----- mechanical exhaust 4.50
Date
Describe work f] addition n—r- 18) Domestic type
to be done O alteration (� repair E] 7 50
incinerator _
residential �` non-residential []
� ------ 19) Commercial or industrial
Existing use of / ---- -
building or property /err' type incinerator v 30.00
Proposed use of --^------- ---- 20) Other i.e.,woodstove,water -- -
building or property- .(�c�..e' heater,solar,clothes dryers,etc,. 4.50
L,rpe of fuel- oil - ?1) Gas piping one to four outlets
_ natural gas (] LPG _�- 2.00 -
❑ electric Fl ------- ----- _
NOTICE - 22) More than 4-per outlet
THIS PERMIT BECOMES NULL_ AND VOID IF WORK OR CON- _-- -- --
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 SUBTOTAL
/lr,Gu
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED on
_ 5'�SURCHARGE
-gANDONED FOR A PERIOD OF 180 DAYS AT ANY TVIE AFTER ^- - -
PLAN REVIEW 25g',OF SUB-TOTAL
WORT'IS C'OMMENCED.
Special Conditinns TOTAL
Date issued-,
Lo�
CTTY OF -116*0RD RECEIPT OF' PAYMENT RECEIPT NO. : ,)A-2 15433
CHE%CK (4MOUNT 16. do
NOME n BELL HEATING CASH AMOUNT 0. 00
ADDRESS n 15350 SE PIAllA PAYMENT DATU" c 0`7/16/91
SUbro I V I G I ON
Cl-ACKnMAF-.'), OR 97e-.24--
P-URPOSF OF PAYMENT AMOLIN PA I1' PURPOSE OF PAYMENT AMOUNT PAID
MlrlwHANICC�L GE 16. LAIA ST. BUILD PER 0. 80
115196 SW KENTON DR
TOTAL nMOLJNT PAID 16. 80
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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested -_1_ Qr�zrry Time — A.M._ P.M.
Address _ �_ _1_ .'1_�,a i_L.1�LL�e:s/ T4 ! Permit #```` i '�=U
Owner — --------- — _— -- Lot
Builder
The following B ilding Code deficiencies are required to be corrected:
r
Presented to - � ------�--- ,,�--
��} Approved
Inspector [_� Disapproved
Date
CALL POR REINSPECTION
M YEs EJ NO
,t
'c
INSPECTION NOTICE
e�
City of Tigard Building Department
P.O Box 23397
Tigard, Oregon 97223
Phoneeej: 639-4175
Type of Inspection
Date Requested
Address - —+L-L l fF� , �J' _ Permit
Owner _-__ _ _ Lot #_ _
Builder ---
The following 13uild4ng Code deficienr?es are required to be corrected:
Presented toT+pproved
Inspector ._ �_� Disapproved
Date -- ---
CALL FOR R ,INSPF,CTh0A'
[ YES I_J NO
INSPECTION NOTICE
Ci'v of Tigard Building Department
p.0. Box 23397
Tigard, Oregon 47223
Phone: 639-4175
Type of Insoection ' A.M--
/
Time.j- -- 5
Date Requested_ --b►--'- permit �—
Address - Lot -
Owner -
____--
Builder
The folloYling Building Code deficiencies are required to he corrected:-- — -�_
_-____---------- Pproved
Presented to Disapproved
Inspector
Date
CALL FOR RFINSPF,CTIOI
❑ yF ❑ NO
INSPECTION NOTICE
City of Tigard Building Do, irtment
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
type of In,pection
Date Requested S c�1 —
Address ��� �-/����--' � Permit #�17(,l
Owner_ _ Lot
BuilderThe following B,ifitding Code deficiencies are required to be corrected:
Presented to 1-kYfpioved
Inspector [j Disapproved
Date
CALL FOR REINSPECTION
❑ YES 11 NO
RUILZING F"LIAMI'T
CITY OF TIGA RD ct1 OrTisma
PERMIT 1,a E3UEi93 CAU
COMMU14ITY DEVELOPMENT DEPARTMENT \ DATE. ISSUED . 7/:'(I/R9
13125 SM Hall Blvd..V.G Box 23397 Tigard-U_W-9;M.(503),631.41171, LSF;'3:M PMI .NO . R93-540
Jt:IF3 AoowE SS : 151.96 SW KENTON UR I_ i . 1.06 FaK
'TAX MAW/L.OT ?$I x.'i„?
SUB : ASHFORD OAKS
I-AND 1JSF, : P7P0
VAL.UATION ill 73-93.A 5E:TFAC:KS
F.PONT 20 PE.AP
WORK GLASS: NEW DWE:I...L. .UNITS : 1 L.EF'T . 5 PIGI•il 1 43
USE: I'YT E, -. SINGI_1. F AM3.L.Y NO.EIEDROUMS : P E::XT .WAL.L CONST .
