11277 SW 91ST AVENUE ? w w w l5P
-tea SW 91ST COURT _
;i
T
CITY OF T164,� � CE=:FtTIf"ICA�f: OF
COMMUNRY DEVELOPMENY DEPARTMENT aeroora OCCUPANCY
13125 SW FW Blvd. P.O.Box 23397,Tpud,Or.gm 97223(FM)C 0.4175 �. � PER A I T #. . . . . . . s MST91-0026
DATE ISSUED: 02/14/92
SITE ADDRESS. . . s 112-17 fit! 91ST Cl PARCE L s l S 135D8-GR l 1
:_iUSDIVaSION. . . . s DAKOTA GROVES ZONINGS R•-4. 5
BLOCK. . . . . . . . . . t LOf.. . . . . . . . . . . . . s11
f.;LASS Ot" WORK. t NEW
l'YV'4E OF USC. . . s SW
OCCUPANCY' URP. :133
C)C;C:urANCY LOAD:P25 4
TENAN'r NAME:. . . s
14eIII Ekt"
DEVELOPMENT CO.
.17707 SE OATF 1 ELI)
F31-AD STONE OR 91027
r'hone #t 652-709E,
!..r,,ntr^asters ._... _._..................._.__..._._. ,_..._._......_..._...__.__.-
A & I- DEVELOPMENT CO.
t 7707 OE OM"F I ELLS
11LAD STONE OR 970,P7
i�hone #t 652 7092
:r W n O. . t 57484
4-t- _ paanc•y of the abnve referenced building is hereby given„ and cel-tifies
the cuupliance with the (3t,atg Of Ot"99011 Specialty Codas for, the Q -cup,
occupancy, and use under which the referenced pet-ro" was issited.
F I FtE
DEPARTMENT
.ate
Ell_IIL.DIN FFIf,IAL.
POST IN CON;SP I CUUuS PLACE
!I w w w i1 1w ! w
IMSPEClION NOTICE
City of Tigard Building Departwent
73125 SM Ball Blvd. Tigard, Oregon 97223
Inspection Lite (Rec-Cl-Phone): 639-4175 Busine,as Phone: 639-4`71
Inspection:--
Footing Plbq. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Poet/Be.-.m Struct. San. Sewer Framinq -B�
Po :/Beam Mech. Rain Drain Insulation -Plume.
Plbq. Underfloor Nater L'_ne Gyp. Bd. (-Noa
Date Requestedt [� Timet __AM PH
Addreus: 11Z-77 S CLI 9i Permit is Q/' r3tz-, i2v
i
Builder:
THF. !h)I.I.OWINI: CORRECTIONS ARE RBQUIRED:
------ trL� 00,
---
V /
r: ')ate:
APPROVED 111SAPPROVED APPROVRD SURJRCT TO ABnVE
--_-_`Call For Reinsp.
A_
i
wo S ___
INSPEC'P101: �FOTICE
City of Tigard Bui.liing Department
13125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): L39-41.75 HusLnems Phose: 639-4171
Inspe_tion: --
Footing Plbg. Underslab Me-ch. Rough-0. Appr/Advlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. Ban. Sewee Framing Bldg. )
Poet/Beam Meth. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Lino Gyp. Bd. —Mech. )
Date Requesteds `�O Time: AM PM
l�Addree sa s:
Ad Permit is
hu i Idor: all
THE FOLLOWING CORRECTIONS ARE REQUIRED:
/,0z:7 Iy
i
Inepecters ✓�� Date:
APPRMD DISAPPROVED APPROVED SUBJECT TO PJ1OV8
r Call For Reinsp.
i
INSPHCTIf_N NOTICE
City of Tigard Building Departsent
13125 SN Ball Blvd.. Tig", Oregon 97223
Inspe-:tion Line (Rec-O-Phone): 635--}•.175 Buainess Phones 639-4171
Inspection:
Footing Plbg. Underelab Mech. Rough-in Appt:;:.1k
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mach. Rain Draln Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -mec
Datn Roquestsds L�..._ 'O�Y / Tim ----AM --PM
Address ��7/•s _ Permit:_
THF. FOLLOWING CORRECTIOMS ARE REQUIRED:
Inspectors.—_ .� /kvsk�� Datws_q Xr --24_�
_APPROVED _(' DISAPPROVED APPRCSIED SUBJECT TO ABOVE
►11 r IEeinep.
