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12465 SW 114TH TERRACE ADDRESS: o I:Vecor t' i a p • • • •in g.doc 4 li CITY G TIGARD ELErTRICAI_ PERMIT DEVELOPMENTSERVICES PERMIT #: ELC97--05"'9 13125 SW Mall Blvd., Tigard,OR 97223 (503)639-4171 DATE ISSUED: 03/O5/97 PARCEL: E'S 1 O?,AC--O390O is 'I'E iilillf f 'aS, » . : 124G5 SW l 14TH 7Libii 'EDTVISION. . . . :WALNUT GROVX1JBD ZONTIN40-.R--4. C., • i__OC1{» » . . » LOT. . . . , . . . . . . .8 !I,JRISDICT!Oh!- TTG o j Pct Dei scr-i.pt i crri : Instaling first branch circuit .--RE'SIDENT IAL UNIT_._._. -TEMP SRVC/FEED1:'R'7., 11ISCELL rNEOIJS_ ...,..._.... 000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . ; 0 PUMP/iRRTGATION. . . . : 0 ACH ADD' L 5OO5r. . . : rm 2:01, 400 amp. . . . . . . . 1Z SIGN/OUT LINE L.TG. . : 0 TMITED ENERGY. . . . . ; 0 401 GOO amp. . . . . . . ; 0 SIGNAL/PANEL. . . . . . . : 0 ilNr. t-IM/ ::>'JC'C"DIZ. . : 0 6011-amps 1000 volts, : 0 MINOR !_ADEL (10) . . . : 0 __.....cIERVICG /rCEDrR -___._ _..—•--13RAIVCH CIRCUITS------ --ADD' L INSPECTIONS--__. ^00 ��mp. . . , , : 0 W/SCRVIC;E OR rE COC.:R: 0 PER INSPECTION,, . . . . : �? �J1 4O0 amp. . . . . . : 0 1st W/O SRVC OR rim .- 1 PER '-1OUR. . . . . . . . . . . : 2 ID I COO amp. „ . 0 EA-ADU' L_SRNCH CIRC: 0 T N Pl..0NT. . . ,. . . . . . . . : +0 ?11 1000 amp. . . . : 0 —F'I_AN REVIEW �OOi amp/volt.. . „ » . ( ) 4 RE'S Ul'IITS. . . . . . . . > GOO VOL.T NOMINAL. . econnert ori 1 y. . . . . 0 SVG/FDR > = k2'%2'5 AMPS. . : CLASS AREA/SPEC OCC. �gnei,: _. . .. _... - _ _.. _.__._. . _ . .. _ __....__.__ - _ FEES _. . .. EBBIF DISTANT type amol.tnt by data_ r-ecpt ,"ir,5 SW 114Th TE;RR PRMT :5. 00 11 O8/05/97 77 .x'.7797'. IGARD OR 97223 SPCT $ 1. 75 B 08/O5/97 97--2'97?79 !}one #. InRPr ELECTRIC INC' $ 4,r„ 75 TOTAL 'GAJ SW RIGGS _....__._._ REQUIRED INSPECTIONS _E�VE�RTON OR 97007 Rough-•in E11ect;' 1 Fi s,.- i lione #: 642--79.37 UlPL�t' 1 Service is pet-sit is issued subject to the reg'ations containeJ in the Tigard Municipal Code, State of Oregon Specialty Codes and al; other plicab a laws. All work will be done in accordance with approved plans. This pereit will expire if work is not started within 180 ,ys of issuance, or if work is susjV-due `oe Fiore than 188 daye, ATTE:NTIONr Oregon law requires you to follow the rules adopted by e Oregon Utility Notification Cent - rules are set fortis in OAR, 952-001 0010 through OAR '352-0@1-1987. You may obtain a copy these rules or direct questio o t7.:' 11ing 1503) 46-1987. 1'te: Siurt ,;I.tr V. sI_te�i a _.. . .____.____._�._...._........._...___.__._OWNER INSTALLATION r 110 ir'stallation is bei.nu m7rle on laroperf:y T own t•ilich iti nut intended for- t— i1e, leak3Ee, or rent . -� JNER' S SIGNATURE: DATE; W rrNT1r41(7Tr1R TN^Tr11 I t)TT17P1 r)NL_Y ___....._._..... J � —,NATURE or Sum EL—r:—r' tv : Q1 04V (� _U�,__ DATF CENSE NO: �tT_ f-1 +4-++4A4 •I-_r..r ; 4 +-4++++-+ 14++4.-t..1 +-1 +-1+1 +4++ 4.._4 ++4+++++++4.4- 1 1-+4+-+•1"+++�-44.+•44-•N+++1-•#-4- Cal l 6379-41.75 by 6:041 p. m. fine ren inspec,f: i ori nt edeJ .Ire iiext bi.tsines3 day i r r r r , 1 , ,. 1 F , r r 1 1 1 + 4 4..1 1 k 1 1 0 r I I ++++++i•+-! + +++++++++-;`+++-F+ •++++++.+.+-+++ +{. •+.1..}f. CITY of TIGARD Electrical Permit Application Plan Check k 13125 SW HALL BLVD. Recd By _ TIGARD OR 97223 Date Recd-IL- Date to P.E. Type Phone (503) 639-4171, x304 r Date to DST p ) Inspection 503 639-4175 Print or ,)pt? _�� - Incomplete o� i'legible will not be accepted Permit q F� �3) 684-7297 Called n Address: 4. Complete Fee Schedule Below: -� N • of Development I- Number of Inspections per permit allowed Name(or name of business) (:Ujl�', /J t�� t Service included: Items Cost Sum AddreSS--Ij.7�'�.r-i)1y l' �r H _ 4a. Residential-per unit Ci /State/Zi -ach adsq. itft.or less $110.u0 q City/State/Zip P _\J - _ � L'-ach additional 500 sq.ff.or Commercial F3 Residential portion thereof $25.00 _ t /(� � Limited Energy $25.00 Fa„h Manuf'd Home or Modular D 1 2a. Contractor installation only: wolling Service or Feeder $68.00 (Attach copy ofaU cprrent license 4b.Services or Feeder* Electrical Gontracto C e /r, � Installation,alteration,or relocation Addr s C r 200 amps or loss $60.00 _ 2 ��•• - - 201 amps to 400 amps _ $80.00 2 City State �11�- ipZ `r 7(l(1 -7 _ 401 amps to 600 amps $80.00 2 Phone No. (L(f;� �� 3 601 amps to 1000 