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-71CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT CERTIFICATE OF
13125 SW Hall Blvd.TlOud,Oregon 67223.6166 (503)636-4171 OCCUPANCY
1 PE RM.T M. . . . . . .
t a9-r+171 llATE- ISSUED: 10/14/94
PARC-EL: 2S I O•?A13-02401
!
SITE ADDRFa",3'. . . : IP-511 5W MAIN ST
SUBDIVISION. . . . z ELECI*Pll:,' ADD. TO TIGARDVIL.L_E ZON1NC cCBD
BLOCIA. . . . . . . . . . t LOT. . . . . . . . . . . . . . 15
GL.AISS OF WORK. :ADD
TYF-'1(7 OF USE:. . . :COM
flClwUF?f�Nf,'Y C;Rp. z iAr: t
I:ICCUPANCY i-OAD,3
! l'E„PIF;NNT NAME. . . zMErL_E'fT L1P110L.Gl'F:-:F?Y
Remarks: Kepler' s Upholstery- Addition to existing building
I
OON WANSON i
1. '51 1. SW MAIN ST
I(;, ,"J) OR 97 .-.23
Phui,(, �j 639_..,212100
C:'ontracctors
!'07A1! ENTERPRISES INC.
'711 N MOL.Ai...L.A AVE
f
MOLAL.-L.A DR 97058 f
Phoney #z 658•-6717
Reg It— : 77219
(Jcc upancy of the Abovee referenced bui .ldiricl s hereby given, and certifies �
F.he compliance with tha_ State Of Oregon Specialty Codes for th-, group,
)—'upAncy, and cl5e under Which the reforeric ed permit was issued.
LDIW' IN4, ILCI OR
it
e
f PU L L I Of r ;I AL_
r:,OSLT IN CONSPICUOUS PLACE
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T�NSPECTION NOTICE
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inapection Line (Roc-O- hcne)s 639-4175 Businean Phone: 639-4171
I
CQ
Inspection: _e r
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line
Post/Beam Struct. San. Sewer Framing -eldg. J t�—
Post/Beam Mech. Rain Drain Inuulation �-Plumb.
Plbg. Underfloor Water Line Gyp. Bd. NeC
Date Requeeted:_ f U 1 __Ti.: AM PH
Addree a. �_ `; �L Yom. 5 Permit ►:
.�_��_ [
■
Builder: r i _ ,)
THE FOLLOWING CORRECTIONS ARE REQUIRED:
1
Inspector• :/ _ Date:
_-APPROVED DISAPPROVED C� PROVED SUBJECT TO ABOVE
��Cell For Reinsp.
1 Y
r � �
i
INSPECTION NOTICE
City of Tigard Building r-eP.rtmmt
13125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Line (R�c-O-Phone" 639-4175 Business Phone: 639•-4171
inspection:- --
Y
Footing Plbg. U eralab Mech. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Cas LineNALy
Post/Beam Struct. San. Sewer Framing
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line O1'p Bd. -Mach I
._ ( —
Date Requested: �L _ T�- AM PX
Address: /')-SI J.- Permit /:��'Lk-._L_7��' c� ,
Builder• 14 D 13
THE FOLLOWING CORRECTIONS ARE REQUIRED'
42 z
s.v-..rte: tic G
Inspector= Data= ,
APPROVED DISAPPROVED APPROVED SUMECP TO ABOVE.
Call For Reinop.
�i
INSPECTION NOTICE
City of Tigard Building Department
13125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
1
Inspection: -"---
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor O�
W ter Line -d_ -Mech.
4'
Date Requested: �� Times
�J �LAN _FM
Addreee: 1� ` C�( y1 ��1� --- Permit i:_ Z" •
Builder: G• L' - �G�• 3 __ _
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector:_ —,- --_—_--—_-- Date: ',
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinnp.
� j
INSEECPION NOTICE 2 ,
City of Tigard Building Department
13125 Sit Ball Blvd. Tigard, Oregon 97223
Inspection Liinne (Rec-0-Phone)s 39-4175 Business Phone: 639-4171
Inspect ion:
Footing Plbg. Urderslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gan Line FI
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation 1
Plbg. Underfloor Wader Line Gyp. ed. -Mach.
Date Requested:_ �/ /`) Time: gyp^' AM PM
Address:..) i.J_[�� /� Permit
/ —
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: --- — ----- Date-
—.APPROVED DISAPPROVED V�P_ROVF.D SUBJECT To ABOVE
-Call For Reinsp.
