12621 SW SPRINGWOOD DRIVE 12621 SW Springwood Dr.
1 y '.e �,�,,�e _'-"'��'�- w. ,� L.>t fon+ --+:� T'•_ � t
i � �'L'��'+RL% ;..1Y �.�� i-�C'j i wr �'Svy,9.s �; j �... � .. � ct _„"C.� •�...Y �fY'ti 't���il
� --�„� � � .. �-: �_ 3-:� ..•-�'._— �r�,:r.�r�, �x•s�_�y�y" ,.yam may{'} �y1��, l� ,
1` •.r �ti of ...rrJ� Si �r� - �i 'R� �iq~~ - ti
�Pw
> CAS0C -CyC 4
CITY OF TIGARD
OREGON
{ BU8907a3 t>
Owner: Don Morissette Permit No. '
> ` Address: P.O. B-..)x 19524, Portland, OR 97219
�
12621 SW Springwood Dr.Building Address:
Occupancy: R3 Land Use Zone R7PD Bldg. Type N �_��Vi �
Comments:
Certificate is hereby given this 25th day of August ' 1989
� �►:��
id b
that said a and that it complies wa ': • ``<i'
g my be occupied lwith ied P P
requirements of the Building Code for the City of Tigard, as approved
3t5�i by the Tigard City Couaeil.
• �\
'�•"� � -�_
Fire Dept. �FFYY J� Building Insp ,
Buil ing Official'
': . P _ Certificate in Conspicuous Place = '
( ,
,dIF W
SL
't=\1 '� is 4-
h
(i1 ',, • i{J
` �P�_.�_,r+':� Y �(j - - � � Y--i3• V, lL��\/� ................
ar
'�`>.`!7 � � s1 W.,,.'*.+",.. `' X11 -:. W.�� �`��y ,. 40
�-.i1d. a' _ •-rl
iS'" //' '•r tea' . I �'^+i Jw�� '.i•fr• JWP.'/ 1'.i _ A'" _ •Pf•'.rly. u rr ...
7'r" ' �. �•tYAf .i:'• Qq, t�.W �+�q•,,', Ste' .�y� �¢ .\- rf 1V'•ti
�p • �W.r'�.� S!'t � i YF,�,��?_ *- ; --•.��
1 ,� •� � �"+�;,r'",�� �`� r' `�1��:�w�al��.' '��,r'��•.a,,��„a���.��,��„ny�� �..�•r�„r0�r✓�C4w`• •5�.�•'�,�"4}r,�. .Si i
INSPECTION NOTICE
City of Tiga:d Building department
P.O Box 23397
Tigard, Oregon 97223
Phone 639-4175
L �
Type of Wspection —
�f c �—
Date Requested Time �,/ A. .M
Address �!_��'�/ - �'ZL c �trZ'7�[ Permit _
Owner _ Lot #—
i
Builder --- 27
t'
The (following Building Code deficiencies are required to be corrected:
Q �
Presented to
Approved
Inspector ._.. _ Dlsepproied
Date
CALL FOR REINSPECTION
❑ YEb ❑ NO
INSPECTION '90TICE
City of Tigard Building Dp.partmpnt
P.O Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Tvpe of Inspection es-
Date Requested —,-2 if Time A.m
AddressP.It
Owner Lut
Builder Z2
The following Building Code deficiencies are required to be corrected:
f
Presented to ❑ Approv(,d
Inspecto- Disapproved
Date
CALL FOR INSPECTION
YES NO
9 LEA EX
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23391
Tigard, Oregon 97223
Prone: 639-4115
Type of Inspection
Date Requested `� _ Time A.M. P.M.
Address _ L4;�4.C.t=Fr�'� Permit
Owner ,,. _ _ Lot It
BuilderThe following Building Code deficiencies are required to be corrected:
Presented to -� �71 Approved
-�' oL/
Inspector �_. __ _, Lj Disapproved
Date 12— --
CALL FOR REINSPECTION
0 YEB L) NO
INSPECTION NOTICE
Cit; of Tigard Building Department
P.G Box 21.1q7
Tigard, Oregon 47223
Phone- 639-4175
Type of Inspect;on
(late Requested _ �a k Q Ti a A.M. P.M.
