13379 SW SCOTTS BRIDGE COURT 13379 SW SCOTT BPlDGE COURT
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INSPECTION NOTICE
City of Tigard Building 0epartJ08nt I
13125 611 Ball Blued. Tigard, Oregon 01223
Inapectien Line (Rac-0-Phone): 639-4175 B-atness Phone: 6.39-4171 y
1
Inspection:
Footing Plbg. Underslab Mach. Bough-in Appr/Sdwlk
Found. Plbq. Top Out Gas line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain insulation -Plumb.
Plbg. Underfloor Water Line oyp. Bd. -Meeh.
Date Requestedt�//:Z4" TiI' ----AM PM
Address / permit f: Q..�%��9 7���—
Builder: It7�r +— ^�4
THE ■OLLOWINO CORRRCTIONS ARRE�REQUIRRD:
ky
Inspectors _ _ Dates.
APPROVED DISAPPROVED APPROBZD SUBJR('T TO ABOVE
Call For Reinap.
a.
INSPECTION NOTA
City of Tigard Building DepartAeat-
13125 SM Ball Blvd. Tigard, Oregon 97223 l�
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections_
Footing Plbq. Jnderslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out r-as Line FINALt
Pool./Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation Plumb
Plbq. Underfloor Nater 11ne Gyp. Bd. -Mech.
Date Requestedt Time: AM PM
w1 '
Addressr c
Builder•
THE POLI04IIMG Con ONS ARE REQUIRED!
Inepectors Date:___ — _
PROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call Por Reinnp.
IN�TION NOTICE
City of Tigard Building Der•irtmPnt
P.O. Box 23397 p
Tigard, Oregon 97223 H^;�
Phone: 639-4175
Type of Inspection
Date Requested �_ qv Time A.M. .
Addiess j ] �.ff��-/—c,parmit #-'f 3V
r1
Owner _A Lot #
Builder
The following Building Jde deficiencies are required to be corrected:
�I�l'FT�Y�b /a5 N
Presented to _ Approved
Inspector _ ❑ Disapproved
Date 7 G '-4 _
CALL, FOR REINSPECTION
0 YES ❑ NO
INSPECTION NOTICE
City of Tigard Building Department
P O Box 23397
Tigard, Oregon 97223
Phone 639-4175 y 3C
/C,
Type of !nspection - - ---
Date RequestedG _ —. Time w A.M.. �•
Address ._ � pRermit # �..
Owner _ __ _- —_— Lot #—
Builder ---
I 'n ode deficiencies are required to be corrected:
The following 8ui di g
Prr-mn!ed !n Approved
%y, --
In.��rctnr �� __------__...____ __..R. [] Disapproved
Date �—
CALL FOR REINSPECTION
YES El NO
INSPECTION NOTICE
o Ly of Tigard Building Dena '� ✓/
wA4PP.O. Sox j
Yig Or
;'
Ph
n 175 _ Q
Qe of Inspection
Date Requested d`� "� Time A.M. F.M.
Address 3- � - ILAL Permit #
Owner
Lot # `90 70
,—. --
Builder ,
L�..--
The following Building Code ofeficiencies are required to be corrected:
-
Presented to _ _-_ _ — Approved
7�7
Inspector Disapproved
Date
CALL FOR REINSPECTION
YES ONO
i
CITYOF TIFARD HUILDING REKNIT J
PERMIT NO. : BU892034
c6b Baan
COMMUNITY DEVELOPMENT DEPARTMENT O0e°°� D TE ISSUED: 10/31/89
13125 S.W.Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223,15031639-4175 j Iq.PMT.NQ. 880492
JOB ADDRESS: 13379 SW SCOTTO BRIDGE DR
TAX MAP/LOT S214AB3600 SUB: MORNING HILL PH3 LT:69 BKe
LAND USE: R4.5
LOT SIZE: VALUATIGN: $ 14,000 SETBACKS
FRONT: 20 REAR: 5
WORK CLASS: DWELL.UNITS: LEFT: 5 RIGHT: 50
USE TYPE: SINGLE FAMILY NO.BEDROOMS: 3 EXT.WALL CONST:
CONST.TY',E: VN NO.BATHS: 2 N: St E. W.
