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16384 SW 107TH COURT ADDRESS: I(ZBPP �� 107 1:\reoords\mlcro(Im\tcrgetsV�Ufl iing.doc 0' rTY OF TIGA RD CM PLUMBING PERMIT COMMUNrTY DEVELOPMENT DEPARTMENT 01200N PERMIT #. . . . . . . : MST93-0035 C 13126 SW Hall Blvd. P.O.Box 2339'/,Tigad,Oregon 97223 (6031639-4175 C�77 DAM ISSTTED-F-VT72r,-5�77-- SITE -- ADDRESS. . . :c 16384 SW lQ77:4 CT' PARCEL: 2S1. 15A(.v-BE017 SUi!,DIVISION. . . . : BERKLEY ESTATECE, ZONING: BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .. 17 ----------------------------------------------------------------------------------------- CLASS OF WORK. . :NEW GAFBAGE DISPOSALS. . : 1 TYPE OF USE. . . . . SF WASHING MACH. . . . . . . : 1 BACKFLOW PREVNTRS. . -O OCCUPANCY. GRP. . ;R3 FLOOR DRAINS. . . . . . . :Q, TRAPS. . . . . . . . . . . . . . :0 0 STORIES. . . . . . . . ;2 WATER HEATERS. . . . . . : 1 CATCH BAS114S. . . . . . . :0 F I LAUNDRY TRAYS. . . . . . : 1 SF RAIN DRAINS. . . . . .. I 51 NKS. . . . . . . . . . : 1 GREASE TRAPS. . . . . . . SO LAVATORIES. . . . . :4 OTHER FIXTURES. . . . . :0 TUB/SHOWERS. . . . .- SEWER LINE (ft) . . . . :0 WATER CLOSETS. . .3 WATER LINE (ft ) . . . . : 100 DISHWASHERS. . . . s 1 RAIN DRAIN (ft) . . . . :0 Remarks: PATH I OWNER: -------------------------------- -------------------FEES--------------- JAY MILLER TIF $ 1460. 00 JH 01/25/93 - PO BOX 23291 BPRT $ 409. 00 JH 01/25/93 - BPLC $ 40. 00 JLH 01/19/93 93-235716 TIGARD OR 97281 B5PC $ 20. 45 JH 01/25/93 - Phone #z 684-7543 SSDC $ 280. 00 JH 01/P5/93 - PARK $ 500. 00 JH 01/::5/9;3 - Plumbing MPRT $ 39- 00 JH 01/25/93 - MPLC $ 9. 75 JH 01/25/93 - OmAka m e M5PC $ 1. 95 JH 01/25/93 - - I- Address ._ PPRT $ 155. 00 JH 01/25/93 City St'A e P:�PC $ 7. 75 JH 01/25/93 Zip:___.___ _ one#c.-- Reg #: ------- REQUIRED INSPECTIONS 'This permit is issued subject to the reg- ulations co.,tained in the Tigard Municipal Foot/found Insp Rain drain Insp Code, State Of Ure. Specialty Lodes and all Post/Beam Struct Water, Line Insp other- applicable litws. All work will. be done Post/Beam Meehan Appt-/Sdwlk Insp in accarriance with approved plans., Th, s PIM/Undslab !nsp Mechanical Final permit will expire 4 , work is not started PLM/Underfloor Plumb Final within 180 days of issuance, or- if work is Mechanical Insp Building Final suspended for murt than 180 days. Plumb Top Out Erosion Control Framing Insp Crawl Drain Fireplace Insp Gas Line Insp Insulation Insp x Gyp Board Insp A �ho;�ized PlU"iW9-­­Contrra�c or Sig lature Call for inspection 639-4175 Contractor Notes. CC.R I tw"I L. (j! 0 , f CITY OF TIG►ARD #. . W. . . .. . --,ANCY COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd.Tigmrd,Oregon 97223*8199 (603)639-4171 1ATE ISEZUED. 