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If this notice ahhears clearer than the
document, the clocument is of marginal quality. 3/4/97
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CITY 4F TIGARD Ct Ct r Of;OCCUPANCYl[�ANC:1 f ,PANC OF
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COMMUNITY DEVELOPMENY DEPAA7 gNT PERMIT #4. , . . „ . . : MGT94—OZi58
131-5 SW Hall Blvd.Tigard,Ornpan 97223.0i9f (501))30.4171 DATE I SSUE II: 05/IS/95
PARCEL:: 2'�,104CD--01.kib0 w
SITE ADDRESS. . . c 13779 �+W H ILLSHI RE DR
SUBDIVISION. . . . a HILL..faNIRE: ESTATES ZONING: R -7 PO
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :12114 ,
CLPIGS OF WORK. :114EW
TYPE OF' USE. . . e SF
Occ-UPANCY CR4'. :ft3
it OCCUPANCY L.OAD:c'31 �► �
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TENANT NAME. . . : a
Remaolt % : PATH I p
it
Owner,.-
NORTHWEST DREAM H0MEc3
1:3906 TAYLOR'S' CREST HOMc._;
! LAKE OSWEGO OR 9i035s i
'hone #k: 636-66.38
i
NORTHWEST DREAM HOMES
13906 TAYLORS CREST LN
i
LAKE OGWE(30 OR 9711135
Photiv #F: 6:36•-6438 BUS
� Reg #. . a 66979
i
i This Cr.rtifira,c r_e► tifies that ie above r~pfe• ,enced huilding or- portion
1 ther'euf has been inspected for, c.-ompl ian`a with the Tigard Building Code
I for the T#r•oi-ip and division of oc:cupmric.y i;md use for which the above
r-eferenced permit was issued, and occ:upanc.-y ii here-by
i
bUIL.DING INf3PECTOR BLiLz n--irf-F ,IAL
POST IN ONSPICUOUS PLACE
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CITY OF TIGARD BUILDING INSPECTION NOTICE1
Ir�pection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
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Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Bearn Struct. Plbg. Top Out Elec. Rough-in
Post/Beam Mech. San. Sewer Gas LineCu�
Plbg Underfloor Rain Drain Framing Plumb. d�–
Alarm Wate; Line Insulation o
Underilr. i,.sul. Shear Wall Gyp. Bd.
.Elect. 0
Date Requested: `, ' ``�–�q�_Time: AM PM
Address: Cl '^
CM 0�-;
Builder: _ Permit #:_ _ -
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector ��/`�� " Date:
—APPROVED —DISAPPROVED —APPROVED SUBJECT TO ABOVE
�7- —Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Lire (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Strucr. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line
Plbg. Underfloor Rain Drain Framing -Plurnb.
Alarm Water Line Insulation / ec�, Cute,
Cf� I
Underflr. Insul. Shear Wall Gyp. Bd. •�' -Elect.
Date Requested: ( / Time: AM PM "
L Ajdress:_ /3-7
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Builder: Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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�'t Inspector:
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_APPROVED _DISAPPROVED ZAP PROVED SUBJECT TO ABOVE
Call For Reinsp.
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1 wli10PFICC PMODUCTS 228-2243'
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone). 639-4175 Business Phone: 639-4171
Inspection: ISI N�1'v
Footiuy Susp. Coiling Sprink. Rough-in Appr/5 '
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg. I
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall/ Gyp. Bd. -Elect.
Date Requested: -� ( /`J Time: AM PM
Address: / 32 7 _kc y
Builder: Permit #: CJ C/
THE FOLLOWING CORRECTIONS ARE REQUIRED:
i
Inspector:. G-(� �$_ _ Date: -/ --q
APPROVED __DISAPPROVED _APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
�f•
C ITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling 5prin✓.. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-ir Fireplace
Post/Bearn Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing PIumB.) S
Alarm Water Line Insulation -Mech. I
rinderflr. Insul. Shear Wall gyp. Bd. -Elect.
Date Requested: � r: _Time AM PM
Address:
Builder: _ Permit
THE FOLLOWING CORRECTIONS ARE REQUIRED:
G
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Inspector: ! /�
_ � Date:_.'
–APPROVED DISAPPROvED APPROVED SUBJECT TO ABOVE
—Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Intpection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
'Inspection:
Footing Susp Ceiling Sprink. Rough-in Appr,Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in c'IFINAL:,
Post/Beam Mach. San. Sewer Gas Line -Bldg." /
Plbg. Underfloor Rain Drain Framing -Plumb.
p. Alarm Water Line Insulation -Meeh.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: 4 Z7 e-� e
eG Time: AM PM
Address:
Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ti tL,f
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Inspector. '"'�
Date:_ L, LZ Z5.5
_APPROVED ISAPPROVED _APPROVE[! SUBJECT TO ABOVE
"Call For Reinsp.
