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12567 SW 114TH Tenr'r•acG
C17YOFTIFARD
awOFTMRD�
COMMUNITY DEVELOPMENT DEPARTMENT 0414m CERTIFICATE OF'
13125 SW Wp
l BW P.O.Elm 23",r.TjW,Oregon 91 (503)63g4l,)S ;7 OCCUF ANCY
PERNIT
bZ)'J-4171
0"TE ISSUF.Do 12/07/99?
SITE ADDRESS. . . a 121556-7 SW 114TH DR PARCEL: 23103AC-04400
SUBDIVISION. . . . : WALNUT GROVE SUBP 70NINGt P-4. 5
BL.00K. . . . . . . . . . a LOT. . . . . . . . . . . . . a 13
CLASS (IF WORK. ANEW
TYPE OF USE. . . ;SF
OCCUPANCY GRP. :R3
LOAD S225 4
TENANT NAME. . .
Rettlarleas
uwllet-I .......—
FOUR 1) CONSTRUCTION
PC :.k0X 1577
BEAVERTON OR 97075
Phalle #2 641-0935
Contractors
KOUR D CONSTRUCTION
P(l BOX 10577
K-SIVERTON OR 97075
Phone Ipp 641 -0935
Hog ll. . s 71037
UVc."ApAllry of the above referwncecj building it; hereby pivell. sknrj, rer,t- ifies
the complionre with the 9+ato Of Oregon 19pok.,imity Cod@,A for, the rp"oup,
accupanc.,y, wid ur.v tindov- whicl, the r,pl7p
t,vjj(,o(j permit waa j Lle(i
FIRE DV7PAR7Mfg NT'
POST IN CONSPICUOUS PLACE
M
INSPE(.'TION NOTICE
City o!f Tigard Building Department
13125 Sit Hall Blvd. Tigard, Oregon 97223
Insper_tion Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:___
Footing Plbg. Underslab Mech. Rough-in Aper/Sdwlk
Found. P?.bg. Top Out Gas Line lINALt
Post/Beam Struct. Son. Sewer Framing
Poet/Beam Mech. Rain Drain Insulation -dumb.
Plbg. Underfloor Water Lino Gyp. Bd. -Mech.
Date Requestedt ^1 2, 1 f PH
Addresq: I I �f I 1`-1� L C 1 — PeLmLt 0. -02
Builder:
THE FOLLOWING CLIRRECTIONS ARE REQUIRED:
lnnpert nr: Date$
--APPROVED --- DISAPPROVED -- APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INSPECTI_OK NOTICE
City of Tigard Building DepattaKunt
13125 SR Ran Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-41'7r Rosiness Phone: 630-4171
Inspection:
Footing Plbq. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Tap Out Gas Line FINALt
Poet/Beam Struct:. San. Sewer Framing -Bld
g.
Post/Beata Mach. Rein Drain Insulation _ply,
Plbg. Underflr>or Water Line Gyp. Rd. -Noah.
Date Requested-_1 / -/ ] 2-
77�� Timrat AM
Address: ����`t? �l ^Z"�--�stmit #t
Bu i Ide r
THE FOLLOWING (3ORRECTIONNSS ).RE REQUIRED:
4,
--- -.____�_ gat• _.[�[�1
_APPROVE" DISAPPROVED ATPROVED SUBJECT TO ABOVE
j. Call For Rel:up.
INSPECTION NOTICE
City of rigard Building Department
13125 SQ Hall Blvd. Tigard, Oregon !97223
Inspection Line (Ree-O-Ph e): 6j9-4175 Business Phone: 639-4171
Inspection:, --
Footing Plbg. Underalab Mech. Rough-in pr/Sdwlk
Found. Plb . Top Out Gas Line FINAL:
post/team Ctruct. San. Sewer ?naming -8107.
poet/P,-,m Mach. Rain Drain Insulation -Plumb.
Plbq. Underfloor Water Lina Gyp. Ed. -Nech.
