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11465 SW PACIFIC HIGHWAY-1 ......,�.. ......._....,.......,. �............._�,.,.......,.�.w.:...,._......:«.........:.w�...�...r.....:.�«..rw...+....+.�..�w....-..�.w�++w.wwM.alr��.rn.W�i+ �_ .. �w+�'t7YM�Mr,IWitMNM'AVMSItiY r Q. n f!) E n N• r� r i l i s 11465 SW PACIFIC (hgl�WCll� - INSPEt'P ON NOTICE City of Tigard Building Depattatont 131.2.9. SW Hell Blvd. Tigard, Oregon 97223 Inspection Lino (Rec-O-Phone) 639-4175 Business Phone: 639-4171 Inspections Footing Plbg. UnderalaL Hoch. Rough-in Appr/Sdw k Found. Plbg. Top Out Gas Line FINALS Poet/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Hoch. Rain Drain Insulation -Plumb. Plb,3. Underfloor Water Line Gyp. Sd. -Hoch. Date Requeetedsy -72-- Pimet �AN PM Address: 7.CI'j ta�rmLt #t -2 -& Builders ��c _� 3y/ TNR FOLLOWING CORR2 .'TONS ARE REQUIRED- -- — —_ InspectVr Dater —APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinsp. iNSPECTIOH NOTICE City of Tigard Building DepArt„'nt 13115 an Ball Blvd. Tigard. ovagon 97223 Inspection nQo�(Rec-O-Phone): 6 -4175 Business Phone: 639-4171 Irepection: Fcx)ti:.g Plbg. Underrinb Mech. Aourh-ifn APPr Sdwlk -eound. Plbg. Top Out Gas Line FINAL: pent/Besam Struct. Ban. Se++ei' Framing -Bldg. Post./Beam Mech. Rain Drain Insulation -plumb. Plbg. Underfloor NateLine Gyp. ad. -Mach.Time: �AM� Date Aequentedt � PN i Permit is L Address t Builder THE FOLLOWING :70RRECTIONS ARE REQUIRE D. 1 j J .i: � 444 al — Inepe.aor r_ APPROVED DISAPPROVED —•_ APPROVED SUBJECT 'f0 Aww7 Call For Reinsp. }SIS PEt:T�QN�7QT I CE City of Tigard Building Department 1.1125 SW Hall Sled. Tigard, Oregon 97223 Inspection Line (Rea-o-Phone)= 639-4175 Bueineee Phones 39-4171 InspmationI `— r BdWlh Flbg. Underelab � Koch. Rough-Ln 1►PP Found. Plbg. Top out can Ilse Muil Poet/Beam 8truct. San. sewer Framing -sl Poet/Beam Mech. Actin Drain Ineuiation -plumb. Plbq. Underfloor Water /Line Gyp. Bd. -mch. Date xAy,ieeteds_ Addrees:_- Bu1l.der: _..- THP FOLLOWING CORRECTIONS ARE REQUIREDt ---� ✓ =8OV r�Y Inspector: ------— l APPROVED DISAPPROVED APPROVRD NUBJE TO Call For Reinsp. CITY OF TIGARD RECEIPT OF PAYMENT RECFip'C NCJ. C t4ECJ� AMOUNT a 42. 50 CAryl AMOUNT s '0. 00 NAMF: s BLAZE Fit( N CFiYMFN1' DATE a 04!'If+".7 ADDRL-.\",+ s po BOX P5357 SIJBD I V 191 ON Ga'C)f)1'L_1.1N13, OR 97225— PURP0,5E. OF L-nYMENT faMC)Ur4T PAIDPURPOSEOFf�AYME-PJT F',MC1l.JN'f F�FaiD ` 191..1 I L.D I NG PERM ST, BUILD OER I. ?5 � i I f TEXACO STAT 1014 11 ►'/`3 qw f"'AC:i F I C: HWS` �. 4� TOTAL_ AMOUNT PAM C i t - �. CITY OF TlGrAR Wrf A4 COMMUNITY DEVELOPMENT DEPARTMENT �,� � l. . . . . k ERM 1 C 11125 SW HWI Blvd. P.O.EkW 23347,Tiprud,OreWi W72V(603)839.4176 PERMIT' #. . . . . . . : 1 U! 9 —4�rtl!W c:, 39- 41 71 DATE ISSUED: 04/06/92 :;ITE ADDRESS. . . : 11465 SW PACIFIC 1414Y PARCEL : 151 ,6Ar` SUBDIVISION. . . . : ZONING: BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . ------- REISSUE: FLOOR AFEAS— ---- --— EXTERIOR WAI_t_ UONSTRUCT I ON- CLASS OF WORK. :ALT FIRST. . . . : 1370 sf N. S: E: W: TYPE OF USE. . . :COIh SEI,OND. . . : sf PROTECT" OPENINGS?—__..-__.___-_.__. 1 YPE OF' CONST. :2N THIRD. . . . e sf N,-. S: E: W: OCCUPANCY URP. :Etc TOTAL — -- : 1370 s f ROOF CON T:A FIRE RET?:Y rJCCUPANCY LOAD: BASEMENT. : sf AREA SER. RATED: STOR. : 1 HT. : 14 ft GARAGE. . . : sf (.DCCU SEP. RATED: 13SMT":N MEZZ?:N READ SETBACKS-----__.-._ REQ1!1RED--.____-_.—_ ______ FLOOR LOAD. . . . : 125 ps f LEFT: f t RGHT : ft F I R SPIML:N rMOY. DET. . :hI DWELLING UNITS: FRNT:50 ft REAP,: ft FIR ALRM:N HNDICP ACC:Y 13FA)RMS: B11THS: I11P SI-1RFACr: PRO CORR:N PARK I NG: VALUE. $ : 20000 Remarks: Construction of rew 48ft by 28ft steel canopy. Carnopy misst be not les,, than 50 ft from trig c. enterlinF of Paci.fic, HWY. Owner: __________--.--...-.-----__...__.______.____._...__..__ _____.._.__.________ FEES 1'F.XACO USA t ype amc1'.Int by date reept 1.800 SW FIRST AVE PRMT f 140. 50 JLI-I 04/06/92 — PLCK % X31. 33 JLH 03/30/92 253E PORTLAND OR FIRE $ 56. 20 J1_H 03/30/92 :::253f- i-'hone #: 21,25•-4223 5PCT $ 7. 