12734 SW MORNING HILL COURT r•rr.1+.•.M.rM-r. �,.d. wn -sf..^'-.w""�f�.."r'"""�"b- e+rwM .... nwrt�n►,.J u'`.we '}�.` ,y, y+`l-m'w+,
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CITY OF TIGARD CERTIFICATE OF
COMMUNITY DEVRILOPMltNT ORPARTMRNT OCCUPANCY
171 as ow Ma BW.Tie wd,Ome" OTM91109 (!00)'01-471 PERM i T #. . . . . . . a MST93—9108
DATE~ ISSUEDe 07/13/93
PARCEL a 28104AC.--07800
SITE ADDRESS. — . 12734 SW MORNING HILL CT
SUBDIVISION. . . . s MORNING HILL 09 ZONINC3a
BLOCK. . . . . . . . . . a LOT. . . . . . . . . . . . . a221
CLASS OF WORK. a NEW
TYPE OF" USE. . . a SF"
OCCUPANCY GRP. a R3
OCCUPANCY LOAD1222 4
TENANT NAME:, , . a
Rema+i ksa P"'4TH I
Owners
,TAY MILLER
P(Tj BOX 23291
' 1IbARD UP 97201
PhoTIL #1e 684-7543
s JAY MILLER
9 PO Box 2:3291
Y'1GARD OR 9*7281
Phoney #t 684-7543
Req
Occupancy of the above rPfprenced building is he.•eby given, and certifies �
the compliance with tha Staite! Of Oregon Specialty Codes for the group,
oc-cupancy, and uFe under which the refererneptj was i +saued.
--.�... .....,....._...._........_.__.._.._..........._. _...e!�_..1. ...ate- _�.wi�l.le'�:r......w......._............__._�____.....
F=IRE RTWIPifMENT
JLNCS
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POST IN CON6P I 1.LlC1U5 P (SCE ,
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�`pp IttexiLOR NOTICE �.
city or Tigard Building Depart:aent i
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13115 6W Ball Blvd. Tigard, Oregon 97223
Inspection L'.ne (ROC-O-Phcne)t 639-4175 Business Phono: 639-4171
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Inspection:
Footing Plbg. Underslab Hach. Rough-in Appr/Sdwlk f
round. Plbg. Top Out Gas Line , NIl ALt i I
Post/Beam Struct. San. Sewer Framing -Bldg.
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Post/Beam Mec'i. Rain Drain Insulation -Plumb.
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Plbg. UnderfloorNat r Line Gyp. Bd.
Date Requested: ,17 T1eMt
Address:_ C\\\� C Pmt71t #t
Builder: J M—
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TBE FOLIANING CORRECTIONS ARB REQUIRED:
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Inspector: — Date:
1K1.PFFROVED —, DISAPPROVED APPROVED FUBJECT TO ABOVB� -
0211 For Reinap.
,
PEc'^_10N NDTICE
City of Tigard Building Department
13125 SA Hall Blvd. Tigs d, oregnn 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:-
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top out Gas Line FINALt
Pout/Boom Struct. San. Sewer Framing -eld
Yn�t r
• Post/Beam Neck, Rain Drain Insulation -Plumb
Gyp.
Plbq. Undatfloor Nate! Lige Gyp. Bd. �` _p�h,
Date Requestedt f
Times AN — (PH wxrR
Address t_ )/ !ormit
n
Builder: h
THE FOLLOWING OORRacTIONS ARE REQUIRED: � }w
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,) .. �..� ` cv4,•.�t+v��-,�j�t.2.-,cam °zaj �,
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Inspector: //,
—, Datet
_APPROVED DISAPPROVED APPROVED SUBJRCT TO ABOVE
Call For Poinep.
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INOPNCTION NOTxCE
City of Tigard Building Departnent_ N
13125 811 Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
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Inspection:___
Footing Plby. Underelab Koch. Rough-in Appr/8daik •
Prnmd. Plbg. Top Out Cas Line lINALt I
a.
Pout/Beam Struct. San. Sewer Framing -Bldg. e
g Post/Beam Keith. Rain Drain Insulation -plumb.
d Plbg. Underfloor Nater Iine /Q Gyp. Bd. -Koch.
Date Requesteds -2Y TL=s A_ AN 11
AKM-
hddress l i 2r.rmit #1 73— L
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: _— Date: 1i 1
F„
_APPROVED _ DISAPPROVED i� APPROVED SUBJECT '[O ABOVE
---_Call For Rei.nsp.
