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9600 SW OAK STREET STE 550 moo {y�y1' 1/R�YI�MR/1�1MvM"T"wrM w+�Meyw,y"XxT•T�'f� f •.. „irK k r. � o M ti I �t I I ✓ i t -CITYOFTIFARD OF CrTYCOMMUNITY DEVELOPMENT DEPA9TMENT oa�� L � f 19126 SW Hen Blvd.P.O.Box 23397,Tipvd,Orem 97723(603)6394176 ��- ^- --- - — PEU ING PERMIT PERMIT DATE. ISSUED: 08/20/91 5I TE ADDRESS. . . '3600 SW OAK ST PARCEL: 1 S 135BD-0010 1 � SUBDIVISION. . . . : ASHBROOK FARM ZONING: C--F' BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :5 CLASS OF WORK. ., :ALT GARBAGE DISPOSALS. . : 1, MOBILE HOME SP'ACES. : +! TYPE OF USE. . . . :COM WASHING MACH. . . . . . . : BACKFLOW PREVNTRS. . : OCCUPANC=Y C_3RP. . :B;= C=1-.00R DRAINS. . . . . . . . TRAP'S. . . . . . . . . . . . . . . STGRIES. . . . . . . . :5 WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . : LAUNDRY 1-RAYS. . . . . . : SF RAIN DRAINS. . . . . : + SINKS. . . . . . . . . . .2 URINALS. . . . . . . . . . . . . GRE=ASE 'TRAP'S. . . . . . . . LAVATORIES. . . . . : OTHER FIXTURES. . . . . : "LIB/SHOWERS. , : SEWER Ll1• '= (ft ) . . . . : WATER CLOSETS. . : WATER L l NL. (ft ) . . . . : DISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . . . : Remarl-(s : Tenant Mod: Adietion, deletion of interior walls, fifth flr. Owner-: -__._._.__.______._----.--_._._.___.._. FEES SUMMIT CONSTRUCTION type amol-tnt by date rer_Rt; P'RMT 1, 37. 50 JLH 06/20/91 - P'LCK t 9. ::37 JLH 08/20/91 - FP $ 1. 66 JLH 0R/20/91 - Phone #: ANDERSON P'L U1.1B l NG -------------------------------- Phone it- 48. 75 TOTAL Pug #. . 57 ?18 REPU 1 RE D INSPECTIONS This permit is issued subjeri to the regulations contained in the Rol.tgh-in lrtip Tigard Municipal Code, State of Ore. Specialty Codes and all other Tori -oLtt l-rsp applicable laws. All work will be dono in accordance with Final. Inspection appro•i9d plans. This permit will expire if work is not started tithin 18d days of issuance, or if work is suspended for %nre than 180 days, I'?P r•m i+t e� }�� rI n ai t -'r'e :,/�.��..�--•'�._...__.._._...�__...__ ___.__..�.�____________.._.._. .....�.._.w.�__.__.._»..___.--- I s s u i e d Ely : Call for inspection •- 639-4175 i< r, or t k. 4 � `I 1 V { C { .._.. ._.... ........_......... ....a.r.....�,,iT""_.�.....�_.....�. ....«__..-....._._.._..........._r.n.,.r.....�.�..._....«...r....�..w..�_r-..r. - _-.r.r.�....,�._..�-..r�...w..r.._+ �.....w.._... � f CITY OF TIGARD RECEIPT OF PAYME-W RECEIPT NO. CHECK AMOUN'1 a 4A. 7t idpME`. �sIJMM'I'I' L,Oh15'f RUC 1"I CIN f.� 481-E AMOUNT + • nYMENT DATE" 08/20/91 i-,URPrlS': OF F'f1YIIElv'f AMOUNT PAID I.'URPOSH OF PAYMENT" 0MOUNT RAIU 9. 37 I E't_UMEaXNf.; PERM 37. 50 P .AN rCHECK FE { T, BUII_I? PER 1. 88 !i i I� j ranlFa i t'O rA�. r�rla►�Ivr. �,�.