15245 SW THURSTON LANE 15245 SW Thurston Lane
INS?ECTI 00k(Mi qE
City of Tigard Butldlnq Depar-tAK"It
13125 SW Ball Blvd_ Tigaw,A. Oregon 91123
Inspecti.in Line ((Re/c-O-Phone)
)- 639-4175 ' -sineav Phonet 639-417
-----
Footing Plbg. Undsr•.lah Na^!�. Stough-in App?/Sdw1k
Found. Plbg. Top Out Can Line PINALt
Pont/Beam Struct. Sart. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plssmb•
Plbg. Underfloor Water Line Gyp. Ed. -Neeh.
Date Reotasteds— �� � _ Times 4__AM PM
Addreaatj, 1011-
Penni
Bulldert
T11Z FOLLOWING CORRECTIONS ARE REQUIRED-
'-
t nspector s_ �'��_ _ - _ Dates
I/ APPROVED _ DI54PPROVSD _ 1PPROVED SUBJECT TO ABCriIS
1'c Call For Reinsp.
MECHANICAL
CRYOFTIGARD PERM I r
C OKIMUW,Y DEVELOPMENT DEPARTMENT WOFTWARD PIERMI V #. . . . . . . : MEC91-0009
anooN
131i5 SW HWI 93W. P.O.ScA 71307,T19.M,OnogDn 97223(6W)6394175 DATE TSSUED: 01/22/91
Hiji,HL.o. . . 15 :45 aW i HURS I �JW L-N PARCEL: ES112CA-06200
SUBDIVISION. . . . ASHFORD OAFS ZONING: R-7
RLOCK. . . . . . . . . . q LOT. . . . . . . . . . . . . : 16
Cl-ASS OF WORK. . -ADD FLOOR FURN. . . . EVAP COOLERS:
TYPE OF ,)SE. . . . -SF UNIT �jv-..ATERS. . VENT FANS. . . :
OCCUPANCY GRP. . :R3 VENTS W/O ADPL: VENT SYSTEMS:
STORIES. . . . . . . . I BOILERS/COMPRESSORS 1-40ODS. . . . . . . .
FUEL TYPES-------------- 0-3 HP,. . . . : DOMES. INC;IN:
: /WO.')/ 3-15 Fig'. . . . : COMML. INCIN-
MAX INPU'T : BTU 15-30 HP. . . . : REPAIR UNITS:
—50 HP. WOODSTOVES. . - I
FT IRE DAMPERS)?. . : -30
GAS PRESSURE. . . : 50-+ HVI. . . . CLO DRYERS. . :
NO. OF UN T IS AIR HWDLING UNIT-C, OT'HER UNITS.
FlAPN ( 100K STU- 1,0000 cfm - GAS OUTL.EI'P,.
TURN B'ru: 10000 cfm:
Pemarks : Woodstave net-mi.t.
Owner,. FE11S
MICHAEL BILL.E'rs type amol.mt by date r-ecpt
15245 SW I ;RUSTEN L.A14E PAYM $ 15. 23 JLH 01/22/91
PRMI $ 1 .14. 50
TIGnRD. OR 97e24 5PCT $ Q1. 73
Phone #.- 6r.-_,0-1238
OWNER/C ONT-RACTOR
----------------------------------
0hone 15. 23 TOTAL
Req
REQUIRED INSPECTIONS
This nersit is issued subJecL to the regulations cortainel :n the Final Inspection
Tigard Municipal Code, .,tat,? of Ore. Specialty Codes and a)! other
applicable laws. All work will he done in accordance with
approved plans. This persit toil! mire if work is not started
within !88 days of issuance, or if work is suspendeL for an, o
then 160 days.