0,4/08/93 "'i 50A 08510L'i -).1.T[I 1)1)D R Ef 16-38/t SW 10TTH Cl PARCEL I SUBDIVISION— . BERKI-1-Y ESI'OTES LONINGg SLOci/. . . . . . . . . . a LOT. . . . . . . . . . . . . Y 0, 17 171-WiS OF wor?t-,,. INEW rypE ou., I)CC OVIANCY GRVI. -.R3 OCCUPANCY LOAD 1222 4 TE'NOINIT NAME . . . -. R e ma r-k!, k r'A T!A I ,10'e PO BOX rl'-*13291 7,11.10HO OR 9728I P"honp #- 684- 7543 Contractor JOY NILLUP 1117 BOX 23291 11GORD UP 97281 Phons.! 4$1 (.1-14-7543 Re #--- 30109 OC-T.'LIPPICY cif the abovo roFerenced bmildiny is her etty Wivian, imnd if i el ti-10 With tt'je r3tafe 01 th-pgon 'JpecA,*41ty Codes fur the rli 40)�), 0(:(_-Ljjpatjr'y, md uncier whirh the refer-em.od pet-mit was ip %med. i i rt r,i i Flrr r mtai i I" Lj T I :r 1�1!";1. u, f! iR IIV -i J1 W -b #u L r. F I C I 1A cc INSPECTION NOTCCE City of Tigard Building Department 13125 SW Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec•-C-Phone): 639-4175 Business Phone: 639-4171 Inspec_tion:_ Footing Plbg. Underslab Mech. Rough-in Appr/Sdw1K Found. Plbg. Top Out Gas Line FINRLs fiat/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Hoch. Rain Drain Insulation -Plumb- Plbg. Underfloor Water Line Cyp. Bd. -Mech. Date Regveated: V -73ll Time: �-AM _______PM Address: !/J�% �/ L / Jh Permit f:� Builders THE FOLLOWING CORRECTIONS ARE REQUIRED: In"ctors -. Date:_ /^ APPROVED DISAPPROVEII APPROVED SUMINC1' TO ABOVE `Cell For RaInap. INSPECTION NOTICE City of Tigard Building Department I'(/ 13225 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171 Inspections __­ Footing Plbg. Underslab Mech. Rough-in Appr/Sdw1k 'tea_ Pound. Plbg. Top Out Gas Line FINAL: Port/Beam Struct. Son. Sewer Framing -Bldg. Poot/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor water Line Gyp. Bd. -Mech. z 4 `L1 Date Requested:_ �� Time: -, AH PM Address:_,. Zlc�.�1 !/ .7 _ Permit flu i Iden: THE FOLLOWING CORRECTIONS ARE REQUIRED: Inspector: il —- --- - tante: - __APPROVED DISAPPROVED APPROVED SUMIECT TO AY1OVE call For Reinsa. INSPECTIONNOTICE City of Tigard Building Department 13125 Sit Ball Blvd. Tigard, Oregon 9722 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: �-4171 Inspections — Footing Plbg. Underslab Hach. Rough-in Appr/sdwlk Found. Plbg. Top Out Gas Line FINAL: Post/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Mach. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Hoch. PH Date Reques ods / -T Address: � Permit #s�y(_�J_CJC/ Builder: THE FOLLOWING CORRECTIONS ARE REQUIRED: n_ F-- C-1 ZKY`nspector: - -- -- ----- — Da!e:1 APPROVED hiSAPPROVRD APPROVED SUBJECT :O ABOVE -Call For Reinap. INSPECTION NOTICE �---� City of Tigard Building Department 13125 SW Ball Blvd. Tiqard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection:— __— Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk Found. Ylbg. Top Os: Gas Line FINAL: Poet/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain Insulation ;VMV Plbg. Underfloor Water Line Gyp. Rd. -Mach. Date Requested: C, -: -- Times AM --_YM C-- _ Addreee:__L( - 3 Permiit� /! 