9455 SW MOUNTAIN VIEW LANE' T,- � .1 � �� ' ���. I yl I �I'j 1���' '�' � , � 1. I-. - I { �l, '� I ,. �, ' � .'r'� �Y`p ��• � ,y, P '��. 11 � �.�'��
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jsPECTrgN NOTIrE
city of Tigard Building DeEj
ot i
lgi2_, SN Ball Blvd. Tigard, O97
Inspection Lin* (Rbc-o-Phone�): 639-4175 �th n �63 - 71
Inspection: ✓�' �'�' s���--= C�
plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Footing
Pound.
Plbg. Tol. ;Alt Cas Line
i
Vogt/'Beam Strutt. San. Sewer g
Post/Beam Meth.
Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. oc i_>
ZO
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-AN PM
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Date Requested: CL�ei erynitt
AddreeB: ti bV1r ��
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THE pOLI,ryWINC CORRECTIONS ARE REQUIRED:
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Date 7 77
APPROVED DISAPPROVED APFROVED SUBJECT TO ABO
Call For Relnep.
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INSPECTION NOTICE
City of Tigard BuildlLng Department
13125 SW Bail Blvd. Tigard, Oregon 97223
Inape ion Lines (Rec-O-Phone): 639-4175 Busineee Phonat 639-4171
i
Inspections
laoting Plbg. Underelab Hoch. Rough-in Appc/Sdwlk
w
Found. Plbg. Top Out Gae 1.1110 FINAL:
"-st/Beam Strvct. San. . ,ver Framing -Bldg.
Poet/ream Hoch. Rain Drain Inculation -Plun:l.+. i
Plbg. Underfloor Nater Lino Gyp. Bd. -Hoch.
Date Requeetedt IV _ -_Times _-L—AN PFI
/ J T V/C c Permit p i s � }) c X16
Address:— — � 7-� _
BuJ lder: C� C_'/ 'r L-1 ('
THE FOLLOWING CORRECTIONS ARE REQUIRED:
>> _� > >/ In t % AYU^zc~
AL6 is ?53c-
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Inspectors v � — Date:-
APPROVED
ate:_APPROVED DISAPPROVED APPROVED SUB.IECT TO ABOVE
Call For Reinep.
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INSPECTION NOT7E `
City of Tigard Building Department
13125 811 Hall Blvd. Tigard, Oregon 9,223
Inspection Line (pec-o-Phone)t 639-4175 Business Phone: 639-41.71
n
Inspection:
Footing Plbg. Underslab Nech. Rough-in Apps:/Bdwlk
Pound. Plbg. Top Out Gas Line tINALt
I
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Be m Mech. Rain Drain insulation -Plumb.
Plbg. Underfloor Water Line C ( Gyp. ed. �)�N
v a i
Date P.equeeted:_.� .'�a / l Ti'ymet C� 11M_f�.��-{�
Address= L ` c� b i Permit�t /
Buildert
: -
THE FOLLOWING oORRECTIONS ARE REQUIRED: _
`
-��� �` \ ?�/�-'\ to � ..._-L,.f". �� � `• '•�1�� ��.�'..�-�.J/�
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Inspectors i L �-- --� Date t -
APPROVED ___\. �DISAPPROVED APPROVEn SU�,JF.r.T TO ABOVE j
tall For Reinep.
CC
NS ECfION NOTICE �!
City of Tigard Building Depextaent
13125 SW Ball Blvd. Tig.,rd, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Buainear Phone: 639-4171 i
Inspection:
Footing Plbg. Underrlab Much. Rough-.in Appr/Sdwlk
Found. Plbg. Top Out `Ou Line / 1INALs
Poet/Roam Struct. San. Sewer Framing _Bldg,
Post/Beam Mech. Rain Drain Ineuletion _pluasy,
i
Plbg. Underfloor /water Line Gyp. Rd. h,
Date Requested: [�' _Times AM PM
Addreaeqd��A 4 ) C pwrmit !s D�
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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InspectorsDate-
DISAPPROVED
APPROVED V APPROVED 8 iBJECP TO ABOVE
Call For keinap.
Pa.�pWl+Nssitm+asr+w.m..a.v...........+e....... ,......... ...__.-.._..._... ` 'r
... ;«pH.^•,ty ��;,�.;,«.. ,. .. rkG a.«+. .. v ,• ,k.yy„ :Yr rnrMUY ar`�tlpe.
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INSPECTION NOTICE
City of Tigard Building Departmamt
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Ree-O-Phone): 634-4175 Busineas Phone: 639-4171
i
Inspection•
Footing Plbg. U,rderalab Mech. Rough-in Appr/Sdwlk
t �
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Found. Plbq. Top out Cas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
- way
Poet/Beam Mech. Rain Drain
�1mr3atlpp —Plumb.
Plbg, Underfloor Water Line
Gyp. 8d� -Hoch.
Date Requested: Time:
AM _ _pM
Address Permit
Builder:-
THE FOLLOWING CORRECTIONS ARE REQUIREDA
TT _
Inspector
i — ----- -- Dates�G '
—_—..
APPROVED —�
DISAPPROVEDAPPROVRD SUBJECT TO ABOVE
Call For Reinsp.
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INSpECTION NOTICE
City of Tigard Building Department
13125 Sp Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone: 639-4175 Business Phone: 639-4171
Inspection: -- �� "--
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out /Gas Line \ FINALt
Poet/Beam Stsect. San. Sewer /��rF_raming_._ ) -Bldg.
