Case File A
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CITY CSF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT FE.RTIF FATE OF= �
13125 SW Nell Blvd.Tigard,Oregon 97223.8199 (503)d39-4171 OCC^1.1PONC Y
x Ax PERMIT #. . . . . . . : MGT9::3--026(
639--4171 DATE ISSUEGs 1x::/09/93
PARCEL: 2G 1 140B-1 f3000
ITE: ADDRE-55' : 1f:�c.'a�i SW 103RD AVE .
IUSDIVISION. . . . : RIVERVIE:W EsTATE.r I_CINING:R -7 PD
BL.,OCK. . . . . . . . . . : L01.. . . . . . . . . . . . . :26
CLASS OF WORK. r NEW
7 YPE OF USE. . . u SF
OCCUPANCY ORP. :R3
OCCUPANCY LOAD:221 4
TENANT NAME. . . I
Remarks: PATH I
Owner: -.._._..___.._.._._... _..... __.___._.......__....._...__.. ._.._.._.._._..�..__..
MAJESTIC HOME!:) INC
25 82ND DR
SUITE 102
CLADS"(ONE OR 917W7
Phom., #3 635-6263
Contractor; _._. .._.. _..__._._.. .__ __.__.._.._._.....____.__... _,..
MAJESTIC. HOMES INC:
R5 82ND DR SUI TF 102
GL.kDSTONE;. OR
F-'honv 1P: :303-E+'..'i',,.J`''-6. ..
pey #. . s 59286
Occupancy of the above referenced building i6 hereby r;i pen, and certifies
the compliance with the State Of Oregon 5pec:ialty codes for the yruup,
or.c�.tpaiw:yr and use under which the referenced permit w-its is;sued.
jje-- .e,
F I RC DEPARTMENT 110 L.. 6 I N9r 'TOR --
NLTI l_1:1�'NI?�C F F 'IAL
POST IN CONGPIC:000C: F'LAC:F
.J
EXEMPTION FROM )WIMUM SHADE POINT SIGHT STANDARD
I/we, the undersigned, as legal owners of record of the property
described as:
Lot 1 .7 of Riverview Estate, Subdivision
Tigard Address 102.76 SW Picks Wav
Tax Map and Lot :Dumber 2S114RR , 18100
do hereby release the property owners of adjacent Lot 1 26
of Fri yF+ry i n Feta I-FS Subdivisi:n. also known aA Tigard
address 16285 SW 103rd
and as Tau Map and Lot Number 2 11410 18000
from complying with Conun"Ity Development Code Section 18.88. 050.G
(Ma-ia:um Shade Point Height Standard) ; and agree that the utructure
may have a shade point height of 27 feet:, tPereby allowing shade
on an area otherwise protected by Code tn 18. 88.050.D.
In addition, I/we also release the Cit / o Tigard from liability
for damages resulting from this adjus e
Signa e
Signature
State o," Oregon )
ss .
County of c�LIA.•�.A`"z--- )
This instrument was signed or attested to before me by
and — ---
on
.`' OFFICIAL SEAL
JUDY A. BRADSHAW l
NOTARY PUBLIC OREGON
COMMISSION NO. 006782
MY CO MIS I N EXPIRES JULY 26, 1995 STcjnatnee of Notarial Otf i ce
(Nal' My Commission Expires.
br/rlt/Exempt .Nst
Post-It"brand fax transmittal memo 7671 r o1 payee
TO
Dept. hone h -
For M ";OWN
i �. '�
CITY OF TIGARD
Ulf ► 1.
COMMUNITY DEVELOPMENT DEPARTMENT 77
13125 SW Hall Blvd.Tigard,Oregon G7;C'3•A100 (503)839-4171 L, . i L--;,.j"i
1..'J t�f�.' � • . » w ,. .. . « I_tJ�• � �. . • . F v Y i 4„rJ
lrtFlc:.Kf-"LOW PRorVNTRS. . 0
n . . . . . . . . . . . . , ki
Ek. ki..-(ITERS. . . . . . z l GAT&I F%fas1Ns. . . . .
