11790 SW 129TH PLACE-1 e
i
I'
s
1
117'90
{
CERTIFICATE: OF
CITYOFTIGA
RD � �!ry OCCUPANCY
r x > crry Ffl�:ARD PERMIT 0. . . . . . . a Pl'P892241
COMMUNITY DI:VELOPMEhT DWP 24VfT WEGON PRIM. C'Erci-iii N. s d92241.
13125SWI1eIIP,MJ. P.O.Eux23397,Tie rti,Ck&gon 97223(603)B394175 lain IC ISSUED& 105/04/10
SITE ADDRESS. . . v 11'190 9v 129T11 PL PARCEL.s 1S1331)D.-01400
SUBDIVISION
. . . . . a ry7 !y 1'ON,INOr
BLOCK. . . . r • r . r r 0 L.{7 1 r rt r 11 r • • • • • r r r �J7
CLASS OF WORK. uNEW
TYPE OF USE. . . a SI~ i
OCCUPANCY GRP. tR3
OCCUPANCY LOAD&
1'E''Ni0l C NAME:. . . o
trema rocs t
ICON MORISSETTE
RC) PDX 19524
PORTLAND OR 00000-0000
Phone #s 000- 000-1*00
Contractor
DUN MORISSETTE ELDERS, INC:.
P 0 ))OX 1'-4524
PORTLAND OR 9',1219
Phone 11: 503-244--9314
Rep #.- 1 r 351833
Occupancy of the above referenced building is hereby given, and certifies
the complialric" with the+ fatale Of Oregon Specialty Cries for th• group,
occupancy, and uxw under which the refere-ced permit was issued.
FIRE DEPARTMENT UILDINO I
Lam......:
BUILDI,00 Of`FI1, AL
PJST IN CUNSPICUOUS PLACE:
i
i
I
I
I
INSPECTION NOTICE
City of Tigard Building Department
P.Q. Cox 23397
Tigard, Oregon 97223
Phone: 63� 4175
Type of Inspection
�� C
Uate Requested_ J Time A.M. ^ P.M.
Addrass l l(L �'� —_ Permit 01 —
Owner Lot
a
Builder
The following Building Code deficiencies are regvired to be corrected:
Presented to _ Approved
,4; U Disapproved
Inspector S
Date
CALL, FOR REINSPECTION
❑
YES L�l NO
I
i
i
I
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of !nspection
Date Requested `1 �-� .� � Time _ A.
i
Address ___--,�r.7 ----/'2T`^" Permit
Owner —__ —�� — Lot
Builder — —
The following Building Code deficiencies are required to be corrected:
,t
Presented t.o _— � �_— _ Approved
Inspector — I .I Disapproved
Date _____-4 —ZL) -90
CALL FOR REINSPECTION
❑ YES NO !
TNS'E.CTION NOTio;E
City of I card Bui;.Jing D,qpattrnent
P.C. Box 23397
T,�,,ard, Oregon 97223
Phone: 639-41'5
Type of Inspection
Date Requested Time A.M. P.M.
Address Permit # Al2,-41!2—
Owner Lot #
Builder
The following Building Code dc(icif-ncies are required to be corrected:
7�
Presented to Approved
Inspector Disapproved
Date
CALL FOR REINSPECTION
❑ YEI C1 NO
maim--
INSPECTION NOTICE
City of 'Tigard Building Department
P.O. Box 23397
I
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection �y '
Date Requested 3_ —�--�— Time A.M._ P.M.
Address /7. — �v Permit #.
Owner____ _ Lot #
Builder �' �C�'�el� ---
The following Building Code deficiencies are required to be corrected:
4U,Aj: 'k A,,Vl
Presented to _ _ _Approved
Inspector _. [_j Disapproved
Date '
CALL POR REINSPEC77ON
❑ YES 0 NO
TRI CITY DWiFT Fr,X 786-0492-------- PAGE 01
TRI - CITY DRAFTING, 1C,
6621 OAK RIDc��DR.
GLADSTONE,ORFQON 97027
(503) 669.3445
FAX NO. 786-0492
F A X T R A N S M I T T A L
DATE:
RE: �/�✓ /1/141x/S S.E'T"�ic' !/��- �
NO. OF PAGES INCLUDING THIS SHEET:
NOTES:
SIGNED:
uwki�
TRI CITY DRAFT FAY 786-0492-------- PAGE 01
rd
ANALYS I S
Xz 7
PREPARED BY: TRI ,CITY DRAFTING
GLADSTONE, OREGON 97027 (503) 659--3445
Client : DON MORISSTTE BUILDERS
project : PLAN NO. 9&
Location ; GAktAGE F)OOR HEADER
Da t e : 03 08 1-00
Comment ; usE 4 X 14 BEAM
BL-'AM AND LOAD DIAGRAM
IiHIIHIIIIHHiiliHfiHHfiHiffiilHHHIiHIJHHHffHHHif
J
J . $
R2
Reaction RZ 2, 520. 0 lbs .
