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13()n0 Sw Pacific Highway
CITY OF T167A RD � ME'E',I--IAN:[(:;Al PEAMIT
PE14MIT NO. ME.0e2AII.J.
crrfOFTWARD
COMMUNITY DEVELOPMENT DEPARTMENT one
13125 S.W.Hall Blvd P.O.Box 23397 Tigard,Oregon 97223,(503)6394175 DATEE itiSIIJED: .12/13/H8
1:3000 jW I"'()(:".1:FJ:t:' 1--IWY
IAX MAP/1-GI SUB : LT : IiilK
I
I'FM: NO :
W01:41< 6-1,1ECTAT'MIN F'1JWNA- (',F- (1.001< :1. AID VIANDI R 0.0
TYPE' : AAP 11AND1..A J.01(
I*L.00P F1.44NACE EVAP EA
JI-1 , GOP . 1-11"A VFP WENT FAN
Vl:::N*Y' VIENT . tiYSTEM
1A.R/COMP <31AP 140(:11)
01.1:41COMV, X.-I.15HP I'N('.'J:NE'A."WTOP(0011
r-?I-R/C0MI:-` PATO I'll 4 COM
(.:AS H.I.A/C1101,11%, 30 R50I.-IF, 1:41;;PAI R UNJA'Si
MP(.JT 30+14) OTHER
1 DMPP57 GA5 PIPIWo' OUTLETS I.
IIs I I I)F 4 1;::q,
X6,6
r1r1141<5
0
W lAAIt.;4ii VW PE P 1.)L."Vl WE T 111.0 . 00
N 1 .5000 SIA) PAC-I.F .11; Hwy 1:"LAN 94l:::V:EEW
E
R I .1*(';Al:*fL) (711 9*7k'-22:*x FIXTI)RES $8 . 00
STATE: TAX $ .90
01,114K
C
0
N NOPMAN
I T'Y F AR-0 T*TON
R ,
A !'1W 1 :11-APE) !:;I*
C
0
R
I NO, 1831.3 TOTAL. : 1111.a .90
This permit is Issued subject to the regulations contained in Title 14 PECEIPT NO -7
of the TMC. State of Oregon Specialty Codes,zoning regulations »""""""""""""""""""'"""'""""...... ..........."-
and
..and all other applicable codes and ordinances, and It Is hereby
agreed that the work will be done In accordance with the plans andA 91 1. 1 N Fi.
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 P(A.K.-Al 1.N
business tax permits This permit will expire and become null and F :1.N M- L.
void if work Is tint started within 180 days,or it 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.
A4A--t
Permittee Signa
Issued By 74�--Z—J -
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
U1 I Y ut- i IUAHU MECHANICAL PERMIT id
Description
Table aA IMeohanlcol Cod• CITY PRICE AMT
City of Tigard 1) Permit Fee -0- .0- 10.00
13125 S.W. Hall Blvd.
P.O. Box 23397 2) Supplemental Permit 3.00
Tigard, OR 97223 _. --_ - __-_-- - ---- —
639-4175 1) Furnace to 100.000 RTU
1 incl.ducts R vents "'�
2- ) Furnace 100,000 BTU +
incl.ducts&vents 7.50
Name of D"vekilimant3) Floor Fu-nace 6.00
P�
G G
) I� incl,vent - - - -- -
jot) Aafr•s, - 4) Suspended heater,wall heat+ar 6
.00
Address -T-1 CA pr
ft.(7 p V-- or floor mounted heater
--
T., Map No — - 5) vent not incl.in 3.00
Lot Block Subduns,on — appliance permit r —
Name for name of Nniiness) 6) Repair of heating,r-fr ig., 600
6 V (L IF f A-t 1t- cooling,absorption unit _-
Boiler or comp to 3 HP
Owner Marking A�ea�s� O'M 7) absorp.unit to 100,OOJ BTU 6'00
--
crtyrs at• ---
Zip --- ) Boiler or to 3 I+P-15 HP --
8 11.00
absorp.unit to 500,000 BTUName
Boiler or comp15-30 HP
S fe(-I A(-<7 IC 2u 9) absorp.unit 1 -1 million , t 5'00
Marw+g Address Ft"rvs _ 10 Boiler or comp to 30-50 HP 22.50
l f e� S w' AVLf9 T7. ) absorp.unit 1 -1.75 million ^
Contractor ---- - Boiler or comp to 50 HP
Gtyrslate Zip 1 1 31.50
A,(t v Ufl- 01 -7 -t L 7 ) absorp.unit 1,750,000 BTU -^
Stale R•gistrst+on No- City Sus Ta No 12) Air handling unit to 4
.50
10,000 CFM .---------- --�-- - -
I hereby acknowledge "i I have reed yr, 13) Air handling unit 7.50
epdiution That the information ghron n 10,000CFM a.