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I', Cel 1 CRY OF TIGARD BUILDING INSPECTION NOTICE t
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639 4171
Inspection: ;
t I
Footing Susp. Ceiling Sprink. Rough in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
i
Post/Beam Struct. Plbg, Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
i
Plbg. Underfloor Rain Drain Framing -Plumb.
r
Alarm Water Line Insulation Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
! Date Requested: Timo: AM PM j
Address: E y�
Builder: Permit#:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
NS eyu C3 Le G✓ �-'
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Inspectc.r: Date: h
—APPROVED _DISAPPROVED . -_APPROVED SUBJECT TO ABOVE r
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Call For Reinsp. '
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CITY OF TIGARD BUILCING INSPECTION NOTICE
Inspection LineRec O P,lone): 639-4175 Business Phone- 639-4174 Z
r { inspection:_
Footing Susp. Ceiling Sprink. Rough in Appr/Sdwlk ,
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/13eam Struct. Plbg. Top Out Elec. Rough in FINAL:
r
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect. •
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Date Requested: L
L-( / S Time._AM PM
Address: /3 -77
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Builder: Permit #:�� L%�j fS —C=C j f_—
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THE FOLLOWING CORRECTIONS ARE REQUIRED:
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p ;� Date: ', r I I t,A ,�•�a,
/"-APPROVED !DISAPPROVED _APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
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. CITY OF TIGARD
f COMMUNITY DEVELOPMENT DEPARTMENT
j 13126 SW Holl Blvd.Tigard,Oregon 97223.6199 (503)634-4171
3 PLUMBING PL RM 1 f
1--ERM1•1- 4t. . . . . . . : Pl-m9b--00 6
6S9-4171 DATE ISSUE=D: 03/30/95
PAR�_E;:L: 232104CD-0. 400
ADDRESS. , . : 13779 SW H I LL.SH I RE. DR
:JNDIVISION. . . . : HILLSHIRE ESTATE=S ZONING: R-7 T)
Ek LOCI'.. . . . . . . . . . . i_tJ i . . . . . . . . . . . . . .4.114
-------------------------
GLASS OF WORK. . :Alli) 6ARBAUE D I SPUSAL.S. „ MOBILE:. HOME SPACES. :
I YPIE Ui-� Ucol_. . . . :SF WPSHING MACH. . . . . . . : BOLRF-LOW F-HLVNIRS. . : 1
OCCUPANCY GRP. . e R3 FLOOR DRAINS. . . . . . . . TRAPS. . . . . . . . . . . . . . :
S`F"URIES. . . . . . . . : 1 WATER HEATERS. . . . . . : CATCH BASINS. . . . . .
LAUNDRY TRAYS. . , . . . : 9F RAIN DRAINS. . . . . s
SINKS. . . . . . . . . . :
URINALS. GF<E_ASE TRAPS. . . . . . . :
LAVA1 LlfiIES. . . . . : C] -HER FI X1'URE'5. .
i U8/SHOWLRS. . . . : SE=WER LINE (ft ) . . . . :
WAIER LLOSETS. . : WATL!-' LINL (ft ) . . . . :
016HWOSHERS. . . . . RAIN DRAIN ( ft ) . . . .
ERemar^I! INSTALL RESIDENTIAL BACKFLOW 1)t::V1UE.
Owne—. _.._._._____.___..____..__.____._._..___._.__ _________._.__---______ FEES
NORTHW'-ST DREAM HOMES type amount by date r^ec:p-t
J 3.10& SW TAYLORS CREST LANE. PRMT $ i b. 011A bW 03/1�10/95 95—c
5pCT $ 121. 15 5W 03/30/')5
LW:-CE USWLUO UR 9703!5
'Qhone 0: 636-6438
L:ontractor^:
gNGT"IL PLUMBING
tb9v.Ild IbW ',1Lk1_U RD
BEAVE.R70N OR 9700b
i
I'-,n o n e #. 6421-7,3F.3 $ 15. 75 TOTAL
Reg #. . : 24184
-------- REIRU I REL) INSPECTIONS
--- --
this pereit is issued subject to the regula.ions contained in the FIP/baickfl.ow Pr,ev
Tigard Municipal Code, State of tyre. 5peciaity Codes and all other Final 1nspectiol7
applicable lcwt. All work will be done in accordance with
approved pians. This pereit will expire if work is not started
within 180 days of issuance, or if work is suspended for !.,e
t)a. lu days,
ermi ttee Signature :
: s s t.t e d By . �t�.Y��L�1�•�__._._
L.:all for inspoction — 6,39--4175
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City of Tigard PLUMBING PERMIT APPLICATION Flanck/Rec. #
13125 SW Hall Blvd. Permit # FAY',95-�'to
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE+ST. SURCHARGE
ft—
rA C�) �/ �� ��_S New 31imle Family Roeldencea Only
1 1 BATH HOUSE$140.00 ❑2 BATH HOUSE$195.00
Job A.... - 7 . �v��� C rl S �1 t C3 ❑3 BATH HOUSE 3225.00
Address mwftw cr Fee inxdudes all phunbN fbrtunss in the dwih*V and the AM 100 Iset
l I /r _ of water service, sanitary sewer and storm sewer. See fees below.
"""�•"'"'r' ""'r / FIXTURES CITY PRICE AMT
Sink g,00
""•""` ^ Lavatory 7.00
Owner Tub or T_ 'power Comb. 9,00
Shower Crh 9.00
Water Closet 9,00
" ""'�� " � Dlehwosher 9.00
.')crupant S/ �Nr 'j Gadmge Disposal 9.00
W."
