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11241 SW SUMMER LAKE DRIVE - 11241 SW SUMMERLAKE DRIVE - ■ r CERTIFICATE OF OCCUPANC:Y CIT Y. 0r,-w TIGA RD CITYOFTim RD PERMIT M. . . . . . . a 1-UP892530 C Or MUNfTY UEVELUPMENT DE:ViAATMtW ORNM PRIM. PERMIT 0. 1 892330 1'1126 SW Fish Blw!. P.O.Bax 23397,'Tigard,Oregon 97223 (503)839-.175 � DATE I S S UE D a 95/23/99 SITE ADDRE:SS. . . s 1.1241 SW 5UMI0,r.:.h1.0=u'' ::C< PARCELs IS133AD-158911 SIJBDIVISION. . . . I SUMNE:RLAKE 7.ONINGi R•-7 SLOCK. . . . . . . . . . s LOT. . . . . . . . . . 13� ------------ CLASS W.' WORK. sNE'W TYPE OF USE. . . ISF OCCUPANCY ORP. IR3 OCCUPANCY LOADI TENANT NAME. . . s Remarks) DON MORISSETTE PO PDX 19524 PORTLAND OR 0064910- 0000 Ph vnrw He X100-gHPJ 0000 Contractors _....... .__.._....._._.. ---..w__.....__.._---- PON MORISSETTE BLDE.RS, INC. P 0 BOX 19524 PORTLAND OR WE 19 i IPI-ione Ox 503-620-- 71.538 Reg M. . s 35533 Or_°c'upanr..y of the elbovp referenced bi.ci lding is hereby given, and c vrti f f es the c omplianr.e with the State Of Oregon Specialty Codes for the grraccp, OCCUI)A c-y, and c.iso under which t:hv refPrenced permit was issued. FIRS. DEPARIMENI J� -DINA INCE BUILh OFFIL'TAI. POST IN CONSPICUOUS PLACE ■ W W INSPECTION NOTICE City of Tigard Building Department i P.O. Box 233,97 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested v-' Z 3 Time A.M.______— P.M. P.dress �:.l Z' y ->« `1ti i cam" Permit # _— Owner ,_ Lot # Builder — — — ----- —"��_. Tue following ?nUding Code deficiencies are required to be corrected: Prn,,entert to ----- --- ��Approved -- - Inspector Disapproved �1 Z Date — 3 ------. CALL FOR REINSPECTION � NO I YES L INSPECTION NOTICE /fes f City of Tiyard Building Department �/ y P.O. Box 23391 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection _ �_ �✓ _� Date Requested V q Time__;� A.M.---P.M. Address .._��s!�� ' _ Permi+ Owner Lot " Builder The following Building Code deficiencies are required to be corrected: v v Presented to y� Approved Il'ipector I Disapproved Date — CALL FOR RRINS.PWTION YES O NO INSPECTION NOTICE ity of Tigard Building Department P.O. Box 23397 Tighrd, Oregon 97223 Phone: 639-4175 Type of Inspection L�-) Dave Requested Time KP.M. Address Owner Lot Builder The following Building Code deficiencies are required to be corrected: 5- Presented to _ 'Approved Inspector U Disapproved C-7 Date - e I/ CALL FOR REINSPECTION DYES 0 140 A INSPECTION NOTICE City of Tigard Building Department P.O Box 23397 Tigard, Oregon 97223 Phone: 639-4175 77 -Type of of Inspection —_'61 Date Requested Time--"X A.M. P.M. �_-- Address , Cd. .c'Permit #_ Lot -- Builder — The following Building Code deficiencies are required to be corrected: Presented to Approved nspector U Disapproved Date CALL FOR REINSPECTION 0 YES ❑ NO INSPECT!ON Nr fiC City of Tigard Building Departme,t .' P O Box 23397 Tigard, Oregon 97223 Phone. 