OCCUP.Gf,-. t R3 PROT.OPENINGSt
OCCUP.LCAD N: S: E: W:
TOTAL AREA: 606
NO.STORIES: 2 1ST: ROOF CONST: C FIRE RET?
HEIGHTt 18 2ND: 696 AREA SEPAR? RATED:
BASEMENT? 3RD: OCCUP.SEPAR? RATED:
MEZZANINE? BASEM'T
FLOOR LOAD: 40 GARAGE: FIRE SPRKLR? ALARM?
FLOW(GPM) DETECT? TES
HEAT TYPE: GAS HDCP.ACCESS? CORR?
PLAN CHECK BYt r1t
REMARKSt
upstairs addition REISSUE OF NO.
LAST' REISSUE II
FEESt
o PERMIT $104.50
N 13250 FALCON RISE DR I PLAN REVIEW $67.93
E tigard OR FYRE DEPT
R STATE TAX $5.23
OTHER
�— - -� -- --,-- DEVELOPMENT CHARGFS9
p SDC(STORM)
N WEDGEWOOd HOMES SDC(STREET)
R 13258F,4LCON RISE DR PDC(M1 >
C tigard OR 97223 PREPAID ( i
T PHONE (503) 292-3563
li
REGISTRATION NO. 3338 TOTAL: $177.66
RECEIPT NO.
This hermit is issued 9ublect to the regulations contained in Title 14 -----------•--------•----
of the TMC. State of Oregon Specialty Codes.zoning regulations REQUIRED INSPECTIONS
and all other applicable codes and ordinances, and it Is hereby FRAMING
agreed that the work will bg done In accordance with the plans and
specifications and in compliance With all applicable codes and PLB.TOPOUT
ordinances. The Issuance of this permit does not waive restrictive INSULATION
covenants. Contractor and subcontractors shall have current city GYP. BOARD
business tax permits. This permit will expire and become null and FINAL
void if work is not started within 190 days,or it work is suspended or
abandoned for a period of 180 days any time after work has
commenced. It shall he the responsibility of the permittee to assure
all required inspections are requested and approved.
Per teedg nature
Issued y � ' CA _FOR -INS0ECT
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
PLUMBING PERMIT
CITY OF TIGM
RD
, PERMIT NO. , F'LA'�c070 %
� arrocncAftu
oekoo�
COMMUNITY DEVELOPMENT DEPARTMENT D rE ISSUED: 10/31/89
13125 SMHall Blvd.,P O.Box 23397.Tic rd Oregon 97223.15031639-4175 R M.PMT.NO. 880492
JOB ADDRESS: 13379 SW SCOTTS BRIDGE DR
TAX MAP/LOT S214AB3600 SUB: MORNING HILL PH3 LT:69 RK:
LAND USE: R4.5
LOT SIZE:
ITEM: N0: NO:
WORK CLASS: ADDITION WATER CLOSET 2 TM)P
USE TYPE: SINGLE FAMILY URINAL BKFLOW PFVNTR
CONST.TYPE: VN L.AVORATORY 3 TRAP PRIMER
OCCUE'.GRE'. : R3 TUB SHOWER 3 GREASE TRAPS
DISHWASHER
GARBAGE DISPOSAL
NO.SIORIE5: 2 WASHING MACHINE
DWELL.UNITS: LAUNDRY TRAY BLDG.TIRAIN (DIA
FLUOR DRAIN
SINK SEWER (FT)
WATER HEATER STORM/RAIN (FT
OTHER
REMARKS:
upstairs addition
FEES:
O PERMIT $60.00
W
13250 FALCON RISE DR
E tigard OR I FIXTURES
R $3.00
STATE TAX
OTHER
C
O
T SWEETWATER PLUMBING
R 19185SW MURPHY CT
C ALOHA OR 97007
C
T
OREGISTRATION NO. 37700 10'iAl
R : f63.0E1f
RECEIPT NO.
