12433 SW NORTH DAKOTA STREET i
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12433 SW North Dakota
INSPCT�O NOTICE
City of Tigard Building Department
1.3125 SM Ball Blvd. Tigard, oregon 97223
Inspoction Line (Rec-0-Pho �: 639•-4175 Business Phone: 639-4171
i I
Inspection:__
Footing Plbg. dderslab Mech. Rough-in � lk
i
Found. Plbq Top Out Gas Line FINALt
PostfDeam Strur..t. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbq. Underfloor Nater Line Gyp. Bd. -Hoch.
Date Requestedt zz �__Tim9t _ AM PN
Permit
Builder: ((/ C, /-7f
THE FOLLOWING CORRECTIONS ARE REQUIREDt
�L" ._1 a y Cc c �tiAt.I..
lnapeCtPXf�L-L{. LL- •,(, L- y L� 1----..� betel
__-__APPROVED , ISAPPROVj APPROV1tn S11H.71Sc'T Tin Anovp
(2�Call For Reinsp.
C'TYOF TIGARD CERTIFICATE OF
WYO FMAIM OCCUPANCY
COMMUNITY DEVELOPMENT DEPARTMENT OMG*N . . . . . . . i MST91--0050
13125 SW HWI 6W. P.O.&K 23397,Tip,Oregm 97 (603)eP4476
:'_ITE ADDRESS. . . 12433 SW NORTH DAKOTA G7 PARCELs IS134CO-07 LOCI
,:iUBDIVISION. . . . r AN'rol') PARK ZONINGe A-7
BLOCK* . . . . . . . . . r LOT. . . . . . . . . . . z33
LASS OF WORK. PNEW
IIF OF USE. . . r 8
,JCCUPANCY GRP. cR3
OCCUPANCY LOADv3�5 4
I'ENANT NAME. . .
)�emarlf 6 1
JEFF OIDELL CMISTRUCTION
0 BOX 230273
fIGARD OR 97223
Flhone #% 50316206732
t.orpt %-,act or: --
,JEF=F= Ork.1-L CONSTRUCTION
0 0 BOX 230873
YIHARD OR 972c.,3
F)hone 0: 6134-8158
Peg #. . 1 !!3603
Occupancy of the above referenced buildint., is hermby [liven, and certifie-
the complianre with the "itate Of Oregon Specialty Codes for the group,
()uvi.tpency, and use kinder which the referent.-ed permit was issued.
VIRE DEPARTMFNT I,/ BQL>PINKS I NSF
Fij LITT
POST IN CONSPICUOIA" PLACE
IPSP&M V NOT 99
City of Tigard Buildinq Department
13125 SU Ball Blvd. Tigard, Oregon 97223
Inspection Lina (Roc--o-Phone): 639-4175 Business Phone: F.19-4171
Inspections
Footing Plbg. Underalab Nect.. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL%
Poet/Beam Struct. San. Sewer FramingBldg.
Poet/Ream Mech. Rain D) .1 Tnaulation -Plumb.
T11bg. Underfloor Water Line Gyp. Bd. -Meah.�
Date Requested:__
r,:}dresst .-.��___._...._1— _ld�7(��E!Z/3,.c— Pexmit #t
Builder:_ _ �: �.�C.�� —L..C! -• r- ---
;moi.-.._
THE FOLLOWING CORRECTIONS ARE REQUIRED:
..
--� _ --.
Inspectors y� Date,
— -- -—/
APPROVID DISAPPROVED / APPROVRD SUBJRCT TO ADM
_-Call For Reinep.
1
INIP39TION NOTICE i
City of Tigard Building Department �
33125 811 Hail Blvd. Tigard, Oregon 97223
Inopection Line (Rec-O-Phona): 639-4175 Business Phone: 639-4171
Inspection. —
Footing Plbg. Undorslab Mech. Rough-in Appr/Sdwlk
Found. Pl.bg. Top Out Cas Line FINAL:
Pont/Beam St.ruct. San. Sewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation Plumb.'