coned,Thal I an+the owner a auttwntad agent of the owner,that plans submitted are in -- --- --
compliance with Slate laws,that I am registered w+lh e+e State BuMars'Roard,that the Non portable
number given is aired (ll exempt from State registration pieaso give reason below) 14) evaporate cooler 4.50
15) Vent fan connected
- -- - --- to a single duct 0
--- -- - - - Ventilation system not
16) included in appliance permit 4.50
Hood served by r
mechanical exhaust 4.' )
signature(owner or agent) Date Domestic type —
Describe work l addition ❑ alteration repair F) _1H incinerator "0
Ll
to be done residential ❑ non-residential ) t 9) Commercial or industrial 30.00
Existing use of - type incinerator - -- -
building or property_ .-• 1g---Q-A----�------- - 20) Other i.e.,woodstove,water
4.50
Proposed use of
heater,solar,clothes dryers,etc.
-- - --
building or property - 21) Gas piping one to lour outlets 2.00
Type of fuel-• oil (-I natural gas LPG Q electric ( 1
22) More than 4-per outlet
NOTICE _-- -- - -' -
SUB-TOTAL
THIS PERMIT BECOMES WILL AND VOID IF WORK OR CON- -
STRUCTION AUTHORIZED IS NOT COMMENCED WI CHIN 180 S0I0 416 SURCHARGE
DAYS, OH IF CONSTRUCTIO14 OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A HEAInb OF 180 DAYS AT ANY TIMF AFTER
WORK IS COMMENCED TOTAL
Special Conditions
I t.lht•,�,wv1 I �
PIF w w w w w FW IM
Permit No. SP 136-87
CITY OF TIGARD
SIGN PERMIT APPLICATION
The applicant hereby applies for a permit for the work indicated or as shown
in the accompanying plans and specifications.
SIGN LOCATION ADDRESS: 13080 SW Pacific Hwy. ZONING: C-G
NAME OF COMPANY: Dougs, VW Service s _�
APPLICANT/AGENT: Ann Powers 636-4805__
The City of Tigard imposes an annual Business Tax which must be kept current
on all persons doing business in the City. Do you presently have a current
Business 'Tax? n,,r in y,-uainems yet
PROPOSED SIGN:
PERMANENT ( xio FREESTANDING ( )
TEMPORARY ( ) WALL (Xy)
BILLBOARD ( )
SIGN DIMENSIONS: 16 ' x 4'
TOTAL SIGN AREA (Sq. ft. ) : 64 sq. ft.
WALL AREA (Sq. ft.): 521.5 se. ft.
HEIGHT (ft): N/A
PROJEGTION: _ N/A
ILLUMINATION: YES ( ) NO ( )
COPY: DOUG I s VW Service ___--
tIATERIALS: Siangard —
E,'ISTING SIGNS: LjQne
OTHER PERMITS REQUIRED: YES ( ) NO (XX)
COMMENTS:
PLANNING DEPARTMENT All sign permits must be accompanied by a
Permit Fee: 25_00 _ scale draw irig and plot plan. If work
Receipt No_: 2543] _ authorized under a sign permit has not been
Approved By: da _ completed within ninety days after the
Date: 2g/R7 _ issuance of the permit, the permit shall
become null and void.
I CERTIFY THAT I AM THE RECORDED OWNER OF THE
PROPERTY OR AN AGENT AUTHORIZED BY THE OWNER.