rlet�mittve
Teist.teiJ Bv:
Call lar, inspection 639-4175
A
CITY CIV TIGARD RECEIVIT OF PAYMENT RECE11"-IT NO. t 9:t-208826
I-HECK AMOUNT : 15. 1.213
IqAMF BIL.L.r-TS, MICHAt-A.- CASIA iWO1 JNT 1 0. 00
01)D R E S 3 S e 152,45 SW THRUSTON LANF7 PAYMENT DATE ; it)I J1:*it i F/
rmmm) 97224-
SURD I k)I f3 1.ON t
FuRposu-;. of- PAIN MPN I 0MOUNT PAID PURPuSE or* UlOYMENT AMOUNT fl."AID
1-0001.) 14. 50 ST. BUILD PER 0. 73
FlITM. AMOLIN'r ppfl)
r
CITY OF TIGARDIViE�H.4N�!�AL PERMIT f�eceipl a -_--- ----
13125 SW HALL BLVD. S'enntt 1p -_.-----_-,-_--
P. O. 50X 23397 _
'y Description
T IGARD, OR 97223 C 'QC �I _Table 3A Mechanical Code - —�- QTy PRICE AUT
(.503)639-417.5 � } C l` 1) Permit Fee
-0- •.0- 10.00
r not Develofxnorrl `-----—--------------- -
2) Supplemental P,3rmh 3.00
Job Address 1 I Furnace to 100,000 BTU -
Address c =+„�j S(J Tht_rsiOvi ane°. incl.ducts&vents 5•00
Tax Lot Map No. 2) Furnace 100,000 BTU +
subdivisionl.M
incl.dljcts&vents 7.50
ebck ----
Pis i (or name of busiri a) 1 ;3) Floor Furnace i .00
6)�l
)CL -incl.vent- ---
c
Ma"Addran A,one 4 Suspended heater,wall heater
Owner
15 0�4 SW 271,k r S ,�Laid �a10 Z t ) or floor mounted heater - 6.00
e�lyr�rw -T,p - 5) Ven'not incl.in 300
t r c L�k �! 1' O.y apt• -in(e permit -_
Name( name of business) -� 6) Repair of heating,ref rig
.,
_- cooling,absorption unit 6.00
(kc��pant Marling Address p � _- 7) Boder or comp to 3 HP ^�
abso(p.unit to 100,000 BTU 6.(Iu
Zip_— 8) Boiler or comp!o 3 HP-15 HF - 11.00
absorp unit to 500,000 B I U
Name �Boiler or comp 15-30 HP -
9) absorp.unit 1/5,-1 million 15.00
iasiilrq Address - -` -- _�0)_ Boiler or comp to 30-50 HP ---- -�
_ absorp.unit 1 -1.75 million 22.50
Contractor ;estate - 1 1)�Builer or wmp to 50 HP -� -
_ absorp.unit 1,7.50,000 BTU 31.50
:,tate Registration No. City Nus.rax No 12) Air handling unit to
10,000 CFM 4.50
I h„,retry ,ecka�r,o, that w lioAir handling unit
�a �t I haread this application tlnat the inlorman given is 13) 10,000 CFM + 7-�
r—Ted,that I am ltxr owner or atrMror r.od went of the owne•,'!,at plans submitted are M _
-"ante with State laws,Hull I am registered with the F.,ate Builders•Beard,that the Non portable
rxxrnbm given is eorrerf (h exeirpt from,State registralrn ofease give reason below) 14) evaporate couler 4.50
Vent fan connected
--- - -
to a single duct 3.00
- - Ventilation system not
--_ 16) included in appliance '4.50
_-- � app permit
17) Hood served by
mechanical exhaust _ 4.50
ski►+ (owner or agenqrT r,lr -- Durryestic type - -
Ntscxibe work ❑ addition ❑ alteration ❑ repair El1R) incinerator 7.50
to be done residential non-residential E) Commercial or industrial
Existing use of - 19) type incinerator _ 30.00
building or property 20) Other i.e.,woodstove,water - --
Proposed use of - heater,solar,clothes dryers,etc.
building or property -
21) Gas piping one to four outlets 2.00
Type of fuel-- oil L] natural gas ❑ LPG ❑ electric I I
22) More than 41w outlet —_ I
NOTE -
- - ---L-
THIS PERMI r BECOMES NULL AND VOID IF WORK OR COW- -_ SUB-TgTAL �5 L
:TRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 5%SURCHARGE
)AYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED Oil -7
pU,N REVIEW 25%OF SUB-TOTAL.
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER - —_
WORK IS COMMENCED. TOTAL_ j
Special Conditions
Date issued _ ,.-----by- _
MIA 1/IV'i� b' rIM', ' S�L''.o"' !i¢`r'•.Yi "'" / �.+ ' -,�;�,
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`� �• �� "+��, �. 7, :`ti �,,�.�c \'¢»" i' Ni`� � SII( .,�,,,,��r '{
'� �`-_•.moi. ._ -' 'M••'M,,,..n.:,'�'�`�, ttR .w.. ^"�',.� A,�w`"" � a.8.s� ttry;, i.�n.'S'76�' fir.._,+. n :�:,g� -a•,. ''qfl.'iy+
i
INSPECTION NOTICE `
City of Tigard Building Department ` Y
P.O. Box 23397
Tigard, Oregon 97223
(Phone: 639-417(5
Type of Inspection ._ __. _ �C^ Qr(�t�CI—C 1(/ Z.,
Date Requested � � r Time � A.M. P.M.
