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- 15610 SW 76th Avenot. —
CITY OF T I GAR[
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223e8199 (503)639-171
CERTIFICATL 01
OCCUPAW-Y y.
PATF ISSUED1 0410c, 1;,31
I I It. MAMILS'.". 15611A SW 76TIA
WOOP.; 1 1 2 ON I Nb:
u4s"; cr' WORk NEW
YPE' OF' 'JISE. . . i;or
L.0()Drr',2!:,, 4
01 A V`k
"--106S
4j .
t t
ti-.NFA 1rS5(4N(-lE W.
SW WILIJIMC-TTL. I Df)
"S1
— LANN (Jr? 1,4706f.,
11(me
110 COMPI jar)(.,q Wif", 44119 _;t.Rto Of t)
�
lit ' , ,�pw(-AAlty Cales for tho q,
nder WhiCh 1hp permit wa-i issued.
T V1 1,
r 9f
131)1 L I
POST IN
i
INSPECTION NOTICE
City of Tigard Building Departmwrt
13125 SW Rall, Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639--4175 Buni_ness Phone: 639-4111
Inspection:
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALt
Poet/Ream Struct. San. Sewer Framing Bldg.
Por+_/Beam Hoch. Rain Drain Insulation -plumb.
Plbg. 'UnderfloorWetor Line Gyp. Bd. -Neth. I
Date Roqueetedf Time: AM PH
Address: ? Permit #:
Builder: �Q�7L�)i
THE FOLLOWING CORRECTIONS ARE RSQUIREDt
i
S'ECrI 4�o d,�,�► ��,�ti�4 G'cc v�� wl_+ �'�'�'..- -�
Inspector: �— -----_ Datet—��C?
PPROVED - -- DIBAPPROVRD —_ ^PPROVRD SUBJBrT TO AHOVS
Call For Reinap.
INSPECTION NQTICE
City of Tigard Building Department
13125 Sit Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phui. J: 639-4175 Business Phone: 639-4171
Inspection: __
Footing Plbg. erelab Mach. Rough-in QAppr/Hdwl
Fou::d. Plbg. Top Out Gas Line FINAL,
Poet/Ream Struct. Ssn. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested, —3 /�- Timet /AN /S PH
Addresst 4, 7v//,, -� Permit is �! Li����
1y
Builder t
TBE FOLA)MINQ CORRECTIONS ARE REQUIRED:
Inspector, 1-f— fl)Z ---- DatetZ-_c�
�AlPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INSP___ECTI ONNOTICE ^y�
City Of Tigard Cvilding Vepartnent
13125 Sw Hall Blvd. Ti Cry
nspection Line (Roc-O-Phrine gam' Oregon 97223
): 639-4175 Business Phone: 639-4171
Inapectlon:
Footing ----
Plbg. Underelab Mech. Rouqh-in
< APpr/Sdwlk_
Found.
Plbg. Top Out Cas Ane --
Poet/Beam Struct,
Ban. Sewer Framing FINAL:
Peet/Beam Koch,
Rain Drain Insulation -Bldg.
-Plu,nb.
Plbg. Underfloor Nater Line
OYP• Bd. -Mach.
Date Requested, '���—l .�� -AN
..�v
-- Timms
Address: lo�0 _ — PM
Permit
Builder: �[
THE FOLLOWING CORRECTIONS ARE REQUIRED: r --
i v �f
_ — ----__
-i
-��
Inapectori
APPROVED DISAPPROVED
_.�"APPROVED "R JRCT To ABOVE
Call For Reinap.
INSPECTION NOTICE
City of Tigard Building Bsepartsaent
1312S SM Ball Blvd. Tigard, Oregon 9728
Inspection Line (Rec-O--Phone): 639-4375 Buninear Ph e. 639-4171
Inspection:
Faor-ing Plbg. Undoralab Mech. Rough--in ,pr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/seam Struct. San. Sewer. Framing -Bldg.
Post./Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Undorfloor Water Line n sOyp. Bd. -Hoch.
Date Requested: Times AM _PM
Address: 24, _ _ Permit
Builder: h— i-22-�_`
THE FOi._.OWING CORRECTIONS ARE REQUIRED:
Inspector _--� Date/ __ r
t APPROVED DISAPPROVED APPROVED SUBJRCT TO ABOVE
Call For Reinnp.
