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12487 SW 114TH TERRACE a J 12 I:Vcoordslmicrol(rn\largels\l)uilr+;ng.doc W J CITY aF TIGARD COMMUNITY DEVELOPMENT DEPARTMENT CERT IF I CATE Or' 13126 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639.4171 OCC UP,AN C Y tt 1;.',487 SW 114T11 DR WOLNUT 6KWE Z ON I NG . . . . . . . . . . .. . 17 I ASS OF WORK. NEW T'VPF. C)f:' Ljf3t. . . 4:F- CoRP. t R3 OCCUP�-,INCY i.OAV-c`2ffF 4 11-NANT NOME:- Pemark c;- PINNACI-ri. HUMES 1'2735 SW GLACIER LILY PINNACIA1 HOWS !2735 i--M GLOCIL.R LILY CTF?CLJ.-. fGAM) OR 91Pc s Phol-le 41 4711 Rel ff s 11'1 r Or-.,Apancy r1F the Above -.,uferew�'cd hk.kildinq i =t hereby oiveyi, o.ncl co-'r-t- if jes the compliam-m WiHl thea State Of Oret.lan 1,3pr*c:is1ty Utidos for ti-w qj-(y,tp, ocr,upancy, and use under which the rf.,ferPticed permi-t wAs isr;med. FIPL J)EPRRTMk,N1 WILDING INSPECTOF SUILDINO OF 11' 101 POST IN 11-4-ACE PLUMBIN'3 PERMIT PERMIT J. . . . . . . : MST91-0183 DATE ISSUED: 11/12/92 SITE ADDRESS. . . : 12487 SW 114Th DR PARCEL: 2S103AC-04800 SUBDIVISION. . . . : WAJ,NUT GROVE ZONING: BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :17 -------------------------------------------------------------------------------- CLASS OF WORK. . :NEW GARBAGE DISPOSALS. . :1 TYPE OF USE. . . . :SF WASHING MACH. . . . . . . :1 BACKFLOW PREVl;TR3. . :0 OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0 STORIES. . . . . . . . :2 WATER HEATERS. . . . . . :1 CATCH 3AOINS. . . . . . . :0 FIXTURES------------- LAUNDRY TRAYS. . . . . . :1 SF RAIN DRAINS. . . . . :1 SINKS. . . . . . . . . . :1 GRE'iSE TRAPS. . . . . . r0 LAVATORIES. . . . . :4 OTHER FIXTURES. . . . . :0 TUB/SHOWERS. . . . : SEWER LINE (ft) . . . . :0 WATER CLOSETS. - :3 WATER LINE (ft) . . . . :100 DISHWASHERS. . . . :1 RAIN DRAIN (ft) . . . . :0 Remarks: OWNER: -----•-----------------•------- -----------------FEES---------------- PINNACLE HOMES TIF $ 1380.00 JH 11/12/92 - 12735 SW GLACIER LILv CIRCLE SSDC $ 280.00 JH 11/12/92 - P7,RK $ 500.00 JH 11/12/92 - TIGARD OR 97223 MPRT $ 39.00 JH 11/12/92 - Phone : MPLC $ 9.75 JH 11/12/92 - M5PC $ 1.95 JH 11/12/92 - Plumbing Contractor:----------------- PPRT $ 147.50 JH 11/12/92 - / , P5P(. $ 7.38 JH 1.1/12/92 - Name: -- ((�� BPRT $ 424.00 JH 11/12/92 Addres li') ji. XV BPLC $ 275.60 JH 11/12/92 - City: Q re 1 State:_�= B5PC $ 21.20 JH 11/12/92 -3 g 7 oy s Phone#: S,L �2 L— Reg #: �)c(y3C• ------- REQUIRED INSPECTIONS ------- This permit .is issued subject to the reg- ulations contained in the Tigard Municipal. Foot/found Insp Rain drain Insp Code, State of Ore. Specialty Codes and all Poet/Beam Struct Water Line Insp other applicable laws. All work will be dine Poet/Beam Mechan Appr/Sdwlk Inep in accordance with approved plane. This Plm/undslab Insp Mechanical Final n permit will Expire if work ;.s not started PLM/Underfloor Plumb Final within 180 