13611 SW MICHELLE COURT >tti'.:.�.y,�•-»:.j�:a. i� 40OW
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--- CC'ERTIFICAIE OF
OUPACITY QF TIGARD PERMIT #. .... . . . i MSTri.s -0144
COMMUNITY DEVELOPMENT DEPARTMENT DATE r 3SUEDx t0/2' /iR3
13126 SW Hab Blvd.Tigard,Oregon 87223•P190 (E03)830.4171
PAf?C;'EL: r=.: 104Cf1 -�41�4b
I TE ADDRESS. . . :. 3E,1 1 SM M I CHELLE CT
�.)UBUIVISICIN. . . . a HILLSHIRE ZOfdrNGiR•-7 Pr) !
r3l . . . . . . . . . . a L.OT. . . . . . . . . . . . . :@41
CLAS G OF WORK. :NEW
f'YPE OF UC:fE'. . . :GF �
OCCUPANCY GRP. -.133
OCCUPANCY L_OAD:22'6 4
TENANT NAME.
Pp-parks a PATH r
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HOME(G) INC
715'.:1 Sw VARNIS
1"nR1"LAND OR 91c.`2:5
f-lhuni 10a 684-6453
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=::'AH(...I SCH HOMES INC.;.
15100 814 KOLL PKWY
SUITE E"
IkE:AVE_R'T'ON OR "I70"116
0honp #: 634--6453
'?cog #. . . 40_067
Occ.tlpanmy of the Above r,eferenred building is her-aby yi.verl, anti car^tifieS
;.he c_amplianre with thN 'State (If Dr^egon 5pef.ielty cocles for, the group,
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')c'c q-tpanc,y, and P.mcler which the refer^erweiJ per Wait was, issued.
BUILDING N��PE- OR t f IAL.
POST IN CONSPICUOUS PLACE:.
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j"EC'PIONQTICE \�
City of Tigard Building Departarust
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13125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 619-4175 Suelnese Phone: 639-4171
Inspection:---- � -r- I V Il_J 1 --- -
Footing Plbg. Dnderelab N*ch. Rough-in Appr/Sdwl.k
Found. Plbg. Top Cut Gas Line �FINALs
-..N f
Poet/seam Struct. Sen. Sewer Framingdq�j
Post/Bream Hoch. Rein Drain Insulatlnn -Flub.
PLbq. Dnd, rfloor Nater Line Gyp. Od. -21--m
-Nmpb.rt
Date Requested: �.) Y_ m PM
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Addreen:_l � �1' frr 11- ( i`'o ' � ,
Builder:
TBE FO INO OORRECPIONS ARS Ds
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Inspector: Dates U �R
APPROtRD DISAPPROVED - APPROVED SUSjECT To AgOVIt
l l I• /� T- Call For Re f nsp.
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INSPECTION NICE
City of Tigard Building Departwmt
13125 BW Ba11 Blasi. Tigard, Oregon 97223 _
Inspection Line (Rec-O-Phone): 639-4175 Duniness Phcrt: 639-4171
Inepections._� _� K
Footing Plbg. Dnderelab Mach. Rough-in IrpVr/Sdwlk
Found. Plbg. Top Out Gas Line C FINALs)
Poet/Beam Structs. San. Sewer Framing ,Bldg,
Poet/Beam Mach. Rain Drain Insulation ptn�yl i'
P:►u. Underfloor Nater Line Gyp. Bd.
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Date Requeeteds '`� �• �� T1mef PM
Adare..t Permit fs �
Builders
THE FOLLOWING CORRECTIONS APE RSQDIRFDs
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InepecCors, - nater l V \ L. 5'
APPROVED DISZalirr
VED APPWWED SUBJECT TO ABOVE
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RMP CTION NOTICR
City ci Tigard Building Department
13125 811 Ball. Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Pl.bg. Top Out Gas Line 7S�AL
Poet/Beam Struct. Sar. Sewer Framing -B1d5Tt
l .,.,�.l
Foot/Ueam Mech. Rain Drain Insulation
Plbg. Underfl.00r Water Line typ" Bd. -Mec
Times AH PM
Date Requested:_,__-_ (( -- -
`J. Permit 1: `1_ U�4�
Builders_
THE ING CTIONS ARF. REQUIREDI
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Inspector: Dates
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APPROVEDyDISAPPROV�jD APPROVED SUBJECr To ABOVE
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INSPECTION NOTICE
City of Tigard Building Dopartment )+ b,
1312.5 811 Hall Blvd.