�Ix� , 14S. 7G� ;tu IMP i 1 n CITYOFTIVARD CERTIF'ICATE OF OCCUPANCY DEVELOPMENT DEPA (�T �,,� 7 P ,M IT et. . . . . . . . BIJP90-0040 13125 SW HWI Blvd. P.O.Ba 23W,TkPA.OrW YT 609 %175 _ -- ---- 1l - — DATE IOSULI)a 04/06/9' SITE, ADDRESS. . . c 9600 SW OAK ST ,�J 5 v PARC:ELa 1S135SD-0+ 100 SUSS I V I S I ON. . . . i ASHBROUK FARM g Z ON I NG s C--P BLOCK• . . • . . . . . . a LOT• . • . . • . r • • • • • a J CLASS OF WORK. a ALT TYPE OF USE:. . . a CCDM 4 OCCUPANCY GRP. s D2 OCCUPANCY I.-CAD:Ham-' a■� i rENANT NnME. . . s ORE 60N NUR£3CS ASSOC:I AT i ON Pemarkaas Tenwit, Mods addition, deletion of interior walls, fifth flr . ` i PLAZA WEST iW-00 SW OAK ST TICARD 1R 972'23 Ph one As Contractors SUMMIT CONSTRUCTION PO BOK 10345 r 4 PORTL.A14D OR 97210 phor►e Na Reg #. . 1 E:30.49 Ocr.upmnc:y of the abcove refer,vnc-ed building is hereby Wi4en, wid corti.fie® the comp,limncae with the. S+tato Of Clreg-m Specialty C ode% fear t;,@ group, Frcc:,upanty, and ube under which the referenced permit; wa 4 i r—sk.ted. �. 0, _ FIRE DEAR?MINT _ -�-;,I..v r -INSPECTOR 1='()GT IN CONSPICUOUS PL.ACF : ,.,.� 17 P�PZTWIAU IN TUALATIN VALLEY FIRE & RESCUF. AND BEAVERTON FIRE DEPARTMENT FIRE MARSHALS OFFICE - ,� (503) 526-2469 POSTED &Rjjjj ESGJ � r OCCUPANT a'. ` J 1u — `' CONTRACTORBLDG. PERPIIT 16 tt _ -- PROJECT NAME V I ,� T PLAN REVIEW It i LOCATION �� rf JURISDICTION: 1= Be. 2= Du. 3= I:,C. 4= Ti. 5= Tu. 6= Sh. 7= Wi, 8= CC 9= WC 0= PIC COVER FINAL SP FOLLOW-UP/REINSPECTION ATTVIPTED FINAL ` ❑ Framing ❑ Separation Walls ❑ Sprinkler System ❑ Shaft ❑ Fire Dampers (Overhead/Underground) ❑ Alarm System El Hood' Extag Systems ❑ Conference ❑ Spray Booth ❑ Ceiling Cover ❑ Other V Date: Inspector. ) T 7 V CI VI G V r • �� J V'� r Yeti s " ......w.v,.....,+..i..o.•eiu4R MECHANICAL f� C11YOF TIVA� 1'F'RI*IIT ` 70REGON RD1 PERMIT 0. . « : MEG"�0 0041 • COMMUNITY DEVELOPMENT DEPARTMENT � PRIM. PE:RMI*T 'T F 13125 SYV F1dl BNox d. F.O.B23367,Tlpaid,Oregon 07223 1:=)&W-4176 T'�', •�-� p�.1C,t I F�I) -- _ PARCEL: : 1S 1 3t;TcD -00:I.0,i_1 SITE ADDRESS. . . . 9GOO SW 0 A K S T ZONING: C-r' SUBDIVISION« . . « e ASHBROOK f"ARhI ° BLOC V.. . , « . . . . . . :' l..Ll'.. , . « « « « « « . « . « _..._._;_._.._._.._._. FLOOR FUTON. . . » EVAP COOLERS: CL.ASS OF WORK. « :ALT UNIT HEATERS- - c a VENT F AMS. . • a TYPE OF USE« . . « :COM VENT SYSTEMS: OCCUPANCY URS'« . aB2 VENTS W/O APDL ". �• F.�OxLERS/GC7rlr�'F•�F::�:i�:>I:IRS HOODS. . . . . . . :1 S'TORIES. . . . « . « « ..5 DOMES. INCINa ;F .... ;FUEL T•YPES_._._.."'--"'*"-_. .......... 4d 3 HE'« , .. , ;; ::3-•'15 HP- « . COMI'IL.« INCIN. 11 T :'.