Loading...
Case File 4 ADDRESS- A M I� ,l • ,Or ' 3 AMAEK L. lAre l r' r. 1 A , ,I NI •• • • ! •• i I CITY OF TIGA R® CFIYOVTWARD� COMMUNITY DEVELOPMENT DEPARTMENT Omf*N 13125 SW Hell Blvd. P.O.Box 23397,ToLrd,Oregon 97223 (603)Wf"l 75 XX Xx I T It. . . . . . . 115192 -OW 639----4171 DOTF S I TE ADDRESS. 16-363 SW 103RD AVE pf-INCF.A... 1 .14 118.-1 76 0 bUBDIVISION. . . PIVERVIF.W EASTf-ATTS ZON11\15p P - i 1'1) BLOCK. . . . . . . . . . .. . . . . . . . . CLASS OF WORK. g NEEW -1 YF-:'E OF USE. . . c SF OCC UMINCY GHP. I R3 �ICTIWVINCY LC1AD;21:2'8 4 TTNANT 1+11VIE. . . I Pleffliark% l 0wriert GENE JAATY CONST. Pholle It: cantravi ort r3C-.'NE DA"fY CONSTRU11", C)N 10045 ERW INF-111 1-4- TIGARD MR 97PL14 Phone 41k 639- 1719 Reg 0. . ; 8P007 Occupant", (of I-Ile .1bovp building j hereby I)iveri, faid vertifieli the compll.Anr�p with the State Of Ulreqon lipecialty C'Odes for the qt,(,)Up, nu�ck4parlcy, and use undfAr WI-lich the oermit WEIS __ _..___w __.__ r __ ` ___.__..__. Z. FiRE DUPOR TME'N't INSiPPEC-TOR L 1.111- OF I-T C I AL P10' ,f* IN LOW.)PIC.0011IF4 PLACE INSPECTION 13TICE City of Tigard Building Department 13325 SN Hall Blvd. Tigard, Oregon 97223 'Inspecti.on Line (Rec-O-Phone): 639-4175 Business Phones 539-4111 Inarections Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINALS Post/Beam Struct. San. Sewer Framing Bl.dg� Poet/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Lisse Gyp. Rd. -Mech. Date Requested:__ — Times f AM PM Addrees: & Ga _ /L/•� Builders TRE TOTA OWING CORRECTIO S REQUIRED: i Inspectors _ Dates / ,APPROVED DISAPPROVED APPROVED SUBJECT Ttl ABOVE Call For Reinsp. !NSPECTION NOTICE Ctty of Tigard Building Department \I 13125 SW Bull Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone 639-4175 Business Phone: 639-4171 Inspections Footing Plbg. U aerelab Mech. Rough-in Appr/Sdwlk Found. Plbq. op Out Gas Line FINAL: Poet/Beam Struct. San. Sewer Framing Poet/Beam Mech. Rain Drain Innulation -Plumb. Plbq. Underfloor Water Line Gyp. Sd. -Mech. Date Requested- - CfATime s _ AM —c ?—M Addreeer_/G — L Permit 07_J 1lrJ Builders —. THE FOLLOWING CORRECTIONS REQUIRED: 1i Inspectors �irf�M 2 Dare:_2 lj _y_APPpQVEO DIS"PROVtD APPROVED SUBJECT TO ABOVE call For Reinep. INSPECTION NOTICE City of Tigard Building Department 13125 SW Ball Blvd_ Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phones 639-417; Inspections Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Can Line FINAL: Poet/Beam Struct. San. Sower P',!-ming -Bldg. Post/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Mech. Date Requenteds___.,,/_-,A -ez� Time: - AM _. _PM Address:,' / Permit_ 1 _ Q Builder:---'� _ THE FOLLOWING CORRE ONS ARE REQUIRED: Ln CIO LL) Inspectors (�-�- L j4-yMj.3 Dates 2'S S APPROVED DISAPPROVED -_L.,t/APPROVRD SUBJECT TO ABOVE Call For Reinsp. INSPE'C'TION NOTICE_ City of. Tigard Building Department i 13125 SW Ball Blvd. Tigard, Oregon 97223 inspection Line (Rec-O-Phone): 639-4175 Busineou Phone: 639-4171 Inspection:_-_ Footing Plbq. Underslab Mach. Rough-in Appr/Sdwlk Found. Plbq. Top out Gas Line FINAL: Poet/Benue Struct. San. Sewer Framirg -Bl.dg. Post/Beam Math. Rain drain Insulation -Plumb. Plby. Underfloor Water Line Gyp. Bd.