INSPECTION NOTICE
City of Tiqard Building Department
13125 SN Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4177
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gay, Line FINALS
Post/Beam Struct. San. Sew?r Framing -Bldg.
Poet/Beam Mech. Rain Dra_n Insulation -Plumb.
Plbg. Underfloor Water Line yp. Bd. _Mech.
/
Date Requestedt !�L.i/-
Address: 15//,1y 2to �` Permit is I U
Builder: /— I M
THE FOLLOWING CORRECTIONS APZ PJMIRZU:
Inspector: . __..._ Date:L����-� :V
APPROVED pISAFFR APPROVED SUBJECT TO ABOVE
For Reinsp.
INSPECTION NOTICH_
City of Tigard Building DepartseT:t � r
13125 SX Ball Btvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171
inspection:----
Footing
nspection:— —Footing Plbg. Underslab Mach. Rough-in Appr/SdvIk
Found. Plbg. Top Out Gas Lina FINAL:
I
post/Beam Struct. San. Sewer Framing --Bl-dg.
Post./Beam Mesh. Rain DrainInsulation -Plumb.
s
Plbg. Underfloor Water mins Gyp. Bd. -Hoch.
Dnto Requested: I L -Z �I Z- Times ��AN PM
1 is i
Address: t� ) _ Permit #s �I
l
Rui lder:
F
THE FOLLOWING CORRF.GTloNS hRF REQUIRED:
e
1
Inrpect:ors / - ___ Date:����
APPROVED DISAPPROVED �.PPROVED SURJRCT TO ABOVE
Call For Retnap.
INSPECTION NOTTCE
City of Tigard Building DepartAnent
131.25 SW Ball Blvd. Tigard, Oregon 97223
Inepection Line (Rctc-O-Phone): 639-4175 Business Phone: 639-4171
Inspect ion• —----
Footing Plbg. UnderslabFFrawmLn
ugh-)n Appr/Sdwlk
Found. Plbg. Top Out e FINAL-
Post/Beam Struct. San. Sewer -Bldg.
Post/Beam Mech. Rain Drain Insulation -plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Nech.
Date Requeuted: 2 `� L`�� TilOet AM PN
AddresF:J c� poreit #t
Builder;� [� — /�, ]ZA
THE TJLLOWING CORRICTIONS ARE REQUIRED:
Inspector: _ --- __ — - - ----- Datee77t 4�,_-----`--j-�.�
4 APPROVED DISAPPROVED APPROVED SUMIECT TO ABOVE
Call For Reinap.
INSPECTION NOTICE ~~—
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Ree-o-Phones 539-4175 Business Phone: 639-•4171
Inspection:__ j I � ( �V�b. R�`I(, k - 1y1
Footing Pl.bg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALt
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Hach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Una Gyp. Rd. -Hach.
Date Reguestedi "" 1 q — Z Time% _ AH PH
Address: 1 l[l( �� Parmit #s—Q
Builder•
THE FOLLOWING CORRECTIONS ARE REQUIRED:
J
16
r
Inspecto a Data[
APPROVED DI8APPR(MD APPROVED SUBJECT TO ABOVE
Call IrOr Rainap.
MOUNKALMOULMW
INSPECTION NOTYCE �_r_
City of Tigard Building DcI'artae>n`( }/.L
13.125 SH Ba11 Blvd_ Tiqard, Oregon 97T23
Inspection Line (Rec-O-Phone): 639-4175 Buninene Phone: 639-4171
Inspections_ -- —
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gan Line FINALS
i
Poet/Beale 8ttuot. 1 fln.j. Sewer Framing -Bldg.
/Beam Hach. 1 Rain Drain Insulation
Mg. Underfloor Water Line Gyp. Bd. -Mech.
/JAM PN
Date Requesteds f� /� ! Tom'
Address Permit s ._
x
Builder: -
TBE FOLLOWTNG CWRRECTIONS ARE REQUIRED!
r
F
f
Inspector: -
-
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INSPECTION„ NOTICE
City of Tigard Ou"drop Department
13125 SSI Nall Blvd. Tigard, Ordgon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phonj-I�i4-4171
s
Inspection:----
Foot i n(I
nspection:_____„_Footing Plbg. anderslab Mech. Rough-in Appr/adwlk
Fourd. Plbg. Top Out Gas Line FINALt
postfReam Struct. S_ S 1 Framing -Bldg.