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..... .. _,._w_.... ..,..,_,. ,.._Y tlJi'�PI✓F?t � tit-i'i',�. »ilt
. . . s i GRLASE TRAP6. . . . . . . .rG+
.. i. T i S' $ y.�'•!•1.
s.,(�iC)':ii.C/Ni:. i..irl '.� ,'��I;:.::; !a�`r-'C '1 �;�. K►�l ,orf �.;�i�:�t[�r�:�,:,
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10p Q'.itic;.9. i._ i .:.r;. !.i t:C:' .- aTTL �T.f 1. f ost/8ea1i
lev, oppi ,i.'-able liaw-s. I, t1 wi 4I be qutia ;-'clst/beam Ml LathAn Appy'/SlAw1k in
JVE?0 1.;J %1°' Ril'J` (-•4(li,.tnUsi.EALt 1n,,p �Gt"',iT1J"'cl� l� lr}d
+gym it wi l i Ape+ «i i f wNovk isl not it ' PLM/Under'flnnr'
ti t 1 i,i y t . J. .. '.vf, �?TIS::Py Uf` I N&:.:Ii,iII . :.? .i I'1 p l.9+,1ildihu !' Anal
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CITY OF TIGARD �'
COMMUNITY DEVELOPMENT DEPARTMENT . . . . . . . ..
13125 SW Hall Blvd.Tlgard,Orogon 97223@8199 (603)83 9-4171
N)
41,, F)Vi= Pf AE S I
t ll
.. . . . . . . . . . . . . . . . . . . . . .
BUILDING
DWE"LLING CA:j LML:N'r.
4 BATHS. 3 U 0 R(46 E. . . . . . . . .
(J- WO RK. :N1_.
R L U U I i L D .)L' I P. L
Ll" L) JSL.. 4 ,-)l r,L(Alk,
r.)F CUNS 5N F:I Rbl . Sf LEFT. .5 ft RIGHF. b
URP. a H'-' FRONT. :i'0 ft 16_qR,
TH I RD. REOUI RED----
M
L.. L DE.
00k LOAD. :40 p s f VALUE_ . . $. i 1067;e- PARkINS ,SPACE
r
PLUMBING
ORAINS. . . . :121 PkEVN"RS'. .0
IVATORIE5. - 4 WATER HLATC-RS. . . I rHAPE�. . . . . . . . . . . . . 1 :0
11I Mi1JWE !'i: LOJN714Y I R4YS. .0 A Tt�H BAS 10--.
ER GLObL.''! SE AE I-INC (ft ) . :i7l &REA )L, 7RAP,1 . . . . . . . .u-)
1_34WASHLW: WATER kft ) . : 100 U- HEFF1 X TU V1
+-�RSAGF I RAIN DRnIN (ft ) . 70
SF i<('11 DRAINS. I
mc CHAN I C'PL
fl"F',-3, U114 T ,r i 1 I Rig;. 0 t"y ;A in 0 1- fj c,p
VEWU :0 T I f s 1,+6V1. 00 Jr�-i Ob/L20/9&
IA 1.t+1`(1 01 L Lj
FAM,. .5 APIR S -460, 50 j1-1 0�j/217119.3
J W`o lZj . . . . . .
DPLC S c29 9. 33 J%Fi Ob/20/93
!.URN
1,60. eel J1,1 (4 ,
J f)R n
�.:j T, 'A
J M P R7, $ a. wo ;1H 0-;/
m5pc 4 40 rH
5Q1 J, I
38 jH 0"i
r7-
�,_`40. 1.4 T01'fiL.
rtgulAhus L:Atamec in he REQUIRED INSPELT [ON1,3
Codes and aE Ar!ar FOUt/1-OLIVId IVISP i' ireplciQL, Insi
LLI
6i s Limo Insp
Po"t/!' oAm flechalm It)S u I i,1, JL I ti�I
Plm/unof&1ab Imsp Uyp
lour Rain
1V1PL:hi_Ar'1L.a.1 1f1%jJ Water LITIC, IV)
f."Immij 'up PA Prjprt'Sdw1k I n sp
r-' raAmirig Insp N0Chckl*) I a i I ifiOit
CITY OF TIGARD
COMMUNITY DEVELOPMEAT DEPARTMENT
13125 SW Hm:?Blvd.Tigard,Oregon 272234199 (503)639-071
UN
P FE 1 111 T
i---RN,1'T 4. . . . . . .
