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12180 SW LANSDOWNE LANE-1 1,2180 SW Lansdowne ui. I i J b �1 CA N w +� eeen ea -V feew fm eeI► QTYC0F71QvA1PD CERTIFICATE OF` COMRMUN TY DEVEL0PMENT DEPARTMENT \ary ami w OCCUPf 13126 SW HCl Blvd P.O.Nor 23397,7 ow,,o nmon o>?m(w oS"i 76 \ PERMIT N. . . . . . . I M a'I 91D.. - DATE iSSUE_D: 07l09i'91 SITE ADDRESS. . . I :1,21130 SW LAN 3DOWNE LN PARCF_l.n aG t 0 BC--@b600 aUND I V I U ON. . . . I F YRESTONF 1 ON I NG a P-4. 5 LL.00K. . . . . . . . . . s ! .0'r. . . . . . . . . . . . . 15 CLASS Or WORK. I NF.'W TYPE Car' usE. . . I SE' OCCUPV.it".v ARP. I R3 UU: .'OPANCY L_,IAD c 220 4 ENAN r WAME. . . I Remark S I Ownere - -_.. _.__..._.. _._ ...__ ._,_...__..._. _....... ..... MA.7F 3T I C HOME'S INC P 0 BOX E65 CLACKAMAS OR � Phone MI "3036^iH t I 1 ! Cont r'litctar'c _ ___.. _.._._ _... .. . ....__. .....__........ , 1V1HJ ;TIC' POME:S INC P 0 BOX i26-' C LAC KAMAS OR Phone #I % -'N8 -4111. P.e g #. . : 5c1266 Occupancy of the above rpfer-snc:#d building is hereby riven, and cpvtifiei the compliance wfl-n Stage of Oregon Sper:i.alty Codes for thn. group, occupancy, and use under, whic•n the referenced permit wss ?.Sauer.'. F 1 RF DEPARTMENT P0,LL.D I NG 1 NSPE:C T'JR I;UIL.DT..1,IC: Fc-IAL LOST IN CONSD I CUOUS PLACE ss� sr► mire � nv we w e ��• �►,: w� en �jg��ON NOTLCF' x� City n1< T1.9a-S Flulidin9 Department r 13125 'M )1&6 I Mlvd. Tige.1. Oregon 97223 Inu�rx-tion Lin- 'lee-O-Phoneys 639-4175 Buniness Phono: 639-4171 Inspection:_—„_ I Footing Plhg. Unde.slab Mech. Rough-in Aper/Adwlk Found. Plbg. Top out Cas Line FIp11i.s Pont/B*,,n S�:ruct. Sen. Sewer Framing __:B l/lBldq.) = Pust/Beam Mech. Rain Drain Innulatinn -Plumb. Plbq. Underfloor Mater Line Gyp, Ed. L_ Mech.) Date Rwquented: —Times AM _:4_PM Address:_ . �j R_..Permit is-,�_ �� r Builder:.-_ TMR FOLLOVII110 CORRA::: 18 ARA REQUIRM ---,%- '`�r'Po ter'- u,.,�:'_� r'�.017:��►..s�,�,�;�� �J � Sy /,I C77- ---r-0 Inspector: _ _t - _1�Date- _7L--- A.2 ate:_7L A.:k MZD _ — DISAPPROVED _— "PROM) SUBJ SCT TO ABOV- Gll for Reinsp. 000s.ar W c - sew RW wa tna City of Tigard Nallding Department. 13.125 M Ball pled. Tigard, Oregon 97223 Inspection Line (Rec-O-Ph e): 6_39-4175 Businiss Phone: 639-4171 Inspect:ans __ —_— — rooting Plby,' Undelalab Mech. Rough-in Appr/Sdwlk Found. P)bg. • Out Gas Lina VVINALs Post/Beam 3truct. San. Sewar Framing -3ldg. Post/Dean. Mach. Railvi Drain Insulation -Plumb. Plbg. t F , loor WaterLino Gyp Bd. y�-Mach. Datn u—niestod: �cT� Times , `_AM —PM / 9 Addresat G' rmit — Builders -- TRE FOI.LONiN(i rDRRECTION8 ARE REQUIRED- �-7 '� Inspectors L ' v nates_ 1 APPROVRD ___ DISAPP D APPROVIiD SUBJECT To ABOVE �7` __Call Fo: Roinsp. �nspecrro�, NOT�c� f"� Cit of Tigard Building Depar '.aent T 13125 Bp Hall Blvd. Tigard, Ore7r.n 97223 action Line (Rec-O-Phone: 639-4175 BUet"Oss Phona: 639-4171 Insp :. Footing Plbg. Underslab Mech. Rough--in Appr/Sdwll: Found. Plbg• Tep Out Gas Line FINAL: PuRt./beam Stn:ct. San. Sewer Framing -Bldg. Poet/seam Mech. Rain Drain Insulation lumb, i Plhg. Underfloor {later Line Gyp. Bd. -Meeh, nate Re,masted:— ��l� �1 / ----Time: Addrese:`1 _f,[� / i )lyer:eit f: Builder:_ L/ � THR FOLLOWING CORRRCTIONS ARE RRQUIRRD: I -41 1��_7 .2 --� " - ---z _� Inspector: ( ---- Date: - APPROVRD DISAPPROVED APPROV-&D SUBJECT TO AWJy; Call Far Reinsp. �I i�tCT—{.O 1NOTICE city of TlAlard Building DeperimPnt 1j125 SM Hall. Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phonv): 639--4175 Buninene Phonot 639•-41.71 Int;pection:__V___ Footin5s Plbg. Underslab M© .... Rough-in A;+pr/Sdw0'1k Found. Plbg. Top Out One Line Frj4Al.: Post/Beam 5truct. San. Seweir framing -Bldg. Post./Beam Mech. Rain Drain insulation _.plumb. Flhg. Undorfl.orr. NAtae Una /7` -Mech. Date nequeetedt Address:�d f� Permit �s Builder:_.—! "�/ -- ------_— _—,- _— THE FOLLOWING COR IONS ARE RItWIRED: Inspector:_._ APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Cal, For Reinsp. .q City of Tigard Building Departscnt 13125 Bw Bali Bled. Oregon 97223 Inspection Lire (Rec-6-Phone): 539-4175 Businese Phone: 639-417�� \'1 Inspections- Fonting Plbg. Underslab Mech. Rough-in Appr/5dwlk Found. Plbg. Top Out. Cas Tine FINAL: Post/Beam Struct, San. Sewer Framing -131,1g. Yost/Beam Meeh. Rr,in Droln Insulation -Plumb. PlLq. Vnderfl.00r hater Line Gyp. -Mach. Date Aequ�asted: _�_ _ Times ? —�--,PM TRE FOLLOOPYING CORRF.CTI ARE REQUIRED: i —' _ InspectorsDate: -- - - - —- T.t"PROVRD DISAPPROVE!) - C-W!PROVED RUBJECP TO ABOVE Call Fo% Tleinep. 7 1 INBPECTI0.i 1'OT I—c" City of Tigard Bull-ding Department- 13125 S11 Ball Blvd. Tigard, oregon 97727 Inspec-tion TAne (Rec-o-Phone): 639-4175 Busineea Phone: 639 ,4171 tooting Plbg. UnderalAb (Mech. Rough-in Appr/B lk T Found. Plba. Top Out Gas Line / FINAL* Port/Beam StrLct. San. Sewer Framing -Bldg. Post/Beam Mach. Rain Drain Insulation -Plumb. Plbg. Underfloor water line Gyp. Bd. -Meeh. ��- _ Data Requested:__/ Timet C-Awrmit #: i/ 'luilder:� � 7 THY. FOLLOWING CC RCTIONS ARE REQUIRED: Inspector: J De.:ef_� �. APPROVE<' F)ISAPPRCVED APPROVED 9UPJECT TO ABOVE Ca1I For Rainap. city of Tigard SuildiM Depart-wnt 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec•O-Phones 635-4175 Business rhont. 639-4171 Inspection:. L.U�h10:-� _ —.�-------...-- Footing Plbg. Underslab Nett. 