Post/Beam Mech. .Rain Drain Insulation -Plumb.
/Pibg. Undert loot / `Nater L1'1eGyp. Bd. - h•
Bsquestedt `1 - PN
Addresses /� -_ Permit
Builders /&_ �'.,9tlJ.
TBS yOLi.ONINO ODRRSCTIONS AAS R32UIRSDI
Ilk
i� �� s-�-�L-
Inepecto/ri Dates 16
/ APPROVED DISAPPROVED APPROVED SVSJSCT TO ADM
F- Call For Reinsp.
IhSPE(_fION NOTICE 4�
City of Tigard Building Departient
13125 Sit Ball. Blvd. Tigard, Oregon 97223
lnnpection Line (P.ec-O-Phone): 639-4175 Business shone: 639-4171
Inspection:__------- ---- -- --
Footing Plbg. Underslab Hech. Rough-in Appr/Sdwik
Found. Plbg. Top Out Gas Line FINAL-
Post/Beam Struct. San. Sews Framing -Bldg.
Poet/Ream Hach. in Dra Insul..tion -plumb.
Plbq. Dnderflocr 1 Gyp. Bd. -mech.
nate Requestedt ( 'T 7,� Time: M�� -7 2 SPH
Address: Permit, / "j
• T�
Builder:—f.—S"-n
i
i
THE FOI.LOWINti CORRECTIONS ARE REQUII:ED:
-- —/7
I 110poct
Inspect it
��� AFPROVtD OIS"FIIOVIM APPR01'ED SUBJECT 1-7 ABOVIR
call For Reinap.
I
CITYOFTWARD
�,cnyOFTWIV
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW HWI BW. P.O.Box 23397,Tirwd,Orogen 97223 (SM)636-4175 e MASTER PLRI11T
P6_'RWz HST91 03-3-4
639-4171 DATE ISSUED: 09/29/92
SITE ADDRESS. . . : 15610 SW 76TH AVE PARCEL: 2SI12CA-RW52
bUBDIVISION. . . . : HENAISSANCE WOODS II ZONING:
bLUCK. . . . . . . . . . : 'JT. . . . . . . . . . . . . ..52
------------------------------------ BUILDING
RLISSUEsMST90-0364 DWELLING UNITSil BHSLMENT. . . . . . . . ..0 Sf
t-LASS OF WORK. :NEW BEDROIS:4 BATHS;:3 GARAGE. . . . . . . . . . :775 Sf
IYl-,E OF USE. . . :SF FLOOR AREAS----------- REQUIRED SETBACKS-
TYPE OF CONOT. :5N FIRST. . . . : 1488 S LEFT. . c5 ft RIGH T. :5 ft
ULCUPANCY GRP. :R3 SLCOND. . . -. 1202 s FRONT. :20 ft REAR- 1126 ft
LiTORIES. . . . . d - 12 1HIRD. . . . .0 s REQUIRED----------------------
HLIGHT. . . . . . . . 125 ft TOTAL------:2698 Sf SMOKE DETECTORS. :Y
FLUOR LOAD. . . . t40 PSf VALUE. . . . . $ : 138058 PARKING SPACES. . : 1
Remarks: PATH I
------------------------------------- PLUMBING --------------------------------------- -
SINKS. . . . . . . . . . .2 FLOUR DRAINS. . . . 90 BACKFLOW PREVNTRE-,. . :O
LAVATORIES. . . . . :5 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . to
TUB/SHOWERS. . . . :3 LAUNDRY TRAYS. . . Al CATCH BASINS. . . . . . . 10
WATER LLUSLIS. - :3 SEWER LINE (ft ) . 10 GREASE TRAP'S. . . . . . . 't+
DISHWA3HERS. . . . : i WATER LINE (ft ) . cIOO OTHER FIXTURES. . . . . ..W
GARBAGE DISP. . . - I RAIN DRAIN (ft) . :O
WASHINU MACH. . . : 1 SF RAIN IJRAINS. . : i
---------------- ME LHONILAL --------------- ----------------- FEES
FUEL TYPES--------------- UNIT HIRS. . -.0 type amount by date reept
/UAS/ VENTS . . . . . set TIF $ 1380. 00 JH 09/29/92
MAX INPUT:0 BTU VENT FANS. . e4 BPR-1 * 530. 50 JH 09/29/92
FURN ( 100K . . :0 HOODS. . . . . . 11 BPLr *
4- 40. 00 JLH 12/31/91
FURN ) -100K . . - I WOODS,rovFis- io B5PL * 26. 53 JH 09/29/92
FLUOR FURN. . . . :0 CLU DRYERS. : I Bf-',LC $ 15. 00 JH 09/29/92