Plbg. Underfloor water Line Gyp. Bd. -Koch.
Date Rraque9larii / Times AN PK
Address:_ �_'2 y33 Permit ti
Builder:!_ �.—
TAE FOLLOWING CORRECTIONS AR= RAQUIREDs
Inspector:
�7 APPRiIVFD DISAPPROVED APPROVRD SUBJECT To ABOVF.
call For Reinip.
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INSPECTION NOTICE
Citp of Tigard Building Departmnt
13125 SW Hall Blvd, Tigard, Oregon 97223
Inspection Line (Ree-O-Phone): 639-4175 Business Phone, 639-4171
Inspection:
Footing Plbg. Underelab Mech. Rough--in /-1 Appr/Sdwlk
Found. Plbg. Top Out: Cas Line FINAL,
Poet/Ream Strurt. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation
-Plumb.
Plbg. Underfl.00r Water Line Gyp. Bd. ,-Mach
Dr t:e Requested: /0-A0 " _TLne: /,AN __PM
Address:- Permit 1:
i
Builder:
THE FOLLOWING cORRECTIONS ARE REQUIRED:
a
Inspector: 7L,I, Z=4t�
,late:APPROVETD APPROVED 3U8.1Et'7 n ABOVE
Call For Reinep.
ei � Iyer cee en It s� ser w
INSPECTION NOTICE
City of Tigard Building Depart—t
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 634-4171
Inspections
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet./Beam Struct. San. Straer Framing -Bldg.
Post/Beam Mach. Rain Drain Ins�ulatiioon -Plumb.
Plbq. Unuerflcor Nater LiinneO' yp. Ed. -Mesh.
Date Requested: �T/� Nimes _X_—AM PM
Address:-- 1 33 _7& permit
Builder: .J:.G. Ltl -- — W— -----THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspectors
_L�_11PPROVED DISAPPROVED APPROVED S11MIECT TO ABOVE
Call For Rainep.
j!SPECTION NQTICE
City of Tigard Building Department
13125 SN Ball Blvd. Tigard, Oreton 97223
Inspection Line (Rec-U-Phone): 639-4175 Business Phone: 639-4171
Inspection:. _
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plty. Underfloor Water Line Gyp. Rd. -Mash.
Date Requested: S ,_,.__Time: All
Address: Permit f:
Builder:
TRIC FOLLOWING CORRECTIONS ARE REQUIRED:
tnnpectuc:___ � Date:__ .___
"PROVSD 01ORPPPNOVRD APPROVED SUBJECT TO AROVE
►!call For Reinap.
INSPECTION NOTICE
city of Tigard Building Department
13125 SW Ball Blvd. Tigard, Orogon 97223
Inspectl.on LLne (Rec-O-Phone): 639-4175 Business Phone: 639-41'71
Inspection:__
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL%
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Bnam Hoch. Rain Drain Insulation -plumb.
Plby. Underfloor Water Line p. -Hoch.
y7
Date Regusetsds
IL y2_3 �*� �_Tt AM PM
Address: Permit #:
Builder: /J CDC �lC7
THE POLL04ING CORRECTIONS ARE REQUIRED:
L..
----------------- ------ - - --
inspector:___— /-- -�-----.._. _ Dater
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Neinap.
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I.RBPECfION NOTICE Y
City of Tigard Building Department
13125 Bt Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone(t 639-4175 Busineae Phones 631-4171
Inspection:__
Footing Plbq. Underslab Hoch. Rough-in Appr/sdwllt
Found. Plbq. Top Out Can Line FINAL:
Post/Boam Struct. San. Sewer Framing \) -Bldg.
Com. -�
Post/Ream Mech. Raln Drain Insulation -Pltwb.
Plbq. Underfloor Water Line Gyp. ad. �Mtl11.
