11905 SW 125TH COURT ADDRESS:
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i:Vecords\microtlm\ta rgetslbuiiding.doc
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CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT f�ERTIF .Il.�caTE OF
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839.4171OCCIJPANC�
PE:.1"MI T ##. . . . . „ . a I10T°3�' �L►�31�+
DATE 191..,LIED: 0,1/27/93
c iTt: NUl'fdF,17.'i« . . 7 11."3r71`,i SW 125TH L T
PAPUA- IS1;3DD I i;'�k'�
�XIBD M S I ON. . . . : V I LLOGE AT SLIMMER LAKE F='ARK 4 ZON I NC3 r R...4. 5
BLOCK. . « . « . . . . . a LOT. „ . . . . . . . " . . . . 141.9
i:.:lJISS OF WORK,. a 14EW
TYPE OF a SF
CFCCUPANC% Cii l'. ,I R.3
OCCUPANCY 4
TENANT 1'10ME:. . . a
E?emarks, . POTH I UTREL'.I' OPENING PI: RMIT (E' RLUUTRED
13wnerr . ..... __ ....,.... .. ..__._...__. ._ _.. ....... . ._..
MOR I f.ASI T.((.. HOMES
15555 SCJ 1:ANGY FAD
LWE Da'WE:CiCI OR 970,5.
Contract or: _.._....._.... .._, _.......__. .. _ __.
D01'4 MORISW1'TL SUILDE P.5, INC.
155)55 V)W E►F W-W RD.
#20 1
LAKE 05VIE'CAI OR 97035
Ph o n p #: 6420 715:38
Reg ##. . 5533
Oc:c:up,anc-,y uF !;hey xibuve rf fet-erced building sr: hereby givon, Aare.! cvytif'ie
the c oMpl ) :Arrc.'v with the State Of Or.eq on SpecA alty Lodes f''ur the gr oup,
ucc".Ip,,anc.•y.' ,alld user +Iricirr I-AlLch the rpt`aronr. ed permit was issued.
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VIOST 114 CONLLp I CUt,ll1S PILAU'.:
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INSPECTION NOTICE
City of Tigard Building Department
13125 Sit Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171.
'Cnspectiont__ — --—
Footing Plbg. Underslab Mech. Rough-in Appt-/Sdwlk
Found. Plb -Top Qut_ Gas Line FINT.L:
i
Poet/Beata Struct. *Rain
wer_ Framing -Bldg.
Poet/Beam Mech. ain Insulation -Plumb.
Plbg. Underfloorine GYP. Bd. 2-�ech.
Date Requested- a� J Time:��_3 AM PM
Address '7J Permit i:(/�
Builder: d,L , / �, , ....
—
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Date:
Tnepect�t
APPROVED DISA7PROVED APPROVED SUBJECT TO ABOVE
Call For Reinap.
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
Inspection:_ ----
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
POOL/Beam Steuct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
CPlbg. Underfloor Water Line Gyp. Bd. -Mech.
///
Date ^9queatedss� 1 �T/�, / Time: _ AM --PH
Address:
Ruilder:�_
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors.//// /—/-- -�— netes�_(
.____APPROVED DISAPPROVED - APPROVED SUBJECT TO ABOVE
/ Call For Reinap.
INSPECTION NOTICE
City of Tigard Building Department
13125 EM Hall Blvd. Tigar3, Oregon 97223
inapecti.on line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: _
Footing Plbg. Underslab Mech. Rough-in Apor/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
P. at/Beam Struot. San. Sewer Framing -Bldg.
t/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor water Line z Gyp. Bd. -Mech.
Date Requested:� —�J Timet AY .� P
Address: 12_—_ Permit t:
Guilder:
THE FOLLOWING CORRECTIONS ARE REQUIREDt
Ui
Inspector:_
APPROVED DISAPPROVED v APPROVED SURJSCT TO AROVY
Call For Reinap.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Pec-O-Phone): 639-4175 Business Phone: 639-4171
{ Inspection:
Footing Plbq. Underslab Mech. Rough-in Appr/Sdwlk
Found. P1bQ. Top Out Gas Line FINAL:
Poet/Beam St-ruct. San. Sewer Framing -Bldg.
Post/Beam Mech. !fain Drain -Tneulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Meeh.
