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CITY
OFTIGARD OCCUPANCY
PERMIT #. . . . . . .
s MST94--0169
CO''.9MUNITY DEVELOPMENT DEPARTMENT DATE: ISSUED: 08/03/94
13125 SW Hall Plvd.Tigard,Oregon 97223.8188 (503)879-4171
I-1ARCEL: 2SIO DD-02200
C;I TE: ADVREESS. . , 08581 SW MERLYNE CT �
SUFAD I V 191 ON. . . . s F I NLEY PARI{ Z ON I NG:R-•7
BL.00K. . . . . . . . . . s LOT. . . . . . . . . . . . . .O0F
CLASS OF WORK. s NEW
T' I:,E' OF USE. . . s Sr"
XUPANC:Y ORP. s R3
OCCUPANCY LOAD:O t 4
TE-WONT NAME. . , s
Rpmark s s F-'ATH El
Ownerp �_.._.._....._.__....__�. _._.. ._.w
TIM WIL.L.ER
1:3027 SW TAME PA CT
T 'I. -tArtC) Off 97,224
Phones #% 190-3574
TIM MILLER
t 3Oc 7 SW T I MAR(3 LN
r WARD OR 9742'4
F'hcane #s 598--8974
)pjj #. . s E14E87
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OVC'. pancy of they above referenCed hUiWing i ,3 hereby given, and certifies
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the r.,crmpl lanae with the State Of Oregon 4aC.e iolty Codes for the group,
i accl.tpancy, and u%e under which the referenced I-e Chit was i sa
{ ILDIN INSPECTOR
Of-F I C:I AL
POST IN CONSP I CUOUi:3 PLACE
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INSPECTION NOTICT3
city of Tigard Building Departmr_nL ��
_ 13!75 SM Mall Blvd. Tigard Oregon 972;! -
Innpectinn Line (Rec-O-Phone): 639-4175 Business Phone: 639
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Inspet ion:_- -- --__-.___ —___ — —�_
Footing Plbg. Underelab Mech. Rough-in Appr/t3dwlk
Pound. Plbg. Top Out Gas Line 1INAL!
Poet/Beam Struct. San. Sewer iframinq ,Bl
Post/Beam Mech. Rain Drain Insulation -Plumb.
Pit.,. Underfloor Water Line Gyp. Bd. C�
Date Requested:__11 _3 - I / Time= AM !^ PM
Pe tri=�t4 01
Builders V \\{ Y� I ��i� e� (��� —
THE FOLLOWING 0r)RRSCTI9XY-9tMr QQOLRED
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Inspector: �r peke:
APPROVED DISAPPROVRD APPROVED SUWgCP TO ABOVE
......—Call For Roinap.
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INSPECTION NOTICE
City of Tigard Building Department ry
13125 tiff Hall Blvd_ Tigard, Orregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
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Inspection:___-.____. ---_-- --
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plhg, Top Out Cas Line �- FINAL: J i
Post/Beam Struct. San. Sewer Framing -Bldg. �.
Post!Beam Mech. Rain Drain Insulation -Plumb.ij
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
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Date Requested: !J 3 - `1 LI Timet AN �PMC-1 LI
Address uPermi
Builder: \ '✓
AL, ,t Y- �� 3 �50
THE VOLLONINO CORRECTIONS ARE REQUIRED:
I nspectoDate s
APPROVED _ DISAPPROVED APPROVED StlBJECT '
_Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 BW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:_.___.-
' Rooting Plbg. Underslab Mcxh. Rough-in `4Cp /Sd
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg. a
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Rd. -Meeh.
Date Recp:ented: �- 7_=� % A!f PM
----—
Address:
/ --� ,�_,-L{ — - Permit
Builder:_
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector:— Date:
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APPROVED -- DISAPPROVED PROVED SUB.:.?CT TO ABOVE
Call For Reinsp.