'sough-in Appr/Sdwlk Found. Plbg. Top out Gas .ine FINAL, host/Beam Struct. Ban. Sewer Fram'_nq -Bldg. Poet:/Beam Mech. Rain Drain Iusulation -Plumb. Plbq. Underfloor Water Line Gyp. Bl. -Nech. Uat.j Requestee 2-qq--/1( ---_ .Time: -- -AN ---PN Addtess:___. I2(��_ ,,,1^- Permit aullde*r•_ 1'1 �C_ _ h #_ T ( -THE FOLLOWING'�0ORRE`C'TION'S` ARK R6QU:RED: ;Zl r Cry v►, c' �` - 'L � I lQ ��, 111_ Q C-5L` / Y Inspectors_ ( G1�J�r :t_._ -.- Dater APPF.OYEO I P41 0 __ APPROVED EUP.TIC"T TO ABOVE all For Reisirp. sst� sD ssI 7 NAM` 11WE ssr NIP M #fT III$PiCfION lOCY,�,cF; city of Tigard Building Departs t 1.3125 SSI Ball Blvd- Tigard, Oregon 97223 Inspection Line (Rar-O-Phone): 639-•4175 susinuse Phone: 639-4 7 Inspections.Y_—___­ --- --- - Footing Plbg. UnAerslab Mach. Rough-in Appr/Sdwlk Pound. Plbg. Top out Gas Line FI.RALs Pont/Beam Struct. San. Sewer ,Framino -Bldg. Poit/Beam Much. Rain Drain Innulat on -Plumb. Plbg. Underfloor Water Line Gyp. Bd. •-Nech. Data Raguecteds p? - ��_.,-Times �_AM _ PM ^ ' r Addr.aes: (.ic_,d nu i l dor: -- TRE FOI.LOWINO om"crIONS ARE REQUIRED: Inspector:_ y/ � _— -- -- Dates_�2 i APPROV&D DISAPPROVRD / RIPAOV13 SUBJECT TO ABOVE _-__Call For Reinsp. s INS a.M9N___"QT I CE City of Tigard Building Department 1]125 8! Ba-11 Blvd. Tigard, Oregon 97223 inspection Tine (Rea-O-Phone)IIt 639/-4175 Ruslneen Phone: 639-41 T.:spection:------ Rootinq Plbg. nderelab Mach. Rough-in Appr/Sdwlk Po:tnd. Plbg. Top out Gas Line PINAL: Post/Ream Struct. San. Sower Frcminq -B11q. Poet/Beam Mech. Rain Gral.n Insulation -Plumb. Plbg. Underfloor W:alter Line Gyp. Bd. -Mach. Date Requested T11Mt _AM Address:ls�—1 i6c) LekV� __ Permit tt q6 '6L1 40 _ Builders im FOLLOWI:NC CORRECTIONS ARTS R30UIRED: Inspector: t IAII7 "PPRCVED DISAPPROVED LPPROVESt SUIWECT TO AAOVE —Call for Reit,,; . . -E P9-4171 City of Tirjard Building Departsen•L 13125 BM Ball Blvd. Tigard, Oregon 9723 Inspection Line (ret-O-Phone): 639-4175 Business Phone: Inspection:__ `_—_--—_—_-- ,— Footing Plbg. Onderslab Mech. Rough-in Appr/Sdwlk Found. -Plbg Top Out Gas Line FINAL: Poet/Berm StruC.t. San. Sewer PramLng -Bldg. Poet/Hearn Mech. Rain rrai.n 7veulation -Plumb. Plbg. Underfloor Neter Line dC Gyp. Bd. -Hoch. Date Requp.i.er1:—_�- /� 7 U Timet __—AM --PM Permit �s�•-f� Builds T-M FOLLOWING OO CTIONS ARE REQUIRED: i I Inipectort _CYA(— APPROVED —_- DISAPPROVED —� APPROV1i' SUBJECT To ABOVE Ca11 For Reinsp. a•=i � � R lil � � � � 1K§ �iSc_IC�1_NOT1,CE 400007 city of Tigard Stilding Departsent 13125 SW Ball Blvd. Tigard, on3gon 97223 Inspection Line (Rec-O-•Phonet)f 639-4175 Business Phone: 639-4171 Inspection= y (�UVV()I 1�1�—` ? �✓�— '�--���'y,/�1 J 1 Footing P11-4. Underslab Mach. Rough--in Appr/Sdwlk Fc•und. plbg. Top