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CERTIFICATE OF
OCCUPANCY
CITY CSF TIGARD NERMI I SUED% 10/30/95
DATE I SSIJEp t
COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hall Blvd.Tigard,pnpon 97223 8109 (603)639-4171n
FARL;LL.t 25104BA-_121GE-0 n �}
(A 1)DR1: r W NORTF(VIE 111
SUBDIVISION. . . . s CA:"; rl_E HILL. 0" ZCININCtR-12 PD
BLOCK. . . . . . . . . . s I.OT. . . . . . . . . . . . . .095
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(LASS OF WORN.. c NEW
T'YPE OFF USE:.. . . s SF
OCCUPANCY GRP. t 5N
OCCUPANCY LOAD 222
Remark% a PATH i �
Clwners _.._ _»_._..»..._»._._....__.._»........___.__....._.
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DCN MORISnETTE
i 5000 SW MEADOWS RD i
';UITC 151
r LAKE C7SWE(3O OR 97235
1='hung bks
620-7533
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DON MOR I GSETTE. 1-(OM(='5
`59)00 SW MEADOWE3 RD i
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I LAKE 1.)SWEC90 OR 97035 f
phone #1 620•-7530 �
„ Reg #. . 1 35533
this C;ert'• ific:ete grants occupancy of the Above referenced building or, portion
thereaf and confirms that the building has been inspected complian(-e with
the btaate of Oregon 5peciarlty Codes for the 91, oOLI :,, occupancy, and use under
which the, rtrfarenr_ed permit wals iss�,reci.
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F3UIL.O1NG INSPECTO E:llll_DING O("FICIAL
V,OST IN CONSPICUOUS PLOLE
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CITY OF TIGARD BUILDING INSPECTION NOTICE ' a
Phone : 639.4175 Business Phone: 639
Inspection Line (Rec O )
f Inspection:_ wlkSprink. Rough-in Appr/Sd
Sus . CeilingFooting ur;�aAf'
Mech. Rou h-in Fireplace
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Foundation Plbg. Underslab 9
Post/Beam Struct. Plbg. Top Out Elec. Rough-in
Post/Beam Mech. San. Sewer Gas Line
Plbg. Underfloor Re;n Drain Framing r
Alarm Wats-Line Insulation ech, '
Underilr. Insul. Shear Wall Gyp. Bd. �t _
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'� Time: AM PM '
Date Requested: U /q-5
Address: /3 2 / �
Builder: -7 -5—Z2 Permit p: M/ 9S-a/36
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Date:
Inspector:
DISAPPROVED _APPROVED SUBJECT
ECT TO ABOVE
Call For Reinsp.
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CITY OF TIGARD
BUILDING NG
INSPECTION NOTICE ,
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inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
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Footing Susp. Ceiling Sprink. Rough-in Appr/Sdw1k e'
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mach.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: /2-7 /l y Time AM PM
Address: -3 Fa L1 *1 LO
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Permit #: SL`CY —
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THE FOLLOWING CORRECTIONS ARE 1'�EQUIREU:
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Inspector. ` e 1 Date:
_APPROVED _DISAPPROVED —APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
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' CITY OFTIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phon,3: 639-4171 q
Inspection.
I Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Fireplace
Foundation Plbg. Undorslab Mech. Rough in
Post/Beam Struct. Plbg. Top Out Elec. Rough in FINA
�.
I Post/Beam Mech. San. Sewer Gay Line �-Bld .Plbg. Underfloor Rain Drain -raming
Alarm Water Line Insulation ech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect. i
Date Requested:
1 V _21 '_L��� Time: AM PM I
Address: `��7i� �` +''�'".1 uta i 4 •
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Builder. ? 4 - S� Permit #: a�3 ZZ'�
THE FOLLOWING CORRECTIONS ARE 1EQUIRED:
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Inspec',or: Date:
APPROVED k ISAPPROVED _APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE wt1
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Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: 'Ey'
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Footing Susp. Ceiling Sprink. Hough-in AppNSdwik
4 ;
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underfir. Insul. Shear Wall Gyp. Bd.
Date Requested: lee'-) �Z�O /7,S7' Time: AM PM +
Address: 13 aa�
Builder812.4/ �.3�`.S Per.nit #: 'C
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: l��i C 4P / Lt Date:'
_APPROVED DISAPPROVED _APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec O Pnone): 639-.,'75 Business Phone: 639 4171
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Inspection:
Footing Susp. Ceiling Sprirk. Rough-in Appr/Sdwlk i
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough in FINAL:
i
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Undertlour Rain Drain Framing lumb
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: � �Time: AM PM
Address:1 3 U ,; S–
Builder:__ _Permit#: / `� C) 13
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THE FOLLOWING CORRECI IONS ARE REQUIRED:
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Inspector:_ — Date: __ $`"
_APPROVED 6-151SAPPROVED rAPPROVED SUBJECT TO ABOVE
1��Call For Reinsp.
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CITY OF T,aARD BUILDING INSPECTION NOTICE
Inspection Line (Ric-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Snuct. Plbg. Top Out Elec. Rough-in FINAL: " 's
Post/Beam ble.-h. San. Sewer Gas Line -bldg.
Plbg. Underflcar Rain Drain Framing Plumb.
Alarm Water Line Insulation -Mech.
Underflr. I•Isul. Shear Wall /G Gyp. Bd. - lett.
Date Requested:_ ��/A0 L L Time: AM
Address:�_3
Builder: Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED: �� 3
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Inspector. /:�1�Yit�� Date:
__APPROVED _DISAPPROVED A�,A D SUBJECT O E
_Call For Reinsp. r
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CITY OF TI(',ARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
i
Inspection:
Sprink. Rough-in Appr/Sdwlk
Footing Susp. Ceiling y
Foundation Plbg. Underslab Mech. Rough in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL
Post/Beam Mech. San. Sewor Gas Line Bldg.