U, 41.-e"I 1,131SUV.D.-
jiLIE05 SW 'I.Z3RI) AVL PARCLL: 2S114BB-18VIYN
WIVLRVIEW ZONING. R-7
.. . . . . . . .. . . . . . ..iE&
. . . . . .. FIXTURE. UNIT'S. —
OF
w0ki". i"ILW DWELL I NG UN 1 i'S. I
11"L OF USE. . . . . NO., DF PUILDING:3. I
ALL DLJ:: , IMPERV :.-)%-1RFiA0E.
W;Tb-i
FEES
!VMLS !WC t;vpe a to C)[.,.I t by data: re
5 & ND DN PRMT c1t100 JH05/20411913
Li"ITE io", I IN 3 r-, 1, 1)z jH W5
—A1)3'10NL- OR '370"- 7
1P1VR01JUi- 4 U'T ON I it L
",135135. 00 TUT iiL
RLUUMED 1 7 ONS
i� Appl;cant agrees tc cooply w-Ah ail the rules and replatimis 'A?Wel, In Spect 1rill
Un;litd 5"#Wap puency. The permit expires, 160 'Ayi trill
ddtF ks,iul- 'he total asount pal: will be tarfelted it the
sat wires. Phe Aiency deem not pa,-- up the ap.mary 0 the
;f spwpr laterais, if the sewer t r, aced at Np vpa--;rpment
W., tht v,stallpr A&II pm... I all
6 dictanrf given. If nat so !Dg-al
'Tap an; We Sewer' Pproit a,
C-2 L�l I fur- inspecti uti 6 '•175
INSPECTION NOTrce
City of Tigard Building ^epartdmmt r
13125 S1 Ball Blvd. Tigard. DL-:. ,n 97223
Inspection Line (Roc-O-Phone): 639-4175 Business Phone, 639-4171
Inspection:
Foot' 19 Plbg. Underrlab Mach. r ugh-in Appr/Bdwlk
Found. Plbg. Top Out Gas Line FINALI
Poat/Brum Struct. San. Smser Framing �81dg.
Post/beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line/ OYp. Bd. p�''-Hoch.
Data Requested: ( '1 _ Times G�rr__f AM PM
Adds or r s 7 (�/ ��( _ Penni:. #11'25-62-(4
BuildersL � lab3
THR FOLLONINO OORRECTIONS ARE REQUIRED,
TO
CD
LLI
�1 GG
Inspector:_ �
s�Y VE���_Y DISAPPR 1,/ APPROVED SUBJECT TO ABOVIt
`Call For Reinsp.
MSPECTLON NO4'ICE
City of Tigard Building Departeent j
13125 BN Hall Blvd. Tigard, Oregon 97223 /
Inspection Lire (Rec-O-Phone)s 639-4175 Business Pho U-4171
Inspection:_
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Strutt Ban. 8 Framing -Bldg.
Post/Beam Meeh. Rain Drain Insulation -Plumb.
Plbg. Underfloor WaterLineGyp. Bd. -Hoch.
DatG Requested: / „Time: AN PH
r
Address: l� J r� Permit
Builder:
THE FOLLOi1ING OORRECTIONS ARE REQUIREDt
i
Inspector: _ Dates
APPROVIM DISAPPROVED APPROVED SUBJECT TO ABOVE
call For Reinap.
,LNSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
Inspections
Footing Plbq ab Koch. Rough-in) Appr/Sdwlk
Pound. Plb 9sjt ! Gas Line nXL FINALS
Post/Beam struct. San. ewer -Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Hoch.
Date Requested ( 1 _ Timet AM PH
Address: �'Y �J / �j�� T� Permit fit .-Q2��
1
Builder: /
THE FOLLOWING OORV PCTIONS ARE REQUIRED:
No /
a
0.
Inspectors_� __ I Datet
APPPOVEDDI PPROVItb APPROVED SUB"cT TO ABOVE
_Ca 11 For Reinsp.
NSPECTION NOTICE ,
City of Tigard Building Departnen= ��.
13125 SN Ball Blvd. Tigard, Oregon 9/223
Inspection Line (Rec-o-Phone)s 639-4175 Business Phone: 639-4a71
Inspection%`
Footing Plbg. Underela`b Mech. Rough-in Appr/Sdwlk
Found. ( P'bq. "V Out ) Gas Lina FINALS
Poet/Beam Struct. Ban. Sewer— Framing --Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb-
Plbg. Underfloor Nater Line Gyp. Sd. -Mach.