INSPECTION NOTICE,
City of Tigard Building Department
1.3125 Sw Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639••4175 Business PhoA f 9-4171
Inspections --•- —— ----- 4- •
is
Footing Plbq. Underelab Mach. Rough-in Appr/Sdwlk
r
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. Sen. Sewer. Framirg -Bldg.
Poet/Bee.m Hoch. Rain Drain Insulation -Plumb.
A AL
Plbq. Underfloor Water Line I 6-Y p. Bd. -Meeh.
Data Requested: �' �1 Time: AM PN
ft a
Addreae: � C-7 � � ��Cl..l.i.�- Permit
r � �
Builders Cu_ 20,ax
� cl.�C i C k J 1,��C�
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: _ _�___m� _ __ Date:
�--REPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinep.
s
r
INSPECTION NOTICE N
City of Tigard Buil4ing Department
13125 SW Ball Blvd. Tigard, Oregon 9727.3
Inspection Line (Rec-a)-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Pl.bg. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Team Struct. San. Sewer Framing -Bldg.
Poet/Roam Mech. Rain Drain insuiation -Plumb.
P109. Underfloor Water Line Gyp. Bd. \-/Mech.
Date Requested: _ �- cc Times _AM �_PM
Address: �`�' J I1I rn/Cl.�/11 /`• Pi mit�i: � V Ic �-
Builder: `_-/C0 T I Q 5 R -
THE FOLLOWING CORRECTIONS ARE ARQUIRED:
Inspector.__ Dater
—�APDO DISAPPROVED APPROVED SUBJECT TO ABOVE
_ Ce Lt For Reinsp.
k 1
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INSPECTION NOTICE `-
city of Tigard Building Department
13125 SN Fall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
a
Inspection: --_---
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing --Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested: , I Time: AN PM •
�� 1
s �
Address: ) �Ca-L L� -+ - Permit
Builder:__���� �
THE FOLLOWING CORRECTIONS ARE REQUIRED: S
Jit kt A ,
hre
9
Ins cto Datu:
APPROVED DISAPPROVED V APPROVED SUBJEr"I TO ABOVE
Call For Reinnp.
'Nry4Y.
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INSPECTION NOTICE
City of Tigard Building Departmnt
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:--- ��--- ----_ —_-�
Footing Plbg. Underelab Mach. Rough-in Appr/Sdwlk
1
Found. 1 g. Top Gas Lire 4ldFg Poet/Beam Struct. San. Sewer Framinq .
Poet/Beam Mach. Rain Drain Insulation
Plbg. Underfloor Water Line Gyp. Bd.
Date Requested: _l— __�/ Time: AM _ PM
til
Address:1 �L11!_I_ ` �erm1it o:c1A_
Builder:--- — l0 1
THE FOLLOWING CORRELTIONS ARE REQUIRED:
Inspects
Date: i • v �� Ya
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Roinsp.
I I�:
i
3L
:
e JJl I
IISPECfION NOTICE
City of Tigard Building Department
13125 811 Ball Blvd. Tigard, Oregon 97223
Inqpection Line (Recc-O-Phone): 639-4175 Business Phone: 639-4171
01 1
Inspections_ l 01c Z._(.. �,Y/(L b --- e
Footing Plbg. Underelab Nech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Can Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
Date Requested: / _,-Times
,PM
Address:
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED: p/]
—_
k
Inspectors— —`�— Dates_
_APPROVED DISAPPROVED APPROVED SUM,RCT TO ABOVE
Call For Relnsp.
I \
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f.,1 r`!V i"V:wA,w,
«.•„nr”1 rr.
ktk3
INSPECTION NOTICE
CitX Of Tigard Building Department
13125 all 8x11 Bird. Tigard, Oregon 97223
Inspection Line (Rec-O-Phones 639-4175 Business Phones 639-4171 .0
„ r
Inspections
Footing
Plbg. Dnderslab Hoch. Rough=
Y
C11Y OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hai:Blvd.Tigard,Oregon 97223.81gg (503)833-4171
PLUMBING PERMIT
PERMIT #. . . . . . . : p'LM94--0120
639-4171 DATE ISSUED: 06/:8/94
PARCEL: 2S 1 02AB--02401
SITE ADDRESS. . ., : 12511 SW MAIN GT
SUBDIVISION. . . . : ELECTRIC ADD. TO TIGARDVII._LE: ZONING: CBD
BLJCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .. 15
--- -------------------
CLASS OF WORK. . :ADD GARBAGE D I SPOSAL.S. . : MOBILE HOME SPACE'S. :
TYPE OF USE. . . . :COM WASHING MACH. . . . . . . : BACKFLOW PREVNTRS. . :
OCCUPANCY GRP. . :B2 Fl_OJR DRAINS. . . . . . . . TRAPS. . . . . . . . . . . . . . .