days issuance, or if work .is Mechanical Insp• Building Final V) suspended for more than 180 days. Plumb Top Out Erosion Control r Framing Insp Crawl Drain ~ Fireplace Inep J - �� Gas Line Inep _ Insulation Inep _ w x //(, 4—, Gyp Board Inep _ -' l"fthorized Plumbing Contractor Signature Call for inspection - 639-4175 Contractor Notes: INSPECTION NOTICE r 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. Underolab Mach. Rough-in Appr/Sdwlk Found. Plbg. Top O:t Gan Line PINAL� Post/Beam Struct. San. Sewer Framing Poet/Beam Hoch. Rain Drain Inaulati.on (Plumb. Plbg. Underfloor Water 'Line Gyp. Ed. -Mach../ AV— Date Requested: �7 '2-�� Time: AM PM Address: rt Z ` l �1 L Permit #: /fYL Builder: - > Z `t 'l 7! THE FOLLOWING, CORRECTIONS ARE REQUIRED: z r� J L7 W J Inspectors_ /// APPROVED . DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinap. INSPECTION NOTICE ,. city of Tigard Building Depa-gent 1,?125 SW Hall Blvd. Tigm.4, Oregon 97223 Inspection Line (Rec-O-Phone); 639-4175 Business Phone: 639-4171 Inspection: P;otinq Plbg. Underelab Mech. Rough-in Appr/Sdwlk Found. Plbq. Top Cut Gae Line FINAL: Poet/beam Struct. San. Sewer Framing -Bldg. Poet/[seam Mech. Rain Drain ILsulation /' � -Plumb. i Plbg. Underfloor Water Line Gyp. Bd. ech. Date Requented:� Time: AN Address: Permit THE lOLLOWING CORRECTIONS ARE REQUIRM CL Cr — — -- Lo- J C7 W J Inspector:-. rjr — Date: Z .7 - APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinep. INSPECTION NOTICE City of Tigard Building Department 13125 SW Hall Blvd. Tigard, Oregon 9722? Inspc.,^�iv� Line (Rec--O-Phcne): 639-4175 Business rhone: 639-4171 Inspections _ Footing Plbg. Underalab Mach. Rough-in Appr/Sdwlk i Found. Plbg. Top Out Gas Line FINALS Poet/seam Struct. San. Sewer Framing -Bldg. Poet/seam Mach. Raln Drain Insulativu -Plumb. rlbg. Uiderfloor Water Line Gyp. Bd. -Rech. Date Re.paesterl:_1,:5- T . AM PH Address: /Akl�7_��_ _ �Q Permit Builder12 �� PHE FOLLOWING CORRECTIONS ARE REQUIRED: cC _n lv J L 7 Inspector s WH A -fill ill4 ) Dates APPROVED __ DI8APPROVED APPROVED SUBJECT TO ABOVE Call For Reinsp. INSPECTION NOTICE City of Tigard Building Depart=int 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspe^tion Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection:_ Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mech. Rain Drain Insulation -Plumb. r• Plbg. Underfloor Water Liaee Oyp. Bd. -Mech. Date Requested: l f?.� Times _X__AM _PM l _ Address: r? 7ll / Permit f: Builder: THE FOLLOWING CORRE('TIONS ARE REQUIREDs CL I—$ Cc cr, m LU J Inspectors, !.'i V — ` Dates /4 3 11PfM10V/0 DISAFPROVRD APPROVED SUBJECT TO ABOVR Call For Reinsp. 1 INSPECTION NOTICE ,_ City of Tigard Building Departisent 13125 iii Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phones b39-4171 Inspections Foocing Plbg. Underslab !tech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINALt Post/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Hoch. Rain Drain Insulation -Plumb. Plbg. Underfloor hater Line Gyp. Gyp. ed. -Rech. Date Requestedt �� / f `? ]� / Timet AM _FN Addresst ? 