12905 SW 135TH AVENUE ADDRESS:
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CASCADE PHILLIPS CO.
SAM-P T
P.O. Box
OREGON ITY, OR �N $7045
656-9415 3 5 9009
1 800-4528379
S OME 'S OP.ER NO HONEGATE
NAME
ADORES"
SOLD BY CASH C.O.D. CHARGE ON ACCT. MDSE.HET'D, PAID OUT
QTY. DESCRIPTION PRICE AMOUNT
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All claims and returned goods
1057 MUST be accompanied by this bill "Than 1K. GYou
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INV. # `2892 INV. DATE 06/16/92 !TERMS: NET 30 DAYS
OT CONT. # 3651 P.O.# JOB#
,7
i 97045 BILLING PERIOD
379 (16/01/92 1U 06/30/92
-9009
• DESCRIP71ON
SW FERN S":""
PIMA 100 GAL � f- 184.00
8 '135Z1E PUWE D 15(10 S E/5 1_3530
3 y 3u st.�/ 270.00
PP OVER FOR:PAYMENT
�ROIECT # nC;i - /R'00 ".
A
ITE # alz/r
U SUPL. W. .RL. OTHER i
ED A PfiRIODI RAT F-1-1/2°ro PER MONTH WHI H
ISA K1 `? Al XI N-'A ERA E OF 164'.f APP0 D TO PAST DUE BALANCE
. 90 DAYS TOTAL DUE SUB TOTAL 450.00
SALES TAX 0.00
01.00 0.Ofl 450.•00 DUE THIS INVOICE 450.00
90 DAYS
SALES TAX
DUE THIS INVOICE
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SEWER C0NNEc'rIUN
• CITY OF TIVA110 V IRM I T
CffyOFTWARD ERMIT #. . . . . . . : SWR92-0144
OR ON
COMMUNrrY 7 10 �DEVELOPMENT DEPARTMENT 17
13125 SW Holl Bfvd. P.O.Sm 23397,Tig�,Onipgon 97223(603)639-4175 �nT,`7 ISSUED: 04/30/92
SITE ADDRESS— .- 1':905 SW 135TH PARCEL: 2S104131)-Q26IZ-.111
"JUDDIVISION. . . .. : VISTA [,.Al-,E ZONING5. R-6
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :3
-----------
TENANT NAME. . . . . :
USA NO. . . . . . . . . . . FlvrORE UNITS. . .
CLASS OF WORK. . . :ADD DWELT-;NGUNITS— : 1
TYPE OF USE. . . . . ;SF NO. OF BUJLDINGS: 1
I NSTAL1_ TYPE"- . . . -L',IJ!7:,WR IMPERV SURFACE. . : - -,f
Remarks : CUTine(--,t existing SFI) -to sewer-. Septic, tank mi-tst be pl.tmLted & filled wit!
S.ATid or, gr-,avel. Hof,Atp constructed r)r-iot, to 7-170.
0wrier— FEES
REIN MAGI type Amoi.int by date )"ec-pt
12'90t' SW 135TH AVE f,
RMT $ 300. 00 JLH 04/30/90.,
-
INSP $ ~i. 00 jLH 04/30/92
TICARD OR 9-12123
Phone #:
OWNFP
-----------
Phone $ 335. 00 TOTAL
Rep #. . a 00000
-------- REOU I RED INSPECTION',;
This Applicant agrees to comply with all the rules and regulations Sewer- laspect ioTi
of the Unified Sewage Agency. The *Permit expires 160 days from Septic: Tank Fill
the date :sued. The total amount paid will be forfeited if the
permit erpires. The Agency does not guarantee the arcuracy of the ---------
s;dp sewer laterals. If the sewer is not located at 0e measurement
given, the ,staller shall prospect 3 feet in all directions from
the distance h-ven. If not sr located, the installer shall purchase
ATap and Side Sewer- Permit and the Agency will install a lateral,
m i t t S i. t'j
B y Ilk
LL 74
Call for, inspect ion 639-4175
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Swlla6lvd. PLNCK/RECT #
POI � I397CIYY Cr TKI"ARD 3u _
PERMIT # —Swh'�.�
COMMUNI'll' 1)F-YE'LO I'M ENT 1)EIVAR'1'MENT Tigard,Orcgon9'IW
(503)639-4171 DATE ISSUED
JOB ADDRESS: /.tip OS s �, i_ s'" A�� —_ TAX MAP/LOTr-)V 0 �G J
SUB: LOT: _- LAND USE:
VALUATION:
OWNER SPECIAL NOTES
NAME: i✓',��� �� REISSUE OF:
ADDRESS: _ LAST REISSUE:
FLOOD PLAIN/
PHONE: SENSITIVE LAND:
CONTRACTOR .APPROVALS REQUIRED
NAME: _ PLANNING: _
ADDRESS: ENGINEERING:
FIRE DEPT: _
PHONE: __ OTHER: _
CONTR. BOARD #: _ _ EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: _ _ LIST/SUBCONTRACTORS: _
MECH: v _ _ BUS TAX:
ARCH/ENGINEER CALCULATIONS:
NAME: _ M TRUSS DETAILS:
ADDRESS: OTHER:
CL PHONE: _
Ce
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>- PROPOSED BLDG. USE: _ J� -
' COMMENTS:
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APPLICANT SIGNATURE
Received By: Date Received:
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE ,
10-432 00 Building Permit Fees
10-431 00 Plumbing Permit Fees
10-431 01 Me;.hanical Permit Fees
10-230 01 State Building Tax (5%)
Building
Plumbing R
Mechanical
10-433 00 Plans Check Fee
Building
Plumbing
Mechanical
10-230 06 Fire
30-202 00 Sewer Connection
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees
25-448-04 Industrial 7IF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees
►. 52-449 00 Parks System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) �i— --- -- --
�t
24-445-01 Water Quality (Fee ii lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL
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sEi:u SEIYU INTERNATIONAL
TEL: (503) 245-4090•(503) 245-4435 FAX(503)245-4351
date :
To. whom it may concern;
of
has contributed to our satisfaction on the public sewer line that
we have installed on 135th Avenue , Tigard .
Project # 89340
summit at Bull Mountain , Phase I
This letter is to serve as a "Letter of Participation" concerning
the above public sewer line project .
Si.ncercly,
Kurt VanVolkenburgh
C' General Manager
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Lincoln Center 10220 S.W. Greenburg Suite 450 Portland, Oregon 97223