Applicant' s Signature I
AddressTelephone
DAS:bs62 001 - (�-,7�0 ,P f
jam'
Permit No. .S�3c�
CITY' OF 1 TGARD
SIGN PERMIT APPLILHiION
The applicant hereby applies for a ` . ,,,:t for the work indicated or as shown
in the accompanying plans and specif. cations) .
ST+;N LACAI.LON ADUI2FSS: V C� f7cjy, ZONING:
NAME OF COMPANY: W ____ Y ✓► L C__. ___.
APPLICANT/AGENT : y '44,t3
The City of T-igard imposes an ann;aal Business Tax which must be kept current
on all persons doing business in the City . Do you presently have a current
Business Tax? 1 SS 1-e
PROPOSIA)
PLRMANE.NI (,7'} FREESTANDING ( )
TEMPORARY ( ) WALL- .j
1 BILLBOARD ( )
.: IGN DIMCNSILONS: ,__ _
TOTAL. SIGN AREA (Sq. ft
WALL. AI4EA (Sq. ft. ):
HEIGHT" (ft) : _ 4
PROJECTION: _
ILI._LIMINATION: YES ! ) NO
c ( )
COPY: } r V"I (_IL_
. _
MATERIAL.`;:
EXISTING UGNS:
OTHER PERMITS REQUIRED: . YES ( ) NO
COMMENIS:
PLANNING DELARTMENI All sign permits must be accompanied by a
Permit Feer scale drawing and plot plan. If work
Recent Nom,_ o -- authorized under a sign permit has riot bean
�Pproved B 10 C, _µ completed within ninety days af►,er the
Date:__ issuance of the permit, the permit shall
become nu I1 and void.
I CERTIFY THAI i. AM THE RECORDED OWNER OF 111E
PROPERTY OR AN AUENT AUTHOR.UFA) BY 114E OWNEER•
i
Applicant's Signature
Address telephone
DAS:bs6Z
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SEWER PERMIT 33423
UfniSawa�age 4 Agency Tigard 1987
of Washington county CITY OFT DATE - —
OWNER : Anthony Capone _ PHONE : 63604805
LI
OWNER' S ADDRESS s_tenant: Douglas Powers
G :
rTYYPE OF INSTALLATION:
[2 BUILDING SEWER L_1 LINE TAP AND BUILDING SEWER ❑ LINE TAP
TYPE OF OCCUPANCY :
NEWCOMMERCIAL
❑ MULT . RES . ❑ INDUSTRIAL
FIXTURE UNITS 11 DWELLING UNI"rS 1
ADDRESS OF STRUCTURE : 13080 SW Pacific Highway
Permit Conditions: The applicant agrees to comply with all rules and regulations of the Unified
Sewerage Agency. When calling for an inspection, please refer to the Permit Number. The Permit
expires one hundred twenty (120) days from the date of issuance. The total amount paid (permit
fee, connection charge, line tap fee and/or other charge) will be forfeited if the permit expires.
The Agency does not guarantee the accuracy of the location of side sewer laterals. If the sewer
is not located at the measurement given, the installer shall prospect three feet in all directions
from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer"
Permit at the current charge and the Agency will install a lateral.
FEES:
PERMIT FFF s
45.00
CONNECTION CHARGE 9,75.00 '
LINE TAP INSTALLATION
ISSUED BY
OTHER _
. .��1,020.00
TOTAL DAT[. OF ISSUANC-. E
APPLICANT DATE OF EXPIRATION
SEWER PERMIT
ADDRESS OF STRUCTURE _ __4-3 _SW Pacific liqlzaay,-91223--_—
TAX MAP 2S1-2CB, TL 1800 TAX LOTloon QUARTER
�- - SECT ION -- ---- —
i
LOT _ BLOCK _ OF
arlu
APPR VED BY DATE U E D BY CA -E Olt IS UANCF
D. U. ' S 1. REMARKS 4" pipe regd. tw6717
ilA i1R� �► � t#T � � ''!