� 3t� 1AP.. •• •• . REPAIR UNITSa2 MAX INPUT: NTU WOOD5TOVES. « a °•, � . -� 30.._;0 HF'« , « . : FIRE DAMFERS: . « ;N CLO DRYERS. . : GAS N'RE BSUF�h. « E - " 0+ HP. . . . " AIR hiAhlDl_IhIG UN:C'TS OTHER UFII'TS« a NO« OF UNITS-- - GAS OUTLETS. a F"URN < 100N. BTU , <-- 10000 cfma Fl.1RN >-'J.(�0K BTU: > 10000 cfm: r,emarEr.ssa Tenant Mod '. acldj.tj.cani, cdc+!.cati.c�� of i.ni't�rj.c�r Walls, fj.ftI� FEES (awne•r a __._..._.....__....._..._._..._..._.__._..__._....._.._ .._-_...__......"._... date rec:p'l': type amount by a SUMMIT' CONSTRUCTION F I M'T' $ 26. 50PLCK ! ! / ! Phone 0". CONTRACTOR NOT ON FIC.E. 34. 45 TOTAL Phone # Req #« .• _._....._...._ REQ .._ - REQUIRED INSPECTIONS -- ---- contained in the Mechanic_aI Insp ...._.... ...-_..__.._.._.._.--• .._ This permit is issued subject to the regulations Fia>,1 Municipal Code, 'State of Ore. Specialty Codes and all other I'ieatinq Unit 11-ISP ........."..... _._..._.._"___-•.-•-.•-••.,_- - Ar, iicable laws. All Mork Mill be done in accordance with coolinq Unt Insp __._._•• -" ""�-'-" "' -"- ppraved plans. This permit will expire if work is not started Fi.re Damppr Insp �__ _.._____._. _ •-__- within IAS days of issuance, or if work is suspended for more Fil7c a1 Inspe 'r:tc)I" ------- than. 188 data. ._.._.....__._.._.__. ..._.__......._....._._...__....__._._.. [•'ermi.tis! t _. `r...... _.-_ _ ._.._..._. __._.._.__......____..___.._.. _T._ F.r;S c.c e ci H 1 ........-_._._ ..__..._._..._ _...._._......_.__..._.__.............___....._ __ _ ___._.. _.__.... fic�r in!;per. Fi3 417 i ....•e:•pWpy *7y.w°�hwt+m.`N^^r°n+"^-....,..+w.. .».v......r..wyyAM4'MOnMwMIM .w.."..w.•.••.y. , ' {91'Yp��YJ�a.l �$.f�'>��P•. �r P "4 s I ,I s w I ;I"fY OF TI11r^,RD RE:CTIPT 1.')F P' )YMENT FECE11"T No. 4 ' l G[lECr AMOUNT z '�4. 4 IJAME a AIR FATE C ONT ROL. INC (_ASIA AMOUNT C ADDRESIS 1 S. E. !1111 AVLhlIJf: F'AYME:NT DATE N='CP"R.-AND. CIG' 97:"!1SW ()(4% ^Tr:EUT !( PURF•'ME OF F*AYMENT i;r'iCal.TI, PAID 4"IJFtF'01,;E; 01,*� PAYMENT AFIf')UM, PAI:I) l MECH1AN I C;AL. PE_ f),)41 5 ;31". `P-J 1 LD 7 Mf F::F t. f I �I tl: vl �x 1 TUALATIN VALLEY !FIRE & jtESCUE AND e l BEAVERTON FIRE DEPARTMENT__ FIRE. MARSHALS OFFICE l �.. (503) 526-2469 POSTED OCCUPANT BLDG. PERMIT 11 CONTRACTOR PROJECT NAME PLAN REVIEW '�l UI�C) GQ K 5 7) LOCATION _ r-r JURISDICTION: ;1= Be. 2= Du, 3= P..C� 4--�T�� 5= Tu. 6= Sh. 7= Wi. 8= CC. 9- WC 0=„PiC (� COVER FINAL SPECIAL FOLLOW-UPIREINSPECTION ATTEMPTED FINAL ❑ Framing ❑ Separation Walls ❑ Sprinkler System ❑ Shaft ❑ Fire Dampers (Overhead/Underground) ❑ Alarm System ❑ Hood' Extng Systems ❑ Conference El Spray Both ❑ Ceiling Cover ❑ Other Ode 1-6) 4" mj,�f e X ► rt/[, l/ 1 5 ►�t It S - ' I� t. (j e-.1 c 55 ti, e c- TT,) i r Date: � � q,,U Inspector: + JS L s�' x♦, s �'fi �Vd�. �+ � ani a,7 � 1 n Y . f ( f At,; INSPECTICjV NOTICE City of 1i9nd Building Department - aDe r �'� ,Y,,• P.O. Box 23397 Tig'Ard, Oregon 972K Phone: 639-41;5 Type of Inspectionf �� � rr Date Requested —!.2 7U Time�r. A.M. P.M. Address --- � Permit # �a Owner_-- � — Lot # Builder --------._.