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INSPECTION NOTICE
City of Tigard Building Depart.ent
131-25 Sit Ball Blvd. Tigard, Oregon 97223 -d 1 1
Inspection Line (Rec-O-phone): 639-4175 Business Phu
ne: 6
Inspection:__
Footing Plbg. Underniab ►' ugh-in Appr,'Sdwlk
Found. Plbg. Top Out a� s Ligwy FINALt
Post/Beam Struct. San. Sewer C/
t Framing -Bldg.
Poet/Boam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
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Datq Requested:-- ( fl �.1 �y 3 _ Time: AM _PM
Address: 1, / ,-1( eFzmit f:� �U OILY
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Builder:-�� _
THE FOLLOWING CORRE TIONS ARE REQUIRED: —
Inapec�nrf _
Dates � G. � t
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_APPROVED DISAPPROVED _^ APPROVED SUBJECT TO ABOVE
—_Call For hjinsp.
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INSPECTION NOTICE ILL, -yam—
E City of Tigard Building Department i
13125 Sit Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: --� -- ----
Footing Plbg. Underslab Mech. Rough-in Appr./Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
1
tti
Post/Beam Struct. San. Sewer Framing -Bldg. tt
PoHt/Beam Mech. Rain Drain Insulation -Plumb. `1
Plbg. Underfloor Tatar Line �p. B2fj. --Mach.
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Date Requested—:7 ,{ r �C i --J- Time: CJ AM _PM
Address-L l J� , s'
L Pemit 1i (
Builder:— C• � C� —
THE FOLLOWING CORRECTIONS ARE H . ,IRED:
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/ 1Inspector� - ------_--------- DAte: C.
/ —APPROVED — _ DLSAPPROVED APPkOVF.D SUBJECT rO ABOVE
___Call For Reinap. 1
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INSPECTIAN NOTICE
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223 h
e
Inspection Line (Roc-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslsb Merh. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct, San. Sewer Framing -Bldg. +
:-
Pont/Beam Mach. Rain Drain ,x-neuletl�ry� -plumb.
Plbg. Underfloor Nate Lina Gyp. Bd. -MRCh. ,
Date Roque 8ted t , , y� Time (� _AM p/PH
Address:__ �` J ;1 I LI �'r `Y Permit Is / Q QIJ
Builder:
( J�
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector:_____--
I
APPROVED DISAPPROVED a'-/APPROVED SUBJECT To ABOVE
Call For Reinap.
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INSPECTION NOTICE
City of Tigard Building Department /
.13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Businees Phone: 639-4171
1�
Inspection: �{y =��g r
Footing Plbg. Underslab ` Hech�lA Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Strurt. San. Sewer -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested: /� Time: AM
PM
c�
Address•__ _
Permit is —�
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
C7 �-
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1Ut 4 y1,�M1pb I �L �
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y,� ii td�'1Y iS�1r1 p��l�r
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Inspector= Date
_ _ _ e
APPROVED DISAPPROVED _ APPROVRD SUBJECT TO ABOVE
Call For Relnsp.
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INSPECTION NOTICE /�/1----"
City of Tigard Building Department 666
13125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4375 Business Phone: 639-4171
Inspection:_
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
■
Found. Plbq. T� o�t_ Gas Line FINALS
Post/Beam Struct, San. Sewer Framing -Bldg.
Poet/Beam Much. Rain Drain Insulation -Plumb.
Plbg. Underfloor hater Line Gyp. Bd. -Mech.
Date Requested: /r^� � Tis X_AM PM
Address: i •� q 3
/J '64;/4t1t #: _
Builder•
THE FOLLOWING CORRECTIONS ).AE REQUIRED:
4
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�Cy<
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� ,a>�,•kAl �t#y V
,VI
Y•+4' i �C��d� dui f'.n7 � "
Inspect r /
Date:
- --
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVR X11 YY � s ,�
Call For Reinsp. your attr 't
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INSPECTION NOTTCE M '^
City of Tign-d Building Department
12125 Sit Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Bunineen Phone: 639-4171
Inspection:
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. t,,t
Pibg. Top Out Gas Line PINAL:
M1
Poet/Beam Struct. Sewer; San. Framing -Bldg.
g.
oSt/Beam Mech.
Rain Drain Insulation -Plumb.
+ ,
�. Underfloo
Gyp. Bd.