Out Cam Lire FINALE Poet/Beam strur_t. San. Sewer Framing -Bldg. Poet/Spam Mach. Rain Drain Insulation -Plumb. Plbg. Underfloor Wster Line Gyp. Bd. -Mach. Late Requested: d --Timef -,—_—AM _q_—PM Ru t lder sTHE VOLLOWING OOHRECTIONS TRE REQUIRED= Inepeti:tor•-^_ -- --- --- Date= J — _ APPROVED DISAPPROVED AVRCNED SUBJECT TO ABOVE Call For Reinsp. i �Y ww sen wn ew' 111E ea !A # k""MOIL NOTICE \ City of Tigarl Building Departrent 13121. SW Ball Blvd. Ti. srd. bio's 97223 1 7 Ins3ection LIne (Rec-O-Phone; : 639-4.175 Business Phu.:et 639- 9 Inspaction.--- — — -_-_ - --- ------_--- Tooting Plbg. Undaralab Mech. Ro:lDh-In Appr/Sdwlk :'ound. Plbg. Top Out Gas Line FINAL: at/Beam Struct. Ban. Sewer Framing -Bldg. st/Beam Nech. Pain Drain Insulation -Plump. Plbg. Underfloor slater Line Gyp. Bd. -Mw:!h. Date Regvestad:_—_ Ti—* ---__—PM Address:_��/�O Builder:-- �` ---- --- TAE FOILOWI4',,7 CORRECTIONS ARE REQJIRIlDt Inspectors i Dates /— U i f�__APFROVan _ — DISAPPitIRM) APPROVED BUBJEC'r TO ABOtrR Cali Far Reinap. IMSPRCTIM MOTS city of Tigard Building Departsment 33125 BW Hall Blvd. Tigard, Oregon 97223 Tnspecu—s, Ane (Roc-O-Phone)s 639-4175 Business Phones 639-4171 Inspection: — Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FIMAas Post/Beam Stxuct. San. Sewer Framing -Bldg. Post/Beam Hoch. Rain Drain Inr,ulation -Plumb. (PIbg. Underflo,r Mater Lino Gyp. Rd. -Mach. i Date Requested:_ ----Timet --- - PM Ad3resss Permit #s1_Q;` Builders THE FOI.LOIIIHG roRRECTI0M8 ARE RE/QUIRED: /f T i Inspector /�� Date: �- I APPROVBD DISAPPROVED APPROVED SUBJECT TO ABOVE Cala For Reinsp. M ni � IMF W W INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 i ype of Inspection � -- Date Requested ---_,.1�6 Time 1A.M._—P.M. Address _�..� C.�---� { Permit Owner__—)� )�,� --- – -- lot _.— Builder –'L �� ------ — — The following Building Code deficiencies are required to be corrected: Presented to _ --- ---- --- ,QApproved Inspector7( �-�i __ --_— I Disapproved Wo–Date – CAI-I. r'OR REINSPECTION I 1 YES F I NO 1 INSPECTION NOTICE fir` City of Tigard Building Department I li 1 P.O. Box 23397 U(J Tigard, Oregon 97223 1 ( / Phone: 639-4175 Type of Inspection -- Datb Requested — U _ Ti A.M. P.M. y' r Addres: . Permit17 # G� Owioer Lot Builder The following Building Code 60iciencies are required to be corrected: -- �' i i Presented to Approved Inspector _ / _ [ ] Disapproved Date — CALL FOR REINSPECTION '# ❑ YES ONO SEWER CONNECTION C1W11XT1GA;wPD F-4.RMIT PERMIT SWR90–,�-. 