I r �
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line insulation -Mech.
Un1ertlr. Insul. Shear Wall C-9109�) -Elect. ,
Gate Requested: / 11�1 ��.5 Time:!AM 4PM
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Address:
Builder: Permit #: O ( 3
THE FOLLOWING CORRECTIONS ARE REQI;iRED:
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Inspector: Date:
APPROVED DISAPPROVED 4V-ED SUBJECT TO ABOVE
_Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639.4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbo Underslab ech.jRough-in "fFireplace
Post/Beam Struct. Plog. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain rare -Plumb.
Alarm Water Line ,u ati c -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. 1� •Elect.
Date Requested: /� 4 t Time:T AM PM
Address:
Builder: Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: Date:
_APPROVED DISAPPROVED XPPROVED SUBJECT TO ABOVE
I ( —Call I-eMI Mp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): E39.4175 Business Phone: 639-4171
Insoection:
Footing Susp. Ceiling Sprink. Rough-in .Appr/Sdwlk
Foundation Plbg. Underslab ec(vl Ro_- / Fireplace
Post/Beam Struct. Plbg. Top Out q/l Elec. Rough-in-6v/5'- FINAL:
Post/Beam Mech. San. Sewer r-lTis U 0 -Bldg.
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Plbg. Underfloor Rain Drain �'rami �/� -Plumb.
Alarm
Water Line 4� -Insulation -Mech.
Undeiflr. Insul. Gyp. Bd. -Elect.
Date Requested: Time: AM PM
Address:_Aq
Builder:_ Permit #: ofl�
THE FOLLOWING CORRECTIONS ARE REQUIRED: C)
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Inspector: Date:
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APPROVED ,DISAPPROVED _APPROVED SUBJECT TO ABOVE
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CITY OF TIGARD BUILDING INSPECTION NOTICE
frispection Line (Rec O Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struc,. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech. ,►
Undc rflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested:` Time: AM ___FM
M-
Address:
Builder: Permit #: -
THE FOLLOWING CORRECTIONS ARE REQUIRED: PS -2-- " 6 T/
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j Inspector: Date: 7 '
_APPROVED DISAPPROVED _APPROVED SUBJECT TO ABOVE
-Gall For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 63�9-�417J5 Business Phone: 639-4171
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Inspection:
I Fuoting Susp. Ceiling 1,prink. Rough-!n Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post,'�..•am Struct. Plbg. Top Out < ec. Roug -!FC, FINAL:
1 PostiLleam .1.4 e c h. San. Sewer Gas Line -Bldg.
r , f.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech. -P
Underflr• Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested-
._ 2L Time: AM PM
Address: -s l�—C,Q.� F�
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Builder:6L,rL ., Permit
THE FOLLOWING CORRECTIONS ARE REQUIRED:
4 77.
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Inspector: r , Dat,):
PPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
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Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 SW tall Blvd. • •
Tigard,OR 97223 PF.RMI #
Phone(503)639-4171 DATE ISSUED 01
FAX(503)684-7297 -—i--1– —
TDD No. (503)684-2772 _ . Mt �eu l".'
CITY OF TIOARD Inspection (503)639-4175 ISSUED BY
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
RESIDENTIAL—Restricted Energy fee. . . . . . . . �.pQ
Address
(FOR ALL SYSTEMS)
�7 2 ;.
City State Zip Cjx.sk Type of Work Involved: c
PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND EXPIRE IF WORKfwdio and Stereo Systems•
IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
❑
150 DAYS. Fillrglar Alarm
Garage Door Opener"
2. CONTRACTOR APPLICATION ❑ Heating,Ventilation and Air Conditioning System*
Contractor ,i-TiEeCI Type_12Es�4En'}L ❑ Vacuum Systems'
} 8�Ilii I19�• ❑ Other -
Address 3S� fV� ��'y ►4_.11 ._----
Date-4 ___ COMMERCIAL—Fee for each system . . . . . . . . $40.00
h,
(SEE OAR 918-260-260) ?' '
Property Owner .Check Type of Work Involved:
=ontractnr's Board Reg. No. �Q 7Q _ ❑ Audlo and Stereo Systems"
❑ Boiler Controls
Phun. # - a – L a� __ p ❑ Clock Systems
❑ Data Telecommunication Installations
3. OWNER APPLICATION ❑ fire Alarm Installation
❑ HVAC
i Phone No
Print Owner's Name ❑ Instrumentation
Address ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
City State Zip ❑ Medical
This Permit Is Issued under OAR 918-320.370.This applicant agrees to make only El NUr5e Ca11S
restricted energy in.,tallations(100 volt amps or less)under this p.rmil and to do the ❑ Outdoor Landscape Lighting*
following:
❑ Prolective Signaling
1. Only ase electrical licensed persons to do installations where required.(Certain
residential and other transactions are exempt from licensing.These have ❑ Other _
asterisks(').All others need licensing).
2. Cali for an Inspection when all of the Installations under this permit are ready
for Inspection at 503-639-4175. ❑ Nlanber of Systems
3. Purchase:separate permits for all installations that are not ready for inspection
•No licenses are required. licenses are required for all other insgllatlnn•,
when the inspector is out to Inspect under this permit. t
( 4. Assume responsibillty for assuring that all corrections required by the Inspector ya
are done,and
S. Assume responsibility for calling for a final inspection when all of the corrections 5. FEES
are completed, t�
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9 The person Signing for this permit must be the applicant or a person a. Enter Fees $_ tfi�
� authoriz d to bind the appli t. C�
b. 5% Surcharge(05 x total above) $_�_ _
Signature TOTAL $ _
Authority if other than applicant
FNERGAP.CHP
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-417
Inspection:
Footing Susp. Ceiling Sprink. Rough-in App
oundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. T6g.Top op Qu' Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Undnrfloor Rain Framing -Plumb. • e
Alarm C Watcr Line Insulation -Mech.