Tigard, o'cegon 97223 �+
Inspection Line (Rec -O-Phone): 639-4175 Business Phone: 619-4171 e t' �j � `4y`•Mµ'
Inspection: _ — Pu4 1 soy
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mating P1b9• Underelab Hoch. Rough-in , A�r/Sdwlk
Found. Plbg. Top Out Gap 1.1116 FINALS
Post/Beam Struct. San. Sewer Framing -Bldg.
Port/Beam Hoch. )rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line oyp. Rd. -Hoch.
Date A�vquesteds— P � G ��f �w Times _ AN PM
Ac'4reses I �J(pi I � , Permit
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED:
S TA c.C. 0/2 4 i/✓ C 111v& TO C Z/-'M1V6---
C. -AYUK1460 TO?__�'�`ICAC-T r-144 S_-7L--
Inspectors ( �� ��S _ Date ^2J _
APPROVED DISAPPROVED PPROVED SUBJECT To ABMr'E
__Call For Reinsp.
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MSPES ION NOTICE;
City of Tigard Building napartsent
"125 SW Hall Blvd Tigard, 2/regon 97223
Inspection Line (Rec-O-?hone: 639-4175 Business Phone: 639-4171
Inspections
Footing Plbg. Underelab Hoch. Rough-in � . 11ppr/Hdwlk `)
Found. Plbg. Top Out Gas Line FINALt
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -plumb.
Plbq. Underfloor Nater Line Gyp. Rd. -Hach.
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Date Requestedc_ J -Ct J
Times r0h4( AN
Addrosat �C 1 f�_�a, �C
— permit o:_
Huilder:
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TEP► FOLLOWING CORRECTIONS ARE REQUIRED,
A/ I N r Aj te-1' it/C, _ To
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Inepectort L_ 7S
Date:
APPROVED DISAPPROVED APPROVED SUBJECT To ABOVE
Call For Reinsp.
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INSrUCTION NOTICE z"
City of Tigard Build1mg DepartmKmt
11125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Bus4nens Phones 639-4171
Inspections_ Y•u ti�-�_. ___�T_. — dr
Footing Plbg. Underelab Mach. Rovgh-in Appr/Sdwlk
Pound. Plbg. Top Out Gas Line FINALS
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Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulatioan -Plumb.
Plbg. Underfloor Nater Line <=yp. Bd. -Mach.
Dake Requested i / z7� TimN PH
Address: Pormit 1
Builders ��_
THE FOLLOWING CORRECTIONS ARE REQUIRED: II
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Inspectors �V" -� Data:
APPROM DISAPPROVED V APPROVED SUBJECT TO AnOVE
' o __ Ct..11 For Rainsp.
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INSPEIO-_"OTICE
City of Tigard Building Departient
13125 SM Hall Blvd. Tigard, Oregon 97223 SAI p ,•
Inspq�^tion Line (Rec G-Phone): 639-4175 Business Phone: 639-4171
Inrpect ion:__------- —.e
Footing Plbg. Undorelab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALt
Poet/Beam Struct. Sar:. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Lino Gyp. Bd. _Nech.
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Date Requestedt_ _./ ^ % / Times ........M PN
Addreee: a t' Permit f t 3 Q
Builder:
THE FOLLOWING CORRECTIONS ARE REQOIREDt
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Inspector: / Late:
V APPROVED DISAPPROVED ” APPROVED SUBTECT To ABOVE
Call For Reinsp.
