13530 SW FERN STREET-1 ADDRESS:
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INV.# 52892 INV. DATE 06/16/92 TERMS: NET 30 DAYS
T CONT.# 3651 P.O.# JOB#
7
97045 BILLING PERIOD (16/01/92 7U 06/30/92.
379
-9009
, AMOUNT
DFISCRIPTION PRICE
SSV FMN SIR= KWM 1 GAL J�S� 160.00 -
SW 135711LI Q) 1500 6/5 ��90 S S /3
i6 13530 S. 1 raAl 270.00
WP� WED FOR,PAYMENT
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PROJECT #
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.4 kir
we'ED APERIODIRAFJ-1/2%PER MONTH WHI H
L. NTA E RA E OF 18%1 \PPTO PAST DUE BALANCES
SUB TOTAL 450.00
1 • SALES TAX 0.00
0.00 ,-0.00 450.00 1 DUE THIS INVOICE 450.00
ILIF SALES TAX
' '" "' DUE THIS INVOICE
ASCADE PHILLIPS CO,
SAMI-POT
P.J Box 47
OREGON CITY, OREGON 97045
656-9415 3146-9009
1 800452.8379 j
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All claims end returned goods
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O I 0 MUST be accompanied by this bill L hank`You
INSPECTION NOTICE
City of Tigard Building Departsrent
13125 SU Ball Blvd. Tigard, Oregon 9722L
Inspection Line (Rec-O-Phone)t 639-4175 Business Phone: 639-4171
Inspectiont _
footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. �-SSF 3awer11 Framing -Bleg.
Post/Beam !-;wh. Rain Drain Insulation -Plumb.
Plbg. Underfloor /I Water Line y Gyp. Rd. -Meeh.
Date Requested: � .7 q Time: AN Ff _PN
Addreses _ _ Permit f Q J
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
r
APPRO�'F.D _ DISAPPROVED _ APPROVED SUBJECT TO ABOVE
,CJ�—
—call For Reinap.
SEWER CONNECTION V-111"
• 04
PERMI11
CITY OFTIFARD 7 r-,ERMIT ** — * _ - 61IR92-,0159
CrTU-PTE ISSUED: 05/1E/92
COMMUNITY DEVELOPMENTDEPARTMENT13125 SW HWI BNd P.O.BON 2M.TIPM,Orepn 9=003)01)-1176
SITE ADDRESS. . . : ! 35,30 SW FERN ST PARCEL: 2S104PD--0240QA
SUBDIVISION. . . . : VISTA LAKE ZONING: R--G
BLOCK. . . . . . . . . . : . . . . . . . . . . . . . 31
TENANT NAME. . . . .
USA NO. . . . . FIXTURE_ UNI IE-. . . :
CLASS Or-' WORV.. . . ADD !,,WELL i NG UN I TS. . - I
T'Yr,E OF USE. . . . . .SF NO. CF SMI.MINGS.- I
NG)TAL.L.. T'/P,E. . . , :BUS14n IMPERV SURFACE. . : S f
Connect exi � ting c.3FD to sewer. House consti-Ltc-ted prior to 7-1-.70.
Septic tank ml.ist he poimped and filled.
LJWner ,— --------------------------------------- FEES
ALAN WILLIAM type 'A m o 1-m t; by date reept,
13530 SW FERN ST PRMT $ 300. 00 BCR 05/12/92
INSP t 35. 017.1 R C IR [Mri/ 9 2
TIGARD OR 97223
["hone #*
Contractor: ---------------------------------
OWNER
Phone #: $ 335. 00 T01 AL
Req #. . - 00000
REOUIRED INSPEC71ONS
This Applicant agrees to co4ply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The nersit expires 160 days from sept it 'rant( Fill
the date issued. The total asoint paid will be furfeited if the
Dervit expires, The Agency dies not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the veasuremt
given, the installer shall prospert 3 feet in all directions from
the d0tance given. If not so located, the installer shall purchase
a "Tap and Side Sewqr" Pei-sit and the Agency will in.stal! 4 lateral.
ermitteem
1_1V_
S S 1-1 e d b
Call for insnection 639 -4175
icry OF TIGARD ... RECEIPT OF PAYMEN'r RECEIPT NO. c98-227108
CIAEU', 3315. 00
NAME Wll.-LfSMS, ALAN DIANE CASH Atli 0. 00
13530 SW FERN PAYMENT DATE 05/12/92
SUBD I V I S TON
TIGARD, OR 0722:5_.
PURPOSE: (IF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT Pn I D
SEWER USA S1'1RI)2-159 300. 00 SEWER INSPECT 315. 00
SEWEER CONNf.:--(,'I'ION FU.-
TOTAL AMOUNT PAID 335. 00
SEIYU
SEIYU INTERNATIONAL
TEL: (503) 245-4090•(503) 2454435 FAX (503)245-4351
date : G � _1� �_
.:o whom it may concern ;
has contributed to our satisfaction on the public sewer line that
we have installed on 135th Avenue, Tigard .
Project # 89340
Summit at Bull Mountain , Please I
This letter is to serve as a "Letter of Participation" concerning
the above public sewer line project .
Sincerely ,
Kurt VanVolkenbur.gh
General Manager
Lincoln Center • 10220 S.W. Greenburg • Suite 450 • Portland, Oregon 97223
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