Date Requested: n�~! L� Time: _AM PM
Address: / vl� �' Permit !:_ r Q
Builder:
THE FOLLOWING CORRECTIONS ARE &4QUIREDs
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Inopector:_ _ Dates
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APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
/T�� call Por Reinap.
111SPEMION NOTICE
City of Tigard Bu.flding Department
13125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone): 639-4175 Busineae Phone: 639-4171
Inspectiin:
Footing Plbg. Underslab Mach. Rough-in) Appr/Sdwlk
Found. Plbg. Tr;2 Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer FramLng --Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Lina Gyp. Bd. -Meeh.
Date Requesteds �r� •� ^� Times AM PM
Address: /' � Permit #1 _ ?�
Builder:___v
THE FOLLOWING COFMCTIONS ARE REQUI:RS s
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inepeotorl nate: Z
APPRdVlD DISAPPROVED APPROVED SUBJECT TO ABOVE
--Call For Reinsp.
INSPECTION NOTICE
city or Tigard Building Department
17125 SN Pall Bled. Tigard, Oregon 97223
Inspection Line (Roe-O-Phone): 639-4175 Business Phone: 639-4171
Inepe.:tl.on: _
Footing Plbq. Underslab Mech. Rough-in Appr/Bdwlk
Found. Plhq. Top Out Gas Line FINALS
�Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain insulation P ssmb.
Plbq. Underfloor Ovate—r7 Ling Gyp. Bd.
Date Requenteds PM
' /1(
Address s�! ��'S J'. � �� Permit
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Builders��
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors Dates
APPROVED —_ DI9APPPrwsD APPROVED SUBJECT To ABOV[
Call For Reinsp.
j !SPECTION NOTICE
City of Tigard Building Department
13125 SR Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
Inspection: —
Tooting Plrg. Underelab Koch. Rough-in Appr/Sdwlk
round. Plbg. Top Out Gas Line FINKLt
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Koch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Koch.
Date Requestedt �g ~/!9 Times
C
Address �tT� Permit
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIREDt
IU _
Inspectort� _ Datet�y `!
APpROVtD DISAPPROVED APPRAVED SURJECT TO ABOVE
Call For Reinap.
INSPECTION NOTICE l
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone: 639-4175 Duoiness Phone: 639-4171
Inspection:^
Footing Plbg. Underslab Mach. Rough-in Appr/Sd-!
Pound. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewsr Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulat! m -Plumb.
Plbg. Underfloor Water Line/ Gyp. Dd. `x/-Mach.
Date Requested: Time: �`� _AM --PH
Date
/ f `
Address: � U� er � � �� Permit 1:
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectort L.rlf +'��lytfi-� Date:
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RPPUMD DISAPPROVED APPROVED SUBJECT To ABOVE
_Call For Relnep.
INSPECT70N NOTICE
City of Tigard Building Department / (�
13125 SW Hall Blvd. Tigard. Oregon 97223
Inspection Line (Rec-O-Phone: 639-4175 Business Phone: 639-4171
Inspection: __ �^
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line CMAL8
Poet/Beam Struct. San. Se•4er Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation <t��
Plbg. Underfloor Water Line Gyp. Bd. -Koch.
Date Requested:_ a, C Time: AJ( PH
Y-K
Address: I� %UwS �c- 7 _ Permit
� 1 ` `��j 0--4/Builders _ / , w �!!1 C (07 _ cX �� ' / 7 6)
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors _ L'`'" __ Dates
APPROVED DTSAPPROVEDAPPROVED SUBJECT To ABOVE
_ —call For R��—��—einsp.
INSPECPION NOTICE l
City of Tigard Building Department.
13125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Busineee Phone: 639-4171
Inspection:_
Footing Plbq. '.rslab Hoch. Rough-in Appr/Sdwlk
Found. P1hq./Top Out Gas Line FINAL:
Post/Beam Struct. San. Sawer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Mach.
Date Requested: r //y�/ TLms AM PN
Address. ZZef'1/) � 1 ` ` P..Lt ft
Builders r
THE FOLLOWING CORRkCTIONS ARE REQUIRED:
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Inspector: LILA 14 Al W' _ Dater
ITAPPROVED DISAPPROVED _ — APPROVED SUBJECT To ABOVE
Call For R+insp.
INSPECTION NOTICE
City of Tigard Building Departavant
13125 SR Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phones 639-4171
Inspection: —
tooting Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer rraming -Bldg.