STORIE:S. . . . . . . . : 1 WATER HEATERS, . . . . . : 1 CATCH BASINS. . . . . . . .
FIXTURES ---- --- -__.___. LAUNDRY TRAYS. . . . . . : SF RAIN DRAINS., . . . . :
SINKS. . . . . . . . . . . URINALS. . . . . . . . . . . . . GREASE TRAPS. . . . . . .
LAVATORIES. . . . . : 1 OTHER FIXTURES. . . . . :
TUB/SHOWERS. . . . : SEWER LINE (ft ) . . . . :
WATER CLOSETS. . : l WATER LINE (ft ) . . . . :
DISHWASHERS. . . . : i2AIN DRAIN (ft ) . . . . :
Rema-)(s : Kepler' s Upholstery-- addition to existing building
Owner: ___ ..__..____.-_.....__._._._.___.._._.. ..__._______.__.___-_____._______._________ FEES
KEPLER' S type arnol_tnt by date recpt
1.'2511 SW MAIN ST PRMT $ x'5. 00 SW 06/28/94 -
`,PG? $ 1. P5 SW 06/08/94 -
T1(..ARD OR 97223
Phone #:
Contractor:
VAST PLUMBING INC
1723 N. JESSUP
PORTLAND OR 97217
Phone #: $ 26. 25 TOTAL
Reg #. . : 72629
REOUIRED INSPECTIONS ----____
This permit is issued subject to the regulations contained in the Top-out; Insp ^_
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final I:n s p e`t i o n
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 188 days of issuance, or if work is suspended for more
than 180 days.
Permittee Signature.
Issued By:
Call for inspection - 639-417 ;
I
1
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i
.,.M+.wMrnw/Al7W.mt.*r�uk s} xdE1��Frrr�K'eM,eu._wunr.,ws .. . R„u.,.. . ,....«... _.
City of Tigard PLUMBING PERMIT Planck,'Rec. #
13125 SW Hall Blvd. ti�`l APPLICATION Permit #
Tigard, OR 97223 AU?
(503) 639-4171
t �
.,» � — escnption
ORS 814.21-610 _ QTY PRICE AMT
i .lob j j�� Jct /'lilr,l FIXTURES
Address _ — Jin
k 7.50
Lavatory --T.50
..» �..� I ub or I u owerom .
S>�ern y _
«. ater Closet
Owner
Dishwasher
o ge isposaT
as ingirk— o
Moor Urain 7.509
Water Reaier� 7.50
7
wwv »: — — su ry oom ray -
Occupant r,n-'aT-- 736—
Other r Fixtures peG
- —
0
MISCELLANEOUS
Contractor - — — —�- -
``�i - _/` �- wer is; —
n•�i . o. 50.60
- .. o. wer ea.kidit.
