8695 SW REILING STREET ADDRESS:
Orecords\microfim\targets\buiiding.doc
CITY OF TIGARD
COMMUNITY DEVELOPMENT k EPARTMENT
131181W Heli V4,T11Wd,Orpon 07118001" (808)83e-1171
� C:E::RT IFICAI"E: UF
UCCUPANC Y
PERMIT #. . . . . . . e Mi3T9300 ,.,
639--4171
DA.1 E I SSIJED s O E,�/I F ),1
SITE ADDRESS_ : 08695 $14 WILING ST PArCEL s
SUND M S I ON. . . . s SC;HELKLA PARK ESTATES ZON I NG s R-4. 5
BLOCK. ,. , .. a I_(:17. . . . . . . . . . . . . 89,1
GLASS OF WORK. s NELW
TYPE- OF USE. . . a SF
OCCUPANCY GRP. s R:3
OCCUPANCY LOAM)s 224 4
TENANT' NAMF. . . s
Remarks e PATH 8
Owners - .._..._.... _._... _._.._,..,_-.._.__._.._.._..__.._........ _..._. . ._. _._.._.�_
TOUCHSTONE HOMES INC
11885 SW BLILL.. 01T. RD
T I OARD OR 97224
Phone Oke 639-3829
Contractor,: _ ._.___�____ ..._.�_.___. ._................ .._,_..__._..._
TOUCI-4STONE:: HOME'S, INC
PO BOX 231088
TIGARD OR 91281
Phone Ike 6:.39--38c9
Reg II. . ; 50948
Occupancy of the above rerferRsne d building i5 hereby given, and certifies
the compliance with the State Of Ovegon Specialty Corley for the group,
or.cupancy, and use tinder which the r^eferenreri permit was issued.
i
F I RIE. DEPARTMENT Hll 0 11 LTOrk
1 __,. ..�� . _. .... _. ..
� BBUILD , :)F CIAL
POST IN L;0I,49P 1 CUOUG P ICE:.
INSPECTION NOTICE
city or Tigard Building Department
13125 SA Bel) Blvd. Tigard, Oregon 972 I---
Inspection Line (Rec-O-Phone)s 639-+''75 Busine Phone: 639-4171
Inspections ---- - --� -_-
Foot inq Plbg. Underslab Mach. Rough-in A.ppr/Sdwlk
P:nsnd. Plbg. Top Out. Gas Line FINALt
Post/Hgam Struct. San. Sewer Framing -91dq.
Post/Ream Mech. Rain Draln Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Hoch.
Date Requestedt , (/ Times AN L K J,7
-k
Acidrese: l - Permit f c
Builder: l
TNS FOLLOWING CORRECTIONS AM R201RRDI
C ^� r
r I
Inspector: ---�— -------� Data:
APPROVED nISAPPROVBD APPROVED SUBJR(7T TO ABOVE
Call For Reinsp.
7
INSPECTION NOTICE
City of Tigard Building Departarnt
13125 SW Ball Blvd. Tigard, nregon 97223
Inspection Line (Rec--O--Phone): 639-4175 Business Phone: 639-4171
Inspection: _. -,- ----- —_.,--
Footing Plbg. Underslab Mech. Rough-in Apyr/Sdwik
Found. Plbg. Top Out vias Line FINAL-
Post/Ream Strutt. Sen. Sower Framing �{� Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. P.d. -Mech.
Date Requested: -f, -----_Time: AM PM
Address: JOC� Permit #t`%e
Builder:
TNM FOLLOWING CORRECTIONS ARE REQUIRED:
Inawlort Date A _
APPROVYD v D APPROVBD APPROVED SUBJECT TO ABnVE
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department 1 -
13125 BW Ball Blvd. Tigard, Oregon 97223 '
Inspection Line (Rec-O-Phone): 639-4175 Business Phones 639-4171
Inspection:_
Footing Plbg. Underslah Mach. Rough-in Appi/Sdwlk
FOL•'n.. Plbg. Top Out Gas Line FINAL:
t'ost/Bsnam Strurt. San. Bower Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb,
Pl.bg. Underfloor Mater Line Gyp. Bd. -Hoch.