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INSPECTION NOTICE
City or Tigard Building Department
13125 SS Hall Blvd. Tigard, Oregon 97223
Inspection Lino (Rec-O-Phone): 639-4175 Busineas Phone: 639-4171 EIR
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
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Found. Plbg. Top Out Can Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line �Cyp_Rd. �-/Much.
Date Requestteed: �i ` S �� 1 Timwt [7�� K:- -Ax /')'// PPM
Address• O t5 t7 �� "r' `Pw'�iCs„ 1��rL.Sft_L
R:ilder: �rY 7� � / c a7' )S r. /O el- •.2Z0
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THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inepecta - --- -- Date:
-APPROVED ZbISAPPROVRD i APPROVED SURJRrT TO AWVE
✓+Call For Reinsp.
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INSPECTION NOTICE
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Cit} of Tigard Building Department
13125 Sit Hall blvd. Tigard, orogon 97223
Inspection Line (Rec-O.-Phone): 679-41'15 Busineee Phone: 639-4171
Inspection:
Footing P1bg. Underelab Mach. Rough-in A
ppc/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
4
Post/Beam Struct. San. Sewer
Pramin9 -Bldg. ,.
Past/Beam Hach, Rain Drain Insulatl.on _plies,
Plbq. Underfloor Nater Line Gyp. Ad -Mach. r
Date Roquented: �'f27 _ rnTime: AN PH
Address:_/ ' Perm 1: T�
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspect " �� r
nates
APPROVED DISAPPROVED
APPROVED SU&JF.CI' TO ABOVE
_—ACa11 For Re1••ap.
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Iori NOTICE
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Cicp of Tigard Building Department
13125 BA Ball Blvd_ Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Bueinens Phone: 639-4171
Inspection:- ._
Footing Plbg. Underalab Mech. Rough-in Anpr/Sdwlk
Pound. Plbg. Top Out Cas Line FINN et
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain C Insulation -Plumb.
Plbg. Underfloor Water Line p gyp. ad. �fsch. d
Date Requested: rJ�` / T(Mt� rrw _PM
�Ad�rene:_ ! {/Yl�r l enc �' t� Permi9t tt�L_LGLS�L_
Builder: /r �/ / /71 , //C 7!�e/ c /V
THE rF-O/LLOWING CORRECTIONS ARS RE/Qy�UIR$Ds 'D
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Ins
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APPROVED DIL'APPROVED APPROVED SUR,TP;Cf TO ABOVE
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Call For Rwinap.
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SPECTION NOTICE /
City of Tigard Building Departeent
13125 Sm Ball Blvd. Tigard, Oregon 972Phone
Inspection Line (Ree d-Phone): 639-4175 Business 639-4171
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Inspections .____-_ -
Footing Plbg. Underslab C Mach. Rough-in Appr/Sdwlk
Found. ( Plbg. Top Out ,, Cas Line FINAL:
Post/Beam Strur_t. San. Sewer �lraming -Bldg.
Post/Ream Hoch. Rain Drain insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Rd. -Mech.
Data RequesCtod: y� TimstAM _PM
Addresst k�� �/ /e Y / Parma]"#
Builders / �`I� ��7, /Gc r
TMS FOLLONIMO CORRECTIONS ARE REQUIRED:
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Inspector-_ Dates
L APPROVED DISAPPROVED tPPROVED SUBJECT TO ABOVE
Call For Reinsp.
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INSPECTION NOTICE /
City of Tigard Building Department
13125 Sw Ball Blvd. Tigard, Oregon 97 j
Inspection Line (Rec-O-Phone): 639-4175 Business Phona: 639-4171 I -
Inepe..tLon:—--- - — ----- 4
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
Poet/Bemo struct. San. sewer Framing -Bldg.
Post/Beam Mech. r� Ram "� Insulation -Plumb.
Plbg. Underrloor inter _Gyp. Bd. -Mach.
Date Requesteds v ` �)y�o / 7 Timet _k._AN PM
Address: ��O / / r/C. ✓ ! ntf,-q�� o�� q
f ►�y� Permit t
Builders 1 i n7 / �/ f.'