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I!ISPEGTION NOTICE
City of Tigard Building DeparAA*'-nt '
13125 SM Ball Blvd. Tigard, Oregon 97223
Crory,jr ^+r' ;�Ysi Inspection Line (Rac•-O-Phona)s 639-4175 Business Phone: G39-4171
Inspections
Tooting Plbg. Underelab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out 'Gas Line y? FINAL:
Poet/Beam Struct. San. Sewer Frvoing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Reque`steds �- l�_ l Times ✓ 1 AM (� [�PM
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Address: 1 l Parm}t #, 9-5
Builders �) a\^• ate, c��^ r —
THE FOLLOWING C.ORRECTInNS ARE REQUIRED: T
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Inspectors Dates
APPROVED DISAPPROVED APPROVED SUI_LYNCCTTOTO ABOVE
Call For Rainep.
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INSPECTION NOT:CE
City of Tigard Building Dep&rtnenv 1
13125 BR Hell Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 By-inees Phone: 6.39-4171
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Inspections
Footing Plbg. Dnderelnb Meah. Rough-L,,,� Appr/Sdwlk
Found. Plbg. Top Out Cas Lina FINAL:
ea►
Poet/Beam Struct. San. Sewer prY,in -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. underfloor Nater))Line Gyp. Bd. -Meeh.
Date Requested: C -C7`J_ TiMe: O AM/� d PM
Address: 13 /47
� �t ��(�e � permit 1: r-5�� y
Builder:_ _
TAE FOLLOWING OORRECTIONS ARE REQUIRED: \PCT
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ol- � 45-k-a yrs --a a< `
Inspector: Date: Z49 S 1
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-APPROVED DISAPPROVED APPROVED SDSJJCT TO ABOVE- --
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'INS PECT�ON h0'!'IC9
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City of Tigard Building Department
13125 811 Ball Blvd. Tigard, Oregon 97223
Inspect.icn Line (Rec-o-Phone)s 639-4175 Business Phones 639-4171
Inspoction:__
Tooting Plbg. Underslab Nech. xough-ie 11ppe/8dw1k
Found. Plbq. Top Out Oae Line ;' 1PIN11L8 s
Post/Beam Struct. San. Sewer Frame 9� -Bldg.
1.
Post/Ream Menh. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. B3. -Mech.
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Data Requesteds ��' \ r 1L%l Time: AM _PN
Address:_ 13, CD , ' �� 0 <�_t (Ir-wit
Builders
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THE FOLLOWING CORRECTIONS ARE REQUIRED1
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((JJ +�`� �, $!Sj„✓E�flJk4 111
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h�JE� � r✓o I Y � , / ..,,.... ._.. I,-' � Y`(�E^ 'F I!�4��,._����t�kr� f�4-���t$� ..
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Inspectors '�--- Date: .� !�Y ��4'� n e Isla ^
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__APPROVED DISAPPROVED APPROVZD SUBJECT TO ABOVE
Call For Reinsp. a
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INSPE9LION NOTIC? -'
City of Tigard Building Department
13125 SA Rall Blvd. Tigard. Oregon 97223
Inspection Line (Rea'-0-Phone): 639-417 Bualnesn Phone: 639-47.71
Inspection: ---
Footing Plb{. Dnderslab Mech. Rough-in Appr/Sdwlk
Found. Plbq. Top Out Gas Line FINAL: aft
Post/Beam struct. Ban. Sewer Framing -Bldg.
Post/Bo^m Mech. Rain Drain Insulation --Plumb.
Plbq. underfloor. Mater Line Gyp. Bd. -Hoch.
Date Requesteds� 1� ___Time: AH PH
Addreses � �zz l Permit 1: /L
Builders
TBS FOLLMINO CORRECTIONB ARS REQUIREDs
'— _-- -
Inspector, i _ _ Dates
ltd�APPROVED DIBAPPROVEO APPROVED ddBJECT 1b ABOVE
4
Call For Reinsp.
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INSPEC'T'ION NOTICE 1
city or Tigard Building Department
1.3125 811 Ball Blvd. Tigard, Oregon 97223 .
Inspection Line (Rec-O-Phone): 639-4175 Baeine"s Phone: 639-4171
Inepoct-iont��
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
Poet/Beam Struck. San. Bower Framing -Bl.dg.
Poet/l.eam .Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Mater Line Gyp. 8d. -Nech.