� -Mach. i rata Requested: /�L? Time: AM (_/ PM Address: / j`r1� Permit fs _` V�_ Builder: TBE FCLLCWINC CORRECTIONS ARE REQUIRED: 7 J J Inspecti. _7k APPROVED DISAPPROVED NPPROVED SUBJECT TO ABOVE Call For Reinsp. c� INS1 E'M' ON NOTICE �'! City of Tigard Sul-ding Aepartment 13125 5M hall Blvd. Tigard, Oregon 97223 I..epection Line (Rec-O-Phone): 639-4175 B,•aineae Phone: 639-4171 Innpectiont Footing Plbq. Underslab Mech. Rough-in Appr/Sd,,:k Found. Plbg. Top Out Gaa Line FINAL: Poet/Beam Stivct. San. Sewer Fr., ing -Bldg. Poet/Boam Mech. Rain Drain ( nsu!.+tion -Plumb. Flbg. Underfloor / Rater Lin- Gyn. Ed. �+r� -Hoch. Date Rvqueetedt �/",r"� !� x _Time: �I AM _PM Addresn: �(pJ W�iS,. �Qyj �� A� --- Permit it f<4 Builder: THE N'OI.LOWING CORRECTIONS ARE R$QUU:iD% J Inspector: APPROVED DISAPPROVED - - APPROVED SIIBJRCT TO ABOVE -call Por Reinnp. INSPF;CTIOIi NOTICE � f City of Tigas.d Building Department 1.3125 SW Hall Blvd. Tigar,], Oregon 97223 Inspection Line (Re fOrPhon+e): 639-4175 Business Phone: 639-4171 Inspection: Footing �jlbg. Underslab Mech. Rough-in Appr/Sdwlk Found. Flbg. Top Out Cas LLne FiNALs Post/Beam 8truct. San. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line :`W -Mech. _ i 7 Date requeeted:.—/-/ - 1` Timet — AM _�PM Address.-_ .{� � G1� P•jrmit /s Builder: THE FOLLOWING CORRECTION E REQUIREDs Inspectors_ _ 4 Date: APPROVED DFSAPPROVED APPROVED SURJF.CT TO ABOVF. Call For Reinsp. INSPECTION NOTICE City of Tigard lh,Uding Department 1.3125 SW Nall Blvd. Tigard, Oregon 9'1223 Inspection Line (Rec-O-Phone): 639-4175 Busineee Phone: 639-4171 Inspection: Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: ter--------� Poet/Beam s•truct. ian. Sewer /Framing -Bldg. Poet/Beam Mech. Rain Drain Insulation -plumb. Plbg. Underfloor Water Line Gyp. Bd. -Mech. 7 Date Requested:_ 7 '�' Times --_`AM PM Address: % -3 /'CJ y Permit #i 2 t_w Builder:-s_���-�' THE FOLLOWING CORRFCTIO ARE Rh,UIREDt Inspector _ L ---�'� Dates//-"3 - /-"3 - L \ APPROVED DISAPPROVED APPROVED SUBJRCT To ABOVE __call For Reinap. INSPECTION NOTTCE City of Tigard Building Department 13125 SM Hall Blvd. Tigard, Oregon 97223 Inspection Line (Ree-O--Phone): 639-4175 Business Phonr.: 639-4171 Inspection: Footing PLbg. Underslab t�lsch. Rough-in / Appr/Sdwlk Found. Plbg. Top Out as Line FINAL, Poen/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Mech. Date Requested: `Times _—AK _ PM Address: _ /L / Permit Builder: THF FOLLOWING CORRRC708 ARE REQUIRED: Inspectors _.