Date Requested t —Times AM PM
Addreses �- '� _--J� _ Permit
Builder:__ fL..<aL�y _---��.--�--
THE FOLLOWING CORRECTIONS ARE REQUIRED:
-
T
1
C
k
Inspectors r' Dates-
APPROVED DISAPPROVED _ APPROVED SUBJECT TO ABOVE
Call For Reinsp.
xNS_ JqN NOTICE
City of Tigard Building Department
13125 SM Hall Rlvd. Tigard, Oregon 97223
Inspection Line (Ree-O-PhnnP;. 639-4175 Business Phone: 639-4171
Inspection:_
Footing Plbq. Under s. ab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post./Roam Hoch. Rain Drain Lneclation -Plumb.
Pl.bg. Undorfloor Watcr Line Gyp. Bd. -Mach.
r..
Date Requested: l _Time: AM PM
Address:_/--'-`7 Permit
i
Buildert__�_z_
THE FOLLOWING CORRECTIONS ARE REQUIRED:
i
Al1
I
Inspectors Date:
_APPROVED DISAPPROVED APPROVED SUBJECJ To ABOVE
`iCall For Reinsp. 9
1
ttt. set a tae t� tw e� � tier 7`"�
INS PzCTIOII IIOT 1 CE
City of Tigard BV=ldinq Departaent
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line�(Rec-O-Phone)s 639-4175 Business Phones 639-4171
InspectiontJ2% .5�.�c�
Footing Plbg. Underslab Mech. Rough-in) Appr/Sdwlk
Found. Plbg. Top Out /-Mas Line FINALt
Poet/Beam Struct. San. Sewer Framing -Bldq.
Post/Beam Mech. Rain Drain Insulation .-Plumb.
Plhq. Underfloor Water Line Gyp. Rd. -Mech.
Date Requested: Times _ AN rrPH
Address:__2L.) Permit
p
Builders � '�„r� -- •--
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inepectors�/ �7 7r` Date:
APPROVED DISAPPROVED DISAPPROVED —. APPROVED SUBJECT TO ABOVE
Call For Reinsp.
w w w w w s w w w
1NGU„F9TION_N0TI^E
City of Tigard Building Departsent
13125 BN Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections
Footing Plbg. Underslab Mech. Rough--ir Appr/Sdwlk
Found. Plbq. Top Out Cas Lia-- FINAL:
Poet/Beam Struct. g San,. e7W! Framing -Bldg.
Post/Beam Mech. in Drain Insulation _ulumb,
Plbg. Underfloor Nstar L •> Gyp. Rd. -Mach.
Date Requested
ss ��,�J Time:-444'e'.'I pM
Address: �e(�� �• �L�/�w-�a Permit 1:
—
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: Datee_a ' ✓ �Z�
APPROVED DISAPPROVRD APPROVED SUBJECT TO ABOVE
Call For Reinsp.
j(I�g��O(i P10TICE
City of Tigard Building Department
13125 SN Nall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Busi.neas Phone: 639-4171
Inspection: A�
Footing Plbg. Undorslab Meeh. Rough-in Appr/Sdwlk
Found. Plbg. Top Out gas Lind FINAL:
Pont/Beam Struct. San. Sewer PALPI
-Bldg.
Rain Drain In.ulation -Plumb.
Plbg. Underfloor Nater Line gyp. Bd. )!tech.
Date Reguestedt 5 7� �_ T1A:et %,ZAN PH
3
Addceee: /` 41 � ��, .� Pb:-mit f t1�r �•,v
Builders—
THE
uildert—THE+ FOIZOWING CORRECTIONS ARE REQUIREDt
r Apolz
/ u,✓g:2 Is" A005. i.vSu.4Aroti./ C
-��krgg- of r7ej2 IA.A.S o IT
Inspector: Date:
T APPROVED ✓ISAPPROVRD__ APPROVED SUBJECT TO ABOVE
Call For Reinap.
inspWrioN NotCE
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone: 639-4175 Business Phones 639-4171
Inspection:_
Footing Plbg. Underelab mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Strum:.-, San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line / Gyp. Bd. -mech.