r,
BUILDING PERMIT APPLICATION DATE ' tg.-_-_� (W1 7
THE UNDEHSIGNED HEREBY APPLIES FOR A PERMIT cOR THE WORK HEHE!N INDICATED BUILDER PHONE '_3_(_�4 __'
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO. _ �.� _TI,- d&
OWNER 11111 17C711v — ,JOB� ADDRESS 1.3090 SK d'CjffC it !!Y_._ ARCHITECT ---_ - --
ENGINEER
BUILDER ADDRESS DESIGNER
STRUCTURE ❑ NEW Fj REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE L.0 DEMOLITION
[A RESIDENCE 1I'1,OMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE Ll STORAGE ❑ SLAB FENCE
OCCUPANCY + lN_LAND USE ZONE =_Mi BLDG.TYPE AFIRE ZONE---.-__PLAN CHECK BY _ —F-ITHEAT_—V kK3
addsting gump for use as auto sap sir i storage famUlt1(Lntwiior,twp-atixictuZa1).
%- bWJC:t t'IO fisc dOPa drool.. >Ystl 6bq R Imft:1d m iCR1 pm7ldto regtired. 11 faxtum mics
------ -----
SEWER PERMIT N =2X UkA)
OCC.LOAD FLOOR LOAD CUM HEIGHT_ — NO.STORIES � — AREA OW NO.BEDROOMS VALUE
BUILDING DEPARTMENT— SET BACKS Ff10NT 148 REAR 1 5 LEFT SIDE 1003 - RIGHT SIDE 12
Permit 32•50HIS PERMIT &Issue SUBJECT TO THE REQULATIONS�CONTAINED IN THE BUILDING CODE,ZONING
21.1 REGUT ATltrAS ANO ALL APPLICABLE CODES AND ORDINANCLr8,AND IT IS HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
1 WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total _ '""' RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY 9108INESS
-
State Tax _1.3D -� LICENSE.SEPARATE PERMITS REQUIRED P01 SEWER,PLUMBING AND HEATING.
Total -5.23 SDC—
By ---21.13 PDC1 APPLICANT OR AGEN
Approved Receipt No.4y^� .� ' n
: --_33-80 _
•
i
DATR INSP. TYPE INSPECTION REMARKS PLUMBING DATE
via r
d0;r �eVtractor.
Permit No.
Rough-in
Fixture
Final
HKATING
Contractor
Permit No.
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
IR ain Drain)Final
Sidewalk
Curb&Street Final
Approach
AL-- _iE_Mk A Y
bCDG DEPT. ri4 TCFRTIFICATE OCCUPANCY OCCUPANCYFinal
Lan&caping
Zoning Final
CITY OF TIGARD
MEMORANDUM
TO: All building contractors
FROM: Brad Roast , Building Official
SUBJECT: Sewer connection fee increase by Unified Sewerage Agency
DATE: June 5, 1987
Effective July 1 , 1987 , each dwelling unit will be charged an $1 ; 100
sewer connection fee by USA. (The present rate is $975 ) .
For all applications submitted BEFORE July 1 , 1987 AND picked up
BEFORE July 31 , 1987 , will be Charged at the existing rate of $975
per dwelling unit .