BUIl.,1CMP ( 3HF-1:0 U1 HER UNITSil SSDC * 280. 00 JH 09/29/92
GAS UUTLETSal PARK $ 500- 00 JH 09/29/92
Uwnerss 11V,RJ 11, 45. 00 JH 09/29/92
kENPISSANLL DEVELOPMENT MPLL $ 11. 25 JH 09/29/92
2098 8TH M5PL $ 2. 25 JH 09/29/92
PPRI 4. 170. 00 JH 09/29/92
WLSF LIMN 014 PbPU 8. 50 JH 09/29/92
Phone 4s b0.3L,575739
Contractor:
HENAlbSANLE DLVLLUPMEN1
t61c3 bW WILLAMLTTE FALLS UR
WL'L) l L11414 LIH 970L,8
Phone 557- 81616112)
Reg #. . : 49955 $ 3009. 03 'TOTAL
This pereit is issued subject to the regulations contained in the -------- REQUIRED INSPELIIQNS ------
ligard Municipal Lode. State of are. Specialty Ludes and all uther Foot/found Insp Fireplace Insp
applicable laws. All Mork will be done in accord with approved Post/Beam Struct Gas Line Insp
plans. this pervii Will expire if work is not ed within ILW post/L%eam 1A �chan Insulation Insp
days of issuance, or if wirk is suspended f e than i(A days. Plm/kindsla nsp Gyp Board Insp
PLM/Unuierf I,it- Rain drain Insp
I-lei, tt, ee Mechanical Insp Water Line Insp
Plumb Top Out Appt,/Sdwlk Insp
I m e d ly-1- Framing Insp Mechanical Final
Lail for- inspection — b39-4175
CITYOF TIGARD �cmoFmwRl)
COMMUNITY DEVELOPMENT DEPARTMENT 01100N SEWER CONNECTION
13125 SW HWI Blvd. P.O.BM 23397,71PM,Onloon 97223(603)6394176 7��7 FIE RIA I T
PERM I 'f. .—. . . c— r_
6;39•-41'71 LATE ISSUED- 09/29/92
B1 UE ADDRESS. . . 15610 SW 761H AVE PARCEL: 2S112CA—RW52
SURD I V I S I ON. . . . RFNA I SSANCE WOODS II ZONTNG:
BLOLK. LOT. 5
. . . . 2
TENANT NAME. . . . . :
USA NO. . . . . . . . . . : FIXTURE UNITS. . .
CLASS OF WORK. . . :NEW DWELLING UNITS. . : I
TYP,E OF USE:. . . . . .SF 1\10. OF BUILDINGS: 1
INSTALL TYPIE. . . . :BUSWR IM[-.ERV SURFACE.
Remark,= -., MATH I
Owner: FEES
RE19AISSANCE fEVELOP-MENT type aniol.trit by date recpt
L090 8;+: P,R M T $ 10 0. 00 JH 09/P9/92
I N S V` $ 35. 00 JH 09/29/92
WEST LINN UH ') tklu,13
V-1hone #-
i-ONTRIHLIOR NUT ON FILE
i 'llone #: $ 2135. 00 TOTAL
P I.A
REQUIRED 11,4PPECTIONS
Thii4pplicant agrees to comply with all the rules and regulations Sewer Inspection
or the Unified Sewage Agency. The permit expires 180 days from
the date issued. the total amount paid will be forfeited if the
1?TnjK,does,not,yug[ayt,@!t exuractaof the
H51'14011hrilt. sewer i n 0 tA e a surement
given, fhe installer shall prospect 3 feet in all dirf
l
the distance given. If no, so located, the install shall onurroase
Z .
a "lap and Side Sewer" Permit and the Agency in
I,ermittee Signature :
I ss _(ed Dy :
La I A for inspection 6.39-4175
arf C* TIFARD
COMMUNITY DEVELOPMENT DEPARTMENT 00100N [",11-UMBING PERM FF
13125 SW HWI Blvd.P.O.Bm 23M,npM,Oregon 9rM(M)030-4175 . . . . . . . . ms"i 91.- o,?.'y/4
DATE ISSUED%, 09/a9/92
ADDRFSI��'_ : 1561VI SW 76TH AVE PARCELi 2SL12Cf1RW7-;`
SUBDIVIGIUN. . . . s RENAISSANCE WUODS 11
5LOCK. . . . . . . . . . o LOT., . . . . . . . . . . . . x52
,_1-ASG OF WORN.. . a NEW GARBAGE DISPOSALS.