I-nderflr. Insul. S�ie T'1Na+ Cyp. Bd. -Elect.
Date Requested: ���1h Time: AM PM
Address:
Builder: Permit
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspect//or:
%--_ PPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
{ I
Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE �\
!nspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 V
Inspection:
Footing Susp. Ceiling Sprink. Rough-in App,iSdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line /' Insulation -Mech.
Underflr. Insul. Shoar'// Gyp. Bd. -Elect.
Date Requested:
l`��l`i Time: AM PM
Address:
Builder: Permit
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: Date:
_APPROVED &QISAPPROVED ^APPROVED SUBJECT TO ABOVE
1
all For Reinsp.
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Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. #
Permit # 02
Phone (513) 639-4171 Date Issued :25
1 CITY OF TIGARD FAX (50,•) 684-7297 Issued by -
TDD No. (303) 684-2772 K
Inspection (503) 639-4175
( 1. Job Address: 4. Complete Fee Schedule Below:
Name of Development (06W ICES r DEnl c d D Number of Inspections per permit allowed -
Address /3 6 2$ SW Noa-fK✓f e*LJ .DR. Service included: Items Cost(ea) Sum
City/State/Zip T/Gil R o. 02EGON 971 z3 4a. Residential-per unit 4
r 1000 eq If or Isaa {110 00 /
Name or name of business Dov /Volt werrf portion theHomes Each addilireof 00 eq It nr {26.00
( ) 1
� r UO
Commercial 13Residential IR Limited Energy $2500
Each Manu1'd Nome or Modular 2
Dwelling Service or seder 566 00
2a. Contractor Installation only: 4b.Services or Feeders
I Installation,alteration,or relocation 2
Electrical Contractor rmz EL a1-tL I G� (7v G. 200 amps or lose $6000 2
Address lo,0. BOX 3 9 9
201 amps to 400 amps se0 00 2
D State OR Zi 401 amps to Hoo amps $12000 2
Ci Do A) L-
.P 97020 601 amps to 1000 am pe S180.00 _ 2
Phone No. 1- 70 /3 SS over 1000 amps or volts $34000 2
Contractor's License No. ;?y-/n�G Reconnect only 515900
Contractor's Board Reg. No. 2.0 9/9 4c.Temporary Services or Feeders
T n Installation,alteration,or relocation 2
Signature of Supr. Elec'n - 200 amps or less 55000 2
201 amps to 400 amps $75 00 2
License No. /L.2 S Phone No. 478'1355 401 amps to 600 amps $10000 _
over 600 amps to 1000 voila
2b. For owner Installations: see•b•above
P4d. Branch Circuits
Print Owner's Name
New,alteration or extension per panel
Address__ _ a)The lee for branch circuits with
City State_ Zip purchase of wrvke or beder f e. 2
Each branch circuit $500
Phone NO. b)The fee for branch circuits without
The installation is being made on property I own which is purchase of aarvks or heater be. 2
not intended for sale, lease or fen'. First branch circuit $35 Do 2
Each additional branch circuit $5 DO
_I
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (it required): Each pump or irrigation circle $4000 2
Each sign or outline fighting $4000
Signal circuit(s)or a limited energy 2
Please check appropriate Item and untar fee in section 58, panel,alteration or extension $4000
4 or more residential units in one structure Minor Latxale(10) $10000
Service and feeder 225 amps or more
System over 600 volts nominal 4f.Each additional inspection over
Classified area or structure containing special occupancy the allowable In any of the above
ae In Plant $5500 described in N.E.C.Chapter 5 rer ,.notion $3500
Per hour $56 00
Submit 2 sets of plans with application where any of the above 1
apply. Not required for temporary oor,struction services. 5. Fees: fi(
NOTICE 5a. Enter total of above fees $
5%Surcharge(.05 X total foes) $ Ty v
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Su ! L?o, 30
Sb.Enterer 25 25%of line A for
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF Plan Review if required(Sec 3) $ X
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Subtotal $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED ❑ Trust Account N
$ �
Balance Due $ 1" Sa
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.��Y f��r��ANdS%'IRM�NWe^WRWic`en�fr.�0.'e'e�nr,blMrn.�IMRanew.+rMwae�.adrr<wnwu,.ew.r.,..�.:4,aa.1:.p.u,w[Aytb�l.r,Ne{rt,4u+erwYlwY.11'PlOF4'Ct6�
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r U IMr I SEAF1 RI_ECT R I F, MC [;F14iF1 (dtlO11N f a 0. 0.40
Ai)t'►14 I r."'MA5 BUT'TE::V 11 I ( hdl f NI PAYPIVN I 1);-11V I SYN
Po BOX 389
r1OWL.1) OR
(.IF* NlYMEIVT V1111t1N1 I44J1, t.tt►''t t1 ,I l)I f�l1ti''MF:NI (,rlt.f�)raI F'(►XI) I
tJ 141CA-1~ I+ 12M1T
it I
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t 382"1 3W Nt1R'T I-IV 1 I:W OR
I.:L 9 vi—fAr.';3''9
jt)'Tj)L AMOUNT PAID 220. NA
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C I-rY OF T I GARD — RECEIPT Or PAYMENT RECEIPT NO. -95--i?( 1201
CHECK F mntJNT i 1711. 50
�INAME a G I TY ELECTRIC & SUPPLY CO CASH AMOUNT a 0.00
ADDRFSS a 10414 SW CANYON RD PAYMENT DATE O6/26/95
PORTLAND, OR ,UDD M G ION t
9 722 r•-
I) PURPfJOC" OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAIL?