MF'-?e'0 UCCOPANCY F11 r.--. LIST MAY 11/, 1907 10: 34: 36
TUALATIN FIRE DIt5T (CPU A) Pace J
Kf-Y SCREEN
1. Name Dot)(1115 V. W. S['--RV1C[:.
2. Zone-Occ 293C -3521-000 1). Special 'iortl :
Address 13080 SW PACIFIC HW TJ 6. Special
Category Spc-cii;l irjrt.3:
BA!:il(: SCREEN
1. 0(-c Phone
J6. CE111teLIS Tract: J01:1
2. Manager D(JuQlas: Powers 17. Cade Edition: I V,9 5
3. Phone 10. 11) (10 Vallic, $100 900
4 Mail - Apt#: 19. colitelit Va] $0
5. A d d r V S S ;-.10 Othel. Value. $0
C t 14, St, Z p 2 )GO Clan-s
7. Bldg Owner 22. un nu c- j /ft 71+
E3. 1-1 h n P '13. r-jr(-, Alrm SgNONI'
Suite-Apt: 24. Alarm Z:iyst It:
10. Address P5. Prop in Unit- Y
ll . Cty' St, Zp: 26. Date Built
12. Emrg Contct: Jrff Dunn or Douglas Powers 27. Date Remod(,l 05/00/07
13, Emerg Phone: (5 n 3 6 3,4) -Al 0 0 la .23. Ground Arei- 871/
14 1w: Tqpp/Mo- INI- j P
15 901 Occ Use: 573 Motor vehicle repair, pai
E=IRE 13RO1LC1 TON SCREEN
1. Alarm Shutoff Location NONE
- Power Shutoff Location
'3. Water Shutaf".' Lac;-,tion
4. Natural Gas ;shutoff Location:
F) r:DC Location NON[-
6. Sprickler C011tP01 I-otation NCIN(7
7. Stand Pipe Location
NONL
S. Attic Access 1-n( dtion
9 Special llazai,d *TLjpc, Cude
10. Special Hazard lupe
11. Special Hazard Lo(-ation
12. Water SOUT'Ce Location HYDRANT
13. Stairway/Vert Shaft; Prot Y/N: NONE-
CON STRUCT I ON SCREEN
I Const Type 5O V--N 1 N Prop Line 99 /30 CE-N-rrm-TNE 01- SIREII-T
I Wall Prot 00 NO WALL VROIECIION
A Basmt Area 0 1 LA. 9 P r a F) Line 5 /10 VREPL.RIY LINE
4. Total Area 9 19- Wa I I Prot 21 'r-_' HOUR WALI. FROTF'.C*rt.-'.D OPCNJ
5. # Stories
20. E Prop Line 99 /10 PROFIE13-IY LINE-'
6. Height-ft
10 2; . Wall Prot 00 NO WALL PROTECTION
7. Inter Colmn: 11 WO POST 22- W Prop Line 99 /30 CFN,rt-.Ri-JNE OF STREET
S. Roof Const 10 WD JOIST 23. Wall Prot 00 NJ WALL PROIECTION
9. Roof Cover 04 ORD UNKNO 24. Area Wal : NONE
10. Roof Area ?00 25. Area Wal !
11. UBC Occ2/ft: 22 13 -P 83 t"-"6. A i-e a Wal :
12. UBC Occ3/ft: 27. Plan Lac :
13. UBC Occ4/ft: 214. Misc
14. Auto SP Use:
15. ' Uto FA Use:
�G.
IMMM HUI HU PRUMIS EMU
P.O. BOX 127 • TUALATIN. OREGON 97062 • PHONE 682-2601
DOUG 'S V. W. SERVICE flay 13, 1987
13080 SW PACIFIC HW TI
CITY OF TIGARD 2,1884- 1
253C -35 -000 Insp. Type RAF=
Dear Doug Powers,
This is a Fire and Life Safety Plan Review and is based on
the 1985 editions of the Fire and Life Safety Code (UBC ) ,
Mechanical Fire and Life Safety Code (UMC ) , Uniform Fire
Code (UFC ) , and other local ordinances and regulations.
Provide not iess than 2 layers of gypsum board sheathing
under the 1 /2" T-111 siding on the south side of the build-
ing ( front door facing north ) .
Provide an additional exit from the shop area. Exits shall
be separated by not less than 1 /2 of the diaoonal dimension
of the area served. Recommended location ldjacent storeroom
In west wall. Landings shall be provided and door thresh-
old shall not be more than one-inch above the landing and
floor level .
Equipment capable of igniting gasoline shall not be located
closer than 18-inches to the floor
Not less than one cfm/c,q. ftr of floor area mechanical ?x-
haust sh. 11 be provided in the rear areas
Exhaust tube _hall be installed for each repair bay If
the exhal.-t tube is over 10-feet in length, then a riechani-
cal exhaust system shall be installed If such systPn is
required, it shall exhaust not less than 300 cfm.