amps $12;.00 2 Job No. Over 1000 amps or volts $;40.00 2 Elec. Cont. Lice. No. - �1 Exp.Date - 7 Reconnect only 4_ $50.00 - 2 OR State CCB Reg. No. S�i ky Ex Date 4c.Temporary Services or Feeders COT Business Tax or Metro Exp.Date Installation,alteration,or relocation 200 amps of less $50.00 2 Signature of Supr. Elec'n r 201 amps to 400 amps _� $75.00 _ 2 401 amps to 600 amps $100.00 2 -� �� Over 600 amps to 1000 volts, License No. 7 `! S Exp.Date,,&- -'1 see"b"above. Phone No. +- - - - 4d.Branch Circuits New,alteration or extension per pan it 2b. For owner installations: a)The fee for hrant,n circuits with purchase of service or Print Owner's Name feeder fog. Address -` Each branch circuit $5.00 b)The fee for branch circulte City State Zip, _._ without purchase of Phone No. __ service or feeder fee. First branch circuli ` $35.00 '-" 2 The installation is being made on property I own which is not Each additional branch circuit $5.00 _ _ 2 intended for sale,lease or rent. 4e.Miscellaneous Owner's Signature (Service or feeder not Included) 9 Each pump or Irrigation circle $40.00 Each sign or outline lightlag $40.00 2 3. Plan Review section (if required):* Signal circuits)or a limited energy panel,alteration or extension $40.00 a Please check appropriate item and enter fee in section 5B. Minor Labels(10) $10o•oo-- �_4 or more residential units in one structure Each additional Inspection over _ Service and feeder 225 amps or more li e allowable in any of the above System over 600 volts nominal Per Inspection $35.00 Classitieo area or structure containing special occupancy Pet hour $55.00 __.. as described In N.E.C.Chapter 5 In Plant $55.00 _J *Submit 2 sets of plane with application where any of the above apple. 5. Fees: C7 Not required for temporary construction services. 5a.Enter total of above fees $ J 5%Surcharge(.05 X total fees) $ NOTICE Subtotal $ -- 5b.Enter 25%of line 6a for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review if rcz.v r (Su .3) $ -NOT COMMENCED WITHIN 160 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ ---IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. L�--l Trust Account B $ { Total balance Due I kn5T51E1 CT,A- new 10r, CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Phone: 639-4 171 Date Re'-I uested: s i �c -- \ I A.M. P.M. _ MST: Location: /d- I`� �•-��/�� BUP: ---— _ Tenant: Suite: Bldg: MFC: r Contractor: Phone: o� U - ( PLP.i: (honer:.—_— —, Phone: -�- ELC: El,R: SIT: BUILDING BLDG(con'tj PLUMBING MECHANICA ELECTRIC SITE Site Post/Beam PosU73cam ast eam crvice Sewer/Storm Footing Roof Undl'i/Slab Rough-in Ceiling Water Line Slab Framing Top Out Gas Line Rough-In UG Sprinkler Foundation Insulation Sewer Ilood/Ihict Reconnect Vault Bsmt Damp Drywell Storm Futnacc Temp Service MISC. Masonry Ceiling Rain Thain A/C` UG Slab Shear/Sheath Fire Sinklr/Alm Crawl/Found Dr Ihat Puml, Lova Volt Approved Approved pprovcdiprovcd � Approved Appr/Sdwlk Not Approved Not Approved o ovcd oM-1511)r:)ved Not Approved FINAL FINAL FERAL FIN FINAL 2 H Y .-r i� W 0 Call for rein. ' I O Reinspection fee of Srequired before next inspection C1 I)nnblc to inspect Inspector: _-- _—�- Date: �/ �/ ,_ Page_ _ of CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspe;otion Line: 639-1175 Business Phone: 639-4171 Date Requested: j C? A.M. _ _ P.M. MST: Location: BUY: Tenanf: _ Suite: Bldg: MEC: _ �a6 ctoPhone: _� __�C, PLM: Owner:i Phone: ELC: 7 4:enb C_tJc.q F—R: SIT: -- BUILDING BLDG(can't) PLUMBING MECHANICAL ~ELECTRICAL SITE Site Post/Beam Post/Badn Post/Beam Cover/Service Scwer/Storm Footing Roof UndFUSlab Rough-In Ceiling Water Line Slab Framing Top Qat Gas Line Rough-In UCi Sprinkler Foundation Insulation Sewer Iiood/Duct Reconnect Vault Bsmt Damp Drywall f,totm Furnace Temp Service MISC. Masonry Ceiling Zain Thain A/C UG Slab A •c Shear/Sheath Fire Spklr/Alm Crawl/l'ound Ih I lent Pump Low Approved~ Ar,,,)ro-Ld F�pproved Approved Approved Appr Sdwlk Not Approved Not Approved Not Approved Not A yed Not Approved FINAL FINAL FINAL FIN FINAL t G LL J C7 W l Call for ruinspection O Reinspection lee Of S required before next inspection ❑Uaable to inspect Inspector: `-7 Ddte —��"> Page 1 of U CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 6394175 Business Phone: 63?4171 Date Requested: I v `55` � -7 -A.M. P.M. MST: Location: 4,1^t`�'�- _ BUP: _ Tenant: _ — Suite: Bldg: MEC: Contractor: Phone: 763 PLM: _ Owner: Phone: ELC: _ ELR: SIT: BUILDING 44LDG n') PLUMBING MECHANICAL ELECTRICAL SITE Site Famearn Post/Beam Post/Beam Co%er/Service Sever/Stonn Footing R UndFUSlab Rough-hi Ceiling Water Lute Slab �Nf n �� Top Out Gas bine Rc.tgh-In UG Sprinkler Foundation Insulation Sewer Hood/Duct Reconnect Vault Bsmt Damp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Drain A/C UG Slab Sheh-/Sheath Fire Spklr/Alm Crawl/Folmd Dr Heat Pump Lov. Volt vedApr.roved Approved Approved Apprcved Appr/Sdwtk roved Not Approved Not Approved Not Approved Not Approved FINAL FINAL FINAL FINAL FINAL 1.3vP.ZZ:?k"'Cle ,SEE ,e2 A57- &I�A C//, e*rra4l 57 ce V t T H J m LO W - J C7 Call forein tion O Reinspection fee of S _reyutred=fo ext inspection O Unable to inspect inspector:. _ Date: f Page_ of CITY OF TMECHANICAL DEVELOPMENT SERVICES PERMIT A, 13125 5W Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . : MEG97-028'�DATE ISSUED. 08/04/97 Pnr,CEL: 2S 1 O3nc--o39OO ITE ADDRESS. . . : 12465 ,raw 114TH TERR 3UBDIVI TION. . . . : WALNUT GROVE. SURD ZONING: R-4. S DLOCF. . . . . . . . . . . LOT. . . . . . . . . . . . . :8 JURISDICTION: TTG CLASS OF WORK. . :ALT F='LOnR TURN. . . . : 0 E"VAP COOLERS: 0 TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0 OCCUPANCY GRP. . :R? VENTS W/O nP!"'I_,: r� Vr!VT SYSTEMS: 0 STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS, . . . . . . : 0 TUEL TYPES-.- _ ..___..__--- 0-3 1-IP. . . . : 1 DOMES. I IVC I N: 0 GAS 3-15 HP. . . . : 0 COMML. I NC I N: 0 MRX INPUT: 0 BTU 15--30 HP. . . . . 0 REPAIR UNITS: 0 FIRE DAMPERS!. . : 30-50 HP. . . . : 0 WOODSTOVE5. . : 0 CTAS PRESSURE. . . : 5O1 HP. . . . . 0 C: ._0 DRYERS. . . 0 NO. OF UNITS--. —.-----•— AIR HANDLING UN I T5 01 HE R UNITS. : 0 FURN ( 1O0K BTU: 0 (= 10000 (.'fim : 0 GAS OUTLETS. . 0 TURN ) -1001( BTU: 0 > 10000 c F m: 0 ^e m a r k s : Installing outdoor A/C unit. Unit must not encroach into 5' side or rear yard setback. UWTIeI, -___ -.._.._._. _.__ ____-_ _ --__._._.. - _ _ --- ._ ... _ - FFEf3 — _ _.__ ._.._..._.... DEBBIE DTSTAI:T type amor.rnt: by date r-eclat 12465 SW 114TH T1=RR PRMT $ 25. 00 JD 08/04/97 97-297918 TIGARD OR 972='3 SPCT $ 1. � 5 ,TD 08/04/97 77 2'97918 Phone #: Corrt r'act or^. SPECIALTY HEATING ti• FABR I CA'i I O 9 528 SW TIGARD ST .. S :6. 25 TOTAL TIGARD OR 97223 Phone #: C20- 5643 Reg tb. . 00G(,'"7 _._.._.._.___ REQUIRED INSPECTIONS' ._.____...-. This pervit is issued subject to the regulations contained in the Misc:. Inspection ----__�-�_.___..__ Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection ........ applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for Bore than 190 days, ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Cent@,•. Those rules are yet forth in OAR 9524014010 through OAR 952401-0080. You ray r' ibtain cuptes cf these rules or direct questions to OUNC by calling ;503)246-9187, UJ ��"�— I'ca r m i i;t;e e i n a t�.c r^a �rtj�N1� + r +++4+i-t+++-►-t•++-i- r r r r ++++++ ++++-4++++++•++++-++++++++++4.4 4 ++++-r•4•r+++++-+++++++44 Call 63'3 41•'5 by 6:O01 p. m. ?-or• inspectiorns needed the next business day ., -,4 1 .r r I 1..} 4 + 1. 1 }-4. 1 -t..: _1. _1 J.._L-3 4...}4-L+-r.+•h+++•t+++++++++++++++++-F+-h++++•+•+++t.+•i-++++.. Plan Check# CITY OF TIGARD Mechanical Permit Application Recd By 13125 5W HALL BLVD. Commercial and Residential Date Recd_ TIGARD, OR 97223 Da•'to P E _ (503) 639-4171, x304 Da* to OST Print or Type Permit 0 Incomplete Called_ plete or illegible applications wkll not be accepted _ i Name of CeveiopmenbProiect Description Table 1A Mechanical Code QTY PRICE AMT Job street address A) Permit Fee -0- -0- 1000 j Address SCJ 11-WA r/ _ elder — cnyrstate zip BI Supplemental Permit 3.00 •lame iCr name of businessi 1 i Furnace to 100.000 BTU 600 Owner V `71e /�/:5la-ii a-i lincl.ducts 3 vents 4� 1'l.