Reaction RI 21520, 0 lbs .
Total load = 5, 040 . 0 _lbs . , overhng .
Dimensions : Clear spat' 16 . 0 feat , ----- --a--- -
No point loads
No triangular loads . 240 Ills . total ) .
Uniform beam weight= 15 lbs/lf
Uniform loads : Ul = 300 . 0 Ib:j/ IL at 0 . 0 feet to 18- 0 feet .
Beam spacing :- 12. 0 inches .
( live load plus
Deflection limit =dead load ) ; 1/240.77
BEAM TYPE: WOOD: FIRJARC1I 4X 41
COMPUTED STRESS/STRAIN DESIGN VAL. pJj0PLRTIES REQUIRED A CTU A 1,
95 . 0 Area (sq- 1n . ) 40 41
Shear (lbs ) 2, 520, 0 FV at ki ,
Moment ( ft - lbs ) 10, 080. 0 FB 1 , 51)0. 0 Sect .Modulus 322 47 /1
Deflection ( ill ) 0. 80 E 1 . 80E6 mum. Inertia *==0Z
ximum Deflection 0. 54
Actual Ma
Maximum Defluctioll occurs at s . o feet .
Maximum Moment occurs at 8 . 0 feet .
Beam size (W X 11) : 00fay l i7 6a
BEAM AREA: 41 - 15
DETERMINING FACTOIR
i
I
P 01
A !?loa BOOS 'tftr►. (SvrJ
i P.Q Box 19524 t
�C�B 72/e �
11.790 SIN 12 .7*► lcotb (S033))22414PbrtlR94-9331414
The FounAsUoo For LlloH6lle Home,
�t(iur• �E/tWllr � ��' t24-t
i
CDRR.rCT rI 00L Jo(SY »L-AM LAYOUT /#J �4o4jit
1�
.j
�j
N_
k
1 ► �r U1 O
J
4-K 14 N 6APCR
I
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection —_ •��
)ate Requested �� Time A.M. P.M.
>ddress ��� -- � ft1 — Permit
3wner "yy _ Lot #—_
3uilder
rhe following Building Code deficiencies are required to be corrected:
"w. �` .�/c�...'-_[' ,/-��_s-.��,.�'��.lr i•i<i•!'i '''/ ��c C��Z. rC'/�C _ _
>��� !•..� �S /�i-'� t7�
I 21f
Presented to
__ Approved
Inspector Disapproved
Date ------
rALL FOR REINSP C77ON
r-i vct F) nin
rM
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223 �(-
Phone: 639-4175
Type of Inspection --
Date Requested
Address __ �� r�9D �a °j - Permit
Owner__.
_ _ Lot #
Builder
The following Building Code deficiencies are required to be corrected:
d
T- t
1
Presented to Approved
Inspector / t—' D Disapproved
L r �
Date
CALL FOR REINSPECTION
❑ YES ❑ NO
i
INSPECTION NOTICE
City at Tigard Building Department
P O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested /�' "_�� Time A.M.---LI-P.M.
Address — &-2 l�'� -- Permit #
Owner Lot #
Builder / ,/Z _ —
The fol;owina Building Code deficiencies are required to be corrected:
Ar AAZzgiE�Z'
62
Ve' 72
Presented to _ —..-T�pproved
In..pector _ Disapproved
Date '/
CALL FOR !i V I V;,PECTION
I-"1 ♦lid L-I NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397 J'
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection ----- -
Date Requested.—/_=1__� Time _- - A.M. P.M.
Address �� f� _ _'` -- Perr,iit #
Owner /y/yam- -__ _ Lot #
Builder ---
The following Building Code deficiencies are required to be corrected:
Presented to "Approved
Insre,;tor _. ❑ Disapproved
Date
CALL FOR REINSPECTION
C1 YES 0 NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223 I _ /u C��
Phone. 639-4 75 'U"`"P_G
<Type of ln.nect ,it 1-4mr e 6"" �
Date, Requested — 7l-d 2 Time ��_A.M. qP.M. �
Addres �/ls Permit #_ �!