CONST 'T'YC VN NO. BATHS : r2 N: S : E. rJ
OE'-CUP (ARP . : R3 PLOT' . C;uENING:S
O(:C�IJI> I..OAq N 5 : E: . W
I 0I AL. AREA: 3.59 7
No . STURIE'S 1. .ISI' : 3.597 ROOF” CONS1 C F 3:FtE: PET7 i
HE:IGH 13.6
2ND : APE.A SEPAR'7 I tAl'L:q
f�3�+►�.ih:ME:N'1"? ;PD: OGC:IJW . 5F':!"'AR7 RA'T'E:q
MF::"I.:ZANINE:'? BASE:M'T
F L..1.J(J1=f I...()Ai1 . 4U GyARAtaE:. : 41Q FIRE 'al�'T�KI_.F2'7 AL.ARM'?
FL.OW(GPM) qE:TE-'L'T 7 YE S
L I-IF;.A'T' T YPF:: GAS HIJGP .ACCESS'? - CORR7
PI...AN (:IiCr.:CK HY x1.14
F2F'MARKS
REISSUE: OF NO.
L.AS'T' P iASSLIE
U MTL11..F:R .JAY
PE.RMI'T tk�iA9 UU
W
►�
P . ct . BOX i?.-?93. PL-AN F+E:V]E W
TIGAIII) (31i FIRE DEPT
R SI ATE: TAX
t TIAER i
C)Ekol-L.OPME:N'T' CHARGES: j
C SIX1.I STORM) 1111250 . Ut)
o M'1:1...1...{ F1 JAY $11 UU . UO
N ,.TAY MI1,..1...E:.R BtjjI...uE:R SDC(STWEE T I
T I WIC(#1. 1 $250 . 00
A T 3:11.AFiq CIN 972P3PgF:{'A?.C) < 1R10U . OUi
c�
T f�1 ItlN1: (:'.0 3) 604 '754:3 'T'CII AL. : $1 ,n9:i 3o
R F2E-G:3:�:i'TNAT3:(:IN NCI. :303.09
PECEIPT NO.
1 his permit is issued sublec to the regulations contained in Title 14
of the TMC, State of Oregon Specialty Codes.toning regulations RFQUIPEq INSPECTIONS
and all other applicable codes and ordinances, and it is hereby F-00TIN(3 StE•WE.R
agreed that the work will be done in accordance with the plans and FOUNDATION ION WAI._L.. PAIN D WAINS
specifications and in compliance with all applicable codes and WA'T�E P LINE:
ordinances The issuance of this permit does not waive restrictive FtE:AM
covenants Contractor and subcontractors shall have current city P1..F3 .UND R4a1...AF) CI'T'Y AF�'UT�CH/tiW
husiness tax permits This permit will expire and hecome null and 151 AFit F rl�Al_
void If work is not started within 180 days,or if work is suspended or PI_H . TOPOUT
abandoned for a period of 180 days any time after work has F'F�AM:I:NL;
commenced It shall be the responsibility of the permittee to assure
Fill required inspections are requested and approved F:I:RFF1.)L.ACF?:
(aA5i 1...INE:
�_. :T N51.11-AT I(IN
Poli tittee Si not e
issued B a11- - FFi•-T-AF!+iF(,i -
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN Df:SCRIBED ABOVE
PF
c&891.577
NO
St.1t.)FD: 7/20/89
rTYOFTIOARD C I T A;ft 10 0 D A'I'F-.'.
COMMUNITY DEVELOPMENT DEPARTMENT ontow NO - a9t15,40
13129,S.W.Hall Blvd.,P O.Bo"23397,Tigard.Oregon 97223.(503)639-4175 1.1 iry Fl NOMr3E": Z9()O
1.06 BK :
96 45W Kl::.N'I*(JN L-T :
,Jor: ASHFIOIL) (:AK15
-1-pix MAV)/L-01' PCII 12
R'IPD
1-o'l, C w
1.
WOPK C,11-14`351 : NEW
F*(hMjj..Y
USE.
and
j!j t.1 o 'The, t t ia
w*.,.tj.1 dj: t,(..l iji, -.d
�I,&yjj; 42rciln A g PIL r
'11110. t
Agc��nc:y . 11-le Pei it ext.)ire% .
Will 1:)ea 41cil-TiFaitcAd iii
mide
J-11
me.nt 15 t I&
nut )0littv.-id given . ncit %41 thR
.1.r. jit
CH-15tv. t t
d i r in :L n n 1: -F A 11 C e 1-1
Pe!
