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C11YOFTIFARD
COMMUNITY DEVELOPMENT DEPARTMENT
1 126 BW HmH Blvd P.O.Bax 23397.Tlp M,Orpa:07223(60M)430.4176 C F.R T I FF'I C:A T E, f)r
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SITE= ODDRES S. . . 1 0E3261 514 I'1A1.1HE,W PFIRIA ST PARCEL: 8Gl t213C--1C,,-)lA r
;iUi:�li I�!I E,t ql+F. . . . s MFi T'rNE:W F'f�lrl'14 Z C1N I IV1.3
BLOCK. . . . . . . . . . 1 I__Cl I'. . . . . . . . . . . . . s 6
CLAGSOF Wf]F2Ft. iNEW -"_w_........_..._.......�.._,..._....�..�.._....-,.........__....._..._..,._....____._..__._,... . ........,...____.....�_.
TNT"E. OF USE-. . . s SF
OCCUPANCY GkP. s R3
OCCUPANCY LC ADP 1 ifs 4
rENANT NAME. . . s
Ho marl; PATIA I
,IAA MILLER BUILDER INC
C•'. CI. BOX 232,91
T I CART) OR 97261
Phnne #s 0964-754:3
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JAY hi l I...L_ER
Po BOX 23ip9 i
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T I1;3ARD OR 972,81
►h Otl e #4 684-7543
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f7cc:upalnr. y Of the above rweter•enc ed hux ldi.nW It horeby giv1!n, and r.-pr•t if i r-,
tho compl ,lalicls witpl the Staatra Of Ot,e ren F3pror.:iralty C.:rlc.les fur- tF1(3 prouF11
ocr�upnncy, And use uncier- wili.r.h thle referenced permit issued.
FIRE' DE F AFi'C MEN T' NlJ I I_iy I hili I NSVILL.101i
NUJI.,rfIhci or-rIcIAL
POST IN C ONE l"'CC:;UOUS PLACE
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INSPECTION NOTICE
City of Tigard Bulldlug Department
13125 SSI Ball Blvd. Tigard, Oregon 972231a
'Inspection Line (Rec-•O-Phone): 639-4175 Busi.ueas Phone: 639-4171 1
Inspections
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Can Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bl.dg.
Poet/Beam Hach. Rain Drain Insulation
P;bg. Underfloor Water Line Gyp. Bd. -Hoch.
Date Req+ e, t.edi ZZ,.- e Times �AM PH
Address:
8uilder:�
THEFOLLOWINGOORRP)Wrfbh� ARE RRQUIREDs
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Inspector: Dates
APPROVED —� DISAPPROVED APPROVED SUBJECT Tsl ABOVE
_--Call For Reinsp.
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City of Tigard Building Department
13125 SN Ball Blvd. Tigard, Oregon 972.23
Inspection Line (Rec--U-Phones: 639-4175 Business Phone: 631-4171
i Innpections____. _ C_. _I-.a k-, — --
Footing Plbg. erelab Ae^h. Rough-in Appr/Sdwlw
Pound. Plbg. Top Out Gas Line FINALS
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Poet/Bram Struct. San. Sewer Framing -Bldg. �
Poet/Ream Mech. Rain Drain Insulation -Plumb.
Plby. Underfloor Water//Line Gyp. Bd. -Hoch.
Date Regsesteds (1� /-� J Times AN _PN
Addroes:_. �,nom/ 1 �Jw1� Permit
Builder•-__
TBE FOLLOWING CORRECTIONS ARK REQUIRED:
inspector: f TJ cam, 2:12 Dates
,..� __[,_APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Rainap.
