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CITY OF TIGARD CERT OCwCUpCCE OF
ANCY
COMMUNITY DEVELOPMENT DEPARTMENT PI-ILMI T #• • . . • • • i MST93-0458
13125 8W Hall Blvd.Tigard,Oregon 97223.8149 M3j68M4171 DATE. ISSUED a 04/06/94
PARC EL,a 1 a 1.34AC.-039fd0
317E ADDPESS. . . a 10 795 SW MANY PL.
SUBDIVISION. . . . it HART' S I._ANDINU ZON1NGaR-"-'r. 5 An
BLOCK. . . . . . . . . . a LOT.. . . . . . . . . . . . . 1010
CLASS OF WORK. aNEW
i 'rYr,E OF USE. . . a S r
occUPANC;Y GRN. a R:3
OCCUPANCY LOAD 1228 4
TENANT NAME, . . a
I?emArl(53 PATH I
P NA I SSANICE DEVELOPMENT CORP
1672 ,W WIL.LAME rTF FALLS DP
I
WEST I-INN OR 97068 j
Phone #: 50.3--557-8000
Iontrac.tdr^a -•--._.._. _.._ __ ....._.._........__._.._._.._ ._.,,__w__-_•-
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# Rf»NA I SSONCE I.E''VE:L OPMEN7
1672' `:3W W I ULAM .T"m rALt_S j)R
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WlEkSl LINN OR 9.7066
Rhona #a 557--8000
Reg #. . c 49955
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OccupAncY of the above referenced building ra hereby given, and certifies
the c^omplienr.e with the State Of Oregon Specialty Codes for the group, �
roc^c uPar)c V, and use under which the referenv.!ed 1:►et,mi`P•"'Was issued.
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_SPECTION NOTICE
City of Tigard Building Department
Hall Blvd. Hard .3
13125 SN g • Oregon 9722
Inspection Line (Roc--G-Phone): 639-4175 Buniness Phone: 6.39-4171
Inspections
tooting Plbg. Underslab Mec),. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas 'Line
Pob•1:mam Struct. San. Sewer Panning Bldg.y�
T�
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Wats L ne Gyp. Bd. ech.
Date Requesteds� e ' //� Times AM _ V,PM
`
Address: /y 7 J1 / _ Permit i�r
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Builders —_� f�/�/ �el-
THE FOLLOWING CORRECTIONS ARE REQU:MD:
In pectora
Datei-�%
PROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
' Call For Reinsp.
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INSPECTION NOTICE
City of Tigard Building Departsman-:
1.3125 811 Hall Blvd. Tigard, Oregon 97273
Inspection Line (Rec-O-Phone): 639-4175 Busine3a Phone: 639-4171
Inspections ■
Tooting Plbg. Underelab Mech. Rough-in ,Ap11C/Sdwlk
Ail'
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round. Plbg. Top Out Gas Line yTpu,t
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Poet/Beam ^truct. San. sewer Framing -Bldg.
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Post/Beam Mech. Rain Drain Insulation -plumb,
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Plbg. Underfloor Water Litre Gyp. Bd. -Meeh.
tD Date Requeeteds Timms AM PM
fr Addrenn:_� 2 1 P•rmit
Builder:
F 4,
THE FOLLOWING (•ORRECTIONS ARE REQUIRED:
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Dates --
APPROVrb DISAPPROVED V APPROVED SUBJEsT TO ABOVE
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Call For Relnnp.
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INSPECTION NOTICE
city or Tigard Building Department
13125 S11 Hall Blued. Tigard, OregM 97227
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections
Footing Plbg. Underalab Mach. Rough-in A
ppr/Sdwlk
Found. Plbg. Top Out Gas Line
FINALS
Post/Beam Struct. Ban. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation
-Plumb.
Plbg. Underfloor Nater Line Oyp, Bd.` t/Bph.
Date Requosted s �� / it Time:
PM
Address: �� I r�' 1I t
I Ai L4"S �/ Permit i=
Builder:i C ti/yt ':"'eL-vN"rQ. Cnl l(
TSE FOLLOWING CORRECTIONS ARE REQUIRED:
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APPROVED DISAPPROVED __L_1'0PROVED :IU"CT TO ABOVE
Call For Reinsp.