03 .7LH 04/06/92 - i,writ ractOr: ___ -_._.-__-_._._ .r__...._____._.. .---•--.____ PEMCO PCI BOX 11569 �10H I l_AAND UR 97211 pti on e #. r E3;S _'151 $ 21)5. 06 TOTAL Reg #. . - 43740 ------_. REOU I RED T WJ-,ECT I CINS This permit is issued subject to the regulations contained in the Foot/; c1u n d I.1a p Tigard Municipal Code. State of pre. Specialty Codes and all other St ri.1c Steel Ins p applicable laws. All Mork will be done in accordance with Framing I n s p approved plans. This permit will expire if work is not started Final Inspection within 18@ days of issuance, or if work is suspended for more than 18@ days. remittee 5i.gnat .lrt . G��.: / IiA Lsslied By : Cal 1 f'or in-:pect ion — 639-417..5 __J WE 1w 9 m CITY 01'.' TIGARD RFC EIPT OF I.",IAYlylt:NT RECEIPT NO. 9 Z" 6 7 3 CHECK AMOUNT 147. 53 vinmE. c RITCHEY, LARRY CASH AMOUNT Z 0. 00 F-,()YMC-,'N I DATI: : 04/06/92 SUBDIVfSICN OF PAYMENT AMOk IN T V'A I D pUppOE;E OF PAYMENT PMOUNT PAID plill-DING PERM 140. 50 SLIrLD PER usn tl4l..,.5 Sw pAr,1171,C HWY :It 13 1 -r(]T(-)L. AMOUNT PAU) 147. 5.3 CITY OF TIGARD OREGON April 2,1992 Larry W. Ritchey Permit Consulting Services Inc. 122 S.S. 27th Avenue Portland, OR. 97214 proje ,,;% Texaco Canopyr quP92-0079 11465 SW Pacific Highway Dear Mr. Ritchey: no far this project have been reviewed for conformity Plans and calculatio with applicable codes and are approved- The only item to note is that the om the plot plan was not of sufficient detail to Y tThatnajasurene t mist o the distance rbe not canopy to the cent obsite copy of hw less than 50 feet. This dimension has been noted on the j the approved plane. The permit for this project may be obtained at your convenience. If you have qulsti.ons, car if we may be of ass.intacIce' please contact. us. Sincerely. I•. I: i.m Ja Plans Rxami.naRr. Thl (503)604-7297 13125 SN Hall Bt/d•,P.O.Box 23397,11(,ard,Oregon 97223 (503)639-4171--- ��GSC 131PLNCK/RECT # 15 SW Flall blvd. CiTir OF TIGARDPO Box 23397 PERMIT # 1 ieud,Oregon 9111) COh4MUNIT'lt DEVELOPMENT DEPARTMENT (-W)639-4171DATE ISSUED 1 S c,� �} C I f--( #W�/ TAX MAP/LOT ,��%3(v �� —�0 JOB ADDRESS: __L' LOT: LAND USE: SUB: __ --- - VALUAT ION: SPECIAL NOTES OWNER C�fs'� REISSUE OF: NAME: -�+��-� _ 1 ��G'C LAST REISSUE: ADDRESS: - -Y r,7- JID _ FLOOD PLAIN/ SENSIFIVE LAND: PHONE: APPR01'ALS RE UIREO� ,�� 4E�r CONTRACTORy a/P�' PLANNING: �F� .�'� F ''r�C' Nlti NAME: ENGINEERING: ADDRESS: ���„�� ,��'- `�_7 � 1 � _ FIRE L EPT OTHER: PHONE: -r — CONTR. BOARD #: �'3 7 %r- EXP DATE: ITEMS REUUIRED SUBCONTRACTORS: PLUMB: -- LIST/!UBCONTRAC70RS: MECH: BUS TEX: CALCULATIONS: ARCH/ENGINEER _ — ------_— -- _ - TRUSS DETAILS: NAME- _ -__---__---- OTHER: ---- ADDRESS: _ _ ------- -- PHONE: t5tPROPOSED BLDG. USE: COMMENTS: �_-- � 1�7U4 Ic A' AR'rLiCANT IGNATURE Received By: Date Received: ��- PERMIT 9 ACCT b DESCRIPTION AMOUNT AMOUNT UD. BAL. DUE 10-432 00 Building Permit Fees 10-431 00 Plumbing Permit Fees 10-431 01 Mechanical Permit. Fees 10-230 01 State Building Tax (5%) 1.D-3 ' Building Plumbing _^ Mechanical 10-433 00 Plans Check Fee Building Plumbing Mechanical 10-230 06 Firedlo --_ - 30-202 00 Sewer Connection 30-444 00 Sewer Inspection _ 25-448--02 Commercial 11F Fees 25-448-04 Industrial TIF 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 'hrg (SSDC) 24- 445-01 Water Quality (Fee in lieu of) 24-445-02 Water Quantity (Fee in lieu of) TOTAL nm/3587P.WPv • CITY OF TIGI)RD FECTIPT OF PAYMENT RECEIPT NO. CHECK AMOUNT 147. 5,75 NAME a RITCHEY, LARRY CASH AMOIJNT 0. 00 ADDRESS a PAYMENT tNaTE 03/30/92 SUBDIVISION P(IRPOSE OP PAYMEN1 AMOUNT PAID PURPOSE OF PAYMF--'NT AMOUNT VIAID VALL TEXAM f-aiTATION CANOPY 11465 SW PACIFIC HWY i,o*rAL. AMOUNI PAID > 14 7. 53 SIGN PERMIT PERMIT #x SGN92-0040 DATE ISSUED. . . . : 03/2G/992 EXPIRATION DATE: t95/c%/ /- PARCEL. . . . . . . . . : 1S136AD-•05800 ZOfjE. . . . . . . . . . . . C-G BUSINESS tjMa. .: TEXACO SIGN LOCATION. . : 11475 SW fACIFIC HWY AL`PLICANT/AGENT: DAVE WHITE BUSINESS TAX NO: aaaaaaenm-.a aseszasaaarvrs.zs.a.