This permit is issued subject to the regulations contained In Title 14 --------------------
of the TMC. State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances. and it is hereby
agreed that the wurl, will be done in accordance with the plans and
specifications and in compliance with all applicable codes and POST A BEAM
ordinances. The issuance of this permit does not waive restrictive WATER LINE
covenants Contractor and subcontractors shall have current city pl B.TOPOUT
business tax permits This permit will exnlre slid 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 F INPL
commenced It shall he the responsibility of the permittee to assure
Fill required inspections are requested
and approved
l
petml 1p Signature
t
Issued By CALL FOR 1-t4U,LCTI1IN 639-4175 . J
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN FIESCRIBEU ABOVE
CITYOF
TIGARD MECHANICAL PERMIT
�4 p'FRIg1'f NO. : ME.692071
Clr(6 T ARD
COMMUNITY DEVELOPMENT DEPARTMENT D E ISSUED: 10/31/89
13125 S.W Hall Blvd..P.O.Box 23397,Tigard,Oregon 97223.(503)639-4175 I M.PMT.NO. 880492
.TOB ADDRESS: 13379 SW SCOTTS BRIDGE DR
TAX MAF?/LOT S214AB3600 SUB: MORNING HILL PH3 LT.69 RK:
LAND USE: R4.5
LOT SIZE:
ITEM: NO: NC i
WOkK. CLASS: ADDITION FURNACE (100K AIR HANDLR (10
I.ISE TYPE: SINGLE FAMILY FURNACE 100K+ AIR HANDLR 10K
CONSY. TYPE: VN FLOOR FURNACE EVAF'.COOLER
OCCUP.f.RF''. : R3 HE►.TER VENT FAN 1
VENT 6 VENT.SYSTEM
6LR/COMP (3HP HOOD
NO.STORIES: 2 BUR/COMP 3-15HP INCINERATOR(DOM
DWELL.UNITS: PLA/COMP 15- 30HP INCINERATOR(COM
FUEL TYPE GAS BLR/COMP 30--50HP REPAIR UNITS
MAX. INP IT BLR/COME' 50+HP OTHER
FIRE. DMPRS? GAS PIPING OUTLETS
HIGH PRESS?
LOW PRESS?
REMARKS:
77pstairs addition
L
v FIE R'MI 1 41F;.00
IN 13?50 FALCON RISE UR PLAN REVIEW
tigard OR FIXTURES $21.69
STATE TAX $1.55
OTHER
L•
0
T FOUR SEASONS HEATING AIR GOND.
A POBox66409
C Portland Or 97266
o PHONE (503) 775-5919
R REGISTRATION NO. 48283 TOTAL: $40.30
-
This permit is issued subject to the regulations contained In Title 14 __.._______RECEIPT NO. ICA y?0 3
of the TMC State of Oregon Specialty Codes,zoning regulations kFOIJ?RED INSPECTIONSand all other applicable codes and ordinances, and It is hereby
Agreed that the work will be done in accordance with the plans and GAS LINE
specifications and in compliance with all applicable codes and POST R RCAPI
ordinances The issuance of this permit does not waive restrictive ROUGH--IN
coveients Contractor and subcontractors sha;l have current city FINAL
buainess tax permits Thiv permit will expire and become null and
void If work is not started vithin 180 days,or if work is suspended or
abandoned for A period of 180 days any time after work has
commenced It 00 be the responsibility of the permittee to Assure
Fill required inspections are requested and approved
P9r,it e�ignatura
Issued 8y ----_,--_-. FALL FOR INSPECTION 639-4375 J
SEPARATE= PERMITS REQUIRED FOR WORK OTHER THAN. ZiESCR19ED ABOVE
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ITY
OF
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PLl1N E1ECK APPl7 ZON
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commoNKTY OEVELOP&IENT OEPNR7 NIE(4Y
•1ITS Sv,_1<.�m.A_P•o•oo.urr.7lv..d!•?'cW^srz7.(50.11 - / DATE ISSUCI) _ ----------
��
JOG ADDRESS: LAND USE- - - ---
Sun: VIAr�,�1 ati�(si rt.� -- i OT: ------ --
VALUATION: 4 ---
SPECKW_ NOYES
OWNER REISSUL OF:
NAME: ` - C
LAST REISSUE:
ADDRESS: (�33-5-7 S, W S G�' �'A vo- - FLOOD PLAIN/
SENSITIVE LAND:
APPROVALS R`QUIREO_
PLANNING: _
QOtn'RACTOR ENGINEERING: —
NAME: L(.� t;UG*' � � -E�lG'Ytf FIRE DEPT
AOORESS: (3 zS_-� S' • Gv. ��4L �+• 01� —
oTT1ER
PHONE: ITEMS REQUIRED
LIST/stjOCONTRACTORS: —
BUS TAX:
-ARCH/ENGINEER CALCULATIONS: _--
TRUSS DETAILS:
ADDRESS: - - PARKING PLAN:
— - LANDSCAPE PLAN:
OWER:
:
PHONE: ?rI UZ!