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City of. Tigard Building DapartebnE` `
13125 BW Ball Blvd. Tigard, Oregon 97223'-
Inspection
7223-Inspection Line (R&^-O-Phons)e 639-4175 Business Phone: 639-4171
Inepectior..
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found, Plbg. Top Out Can Line FINALr
Post/Beam Struc Ban. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation ) -Plumb.
Plbg. Underfloor Nater Line Gyp. Rd. -Hoch.
Date Reyuestedr —`r ._�..�..�..�.�7� Time: K'AM —PM
Addreass_& x`77Permit Is
Builderr —^-, // F"jV V ---- --__i
TBE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspectors �` bat-If
_L��AIIPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
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Call For Rainep. Mw a
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INSPECTION NOTICE
City of Tigard BuildLoq Department di
13125 SW Ball Blvd. Tigard, Oregon 97223 �.
Inspection Line (Rec-O-Phone)i 639-4175 Business Phoney 639-4171
!
Inspections_
Footing Plbg. Underslab Mech. Rough-in) Appr/Sdwlk
Found. a FINAL:
Post/Beam Struct. San. Sewer C Framing,_ -Bldg.
Post/Beam Hoch. Pain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. ad. -Hoch.
Date Requestedt-.':!�--�l ektS �-_AM _PH
Addrsss: �y�Slti� yS l/�Cr Permit f:
Buildert_ 1`1 --
THE FOLLOWING OORRECTION6 ARE REQUIRED:
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�;yJnepectort�-� w � Date:___
PROVED _ _— DISAPPROVED - _ APPROVED SUBJECT To ABOVR
--Call For Rainsp.
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jjlM39TIO-N NOTICR �_
Cita of Tigard Bu'.lding Departaent /
13125 all Ball Blvd. Tigard, OLvgon 9722
Inapew.ion Line (Rec-O-Phone): 639-417S Business P o s 3
Inspection: —
Footing Plbg. On Hoch, Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
r
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Hoch.
Date Requested:,_ / / l _. Time: AM _ PN
I (��
Addreesa� ��� - � Pe-mit OsY �1.17_— k
Builder:_
TBE FOLLOWING CORRECTIONS ARE RMQUIRED:
Inspector:_ _. _. Datse � � 1�
V APAPPROVED DIJAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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NI SPWTIOn NOTICM
City or Tigard Building Departaent
1!125 SIX Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: ()41V
Inspection:
Footing Plbg. Underslab Hach. Rough-in Appr/Sdwlk I
Found. Plbg. Top Out Cas Line FINAL:
Alt/Beam 8truc San. Sewer Framing -Bldg.
0C Rain, Rain Drain
Insulation -Plumb.
Plbq. Underfloor Nater Line
Gyp, Bd. _Neth-
m r ° Date Requested: ��/ Time: AM
-14--PN
AddreserZL� / ! -fi/ cPermit
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Builder:
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THE FOLLOWING CORRECTIONS ARE REQUIRED:
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— �' �`-��'�L�szT �`'/���=�.r Fes-• r— F� wry
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Inspector:
Datei_LL_�LL"
_APPROVED — DISAPPROVED — APPROVED 8USJECT TO ABOVE
Call For Rainsp.
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INS)'BGTION NOTICE � '
City of Tigard Building Department
131.25 811 Ball sled. Tigard, Oragon 97223
Inspection Line (Roo-O-Phona)e 639-4175 puniness Phone: 639-4171
fInspection:_
Footing mg. Onderslab Hoch. Rough-in Appr/Sdwlk
Found. Mg. Top Out Gas Line ANAL:
Post/Beam Struct. Ban. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Rd. -Hoch.
_ I
Dote Reyusetedr _ Times ____AM PM
Addrese:_ 1 (le" IV\A_I/ : t Permit is
But lder: ��/r LIA 1 V\ --- —
THE FOLLOWIIIG OORRECTIONS ARE REQUIREDI
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Inspector: �` t,ate:_ IX
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APPROVED DISAPPROVED APPROVEr SUNJECT TO ABOVE
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Call For Reinep ;.
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XNSPECTION NOTICE a ;i
city of Tigard Building DepertJ2eat
13125 sm Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:__
Footing plbg. Undexelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cao Line
FINAL:
Poet-/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Meeh. ('Rain Drain Insulation -Plumb.