=a__. -- SIGNS FREEWAY ( ) Pi3RMANENT (X) FREESTANDING (7C) TEMPORARY ( ) WALL ( ) ELECTRONIC ( ) ( ) BILLBOARD ( ) BALLOON OTHER ( ) SIGN DIMENSIONS. . . . .. : TOTAL SIGN AREA.. . ...: 69 sq.ft. WALLAREA.. . ...... . .. .: sq.ft. WALL FACE (DIRECTION) : NA SIGN HEIGHT. . ... . . . . . . 20 ft. PROJECTION FROM WALL.: in. ILLUMINATION. . . . . . . . . : INT DESCRIPTION OF SIGN: PERMANENT FREESTANDING SIGN. 6' X 6' X 5.6' X 6' X 2 - 69 SQ.!'T MATERIALS. . . . . . . . . . . . 'STEEL PLEA EXISTING SIGNS. . . . . . . 1 ELECTRICAL PERMIT REQUIRED: YES BUILDING PERMIT REQUT.RF.D. . : YES ADMINISTRATIVE EXCF.PTIONIS. : N/A PERMIT FEE: $ 35.00 N l APPROVED BY: -- -- �_ DATE: 03/26/92 -1'■1'■NI"11l 1a —_ rLw(14"tWry7Rrr • I _ Alr✓A 170GAMWI Itl K00!14%InA.wr IIa C.I ry/trR:le rtl/•aw \\ C�QA V✓� 1 1✓nitlRrlJAtr✓A■oo N-•r�,(,IKQj,12,�� -PA'0 re IAIRrt 1Il•C■Ir ---- --_ tArcroo 11184..*LfT'Aco•.1c Ar Rles�VI± OMOO— ^,.I ' �'� I 1.10,.11Aovtlw r. n tRr 1000 a"',/0 4100 tAcw/rw rra Urileeded A y' S-olf serve 0300 10 14ow Offering � super Unleaded 0■0'0 Diesel .. ,-.,_... --...-_-.---. —�. --_.._.— I"11-✓If\t MRN( /+/� 1 Nrwru✓1Y 1. (• v tr1 ACC(/!COvt•n1Arr r oo Moi — t�out.• «ort IR(/tlRrelrL 1 MM'1-O+r10/aA1 �� �,„- y� rd or FL rrf r:r 'fi- � 3 f•::::;•�� 7.�Ou R�c,n rlv.,ryrn , _ . 1 �', �•• '(•: COWME rt RMll tlIrAN•:;{ '.'• I roM Com"It/M1t Ir;*,M,t a `�'l�• �:.••r. /p0tl111 rwf■OA rt�{� + �i 0.IA11 ••� 'e •l.: .R►qtr '1• r.•••-.- /tn Ar t'.1'rlar lRuM 9^� I • - row MXA.OArIOat 8140■% .! Rt1AR 1,•• .#....� � 1 � 111ao'o y $Mrs R gt \�� l �-T,?�. �V': .i•k j.1.yt� x •� : 1V.l�lrt�{y� CIRicI ova”IOIAI/O.1fIOM Ot/K AXd~W'•tlY//pY�uO+/�IdM�/,p� i JUS T��;;�ca Sign �+L::'J: AN DTEG0 31Ir'f 'T 39;,:_l FIARNEY ST, SU:LTE 202 1 S,:in Diegor C) 921.10 114Y : � �f No. 2 -:?:L (6:1.9) 543•-122'2 of ,L CLI E--N'T Blaze Sjqns L_OCAT.10N: Tig-AT•ci , 0R' WIND; Ba<<ic): Wi.nci = >?0 m1:�h qs. = 1.7 psf Design Wind Pressures'. 2(3.6 psf 0 - 40' 30.9 p s f ,h 40 r.0, 60 ' -10038 . 1 ps'f � N IOC --.1.", O' 4'.2 0 psf r °0 �pErJ � D l,4 N1 `� �1�PIiUv1;D 764 Y rrrY OF 7><cna�n 3131/9s l 7 /I-- DATE:: 31.-vicar--92 JOB Te-oacn Sa.gn SEI SAN 1:11:E00 SHEET 935 Hornet' '202 2 Sian Isiego, GA 92110 No. 222 -21. (619) 543-12222 o AI;E::A F'OF;(:E AF;M MOMENT F'IE]GIHT s i.g n 38.,; 1.099 10 1 1,59 1:1.636 1:?oleo 1.1 .4 v:'5 8,50 2765 1.425 1.4401. 1.0. 1.1. FOOT:I:NG 1001L. F'FiE SSI.)f'F.. -= IV50 ,. _. x%00 PS)F /Fl (UpC TABI...E 29-B UAI_UE 2, I"'ER F0CIT N0TF' 4) F 1.425 LBS FI 10. 11. FEET Fs = 0 FEET 609 58 A - 2.34 .. F'' / (S1. X F.0 - 7. :1.9 A ( :l. ( 1 4 .3 r., X N / A 6. a.2 F- �k<*k<W*?k*k<W?k�'�k%:�k?k.iF.*:F:?I�.*:4�*�K*.�'.*�'.�.%V.�•.*�k C0L..UMN TUBE'. STE:E L -. ASTM A500, GRADE:. B ?> 1.4401. XI. /( 1. ,33x1'4000) 5.4 @ 0 .0 1='r 6.0 "TUPE w== 14 .` #/.rt: t':=0 . 1FF • M1:N:FMl.1M a IN Permit CITY OF TIC-ARD SIGN PMUT APPLICATION The applicant hereby applies for a permit for the work indicated or as shown in the accrepanYing Plans and -,pec.;ifi-cat.ions. SIGZd LOCATION ADDRF'�..aS: jig�05, ��� ����L (, ZONING: — — NAIL OF BMIN03S: ��A CeD ,2q—'P-`Jq670 _ APPLICANT/AGEPFI'-.� OCMPANY: Z S/l�� F'J toN>;: The City of Tigard imposes an annual Business Tax which must ba kept current on all pexsais doinj b Lsi.ness in the City. Do you presently have a current business tax? YES NO ( ) U.L. Label ,# : - PROPOb'FD SIGN: (Check as many as apply) PEW&N NT FRE. MNDIJG FP104AY ( ) ITMPCI ( ) WALL ( ) LIBOIT4VIC ( ) OTHER ( ) BILUBOAM ( ) BALL" ( ) SIGN DIMENSIONS: �1 0 _ �'` — EXPIRATION DATE: TOTAL SIGN AREA (Sq. Ft.) - WALL t.) :WALL AREA (Sq. Ft.) : _-- WALL FACE: HEIGHT (Ft) : PnWECrION FROM WALL: — II.IlMNATION: YFS ( ) Nn ( ) TYPE: &Q r"A — OWY: _ �• 61kS 119?!MATERIALS: — EKISTING SIGNS: AEK NISIRATIVE E(CITTION: N/A ( APPRWM ( ) HOW MM __-_-% AREA ( ) HEIGHr ( ) PLANNING DF�?ARTMFNT _— All sign permits must be acompanied by a scale Permit Fee_ `P Under _ drawiM and plot plan. If work authorized «, a sign permit has not been ocElpleted within ninety oeiut Re -No:(. �_ days after the i�quance of the pecm.it, the permit '�-- Datshall becanull and void. e_._ 3 —��_---- me ELEr,RICAL PFI34I r I CF�2TIFY THAT J AM THE RB-XMED OWHER OF THE RF�[JIR)~D: YFS (�NO AGENT ACTIIiOPIJI BY THE M4ER• , WILDING RPD:PM4rr� — --- —_ RB7jjy NO ( ) Afiiplicant's Signature 235 SA,-Z CP(111WLFM1' Address Telephone N:\W0W\CTM V\ SIuN PERMIT PERMIT N: SGN92-0041 DATE ISSUED. . . . : 03/26/92 EXPIRATION DATE: 05/26/92 / PARCEL. . . . . . . . . . 