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CA 77-77
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INSPECTION NOTICE
City of Tigard Building Departeent
13125 SN Hall Blvd. Tigard, Oregon 97223
Inspection Line (P.ec-O-Phone): 639-4175 Business Phone: 639-4171
Inapectlon:
Footing Plbg. Underalab Mech. Rough-ln ( "Appr/Sdwlk
Found. PIbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Boam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
-�-�.�
Date Requ,eta�djt �� /Timet _AM PM
Address: O Z. 1�7� �IOL�_l"'�jCYenoit f t
Builder:
THE FOI.LOWINr CORRECTIONS ARE REQUIRED:
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Inspector:__ �H/1 Dater`
APPROVED _ DISAPPROVED _ APPROVED SUBkTECT TO ASM
_Call For Aelnep. ? '�� � (r •
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NSPECTION NOTICE
Clty of Tigard Building nepart�ent
13125 SN Ball Blvd. Tigard, Oregon 97
Inspection Line (Rec-O-•Phone): 639-4175 Busine.,n Phone: 639-4171 �1r,
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Pouting
Plbg. Underslab
Mech, Rough-in Appr/Sdwlk
Pound. Pl.b
y• Top Out Gas Line FTNALs
Pnat:/Ream Struct. San. Sewer
Framing -Bldg.
lost/Beam Mech. Rain Drain Insulation
bg. Underfla-)r - —
Weter Line Gyp. Bd.
-Mech.
Data Requested: —'
Time: AM PM
Address:
Permit 1:
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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inspects c�— / V /_"
J/ nate:
_____APPROVED DISAPPROVED
APPROVED 3CY13JF.CT TO ABOVF.
__Call For Reinsp.
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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 Business Phone: 639-4171
Inspection:._ --
Footing Plbg. Underslab Mech. Rouyh-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line 2 Gyp. bd. -Meeh.
Date Requested: �``J _yyZ Time: AH _ PM
Address:��% c�/ alt/ J`2�sr'r1cc Permit
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BuIlder:�__� -- -'
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector __ Data.
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinap. i
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INSPECTION NOTICE
City of Tigard Building Departar::t
1317.5 SH Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: _-_
Footing Plbg. Underalab ;tech. Rough-in Appr/Sdwlk
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Found. lbg. Top Out Gan Line FINALo
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Post/Beam Struct. San. Sewer Framing -Bldg.
Poet./Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underflonr water Line Gyp. Bd. -Mech.
Date Requested: Time: PN
Address: O l-2-C' /+ZL,� --Permit is
Builder:
I �i � f THE N'OLI.OWING CORRECTIONS ARE RE¢UIRED:
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�ApP1tOV[D DISAPPROVED APPROVED SUBJECT To ABOVE i
-----Call For Reinep.
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INSPECTION NOTICE I
city of Tigard Building Department I t
13125 SW Hall Blvd_ Tigard, Oregon 9722
Inspection Line (Rec-O-Phone): 639-4175 Business Phan
Inspection
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. - Plbg. Top Out Gas Line P'.NALt
ost/Beam Struct. San. Sewer F-.ming -Bldg.
Rain Drain insulation -Plumb.
j1fboog. Underflr Water Lina Gyp. Bd. -Mech. '
Date Requestedc
Z Times AM`-t� PN
Address.-
Builder:-
THE
ddress:BuildersTHE POLLOWINn CORRECTIONS ARE REQUIRED:
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Inepactot Data I
—_1RPPROVMD 13I8APPROVRD APPRMD SVSJ8CT TO ADM
Call For Reinep.
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INSPECTION NOTICE
City of Tigard Building Department
13125 861 Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Puniness Phone: 639-4171
Inspection: _ ■
Footing Plbq. Underslab Mech. Rough-in Appr/Sdwlk '
Found. Plbq. Top Out Cas Line FINAL:
Poet/Beam Struct. S&n. Sewer) Framing -Bldg.
Poet/Roam Mech. < Rain Drain Insulation -Plumb.
L � .
Plbg. Underfloor mater Line_ Gyp. Bd. / -Mech.
Date Requested:� �` ? Time: /`:!_AM PM
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Address:
re-f4rmit 1:
t Builder:
ter— ---
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ii THE FOLIAWINO CORRECTIONS ARF. REQUIRED:
Inspector: Date- —�—
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APPROVED � DISAPPROVED APPROVED SUBJECT TO ABOVF.