THE FOLL.OWiNO CORRECTIONS ARE REQUIRED:
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Inspector:_ - ---_ _�-- Dates. C
APPROVED _ DISAPPROVED APPROVED SUBJECT TO A
Call For Reinsp.
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INSPECTIW NOTICE
City of Tigard Building Departneat
1311.5 SM Ball Blvd_ Tigard, Oregon 97223 /��/ •
Inspection Line (Rec•-O-Phone): 639-4175 Business Phone: -4171
Inspection:_
Footing Plbg. Underslah Mech. 'uugh-in Appr/Sdwlk
Found—._. Plbg. Top Out Cas Line FINAL:
�. �POat/Beals Btraot. Ban. sewer Framing -Bldg.
Post/Beam Meoh. Rain Drain Insulation lauab.
Plbg. Underfloor Mater Line Gyp. Bd. p T
h.
Date Aecpiesteds Time: � AM PM
Addrens: (( CL
RU ildel':
7Z A7 I fle (L)5
THE FOLIOWINO CORRECTIONS ARE REQUIREDs /D /
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Inspectors Date:
APPROVED DISAPPROVED APPROVED SURjjtCT
Call For Reinsp. Ii
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INSPECTION NOTICE ✓/�%�
City of Tigard Building Departs:ent
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Bu9iness Phone: 639-4171
Inspection:
Footing Plbg. Underelab Mech. Rju?h-in Appr/Sdwlk
Found. Plbg. Top Out Eau Line FINAL:
Poat/B+am St San. Bawer Framing Bldg..
Post/B*am Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor atorLina r Gyp. Bd. -Mach.
Date Requested: % -r? r Time: AM PM
Address: '/� / '? Permit #sBuilderi
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TNF. FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector.. -- Date:
_.APPROVED � DISAPPROVED � APPROVED SUBJECT TO Al',OVP.'
___Call For Reinsp.
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INSPECTION NOTICE
city of Tigard Ibillding Department:
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Ree-O-Phone): 539-4175 Busine-a Phone: 639-4171
Inspection: _ �_—
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Li-.o FINAL: p
Post/Beall Struct.") San. Sewer Framing -Bldg.
Post/Beam Mech\ t n Dr4i7f1� Insulation -Plumb.
Plbg. Underfloor Watey. LinerJ Gyp. Bd. -Hoch.
Date Requeeteds_ ��'�✓ jq Time: ^�AM PH
Address:_�Y /f"Ff C /�/L( C�tfP..Lt
Builder: .r /�'!r� 1kr- 62-nS n - ZLI- 2106
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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inspector. ------ — Dates �` 66
APPROVED DISAPPROVED -- APPROVED SUBJECT TO ABOVE
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.._Call For Reinnp.
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INSPECTION NOTICE / I
city of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inslxction Line (Rec-O-Phone): 639-4175 Business Phon 9-4171
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n__ation:___— --- -- --- ���----
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looting 1 Plbg. Underelab Mech. R,.:.gh-in Appr/Sdwlk
bund. Plbg. Top Out Gan Line FINAL: e).
Poet/Beam Struct. San. Sewer Framing —Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. 91. -Mach. a
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Dake Re :esteds ..�- ��' i �� Trfim��offs AM PM �
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Address: 1 )e e_ X. T# LO
Builder: / /� 1 //i/ ter-
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors-- — Date: /
OVED DISAPPROVED APPROVED SU cT
--.---Call For Reinsp.
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CITY QF TIGARD PLUMBING PE �y
PERMIT #. . . .. .. .. .. : MST'94•-0169
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 05/11/94
13125 SW Hall Blvd.Tigard.Oregon 07223.6199 (503)630-4171
PARCEL: 2 S 102DD-02::00
SITE ADDRESS. . . : 08581 SW MERLYNE CT
SUBDIVISION. . . . : FINLEY PARK ZONING: R-7 �
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :006
__--____-_.-_-_-_..----__...-.-.__._------.__----__ -
CLASS OF WORK. . :NEW GARBAGE DISPOSALS. . : 1
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . s1 BACKFLOW PREVNTRS. . :0
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . 10 TRAPS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . :0 WATER HEATERS. . . . . . s 1 CATCH BASINS. . . . . . . :0
FIXTURES----------------- LAUNDRY TRAYS. . . . . . :0 SF RAIN DRAINS. . . . . : I �.