Late Roqueetadt Timet AM PM
Addre e as i/ �W// %L G/tl�1fZ..� C _ �_ Permit f t `'"(
Builders
TBE FOLLOWING CORRECTIONS ARE REQUIREDe
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Inspectors -- -_ Date:
LAPPROVZD DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Rel,nep.
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INSPECTION NOTICE �4
City of Tigard Bullding Department
13125 BW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phoneb: 639-4175 Business Phones 639-4171
Inspection:
Tooting Plbg. Underalab Hoch. Rough.-in Appr/Sdwlk
Fcn:nd. Plbg. Top Out Gas Line FINAL: ,
Post/Beam Struct. ` Ban. Saha! Framing -Bldg.
Post/Beam Hoch. leain Ota Insulation --plumb.
Plbg. Underfloor r 6 (Nato! L1Mji Gyp. 9d. -Mach.
Date Requested/3a`J J�j7 ,% L� Timet,X / PN
AN
Address t � 1� //�L LA/_���e, � � Permit #2
Builder:
TBE FOLLOWING CORRECTIONS ARE REQUIR
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Inspector: _ Date:
APPROVED UISAPPRrAMD APPROVED Bt1BJRCT TO ABOVE
Call For Reinsp.
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INSPECTION-NOTICE O
City of Tigard Building Departawt ».,,• ,'.
131.25 SW Bal-. Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: — —
Footing Plbg. Underalab Mach. R ugh-in Appr/Sdwlk
pu)-d, ) Plbg. Top Out Gas Line FINAL:
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Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Meeh. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Rd.. Hoch.
Data Requested: J ' /�� _Ta`' AM PN
Addrass: '�/ /JA�tG �-- L_ Permit #t -3
Builder:
TBE FOLLOWING CORRECTIONS ARE RRQUIRED:
1
42 OR
Inspectors Data: J ��
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��APPROVED �` DISAPPROVED u_ AFPROVED SUBJECT TO ABOVE
Call For Reinsp.
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' I"SPzg .ION NOTICE
Ci T of Tigard Building Department
13125 BW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)t 639-4175 Business Phones 639-4171
Ins"ation:
i
Foot Plbg. Underelab Meeh. Rough-in Appr/Sdwlk
Plbg. Top Out Gas Line FINAL: W,
at/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Pl:w:b.
Plbg. Underfloor Water L..ne Gyp. Bd. -Mach.
Date Requested: }V Time /�AM PH
Address:�:j(iJ U l L 1 Permit #i G
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THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector:T1 — Date:
JV /APPROVED DISAPPROVED APPROVED SUBJECT To "MEA-
It 1Y
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CITY OF TIGARD i:,E RmIlT yLi hl , M
COMMUNITY DEVELOPMENT DEPARTMENT
i 13126 8W Hall Blvd.Tigard,Oregon 97223.8199 (603)630.4171 DA TL I SLUE D a 04/07/93
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H.' AL)DREUG. . . i,G I 1 CiW III CHE:LLL C.: I PARCEL-: i2:31040e)e) Ii
I..UBDIVISION. . . . : HILLSHIFIE ZLJNINCi. !-r
9L�lC r,. . . . . . . . . . LUT. . . . . w . . r . s 041
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BUILDING _.._._.__...__.�_.._____._...__..___._._.._.. .._ , ...... _ _ . ..._
-iL I SSUE: DWELLING UNI.f a a 1 BASEMEN,.. . . . . . . . e QI s('
:LASS OF WORK. t NEW BEDRMS: BATHS G 3 GFiRAGL. . . . . . . . . . -'704 5 f,
r''(1-•£ OF LJOC. . . s£3f` 1 L.U011 1+E21. A: ........................_._. REOUIRED GL_ fDAC:hSS-_,_.--- ._._.._.....—
'PE OF CONST. a t`iN F I RS7'r . . , e 1066 s f LEFT. 7 ft RIGHT. s`r �
1 UF'FtNC;✓ UK,. aR% 1' F'RON1'. :20 Ft LirAR. . ..
L RIES. . . r . . . :E: THIRD. . . . 30 sf RLUUIREL...___. ..__..., ... .. l
dL.16H1.. . . . . . . . s u.b i'L 'TG i'i=ti_ ..._ s c.1F L iIYIO{E DLl
i LUOR LOAD. . . . :4111 psf'' VAL..ULi:. . . . . $ * 11022`34 VIARKINLa SPACES. . : i.