Owner Lot #
Builder G��� �� •, r :.��,�, �'`� ,� �/'��a�
The following Building Code deficiencir s are required to be corrected:
V
Presented to ffApproved
Inspector ^ � ❑ Dfgpproved
Dat-
CALL FOR REINSPECTION
4
❑ 'VES 0 NO
I
1
1
i
i
INSPECTION NOTICE f��
City of Tigard Building D*lpartment
P.O. Box 23397
Tigard, Oregon 9722;1
Phone: 639-4175
Type of Inspection
Date Requested_ `a O Time A.M. P.M.
Address _ � _ Permit
Owner- �i.� a Lot #
Ruilde — .,. � �� �.- �t�. 1L c3 d
The followicp oui;din,; Cude JRficiencies are required to be corrected:
Presented to Approved
Inspector �7� �T /[ Disapprov@6
Date --
CALL FOR REINSPECUON
❑ YEa 1-1 NO
r
INSPECTION NOTICE
I
City of Tigard Building Department
P.O. Box 23397 i
Tigard, Oregon 97223
Phone! 6�39--4175,,
Type of Inspection
Date Requested__ / — � � Time__ A.M. P.M.
Address ! Q __ Z Permit #el
Owner_._. _ Lot
Builder ; 1111C
The following Building Code deficiencies are required to be corrected:
i
Prciented to �Approveo
Inspector q -- _ i Disapproved
Date
CALL, FOR REINSPECTION
El YES ❑ NO
i
II
INSPECTION NOTICE
City of Tigard Building Department `
P.O. Box 23397
Tigaro, Oregonon977223
Phone: 639-4175
Type of Inspection --
Date Requested Time_ _A.M. _P.M.
Address r 7 Zr 1 .5 !-<2 Z 2 _ Permit #_L''c1 �' `t
Owner_ Lot #
BuilderThe following Building Code deficiencies are required to be corrected:
t
Presented toApproved
Inspector -- I Disapprov a
Date —
CALL FOR REINSPECTION
0 YES ❑ NO
i
I
j
INSPECTION NOTICE
City of Tigard Building Department '- t
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection-4! �&X-'_/� V_
Date Requested = Time
Address _ L1� __. °�-5' Permit #.
Owner `
r ----.__ _ Lot #
Builder
The following Building Code deficiencies are required to be corrected:
Presented to
�� -- - El Approved
Inspector _
-- -_ Disapproved
�.
Data
CALL FOR $EINSPECTION
CiEa [� No
►
f
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requnsted Z �� Ti e A.P. P.M.
Address�� �� Permit
Owner Lot #
Builder
The following Building Code deficiencies are required to be corrected:
Presented to _. � ^A
� v4pllr'ved
Inspoctor i
Disapproved
Date
CALL FOR RElNSPFCTION
C1 YES ❑ NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection `�- `✓ —�
Date Requested— - Time--A A.M. P.M.
Address
7r� z` Permit
Owner Lot #
Builder —
The following Building Code deficiencies are required to be corrected:
Presented to _._ f Approved
Inspector ��4 — ---- Disapproved
Date -
CALL FOR RFINSPFC77ON
F-1 YES U NO
BUILDING PERMIT
CITY
OF TIGARD PERMIT NO. : BU592241 s, '
ctrroir n6.aRn
COMMUNITY DEVELOPMENT DEPARTMENT TE ISSUED: 11/27/59
13125 S W Nall Blvd,P.O Box 23397.Tigard,Oregon 97223,(503)6394175 P' IM.PMT.NO. 592241
JOB ADDRESS: 11790 SW 129TH PL
TAX MAP/LOT iS1 33DD SUB: VILLAGE AT SUMMERLAKF 2 LT:53 BK:
LAND USE: R4.5P'D
LOT SIZE: VALUATION: $ 95. 145 SETBACKS
FRONT: 20 REAR: 13
WORK CLASS: NL-:W DWELL.UNITS: 1 LEFT: 5 RIGHT: 29
USE TYPE: SINGLE FAMILY NO.BEDROOMS: 3 EXT.WALL CONST:
CONST.TYPE: VN NO.BATHS: 3 N: S: E: W:
OCCUP.GRP. : R3 PROI.OPENINGS:
OCCUP.LOAD N: 5: E:: W:
TOTAL AREA: 2120
NO.SIORIES: 2 1ST: 1266 ROOF CONST: C FIRE RET?