639-4175 t f Type of Inspection � �'" ..�• Date Requested'' Time. A.M. —__P.M. Address`Jr _7� Permit Owner _ Lot #T Builder The following Building Code deficiencies are required to be corrected: Presented to �pproved Inspector --Ll1t' ❑ Disapproved Date CALL FOR REINSPECTION 0YE8 ❑ NO A � INSPECTION NO-ICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 6394175 r Type of Inspection ff — Date Requested ___�T Time A.M. P.M. fsermit #� Address -__ 2 ' Lot Owner # �_ BuilderThe following Building Code deticiencies are required to be corrected: ---Ltd i?`t? ."� •L7 KI fJ �. C =�r----TD �!.)/�iii�.cI 11 J;e cif .lam-.�- -i l` i/�/S� t� �f•� ppruved Presented to ._..- Inspector (� Disapproved Date CALL FOR RLINS'PECTION ❑ YES C NO INSPECTION NOTICE City of Tigard Building Department P.O Box 23397 Tigard, Oregon 97223 Phoi 639-4175 Type of Inspet.tion � ---- Date Requested— Time A.M. P.M. Address y� �� Permit # Owner Lot Buiider 47k�-� �r The following Building Code deficiencies ere required to be corrected: Presented torrlImved Inspector -- _ u Disapproved Date CALL FOR REINSPECTION YEs CJ No INSPECTION NOTICE City of Tigard Building DepartmF nt P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection — Date Requested- '--�- Time M. Address �.�rX(� � Permit 02�� Owner_- — Builder The following Building Code deficiencies are required to be corrected: Presented to / ___._ _- --- _--- -- Approved Inspect-,r l 1 `?L, 1! �tll] - -------- - Disa -oved Datrr If --- CALL FOR REINSPECTION (� YEI ® NO INSPECTION NOTICE City of Tigard [wilding Department P.O. Box 23397 Tigard, Oregon 97223 r` Phone: 6394175 Type of Inspection �� v — —ea- Date Requested _ .S -- Time A.M. P.M. Address L�l �0'0'�' ' �� ;C� Permit # La3U J Owner _ _. _ __ Lot # - ' BuilderThe following Building Code deficiencies are required to be corrected: -Af.' +✓� PrAsented to --_ _ Ft� Approved Inspector ` = __ _.�-- �_� Disapproved Date CALL FOR REINSPECTION 0 YES 0 NO INSPECTION NOTICE Citv of Tigard Building Department P.U. Box 23397 a— Tigard, Oregon 97223 C � Phone: 639-4175 Type of Inspection — ----_- 2, / Date Requested _ . _ — Time�`— A.M._ P.M. Addresses�lL _ Permit # Jpr Owner __- _ _. Lot # Builder The following Building Code deficiencies are required to be corrected: a i ?resented to � _ � Approved Inspector / r] Disapproved Date CALL FOR REINSPECTION O YES El NO INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 7 Type of Inspection Time.