ELECTRICAL. PERMIT t63O. ISO ST. BUXLE)~ PER St. 50
I
1
I
1:31323/t 383 a/ t 38E- 3/ 13892/14O 12 OW L_I DEN, DR
13760/13825,113887 SW NORTHV i EW DR ww,
1 TOTAL AMOUN'r PAID _ -> 1711. 50
I..., ..,.,,w...-._........W._..._...�..__"___ ...__ _-..._.,.,� _... ..._...r.._..__r�._:•_._.. .._.. !.«..."-.._........_ .._..`!':.._. ._-._t._ !.._.__.1...-.- .___ ....._ .�-_ .._ter__.......,_._..-��._ - -
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WASHINGTON COUNTY ELECTRICAL PERMIT
Department of Land Use & Transportation
Electrical Inspection Section
155 North First Avenue, !!350-12
APPLICATION
Hillsboro, Oregon 97124
Information: (503)640-3470 Fax: (503; 693-4412 Permit
.1�' -
. .
Number � '�, OIC?I Date
PLEASE
Please complete _ 4. Complete Fefa Schedule below
Number of Inspections per permit allowed
1. Location of Installatio Service included: Items Cost(ea-) Sum
Address 13k�e; 5A% or�`�i tI etc)
Building A. Residential-per unit
City _ Suite o. 'O -(J 4
1000 sq.ft.or less $110.00
Tenant Name Each additional eq.fl �QQ
(H commercial) or portion thereofeof $25.00 ,
Limited Energy $25.00 1
Map No. _Tax Lot - Each Manuf'd Home or Modular
/ Dwelling Service or Feeder _-
$W-00 2
Thomas Map Book: Page: 12� - Section:AlY-
Directions------ ---- B. Services or Feeders
_ Installation,alterations or relocation
200 amps or less $60.00 2
Commercial F] Residential 201 amps to 400 amps =_ $80.00 2
401 amps to 600 amps $120.00 2
601 amps to 1000 amps $180.00 2
2a. Contractor 1 tall, only: Over 1000 amps or volts $340.00 2 J
Electrical C ntraetor 1' f Reconnect only $50.00
Addr -Ck State ZIP C. Temporary Services or Feeders
City Installation,alteration or relocation
Date4-� Job Number - 20o amps or lase $50.00 2
Property Owner _ ` � `' 2
201 amps to 400 amps $75.00
Contractor's License No. 21 -14'9 I!f. - 401 amps to 600 amps $1oo.00 2
Contractor's Board Reg. No, -��2_Z._ over 600 amps to 1000 volts see's•above
Signature of Supr. Elect D. Branch Circuits
License No. ?c]?a� Phone N0. � [�/ New,alteration or extension per panel
a) The fee for branch circuits with f
purchase of service or!seder lee. +
2b. For owner installations: Each branch circuit $5.00 2
b) The fee for branch circuits without
nest Phone No. purchase of service or feeder lee.
_ First branch circuit 2$35.00 t
rase Each add'nl branch circuit $5.00 2
E. Miscellaneous (Service or Feeder not included)
Each pump or Irrigation circle $40.00 2
The installation is being made on property I own Each sign or outline lighting $40.00 2
Signal circuit(s)or a lim;ied
which is not intended for sale, lease or rent. energy panel,alteration
or extension $40.00 2
Owner's Signature _ - --
F. Each additional Inspection over the allowable
In any of the above
Per inspection $35.00
3. Plan Review section (if required) Per hour _ $55.00
Please check appropriate Item and enter fee In section 59. In Plant $55.00
1_4 or more residential units in one structure 5, Fees 9 i
_Service and feeder, 800 amps or more /0,
__System over 600 volts nominal A. Enter total of above fees $ a
5% Surcharge (.05 X totai fees) $ 117
Classified area 0r structure containing special
Subtotal $ -
occupancy as described in N.E.C. Chapter 5 B. Enter 25% of line A for
Plan Review if required (Section 3) $ - -
Submit 2 sets of plans with application where any of the Subtotal ---
above apply. Not required for temporary construction C�
❑ Trust Account $
services.
Balance Due
For Inspections call This permit becomes null and veld If The work authorized by the permill to nos comrsenoed
640-3561 or 693-4415 within IN days from dale of Issuance of such permit or M the work authorized
Is
suspended or abandoned at any time after work is commenced tot a period of 160 days,
24-hour recorder, one working day In advance of need Electrical Permits are non-refundable and non-Iraneferable. 8/94
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (11ec-()-Phone): 639-4175 Business Phone: 639-4171
Inspection:.
Footing S sp. Ceiling Sprink. Rough-in Appr/Sdwlk
Founda' Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Stru Plbg. Top Out Elec. Rough-in FINAL:
� t q San. Sewer Gas Line Bldg.
t, lhgrrder4leet� Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall ( Gyp. Bd. ElElect.
Date Requested: ��' �- I 1 5 __Time:
jfA6N �—PM
Address:_
Builder: Permit #: S
THE FOLLOWING CORRECTIONS ARE REQUIRED.
Date: � Z Z-
Inspe tor: —
/APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
i
/�� _Call For Reinsp.
a ,. :LTi •.
CITY OF TIGARD BUILDING INSPECTIOV NOTICE
Inspec' ne (Rec-O-Phul*. 639.4176 business Phone: 639 4171
>4':
Inspectio
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk ;N
Foundation Plbg. Unders!ab Mech. Rough-in Fireplace
p t. Plbg. Top Out Elec. Rough-in FINAL:
P eam M� San. Sewer Gas Line -Bldg. --
pjTl�_ Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mach.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect. '
Date Pequested: /�–� .5 Time: AM PM
■
Address:_ _
Builder: 7 y– l i' 's S Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
ti
�/.✓ / 11E )
Inspector.'/ _ Daic: --'7 --
//—,--APPROVED _DISAPPROVED __APPROVED SUBJECT TO ABOVE
Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk f
Foundation Plbg. Underslab Mach. Rough-in Fireplace
Post/Beam Struct. Plba.ToR.Out Elec. Rough-in FINAL:
Post/Beam Mach. San. r Gas Line -Bldg.