Date RequestadsTimes/ _ AM PM
Addreass ���0� ( —�(�^� � Permit As
Builders
THE FOLLOWING OORRECTIONS ARE REQUIRED-
Inspec�tAPPROVND
V� Datot— _
DISAPPPOVED APPROVED SUBJECT fo ABOVZ
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Depart- nt
13125 BR Hall Blvd. Tigard, Oregon 97
Inspection Line (Rec-O-Phone): 639-4175 Businesse: 639-4171
Inspection: I
Pouting Plbg. Underslab Hoch. Rough-in Appr/Sdvlk
Pound. Plbg. Top Out Cas Line FINAL:
�ost/Beam Struct. San. Sewer Framing -Bldg.
t
ppsfJeamMesh`) Rain Drain Insulation -Plumb.
g11q. 0 erf—loot/ Water Line Gyp. Bd. -Hoch
Date Requested: ^•ime: !1M PN
Address: /( M 3 r a Permit #:
Bulldet:
THE FOLLOWING CORRECTIONS ARE REQUIRED-
Inspectors -- __-- — Date$` L
APPROV=D nI3APPPnvRD APPR(7VND 9UBJTC" TO ABOVE
Call For Reinsp.
�]('SPECTION NOTICE /f�
City of Tigard Hull:iug Departsent /
13125 SM Bali Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171.
1//Oot11q Plbq. Underelab Mcch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas .ins FINAL:
l
Past/Beam Struct. San. Sewer Framing -Bldg.
Post/Be!.m Hoch. Rain Drain Insulation -Plumb.
Plbg. Und,vrlloor .� Nater Line Gyp. Bd. -Koch.
Data Requomteds. `_� 7 TAN p!1
Addresas �.��) � ����� Permit #s
:guilders •/ �� �� ��
TBE FOLLOWING CORRECTIONS ARE REQUIRED:
- -- -- +- --_-- -- -- _-- _ -
i nep�ctor:
J
APPROVED DISAPPROVED APPROVED RITBJECT 710 ABOVE
Call For A-tinap.
INSPECTIU[y NOTICE
City or Tigard Building Department
13125 SW Hail Blvd. Tigard, Oregon 9712
Inspection Line (Rec-O-Phone)s 639-4175 ausineas Phone: 639-4171
Inspection:____
Footing Plbg. Underelab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Cop Out Gas L'-ne FINAL
Poet/Beam Stzuct. Ban. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater. Line ( Gyp. Bd. -Mech.
Date Requested: Timet AM PM
Address: /L/, �� �L�. 3 Permit 1t �(C
Builder-_-_
THE FOLLOWING CORRECTI B ARS REQUIRRD:
t
Inspectors ' Dates
APPROVED DISAPPROVED APPROVED SURJEL'T TO A90Vv
_Call For P.einsp.
INSPECTION NCTI�CF
City of Tigard Building Departeent
13126 SAA Hell Blvd. Tigard, Oregon 97223
Inspection Line (Ree-O-P(h�one))t 639-4175 Business Phones 639-4171
nepect ion:.
Footing Plbg. Underalab Mech. Rouge:-in Appr/Sdwlk
Found. Plbg. Top Out Lias Lino FINAL:
PostfBeam St_ .ct. San. Sewer Frcming -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor :Astor Line i Gyp. Bd. -Mech.
Dcte Requested: i > Time: AM _ PN
Address: _ Permit #:
Builder: 11_(1n��� 51111tj
:n:. FOLLOWING CORRECTIONS ARE REQUIRED:
InBpeotorf
�i APPROV20 nISAPPROVED APPROVRD SUB"CT TO AHWE
/ Call For Reinup.
r'-sPECrIgn NOTI-%
City of Tigard Building Jepartr�ent
13125 an Ball Blvd. Tigard, O�regoo 972 3 l
Inspection Line (Rec-O-Phone)s 639-4175 Business Ph a 939-41'71
Inspections_
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
round. Plbg. Top Out Gas Line � FINAL
Poet/Beam Struct. San. Sewer Framing ld
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfior,r Nater Line Gyp. Bd. -Koch.