Post/Beam Mach. Rain Drain \(/ lnaulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requeatedt
_Timed _AM _�PM
Address:
Builder:_
TME FOLLOWING CORRECTIONS ARE REQUIRi:Dt
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Inspectors Date:
APPROVED DISAPPROVED APPROVCD SUBJECT TO ABOVE
i Call For Reinsp.
`.'i � .. , }p�peyHrNswe.r,uuRi�•*'"°a.unw•:«•.+oawlNp}g:�..rwarara�etieYasn}FNNrurA�ruiSa, '.
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LECTION NOTICE
City of Tigard Building Departsr_J:t
137.25 SW Ball Blvd. Tigard, Oregon 97223
Inspectio
'no (Roc-O-Phone): 639-4175 Business Phone: 639-417.1
Inspections _
Footing 1Tad rt�slab Hech. Rough-in ApQr/sdwlk
Found. ` Plbq. Top Out 1 Cas Line FINAL:
--�
Poet/Beam Struct• San. Sewer Framing -81d
g.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor /Water Line Gyp. Rd. -Hoch.
Date Requested: 4�
Timet 11H ---��--��'
Addroae: Permit
ri
Duilder•
rV THE FOLLOWING CORRECTIONS ARF. REQUIRED:
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Inspector: ✓..� -�
Dates
APPROVED _� DISAPPROVED APPROVED SUBJECT TO ABOV
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_Call For Reinsp.
i
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INSPECTIGN NOTICE
City of Tigard Building Department
13.125 SW Ball Blvd. Tigard, Oregon 97223N
Inspection Line (Rec-O-Phone): 639-4175 Busineue Phone: 639-4171
Footing Plbg. Underalab Mach. Rough-in Appr/Sdwlk t
PP i•;N''t,,
Found. Plbg. Top Out ` Gas Line FINAL: {
Poet/Beam Struct. San. Sewer
Pra:01t� _Bldg.
Poet/Beam Mech. Rain Drain Inaulat LOA �� �'•
-Plumb.
Plbg. Underfloor Wat4r Line Gyp, 8d, -Meeh
Data R.,questedt.- --Z I /
_-,_Time: _ Q AM PM
�'�]
Address: �7 V�J / /7 F cJ t ( Pl,,i 7fsVJ25� 7�/
7
Builder:� 1 -A
f THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspactars
APPROVED t/ DISAPPROVED APPROVED SURIE('T TO ABOVE i[
✓ _Call For Reinsp. RR
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IMBPIZCTIOM NOTICE
City of Tigard Building Departamt
23125 SW Ball Bled. Tigard, Oregon 97223 P
Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
Footing Plbg. Dnderelab Mech. Rough-in Appr/sdwlk 0
Pound Plbg. Top Out Can Line FINAL:
Poet/Beam Struct. C an. sewer Pram ng --Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plhg. Underfloor Wafter Line !/ Gyp. Bd. ��\�ech.
Date Requor,ted:/ CL' � c' �1 Ti"3 11�Mf PM
it
Builder:
Builder: Zx
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TRE POLLOW114G OORRECTIONS ARS REQUIRED:
S-E CcxW
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V AP+ROVED _--- DISAPPROVED — APPROVED SUBJECT TO ADM
Call For Roinnp,
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5 CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT PLUMBING PERMIT
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171
r�'fwriM I T #. . . . . . . : PLMci 4- 0080
DATE ISSUED: 06/06/94
i"'ARCEL: 2S 1 1 1 ESA 08400
,ITE:.' ADDRESS- - 09455 SW MOUNTAIN VIEW LN
.3UBD I V I S I ON. . . . : BRE::LYNN WOODS ZONING: R-4. 5
BLOCK. . . . . . . . . . . L01 . . . . . . . . . . . . . .001 m►
CLASS OF WORK. . :MOV UPRBAGE. D I SPUSAI_S. . : 1 11UB I1_E: HUIr1F SPACES.
T-YF'E: OF USE. . . . ASF WASHING-: MACH. . . . . . . : 1 BACKFLOW PREVrt1TRC3. . « 1
(:)C CUIDANCY GRP. . :Ru FLOOR DROINS. . . . . . . .. TRAPS. . . . . . . . . . . . . . .
STORIES. . . . . . . . : 1 WATER HEATERS. . . . . . .. 1 CATCH BASINS. . . . . . . s
1 'I XTURES-- _._ __._.___.-- LAUNDRY TRAYS. . . „ . „ 1 SF RAIN DRAINS. . . . ,
[NKS. . . . . . . . . . :3 GREASE TRAPS. . , . . . . .
LAVATORIES. . . . . .0 OTHER FIXTURES. . . . . :
1UB/SHOWERS. . - . :2 SEWER LINE (ft ) . . . . :
WATER CLOSETS. . .-2 WATER LINE (1=t ) . . . . :
L)I SHWASHE:RS. . . . 91 PAIN DRAIN (ft) . . . . s
Rpmarlis : MOVING IN HOUSE INSTALLING ALL NEW r''LUMBING
i lwn er: ___.._______ ___.__.________.-- FEES
i�OH AND DINAH ROGER- type amal_int by date r^er_pt
:075 SW RALE,IGHVIEW 1.)H PRMT $ 97. 50 SW 06/06/94 --
5PUT $ 4. 88 SW 06/06/94 —
10PTLAND OR 97225
�'hOne #: 2:91-7166
1) It F PLUMBING
N. ALBINO AVE
I ,uR I LAND OR 97217
Ohone 11 : 0132-0993, '1 102. 38 TOTAL
REQUIRED REG:) INSPEC:TIONS
This permit is issued subject to the regulations contained in the l op—nut Ir1sp .______.
igard Municipal Code, State of Ore. Specialty !odes and all other Final Inspection
applicable laws, All work will be done in ar_ordance with
approved plans. This permit will expire i` work is not started
within 180 days of issuance, or, if work is susoenjed for more
PO days.
l-'a r•m i t t e e 1S i q ri a t i_i r'e :
Le11 for, inspection — 639--4175
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plastics
development
inc.