03,48 Cff Y-0—FTMORD V`RT11- FIER1111T 00. - MST90--OP96 COMMUNITY DEVELOPMENT DEPARWEN1 DATE' TSS(JEI)c 1.0/04/90 131258WHm118W. P.O.Boer 28297,T1q&W,0NqDn 97223(603)63"176 4- *�4.A !:i LJ B 1)1 V1 S'I'O N. . . . : VYRLSIONE ZONING: 141 OCK. . . . . . . .. . . . L 0 1 . . . . . . . . . . . . . . TENANT NAME. . » » « n USA NO. . . . . . . . . . ..42394 FIXTURE: 1JNITS. CL-Ass nF WORK. .. . .-NEW DWELL I NG UNI TS. 1. OF USL— » » » :SF NO. OF BUILDINGS- 1 INSTALL TYF:11---. -BkJSWk IMPERV SLJRFACE. Isf R e?ni a-r k e n Owi-ier: FE'IS 110JESTIC HOMES INC type <inlcn-tllt by data reept BOX 265 P R MT .1500. 0P) (:;L(I C 1S A 11 A G OR A 11 g 1.53 5. 0 0 JLH 10./0,3/90 Phone 0.- 503-658-4111 N A J K STIC HOMES INC 1*1, 0 B 0 X 2 6 5 OR Pl,ic)vie Or. 503 (:51,.-41.1.1 $ V535.00 TOTAL- REQL)IRED INSPECTION'.3 This Applicant agrees to omply with ell the rules and regulations Sewer Iiispectiori of the Unified Sewage Aqe,ic,y. the pe-mit expires 120 days from the date issued. The total amount oaid will be forfeited it the ......... persit excires, The Ageni:y does not guarantee the accuracy Y of the —----------- side sever laterals. If the sever is not; located at the meac;;rpoent ......... .......... iiven. the :installer shi,11 prospect 3 feet in all eirections from the distance given. If -tot so located, the instal r purchase a "Tap and Side Sever" Permit and he r 1 n, all r V,e-r w i 1-,t P P S j.q 11 a T,U Ve ........... 15istied By." C--%1:1 f-r J.ri s i v.-i t i o r 1 639--41'75 PIASTER PIER111IT CITY OFTIGAIRD P,rr.*:R M I T #. . . . . . . .. MST90­0296 V,RIM. PERMIT 0. : MST90­0296 COMMUNITY DEVELOPMENT DEPARTMENT DATE I15SUI-'7D: J.0/03/90 13126 SW Hell BW. P.O.Box 23397,Tigard,Orepon 97223(603)109-41175 I'!:!. i.;(JDD IV ISION. I'- T i<ESTONE ZONING-. D 1.-0 Cl 1/%. . . . . . . LOT. . . . . . . . . . . . . ..5 BUILDING REISSUEv DWE.LLINr_-j UNITS-. 1 BASEMENJ.. . . . . . . . :0 Sf CLASS OF WORK. r NEW 11 It-D R 11 F.3 s N BATHS:3 GOR(IGE. . . . . . . . . . .0484 S f TYP'E OF' USE. . . :SF FLOOR REQUIRED SETRACKS-­­­­­­­ Y`yf:'F OF CONST. -5N FIRS 1'. . - 1144 5 f LEFT. . - 10 ft RIGHT . -5 ft OCCUPANCY GRP,. i R3 SECOND. . . .- I:L07 1'.i f FRON'T .. :20 ft REAR,. s 15 f t 3TOR I E S. . . . . . . s2 'THIRD . . . . -0 19f R Ei I U I RE D— 14E 1(1 H T. . . . . . . . ..20 ft S;f SMOKE DETECTORS. sY F I OOR LOAD. . . . -.40 psi` VALUE. . . . . $- 112258 A h,I-,,,I N 0 13 P,A C,E 0 Rvs ni a-r k S ..........._......_.__.._.»....._.___.__» r11..UM14ING 5:31:1`1K S. . .. . . . . . . . .*. I F L.0 0 IR D RO I NS. . . . ..0 BACKFLOW I:IREVNTRS. . s0 LAVATORIES. . . . . :5 WATER HEATERS. .. ., - I TRov,s. . . . . . . . . . . . . . ..0 I'UP/SHOWERS. . . . .3 LAUNDRY PRAYS. . . -.0 CATCH R(4 :;INS. . . .. .. ., .. -0 WATER CLOSETS. . :3 SEWER LINL (ft) . -0 GREASE TRAPS. . . . „ . ,. .0 DISHWOSHERS. . . . - 1. WATER LINE (ft) . - 1.00 o'r H E R FIXTU R I..Sy. ., ,. . . 