1S136AD-05800 ZONE. . . . . . . . . . . C-G BUSINESS NAME. . : TEXACO SIGN LOCATION. . : 1..45 SW PACIFIC HWY APPLICANT/AGENT: DAVE WHITE BUSINESS TAX NO: SIGN: PERMANENT (X) FREESTANDING ( ) FREEWAY ( ) TEMPORARY ( ) WALL (X) ELECTRONIC ( ) OTHER ( ) AILLBOARD ( 1 BALLOON ( ) SIGN DIMENSICNS. . . . . . : 2.6' X 3.4' TOTAL SIGN AREA. . . . . . : 50 eq.f.t. WALL AREA. . . . . . . . . . . . . 848 sq.ft. WALI. FACE (DIRECTION) : S FIGN HEIGHT. . . . . . . . . . . 12 ft. PROJECTION FROM WALL. : 8 in. ILLUMINATION. . . . . . . . . : INT DESCRIPTION OF SIGN: PERMANENT WALL SIGN. 2.6' X 14' = 50 SQ.FT MATERIALS. . . . . . . . . . . . . dN/PLEX EXISTING SIGNS. . . . . . . : ELECTRICAL PERMIT REQUIRED: YES BUILDING PERMIT REQUIRED. . : NO ADMINISTRATIVE. EXCFPTTONS. : N/A PERMIT FEF.: $ 25.00 APPROVED BY: j DATE: 03%26/92 Permit No. S66 Tx - 41 CI'T'Y OF TIGARD SIGN PERMIT APPLICATION Me applicant hereby applies for a permit for the work indicated or as shown in the accunpanying plans and specifications. SIGN LOCATION ADDRESS: O'k/I Ami rl e /•%% 7,OKING: _C, _ NAME OF BUSINESS: APPLICANT/AGENT: OL Lr T,`' al7MPANY: j%f� ,E 37Q�.'-�_ PHONE: 4�&Jg6l `i2ie City of Tigard imposes an annual Business Tax which mist be kept current on all persons- doing business in the City. Do you presently have a current busine._,s tax? YES ( ') NO ( ) U.L. Label — - PRDPOSED SIGN: (Check as many as apply) PERKANENP FREES'PANDING ( ) FREEWAY ( ) TTIP'ORARY ( ) WALL (X ) EIMRONIC ( ) MEM ( } BIITBQARD ( ) BALLOON ( ) r SIGN DIMENSIONS: ,,2 G- 'x /Y ' �,� ` D„�M/ EVIRATION DATE: TUPP.L SIGN AREA (Sq. Ft.) _ WALL AREA (Sq. Ft .) : WALL FACE: fiEIc-d-CP (Ft) 01-1;;711e) P12 X=1ON FRCI MU,: MUN INATION: YES (k/) NO ( ) TYPE: -COPY: EXISTING SIGNS: AEMINISIRATIVE EXCLYTION: N/A ( ) APPROVED ( ) HOW C MMENTS - AREA PLANNING_DEPA ZIM MAll y �-i ign pexn�its mi%t be anied by a scale Permit Fee: — drawing and plot plan. If wank autho.:ized under teoei t,No: - S - a sign permit has not been ccmpleted within ninety AApproved �A _ days after the is�-uanc of the rmit, the permit Date: _ a �6 `l _. shall beccxw. *iul] and void. E11)=CAL PEE44IT I CUMFY WAT I AM THE REUDRDIT) MTER OF THE RE7JIRED: YES NO ( ) PROPERTY OR AN AGENT AUTHORIZED BY 7!WF C"aI_ BUILDING PERMIT - ---. ----- - RA•KJ RED s YES ( ) NO __ CCC lrant-s Signature cp/BICMPERMT Address Te.]ephone N:\WCM\(UMF.V\ ea � .rte ' • .�` VA- DIA / rl T ,OI co I i -- CPx6PY -NORTH ELEVAYION DIS• CANOPY-SOUTH ELEVATION 7 � DIA - A I�I'ROVED CITY Ol: TIC 1 RD CANSY -WM F_I.EVA110M4 7��i7' �C��_.Mooe/ -rg�2 i f J. MEDFOFIO • • : MEDFORD.OR 97501 15011779 oil(ll PORTLAND • ti OF PAYME.N1 lf:-f NO, V 49 CITY Qt- TIOARD AMOUNT 0110UNT n 0.013 1.4 A 11 L a vq"(A;lT SIONS Or AM f.,V, r;fA,fjjv-,N,l* 1'I;IE2TC AND,PoPkE.Si" �,.O. Box ps�An7 139UTID'.(VISTON OR 2'5 9,7225— IMM.1141 PAID i:M(ll IN T PA 11) PURPOSM, M: PAYME'I pi,q'iV,USF� OF PAYMC-441' Irl.AN LHFr-K FE R561 00 f- 92 44*'4 1 -F(m 35.00 IUN m-� ,3p P.)TAL 0110UHT PATI) CIT1(O TIOARLQ 7!�� COMMUNITY DEVELOPMENT DEPARTMENT 13126 SW Heil Blvd. P.O.Box 7,3397.Tig&M,Oregon g7M(6W)G.IW4i 75 i: PERMIT #. . . . . . . . 41DA-r 17 ISSUED, 04108191 PARCEL: 1G136AD-- PI)DRESS,- - - '- 11465 SW PAC I1'-'Ir- HWY ZONINGi ;UBDIVISION. - - - : UIT. . . . . . . . . . . . . LULK. . . . . . . . . . : MOBILE HOME SPPCES- " ASS OF WORK. . :ALT GARBAGE DISPOr�SAI-S. LWASHING BACKFLOW FIREVNTRS. - Y WE LJF UbE- COM MACH. . . . TRAPS. . . . . .*. . . . . . . . )CCUPANGY GRP. . : FAA FLOOR DRAINS. . . . • • • CATCH BASINS. . . . . . . : 7"TO R I E 5. . . . . . . . : WATER HEATERS. . . . . . SF PAIN DRFIINS. . . . . : LAUNDRY TRAYS. . . . . . : GREASE TFRAPS. . . . . . . .. URINALS. . . . . . . . . . . . .. "SINKS. . . . . . . . . . 