oomENTs: I ts-. +S u Lo-C, S t--r-r
PERMIT N AOCT'N OESC4IPTION AMOUNT AMOUNT PD• GAL- Dl,`-'
_ 10-432 00 Building Permit Fees
�)f1 10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees
10-?30 01 State Building Tax (5%)
Building
Plumbing -� G
Mech
10-433 00 Plans (deck Fee --
Bu i ld ing G r
Plumbing _
Mech _ �?
30-202 00 Sewer COnn@C"On -
30-444 00 Sewer Inspection -
51-448 00 Street System Oev (lvarye (SOC) _ ------
52-449 00 Parks System Oev :barye (POC) ---
31--450 CO Storm Drainage SYst Ocv Chrg (SSOC)
10-230 09 TRFO --- --
10-230 06 Washingt-cn CeuntY Fire NL (951)
10-220 00 nmart/Wedgewood - �
lofnt-
nPl NT S LGIunTURE
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Received ny: Uate Received: -
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INSPECTION NOTICE
City of Tigard Building Department
P.U. Box 2.3397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection • `�l �/�� /
Date Requested _ _�� ?lata A.M._ __�_P.M.
Address Permit # j
Owner Lot
Builder
The following [iuilding Code deficiencies are required to be corrected:
�5
Presented to
Inspector Disapproved
Date
CALL FOR REINSPECTION
YES 1-1 NO
INSPECTION NOTICE
Cite of Tiq_and Building f)epartrnent
P O Box 23 ,,,7
Tigard, Oregor. 91723
Phone. 63��-4 175
Type of Inspection -------—
Date Requested Time A.M.
r.
Address
Owner __-_ Lot #
Builder ------ --
The following Building Code deficiencies are required to be corrected:
4
Presented to _ ❑ Approved
m
Inspector __ 91 —sapproved
Date
CALL FOR REINSPECTION
❑ NO
!ti I
I
INSPECTION NOTICE
City of Tigard Building Department /
P.O. Box 23397
Tigard, Oregon 97223Phone: 639-4175
Type of Inspection
Date Requested + Time ✓' A.M. P.M.
Address / -3 3 2r I1 C.J( t�G�-- Permit yj 2--
Owner LG _—__-- Lot #
Builder
The following Building Code deficiencies are required to be corrected:
--� — 4 42 - --
Jf-v'
i
Presented to Approved
inspector ❑ Disapproved
Date ----
CALL FOR REINSPECTION
❑ YES l_J NO
I
INFECTION NOTICE
City of Tigard Builth -1 Diapartmpnt
P O. Bo,,
Tigard, 0;Igor, J72�
Phone 639-4175
Type of Inspection C,
Date RequestedG� ^� Time_IX A.M. P.M.
Address .�`, / :�C�1�� ,�i Ld -2_ Permit
p
Ownerp l , / _ Lot #_
Builder IJ�LE"d ..Lf..u cro C - —– ---
The fol owing Building Code deficiencies are required to be corrected:
i
Presented to ..•_- �._ roved
Inspector r-� ❑ Disapproved
Dute
CALL FOR REINSPECTION
YES (_) NO
r
INSPECTION NOTICE
City of Tigara Building Department
J. P O. Box 23397
��, J Tigard, Oregon 97223
C u r)t� 1�, Phone: 639-4175
2_ 172 _>S63 N / �c-1_11t_C_ "/
Type of Inspection
Date R.:quested
A.M. P.M.
Address ____�_____ _—
cjL-� - hG_ Permit
Owner--- — — u–! `a/��/L __ of #
Builder _ _--
The fol owing Building Code deficiencies are raquired to be corrected:
1P. 4 /1�� L;U lk 55 57 1
TTr.t L� orf� t�:�[-` -u v7
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me 1,
t dw
Presented to ElApproved
Inspector _ r}6isa��proved
Date —
CALL FOR REINSPECTIoN
DYE$ ❑ NO
INSPECTION NOTICE
City of Tigard Butiding Department
P.O. Box 23397
Tigard, Oregon 97223
Phone639-41,15
Type of Inspection .