3 U Builder:_-1 _ - __ . TBS FOLLOWING CORRECTIONS ARE REQUIRED: / V _ CIOR, f— r. LL) i Inspectors_ L_? /� -- Dates _ APPROVEr) DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinep. IN3pECTION NJElcF City of Tigard Building Department./ 13125 SW Ball Wlvd. Tigard, Oregon 97 3 Inspection Line (Rec-Opphons): 639-4175 Bucinnee Phone: 639-4171 Inepection:_�_7_ Footing Underelab Mach. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post/Beam Strur_t. San. Sewer Framing -Bldg. Past/Beam Mach. Ra'n Drain Inaulacion -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Mach. Date Requested: -/ Time: _ AM PM Addreas:� � ,�z leg � `., Permit 3-5 —T- Builder: T:11 FOLLOWING CORRECTIONS ARE REQUIRED: v= _ r, Inapecto z APPROVED DISAPPROVED APPROVED SUBJECT TO ADM Cell For Reinep. INSPECTIOM NOTICE City of Tigard Building Departmenk 13125 SK Hall Blvd. Tigard, Oregon 972 Inspection Line (Rec-O-Phonc): 639-4175 B,iaineas Ph 639-4171 Inspection• Footing Plbg. Underelab Mec!,. Rough-in Appr/Sdwlk Pound. _ Plbg. Top Out ..e Line FINAL: Poet/Beam 8truat.> San. Sewer Framing -Bldg. oat/Beam Mach ' Rain Drain Insulation -Plumb. bg. Underfloor Water Line Gyp. Gyp. Bd. -Hoch. Date Requ._+nted:_ a;? �'�+ C'—� Time? � PH Addreea:_ J/Z) 7 Permit Builder:_ THS FOLLOWING CORRECTIONS ARE REQUIRED: Inspectors Date: APPROVRD DISAPPROVRD APPRM M SUBJECT To Awn Call For Rainnp. INSPECTION NOTICE City of Tigard Building DepartsK•:'t �? 13125 SB Hall Blvd. Tigard, Oregon #7223 Inspection Lire (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inapection:- ^_ —___ Footing Plbg. Underalab Mech. Rough-in Appr/Sdwl.k Found. Plbg. Top Out Gas Line FINAL= Post/Beam Struct. CSan.'Sewer Framing -Bldg. Poet/Beam Mech Rain Drain Insulation -Plumb. Plbq. Underfloor C wa wr Line Gyp. p•l. -Mech. Date Requested: r-� /% J Time: AM{/� PM Address: ���0 r C� Permit f:J� M35'_ Builder: - THE FOLLOWING CORRECTI^NS ARE REQUIRED: R Un L/ .J GA J Inspector: /�J-- - Date:__ APPROVED DISAPPROTrxD APPROVED SUBJ&-r TO ABOVE ,,4 Call For Reinap. INSPECTICN NOTICE ------7, i City of Tigard Building Department 13125 Sw Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: ----- Footing Plbg. Underalab Mech. Ro,:gh-in Appr/Sdwlk Found. Plbg. Topp Out Gas Line FINAL= Poet/Beam Struct. (—Zn. Sewer , Framing -Bldg. i Poet/Beam Mach. \gA _ Lneulation -Plumb. Plbg. Underfloor 'Water n00. — Gyp. Bd. -Hoch. Date Requested: 1_ Time: _AM IJ `PM 7 Address:__ 5 d __ � -- Permit t: Builder:— THE FOLLOWING CORRECTIONS ARE REQUIRED: J J Inspector t -- — - -- ----- Data: APPROVED DISAPPROVED APPROVED :iUBJECT TO ABOVE Call For Reinnp. aw INSPECTION NOTICE City of Tigard Building Departarnt 13.125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Roc-O-Phone)s 639-4175 Business Phon -4171 Inspection: CTootin9 Plbg. Underslab Mich. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post/Beam Struct. San. Sewer. Framing -aldg. Punt/Beam Mach. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. Mech. Date Requented:__z _Time', AM _ PN Address: /iJ C2 ;z _— � PermiC #:i Builder: THE FOL'.OWING CORRECTIONS ARE REQUIRED- / i Inspector: -_-------- Date: (� APPROVRD DISAPPROVED APPROVED SUBJECT To ABOVE CAH For Rainsp. ANCPECTION NOTICE City of Tigard Building Department 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-•O-Phone): 639-4175 Business Phone: 60 171 Inspection: Footing \, Plbg. Underslab Mach. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Poat/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Watery Line Gyp. Bd. -Mech. J N Date Requested: �� �)[�.� Time: AM �.� Address: � Permit 1:.`L�.�O�--� Builder:-2_22 ?6t__ THE FOLLOWING CORRECTIONS ARE REQUIRED: Inspeatort ----_—__-- Datera--��— !► DiSAPPROM: APPROVED SUBJECT TO AW)VS Call Foo Reinsp. INSPECTION NOTICE City of Tigard Building DepartAoent L_' L312S Sw Ball. Blvd. Tigard, Oregon )7223L' 'r Inspection Line (Rec-o-Phone): 639-4175 susines9 Phone: 639-4171 Inspection: _ lk_ Footing Plbg. Underslab Mech. Roiggh-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL l I Poet/seam Struct. Sail. Sewer Framing -Bldg. , Poet/neam Mech. Rain Drain insulation -Plumb. Plbg. Underfloor Slater Lin Gyp. Dd. ech. Date Requested: C x ,Times AM PN Address: I �� Q /0 ��_ Permit t:- cy Builder:, THE FOLLOWING CORRECTIONS ARE REQUIRED: CL C,7 ex w -- CD LLJ Inspectors Dates � �_ APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinep. IN.SPFCTION NOTICE City of Tigard Building Department 13125 SN Ball Blvd. Tigard. Oregon 47223 Inspection Ltne (Re.--O-Phone): 634-4175 Bmsiness Phone: 6 -4171 Inspection:___ Footing Plbg. Underalab ch.,Oough-in Appr/Sdwlk Found. lbg. Top Oss*✓ Gas Line FINAL- Pont/Beam Struct. San. Sewer Framing --Bldg. Poet/Beam Hech. Rain Crain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Hoch. Date Requested: � _ r _� —Timet AM --PH Address: Permit i:� S e3o-3 Bu i 1 der s- -- TBE. FOLLOWING CORRECTIONS ARE REQUIRED: C2 rZ — R t/1 F- o--. 03 C.7 - w J Inspectorsn.,t s . APp:�VrD DISAPPROVED APPROVED Rtlti.IF.CT TO ABOVE call For R inep. CITY aF TIG, RD CM - TM MASTER PERMIT wi PERMIT #. . . . . . . 1151-93-0035 COMMUNITY DEVELOPMENT DEPARTMENT 13126 BW HWI Blvd. P.O.Box 23397,Tigisid,Oregon 97223 -4 75 4 1 i 1 C-7 DATE ISSUED: O.L./c: SITE ADDRESS. . . : 16384 SW 107TH CT PARCEL: 2S115AA--BE0l'7 SUBDIVISION. . . . : BFRKLEY ESTATES ZONING: BLOCK. . . . . . . . . . . LOT. . . . . . . : 17 --------------------------------- BUILDING REISSUE:MST92-.0107 DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 sf CLASS OF WORK. :NEW BEDRMS:3 BATHS.3 GARAGE. . . . . . . . . . :418 sf TYPE OF USE. . . :SF FLOOR AREAS----------- REQUIRED SETBACKS----------- TYPE OF CONST. :5N FIRST. . . . :970 sf LEFT. . :6 ft RIGHT. :5 ft OCCUPANCY GRP. :R3 SECOND. . . :864 sf FRONT. :20 ft REAR. . :36 ft S1 OR I ES. . . . . . . : :-:' THIRD. . . . .O sf REQUIRED----------------------- HEIGHT. . . . . . . . :C',?. -ft TOTAL-------: 1834 sf SMOKE DETECTGRS. 