0 CiORDALIF. DISPI. . . i J. RAIN DRAIN (ft) . -0 WOSHING MACH. . . P1 SF RAIN DRAINS— :1. MECHAN ICAL FEES LIE:.1... 1 Y PE S­ U III T 1-4 T R 1,% x0 type aMOU111t by date r ec P t /GAS/ VENTS . . . . . ..0 r:1AYM $ 100. 00 JLH 08/29/90 t'?04219 IMAX 1:111"'UT10 DI VEIN"' FONS. » '4 BF:'RT $ 4C.5.50 F'URN ( JWOK 0 HOODS. . . . . . .1 :1. HPILC $ 302. rig 11JRN >=100K . . t: 1 WOODSTOVES. to B 1,5 P C $ 23. 28 F:LOOR FURN. . . . ::(I CLO DRYERS. : J ST 1)11 Irl 600.00 1:+('.)11../CMP o,rH[:R UNIi'S:0 SSDC $ ;37`.'. 00 GAS OUTLETS,. 1 F:IORK $ 2150.00 Owner MCIRT $ 4 0,.'.-;0 MAJESTIC HOMr:-.S INC MI'-'LC $ 10. 13 (:3 BOX 265 11131"IC 1. 2. 03 155. 00 I OCKAMAS OR 7. 75 1:-'florke 09 503--658 4111 F-'(1 Y M 2131. 77 JLH 10/03/9(7 Cc)v)t ra(:,,t o-r v .......... N As r sTI C H C)11 ES I N C 11 U 13C."X 265 I OCKOMAS OR i7-I'lcarie 0.-. `503-658-4111 kpq 59286 $ .?231. 7*7 TOI Al_ This permit is issued subject to the regulations contained in the REOGITRE') TNSP,ECTIONS Tigard Municipal Code, State of Or*, Specialty Codes and 411 other FOC)t/fOLMd Ivivu, Meeflavii.cal yrlEip applicable laws. All work will be done in accordance with apprnved Wtr Pronf:kng Fisni Pllt.tmb 'Top OUt Plans. This permit will expire ii e0 i not art within tag Post/Ream StrUCt F-ramirig -11sp nays of issuance, or if work is sus r a P'Osit/Elleam Me0,aii Fi-replare frisp C-raw]. Drain Gas IJ.iie 111rin f ni i t t e e S j,q n at� .4,r t P'1.Pi/t.tnd%1ab Iiisp Illst.ti:4tj.r FILM/Underfloor Gyp Board Tiicp 1 !;,s;1.1ed Fly: F t n q Dr,%.i.ri Bsnot Rai.r1 drAj.vi C a 1.1, for inspection 639-4175 MEN-UK CITY OF TARD RECETPT OF PAYMENT RECEir'T NO. CHEC , AMOUNT 1'd'E s MAJESTIC HOMES ("ASH AMOUNT PAYMENT DATE s 10/07/9.) SUBDIVISION 12100 LANSDOWNE FLIRPOSE OF PAYMENT AMOL)NT PAID PLIPPOPW OF PAYMENT AMOUNT PAID rWILDING PERM MST90-0296 465.10 V"L.(JMEilNG FERM 155.00 MEzH()Nl(',AL PE 40.50 ST. BUILD Prk 7;7. 06 PLAN CIALO'. FE. 212. 'I1 SEWER lJSA 1500.00 SEWER TNISPE.CT 35. 00 O)TREET SDC 600.00 PAWS SL)C-' '710 5TOPM DRrIN SDC 77'.5.0 i TOTAL AMOUNT PAID 3666. 77 aw rw a tWWRKM TIIFARD ,�,�, ,,,z5 CITYOF JT19-1 r.o.Dm2.1av7 _PLNQ /KECP tq 1Oregon ( 3)639-d71 PERMIT ifCOMMUNITY DEVELOPMENT DEPARTMENT Ui •� ]/r=7�/ DATE LSSUID JOB ADDRESS: / CI'D CrJ/'J�_ .L�, - Z`AX MAP Im SUB: _ (LQ��on1f - ior: LAM) USE: - OWNER SPDCIAT, NOTES NAME: _ ►��_AW11 c ✓►+tL i+�[, RFJSS[)E OF: ADDRESS: _P, �,.A oy�� LAST REISSUE:--- ..l�c FU)OD PLAIN/ ---- Pt IcxdE. (,!Z$ q , , - S-FN,MVE LAND: r-- fit JIItA(1108 - iAPPPOnV lk% RFD NAME: Sp-,V,ox _ kI)GIJEE RING: -. ADI1RESS: - -_. FIRE DEPT _- ---- (YTHER: — BUILDERS AC1 M if: r.. -- EXP DATE: /suDo0[ me