Dianna Rogers
Genera!Manager
5565 S.E. International Way•Milwaukle,Oregon 97222
Phone(503)654-7682 • FAX(503)654-9995
Shop Floor(503)6544346 after 5:00 PM
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City of -ilgard PLUMBING PERMIT Planck/Rec. # _
13125 SW Hall Blvd. APPLICATION Permit #
Tigard. OR 97223 / r�
(503) 639-4171
escripli -
!`J `> ORS 814-21.610 QTY PRI('E AMT + i
Address r, �__' ' "��I �) FIXTURES
Sok
CC.v l t�V g 7v� avatory 73D
I L-b or I ubower om . _ T.
L,c0i- >1 ��O`�Cy owerOrTy—
u Water -----
ose
Owner lt^'7`� 5,4�' 1Ej �
L Dishwasher /• ��U
j •u age ispos ? Jv
7 1 5 WisFiing Machino -
T— l i U
� rW r'C�- Mor Dram
Ci r f U 'Y �L L SO�1 atereater 7 �V
Occupant ». / �—�i uno ry oom ray 7.5U1_t U
Unnal 1.5u
J er +xtures pea +.� ,, i.
7.50
Contractor, w� c MISCELLANEOUS
wer st 100, -
tiw --r- uw T.,N. Sewer-ea. +t. -
Water Service lst -
r y ac owTeage tfiaFT rave lea its a�Tip ca an, a Water Service ea.Adr'it. 200' 15.00
information given is correct,that I am the owner or authorized aye^!or _
the owner, that pians submitted are in compliance with State laws,that i Storm 8 Rain Drain 1st 100' 30.00
am registered with ft Construction Contractor's Board,that the number Storm 8 Rain Drain Addit. 100' 15.00
given is correct. (If exempt from State registration, please give reason _
below) I Mobile Home Space 25.00
_,_ ----
Back Flow Prevention
Device or Anti-Pollution Devird
" °ateAny I rap or Waste Not - - -
Connected to a Fixture 7bv
son wrTc- newU A +Lon-Tj-T-15TCerab'on—k_}` repair U CatchBasin to he done residential Q non-residential C') - --4_U_T)r<'f
Insp.of Exist. Plumbing ,ger hr
Specially Requested Inspections per hr
Existing use of air Drain, sing a famiFy --
buikfng or property
dwelling � 15.00
Residential ac. ow prevonbon
devices 15.00
Proposed use of
buikfng or property _
xcep irside.nra ac ow —
p prevention devices)
NOTICE 'Minimum Fes$25.00 S+:BTOTAL
PERMITS BECOME VOID IF WC RK OR CONSTRUCTION 5%SURCHARGE
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS PLAN REVIEW 25%OF SUBTOTAL
COMMENCED.
TOTAL
Special Conditions
Date;slued by
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1101 I IN I 9 i `sit)
hIWE' x 1) E NID F. PLUMB 1I'll i , ,I i 1 11.1t II 1111 "1. 00
1'if►1)F<k: 11'I tit 463,6 la f'It.FONA Gat;I I °I f I��I t 1I lt1I I M G11,i 1t� �iy
F opii_siIVC?. op
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I-i LJMN I Nf1 F't Rtwl i- l P194 -0144040 *{. 11!
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PERMIT
CITY OF T PERM IT #. . .. . . . . MEC94-0116
COMMUNITY DEVELOPMENT D&*RtiltNT DATE ISSUED: 0'5/09/94
13125 SW"all Blvd.Tigard,Oregon 07223.6199 (503)030.4171
PARCEL: 2S 1 1 1 ISA--17x8400
`aITE ADDRE13f . . . : 09450 SW MOUNTAIN VIEW LII
SUBDIVISION. . . . : BRELYNN WOODS ZONING: R-4. 5
13LOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . ..001
_____________... _
CLASS OF WORK. NEW FLUOR FURN. . . . EVPP COUL.ERS:
'TYPE OF USE. . . . :SF UNIT HEATERS. . : VENT F=ANS. . . : r
OCCUPANCY GRP. . :R3 VENTS W/O APDL: VENT SYSTEMS:
STORIES. . . . . . . . : i BOILERS/COMPRESSORS HOODS. . . . . . . : Y
FUEL TYT'ES----___________ 0_3 HP. . . . : DOMES. I NC I N: d
: /GAS/ / / 3-15 HP. . . . : COMML. 1NCIN:
MAX INPUT : BTU 10...30 HP. . . . : REPAIR UNITS:
F1 RE DAMPERS?. . : 30-50 HP. . . . : WOUDSTOVES. . :
GAS PRESSURE. . . : 50+ HP. . . . CLU DRYERS— :
NO. OF UNITS----------- AIR HANDLING UNITS OTHER UNITS. :
TURN < I 00 BTU: 1 (= 10000 cfm: GAS OUTLET3. : 1
F'URN >=100K BTU: > 10000 cfm:
Remar-ks: INSTALLING NEW FURNANCE
OwT•rer^, - -----_»_._________________.._____._..__.__.___._.______________ FEES
DOB AND DINAH ROGERS type amol_tnt by date r^cpt
3075 SW RALEIGHVIEW DR PRMT $ 25. 00 BLT 05/09/94 r
aPC:T $ 1. 25 BLT 05/09/94 ,
PORTLAND OR 97c:25
Phone #: 297-7168
Contractor:
111IONE.ER FURNACE:_
3615 NE BROADWAY
PORTLAND OR 97232:
Phone it : 249-3000 t. 26. 25 TOTAL
Rey #. . : 3b10c
- -' -- REGrU I RED INSPECTIONS -------
This permit is 1S5Ued subject t 'he regulations contained in th@ Final Inspection
Tigard Municipal Cade, Stat- o I Specialty Codes and all other
applicable laws. All work will gone in accordance with �`-
approved plans. This permit wii, expire if work is net started
witi,hin 180 days of issuance. or if wor• is s,.spendell for more _
than 189 days.
