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11945 SW 126TH PLACE ti / -SW 126th Place / 1 Gi r . i I ti, �17Y OF TIFA � CERTIFICATE OF cmroFl96s4Ft! occuPANr.Y COMMUNITY DEVELOPMENT DEPARTMENT CMeooN ,C RM I T #. . . . . . . : M T91 -001 13126 SW Hall Blvd. P.O.Box 23397,Tigard,Oregon DTp,(603)&394175 / ` SITE ADORES.. . . e 11945 SW i 26TH CL. PARCEL. e 1 S 1 33DD •1":."500 SUBDIVISION. . . . : VILLAGE AT SUMMER LAKE. PAW 4 ZONING: R--4. 5 BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . : Icl2 CLASS OF WORK. :NEW TYPE OF OCCUPANCY GRP. :R-3 OCCUPANCY LOAD 1220 4 TENANT NAME. . . pemawks : LARRY F2. CHRISTENSEN CONST 17675 SW IVY GLENN DR ALOHA OR 97AA07 F-"hunp 0: 642--9P'79 Gontrm tor: _ _.__....__..._._._...._._._ ..... ._. _..._.._....__ l..ARRY R. CHR I STENSF N CONST 17675 SW IVY GLENN DR. OLOHA UR 9'7 007 Vhtinp #e 642-W79 R o o N. . : 53099 Occupakncy of the axI'1o4'e refe.renCeCI b+.tilciinD la herehy given, t1nd cor'tifies i•he compliance with the 7,tater Of Oregon Specialty Codas for the uroull, or.:cupancy, and oLle uncle — which the re "eranr-PO permit ways ic,r-+.red. FIRE DEPART ME:NT 1 1 I LD I NG I SPF MIR FKI C L[+I NW(.1FF I F:I AL P05T IN CONSP I(::I ICIU5 PL A(A. INSPECPIGN NOTICE City of Tigard Building Deportment 13125 Si Nall Blvd. Tigard, Oregon 97223 Inapecti x �Lne (Roc-0-Phone): 639-4175 Business Phone: 639-4171 Inepection: Foot f.lq Plbg. Underalab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINALS Poet/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mech. Fain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Koch. Date Date Requestede 15 �%�l _Times J AM/��, PH Addrenss ] ..--_--- Permit Builder: THE FOLLOWING CORRRCTIONS ARE REQUIRED: G L�c7 r���C• f�.y�1 C 2 �1 ' 0S-r ALfl2-W SS 3 u wr"r,�„=2 n� J Inspectors - Dates APPROVED DISAPPROVED APPROVED SUWBCT TO ASM tall For Rainap. r KNI rw INSPECTION NOTICE City of Tigard Building Depa.rtaent- 13125 BW Ball Blvd. Tigard, Oregon 97223 Inspection Lina (jec-O-Phonej: 639-4175 Business Phone: 639-4171 v �s Inspection: _ Footing Plbg. U .slab Mech. Rough-in Appr/Bdwlk Found. Plbg. Top Out Gas Line FINALt Poet/Beam Struct. San. Sewer Framing -Bldg. Post/Ream Mech. Rain Drain Insulation -Plumb Plbq. Underfloor Water Line Gyp. Bd. -Koch. /. rlAI Dake Requested: .6 � // 7Time: AM �__.PM Addreen: �c�L/ �.J�.- _ Permit #: Builder: THE THE FOLLOWING CORRECTIONS ARE REQUIRED: Inspector �J _APPROVZD DISAPPROVBD APPROVED SUBJECT To ABOVE Call For Rainep. CITYOF TIGARD My TW_W_ PLUMBING PET'RMI COMMUNITY DEVELOPMENT DEPARTMENT 011141*N 'ERM, 'E #. . . . . . . . PLM' 1 -0071 13126 SW Hall Blvd. P.O.Boot 23397,TOW,Oregon 97 (503)639-4175 DATE ISSUED. 05/14/91 SITE ADDRESS. . . : 1. 1945 SW 1E61'H FL PARCE-i"L: ISI­7ADD- 12500 SUBDIVISION. . . . : VILLAGE AT SUMMER LAKE PARK 4 ZONING: R-4. 