Not less than one ( 1 ) approved fire extinguisher
with ,atintj of not less than 2-A: 10-13 C shall be
provided for each 1 , 300 square feet of floor
area or fraction thereof. The travel distance to an
extinguisher from anti portion of the building shall not
exceed 75 feet. UFC 9tandard 10-1
� ' IUfl �fl11U HUI HE PRUME EMU
P.O. PDX 127 0 TUALATIN, OREGON 91062 a PHONE 682-2601
Address shall be conspic,rously posted on or adjacent the
building.
Exit doors shall be openable from the inside without the use
of a key or ar ,l special knowledge or effort. Manually
operated edge or surface mounted flesh bolts and surface
bolts are prohibitc,d. OBC 3304(c )
ming of front Pxit door shall swing in the direction of
exit travel .
Approval of submitted plans i- not an approval of cmissions
or oversights by this office � r of non—compliance with any
,:�aplicable regulations of local government.
if we may be of any assistance to you in the future, please
feral free to contact us at 649-8577.
Sincerely,
Gene Birchill
Fire Prevention Bureau
I
I�
1
r
CITY OF TIIFARD
OREGON
25 Veors o/Servide
April 1, 19F7 15614986 `
Anthony Capone
13066 S.W. Pacific Hwy.
Tigard, OR 97223
RE: W TM 2S1 2CB
TL 2600
The address for the above described property has been approved by
this office. The new address is:
Doug's Volkswagon Service
130130 S.W. Pacific Hwy.
Tigard, OR 97223
We have notified the posbal service, utilities and city and county
agencies of this address and have amended our records.
If you have any questions, please feel free to contact this office
at 639-4171.
Laura McLellan
Cartographer/Engineering Assistant
LM/mj
i
13125 SW Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223 (503)639-4171
for inspections call 639-4L,` PE IT N0.
CITY OF TIGAARO 639.11'(1 DATE 19 -
BUILOING PERMIT - �I SUODIVISION
P.O. Bou 23397 Tigar OR 91223 TAX MAP LOT NO. -
cam: o � L„
OWNF JOB AGGRESS -"-'
Ay nye-r STATE REG.NO. _EXP.DATE _
BUILDEn
BUILDER'S PHONE (0 J -
PHONE OTHER
ARCHITECT---- -- - -
_ REMOOEL O AOO;TIOw ❑ REPAIR ❑ MOVE O OTHER O OEMOUTIOr+
STRUCTURE O NEW W
O RESIDENCE CObIM ❑ EDUCATION (3 INO . IJ i ELIGIOUS ❑'ACCESSORY U GARAGE O OTHER ❑ FCNCE
G SLOG.TYPE /-_...FIRE ZDNE__._PLAN CHECK BY 'T
_ LANG U�SEEZZONE
CXX UPANCY �_��
SE'WEP PERWT/,
OCG.LOAD FLOOR LOAD HEIGHT
N,I,STORIES AREA �� No.BEDROOMS VALUE
BUILDING D£PARTM£NT REAR ` LEFT SIDE RIGHT SIOF.
_ SET BACKS FRONT .%�% � -
pwmll THHI-E M.T R:ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUIL04HO CODE. ZONING
REGULATONS AHS ALL APPLICABLE CODES AND ORDINANCES.AND IT IS HEREBY AGRE5D THAT THE
WILIL Be DOVE IN ACCORDANCE Plan Check 3 WORKTNCE MATH THE PLANS AND SPECIFICATIONS ANO IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES.'HE ISSUANCE OF THIS PERMIT GOES HOT WAIVE
PI {IL Fri RESTRICTIVE COVENANTS.CONTRACTOR AMC)SUL JNTRAC'TORS TO HAVE CURRENT CITY BUSINESS
TAX PERMITS.SEPARATE PERMITS REGUIREO FOR SEVER.PLUMBING AND HEATING.
State Ta. �7 SSDC
--- - — SOC- --
Total 5 y APPLICANT OR AGENT
PDCJ
PrepA. .� � � 3 Rece1P1 No. ADORES:---_^`—__-__
"`----
Bar.Ove � � O
Issued By-_ -----Approved
SSDC --- s
i0C - _ - RECEIPT a
IOC -- -_� --' DATE Pp.