Address _- -_lel"� •� / � ��g ��Q _ rmit #t
Owner - Lot # _
BuilderThe following Building Code deficiencies are required to be corrected:
Presented to [1 Approved
Inspector �- ❑ Disapproved
Date ---
CALL FOR RF,INSPECTION
❑ YES ❑ 140
Ill_: ECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection _._Z1;
. _ _ �G� 4.�
Date Requested Time___
ime__�__ A.M.----P.M.
Address Permit # c��
Builder —. -------
The following Building Code deficienc;..., are required to he corrected:
Presented to Approved
Inspector Disapproved
Date
CALL FOR REINSPECTION
0 vEa 0 No
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 631)-41 75
Ty-e of Inspection
Date requested_ `" �.. I�e - _P.M.
i �p rrr
Address Permit #� -A0-
Owner - - ----- ------ Lot # ----
Builder —
The following Buildinq Corse deficiencies are required to be corrected:
Presented to --.._ Approved
Impactor - ` -------__--�— L Disapproved
Dale —
CALL FOR REINSPECTION
I� ❑ YES 0 NO
INSPECTION N01 ICE
City of Tigard Building Department
P.U. Box 23397
Tigard, Oregon 9722.3
Phone: 639-4175
Type of Inspection
Date Requested,_,___, _— Time_� A.M.__._ P.M.
Address --- Permit
Owner- --- _ Lot
Builder —
The f)llovvin- Building Code deficiencies are required to he corrected:
Presented to ---T-- _ _-_ _-__-__-_-- FrApfrroved
Inspector _�1�%7__�___ _ _ _ C� Disapproved
Date
CALL FOR REINSPECTION
[�] YEa 0 NO
INSPECTIGN NOTICE
City of 'Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection t-'` �• -�-� -
Date Requested Tims A.M. < P.M.
Address ___ _ Permit # L'z
zJ
^
Owner _ Lot #
Builder ----
The foA11 wing Building Code deficiencies are required to be corrected:
Map
` 0 -
- _ - Yj
Presented to Approved
Inspector — r I_� Disapproved
Date
CALL FOR REINSPECTION
L] YEe O NO
INSPECTION NOTICE
City of Tigard Building Department /
P.O. Box 23397
Tigard, Oregon 97223 i
/,,Phone: 639-4175
Type of Inspection _�---1- -4-
Date Reauested_ — �� �l Time A.M. P.M.
Address _ 4�4' 4a"::�, � C-e, Permit
OwnerLot #
Builder
.!1'I .�� �---
The following Building Code deficiencies are required to be corrected:
C�
Presented to _ — _ f"1 Approved
Z77 Inspector �— ❑ Disapproved
Date _
CALL FOR REINSPECTION
[I YES L] NO
May 30, 1989 C11Y OF TIGA RD
Don Morinsette \ OREGON
PO Box 19524
Portland, Or
97219
i
RE: AMART Chayes
Dear Don,
Our records show that 1111ART has been paid in full. The . ollowing projects
reflect an over payment tc this account, and subsequently a refund has been
requested.
Building Perm)t 4
12650 SW Springwood Dr. 350.00 890403
11209 SW Suruner Lake Dr. 360.00 890177
127'}`+ SW Sorrel Dock Ct. 360.00 890398
12665 SW Sorrel Dock Ct. 360.00 890402
12654 SW Sorrel Dock Ct- 360.00 890803
13270 SW Laurmont Dr. 360.00 890404
13045 SW Tamera Ln. 360.00 890384
12756 SW Sorrel Dock Ct. 360.00 890401
12701 SW Sorrel Dock Ct. 360.00 881733
11312 SW Summer Lake Dr. 360.00 890796
12621 SW Springwood Dr. 360.00 890798
12663 SW Springwood Dr. 360.00 590799
Total $4,320.00
All pending projects have been adjusted tj reflect this change. If you have
aiy questions, regar_dirig this matter, please contact me at 639-4171 Monday
through Friday 8:00 pw to 5:00 pm.
Thank you,
Ile
ancy B. White
Building Permits Clerk
13125 SW Mall Blvd.,P.O.Box 23397,Tigard,Oregon 97223 (503)639-4171 ------------- ----
Y
INSPEG'fSpN NOTICE
City of Tigard Budding Department
P.O Box 23397 I
Tigard, Oregon 97223
Phone: 635-4175
Type of lijsaection C G
A.M. —_P.M.