KSPFG'TION_NOT:CE J
City of Tigard Building Departyent `
1.3125 fM hall Blvd_ Tig.nrd, Oregon 97223
Inspection Une (Pec.-O-Phon>): 639-417` Rumness Phone: 639-41.71
Inspection:______ -
looting Plbg. Underelab Mech. Rough-in Appr/S3w1k
—.
Found. Plbg. Top Out Gas Line FINAL.:
Post/Beam struct. San. Sewer. Framing -Bldg.
Post/Ream Mach. Rain Drain Insulation -plumb.
Plbg. Underfloor water Line Gyp. Bd. -Hoch.
Date Requested: /3 _�! _ Time: AH PH
Addrese:� 7 r� S r , /— permit
THE FOLLOWING CORREC['IGNS ARE REQUIRED:
I
(
P 1,1VUA I AM _ 9
Lx-�L �.o .
—LTJ_ �-�-
2 Y U c t CJvu Az t OTulln,/�
Inspector s.-JA ?v. :DVIA
[ -AppROV►� IPROVUD APPROVED SUBJECT TO ADM
l,' -all For Rainsp.
IN PECTI0N NOTICE
City of Tigard Building Department
13125 BN Hall Blvd. Tigard, Oregon 97223
Inspection Linc (Rec-O-Phone): 639-41,� Buetneee Phone: 639-4171
( i
Inspection: — -
Footing Plt+g. Uneerslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Lino FINAL:
poet/Beam Struct. San. Sewer _ Framing -Bldg.
Post/Ream Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Dste Requestedt�� ___------Timm. —AM "M
Addreses Z 7 7 ! --_ Permit 1:Builders
ti �." C S'V�L�►.�c c
Thl► volAD -NO C%)Rk WTION8 ARE RMUIPMI
Dater_ _ 1
J1PPl10VlD
0I8"PROVBD APPROVED SUBJECT TO ABOVE
Call Ior Minep.
INSPECTION NOTICE
City of Tigard Fuilding Department
13125 BO Hall Blvd. Tigard, Oregon 97223
Inspectlin Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:-
Footing Plbg. Underalab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out i Gas Line FINAL:
Poet/Beam Struct. San. Sewer Fvaraing -Bldg.
Poet/Beam Meeh. Rain Drain Inaulation -Plumb.
F'•q, Underfloor Water Lino Gyp. Bd. -Mach.
Data Requested:__ (/7 --Time: LAM _ PM
Address• ? G�� St Permit t t y
Hui Ider:__
THE FtAJ OWING CORRtCTIONS AIR RRQUIRED:
Inspectors nate:
„L A�P1�QV� DIDAPPROV80 APPRO -FD Stln.TR(-T To AFM)VF
fes_ Call Por Miaep.
r
INSPECTION NOTICE
City of Tigard Building Departm:+t
13125 SW Hall Blvd_ Tigard, Oregon 97223 A
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 , I
Inspection:-
Footing Plbg. Underslab Mech. Rough-in Appr./Sdwlk
Found. Plbg. Top Out �G re 1.in� FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insu-ation -Plumb.
Plbg. Underfloor Water Line Gyp. Rd. -Mech.
Date Requested: 7—/60Time: AM --_ PM
Address:—,�A/ L 77'7 rl/-1� Permit s
Builder:._.1 -� !". ��✓iL_fj�/L 5.. �- --THE FOLLOWING CCO�RRE�CTIONS ARF. REQUIRED:
Inspector:) /'"! ----- Date:_7_/b
APPRO'!ED DISAPPROVED APPROVED SUBJECT TO ABOVE
---Call For Reinsp.
IN SPECT ION,NOTICA
City of Tigard Building Departaeat
13125 SB Ball Blvd. Tigard, Oregon 97223
Inspect Lon Line (Rec-O-Phone): 639-4175 Buei/nese Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Fosnd. d Plbg. Top Out gas Llno P.-.NAL-
San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor // Water Line Gyp. 13d. -Koch.
Date Requested: 1p.� -115 '4-9 —_ Timet _ PM PN
Addreea: ��� ��`, � Sz.. � Permit #t�
Builder: _ z2J tt•"'
THE FOLLOWING CORRXCT70MB ARE REQUIRED:
/.v
62'40. /�e.K- ��/S.�s_�CT.+tst, I?�C1b�/t L'1j.c/riL,c�a•c.+�'S _�
i k
Inspector:i �-._-, -- _�^-Dates
APPROVED DISAPPROVED - APPROVED SUBJECT TO ABOVE
call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13115 OW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:___
Footing -1bg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post!Beam Mach. Rain Drain Insulation --Plumb.