�_ The following Building Code deficiencies are required to be corrected: r � " 4 • ere,.2 �•.�.rti _ L _ -- — J i R Presented to I - _ Approved J !nspector -J _ r; Disapproved Date CALL FOR REINSPECTION ❑ YES NO f t ' ( y f f 'wF t V INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested =_�� 6?6 Time Address U _ Permit Owrsr /. ® Lot #_ Builder w The following Building Code deficiencies are required to be corrected: " F i ti s i Presented to _ z Approved Inspector Disapproved Date CALL FOR REINSPECTION C_1 YES ❑ NO w,. . s c INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639.4175 Type of Inspection _ f -2 ,_ Date Requested `--� _�` �l� Time A.M._ P.M. �1 �r Address �-;4 42 �,: Permit #_ Owner _ Lot # _ Builder = ----- The following Building Code deficiencies are required to be corrected: r Presented to — Approved Inspector Disapproved v�S - Date ___ C CALL FOR REINSPECTION YES ❑ NO .' ., .,..nwM.+wh-:ild>'M ..aY1v.kel.www.✓.,..-: r ...rw...-..w.w wM r� �V���Mt11l1N�IAlI�luEirap�wuiew�ar-n,rivrq.;r* �... .n:ww„ •_... 4 ► 4 w TUALATIN VALLEY FIRE & RESCUE AND BEAVERTON FIRE DEPARTMENT 4755 S.W. Griffith Drive• P.O. Box 4755 • Beaverton, OR 97076• (503) 526-2469• FAX 526-2538 , March 8, 1990 Summit Construct-i.on P.O. Box 10345 Portland, Oregon 9721.0 Pe: Oregon Nurses Association y600 S.W. Oak Tigard, Oregon � Gentlemen: This is a Fire and Life Safety Plan Revi;w and is based on the 1985 editions of the Fire and Life Safety Code !UBC), Mechanical Fire and Life Safety Code (UMC), Uniform Fire Code (IJFC) , and other local ordinances and regulations. Plans are approved as resubmitted. 1. Exit Door Hardware: All doors shown on the drawings must be " openable from the inside for immediate exit at all times without the use of a key, special knowledge, or effort. UBC Sec. 3304 2, Exterior Exit Door: Hardware for the exterior doors and key operated deadlocks may be permitted where there is a sign posted on or over the door reading, "THIS DOOR MUST REMAIN UNLOCKED DURING BUSINESS HOURS" in letters not less than one-inch in height on a contrasting background, UBC Sec. 3304 3. Fire Extinguisher Requirements: Not less than one (1) approved J fire extinguisher(s) with rating of not less than 2AlOB:C shall be provided for each 3,000 square feet of floor area or fraction thereof. The travel distance to an extinguisher from any portion of the building shall. not exceed 75 feet. UFC Standard 10-1 4. Approved Plans on Job Site: One set of approved plans bearing the stamps