."M*" ^'"" Washing Machine 9.00
C' — (, b C t",k Lt t. __r Drain
9.00
""` r' 4ater Heater 9.00
tct kt ���ey r�- Laundry Room Troy 9.00
P t/ Urinal 9.00
/1// � /N-17 Other Fixtures (Specify) 9.00
YrY"ANw /�,.,w
9.00
Cor,lractr,r
�"aC! ,l i1�FI'l e ��;;7-_�j 3 9.00
7.. A' _ 9.00
/
V • G� 7 U�tc:' Sewer 1st 100' 30,00
~" of car ar.r'w Sewer•as. Addit-100' 25.00
��q /�,(� ,�C " /el, Water Service let 100' 30,00
I hereby acknowledge that. I have read this appllratlon, that theWaMr Ser:l-a es. Addf. 200' 25,00
information given is correct, that I am the owner or authorized agert of
the owner, that plans eut,mitted are in compliance with State laws, that Storm &Rain Drain 1s( 100' 30,00
1 am registered with the 1 matruction Contractor's Board, that the Storrs &Rain Drain AddiL 100' 25,00
number given (correct. 'If exempt State registration, please
give reason low.) Mobile Home Space 26,00
Balt Flow Prevention
Device orAnti-Pollution Device 9,00
Any Trap or Waste Not r
Connected to a Fixture 9,00
Describe work new ' addition 5 altera_tion 0 repair U Gatch Basin 900
to be done residential Q non-residential 0 Insp. of Exist. Plumbing 40.U0/hr
Specially Requested Inspections t0.00ft
Existing use of
building or property Rain Drain, single-family dwelllrg 30,00
Reslddntlal bacxflow prevention
devices 10.00
Proposed use of
building or property _
—` '(Except reslcentlal baclxrlow
preventfon devices)
NOTICE •Minim•�m Fee $25.00 SUBTOTAL
PERMITS BECOMF VOID IF WORK OR CONSTRUCTION
AUT11ORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE
CONSTRUCTION OP`NORK IS SUSPENDED OR ABANDONED -- c
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL
Special Condi.ions
l._ TOTX'
�- -- Date blued by
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CITY OF T I GAPE) - RFrE 1 PT I"F PAYMENT RECEIPT NCI. s95--26359t
�
CHECK AMC]UNT
I NAME a ANCTII_ PLUMBING INC. CASH AMOUNT
Af)llRE"£31 a 16900 SW ME RL.0 RoPiD POYMENT DATE a 03/30/9`,5 ,
BEAVERTON, OR S:_801 V I S I ON a !
iI 97006•-- 4
I,
l F,URPOSE OF PAYMENT AMOUNT DA I D PURPOSE: OF PAYMENT AMOUNT PAID
UMt�INa PERMw AL M9rS -0751;. _ 1 » 00
ST.
.-.I;lllt..D ,E
.1
1 3'?i9 £3W HILI.9H I RF:
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.: � 1CyTAl.. f:ahlOUidT PF,11:i
` INSPECT ON NOTICE
3A
City of Tigard Building De&i rtmftnt
11125 3w Ball Blvd. Tigard, Oregon 97223
E
_q
Bu
aineea Phone:
• � Inspection Line (Aec-O-
Phone : 639 •,,
Inspectiont_ ---
i
FootingPlbg. Underslab Nech. Pough-:.r Appr/Sdwlk
Pound. ^lbg. Top Out Gas Line PINALt
Post/Beam Struct. Sar.. Sewer Framing -Bldg.
Post/Beam Nech. Rain Drain Inanlation -Plumb.
Plbq. Pnderfloor Water T. a Gyp. Bd. -Nech.
i Date Requostedt -Timet AM _ PN
Addreee L K'�' t.'r Permit #s e;,O 7'�`
clBuilder.: / ?--7 7 ---
THE lOLI.OWING CORRECTIONS ARE REQUIRED:
r
Inspector: � 7 Date:
APFAOVED DISAPPROVED �(�A _PROVED SUBJECT TO ABU
--"------ I
Call For Reinap
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17
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CITY OF I IGARD BUILDING INSPECTION NOTICE 1
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:_ -
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plba. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech, Sen. Sewer Gas Line -Bldg. 7I
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underilr. losul. Shear Wall Gyp. Bd. -Elect.
Date Requested: ( '' I �.S -rime: AM _ESM
Address'
y
Builder -11.1 - 7�' �_ Permit N: r T
THE FOLLOWING CORRECTIONS ARE REQUIRED:
1
j iyt4��r4�,r�ht�
'�-f✓ �y M./7 L.. "'.T'C� e-.'✓.L'T��IZ. '��Oui i Y/,;'S%_,
C� J=i01C'y et= J A-C'('1SZ(
7! CCJVL%7Z. 4_=x
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`i�T1 ./l�7`�'/ lGa� �L 7Z✓<>L A/ —r-3 — —
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Inspector:__ -- Date:—
APPROVED DISAPPROVED �— -hPPfiOVFD SUBJECT TO ABOVE
`Call For Reinsp.
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INSPECTION NOTICE VJ
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fx >+t Cxcy of Tigard Building Department
13125 SR Ball Blvd. Tigard, Oregon 97223
, r Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
A.Y q r
Inspection: — —---
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
` Found. Plbg. Top Out Gas Line FINAL:
Post/Ream Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation / -Plumb.
Plbg. dndertloor Rater Line Gyp. Rd. -Meth. I
D:.te Requested: 1 (%^ Time: AN PM
Address: Perm:t #: _
Builder.:
TIM FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: Dates I T,)
,Y �
APPROVRD DISAPPROVED ✓A_PPROVED SUBJECT TO ABOVE
For Reinsp.
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. �PECTr�X NOTICE
City of Tigard Building Dept
13125 sw Ball Blvd. Tigard, Oregon 97223
Inspection Lino (Rec-O-Phone)t 639-4175 Business Phones 639-4171 1(
Inspections
i
Footing Plbg. UnderslabI'
Mech--Rough_in Apps/Sdwlk !
Found. Plbg. Top Out
Cay Llne IINALs
Post/Beam Btruct. Ban. Bower C
Framing
-Bldg,
Post/Beam Mach.
Rain Drain Insulation
-Plumb.
Plbg. Underfloor Mater Line -Mach,
_ GYP. Bd.
Data RegaaatedsS
7 1 Times G
f Address s �� ����'� ��`
Permit #119M
Builders )
l
i
THE FOLLOWING CORRECTIONS ARE REQUIRED, j
----------------
--------------
------------
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Inspectors
Dates
-L�PPROVED DISAPPROM
APPROVED SUBJECT TO ABOVE .
call For Rainsp.