IYPE OF USE. . . . vSF WASHING MACH. . . . . . . 21 FAFlCKI'*1.UW PREVNTRb. . :0
C)CLUPANCY LiRP. . 9 R3 FI-OUR DRAINS. . . . . . . ..0 MAPS. . . . . . . . . . .. . . . go
1�ITURIES. . . . . . . . z i? WATER HEATERS. . . . . . t CATCH BAS 119B. . . . . . . A L71
I!-'I X I*URES LAUNDRY TRAY"). SiF RAIN DRAINS. . . . . '. I
::,1 I'lks g 2 GRL*AEE TRAPS. . . . . . . r0
1.AVI41 ORILS. . . . . :9 OTHER FIx-rupF9. . . . . .vi
-,H0WERk3-.b . . , �(ft). � . . .W.
# -W 1-INL.
(J...0.5ET8. - a3 14a)_[i.`R LINE Ft) . . . . 11,00
I SHWqE-,,HERS. . . . RAIN DRAIN (f t ) .
k'emark— PATH I
'JWNER;
14'NAII�;_;ANGE DL�VELOPMENT TIF $ 00 JH
L:098 8,01 BPRT t 5,30. 50 JH 09/29/92
BPI_c $ 40. 00 JLH 12/31/91
WEST' I..INN OR 97066 1135P(.", $ 26. 53 JH 09/29/9P
Phone #: 5036575739 FPLC $ 15. 00 J44 09/29,1190,
SSDC f is eli. vio ill 12719/29/92
t1-imbiny Contractor--: PARK 1� 5111 r,01121 JH 09/29/92)
MPPT b It 5. 00 JH 09/1-.19/9►
Name MPLC $ 11. 25 JI-4 09i29/92
Z'.. Ls j11 014/29 `42'
I L y EITW6
PPRT $ 170. 111 JH Q)r)1291r)Q
Zip% PSPC $ JH 09/29/9L,
RF ut(J I RU:I) 1149L T .1[)NFi
I'his peer'mit'
mit' is issi-AeV-
rl vAt7joct to the 09—
0ations, contAinod in the �inPk
',d' M u fl I c-i OA I' !FcOt/found Jn6,r RL4in dom
rin Intip
. v
(icle, State of Ore. ''-ppcialty Codes and all Pu%t/BpAm Struct Water L,tne Insp
c)j.jjpv_ mpplicat)je IjRwi_ Al .1 tqut,+ will twe clone Post/!:Team Merhan Appr/Sdvolk
in accordance with approved 1:)Ialls. 1110Plm/unclslab Insp Me(Aianical Fil,..,
porm,it will r,),.pire if t-jarl, it; ren:. stim-ted FILM/Underfloor Plumb F i n a I
vrt,VK'i'n 180 days of 1gsijavice, rjr if work is !vlechA.ni(:Al Insp Buildinq Final
susl-,)ended for more fhan 180 clays. 17-1lumb Top OLO' Erosion Control
,�raminu 111sp Crawl Drain
Fivrplac:e Insp
:,)as 1-ine Insp
Inumlatio,n In,-,,p
Oyp Board In..In
J:hor i ied III umbi ny Cont rertny cS,I qnAt 1.tr
Call for inij-f?$Jj,(1r1 6134- 4175
i.r,ritrActot Notes -._
CITY OF TICARD RECLEIPT OF PAYMENT RECEIPT NO. :9R—�'i"32159
c
,wu( nmoi.jN,r 5104. 03
NOME RCENAISBANCE CUSTOM 140MES CAIS1-1 AMOUNT 0. 00
nDDRESS 2-'099 SW EIGHT PAYMCNI VATE 09 R9
SUDD
IVISI(lN
WEST L.INN, OR 9-7068
PURF-109F OF PAYMENT AMOUNT PA 10 V,,URPOSE OF PAYMENT AMOUNT PAID
11 ING PERM 530. 50 Pl.UMB I NG PF RM 170. 00
MECHAN I CAL. PE 45.00 ST. BUILA) PER 3-1. 29
PL.,AN CHECK fE 26. 25 SEWER USA 100100
P3r.-'14F,R INS)PECT 35. OQV PARK SDC 500. 00
S'l(JRM DRAIN SIX 2no. mo RESIDENTiot- TRAFFIC FEES 12:F.0. 00
MA*13S TRANSIT TIF FEES- 100. 00
1-0T 32 RENAISSANCE WOODS
ibblO SW '76TH OVENUE
1-411'Al-, AMOUNT PAID ;`5104. 03
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line iRec-O-Phone): 639-4175 Business Phone: 63*-4171
Inspection:_._`_ —� -- ----
Footing Pl.bg. Underelab Mech. K' i��,h-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
Poet/Neam Stract. Sen. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbq. Underfloor Water Line Gyp. Bd. -Mech.