of th% building deparCment issuing the construction permit and this office must be maintained on the project site throughout !' all phases of construction and must be made available to building and fire inspectors for reference during required construction inspections. UBC Sec. 303 "Working"Smoke Detectors Save Lives s a y4 i ti' ' A �'4� „�$ :�t�a��'y����� _ : ,�'�'`�' � a• r`�k�r '�J?" ��y�i,�xP��Aiq��M1����� �I 9�1 ° �;,,. '.. l � ARIA , J Summit Construction ' March 8, 1990 Page 2 5. Required Occupancy Certificate: Prior to the use and occupancy of the project. (space) , a certificate of occupancy or other. written instrument of approval must be obtained from the building department issuing the construction permit. UBC Sec. 307 , ` 7f I can be of any further assistance to you, please feet free to contact y� Mme at 526-2502. Sincerely, Gene Birr..hill Deputy Fire Marshal GB:kw cc: Tigard Building Department Wardlussey/Gibbons, Iric. s i A, Y.h i .6 ti 4r i INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 629-4175 Type of Inspection i Date Requested _ Time A.M..P.M. Address ���C/��.l�c-�' ,�"1�-' 1 Permit --- 7e Owner _ Lit Builder. 4 The following Building Code deficiencies are required to be cr,rected: - i I Presented to _- _. ApproaeJ Inspector Disapproved Date CALL FOR REINSPF CTION CJ YES I-] NO dil d I M1 4 y4r. ,iflli yr _ I✓ � VN'a , _.....rw...,-.........+. :.,.... _.........�. ._.....,—.. we. ..n....w,.v.....xv.wa.rewwMwr .. INSPECTIQN NOTICE 'riga City of Tigard Building Department P.O. Box 23397 ! Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date .i,.quested -,3 %�- i' Time _ A.M. P.M. AddressPermit # ' ilk —� Owner _ l J Lr� t Y� r Lot # AIS Builder The following Building/Code deficiencies are required to be corrected: K CL 2 i Presented to . _._ _-- ApRroved I 0. r , . Inspector �- taM.;M�.aw,� wr •,:�; - - -_ ___.__ �IDisepproved Date - / `. CALL FORREINSPECTION P—FOYES F77 NO ars, r Elm, A 1 y UK- CITYOFTIFARD C�� 410 COMMUNITY DEVELOPMENT DEPARTMENT « = f 13125 SW FW e1rd.P.O.Box 23397.ngwd.Oregon 97243( )639-4175 -` (TTY 0Z TIGA__Rn—_RATT bjr, p RMTT — — — -— PERMIT #.. .. . .. : BUP90-0046 PRIM. PERMIT #.: BUP90-0046 DATE ISSUED: 03/01/90 SITE ADDRESS. . . : 09600 SW OAK ST PARCEL: 1S135BD-00100 SUBDIVISION. . . . . ASHBROOK YARM ZONING: C-P BLOCK.. .... . . . . . LCT. . . . . .. . . . . . . :5 ---------------- REISSUE: FLOU". :+REAS---------- EXTERIOR WALL CONSTRUCTION- CLASS OF WORK. :ALT FIRST.. ..: of N: S: - E: W: TYPE OF USE. . .aCOM SECOND.. . : of PROTECT OPENINGS?---------- TYPE OF CONST. :2-IHR THIRD. . . . : of N: S: E: W: OCCUPANCY GRP.:B2 TOTAL------:6124 of ROOF CONST:B FIRE RET?-.Y OCCUPANCY LOADs82 BASEMENT. : of AREA SEP. RATED: STOR.:5 HT. 60 ft GARAGE. . . : Cf OCCU SEP. RATED: MEZZ?