Date Requanted:_/� �� Time: —AN -PH
Address -"Perm+t #: `'I
Builder:
TOR FOLLOWING CORRECTIONS ARE REQ(IIRED:
"—MA
G '�l Tam�1,t/]
Inapocto-r= /"-MA J/1�/�1/T'S - -- - ---- Date:
APPROVED DTSAPPROVRD APPROVED SUBJECT 1r) *T40"
G 11 vor Reinsp.
"JLM11MMH__ __M - ___ I
INSPECTION NOTICE /
cic.y of. Tigard Building Depa>.-tment
13125 SW Bell Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): (39-4175 Business Phone: 639-4171
Inspection: — ---------
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam struct. San. Sewer Framing -bldg.
Poet/beam Mech. Rain Drain Ineusati.on -Plumb.
Plbg. Underfloor Water Line Gyp. ed. -Mech.
Dr,te Raquesteds �� -�� % __.__.—Times _AM PK
Address: �? `� / ,. _ Permit 1s
Builders—Z2
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspectors % J � Dates
/ APPROVED DISAPPROVED APPROVED suEJECT TO AEOVE
.-Call Pee 1Miarp.
INSPECTION No:ICE
City of Tigard Building Department
1312S SIX Ball Blvd. Tigard, Oregon 97223 /
Inspection Line (Ree-O-Phone)= 639-4175 Business Phone: 639-4171
Inspection= 11 _
Footing Plbg. Undorslab Mach. Rough-i �App./Sd-lk
Found. Plbg. Top out Gas Line FINAL=
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Koch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water
�Line Gyp. :id. -Koch.
Date Requested=
Address s. /�J��/7 //,V OA—t' rmit
Builders
TER FOLLOWING CORRECTIONS ARE REQUIRED=
s L �Pe ok Ao
oil
mac. r� �'✓h.✓ /=�1/ouva.S,�_
oats � L-
APPROVED DISAPPIIOVlD =' APPROVED SUBJECT To AND"
Call For Reinsp.
IN;'.ACTION NOTICE,'
f' Lr
City of Tigard Building M?partment
13125 SW Hall Blvd. Tigard, rnagon 97223
Inspection Line (Rec-O--Phone): 639-4175 Business Phone: 639-4171
Inspection:__
Footing Plbg. Underslab Mech. Rough-in Agpr%F.dwlk
Found. Plbg. Top Out Can Line FINAL:
Pont/Pearn Struct. San. Sewer Framtng -811g.
Pont/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. x-/Mech.
Leto Requesto:�d:: T� Time: 1 ` AM ,p/N
Address:
du alder
TNM FOL;)WING CORRECTIONS ARE VJWIREDI
r d� LY A,
N
c.�. Lam- s,•.-�C � .-r1 � +�-
Inspectors ! Dates �•►/O - �.�
"PrwvsD ✓sArrRovtD Arrt+ M SVSJR T To ADM
Call ror Reinep.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone): 639-41.75 Business Phone: 639-4171
Inepe-tion:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gas Line` FINAL:
Post/Beam Struct. San. Sewer cami.ng l -Bldg.
Post/Beam Mech. Rai-. Drai:, It on
-Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested: _2 - Time: Ak PM
Address: /c7 GO / 7'J Permit fs Qc
THE FOLLOWI1m. CORRECTIONS ARE REQUIRED:
IMpeCtors / �`-`--�-- bates
,�J1lP*OVBD __ DTSAPPROVRD - APPROVED SUR31lCT TO AHOVR
___Call For Reinap.
INSPECTION NOTICE
City of Tigar-1 Buildi_-g Deplxrtoent
13125 SW Ball Blvd_ Tigard, Oregon 97223
Inspection Line (Rec-t.-Phone,: 639•-4175 Business Phone: 639-4171
Inspections_
Footing Plbq. Underslab Mach. Rough-in Appr/Sdwlx
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Strurt. San. Sewer r—ing -Bldg.
a
Post/Bean, Mech. Rain Drain Insulation -Plumb.
Plhg. Unde,-floor Waters Line Gyp. Bd. -Meth.
Date Requestedt �L7 l
X__AM PM
Addresu: ermit
OL- ?�
Builder:.