I!M, ,I _
Gyp. Bd.
-Meeh.
Water Lineplbg. Underfloor
1' Time: AM
PN
_
Date Requested: ���
04
/ _f Permit #:
Address:_
—
y,,knw Builder:_
lF}" a frk (� -
I d '7!4' THE FOLLOWING CORRECTIONS ARE REQ R D: —
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Inspector: v_ Dale + r
_APPROVED —_ DISAPPROVED APPROVED SUBJECT TO ABOVE
_Cell For Reinep.
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INSPBCTION NOTICE
City of Tigard Building Department
13125 SN Ball Blvd. Tigard, Oregon 9722 i
Inspection Line (R.ec-O-Phone): 639-4175 Business Phone: 6.39-4171
Inapecttons
Doting Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gan Line FINAL:
Poet/Beam Struct. San. Sewer Framing _Bldg_
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor water Lina Gyp. Bd. -Mach.
Date Requoe/teds ICi //���� Timet AM PM
Addreees_1�.� Pe it
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Builder: IVA,(C
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THE FOLLOWING CORRECTIONS ARE REQUIRED:
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In Dates
APPROVED DISAPPROVED - APPROVED SUBJECT TO ABOVF
Cell For Reinep.
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CITY GF TIGARD PERrrI:Tri#E . , . . RMT F11579.:,--0458
COMMUNITY DEVELOPMENT DF.PARTMV'JT DATE. I SSU. D.-. 09/Qt6/93
t 13125 SW Hall 81YO.Tigard,Oregon 97223.8199 (503)539-4171
PARCEL: 1: 134AC -0:3900 i
SITE ADDRESS. . . : 10795 SW MARY PL
SUBDIVISION. . . . : HART" S LANDING ZONING: R-4. 5 PD
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .010 y.'.
i
______._.__.___........._.._..._.._.._._-----_...._. BUILDING _ .. -......_.....__.___._._..-___._._. __._._,..-__. _._..._..._._.__...__
REISSUE: DWELLING UNITS. I BOSCMENT. . . . . . . . :0 s f at
(:Lr`1S3 OF WORK. ::NEW BE.I:IRM3:3 I?AT'F-1S:;s GARAGE. . . . . . . . . . .5`8 S
TYPE OF U,':!E. . . ::3F" FLOOR AREAS- REQUIRED
TYPE OF CONST. :5N FIRST. . . . : 1244 s f L_E:F•-r. . :5 ft RIGH—. :S ft
OCCUPANCY GRP. :R3 SECOND. . . .- 1381 sf FRONT. :20 ft nEAR. . 41Z"r ft
STORIES. . . . . . . :2 THIRD. . . . :0 yf RE'0U.1RE:D___r__..._.._._____.____._
1EIGHT. . . . . . . . :28 ft f 51101�E DEwTECTORS. :Y
f"L_OOR LOAD. . . . :40 ps f VALUE:. . . . . $ : 1,30..__:"4 F"-'ARK I NG SPACES. . - I
Remarks „ PATH I
PLUOIN I NI
SINKNS. . . . . . . . . . : 1 FI_ocm DRAINS. . . . :0 BACKFLOW F'RE:VNTRS. . :O
LAVATORIES. . . . . ..5 WATER Hr%ATERS. . . : 1 TRAPS. . . . . .. . . . . . . . . :0
TUB/SHOWERS. . . . :3 LAUNDRY TRAYS. . .. : 1 CATCH BASINS. . . . . . . .0
WATER CLOSETS. . :3 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . : 1. WA'I FR LINE ( ft ) . - J.00 OTHER FIXTURES. . . . . ..0
GARBAGE DI aP. . . : 1 RAIN DRAIN (ft ) . :0
JA9HING 11A. C t-1. . . : 1. SF RAIN DRAINES. . . 1
MECHANICAL _._ _ _. FEES
FUEL TYPES--- -_......_ ._._._. UnIIT HTRS. . :0 rrpe amount by date recpt
/GAS/ / / VENTS . :0 TIF $ 1520. 00 JH 09/06/93
MAX INPUT :I'll BTU VENT FANS. . :4 Bl.-,RT $ 51.0. 50 JI1 09/06/93
FURN ( 100K . . :0 HOODS. . . . . . . 1 8PLC f 331. 83 JLH 08/2'0/93 93-2-43------
FURN > tOOE' . . : 1 WOOD.:TOVES. :O B3PC $ 05. 53 JI--I 09/06/93
FLOOR FURN. . . :0 CLO DRYERS. -. 1 SSDL `l: 280. 00 JH 09/06/93
LAOIL/CME=' f 314P:0 OTHER UNITS: 1 PARK $ 5017% 021 J1A 073/06/93
GAS OUTLETS: 1 MPRT $ 45. 00 JH 09/06/93
Owrrar: _ ._.._..w... _._.._.______..._.____._.__ .____._._w_.._._._MF'LC $ 11. 25 JH 09/06/93 — f
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RENAISSANCE DEVELOPMENT CORP M5PC $ 2. r"_5 JH 09/06/93 -• t
1672 SW WTI-..E_AIIETTE FALL";i DR PPRT $ 162. 50 JH 09/06/93 —
1, P5PC `b 8. 13 JH 09/06/93 -
' WEST LINN OR 97068
!'hone #: 503--557--8000
Contractor: _...._ _......-........._...._..........___...,.