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INSPECTION NOTICE
City of Tigard Building Department a%r �
13125 SW Ball Blvd. Tigard, Oregon 9722
Zr�spection Line (Rer.-O-Phone: 639-4]75 Business Pho 639-4171
Inspection:_
"Footing Plbg. Underslab Mach. Rough-in Appr/sdwlk
Found. Plbg. Top Out Gas Line FINAL:
I
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain L..sulatlon -Plumb.
Plbg. Underfloor Water Line
Gyp, ed. -Mach. '
Date Requested:__l L� �.�
Times _ AN PN
Address: �� �- �]�/�] d/iNj�
G -�-.-- Permit
Builder:_
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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ROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
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_-Call For Reinsp.
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--'T t;'l_UMA 1,NG PERM 11- _
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hIS1c'. .I
1*fC1 TIFARD .
` ctnr b V ATE l S;yuE.D a 12103/90
COMMUNITY DEVELOPMENT DEPARTMENT o�ooN
4°.e«' +Wr? 4 tr �4°�► I !' pi► j< S'r PAE7cE l_: 2S
BLOCK. . . . . . . . . . 3
LOT. .
CLASS OF WORK. . s14EW GARBAGE DISPOSALS-:1
TYPE? OF USE. . . . o SF WASHING MACH. . . : 1 AACRFL.UW PR VN T REQ. . s 0
OCCUPANCY GRP_ 03 3 FLOOR DRAY"NF,. . . . .. . . :0 rRAPS;,... . . . . . . . . . . . . .0
STORIES. . . . . . . . i 1 WATER HEATER,": . „ . . . . D1 CATCH BASINS. . . . , . . (n
F IXTURf"S._.__.....__.._._.._.._.._._.... LAUNDRY TRAYS. . . . . . :0 SF PATH DRAIN;. . . . . » I
SINKS. . . . . . . . . . R 1 GREASE TRAPS. . . . . .
LAVATORIES. . . . . 43 OTHER FIXTURES. . . . . 30
TUE;/SHOW(.RS. . . . w SEWER LINE (ft) . . . . -0
WATER CLOSETS. . a 2 WATER LINE (ft ) . . . . 0 100
DISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . , . -0
Remarks : PAI-H I
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JAY MILLER BUILDER INC TIF t LA60. 00 ACR 1=/03/92 --
P. 0. BOX 23291 'BPRT t 37:3. 00 BCR 12;'03/92 _ I�
E.%PI_C f 40. 00 JLH 11/20/92 9i?-2 5392`
0 TIGARD OR 97281 B5PC $ 18. 65 SCR t '/0:3/92 --
C'hone 1t: 664 •-7543 5151)G $ 280. 00 BCR 10/03/92
PARK $ 500. 00 BCR 12/0:3/92
P t {.?mtairrg 'ar.tor_ : _.. ._.._. _._.._......_. Ihl'(�T i; 40, 50 BCR 1,2/03/92
Mr-`L.l. $ 10. 1:3 ECR Iii/03/92
Name MSPc $ 2. 03 IAGR 131/03/92
Addre s PPRI $ 1 00 BC''P, IP/03/92'
. N WATTS COIVS�FI 1{�_�._._ .___.. r.5PC $ 6. P.4 1.1CR 12/03/91? _
Zi(�a..... __ ._.... P.0.,80X'230923•
Re q #:___.._ TtOaRD,oREOAN
_..._....... _ _ REQUIRE'D iNSPE1 1 IONS
T'hi % permit is issued subject to the reg-- l
ula<tions contained in the Tigard Municipal F':0Ot/foLind I n a p Rain drain Ls+= p
Code, State of Ore. Specialty Codes and all Post/Beam Struct Wratev ,Lina lnsp
other. a+ppl icah1 a haws. A) .l wort? will he dorir? Post/Beam ftlechan (Appr/Odw114 InRp