Plbg. Undorfloor Water Line Gyp. Bd. -Meeh.
Date Requested: ��^ p / —�� Time: �'� AM PM
llddiemet Permit f1
Builder:
THE FOLLOWING C3RRECTIOMS ARE REQUIRED:
rMin
(,rJ.L G lDilacr�C.
Inspector:
_APPROMD DIBAPPP3%*ND G'1(j;PROVRD SUBJECT TO ABOV?
Call For Rei.nap.
INBPErTION NONCE ?)
City of Tigard Building Department
13125 an Bell Blvd_ Tigard, hrogon 97223
Inspoction Line (Rec-O--Phone): 639-4175 Business Phone: 639-4171
Inepectton:
Footing Plbq. Underelab Hoch. Rough-in Appr/Sdwlk
Found. Plbq. Top Out Cas Line FINALS
Poet/Beam Skruct. an. Sewer Framinc -Bldg.
Poet/Beam Hach. Rain Drain Inri. i,atlon -Plumb.
Plbq. Underfloor Nater/Lina Gyp. Bd. -Hoch.
Date Requested:_ /[� l/c Times AN �_PN
Address: ��-St ��+' Permit is C 2 K -LII
Builders Z 7 7
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector{:,e"= Dote:
e APPROVED DISAPPROVED APPR04Rn SUBJECT TO ABOVE
Call For Reinsp.
iNsr�acTlox NOTICE
City of Tigard Bullding Department
13:25 SW &III Blvd. Tigard, Oregon 97223 �
Inspectinn r .ne (P,,;--O-Phone): 639-4175 BusinFxe Phone: 639-4171
ootin _.�
9 Plbg. Underalab Mech. Rough-in Appr/Sdwlk
ound.� Plbg. Top Out Gan Line FINAL:
0Oat/8eam Struct. San. Sewer Framing --Bldg.
00st/Beam Mach. Ra.tn Drain rv:le, !.on
-Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Neth.
Date Requested: A�- �— Timp
Address:.
Z-----yL-L`� Permit #t
Builder:_14Z F_ ->L ./
T"R FOLLOWING Cn.^,;iECTIONS ARE RNQUIRSD..
1
C.YeV4�6iSDLArC�,)
94
Inspbotors
_ Dater - ri/
APPROVlD DISAPPROVRD �APPROVSD AUBJECT TO ABOVE
Call For Reinap.
C17YOF71GARD PLUMBING PERMIT
�CfTY.OFTWIRD PERMIT �k. . . . . . . MST91-0026
COMMUI*—Y DEVELOPMENT DEPARTMENT
13125 SW HW' cf. p.0.Box 23397.Tqjud,Oregm 97223 (SM)6394 175 DP_ F.'_ ISSUED,.: 05
7 7 PARCFL� 1S135Db-bRI..�:
'.:_�ITE ADDRESS. '-W 91'3T CT ZONING: R-4. 5
r'-.IUBDlVISION. . . . : THE GROVE - (HAZEL HILL)
BLOCK. . . . . . . . . . . L07 . . . . . . . . . . . . . . 11
CLAF)S OF WORK. . ,NEW GARBAGE DISPOSALS. . : I BACKFLOW PREVNTRS. . :0
TYPE OF USE::. . . . :SF W�qSHING MACH. . . . . . . : 1
0(,'CUr_,A1\1CY GRP. R3 FLOOR DRAINS). Tr,.APC. . . . . . . . . . . . . .0
STORIES. . . . . . . . CATCH BASINS. . . . . . . :0
TORIES. . . . . . . . :2 WATER HEATERS. . . . . . : 1 RAIN
F1_IXTURES--------- LAUNDRY TRA'0-3. . . . . . :0 SF GREASE DRATNS. . . . . . .L
-rRAPS. . . . . . . Q1
S I NIKS. . . . . . . . . . : 1
(-iVATORIES. . . . . :4 OTHER FIXTURES. . . — :0
UB/SHOWERS_ . : SEWER LINE (ft ) . . . . :0