Plbg. Underfloor ain Drain Framing -Plumb.
Alam ater Line > Insulation -Mach.
Underflr. Insul. (tear Wall Gyp. 8d. `�`�� Elect. •
7.S Time:\`� AM PM
Date Requested: e - `/
Address: �� 2 S / ()✓T rl ll�C'. �✓
Builder:��� ! Perm! A: 1 5
THE FOLLOWING CORRECTIONS ARE REQUIRED:
`faY
7,�+t
I
4 Inspector: D-Ite:
/
,
/ APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
Call For Reinsp.
pp} Il FI to�Vx'q; rlpl + + I
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AWL ddk.L
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CITY Or TIGARD BUILDING INSPECTION NOTICE /
Inspection I.me (Rec-O-Phone): 639.4175 Business Phone: 639-4171 l/
Inspection:
--- –—�
Fo Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Fou,rdation Plbg. UnJerslab Mech. Rough in Fireplace
Post/Beam Strutt Plbg. Top Out Elec. Rough-in FINAL:
Pnc,/B'am Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm
Water Line Insulation -Mech. •
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Time: ✓ AM PM
Date Requested: `� ` q -
Addi ess./ L.5 r7r �j, ' ec,J yy���r–p.C_ a/-
r3uilder: L.e,J/h ��"S� �J Permit #:/ M►� G✓_^01 J`P
THE FOLLOWING CORRECTIONS ARE REQUIRED: I `
i
i
(�� %l�'A,i.fl/J•N ��Y �" r'iyu�a' L'L�sr.'+!'�an/C ���7i1=
Inspector:_ -
Date:
APPROVED _DISAPPROVED � ROVED SUBJECT TO ABOVE
Call For Reinsp
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.'LUMBING PERMIT ,
' • CITY OF TIGARD DA-rCrISSUEDs• 06/arc/95j._.�'c`�t
COMMUNITY DEVELOPMENT DEPARTMENT
i 13125 BW Hall Blvd.Tigard,Oregon 07223.0190 (503)639-4171 PARCEL.;
t AjBD I V I S I ON, . . . a CASTLE HILL #E
ZONING; R-1:: F'r}
OCtt. . . . . . . L-OT. . . . . . . . . . . . .
.0'3
!_A`S or WOR1!„ . :t'JEw
...1'r?Iw OF.' U SE. . . . r !1
;CF" WASHING MAC'H. . . . . . . a , R:1CKFi.,0W PRE:VN'Ra^. . : 1
,."C .UPFINCY GPF. ., :R3 1"I..Wt.IR I.RAI NIS. . . . . . . :QI 7VAPS. . . . . . . I . . . . . .
ilf?I[ G• , . . . . 1,C, WOTER HEATERS. . . . . . : 1 CATCH BASINS. . . . . , . .0
IXrURES- • i_AUN011Y TRP)'(^. . . . . . .. r7 RPIN DRAINS. . . . . : ': i
z 1 CREASE TPAPS. , . . . . . 10
I NKS. . . . . . . . . .
i_.AVA T 0rilE'13. . . . . a 3 DTI EP t'I XTURE4, . . . . z 0
TUlilr:rltJWGRS. , . . a SEWER LINE Oft ) . . . . :0
C .11 11 ,11
WATC R, C1..1:15CTS. . WATT"R 1-INE (ft ) . . . . ; 1
'?7rHW1aHER9. . . . : 1 RAIN DRAIN !ft ) q0 1
PAZ'l 1 I
c
IWNE.R a
DON I�'QRIS iC t 1C.,Zj. Qr0 rW OG/06:95
1 ;SWP-1 100. 00 SW 06/06/95
I SOZO iW MEADOWS RD
6.':'I . 00 SW k"1C�x/1716/95 _.
I+ I.._AKE 0SWE00 OR 97035 E1PLC f 41 1. 15 SW .3/-4/95 95_-"163,+;,
,3,' Brr.'C 'r :I. . r:r. r W 00/1121,
PARK $ 500. 00 SW 06/06/95
"1PRT i- 4Ff. 00 5141 06/47
', i�•."
06/171 C'/7)5
lame O•e25 SW 0+6i1!i', ;-1
lcidr
C) 225.Qj�'�.Z�• J 3PTId 9src:`'i. 00h 54) QiC�r'4�F..•:'�C�
SW
St''IC
7.i Ct J�-77�� r'R0S zx 64. 00 SW
ey
Aciclitirsn��l fee's rc,r- ;;lio�r lfe;,e, , �
iar?r +ra.t i to the aW
iat iunr contalirlvd in the Tirgavd MuniciPal rooting Insp Insulatir,r .nay
Code, Sta to of q��e. ^.,r(7acialt,, C%)) Ies Vinci ,ill rouridAtion Insr� Do��' T'nr,r
uthfor, applicable laws. All wol^k will be done Post/Seam Str^I.rct Rcin dv�,Ain ?-
i r, -c_ ,t^danr:2 with ,ate( k,avr?d pt.rr;:,. 'rhi ., PV.Fjt ,'Csr?m Mc-,c!-Iat" 1J; t ->t I_ir, I
�,er m;.t will expit,e if wor4- if not 9tar•tVd C;r^awl Drain Water !tier^vic_F Tn
IevlWith.i.n tt39r r_iay,r; of issr.rar,c'e, ar if' �arlr i. s F'llu;uncislab Inal7 Appr•/Sciwik Incap
r.�.rQ��c?ndtrJ fur- movr than 1110 cla'n's• F'LM/Uncirtt f'lcror Me,:hetnir:�.l Final
r1lumb Top [Jut Building riri.a'
rl Aminu Insp
r-i r..eplac.r int:,P
Ga;; i_ ;)e Insp
LU•.
Call for- insper_t; i en (�341,77
`unt'; zir~tor` I'Slotes:
,:;
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t CITY OF TIGARD PERMIT"TER#.. . 1~'.. . :TMST9 3 -013i.