-[_ Mailing Address 2J Furnace 100.000 BTU+ 7 50 / y 4,5 -ttRV4s- ind ducts&vents _ stafa J C P Pnnna 3) Floor Furnace 600 Qfd, d1` 97.21 incl.vent 148MV for name o businersl 4) Suspended heater,wall heater 600 •-am-e— �— _ or floor mounted heater QCCUparit Mailing address 5) Vent net incl in 3.00 appliance ciennit _ CdYrState Lp Pnone 6 l Boder or comp,heat pump,all Gond a 00 to 3 HP absorb unit to t00K BTU ContractorN 7) Boiler or comp,heat pump,air rond. 11 00 ms (Pnor to z e it U 1 tL( N�C_ l n _ 3-15 HP absorp unit to 500K BTU ,ssuance QM ding Address r ' 8) Boder or comp heat pump, air cond 1500 applicant (,�sar , _I Q f(� �( _ 15-30 HPi absorp unit 5-1 and BTU must orovide allSfate —z.,.T Phone 9) Boder or comp,heat pump,air cond 22.50 contractor I ( cLrf( 6Q 97o�.Z.3 e.,20-5` 30-50 HP;absorp unit 1-1 75 and BTU license or Const Cont Board L c s EAP Date DDate 10) bode;or wmp,heat pump,air cond. 37.50 information G 6578 s! i >50 HP uhsorp unit 1.75 and BTU `or COT COT Busness Tax of Metro e 6 Dat 1 1 ) Air handling unit to 450 database) 'F7-,3,355_ �I q _ 10,000 CFM Architect 'Jame 12.) Air handling unit 7 50 r-J-K-4-, 10,000 CTM+ or Mailing Address 13) Non portable 4.50 evaporate cooler _ Engineer cayrstate zip Pitons 14) Vent fan connected a 3.00 �_— to a single duct _ Descnbe work New O Addition O Alteration Repair O 15) Ventilation system not 4 50 to be done Resrdenti,tl O Non-residential O inctuded in appliance permit Additional Descmption of work 16) Hood served by mechanical exhaust 450 171 Domestic incinerators 750 _ Ex•sung use of 18 i Commercial or inr;ustnaltype 3000 bt^~mg or property incinerator 19 1 Repair units 4 50 Proposed use of 20) Woodstove budding or property A ku • 21) Clothes dryer etc. 4 50 a Type of fuel-oil O natural gas LPG O electric O 22) Other units 450 cc I he-eby acknowledge that I have read this application that the 231 Gas piping one to four outlets 200 information given is correct.that I am the owner or authonzed agent of the owner, that plans submitted are in compliance with Oregon State 24) More than 4-per outlet (each) 50 J laws Signature of Owner/Agent Date QTY.SUBTOTAL J 'SUBTOTAL / -- Contact Persinn Name Phone 5%SURCHARGE • C 5 PLAN REVIEW 25%OF SUBTOTAL TOTAL ds:mechpmt doc (rev 7,961 *Minimum permit fee is 325+5%surcharg 1• I Z � M u ; � 7 r ECTION NOTICE City of Tigard Building Department 13125 gW Ball Blvd. Tigard, Oregon 97223 Irttpection Line (Rec-o-Phone): 619-4175 BueLness Phone: 639-4171 Inspect Lon x_ Tooting Plbg. Underelab Mach. Rough-in Appr/Sdwlk Pound. Plbg. Top Out Gas Line K`FINALe� Poet/Beam Struct. San. Sewer Framing 1id9•� Post/Beam Hach. Rain Drain Insulation -Pluotb. Plbg. Underfloor Wa11tQer Lino Gyp. Bd. -Neoh' Date Requefsteds __ Times -PH 2 Acldreee: Permit #t f '�L10 U Uu:!der'Ti Y11(1L11�1�Q 1` QS THE FOLLOWING CORRECTIONS ARE REQUIRED: -� ` ' -- a Inspsotor t natal Zo ^-----r kTD DISAPPROVEDAPPROVED SUBJECT To ABOVE Call For Reinsp. �IiSPECTIUNNOTICE `l: \ City or Tigard Building Department 1312S SB Ball Blvd. Tigard, Oregon 97223 Inspection Line (Roc--o-Phone)i 639-4175 Business Phone: 639-4171 Inspections_ Footing Plbg. Underslab Hoch. Rough-in k Appt/glow; Found. Plbg. Top Out Gas Line -1IlU1LI Post/Beam at-ruct. San. sewer Framing -std 4• Post/Beam Hoch. Agin Drain InnulAtion -plus.I. Plbg. Underfloor mater Line Gyp. Bd. -Hoch Date Requested[]_/ � /_ / TLos I Addresat� c^T '� /`/ C.petOLE �t 0"2- Builds ' 2I PH Builder! THE FOLLoNIl1O OORREM-IONS AMS REQUITAD: - POZOACZ1 , - tD Inspectore L, Th 6h tl -s A*fHOV1b DISAPPROVED "PROVED SUBJECT TO ABOVE _—Call For Reinsp. N� SPEMC ON NOT City of Tigard BuildiL.- neparta wt 13125 BW Ball Blvd. Tigz, d, M-agon 97223 Inspection Line (Rec-O-Phone)t 639-4175 Bmess Phone: 639-4171 �S _ Inspections �,�- - l�U c / Footing 1�lbg. Underalab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINALt Port/Beam Struct. San. Bower Framing -Bldg. Post/Beam Mach. Rain Drain Insulation --Plamb. Plbg. Undnrfloar Wata; Lina Gyp. Bd -Koch. Date Raquosteds_y Ct% �-Gam' ��.�T c/.,,�Times AN PM Address: �- permit #t /avz % (V Buildors � L-L "Z -3 C_ ! --- THE FOLLOWING CORRErTIONS ARE REQUIREDt ro YV\ �7`�2 • ✓V,) 2- _�.-C�`�_Q, V -� til ��...L►n La� '�-�. d l ✓� A,12 C,04- CL n. y_ -a v~i ��-tin.