-1ATER CLOSETS. . -3 WATER LINE (ft ) . . . . - 100
SHWOSHE RS. . . . : I RAIN DRAIN (ft ) . . . . :0
sitb`,0-0006 conditions must be 's<-Atisfied before plans can be relea��e:
!WNER: --------------------------------- -------------------
& F DEVELOPMENT CO. PAYM $ 100. 00 JL.H 02/08/91 209580
vi/ SL UAT F'I ELD BPRT $ 391. 00 JLH 05/03/91 -
-1
1411-1— 4. 1t J 1— t�1-4 O /V3/9 1 -
LAD srONE OR 91027 E45pc 19. 55 JLH 05/03/91
hone #: Ssc � 3 375. 00 JLH 05/03/91
PARK 4; 500. 00 JLH 05/03/91
MPRT $ 39. 00 JI-1-4 05/03/91
lumbing MPLC $ 9. 7'5 JLH 05/03/91
M5PC $ 1. 95 JL.H 05/03/91 -
PPRT $ 140. 00 JLH 05/0,3/91 -
,iddress '--A Cmpc s 7. 00 JI-H 05/03/9t
171 1_5
TIF $ 1350. 00 JLH 0!5/03/91 -
L�_j
-------- REQUIRED INSPECTIONS
j)].s permit it, issued si.kb)ect to the req-
,.tj.atjons contained in the Tigard Municipal Forit/f ot.tnd Insp vraminq Insp
Foot/found Tnso Fi-eplace I"SP
.ode, State Of (Ire. SDer'ialtv �Asand '-.4 11 Insp Gas Line Insp
ether applicable laws. All work will be done Foot/found
ji, accordance with approved plans. This Foot /found Insp Insulation Ins[,
permit will expire if work is not started Foot/found Insp Gyp Board Insp
within 180 dAvs of ifc;'-tan(-e. Or if wol-k Foot/found Insp Rain drain Ins[.:
51.19n@-ided for more than 180 days. post/Lkeam btruct Water Line Insp
past/lipam IvIechan kppr/tidw1k Ins(:
PIm/undf fab Insp Mechanical FInP
FILM/Underfloor Plumb �- inal
Mechanical Insp Building Final
Plumb lop O+-It Eroqion Control
9
CAII for illspe(:-tion 639-4; 75
cff�
CRYOFTIGARD 7 MASTER PERMI'r
CfTYOFTM PERMIT #. . . . . . . .. MST9 1-0026
COMMUNITY DEVELOPMENT DEPARTMENT 01110ft
13125 SW HWI 6W P.O.Box M97,TigaM,Oregon 9722 1 3(SM)d3g-4175 PATE ISSUED* Q5/0:3/!i1
SW PARCEL: IS135DB-GR12
SUBDIVISION. . . . : THE GROVE (HAZEL HILI-) ZONINb: R-4. 5
C'..00K. . . . . . . . . . : LOT. . . . . . . . . . . . . : 11
BUILDING
REISSUE: DWFLLING UNITS. 1 BASEMENT- - . . . :0 5
CLASS OF WORK. :NEW BEDRMS:3 BATHS:3 GARAGE. . . . . . . . . . ..441 Sf
IVVIE OF USE. . . -GF FLOOR ---- PEQUIRE-D SETBACKS----,
OF' COPW. -5N FIRST. . . . -767 s.f -EFT. . -7 ft RIGHT. : 12 ft
-CIJPANCY URI . :R3 SEC,"OND. 919 Sf FRONT. -.20 ft REAR. 36 rt
---'
FOR I ES. . . . . . . :2 THIRD. . . . :O s
HEIGHT. . . . . . . . :25 ft 1686 Sf SMOKE DETECTORS. .-Y
�LOOR LOAD. . . . :40 psf VALUE. $: 85494 PARKING SPACES. . :0
Remarkst sub90-0006 conditions must be satisfied before plans (:.-,-An be released