(o /tf,,�, I a fresWater Service sf-1
hereby acknowledge at I nave read is apion,that the Water Service Pa.Addit.200' 15.00 i
information given is correct,that I am the owner or authorized agent of —
the owner,that plans submitted are in comp: ince with State laws,that I Stonn d Rain Drain 1st 100' -- 30.00 —
am registered with the Construction Contractor's Board,that the number Storm b Rain Drain Addit. 100' 15.ii
given is correct- (If exempt from State registration,please give reason j
belaw.) - Mobile Home Space - 25.00
Back Flow revention
Devicx cr Anti-Pollution Device 7.50
ny rap rr We e o
Conner.ted to a Fixture 7.50
scn w new 53TR—IOFCT alteration repair U CatchBasin
to be done residEntial O non-residential
Insp.of Exist.Plumbing per hr
40.00
Specially Requestod Inspections per hr
Existing use of Rain Urain, singe ami y
building or property �r rn�+c _ dwelling -- 15.00
—11esi�Cen a backfiow prevention
devices 15.00
Proposed use of ( -
i building or property -
- (Fxcept residential ac ow
prevention devices)
::JTICE 'Minimum Fes$25.00 SUBTOTAL aZj
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5%SURCHARGE / zs
AUTHORIZED IS NOT COMMENCED WITHIN 1P-0 DAYS,OR IF —
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED PLAN REVIEW 25%OF SUBTOTAL
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. I
-- TOT____ I
AL
Special Conditions
Date issued by
wvwueruT
.artaund.v
i
r
•
p 4
x
M
CITY OF' T I GARD — EiECE' I PI OF PAYMENT FiF:GE I PI NO). t 94—P53979
GHEC:K AMOUN T 26. a5
JJAME= VAST PLUMBING SERVICES
S CASH Nah1ClUNT' x �• ��
PAYMF_'N'1 DA T+ V 6/;28 94
i�UI)F2E' f3 2-6506E. F!WFtK AVE I;UDD I V US I(IN a
M I L.WAUK I F, OR
>'UFtE'U OF PAYME":NI AMOUN1 PAIDt='IJItF'1'�;-;t (:iE t='WYMk:.NI AMUI.IN'T PAI 1)
N'I—UMHING PFRM F1I.M94r--0120 i'i5. NN f4-1 . SUIL.I) PER
M1
M � ,
a
i2l5i i 3W MAIN
40TAL AMOUNT PAID — — ^> P6• 25
4
N.
1,a4
BUILDING PERMIT v
--CITY OF TIGARD PERMIT #. . . . . . . : BUP94-•Olaf
COMMUNITY DEVELO FENT DEPARTMENT DATE ISSUED: 06/06/94
13125 SW Hall Blvd.TI9ard,On, '123.8199 (5031 9-$1�l1' '
PARCEL: x::51 ORAN-0401
SITEr ADDRESS. . . : 3,2.511 :aW MAIN ST
SUBDIVISION. . . . : ELECTRIC ADD. TO 'TIGARDVCLLE ZONING: CBD
FLOCK. . . . . . , . . . . LOT. . . . . . . . . . . . . : 1:,
REISSUE: FLOOR AE2EA:i-_-- --- EXTFRIOR WDLL CONSTRUCTION-
CLASS OF WORK. :ADD FIRST. . . . .300 sf N: S: E: W:
'TYPE: OF USE. SECOND. . . : sf PROTECT' OPENINGS"-------
---- --
1 Y1=�E OF CONST. :5N THIRD. . . . : s f No S: E. W.
UCt'UPANC:Y GRP'. :B2 TOTAL--_.__.__: x,00 s f ROOF C t�NS'T:L FIRE RET? :�"
UIXUPANCY LOAD:3 BASEMENT. : sf AREA SEP. RATED: �
GTOR. : 1 HT. : 1 1 ft GARAGE_.. . . : s f OCCU GEF. RATED:
1ISMT?: MEZ Z?: RECD SETBACKS--.-______ rEUUI RED._-_-__.-__-____-__-_-...
FLOOR LOAD. . . . : psf LEFT: ft RGHT: ft FIR SPKL:N SIhOK DET. . :N
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM:N HNDICP ACC:Y
BE:DRMS: BATHS: IMP SURFACL: PRO CORR:N PARK I NG:
VALUE:. $ : 14000
Rr . arks: E4epler' 5 Upholstery-- addition to existing building
Clwner, _. .._.._._....______._..__..___ .._ __.____..____.__._ ___ _ _._�.____ .__.__.._ FEES
DON HANOON type amount by date recpt
1.2511 SW MAIN ST PRMT L 104. 50 SW 06/06/94
PLCK >6 67. 93 - 05/04/94 94-2520L&:
1 IC„ARD OR 9722.3 SPCT $ `i. E3 SW 0F/O6/1)
Phone #: 639-2000 TIF $ 51. 00 JLC 05/11/94 -
Contractors
KOZAK ENTERPRISES INC. !
711 N MOLALLA AVE 1
MOLALLA OR 97058
Phone #. 658-6717 $ 228. 66 TOTAL I ,
! Reg #. . : 77219
_------- REOU I RED INSPECTIONS
This perait is issued subject to the regulations contained in the Foot/Found Insp ........