L_ I
INSPECTION NOTICE \�.
Citi of Tigard Building Department V' t
13125 M Ball Blvd. Tigard, Oregon 97213
Inspection Line (Rae-O--Phone)s -4175 Business Phones 639-4171
Inspections � �x Ll
Footing Plbg. Undorslab h. AouQh- Appr/Sdwlk
Found. /Plbg. Top Out Gas Lina FINALS
st/Roam :t/,/,-San. Sower ��'` C'framinq -Bldg.
Poet/Beam Meeh Rain Drain Insulation -Plumb. .
Plbg. Underfloor Nater Line Gyp. Bd. -MMctyr/��__
Date Requested: Tfasae PH
Addraass Permit f:� ■
Builders -
TBE FOLLOpINO CORRECTIONS ARE REQUIRED:
CA
\,A�J Ct C� �-- ' l V-1 civ r
A.
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+ Inspectors_ �`� 1^- Dates
i
__APPROVED DISAPPROVED y APPROVED SUBJECT TO AgOvg
__Call for Rainsp. �- +i
INSPE�'TTeN NOTICE ���
City Of Tigard Building DepartmOnt
L7l25 SW gall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
Inspections _
Pq. Onderelab _�sc,�1. Ro�Tfi�o' Appr/Sdwlk
lb
� Footing
Found.
Plbg. TOP Out Gas Lined FINALS
San. Sewer `' Fr__. q... / -Bldg.
Rain Drain Insulation -ply•
os e
plbg. Underfloor water Lin Gyp. Rd.
-M ^h. �
1 ( �- s Time: P
!9 Date Requesteds
5
Perm+
it Is_
t Address: g
1 Builder:
THE FOLLOWING CORRRCTIO148 ARE REQUIFSOs
�1 � V
Cl-
T c
CTALP
AL
Inspectors ~- -- Dates 1 �
I APPROVED -1--DISAPPROVED APPROVED SUBJECT TO ABOVE
-Call FOL Reinsp.
bks;. •.
loft
i
INSPECTION NOTICE
City of Tigard Building Department
13225 M Hall Blvd. Tigard, Oregon 97223
Inspection Line (Aec-O-Phone)t 639-4175 Business Phones 639-4171
iInspection:
i
looting Plbg. Underslab Mach. Rough-in Appr/Sdwlk
u
I Found. Plbg. Top Out Gas Line FINALt
Post/Beam etruct. Ban. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Mech.
Date Requestedi _Times AM PK
Addres•cPermit 1� _ cc
'i
Builder:
TBZ FOLLOWING ODRRECTIO148 ARE REQUIREDt
v✓t/ `h v
l
Inspector: L �.�.r--
1v �� Dats,
APPROVED DIBAPPROVED APPROVED 8U&TECT TO ABOVE
t
5..
' /Call For Rsinsp.
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INSPECTION_NOTICE
City of Tigard Building Department MV, F
13125 SW Ball Blvd. Tigard. 'Oregon 97223 i
Inspection Lina (Rec-o-Phone)s 639-4175 Business Phone: 63 4171
Inspection:
Footing l+lbg. Underelab Hoch. Rough-in Appr/SdwlkKK
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer framing
-Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb. .
_ y
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
��- r� ) -Times
Dass Requosteds � � - __AM PM �
Address: --7L �._i- 1.1 /. _ Permit /: —
Builder: / t - .4 [
5. THE FOLLOWING CORRECTIONS ARE REQUIRED:
II .�
s�
Inspector: Oates9� ��
APPROVED DISAPPROVED i/ APPROVED SUBJECT TO ABOVE
—_Call For Reinep.
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INSPECTION NOTICE
City of Tigard Building Department
13125 811 Ball Blvd. Tigard, Oregon 97223
Inspection Line (Roc-O-Phone): 639-4175 Business Phones 639-4171
i
Inspection:
Footing Plbg.—Underslab Hoch. Rough-4n Appr/Sdwlk
Pound. .--Top Outer, Gas Line PINALs
Post/Beam Struct. San. Bawer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb. •
Plbg. Underfloor Water Line / Gyp. Rd. _Koch.
' Date Requested: l•� /� I �� c Timet
Address: 1_ .3 /�1 ��1.(/(_� Permit i
Builder:_661 �
i
THE FOLLOWING CORRECTIONS ARE REQUIRRD:
i
— — 7
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Inspector� Data:
"Z/ r
APPROVEDDISAPPROVED APPROVED SrHJECT TOO ABOVE
__Call For Reinsp. M
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4000",6wo,AW Owiwwwok-
6
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INSPECTION NOTICEc? nr ti �;jir u r '•
City of Tigard Building Department .
13125 SM Ball Blvd. Tigard, Oregon 97223
Inspection LA,no (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspwction:
' looting Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Cas Line FINAL:
Post/Beam Struct. 01ME:3ewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
I
i
Plbg. underfloor Water L e Gyp. Rd. -Hoch.
Date Racptostadt �� Times __AM PH h
Address: ,
Permit
Builder:�1S�C�/ -7 _
j (
THE FOLLOWING CORRECTIONS MM REQUIRED:
J
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_
i
<� L/AiI -
61
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4
Inspector: / oati
PROVED DISAPPROVEDPPROVEDat
3UBJE. TO ABOVE
For Reinsp.