Post/Beam Mech. Rain Drain Insula -Plumb.
Plbg. Underfloor Water Line Gyp. Ed. -Me-h.
Date Requested[_ - Times AM _2!�rM
Addreas: ��—y Permit #_
Builder,��
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: Dates
APPROVEb DISAPPROVED APPROVED SUBJECT TO ADM
Call ror Reinep.
INSPECTION NOTICE
City of Tigard Building Departsaent
13125 Sit Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171
Inspection.•_
Footing Plbc. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gan Line FINALS
Poet/Ream Struct-. San. Sewer Framing / -Bldg.
Poat/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water�Line Gyp. Rd. -Hoch.
Da--e Requested, - L _ _-Times AM PH
Address&►/ ! 0 X� Permit Es L— _
Bvildersill-)�
THE FOLLOWING CORRECTIONS ARE REQUIREUs
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Inspectors_ Dates
,01�APPROVED DISRPPROVRD "PROM SUBJ=CT TO AHONK
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)e 639-4175 Business Phone: 639-4171
Inspection: --
Footing Pl.bg. Underslab 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.
Plhg. Underfloor Water Line Gyp. Bd. -Mech.
/ �_ _ /l �AN PM
Date Requested: / .T ��U Time: C'/+) ___PH
Address:// v S XP armit
Builder:
THE FOLLOWING CORRECfION4 ARE REQUIRED:
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Inepecto'rt/
v APPROVED DISAPPROVED APPROVFD SORJECT TO ABOVE
Call For Reinap.
---C TY OF TINA 10
---------
ASTER PERMIT
Mcn RD PERMIT #. . . . . . . : MS f92-0314
COMMUNITY DEVELOPMENT DEPARTMENT 01111160N
13125 SW Hail Blvd. P.O.BOX 23397,T1901d,Omg97W3_46M)43"1 T5 DATE ISSUED: 12/29/92
SITE ADDRESS. . . : 11905 SW 125TH CT PARCEL: IS133])D-11200
SUBDIVISION. . . . : VILLAGE FIT' SUMMER LAKE PARK 4 ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 149
----------- BUILDING
RE I -'c3UE: DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 s f
CLASS OF WORK. :NEW BEDRMS:4 BATHS:3 Gpr:)GE. . . . . . . . . . :488 sf
TYPE OF USL. . . :SF FLOOR AREAS---------- REQUIRED SETBACKS-----------
TYPE OF CONST. -5N FIRST. . . . : 1350 sf LEFT. . :6 ft RIGHT*. :6 ft
OCCL;'*ANCY GRP. :R3 SECOND. . . :930 s f FRONT. :20 ft REAR. . :a3 ft
STORIES. . . . . . . .2 THIRD. . . . ..0 sf REQUIRED-------------------- I
HF_' IGN,T
EQUIRED-------------------
HEIGKT.. . . . . . . . :26 ft TOTAL-------:2280 sf SMUKE DETECTORS. :Y
FLOOR LOAD. . . . 140 PSf VALUE. . . . . $ : 113664 PARKING SPACES. . : i
Remarl(so PATH I STREET OPENING PERMIT IS REQUIRED
PLUMBING
C
.;!N S. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :0
LAVATORIES. . . . . :4 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :O
TUB/SHOWERS. . . . 14 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . :0
WATER LLOGETS. . :3 SEWER LINE (ft ) . :O GREASE TRAPS. . . . . . . :0
DISIiWASHERS. . . . .- 1 WATER LINE (ft) . .- 100 OTHER FIXTURES. . . . . :0
GARBAGE DISP;. . . : l RAIN DRAIN (ft ) . :O
WASHING MACH. . . -. 1 SF RAIN DRAINS. . : 1
--------------- MECHAN I CAL ----------------------------------- rLES
FUEL TYPES----------- UNIT HTRS. . :O type amount by date reept
/GAS/ V E 1\1 TS . . . . . :0 T I F $ 1460. 00 JH 12/29/92 -
MAX INPUT*:O BTU VENT FANS. s4 BPRT $ 468. 00 JH 12/29/92 -
FURN ( 100K . . .-0 FLOODS. . . . . . : 1 BPLC $ .304. P-0 JLH 12/15/92 92-234710
FLI.iN ) =100K . . : I WOODSTOVES. -.0 B5PC $ 23. 40 JH 12/29/92 -
FLOOR FURN. . . . #0 CLO DRYERS. : I S S,D C $ 280. 00 JH 12/29/92
BOIL/CMP ( 3HPi0 OTHER UNITS: 1 PARK $ 250. 00 JH 12/29/92
GAS OUTLETS: 1 11PRT $ 45. 00 JH 12/29/92
Owner: ----------------------------------MPLC $ 11. 25 JH 12/29/92
MORlSSITTE HOMES 115PC h 2. 25 JH 12/29/92
15555 SW RANGY RD PPRT 155. 00 JH 12/29/92
Pbr-C $ 7. 75 JH 12/29/92
LAKE OSWEGO OR 97035
Phone #: 620-7538
Contractor: ---------------------------------
DUN NORISSETIE BUILDERS, INC.