Urte Requested r/ter z' 1 , _,_Time s _L-AM PN
Address: i�� OS tV� rPermit #/t�-32-
0 """
Builders 1 ' �`i �r � lA��- (Q) 1gF
THIS FOLLOWING CORRECTIONS ARS REQUIRED' t0
N
h-
J
wr
m
W
J
Inspe.:torf _ _7^ Dates/_G
Z/2/Z?
APPROVED PROVEl,�TPRO"D SUBJECT TO ABOVR
��efrI dor Reinsp.
IMBPECTION MICE
City of Tigard Building Departsant
13115 811 Ball Blvd. Tigard, Oregon 9723
Inspection Line (Rec-O-Phone)s 639-4175 Business Ph
14-639-4171
Inapection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found, Plbq. Top Out Gas Line FINALS ,
Post/Beam Struct. San. Sewer Framing
Poet/Beam Mach. Rain Drain Insulation
Plbg. Underfloor 7 Water Line Gyp. Ed.
Date Requesteds �! - % 7
Time: ^AM PM
Address s � sL(.� .�� Permit ft.q3-y 2 6
/ r-
Builderf_ pC
THE FOLLOWING OORRECTIONS ARE REQUIREDr
— A,�7 7—
r
Inspector: DAte
APPROVER DISAPPROVED APPROVED SUBJECT To ABOVE
Call For Reinsp.
CITY oF, TiGnpr) - PECFTPT OF r:,i'-)YMFN'r' 1-?E('FIPT NO. 93-23,9889
CHECK n140UNT 1500. 00
NAME MAJESTIC HC)Mf:."�5 Gnf-11-4 AMOUNT V1. 00
ADDRESS r PAYtl('-"NT pr4'ru 0 7 9 3
BUBDIVIqION
PURPOSE OF PAYMENT AM0UN*r P,r4iD PIJRrV7-3P-. OF PAYMENT AMOUNT PA I D
tjiECK V'E 21,0. 00 PLAN CHECK FE 25-0. 00
CC
1.
LD
LOT 60 RIVFRWOOn F.F4T
LUJ iF,'(, PIVFRWn-nD EST
TOTAL AMOUNT P)AID - - -- -> 500. 00
CITY CIF TICAPD RECEIPT OF PAYMENI FSE'CE11:11- NO. 03-0'40342
CHECK AMOUNT : 5 1 1/f
NAME s MAJESTIC Howl CASH AMOUNT z 0. 00
4DURESS s rJFIYMEN*r DATE- : on.,/,,v/93
GLIB D I v I S I ON r.
UNPOSE OF PAYMI"NT AMOUNT PAID PURPOSE OF POYMENT AMOUNT PAID
Ln
�(JTLDING PERM 460. '50 f-IL-L)MBIN(3 PERM 147. 50
'UCHANICAL. PE 48. 00 ST. BUILD PEP
32. Bt
LAN CHECK FE 61. 33 SEWER USA 2100. 00
E.WLR INSPECT 3'5. 0 it) PPRRG SUC 500. 1710
JORM DRAIN GDC 00 RFSIDENT IAL TRAFFIC FEES 11350. 00
IASS TRANSIT TIF FFES 110. 00
I_ CLT26 RIViRVIGW EST
6.435 SW 10RD
TOTAL AMOUNT PAID 51PS. 14
na CHECZ &rMCAII08
CITYWtv
GAD C.YOET PZd11 s N
DmA�IT o CLni`
t�wertar.7d•0.�� ICK - DAA LSSIIFD—
yoo
TAX crap/T ----
• v TAND USS: r
_
is. om: ��r:��wBFAS LFFr:Z
MOM aASS: Froom Lc"-.
oss= BUT =-F-- San:
Cox= %TM ___. $Asp:
SO SSM: Z
Iw SMTAM _ SrZaAL MOnaEs
APMOU—W o�:
Lug-ersss�: � TM ------ �
IM SrAMUC rtM: —
OMMM XAMSCM rias
OTW:
pr ur cLg= IT:
--..1 r - s,. , r pp. sAL• ouE
ipTlom Building Permit Fees
rn 9G
ILO_4370.