Date Requeeted: �7 // __�___r1�= AM PN
Addreee:—��`1 �� ZZ, Permit
Builder: --
THE
uilders_THE FOy.I.ONING CORRECTIONS ARE REQUIRED-
I- /U JT
1G��v y wNG L
T
iel✓S GS ATv�
!%
Inspector: Date:
__APPROVED i� DISAPPROVED I_— APPROVED SUBJECT TO ABOVE
Call For Rei.nep.
IMSPEG 100 NOTICR
City of Tigard Building Department
13125 ON Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phones 639-4175 Business Phones 639-4171 X 1
Inspections
Footing Plbg. Underslab Mech. Rough-ir Appr/sdwlk
round. Plbg. Top Out Gas Line FINALS
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor WaterLineGyp. Bd. -Mach.
Date Requesteds_S / /�� _Timer _ AM PM
Address: n/�r/- � /y. / </ Cc�+- Permit 9 t 7 ' 0o
Builders o`L
THE FOLLOWING CORRECTIONS ARE REQUIRED:
3SGb ?ter
Inspectors
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
----Call For Rainap.
t
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INSPECPIQN NOTICE
City Of Tigesd Building Departaioet
13125 BW Ball Fled. Tigard, Oregon 97223
Inspection Line (Roc-O-Phone)t 639-4175 Business Phone3 639-4171
Inspections
Footing Plhg. Underelab Hoch. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out an@ Line FINALt
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Cain bra- Insulation -Plumb.
`lbg. tlnderfloo;. Nater Ling. Gyp. Bd. -Mach.
Date Requestodt _Z(/ z _ Timet _-AM PN
Address: Nc,r _--A Permit ftm'.5147 __
Builders
TRE FOLLOWING CORRECTIONS ARE REQUIREDt
dw
j 27
a
Inapectort Dater
4
^1 APPROVED DISAPPROVRD APPROVED SU&71tCf TO APOVE
---,---Call For Reinsp.
IRBP=CTTQN NOTICE
City of Tigard Building Department
13125 M Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)t 639-4175 Business Phone: 639-417
Inspections —
� P1 Underslab Mech. Rough-in Appr/8dwlk �.
noting I bg
Found. Plbg. Top Out Gas Line FINALS
Post/Beam 8truct. Ban. 8ewsr Framing -Bldg.
Post/Beam Koch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Rd. -Koch.
t- 5'q P,1(-
Date Requesteds ��l — / _Times —i+K PK
Addreses
y3 I Permit
r
Bx.ilders — --
TNN FOLLOWING CORRNCTIONB ARN RNQUIRND'
27w� f ell
'4e4D -
,Y C y.
Inspectors --- — Date:
APPROVED DISAPPROVED APRM95 SUBJECT TO ABOVE
Call For Reinsp.
CITY OF T I GA Rn
4fMASTER PER111 'r
COMMUNITY DEVELOPMENT DEPARTMENT
CrrYOFTWID ERMIT #• • • • • • • : MST91 --0(050
ond �'
13126 SW HmIl Blvd. P.O.Bac 2W97,Tigaid,Oregon 97223(M)63D4175
I
i--,f1 /1 DAIL ISSUE b : 03/27/,.)l_
I i L HLURLb,-i. SW 140R]H DAKOTA ST PARCEL: I51.34C130/ 100
SUBDIVISION. . . . : ANTON PARK ZONING: R-7
PLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . .
BUILDING
REISSUE: DWE-LL.ING UNITS: 1 BASEMENT. . . . . . . . :0 5f
CLOSS OF WORK. eNEW BEDRMS:2 BATHS:2 GARAGE. . . . . . . . . . :436
I YPE OF USE. . . :SF FLOOR AREAS------------- REQUIRED SE
iY►-If. UF- r0NF)T. :5N F I RST. . . . .224 S f LEFT. . :5 ft R I GHT. 20 ft
OCCUPANCY GRP. :R3 SECOND. . . :59E s F RONT. :;20 ft REAR. . 15 f t.