Date Ryquested r
/ / 1
Address _��C.,i v�(x Permit #
�Z.�-� i
Lot
Owner
Builder 1 - ��.-� � .------- -
The following Building Code deficiencies are required to be corrected:
Presented tk, — / - --I Approved
Inspector — i 'J _----- C� Dis.noroved
Dite
CALL FOR REINSPECTION
[] YES ❑ NO
i
i
2
i
�CuF INSPECTION NOTICE
City of Tigard Building Department
r P.O. Sox 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested '!L _SZL_ Time A.M._-��r4 P.M.
Address ,` t i:2 ���r�C-%��i L C��aCJ� Permit
Owner _ Lot
Builder -------
The fo4owing Building Code deficiencies are required to be corrected:
or
Presented to ; Approved
Inspector /<h't 7 ---— 1't Disapprove,!
Datil
CALL FOR REINSPECTION
14--'48 ❑ Pjo
y.
F )T I DIM,' 1:'I::.rlMl' f
l::'I:::PM'.L V NO : Eftk 0390 798
C�TYOTIGARD
cm a
COMMUNITY DEVELOPMENT DEPARTMEN r DAIF 15/1. a/89
13125SW Hall Blvd.P.O.Box 23197.Tigard.Oregon 91223,(503)639A175 P111 M• PM 1' . NO k-390 75tH
JOD ADI)NIESS : 3.26e.2.1. SW 51'RJ"N(,',W(:)O0 DP
TAX M(-1P:'/I-U*T' V'J. 33AD :1.15900 SUB: SUMME'PLAKE LT :8 HK :
LAND U51::' : P71:)I:)
VALUATION: $ "el.''el
P:*PON'T*: 20 PEAR: 1.C
WORK (J ASS : NEW DWELL .t.JN:I*. T 5 : 1 5 PIGH'T : 3i-.'.
U5k.:'. 'TYPE : SINGLAK FAWEL.Y NO . DE.11311:4.31OMS : 3 EXT . WAI L CONST :
C'ON%1' . 1'f1A::: VN NO. 131A'1'1-111:1 : 2. N 5 E W
OC.GUP.UPP . : P43 P14101 . UP17.:NTN(.,S :
UCCUP .LOAU N S : E : W
TOTAL A14EA : 1.::175
NO. STORIE"S : I I S'T' : 1.57 5 r4(:)UF GONGT : G FT PE RE 1"?
HET W+T : :1.(11 PNI): nPEA SEPAW? NATED:
OCCLA". 5l:-rPAPl? RATED:
MEZZANIN!:i"? RASE E M I I
1:A-11fXR -110 GAPAGE: 376 P"IPE SPAKLP? ALARM'?
FL(JW(UP 11) YES
VlFil'0' GAS 1-11)011 .ACM.KSS'? C(7RP7
PLAN (*'HE"Cl< RY : 1--1-t
1:4-:'MARM, :
1--k.)d JAI-lif-lu F.Ixtvy vc1l.)y PEISSUE: (IF NO .
m c)n j:s is I: T T r= DON l"'U'AM 3:T 113416. 00
N P C) OUX 19!52'ri P LAN PEVIEW $'010 . 00
m ll-1 t 1.at.ii d to I', IPE Ul:'*17'1*
TAX 1017 . 30
UTHEV-tl $15 . 00
lA'.:'V1i--.L.C)PME:N1 (:,HAP('.;F'.:S .
0 M01"413'.SGEA-M.: DON SIM( S'TORM) It I.?")0 . 00
N
T T 1) OINE
UN MPPTTE 9LJ3:l 1)1*-::RSi T.W . S0111( !:0'PF.:E1') 11c,00 . 00
FR p cl BOX q,23() . 00
A
C 17 ri I,Ill.1%1')d co r 9,721.9 < 11111110 00>
T PHONE (,"503) 2441-931,e4
0 0
R REKCA*.�-OPATION W." :3.".15 3:.3 TLYT AL : 1!T 8.Z'
PE137".1PT No .