HEIGHT: 20 2ND: 560 AREA SEPAR? RATED:
BASEMENT? 3RD: OCCUP.SEPAR`? RATED:
MEZZANINE? BASEM'T
FLOOR LOAD: 40 GARAGE: 5061 FIRE SPRKI_R? AL.ARM-�
FLOW(GPM) DETECT? YES
NEAT TYPE: GAS RN �5? _CORR' —
PLAN CHECK BY: rlt
REMARKS:
REISSUE OF NO.
LAST REISSUE
FEES:� , ------__ ----- ------------ ----- r
$430.08
MORISSETTE DON
N PERMIT
po BOX 19524 PLAN REVIEW $279.50
Portland or FIRE DEPT
STATE TAX $21.50
_ OTHER
-�� — DEVELOPMENT LHARGFS:
O MORISSETTE DON SDC(STORM) $250.00
NDON MORISSETTE BUILDERS INC. SDC(STREET) 6h00.00
R PO BOX 19524 PDC(01 ) $250.00
�
Portland or 9721'3 PREPAID $100.00)
T PHONE (503) 244-9314
R REGISTRATION NO. 35533 TOTAL: $1,731.00
RFCEIPT NO.
This permit Is issued subject to the regulations contained in Title 14
of the TMC, State of Oregon Specialty Codes,zoning regulations RLOUIRED INSPECTIONS
and all other applicable codes and ordinances, and it is hereby
Agreed that the work will be done In accordance with the plans and FOOT I NO SEWER
specifications and In compliance with all applicable codes and FOUNDATION WALL RAIN DRAINS
ordinances The issuance of this permit does not waive restrictive POST R BEAM WATER LINE
covenants Contractor and subcontractors shall have current city PLB.UNDERSLAD CITY PPPRCH/SW
business tax permits This permit will expire and become null and F i NAL
void it work Is not started within 180 days,or if work Is suspended or SL AB
abandoned for a period of 180 days any time after work has pL 0.1 npOU1
commenced It shall be the responsibility of the permittee to assure FRAMING
all rept ;red In ectons are requasl�d and approved FIREPLACE
GAS LINE
TNS111-A1 ION
_.' GYP. BOARD
Perrnillpe Signehinv
Issued Byeot:LdR-iif9f*eTffW !s 39-4t 7
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
t 1• i l� �
SEWER PERMIT
CITY OF T167A RD CAP
� PERMIT NO. : SE892 385
COMMUNITY DEVELOPMENT DEPARTMENT TE ISSUED: 11/27/89
13125 S W Hall Blvd..P O.Box 23397.Tigard.Oregon 97223.(503)b39A175 I M.PMT.N0. 892241 e
JOU ADDRESS: 11790 SW 1291H PL USA NUMBER.: 39127
TAX MAR/LUT ISI 33DD SIIB: VILLAGE AT SUMMERLAKE 2 LT-53 BK:
LAND USE: k4.5PD
LOT SIZE:
SECTION: 33 TWP: 1s RNG: 1w
WORK CLASS: NEW
USE TYPE: SINGLE FFAMILY
The applicant agrees to comply with all rules and requ.lations of the Unified
Sewerage Agency. 'The permit expires L20 days from the date issued. The total
amount paid will be forfeited if the permit expires. The Agency does not guar
antee the Accuracy of the location of the side sewer laterals. If the sewer is
not located at ttie measurement given, the install.el shall prospect 3 feet in
all directions f am the distance given. If not: so located, the installer shall
purchase a "Tap and Side Sewer" Permit and the Agency will install a lateral.
INSTALL. TYPE, HI.IILDINI, SEWER IMPERVIOUS AREA:
FIXTURE UNITS: TENANT IMPROVEMENT:
DWELLING UNITS, 1
NO. OF BLDGS. : 1
FEES:
W MORISSETTE DON PERMIT (35.00
N po BOX 19524 CONNECTION CHARGE $1.250.00
E Portland or LINE TAP 1NSTALI .
-- -- --- --------- -- — -- � OTHER
C
O MORISSE:TTE DON
T DON MORIS5�ETTE BUILDERS INC.
R po BOX 19524
A portlon6 or 97219
T PHONE (503) 244-9314
R REGISTRATION NO. 35533 TOTAL, $1,285.00
RECEIPT NO.