Address 1115y L
Permit #_� zcof Q
Owner _ Lot #77 _
Builder
The following Building Code deficier•cies are required to be corrected
Presented to
� - i Approved
Inspector � r Disapproved
Date
CALL, FOR REINSPECTIOA'
❑ YES U 140
-,
L.DNG PEPMIT
PEPM:ET NO. - BU082010
r
C'� OFTIGARD to
.ny
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED. A 0 EAl/BE)
13125SW Ha11Blvd,P0 BoxMV Tigard.Oregon 97223.(50))639A175 FIRTM. P101T.N0. 32010
'1AEA ADDRESS : 3.45241,5 !aW (1--11.11-4!YTON LN
le--X MAF /L.0T PSI I PGA '511 B ASHF(: PE) OAKS 3: L.T : :I.6 Bl< :
L.ANL) USE: 147
LOT SIZE : VAI UAT T ON. IlIll '711,0AE) SEJUACKS
FIAJINT : 20 REAP : 6
WORK ('111 ASS : NEW OWFEL.I....UNITS : I LEFT: 6 PIGHT : 30
TYPE : 15INGA.F" FAKELY NO. DEWPOOMS ; 3 EXT .WALI. r.ONST :
1. , 3 E:* W
.)NG*T' . TY11:1:1: VN NO. BATHS . N S :
U."Llir-1.C;AP . : P3 )PUT ,UPEN I'N(*.;S :
OLGLIP .LOAD N 5 E W
TOTAL. AWEe-A . :1.636
NO . STOPIES : P. 1.'.:i I* : 909 ROOF (,'ONST : C FIPE PET7
(1,1-11, : 2ND 7"r..'.'7 AAEA SF*.-:P0A7 WATki,r):
BASEME.:N T"? 311D O(:: up SEPAP17 PATE :
ML7ZANINU:7 BA51:;JVT
1 01311 1 OAD: q0 (,ALTA(.,LK 441 F"IPE SPPKL 147 At ARM7
Fl-OW K;P-M) DETI:;X-11-7 YFE-i
1-11ii:A1, 'TYPL: 1111XP A(XE:557 Wpp?
PI-AN U-4ECK LAY : r-11,
REISSUE 10P, NO .
1. AST PEISSUE
W 0 M-11 I-E...:14 111 r PLI-:MTT $358 . 00
N 1.) 1r F.4(,.)x 14?3299. PLAN 1:*:VJ'r--.'W $23P . 70
E 014 I mc: i:)E.,P,r
R
S'TA*7 L* TAX $1.7 .90
C 01 .1JELOPMENT (:.I-1APGr.-:G .
0 M1AA.A.-.:P JAY OCII(S T OPM) $P50 . 00
N .jAy MT
.j_I Lp E)F.;:F;j S DC, S( T AEK T $600 . 00
T
R V) c) fi.4OX 23P291, *P- 4,r;50 0 0
A C�A
JA
C I . RD 011 97P,,*!)3 PAF::PA3'D < 11000 . 00%
T PI-IONK (50Z.5) 60.1 f It-5,13
0 l't:VTAATV:)fl NO ;30:1.0Q I UTAL $.'. , 608. 60
R
NO, 7 3
This permit is issued subject to the regulations contnined In Title 14 ..................... .. ...........
of the TMC. State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances, and it is hereby I.2F.WUT
1*:001 T.17 140o SEW."A
agreed that the work will be done in accordance with the plans and
specifications and in compliance with all applicable codes and 1:11UNDATTON WALL PAIN DPAtNS
ordinances The issuance of this permit does not waive restrictive P0!;i*1 & BL AM WATEP L*1Nr-,-
covenants Contractor and subcontractors sh,-11 have current city I"'1-.r3 . UNLAInsi. At) (7,1'T*Y APPPt-.I-I/SW
business tax permits. This permit will expire and become null and F I NAL
void if work is not started within 180 days,or if work is suspended or (.;1-AB
abandoned for a period of 180 days any time after work has PL.0 . TOPOUT
commenced It shall be the responsibility of the permittee to assure r nAMING
all required inspections are requested and approved FJ REPI-ACE
GAS LJNF.