RE14AISSANCE DEVELOF'ME:NT
1(, 7 SW WILLAMETTE FALLS DR
WL'b F LINN OR 97068
Phone #. '5157 -8000
'= Rp q #. . 49955
f 3396. 99 TOTAL
This pe, is issued subject to thr 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 wrrk will be done in accordance with proved Post/Beam Strt_tct Gas Line Insp
plans. This per_it will expire if Mork is no .tarted w' in 198 Post/Beam MecEtan. T,r7 s .r 1 gat .i ren Insp
days of issuance, or if work is suspended f _ore tha days, H'lm/Ltndslab Insp Gyp Doard Insp `
�) ! h/UnderFloor Rain di"ain Insp
Permittee F,i.yr1atv1 C' _._._. 4 _::.. w ._.._._..._. Met._-haT . A1. Inrsp Watei ;..ine Insp
Pll,!mb Top Ottt Oppr/Gdwlk Insp
Ts5uod Py: c� _ Framing Insp Mpr_hanic_al Final
Call for inspection 639--4175
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CITYOF T!GARD `-:sC WCC CONNECTION
f ION d;
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COMMUNITY DEVELOPMENT DEPARTMENT PE RMI T #. . . . . . .. : SWR93'-0?,9c":'. ;
13125 SW Hell Blvd.Tigard,Oregon 97223.8194 (903y'61104471 DATE 1'_SUED: 09/06/913
PARCEL: 1 S 134AC 031)00
51 1 E. ADDRI�'S',;. . . : 10795 SW MARY PL
SUBDIVISION. . . . . HARTI S LANDING ZONING: R-4. 5 1:-_.1D
BLOCK. . . . . . . . . . .. LOT. . . . . . . . . . . . . .010
TENANT NAME. . . . . .
USA 1\111. . . . . . . . . . . FIXTURE UNITS. . . :
CLASS OF WORK. . . :NEW DWELL_1 NG UN ITS. . : I
TYPE OF USE=. . . . . .SF NO. OF AU I LD I NGS: 1
IN:)TALL. '1"a-,r:. . . , ;C{I..riwrW IMPERV 5URFACE:. . : : sf
Pemar-ks : PATH I
I�rcvner,. _._._....___..._._._._._....._...___..._.__ _.___.____.___._._.___.__._._------_-_-_.-•-_ FEES -._._.--.---.---_--._
RENAISSANCE DEVELOPMENT CORP type amount by date recpt
1672 SW WILLAMETTE FALLS DR !'RMT $ 2200. 00 J11 09/06/93 —
TN..iI' 4 35. 11.10 ,JI,1 0')/06/'3..: _
WEST L.INN OR 97068
Ph o rr p #: 503-557...6000
C0nt-1-aCt or, ^.
-_
�NTRACTORNOT ON FILE
f-h o n e #: $ 2235. 010 TOTAL...
Reg #. ,
__...__.__....- REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewpr Iri�g..)er_,tion
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 m asurement
given, the installer shall prospect 3 feet in a 1 direct ns fro<<
the distance given. If not so located, the i miler 1 purchase
a "Tap and Side Sewer" Permit and the Agen will i i I1 a lateral.