THE FOLLOWING CORRECTIONS ARE REQUIRED: �f
.yam :i`�Q �n•�/
Y- _ o
Inspectors _ Date:
APPROVPD DISAPPROVED �_ APPROVED SUBJECT To ABOVE
Call For Reinsp.
I
INSPECTION NOTICE
City of Tigard Building Department
13325 M1 Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-•Phone): 639-4175 Business Phone: 639-4171
Inspection:_
i
Footing Plbg. Undrzrlab Mach. Rough-in Appr/Sdwlk
Found. P1H- Top Out Gas Line FINAL:
Poet/Beam St.uct. Ban. Bearr Framing -Bldg.
Post/Beam Rech. Rain Drain Insulation -^'umb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
s,
Date Roqueeted:_ — icy— _Time: - l1
Address:_ C, / �� Permit #:_[�
Builder:
THE FOLLOWING COCTIONS ARE REQUIRED:
inrprotozf �/ MC;
v_xPPR0vRD otsAPPROVEU APPROVED SU IECT TO ABOVE
.Call For Reinrp.
i
INSPECTION NOTICE
City of Tigard Building Departs nt
13125 SK Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone: 639-4175 Business Phone: 639-4171
Inspection:__
Pec _,_
Footinc Plbg. Unierelab Mech. Rough-in Appr/Sdwlk I
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam St:ruct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plums.
Plbg. Underfloor Water Lino Gyp. Bd. -Koch.
Date vyquested: i� �� �9iS Times*2 -cjAM ----PM
—� „�� - /�.�..t' Permit. 1:2/ - C7•���
Builder: ,-
TNM FOLLOWING CORRECTIONS ARE REQUIRED:
Inepeetoce Dater L
`__APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Rsinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 SK Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 633-4175 [tuninean Phone: 639-4171
Inspection:
Footing Plbg. Unde:alab Mach. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gas Line FINAI.s
at/Beam St San. Sewer Fram.ag -Bldg.
..�.._..
-^-�pogt7-8-eam Rain Drain InauJ.atlon -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. /J -Mach.
Date Requested:,— /�J� -�j ,Z _ TU.W A4 7tM PN
Address:_ � �; /��� tiPermit is �L
Builder:_----A�-L�• --- —
THE FOLLOWING CORRECTIONS ARE REQUIRED:
� v
Impactors Dotal
APPROWM DISAPPROVRn APPROVED SUBJECT TO ABOVE
--_Call For Reinsp.
INSPECT ION NOTICE /�Lyty
City of Tigard 9uilding Department o
133.25 SW Hall Blvd. Tigard, Oregon 97223
?neptctios. Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
----
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Pont/Beam Mach, aiFDraln Insulation -Plumb.
�Lbq Underfloor at / Gyp. Bd. -Mech.
Date Requested:__�_ _�
Address•__
Builder: FU —
THE FOLLOWING CO CTIONS ARE REQUIRED:
Inspector: A_ -; _" -- --- Data-__24
V_rAPPROVED DISAPPROVRD APPROVED SURJECf TO ABOVE
Cell For Reinap.
INSPECTION NOTICE
City of Tigard Building Departwent
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O--Phone): 639-4175 Business Phone: 639-4171
Inspection: _
L-und
` Plbg. Undersias Hach. Rough-in Appr/Sdwlk
Plbg. Top Out Cas Dine FINAL&
Poet/Seam Struct. Sun. Sewer Framing -Bldg.
Port/Bean Rech. Rain Drain Insulation Plumb.
r1bg. Underfloor Water Line Gyp. Bd. -Hoch.
i
Date Requested: �� " �/ Z� _Time: AH _`PH
Addrasss ��G� 711-4
Builder& LJ�4)-
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Y p
Inspector: ,, Date: 6 ✓U / Y�.
_APPROVED __ DISAPPROVED _ APPROVED SUBJECT TO ABOVE
`_Call For Rsinsp.