- - - _---- Dates APPROVED _� DISAPPROVED __ APPROVED SUB.JSs-r TO ABOVE call For Retnep. INSPECTION NOTICE City of Tigard Building Department 13125 SW Hall Blvd. Tigard, Oregon 97,223 Inspection Line (Rec-O-Phone: 639-4175 Business Phone: 639-4171 Inspection: Pooting Plbg. Underal Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: poe+:/B-am Struct. San. Sewer Framing -Bldg. .Rost/Beam Mech. Rain Drain J,isulation --Plumb. Plbg. Underfloor. Water Line 7yp. 3d. -Meru. Date Requestedt_ L1 _ —Timet AM/} (� PM hddrses:__ tiyd Permit v `1 Builder: 'M FOLLOWING CORRECT S ARE REQUIREDs Al --- inepect/o1c: _ _—_ Dlte:�� APPRO6-ED DISAPPROVED APPP/ri/RD SUB.IF(-r TO AROVE //�� __Call For Reinsp. INSPECTION NOTICE J\ City of Tigard Building Department 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 E1.0 Plbg. Underslab Noun Pough-In Appr/Sdwlk .� Plbg. Top Out Gas Line FINAL. Posthleam Struct. San. Sewer Framing -Bldg. Poet/Boem Mach. Rain Drain Insulation -Plumt). Plbg. Underfloor Water Line Gyp. Bd. -karch. � J ^ IC4i�' Date Re,luestP/d: // �a7� �c�' TLue � PM Add�aest f 10 /U� vd Permit Builder: THE FOLLOWING CORRB ONS ARE REQUIREDi Inspector _ _�.-- Date: APPROVED DISAPPROVED APPROVED SUBJECT TO A90118 Call .for Reinrp. MM INSPECTION NOTICE City of Tigard Building Department 13125 M Hall Blvd_.Tigr.rd, Oregon 97223 inspection Line (ROC-O-Phone):/139-4175 Business Phone: 539-4171 Inspection: i 7"�_` / Footing Plbg. Undeq/s1.Ab Mech. Ru:4n-in Appr/Sdwl): Found. Plbg. Top 01 `. Gas Line FINAL: Post/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain Insulation --Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Hoch. - � ' Date Requested: ..� Time L" AM PM Address: Permit Builders�,l�f,.! THE FOLLOWING CORRB$j&NS ARE REQUIRED: Ci F w Inopector: Datm:�� rr ArrRovsd MAPPROM "room sus m TO ADM Call For RNinep. INSPECTION NOTICE city of Tigard Building r-1partisent 13125 SW doll Blvd. Tigard, Oregon 97223 Inspection Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171 Inspection:__— Footing pl.bg. Underrlab !loch. Rough-in Appr/Sdwlk Found. Plbq. Top Out Gas Line FINAL: pt.st/Beam Struct. -Batt. Sewer gaming -Bldg. Poet/Beam Mech. n 1 Insulation -Plumb. -Rech. p1bg. Underfloor t.ter Lint/^ Gyp. Bd. Date Requested: �-L Time: _d Permit Address: Builder: — - THE FOLLOWING CORPS ONS ARE REQUIREU: r (1: to H r-. r-r N - C7 r — Inspector:— Date: ApPROM DI8APPROVBD 11PPAOV80 BUSJVCT TO ADM Call For Reinap. INSPECTION NOTICE City of Tigard Building Department 13125 BY Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection• Footing Flbg. Underslah Mech. Rough-in Appr/Sdwlk Found. k'1bg. Top Out ,as Line FINAL: Pout/Beam Struct. San. Sewer Framing -Bldy. Post-./Beam Mech. R,tin Drain Insulation -Plumb. Plbq. Underfloor' Water Line �y Gyp. Bd. -Mech. Dat,: Requested. _-Ora _Timet AN PH Address: ��1Permit 1: Builder- - THE FOLLOWING CORRECT S ARE REQUIRED: y Inspectors Dates APPROV=0 DISAPPROVlO APPROVED MWICT TO ADM call For keinsp. CITY®F TWARD P I UMB114G PERMIT # COMMUNITY DEVELOPMENT DEPARTMENT PERMIT . . . . . . . M-33T92-0189 13126 SW HWI Blvd. P.O.Fm 23397,TigamI,Oropm 97 (SM)6304175 On i C I r;,RUFQ ;I1LZ ADDRESS. . . : 16363 66 0713RD AVE PARCEL: 2S114BB--17600 �)UBDIVISION. . . . t RIVERVIEW ESTATES ZONING: R­7 PD FLOCK. . . . . . . . . . . Lai.. . . . . . . . . . . . . C22 CLASS OF WORK. . sNEW __GARBAGE DISPOSALS— : 1 IYPL OF USE. . . . PSF WASHING MACH. . . o . . . : 1 BACKPLOW PREVNTRS. . 