SINKS. . . . . . . . . . : 1 GREASE TRAPS. . . . . . . :0
LAVATORIES. . . . . :2 OTHER FIXTURES. . . . . :0
TUB/SHOWERS.....— SEWER LINE (ft ) . . . . :0
WATER CLOSETS. . .-2 WATER LINE (ft ) . . . . : 10o
UlSHWAC;HI=-R5. , . . : 1 RAIN DRAIN
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RemarKs: PATH a
OWNER: ------------------------------ --FEES._-
TIM MILLER TIF $ 1.520. 00 SW 05/11/94
13027 SW TAMERA CT BPRT $ 322. 00 SW 05/11/94 ,
BPLC f 209. 30 SW 04/29/94 94--25185,�
TIGARD OR 97224 B5PC $ 16, 10 SW 05/11/94 ,
Phone #: 598•-8574 SSDC $ 280. 00 SW 05/11/94 ,
PARK $ 500- 00 SW 05/11/94 ,
Plumbing Contractor,: --_____.__._.___.__. .\_ MPRT $ 40. :10 SW 05/11/94 ,
1 MPLC" $ 10. 13 SW 05/11/94 ,
(V,�mE� : �..!.! !�- �� M5PC $ 2. 03 SW 05/11/94
Address :�0_y _. _� 4 _.. PPRT 117. 50 SW 05/11/94
1,1 t y s. .._.�'_L. Q_.__..._._..-----...._.. _.States _C3� PSPC $ 5. 88 SW 05/11/94
Zips '?ZW- k'hone#: �� -+
Rey #:
This permit is issued subject to the reg REGIUIRED INSPECTIONS
ulations contained in the Tigard Municipal Foot/found Insp Rain drain Insp
Code, State of Ore. Specialty Codes and all Post/Beam Struct Water Line Insp
other applicable laws. All work will be done Post/Beam Meehan Appr/Sdwlk Insp
in accordance with approved plans. This Plm/undslah Insp Mechanical Final
permit will expire if work is not started PLM/Underfloor Plumb Final
within 180 days of issuance, or if work is Mechanical Insp Building Final.
suspended for more than 180 days. Plumb 'Top Glut Erasion Lontrol.
Framing Insp Crawl Drain
Fireplace Insp
Gas Line Insp
Insulation Insp
x - _ Gyp Board Insp
Author izedPlumbing Contractor Signat�_lre - ______. ___.
Call for inspection - 639-41.75
Contractor Nates :
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. CITY OF TIGARD MASTER PERMIT ' }
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . : MST94'-111169
13125 9W Hall Blvd.Tigard,Oregon 97223.6109 740*ifti=1171 DATE ISSUED: 05/11/-34
PARCEL: 2S 102DD-0 201 1
SJ TE ADDRESS. . . : 08581 SW MERL.YNE CT �
SUBDIVISION. . . . : FINLEY PARK ZONING: R-7
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :006
-..--_.__------------------------------ BUIL_DING ------------------------------------------
REISSUE:
----------_-•--_ _----_REISSUE: DWELL ING UNITS: 1 BASEMENT. . . . . . . . :V-' sf
CLASS OF WORK. :NEW PEDRMS:3 BATHS:c GARAGE. . . . . . . . . . .480 sf
•TYF'E Cllr USE. . . :SF FLOOR AREAS------- REGIU I RED SF TRACK :i_'___._.-_-_--
TYPE: OF CONS"f. : `.iN FIRS [. . . . : 1179 sf LEFT. . :5 ft RIC-HT. :5 ft
OCCUPANCY URF='. :R3 SECUND. . . :0 sf FRONT. :20 ft REF- R. . :34 ft
STORIES. . . . . . . :0 THIRD. . . . :0 sf REQUIRED--__________.____._._____...