__
I igard Municipal Code, State of Ore. Specialty Codes and all other Framing Insp
and icable laws. All work will be done in accordance with Roof n a i 1 n g Insp
approved plans. ',his perait will expire if work is not started Insulation Insp
within 18@ days of issuance, or if work is suspended for sure Gyp Board Insp
than 18@ days. S u s p C e i 1 n g I n 3 P
F i n a l Inspection
Permittee Siwiature
I s s 1_I e d B y
Call for inspection - 639-4175
ad ;�;.a• i.r 7
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Commercial Building Permit Application V
4
City of Tigard
ly
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
`Jobslte Address: T
Office UsP Onlyw ,3
��Tenant: Kr.,IL-, 2'e 4,i=+k,I Suite# _$
II Planck/Red#
Valuation: �l, o Ao l ■
_T Permit #
Owner: �� – ', _s a & TL# l
_ :..Map
■
Address: A�pi rovals Required
Planning
i
Phone: E — Engineering
Other
.ontractor: r,z,I►<
Address: Ir
``'' ���'�
Type of const: < xcr*4- N r
Occupancy class:
Phone: y5� � j� �
Sprinklered? Yes No l
Contractor's License # 7 c
A__ d
(attach copy of current Oregon license) Sq. ft. of project: Is 40ai.
i
Story (1 st, 2nd, etc.) s,
Archltect/Englneer: �1 .t. �•� l I< Proposed use:
Address: %"`��`t� PPrevious use:
Note: Plumbing & mechanical plans
must be submitted at time of
Phone: --�' ' 11J� ?Z' 7.5 building permit application.
COMMENTS:
, liaJ S gnAture & Phone number
Received by: --�F- Date Received: ==L
1
Stl 1 4 • s r i t t r, Y 4f
f��' �41`1`�,��n � I l., r :, �, vt ,ra Y3 A;; ��';�J y�,r��'"u 6 �� S�.p"� .�•
Permit # Account Description Amount Amt. Pd. Bal. Due
a
i
s
B4 N-0–0 Bldg. Permit (BUILD) _ •�`� �/ ,
Plumb. Permit (PLUMB)
Mech. Pemut (MECH) _
State Tax (TAX)
i
■
Bim: —
Plumb:
■
Mech:
Plan Check (PLANCK) _ �� �–y�✓ '�
Bldg: _
Plumb:
Mech:
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Storm Drainage Chg (SDSDC) _
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
� oG vv 111.
Commercial TIF (TIF-C) y�, ' , ).
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS) _
Office TIF (TIF-O)
Water Quality (WOUAL)
Water Quantity (WOUANT)
Fire District (FIRE) {
TOTALS:
U -\
J
LZ
i
STATE OF ORECON I "CgNSTRUCTION CONTRACTORS BOARD
Bond [ 1��OU¢z, ,
Registeredas ;� t,;7Z99.t ;�Irisur nce liA ���1,. #VALTY CO
SEN CONi`RlA� > 11Ct11il $`
:XEMPT PAi�773478
:ORPORATI0IT( .
r ,4 ' 1 EmployerAocountsi
1
N flLlf
� res[ /9�i c� q ,
RevY a P,.
<OZAK ENTEI $ SNC" WC
QLALLA 0 OdC10 {
e,
. ... ...._._..t1'r1.�1�—i.LiT- '�iy►-..._.-.L.�.JL� .�—..._ _ �arm..
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DATE PLANS CHECK NO-
PROJECT TITLE
COUNTYWIDE
TRAFFIC IMPACT FEE V CAN T:
IP
WORKSHEET
(FOR NON-SINGLE FAMILY USES) G ADDRESS-_� �
/ G— xe_ -
CfTY/ZIP/PH NE
RATE PER
LA Q USE CATEGORY TRIP TAX MAP NO.:
RESIDENTIAL $152.00
BUSINESS D COMMERCIA 38.00 SITUS NO.ADOR
QF+lCE $140.00
6 /
147.00
Fj INSTITUTIONAL $63.00
PAYMENT METHOD:
WCHECK
CREDIT INSm1IT10 M ONLY:
BANCROFT(PROMISSORY NO uwD usE cATECORY icw,$mPnON OF USE KDAY AMQ TRW RAI WEEKEND AVE TRIP RATE
DEFER TO OCCUPANCY
BASIS: e2of � e30 7
I
CALCULAnONS: p
J-1
' / i
, 3. S
oil
FROM=TRIP QMERA'"ONx
3 ,
FEE: >$ S/. oe
ADOMONAL.NOTES: FOR ACCOUNTM PURPOSES ONLY:
RWAML: - C
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TRANSITAMT.:-- /n OSS T/rW
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ax WASMOGITON couNTY
TSF NOTfaoou
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