1 H Ky'� Permit �t Buildert YLL'C�C' 1J J �— THE FOLLOWING CORRECTIONS ARE REQUIRSDt [Y r _ W F- J .-r r-r Lo t11 inspectors Dates �� �5— X_APPAOVtD DISAPPROVED APPROVZD sUBJ=CT TO ABOVE Call For Reinsp. INSPECTION NOTICE �( City of Tigard Building Department 1312F SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phones F39-4171 Inspections _ Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk Fcnind. Plbg. Top Out Gas Ane FINAL: Pont/Beam Struct. San. Sewer Framing ! -Bldg. Post/Beam Mach. Rain Drain Insulation -Plumb. Plbq. Underflr:,r Water Line Gyp. Bd. -Koch. Date RequestrAs,-2 Adf+•ess:_ �1 �j' ��`7 Permit #s `i 3 Builders TBE FOLLOWING CORRECTIONS ARE RRQUIRBDs CL r _ V) W J Inspectors- _9/_229 Datesc; _3 APFROVEO DISAPPROVED APPROVED SVSJIQ7 TO ADM call For Relnep. INSPECTION NOTICE / ' r- City of Tigard Building Departaent 13125 811 Ball Blvd. Tigard, Oregon 97223 Inapection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171 Inspection: Footing Plbg. uneerslab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top OutGas Lin• FINALt Post/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Nater Line Gyp. Bd. -Meeh. Date Requeatede / -2 - c Time: AFI PM Address: l z'��/�Dr� �,()14+t" �l N i Permit t s Builders Lj_ �l�l - t'ky-M',k_/'t l`vQ_� _ TM FOLLONING CORRECTIONS MR PEQUIREO: N Inspectc+rr Dater APPRDVlD DISAPPROM "PROM SISJMT To AMM Call Por Rein". INSPECTION NOTICE City of Tigard Building Department 131.25 SK Ball Blvd_ Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: C -_— Footing Plbg. Underelab Mach. Rough--in Pppr/Sdwlk Found. Plbg. Top Out Cas Line FINAL: Poet/Beam Strutt. a ewer Framing -Bldg. Post/Beam Mach. Rain Drain 'nsulat..on -Plumb. Plbq. Underf.00r Fater Linc Bd. -Mach. Date Requesttads/ / J Times AM G PM 'Idrean s / �7 -Permit f:!�/-e/O . Bu ..der s - TFFE FOLLOMIMO CORRECTIONS ARE RBQUIREDs CL cl� --- F- N F- f7 W J Inspector / r Dates /� 1 APPROVED DISAPPROVED APPROVED SUI3JF(-r TO ABOVE Cali For Reinep. INSPECTION NOTICE ' I City of Tigard Building Department 1312` SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phunec 639-4171 Inspections, -- Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Hoch. Rain Drain Invulation -Plumb. Plbq. Underfloor Water Una� l:yY. ad. -Koch. Date Requested:_1y 3 T� AH PH Address: 11n-'1 'I�� '-�+`'od -£tr�r c2� P. it r�q l-('I q3 Builder: we"LA��S T,.