TNSULATION
tu-e
Permittee a k C;y V, BOARD
Issued By (-2,ao15-
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
1` . :
CITY OF T167A RD 10
Cr -rWARD
COMMUNITY DEVELOPMENT DEPARTMENT RIG),4
13125 S.W Hall Blvd.,P.O Box 23397,Tigard.Oregon 97223.(503)639-4175 ISSUED: 10/211/sH
P11-41MAHIMIT.N0. 882010
JOS ADUPESS : t5243 SW '1'l-1UAST'ON I N USA NUM11311i:P: 0 3 dieUr 2
'T/1X MAP/L.0-11, PSI IMA %AAB: AS11-111-:1.1RU OAK I L'T : 1.6 ICK
LAND USE : P't
SEC TION: 12 TWP: at$ IQ?4(; : 1.W
WORK CLASS : NEW
.1
USE ryF'i--* : SINW 1;--. F-'AMTLY
*1 fie appl icurt t Ing I-ee�a to r-:clnP:I.�) with P0.I i-L41cefli arid r-wqmlattimrim a-Ii t tie Uri j.f i a ci
Sewei-age Agwnc.,y . par�mit wxp:I.r,a,% I.LM d4iiyi9 fi,c)m thea date 1,11.1v totle.l.
in in C1 1.111*t' pwi.d Wi 1.:1. be f 1:1r-r ei t.e d :i,f t I IWO p e r,to-1.t e X wi.I-e Ili . I I le A C ro 1*''::04 d 1*1 C-)91 Mot
&Iit'we the actzmr-aey of t'he lac-atioil of LI-10 'Xi-C110 MeWQbf" J.iltJFUI"al.* T f th a Ilic-1wer. it%
114:11, lacutod Mt the IntoMiNt.it-willnelit given , 1.11*? if-Ist".1ler, 111hall pl.clilili:leut 3 fe lr�'1. :1.1.1
all dii,eciAorts -11r,min the di.fiilt'allv�e giverl . :1*f riot 160 1.0C&t0(J , ti-le .1.11mn
t 'll.e %
r, [jiltill.
PI-111-0-11"11100 at "'(flocsairld �i:idtp Sewer," Plfwi,wit arid 1.11re Aqerir;,ij w:1 '1.*I. iiiiital'i.j. m. lilitpr-iol .
11,45 TALL. , ryPE : E'31-1111-DING, !'5FAJEP IMPE1141VIOUS APEA:
FIXTUPIF: UNITS : T'ENAN'T' TMIZIPOVEIMIF-KINIT :
OWEI.A.—ING UNI'rs : 1.
NO . Of:;' SLOGS .
0
W MIA I PEW] 111135 . 00
N BOX 2329:11. (:,(:)NNF'C'TA:UN G.HAAGE 11111. 1100 . 00
E
'A LINk-i. 'TAP INS"I'Al L.. .
R up
011-1ER
C
0 M.T.I r t--;P .JAY
N
T dAY MILLER SU111-DIED
R
A
C TIGAHO 01:1 97Pf.'N's
0 T PHONE (503) 691-1-7.5,13
R I PEG1S'1'PA'T*TON NO . 301.09 $1 , 135 . 00
This permit is Issued subject to the regulations contained in Title 14KtFi NO.
of the TMC. State of Oregon Specialty Codes,zoning regulations ................
and all other applicable codes and ordinances. and It is hereby ;)EQUIPED INSPECI TONS
agreed that the work will be done in accordance with the plans and ROUGH—IN
specifications and in compliance with all applicable codes and
ordinances The issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have current city
business tax permits This permit will expire and become null and
void if work Is not started within 180 days.or if work is suspended or
abandoned for a period of 180 days any time after work has
commenced.It shall be the responsibility of the permittee to assure
all required inspections are requested and approved
2- gnatt�eL
P
Issued By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITY OF TI6A RD
ME(,'I-I(.)NIC;Al PERMIT
ct1Y IID V
1:)I*---Rm:[,T* N .0
COMMUNITY DEVELOPMENT DEPARTMENT n ".)