1 OTHCR FIXTURES. . . . . : - - - - I SEWER LINE (ft ) . . . . : rUB/SHOWERS. . . . 2 WATER LINE (ft ) . . . . : WATER CLOSETS- - 9 RAIN ORAIN (ft ) . . . . : 1)1 bHW"�3HE HS. . . . ! r;,Mav-ks ' REMOVAL OF F;LJMP PUMP, AND FLOOR DRAIN FEES 1moi.mt by date T,ecpt Ljwner: type TEXACO PRMT 4, P5. 00 1. 1,465 SW PACIFIC HWY 175PCT 1. *2!_5 26. ,:,5 ji-H 04/0E1/917AYM 1- 10ARD OR 9722,s Phone 01 P- / NE G BLVD COLUMBIA ------------------------------------------ PORTLAND OR c)7214 .='6. 25 TOTAL Phone #: 43740 REQUIRED INSF-1ECTIONS -eaulations contained in the Fina tispec!ti0y) aeroit is issued subject to the - es and all Othtr igard Municipal Code, State of Ore. Specialty Cod nDlicablt laws. All work will be done in accordance with git will expire if work is not started itbin 180 lop-royed plans. This per of issuance. or if work Is susoended for fore s than ISO days, )pt-m i t t ee Ir'st-led BVI 639-4175 fur- inspection CITY OF TIGARD PLUMBING PERMIT 13125 SW HALT. BLVD. P. O. BOX 23397 Applicanh must hc4d Oregon Registration to coodm:t a plumbing TIGARD, OR 97223 business or must be property ownyloperator no B,iring cwtside help. (503)639-4175 bP^ - --E, )t f-C _0 Plumbing Permit No. --- — Addre Dosmption "r //' C( [J OHS814-21-610QUAN. PRICE MAI. Job Tax Lot Map.No. - Address FIXTURES Loi ilkncic Srbdrvlsbn �`---- -- -.�- Sink 7.50 ams or namess - Lavatory --- 7.50 Tub or TubfShower Comb. 7.50 a�7Rlirss.+ — �- Shower Orny 7.50 Owner City/Stale 2,p -- WalerCbsC - _ 7.50 Dishwasher 7.50_ Phone Garbage Uisposaf 7.50 N" ---- Washkg Machine _ 7'.50 Floor Drain 7.50 _ g� Phone Water Neater 7.50 Occupant —�— t aurdry Hoorn Tray-- 7.50 _ p City/State zip Urinal 7-50 ams Phone Other Firhxes(14—ty)� — 7.50 as•�� �., z4 !Phone 7-50 (A)Mractor gw,state Dp ��_ 7.50 _l— T L 4+J�J 4 N►G Q 7--�I4- MISCELLANEOUS City Sue.Tax No. $e1r 1$11 W 30.00 .,tats Board"^'v' le t,kxnbws—Mir--Tic.M.- Sewer-ea.Addit 100'-- — 1500 (Hesxbntiaq Water Service 1 st 100' 20.00 I hereby advxnvledge thet 1 have road this applicatim OW the Irdonnatior, Water 3er6oe on.Ad M 2W' -- --- 15.00 gr~is oorred.that t am registered with the State GL%kWs Board.and ata Suras 6 Rain Drain t st.109 30.00 have a State Pknnbk►q ioense that Ifne mxr#rers Q"n are oorreM that an -- - pkmntwq work will be done kn accordance with"Scat"pm wons of Oro- Storm b Pyn Drain Addif.100' -_ 15.00 - Qon Revised Statutes Chapters 417 wxl M aril applicable codes at KI that MobMe Fiore Spam 25.00 no help wN be empi ed" -s Mooned under ORS G (M erempt from -- - - -- Stab registration.Ptak"give reason below). Back Flow Pravenbon NEOW,4CnS-1 hereby oertily Ov d I ora the owner of the Progeny de- Device a M6 PolhAion Devi,e 7_50 OM arsnbed above.nt wtridn location i propme b maks a o'wT"r Q k*%Kadon for Arty Trap or W ass Not M own rue and tido proporty Is root bdnp constrvdrd lot safe.lease or rent. Connected to a Fizhxe - 7.50 Catch Basin 7.50 inap_of F_rdel.Pkrntuhg 43.00 Per K. Specially Requested kupeWons 40.00 Per K. Mbar.d Pkanbkhg within _---an Existing 81d11 15.00 min. AAILM"IM u SfGNATVF+c_ _ oats New Bldlh-or MAH.Addlflon - — -25_00 min. Daarxibo work new❑ addition[] altemtkm❑ repels F.] �plj i 15.0b 9�� tasidential F1 non-meldenfielF] _ -- Fxtstkv use of $25.00 minimum SUB-TOTAL k k+ U"01 5% SURCHARGE 0rPi0f 't'- - _ ---- ----- - - _ ... --- 25+k PLAN REVIEW ----- Thfa pw mit be nornea rvA and void if work at orxutruorbn arrthxsrltad k not torn- TOTAL www*d wtlhfrl 100 daye,or K owwftw%n or wont is WAVerdod or dwswkrned for a;rwlcA of 180 days rd any 6nw ate wock Is oormwcmd 111"CIAL.C47MCtT IONS -- Ogle lasuec! thy -- I hFCEIPT No' i CI'T'Y OF T I GARD i�E"C.� It Or.' 6'R4"ME NT t.,AEC K AMOUNT s r" I CASH AMOUNT s �• �� 11AME: RITCMEY, I—ARRY pAYMENT DATF s 04/08/91 F�DDRE`r,S s pCS OC;CCIUNI SuBD M S I ON I AMCI!;I IT PA I D F-ti1J12E='OSE. UF' PAYMENT AMOUNT PAID PURPOSE OF PAYMENT UMt�INO F'E4�M^ F'C.M91-00,x`3 i. STATION i✓'1._UMEa I IVL3 f 1JIM I T SW pAC 7 F I C: 1- (1Mf)l.IN1' PAID ._ .._ ._) c'b. 25 I i I i 2s �0pRIj ��1 sry It. 