�:�. %Ad 'o. , ..tlti�iL., ° q1,-."� +.. � fu :r,r. ?I .,. -. V;f'tr• fr�,;. , -�:�1 r,(,i_
ti
INSPECTION NOTICE y
City of Tigard Building DeparbWWt C �✓
13125 611 Ball Blvd. Tigard, Oregon 97223
Inspection Line (Roc-o-Phone): 639-4175 Business Phone: 639-4171
lspections j
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out pias Line FINALS
a
Post/Beam Struct. San. sewer Framing -Bldg. .
Poet/Beam Mech. n Drain Insulation -Plumb.
�
Plbg. Underfloor Nater Lino O;p. Bd. -Meeh. *.-�+ • �
r `x/
Date Requestods_ �. Times ' ` AM _ PM
C J
7
Addreses-1 �// Permit is
Builder:__ / 74�'_ 1 "d
g
THE FOLLOWING CORRECTIONS ARE REQUIREDs
h
C/
i
I
Innpector: Date:
IY` "PROVED DISAPPROVED APPROVED SUBJECT ABOVE
tttCall Por Reinep.
� I
j]18PECTI__ILNOTICH
City of Tigard Building Depart—t
131.25 6N Ball Blvd. Tigard, Oregon 97223 r
inspection Line (Roc-O-Phone: 639-4175 Business Phone: 639-4171
Inspection:
rooting Plbg. Underalab Hoch. Rough-in Appr/sdwlk
round. Plbg. Top Out Gan Tine FINAL:
F
Post/Beam Struct. San. Sewer Pramir.Q -Bldg.
I
Post/Beam Hoch. Rain Drain Insulation -Plumb. a ��
-Hoch.
Underfloor
I'
bq. Underfloor Water Line GYP• �•
Time: AM /CPN
Date Requested:
Address: -� Gf �7`�� �' _ Permit
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
i'
4
I
1�
Ins for r, Date:
I� � 4
r
APPROVED DISAPPROVED APPROVED SU CT TO ABOVE
Call. For Reinsp.
r
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p
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4
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a
a
INSPECTION NOTICE
City of Tigard Building Department /
13125 BN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Roc-O-Phone): 639-4175 Business Phone: 639-4171
Inepoction� _
0o ng� Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
ound. Pl'.V. Top Out Gas Line FINAL:
Post/Beam Etruct. San. Sewer Framing -Bldg. '
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor (Water Line Gyp. Bd. -Hoch.
Date Requested: 1 " u� Time: AM PM
Addreees1 r����qq�_l�_� Permit 1:0 !� ry
Builder: W
THE FOLLOWING CORRECTIONS ARE REQUIREDs
N
V
� a
t
Inspector: _ Q
_ Dates �Q
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinep.
y i
INSPECTION NOTICE,'
t City of Tigard Building Department V
13125 BW Ball Blvd, Tigard, Oregon 97223
Ins Line (Roc-O-Phones 639-4175 Business Phones 639-4171
t
r Inspections —
s ,
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
i
Found. ^i.bg. Top Out Gas Lina FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Rd. -Mach.
Data Requsseted?:�7 � � / L / Time: /�. AM (QPM
Address:_ �✓ / � �( /S` t ✓y Permit #s6il1 0 ��Q
'
Builder: AV/ 16 ,,'-e_�-+�(,•� � _
w TBE FOLLOWING CORRECT'-INS ARE REQUIRED:
NA
�._ CJw -
60
In'pector: 0 - y�
Dates
i
APPROVED DISAPPROVED •,__APPROVED SUBJECT TO ABOVE
w / ,> Call For Reinsp.
.....—....�......._.�.,+w.....,...r•+rwvw...,..+rn... a...,r. .. :v,...r¢or-a rn�w.:,,.
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6&From FINANCE/KAKI, 24 Oct 94 2 of 3 aG
°From: FINANCE/KAKI °
°Subject: JEFF WITH NW DREAM HOMES CALLED AT 887-1250- 14E NEEDS YOU °
°To: RICK
°X-To: RICK
°Date: 24 Oct 94 08 :49 :12. °
0 °
OTO RUN OU"_' TO HILLSHIRE LOT 14 MST 94-0358 13779 SW HILLSHIRE. THERE IS A °
°LITTLE PROBLEM REGARDING ENGINEERING THAT HE WOLTLD LIKE TO SEE YOU ABOUT.
0 0
rt 0 0
0 0
° 0
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1 ° °
0 0
0 0
� ° 0
k' ° 0
t 0 0
i
0 0
0 0
0 0
0 0
AAA& +/- <F5> <Del> Archive Copy Forward Headers Move Print Reply eXtract 66661
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CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT t#• • • • . . : MST94--01 58
13126 SW Hall Blvd,Tigard,Oregon 9722341116 (603)630.4171 DATE: 1`3EiUF D: 10/14/94
PARCEL: ._S i 04C:D--0140l,!
i SITE. ADDRESS. . . . 1.3779 ' W HILLSHIRE DR
SUBDIVISCiION. . .. . : HILLSHIRE ESTATES ZONING: R-7 FIT]
l BLOCK. . . . . . . . . . . L_0T. . . . . . . . . . . . . :014
CLASS OF WORE'.. . :NEW GARBAGE D I SPOSALE3. „ : 1 f
TYPE OF US;E. . . . :SF= WASHING MACH. . . . . . . : 1 BACKFLOW PREVNTRS. . : l ` !