5 BLOCK. . . . . . . . . . . LCI!`. . . . . . . . . . . . . : 162 CLASS OF' WORK. . :NEW GARBAGE DISPOSALS. . : MOBILE 1-40ME SPACES. : IYPE OF- USE. . . . iSF WASHING MACH. . . . . . . : BACKFLOW PREVNTRS. . : 1 OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . . rpnps. SJORIES. . . . . . . . :2 WATER HEATERS. . . . . . : CATCH FIX'TL1RES -_....._._._.W_._.__.._._ LAUNDRY TR(-4YS. . . . . . : SF RAIN DRnINS. . . . . SINKS. . . . . . . . . . : URINALS. . . . . . . . . . . . : GREASE TRAPS. . . . . . . : LAVATORIES. . OTHER FIXTURES. . . . . : JULA/ESHOWERS. SEWER LINE (ft) . . . . : WATER CLOSET'S. . WATER LINE , Ft) . . . . - DISHWASHERS. . . . RAIN DRAIN (ft ) . . . . kemar,ks : ".i1PRINKLER SY151'EM Uwner: PEES LARRY R. CHRISTENSEN CONST type arnot.tnt by date recpt 17675 SW IVY GLENN DR 'RMT $ 15. 00 JLH 05/14/)1 5PCT $ 0, 75 JLH 145,114.,191 Al-01-10 OR 91007 �-Inone #.- 642-9279 Contractor,: ---­---­------------------------ DIVER91FICi,I) LANDSCAPE CONTR. t8805 CAMELOT LANE HILLSBORO OR 47123 Phone #: C,28-8158 O 155. T5 T 0 TAL Req #. . 1 5877 --- --- REQUIRED INSPECTIONS ------- This permit is issued sub.iect to the regulations contained in the Final Inspection Tigard Municipal Code, State of 0-t. Specialty Coats and all other applicabli, laws. All worl, will be done in accordance with aoproved plans. This permit will expire if work is not started within 180 days of issuance, or if worh is susainded for more than 180 days. 1 —il.ted By -, Call for inspection 639-4175 s INSPECTION NOTICE City of Tigard Building ' apartment 13125 8W Ball Blvd_ 'figard, .wegon 97k23 Inbpsea ion Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection4_ '-- _—,-- --- _.- -- Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post/Beam Struct. San. Sewer Framing -Bldq. Post/Beam Mech. Rain Dratn Insulation Plumb. Plbg. Underfloor Water Line / Gyp. Bd. -Mech. Date 'Requested: _'"� �/ Times AN PH Addross: r Builder: l :► ""� THE FOLLOWINO LU6CrIONS ARE REQUIRED: —r - Inspectors /100V _19V _ Dates,'�; _ _` APPROVED DISAPPPOVRD APPROVED SUBJECT TO ABOVE \ C�11 For Reinsp. INSPECTION NOTICE City of Tigard Building Department 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Lina (Rec-0-Phone): 639-417F Business Phone: 639-4171 Inspection: _77- Footing 7Footing Plbg. Underelab Mech. Rough-in C��Zfdvslk / Found. Plbg. Top Out Gas Line FINALt Poet/Beam SLruct. San. Sewer Framing -Bldg. Post/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Koch. Date Date Requestedt / _,_Timet AN PM Address: i i`1%-� � �' Permit 4: BuildersTHE FOLLOWING CORRECTIONS ARF. REQUIPED: ^ Q A C 12 /// / L , rte_ ► ` 1 Inspectors ( `Y.