'j.CsNr Lf� ♦ 9362 „ ORStCOif �r Roar- OE� (Wwx 77 _ �CrAS WKS. `�Ll ��'s11(�ti� 10 �y��`'�� 11,1 i (.(,u t,. L ,LSI ��♦ tib,�tS ( I��-��`�� �i'a� I'� �-1 L L .1,1o45J N1 w �UgS It•4�?S 1 ,�,�1•�15� �� ►u�L� =- 2b►63o5 T4 Ft' Mlz u 11 )L. vulvl �'' a► a��,,� '-"'�.� Fti a 11. 14 f �o " a ,4 W C z. .QOL`1S c1')� '}" ►fjll } rpU, L► oy �Ltic.�1C 11� �s),� . IIc� Cit, ti��7 'LcA air Fb • jw By_ --- � pq�n P,y - --- ----------- i� I U n�� DATE __------ --- JOB NO.0Ziti -- MACKENZIE ENGINEERING INCORPORATED CIVIL_ • STRUCTURAL • TRANSPORTATION SHf. I OF �— 0690 SW BANCROFT S1 REET • PO BOX 69039 r 1McNENDE EN6iNEFRIHO iNCORPORATEO PORTLAND.GREGON 97201-0039 • (503)22^'9560 0FAX(503)220-1285 I 0 iW2ALy FlnHT9RE9ERVE0 IWL lREAll r- Ib�1S')c L ,h, tiuu fj , Ys: Th p A �� gut . ��`�� 1���� , (P— 1b--)(1 by I �� M a 7,V'aVl� Cq S � = (0� ,�1.11 I� � Vr�(3� IanC�1 (,1►�t 11 `.r. L ti� �S 1� /'ir = Tp.k- 0 L-v P-r -0wr-r -OIL) N% V N A 1. SN o •J ' r g(e SY 1 ( ` (.'L• G�•kyL CJS S 1 u-xl U'Y !Y) I C, M _ BY_516"—_ DATE ---------- - - --------- — .JOB NO. MACKENZIE ENGINEERING INCORPORATED CIVIL • STRUCTURAL • TRANSPCRTATION SNT _l OF . 0690 SW BANCROFT STREET • PO BOX 69039 PORTIJINO,OREGON 97201-0039 • (503)224-9560 • FAX(503)228-1285 O ,��RIGHTS RESERVED ORmw`�D� i (3otis c P t $. wc-I aA 6or,-r1, ( 11/i at A 7U1 #j T6„�r = �,- c� — 3, 3� } 2,SC73H '`C 16-�»)i►�1, w, r� /L— lu Ao Fc�o r�n15 S ` v1 S�-iM-t* X 6 ' —b" DC�P J_$5-7 L foo IG yin Pat cl = (, b Path- 1'1`6)0 �11► �l,L j ��,`6� Cult) yrr� 0 PROF CO 962 11 WIW,.M''�.w� ORtCOM Oo ?I. SAS WRVS BY ��p- – d_ DA1 E qqLo� MACKENZIE ENGINEERING INCORPORATED J013 NO. �l ICIVIL • STRUCT•IRAL • TRANSPORTATION SHT-.—43-- OF _– 0690 SW BANCROFT STREET • FO BOX 69039 -- PORTLAND,OREGON 97201-0039 • (503)224-9560 0 FAX(503)228.1285 I �GIENLE ENOINEERV;,j rNCORRORATEO �-M ALL RIGHTS RESENVED G e) e �25_ P 5F Soo%4 by 9382 . 011140" 5E1Sntcr Zc,n.��. 2Q CCAS WRENN�l�L MA-sPRD Seurat, 3 * 1,�s GA (, G = OL111 "1 FP+SLIN Pint n-S Coo" TAIL i \-t4" WNG WIND Lu NZ = 11 X. •'l X WL , ,0�1�11N PSL G _ , YY1 b 3g. L5, _I•IS03 f�, = �ocic,Il.l.:�r,•s`�b t yunau -L- 4 18IXt9/bti-K 1 i M 1% ( N Llk z Z: r )( = . 0Zo3 It-I' L S = , �`� ��'' Ste = .n�15 �►Jy Y C15 �g�� (.��1 —� V z1r3 �9Su� �II WL-W)M So .0 ) ot�5 C,,�,ky,I 'v_3 i t PSZ UA DATE MACKENZIE ENGINEERING INCORPORATED JOB NO. CIVIL • STRUCTLIRAL • TRANSPORTATION SHT. --I— OF 0690 SW BANCROFT STREET • PO BOX 69039 PORTLAND.OREGON 97201-0039 • (503)224-9560 • FAX(503)228.1285 MACKENZIE ENGINEERING INCORPORATED 1"I ALL RIGHTS RESERVED � '--- _. ._ �.. L �int �►,w j��tX 1 �'���:��. .. _ . . Dx►! PUP ruveTc sR�1� C• Nt)S pNq '('raPC a ►v "��` n-�►3'1 Z►" PD= I•aZ7Ls �r�0�0�1 T (3r(0�96 )( .D��1•J C Tz i(�,,�5 •,/.)2 1 cl o - 1-1 Ito a 163,4„ LA fb = Ci 3, t el 3 (:•07cjo t) - 1"71.`1 (o + "C�-1 e- , 613 Tse _1 'b`N - CU, 1 1 , us U) -- ' --- by ,uSr•S BY O �, rL. DATE 3 IQ 15 91. MACKENZIE ENGINEERING INCORPORATED JOB NO. 19 OW I CIVIL • STRUCTURAL • TRANSPORTATION SHT. 1/ OF 0690 SW BANCROFT STREET • PO BOX 69039 - --- PORTLAND,OREGON 97201-0039 • (503)224-9560 • FAX(503)228.1285 MACKENZIE ENGINEERM INCORPORATED ® 1991 ALL RK➢NTS RESERVED z. T ISZ� L, BY_atA) DATE -- -- JOB NO. MACKENZIE ENGINEERING INCORPORATED CIVIL • STRUCTURAL • TRANSPORTATION SMT. _ 3 OF -� 0690 SW BANCROFT STREET • PO BOX 69039 MACKENIIE ENGINEERING INCORPORATM] PORTLAND,OREGON 97201-0039 • (503)224.9560 0 FAX(503)228-1285 0 1291 ALL R*KT9 RESERVED t pN45 zzl SfC-'T10 lXy,� Lo�lto L,S�� ly L�.w-A6 X ,,IWSH�� �,l�i,l�t�.. 2.�1�1�15�1x� l0`-1� — ,4 - 'Il I,u s--i 141 S-1 Q o�i�� C o►-+N C Lit c,�J ; `'L� SJR I� � � 3►+'� �� �-�S �t ��u Ic. G-) L PSL L � �uctG' La�1 j o T k (LCMAI(4 UrJCI�/%NGUO / TIir- TD 10 nNr-jM � IS RE�1Vv Ll W 7)A, /�Do11)a-j k-1) N n��, PALV )UV-.