1Y FLOOR LOAD. . . . :40 i)sf IIALUE. . . . . $ : 91888 PARKING SPACES. . : 1 Remarks: PATH I PLUMBING --------------------------------- ---- - - S I NKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :O LAVATORIES. . . . . :4 WATER HEATERS— : 1 TRAPS. . . . . . . . . . . . . . :0 TUB/SHOWERS. . . . :3 LAUNDRY 'TRAYS. . . : 1 CATCH BASINS. . . . . . . :0 WATER CLOSETS. . -.3 SEWER LINE (ft) . :O GREASE TRAPS. . . . . . . cO DISHWASHERL. . . . : 1 WA'fER LINE (ft ) . -a100 OTHER FIXTURES. . . . . .0 GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :@ WASHING MACH. . . : 1 SF RAIN DRAINS. . : 1 —-------------- MECHA141CAL ----------------------------------- FEES FUEL TYRES----------- UNIT HTRS. . :O type amount by date recpt /GAS/ VENTS . . . . . :0 TIF $ 1460. 00 JH 01/25/93 - MAX INPUT:O BTU VENT FANS. . :4 BPRT $ 409. 00 JH 01/25/93 - FURN ( 100K . . : 1 140ODS. . . . . . .. 1 BPLC $ 40. 00 JLH 01/19/93 93-235716 FURN ) =100K . . :0 WOODSTOVES. iO B5PC $ 20. 45 JH 01/25/93 - FLOOR FURN. . . . :0 CLO DRYERS. : I SSDC $ 880. 00 JH 01/25/93 - BOIL/C1v1P ( 3HP.-0 OTHER UNITSiO PARK $ 500. 00 JH 01/25/93 - GAS OUTLE,rsil MPRT $ 39. 00 JH 01/25/93 - Owner: ---------------------------------------MPLC $ 9. 75 JH 01/25/93 - JAY MILLER M5PC $ 1. 95 JH 01/25/93 - PO BOX 23291 PPRT $ 155. 00 JH 01/25/93 P5PC $ 7. 75 JH 01/25/93 TIGARD OR 97281 Phone #t 684-7543 Contractor: JAY MILLER PO BOX 23291 TIGARD OR 97281 can Phone #1 684-7543 Reg #. . z 30109 ----------------------------------------- $ 2922. 90 TOTAL This permit is issued subject to the regulations contained ir. the ------- REQUIRED INSPECTIONS Tigard Municipal Code, State of Ore. Specialty Codes and all other F00t/f0U',1d Insp Fireplace Insp applicable laws. All work will be done in accorciance with approved Pest/Beam Struct Gas Line Insp plans. This permit will expire if work is nct started within 180 Post/Spam Mechan InSUlation Insp days of issuance, or if stork is suspended for more than 180 days, PIM/Undslab Insp Gyp Board Insp PLM/Underfloor Rain drain Insp fuer C; -mitt;ee Signati-ite Mechanical Insp Water Line Insp� Plumb Top Out Appr/Sdwlk Insp Issued By : Framing Insp Mechanical Final Call for inspection 639-4175 J CIWOFTIGARDCRYOF.IQIRD r SEWER CONNECT I UN COMMUNITY DEVELOPMENT DEPARTMENT orsooN PIE RIyIIT 13125 SWFWIBNd. P.O.Bac 23397,TlumM,Onpon 97223(6W)639-4176 FERMI T #. . . . . . . : SWR93-003 5 609--4171 DRTE: ISSUED: 01/25/93 SITE ADDRESS. . . : 16384 SW 107TH CT F•ARCEL: 2S115AA—PE017 SUBDIVISION. . . . : BERKLEY ESTATES ZOI\I I IVr: BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . 17 ------------------------------------ TENANT NAME. . . . . : USA NO. . . . . . . . . . . FIXTURE UNITS. . . . CLASS OF WORK. . . :NEW DWELL.INC UNITJ. . : 1 TYF,E OF' USE. . . . . :SF NO. OF BUILDINGS-. 1 I NSTALL TYP,E. . . . :BUSWR 111PIERV SURFA(:;E. . ; ss f- Reniav-ks : F'ATH I Uwner: _______.______.. _______________.