�—A.M. P.M. Date Requested_ Q Address Owner Lot # __ ._ Builder n The following Building Code deficiencies are required to be corrected: Presented to _ AA1P' Proved Inspector �_ isapproved Date ::�:L ---+�—�— CALL FOR REINSPECTION 0 YE8 ❑ NO ss INSPECTION NOTICE City of Tigard Building Department N P.0 Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection _.— Date Requested Time. //A.M. P.M. Address __��_ � _ �--P`rmit Owner Lot #--- -._---_ Builds( r�� I/I�t 0e-1The following Builriing Code deficiencies are required to be corrected: Presented to . -- Approved Inspector [_] Disapproved Date 4e CALL FOR REINSPECTION [] YES L_1 NO MECHANICAL. CIIYOFTIFARD L PERM l:T CITX7FT COMMUNfTY DEVF� RD PERMIT N. . . . . . . : MEC89257O,�PMENT DEPARTMENT � ortaooN 13125 SWHWIBlvd. r.O.Box z3s7,nqws,Oregon 97n,tWie }�6 / PRIM. PERMIT #. ."#. ." 89253O ---- ----------_ ___-- - - - DA1 E ISSUED: O2/22/90 SITE ADDRE:i:; 11.241. SW SUMMERL.AKE DR PARCEL.. 1 S 1.3,3AD.•..1.513OO SUBDIVISION. . . . : SUMMERLAKE y ] ZONING: R--7 BLOCKa 1_07 . . . . . . . . . . . . . :39 .............._..__.._........._.._....____.._............._....._......._...._.... CLASS OF WORK. . I NEW FLOUR TURN. . . . : E.VAP COOLERS;: TYPE OF USE. . . . :SF UNIT HEATERS. . .' VENT FANS. . . : 2 OCCUPANCY GRP. . e R3 VENTS W/O APDL.: VENT SYSTEMS a STORIEi. . . . . . . . . :l BOILERS/C:OMPRE"BSORS HOODS. . . . . . . : 1 f'UF:I.. TYPES _..._.........._.._._.._..___._. 0-3 HP. . .. . DOMES. INCIN: :GAS 3--15 HP. . ,. ., ;, COMP1... INC:IN: MAX INPUT: 141 U 1 30 HP. . ,. ,. ;; REPAIR U11ITS: F'I RE:: DAMPERS7. . : 30 50 HF'. . ., . WUODSTOVES. . : GAS PRESSURE. 50+• HP. „ r CLO DRYERS. . : NO. OF UNITS -_.._._._.__._.... AIR HANL'L.:ING UNIT'S OTHER UNITS„ e 2 F'URN < 100K k:+Tl.l: 1. <:::: :10000 r_i m: GAS OUTLETS. : 1. TURN >-1O0K BTU: > 10000 cfm: Remarks: DUN MORISSiETTE type anIOUI-It by date •rec:pt: PO BOX 19524 PRMT $ .10. 00 MAN PI._CK $ 9. 38 MAN / ! PORTLAND OR 00000-.•0000 5PCT $ 1. 88 MAN Phone N: 000...000-•0000 F'RMT $ 27. 50 MAN PAYM $ 48. 7G .TI._H 04/2O/90 Cantractorc I P.:A_L_ HEATING INC 1.5550 SE PIAZZA AVE:: i CI_.ACKMASi OR 97O15 _..................._.__.__._.__...._..__..____..__..__.._..__..___._.. ... C,Fic:111e ##: $ 48. 76 TOTAL. I;;e g 0. . . 4 47 ......_._.._._.._-.. ' _.._..__...._....... Ihis pewit is issued subject to the rejulations contained in the REC�UIRED INSPECTIONS Tigard Municipal Code, State of Ore. Specialty Codes and all other _ applicable laws. All work will be done in accordance with approved plans. This pereit will expire if work is not started within 180 days of issu,nce, or if work is suspended for more ._.._...__ �. __._. _.___.____.. .____. __..