80 OCCUPANCY GRP. . vR3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0 ,IORMS. . . . . . . . c4 WATER 1`4CA7Lfk5 : 1 CATCH LAPSING. . . . . . . 10 F T LAUNDRY TRAYS. . . . . . c0 SF RAIN DRAINS. . . . . : 1 S I 14KS. . . . . . . . . . c 6jRLf4SE TRAPS. . . . . . . c@ LAVATORIES. . . . . :5 OTHER FIXTURES. . . . . :0 fub/GHOWERS. . . . a SEWER LING (ft) . . . . :0 WH!"ER CLOSETS. . .3 WATER LINE (ft) . . . . j 100 Da'SHWASHER06. . I v 0 RAXN DRAIN (ft)�. ,. ir +(emav-kss PATH I OWNER I; 0ENE BATY CONST. TIF '4 14 6 OP. IZI III JF 09/21/92 BPR v t 448. 00 JF 09/ZA/92 BPI_..0 $ x.:91. 20 jLH 013/19/92 83;0 b 5;_.u ii� i22. 40 JF 09/21/92 — Phalle #1 11,S,D r, $ LBO. 00 .]F 09/21/92 — PA'RK $ 500, 00 .JF 09/ri?I/9 2 — i-'I u m bi ng Contract ars MPRT $ 45. 00 JF 09/x:1/9d 01FILC $ 11. 25 JF 0 /21/921 Name- IV15PC 6 r%'. 25 JF 09/PL/92 7,9l 11 oe_0. PPRT $ 155.. 0111 JF k)9/21/92 b t Get e p5p(: $ 7. 75 JF 09/21/92 d. I p PhorieOr g this per mit is issued subject to the v,seq­ kIl&Ui0TlS C0nt,4i7led in the 11111FAt"d MUnit.-1pal Foot/faund Insp RAin cirmin 1nsp C dd e, S t a t tA u F Ora.. 9 p a c t n i t v r or#.3 a n m A*I i Stt-ktct Water Line Insp other applicablp lewsF. All wor,14 will hp done Post/beam Merhan (Ippr,/Sdw1k Insp �ccov,dilnce with appi,oved plans. This Plo/undslab Insp Mechanical 1'" iti;l i pe I-mi3. t wli expire if work is not etar,tod PLM/Under fluor Plumb ring) v within 18111 days of ig%Uance, at, if wai�k is Mcs(_,hanical Insp Building Fmal rilIsppnded foi more than 180 Plumb Top OU'b Erosion Con-1 r­1 -7� Fvaminy In%p Cr-owl Dt'aiyl F_. Fir-eplace Insp Gas Line Insp InsulmItian Insp Gym Board Insp t4kithor,ized P'lumbinp Loritl-actt)t- E31t4latkWO Call for- i n s pert i otv 639--4175 t'orf t rc;kct at, Not 0 5 1 MASTER PERMIT CITY OFTIGARD PERMIT #. MST92-0185 CffYOFTM COMMUNITY DEVELOPMENT DEPARTMENT 011100N 13126 SW Hmil Blvd. P.O.Bim 23397,TiqRd,Orern 97iii4WMi3b4l ItS T7 DATE ISSUED: 09/21/92 SITE ADDRE=SS. . . : 16,363 SW 103RD AVE PARCEL: 2S114BB-RV22 SUBDIVISION. . . . . RIVERVIEW ESTATES ZONING: R-7 P`D BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . :22 BUILDING REISSUE: DWELLING UNITS: 1 BAS)EMENT. . . . . . . . .0 Sf CLASS OF WORK. : BEDRIvIS:4 BATHS:3 GARAGE". . . . . . . . . . :490 s f 1 YPE OF USE. . . :SF' FLOOR AREAS------------ REQUIRED SE1'BACKS---------------- TYPE OF CONST. :SIJ FIRST. . . . : 1009 s LEFT. . :5 ft RIGHT. - 10 ft OCCUPANCY GRP. :R3 SECOND. . . . 1082 sf F RON'T. :20 ft REAR. . :36 ft ST*ORIES. . . . . . . ..ID TH I RD. . . . :0 s f REOU I HL I GHJ.. . . . . . . . ..26 ft TO-NAL- 2091 s f SMOKE DETECTORS. :Y FLOOR LOAD. . . . :40 psf VALUE. . . . . $ : 105006 PARK ING SPACES. 