Date Requestedif /� t'/ Time: AM -PM
1. 7
Addressi L C r Permit #ice% -' .Z,�3�
� 1
Builder: f 7
THE FOLLOWING CORRECTIONS ARE REQUIRED:
A e;??X Gni 7Trl�.L�_
41 IS
Inspectors �- - u Dato:�
APPROVED L DIFAPPROVED APPRr)VED SUBJECT TO ABOVE
Call For Reinsp.
aIt s�Ec'TION NOTICE �p
city of Tigard Building Depart-sent
13125 SW Ball Blvd. Tigard, Oregon 47223
Inspection Line (Rec-O-•Phune)s 639-4175 Business Phones 639-4171
Inspections —• -- —
tooting Plbg. Underalab Mach. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gas Line FINALt
Post/Beam Struct. Snn. sewer Framing -Bldg.
Post/Beam Meah. Rain Drain Insulation `(_-Plusb�
Plbg. Underfloor Nat/er Line Gyp. Bd. -Mech.
Date RwpostedI �l - rimes K _ tM
1 G7 ",I /,
Addreus � ' _ Permit /t -� yy �_
Builders `
WE tOLLONIBG CORRECTIOIIlt ARE PJWIREDt
Inspector: Dato:_
APPROVED DISAPPROVRD APPROVED SURJRCP TO ABOVE
Call For Reinap.
INSPECTION NOTICE
City of Tigard Building Department
13125 SN Rall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171
Inspect ion• ---
Footing Plbg. Underslab Mech. Rough-inAppr/Sdwlk
Found. Plbg. Top Out Gas Line
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line ,yp. Bd. -Mech.
Date Requested: _21 -T AM ,PM
Address: _ tL� Permit
Builders
THE FOLLOWING CORRECTIONS ARE REQUIREOt
AIL F, 17 oln
TCS Ft�c
Inspector: 72 Yij Dates
��
APPROVED DISAPPROVEb APPROVED SUBJECT TO ABOVE
Call For Reinep.
INSPECTION NOTICE
City of Tigard Building Department C
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspectio. Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
Inspection: —
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Can Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line �yp. Bd. -mech.
73 Date Requested?_ — Time: AN PN
a 3-A
Builder:Address: S _ Permit. i:C��—'J
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
7174; !1
Inspector: Dates T
\ APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INSPECTION NOTICE e!
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171
Inspection•_
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top OutGas Line FINAL:
Post/Beam Struct. San. Sewer �(1 Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested: s _ Time: J' PM
Address: — Permit #:`'/ 3
-97
Builder
THE FOLLOWING CORRECTIONS ARE REQUIRBD:
Inspectors _ Dates,�`
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinap.
n
INSPECTION NOTICE
City of Tigard Building Department
13125 an Ball Blvd. Tigard, Oregon 97223
Inspection Line (Re/c-O-Phone): 639-4175 Business Phone: 639-4171
Inspectiont_ ( ! ` — —_.___
Pouting Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL.t
Poet/Beam Struet. San. Sever Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Plbq. Underfloor iter Line) Gyp. Bd. Hech.
Date Requested:
�. _ _Time: '� AM '�6/ PM
Address: _ Permit.
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
i
Inspector � _- Date:
APPROVED __ DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinep.
INSPECTION NOTICE r
City of Tigard Building Department
13125 8N Ball Blvd. Tigard, Oregao 9722
Inspection Line (Rec-O-Phone): 639-4175 Business P 639-4171
Inspections
Footing Plbg. Underelab Mech. Rough-in) Appr/Sdwlk
Found. Plbg. Top Out Ga;Line FINAL:
Post/Beam Struct. San. Sewer Framinq -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requesteds _Times AM _ FM
Address: ' Permit is
Builders
THE FOLLOWING CORRRCTIONS ARE REQUIRED:
-
Inspectors Dates
APPROVEDell DISAPPROVRD APPROVED SUBJECT TO ABOVE
Call For Reinep.