CITYOFTIFARD
Cf�Y ,�� MASTER PERMIT'
COMMUNITY DEVELOPMENT DEPARTMENT OsIWI ERMIT #. . . . . . . : MST91-074
13126 SW Fill SNd.P.O.Som 23M.Towd.Oregon 07223(603)630.4176
;ITE ADDRESS. . , . 1256 7 SW 114TH 8 _7_<1r, .-
3UBDIVISION. . . . : WALNUT GROVE SUED ZON iNG: R-4. 5
OLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . 1:;
..------------------------.-_--..-_- BUILDING
E I SSUE:MST91-0227 DWEI._L I NG UNITS; 1 BASEMENT. . . . . . . . :0 s f
;.,LASS OF WORK. sNEW BEDRMS:3 BATHS:3 GARAGE. . . . . . . . . . :440 st
T-YPE OFF USE. . . :SF FLOOR AREAS------------- REQUIRED SETBACKS------------
I YPE OF CONST. :5N FIRST. . . . :935 sf LEFT. . :8 ft RIGHT. :20 ft
OCCUPANCY GRP. :R3 SECOND. . . :949 s f FRONT. :20 ft REAR. . :2 3 i
,-j F OR I ES. . . . . . . :2 THIRD. . . . :0 s f REQUIRED---------------_.---
HEIGHT. . . . . . . . 925 ft TOTAL---------- : 1884 4f SMOKES DETECTORS. :Y
FLOOR LOAD. . . . :40 psf VALUE, . . . . t : 94584 PARKING SPACES. . :O
Remarks :
---------------------------------- PLUMBING ----__-------.-_--.---____--.__-.
:�INK:�. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW F,REVNTRr. . :0
LAVATORIES. . . . . s4 WATER HEATERS. . . : ] TRAPS. . . . . . . . . . . . . . :0
-fUB/SHOWERS. . . . :3 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . ,0
WA4ER C:LOSETS. . :3 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :0
D I SHWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FI XTUREa. . . . . :rl�
GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :O
WASHING MACH. . . : 1 SF RAIN DRAINS. -:1
----------------- ME_CHAI IICAL --------------- _.__------ ----_.-_- FEES
I- UEL TYPES--------------- UNIT HTRS. . :0 type amoltnt by date recpt
/INNS/ / / VENTS . . . . . :0 TIF E 1380. 00 PLL. 06/11./92 -
MAX I NPL T;O BTU VENT FANS. . :4 BPRT $ 418. 00 PLL -
FURN ( 100K . . s 1 HOODS. . . . . . : 1 BPLr. $ 40. 00 JLH 12/.30/91
F URN ) =100K . . :O WOODSTOVES. :0 B5PC t c0. 1)0 PL.L 06/11/92 -
F I-OOR FURN. . . . s@ CLO DRYERS. : 1 SSDC E 280. 00 PLL 1216/11/92 -
BOIL/CMP ( 3HP:0 OTHER UNITS:O PARK $ 500. 00 PLL 0•w,/1 .1./92 -
GAS OUTLETS: 1 MPRT f 39. 00 PLL 06/11/92 -
Owner; ____-____.__.____..._.__.___....._-.---.-.-- -___.........- MPLC $ 9. 75 PLL. 00' / 11/92
F-'OUFi D CONSTRUCTION M5PC f 1. 95 P' 06/11/92 -
I:'() BOX 1577 PPR 1 $ 1.41. 50 PLL. 06/11/9- c?