This permit Is issued subject to the regulations contained in Title 14
of the TMC, State of Oreocin Specially Codes, zoning regulations 1:4F-(4tj1:PED INSPECTIONS
and all other applicable codes and ordinances and It is hereby
aqreed that the work will be done In accordance with the plans and F 00 T•1•N1.' 5EWER
specifications and In compliance with all applicable codes and 1::'0LJNl)ATTON WALA IIAIN UPAINS
ordinances The issuance of this permit does not waive restrictive E)F'f)M
WAI'F:-*P 1 :1 NE
covenants Contractor and subcontrReto , shall have current city PLA) . k.JN1)l;.A:41*31-.W.') CA' TY f,I'-'P Al C H SW
busin-iss tax permits This permit will expire and become null ar.d 5 L.A r-.3 FT'NAI
void if work Is not started within 180 days,or if work is suspend,-,d or PL.8
abandoned for a period of 180 days any time after work has
commenced It bliall be the responsibility of the permittee to asaute. F11AMINC'
ed
all required ' actions are requ d and approved
re"
GA I I NE
1:NSUL.A'T*T':)N
GYP - ROARE)
Pelmitte naitire
o
Issued Dy PAI 1 FOR —f.HS 104H —6510 10411tTri
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
P1_UMB*LN(3 PI.*::WM'.1:'T
PI;:_'AM17* NO . : F'11_8901365
CITY OF TIGA RD
CORD
COMMUNITY DEVELOPMENT DEPARTMENT D(VVE. ISSUED: .5/1.2/69
13125 S.W.Hall Blvd_F 0 Box 23397,Tigard.Oregon 97223.(503)639-4175 V'RJ:Ijv1. F)M7'.NO . 890*798
F'i ADDRESS : J.k-2621 SW !'51:*'1:0:N(;WO(11) Wil
1 AX MAP/1 01 I.S1. 3 3A 1.5900 SUD UMME'PLAKE., LJ :F) 8K :
I AND USE: . 11471011
1._011, SIZE:
.r. r NO : NO:
WORK CLASS : NEW WA: ri F
USE !:iJ.'NG'I_E* FAMIA.-Y RKF's_(JW PPVN*1'1.1
CONSTAYPE: : VN I AV(:)PA'1'(:)AY
O(XLJP . ('.;PP. : 1:43 '11.18 UHOWER
VISHWASHEP
GARBA(AiK I):l:51::,O!iAI I.
NO. !5l'OPIEKS: 3. WA!:iHTN(.-, MALH].Niii: I
L)WEA.A.— UNI'T'S : I I.-AUNIA'-4'Y '1*14AY HLDG. DPAIN 11 D:EA
51NK SEWRA (F"T')
WA*T EA S'T*OPM/RAXN (F"T 1.
C)THEA
r4FMAP1<5
FEV:!:i :
0 Manx E; DON VIE341110111, $111 50
W
N )1143 1-.4(:)X 1.952-1
E 13 C)r-t 14111-1 d tar V T X'1'Ili f. 5
I A TI: J A X $3 .
I FIER
C
0 Cil-.110L.MAKEA HAPOLA)
N
T PLUMB1W.,
R 1:)t:1 13 C)X 12 5(41
A
C ri?vi i.1!w ncl at tor, 19i'Ocl.',
T PHONE'. (!`503) 4l,30-1712.113
0
R 14F.*-'(-')'.I:!;i'Y'I:�(-)I*:I.(*)N NO. '39P.P. 'TC)TAL : tM J.P.3. 30
PECL:I P T' NU. )
This permit is issued subject to the regulations contained it -tie 14
of the TMC, State of Oregon Specialty Codes.zoning regu )"'
and all other applicable codes and ordinances, and it Is I9by
agreed that the work will be done in accordance with the plans and PLD •LJNEA.:."'Sl A Ili.?