in accordance with approved plans. i'h.i:, Plm/undsrlatb .Irssp Mechanical. I
permit a)il,l e)ipre ii, wo .#s not 4t.artv.d Pl_i1il„n1d90fIocrr E={lumb Final
wit_lik'n 180 days of is suainco, or if work is Me?,hatnical rnr?p s: Oil? ing Final
51.14t.pended fdr. more than 180 drays. K='l s..?mb TrJta Out; Eros i on C.:nntrol
Frasminy Tnsp Crawl Pr.r►in
r y F ireplave Inst'
Gas Line Insp
InsL.rl of ion Inap �. .Y..__......____..,___ .._
.._... Gyp Board Insp
Authorized PI s_rmbi n►l Cantron or Sai Rnat ure
Call for inspoc,tion 639-417`S
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Contractor Not'as :
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a7YOFTIFARD
/� PERMIT
MASTER . . . .:'f
��rr PF_RI�I I T #. . . . . . . . L+IST9:' �c l5
C�T16A-
COMMUNrrY
DEVELOPMENT DEP�A�•'AT�II
13126 SW Hell Blvd. P.O.t1m23397,Tip M,Oregon o7jW(5W) 1 6 DATE ISSUED: 12/03/92
i.,
SITE ADDRESS. . . : O8261 SW MATTHEW WARN: S1 PARCEL: 2S1 J.21BC•-MPKO6
SUBDIVI'SION. . . . MATTHEW PARK ZONING:
BLOCK. .. . . . . . . . . .. LOT. . . . . . . . . • • • \ :E+._...._....________._.___.
BUILDING
REISSUE:IIST92--01 52 DWELLING UNITS-, 1 BASEME=NT. . . . . . . . :0 S f
CLASS OF WORK. :IVEW BEVRMS:36 BATHS-.2 GARACJE. . . . . . . . . . :400 s f
TYPE OF USE. . . :SF FLOOR AREA'a-- -- -------- REOUIRE'D SETBACKS__..___.__-.___
TYPE OF CONST. :51V F I RST. . . . : 1568 s f LEF T. . : 1 1 f t R I GHT. :6 ft
:
OCCUPANCY GRE'. :R3 SF•CIJIVU. . ,: :0 S f FRONT. :cO f t RE=AR. . :30 ft
STORIES. . . . . . . : 1 THIRD. . . . :0 5f` REQU I
HEIGHT. . . . . . . . : 16 ft rO'rAL--_---_._: 1568 sf SMOKE DETEC'TGRS. .l
FLOOR LOAD. . . . :40 ps f VALUE. . . . . $ : 79:328 PARK I NG SPACES. . : 1
Remarks : PATH I ?'
SINKS. . . . . . . . . . : I FLOOR DRAINS. . . . :0 BACK -LOW F'REVNTRS. . :111
rK ;
LAVATORIES. . . . . :3 WATER HEATERS. . . : 1 TRAF'S. . . . . . . . . . . . . . .0 }k.
l"UB/SHOWERS. , . . :j, LAUNDRY TRAYS. V) CATCH BASINS. . . . . . . :0
WATER CLOSETS. . -2 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . .0 ! ''t
DISHWASHERS. . . . : 1 WA'T'ER LINE (ft ) . : 100 OTHER F IXTURLii. . . . . :0
GARBAGE DIST,. . . : i RAIN DRAIN (ft ) . :0
WASH I NG MACH. . . : 1 SF RAIN DRP I NS. . : :L I '
--------------- MECHANICAL MECHANICAL -..._______.___.___.__._.__..___________.___- FEES
FUEL TYPES--•----------- uNI T IlTRS. . :0 type amol_1nt toy elate recpt
/GAS i / / VENTS . . . . . :0 TIF $ 1460. 00 BCR 12/03/9:_
j MAX INPUI :0 BTU VENT. FA :3 [.PR'T $ .3 ';3. 00 BC 1-3 12/03/92
j TORN ( 1001: . . . 1 HOODS. . . . : 1 BPLC 1, 40. 00 JLH 11/20/92 92 :23392
FURN ) =100K . . :0 WOODSTOVE:S. :0 B5r'C $ 10. 65 ECR 12/O3/92 -
FLOOR FURN. . . . :0 CLO DRYERS. : 1 5SDC 1, 280. 00 BCR 12/03/92 -
BOIL/CIYIP ( 3HP:0 OTHER UNITS: l PARK $ 500. O11) BCR 12/03/92 -