PLUMBING -----------------------------------------
S I NWIS. . . . . . FLOOR DRAINS. . . . TO BACKFLOW PREVNTRS. . -0
LNVPI'OkIES. . . . . :4 WATER !-17'AT ..ERS . . : 1 TRAr's. . . . . . . . . . . . . . 1.,0
-IUB/SHOWERS. . - - :2 LAUNDRY TRAY13. . . :0 CATCIA BASINS. . . . . - - -0
WATER CLOSET'S. . -.3 SEWEk l- INE (ft) . :O GREASE TRAPS. . . . . . . :0
1)15HWASHERS. . . . : 1 WATFR L INE (ft ) . : 100 OTHER FIXTURES. . . . . :0
GARBAGE DISP. . . : i RAIN DRAIN (ft ) . :O
WASHING MACH. . . : 1 SF RAIN DRAINS. . : 1
--------------- MECHANICAL FEES -__-___-.______
1-lJEL UNIT 14TPI-. . :0 t ype Amooint by date r,ecpt
GAS/ V(-NTS . . . . . .*0 V1AYm $ 100. 00 JLH 02/08/91 :,09580
ly'iPX INIPUT:0 OTU VENT' F(4NS. . :14 BPRT $ ;39 1, . N0( J1.1-1 05/(73/91 -
H' FRN
FJRN ( 100K . . : I HOODS. . . . . . t BPLC $ 254. 15 JLH 05/03/91 -
) =100K WOODC-TOVE.;. :0 A5PC $ 19. 55 JLH 05/03/91 -
__OUR FURN. . . . tO CLO DRYERS. SSDC $ 375. 00 JL.H 05/03/91
:ACJIL/CMP ( 3HP:0 OTHER UNI TS:0 (:1ARV $ 500. 00 .-,L.H 03/03-/')1
GAS OUTLEIS: 1 MPRT $ 39. 00 JLH 05/03/91
)wner: Iy1PI-C $ '). 75 JL.H 05/O3/91
M & F- DEVELOPMENT CO. M5PC $ 1. 95 JLH 05/03/91
17707 SE 00TFIELD PPRT $ 140. 00 JLH 03/03/91
-
P PC $ 10 JLH 05/03/91
il-fll) S['ONE OR 97027 TIF $ 1350. 00 JL.H 05/03/91
L-,r)otle #-. bbe-7092
ontractort ----__----.___....____.....______-.-._-
1 R F DEVEL OIDMENT C.D.
707 SE OATFIELD
iPSTONE OR 97027
652--7092
57484 ----------------------------------------
1i 3087. 41( TOTAL
rhis permit is issued subject to the reaulations contained in the REOUIRED INSPECTIONS
'igaro Municipal Code. State of Ore, Specialty Codes and all other Foat/fol-mcl Insp Firepiace Insp
ar -1.1ct Gas Line Insp
q0licahip laws, All worts will t@ done in accordarce with approved Post/seam Stt
plans, This permit will expire if work is nPI started within 10 Post /seam mect)An Insulation Insp
days of issuance, or if work is suspended for more than 180 days. Plm/undslab Insp Gyp -,ard Insp
►-ILIYI/Undev-f I ant- Rai" drain Insp
+ t pon -tiIv1*(:I1a01.LA1 i114;P Water Line insr,
"07"
Plumb Top Out Appr/Sdwlk Insp
;S tprl Py - Framinq Insp Mechanical Final
C- All. for inspection 639-4175
SEWER CONNECT ION
PERMIT
CITYOFTIFARDHERMIT #. . . . . . . : SWR91-01 -17
C0"0AI
KPIIDCDMMUNITY DEVELOPMENT DEPARTMENT 07
13126 SIV NdI Blvd.P.O.Box 23397,Tlpvd,Onpon 97223(603)9396.4176 ()PTF I`:i Fi U F D:
7
HUIJRESS. . . : �` SW 91sT CT PARCEL: 1S135DB-GRlc
5USDIVI aION. . . . : THE 6ROYE (HAZEL HIL.I_) 'ZONING: R--4. 5
BLOCK. . . . . . . . . . .. LOT. . . . . . . . . . . . . .. 11
VENANT NAME. . . . . :
_ISA NO. . . . . . . .. . . :43632 FIXTURE UNITS. . .
LASS OF WORKS . . -NEW DWELL T r•JC; UN I TS. . : 1
i Y►-,H GF USE. . . . . :SF NO. OF' BU I LD I NGS: 1
NSTALL TYPE. . . . :BUSWR IMPERV '.SURFACE. . :
;.4emav,ks : si.tb90-12.101216 conditions m�tat be satisfied before plans can bp release.'
reed rorr"ec-t tax lot and addr^ess
I
(.)caner: ---------------------------------------- ------------------ FEES
;1 & F DEVLLOPMENT CC). type amol.lnt by date recut
i i 10Y SEE OATFILLD PRMT $ 1500. 00 JLH 05/03/91 -
1NSP $ 35. 00 JLH 05/03/91 -
,LAD STONE OR 97027
,hone #a 65e-•7092
:.ONTRACTOR NOT ON FILE
------------------------------------------
i,ane #a ! 1535. 00 TOTAL
?Ptd #• a
------- REQUIRED INSPECTIONS -----
'tit:• Applicant agrees to comply with all the rules and regulations Sewer Ins;pe.•--t ion
of the Unified Sewage Agencv. The permit expires 120 days from
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency dots not guarantee the accuracy of the
Side sewer laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a "Tao and Side Sewer" Permit and the Agency will install a lateral.
fl i ttPe ignat 1.11'"E?