specifications and in compliance with all applicable codes and & 8EA.-i
ordinances The issuance of this permit does not waive restrictive WA*T*F.;:r4 I I ML
covenants Contractor and subcontractors shall have current city
business tax permits. This permit will expire and become null and
void if work Is not started within 180 days,or it work is suspended or PA1.11N DRAT.N5
abandoned for a period of 180 days any time after work has
commenced. It shall be the responsibility of the permittee to assure
all required In tions are requested and approved
required in tions
Permittee Sill ature
Issued By HS PF 49' '
6A9
SEPARATE PERMITS REQUIRFED F-OR WORK OTHER THAN DESCRIBED i5_-_01VE
MLJ-IAN1(:,AI PENIVIT U
I*-'I;;'1RM:IT O
N . Ml:-*:8H
9066
CITYOF T117ARD ( CITY.OFIIGAltr
COMMUNITY DEVELOPMENT DEPARTMcNT OR10011 5/1.2/89
13125 S.W.Hall BIV,4 11 0 ri,x 23397.Tigard,Orrgan 97223,(503)639-4115 1::'11).M. [:)M'T* .NO. 890798
JU13 1.;iW SI:)P1N(.-,W0OI) Uk
M A F"/L 0 1.S 1. 3*3AD 1.51900 S(. H: !nLIMME.111 AKE LT :8 RK :
I AND USE' : p7l:)E)
LXXT ti]:ZE:.-
1:TEM . NO : NC)
W(')Pl< GL.ASS : NEW F1.44NACL < :I.oOl< I AD4 1-1ANDI.J.4 ( 10
LI S 1151NGLE I: AM]:I._Y IL-IJANA(*.11I_ 1001<4- AtP HAN01 1:4 3.OK
(*.;(:)NS*T .*7YV1I;:. : VN FUJOP FL)WINIACE. 1:::VAP . 11001 EP
(:)CCU!::1 . G14P. : P3 VENT' r-'AN
VIEW Vl---'N*Y* . SYS'TEM
<31-IP 1-10013
NO. STC 131 rl/COMP 3 1.511,1P J.N('.I 1:NE.PA*I'(*)r4( DOM
r.)WEI..I- . UWTS : I 01.A:4/(`(.)MI:) 1.5 30HI::1 TN(',:I:NEPATOP(COM
FUEL `TYI:)F:* G,A 5 30 115 01••11:+ REPAIP L)IN11"I'S
MAX . INPU7, F)LIWCOMP "504-111P ("YTHEP
FIRE DMPPS..? GAt5 F-`:IJ)TNG C.)UTLEA5 I.
111GH PRIESS?
LAW PRESS,?
PE:MARKS :
WO
M(:)PJ:SSlIi:A-*TI::: DON PF PM I T $1.0 . 00
N P 11:11 DOX 1.9r.
5 PL.AN PF—ViE0 $9 .30
E p m r t 1 in.ri d TUPES *;R7 .15 0
R
51WT' 'TAX $1 .
01 HE.11
C
0
N
T BEL.I.- HEAT NG ]'N(:; .
R 1.15,1550SV.: PIAZZA AVE
A
C (:,'I ACKAMAS OR 97013
T r.)I-IONF--' (503) V.413--t184
0 . -.13T. ''Tr .) -147
RE % 4AI*].(.)N N('
This Permit is Issued subject to the regulations contained In Title 14
of the TMC. State of Oregon Specialty Codes,zoning regulations I' E QU:I:PEI:) INISPEZUTTONS
and All other applicable codes and ordinances, and it is hereby
agreed that the work will be done in accordance with the plans and L.TNE:
specifications and In compliance with alf applicable codes and P01:VT EIE.AM
ordinances The issuance of this permit does not waive restrictive POLK.4-1 N
covenants Contractor and subcontractors shall have current city F*TNAI
business tax permits. This permit will expire and become null and
void If work is not starteH within 180 days.or it work is suspended or
lb,, doned for a period of 180 (a, . any time after work has
commenced It shall be the responsibility of the 'it I
and
��;rmi as to assure
all required ins ns are requested ai 0 d
u
re
Permittee Signa ure
Issued By 00' C7 FOR
SEPARATE PERMITS REGUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITY OF TI�� F'.W F.A PF PM 1''T
PF I M V I NO. SEA9096*7
RD Cl% 11�ARD
I—
Ty"