OCCUPANCY GRE'. . : R3 FLUOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . ..0
STORIES. . . . . . . . :2 WATER HEATERS. . . . . . . I CATCH BASING. . . . . . . :0
F=IX•TURES__.-._---..--.__..____.._.....-- LAUNDRY TRAYS. . . . . . : 1 SF RAIN DRAINS. ,, . . . : i
SINKS. . . . . . . . . : 1 GREASE:: TRAPS. . . . . . . :0
LAVATORIES. . . . . .4 OTHER FIXT'UREr L=,. . . . . :10
TUB/SHOWERS. . ,. . : f=iEWER LINE= (ft ) . . . . :0 � I
WA•CER CI_.0 SE�TS3. . :3 WATER LINE (ft ) . . . . : 100
DISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . . . :0
Remarks : I- Al-H I
OWNER:
NORTHWEST DREAM HOMES ]-IF $ I3: jO. 00 KS 1.0/14/94 -
13906 TAYI-OR5 CREST HOMES BPRT $ 753. 00 KS 10/14/94 -
H i i_C $ 489. 45 JF 09/06/94 94-256444
LAKE OSWEGO OR 970;;5 S5PC $ :.:,7. 65 K9 10/14/94 - I
Phone #: 636-•-6438 SSDC $ 280. 00 KS 10/14/94 -
PARK $ 5500. ON K.:i 10/14/L -
FIlumbing Contractor,: - _ ...__.._..-._.__..__..__...___._. MPRT $ 45. 00 1;13 10/14/94 -
' ' .^ MPLC $ 11. 25 KS 10,'14/94 -
Name �Oh. jN_C,. lyl5p'C $ L. 25 KS 10/14/94 -
Address : 313TH $ L25. 00 KS 10/.14/94 -
City - _ 1.3t ate : F-,!5PC:; $ II. c_5 KS 10/ 14/94
7 _._. ....._........__-.. Phone#:�_�__ EROS $ 88. 00 KS 10/14/94
y p, _.
Reg #:-.---....... -___-. _. _._.__....__. _ .._. _ -�_. _ � A d d i.t i o n a l fees, not; shown Her•e. . . . . . . . .
REQUIRED IN PECTIONSi ......
This permit is issued subject to the reg--
ulations contained in the Tigard Municipal hoot/found Insp Rain drain Insp
Code, Gtate of Ore. Specialty Cosies and all [Dost/beam S3truct Nater Line Insp
other applicable laws. All work will be none Post/beam Mechan Appr/Sdw1k Insp
in accordance with approved plans. This Pl.m/undslah Insl_; Mechanical final. N.
permit will expire if work is not started FILM/Underfloor Plumb Final
within 180 days of issuance, or if work is Mechanical Insp Building Final r
suspended for mc,re than ! 30 days. Plumb Top Out Erasion Control
Framing Insp Crawl Drain
Fireplace Insp
Gas Line I n s n __ __ _--•-___.___._._
1 ,�p Insulation InspGyp
Board In-,I')
P,uth cxed P11_imbing Contractor Signature �
Call for inspection - 639--4175 !
' C o n t r r;r_t o r^ N a L•e s : _M�.-__-__...____. __.f_ �.___.._.___.
1
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� CITY OF TIO ARD
COMMUNITY DEVELOPMENT DEPARTMENT MASTER PERMIT' 4
131269W Hall Blvd.Tigard,Oropon 97223.8108 (603)830.4171 PERM I T #. . „ : MST94"'-0358
E,.: r ...ri171 DATE ISSUED: 10/14/94
PARCLL: 2Si 104CD-1211400
SITE ADDRESS. . . . 13779 SW H l LL_SH I RE-.. DR
SUBDIVISION. . . . : HILLSHIRE ESTATES ZONING: R-7 PID
BLOCK. . . . . . . . . . , LOT. . . . . . . . . . . . . :101.4
101.4 �
-- BUILDING
REISSUE:: DWELL I NU UN TTS: 1 BASEMENT. . . . . . , . :0 s f
CLASS OF' WORN;. ::NEW BEDRMS:4 BATHS:3 GARAGE.. . . . . . . . . . :672 s f
TYPE OF- USE. . . :Sl:: FLOOK AREAS--_------.-_.-___-- RE.UU 1 i ED SETBACKS-_...___.___.____
TYPE OF CONS]". :5N F:I RST. . . . : 1459 s f LEF T. . :5 ft R IGHT. :6 ft
9
OCCUPANCY G16". : R3 SErCOND. . . : 1888 s f FRONT. :20 ft REAR. . :40 ft �
STORIE_P_ . . . . . , :2 F'INBSME NT•:0 S REDUI RE.D-----__.._._.________..__.__.._
11E I GH(. . . . . . . . . 1 ft TOTAL ---:3,347 s f SMC?KG= DETEC,TCIRS. :Y I
F-1.00R L0AD. . . . :40 psf VALUE. . . . . : 227350 PARKING SPACE 9. . : 1
Remar-ks : PATH I
PLUMBING
SaINFS. . . . . . . . . . : 1 FLOOR DRAINS- - :0 BACKFLOW PRLVNTRSi. . : 1
LAVA,rORlES. . . . . ;4 WATER HEATERS. . . ; i. TRAPS. . . . . . . . . . . . . . :0
TUB/SHOWL.RS. . , . : Lf1UIVDRY TRAYS. . . : 1 CATCH BASINS, . . . , . . :0
WATEF` rLOSETS. . SEW:' LINE (ft ) . :0 GREASE TRAPS. . . . . . . .0
D I SHWOi5HE:RS. . . . : 1 WATER LINE (f t ) . : 1.00 OTHER FIXTURES. . . . . :0
GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :0
WASHING MACH. . . : 1 SF FRA I N DRAINS. . : 1