- ►��--^ � 70-0 �2, CD W inspootors Y Datet_l0/ �- J fl3 APPMOM DISAPPROVED _ APPROVED SUBJECT TO ABOVE Call For Reinsp. INSPE MON NOTICE City of Tigard Building Department 13125 BN Ball Blvd. Tigard, Oregon 97223 Inspection Line (Ree-O- one)ss 6639-411775 Business Phone: 639-4171 Inspection:_ Footing Plbg. Undersl 'UJ6=h. Rough-in /� Appr/Sdwlk Found. Plbg. Top Out Cls Line FINAL: Post/Beam Struct. San. SewerZf�ruinq -Bldg. lost/Beam Mach. Rain Drain Emulation -P1u-mb. Plbg. Underfloor ter /yLine 0". Ed. -Meeh. Date Requesteds0 - /_ -Time: AM PN Addresns 1 y� `7 _ -Permit i 2-' Builder:_ �•�fi72�Y1� ___ THE FOLLOHING CORRECTIONS ARE REQUIRED: O. 0-4 F- t/7 r H J m - W W J Inspector: Dates - APPROVED DISAPPROVED APPROVED AUBJNM To ABOVE Call For Reinsp. INSPECTION NOTICE City of Tigard Building Depsrtmont 13125 SN Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-B--Phone)t S39-4175 Business Phone: 639-4171 Inspection: _ Footing Mg. Underslab tech. Rough-in Appr/Sdwlk Found. Plbq. Top OutOddi LI e, FINALt Post/Deem Struct. Ban. Sewer Framing -Bldg. Post/Beam Mech. Rain Drain lneulation -Plumb. Pl.bg. Underfloor Nater ,Line Gyp. Bd. -ttsch. Date Requested: ��'j �� Timer -AM _ PN Aaareae: l �`A '!�/ -' Permtt Builders ME FOLLOWING CORRECTIONS An REQUIRED: i Inspector: r� —_APPPOVItD nTSAPPA(7VED AP-PROVED SUBJECT 710 ABOVE call For Rsinsp. INSPECTION NOPICK city of Tigard Building Depart mot 13225 S'M Ball Blvd. Tigard, Oregon 97223 Inspection Linc (ken-O-Phone)e 639-4173 Business Phones 639-4171 Inspection: ,.-I l) _14L_ Footing Plbg. Underalab Hoch. Rough-in Appr/Sdwl': Found. Plbg. Top Out Can Line FINAL: ['oat/Beam Struct. San. Sewer Framing - ` -Bldg. Post/Beam Hoch. Rain Drain insulation -Plumb. Plbg. Underfloor /Mater Line Uyp. Bd. -Mech. Data Requested: Y /L/ Time: AM PM Tddrnss: � � Permit f Builders L THE FOLI.O4INC3 ODRRZCfIONS AM REQUIRED: n_ cc �7 .J L CLI LO �1 Inspectors Dates 73 __`APPROVED DISAPPROVED APPIMYED SUBJECT TO "aft Call For Relnap. 7 - INSPECTION NOTICE City of Tigard Building Department 13125 SO Ball Blvd. Tigard, oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspections Footing Plbg. Undorslab Mech. Rough-in Appr/Sdwlk Found. )jll--(- Plbg. Top Out Gas Line FINAL: Pont/a"am Struct. Ban. Siff!- Framing -Bldg. Post/Beam Mech. Rain Drain Insulation -Plumb. Plby. Underfloor /Mater /Lin**, Gyp. ad. -Mach. nate Requested: Ll / "/ i Ttme: _Z,_AM PM Addressr� / "S " lPermit Is 2 i nuitders THE FOLLOWING CORRECTIONS ARE REQUIRED: c. O_ F� to J r., C7 W -- ---- J Inspectors _ --- Dates -_- AlT1fDYlD DISAPPROVED APPROVED SUBJECT TO ABOVE Ca11 For Reinsp. INSPECTION NOTICE City of Tigard Building Department 13125 811 Ball Bled. Tigard, Oregon 97223 Inspection Line (Rec-O-Phones 639-4175 Business Phones 639-4171 Inspection:_ Footing Plbg. Undera�24*m labb Mech. Rough-in Appr/Sdwlk Found. `� Gra Line FINALS .Post/Beam Struct. Framing -B-'dg. Post/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Nater Line Gyp. Bd. -Mech. Date Requesteds _Times AMPM Addreews -1 _ Permit t, —O Buf lders e! .ell TFM FOLLOWING CORRECTIONS ARE REQUIREDs a F- V T F— rr -� J rr 0 Ui J Inspectors_ 11P?ROVID DISAPPROVRD APPROVED SUBJECT TO ABOVE Call For Reinap. INSPECTION NOTICE City of Tigard Building Department 13125 SN Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Businens Phone: 639-4171 Inspection•_— Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Poet/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mech. Rain Drain neulatior� -Plumb. Plbg. U-•erfloor W7;r Line Gyp. Bd. -Mech. n-,te Requested:__ I s _ Timet -.�T4 PM n tdceae:' LAO l/T , A Permit �: �r� C��'�' THE FOLLOWING CORRECTIONS ARE REQUIRED: rl Ln r J r� - C7 W — Inspector: _ --- — nate:_..!*._r._ ApPROVRD DISAPPPOVRD APPROVED SUBJECT TO ABOVE Cell For Re'_nsp. INSPECTION NOTICE City of Tigard Buildic_g Department 13125 SW Hall Blvd_ Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inf,pect-on: tIng Plbg. Underslab Mech. Rough-in Appr/Sdwlk Pound. Plbq. Top Out Gas Line FINALS Pnnt./Beam Struct. San. Sewer Framing -Bldg. P—it./Beam Hoch. Rain Drain (InaulatiarL}.� -Plumb. Pl),<:. Underfloor WAte Line Gyp. Bd. -Mach. nai n Requested: 77 / 3 Time: AM PM nt,c ess: Il Y tG C Permit #: /,_ U 2-G ff ,{„f l der s_ lrr, - L'L Y 1-C,G (O �0 I'll" FOLLOWING CORRECTIONS ARE REQUIRED: 1]. ►r F- N H J t9 W -- - --- - - --- - --- J Inspector'` �"`�.� [)At R1 APPROVED DISAPPROVRD APPROVED SUBJECT TO ABOVE --call For Reinap. INSPECTION NOTICE City of Tigard Building Department 13125 SW Hall Blvd. Tigard, Oregea 97223 Inspention Line (Rec-O-Phone): 639-4175 Business Phones 639-4171 Inspections Footirj Plbg. Undersiab Mach. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: et/Beam 8t San. Sewer Framing -Bldg. oat/Be h. Rain Drain Insulation -Plumb. Plbg. Underfloor Na/ter Line Gyp. Bd. -Mach. Date Rmpsesteds_ 1', Times q Mt PM Addreast 4 ` Permit is Builders THE FOLLOWING CORRECTIONS ARE REQUIRED: Cz.) c , a CC F- r F— J L C7 W J Inspectors Dates e �y� APPR0IRD DI8 PROVED APPROVED SUBJECT TO ADM Call For Reinsp. �iNSPECTION NOTICE Cita of Tigard Building Departaent 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639--4171 Inspection: — Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: est/Beam St— San. Sewer Framing -Bldg. e beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Meeh. Date Reguestedt � Times AM __ PM Addreee:�o� �'� `�-/ ZB�rmit f:. -1�/��O Builder: i�1iJ THE FOLLOWING CORRECTIONS ARE REQUIRED: 2 H _J G` c.7 W _ J Insp•ctort �� — Date•_tY–�� -�� "PROVED DISAPPROVED v APPROVED SUBJECT TO ABOVE Call For Reinap. INSPECTION NOTICE City of Tigard Building Mrjartnent 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Linr. (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inapuction:_ Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Poet/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain Insulation -Plumb. lbq. Underfloor water L ne Gyp. Bd. -Hoch. Date Requested:_ Times - AM .PM Address: /�� lDJ I � t IC/l Permit 1 s7� 6 C�-6 Builders -SOY- q7 THE FOL•.OWING CORRECTIONS ARE REQUIREDs C[ N F- Ll W InepRctnrs� APPROVFD DISAPPROVED APPROVED SUBJECT To ABOVE ��"��" Call For Reinep. INSPECTION NOTICE City of Tigard Building Department 13125 SN Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-o-Phone): 699-4175 Business Phone: 639-4171 InFjpection:_ — - Fcwwt inq Plbg. UBderslab Mech. Rough-in Appr/Sdwlk Etoun.l. Plbg• Top Out Gas Line FINAL: Pont/Beam Struct. n. Sewer Framing -Bldg. Pnwt./ream Mech. �ftein Drain ) Insulation -Plumb. -Mech. Fibs. Underfloor �"Water Lina � Gyp. Bd. Time: AM PM Fi'tP Regw fisted: Add r!ana: � s vim- Permit Bn i I dor:: ,I,ffR FOLLOWING CORRECTIONS ARE REQUIRED: f,. ►r F- N > i F- - J �.r [O 0 _ - W J inopootor - p4 APPROM DISAPPROVED APPRCVRD SUSJMCT TO ABOVE Call For Aeinsp. INSPECTION NOTICE City of Tigard Building Department 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection:^_— Foo Plbg. Underslab Mech. Rouyh-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Poet/Beam Struct. San. Sewer :Taming -Bldg. Poet/Roam Meah. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Hoch. Date Requested: — Tim M PM Addreess� Y(��.J /•�L�"-� Permlt Builder: THE FOLLOWINo comacTIONs ARE REQUIREDt n. Cr ---- I— N r F-- J t W J Inspoctort r Dates Z APPMM nTSAPPRovED AppROVRb EUnj CT To ABM _—call For Reinsp. CITY OF TIGARD CLN"liFICAVE OF COMMUNITY DEVELOPMENT DEPARTMENT OCCUPANCY 13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503),839-4171 PERMIT #. . . . . . . s IVIST92-026L DATE ISSUED: 9 PARCEL: siTE ADDRESS. . . : 12465 SW 114TH TERR SUBDIVISION. . . . c WALNUT GROVE BUDD ZONING:R-4. 5 BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . : 1a CLASS OF WOPK. :NEW TYPE OF USE. . . :SF OCCUPANCY GRP. :R;3 OCCUPANCY LOADg229 4 TENANT rqmc. . . - Remr!%rks,., PAT(-.I I Owners PINNACLE HOMES 12735 PW GLACIER LILY CIRCLE 1IGARD OR 97223 Phone 011 644--4017 contractor: PINNACLE HOMES 12735 SW GLACIER LILY CIRCLE T10ARD OR q7P23 Phone Ot 524--4711 Reg #. . s 16177 Occupancy of the above referenced building is he.-eby given, and certifies thi'r compliance with the State Of Oregon Speci-lklty Codes for the group, occupancy, and i.kso under which the referenced permit was issued. FIRE DEPARTMENT D ILO INSPECTOR TBUILDING OFFICIAL POST IN CONSPICUOU9 PLACE V1 CITIf OF T I GA RD COMMUNITY DEVELOPMENT DEPARTMENT 0219M PLUMBING PERMIT 13126 SW Hell Blvd. P.O.Box 23307.TlgsM,Orawn 9=(SM)6394176 PERMIT #. . . . . . . : IvIST92-0268 DATE ISSUED: 02/25/93 SITE ADDRESS. . . . 12465 SW 114TH TERR PARCEL: 25103AB-03000 SUBDIVISION— . : WALNUT GROVE SURD ZONING. R-4. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 18 -------------------------------------------------------------------------------- CLASS OF WORK. . :NEW GARBAGE DISPOSALS. . : ) TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : 1 BACKFLOW FIREVNIRS— :0 OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0 STORIES. . . . . . . . :2 WATER HEATERS. . . . ;. . LJ CATCH BASINS. . . . . . . :0 FIXTURES----------------- LAUNDRY TRAYS. . --:O SF RAIN DRAINS. . . . . : i S I NKS. . . . . . . . . . .. 1 GREASE TRAPS. . . . . . . :0 LAVATORIES. . . . . 