t
Date Requested: Time: _ AM PM
Address: ���/��/D -Ila 1r� _ Permit
Builders_�_� S��CL-,�C,C�Ce
THE FOLLOWING CORRECTIONS ARE REQUIRED:
{
Inspecto _ Date:_
APPROVED MISADf11CM APPROVED SUSJRCT TO ABOVE
Call Mbr ReLuBp.
131 LS SW lia111;tvd. PLNCK/RECT # '/�7
CITY OF TI GARD 1O Box 23397
C01t1tUNITI DEVELOI r,%lv.' 'T DEPARTMENT
Tigard,Oregon 972'3 PERMIT # `�t y/ G'3 3 y
(503)639-4171 DATE ISSUED
JOB ADDRESS:j5(e/y' S.W. 76TH AVENUE, TIGARD, OREGON TAX MAP/LOT Z—
SUB: REN WOODS PHASE II LOT: 5 _ LAND USE:
VALUATION: /_ X`. ti
OWNER SPECIAL NOTES
NAME: PENAISSANCE DEVELOPMENT CORP. REISSUE OF.
ADDRESS: 2n9S s_la_ ATH AyMiE _ LAST REISSUE:
WEST L,INN OREGON 97068 FLOOD FLAIN/
PHONE: 657-5739 SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME: _ CAWL AS ABUXIE __ _ PLANNING:
ADDRESS: ENGINEERING:
FIRE DEPT:
PHONE: OTHER VI:
CONTR. BOARD #: 49955 EXP DATE: 5/92
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: -"LE_P MING CO. LIST/SUBCONTRACTORS:
MECH: TRI COUNTY 'TEMP CONTROI, BUS TAX:
ARCH ENGINEER CALCULATIONS:
NAME: AJAN MASCORD DESIGN TRUSS DETAILS:
ADDRESS: 1515 N.W. 23RD AVENUE SUITE 1.00 OTHER:
PORTLAND, OR 97216 ~~
PHONE: 225-9161
PROPOSED BLDG. USE: RESIDE'NTIA1, NEW HOME CONS".RUCTION.
COMMENTS: REISSUE OF' LOT 12, REN WOODS PHASE I
i
APPLICf,NI SIGNATURE -�
Received By: ,,-,- ^ _ Date Received:
�T
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
f 1',l e '?, 10-432 00 Building Permit Fees S3 v,
10-431 00 Plumbing Permit Fees ✓ 17C.
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (50)
Building 76.S'3 f
Plumbing
Mechanical 2-
10-413 00 Plans Check Fee
Building v I �
Plumbing
Mechanical = �►-� /
10-230 06 Fire
7 z-(1;bX• 30-202 00 Sewer Connection acs ✓ /��__
30-444 00 Sewer InspectiGn
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
25-448-01 Re�,-,dential Traffic Fees 1 80.00 1.2 v,O°
25-448-05 Mass Transit TIF Fees �ao.� _ �� C'a, #
5!-419 00 Parks System Dev Charge (PUC) S� � _ Soy
31-450 00 Storm Drainayc list Dev Chrg
(SSDC) -� � 2 e
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL ! 4 �
y,
nm/35871).WPF