•N REQD SETBACKS-------- REQUIRED----•--------------- r BSMT?:N III FLOOR LOAD.. . . :50 psf LEFT: ft RGHT: ft FIR SPKL:N SMOK DET. . :N DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM:N HNDICP ACC:Y BEDRMS: BATHS: IMP SURFACE: PRO CORR:Y PARKING: i Remarks: Tenant Mod: addition, deletion of interior walls, fifth flr. Owner: ----------------------------------- ----------------- FEES -----------•--- SUMMIT .7ONSTRUCTION CO. type amount by date recpt 2130 N.W. YORK ST. PRMT $ 427.00 PLCK. $ 277.55 PORTLAND OR 97210 FIRE $ 170.80 Phone #: 223-9703 5PCT $ 21.35 PAYM $ 448.35 JHJ 01/29/90 107104 Contractor: ----------------•------------- PAYM $ 448.35 JLH 03/01/90 W W -------------------------------------- i Phone #: $ 896.70 TOTAL Reg #. . . ------- REQUIRED INSPECTIONS ------- This permit is issued subject to the regulations contained in the Slab Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Framing Insp applicable laws. All work will. be done in accordance with Insulation Insp approved plans. This peLzrit will expire if work is not started Gyp Board Insp — within 180 days of issuance, or if work is suspended for more Susp Ceiing Innp than 180 days. Final Inapection Permittee Signature: Issued 9y: -- --- L -- - --- _ ----- Call for inspection - 639-4175 5 r v a� j. R 1 CITY OF TIGARD _ Rf CF_1P1" CIF Pi-Wr1ENT REC NUx 00107547-, (I � S CWEf.k: AMOUNT a 44ES.75 . t.WM{ t SUMMIT CONSTRUVION CAaW AMOUNT o .CIO �aC�C�F'ES5: PAYMENT DATE s 0,$--01—cW PORTLAND. OR 9721.0 EL.OLK NO/AI1LiR: r: 1 (x600 SW UAV, { PUPPOSE" OF F('o'MENT AMOUNT PAID PURPOSE Or PA4-MEN7 AMOUNT PAIL) i�HA)ING PERMI I (90-0046) 427.00 ;Tf4TL BUILD PERVIT TAx li d [ 1 E qq� .I TO1AL 01,10UNT PAID — — 446,77 'I if I I iia .,ea.� ^,• r ,M �i' Pt�N vq TUALATIN VALLEY FIRE & RESCUE AND BEAVERTON AFIRE DEPARTMENT FIRE MARSHALS OFFICE 503) 526-2469 POSTED: ARE OCCUPANT C; k' CONTRACTOR BLDG. PERMIT 0 PROJECT NA.1E V� �S .) PLAN REVIEW 0 LOCATION _ D 3 Oak � JURISDICTION: 1= Be. 2= Du, 3= Ii,C. 4= Ti. 5= Tu. 6= Sh. 7= Wi, 8= CC 9= WC 0= K COVER) FINAL SPECIAL FOLLOW-UP/REINSPECTION ATTEMPTED FINAL Framing ❑ Separation Walls ❑ Sprinkler System ❑ Shaft ❑ Fire Dampers (Overhead/Underground) El Hood' El Conference El Alarm System g Systems i ❑ Spray Booth ❑ Ceiling Cover ❑ O har f o v U �tA, — r +� , ,1 `\ i 7 bnf.e: inspector: w. f J L' Oki r { tl " INSPECTION NOTICE l_-- City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection -`Rr'`�-" ----_ Date Requested Time_ A.M. P.M. Address —� � Permit # ^ Owner _�__ - _ Lot # Builder The folir.wing Building Code deficiencies are required to be corrected: Presented to _ ----.