15555 SW BANDY RD.
#201
LAKE OSWEGO OR 97035
Phone #j 620-7538
0- Reg #. . e 35533 ----------------------------------------
3006. 85 TOTAL
Ln 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 !lith approved Post/Beam Struct Gas Line Insp
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plans. This permit will expire if work is not started within 189 Post/Seam Mechan Insulation Insp
4
days of issuance, or if work is suspended fo more thanays. Plm/undslab Insp Gyp Board Insp
C-3
UJ 'LM/Underfloor oat- Rair drain Insp
Permittee Signature: nj4lecw PrAl e ch a n i c a 1 Insp Wat&r Line Insp
Plumb Top Out Appt-/Sdwlk Insp
Issued By ., f r-raming Insp Mechanical Final
Call for inspection 639-4175
-----------
CITY®F I'GARD
WYOFTWARD SEWER CONNECTION
'COMMUNrrY DEVELOPMENT DEPARTMENT 0*100" P,ERNIT
13126 SW HWI Blvd P.O.Box 23397,nqwd,Oregon 97223(603)6394176 V-,ERMII #. . . . . . . : SWR 92--04-95
639--4171 DATE ISSUED: 12/219/92,
bITE ADDRESS. . . : 11905 SW 125TH CT PARCEL: IS133DD--11200
:)UBD I V 15 1 ON. . . . . V I LLGE AT SUMMER LAKE r-,ARK 4 ZOI\111\16: R-4. 5
LALOCK. . . . . . . . . LOT. . . . . . . . . . . . . : 149
I EI\IqNT NAME:. . . . . :
LISA 1\10. . . . . . . . . . : FIXTURE UNITS. . .
CLASS OF WORK. . . :NEW DWELLING UNITS. . : 1
IYV,E OF' USE=. . . . . :5F NO. OF' BUILDINGS" I
INSTALL TYI-,E. . . . :BUSWR IMP,ERV SURFACE. . :
kemarks : PIATH I
Owner: FEES -------------
HORISSITTE HOMES type amol-tnt by date retzpt
15555 SW RANGY RD F,R MT $ 2,10 Vi. 0 0 JH
I N13P $ 35. 00 JIi 12/29/92
l._.AIAE OSWEGO OR 97035
14ione #- 620-7538
Lontrac.,tor:
f ONTRACTOR NOT ON FILE
------------------------------------------
1-11-ione It: $ 2135. 00 -. .'-TAL
Rey #.
------- RLUUIRED INSPECTIONS
This 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 "Tap and Side Sewer" Permit a� he Agency will install a late al.
Permittee 5iynat 1.t i e
Issi.ted By :
o Call for inspection 639 -4175
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CITY OF TIGORD - RECElPT OF PAYMENT REC[--*Ir-,T Nn. a 9r=' 594
CHECK AMOUNT : Fj I Ot. 8!7.