ed By
Call for ins:vection - 6:39-4175
it
/44.70F JIGARD R[7CFIPT OF PAYMENT RECE I PT NO. 3 91--212 788
t, CHECK AMOUNT : 3172. 40
NAME M&F DEG.!&w---NT CASH AmnUNT i 0. 00
ADDRESS a PAYMENT DATE : 05/03/91
SUSDIVISION t
PURPOSE OF PnYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
U—L 1, —0- PERM- 391. 00 PLUMBING PERM 140.-00
MECHANICAL PE 39. 00 ST. BUILD PER 28. 50
PLAN CHECK FE 163. 90 SEWER USA 1501A. 00
SEWER INSPE(..T 35. 00 PARKS SDC 1100. 00
qTtlRtvl DRAIN SDC 3,715. 00
11263 SW 91EST CT LOT 1. 1, THE GROVES
TOTAL AMOUNT PAID 317*c-'. 40
TRAFFIC IMPAC' FEE
Installment Payment Application aad Disclosure Statement
In the Matter of the Traffic Impact Fee for _ f F �� y 7
Tax Map /5% 35vL� -L�'L Lot Number(s) Building Permit !»57 9/ �U� Z&
Site Address -1 L? 3 S� ,5f/fir CUtfC r Subdivision TifF L�t`'DUG
Case File SuC� TIF Lane: Use District 1�r5i�rN>iAL
(Description of Property)
To the City of Tigard:
In accordance with the provision of Oregon Revised Statute 223.208 and Washington County
Ordinance No. 379 which relates to the imposition of a traffic impact fee for the financing
of major collector roads and arterials of Washington County, I HEREBY MAKE APPLICATION AND
AGREE, JOINTLY AND SEVERALLY, to pay my traffic impact fee, as his been determined by
Washington County Ordinance No. 379 in _Cp semi.-annual installments of the amougt financed
together with one-half of one year's interest- thereon at a rate of Z%o annual_L_
percentage rate on the unpaid amount owed. The lien date is the first day of the month
following the date the applicat'_on is signed. The first payment is due six months thereafter
and at six f6) month intervals thereafter for a period of 3 years. Each installment-
payment willinclude principal and interest.
If I neglect or refuse to pay any part of the installments pLcvided herein, including
interest, within one (1) ,year after the same shall have become due and payable, then the
whole amount of the unpaid assessment shall become due and payable at once and shall be
collected in the manner provided by law including foreclosure on the above-described real
property.
The traffic impact fee, annual percentage rate of interest ( Z$) and finance charges which
I agree to pay are as follows:
HIGHWAY TRANSIT
1) Amount of Traffic Impact Fee. . . . . . . . . . . . . . . .$ /ZSE 00 _100-De)
2) Amount Financed. . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ i z r0 .00 l0 0 .00
3) Equal Semi-Annual Principal Payments. . . . . . . .$_ 209 • 3 3
4) Interest on Balance at Rate of. . . . . . . . . . . . . . q. z `.
46
I understand that the amount owed, as stated above, shall be a lien on the above-described
subject property pursuant to Washington County Ordinance No. 379 Section 6 (D)
and ORS
223.230
DATED this day of il 19.11-
Signature of Pr sty Owners(s) Lynature of Prolferty�eo
STATE OF OREGON } Name (Please Print) : �1 etre e f7
}
Address: PU �ax •�33�17. 7 le Ci7��_�
county of Washington }
SUBSCRIBED AND SWORN TO BEFORE me this day of ► 19•�'
Notary PP lic for Oregon \
My Comm`lssion Expires: _� 'S 213
Fl:\1asin\debre\1'IF.WI.
CITY OF TILARD RECEIPT OF PAYMENT RECEIPT NO. :91-0.09", 0
CHECK OMOUNT a 100. 00
NPME a M & F DEVELOPMENT CO. CASH AMOUNT a 0. 00
ADDR179S s 17707 5. E:.'. OATFIELD PAYMENT DATE a 02/08/91
SUBDIVISION
(3LADSTCNE, OR 97207—
! ,UPPOSE Or- PnYMENT AMOUNT PAID PURPOSE (IF PAYMENT AMOUNT PAID
CHECK 100. oet
"LUT i.l,, — -ri-ir-.' GROVES"
T0101 "IYIO()N,r PAID
I
t
i
t
I
j
I
� I
I I
I
,I
I
i
j
i�
ci
I
j�
II �
UP.t k
i
i
t �
I
�1
w 11
Ou
s'�/,lr
r