HEIGHT- - - : I ft TOTAL- .•-• - -: 1 179 s f SMOKE DETECTORS. : !
FLOOR LOAD. . . . :40 p s;f VALUE. . . . . S : 62B74 PARKING SPACES. .
Renlar•ks : PATH B
PLUMBING
S1BKS. . . . . . . . . . : I FLOOR DRAINS. . . . :0 BACKFLOW PREVN•TRS. . :O
LAVOTURLES. . . . . :2 WATER HEATERS. . . : 1 TRAVIS. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . :c LAUNDRY IRAYS. . . :0 CATCH BASINS. . . . . . . :0
WATER CLOSETS. . :2 SEWER L..INE (ft ) . -0 GREASE TRAPS. . . . . . . :0
D I,SiHWASHERS). . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXTURES. . . . . :0
GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :O
WASHING MACH. . . : 1 SF RAIN DRAINS. . : 1
MECHANICAL _._____.___.________.__.____-..__..._..______.--_- FEES
FUEL TYPE_S._-_-.___----- UNIT HIRS. . :0 type amol_rnt by date recpt
/LiF=1ra'/ / / VENTS . . . . . :0 TIF• $ 15c'0. 00 SW 05/11/94 ,
MAX INPUT:O PTU VEN I FANS. . - 3 81DR I $ 322. 00 SW 05/11 /94 ,
FURN ( 100K . . : 1 HOODS. . . . . . : 1 BPLC $ 209. 30 SW 04/: 9/94 94-251854
FURN ) -100K . . -0 WOODS3TOVI_S. :QI DSPC $ 16. 10 SW 05/1. 1/94
,
FLOOR FURN. . . . -0 CLU DRYERS. : I SSDC $ 280. 00 SW 05/11/94 ,
1_AOIL/CMP l 3HP:0 01HER UNITS: 1. F'ARI; $ 500. 001 3W 03/1. 1/94 ,
GAS OUTLETS: 1 MPRT $ 40. 50 SW 05/11/94
Owner: ______.__ ___..-------_______.___.-.----.--___..___MI'L_C $ 1.0. 13 SW 05/11/94 ,
T1M MILLER MiPC $ 2. 03 SW 05/11/94 ,
1302:`7 SW TAME::RA CT PPRT $ 117. 50 SW 05/11/94 ,
P5PC $ 5. 88 SW 05/11 /94
T IGARD (]F7 972:24
Phone #: 598-8574
Contractor:
I1:M MILL.E:R
1:302:7 SW f 1 MARA LN
T IBARD OR 97'.E4 a
Phone #: b98-8574
Peq #. . : 64687 _______.___________._____•--__-_.______.-----_-__--
$ 3023. 44 OTAL
This permit is issued subject to the regulations cortained in the --- -- -- REQUIRED INSPECTIONS -- ---
Tigard Municipal Code, State of Ore. Specialty Codes and el other Foot/found Insp Fireplace Insp
applicable laws. All Mork will be done in accordancy)iO approved Past/Beam Strl.ict Gas Line Insp
plans. This permit will expire if work is n star tl in In Post/Beam Meehan Inskilat ion Insp
days of issuance, or if wcrk is suspended o mor days. Pim/l.rndslab Insp Gyp Beard Insp
PLM/Underfloor Rain drain Insp
Per,mitteP Si at _rre : _ 4v t+iechanical Insp Water Line 1nsP
Plumb Top Uut Appr/Sdwlk Insp
Isst.ieo By • __ _ _._..__.Y._._.- _..____..__.._._.__-. Framing Insp Mechanical Final
Lal l for inspection - 6.39-•4175
I
ir TO
CITY OF TIGARD SEWER CONNECTION
PERM I'T
COMMUNITY DEVELOPMENT DEPARTMENT PERM I1 #. . . . . . . : SWR94-01'70
13126 BW Hall Blvd.Tigard,OrngLn 97223•818 (503)i6bW-1171 DATE ISSUED: 05/11/94 I
PARCEL: 2S102DD-02200
SITE ADDRFS!a. . . : 08581 SW MERLYNE CT' 1
SUBDIVISION. . . . : FINLE_Y PARK ZONING: R-7
BLOCK. . . . . . . . . . . L.OT.. . . . . . . . . . . . . :006