^ FOLLOWING CORRECTIONS ARE REQUIRED: i Inspectors_ nate: APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinap. INSPECTION NOTICE City of Tigard Building Department 13125 SM Hall 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 cgs Line FINAL: Post/beam Struct. San. Sewer Framing -Bldg. Post/Beam Mech. Rain DrainInsuiatio_ -Plumb. Plbg. Underfloor / Water Line Oyp. ad. -Hoch. Date Requested: /� �-� Thee: _ � AM PM 1,�-�/6 / �'�y-� _�ir/�-�6rmit : _"G II Address: Builder:-__ 13Kaz-'?7j'I THE FOLLOWING CORRECT�IOONNS ERF, REQUIRED: a Z- vi T F- J W J Inspector:__ _-_ Date: 0APPROVED DISAPPROVED A APPROVED SUBJECT TO ADM call For Reinsp. INSPECTION NOTICE City of Tigard Building Department 13125 SW Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 /01' Inspect ion:u L(��—_ -- Footing bg. Underelab Mech. Rough-in Appr/Sdwl.k Found. Plbg. Top Out Gas Line FINAL: Post/Beam Str::ct. San. Sewer Framing -.Bldg. Post/Beam Hoch. Rain Urain Insulation -Plumb. lbg. Underfloor ) Water Line Gyp. Bd. -Hech. Date Requested: -� _Time: AH PN Address: / 2 O O Builder: THE FOLLOWING CORRECTIONS ARE REQUIRED: o. r-� 1- N CD W J Inspector:--- A--� Date:._ APPROVED DISAPPROVND APPROVED SUBJHCT TO ABOVE Cell For Reinep. INSPECTION NOTICEy/ City of Tigard Building Department 13125 SR Ball Blvd. Tigard, Oregon 97223 , Inas :tion Line (Rec-O-Phone): 639-4175 Busi--tas Phone: 639-4171 Inspection: Footing Plbg. Underslah Mech. Rough-in Appr/FJwl% Pound. Plbg. Top Out Gas Line FINAL. Pont/Beam Btruct. an. Sewer Framing -Bldg. Post/Beam Mech. ain Drain-,) Insulation -Plumb. Plbg. Underfloor er Line Gyp. Bd. -Hoch. Date Requested• � � /2/ Time: AM�L��M- Addrenn: �,J 7 �� Permit 1:� �_ Builders THE FOLLOWING CORRECTIONS ARE REQUIRED: i O. F-• to � w F— J rn -- .-r C'3 41 J Dat 0! —v^. APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinap. INSPECTION NOTICE City of Tigard Building Department 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone)i 639-4175 Business Phone: 639-4171 Inspec'ti�oon:- — Footing 1 Plbg. .:..derslab Mech. Rough-in Appr/Sdwlk ��­ Found. Plbg. Top Out Gas Line FINAL: Poet/dean Struct. San. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Mech. Date Requested: /C;x— Time: AM PM Address: /,-,2 7 / ` — Permit 1: q Builder:_ THE FOLLOWING CORRECTIONS ARE REQUIRED: t1 CL N - - -- - — J C7 LLLt _... -------- -- —.— _. - ---- --- J Inspector: _ ' _— ---— —— Date: �A?PIIOVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinsp. MASTER PERMIT 00-PITY OF TINA RD PERMIT #. . . . . . , : MST91-0183 400 �CIT f OF I—WARD COMMUNITY DEVELOPMENT DE00ftkift DATE ISSUED: 11/12/92 lir"W , !0!2P07 PARCEL: 2SI03AC-04800 bUSDIVISION. . . . : WALNUT GROVE ZONING: BLOLK. . . . . . . . . . : LOT. . . . . . . . . . . . . : 17 7 BUILDING REISSUE: DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 sf CLASS OF WORK. :NEW BEDRMS:4 BATHS:3 GARAGE. . . . . . . . . . :600 sf TYPE OF LJSE. . . -.SF FLOOR AREAS---------- REQUIRED SETBACKS---_______ TYPE ETBACKS---------- TYPE OF COIqST. :5N FIRST. . . . :884 sf LEFT. . :5 ft RIGHT. c;RO ft OCCUPANCY GRP. :R3 SECOND. . . :980 of FRUNT. -.20 ft REAR. . : 15 ft STORIES. . . . . . . :2 THIRD. . . . :0 sf REQUIRED-------_____________ HEIGHT