'il.:NANT jMPROvF.:-,ME:N
UNITS :
UN1115 :
OF' ------
........... $35 . 00
IN."y CHARGE 2.50 00
MIL.L.5-P! C,0 N N r-*.Ull 10 N
DOX 14S'TAI L.
N
(Irl-W.44
E r 4 JAY
o JAY
N P MIX 2,3P9 I
T OVA 91722-3
R 'V1G*1'aP00
A 68A-75/43
C
TNO. 30t0"9 AECElp"I' NO.
0
R .».........
This permit is issued subiect to the raguintions contained in Title 14
- on Spez1altY Codes,zoning reis gulations
of the TMC, State Of Ore and ordinances, and it hereby
and all other applicable gcodea rdence with the plans and
agreed that the work will be done in acco 11 applicable codes and
specifications and in compliance with 8
ordinances The issuance of this permit does not waive restrict:t,e
covenants Contractor and subcontractors shall have current city business tax permits.This permil will expire and become null and
void if work is not started within 180(j-'-_or if time ork is suspendrked has
or
abandoned for a period I" iou days any tafter wo
commenced.11 shall be the responsibility of the permittee to assure
all required inspections are requested and approved,
at4 J/ ce.
Permittee t r J'j - —el I
I fit,I I i i 1*0N 639
Issued BY' UIRED FOR WORK OTHF.R THAN DESCRIBED ABOVE
SEPARATE PERMITS REQ
l:)I:::PM'I:*1' NO . PI 89:1-575
CITY`JF TIGe4 RD CITYOFTIGARD 7/R0/(iJ9
\
COMMUNITY DEVELOPMENT DEPARTMENT 0 MON Fill I NO k:l 19 1.!-3/4 0
11121 S,W Holl Blvd-P O.Bnm 231111,Tigard,Omgn 97221,(101)639-4171
TAX MAI'/L.. J1' es:[ 'I 5UF3: ASHFORD OA10:1 1 , 1 106 E.4 K
I AND A71-4)
XTEM: NO . NO :
W(JRK CLASS : NEW WA11"P, CILOSEA* 2 1 PAP
USE 'Y'YP-I;:: : S'.ENGI-E. 1-:'AM.I.I...Y UP'11SIAl 130:1-OW PIWN'TR
C(:)N!.:*)*T' . TYPE : VN I AVOF4A'T'(:)RY 3 TPAI:� PPJ.'MI:-J4
M'.11CUP . 1,L)a SHOWE".11 'T'PAV'S
173:5HWA5I--IF:P I.
GAABAGE'
NO . STDPIE-5 : :1. WASI-111W, MACI-11N'. I.
DWELL .UWLTS : 1. LA(.JNDF2Y 'T'PAY :1. 131...1:. I)PAJ:N 4 D:[A
1.1-001:4 Dl--4AIN
WA*I*E:Fl HEWTER I. S"I'ORM/1*4AT.1"I IVY
(XTHEP
PE.MORKS :
Mil LLP JAY "'30
0 6OX
W
N T*:I:('.,API:) OP VA:XTURES
E
R OTHER
C WA'TTS i K I.:.l'!
U 10KNI WA'T**I'!:i PLUM14T.W.',
N 1:) WOX P-3092!'5
T
R t:i.ClUr"Cl cir. 972r.13
A 1:1-IONE' (503) 68/4 6626
C
-r PE,G:I:5*1I'RA'1':I:(:)N NO. 50078 $139 . 1.3
0
R I I REC.ElPT NO
.......... ......
This permit IS Issued subject to the regulations contained in Title 14 J.NSWEWT:EONS
of the TMC. State of Oregon Specialty Codes.zoning regulations PLU. 1.JN[*':PGLAB
and all other applicable codes and ordinances. and it is hereby
agreed that the work will be done in accordance with the plans and POST & DI-KAM
Specifications and in compliance with all applicable codes and WATE11:4 LJNE
ordinances. The issuance of this permit does not waive restrictive 1:4.B . 'TOI::'('AJ*r
covenants, Contractor and subcontractors shall have current city PAIN DPAXNS
business tax permits. This permit will expire and become null and F I NIAL
void if work is not started within 180 days,or if work is suspended or
abandoned for a pe lad of 180 days any time after work has
commenced. It shall be the responsibility of the permittee to assure
all required inspections are requested and approved.
Permittee Sigh re
CAL.11- FOP INSPECTION 6.39
Issued By:
SEPARATE PERMITS REQUIRED FOR WORM OTHER THAN DESCRIBED ABOVE
I.-IAN3.