___.___.____________._._____._ FEES JAY MILLER type amol-int by date recpt F10 BOX 23291 FIRh11 2100. 00 JH 01/25/93 — IN5P 4, 35. 00 JH 01/25/93 -- T'IGF`RD OR -)7281 FIhone #- 684-754, Cor:crart or-: ;ONTRACTOR MOT OIV FILE Fhone #; $ 2135. 0141 TOTAL Rey #. . . -- -_ -- - wuu I RED I NSF'ECI I ONS ---- — This Applicant agrf,s to comply with all the rules and regulations Sevier Inspection of the lhiifiod Sewage Agenry. 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 gide sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance Oven. If not so located, the installer, shall purchase a "Tap and Side Sewer" Permit and the Agency will install a lateral. F'Iernrittee Siynat�_rre ; I s s i_i a i3 P y : Call for inspection — 639-4175 _J C',Y[Y OK TI(ARD -- RECEIPT OF PAYMENT HcL-,i i,,r NU. t,43—c".45960 C HEtK AMOUIAT 5017. ')'A Wllk" a MILA-LI4, Ifvy A:>H AMOUNT 0. V. W)DREE)b POYMN'T DATL 411 9 3 SlAW I V I S 1014 URPUSE OF' PAYME114t, qMOUNT PAID PURPOSE IJF PAYME141 r)moi.jNr Pfifr) UILDING PERM 409. 00 PLUMAING Pr:.RH 155. 0121 W.CHANTLAL PE ;a.9. 00 '-.J. BUILD PER 30. 1 t"), ("HEC1.1, F'E 9. 75 SEWER USA 2100. 0111 T"R INSPECT 35. CIO PARKS SDC 500. 0121 ,,41 rmAlN SrT, J:30. ,)o REL;IDENT IAL_ TRAFFIC F'E'ES 1350. 011 1.1";B) IRANSIT TIF FE-T.q 110. 00 LOT t7 RERKLEY ESTATES I-',3P,4 SW 1077+1 LT 107AL AMOUNT PAID 5L-41 7. X40 CIA,"7�W �:res SW Ifall tabid. PLNCK/RECT # - 1 - CITY OFT. IGAIRDPERMIT # l�?Sly�� COMMUNIT it DEVELOPMENT DEPARTMENT Tigard,Oregon 97M (SW)6394! DATE ISSUED JOB ADDRESS: /&3 tI U-) /C. l ' I _ TAX MAP/LOT SUB: Pe_✓k La Lj �LOT: / 7 LAND USE: VALUATION: OWNER SPECIAL NOTES NAME: TQ{ ����� ►' f�rdr _ REISSUE OF: ADDRESS: fo /3 3 z'b / LAST REISSUE: _ 7 2 �/ FLOOD PLAIN/ PHONE: F1/ 76, � _ SENSITIVE LAND: _ CONTRACTOR APPROVAL:, REQUIRED NAME: � (TILLI- PLANNING: ADDRESS: ENGINEERING: FIRE DEPT: PHONE: OTHER: CONTR. BOARD #: EXP DATE: // ITEMS REQUIRED SUBCONTRACTORS:— KUMB: � 1 /? VN0 tj_� — LIST/SUBCONTRACTORS: ME:CH: �� �i tI�� _. BUS TAX: . ARCH/ENGINEER CALCULATIONS: NAME: TRUSS DETAILS: ADDRESS: OTHER: in PHONE: PROPOSED BLDG. USE: COMMENTS: _J APPLICANT SIGNATURE Received By: – Date Received: _ /. / 9 9 3 PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE h1 3 -od 1 10-432 00 Building Permit Fees 10-4.-1 00 Plumbing Permit Fees 10-431 01 Mechanical Permit Fees 10-230 01 State Building Tax (5%) _3u.1��,/ _ 3o,t Building y� Plumbing — I Mechanical 10-433 00 Plans Check Fee � _ �' Building t�U Plumbing Mechanical 10-230 06 Fire i" SGS' -vo33 30-202 00 Sewer Connectiony _ t �p 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 _ 25-448-0: Residential Traffic Fees Z�3So _ / 3.5a 25-448-05 Mass Transit TIF Fees 52-449 00 Parks System Dev Charge (PDC) 31-450 00 Storm Drainage SYst Dev Chrg r (SSDC) a un 24-445-0I Water Quality (F:.e in lieu of) 24-445-02 Water Quantity (Fee in lieu of) m Lo LO TOTAL. .50 -j_ r'ol 'l, nm/3587P.Will —�'