EQUIRED------------------- HEIGHT. . . . . . . . ..25 ft TOTAL------: 1864 sf SMOKE DETECTORS. :Y FLOOR LOAD. . . . ..40 psf VALUE. . . . . $ : 96544 PARKING SPACES. . :0 Remarks: ----------------------------------- PLUMBING --------------------------------------- SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PIREVNTRS. . zO LAVATOHIES. . . . . :4 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :O TUB/SHOWERS. . . . :2 LAUNDRY TRAYS. . . : 1 CATCH BASINS. . . . . . . :0 WATER CLOSETS. . :3 SEWER LINE (ft) . :O GREASE TRAP'S. . . . . . . :0 DISHWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXTURES. . . . . :0 GARBAGE DISP. . . % I RAIN DRAIN (ft ) . :O WASHING MACH. . . : 1 SF RAIN DRAINS. . : 1 --------------- MECHANICAL -------------- ------------------ FEES FUEL TYPES------------ UNIT HT RS. . :0 type amount by date recpt /GAS/ VENTS . . . . . :0 TIF $ 1380. 00 JH 11/12/92 – MAX INPUT,O BTU VENT FANS. . c4 SSDC $ 280. 00 JH 11/12/92 – FURN ( 100K . . : I HOODS. . . . . . : I PARK $ 500. 00 JH 11/12/92 FURN ) =100K . . .-0 WOODSTOVES. iO MPRT * 39. 00 JH 11/12/92 FLOOR FURN. . . . :0 CLO DRYERS. : I MPLC $ 9. 75 JH 11/12/92 BOIL/CMP ( 3HP:0 OTHER UNITS:O M5PC $ 1. 95 JH 11/12/92 - Owner: ----------------------------- ------- P5PC $ 7. 38 JH 11/12/92 GAS OUTLETS: 1 PPRT $ 147. 50 JH 11/12/92 PINNACLE HOMES T-IG 1z RD &- R LILY CIRCLE SPLC $ 275. 60 JH 11/12/92 – ASWOEMS Phone #z Contractor: ----------------------------- PINNACLE HOMES 12735 SW GLAZIER LILY CIRCLE Phone Ot 644-4017 PARAVP. QR Rf&$3 --------------------- --------------- CX $ 3086. 38 TOTAL This permit is issued subject to the regulations contained in the ------- REQUIRED INSPECTIONS Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Fireplace Insp applicable laws. All work will be done in accordance with approved Post/Seam Struct Gas Line Insp plans. This permit will expire if work is not started within Is@ Post/Beam Mechan Insulation Insp wdays of issuance, or if work is suspended for more than 160 I-lys. Plm/undslab Insp Gyp Board Insp PLM/Underfloor Rain drain Insp 1 ,ermittee Signature . Nerhaniral Insp Water Line Insp Plumb Top Out Appr/Sdwlk Insp Issued By : Framing Insp Mechanical Final Call for inspection 639-4175 ——--------------—----------- C'1YOFTIFARD SEWER CDI\11\IEC"IIOI\l MYOFTIORD PERM I T COMMUNr,I DEVELOPMENT DEPARTMENT MOM PERMIT #. . . . . . . : SWR91-0206 13125 VV HWI Blvd. P.O.Box 23397,Tigaid,Oregon 97 (603)M4176 b �9-41 / I ----UHIF ISSUED: 11/12/92 SITE ADDRESS. . . : 12487 SW 114TH DR PARCEL: 2SI03AC--04800 SUBDIVISION. . . . . WALNUT GROVE ZONING: BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 1. TENANT NAME.. . . . . : USA NO. . . . . . . . . . : FIXTURE UNITS. . . : CLASS OF WORK. . . :1\11':.W DWELL I NG UN I TS. . : 1 TYPE OF USE. . . . . :SF NO. OF BUILDINGS. 