�/r ,7y.. 1, c< k-4 c I Dates APPROVED 0I8APPROpPROVRD BULIBCT To ARM -Call Por Reinsp. INSPECTION NOTICE City of Tigard Building Department 13125 SW Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-0-Phone): 639-4175 Business Phone: 639-4j!i --- Footing Plbg. Underelab Mech. Rough-in Appr/.Sdwlk / Found. Plbg. Top Out Gan Line FINAL: Pcet/Beam Struct. San. Sewer Framing -Bldg. Foot/Beam Hoch. Rain Drain Insulation -Pitmb. i-lbg. Underfloor WaterLinoGyp. Bd. qq -Hecch. Date Requeetod:_ !`� Time:�Cl1G PH addreoes �7 6E' ~ Permit Builders d/LA1 TIME FOLIA-MINO CORRECTIONS ARE REQUIREDs Date: ' Inspectors_ . Z� �r APPROVED ( _ DI/AP! A'YF RD S1IRJECT TO ABOVF wRall ►Or Reinep. INSPECTION NOTICE City of Tigard Building Department 13125 SN Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-417 Inspection:___ �— Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Can Line FINAL: Poet/Beam Struck. San. Sewer. Framing Bldg. Poet/Beam Mach. Rain DraLnInsul'at ion -Plumb. Pl.bg. Underfloor Nater Line Gyp. Ed. -Meeh. Date Requested:_ ✓ �/ Time= 5 9X AM �7^ PK Address: �/%t1� ` r�� Permit #t Builder:_ l i�l'S THF. FOLLOWING CORRECTIONS ARE REQUIRED: I Inspectort_ i —Xf+PROVEb DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Pelnsp. 1� a � � 01 ■1 �' � � i i INSPECTION NOTICE City of Tigard Bul-l.ding Department { 13125 Sw Hall Blvd. Tigard, Oregon 97223 ' Inspection Line (Rec-O•-Phone): 639-4175 Business Phone: 539-4171 / Inspection:__ -- �---- Footing Plbg. Underelab mo&. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas FINALi i Post/Beam Struct. San. Sewer `Framing; -Bldg. Poet/Beam Much. Rain Drain '! Insulation -Plumb. Plbg. Underfloor Water Line Gyp. ad. -Rech. — C� h ) - Time: M Date Requestedi - Address: -- Permit ii Builder: ( /��'i� "72741--- THE)FOLLOWING CORRECTIONS ARE REQUIRED: / 1ey ed,17 "r '7✓ / o,5'i Inspectors_ _ Dates s �_ `AFPROVln DISAPPROVED APPROVED SUBJECT 110 ABOVE Call For Reinap. INSPECTION NOTICE City of Tigard Building Department 13125 SM Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-.Phone): 639-4175 Business Phone: 639-4171 Inspection: Footing Plba. Underelab Mech. Rough-in Appr/Sdwlk Found. lbq. Top Out �l Gas Line FINAL: Poet/Beam Strruc`t._ San. war Fr Framing -Bldg. Poet/Beam Mech. Rain Draln Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Mech. Date Revuesteds -:5 /� �Times � AM/�j� 2 PM Address: C! y� Pe t 1 s Builders THE FOLLOWING CORASCTIOMS ARE REQUIRED: Inspectors_ at. I _j�_APPROVRD M SAPPROVtD APPROVED SUBJECT TO AnOVE ,_Call For Reinsp. N� SPEGTION NOTICE City of Tigard Building Department 13125 SW Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4.775 Business Phone: 639-4111 e Inspection: -- Footing Plbq. Underelab Mech. Rough-in Appr/Sdwl.k Found. Plbg. Top Out Gas Line FINALS et/Baas 8tru San. Sewer Framing -Bldg. at/Beam Mao Rahn Drain Insulation -Plumb. Mg. Underfloor Nater Line/ Gyp. Bd. �(1�-Mach. -,,a -�7� Times PM Date Requested$ //': lF � /-,1� Peciai#: Sr1.1_ Address$ �j Builder:_ THE FOLIOWING CORRECTIONS ARE REQUIRED$ Ad ICA IM Lr Z__ Iuapactor$ Date$ —APPWM DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Rafnap. INSPECTION NOTICE City of Tigard Building Departaent y 7 1.1125 SN Ball Blvd. Tigard, Oregon 97223 Inspection Line (Ren-o-Phone): 639-:175 Business Phone: 639-4171 Inspection: rootingPlbg. Underslab Mach. Rough-in Appr/Sdwlk Gas Line FINAL: Found. Plby. Top Out Poet/Beam Struct• San. Sewer Framing -Bldg. Poat/Beam Mech. Rain Drain Insulation -Plumb. �---� -Mach. pjbq_ Underfloor Nater Line GYP• ed. �� Date Requeeted1iW Address- Builder-- THE ddress:Builder:_TME FOLLONING IONS ME REQUIRED: — i Inspectors,�� — —_— Date+ _ 1. ) FROM DISAPPROVRD APPROVED SUBJECT 'YO 11E0VE Call For Aeinep. c i INSPLMION NOTICF City of Tigard Building Departspnt 13125 SN Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Busineas Phones - 171 Inspection: Footing Plbg. Underalab Mech. Rough.-in Appr/Sdwlk Found. Plby. Top Out Gan Line FINAL: Poet/Beam 3truct. San. Sewer Framing -Bldg. PoaL/Beam Mech. in Drai Insulation -plumb. Plbg. UnderfloorWater Line Gyp. Bd. Mech. Date Requested: Til*-&— M hddress:_ Builder:__ THE FOLLOWING CORRECTIONS ARE REQUIREDt Inspectors y ae�T. •_.u---------- — — - Data: APPROVED DISAPPROVED APPROVED suniKeT TO Atu)vr / Call For Reinsp. INSPECTION NOTICE City of Tigard Building Department 13125 SII Sall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-417 Inspection:_ /.ting Plbg. Underelab Mach. Rough-in Appr/Sdwlk ound. Plbg. Top out Gas Line FINAL: Poet'/Beam Struct. San. Sewer. Framing -Bldg. tt f Poet/Beam Mech. Rain Dram Insulation -Plumb. Plbg. Underfloor water Lina Gyp. Bd. -Mach. Date Requested: -L=-e Time,L�_ AM PM Address:- �5.✓ -. �G/' e✓1� rmit 1: �T ...� I TI4E FOLLOWING CORRECTIONS ARE REQUIREDi �— A? /y0 -- ?i' V/17-2t-- /C0A/a-i�7J �:y(z i 'T-) AQL",�Z/Z / _ _ LsIr1.�L 07P�/9C C .t/T, `J C L _ L _ 1109c j ''lli v2 TZ) f�i{��G s.�c��r oma ,- rt.=rte Inspectors Date: APPOMD DISAPPROV'CD_�APPROVRD SU;URCT TO ABOVE Cal! For Reinap. PLUMBING PERMIT CITYOFTIVARDAi�� PERMIT #. . . . . . : MST91-0013 C11Y0FTWA COMMUNITY DEVELOPMENT DEDARTMENT ORIGM , DATE ISSUED: 01/30/91 13125 SW Hall Blvd, P.O.Box 23397,Tigard,Or»pon 97;13 (503)639-4175 SITE ADDRESS. . . : 11945 SW 126TH PL. — PARCEL: 1S133DD-12500 SUBDI�►ISION. . . . r VILLAGE AT SUMMEh LAKE PARK 4 ZONING: R-4. 5 BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . : 162 CLASS OF WORK. . :NEW GARBAGE DISPOSALS. . : 1 TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : I BACKFLOW PREVNTRS. . :O OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0 STORIES. . . . . . . . :2 WATER HEATERS. . . . . . .. 