}` Water Line -Mech.
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Date Aesluoeteds r��Y1C T �G -AM _PM
ro Address: 3
Builder: —
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THE FOLLOWING CORRECTIONS ARE REQUIRED:
F
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e ierM6�•,:
,
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Inspectors_- Data: ti r Chi
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xAPPROVED DISAPPROVED APPROVED SUBSF.CT TO ADOVFy
t' X1
Call For Reinnp.
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INSPECTION NOTICE
City of Tigard Building Department _
% 13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Lin•q (Rec-O-Phone): 639-4175 Pusiness Phone: 639-4171
Inspection•—
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top out Gas Lind FINAL:
Poet/Beam Struct. Can. Sewer / Framing -Bldg.
Post/Beam Mech. ( Eain Drain) Insulation -Plumb.
Plb3. Underfloor ater Line Gyp. Bd. -Mech.
q
Date Reuested: f Time: AMPM
r Address:
-Builder:
THE
x THE FOLLOWING CORRECTIONS ARE REQUIRED:
y ,
4
Inspector:
Date:—
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
V S i
Call For Relnnp.
INSPECTION NOTICE �
City of Tigard Building Department-. t,
13.125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Foocing) Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Found.;} Plbg. Top Grist Gas Line FINALS
Poet:/Beam Struct. San. Sewer Framing -Bldg.
Pont./Beam Mach. Rain Drain Insulation -Plumb.
} Plby. Underfloor Water LinLe�J Gyp. Bd. Hech.
i Date Requesteds �--� -T PH
'
Address: / i� -�9J�a l_./— ;*it f:
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Builder: el_e".,L _
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors _ ,L — Dates
APPROVED DiSAPPROVEb _ APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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C17YOFTIGARD Ai�
r
OFTl6a4RD F'l lJlylE+IlVf� PERMIT1
COMMUNfTY DEVELOPMENT DEPARTMENT +nooN , w,.i . . , . , . , : M5793—x,106 ,
13125 SW FWI Blvd. P.O.Box 23397,T)pud,Or"m 97223(603)830.4176
91TF ODDRL55. . . : 12734 SW MORNING HILL PARCEL: 2S104AC-MH2Li
SUBDIVISION. . . . : MORNING HILL #9 ZONING:
LOTs--l
------------------------ -
-- _---__-_-_ -_-____---------_ _ _
CLASS OF WORK. . :Nf W GARBAGE DISPOSALS. . : 1
I TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : 1 BACKFLOW PREVN TRS. . :0
OCCUPANCY F,RP. . : R3 FLOOR DRAINS. . . . . . . :0 'TRAPS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . :2 WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :Q,
FI LOUNDRY TRAYS, . . , . . : 1 SF RAIN DRAINS. . . . . : 1
SINKS. . . . . . . . . . . I GREASE:. TRAPS. . . . . . . :Q1
LAVATORIES. . . . . :4 OTHER FIXTURES. . . . . s til f
TUB/SHOWERS. . . . : SEWER LINE
WATER CLOSETS. . .-3 WATER EINE: ( ft ) . . . . : 1QQ
DISHWASHERS. . . . : 1 RA114 DRAIN (ft ) . . . . :0
Remarks : PATH I
OWNER: -----_____________.___________._ -------------------FEES---_---_-_--.-_.-
JAY MILLER TIF $ 1460. 00 JH 02.:/2:6/93 -
PO BOX 23291 BPRT" $ 409. 00 JH 02/26/93 -
BPLC `} 40. 00 JLH 02/22/93 93--23696.3