$ �D PROP yX@2 ORr60N Q 22, ��AS WRE.NN -- — PY DATE -SILo It MACKENZIE ENGINEERING INCORPORATED JOB NO. 1011 CIVIL • STRUCTURAL • TRANSPORT/TION SHT OF 0690 S.W BANCROFT STREET • PO BOX 69039 _ 1991�LL RIGHTS RESERVE ?ORTLAND.OREGON 97201.0039 • (5031224-9560 • FAX k5031228-1285 MACRENDE ENGINEEPNG INC 1RPORATED D ® �F 1 CITY OF TIIS OREGON July 3]. , 1991 Mr. Jim Valentini 11465 SW Pacific Hwy Tigard, Or 97223 Dear Mr Valentini, This letter is in response to your inquiry as to whether the floor drain in your above service station lube area, can continue to be connected to the sanitary sewer system. T"he answer is yes, if is used only to drain the floor when washed down to clean the occasional drip or spill of oils, solvents, antifreeze, gasoline, etc. . . , associated with normal lube and oil type services. The floor drain is not to be used a waste oil, solvent, antifreeze etc. . . , disposal system, those waste products must be disposed of in a proper manner. It is recommended that an approved oil/water separator be installed on your system to provide further protection of the sewer system. If you should choose to install such a device, please contact the city regarding installation permits, and procedures. The source of my answer is from the Unified Sewerage Agency, of which the City is an agent. I have been notified that the Agency use does not presently require an industrial waste discharge permit for the above usc, but reserves the right to do so in the future. Please rill me if you have any further questions. Sincere+ ~-7 Brad Roast 3uilding official cc: USA 13125 SVJ Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223 (503)639-4171 -- and Marketing Int, tBUU:�W1rs1 venue suite 200 rolNa111.1 0P -ci'201-5'125 -,,y May 24 , 1991 / V RE' ENt1__=F'EDE L RRGULATIONS • FZNAT, RUI_,E-NPDES PERMIT APPLICATION REGULATIONS FOR STORM WATER DISCHARGES SERVICE STATION BAY �RAI:i$ aim Valentini 11465 SW Pacific Hwy Portland, OR 97223 63-183-36^ Dear Mr. Valentin!.: You will recall that Texaco Refining and Marketing Inc. ("Texaco") determined it would plug the lube room drains at service stations connected to sanitary sewer systems in order to eliminate any risk of a prohibited discharge of untreated nonstorm water discharges, spills, and improperly disposed wastes, particularly used oils, into the sewer system. Several dealers challenged Texaco's decision in this matter and requested an alternative to the closure of the lube room rumps and drains at their. stations 991rch had pursuanteen to scheduled by Texaco to be completed by March 25, stem the subject National. Pollutant Discharge Elimination 5y ("NPDES") Permit Application Regulations for ublished Storm theer Discharges, a summary of whicwa in the Federal Register on Environmental Protection Agency ("EPA") November 16, 1990. In response to the challenge, Texaco will postpone the plugging tof the drain for a period of sixty (60) days in order to pe affected retailers to seek and obtain a writt-n acknowledgment from the .local sewer system that i-t will continue to accept all liquid wastes disposed of in the lube bay drains at the particular service station. Please furnish such acknowledgment that san sanitary sewer system local governmental entity which operates handling the discharges and waste presently disposed of in the lube bay drains. Notwithstanding receipt of appropriate documentation, it will still be your responsibility as the dealer to test the to sump and EPA discharges and to monitor the lube sumps p regulations. Fwoog on 8 rredrlior of(duo. May 24 , 1991 Page 2 I trust that the foregoing is a suitable alternative to Texaco's proposed actions to plug the lube drain at your subject service station. Please furnish the documentation requested within the next sixty (60) days. Thank you for your courtesy and cooperati.c- Very truly yours, 1 � .A. Price � 5 JAP:cam rc: TCF BUILDING PERMIT APPLICATION TIGARD DATE ts.: 5058 1-l-IE UNDERSIGNED HEREBY APPLIES FOR A FERMIT FORTH E WORK HEREIN INDICATED BUILDER PHONE OR AS SHOWN AND APPROVED IN THE ACCON,PANYING PLANS AND SPECIFICATIONS. OWNER PHn LOT NO. D ^.+-- OWNER (c:xt�cuy JOB ADDRESS t _ _ ble3u;ku ARCHITECT f?L Webb. Arc.