INSPECTION NOTICE
City of Tigard Building Departzient
13125 SW Ball Blvd. Tigard, Oregon 97213
Inspection Line (Rec-0-Phone): 639-4175 Businene Phone: 6?9-4171
Inspection:__
1 Footing Plbg. Underalab Mach. Rough-in Appr/Sdwlk
Found. Plug. Top,Ou Cas Line FINALS
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insolation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Koch.
Date Requested•. 2- 3 ___Times 4-AM PM
Address: . Permit #s�
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspectors Date:
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
S�Z INSPECTION NOTICE
Z City of Tigard Building Deps►rtaent
r ;C -3125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phan 639- 71
Inspections ———
Footing Pibg. Underelab l Mech. Rough-in , Appr/Sdwlk
Found. Plbg. Top Out �S Fae ne� FINAL:
Poot/Beam Struct. San. Sewer rem ng -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line '' Gyp. Bd. -Meeh.
Date Regtiested• r� `J ` Times 1_AM — PN
Address:__ d V� -�/1 �C4�1'l.� Permit 11
Builders ,� JT ���s� /,(J�L_D
TRE FOLLOWING CORRECTIONS ARE REQUIRED:
7
7 iG
Inspector: - Dates
/ /APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
"tt����" call For Reinep.
INSPECTION NOTICE
' I City
of Tigard Building Depart:ent
/���///�___ 13125 S;W Ball Blvd. Tigard, Oregon 912
O Inspection Line (Rec-O-Phone): 639-4175 Business
Inspection: _.A --
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
et/Beam St V. San. Sewer Framing -Bldg.
`- �..-��Underf
Rain Drain Insulation -Plumb.
�' Water Line Gyp. Bd. Mech.
�. _ 3
Date Requested: Times AM PM
Address: Permit- f:
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector _.___f_—.-__"'.__._-- Dates
APPROV$D DISAPPPOVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Bu lding Departma
13125 811 Hall Blvd. Tigard, Oregon 9
Inspection Line (Rec-O-Phones 639-4175 4usiness Phones 639-4171
I n�specctt ion s _
oot ting Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Can Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Mach.
Date Requested cJt TLs`.,+�"��G' . AM PM
Address: Permit f -z)4,33
Builders �Zt : n
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: Dates — Z�
APPROVED DISAPPROVED APPROVED SUBJECT To ABOVE
Call For Reinap.
CITYOFTIGARD CFFYOFTWARD PLUMBING PERMIT
COMMUNffY DEVELOPMENT DEPARTMENT 0111100H PERMIT 9 . . . . . . .. MST9:. -017133
13125 SW HWI Blvd. P.O.Box 23397,Tig",Oregon 97M(503)810-4175 DATE ISSUED: 01/27/93,
BITE ADDRESS— : 08695 t�W REILIN6 ST PARCEL: 2S I 1 1AD -09BLAO
SUBDIVISION. . . . : SCHECKLA PARK ESTATES ZONING: R--4. 5
BLOCK. . . . . . . . . . i LOT. . . . . . . . . . . . . :61
---------------------------------------------------------------------------------------
CLASS OF WORK. . :NEW GARBAGE DISPOSALS. . : 1
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . C1 BACKFLOW PREVNTRS. . :0
OCCUPANCY GRP. . cR3 FLOOR DRAINS. . . . . . . 90 TRAPS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . :2 WATER HEATERS. . . . . . : ! CATCH BASINS. . . . . . . 10