This permit is issued subject to the regulations contained in Title 14
of the TMC. State of Oregon Specialty Codes.zoning rcyulations REQUIRED INSPECTIONS all other applicable codes and ordinances, and it is hereby
agreed that the work will be done In accordance with the plans and ROUGH-IN
specifications and In compliance with all applicable codes and
ordinances The issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have current city
business tax permits This permit will expire and become null and
void if work is not started within 180 days.or i1 work is suspended or
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all required I ctlons are requested n pproved
f __
Permitt aturi%`"'
Issued By li' -94P INAPFCTION "4-44 7F ---
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
PLUMBING PERMI1
CITY OF TIGA RD CM6F'TMAFM
F'FRt'II T NO
IT f'L.892383 i
OaIOON
AND
COMMUNITY DEVELOPMENT DEPARTMENT E ISSUED: 11/27/89
13125 S.W.Hall Blvd..P.O.Box 23397.Tigard,Oregon 97223.(503)6394175 G' I M.PMT.N0. 892241 —�
JOB ADDRESS: 11790 SW 129TH PL
TAX MAP/LOT 1S1 33DD SUB: VILLAGE AT SUMME.RLAY.E 2 I.1 ;53 BK:
LAND USE: R4.5PP,
LOT SIZE:
ITEM: N0: NO:
WORK CLASS: NEW MATER CLOSET 3 TRAP
USE TYPE: SINGLE FAMILY URINAL BKFLOW PRVNTR.
CONST.TYPE: VN LAVORATORY 3 TRAP PRIMER
OCCUP.GRP. : R3 TUB SHOWER 3 GREASE TRAPS
DISHWASHER 1
GARBAGE DISPOSAL 1
NO.STORIES: 2 WASHING MACHINE 1
DWELL.UNITS: I LAUNDRY TRAY BLDG.DRAIN (DIA
FLOOR DRAIN
SINK 1 SEWER (FT)
WATER HEATER 1 STORM/RAIN (FT 1
OTHER
REMARKSIt
FEES:
W MORISSETTE DON PERMIT 1148.00
N po BOX 19524
E portland or FIXTURES
STATE 'TAX $7.00
OTHER
C
O SHOEMAKER HAROLD
N SHOEMAKER'S PLUMHING
R PO BOX 250
A
C estacada or 97023
T PHONE (503) 630-7728
R REGISTRATION NO. 3922 TOTAL ; $147.00
---- RECEIPT N0.
This permit Is issued subject to the regulations contained in Title 14 _____________________
of the TMC, State of Oregon Specially Codes,zoning regulations REOUIRED INSPECT TONS
and all ether applicable codes and ordinances. and It Is hereby PL$.UNDERSI_AH
agreed that the work will be done in accordance with the plans and
specificatlons and in compliance with all applicable codes and POST R BEAM
ordinances The issuance of this permit does not waive restrictive WATER LINE:
covnriants Contractor and subcontract, rs shall have current city ('ILEI.1 OPOUT
business tax permits This permit will expire and become null and RAIN DRAINS
void,f work Is not started within 180 days,or it work is suspended or
abandoned for a period of 180 days any time after work hr s F INAL
commenced It shall be the responsibility of the permittee to assure
all required inspections are requested and approved
1,, 1
" t
Permitteegnaturn
Issued By �_--f SEPARATE PERMITS PERMITS REQUIRED FOR WORK O"HER THAN DESCRIBED ABOVE
CITY OF TIFA RDMECHANICAL PERMIT
PERMIT NO. : ME892384
C,-
w
COMMUNITY DEVELOPMENT DEPARTMENT w D TE ISSUED: 11/27/89
13125 S W-Hall Blvd..P.O.Box 23397,Tigard,Oregon 97223.(503)639-4175 — F - I I M.PMT.NO. 892241
JOP ADDRESS: 11790 SW 129TH FIL
'AX MAP/LUT 1S1 33DD SUB: VILLAGE AT SUMMERL.AKE 2 LT:53 PK:
LAND USE: R4.5PD
LOT SIZE:
+ ITE.M: N0: NO:
WORK CLASS: NEW FURNACE (100K AIR HANDLR (10
USE TYPE: MINGLE FAMILY FURNACE 100K+ 1 AIR HANDLR 10K
CONST.TYPE: VN FLOOR FURNACE EVAP.000LER
OCCUP.GRP. : R3 HEWER VENT FAN 3
VENT VENT.SYSTEM
RLR/COMP (3HP HOOD 1
NO.STORIFS: 2 BLR/COMP 3-15HP INCINE:RATOR(DOM
DWELL..UNITS: 1 BL_R/COMP 15-30HP INCINERAIOR(COM
FUEL. TY PE GAS BLRiCOMF' 30-50HP REPAIR UNITS
MAX. INPU1 BLR%COMP 5b+HP OTHER 2
FIRE DMPRS'' GAS PIPING OUTLETS 1
HIGH PRESS?