Permittee Signat 7.ire : / � �,J'-� •. �
Iss•_1ed By:
Call for inspection 639•-4175
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 SW Hall Blvd. APPLICATION Permit #
Tigard, OR 97223
(503) 639-4171
i
escnption
/ Table 3A Mechanical Code CITY PRICE AMT
�l
,lob �i'�f J C'l� 7. 1) Permit Fee -0- -0- 10.00
Address
aef, 2) Supplemental Permit 3.00 _
Furnace to TUU��TICI
dx,n1� G 7C 1) incl.ducts 3 vents 6.00 0 t _
/
Furnace +
O'dvnef l _S`O 1 ` 2) incl.duds 3 vents 7.50
WSW Floor Xance
3) incl.vent 6.00
-7, Suspended heater,wall seater —
4) or floor mounted heater 6.00
v en not incl,in -
Occupant 5) applianrA permit 3.00
v 1 e r of heating,re ng.
6) cooling,absorption unit 6.00
Boiler or comp,heat pump,Fir Fo
7) to 3 HP absorp unit to 100K BTU 6.00
V 9611or or comp,heat pump,air connd.
0,. ? �lr'L 8) 3.15 HP absorp unit to 500K BTU 11.00
Contractor i ar oror—com-�iehep a pump,air co -
�L�n� ��(, ��,�33- 9) 15-30 HPabsorp unit.5-1 mil BTU 15.00
boiler or comp, at pump,air conte
7 IL6�L �46 42
10) 30-50 HP absorp unit 1.1.75 mil BTU _ 2250
hereby ac ow ge a ee resd this lip-, x a ion,that the i er or comp,FWFpurrt.n,air-6-on-a.
information given is correct,that I am the owner or authorized agent 11) >50 HP absorp unit 1.75 -nil BTU 37.50
of the owner,that plans submitted are in compliance with State Air handling unit to
laws,that I am registered with the Construction Contractor's Board, 12) 10,000 CFM 4.50
that the number given is correct (If exempt from State registration, —A-ir-1555oling urn
please owe reason below.) 13) 10,000 CTM+ 7.50
Non portable
14) evaporate cooler 4.50
— Vent Ian connected
15) to a single duct 3.00
Ventilation syst,im not
�___.t.�/ ` 16) included in apriianoe permit 4.50
Hood SM y
17) mechanical ex must 4.50
escn wor c new addition alteration repairmmercia:ai industrial
to be done residential Q non-residential Q 18) type Incineratr r 30.00
Existing use of .a.,w'c.>sliovo,�er --
building or property__ 19) heater,sular,clothes dryers,etc. 4.50
Proposed use of 20) Gas piping onefour outlets 2.00
building or property —
21) More than 4-per r itet
Type of fuel•of O net-"I
LPG 0 electric O
l
Nw icE L
1 Minimum Fee$25.00_— SUBTOTAL
_i PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE
IF CONSTRUCTION OR WORK IS SUSPENDED OR
J ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME PLAN REVIEW 25%OF SUBTOTAL
f AFTER WORK IS COMMENCED. ----
TOTAL
Special Conditions —
-- Date issu by_A
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CHEG11% AMOUNT IR 5
rF ANUFA rtJRNAN("F" C;F1faIJ 01,11)(114 r'
NES F4kC)t•at)W Y 1'41YP1F Nd 1 +,fl rt: (►`i%lt ✓".?''
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t 2NSPECTION NOTICE J
city of Tigard Building DOPert2le0t
13125 an Ball Blvd. Tigard, oro on 97223
• Inspect.ion Lina (Rec-O-Phone)t 639-4175 Business Phone: 63 - 171
Inspections _
looting Plbg. Underslab Koch. Rough-in Appr/Bdwlk
nd J Plbq. Top Out Gas Lina lIN11Lt
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i Post/seam Struct. San. Seger Framing -Bldg.
post/Beam Mech. Rain Drain Insulation -Plumb.
Plbq. Underfloor Nater Line Gyp. Bd. -p�h•
Date Requestsdt > J/ ,_Timet
Address:
AM wokwoo..
Builder t_ ��
TNM FOLLOWING CORRECTIONS ARE REQUIREDt
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Inspector: _ Dotes_
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APPROVSD DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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INSPECTION NOTICE
city of Tigax4 Ballding D"rt—t
13125 aW Hall Bled. Tigard, Oregon 97223
Inspeetior. Line (Rec-O-Phone)t 639•4175 Business Phone: 639-4171
Iuepectiont !