13125 S.W.Hall Blvd..P.O.Box 23397.Tigard,Oregon 97223.(503)639.4 175 D(-)'T'E 11i5L.IED: J.()IZ2AII fie
JOB ADDPEtiS : 1-5245 SW *TH(JPS'rON LN P141M. PM'T' .NO. a 8;.*.i 0 1.0
'T'AX MAP/I 01' PSI. IRCA SLID: ASHF'OWD UAKS 1 Dk
I-AND USE! 147
L-01 51ZE:
X'TEM: NO : Ni i
WORK Cl..Af-.;S : NEW FLIPISIACE <100K :1. A'LP HANDL.R <:L0
TYPE: 151NGLE FAMTI-Y F:*t.JPNA(:*,F-* A-00K+ AIP IAANDI-R 10k
E',(:)NS'T . *I'YF)E: VN F-TIRNACE EVAP .CIOOIJ:::I�
A.*5 Vl'-_:Nl' F'AN
VE:N'I' VLN'T . SYS*TEM
<'51-4) HOOD
NO 57T)PIA.:15; 12 l3I-.P/(:.1:)MI 3 1NE',1NERA*TOP(DOM
DWI:7I L..t.,INI*rS : I BL.A/(*,*OMI:" 1.5---301-IP IN(w]:NEPA FOR(COH
IL-L *TYPE (."AS DI P/CI(OMP 30-50HVI REPAIR LJN1:1'S
1f)x 1NPLY1, 13L.P/COMID 30+1-11-" (O'T'HER
L)MPnS',' GAS P1411M, (ATT'l-El"S
__J
0
W
N I it I.I F."14 JAY FIF.1:41VIT.1,
F $10 . 00
1.) 1-1 ROX 2329:1. f,1...AN REVIEW $10 . 98
1,:I*. A P D OR FIX'TUPES 111:3:3 . 50
C
0
N III
T 1-411BER'T'
R
A
C (445 MW x';31.S'1'
T tar9711.3
0
1:1-If")19F.i. 110.3 6*IB----I.J.'59
N(3. 'TOTAL. .
This permit Is ist led subject to the regulations contained in Title 14
of the TMG, State of Oregon Spe-ifilty Codes,zoning regulations PF(AE110"t NO . '7
and all other applicable codes and ordinances, and it is herby
agreed that the work will be done in accordance with the plans and PF`.(411-1111:*:D XNS PEC."! :[(:)NS
specifications and in compliance with all applicable nodes and GAS
ordinances The issuance of this permit does not waive restrictive P(')S'T & HEAM
covenants. Contractor and Subcontractors shall have current city
business tax permits. T!119 permit will expire and become null and POLIGI-4—I N
void if work is not Rttirtf d within 180 days.or if work is suspended or F T NAL.
abandoned for a period of 180 days any time after ,vork has
rommenced It shall be the responsibility of the permiltee to assure
all required inspections are requested and approved
Permute
Issued By
01:11 INSPEC'1JON 639-41. 1-
"
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRISED ABOVE
PI—L.'MBING P1-FPM1.*T*
CITY OF TI17A RD '4 PESM11' NO. : PI-8(320,44 V/
CI OFLIt!)
(011
COMMUNITY DEVELOPMENT DEPARTMENT 15SUED: 10/it-2/1/GF)
13125 S.W.Hall Blvd.,P.O.Box 23397.Tigard,Oregon 97223.(503)6394175 PRIM. PIMIT .NO. 8113i2010
J(30 11.52,e45 SW '11-411AISTON I-N
'TAX MAP/LCYT PS1 12CA SUB: ASI-1111"OPU OAKS 1. LT : 16 8K :
LAND USE: P7
LOT 5TZr-*. :
1"1'I-..M NO: NG :
WORK CI ASS : Nl:;,W WrYTER CILOSE-1 3 1 PAP
USE' 'TYPE: 51N(A.A..: F'AM11 y UF-41NAL. E1KFLOW PPVN7A
C,01451* . *1 YPE:: VN LAVOPATOPY ei MAP PRIME.P
OCC,UP" . (.�,PP . P3 'T'UB 151-40WER 2 G114I:::Ai.-3E: 'TPA135
DI S I-IWA L5 HF:1:4 1.
U,A A E;A G E: 01:( P 0 S A L. 1
N( S'T0 141 F;:lii 2 WASHINC, MA(',1-l3.Nr-. 1.