CITY OF 716ARD
04160" ):)MT .NO 140
COMMUNITY DEVELOPMENT DEPARTMENT
13125 S.W.Hall Blvd.,P.O.Box 23397Jig&rd,Oregon 9?2M(503)6394175
: .I.oea
( AX
L.A. W.) NO
NO:
<JOOK
Wt: PIK GLA55 : 100K+
I
1.1!c: Tyl-ESINGllI-Am I'I .Y
VE-N r F:,AN
C'33
.W-VT TYFOE: VN A Y F_*A
Gr-J" V4 3 . !:,Y�01:M
VF'N'I* I.
Nki'.NA- I)OM
14LA COW.'
.[Nil,'INIEFAA OM
NZ)
V)WEIj... UNIT5 JL [41 r-4 c t.)M V., UWXAS
AS I HE V4
ur'l TYPV
MAX .INPUT
r.)M P R 5 7
I C)W
r1E:MAr4K!5
si.o .00
JAY I*)I::lI:1M1*T* $9 .30
MILLEP aux 23291 1.11:4;VI E W $"2"r .12W
0 r.) . V.) . 14,�i-:-<N�1 I 1F."!i; , $1. .C..1 cl
WT'
N TIGARD CTATE' 'TAX
E
wDE14T
0
N "4.5 NW
T .. 0 1` C?,7 IR'3
R h 1.1,1,N b 1 V59 113TAL AS.7 6
A
C NO . '17P"- —
T REFG'l Y.t
0 XV NO
145PECT WNtw
regulations contained 1 14
n Tiff Akjjj4F.�A)
a
Issued subject to the r n
This Permit is 19su of Oregon Specialty Codes,zoning reed
GAS 1..TNI�-
of the TMC. State applicable codes and ordinances, and it is hereby AM
and all other RPP k will be done in bccordance With the plans and
agreed that the work e codes and IN
d in compliance with all applicabl
specificaflOns and ordinances The issuance of this Permit does not waive restrictive V:JNA1
actor and Subcontractors shall have current city
covenants. COnly
business tax permits. This permit will expire and become null and
void if Work is not started within 180days.orif wis sus
workedor has
abandoned for A period of 180 days any timeork after
COMMenCed.It shall be the responsibility Of the permvediftee to assure
all required inspections are requested and appro
Ita
Permittee
Signatur TN!ipE(,.1*T0N 639"
Issued By SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN PF:SCRIBED ABOVE
IF
V PLATY CHE0 APPLICATION
CITYOF TIGrA RD' � (CFff1r4r ,Ap PLAN CHECK1 NPERMIT COMMUNM DEVELOPMENT DEPARMEW DATE ISSUED _
13126 8W Ha1 Bbd P.O.Bar rjw.T*4 Crepn f1?27(W16041M r�
I S 1 g � S,w. ��•T°'� ►' TAX MAP/LOT
JOB ADDRESS: a J
TOT: /� LAND USE:
SUB: _ A 1
VALUATION: SPECIAL NOTES
OWNER REISSUE OF:
NAME: LAST REISSUE:
ADDRESS: FLOOD PLAIN/
- SENSTTZVE LAND:-------------
_
PHONE: APPROVALS REQUIRED
PLANNING:
CONT----RACTOR A p� ►^ c ENGINEERING:
NAME: ^._ 41 FIRE DEPT
ADDRESS: .__� Y 3� 4 I
a4 OTHER, ---
—, '
PHONE: _ - ITEMS REQUIRED
- LIST/SUBCONTRACTORS:
BUS TAX: -
ARCH/ENGINEER CALCULATIONS:
NAME: _ - TRUSS DETAILS: _
ADDRESS: - PARKING PLAN: _ --
- LANDSCAPE PLAN
OTHER:
PHONE:
COMMENTS:
PERMIT N ACCT k DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10--432 00 Building Permit Fees f
--
,, 10--431 00 Plumbing Permit. Fees
10-431 01 Mechanical Permit Fees -
►.�1,5--1� 10-230 01 State Building Tax (5X)
Building
Plumbing
Mach ---- YL,) t , 3 L2
10-433 00 Plans Check Fee
Building
Plumbing
Mach
30-443 00 Sewer Connection (20X) �.
30-202 00 Sewer Connection (80X) _ 7-
3G-444
30-444 00 Sewer Inspoction -- --
51-448 00 Street System Dew Charge (SDC) _ -�"-=---
52--449 01 Parks I System Dew Charge (PDC) -
52-449 02 Parks II System Dew Charge (PDC) - ;,-
31-450 00 Storm Drainage Syst Dew Chrg (SSDC) -
10-230 09 1RFO (95X1 -
10-435 00 TRFD (5X)
10-230 06 Washington County Fire Nl (95X)
10-435 00 Washirw'-^ ) County Fire N1 (5X) _^
10- 220 00 Am►rt/Aedgewuod 7--- --- ---*— .
TOTAL
C REC N
APPLI( AA1T4(l 't
-
Received By Dates Roroived