AMOUNT PD.
EWER CONNECTION 5 %•�_ -
EWER INSPECTION 4 4 .. _
OWER SURCHARGE
Are-
r4nf-
_Tmmente: ..
PERMIT @
PLAN CHECK L
BUILDING RECEIPT
NAME: �+c..ue __ DATE: 3 1 ' S 7
ADDRESS & LOT # & SUBDIVISION NAME:
ACCT. # DESCRIPTIC AMOUNT
10-432 Building Permit Feei $ _
10-431-600 Plumbing Permit Fees $ _
10-431-601 Mechanical. Permit Fees $
1.0-230-501 State Building Tax $
1.0-433 Plans Check Fee
30-4+43 Sewer Connection (20%)
30-202 Sewer Connection (80%)
30-444 Sewer In. pection $
51-448 Street System Dev. Charge (SDC) $
52-449-610 Parks I System Dev. Charge (PDC) $ _
52-449-620 Parks II System Dev. Charge (PDC)
31-450 Storm Drainage System Dev. Chrg (SSDC)
10-230-50.5 TRFD (95%) $
10-435 TRFD (5%) S
10-230-506 Washington County Fire #1 (95%) $ _
10-4.35 Washington County Fire #1 (5%) $
1.0-220 Amart/Wedgewood $ _
TOTAL
(f ,?.parate Check for Leron Heights $150.00).
(br/12.14P)
s �
CITY OF —GARD BUILDING DEPARTMENT PLAN CHECK NO. :
PLAN CHECK APPLICATION DATE RECEIVED:
P.U. Box 23397, 'Tigard OR 97223 P/C DEPOSIT PAID:
This is to certify that the attached sets of plans have been s.umitted for plan
check pursuant to the Oregon Structural Code and Fire & Life Safety Code, 'Y5 edition.
PROPERTY OWNER: i
6- J ���. _ OWNER'S ADDRESS
i,CNTRACTOP: �� c .)�_c-{ r L� TELEPHONE: 36
ADDRESS: tJ C�� �� r� -i- LUT NO. & MAP: 'G Vc
DESCRIPTION OF WORK: hJ.9 1tt� `� / t4t
Approvals Re uired SPECIAL NOTES
OPlanning Dept. O Reissue
[�
Engineering Dept. O Flood Plain/Sensitive Lands
9® Fire District 0 Sewer Availability
O Other Other 77�
Items Required
0 List of subcontractors yv_^� ,✓
*71
usiness Tax
Calculations
OTruss Details
OParking Plan
OLandscape Plan
G�Other �
COMMENTS: < yt•Fi}� ' ��Y /7E'�d
f
City of Tigard Building Department
I �
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CITY OF TIGARD N o. 212.61
13125 S W. HALL BLVD.
P.O. BOX 23397 Date.-—ar��(,
I
TIGARD, OR 97223
I
i ,
Name
Address v
1
Lot Block/Map Subdivision/Address
Permit M's Bldg. Plumb Cash Check
Sewer Other — Other Rea. By�—
Acct, No. Description Amount
10.432 _ Building Permit Fees_ _-
10-431.600_ Plumbing Permit Fees -
10.431.601 Mechanical Permit Fees
10.230-501 State Bldg. Tax
10-433 Plans Check Fee
30.443 Sewer Connection i
30.444 Sewer Inspection
51.448 Street Syst. Dev.
52.449-610 Parks I Syst. Dev. Charge
52.449-_620 Parks II Syst. Dev. Charge
31-450 Storm Drainage Syst. Dev. Charge
10430 Business Tax
10-434 Alarm Permit
10.227 Boil
10.455- Fines - TrafflclMiadlParking _
10-230- CPTA Traffic/Mild/Vic. Asst.
10.456 Indigent Defense
30-122 401 Sewer Service/USA
30.122.402 Sewer Service/City 30%
30.123 __ Sewer Sevlce/City Maint. _
330.12 Unmatched
31-124 Storm Drainage _
0.475 ancro t Prin. Pymt.
40-471 Bancroft Int.--1yymt. —
--�--- �-- TOTAL
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