TIGARD OR 97281 B5PC 4 20. 45 JH 02/26/93 -
Phone #: 684-7543 SSDC $ 280. 00 JH 02/26/''x3 -
PARK $ 500. 00 JH 02/26/9:3 Plumbing �;ontr^actor,:------ _.___.._._....-_..-•- IhPR7 $ 39. 00 JH 02/26/93 -
�, HPLC $ 9. 75 JH 02/26/93 -
Name: �) _ __ M5PC: 1' 1. 95 JH 02:/2=6/93
Address__ PPRT 1 155. 00 JH 02/26/93 -
City: . _ N `it, -IL-e :.. ...__ �Sp�(� $ 7. 75 JH 02/26/93 -
zip:-. _ :.�T,ISO#$ -TIOK- -----
Fie y k 231f$ZS
14Agfl�OREGON 97281-0925 _..._.__
----- REUU I RED INSPECTIONS -------
'T'his permit is issued subject to the rey-
ulations contained in the Tigard Municipal Foot/found Insp Rain drain Insp
Code, State of Ore. Specialty Codas and all Post/Beam Struct Water Line Insp
other applicable laws. All work will be done Post/V;?am Meehan Appr/Sdwlk lnsp
in acr_•ordanr_e with approved plans. Ihir F='lm/undslab Insp Mechanical F incl
permit will expire it work is not started PLM/Underfloor Plumb Final t
within 180 days of issuance, or if work is Mechanical Insp Building Final
suspended for more than 180 days. f"lamb Top Out Erosion Control
Framing Insp Crawl Drain
Fireplace Insp w_�•__
Gas Line Insp
Insulation Insp
x -,•_ �.._ - (3yp Board Insp
_ a
taut prized Plumbing lantr^actor aignat�.lr•e
Call for inspection 6;39--4175
Contractor Notes: r
„ �n a.r . �• „d�µ,.p�pvp�p,a. ,y,:,.,.,,,:.t^';.�a+q."..y.ti�* ,� ,�/r ro .,p[�.<?�+roy � ?fl ;
CITYOFTIVARD C�iYOF?I�IRD MASTER F`ERMIr
COMMUMTY DEVELOPMENT DEPARTMENT oleo” PE: RN I T• #. . . . . . . .. MST93-0108 �
13126 BWFWIBMa
Blvd.P.O.B23N7.Tlpnd.Onpon 07223(M)6304175 `4r
SITE ADDRL_SS- - - : 12734 SW NORNINb HILL CT PARCEL_: 2S104AC-IYIHr'2J
`]UBUIVIyICIiJ. - . . : IYIORNING HILL. 49 ZONING:
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . ..221
BUILDING
REISSUE.11ST92-0107 DWE L_L I NU UNITS-1 BASEMENT. . ,. . . . . . :0 s•F
CLASS OF WORK. :IVE:W BL DRIYIS-3 BATHS:3 GARAGE. . . . . . . . . . :41B s f ,
T'YF'E OF USE. . . :SF FLOOR AREAS------------ REQUIRED
TYPE OF CONS] . -SN FT RST. . . . :97Qr sf I_.F*F•T. . : II ft RIGHT. : 12 ft
OCCUPANCY VF3F,. :R3 SECOND. . . :864 sf F'RONT. :20 ft REAR. . :31 ft
TORIES. . . . . . . :2 1111P.1). . . . :Qr s f RE QU T
HEIGHT. . . . . . . . : 4 f t TOTAL- -_-- : 1634 s f 511OKE: DETECTORS. : �
FLOOR LOAD. . . . :40 ps f VALUE. . . . . $ : 91(':30-18 (VARA I IVIG SP,(-)LES. . : 1
Remarks : PATH I
____..___.._.__._____-_________..___...__..-•_---- PLUMBING {{
SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 PACKF�LOW PREVN'TRI;. . ;0 0-1i
LVIVA'TORIES. . . . . :4 WA'TLR HEATERS. . . : I TRAPS. . . . . . . . . . . . . . .0
IUB/SF•IOWERS. . . . :3 LAUNDRY TRAY5. . . : I CATCH BASINS. . . . . . . :0
WATER CLOSE'CS. . :3 SEWER LINE••'•.« (fi) . :0 GREASE TRAPS. . . . . . . n N
DISHWASHERS. . . . .1 1 WA'T'ER LINE i f t i . : 100 OTHER FIXTURES. . . . . 9 0
UARBAGE DISF`. . . : 1 RAIN DRAIN (ft) . :el
WASH I IVIG MACH. . . : 1 SF' RAIN DRAINS— : 1
MECHPNICAI_ ---- _.___________._______---....._._.....__ FECES
FUEL FYF`ES-----_-- _-- UNIT' H7'R3- - :0 type amur-rnt by date recpt
/GAS/ / / VENTS . . . . . :0 TIL= $ 1460. 00 JH 02/26/93 -