COMMUNITY DEVELOPMENT DEPARTMENT Ir-5/12/09
13125 S W.Hall Blvd,P O.Box 23397,Tigard.Oregon 97223,(503)639-4175 1:`PM , PM'T' .NE) . 11390,79E.)
,JOB AL)DPESS : :11.26,21. 15W !;PAINGWOOD DR (]Sit) NIIMI*A::P : 037311.3
JAX MAP/1-01 ISI 33AD 3.15900 SUB : !AJMMI:.:I4I-AI<V 1-*T : 0 UK :
I AND UF-&- : p7po
1 0 T 5:11:Z F: :
Sii I'lC,11:0N: 33 *TWP : Is RN('.-', : 1.w
WORK CLASS : NEW
(HAK: TYPE : SIN(;-E: FAMILY
1*11-MY RILP113A.c.nnt, at(,I r,gvr.e ill tl:l (-,vmply With PLA.I. 1`1.11(0111 RVICI I"IN5LO.Utial-114 Of
Agimiiiv.-y . 'T'h*it 13e1`lnit expir-c4m 1.20 +I-CIM th,-I! dlat*i? if-Alli1.10(j . 11-lea titlti&].
illLIN:11.11-11t 13fitid W-J.13. lArl if the 1:1e1`irlit A! envy dcilpi rich. 1ji.itir.-
mrltee-1 thin atc�("N.11"ac"y 041 tl%e lclic�iat,:0:11-1 (341 timni viiii.de. %iyiwer- latter-a L 1 1:4' the molwrei, isle
I'lut, 19.1 'Lh4:1 givell-1 , thoi.nlsistl.7.(',>r Ilihi".11. 3 fc)et irl
it.1.1, fr-cllh 1.1-ICA Qivc' n . 'TT r1c)t m(l the! instia:11tiii. 41.ftilL.I.1
PUI-0-16I.Me. 1IL "'1*I;Ij;) liki-ICI 5j:LCICa -thp. Aclpfri(�y wi:1.3. :i.ri*;ti4LL:I.:I. U
L
INS T*AI L . 'TYPE : SLITI DINI. SEWI::*.P IMPF-PVTOUSs API;.-."A:
1;: IXTUPI-.: UNITS : IF:'.NAN*YIMPROVEMENT :
DWEI-I ING (JIS11TS I
NO . OF BI D(*.,'E i I
0 MUP:I:S5F-**.1Tl:.: D01's PF114MIT 1111135 . 00
W
N lata 13OX 1952ti CONNF:CTION CHAI:K.sE $A ' 11,00 00
E P Ll I,t.1.41L irl d (a1`
R
F I-Ilk-"A 11l 560 . 00
C
0 MOAT rMFIE.1,11: 0014
N DON MOPISSF.E.TTE INC .
T
R 1:3 ri BOX 19524
A
C p a r-tl a 1-1(1 "11'71`.1.1.9
T PHONC: ("303) 2-1/11 931.11
0
R P1:::GTI9TPA*T*ION 140. 355313 VOTAL: $1 1 4195.00
PEC,RIPI NO. Lt
This permit is issued subject to the regulations contained in Title 14
of the TMC. State of Oregon Specialty Codes, zoning regulations r.,F.Q
and all other applicable codes and ordinances. and It is hereby
agreed that the work will be done In accordance with the plans and POLAAM-.1 N
specifications and in compliance with all applicable codes and
ordinances The issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have current city
business tax permits This permit will expire and become null and
void if work Is not started within 180 days.or if work Is suspended or
abandoned for a period of 180 days any time after work has
commenced. It shall be the responsibility of the permittee to assure
all required actions are requested and approved
Permittee Signature
Issued By- PA! POR
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIPED ABOVE
ff
CYC OF TWA WO_
PLAN
CHECK APU
COMMUNITY DEVELOPME=NT DEPARTMENT RD (CnYZ0f�1JCA1W1
PERMIT
1312SSW."ma ef+d_P.O.Box?3197.T1gantOregon 97Y13.(:A3)639-41M DATE ISSUED 1
JOB ADDRESS: 12,(62- 1 S ' r ' -V'V I'U W 0 !< i AX MAP/LOT
SUB: '�Z'"4AAMU("21(t _ LOT: LAND USE:
OWNER SPECIAL NOTES
NAME' _ �J 1 REISSUE OF: i
ADDRESS: J �' � �U c_ _—_ LAST REISSUE:
FLOOD PLAIN/
SENSITIVE LAND:
PHONE: _ �t/61-��• I� --
APPROVALS REIRED
CONTRACTOR PLANNING:+—gU
NAME: ENGINEERING:
ADDRESS: FIRE DEPT -
OTHER. -_
ITEMS RE4UIRED
LIST/SUBCONTRACTORS:
ARCH/ENGINEER -�- BUS TAX: -.