MECHANICAL --_._._____..________-----_-.___...---______._ FEES
FUEL UNIT HTRS. . :0 type amot_tnt by date recpt
/GAS/ / / VENTS . . . . . :0 TIF $ 1550. 00 KS 10/14/;4 - +,
MAX INPUT:O BTU VENT FANS. . :4 LAPRT $ 753. 00 KS 10/ 14/9 . - t
FURN ( 100K . . :0 HOODS. . . . . . : 1 BPl_C $ 469. 45 JF 09/06/94 94-256444 �
F.,URN ) '-100K . . : I WOODSTOVES. :0 S5V'r, $ 37. 6 a KS 10/1.4/94
a•' FLOOR FURN. . . . :0 Cl._0 DRYERS. : 1 SSDC $ 280. 00 KS 1.0/14,'94 -
BOIL/CMP ( 3HE':0 OTHER UNI.TS: 1 PARK $ 500. 00 KS 10/14/94 '-
GAS OUTLETS: 1 MPRT $ 45. 00 KS 10/14/94 -
Ownar: ___.-----________._.__.___._____.___.__._____.__HPLC $ 11. 23 KS 10/ 14/94
NORTHWLST DREAM HOME=S M5PC $ 2. 25 KS 10/14/94 -
13906 TAYLORG CREST HOMES 3BTH $ 225. 00 KS 10/14/94 -
P5PC $ I1. 25 KS 10/14/94 -
LAKE OSWEGO OR 97035 E"RU $ 8a. 00 KS 10/ 14/94 -
Phone #: 636--6438 ERPC $ 28. 6N KS 10/14/94 -
Contractor: ________.________._.____________._.ERF!C $ 28. 60 KS 10/ 14/94 -
NORTHWEST DREAM HOMES
13906 TAYLORS CREWS r LN
LAKE OSWE GO OR 9717134i
Phone #: 636-.-6438 BUS
Rey #, . : 86979
f.; $ 4050. 0'J TOTAL_
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 with approved Post/Beam Strt_tct Gas Line Insp
pians. TJ,is permit will expire if work is not started within 190 Post/Seam Mer.han Inst_tlation Insp
b'
days of issuance, or if work is suspended fer mor• an 190 days. Plm/t_tndslab Insp Gyp Board Insp
PI_M/Under,flout-, Rain drain Insp
Mechanical Insp Water Line Insp
Plumb Top Out Appy,/Sdwlk Insp
I !�t_t e c LAY : ,}L _ T ._-__-- T F r-a n;i n.0 Insp Mechanical F-i-t a 1
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CITY OF TIGARD "T I N711
COMMUNITY DEVELOPMENT DEPARTMENT ,EWl�P CONNECTION
i 13126 SW Hall Blvd.Tigard,Oregon 97223.5199 (603)639.4171 PE RM I T A
F,ERMIT #. . . . . . . : SWR94-0:320 7
71 DATE ISSUE=D: 10/14/94
t
j V"ARCEL : S104CD--014010
SITE. ADDRESS. . . 13 779 SW H I LL5H I RL= DR
SUBDIVISION. . . . : HILE_SHIRE ESTATES ZONING: Ft- 7 PQ
BLO'CK. . . . . . . . . . LO. . . . . . . . . . . . . :014
TENANT NAME. . . . .
USA NO. . . . . . . . . . : FIXTURE UNITS. . .
r,t
CLASS OF WORK. . . :NE'W DWELL I NC UN IT S. 1
TYPE OF: USE. . . . . ..SF NO. OF BUILDINGS: 1
INSTALL TYPE. . . . :BUcjWR IMF'ERV SURF=ACE. . : sf 44
rJ .
Remarks: FIla'TH i
FEES
NORTHWEST DRE=AM HOMES type amol_knt by cute recpt
13906 TAYLORS CREST HOMES PRMT f x'200. 00 KS 10/14/94
INSP $ 35. 00 KS 10/ 14.'1)4 ?,
LNKE: OSWEGO OR 971113 rst `
I Phone #: 636-643E1
+ Lontractar:
' C 0NTRACT;.:)R NOT ON FILE
i
Phone #: S 2235. 00 TOTAL
Reg
-- ---- RE:OU I RED 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 Ag ncy does not guarantze the accuracy of the
side sewer laterals. I' the sewer is no; located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance g'ven. If not so located, the installer shall purchase
P "Tap and Side Sewer" Permit and the Agency w tall a lateral.
n •
)-
'ermittee 1:3 i.r;riat1..rre :
Iszl.red By : _
Call for inspection - 639-4175
4
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N
• Residential Building Permit Application
I City of Tigard
13925 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4979
Jobsite Address:
/ Office Use Only
Subdivision: i �✓ Lot# 1 `r� 1 ,
-Z
PlancWRec # /
Valuation: �_ �� �, �.•
Permit
Comer Lot? Y N
Reissue of
Flag Lot? Y N
Map &TL#,%516
/Owner: Approvals Required
Address: C' 7 r Planning
Engineering
��Phone: Other
�'1 h
Contractor: ----- ` y & a;;;
I�f
Address:
nfractars
Truss Details `
j Phone: - Ottt9QrA= t�
Contractor's License #
i (attach copy of current Oregon license)
} Contact Name & Phone:
Subcontractors: Arch ltect/Engineer: - /` C-
-/Plumbing: l4• Address:
Mechanical:
(attach copy of current OR Contractor's License)
Phone: o
JOB DESCRIPTION:
App li Si ature & Phone number
Received by: Gate Received:
N.IWORMCOMDE"ESAPP
9•f
i
_J
k'