01AX INPUT:Q) B'T-U VEN'r FANS. . .4 BPRT $ 4Q)9. N0 JH 02/26/93 - I
TURN ( 100K . . : I HOODS. . . . . . : 1 BPLC $ 40. 00 JLH 02/22/93 93-c3696,!,
F=URN ) -J.00K . . :0 WOODSTOVES. :0 B5PC $ 20. 45 JFi 02/26/93 —
F LOOR FURN. . . . :0 CLO DRYERS. : 1 SSDC $ 280. 00 JH 02/26/93
BOIL/CMP ( 3HP:0 OTHER UNITS:O PARK. $ 500. 00 JH 02/26/93 -
GAS OUTLETS: 1 MPRT• $ 39. 00 JH 02/26/93
Owner: ----- --- -------------------NPLC $ 9. 75 JH 02/26/93 -
JAY MILLER M5PC $ 1 . 95 JH 02/26/93 -
PO BOX 23291. PPRT $ 155. 00 JH 02/26/93 -
P5PC $ 7. 75 JH 02/26/93 -
TIGARD OR 97281
Phone #: 684-7543
Contractor:
JAY IYIII_LE:R i
PO BOX 23291
TIGARD OR 97281
Phone #: 684-7543
Reg #. . : 30109 ___.____________________-_-•--_____._._____ _
$ 2922. 90 1OTAL
This permit is issued subject to the regulations contained in the --- ---- REQUIRED INSPFLTIUNS ------
ligard Municipal Code, State of Ore. Specialty Codes and all other Foot/ fol_rnd Insp Fireplace Insp
applicable laws. All work will be done in accordance with approved Post/Beam Stri.(ct Cas Line Insp I
plans. This permit will expire if work is not started within 180 Past/Beam MechAn Insulation Insp
days of issuance, or if work is suspended for more than IA0 days. Plm/undslab Insp Gyp Board Insp
PLN/Under fIoar, Rain drain Insp
Vlermitt'ee 5' iynatr.(re: � IYlechanical Insp Water Line Insp C
Pli.(mb Top Out Appr/SdwIk Inst3
is,me(1 By : Framing
Insp Machanicall Final
Call far inspection — 639-4175
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CITYOFTIFARD SEWER CONNECTION
COMMUNITY DEVELOPMENT DEPARTMENT ONOON FERN I T
13125 BWHmHBlvd.P.O.Bam23;1o7,TOW,OrsW 27?Z3(SM)S X4175 I-'F-RMI T #. . . . . . . : SWR93-0098
fr ;3'1 •+17.L liGi7F ISSLJED: 02/26/93
SITE ADDRESS. . . : 127:54 SW hIORIJIIJIS HILL_ Cl" C'AF(l.,E:L:
SUBDIV1S101\1. . . . : MORNING HILL #9 ZON11,4G. ('
BLOCK. . . . . . . . . . . LO'l.. . . . . . . . . . . . . ..
T ENAN7 NAML:. . . . . .
USA NO. . . . . . . . . . . FIXTURE= UNITS. . . :
CLAS:i OF WORK. . . :NEW DWELL I NG UN I TS. . ; 1
TYPE: OF USC:. . , . . �,F NL'. OF PCJ1LU1IJGS: 1
INSTALL T'YFIE. . . . :Bl.1rSWR INh)ERV SURHA."E. , : ; y f
Remarks,:
d"
Owner,: --_________________.._._______.__._..____._. FEE=S
-- `-- _-_.
.TAY PIII._I...ER type amol_(nt by date
P'O BOX 23291 F,RMT # 21(00. 00 JH 042/`6/93 —
INGF•' :,,5, 00 .JH 02/; 6/9:3 -
rTGARD OR 97�H1
F'I'ione #: 684•-7543
Contractor:
CONTRACTOR MUT ON FII__Ec
I'Fi a rr e it' 1 c:'.1 3,). 00 TO rAI.-.
Rep #I. .
This Applicant agrees to comply with all the rules and regulations Sews F1LLiUIFtl1/ .lIJSF'EL:TIOIJ5 --- - -- -
q �r
of the Unified Sewage Agency. The permit expires 100 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 seM.r laterals. If the sewer is not located at the measurement
oiean, the installer shall prospect 3 feet in all directions from _
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" Kermit and the Agency will instal] a lateral. .__.._.._._......
Ct'e r m.► C't e e S it-4 n at .(r e: �J/1 Jc� &-- . j
__._.__ _._. ___._ Y________ __.. __._ _.__._.......
C 11 f 0 inc,pect i on 639--4175
3 L/
Mai".