Rem-:ar,ks : L='ATfi I
I31NKS. . . . . . . . . . . i F'LOiJR 1)R01NS. . . w -0 BACKFLOW PREVNI-TRS. . :0
L.AVA"T'URILS. . . . . :::; WAIL R IA..,.., i i.I;c;. . . . 1 TRAPIG. . . . . . . . . . . . . . :X11
i"U1.'•/SIiUWL,IiL' . . . . ..3 I_IUNDil l I A'rk'y. . . t0 CA1*LH BASINS. . . . . . .. ILI
WATER GLUSC T S. . -.3 SEWL Rt LINE (ft) . :4) GREASE TRAPS. . . . . . . W {
�;HWi4GIZRS. WATER LANE ( ft ) , g10caro ;� IxTL)r�E . . r , . :ul
Cif• RBAGL UISP. . . : 1 FAIN DRAIN (Vt ) . adi
{ WAGilINU MAGI i. w . a I :SF 1' OIhI
MfwCHANILAL ..._.._. .... _...__ ..__._,.._..._ ....___..._,.__. ..._....__ f ELS - . ..�.._._._.._...._...__
.Uai_ .l'YpES ...:... Lltv.l f FI11't1a. . :4; t. ytzemount by date ke c )a.
VE14TS . w . :ILS TIF $ 14160. 00 JH 04/07/93
-IAX 1NPU'i z v1 121 TU VEIN L L:.-FItt U. . ,4 BPR T' $ 460. I'l-0 .JH 01+107193
3
URN ( 1000 . . :0 r OUL)b. . . . . . : 1 Bdi.-L: $ E913. 33 JLH 0:3/1114/9:5 J;S-e,3'1'4, w
;.URN j a;.i th17,Q'. . . -. i idULl[JS'T C1'JE;:i. »q, D5PCI, $ ::. 0,3 JFI 04/07/93
:
t._UUf't F'UT7N. . . . : C:LU DRYERS. a 1 SIM)c 1i �E3N. 00 JH 1114/07/9 ....
3(JIL/LMP t 3HPOZ1 UTHLN1 UNI T'5. 1 t'f4fli'. ? 300. 00 J1 i 04/07/9:
GAS OLJTLLT b; 1 MVIR I i 45. 00 JH 04/0 7/93:
_....... _....._ ..._._ .._....._._ _.._._. __ ....... _.. _..... . _ ...._..I•IPLC, t• 1 1. i`5 JP 04i 0'7/93
A.,H HUML:S INC Mar-°C: $ 25 JN 04/07/93
/It):j SW VARNS f-1VIN; $ 1.55. 00 JH 04/01 11)3
P5PC 7. 75 JH 4."14/07/9 3
,'hone #: 684-6453 t
untr^ac:tur:.; _.._.. .__._._._._.....'- -'- -•....__._ s
:;ALlt_JSGHi 110ilLS IIUC:r I
/J.155 t-iW VARNI';I
i ILARL:r uP 97 S
i11-ioiie T1s F.-84--6453
ide y J4. . x 42067 _.._....._....._..._.. _.._ ._...... _...._ ..._..._ . .�.__......._. _
40 I L:4 4. 1 a ;0)]fHl-
his perait 19 lssurs subject to the regilations contained in the _....... ._w RE:QUiNE1) ,INSI-'EG"i lU,vt; -
igard Municipal Code, State of Ore. Specialty Codes and all other F n of/f fj�.md I n s p t"u—e). l ac e I rr g?..,
4ppikable laws. Ad Mor$ Mill be clone in accnrdanc'e with apprcved Dost;/Boom t.t r 1.1r't, 6a% L.z rti e s rr 5 p
plans. This persit will expot if work 1s not started wit-an 188 Post/kieam heehaw It"5kiIAtiU1-1 1r1s1
ays of issuance, car if' work is suspended for rare than 16d gays. V'Im/i.cndslab lo%p Giyp b,.tar,d Irl'.5
f Iorrr, IA`h.L11 %7jr•;asrr Ln
er m�tte!e Me(.�mAtlir a; Ir-Isp W.�i;rer• Lar•, iiisp J
W Out Appr•'/ :idl,4!k ifii;p
IlgsV tl: lly » ._. .... _. .. _ _ ,... _.._ L r' ,.�m:ir'rq r seg iiNcttrzrlxc: �i c rYr�rf.