___. than 1AN days. .._ Permittee Sig natu'r•e9 I si s t.x e d B y tt C.411 far irIsper•timi - 639--4175 ■ SEWER CONNECTIC)N CITYOFTIFARD APERM I T QqY0F TWO PERMIT b. . . . . . . . SWR892511 COMMUNITY DEVELOPMENT DEPARYMENT 0016011 13126 SW Heil Blvd. P.O.Box 23397,Tigard,Oregon 97223 4176 PRIM. PERM11 892530 GJ 1 'LaroLIED: 92 9 W SITE'. ADDRESS. . . 1 11.241 SW G1J111ME;'RLAKE DR PARCEL.- L.- IS1330D 1.5800 SUBDIVI ;ION. . . . : SUMMERLAKE ZONING: R--7 BLOCCK. . . . . . . . . . .I LOT. . . . . . . . . . . . . .39 TENANT NAME'.* * USO NCI. . . . . : : : *;40466 FIXTURE UNITS. . . CLASS OF WO« K. . NEW D W E L L 1'.NUNITS. . . TYPE OF USE. . . . . SF NO. OF BUILDINGS: 1. INS144.1. TYPE BUSWR IMPERV SURFACE:. . : -sf Rema-rks DO11 MORISSETTE type anloLtilt by date r e 1--'O BOX 1.9524 PRM $ 35. 00 MAN F RMT $ 1250. 00 ITION I"ORTLAND OR 00000 0000 PAYM $ 1.285. 00 JI...H 04/20/90 Phone #,-, 000--000-0000 Caritractar.- DON MORISSETTE PLDE-RS, INC. 1-', 0 BOX 19524 PORTLAND OR 97219 Pliarie 0- 503--244---931.4 $ 128`,.00 TO 14)1.. 135533 REOUIRED INSPECTIONS This Applicant agrees to comply with ail the rules and regulations ...................................................................- -.-.............. of the Unified Sewage Agency. The permit Pxpires 120 days from .......... ..................... the date issued. the total amount paid will be forfeited if the .. ................ �.)Prmit expires. The Agency does not guarantee the iccurary of the Side sewer laterals. If the Sewer is not located at ��p 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 he Agency will install a lateral. P P-r,m J.t t e e G i q 11 a t U'1'0 ................ 1-3 S U ed R y C a i I f c)-r irispect:ic)vi 639-4175 � +� w■► � Iw � � felr elf eee � CITYOFTIFARD BUILDING F!ERMI'T GIIY0F1WARD I.'ERMIT #. . . . . . . : BUF'Ci`2530 COMMUNITY DEVELOPMENT DEPARTMENT ONGWOr PRIM. PERMIT N. : 6' 2530 13126 SW lull Blvd. P.O.Box 23307,Tipud,Oregon 97223(6 j+��.7 D A'T E ISSUED: C2/22/90 11241 SW S3LIMMERLAKE DR P'ARCE:L I I S 133AD_..1."Z!� 00 SUBDIVISION. . ., .. SUMME:RI_AKE. ZONING: R--'7 1:tLOCK. . . . . . . . . . 7 LOT'. . . . . . . . . . . . . I.39 .............. .. REISSUE.-BUP FLOOR APF'A6..__..__.__.„.._._.._._ EXTERIOR WALL CONS'T'RUC'T'ION-- CLASS OF' WORK. .-NEW F-IRS'T'. . . ,. -. 1 78") Sf N: S: E: W« 'T'YP'E OF USE:. . . ISF SECOND— . % $f PROTECT OPENINGS'?- 'T'YF'E: OF CONS3'T'. :5N 1441RD. Sf NI S: E: W- OCCUPANCY GRP'. IR;3 I'D I'AL ., Sf ROOF` CONST:C FIRE RE:T'' OCCUPANCY LOAD: BASE::ME'N1'. : Sf AREA SEI-'. RATEDa S'T'OP:. : 1 HT. : 1.8 It GARAGE. . . It 400 sf OC:CU SEP. RAPED: 14 13MTMEZZ'): RE:. D SETBACKS-._.-.......___.-._. IRE CILIIF�ED __._.._..._._._.._._.._...._...._....... .__ _ F'L..DOR LOAD. . . . : 40 ps f LEFT e 5 ft FIGHT: 5 f t FIR S PKI_I SMOK DET. . :Y DWELLING UNITS', I FRNT:20 ft- IREAR:25 ft FIR ALRM: 11NDICP 0C;C. HF:DRMS1 3 E40IHS» 3 IMF' SURFACE. PIRO CORP: PARKING: VALUE. $: f3c':3;311 RemarF+.s: (awripra ..._._....._._.._......