FIXTURES--- ----_------ LAUNDRY TRAYS. . . . . . :0 SF RAIN DRAINS. . . . . : 1
SINKS. . . . . . . . . . # I GREASE TRAPS. . . . . . . 90
LAVATORIES. . . . . :4 OTHER FIXTURES. . . . . :0
TUB/SHOWERS. . . . : SEWER LINE (ft) . . . . 10
WATER CLOSETS. . :3 WATER LINE (ft) . . . . : 100
DISHWASHERS. . . . : 1 RAIN DRAIN (ft) . . . . :0
Remarks- PATH 8
OWNER: ___._______.....__..___.___FEES_–___–___–._--__
TOUCHSTONE HOMES INC TIF' $ 1460. 00 JH $111/27/93
11885 SW BULL MI. RD BVIN] t 364. 00 JH 01/27/93
BPLC $ 236. 60 JLH 01/15/93 93-235676
TIGARD OR 97224 B5PC * 18. 20 JH 01/27/93 –
Phone #: 639-3829 SSDL. $ 280. 00 JH 01/27/93
PARK $ 5016. 00 JH 01/27/93
Plumbing MPRT $ 4.3. 50 JH 01/27/93
MPLC $ 10. 88 JH 01/27/93
Name --- M5PC $ -::. 18 JH 01/27/93
PddresS�. PPRT $ 140. 00 JH 01/27/93
L i t y . 5 t ate P5PC $ 7. OVA JH 01/27/93
Zips .—Phone#1
Reg #i
REUUTRED INSPECTIONS
This permit is issued subject to the v-eg--
ulations contained in the Tigard Municipal Fuot/faund Insp Rain drain Insp
Code, State of Ore. Specialty Lodes and all Post/Beam Struct Water Line Insp
other applicable laws. All work will be done Post/Beam Mechan Appr,/Sdwlk Insp
in accordance with approved plans. This Plm/undslab Insp Mechanical Final
permit will expire if work is riot started PLM/Underfloor Plumb Final
within 180 days of issuance, ar if work is Mechanical Insp Building Final
suspended far more than 160 days. Plumb Top Out Erosion Control
Framing Insp Crawl Drain
Fireplace Insp
Gas Line Insp
Insulation Insp
GYP Board Insp
UA
0 orized Plmny lont rr toSignature
* CAII for inspection 639-4175
Contractor
® v
CITY OF TIFA RD C11YOFTWARD
COMMUNITY DEVELOPMENT DEPARTMENT 011111111411011411 MASTER PERMIT
13126 SW Hell Blvd. P.O.E=23397,Tipml,Or@gDn 97223(6W)639-4176 PERMIT #. . . . . . . : OIST*93--0033
639-41'71 DATE ISSUED: 01/27/93
SITE ADDRESS. . . z 08695 SW REILING ST PARCELli 25111AD-09800
SUBDIVISION. . . . : SCHECKLA PARK ESTATES ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :61
BUILDING
REISSUE: DWELLINU UNITSill BASEMENT.. . . . . . . . :0 Sf
CLASS OF WORK. .-NEW BEDRMS:3 BATHSz3 GARAGE. . . . . . . . . . ..418 Sf
TYPE OF USE. . . :SF FLOOR AREAS---------- REQUIRED SETBACKS-----------
TYPE OF CONST. :5N FIRST. . . . .-798 s LEFT. . :29 ft RIGHT. : 16 ft
OCCUPANCY GRP. :R3 SECO14D. . . :701 s FRONT. :20 ft REAR. . :36 ft
STORIES. . . . . . . v2 THIRD. . . . .0 s REUU I RED------------ ----------
HEIGHT. . . . . . . . :24 ft TOTAL--- --: 1499 Sf SMOKE DE7ECTORS. 1Y
FLOOR LOAD. . . . :40 psf VALUE. . . . . 76478 PARKING SPACES. . . 1
Remarksp PATH 8
--------------------------------- PLUMBING ----------------------------------------
SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :0
LAVATORIES. . . . . :4 WATER HEqTERS. . . - I TRAPS. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . .-2 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . !0