44 OTHER FIXTURES. . . . . :0 TUB/SHOWERS. . . . ; SEWER LINE (ft) . . . . :V1 WATER CLOSETS. . c3 WATER LINE (ft ) . . . . - 100 DISHWASHERS. . . . : 1 RAIN DRAIN (ft) . . . . :0 Remarks : PATH I UWNERv ----------------------------- -------------._-_--FEES----------_----.. PINNACLE ------------------FEES---------------- PINNACLE HOMES TIF $ 1460. V,O JF 02/25/93 X 12735 SW GLACIER LILY CIRCLE BPRT $ 430. 00 JF 02/25/93 X BPLC $ 279. 50 JLH ll/i2/92 92-233634 'TIGARD OR 97223 B5PC $ 21. 50 JF 02/25/93 X Phone #: 644-4017 SSDC 1. 280. 00 JF 02/25/93 X PARK $ bviO. 00 .1F 02/25/93 X Plumbing MPRT $ 43. 50 JF 02/25/93 X MPLC $ 10. 88 JF 02/25/93 X Name IV15PC $ 2. 18 JF 02/25/93 X AddreS .5, IS M PPRT $ 147. 50 JF 02/25/93 X City : Ler t-a St ate :_ re. P5PC $ 7. 38 JF 02/25/93 X Zip: .......... R e g REQUIRED INSPECTIONS This permit is issued subject to the reg- ulations contained in the Tigard Municipal Foot/fOUnd Insp Rain drain Insp Code, Stat6 of Ore. Specialty Codes and all Post/Beam Struct Water Line Insp other applicable laws. All work will be done 1* ost/Beam Mechan Appr/Sdwll( Insp in accordance with approved plans. This Plm/undslab Insp Mechanical Final permit will expire if work is not started PLM/Underfloor Plumb Final within 180 days of issuance, or if work is Mechanical Insp Building Final suspended for more than 180 days. Piumb Top Out Erosion Control Fri,ming Insp Crawl brain Fireplace Insp Gas Line Insp Insulation Insp Gyp Board Insp rize Plumbing Lantractor Signature 1z 4 AL o r Call for inspection 639-4175 0 r 11, �?ont)ractor Notess AL 10 TIBARD P.LLLtPT LIF PlAYMENI RLCLIPT No. :93-c,:37175 ClAr,LCK (IMIJIAN r x '5067. 44 NA1,11" LASH 14MOUIAT f)f!l.--RLS6 s PlYME.N1 DATIr= Od i 2'5/9;� SIJ13D I V 1:3 I ON OF PAYMENT AMIJUNT PAID PkIRPOSE. UF PAYMENT AMLIUHT rJ()tD 10-III-DING PERM 430. 1710 Pt.LIMBING) PERM 1.47. 50 NF. ( I ION I LAL. PF +3. 50 ST. BUILD PEP 31. 06 PL ON GIAECR lzl!:. 40. 38 SEWER USA100. 00 1,1 WER TNcjr-,EC'T 35. 00 PARKS GDC 7100. 00 GTOPM DRAIN !73l)C aso. 0121 PC810(rNIIAL. TRAFFIC FEI-S 1350. V)'A 11(d35 TPANrITT III' I 10. 01.,L) LOT IS WALNUT C414OVIE J2,465 lc;lW It4TH TE RP TtJT(IL AMOUNT' PAID -- - - -i 5067. 44 MY OF' TIGARD - RECEIPT OF PAYMFINT RECEir,,r NO. :9P-233634 CHECK AMOUNT A 2150. 0Q, NAME A PINMACI-E HIME!! CASH .AW)UNT 0. 00 mymi,N"r DATE. I P9 C:? SUBDIVISION lfjpoSF OF' Pf.)YMEN'r AMOUNT PAID 1.-.,IjriPOSF OF r-,nY[4F-'.NT AMOUNT PA I D AN CHECK FE 250. 00 Lo-r IS WALNUT GROVE 1 X46 SW iWt-j it PR TOTAL- AMOUNT PAID P-50. 00 - -- - ------------------- CITYOFTIGARD ® v CMOFYMRD COMMUNITY DEVELOPMENT DEPARTMENT ofteft 13125 SW Hell Blvd P.O.Bax 23397,Tigami,Om9on 97223(531634-4175 MASTER PERMI I REIRI 1 92-0aba 639--4171 DATE ISSUED: 02/25/93 bill ADDRESS— : 12465 SW 114TH TERR PARCEL: 2SIOSAB-03000 SUBDIVISION. . . . s WALNUT GROVE SUBD ZONING: R-4. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . IS BUILDING REISSUE: DWELLING UNITS: I BASEMENT•.. . . . . . . . :0 sf CLASS OF WORK. :NEW BEDRM5:3 BATHS:3 GARAGE. . . . . . . . . . :440 sf IYPE OF USE. . . ".SF FLOOR AREAS---------- REQUIRED SETBACKS----------- - I'YPE OF CONST. :5N FIRST. . . . :942' sf LEFT. . : 15 ft RIGHT. :5 ft OCCUPANCY GRP. :R3 SECOND. . . : 1019 s FRONT. :20 ft REAR. . s30 ft STORIES. . . . . . . :2 THIRD. . . . :0 sf REQUIRED---------------------- HEIGHT. . . . . . . . ..29 ft TOTAL------: 1961 sf SMOKE DETECTORS. ;Y FLOOR LOAD. . . . :40 psf VALUE. . . . . $ : 98126 PARKING SPACES. . : I Remarks: PATH I ------------------------------------- PLUMBING -------------------------------------- SINKS. . . . . . . . . . il FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . -0 LAVATORIES. . . . . s4 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . .. " TUB/SHOWERS. . . . #3 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . :0 WATER CLOSETS. . o3 SEWER LINE (ft) . s@ GREASE TRAPS. . . . . . . so DISHWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXTURES. . . . . :0 GARBAGE DISP. . . : 1 RAIN DRAIN (ft) . :@ WASHING MACH. . . : 1 SF RA114 DRAINS. . : I ---------------- MECHANICAL ----------------------------------- FEES FUEL TYPES-------- -.---- UNIT HTRS. . :0 type amount by date recpt /GAS/ VENTS . . . . . :0 TIF $ 1460. 00 JF 02/25/93 X MAX INPLIT:O Bru VENT FANS. . :4 BPRT $ 430. 00 JF 02/25/93 X FURN ( 100K . . sl HOODS. . . . . . : 1 BPLC $ 279. 