__._....._..._._....._..______..__._._......_.�_ ..__ _._._ __...._......_..__....__..__...... F-E::E S UClll MORISSE:TI'E type ameaa.(nt by date recpt 1.1) 1:.4OX 19524 PRM'T $ 382. 00 MAN PL..CI; $ 248. 30 MAN PORTLAND OR 00000 0000 5PCT $ 1.`:7. 10 MAN Phc)rie H I 000 ..000. 0000 PAYM $ :100. 00 MAN SSDC $ 250. 00 MAN C:rarit•ractor I -_._......_..__w.__._..___....__....__......___....._.._,....._.._._...._....._ STDC $ 600. 00 MAN DON MORISSE'TTE BL..DE:RS, :INC. P'DCF $ 250. 00 MAN 1`! O BOX 19524 4 PAYM $ 1.649. 40 JLH 04/F-0/90 POR'T'LAND OR 9721:3 P'hicarie N: 503-244-9;31.4 $ 1749. 40 TOTAL 35533 REQUIRED INSPECTIUNS This permit is issued subject to the regulations contained in the tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. Ali work will be done in accordance with approved plans. This permit will expire if work is not started within 188 days of issuance, or if work is suspended for more than 188 days. ____....__.____.._._ __..._ ..._.._. _.....__._.._.._.._.._.._..__._ I'ii mi 1,f;r•.>ea �,i.gnatci•re,« 1.ss s,a.i e d B y: ._..... ._. Call for ia•aspeetic7ai 639­41.75 ■r w Ir CITYOFTIGARD PLUMBING PERMIT C17YOF11 rIT�RD F'Imf;MIT N. . . . . . . : PLMS92569 COMMUNrTY DEVELOPMENT DEPARTMENT oReooN 1='RIM. F'ERMI'T N. : 892530 13125SWFWIBlvd. P.U.Box 233D7,rb..d.or °r oa�frs ►jie DAIS ISSUED: 02/22/90 SITE ADDRESS. . . : 11241 SW SUMME:RI_AKEF. DR PARCEL: 1S133AD.-:15800 SUBDIVISION. . ., .. : SUMME:R1_AKE ZONING: R--7 BLOCK. . . . . . . . .. . . LO'T.. . . . . . . . . . .. . . ::39 CLASS OF' WORK. . sNEW GARBAGE DISPOSAL_':;,. . ; :I. MOBILE HOME SF,ACES. : TYF:'E OF USE. . . . :SF WASHING MACH. . . . . „ „ 1 BACYFLOW r-'REVNTRS. . : OCC:UF'ANCY ORF'. . IR;3 FLOOR DRAINS. . . .. . . % TRAi'5. . . . . . . . . . . . . . . STORIES. . . . . . . . : 1 WATER HEATERS. . .. . . . : 1 CATCH BASINS. . . . . . . : FIXTURES----- LAUNDRY TRAYS. . . . . . : SF" RAIN DRAINS. . . . . : SINKS. . . . . . . . . . . 1 URINALS. . . . . . . . . . .. .. .„ GRE-ASE TRAPS. . . . . . . . LAVATORIES. . . . . s 2 OTHER FIXTURES. . . . . : 'IUB/SHOWERS. . . . : 2 SEWER LINE: (ft) WATER CLOSETS. . s 2 WA'TE'R LINE:. (ft) . . . , : 1 1)1SHWASHE:RS. . . . : 1 RAIN DRAIN (ft) . . — I Owner: -_..____.__..___w_._,.._._.__...__.-._.__._._._..___...._.._._. __._.._.._.__..___.____._._....__.... rF:ES DON MORISSE:TTE type amount by (1<:.Ate recpt PO BOX 1.9524 PRMT $ 117. 50 MAN / / SPCT $ 5. 88 MAN / / PORTLAND OR O0000 0O0E, F'.'AYM $ 1r:3. :38 J1 O4/i?O/`0 Planne #-. 000-000-0000 Contraetcir: SHOE MAKER' S PLUMBING F, O BOX 250 ESTACADAOR 97023 __..__.__.___....._._....____._.__..___..._.._....._.