1 CATCH BASINS. . . . . . . :0 1 FIXTURES------------- LAUNDRY 'TRAYS. . . . . . : 1 SF RAIN DRAINS. . . . . : 1 SINKS. . . . . . . . . . : 1 GREASE TRAPS. . . . . . . :0 LAVATORIES. . . . . :,3 OTHER FIXTURES. . . . . :0 TUB/EHOWE.RS. . . . : SEWER LINE (ft ) . . . . :0 WATER CLOSETS. . :2 WATER LINE (ft ) . . . . : 100 DISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . . . :0 Remarks : OWNERa 1-.ARRY R. CHRISTENSEN~CONST RAYM $ 100. 00 JLH 01/18/91 208788 17675 SW IVY GLENN DR BPRT f 438. 00 BPLC $ 264. 70 AL.OHA OR 97007 BSPC f 21. . 90 Phone M: 642--9i?79 SEDC ♦ '375. 00 PARK f 500. 00 Plumbing Contractor:-------_______-.___ MPRT f 33. 00 MPLC t 8. 23 Name: -E&AQ 1� '" a_�'r MEPC $ 1. 65 Address:..'7p^ C:ZLj Cl93NPPRT $ 140. 00 / C it y:tj lSt at a: - PSPC $ 7. 00 Lip:���40� __ F'honell<:_(p_yZ- '1chl TIF $ 1350. 00 Reg M: _ y_ �_ ___ __ PAYM $ 3059. 50 JLH 01/30/91 REQUIRED INSPECIIONS - - This permit is issued subject to the reg- ulations contained in the Tigard Municipal Foot/found Insp Rain drain Iitsp Code, State of Urea. SE+ecialty Codes and all Post/Beam Struct Water Line Insp other applicable laws. All work will be done Post/Beam Mechan Appr/Sdwlk 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 Mer_.hanical Insp Building Final suspended for, more than 180 days. Plumb Top 0ut Erosion Control Framing Insp Crawl Drain Fireplace Insp Gam Line Insp Insulation Insp X __r Gyp Board Insp Authorised Plumbing Contractor Signature Call for inspection -- 639-4175 Contractor Notes: � ___�_� -.-- ------------ -------- CITYOFTIFARDMASTER IERMIf RD COMMUNITY DEVELOPMENT DEPAMMENT l'LRhII T' #. . . . . , . : MS I'a 1. IhOi 131258W HYI Blvd. P.O.Boz 233W,ripud,o►.oa,°' (�p'►° 76 7DATE IS5UED: 01/30/91 JIi iE ADDRESS. . . : SW 11='61_1-1 KCL. PARCEL: 1S133DD-125O0 SUBDIVISION. . . . : VILLAGE AT SUMMER LAKE= PARK 4 ZONING: R-4. 5 ULOCK. . . . . . . . . . I LOT. . . . . . . . . . .. . . : 162 --..._______________.__-...----------- BUILDING ------------------ - -------------------- REISSUE: DWELLING UNITS: 1 BASF_IIEN r. . .: . . . , . :0 ,f '_ CLASS OF WORK. :NEW BEDRMS:3 BATHS: 1 GARAGE. . . . . . . . . , :516 sf TYPE OF USE. . . :SF !=LOOR AREAS---••---.____.- REQUIRED SETBACKS-----___.__._ TYPE OF' CONST. :5N F I RST'. . . . : 1729 s f LEFT. . :5 ft RIGHT. -5 ft OCCUPANCY GRP. :R,:, SECOND. . . :280 s f FRONT. -,20 ft REAR. . .-25 ft s"rORIE S. . . . . . . :2 THIRD. . . . :0 s f REQUIRED----_____.___ HE I GHT. . . . . . . . :20 ft TOTAL_..,_- . _ .;.,ZliZ19 r,f SMOKE DE:TE.CTORS. :Y FLOOR LOAD. . . . :40 psf VALUE. . . . . $ : 101702 PARKING SPACES. . :0 ---------------------------- PLUMB PLUMBINU _.......___--.-_-_._____-_______------______-_ SIINIKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . BACKFLOW PREVNTRS. . :4 LAVATORIES. . . . . 