1 Remarl(s . PATH I PLUMBING SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVtATRS. 0 Li4VA10RIES. . . . . ..5 WATER HEA-iER5. . . : 1 TRAP'S. . . . . . . . . . . . . . :0 TUB/SHOWERS. . . . :3 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . .0 WA1ER CLUSETES. . :3 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . , . . :0 DISHWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXF'URES. . . . . :0 bAR13AGL DISP. . . : 1 RAIN DRAIN (ft ) . 0 WASH ING MACH. . . . I SF RAIN DRAINS. MECHANICAL [�EES FUEL TYPES----------- UNIT* I-ATRS. . :0 type amoi.tnt by date recpt /GAS/ VENTS . . . . . :0 TIF $ 1460. 00 JF 09/21/92 - MAX INPUT :0 BTU VENT FANS. . :4 BPRT $ 448. 00 JF 09/21/92 - F URN f- URN ( 100K :0 HOUDS. . . . . . : I BVILL, $ 291. 20 JLH 08/19/92 230667 F'LJR.lq ) =11Z10K . . : I WOODSTOVES. :0 B5P( $ 22. 40 JF' 09/21/92 - FLOOR FURN. . . . :0 CLO DRYERS. : I SSDC $ 280. 00 JF 09/21/92 - BOIL/Clylp ( 314P:0 OTHER UNITS: I PARK $ 500. 00 JF 09/21/92 GAS OUTLETS: 1 MPIRT $ 45. 00 JF 09/21/92 Owner. MPILC $ 11. 25 JF 09/21/92 OLINIL Bf4JY CONST. IY15PC * 2. 25 JF 09/21/92 PPRT' $ .155. 00 JF 09/21/92 P5V,C $ 7. 75 JF 09/21/92 Phone #: Contractor- GENE BATY CONSTRUCTION 10045 SW KENT PL TIGARD OR 97224 0hone #: 639-1719 fey #. . : 82007 $ 3222. 85 'TOTAL This persit is issued subject to the regulations contained in the REQUIRLD INSPECTIONS Tigard Municipal Code, State of 0re. Specialty Codes and all other F'oot/foi-ind Insp Fireplace Insp applicable laws. All work will be done in accordance with approved Post/Beam StrLict Gas Line Insp plans. This pet-sit will expire if work is noc started within 180 Plost/Beam NechArt Insulation InSp days of issuance, or if worP is suspended for more than 180 days. PIM/Undslab Insp Gyp Board Insp PLIYI/Un d e v,f I o o r Rain drain Insp permittee Signati-tre ." Mechanical Insp Water Line Insp Plli.imb Top Out Appr/Sdw1k Insp Issi-ted By : F'raming Insp Mechanical Final Gall for insper:tion SEWER GONNECJION CITYOFTIFARD cny 11WARD P,ERMIT PERMIT #. . . . . . . : S W R 922—027 5 COMMUNITY DEVELOPMENT DEPARTMENT one" 13125 SW HWI 8W. P.O.Baer 2W97,Tigaid,O"Von 97M(603)8.'1D-4176 C* 1, ")- + 17 1 P T C;(-� r.. C) SITE ADDRESS. . . : 16363 SW 1273RD AVE PARCEL: 25114BB—RV22 SUBDIVISION. . . . : RIVERVIEW ESTATES ZONING: R-7 pl) BLOCK. . . . . . . . . . : LO ... . . . . . . . . . . . . :22 'I L•• NAML. . . . . USF4 NO. . . . . . . . . . . FIXT'JRE UNITS. . . : CLASS OF WORK. . . NEW DWELLING UN ITS. . : 1 T Y1-1E OF USE. . . . . :SF NO. OF BUILL" INGS: 1 jjq�31-ALL TYP,E. . . . :BUSWR 111PERV SURF-ACE. -. sf Reinav-ks : PATH I Owner': --------------------------------------- FEES GLNE BATY CONST. type ainol.tnt by date rec-,pt [:,RIIT * L100. 00 JF 09/21/92 — I lqsp, * 35. 00 JF 09/LA/92, — I-)D n e # Lontr,actov-: (-A.jN1-RACJOR NOT ON FILE $ 2135. 