F''a r••m i.t t e e S i y n a t r.c r e:" _. _
T ,r.l a Cd N y
CaII for inspection " 63`9-4175
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PLUMBING PERMIT
CITEOF TIGARD PERMIT #. . . . . . .
:
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 09/06/93 �
13125 8W Hall Blvd.Tigard,Oropon 97223.9199 (503)839.4171 PARCEL: 1A;1:34AC--0Ji900
:: rrE ADDRESC-3). . . c 10795 SW MARY PL
SUBDIVISION— . : h{�'�i�' S LF7NIJTPdC� 'ZONING: Rt...,rt. 5 PF)
BL..00:K. . . . . . . . . . . LOT. . . . . . . . . . . . . 0010
GL.ASiti OF WORK. . :NE:W GARBAGE:. DISPOSALS- 11
TYPE. OF U5,E . , . . zSF WASHING MACH. . . . . . . 91 BACKFLOW PREVNTRS. . :4:'� �
0C CUI.'-'ANCY ORP. . :R3 FI.AJOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . 0
�"TURIES. WATER HEATE_RS. . . . . . .. 1 CATCH HASINS. . . . . . . tO
FI)(TWRFs.3 __........._...._ LAUNDRY TRAY13. „ , ., . . . 1 Or RAIN DRAINS. . . . . o J.
SINKS. . . . . . . . . . : I CiREA3E: TRAPS. . . . . . . :@
L,AVATOR i.ES 5 01HEER FIXTURES. . . . . :111
TUB/SHOWER' . . . . : SEWER LINE (ft) . . . . ::0
WATER f.::I._CISETS. . *3 WATER LINE: (ft ) . . . . : JOO
DISHWASHERS. . . . : I RAIN DRAIN (ft ) , , . „ :0
Rtzmarks : 110TH I
!JWNERn _..., .___..,._. ..._.._...._. ...___µ......._._... _.___.. ...._.. _, __. ........_._._._._-_.-FEF:ca.....___...__....___ ... ...._..
RENAISSANCE DEVELOPMENT CORP 1 :L L' $ 1520. 00 JH 09/06/93 --
1672 SW WILLAMETTE FALLS DR BPR`f $ 510. 50 JH 09/06/9,3
I3F'LC $ ;3:31. 83 ,1L.H 121E3/20/93 93 ..24,,,, _....
WEST L..INN OR 1')706(3 ll anC ! G---'Si. 5;3 ,111 09/06/9:3 ---
Phone #1 503-5578000 SSDC $ 2801 00 JH 09/06/93
3 , 1.�.J y I PARK $ 500. 1110 JH 09/06/9:3
Pli-robing C':ontrac:tor^,....... _ .. _.. � IYIPR'T * A-5. 00 J14 09 106193 ....
" MPLC $ 11. 25 ill 09/06/93
Name: _ :_ . '�--C.-��!/�7'L M'5PL $ '.. 2'5 ,1H 1219/06/9
Addrlecav :_ j � �.���r _. PPRT $ 162, 50 J14 01 /06/9.3
C:Jtv ti..., N(� `3t ate .-. �r P5PC; $ 6. 1:3 JH 09/06/1' ..
R _,...J _. _.
Zip: �7i. Flhone#: IAG-
_M ..__.___... ..._._..
Req #:
F2E:.QU l RF I) I NSF1E::t;T I tIN6i ...---__...._..
:his permit is i ssl.ted t,kib.itact; t o the reg 6
..Mations contained in the Tigard 1113nicipaAI Foot/found Insp Rain drain Insp
Code, State of Ove. Specialty (lodes and all Host/Beam struct Water Line In!ip
other, applicable laws. PI1 work will be clone Post/Beam Meehan Appr/9dw1k Insp
in accurcianup with approved plane. This Plm/undslab Insp Mechanil:al, fin., '
pey,mit will expit'v if worlf Js rrotl, tkir 'tnci PLM/UnderfIoat Plumb rinal
vlithin II80 'days of issr.lance, or if work i� ' Mechanical InqAp 9I.Ailding Final.
ui,pc Ood far mare than 1610 dAys. Plumb Top Out Erosion Control
Fr-aming Insp Crawl Drain
Fireplace Insf► _.__—_.__._. ...._ ..._...__.....,_......