13 WATER HEATERS. . . : 1 TRAP'S. . . . . . . . . . . . . . :0 TUB/SHOWERS. . . . -3 LAUNDRY TRAYS. . . : 1. CATCIa FAraINS. . . . . . . :0 WATER CLOSETS. . :2 SEWER LINE (ft ) . :0 GREASE TRAP'S. . . . . . . :0 DISHWASHERS. . . . il WATER L THE (ft ) . : 100 OTHER FIXTURES. . . . . :0 GARBAGE RAIN DRAIN (ft) . :O WASHING MACH. . . : 1 SF RAIN DRAINS. . : 1 ---------------- MECHANICAL- ____....._________ __..______w___._.___ FEES FUEL. TYPES-----------_•- UNIT HTRS. . :0 type amount by date recd /BAS/ / / VE141S . . . . . :0 pAYM $ 100. 00 JLH 01 /18/91 208788 Mf1X I NPU T :O BTU VENT DANS. . :r PFIRT $ 438. 00 r' f I..iRN ( 100K . . - 1 HOODS. . . . . . : 1 SPLC $ 284. 70 f URN ) =100P, . . :0 WOODSTOVE.S. :0 B5pC 21. 90 r / FLOOR FURN. . . . :0 CLO DRYERS. : 1 SSDC SOIL/CMP ( 3HI D:0 OTHER UNITS-.0 PARK $ 500. 00 GAS OU'T'LETS: 1 MART $ 33. 00 Ow"ar: -_-__..___._._...____. _ _�____._.-__._.____._.___ MPL.0 t 8. 25 LARRY R. CHRISTENSEN CONST M5pc $ 1. 65 1.7675 SW IVY GLENN DR PPIRr $ 1W40. 00 PSpC $ 7. 00 l+I.OHA OR 97017 TIF" `E 1350. 00 1 Phone #: 642-9279 PAYM $ 3059. 50 JLH 01 /30/91 Contractor : LARRY R. CHR I ST ENSE:N CONST 1 76 75 ;;W IVY GLENN UP ALOHA OR 97007 Phone f": 1642-9271 Reg #. . : 53099 ___.----------------------I_____________ $ 3159. 50 TO rAL This permit is Issued tubeo iect to the rulations contained in the --- --- REQUIRED INSPECTIONS ------- Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Fireplace Insp applicable Tabs. All No* will be done in accordance with approved post /Beam Str�.Ict Gas Line Insp plans. This permit will expire if Knr.N ,. -r► etarted within 108 Post/Beam Mechan Ins+.flation Insp days of issuance, or if work is sus 9, Pllm/undslcab Insp Gyp Board Insp / ). PLM/UnderfIoor" Rain drain Tnsp ormittee Signaltur , _74/ 1 Insp Water Line Insp mb 'Fop Out Aper/Sdw1k Insp t ss'.ied p " Framinq Insto Mer..hanicm l Fina? Cali for inspect n 639--4175 SEWER CONNECTION ITYOFTIGARD PERMrf Cff Y OF TW64 R�D COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . : SWR91--00le 13125 BW Hell Blvd. P.O.Bak 23W,rood,Oregon 97221(603)6304175 7 DATE: ISSUED: 0l,/30/131 ...-ITE_ ADDRESS. . . i 11945 SW 126TH PL PARCEL: IS133DD-12500 SJUBD I V I S I ON. . . . : VILLAGE Al SUMMER LAKE PARK 4 ZONING: R--4. 5 BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . .. 162 TENANT NAME. . . . . : USA NO. . . . . . . . . . :43158 FIXTURE UNITS. . . CLASS OF' WORK. . . :NEW DWELL I NG UN I TS. . : I TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1 INSTALL TYPE. . . . :BUSWR IMPERV SURFACE. . - Remarks : Owner: ----------------- FEES -----_-----__-. LARRY R. CHRISTENSEN CONST type amount Eiv date r-ecpt 1*7673 SW IVY GLENN DR PRMT $ 1500. 00 INSP $ 35. 00 ALOHA OR 97007 PAYM $ 1535. 00 JtJA 01/30/91 Phone #: 642-9279 Contractor- CONTRACTOR 1140T ON FILE Phore #- 1 1535. 