COMMUNITY DEVELOPMENT Dd ARTMENT DATE. ISSUED: 06/06/9'-) r
t 13126 SW Hall Blvd.Tigard,Oregon 97223.8199 (603)639.4171
PAPCEL. : 23104SA-'06;200
r' AG1)RCF,5- . . : 13825 SW N10RTl1Y`r"W OR
3DIVISION. . . . e CASTLE HILL #E' ZONING: R--12 PD
I . . . . . . . . . . .. 1-OT. . . . . . . . . . . . . .09
_...._.,_._..._..___.. _ .._...._.. __.__._...._ BUILDING -
I't DWELL I NG UN I TG: 1 nASCMENT. . . . . . . . :0 S f
CLASS OF WORK. -NEW ACDRMS:3 BATHS:3 GARAGE. . . . . . . . . . .440 Sf
TYPr-." Or. U^)E. . . :^:F Fi..00R AREAS - _...._........... PEOULRE1)
TYRE OF CCNST. :5N I`I RST. . . . : 1260 s f LEFT. . :20 ft R I GHT. :5 f I
C1C:cur.�N( ''.' rRtw. :17:, SLCnNj). . . : 1390 sf F"PO11T. :213 ft REAR. . :2S fl ■
STORIES. . . . . . . :2 FINESMENT:0 sf RCD.UIRED------._
HEIC3HT. , . , . . . . :; "3 rL TGTAL----. '-- ir ".'MOKE DCTrCTOrtS. :Y
F*"OOR LOAD. . : . .40 pr,f VALUE. . . . . f ; 179155 PARI•<ING SC'flCCS. . ? I
r�PmAv-115 : PATH I
PLUMBING
SINK.".i, . , , . , , . . . 31 rl..00R DrriNa. . . , to nAC!'!,r-'LCiW PRrVNTRS. . : I
LAVATORIES. . . . . . 3 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . .0
TUD/1,'OWCR S. . . . :3 LAUNDP'I TRAYS. . . :0 CATCH PAGING. . . . . . . .0
WATER C;l_CISETS. . 3 SEWER LINE (ft) . :O GREASE TRAPS. . . . . . . ;0
D T.21 4WAS1 JEE S. . . . . I WAT1:r2 L..INE (-rt. ) . : 100 0TH1-- ; r I XTURES. . . . . :0
7ARsAGE Drsr,. . . : 1. RAIN DRAIN (ft ) . :0
WAf',HING MACH. „ . : 1 SF RAIN I`RATN:t. . . 1.
_. _...._.._.,._. MI-CHAP, ICAL. _._.._.._. ...__....._._---,__...__.__...._...___._._._,__._--_ FEES _. .-.
~UE:L TYPES--- irmo.t. . .til F e 'et m43unt try date r 0 C G'
/CIAS/ I ! VENTS . . . . . :0 SWM 180. 00 SW 06/06/95 MAX I Nr'UT:O LTU VONT r HN:.,. . : 4 GW^* 11 101.1. 00.. IS 0(1- /0G/1)
TURN : 1 OOK . . :0 HOODO. . . . . . . 1 f_PRT 6 C�.33. 00 SW 06/06/15 ;
TURN . . . I W1000TO'X.S. .0 I PI—C f 41 1. 1`3 SW 03/1"'4/1'` ".rC L".6-
00
i._00R TURN, . . . :0 CLO DRYERS. ; 1 H"aF'C $ 31. C15 SW 06/06/95
OTHER UNITS: 1 PARK QIO. 00 SW 06Y,0 C., P) +
GAS OUTLET`';: I Mr•RT 't 45. 00 SW 06/06 95
SW 0(:t' 0("/9 5
:.'_IN MORI5SETTE M5PC t 2. 25 SW 06/06/95
5000 SW MEADOWS RD 31)7I I t X21 i. 4';17 SW 0C,/k'.1')/9t
SUI'T'E i5l1 P 5PC f 1 1. 25 113,W 0G/0G;95
;.-AKE. hI,W1EGO OR 97035 Er'C:11 1 64. 00 SW 0"t ,0'./")'1 w,
Ethane ft: 620-75301 t'f:E'C i ^tz'I. 80 SW 06/06/95
CRPC 4 �'0. t30 ";W b'�C•.'arif.:•i1)5
OnN MOR I n3Sr.TTE 1•I0MES7,
:3000 S14 MEADOW!", R1,
SUITE 151
L,Al ' 0)WEGO11�p TOTAL
Phone 4: 620-7538
r
This pereit is issytd subje.t t� the regulations contained in "he -- Rr:'QUIRED Tie"PrLTIC)N.-c
'ioard Muric;pal Cade, Stat t of aro. Specialty Codes and all other r rot my Ins:p r'.1 t.tntb Trip nut
spplicab)k laws. (111 work will bt dont in accord: approved FoundAtt i on InSp Ft-aetir)q Insp
G:ahs. 'his pertit will expirt if wol 1
ai s of iS5''.ia1iG'tt Or if wo"A is POSt/Beam McLhatn Gann ' ille Insp 5
crawl Drain Tnl tj;lat on Ilisp
r' Im, rmd4lr',L: I no,:.ir•c1 Insp
PLM/UnderfIOcr Rain dt^ain Irta.(t
u'.1.1 P UJlv-L� I�ttr. It,;ni::al. n ;l, Wator• Line In
mall for inspection 639-41755
t
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CONNf:C:i 1 ON
PE.Mil I T
CITE OF TIGARD f=CRMI T ##. . . . . . . e SWF r3 -Q11 'A
OFal'E V-7,53
COMMUNITY DEVELOPMENT DEPARTMENT ,
13126$W Hall Blvd.Tigard,Oregon 97223.6199 (603)639-4171 PARCEL;
-.xPTiIVIEW ^R
'uBDIVJGION. . . . .. CASTLE HILL #:: 70NINr: F'D
. . . :lb9'' _ .._....._.._._...