Gas Line Insp
I Insulation Insp
Gyp Board Insp
_... ....._ _. ._.__
Autharized�Pl1_imbing Contractor SirJnatUrE1
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lull for inspectioninspection61;9-417`,
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13125 SW Ifall Blvd. PLNCK/RECT #
CITY OF TIGARD PERMIT # ,�s�9s -Os
COMMUNITY DEVELOPMENT DEPARTMENT Tigard.Oregon 972Z3
(503)63"171 DATE ISSUED
NU r PICA
JOB ADDRESS: Lo '! l JJ cJ �� TAX MAP/LOT /S/ 3f/C, 3100 _
I SUB: HARTS LANDING LOT: LAND USE:
VALUATION: .2 S � �
Wim_
SPECIAL NOTES
NAME: RENAISSANCE DEVELOPMENT CORP REISSUE OF:
ADDRESS: 1672 SW WILLAMETTE FALLS DRIVE LAST REISSUE:
WEST LINN,, OREGON g7nba — FLOOD PLAIN/
PHONE: (503) 557-8000 SENSITIVE LAND:
CONTRACTORPAPA PROVALS REQUIRED SGuBC1Z-{,��j j
NAME: RENAISSANCE DI"VELOPMENT CORP. PLANNING:
ADDRESS: 1672 SW WILLAMETTE FALLS DRIVE ENGINEERING:
WEST LINN, OREGON 97068 FIRE DEPT:
PHONE: — (503) .557-8000 OTHER: f} _
CONTR. BOARD #: 499ss — EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: EAGLE PLUMBING LIST/SUBCONTRACTORS:
i
MECH: TRI—COUNTY TEMP GnNTRnT. BUS TAX: _
ARCH/ENGINEER CAL.rULATIONS:
NAME: ALAN MASCORD TRUSS DETAILS:
ADDRESS: 1515 NW 23RD OTHER:
PORTLAND, OREGON 97210
PHONE: 225-9161
PROPOSED BLDG. USE:
COMMENTS:
i
A4LIeMT VGNATURE
Received By:- Date Received:
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PERMIT 0 ACCT 0 DESCRIPTION AMOUNT AMOUNT P0.• HAL. DUE
0151V-0 58 10-432 00 Building Permit Fees
�z-sy
10-431 QO Plumbing Permit Fees
_ 10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%)
„
Building X5,5 3
Plumbing � 3
MechanicalZ�
10-433 00 Plans Check Fee 31.3 4'
Building •-3/. �-� / � "'�
Plumbing
Mechanical
10-230 06 Fire _ C
E� r
30-202 00 Sewer Connection 2_ r� u r -211,1 � J
30-444 00 Sewer Inspection i / _ � k
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF FeesV ,b
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees / i u
25-448-05 Mass Transit TIF Fees
i
52-449 00 Parks System Dev Charge (POC)
31-450 00 Storm Drainage Syst Dev Chrg
! (SSDC) �?'
24-445-01 Water Quality (Fee in eu o )
1 lif —
24-445-02 Water Quantity (Fee in lieu of) _
TOTAL
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inm/3587P.WPF
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CITY OF.. TIGARD tF'L"F IPT OF PAYMENT RECEIPT NO. C93-244030 r
CHECK AMOUNT 5381. 99
rJAMf a RENAISSANCE DE.VE.L.()PML:.IVI
CASH AMCIf!N'f'
t
6IDDRE SS a PAYMENT DATE" 0'3 9,3
'.il.JSD I V 19,1 Oil
4 'I
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f-'URPOSE OF PAYMf_NT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
PUII._DING PERM 510. 50 PLUMBING PERM 162. 50
MECHANICAL.. PE 45. 00 ST. BUIL..D PER 35, ni
1=i_Alu Ct4FCK FE 9;3. Vi 8 SEWER USA 2f^_QUO. Nva
SEWER INSPECT 35. 00 PARKS SDC 500. 00 q
SIORM DRAIN SDC 0-110. 00 RESIDENTIAL TRAFFIC FEES 1410. 00
MASS TRANSIT TIF FEES
LOT 10 HART!--3 LANDING l
10795 FiW MORY PLACE
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TOTAL AMOUNT PAID — — — > 5381. 99
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