-lit. ENGINEER Z92_9432 PUILCER 1ilAkctleY C�srl'sli . ADDRESS X 53.5[ 18t U. Uji OESIGNER -� STRUCTURE Cl NEW UREMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL 11 ;:IRE DAMAGE ❑ DEMOLITION O RESIDENCE ® COMM ❑ EDUCATIONAL ❑ GOYT ❑ RE'.IGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE 0 STORAGE [I SLAB❑ FENCE OCCUPANCY -J- _LAND USE ZONE - �� �' BLDG.TYPE FIRE ZONE PLAN CHECK BY � H— HEAT_^ -- ---- lnte iur__rrnad_eLof exis-ov-virm-fir - - - Y -- to "Salva" Aren, SEWER PERMIT# OCC.LOAD M FLOOR LOAD 75 HEIGHT NO.STORIES 1 _ AREA 1344 NO.BEDROOMS _ VALUE.ti,a jU. BUILDING DEPARTMENT SETBACKS FRONTi REAR LEFT SIDE RIGHT SIDE Permit 56,50 �Ty1a PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING REGUL:.TIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE Plan Check 36.73 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH ALL ArPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE Subtotal 93.23 RESTRICTIVE COVENANTS. CONTR!C,TOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS LICENSE.SEPARATE PERMITS REQUIRED� FOR SEWER,PLUMBING AND HEATING. Stale Tax 2.26 t } SDC- 1 Total 95.49 .__ . (_\By Cz , PDC# APPLICANT OR AGENT Receipt No. i 1. ,) Approved I)ck _ ADDRESa PHONE DATE INSP. TYPVE INSPECTION REMARKS PLUMBING DATE Contractor Permit No. Fixture Final HEATING Contrnctor Permit No. Gas or Oil Rough-in Final SEWER Final DRIVEWAY Final Storm Drainage (Rain Drain)Final k Curb&Street Final Approach BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY 1 Final CERTIFICATE OCCUPANCY Landicaping Zoning Final CITYOF 71 ARD No. 0030 � 12755 S.W. ASH P.O.13OX 23397 Dat6,l(L ` TIGARD, OR 97223 Name Address bw Lot Block/Map SubdivisionlAadress r, — Permit M's Bldg. Plumb Cash C c�C� _ _ _ _ hh Sewer _ — Other Other ? By Acct. No — Descrlptlon Amount— �I 10.43_2 Building Permit Fees 10.431.600 Plumbing Perm+.t Fees 10-431-601 Mechanical Permit Fees — 10 230 501 State Bldg. Tax - 10-433 Plans Check Fee 10.435 Other Licenses & Permits 30-443 Sewer Connection 30.444 Sewer Inspection 24.448 Street Syst. Dev. Charge _25.449.610 Parks I SEst_Dev. Charge 25-449-620 Parks II Syst. Dev. Charge 31 450 Stone Draina0" Syst. Dev_Charge — _- 10-430 Business Tax _ 10.434 Alarm Permit I 10-227 Bail 10 455 Fines • TrafficlMlsdlParking aT 10 230 � CPTA TrafficlMlsdlVic. Asst. 10.456Ind1gent Defense 30-446.40_1 Sewer Service/USA 30.446-402 Sewer Service/City 31.447 _Stor_m Drainage 40.475_ Bancroft Prin. Pymt__— — — 40.471Bancroft Int. Pymt. _— 10-451 Other Charges for Services —_ TOTAL c;.• I DEPT. '' fps A I THE UNDERSIGNED N�:HEUY AI'r'LIES FUIt APL-HNIII I-UH ITIL 1V0Itn IIC_IIl114 Lu OR AS SROM AND APPROVED IN THE ACCOMPANYMIS PLANS AND SPECIFICATIONS. OV114EI`0110i'l LOT No 5 mac.. >ad AooR�ss 114V� S v n�., tee.._ 11 1 1 _�/' t' lU NEW ,� Q�ENGIN�.Eit 1 pp�� _i OESIGN�p 3Tf/UCTEIgE _ YEW L']IRk"MIIOEI 0-%oolrlos _ ❑RBP:IR ORENF',•/AL - C3FIRE DAMAGE ❑DEMOLI r n"100'CC IRCOMM ClEOUCATIONAL CIGOV'T ❑RELIGIOUS CIPATIO []CARPORT CIGARAGE O STORAGE❑SLAB OF Clr.C_V!ar__Y LANO USE ZOITE 0LOG.TYPE 5N _ PLAN CHECI; BY HEAT_ - r'60e lion \i ser rr r�"n•�- T�I�` t.t/,�mm.��;;�.�� �� �A L E 0- -BEDROOM SEW R RERMIT S;C�l�9P _Dg�,04D HEIGHT NO,STORIES 1 AREA I �`I�L NO.BE�gOOA+S VAt l► I 77 y'11L41ti',DEPAR fMENT — SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE I t�k i THIS PERMIT IS ISSUED-SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, Z ^ REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED TNA T WORK WILL BE DUNE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COhIPLI>,N:E 15J'1I�fAI '�" ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT OOPS NOT _I RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTEN CONTRACTORS TO HAVE CURRENT CITY BUS e`dfI! Tdx n F' LICENSE. SEPARATE PERMITS REOUIRED FCR SEWER, PLUMBING AND HEATING. Tuul SDC - r--- _� PDC# I C IK \/F t3fi APPLICANT OR AGENT A;:pruvFtJ I t, Recelpr Nu. Tr1nR FSSSIX DC (Storm) -�`= I�• Its - Z— �s'�-/ , PDC — S _ _ SEWER CONNECTION it SEWER INSRECTION $ -- e, 7� SEWER SURCHARGE S "9AL �c� SO 744 Comments : _ n�ec'Ij Lo