Footing Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Pound. - Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. ban. Sewer Framing -Bldg.
Piet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Fater Line Gyp. Bd. -Hoch.
Date Requested. 1�I- Timet AM PH
Address: �' `,� V l L� -- PermitX71 `)3-61�
Builder:— — n�L; / (�
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: _ _(r?Yl'J4,54", Date._/ - -1y
__�S4_APPRO'Vtb DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinep.
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INSPECTION NOTICE
City of Tigard Building Depart--ut
131125 BN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone)i 639-4175 Business Phone: 639-4171
I nepect ion:_ _-__ --
40
Footiny � Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Ling FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg. o
Poet./Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Rd. -Mech.
Date Requestedt Timer--=J AM PM
Address: S�� 5cL' Ou"f'A �.. ��1�'w�Permit t• c'� '�'US �
Builder:
THE FOLLOWING CORRF.CT:ONS ARE REQUIRED:
OON C,
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Inspector: Date:__
APPROVED DISAPPROVED APPROVED SUBJECT TO RROVE
�7
�/6 ��.,_,. C __Call For Reinsp. �
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CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT p'E RM]:'1 #. . . . . . . : IhS T93,--O451
-13125 S711 Hall Blvd.Tigard,Oregon 97223.81g&' J3)'AiG/4�71 DATE ISSUED: 01 /2,0/94
(='ARCEI_: L51 1 1 B(a-Oti4OO
SITE ADDRESS— : 09455 SW MOUNTAIN VIEW LN
SUBDIVISION. . . . : BRELYNN WOODS ZONING: R-'4. 5
BLOCK. , ,. . . . . . . . . LOT. . . . . . .. . . . . . . :OO1
BUILDING
RE 18GUE: DWELL I NG UNITS: 1 BASEMENT. . . . . . . . :0 sf rlm►
CLASS OF WORK. :MOV BEDRMS:2 BATHS:2 GARAGE. . . . . . . . . . :440 sf
TYF='E. OF USE. . . :SF FLOOR AREAS..-_._.___.___.__ REQUIRED SETBACKS--._-----___.__
I YPE: OF CONST. : ;N FIRST. . . . : 1513 sf L.EF•T. . :5 ft R IGHT. :29 ft
OCCUPANCY ERF'. : R SEC,ONU. , . :0 sf FRONT,. :20 ft REAR. . : 15 ft
STORIES. . . . . . . : 1 THIRD. .0 sf REQUIRED---____.__.__._______._
I.11=I Cali T. . . . . .. . . : 14 ft TOT'AI---- ._. :0 sf SMOKE DETECTORS. :Y
FLOOR LOAD. . . . :40 ps.f VALUE. . . . . $ : 16792 PARKING SF'ACES. . : I
Remarks : MOVING IN HOUSE AND ADDING A ROOM 127 SO FT FINANCED TRAPFIC IMPACT F
----------------- F'LLIMBING -- -SINKS. . . . . . . . . . :0 FLOOR DRAINS. . . . :0 BACKFLOW PREVN'TRS. . :0
LAVATORIE:S. . . . . :0 WATER HEATERS. . . :0 TRAPS. . . . . . . . . . . . . . :0
i TULA/SHOWE:R5. . . . :0 LAUNDRY ''RAYS. . . :0 CAT(',H BASINS. . . . . . . :0
J WATER CLOSETS. . :0 SEWER LINE (ft ) . :0 GREASE_ TRAP'S. . . . . . . :0
DISHWASHE13S. . . . :0 WATER I._INE (ft ) . : 1.00 OTHER FIXTURES. . . . . :0
GARBAGE DISP. . . :0 RAIN DRAIN (ft ) . :0
WASHING MACH. . . :0 SF RAIN DRAINS. . : 1
MECHANICAL -______.....__._-------_____ .____._._______.__.._.... FEE, ----------------
FUEL
--_--_----._-_FUEL TYPES---•--_.- - _.._ UN11' H'TRS. . :VI type amorant by date recpt
/GAS/ / / VENTS . . . . . .0 BF'RT $ 122. 50 H 08/2_'5/93 �
MAX INP,L.I'T:O BFI.J VENT FANS. . :0 BPL.0 $ 79. 6,E JL.H 08/17/93 93-243352
FURN ( 1O0K . . :0 HOODS. . . . . . :0 BSPC $ 6. 13 JH 08/25/93 --
TURN ) --100K , . :0 WOODSTOVES. :0 GSDC $ 1*280. 00 JH 08/25/93
FLOOR FURN. . . . :0 CLO DRYERS. : 0 F'ARK $ 500. 00 JH 08/25/93 -
BOI1./CMF' ( :311F1:Qi OTHER UNITS:O MF='RT $ 25. 00 JH 08/25/93 -
GAS OUTLETS: 1 MSPC $ 1. 25 JH 08/25/93 -
Owner.: _.._.._....__... ._...... _ _.._ .__.._._.__._..__..__._.____._. PIP RT $ 35. 00 JH 08/25/93 - z:
BOB AND D INAH ROGERS P5F'C $ 1. 75 JH 08/2:5/93
3075 SW RALEIGHVIEW DR TIFF $ 1520. 00 JH 11/01/93
PORTLAND OF 972 :5
Phone #: 297- 7168 r' '
Contractor:
OWNER
1-11lUTIe #:
Re u #. . 00000
$ 2571. 26 TOTAL
This perait is issued subject to the regulations contained in the -- -- - - REQUIRED INSF' :CTIONS ----- --
Tigard Mu^icipal Code. State of Ore. Specialtv Codes and all other Foot/foi.lnd Insp Rain drain Insp
applicable lams. All work will be done in accordance tith approved F'ost/Ream Strr-tet WAter Line Insp
plans, This perait will expire if work is not started wi hire (1Ei F'LM/UncJerfloor, Appr^/Sdw] k Insp
days of issuance, or if work is suspende r more t s. Mectianic,al Insp Mechanical Final
I X Framing Insp F'lr_rmb Final
(-'ermittee Signature; Gas Line Insp B+.lilding Final
Inst_ilation Insp Erosiun Control
) sued By : Plc Gvp Board Insp Crawl Drain
Call for inspection - 639--4175
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Residential Building Permit Application