WATER CLOSE TS. . i3 SEWER LINE (ft ) . :121 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXTURES. . . . . :0
GARBAGE DISP. . . : 1 RAIN DRAIN (ft) . iO
WASHING MACH. . . Al SF RAIN DRAINS. . : 1
----------------- MECHANICAL ---------------------------------- FEES
FUEL TYPES---______--- UNIT HTRS. . :O tyae amount by date reept
/GAS/ VENTS . . . . . ..0 TIF $ 1460. 00 JH 01/27/93 -
[,1AX INPUT:0 134U VENT FANS. . -4 LAPHT $ 364. 00 JH 01/27/93 -
FURN ( 100K . . : I HOODS. . . . . . : 1 BPLU, * 236. 60 JLH 01/15/93 93-235676
FURN )=100K . . :0 WO0DSTOVE5. :0 B5PC * 18. 20 JH 01/27/93 -
FLOOR FURN. . . . :0 CLO DRYERS. : I SSDC * 280. 00 JH 01/27/93 -
BOIL/CMP ( 3HP:0 OTHER UNITS- 1 PARK 1, 500. 00 JH 01/27/93 -
GAS OUTLETSal MPRT 1, 43. 50 JI; 01/27/93 -
Owner-,: --------------------------------------MPLC $ 10. 88 JH 01/27/93 -
TOUCHSTONE HOMES INC M5PC $ E. 18 JH 01/27/93
11885 SW BULL MT. RD PPRT $ 140. 00 JH 01/27/93
P15PC $ 7. 00 JH 01/27/93
TIGARD OR 97224
Phone #s 639-3829
Contractor:
TOUCHSTONE HOMES, INC
PO BOX 231088
TIGARD OR 972'81
Phone #1 639-3829
Reg #. . -. 50948 _._..._._._..__._._-----__---_._-_---__---_-------__-
3062. 36
------------------ -------------3062. 36 IOTPL
This pereit is issued subject
tect to the regulations contained in the -------- REQUIRED INSPECTIONS
Tigard Municipal Code, State of Ore. Specialty Lodes and all other Foot/found Insp Fireplace Insp
applicable laws. All work will be done in accordance with approved Post/Beam StrLICt Gas Line Insp
plans. This pr-sit will expire if work is not started within 180 Post/Beam lylechan Insulation Insp
days of issuance, or if work is suspended for sore than 160 days. PIM/Undslab Insp Gyp Board Insp
Permittee Siqnl�ture: \_0
PLM/Underfloor loot- Rain drain Insp
Mechanical Insp Water Line Insp
Plumb Top Out Appt-/Sdwlk Insp
Issued By: Framing Insp Mechanical Final
VAT_
1 for 3.11rilject i 639-4175
a
CITYOFTIFARD CMOFTWARD SEWER CONNECTION
COMMUNITY DEVELOPMENT DEPARTMENT ORIONDN PERMIT
13126 SW HWI Blvd. P.O.Box 23307,T4pW,O"gon 97223(bO3)630-4176 PERMIT #. . . . . . . : SWR93-0031
639-4171 DATE ISSUED: 01/27/93
ISITE ADDRESS. . . : 08695 SW REILING ST PARCELs 2SI11AD-09800
SUBDIVISION. . . . : SCHC(:KLA PARK ESTATES ZONING.- R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :E1
TENANT NAME. . . . . :
USA NO. . . . . . . . . . : FIXTURE UNITS. . . I
CLASS OF WORK. . . -NEW DWELLING UNITS. . : 1
TYPE OF' USE. . . . . :SF 1\10. OF BUILDINGS: 1
INSTALL TYPE. . . . :BUSWR IMPEF(V SURFACE. . : s F
Remarks: PATH 8
Owner: FEES -------__--.---
TOUCHSTONE HO1*f1ES INC type amount by date reept
11885 SW BULL MT. RD [-#RIIT $ 9=100. 00 JH 01/27/93 —
INSP $ 35. 00 J11 01/27/93 —
TIGARD OR 972,24
Phone #: 639--3829
Lontractor:
CONTRACTOR 1\101ON FILE
["Itione #I $ 2135. 00 TOTAL
Reg #. . : REQUIRED INSPECTIONS
----
This Applicant agrees to comply with all the rules and regulations hewer Inspection
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" Permit and the Agency will install a lateral.