__..____._._.___._._._. PFiane tt: :5O3-6 3O-7728 123. 38 TOTAL Reg W. . '561:315 _._._....__..__ REQUIRED INSPECTIONS ....................... This permit is issued subject to the regulations contained in the Tiqard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with Approved plans. This permit will expire if work is not started _.____ ....__._ .._.___._.�..._... within 189 days of issuance, or if work is suspended for more than 180 days. I'ermit.tH(- Si.gnat(.(•re; I riLl( (� By- Ca 11 for ins;peet1on - 639-4175 M CITY OF 71GARD PECEIFT OF' PAYMENT PEC Nth C01074,38 CHE0 AMOUNT 106.54 NAME. DON MOR ISSE TTE CASH AMOUNT n .00 ADUPESSi PAfMENT DATE t 02-22-90 PORTLAND, OR 97219 BLOCK NO/ADDRs 111241 SW SUMMEPLAVE DR PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID SUILDING PERMIT (8921530) 3>82.00 PLUWAING PERMIT (892569) 117150 MECHANICAL PERM (892570i 37.50 STATE BUILD PERMIT TAX (5%) 2h.E)13 PLAN CHECK FEE 157.68 SEWER USA (892571) 11250.00 SE14ER INSFECION 3'.3.00 STREET SCLC 600.01) PARRS sysTEM DEVELOPMENT CH 2511.00 GTOPM DRAIN SDC 250.011 PEPTUT WILL PE MAILED TO CONTRACTOR' WHEN PPINTrm TOTAL AMOUNT PAIL) •■ w C11YOFTIOARD � a �» PLAN CHOCK APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT ` PLAN CHECK N I j1n S.W.No Blvd..P.o.mor Z3"?,Tigard,Oregon sTm,(Sttr)639417S PERMIT N -1YT�aT Dl1TE ISSUED TAX MAP/LOT -r�L �3 �� foZ JOB ADDRESS: l Z4 I C - LAND USE: SUB: LOT'o SP - - '— VALUATION: g -- SPECIAL NOTE MEOWNER ^_. 0111:44- r � W' I?t�;�,� I l,' REISSUE OF: - _ -- r-� .0 1.4 LAST REISSUE: ADDRESS: FLOOD PLAIN/ 2r cxt �j zr � — __.r^ SENSII IVE LAND:-33 PHONE: _ `" -�) `� �� 5 APPROVALS REQUIRED PLANNING: _ —_— CONTRACTOR ENGINEERING: NAME: _ FIRE DEPT ADDRESS: — OTHER: - ITEMS REQUIRED PHONE: c LIST/SUBCONTRACTORS: BUILDERS BOARD N: EXP DATE: /L f,'J -- BUS TAX: _- ARCH/ENGINEER CALCULATIONS: NAME: _ - i (1 TRUSS DETAILS: ADDRESS: __-_- OTHER: _ -- -- PHONE: - S COMMENTS: SUBCONTRACTORS: PLUMB: ;, PERMIT N ACCT N DESCRIPTION AMOUNT AMOUNT PD. BAL. D.UE 10-432 00 Building Permit Fees - l S 0 S �,y 10-431 00 Plumbing Permit Fees y 7y 10- 431 01 Mechanical Permit Fees - j 10-230 01 State Building Tax (5%) Building /,k Plumbing _ 5 Mech /- 10-4--3 10-4--3 00 Plans Check Feeel�, jv Building - Plumbing 5 7 30-202. 00 Sewer Conrirction ` ��5 30-444 00 Sewer Inspection -- ' 51-448 00 Street System Dew Charge (SOC) 52-449 00 Parks System Dew Charge (PDC) -- 31-450 00 Storm Drainage Syst Dew Chrg (SSOC) S U 10-230 06 Fire TOTAL A—pp 41a, NATURE Received By: Date Received: cn/3507P/18P 1 � �tD APLAN CHECK APPLICATIONITY,0F TI6Ar p arrorticxa' PLAN CHECK N COMMI:"NI TY DEVELOPMENT DEPARTMENT �� 1 PERMIT N __ 99 zze;/�- 13125S.W-f4AB1.Q•P.O.Box 23397•T1grd..Oregon 9=1.