GAS OUTLETS: 1 IVIPRT $ 4O. 50 BCR 12/03/92 --
Owner: -..._._...._._____.._._.__.__..---.___._..__.___.._..._______._..._..____.IYIF'LL" $ 10. 13 BCR 12/03/92 -
JAY MILLER BUILDER INC IhSF'C $ 2. 03 BCR 12/03/92 -
P. O. BOX 23: 91 F'F'RT $ 125. 160 BCR 1:=/IZI3/92 -
F15PC $ 6. 25 BCR J2/03/92 -
TIGARD OR 97281
Phone #: 684--7543
Contractor:
JAY MILLER
T-'O BOX 23291
'TIGARD OR 97281
Phone #: 684-754,3
Reg #. . : 3O1O9
$ 2855. 56 TOTAL
This permit is issued subject to the regulations contained in the ------ ---- REQUIRED INSFIECJ ION'S --------
Tigard Municipal Code, State of Ore. Specialty Codeti and all other Foot/fol.tnd Insp Fireplace Insp
applicable laws. All work wi11 be done in accordance with approved Post/Beam Stri_1ct Gas Line Insp
plans. chis permit will eHpire if work is not started within 180 Post/Beam Meehan Insolation Insp
days of issuance, or if work is suspended for more than 180 days. P1m/l.indslab Insp Gyp Board Insp
T'LM/UndNrfInot- Rain dram Insp
F'er IT'.itter: `jiyrlat1-1r e :c,, c_ia (e Mechanical Insp Water Line Insp
/1 P1Umb lop Out Appr/Sdwik Insp
ISS•_Ied By Framing Insp I+IechAnica1 FinA1
Call for inspection - 6.39-4175
SEWER CGNNE CTIGN
CITYOFTIGrARD PE R1h I T'
CrTYFMRD)COMMUNITY DEVELOPMENT DEPARTMENT 022GON PERMIT #. . . . . . . : SWR9�- 37
13125 BW HWI Blvd. P.O.Box 23397,Tigard,Capon 97223.(600)53%-4176
_ t, a9 -_DATE ISSUED: 12/0„x1 •_
SITE:: ADDRE:SS. . . : 08 :61 SW MA"FTHEW 41ARK ST PARCEL: 2S112BC-MPK06
BLOCK. I. . . .ON.
hIAT'THEWLOT.. ...__ ^ZCINIIVG°
FLOCK.. . . . . . . . . . LOT. . . . . . . . . . . . . :6
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TENANT NAME. . . . . :
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USA NO. . . - . . . . . . : FIX-FURE UNITS. . . :
CLASS OF WORK. . . :NEW DWELL I NO UN I T'S. . : 1.
TYPE: OF USE. . . . . .SFF NO. OF BUILDINGS: l �
INSTALL_ 'TYPE. . . . ..BU5WR 111PEvRV SURFACE. . : ^ 5f .�
Remarks : PATH I
Uwne.r,: ___.________---_____------------------•-----_________.________ FEES ___-----__-----
JAY MILLER BUILDER INC type amol.rnt by date r- rpt
P. O. BOX 23.291 PRIv1T m 2100. 00 HCR 12/03/92
INSP $ 35. 04_' PCR 121031'32
TIGARD OR 97281
F?trone #: 684-•7543
Contractor: --______._.----•---__._______________.__
a:
CONTRACTOR NOT' ON FILE
I
Pti o n e #: 2.135. 00 TOTAL
Rey #. . :
_.._._.-•-.-- REQUIRED INSPE'CT'IONS .___._._--•_---
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewe,e Agency. The permit expires 180 days from _� __•-__ �.___ __ ___� ___ _
the date Issued. The total amount paid will be forfeited if the
permit expires. The Age!r.y does not guarantee the accuracy of the
side sewer laterals, If the sewer is not located at the measurement
given, 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" Permit and the Agency will install a lateral.