ams: BUS TAX: ARCNlENr;INEEit C j NAME: 7 (�1II3UZA`'l'I(ltr.S: •_ _ - - _ 71WSS DETAILS: <� ADDRESS: - _ OTHER: Pf1ON": CaIlENIS: SLIBOLWERAC3URS: PLEB: E 1j � +s_t:-I MBCH: KkOAJN s N Fern A/C PERMLT # V= , DESQ2I ITTCN AM tW AiwD4M PD. BAL. DUE i;/ y c c. kj(, 1.0-432 00 Building Permit Fees _sem --- 10-431 00 Plumbing Permit Fees 153.v0 -- _ 10-431 01 FAxAmni zal Permit Fees u s r 10-230 Ol State Building Tax (5$) J� 6 ;3 Building -_ Z-b - - Plumbing -- Mech J G i 10-433 00 Plans (2xcc Fee /2. 7 I Building L Ste' Plumbic !� mech. /C. i 3 Jcc jGu_c3 q�' 30-202 00 Sewer CXxcwc-tion /5T 0 30-444 00 Sewer Inspection 9 3 51-448 00 Street System Dev charge (SDC) 52-449 00 Pa ks Systc-mt Dev charge (FDC) '23 " ---- ��� 31-45) 00 Storm Drainage Syst D,--v Qirg (SSDC) 10-230 06 Fire 'IVI'AL 371,6. 7 7 ?+PPLIcAW SI Reuei,ved Ry: -- Date Reoeived: of/3587P.WEF — GRADING/EROSION CONTRQLINFORMAIMN GENERAL CONTRACTOR NAME&ADDRESS: CASEFILE NO.: _. PERMIT NO.. _ IaS— APPLICANT NAPAE AND ADDRESS: FXCAVATIONCONTRACTOR — -- NAME& ADDRESS: �— OWNER NAPE AND ADD:ESS: TELEPHONE NUMBERS: —' APPLICANT- (a ['K 4 PROPERTY DESCRIPTION: OWNER;_ — STREET ADDRESS AND CROSS S'IREET/I,OCATED GENERAL CONTRACTOR:— EXCA VATION CONTRACTOR-LL — SIIWIOB�__ LEGAL DESCRIPI'IOIv: 24 HR/AFTER HOURS EMERGENCY TAX LOT NO.: — CONTACT PERSON,TITLE,TELEPHONE: 1/4 SECTION: SITE SIZE,ACRES: _ DISTURBEDIWORK AREA,ACRES: LOCATION&ADDRESS WHERE SPOILS LEAVING SITE WILL BE TAKEN MT /SjTEitrTN01=rDtAWS I O:(CIRCLE ONE) (NOTE:PERTS MAY BE REQUIRED) ( BATCH-BAS DrIiCH PIPE CREEK (CIRCLE ONE) 5t A - - PUBLIC RIGHT OF WAY EROSION/SEDIMENTATION CONTROL (ESCI MEASURES MINIMUM ESC REQUIREMENTS MP-uriUM ESC REQUIREMENTS DURING CONSTRUCTION: FOLLOWING CONSTRUCTION: SEDIMENTATION FACILITIES STABILIZE EXPOSED SURFACE STABILIZED CONSTRUCTION ENTRANCE REMOVE AND RESTORE TEMPORARY FSC PERIMETER RUNOFF CONTROL FP.CILITrr.S CLEARING AND GRADING RESTRICTyONS CLEAN AND REMOVE ALL SILT AND DEBRIS COVER PRACTICES ENSURE OPERATION OF PERMANT rACILITIES CONSTRUCTION SEQUENCE OTHER OTHER PLAN FOR EROSION CONTROL PREPARED AND SUBMITTED IN ACCORDANCE WITH'TECHNICAL GUIDANCE HANDBOOK-. EROSION CONTROL PLAN DRAWING,AS REQUIRED,HAS PLAN CONSTRUCTION N()TES COMPLETE.INCLUDING EMERGENCY PHONE NUMBER. SCHEDULE/STAGING FOR INSTALLAT."?N AND REMOVAL OF EROSION CONTROL., _-ASORES,AND APPLICABLE STANDARD NOTF,. 1 HAVE READ AND WILL COMPLY WITH THE ABOVE AND WILL CONSYRIXT AND M 4INTAIN ESC MEASURES AS NECESSARY T EDIMENT ON THE CONSTRUCTIOP SITE. 7 OWN SIGNATURE APPLICANT SIGNATURE 01-TICIAL,USE ONLY. RE'CEIP'T DATE ACCEPTED Ila: NUMBER RECEIVED i_ BY ! ! ! ! ! ! ! ! ! ! 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