P5PC f 7. 36 PILL. 06/11/92
-
I3I:AVE.RTON C,R 97075 SPI_C $ 15. 00 PL.L 06/11 /9c, -
Plhmne #.- 641-093`'
Contractor;
I-OUR D CONSTRUE f ION
I-'U BOX 1577
®EAVE.RTON OR 57075
Pt►one Ot 641-01.135
F2eq #. . s 71037 ------------------- _—_—_—.-----__---
$ 2859. 48 TOTAL
This ptreit is issued subject it the regulations contained in the -------- REQUIRED INSPECTIONS -----
Tigard Municipal Code, Stitt of Ore. Specialty Codes and all other Foot/found Insp Fireplace Insp
applicable laws. All work will be dore in accordance with approved Post/Beam Struct Gas Line Insp
;lens. This pot-sit will tMpire if work is not started within 188 Post/Beam MecFhasn Insulation Insp
days of issuance, or if work is susoended for tore than IN day . 01m/tmdslnab Insp Gyp Board Insp
OLM/Underfloor Rain drain Insp
F 'mittee Gign,4t '1r•Pr Mechanical Insp Water line Insp
4-IlLimb Top Out Appr/Sdwlk Insp
t .. iI.jP d By: k Framing Insp Merhan io:E11 Fina",
f.'caII foe- inspection, - 639-4175
SEWER CONNECTION
CITY OF TIFARD WYOFTMIM PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT oamoon -.,ERMIT #i. . . . . . . : SWR92-0051
13126 SW Hdi BW P.O.BOK 23907.7191M JkVW Of (5031636 4175
is1t*5. 06"tt"'te!
S'ITE ADDRESS. . 12567 SW 114TH IM7-41/^s PARCEL: 2S103AC—WG13
SUBDIVISION. . . . j WALNUT GROVE SUBD ZONING. R-4. 5
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . : 13
I ENANT NAME. . . . . i
USA NO. . . . . . . . . . : FIXTURE UNITS. . . .
CLASS OF WORK. . . :NEW DWELLING UNITS— i1
! YPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
INSTALL TYPE. . . . :B(JSWR IMPERV SURFACE. . : :sf
I�emarkss
Owner: ----------------------------------------- ----------------- FEES ------------
FOUR D CONSTRUCTION type amount by date recpt
PO BOX 1577 PRMT $ 000. 00 FILL 06/11/92
INSP $ 35. 00 PLL 06/11/92
1-.kEAVERTON OR 1:470-P-`1
Phone #s 641 -.0935
Gontractort
CONTRACTOR NOT ON FILE
----------------------------------
F1ione #e $ 1935. 00 TOTAL.
Reg #. . I
REQUIRED iNSPECTIONS
This Applicant agrees sply with all the rules and regulations Sesser Inspection
of the Unified Sewage - -cy. The permit expires 180 days from
the date issued. The total avoint paid will be forfeited if the
aersit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer it not located at the measurement
given, the installer shall prospect 3 feet in all directions from
Vie distance given. If not so located, the installer shall purchase
"Tap and Side Sewer" Permit and the Agency will IrAtall P lateral.
i-et-mittee Signatures A9 .......... ------
• kied By
Call -For inspection 639-4175
f -
-CITYOF UFARD ® PLUMBING PERMIT'ERMIT'
CfYOFTMnpCOMMUNITY DEVELOPMENT DEPARTMENT oPERMIT 1*. . , . . . .
t MST91-0274t
13126 SW H@11 Blvd P.O.Bac 23307,TOW,QWw 07223(603)630 176
LLtt
DATE: ISSUED: 06/11/9Z,
SITE ADDRE ter,, . . 1247 S11 It 4TH OF -7 ✓�' PARCEL: 28103AC-•Wta t
SUBDIVISION. . . . a WALNUT GROVE: SUBD "ZONING: R-4. 5
BLOCK. . . . . . . . ., . t LOT.. . . . . . . . . . . . . . 13
._-- M
CLpSMC'F-WOfr1{. . ANEW (3ARFAGI=
:� DISPO':SALS.ws•:1......__.__..._.__...__...__.,.....-._....._�__.._.__....___._.
TYPE OF USE. . . . :SF WASHING MACH. . . . . . , : 1 BACKFLOW PREVNTRS. . ;0
OCCUPANCY t.'?co, . :R;3 FLOOR DRAINS. . . . . . . TRAPS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . :2 WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :0
FIXTU1RC9---•-__..._-. ._.__..._.._ LAUNDRY TRAYS. . . . . . :0 SF PAIN DRAINS. . . . . ; 1
SINKS. . . . . . . . . . : 1 GREASI= TRAr,s. . . . . . . .0.