"CNnNT NAME% , . . .
JGA rao. . . . . . . . . . e FIXTUREuNITG_ . .
OWCI_LIN1, IINITG. . : 1
'LASS OF WORK. . . :NEW NO. OF BUILDINGr: 1
403TFLI.. TYPE. . _ . : I M7`EF'J ^,LIRF'fa(,t .. •
7�rnab kaa PATH .T.
__... .__ ._.... .-....__...._...._...______._ _. . FEED ___..._..._... _._..__.._•_.
-,gra tyff7RI5;;" ' : type amount by dater
::,731`4 h GW sr5rE.I)L'WO
c. f:I} PRMT' $ .F✓00. 00 CW O6loc,1,15 1
ul rl" ,1 INSP $ ,7Coe Gw
. t E•/4'�G/'J
LAKE OSWrGO ON 970,'`.70
620 -75:73A
contractor .
,—ONTRACTOR NOT m rILE
,
TOTAL
Req #). : Rr:DUIRE TI T• 17.-7777rh17-
"his Applicant agrees t3 coc:piy with ill tie ''d1N5 and rey,:at;a,s r3�w�r' Ir, 1.:0r.c t ian
of the thlfivd Sewage Arencp, The permit aspires IU da,4 frog
the date ilsued. The total aeaunt paid will bc. f;rfeitfd if the ._. ........
per>si'- expires. The Ager zy "e; nct 20javantec the accaracy of the r 1
side sewer laterals. if the se..er is not iacated at the �F = eluent - -- - -
given, the installer sm"I arosptct fpPt in atl
t i.
the distance given. If rot so located, ar rl- cha4e _.
a "Tap aoJ Side &ewer° Nollit and ttr
polln i.
t;aal l f uv- inspect i r-,
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...,. . ..._......wadi L .
10j 36$
Residential Building Permit ARplicationn =� �
City of Tigard '
13125 .SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jbsite Address: "�� �"� --) 1V Gy4k U CvL
i
✓
Office Use Only �
�Subdivision:���"' �-4�1 � Z Lot#
✓iPlanck/Rec#
Valuation: _ 1`7
Permit D !3
Comer Lot? Y N
Reissue of
Flag Lot? Y N
Map &TL# 2- J k0 q 8R-(�ZUQ �✓ r
Owner. t��lf'�0f 1 Sra�Ti� 4'�D1'll . I A� Aonrovals Regulred:: 1
Address: _w-V11 M� ID• �l���J' I Planning
i
Engineering
K Phone: ��� ��J �J'P� Other
Contractor. � f�1 w.:Items R uired
Address: Subcontractors f
-- Truss Details
t Phone: _ Other
Contractor's License * '5'55-33 mp.
(attach copy of current Oregon license) ( T i F: VOU-C, t
TI
Contact Name& Phone:-MQ�4
Subcontractors: Architect/Engineer.7190146
Plumbing:`, tj ArKE9-1:) T' .UM�11J 0 Address:,E= !WV a Is I
Mechanical: C�UI`h�-1 ��}'l�• f YI" '' 79 �L'
Mec
.W (attach copy of current OR Contractor's License) PQ
Phone: Lac ' �S
fl.
JOB DESCRIPTION: —
r
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Aoplicent Signature & Phone number
Recenieo by: _< \� Q y/L Date Received: _
►t\W DCOMOWV%"SAPP
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Penult# Account Description Amount AmL Pd. Bol. Due
Bldg. Permit (BUILD) 3 7 3
r
Plumb. Permit (PLUMB)
Mach. Permit (MECH)
:,tate Tax (TAX)
Bldg:
Plumb:
Mech:
Plan Check (PLANCK) ' ,�d 060 �� v ✓
Bldg:
Plumb:
Mech: L
s�ti/Z -ll Z Sewer Connection (SWUSA)
Sewer Inspection (SWINSP) 3? > >
Paries Dev Charge (PKSDC)
Storm Drainage Chg (SDSDC)
Residential TIF MF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF MF--C) -
Industrial TIF (TIF-I) _
Institutional TIF (TIF-IS) _
P Office TIF (TIF-0) -
{ Water Quality (WOUAL)
Water Quantity (WQUANT) _
Fire District (FIRE)
Erosion Cntri Permit (ERPRMT)
Erosion Planck/USA (ERPLAN) �'
Erosion Planck/COT (EROSN)
TOTALS: �-y `/ � 4 , S,
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CITY OF TIGARD
BUILDING DIVISION
RESIDENTIAL PLANS SUBMITTAL
APPLICANT NAME: ��"1 �'� PLAN CHECK # _
Y
ADDRESS:
cx�� w Y��-.AQt't-�S. ' PHONE #
�
DATE RECEIVED: RECEIVED BY:
CH:^KLIST (All items must be in packet before plan will be reviewed)
YES N O N/A
3 FULL SETS OF BUILDING PLANS (No red lige revisions I
or tape-ons).
✓,
4.: 2• .. [ ] [ ] 5 SITE PLANS(pcluding tax lot and tax map number,easements,
erosion control provisions, oor elevatir.;. nf garage and main
floor, set ba�dcs, drive-way ("ovation, nor'.h grow,scale, location ,
t and termination of rain drains, comer elevations, and contours
Y if over 15% grade).
3. [ ] [ ] BUILDING PLANS SHALL REFLECT TOPOGRAPHY OF LOT
(if house is designed for a flat lot and the lot is not flat, revised
drawings are required. No red lines accepted).
4. [ ] [ ] REVISION TO PLANS MUST BE FOLLOWED THROUGH
FROM ROOF TO FOUNDATION (detailed sections may be
ar different from the originals as a result of your changes. These
portions of the structure that are affected by the change need to
be reflected on the plans. No red lines will be accepted).