00 TOTAL REUUIRED INSPECTIONS This Applicant agrees to comply with all the rules and regulations Sewer, Inspect ion of the Unified Sewage Agency. The permit expires 12@ days from the date issued. The total amount paid will be forfeited if the permit expires. The Agency dots 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 giver. If not so locate . the ller shall v:;r-#,RsP a "Tap and Side Sewer" Permit and t P A qcv wi I ins14 a 1-11" 17�e P 9 iq n a t t.t r- r --� 0) d 1)y - - ----- Call for insriectio'n 639-4175 CITY OF TlCARD REC.Elr,-T OF PAYMFNT RECEIPT NO. :9 1--20921 CHECK OMOLJNT - 45134. 50 NAME LARRY rl-IRISTEN531--N GONST CASH AMOUNT 0. 00 ADDRESS PAYMENT DATE 01/30/91 ;l,)F-%D I V I S I ON I1945 SW 126TH PURPOSE Or PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID -1N,-U-PERM'ER-M -MS-T,*9 1--0 0 13 438. 00 PLUMBING PERM 140. 00 MECHANICAL FIE 33. 00 ST. BUILD PER 30. 55 f::lLAN CHECK F17'' 191_'. 95 SEWER USA 15300. 00 {.')EWER INSVT ECT 35. 00 RESIDENTIAL TRAFF- IC FETS 1::'510. 0 0 MIA!'33S TRANSIT TllrFEES) 100. 00 PARKS SDC 500. 00 GTC)RM DRAtN SDC 375. 00 40TAL AMOUNT' PAID --- - --- -- 45 '4. 50 rT� t3�u sw tisu ai.e PLNCK/RECT # Cl11 T OF 1V1�.1\� PERMIT # COMMUNITY DEVELOPMENT DEPARTMENT "9 (W)639-4171 DATE ISSUED JOB AD RESS: �0 l�/a _G�c _/tel' TAX MAP/LOT /.5/ 32' l,,0 SUB: o(dip ? �' LOT: _-- ��Z LAND USE: VALUATION: — OWNER /�� SPECIAL NOTES NAME G �Qc X2 L6"7t-W-� �'`'� C'v _ REISSUE OF: --ADDRESS: 7G 'S 9-J /1'/y CteNml '� LAST REISSUE: — -- Az,01�4 , Q,Q FLOOD PLAIN/ PHONE: ��- qa7 SENSITIVE LAND: CONTRACTOR APPROVALS REQUIRED NAME: _ � 'Q jPr 51eW 101) ICNW- PLANNING: _ -- ADDRESS: ENGINEERING: — -.—. FIRE DEPT: PHONE: OTHER: ------ CONTR. BOARD #: 51)06 EXP DATE: / y ITEMS REQUIRED SUBCONTRACTORS: PLUMB: LIST/SUBCONTRACTORS: MECH: AY,At'AJ � BUS TAX: _ ------- — --- ARCH/ENGINW CALCULATIONS: NAME: 1/7/( TRUSS DETAILS: ----T—.__.- ---.�-- ADDRESS: Z-O9 N�IlAlefo A.) _ OTHER: --- ---- ------ -- PHONE: O - PROPOSED BLDG. USE: --- COMMENTS: ------ ----- -- -- ---- PLICA SIGNATURE Date Received: Received BY: PERMIT # ACCT N DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE 10-432 00 Building Permit Fees - 3� _ 10-431 00 Plumbing Permit Fees 10-431 01 Mechanical Permit Fees -33 _ �3 3 10-230 01 State Building Tax (5%) 3�'' ' Building C' Plumbing Mechanical S 10-433 00 Plans Check Fee �12 Building7�_' Plumbing Mechanical 10-230 06 Fire – } -co,L 30-202 00 Sewer Connection � �–L '5- _-- i-- 30-444 00 Sewer Inspection 25-448-02 Commercial TIF Fees _— — t 25-448-04 Industrial TIF Fees 25-448-06 Institutional TCF 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) �1� ; iL 24-445-01 Water Quality (Fee in lieu of) _ 24-445-02 Water Quantity (Fee in lieu of) TOTAL . 1 415 S nm/IY11P.WPF