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CITY OF TIGARD SE:WE:'ri ER111I C.F 1
r.��{�I'�r. -�
COMMUNITY DEVELOPMENT DEPARTMENT ..,c:{?++{t r' #. . . . . . . ; i� ,y.
13126 BW Hall Blvd.Tigard,Oregon 97223.8199 (603)839.4171
L!Al'1 t ilJI.:U: 1a14,'4:l..
` i1:'YE •'.� )IiF:::;a:_;. , . : 1:�E,+SS ::sW i''ia�.. tl..l_L.i.. +... i r�'A�<[,r:L.: a::'aik}.;ee�4,_ y
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JUNLiIVi1Z1Lki. . . . : r iLA- )'HIRE ZUN1NL? R i•I'l
Oi,.i~ILK. . . . . . . . .. . . LOT. . . . . . . . . . . . . .1041
ENANT' NlaME. . .
JGFl NO. . . . . . . . . . . V I X`i'UR& UNTTS. . . f
I',1_OSS D- twD[%i(. . . «NE.W I)WE:1_t_;NC) UIV1T'S. . s1
i YPE: OF' USE. . . . a SF 1\10. OF, BUILDINGS- 1 r
11,45 T ait_1_ I YF'''I::.. , ,. . :EU:;Wt? TF^1PL"Fv I) '4URF ALE. . .
?emw►rk� a r•�HTW I
a Dial°tl_1 Fi }1C.lp'IES INC: type aM01,.1TIt: by date r kr! lat.
lSb5 5W VARWN PRMI" i E100. 00 JH 04/0 '/93
INIL41 3'3. 100 .Tl'i ��►/10.Y ' ...
i. R I LAM) OR 97k�.,
684-6453
y,
3 „ 0 0 T 01 I-I I..
fj
_.._ ...__. _ RE,UU1RLl) I( SVILGFIUNz;
IS Applicant agrees to comply rrlth all the rules an;; regulations wet 1 nsr>Rect x ati 1
;f the Unified :sewage Agency. The permit expires 1C'Ib days froe
1 he date 1554ed. The total aluint paid will be forfeited if the
4111t expires. ;he Agency uoes nut guarantee the accuracy of the
side sewer laterals. if she sewer is not located at the measurement
riven, the installer shall prospect 3 feet in all directions from
the distanc5 given, if not so located, the installer shall p+ircnase
a "rap and Side Se4er" permit and the Hgency will install a iaterai,
I. t 1;f;�
5
...__....._.gin......._...._...__.. ._...... ........_. ............._.._...._ ...
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t :iilsl 6::9-4i",5
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......yyy ! y ............. ...... ... .,•,.«„+"wd,�'^;d1K'N'.;i 'fi�'$�iq{6.h'ti .