LOW PRESS?
REMARKS:
FEES:
w MORISSETTE DON PERMIT $10.00
N p0 BOX 19524 PLAN REVIEW $10.50
E
port 1and 0r FIXTURES $32.00
STATE TAX $?. 10
---- — --- - -- — OTHER
C11
O
N BELL HEATING INC.
A 15550SE PIAllA AVE
C CLACKAMAS OR 97015
T
O PHONE (503) 243-1184
R REGISTRATION NO. 447 TOTAL: $'S4.f10
This permit is Issued subject to the regulations contained in Title 14 RECEIPT NO.
of 1hF TMC, State of Oregon Specialty Codes,toning regulations _— —
____
wid all other appllcahle codes and ordinances, and it Is hereby REQUIRED INSPECTIONS
agreed that the work will he done in accordance with the plans and GAS LINE
specifications and in compliance with all applicable codes and POST 8 BEAM
ordinances The issuance of this permit does not waive restrictive ROUGH-IN
covenants Contractor and subcontractors shall have current city
husiness tax permits This perrnll will expire and become null and FINAL
void it work is not started within 180 days,or If work Is suspended or
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all required I tions arP request"id approved
Permittee'10nehue
Issued By �-��'� eAI:L-FOR-rNSV ECTION 639 41?5
SEPARATE
--
PERMITS REQUIRED FOR WORK OTHER KHAN DESCRIBED ABOVE
'i
rPLAN CHECK APPLICATION
! T16;A-" RD (ASO PLAN CHECK 11 �[�
COMMUNITY OEVELOPMENT O,rm cENTPERtAIT /I
-4 1 , �' , DATE ISSUED
_ "i AX MAP/LOT _%S �_ - ✓ -' ,`Z
S w - ('2 �� r , LAND USE:
708 ADDRESS I I -2, LOT:
St10: �II�4VJ �` � 1 l✓II�� _
VALUATION. SPECIAL NOTES
OWNLR REISSUE OF: —
Nom_ 1 LAST REISSUE:
- {ADDRESS: _ U_ Q 5 — FLO00 PLAIN/
0 KAO
SENSITIVE LAND:
PHONE- 24 314_ APPS A� REQUIRED
PLANNING:
�. IREFDEPT
ENGINEERING: —
��: _ FIRE DEPPTT
ADDRESS: OTHER:
ITF11S RE YREO
PHONE: _
LYST/SU(i00NTRACTORS: ' .
BUS TAX:
AROI/ENGINEER - CALCULATIONS:
r -,,, 1�,
NAt1E: ��2�--C IT -• � 1 1 I\/� SUSS DETAILS'. —
ADDRESS: _ PARKING PLAN:
LANDSCAPE PLAN.
____---- �_----
OTHER: ----
--_'�---- 9-��`✓
COMVkwT
L�
N10U4T AMOUNT P0. GAL. DUE
PERMIT 11 AC(--T 11 DESCRIPTTON r sem .• / „�' ��
2 1I ILO-437. Permit Fees
Permit Fees
10-431 00 Plumbing .�=i--
10-431 01. Mccha.nical Permit. fees I f ,
10-230 01 State Building Tax (5X) -�Q-
Building Q
Plumbing 7.2G
Meeh s! ll l7
1(;-433 00 Plans Check Fee '�
I
Building
Plumbing
tlech
�7�3pr� 30-207. 00 Sewer Connection -�-
;0-444 00 Sewer Inspection __�
51-440 00 Street System Oev Charge (:SOC) U
52-449 00 Parks System Oev Cha (POC)
31--450 00 Storer Drainage SysL'
10 -230 09 TRFD
10-7.30 06 Washingten County Fire Ut (95X) —
10-270 00 Amalrt/Wedgewood
TOTAL --�
f ,
RLC 0 �
+ APPLICANT SIGNATURE
Date Received: - ------'-'-
Received By: _ —
cn/3507P/lOP