17123SwFiauM-d. PLNCK/RECT #
CIrIA70F TIGARD 110 Box 23397 PERMIT #
COMMUNITY DE-VELOPMENT DEPARTMENT Tiprd,Orcgon9723
(503)639-4»i DATE ISSUED
I
JOB ADDRESS: /2-7 3 V 6 W !n0/n)'nQ TAX MAP/LOT
SUB: MDr'nin!� fI i/1 9 LOT: LAND USE:
VALUATION: / c{l I
OWNER SPECIAL NOTES
NAME: REISSUE OF:
ADDRESS: �'0 L30X 23291 LAST REISSUE:
rll
aye., FLOOD PLAIN/
PHONE: 75VB SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME: !)!2Ad PLANNING:
ADDRESS: _ ENGINEERING: _
FIRE DEPT:
PHONE: OTHER: 7 %I
CONTR. BOARD #: EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: el-n Vis LIST/SUBCONTRACTORS: _
MECH: BUS TAX:
ARCHANGINEER CALCULATIONS:
NAME: TRUSS DETAILS:
ADDRESS: OTHER:
PHONE:
PROPOSED BLDG. USE: � ,�J Q.... 0 `/ i" Clk �c.�.� - /[��� 1 5r✓ ��) � ij� C�
COMMENTS:
APPLICANT SIGNATl1RE
(.,ceived By: _—
Date Received:
4
I
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
M -Q OF 10-432 00 Building Permit Fees 460rf
10-431 00 Plumbing Permit Fees 155
10-431 01 Mechanical Permit Fees 3
10-230 01 State Building Tax (5q) 3U. /S _ 30 ./,5
Building0-��s
Plumbing
Mechanical .
10-433 00 Plans Check Fee 5'
Building O
z
Plumbing
Mechanical >>
I
10-230 06 Fire
1 SWR4O d 30-202 00 Sewer Connection u 0
30-444 00 Sewer Inspection
! 25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees /3-5o L3-5 U j
25-448-05 Mass Transit TIF Feesy ' �l U '
52-449 00 Parks System Oev Charge (POC) .S o U 0 R"
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) A*10
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTALU
nm/3587P.WPF
C:I"I`Y OF T 1 GiARD — REU. I P T OF F'A'Y •T � c '
MF:,r1. kECF.1 t T NO. � 1.3 237c 14
CHECK AMOUNT s 50 17. 90 s �
tdAME s MILLER, J'AY CASH AMOUNT s 0. 00
iJ.)l]F2E S.s z PAYML,NT DATE a 067,
i7,
SLISDIVTsIU14 s .
F'I.JRF)OSC OF PAYMENT AMUIJNT PAID PURPU!iE OF PAYMEINIT AM01,.1N'T Pti i D
i1Tl._L71NCa t�C-PM, 409. 00 PLUMBING PERMi155. 00 �
(-HANIC:AL. FBF 39. 00 :;1 . SUIL.D PER 1;0. 15
()N CHFtr;M !—C 9. 75 '3EWRR USA 1.00. ii 0
to ER INSPECT ;.xT. 00 Pi-'WKS SDC
500. 00
rORM DRAIN slat. 21s0. 00 RES:iIDIcNTIAL TRAFFIC: FEES 00
Ivtfl','; TRArdw1T TIF F'EVS 1 i0. 0111
I
I.i►T' 2 1 MORNING HILI_ 9
r 73,4 C+W MORNING 1-111-t- C:"E'
."VITAL. ANUUNT PAID _ w _ 501 ?�i)
r�
CITY OF rTt:441) "-" kl':C.E:.It:,T OF PAYMENT F+E_t.::E_.Tt'r'T W.f. 63
CHI_t'A AMOUNT s 40. 001
NAME e .TAY MI'I.L,FR f3l,iil_.CW.1,1 C',F17'311 AMOUNT s 0. IAO
W)DRFb ; : PAVMF::NT DATF� s OIr"'ice x_'/9:4
t='�.'a SOX ;='3��'�31 !3LlD17Il�TSIC]Id s
rT 1 G1ARD, OR 51?�"..EI1
OF PAYMENT "MOUNT PA 11) PURPOSE CJF E'AI'MF'N T AMUUN'I Pol T V
F."I (.114 CHECK FE. 40. 00
i
Y
A.
1; 734 SW MORNING Hlt..L CT (RET"3GUE 16394 iiW 107 t'.T')
1. 0T I MJ'1 9 Pt-AN
TOTAL. AMUI..JNT PAID 411. Oki
,r
. r
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