Permittee 5iynature : P,
Issued By:
Lall for inspection — 639--4175
l
�! A 13175 SW ifu nwa. PLNCK/RECT #
CITY V1' �,IVARD PERMIT # �'1 �9,S Oa33
COMMUNITY nEVEI.OPMEN'I'DI?PAR'I'MGN'I' Tipard,Oregon 977Zti
(503)639-4171 DATE ISSUED
JOB ADDRESS:
a _ - AX MAP/L,--1
SUB: '(�IICK �'✓.'�s-�� ISS LOT: LAND USE:
VALUA I I ON: ZGp -/ 7
OWNER SPECIAL NOTES
NAME: 0 0 r15 10•l L: ,r�.�.r,t ) � REISSUE OF:
ADDRESS: ( (J"p 5"J 9- JO MA P-A LAST REISSUE:
-2 � � FLOOD PLAIN/
PHONE: x'3`1 b? e-� SENSITIVE LAND: _
CONTRACTOR APPROVALS REQUIRED
NAME: PLANNING:
ADDRESS: ENGINEERING: _
FIRE DEPT: _
PHONE: _ OTHER:
CONTR. BOARD If: rl� 4 EXP DATE:
ITEMS REQUIRE`
SUBCONTRACTORS: PLUMB: �\-sc �-�� `T s C�..�a LIST/SUBCONTRAC IG^S:
-- MECH: I' },c1Qin S ��s r �, . ` BUS TAX: —_
ARCH ENGINEER CALCULATIONS:
NAME: XJ -A" n TRUSS DETAILS:
ADDRESS: iS213 OTHER:
PHONE: a2 ci I b
PROPOSED BLDG. 1'.)E: c,"^. "� ► `.rte ''-� 11 l'�.r�e%t� g
COMMENTS:
APPLICANT SIGNATURE
Received By: Date Received:
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
13-01)33 10-432 00 Building Permit. Fees .�6 .•u _ ..�n�` 4�
10-431 00 Plumbing Permit Fees 0.toU _ )elo, *a
10-431 01 Mechanical Permit Fees 4,3, Sa _ -T,Su
10-230 01 State Building Tax (5%)
Building /?, "sZ.__
Plumbing 7,00
Mechanical 2,
10-433 00 Plans Check Fee
Building 2 - .(vo
Plumbing
Mechanical
10-230 06 Fire
30-202 00 Sewer Connection oo � 0
30-444 00 Sewer Inspection — 3 a �aT
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees e_ _
25-448-06 Institutional TIF Fees
25-443-03 Office TIF Fees
25-448-01 Residential Traffic Fees
2.5-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC) S Gd — S o o
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC)
24-445-01 Water Quality in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL 7
1"I'l" CIF, 'T I LAO?]) I PT OF PHYPIEN'l PLCL I PT N(j. 9 3–c',3,6 0 0 P
CH�U,l, AMUNT 4q4 . 36
NAME r TOUCHsToNr% HOME15 CASH W()UNT 0. 00
3
PAYPIEtVT DATE O �',7/93
k
GULADIVISTUN
PURPOSEL OF PAYMENT AMUUNT PAI 13 PLJNPITE 1 ir f--,r4vmt_:i,4-r i-WULINT PATO
BUILDING PERM 364. 00 PL1_MB1141-, 14(B. 0 Ql
HITHANTUAL PE. 50 SY. BUILD V+JIP7. 36
PLAN CHECK Fl-.7. 511,14LP ul-)f) 2100. 00
c .. L710 c4X:
SEWER INSPELl' 00
STURM DRAIN SOC OL71 3V,..')1.T)1-N7'IAL TRAY TII; PrES 13tiO. 111111
MOSS 7'FRONS TT T*fF FMo' 1 1 fit. 00
LAYT 61 f7i(JiECKLA r,ow
OW)S SW REIL. IN(-,' 13'r
rl_')TAl_ AW-4111T PAID 494 7.
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