50 JLH 11/12/92 92-23363,4 FURN ) =10011, . . so WOODSTOVES. cO B5PC $ 21. 50 JF 02/E7/93 X FLUOR FURN. . . . to CLO DRYERS. : I SSDC $ 2130. 00 JF 02/2'_J/93 X BOIL/CMP ( 3HP:O OTHER UNITS: I PARK $ 500. 00 JP 02/25/93 X GAS UUTLETSsI MPRT $ 43. 50 JF 02/25/93 X Owner: $ 10. 88 JF 02/25/93 X PINNACLE HOMES Mspc $ 2. 16 JF 02/25/93 X 1.2735 SW GLACIER LILY CIRILLE PPR'r $ 147. 50 JF 02/25/93 X P5PC $ 7. 38 JF 02/25/93 X TIGARD OR 97223 Phone #1 644-4017 Cont ractori ------------------------------- PINNACLE HOMES n. 12735 SW GLACIER LILY CIRCLE TIGARD OR 137223 Phone #a 524-4711 Reg #. . s 16177 _________________________ ---___—____—_.-__ 3182- 44 TOTAL this peroit is issued subject ject to the regulations contained in the REQUIRED INSPECTIONS ------ Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/fOlLind Insp Fireplace Insp __j applicable laws. All work will be done in accordance with approved Post/Beam Gtruct Bas Line Insp plans. This p2rott will expire if work is not started within 180 Post/Beam Ilechan Insulation Insp days of issuance, or if work is suspended for vere than 180 days. Plm/undslab Insp Gyp Board Insp PLM/Underf I oor Rain drain Insp Permittee Signature : je" r-16, CL-Mechanical Insp Water Line Insp -4- Plumb goOut Insp Issued Bys CLzq FraminInsp Mechanical Final Call for inspection -- 639-4175 cITYOFTIGARD cn Ai� RD COMMUNrTY DEVELOPMENT DEPARTMENT OR14M SEWER CONNECTION 13125 SW HWI Blvd. P.O.Box 23397,T%prd,Oregon 97223(500)6394175 P,I-R lyl I T #. . . . . . . 639-4171 DATE ISSUED: 02/25/93 '-:)ITE ADDRESS— . : 12465 SW 114TH DR PARCEL: 2S103AJ3-03000 bUBDIVISION. WALNUT GROVE SURD ZOPAING.- R---4. 5 ULOCK. . . . . . . . . . LO?. . . . . . . . . . . . . : 18 TENANT" NOME. . . . . : USA NO. . . . . . . . . . : FIXTURE UNITS. . . -. CLASS OF WORK. —NEW DWELLING UNITS. . : 1 TYPE OF USE. . . . . :6F NO. OF BUILDINGS: 1 INSTALL I YP'F. . . . :PUSWR IIIPERV SURFACE. f Remarks: uwner: ----------------------------------------------------- F E ES ----------------- PINNACLE HOMES type a 111 E)U T1 t by date recpt 12735 SW GLACIER LILY LIRCLE PRINT $ 2100. 00 JF 02/25/93 X INSP $ 35. 00 JF 02/25/93 X TIGARD OR 97223 Phone 0: 644-4017 Contractor: --------------------------------- CONI*RACIOR NOT ON FILE I lione it: 1~ :-:',135. 00 TOTAL ker.] *1. REQUIRED INSPECTIONS this Applicant agrees to comply with all the rul" and regulations Sewer Inspection of the Unified Sewage Agency. The permit expires 180 days from Sewer Inspection 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 .—irchase a "Tap and Side Sewer" Permit and the Agency will install a lateral. r-'(3t'iflitteP 5iynat�.rr e : L ki Tssl.ied By .- Call f-or inspection 639-4175 CITY or TIGARI) 13125swHall BW. PLNCK/RECT # ['o[lox 23397 PERMIT t L_ v (� COMMUNITY DEVELOPMENT DEPARTMENT Ti",rd,Oregon9TM (503)0"171 DATE ISSUED JOB ADDRESS: ' ZTL� // -Gtr ��y u 2 TAX MAP/LOT _-1 S1 03 46 SUB: (,)�Jy,, 4 GYv ,.�- _ LO-j': aT �. LAND USE: _ Go _ VALUATION: FE /26, OWNER -77 SPECIAL NOTES NAME: % h7Qc 44, REISSUE OF: --- _ ADDRESS: 1-:273 t 5 41,) G % ¢+' L'/ j ��" LAST REISSUE: FLOOD PLAIN/ PHONE: �s2 �'T l SENSITIVE LAND: CONTRACTOR APPROVALS REQUIRED NAME: PLANNING: ADDRESS: ENGINEERING: FIRE DEPT: PHONE: OTHER: CONTR. BOARD #: 1 EXP DATE: .r�NE �j Z ^ �- ITEMS_REQUIRED JJ SUBCONTRACTORS: PLUMB: ,� ti L J,e- �. LIST/SUBCONTRACTORS: MECH: ' S.0 r�J �' �-y`''� BUS TAX: ARCH/ENGICALCULATIONS: NAME: TRUSS DETAILS: ADDRESS: OTHER: PHONE: PROPOSED BLDG. USE: �� S I- J COMMENTS: _ w APPLICANT SIGNATURE , Received By: __ �` —_ Date Rece i ved: // /L -fZ_ . PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE Pt 10-432 00 Building Permit. Fees 1-60 10-431 00 Plumbing Permit Fees / .Iro 1y7• SG 10-431 01 Mechanical Permit Fees �L 3'�y �so 10-230 01 State Building Tax (5%) Building 2- U Plumbing '1-3 F Mechanical 2.25• 10-433 00 Plans Check Fee 94.36 - �� 0.3 Building Plumbing Mechanical ` 10-230 06 Fire f'yZ ave 30-202 00 Sewer Connection 92/00 30-444 00 Sewer Inspection 3 S 25-448-02 Commercial 1IF 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 1350 25-448-05 Mass Transit TIF Fees &.0 lie 52-449 00 Parks System Dev Charge (PDC) '5,10 _- '500 31-450 00 Storm Drainage Syst Dev Chrg (SSDC) 24-VS-01 Water Quality (Fee in lieu of) ,> 24-445-02 Water Quantity (Fee in lieu of) Ln TOTALMOW R nm/3587P.Wf'F