LAVATORIES. . . . . . 4 OTHER FIXTURES. . . . . :0
TUN/GHOWERS. . . . : SEWER LINE (ft) . . . . -o
WATER CLOSETS. . ;:.5 MATER LINE (ft ) . . . . i 1.00
DI�HWA •NERS. ,�. . : 1 RAIN DRAIN (ft ) " . . :0 j
OWNERa
POUR D CONSTRUCTION _.____..___.____ __FlrEg_..._________
TIF f 1380- 00 PLL 06/11/92 -
PO BOX 1577 SPR T f 418. 00 PLL
BPLC t 40. 09, JLH 12/30/91 ,
13r._AVERTON OR 9707,E B3PC f c?0. 90 PLL. 06/11/92
tlrane N: 641-0935 SSDC $ -280. 00 PLL 06/11/92
1-�'l.r..imhing Can tr•actor: -----..---- ___-_-__., PARK f 100. 00 PLL 06/11/92
MPRT $ 39. 00 RLL 06/11/92 w
lamp; �� =' 1•% ( MPLC $ 9. 75 PL.I_. 06/11 /92 -
I _ rte. ►w �� ;r. _ M5PC $ 1. 95 PLL 06/11/92
(I,it
r PPRT $ 147. 30 PLL 06/11/92
I, Pyt .r Vhone111aSt.--......_.at'ea .__ � ._._ P5PC $ 7_38 PLL VAA/11/92
f?eg
-_ . __.1_________.. BPLC f 1 �,. 00 PILL. 06/11/92
-
!1 _.
-- -''- REQUIRED INSPECTIONS -
1-his permit is issued subject to the reg-
!latians Contained in the Tigard Municipal Foot/fol..tni Insp Rain drain Insp
,ode, f3t,ate of Clre_ Specialty Codes and allPost/Beam ytr r.�c^t Ws�ter^ Line Insp
ether apl)lir.at�le ls►wg,. Ail. work will be done PostiSeam Me"han Appr/Sdwlk Insp
I Is
Ger mit will e><pirR ifwork is not started PI_.M/U1 der floorap PlumbnFlnmlFinal
+ithi.n 180 daye oP issuance, or if work is Mechanical Insp Building Final
Usprnded far more thakn 180 days. Plumb To Out
P Erosion Contrel
Framing Insp Crawl Drain
Fireplmce Insp
-) Gas Line Insp
T n s u l H t i a n Ingle "—
�__ ;iL GYP Board Insp
Authorized Plumbing Contractor Signartur^e --
Car11 ' fo►� inepert i on - 639-4175
C'ontractnr Notfrsa
i
• r
I'
CITY OF T I CARD -- RECE 11'-T OF PAYMENT RECEIPT NO. t 92-2i..::8390
CHECK AMOUNT t 4754. 57
Nf�P1E: t FOUR D. CONST. CO. CASH AMOUNT IA. 00
IaUUr�E' c t P. O. BOX 1577 y PAYMENT DATE a Of,/11/92
SURDIVI5ION s
BEAVERTON, OR 97075—
POW-JOSE
707a—PI.IW-JOSE OF PAYMENT AMOUNT FSA I D PURPOSE OF PAYMENT AMDUN'r PF)I!)
B1.1 I L D I NC PERM MST41—2 74 418. 00 PLUMBING PERM 147. 50
MECHANICAL. PE 39. 04b ST. BUILD PER :30. 32
PLAN CHECK FE 2"4. 75 SEWER LISA SWR92-61 If)(10. 00
�3EWER INSPECT 35. OR.; STORM DRAIN SDC 00
RESIDENTIAL TRAFFIC FEES 1280. 00 MASS TRANSIT TIF FEES 100. 00
PORKS SDC 500. 47N
1
129. 67 SW 114TH AVE. /1_07' #13 +''
T i l AI. lahlf►t INT PAID — — — --> 475A. 57
f
..�.._- —.._..�._ ._,�___.�_.�_...—Y.._�.__..__.._.-.�.—._._.._._....._._ ..._.,._..•....,.....�._.r.�...._..._-....,�..�r_-_�`.'ate.�_...—_...—_.��..__._.�...__�...�_ .._..i
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