City ot'Tigard
13125 SW Hail Blvd.
Tigard, OR 97223
(503) 639-4171
Jobslte Address: y'S� j
Subdivision- Lot # Lh. Otflca Use Only
Valuation: PiandclRec#
Permit #
Owner:
Reissue of
Address:
Approvals Required
Phone: Planning
Engineering
Contractor:
- ;Qther
Address: >
Items Required
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Subcontractors
Phone:
Contractor's License # Truss Retails
(attach copy of current Oregon license) Otter
Subcontractors:
Plumbing:
Mechanical
(attach copy of cunent OR Contractor's Wense)
Architect/Eng irteer:
Address:
Phone: i
COMMENTS:
I�
Applicant Signature & Phone number
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Received by: —_ Date Received:
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Permit # Account Description Amount Amt. Pd. Bal. Due i
�,G!
Bldg. Permit (BUILD)
1 Plumb. Permit (PLUMB)
Mech. Permit (MECH)
•
State Tax (TAX)
Bldg:
Plumb:
Mech:
Plan Check (PLANCK) / l`
Bldg:
Plumb:
Mech:
Sewer Connection (SWI ISA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Storm Drainage Chg (SDSDC; _
Residential TIF (TIF-R) _
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C) _
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
I Office TIF (TIF-0)
Water Quality (WOUAL)
Water Quantity (WOUANT)
Fire District (FIRE)
TOTALS: r
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cl 'TY OF 4,16111RO 14rfJ.1 ,i cm- I'f=IYMFJUT IlVITIT't NO. v94---c:41fibkl
CHECK AMOUNt 3 30. 60
draMl v I..;L.(1CKFIMAt-; SARKDOST INC C;AF*4 AMO UNI = 0. 00
,1. 1)fu-,SS : PO THCIX 418 VAYM[ NI Dt,4TE : 411/ x/94
GI..A(,KAMAF,, 1-IR SURD f.V I,-i I ON v
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'5--OF V,0YMF•.NT AMOUNT [.'(11C) F'I.JC{I'l.1tiC`: OF I=1(1YMkNT (AMI WIN 14411)
s0:11 W NG I'VRM MS'(9 3- 04 1 1 S. 00 ';1. }t1111.1) VILP 0. 40
I1tr(a(._ AMOUNT I-,'(41I) - —> 3(A. 6(b
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TRAFFIC IMPACT FEE
Installment Payment Application and Disclosure Statement
In the Matter of the Traffic Impact Fee for Bob and Dinah Rogers
Tax Map 2S111BA Lot Number 8400 Building Permit# MST93-0451
Site Address 9455 SW Mountain View Subdivision Brelynn Woods
Case File # SUB92-0010 TIF Land Use District R-4.5
To Be Billed To: Bob and Dinah Rogers
Address:_3075 SW Raleighview Dr., Portland, 97225 Phone #: 297-7168
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To the City of Tigard: �.
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In accordance with the provision of Oregon Revised Statute 223.208 and Washington County Ordinance
No. 379 which relates to the imposition of a!raffic impact fee for the financing of major collector roads and
arterials of Washington County, I/we HEREBY MAKE APPLICATION AND AGREE, JOINTLY AND
SEVERALLY, to pay my/our traffic impact fee, as has been determined by Washington Count,,-Ordinance
No. 379 in 10 semi-annual installments of the amount financed together with one-half of one year's
Interest thereon at a rate of 6.81 annual percentage rate on the unpaid amoun', owed. The lien date is
the first day of the month following the date the application is signed. The first payment is due six months
thereafter and at six (6) month intervals thereafter for a period of 5 years. Each installment payment will
Include principal and interest.
If I\we neglect or refuse to pay any part of the installments provided herein, including interest, within one
(1) year after the same shall have become uui� and payable, then the whole amount of the unpaid
assessment shall become due and payable at once and shall be collected in the manner provided by law
including foreclosure on the above-described real property.
The traffic impact fee, annual percentage rate of interest (6.81 %) and finance charges which I/we agree
to pay are as follows:
HIGHWAY TRANSIT
1 1) Amount of Traffic Impact Fee . . . . . . • . . . . . . . . . . $ 1410.00 110.00
2) Amount Financed . . . . . . . . . . . . . . . . . . . . . . . . . $ 1410.00 110.00_
3) Equal Semi-Annual Principal Payments . . . . . . . . . $ 141.00 11.00
4) Interest on Balance at Rate of . . . . . . . . . . . . . . . . 6.81 %
I\We understand that the amount owed, as stated above, shall be a lien on the above-described subject
property pursuant to Washington County Ordinance No. 379 Section 6 (D) and ORS 223.230.
t
DATED this 1 st day of November, 1993.