STORIES. . . . . . . s3 T'HIRD. . . . :611 sf
HE I GHT. . . . . . . . ..2S ft TOTAL--: 1431 s SMOKE DETECTORS. :Y
FLOOR LOAD. . . . :40 psf VALUE. . . . . $ s 73674 PARKING SPACES. . :@
PLUMBING
SINKS. . . .. . . . . . . tl FLOOR DRAINS. . . . :13 BACKFLOW PREVNTRS. 0
LAVATORIES. . . . . 12 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :N
TUB/SHOWERS. . . . :2 LAUNDRY TPAYS. . . -. I CATCH BASINS. . . . . . . r
WATER CLOSETS. . -2 SEWER LINE (ft ) . :O GREASE TRAPS. . . . . . . .0
DISHWASHERS. . . . : 1 WAIER LINE ( ft ) . - I 1Z.10 OTHER FIXTURES. . :0
GARBAGE DISP. . . : 1 RAIN DRHIN (ft ) . :O
WASHING MACH. . . : 1 SF RAIN DRAINS. : 1
MECHANICAL ------------------- FEES
FUEL UNIT HTRS. . :0 type Amot.int by riate t'ecpt
/GAS/ VENTS . . . . . .0 DAYM $ 100. 00 JLH 03/05/91 210292
MAX INPUT-VA BTU VENT FANS, . :2' BPRT 1- 13515. 00
TURN ( 100K . . : I HOODS. . . . . . : 1 HPLC $ x'30. 75
VURN ) =100K . . :0 WOODSTDVES. :0 SF)PC 1 17. 75
F-LU(JR FURN. . . . :0 CLO DRYERS. : I SSDC $ 37c. 00
BOIL/Cmp ( 3HP;@ OTHER UNITS:0 PARK t 1100. 00
GAS OUTLETS: 1 Ml,'.',RT $ 33. 00
0,,vner-- 21 5
JEFF O' DELL. CONSTRUCTION m5pC $ 1. 65
P 0 BOX 230273 PPRT $ 125. 00
P5PC $ A_ K-5
TIGARD OR 97223 Ilf- $ 1350. 00
F-11ione #! 50362916732 F-A Y M $ L90ii'. 65 JLH 03/27/91
JEFF O' DELL CONSTRUCTION
P 0 BOX 230273
TIGARD OR 970-_'23
Phone #:
Reg #. . : 53603
$ 300:. 65 TOTAL-
This pewit is issued subJect to the regulations contained in the REQUIRED INSPECTIONS
Tigard Municioal Code. State of Ore. Specialty Codes and all other Foot/fotmd Insp Fireplace Inso
applicable laws. All work will be done in accordance with avoroved Post/Seam StrLict Gas Line Insp
plans, This Deroit will expire if work is not started within 1W Flost/1-AeAm Mevhan InsiAlation InsF,
days of issuance, or if work is suspended
Pllm/Lmdslab Insp Gyp Board Insp
PLM/Underfloor-, Rain drain Insp
Permittee Mechanical Insp Water- Line In 1 1-7 n
FIJUMb Top OLtt Appv-/Sdwl k Insp
1sr".1e(j Bv - Framing Insp Mechanical Final
L—a-*1 T T—or- —i,r-i--,;--r)-L--t2 t i:n-
SEWER CONNECTION
C'1YCNTIFARD J�IWND P F-.'R M I T
CITY Twilm -,FRMIT #. . . . . . . . S W R 9 1—0 171,�
COMMUNITY DEVELOPMENT DEPARTMENT opoWN
9,25 SVI HWI Blvd. P.O.Box 23397,TipM,Oregon 97 (SM)630.4175
11Fq11Fn-
�ITE ADDRESS. . . : 12433 SW NORTH DAKOTA ST PARCEL: IS134CB-0-711?1N
',UBDIVISION. . . . : ANT'ON PARK ZONING.- R--7
,..,,LOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :33
ENANT NAME. . . . . :
JSP NLJ. . . . . . . . . . :43605 F'IXTURE UNITS.