DWEL.L. . UNT.TS . 1. 1 AUNDPY T'PAY BL..-)G. I)PAIN (I)TA
FA-UOR DPAXN
51 N K 3. SEWEP (F-1*11
WA TEM 1-1E:A*T'F.:P :L STOPM/PATN (F-1-
01 Hl::'I:','
PE:MAPK!:,) :
0 MT L.I-.E-.r;f JAY $:1.40 . 00
W
N P . m . K"OX
E
':oTAIE: "NX 10 1
0 wo,r*ts
N
T 1<11:4) W116,11-ci I:AAJME11N(.;
R
A
C
0 r 1311-4111NE:: (503) 6844-66P6
R PE.(ITS1001"[11:11N NO .50879 I '1('l TAL $147 .00
This permit IS issued subject to the regulations contained in Title 14 PE.MIPF NO.
..............
of the TMC. State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances. and It 19 hereby
INSFIECTIONS
agreed that the work will be done in accordance with the plans and PI 1::: . UNDEEASI A rs
specifications and In compliance with all applicable codes and PO!5 I & CIE*011411
ordinances The issuance of this permit does not waive restrictive WA1 1..1.4 1 3:NE
covenants. Contractor and subcontractors shall have current city
business tax permits This pormit will expire and become null and
nd
void If work is not started within 180 oam or if work issusaoTided or PAIN DWATNS
abandoned for a period of 180 days any time after work has
commenced. It shall be the responsibility of the permittee to assure
all required inspections are requested and approved
e I X11-4 ignature
Issut!J By Ort
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
i
I
I
PLAN CHECK APPLICA7IOly,
CITYOF TIGARDIL, � PLAN CHECK # )
COMMUNrTY DEVELOPMENT DEPARTMENT CrTYCFT1rARJb PERMIT l7/
o,teooN DATE ISSUED
13125 SW HO Bh d P-O,Box 237977.Tgod.Geon 97223(6W)8J9.4176
JOB ADDRESS: -, `` l/ �W /�)�f/��O/'� TAX MAP/LOT _
SUB: _ l�h ln(Lr-��� LOT: !� �^` LAND USE:
VALUATION:
OWNER - SPECIAL NOTES
NAME'. pct`/ ` ���"/!.� REISSUE OF:
ADDRESS: LAST REISSUE:
_ FLOOD PLAIN/ -
�__ w SENSITIVE LAND: _
PHONE:
APPROVALS REQUIRED
CONTRACTOR / PLANNING:
NAME: 111•0 Lu ENGINEERING:
ADDRESS: FIRE DEPT _
C ` OTHER: --
PHONE: /- 7 ITEMS REQUIRED
LIST/SUBCONTRACTORS:
ARCH/ENGINEER BUS TAX:
NAME: CALCULATIONS:
ADDRESS: _ - TRUSS DETAILS: _
PARKING PLAN: _
_ LANDSCAPE P: AN:
PHONE . _ OTHER,-
COMMENTS:
THER:C OMMENTS:
PERMIT # ACCT # DESCRIPTION AMOUNT AMO:'NT PD. BAL. DUE
0 10--432 00 Building Permit Fees = 3— _
14 10-431 00 Plumbing Permit Fees t% '— jqu
3 10-431 01 Mechanical Permit Fees 143.5v
10-230 01 State Building Tax (5%)
Building / /' 1y
Plumbing _ 7, vu
Mech a • / y
;0-433 00 Plans Chz k Fee �°��35 �l d N3 5Y
Building
Pli.inbing _
Mcch
V 30-443 00 Sewer Connection (20Xj7.
O g�Uy�a 30-202 00 Sewe;- Connection (80%) --��
30-444 00 Swaer Jnspection - j
51-448 00 Street System Dev Charge (SDC)
52-449 01 Parks I System Dev Charge (PUC)
52-449 02 Parks II System Dev Charge (PDC) U �5 v
31-450 00 Storm Drainago Syst Dev Chrg (SSDC) O �SiJ
10--230 09 1 RFD (95X)
10-435 00 TRF- (5X) -"
10-230 06 Washington County Fire M1 (95x)
10-435 00 Washington County Fire #1 (5X) _
10-220 00 Amar•t/Wedgewood
TOTAL /� C
�\ REC #
APPI-TCANT S
Received By: Date Received: /C) -
4. i7r.o 7n