3ignaiure of Pr60ertyOwner(s Signature of Property owner(s
STATE E OF OREGON ) Name (Please Print): �c
Address: S S U-) ��r �v� c�2 92;2�5
County of Washington )
SUBSCRIBED AND SWORN TO BEFORE me this �7- day of j 19 93,
OFFICIAL SAI. No y Public for Oregon
KRISTNlt 6 ANDMIUM j
NOTARY/'1ltiA-0111OON My Commission Expires:
CAMINAIp10"NO.alM14
MY COMMISSION E)KPIItES MW S.itI11'
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L:HF G;F'� ({hII.1111V I 1� a., t f`IfIMF rFllltl .I 4:i7 f.1IN(lF� 1,({`�Ia 3,
AMON 0. le.1111
IFaUDF2E:;�4� s 1'(,`r'hli•.hJ l (1cd I F:. a a 7 / lvt/4,ti
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IMPOSE OF PJAY111 .hl r AMOLJN'r F=twi) I ILlFtF�U:.,1 l.fl- r!AYMEN I' (aMCHN r FI0.1'1) �
M I F.Ca I NU PFRM 11x4•. 50 PLI IMIA i Nfi f lF NI7 s . vtiaa
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CIN OFTIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13.125 BW Hell Blvd.Tigard,Oregon 97223.8199 (503)139.4171 LYA T f.
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1210400
Q194!—,5 5W �I(..JlJl�1 !ftiN VIEW L..i.1
a'�iri. . . . . 1•_tREI._Y!rN wOOD17 Z Iq rel(;
mow, r..,r»+,.:......_........ .. ..... ........._....._.�..._..-........_... r �
>.: 1:71. _L)i ............_._._ ..._.. _......._.....___......._. ._ ._ ..._ .....
i":I 1tli< ,?W L�1 r�a(� t..li'a a 1 r - aYsn
WORK. :MDV E,1:)Rh1G:c EiA'TF-i�:ir. C3f1RWG[�n . . . . . . . . . ..440 c,r
i.l L. . , :cit.. 1"L..('(..i l l=il�(,.ial.i.. _ t:l (..1U I H r '(� ..... . ...... ...._. . ..
_.... i (\Ir ( 1.�1"11,.t.. I.
11-'E. OF CQN:a T. :5N! F I R. 3' 5.l 3 s•r tlL.F...i.. . :5 ft RIGHT. 9 F't + "
GRi . . !?.:• i1 C.fJi�lt)» „ « :tZr fi 1''6dl?hJT, ;,::.14,1 f is FRC:.Wl"�. .
URXE`Ell., . . . . ,. . 1 - l-i'YSRD. . . . lei 5P' REC>lJriRE:U1,4 01 '..C.. .�_:......_..
f IJ ice,t.J.. : Y '...
_OC?R L_ONr). , . , :4145 tr',f' �w1L.U4:. , , , r,
1.; 4 r' PARK 1 NG .ip'WC:C:.U. . : 1.
t�tnt r'�ks : MCWINIG IN, HC2UIBL: C JDA,! 1::'/ C3Gl F 1,* F INANC1 1) TROF'fi'lG IMPAC:; ;' I
i"L.(a(1`� t:'(±i-i 1.t`I'..: . n »IZ! ?ACKI...L OW I '1'tlwVh"
Jf:a1"(.1f'� + "'10 WW'T'E:I tfltiF�?'r� k?C�. . . :1�1 TttAr:'E*), . . . . „ .(�
tl/511.1 1l,-ll 7:T. « .. . r,6�1 1.l i,..!i`•? F?'Y f Ri, r .. . nth 1: I�T'f;i i �1r-�! k,
R C,LnU�t:Ti; IZ SEMLP .INE' tft ) . :0 iaRLAEi i Rt-PS . . . . :0
+7' 4
�I WF1SHE REi. . . ,. :of WF4 TI.P i_.I NE';. Y f'�'s ) � ± :VI
a0 RAIN
MECHANICAL !,Et s
typra clmcauri+ t.)y' d'at c c_i..,.1'.
L-3K)1:s'T $ 104. `2.1 H 0B/::.'1,5 9 y ...
y ,,y B t.l V l.-P•JTaV} h L C K
117 C)s J! li ! . j:3
f„t"iF•'c i A 0 B/ .' r9...
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W 0 01)f 1 C:1Vt f_. 4'. '�l)C; t:'l:34-1, 00 X4 1/,1,
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_lliri t:l.ii 14. . . .. :0 ULxO DRYk_R�i. 0 PORK 'F 5 IZA0. 00 JH QAL3/t-:tjf1)3
, r.., ri
.. l3TF{(:.Ci, ..;h1). r,:s., I I•='t.T' !< 25. 01;:� »iti :I;`,i`a3
E301:3 ULJfI '(ci: :I m5r: 1 1. �_5 JH
00 ,.11.,1
!Y,s HIVY ''�IN6tt4
R 0u1L.iifl t 1. 75 JI-1
"W, R(4X1.t.3(itJ.Tr.W l.1 Ft 1 ..I"' t. ",1..0. 12101 JH t 1 /01 /1)3
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aerlit IS Its-led sub)ttt :'D the C:t"ita:t?d in ChP
"Nerd M itrioai Code, State of th-e, Speuiaita Cueec and atl other t.c;tit,. -rcjurid Ins1-1f«in cit^t in Inrp
1cab1e iar+s. All work will be riche ararov'd Or>t /Pf! 4m �:.tr�.,u.:t Wctf �r 1.. in� Iris ,
This perait will expire 0 wc`x ca wi" " 18P F'!_r!/CJr)r1l�r t' t Dp) Fa F7ra1^✓iSciwl tt I rI tiF
i 5 c' c r•1811.e. or if Murk :t c
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CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT I:IERM I T 0,. . • . . • • WFC w -O:FI.