(503)63"175 G, / DATE ISSUED rI / ZQ JOB ADDRESS: `_ v>w ✓ 1 _.� i AX MAP/LOT - � _ IM (r4 4 I SUB: V1,1 4_ I"- _ LOT: ---- LAND USE: — VALUATION: - — OWNER SPECIAL NOTES P ,� INIUR NAME- l s ( REISSUE OF: -- ""---- — ADDRESS: U O 2 LAST REISSUE: — _ FLOOD PLAIN/ SENSITIVE LAND: w ,- PHONE: 3� APPROVALS WNTRACTOR PLANNIN - NAME: �_NGIN _RING -- RE EPT _ ADDRESS: 0 HER: r _ _— PHONE: ITE S R IREO LIST U ACTORS: AROVENGINEER BUS TA NAME: ` M "1` I L � CALCULATIONS: _— TRUSS DETAILS: ADDRESS: PARKING PLAN: --_ -- - \ LANDSCAPE PLAN: PHONE: _ OTHER: --- COMMENTS: ( -1' �'-L Cc' PERMIT N ACCT N DQE ,AMTON AMOUNT AMOUNT P0. BAL. DUE 10-432 00 BuildiN Permit, ees _ - — __ 10-431 00 Plumbing it Fees �- 10-431 01 Mechanical Permit Fees — 10-230 01 State Building Tax (5X) Building Plumbing Mech _ - 10-433 00 Plans Check Fee AF � Building %44:M 11' PCr Plumbing cl Mach — 30-202. 00 Sewer Connecti(%n 30--444 00 Sewer Inspection _ 51-448 00 Street system Dev Charge (SOC) 52-449 00 Parks Sysl:em Dev Charge (PDC) 31-450 00 Storm Drainage Syst Dev Chrg (SSOC) 10-230 09 TRIO - 10-230 06 Washington County Fire N1 (95X) l- 10-220 00 Amara/Wodgewood - RIC N i �` �u �7_ { -r CI APPI_ICAN1 1(,I1n111RE C c / SU cc, Received Hy . 7,�Gt.J _ Date Received: — S'i Q 3 y 1 q Cn/35BIP/101' 1� CITYOFTIFARD PLAN CHECK APPLICATION PLAN CHECK N 3 COMMI INITY DEVELOPMENT DEPARTMENT o.�ooM PERMIT N 19125S.WNNIMod,P.O.Box 23.197,Y19.nkOrtVm97223,(903)&W417S DATE ISSUED JOB ADDRESS: I ( e.-11 S_G-�. . S V L�.N Q t'a 10(L— i AX MAP/LOT `.UB: Suj,'p7ywe., L4tQ-1 LOT: ;,� _— LAND USE: 7P-y _ VALUATION: OWNER /J SPECIAL NOTES NAME: ��5�� 1Clrs �l1 REISSUE OF: -- ADDRESS: —_ ` > 5 . 2!j LAST REISSUE: FLOOD PLAIN/ --l--�� _ SENSITIVE LAND: PHONE: L1 -L --- APPROVALS. REQUIRED CONTRACTOR -'~ PLANNING: _ NAME: ENGINEERING: —_ ADDRESS: _ ('IRE DEPT PHONE: IT :-REQUIRED T/SUBCONTRACTORS: ARCH/ENGINEER BUS TAX: —NAME: -- --- �� _--_ CALCULATIONS: — ADDRESS: TRUSS. D11--TAILS: PARKING PLAN: LANDSCAPE PLAN: PHONE: OTHER: COMMENTS: PERMIT N ACCT N DESNIPT. N AMOUNT AMOUNI PD. HAL.. D01. r0 3 l 10-432 00 Building � L 10-43100 Plumbing Perhv► t Fees ,1JC1L f 7 10-431 ,01 Mechanicol Per 't Fees 10--230 1,11 State Bui ;ding 1 x (5X) Building '[�, C� �� 3p 3�� 3n Plumbing - Mech o� 10, 433 00 Plans Check Fee B u'l' 4-nq-— 4I .� 15 Plumbing ___ Mech 10- 202 00 Sewer Connection Jry, 30--444 00 Sewer Inspection 51-448 00 Street System Dev Charge (SIC) 52-449 00 Parks System Dev Charge (PD(;) �Sp_ __ V 31-450 00 Storm Drainage Syst Dev Chr•y (SSUC:) 10-230 09 I-RFD 10 230 06 Washington County Iire N1 (95X) 10-220 00 Amar•t:/Wodgewood TOTAL RE C N APPL_. SIGNATl1RE -- -- ---.--____----_ __ L '� keceived By: %t .l Date Received: cn/3587P/18P -- -- — - ----