Date RTl me '' A.M.--P.M.
Address 1�3 `�9 .S'Ly t_-�� i' Permit # 1
Owner _ _ Lot # _
Builder
The following Building Code deficiencies are required to be corrected:
--- �� � ,P-1 t � �!_. /� (1(.fL�IZ T=--' G►�L_. /l�'1_-PIi_.4.•�-''f'�
Presented to Approved
> —
i
Inspector Disapproved
Date
CALL FOR REINSPECTION
nYE8 ONO
INSPECTION NOTICE
City of Tigard Building Department
�� l�1 P Box 23391
� I Tigard, Oregon 97223
Phone 639.4175
Type of Inspection -'11 P.M. _
Date (Requested_— _ _s Tiind 1C— A.M._-_ p{P.M
Address 3_-2 �a ./ Permit #, O Oma' wz'
Owner.-,---- — _ PEZD� _ Lot #-- —— --
Builder--- _—_The following Building Code deficiencies are required to be corrected:
----------
_
-------_.�-=tL�:'.F_d.E '✓.1'_QL�__S�+_lc_��C y cam G�iC�2��
Presented to 4 � � Approved
Inspector �-
------ ---- -Disapproved
Date
CALL F) ? REIMPF,CTION
YES I 1 NO
CITi OF TIGA RD
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COMMUNITY DEVELOPMENT DEPARTMENT NIJMV.�C V-1 'A 1,0 6
131121;S.W.Hall Mvd..P O.Box 23397.TiOrd,Oreilion 0223.(1103)039.411'5
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This pal mit is issued subject to the regulations contained In Title 14
of the TMC State of Oregon Specialty Codes.zoning regulations
and all other applicable codes and ordinances, and It Is hereby
agreed that the work will he done in accordance with the plans and
specifications and in compliance with all applir;ible codes and
ordinances The issuance of this permit does not waive restrictive
covenants. Contractor and subcontractors shall have current city
busin,ss tax permits. This permit will expire and become null and
void if work Is not start(id within 180 days,or If work is suspended or
abandoned for a perlud of 180 days any time after work has
commenced.It shall be the responsibility of the permittee to assure
all required inspections are requysted and approved
Perq�6sylllltule
Issued Bv:
-'FP ATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
A)
C'TYOFT167ARD
CITY OFTWAM
COMMUNITY DEVELOPMENT DEPARTMENT
13125 S.W.Hall Blvd..P.O Box 23397,Tigard,Oregon 97223.1503)6394175
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This permit is issued subject to the regulations contained In Title 14
of the TIVIC. State of Oregon Specialty Codes,zoning mgulatlon '(.'611,1 1 1 11! I.
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and all other applicable codes and ordinances, and it Is hereby
agreed that the work will be done in accordance with the plans and I 111M It>11 I I I'li 1:11-163A,11;!
specifications and in compliance with all applicable codes and
ordinances The issuance of this permit does not waive restrictive P 1. 11`411,-.,
covenants Contractor and subcontractors shall have current city !1
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 I-I It, I I 11111'.)11,11Y
abandoned for a period of 180 days any time after work has
commenced.It shall be the responsibility of the permittee to OSSUre
all required inspections are requested and approved,
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Permittee natime,
Issued By J.I I'm)I I- i 1 .1 1*114 .'11 1
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITY OF TI67A RD rCITYANWARD
GON
GORGON
COMMUNITY DEVELOPMENT DEPARTMENT
13125S,"V Hall Blvd..P.O.Box 23397,Tigard,Oregon 97223.(503)639A175
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This permit Is issued subject to the regulations contained In Title 14 1 4.-if 1. 1 1 '1. 1
of the TMC, State of Oregon Specialty Codes,zoning regulations i I tAf 11-1.-Of- 1.:',1
and all other applicable codes and ordinances, and It Is hereby
agreed that the work will be done in accordance with the plans Find
specifications and In compliance with all applicahle codes and
ordinances. The Issuance of this permit does not waive restrictive 1 I It IM 1 .1 1
covenants. Contractor and subcontractors sh ill 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
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 inspections are requested and approved
Fermitto Big tune_ ):r I (..Ili
Issued By:
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
1 •F71'11 I' NO MEN
CITY OF �'�A RD
CITY OF III ARD
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COMMUNITY DEVELOPMENT DEPARTMENT 0410ON W.)0 4:19)e.