13125 SW Hell Blvd.Tigard,Oregon 07223.8100 (503)630-4171 DATL a.S'SUi' D t 1 1/'011`;x,:
i -)RCEL» c:S I i I HA ' 0840V
AI:iI:)RL:SS. . , e k".1'3455 W MG J1\1T'A1N VIEW i_-N'
1UH1JIVISION. BRELYNN WOOD'S ZC)NING: (1--4. 5 i
. . . . . . .. . . . . .. 1.
JEifl NO. . . . . . . , . . . FIXTURE: UNITS. . . a
i. L VI:.S OF Wl:iRK, ,. ., »MOV DWF LI—I NL'i 1.1N 11*S. : I.
T'YP5 OF." UaE:.. . . . . ..GF NO. Of-BUILD.I:NGSa l �
+:N3'I'(-ALL TYPE. . . . ,VI-R"W(2
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t in irk r s MCI', I M0 IN! E ILII._t`:;+ AND ADDING P ROOM I&I SO F1'
BOB AND DINFII-1 ROGERS type atmoant, by lite
+c+7` OW RALEIC-HVILW UP i":'Ri`1T Y :Li10. ki0 J1--1 OG/25/1.1:3
IN'.)P t 35. 00 JH 00/25/93
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l ane, a+ „ �.? .:;a`.�. 660 TOTAL
,!-i. 4pp;icant ageees to ccx it with all the relies and regulations ::iewrer~ J n ipect; i un
::' the Unified Sewage Agency. The permit expires lb@ clays ft,oe
rl,e date issued. The "otal asoint paid will be fol-feitad if the
�ereit expires. The Agency does not guarante. tie accuracy of the
s-de sewer laterals, if the sewer is rent ' at the measuremert
riven, the installer shall urospect 3 '' , .ins frota
the distance given. If not so located. .__.._._.._..__ _-
a an(,. Side Sewer" Permit and the �` 4
of,t-t t a e i*i:i.W rir,a.,. '�/ �.
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13125 SW14-A box PLNCK/RLCT # �
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CITY O1 TIGARD PERMIT q
COMMUNITY DEVELOPMENT DEPARTMENT Tiprtl Orcgon 9722] !
(503)63"171 DATE ISSUED
JOB ADDRESS: fAX MAP/LOT [
SUB: f �► �l V c�O 1) LOT: " 1 ? LAND USE:
VALUAT I ON
OWNER I SPECIAL NOTES
NAME: L�1 �J REISSUE OF:
ADDRESS: ' �� LAST REISSUE:
J
FLOOD PLAIN/
PHONE: �1J SENSITIVE LAND:
CONTRACTOR APPROVALS APPROVALS REQUIRED 5tlF:;,q1 Z- Oo ( D
NAME: _ (� �� PLANNING: Y- 6, -fXAQ--CK
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ADDRESS: ENGINEERING:
FIRE DEPT:
PHONE: _— _ OTHER: —
CONTR. BOARD #: EXP DATE:
W/v/1(
' A,/ ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: i --- — LIST/SUBCONTRACTORS: ----
MECH: __— �P �( BUS TAX-
AR
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AX:ARCH ENGINEER CALCULATIONS:
NAME: _ TRUSS DETAILS:
ADDRESS: OTHER:
PHONE:
PROPOSED BLDG. USE:
COMMEN S: 3,Vie' .�h �,(C �y7 ��,�(aa(�� �/l �f � ..-•
AhpLISIGNATURE
Received By — Date Received:
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PERMIT # At;CT DESCRIPTION A,1:11JNT AMOUNT PD. BAS. DUE
Y103-0.0gSr 10-432 00 Building Permit Fees
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_ 10-431 00 Plumbing Permit Fees 35.x° _ 35.04U
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%) p Z 3 ` y 7,3
Building
Polimbing /• �5�
Mechanical / Z
10-433 00 Plans Check Fee _�7 93 / _�� S3 Z.T. Vo
Building 6 7,13 �
Plumbing
Mechanical
10-230 06 Fire
,5wR43 T3 30-202 00 Sewer Connection Zl n u ZZoo
30-441 00 Sewer Inspections _
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office 1IF Fees
25-448-01 Residential Traffic Fee:,
25-448-05 Mass Transit TIF Fees I/a
52-449 00 Parks System Dev Oarge (PDC) Sou Suu
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) ,2
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL. 775. G)" '3_ �[ 3
nm/3587P.WPF
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Ca I T'Y OF T I GARD RECEIPT OF PAYMENT RECEIPT NO. s 93--24335i?
CHECK AMOUNT 44. 53
�IVAME a CL.ACKAMAS BARKOUST CASH AMOUNT a 0. 00
'ADDRESS t PAYMENT DATE 06/1'7/93 �
SUBDIVISION 9
1 �
i1-)URPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
f=L AN CI IL C K FE 44. 53
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11ro"f At- AMOUNT PAID > 44. 53
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