.__-----__-_--_----_-_---_.-----___-
TENANT NAME. . . . . :
USA NO. . . . . . . . . . . FIXTURE UNITS. . . :
CLOS, OF WORK. . . :NEW DWELLING UNITS. . : 1
NOW TYPE OF USE. . . . . :SF NO. OF NU I LD I NGS: 1
INSTALL TYPE. . . . .BUSWR IMI./ERV SURFACE. . :
Remarks: PATH 8 µ
Owner. _____-____------__.-_____.._____..____._._____.____---_ __.-______________ FEES
TIM MILLER type aMo1.rrtt toy date recpl;
13027 SW TAMERA CT F'RMT t 2'='00. 00 SW 05/11/94 3�
INSP 35. 00 SW 05/11./`B-1r
TIGARD OR 97224
Phone #: 598--8574 x
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(1)N714ii-TOR 1\101 ON FILE:
--------------------------------
$ 2235. 00 TOTAL_
--- ---- REOU I RLD INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Insper_t i on
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 sewer laterals. If the sewer is not located at the measurement
given, the installer shall prisnect 3 feet in all directi s from
the distance given. if not so located, the i staller 1 urchase -
a "Tap and Side Sewer" Permit and the Age will 1 a lateral.
Perm ttee `,:ii LIAlEaL-r.ir•e :
Call for-, inspect ion - 6 39-4175
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71
Residential Building Permit Application �/
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 0
(503) 639-4171
Y/jobslte Address: M e l yry e (f1Z r
Subdivision: rl r- Lot#_�_ Office Use Only
Valuations
✓/Pei unit # 6,'���-
/Owner: -7/;�L AI11,et- !.-tt'./ = Paissue of
Address: Map& TL# S -� � -�
Approvals Requ
Phone: 7 cf ired
Plannin
Contractur:
Engineering
Address: /'302 7 7i nJ Other
E �y �-, l Items Reqult'ed
Phone: _� ; - 7 - 7 2� f 2(� �
Contractor's License # L 6 57
Subcontractors .
(attach copy of current Oregon license) Truss details
Subcontractors: Other
Plumbing:
t ir1t
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Mechanical:
(attach copy of current OR Contractor's License)
ArchitectiEngineer:
Address: _
I
Phone:
COMMENTS:
i
-7
lica Signature & Phone number
Received by G _ Date Received:
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Permit # Account Description Amount Amt. Pd. Bal. Due
alit Bldg. Permit - S-7
9 (BUILD) ,�r�,c ,c�y ?, „�
Plumb. Permit (PLUMB) 1117, 5-�I // 7 rJ vV :,• x.=
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Mech. Permit (MECH) p, U [/0,;-9 v/
State Tax (TAX) ,v �2
w
Bldg: �� . /U
Plumb:
Mech:
Plan Check (PLANCK)
I Bldg:
Plumb:
I
Mech:
Sewer Connection (SWUSA) Z u0
to Sewer Inspection (SWINSP) �•5~ _;
Parks Dev Charge (PKSDC) 'Soo �U
Storm Drainage Chg (SDSOC) .;2
Residential TIF (TIF-R) f y/ /0
Mass Transit TIF (TIF-MT) _ //0
Commercial TIF (TIF-C)
IndustriaLTIF (TIF-1)
!nstitutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality jWQUAL) _
Water Quantity (WQUA"
Fire District (FIRE)
TOTALS:
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