Permit# Account Description Amount AML Pd. Bal. Due
0 S Bldg. Permit (BUILD) • -> `� ✓ 1.
l
Plumb. Permit (PLUMB) �. .�'Z�..`_"�
Mech. Permit (MECH)
f
State Tax (TAX)
Bldg:
Plumb: Z
f �
Mech: 2
I
I �
Plan Check (PLANCK)
Bldg:
Plumb:
i
Mech: /l • L v
�Su 3 z(1 Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
i
Parks Dev Charge (PKSDC) d V/
Storm Drainage Chg (SDSDC) J _
Residential TIF (TIF-R) / 3 °� 3 OJ
Mass Transit TIF (TIF-MT) / , 12,o V
Commercial TIF (TIF-C)
Industrial TIF (TIF-1) _
Institutional TIF (TIF-IS)
Office TIF (TIF-0) _
i
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire District (FIRE)
Erosion Cntrl Permit (ERPRMT)
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN) 2 S, rG v ✓
i
0
TOTALS: y
I
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94087125
Washington Counly
Page 1 of
I
1
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3
t
STATE OF OREGON
County of Washington SS
I, Jerry R. Hanson, Director of Assess-
ment and Taxation and EkOlclo County
Clerk for_dald county,do her 'tfertify that
the within instrument of writing Qs+eceived
and reoorded In book of M6ords'of said
county.
Jerry R. Hanson 61 rector of
Assessment and'�Laticn,Ex-
Officlo Gounty Clerk
Doc 94087125
Rect: 3.30657 5. 00
09/26/1994 04: 10: 19PM
P
t
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��' .,t, .. ri. . .' N,,:,,,,r N•.Y"as•h`th..,rxK.rM ..... .. ,.-..LM+wYI
h
y
R.
EXEMPTION FROM MAXIMUM SHADE POINT HEIGHT STANDARD
I
I/we, the undersigned, as legal owners of record of the property described as:
Lot # J3 of E6 Subdivision
Tigard Address 1 3 7,6-5- SW fJ 113s 61, V,C_ �►�
Tax Map and Lot Number s I oz-1 C (' - D l 3 0 v ■
I
do hereby release the property owners of adjacent Lot # 1 L
Sf��/'/�`'''!%,f� ! ■
ofSubdivision, also known as Tigard address 137 7,1 SW
and as Tax Map and Lot Number,5_/ v'-/CC - 0/L/dy-), from complying with
Community Development Code Section 18.88.050.G (Maximum Shade Point Height Standard);
and agree that the structure may have a shade point height of 1 feet, thereby allowing shade
on an area otherwise protected by Code Section 18.88.050.D.
In addition. I/we also release the City of Tigard from liability for damages resulting from this
adjustment.
vSi e
r
i
1 \
Signature
State of Oregon )
ss.
County of 4o-
This instrument was signed or attested to before me by and r
P ^� ,on ���1(�en'MW c>)b 1994.
Y
t
OFFICIAL SEAL �� ���� Q
Y VICKI M.MARCHING -
NOTARY PUBLIC-OREGON Signature of Notarial Officer,
(Nota Seal) COMMISSION N0.015419 M Commission Expires: (YLl-�(o
x
(Notary MY COMMISSION EXPIRES JUNE 4, 1996 y P
j�C(rC lel}V/
{•.4a � ��:. ±FPS .. -, ` '�
MIA
Yf,
CITY OF T I GARD - RECEIPT OF PAYMF N1 RECEIPT PT NO. s94-257818
CHECK AMOUN'T' a 6o 3s. 05
NAM=, a NW DREAMHO14ES CASH AMOUNT . 0. 1710
ADURE08 a 13906 TAYLORS GREST LANL PHYMt.N I DWI— 10/14/94
SUBDIVISION s
LAKE: OSWEGO, OR 9
PURPOSE OF PAYMF..N'I AMOUNT PNJ11 PURPOSE OF PAYMk;_'N'I HMCJUNI PAID � I
F BU I I_17I NU PERM MSS 94-01,11,58 8 '7;5:3. 170 PL.L,IMB I Nl3 PERM i: 't 0 V
MECHANICAL PE 45. 00 ST. BUILD PER 51. 15
PLAN CWiCK FF fl
250. 70 i•EWER USA SWH,44> 03imc1V.1 i�'c:a/1171. ub �
' :iEWER INC PEC r 35. 01A PARKIS 114,DC `71 O. 1710
I HF L.- J DEN T I AL TRAFFIC FE 'S 1430. 00 WISS I Ro-skl:. J) TIF F LES 1 e 0l 00
1=.RIILS I GiN C UN i HUI. F�ERM T.1"FE.ks MO. 0111 EROSION I;UN l lit H.., PLAN C;K �.:I1. 60
L ROS I CJN C ON I HLJL. e8. f-0 S T OHM INIH I N } i1 i:.,Ho. 01if
4
1.3179 6W H T 1-L 111 RE: D11
II1_01 14 H1L.I-SHIRF_. EST
1 1
TOTAL AMCJUN'r PAID _ _> 6035, fit r
0
,.+fir.
w, I
ll
I
rJ I OF TJ011PD Pf. C'F II'T Oil W-4Y1M1•.NI I" 1 1 .11'r NO. 04-4156444
OMr.IUN r c'L`i171. 00
i 1 IfSM1 a NORTHWFE31' DRE.PM I ljlvlF ''i 1 I 1 1 I AMOUN`I t 0. ft 0
1.-,;906 TA YLORF 1 FaE'c;f I..N. Pr 101KN 1 DAT'I s 09/06/94
LAKE: 0914"Gll, OR 1,i1,1IA0IV 113ION c
•� 97171;3 --
i 11RPO SP OF PAYINF: N r 14ME111N r PH I D PURI-It h it (if PO Y MF N T AMOUNI I PAID i
_ 1
l'...-j 3R r':l11'1. 00
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1
I i1 I t RF.. (PHASE T I )-' 1 14
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jf 111 iii.. fIMCILI>d 1 L'A 111 ) r�.. .' 00 1�
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