f'e1~m a t l; r}e `..i i yrrat 1-11
Lal l t or inspect ion 639•-4175 $'
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13125 SW HaN ON& PLNCK/RECT S 1
CITY OF TIGARD Posmum PERMIT #
COMMUNITY DEVELOPMENT DEPARTMENT *rwTgko-V-9=
(503)&44171 DATE ISSUED
JOB ADDRESS: $2-1p I 5W/ r"�at he Yy '��� �' TAX MAP/LOT .2S!/Z QC - M PIK
SUB: CA, ffln-tilol,tz — LOT: - — LAND USE:
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VALUATION:1SSve
SPECIAL NOTES
OWNER
NAME; TYaA.e_. . REISSUE OF:
ADDRESS: Z. LAST REISSUE:
FLOOD PLAIN/
k
PHONE: CO' L - i7'T �J SENSITIVE LAND:
QNTRACTOR
APPROVALS REQUIRED
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ADDRESS: _ Y�YYY ENGINEERING:
FIRE DEPT: _
PHONE: _ _ OTHER: It E
CONTR. BOARD f: EXP DATE:
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ARCH/ENGINEER CALCULATIONS:
NAME: _ TRUSS DETAILS:
ADDRESS: OTHER:
PHONE: _
PROPOSED BLDG. USE:
COMMENTS:
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PERMIT M ACCT DESCRIPTION AMOUNT AMOUNT PD. BA4. DUE
-02b 10-432 00 Building Permit Fees 3
10-431 00 Plumbing Permit Fees �' z
r:
10-431 01 Mechanical Permit Fees )-u
10-230 01 State Building Tax (5%) a2G. 913 a!,
Building
Plumbing _ G,L i '`' ■
Mechanical .'2-„ 3 '
10-433 00 Plans Check Fee
Building '4(o
Plumbing
Mechanical 0./3
10-230 06 Fire
S Z•037Z 30-202 00 Sewer Connectionw
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30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees
M 25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees 3S u i135 p
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC) 5 vv SU u
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) ;41'd
24-445-01 Water Quality (Fee in lieu of) _
24-445-02 Water Quantity (Fee in lieu of)
TOTAL q/���. 5 G,�� — s-7J,jZ
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C:I TY oi= T I LARD w RECEIPT OF PAYMENT RECEIPT NO. :92-234326
CHECK,, AMU'UNT 4950. 56 f
'40IME s JAY MI1..L_.ER CASH AMCuwr 0.00 {,
"DDRESS a PAYMENT DATE s 12/03/92
SUBDIVISION a ;
i-URPUSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
BUILDING PERM _. .. . 373. 00 FAl_UMBING PERM __...._.. t255. 00
M 1. 00 ,
MECHANICAL. PE 40. 50 ST. BUILD PER 126. 93 I +
PLAN CHr-.CK FE 1+a. 13 SEWER INSPECT :ani. Oki i
'---'&WE:R USA 2100. 00 RE S I DF..:NT I AL. TRAFFIC; KESS 13`roo. 00 h
MASS TRANSIT T T F rrF 5 110. 00 PARKS sDC 300. 00 � r
STORM DRAIN GDC 280. 00
80.61. SW MATTHEW PARI,,, t_Of #6
MST 9r'--006
Y
TOTAL.. AMOUNT PAID 4950. 5E
A.
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t I r Y
OF T I GARD RECEIPT OF PTIYMCNT RE=C'R I F AT NO.
AMO()NT 40. 00
NFaMC a .TAY M 11_LEr R St-1 i i-DF R CASH AMOI-INT 00
(_1Dr)RJE7G i a P(J) BOX E3291 PAYME-NT DATE' a 1 1/�.."'t�/9A�
T T GAR> , OR SO90 T.V:1 5ION n F
PtIRPLIPPE' OF PAYMENT flMOUNT PO 11) PURPOSE OF PPYMFNT AMOUNT P0IV •�
` PL ON CHECK CK FIR, T1 i __..,. 40...0
i
Sa6 t SW MATTHEW PARK, L.0T 6
P -T GUILIF 07 L CIT 10, MA TTHF'W V ARK
]Y.
u f,11. AMOUNT PA 11) - 40. 00
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