Plumbing Permit Fees -------
10-43100 it Fees
-- 10--431 01 mechanical Per* 1.8
lO-230 01 State Building Tax (S�)
Building
P � in9 --- v - 33 _ S�'
nec
10-433 00 Plans Check Fee
Buildingplumbing
7 �pu
Iz -202 00Sewer erection
�wGp ' 44 00 Sewer Inspection
0e
- pew Charge
Su-eet System e
51-��d 00 Pates System pew Charge
_--
SZ-4,49 00 Syst Oew C" (;**00
-450 00 Storm Draina1ge _--
31 —. —
95Z)
10-230 04 —
10-X30 06 1da�shington County Fire M1 Z
10-220 00 Aftart/wdgewood TOTAL .5.3.
R£C R _---
�Ci1NT SI[GWAiURE
pate Receiw4ed=
Received BY: _ --
pn/3SS7P/1tP
0
�Ay of Ttgatd Pew 9
[3[125 SW[�1�-
po 6aoe 23397
-rGM4 On 9727.3
639:4171 __ --�' aair t star
Y,ban WL U d..;r-A Cbft
Fcnx7es300
so 23
'C"
s�eo�••ra+r —' iso �1OD u� TSD ). �y
sv t, 23 :dd adares.•�
Madam 1401 dfoor
51iwaow
y � emit COO
gp�b100r6[U COO
n b3f1P'ab� _
tq =tSHP', a0it�'
arc o—�aatPn°'0.'r YSOO
Sol
r.�0.jw 3190
uxwr- 7APp lie >9DitPatmo�'r"'Z1!]Sedt3W
tn tgooO� _
s. aa:4 uc SOFT
sloer�s ia:m�w I1A�t tD�r 1S.A0 - tom_t�Ql11O0 Cis[� �..--
zsm
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TSS
0'1 Ac4powc— 251
Ipopoocftd as a f:�n+ SM q :adbBedl"ao sopf flk
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-. �d ESL P{��6iq � — d orsrs•�d �OOO
it SpwayPe1�O1C prr Iir aP� �rarr QAC 490
MOO
� Aex+drr+�aocl�fow P+o"e"`°s 15.t1GD Iq (;ss Op�9"'�b fa�rwAea
do hoes
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sew S75LM SIM
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:r:stxec.7u�wc.E ,�� Grl
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UWAL
CITYOF TI GARD 131?S SW Hill Blvd PLNCK/RECT # S
COMMUNITY DEVELOPMENT DEPARTMENT 7ipedOct"97M PERMIT # In 5
(503)634-11" DATE ISSUED
JOB ADDRESS: ) c� y �ItAe TAX MAP/LOT _ZS 1 N►313 l et?o0
V►,cal S 7A>E'S
SUB: LOT: Z( LAND USE: k- 7 (Pb)
VALUATION: b bta o
OWNER SPECIAL NOTES
NAME: � -�'ljG � - �L REISSUE OF:
ADDRESS: ��gZ ��_ /ate LAST REISSUE:
FLOOD PLAIN/
PHONE: ��S- �Z� 3 SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED,
NAME: '��� PLANNING: �d�CCS 0/C SOL OL�
ADDRESS: ENGINEERING:
FIRE DEPT:
PHONE: - "�Z6 3 _ OTHER:
CONTR. I30ARD #: _ Z EXP DATE-. If :;n,
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: __�__X4$9x. 66(4* m-AZ LIST/SUBCONTRACTORS:
ME:CH: _Mho n*tw�.s BUS TAX: - -
ARCH ENGINEER _ CALCULATIONS:
NAME: __ TRUSS DETAILS:
ADDRESS: 4 �tJ Z /�7/(S OTHER:
PROPOSED BLDG,. USE: A-)
COMMENTS: --
J
APPI I fn4 I S I GNU E
Receivers By: 't Date Received:
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
rnstp3 azGG 10-432 00 Building Permit Fees #�q.SU 50
10-431 00 Plumbing Permit Fees . S,)
10-431 01 Mechanical Permit Fees N�', °u _ S'•a�
10-230 01 State Building Tax (5'%) 32 . _ 2�
Building (2?,3. 0 3
Plumbing _2. 3 X
Mechanical
10-433 00 Plans Check Fee 3U.3 3
Building 3 3
Plumbing _ -
Mechanical .00
10-230 06 Fire
S5 E� 3-0°231 30-202 00 Sewer Connection
30--444 00 Sewer Inspection
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 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC) 500
�?!�
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) _0`1-�-v
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
1OTAL 63 51b
nm/358711.WPF