NAME : MORISSETTE9 DON CASH AMOUNT a 0. 00
(iDDRESS s PAYMENT DATE a I P
SUIAD I V I S I ON
PUPPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
5-ci 1"-1--.—DI 1-4(-3 ,-1,-E-f R—M 4613. 00 PLUMBING PERM 155. 00
ME LHANICAL Pt: 45. oel ST. BUILD PER 33. 40
Pl-i")N CHECK FF 275. 45 SEWER USA r i00. 00
35. 00 PARKS SDC 00
ti '-")TORM DRAIN SDC 2k30. 00 RESIDENTIAL TRAFFIC FEES 13,50. 00
rIsISG TRANSIT TIF FEES 110. 00
uj
LOT 1.49 VILLnGE AT SUMMFRL.nKE 4
11405 SW Ir-'.5744 ( T
TOTAL AMOUNT PAID 1 8
CITY OF TIBARD RECEIPT OF PAYMENT RECEIPT NO. s 92 -j".54710
CHECIA AMOUNT 40. 00
NAME MURISSETTE HOME99 INC CASH AMOUNT 0. 00
ADURFSE; a 15555 SW BANDY ROAD PAYMENT DATE a 12/15/92
LnVE 09WEG00 OR SUBDIVISION
PURPOSE OF PAYMENT nMOLINT PAID PURPOSE OF PAYMENT AMOUNT 1'-1A I D
PLAN CHECK FF 12-43R 40. 00
ui
I 1,)05 SW 125TH
RE. ISSUE OF 9P-0069
fOTAL AMOUNT P(II0
CYIU 13176swH,�113� PLNCK/RECT
� OF TIGARD T OBox 23 7 PERMIT 0 �► �{qZ- �'3/�
COMMUNITY DEVELOPMENT DEPARTMENT
(503)6'"" DATE ISSUED
JOU ADDRESS: i �U S L'-� X02 TAX MAP/LOT /S/ 33 0 0 -112.0 U
SUB: LOT: /`'�� LAND USE:
VALUATION: Il> 66Y-
OWNER
GY-
OWNER J) � SPECIAL NOTES
NAME: rlSSP [_f��t')'1� REISSUE OF:
ADDRESS: 11 64#��� LAST REISSUE:
C _ FLOOD PLAIN/
PHONE: � SENSITIVE LAND: _
CONTRACTOR APPROVALS REQUIRED
NAME: � ��s� ` PLANNING:
ADDRESS: ENGINEERING: _
FIRE DEPT:
PHONE: _ OTHER:
CONTR. BOARD EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: L LIST/SUBCONTRACTORS: _
MECH: 14t!4 fLj,/YUS TAX:
ARC�NSINEER o Til 0. CALCULATIONS:
NAME: _ � TRUSS DETAILS:
ADDRESS: 602( 18 3 OTHER: _
Ind,54 _7
PHONE: _ C�. �`�
(45
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PROPOSED BLDG. USE:
� 7
F COMMENTS:
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APfi ANT SIGNATURE V
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Received By. �� _ Date Received: '
PERMIT # ACCT # DESCRIPTION AMOUNT / AMOUNT PD. BAL. DUE
r,7fy2-u3ic 10-432 00 Building Permit Fees
10-431 00 00 Plumbing Permit Fees
_ 10-431 01 Mechanical Permit Fees y, y��
10-230 01 State Building Tax (5%) 3 .yu (tu
Building qo
Plumbing
Mechanical
VAA
10-433 00 Plans Check Fee 3/S•
Building sL'���. u?
Plumbing _
Mechanical _ Z
10-230 06 Fire _
30-202 00 Sewer Connection
t`
30-444 00 Sewer Inspections 3 )
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 zl S v 3-50
25-448-05 Mass Transit TIF Fees �/ ' //v
52-449 00 Parks System Dev Charge (PDC) TU
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC)
CL 24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL r 10
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nm/3587P.WPF
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13125CITY OF ��`-��� �2s sw HallHallnwd. PLNCK/RECT #
Tigard,Oregon 97223 PERMIT #
COMMUNITY DEVELOPMENT DEPARTMENT
(503)639-4171PATE ISSUED —
JOB ADDRESS: TAX MAP/LOT
SUB: _ LOT: LAND USE:
VALUATION:
OWNER SPECIAL NOTES
NAME: REISSUE OF:
ADDRESS: LAST REISSUE:
FLOOD PLAIN/
PHONE: SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME: _ PLANNING:
ADDRESS: _ _ ENGINEERING: _ _—
FIRE DEPT:
PHONE: OTHER:
CONTR. BOARD #: EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: — LIST/SUBCONTRACTORS:
MECH: BUS TAX: _
ARCH/ENGINEER CALCULATIONS:
NAME: _. TRUSS DETAILS:
ADDRESS: OTHER:
PHONE: - ----
n.
PROPOSED BLDG. USE:
~ COMMENTS: —
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APPLICANT SIGNATURE
Received By: _ _ _ Date Received: __