'LOSS OF WORK. , . :NEW DWELL I NG UN I TS. I
YPE OF. USE. . . . . :SF= NO. OF BUILDINGS: 1
iNSTALL TYPE. . . .. :BUSWR I11PERV 311FRFACE. S f
i-lpmarks:
,-)wn er s ---------------------------------------- FEES
.,'EFF O' DELL CONSTRUCTION type amol.int by date recpi.
0 BOX 230273 PRMT $ 1500. 00
I NSP $ 35. 0121
IGARD OR 97E,=:3 PAYM $ 1535. 00 JLH 03/2*7/9t
'fione #i 503620673P
CIONTRACTOR NOT ON FILE
PI-ione #: 1535. 00 TOTAL
REUUIRED INSPECTIONS
APPIlLant agrees to cemnly with all the rules and regulations Sewer Inspet-,tion
the Unified Sewage Agency. The permit exn�.rps 120 days from
the date issued. The total amount oaid will be forfeited if the
Dereit expires, The Agency does not guarantee the accuracy of the
tide sewer laterals, if the sewer is not located at the measurement
riven, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall ourchase
a 74D. and Side Sewer' Permit and the Agency will all a late
-
isi-ted By -
Lall for inspectioli 639-4175
CITY OF TIGARD RECEIPT OF PAYMENT RECEi rT NO. 9 1--c:I I
CHECK nMOUNT
01 DEL-I-, JEFF CASH AMOUNT 0. 00
ADDRESS PAYMENT DATE r 03/P7/91
SUBVIVtGION
12433 NORTH DPKOTf)
PLIRPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
BUll-DING PERM MST's 1- 355. 00 PLUMB ING PERM I P 03. 00
MEUHANlCAL PF 33. 00 ST. BL)IL.D PER 25. 65
PI,,AN CHECK FE 139. 00 SRWER USA 1.17,00. 00
PpEW1-*_'R INSPECT 35. elo RESIDENTIAL. TRAFFIC FEES 1.2:50. 00
PARKS soc rift. 00 STORM DRAIN SDC 375. 00
MASS 'TRANSIT TIF FEES 100. 00
TOTAL nMOUN"r PA 11) 4437. 65
i
Building Permit No.
COUNTYWIDE
TRAFFIC IMPACT FEE Planning File No. —
PAYMENT OPTION FORM
Tax Map&Lot No.
Dat/e,
Project Name
I realize that I must make a decision on payment of the Traffic Impact Fee (TIF) at this time. Therefore I
request the following (Choose whichever option or options are applicable):
Cash or Check
Credit Voucher
LlBancroft or Installment Payments
and/or
(~1 The Ordinance allows for deferral of payment of the TIF until issuance of the occupancy permit if the
L� TIF is greater than$5,000.00. If the TIF meets this requirement, I also request this option. I under
stand the TIF must be paid prior to issuance of an occupancy permit. I also understand that the TIF
will be recalculated based on the prevailing rates at time of payment. Please be advised that TIF rates
may increase up to six percent each July 1 st. This rate increase is not subject to appeal.
OWN P (CANT OWNER/APPLICANT
CC Building Permit Filo
Payment Option Notebook
frim liff)?
i
I
C:I TY OF T I GARD - REC:F I pT OF PAYMENT V C:E=I AT NO. A 91--i I A�
CHECK AMOUNT a 100
{ IIJAME, ODEL L ! nNSTRUCT I mi CASH AMOUNT 0: oo
I ADDRESS PgYMEN'T DATE 03/Q15 9:1
SUBDIVISION m
l.OT 33 ANTON PARK
`uwCIsr OF PAYMENT AMOUNT PAID PURPOSES OF PAYME:.NT AMOUNT PAID
P!-AN CNI.IE.CK E='E.._3. +R ..... .._.._ 100. 00 ....w..._..__....__._.._.._._......._._.w.__.__.. ......w..,....�._._____..�.
i
-V O T At_ AMnUNT PAID T _ _ _.y ION. 00
i