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i
PLNCK/RECT #
CITY OF TIGAR.D � ,�
� �
PERMIT #
COMMUNnT DEVELOPMENT DEPARTMENT (%3)094171 DATE ISSUED —
i1 �►
I / TAX MAP/LOT
� JOB ADDRESS: l ��� s<<� /i? c..�,��-
SUB: H,•//< r LOT: _y; LAND USE: ger
VALUATION: -Z.2). —
OWNER SPECIAL NOTES
NAME: __ REISSUE OF: —
ADDRESS: — LAST REISSUE:
- FLOOD PLAIN/
--
_ SENSITIVE LAND:
PHONE: _
CONTRACTOR APPROVALS REQUIRED SCI r�qD-QDp l
NAME: Pa A s e!z &am yes PLANNING: —
ADDRESS: 1 -s- Z ENGINEERING:
7-Z Z 2 FIRE DEPT:
PHONE: �. 8 'Y ys OTHER: — ---
CONTR. BOARD #: - - 6 7 EXP DATE: ,L 9
ITEMSREQUIRED
SUBCONTRACTORS: PLUMB: LIST/SUBCONTRACTORS:
MECH: dr e7 - - CIA, BUS TAX:
RARCH ENGINEER CALCULATIONS:
NAME: — May < or _ TRUSS OETAILS:
ADDRESS: /S 1-51- OTHER:
PHONE: 22S7- ` / 6�
PROPOSED BLDG. USE: h/n,.,-.-_� ------_,.—_. -------------- --
COMMENTS: --- ------ --- - ----
r
APPLICANI SIGNATURE
Received By: Dale Received:
uy 1 o-
� A,
J nM'
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUC-A
12t3ftj- Iq 10-432 00 Building Permit Fees •.Z_
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%) 33. v 3
Building a3,o3
Plumbing �7, 7 5-
Mechanical ;2 z '�
10-433 00 Plans Check Fee ¢-I
Building �_!Z_.3 3�
Plumbing
Mechanical
10-230 nr: ; ire
V-202 00 Sewer Connection 00._ Gc�
i 30-444 00 Sewer Inspection 3 j~ 3 `
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 5 L, 135 J _
25-448-05 Mass Transit TIF Fees Ile _ // L
52--449 00 Parks System Oev Charge (POC)
31-450 00 Storm Drainage Syst Dev Chrg
(SCuC) )— —
24-445-01 Water Quality (Fee in lieu of)
24-4,15-02 Water Quantity (Fee in lieu of)
TOTAL3J1
nm/3587P.WPF
I�
f
� � `�
10,h1t n v g ,
c
iytt
CITY OF TIGARD - RECEIPT OF PAYMCNi 14E:CEA P'T NO. i93-J,- 6", 38
CHFC:K AMOUNT a
i`IAf�IE e PAWL.ISCH Ht` OIF.-S INC CASH AMOUNT 0111
f+])1)RES z 7155 6W VAR14S PAYMENT DATE 04/07/93
PORTLAND OR SUBDIVISION
,
t PURPOSE: OF PAYMENT AMOUNT PAIL) PURPOGF OF PAYMENT AMOUNT Pr,,i,!,,
SU I LO T NC3 4{F RM MST9 3--0'144 460. 50 PLUMBING PE.FIM ]S5. 00 �
111F.CHANICAL 1=lr: 45. 00 ST. BUILD PFR ;3..;;. 03
PLAN CHFCK FE 60. 5a SEWER U0A P100. 0k7
TNSPEC.J ,3 5. 00 PARKS SDC Ob?�, 00
-5fOKM DRAIN SM, 280. 00 RESIDENTIAL_ 'TRAFFIC FEES1;::510. 00
I' OLSS TRANSIT TIF" F EE S : 10a. 00
i o,rAi.- AMOUNT PO 11? _. ? 51 i1'9. ] 1
i"T I1 L1F 1 :Iii6cFtt) F? ('.:1 iN'T' iii 11L N-1 FtI CLIF•'1 N(I.
CIAE-CK AMOUN r r tov)
rJi irm: z F'NI fL.I GI'AA HIJMF j, INC L ADH AMLION F' r !;t, 00 � "9
NriYMLN I DW L
,] SW VaiRNS l3H4rtl-.-r #101 Sus1)1VISION e Z
f. 1 IN T I_ IND OR 9 7 ,4 .;._.
PI INPOSE. 6:TF PPYMF':NT AM(JLINT" PAI 1) PLf f,:P( l47 OF Pi)'Y ML N'i AMOLIN T PA I D
r Phi C:HLLCF{ �'F= f��'S0. 0O
i
I
! i
l
IOT 41 HILLS4IIRE.
'TOTAL AMOUNT Pi-1 I b � - 3 e:�rO. 00
I
L__.__ 4