S. [ ] [ ] FLOOR PLAN(S)
i 6• k'9 [ ] [ ] FLOOR FRAMING
L
a• [ ] [ ] [ ] TRUSS JOISTS (engineering, details and layouts)
t
8. 1 [ ] [ ] ROOF FRAMING PLAN (all hips and valley supports indicated
and detailed).
— OVER —
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YES NO N/A
9. ,Q4� [ ) [ ] ROOF TRUSSES (engineering, details and layouts)
10. [ - [ ] [ ] COMPLETE CROSS SECTION(S)
11. [ ] [ ] ALL 4 ELEVATIONS ARE SHOWN - 3 ELEVATIONS FOR
ADDITIONS AND REMODELS
12. [ ] [ ] BASEMENT WALL, FOUNDATION AND RETAININ(; WALL
SECTIONS (will need engineering if walls are 8 ft. high or
higher)
13. [y� [ ] [ ] WALL BRACING (structure must meet table R-402.10, revised
alternate method 93-7, or a lateral design shall be provided)
14. �QQ [ ] [ ] ALL DETAILS REQUIRED BY NO. 13 ABOVE SHALL BE
INCORPORATED INTO THE PLANS. (Attachments must be
clearly legible and fully referenced in the plans).
' 15. BEAM CALCULATIONS (all beams over 10 ft. in length or any
beam that supports a point load).
16. [ ) [ ] ' - ENERGY CODE PATH IDENTIFIED
41
:. DO NOT MAKE CORRECTION IN RED
RED WILL ONLY CAUSE DELAYS
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•,•.. •• �� �� Sw ����v�w pyo •,-
/f Credit No: '
Cala Issued: , ,1
TRAFi=IC JMPACT FEE
VOUCHER
Cn^E7IT Hf=R
't/f •fr.1. / I7 cCCC da,7Ce WIu] t„a Ira, !C InY^ ct Fee ., Corp toaion
Is erttled t0 $1 /5 50
,-_ Cwelits„ =t =n be 2pp,je;, tv T 1F charces
on 10t(s) 60-J;; cf t e Cast/a h'ilI No. 2 C_v
z,,• elcpr,aRt. The use of TIF c-_dits
.A\. are subject tc the rules and Iinitaticrs of t,',e T iF d'� e. '" ' NG:
Or 1„c^RC l b ti n,
This voucher Host ba prasertad at the fine Cf issuance of the =uiiding or if deferral
was granted issuance of P-,-,
Cc�uparev Far,;,it.
MA T,=lX Cc VELOr-MFNT COHPG�;ATION hereby assigns all its right
title and interest in and to that cert:in Trai c lm;act Fee Credit to be granted I
uoon tie 155L'cnCa Of a bUild;'r; ^ '^ t fcr Lot 95
re.,,,!
CA cTr _ /.'/L r NO 2 subdivisicR, Washir,!to County, Creccn, to the order cf.'
DON MORISSETTE HOMES, INC.
5000 S.W MEADOWS ROAD, SUITE 151 p
I LAKE OSWEGO, OR 97035
I TI^
1 is ass; , r'ert cf T ra,`;`c h—_7a:!Fee Crad;'t is rade and_-iven this _)
day cf ;g
hhATnlXGc''=LCF,W=NT CORFOnATION,
an Cr=_,;n Ccr�vratior,
Ey: � Title or PcSitior,��— �
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CITY OF TT13ARD -- RECEIPT OF PAYMENT RECEIPT NO. v95--,266369
CHECK AMOUNT 4491. 15
NAME a DON MOF I Sr3ETTE HOMES CASH AMOUNT a 0. 00
0
ril)DRE SS a5000 SW MEADOWS FRIT STE 151 PAYMENT GATE mL/06/93
LAKE OSWEf3O, OR SURD I V I",::i I ON c
97035—
PURPOSE
703:5—
PURPOS OF Pio"INIM ENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT i=PID
FIL,AN CHECK FF. ..6:.01 R rl."50. Curb BUILDING PERM ...-MST95--013 ;�.....-.._633. 00 r
C�L_UMBINa PERM P215. 00 MECHANICAL, PC 45. 00
S'r. BUILD DER 45. 15 PLAN CHECK rF. 172. 40
SEWER U!-*) SWR95--0128 22100. 00 SEWER INSPECT 3%. 00
PARKS 8DC 500. 00 H20 QUALITY F AC I I-.T TY FEV I f.lo. 00 •
HON1 QUANTI'r'Y FACILITY F C r 1.00. 00 EROSION CONTROL PE'RMITFF:E b4. 00
FRUf: JON CONTROL FAL.AN CK 20. 80 I=ROSION CONTROL. 20. F;►o
136114 SW MARCip DF'.
13825 SW NORTHV I t.W
c
TOTAL AMOUNT PAID _ __ wI 449 1. 15
�F
II 1
CI'T'Y OF T T rillRLI -- RF;r,F'I VIT Or' PAYMEN- RF"r:F:J PT NO. c 95--X163361 I
C'HF CI-'� AMOUNT n 1000. 00
NAIlE DfIll MOR.T 511;TTE 14OMl. q INC:. C;AfiH AMOUN t 0.00 i
iir)liF2F riF3 P(IYME:NT VATF-•. t 03/P4/95
f30.ISD I V I E:I ON t I
1 +i PPnSE: OF PAYMENT AMO(..)N'1' P(i I D PURPOSE OF rAYME:NT tamnUNT FAIL ! �
54R r?3tr1. 00 T'l_AN CFaF CFC FE 3--55R r?SQP. 00
ON C:L1FCK FE:' 3-57R 250. 00 PLAN CHECK FK i—!.iAR P50. QIV.l
1:3809, I38CE3 1;1887 N0PThVIE:W
1 401 P L T r)L-'N 6R
(04141. AMOUNT PA T D - — _> 1000. 00
E
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