___—_--- ---_ Anpiove.d Inspector [ 1 Disapproved Date -- CALL FOR REINSPECTION eORYES ❑ NO r 1• , Y l J' t.. .,v..,.n.rtkaMvnv+MwMN+Prh.4,'Mr4o+•w., ... -•:......,.- .. . : ,.i"f.,.,Wnww,al�.4"MN�M��. --. a ,- . INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-41x5 t Type of Inspection -�t��.____ __ •C-1�c-���_ ���.u'� iy`.�'` Date Requested ).me — A.M. P.M. • Address �!� 1��— �� --� � Permit # Owner Lot # x, +st gr — -- - �,. Builder :r 4z-t+�{� r a Yid + r I� ��; The following Building Code deficiencies are required to be corrected: .t f Hdg' 91t tb I _ _._ --__�____ dyu i L — p y - i9 ), YF s yea ��'r`•.. Presented to � Approved Inspector � 1�--- �_ Disapproved Date �� 2 ✓ — — CALL FOR REINSPECTION d L1 YE5 L1 NO Jw 3 —C' ®F T'��RD c n OFTUAm PLAN Ct1ECK APPLICATION COMMUNITY DEVELOPMENT DEPAR—MENT `0�'" PLAN CHECK N 74C'- 13M&W.HA Blvd-P.M Sm 2Mr.Tiqwtk Omgm 91 .(SW)MMYS 74C 13Ms-w.wAwvd-P_MSm2Mr.Tgwd,Omgmssm.(SW)MMYS PERMIT N DAft ISSUED k. P JOB ADDRESS: I(POC� vL,� �p _- TAX MAP/LOT SUB: _ LOT: LAND USE: VALUATION: i OWNER SPECIAL NOTES NAME: I L�J5(.ht l Ar•1 UJ °` Y.'` 1=i L'L REISSUE OF: ApDRCSS: ,g(� )Lk LAST REISSUE: Qn ort-4 fl�I? FLOOD PLAIN/ —'I It 50 TO AUL. SENSITIVE LAND: PHONE: q ( 7 a — APPROVALS RE R CONTRACTOR PLANNING: _-5 — Y NAME: S)0A& 7 ENGINCCRING: T ADDRESS: ,?6-06- IC,34 _ FIRE DEPT _ i1 ) 61'7 2.', OTHER. _ PHONE: ZZ-5--6j-765 _ ITEMS REQUIRED BUILDERS BOARD N: to3 z4 EXP DATE: LIST/SUBCONTRACTORS: BUS TAX: _ ARCH/ENGINEEr2 CALCULATIONS: NAME: _ W P"t 7� SL- 62 r/aid t1 1-4$ TRUSS DETAILS: ADDRESS: I SL)J -ri1 qLUW- `'T . LIT(' 10-6 OTHER: 9'7 LuS '657 PHONE: — � - 7 COMMENTS: 14' ////// SUBCONT ACTORS: PLUMB: MFCH: I PERMIT N ACCT N DESCRIPTION AMOUNT (1MCIINT PD. BAL. DUE 10-432 00 Buildim Permit Fees '�i�7• �v 10-431 00 Plumbing Permit Fees _ 10-431 Ol Mechanical Permit Fees K 10-230 01 State Building Tax (5%) %• - 2/S S Building _ Plumbing Mech 10-433 00 Plans Check Fee ?7�SS_ Z7l SS j Building Plumbing Mech _ — i. 30-202 00 Sewer Connc±ction 30--444 00 Sewer Insfx±ction 51--448 00 Street System Dev Charge (SDC) 52-449 00 P- z C-ystum Dev Charge (PDC) I 31-450 00 Storm Drainage Syst Dev Chrg (SSDC) 10--230 06 F ire i KU TOTAL REC N /0 / _4_._____ APPLICANT SLGNATURE Received By• -� Date Received: cn/3587P/19P ` 4 A 6.j TORT WWFWANRWK V: i a 1 I ' 1 � 1 f � 1 4 � 4 CITY OF TTGAND RECEIPf [IF PAYMENT r�LC 1,10. 00101104 ( ' CHECK' AMOUNT : 448.:7r., 11AME: SUh111.1I CON TRUCTTON f;A +H AMOUNT ,CSU � T HDUIz•ES;.i: F'q F+fiX 1Cl?.4a 1='(iY'MEt4 DNTf� s i11 PORTI_r+NT1. OR 1r72-0 1 I,' I F:iit'+0SE OF F'ra'iMENT AMOUNT PAM FIJFF'OSE: Oa i•(i'WENT 1.00UNT PA.11) I I F T1 =I I.rel l L:HF:CFi FEE (1 �4C:) _ .:`.� .h ..r�T'I N W 41..1..'r FIRE p: F:f=!a� U 1;17.GO � � f � v I 1 , ? I i � I Y � 11 1 fptif f ... 1. . 1