NAME: I T� I r� CALCULATIONS:
ADDRESS: TRUSS DETAILS:
PARKING PLAN:
_ LANDSCAPE PLAN:
PHONE: OTHER:
44
COMMENTS: -_ L " I S Sy LS Y -1 017 2
71
-T
PERMIT N ACCT N DESCRIPTION AMOUNT AMOUNT ID. BAL. DUE
10-432 00 Building Permit Fees JA uu
10-431 00 Plumbing Permit fees
(e4 10-431 01 Mechanical Permit Fees -3 7 5,`
10-230 01 State Building Tax (5X)
Building / -3���--
Plumbing �� d
Mech
10--433 00 Plans Check Fee
Building Z f /s
Plumbing _
Mech _ .3
30-207 00 Sewer Connection
30-444 00 Sewer Inspection
51-448 00 Street System Dev Charge (SDC) -Lo-(f
52--449 00 Parks System Dov Charge (PDC)
31-450 00 Storm Drainage Syst Oev Chr-q (SSDC) ___;4 C
10-230 09 TRFD _� ---- -
10-230 06 Washington County Fire N1 (95X)
/N-2.20 00 Amart4d(jewood
TOTAL
RISC
AP I TCAN TGNAFURI-
-_.._
keceived By: _�[,��r - -_--- Date Received:
cn/3587P/18P
-elf 3
CITYOF11GARD A4� PLAN CHECK APPLICATION
ff
CITYOFCOMMUN" DEVELOPMENT DEPARTMENT o E o►GiA� PERMITPLANH0CK 0 `
13125 SW Hall BMd. P.O.Bac 21397,Tigard,Oregon 9771)(601)61!}1176
DATE ISSUED
JOB ADDRESS: I'Z L, S•w �P(L(NL MID
SUB: �" ��✓�-� (,K1 4k, LOT: �—"� TAX MAP/LOT �5�--�j 3•�d _
_ LAND USE:
VALUAT70N: �``70 S 5;o-'
OWNER M SPECIAL NOTES
NAME: ►,p('�/S �J REISSUE OF:
ADDRESS: LAST REI
FLOOD PLAIN/
SENSITIVE LAND:
P'�10NE: _ � —
APPROVALS REQUIRED_
CONTRACTOR PLANNING:
NAME: ENGINEERING:
ADDRESS _ _ _ FIRE DEPT _ -
- -- OTHER:
PHONE: ITEMS REQUIRED
LIST/SUHCON'rRACTORS:
ARCH/ENGINEER
� �, � ( � 1 BUS TAX
NAME:
J CALCULATIONS:
ADDRESS: _ TRUSS DETAILS. _
PARKING PLAN: _
LANDSCAPE PLAN:
PHONE, — / OTHER:
COMM-NTS: ---
PERMIT M ACCT N DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
C' 10--432 00 Building Permit Fees ��L� / , _Y •;
10-431 00 Plumbing Perm} ' Fees ,� w 3�
ri l9 N� 10-431 01 Mechanical Pe ,nit Fees -3 J„sv -� �` ,5,,
10-230 01 State Building Tax (5X) 3 , .23
Building
Plumbing
Mech j, � �/�/3Y
10-433 00 Plass Chork Fee - ;Y
Duilding L�U
-- L
Plumbing _
Mech
/ 30-202 00 Sewer Connection
30-444 00 Sewer Inspection _ 3
51 -440 00 Street SVst:em Dov Charge (SDC) .-Cv G:0 c,
52 -449 01 Parks I Systom Dev Charge (PDC) _U 5U
52•-449 02 Parks 11: System Dev Charge (PUC) -- --
31 -450 00 Storm Drainage Syst Dev Chr•y (SSDC) ,�Sy
10 230 09 1RFD — -—
10-230 06 Washington County Fire N1 (95X)
-220 00 Amart/Wedgewood—
TOTAL_
-� R EC #
APPt WANT STGNATURF
Received fly : Date I
--_--_-_` 1bu"�./ Date RLCe1Ved:
ht/3507P/19P