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13125 S.W.Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223.(503)6394175
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This permit is issued subject to the regulations contained in Title 14
of the TMC. State of Oregon Specialty Codes.zoning regulations
and all other applicable codes and ordinances, and it is hereby
agreed that the work will be done in accordance with the plans and
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
husiness 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
ahandoned for a per;od of 180 days any time after work has
commenced It shall bf the responsibility of the permittee to assure
all roquired Inspection I are requested and ap roved
Permittee SI n
to e
Issuer HV
SEPAR TE PERMITS REOUIRED FOP WORK OTHER THAN DESCRIBED ABOVE
mR
CITYOFTIVARD PLAN CHECK APPLICATION
GTYOFTWARD PLAN CHECK 1 �- 3a-
131
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COM UUNITY DEVELOPMENT DEPARTMENT offoon
131x-IV"MBlvd P.O.Bm2397.71p A.Oregon Or?21(M)6394:76 PERMIT f
DATE ISSUED
JOB ADDRESS, .i 'for deTAX MAP/LOT e
SUB:_ LOT: " ^
ft' /1?:ru�.l{.1/ �ANb USE:
VALUATION: rj;l,�, , _ SETMCKS: FRONT: REAR: , LEFT: RIGHT:
WORK CLASS: HEIGHT: '-- 1 TOTAL AREA:
USE TYPE: FLOOR LOAD: 1ST:
CONSTR TYPE: HEAT TYPE: _ 2ND:
OCCUP GROUP: _ DWELL/UNITS: 3RD:
OCCUP LOAD: NO BEDROOMS:�T^ BASEMENT: -�
N) STORIES: NO BATHS: GARAGE: y;
1AP SURFACE:
APPROVALS REQ'D SPECIAL [TOTES ITEMS REQUIRED
PLANNING: REISSUE 0"* LIST SUBCOh,MACTORS:
ENGINEERING: LAST RF.IS_,.E: BUS TAX:
FIRE DEPT,: FLOOD PLAIN/ CALCULATIONS:
OTHER: SEN LVD.: _ TRUSS DETAILS:
PARKING PLAN:
LANDSCAPE PLAN:
PLAN CHECK BY: OTHER:
COMMENTS: -
y.ryLLL� (� 7.. r- LA/
ACCT DESCRIPTION- AMOUNT
OWNED. 10--432 00 Building Permit Fees
NAM: -i4y'rNt � 10-431 00 Plumbing Permit Fees 9Po,,,-:7
ADDRESS: S fo , TALC_,-uoj'g: 10-431 01 Mechanical Permit Fees
T7C-AAi,^ T C7�L e* 0(" 10--230 01 State Building Tax (5%)"
_ 10-433 00 Plans Check Pee y R
P}IONE, ?<730-443 00 Sewer Connection (20x) _
30-202 00 Sewer Connection (80X)
CONTRACTOR 30-444 00 Sewer I,nnpectioa _7 i
NAME: .51-448 00 Street System Dov. Charge (SDC.'. �^
ADDRESS: `-52-449 03 Parks I System Lev. Charge (PDC)
_ 52-449 02 Parks II System Dev. Charge (PDC)
31-450 00 Storm Dr linage Syst Dev Lfirg(SSDC)
PHONE: 10-230 09 TRFD (95X)
10--437 00 TRFD (5%)
ARCH/ENGINEER 10-. 30 06 Washington County Fire /1 (95x)
NAME:_ �:' c 10-•435 00 Washington County Fire 11 (5%) S
ADDRESS: _ -� 10-220 00 Amart/Wedgewood
_ TOTAL 2 817
PIiGNE: r'
-- —-- PREPAID V
REC if 306 vat
/ BALANCE DUE j 7
1IP CANT SIGNATURE
Received By: _ Date Received: ��-��