00 TOTAL REQUIRED INSP,ECTIONS Thio Applicant agrees to comply with all the rules and regulations Sewer- Inspection of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency does 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 `iap and Side Sewer" Permit and the Agency will install a lateral. i :,i,in i t t e e 5 i g n a t r.it-e 1. 5 i-t e d Lay : Ln Call for inspection 639-4175 CITY Or T I GARD —• REZE I FST OF PAYMENT RE=C:E=.I Pl' NO. t 9F "'31114:' I t-JECK AMOUNT s ` 10'7. 85 NAME 8ATY, GENE CONISTRUCT ION (.;ASM AMOUNT 0. 00 AD('�F2Ect t PAYMENT I1ATE. e 09/rPl/92 St JBD I V I S I(IN PURPOSE RPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT ()MOUNT PA I D i `aUll—D:CNf3 PF'RM 448. 00 PLUMBING 'ERM U,35. 00 MECHANICAL. PE 45. 00 $7,1'. CZU I L D PER ,i_. 40 PLAN CHECK FF 5e. 45 s3F-.WE R USA 2 100. 4t0 r�E6JE.R INSPEMCT 35. 1210 PARKS SDC 1500. CIO STORM DRAIN SDC 00 RIKS I DFNT I AL. TRAFFIC FEES 135171. 00 a MASS TRANSIT T-IF FEES 110. 00 LOT 22 R I VERV IE:W ESTATES 16:363 SW 103RD AVE TOTAL- AMOUNT ['-'AID — — — —> 5107. 85 CITY Of TIGAPI) OF PAYMENT RECEI rlNO. :9P--i7l3'A6F,7 CHEC'Ut AMIJUN1 250. 00 NAME a GENE RATY ('01\113TRUC I'101\1 CASH AMOUNT 0. 00 ADDRESS a PAYMENT PATE 08/19/90.' GLJ8n I V I S 113N OF PAYMENT AM(I JNT P'n I D PURPOSE QF" PAYMENT PMOUNT PATD I 'ifiN CHEC'K—FE-,*----*-- 00 LOT P-c RIVF'R'JP-'W rnin,rES 16lb3 SW 103RD AVE TOTAL AMOUNT PAID ;e50. oel 13115 SW Hall llhve. PLNCK/RECT # CITY CSF TIGARD 110nox13397 PERMIT # ~— 5 COMMUNITY DiNELOPMENT DEPARTMENT Tiigard,Oregon 972n (503)639-4171 DATE ISSUED _ JOB ADDRESS: �C =��' '�C' /0,3) Y ��-^c TAX MAP/LOT 3 SUB: v�Y '�w Es4,AeS LOT: 22- 2 _ LAND USE: _ VALUATION: /5-6, 0-00 OWNER SPECIAL NOTES NAME: ��l�N `�� C r,� S�� _ REISSUE OF: ADDRESS: 10Q4-S 5 ,\-J, T-)( , LAST REISSUE: `t-7 2 Z'+ _ FLOOD PLAIN/ PHONE: _ 24-'71 �_ SENSITIVE LAND: _ CONTRACTOR APPROVALS REQUIIREED NAME• S a� if PLANNING: ADDRESS: ENGINEERING: _ FIRE DEPT: PHONE: OTHER: CONTR. BOARD #: 2- C) EXP DATE: �-22``l 3 ITEMS REQUIRED SUBCONTRACTORS: PLUMB: �e�r a �`u,�b; LIST/SUBCONTRACTORS: _ MECH: Iyl a-�-15 a v� BUS TAX: AKULE GINEER CALCULATIONS: NAME: 1Ap.Sc.vr-� we rS — TRUSS DETAILS: AODRESS: OTHER: fA PHONE: -- — 11 1 PROPOSED BLDG. USE: e COMMENTS: dq ATLIGANI SIGNATURE Received By: ;�- _. Date Received: PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE i!1 c 15> 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%) 32, yc i 32•yu Building z2 , g o Plumbing 7, 75 Mechanical 2, 10-433 00 Plans Check Fee -2 U Building v29/.� Plumbing Mechanical 10-230 06 Fire SI-c 27, 30-202 00 Sewer Connection l C,0 ^_ �l�'1) 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 25-40-01 Residential Traffic Fees Iz 25-448-05 Mass Transit TIF Fees /�b•_G?� y _ 11�' 52-449 00 Parks System Dev Charge (POC) C/ 31-450 00 Storm Drainage Syst Dev Chrg (SSDC) kV 24-445-01 Water Quality (Fee in lieu of) 24-445-02 Water Quantity (Fee in lieu of) TOTAL 63 nm/3587P.WPPF