1 INSTALL TYPE. . . . :BUSWR Ilv1P,ERV SURFACE. . s f Remarks: Uwner: FEES I.,I NNACLE HOMES type amol.int by date reept 11 0 BOX 703 FIRMT $ 2100. 00 JH 11/12/92 INSP $ 35. 00 JH 11/12/92 — LAKE OSWEGO OR 97034 Phone #: 5036208505 Contractor: --------------------- --------- CONTRACTOR NOT ON FILL ------------------------------------------- flf-)one 2135. 00 'TOTAL Rpy #. REQUIRED INSF.,ECTION'S This Applicant agrees to comply with all the rules and regulations Sewer Inspection of the Unified Sewage Agency. The permit zipires 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 n9t located at the measurement given, the installer shall prispect 3 feet in all directions from the distance given. If not so located, the installer shall Durr)ase a "!ap and Side Sewer" Permit and the Agency will install a lateral. llei,mittee Sigi,ati.ire : Ijc.-q Logztx ] ,-i,il-ted BY : CL: Call for inspection 639-4175 • C'I [Y OF TIGARD RECEIPT OF PAYMENT RECEIPT NO. 192—P33591 CHECK AMOUNT s 4943. 83 NAME HOMES CASH AMOUNT t 0. 00 PAYMENT DATE s 11/12/92 SUBDIVISION PURPOSE OF PAYMENT AMOUNT PA 10 PURPOSE OF PAYMENT AMOUNT PAID F11.JILD1Np Gk RM 424. 00 PLUMBING PERM 147. 50 MECHANICAL. PE 39. 00 ST. BUILD PER 30. 53 PLAN CHECK FE 7. 80 SEWFr.R USA 2100. 00 SEWER INSPECT 35. 00 PARPIS Svc 500. 00 STORM DRAIN 90C 2130. 00 RESIDENTIAL. TRAFFIC FEES 1280. 00 MAgG-;; TRANSIT TSF FEES 100. 00 !. OT 17 WALNUT GROVE It-'4117 r 114"11-i DR 10TAL (IMOUNT P141 4943. 93 y w�1r1 CIIN Or TIGARD 13'POBox23397 2.5 SW liali d PERMIT ECT # 7,1C _ — �C'C)�iM[1N(T+. DI:VI�;LOI MLN'['I)1:1 AR'1'MGNT '�igard,Oregon 9771 PERMIT #. 1�,��/r/- O 19-3 (503)639-4171 DATE ISSUED JOB ADDRESS: L2487 6w/l4f,X fJr TAX MAP/LOT ZI 03 AC, 6 /7 `:UB: J_ 6�ro SIS. LOT: LAND USE: _ VALUATION: —y OWNER / SPECIAL NOTES NAME: REISSUE OF: ADDRESS: � LAST REISSUE: — C 6 4, 7 2-7__ Z FLOOD PLAIN/ PHONE: _ ✓ u/ �� SENSITIVE LAND: CONTRACTOR APPROVALS REQUIRED S 14:.3 9i-0000'7 NAME: — PLANNING: �_�G ADDRESS: ENGINEERING: FIRE DEPT: - PHONE: i Z? <� ' OTHER: CONTR. BOARD #: �1�-- EXP DATE: ITEMS REQUIRED SUBCONTRACTORS: PLUMB: `1 v�_� ��` �–'� LIST/SUBCONTRACTORS: MECH: _� BUS TAX: ARCH/ENGINEER CALCULATIONS: NAME: _ TRUSS DETAILS: — ADDRESS: OTHER: PHONE: 1 _ - n PROPOSED BLDG. USE: COMMENTS: Li J APPLICANT SIGNATURE Received By: ` — Date Received: PFRMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BA, Y, UE t?10 10-432 00 Building Permit Fees L-1 _ 10-431 00 Plumbing Permit Fees v ;'�'%SO __M 10-431 01 Mechanical Permit Fees 10-230 01 State Building Tax (5%) Building` ' V Plumbing ;7,� Mechanical �J f1J 3 �d 10-433 00 Plans Check Feed Building —�-�-,•-r V Plumbing Mechanical 9J 10-230 06 Fire 1 ✓ EGD /DU 30-202 00 Sewer Connection _ . 30-444 00 Sewer Inspection - S� J 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) 31-450 00 Storm Drainage Syst Dev Chrg (SSDC) ✓ 0 24-445-01 Water Quality (Fee in lieu of) 24-445-02 Water Quantity (Fee in lieu of) TOTAL W nm/3587P.WPF 3