13158 SW LAURMONT DRIVE 1:1158 SW LAURMON`1' DKVE
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INSPECTION NOTICE `,ry,
City of Tigard Huilding Department
P.O. Box 23397
1;7ard, Oregon 97223
F i-.-ioe: d.i2-4175
Type of Inspection _ lUJ(-,n J,_za7 -4----
s
Date Requested_ '� ` �� _ Ti-no__A.M. k� P.M.
Address �� �Ge.Gt L-2'1'2(,[ _, Permit s
Owner Lot
Builder Ion ,J- ("g" _
The following Buildirg Code Deficiencies are required to be corrected:
Prc sented to _ - KApproved
Inspector Disapproved
Dare - t." Z G — g
CALL FOR REINSPECTION
DYES ❑ NO
CIY OF T'6A RD
MEGI-IANIZAL PF"AMHIIA,ENLI. ME8P-3
16
CITY TIGAFM
COMMUNITY DEVELOPMENT DEPARTMENT 0�MON
I)A,1*1:-.. :1.1.4 SUE..1.) i :1 1./V9/08
13125 S.W.Hall Blvd-P.O.Box 23397,Tigard,Oregon 97223 150316394175 882311 A
.A.A." A 1)D 1:4 V:!J S .1. 1—A !JW 1..0 k J 14 il L)N I' E R
IAX MAP/L(:),1 liil 1 E
3 BK :
I. OND 11KO!: :
(A.-OVIS A[ALA416"I 'll(V4 FAMINO-CE: (1.001< ATP I-IANDLA <10
FAMTI-v l"'UNNAGE.'. :11.001<.I. AI'P HANDI 1:1 1.0K
F'l-11100 F'OPNOCE E:J, W' 'C'001 F.P
Vp. , !I, FAN
VE'N'T
N'T V L(4*U . 5 Y3*1 k::M
131 HOOD
NO LILP/GUMP INCAMEAN11 OP WOM
I)WEA-1. I)N:11'13 . 1AA-7/ AIM1:'' 1 N(.',1:Nr-FPA*T(.)r1(C'(.')M
1, IJI-'A I y 1:11:! 30-501-11::' RIEVIA114 LJNJ. I S
M6X I Nl:"1)1 504-1-41:1 0 11-IE:11
LvAS PA.WE NVO (XJ 11 1
Y 1-10ME.: �-1113VEE
VIUMPIARL'y K(i i l-lF.PYN !i`1T.*7 111:L0 . 00
N 1.3 1.5 V,il !:iW L.AlIPMON1' I'll I-.'i..(-)N RIEVIAKW
E
I*I:('.;A 14 D F: :EX i'UPES 11;.q 5
(1)(M) 61p!) nl'A'111. TAX
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0 . ) 7�, L. �.
R I !i T PA'I''.1 014 NO , 5 11i"J.'P TOTAL.
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 appllcat,ie cu4 ;s end ordinances. and it is hereby
agrewl that the work will be done ir,occorclance with the plans and F'J:N A L
speciocations and in compliance wh'i all applicable codes and
ordinances The issuance of this permit does not waive restrictive
covenants Contractor and subcontrae;tors 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 inspections are requested and approved
Flermittee Signature
Issued By .......
SEPARATE PERMITS REOUIRED FOR WORK 01HER THAN DESCRIBED ABOVE
Ss OF ..r aw
1 .0001
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INSPECTION NOTICE
�. City of Tigard Building Department
P . Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested A.M. P.M.
Address _1 j1_��] ���G'4�� � Permit 76
Owner Lot #
Builder�— - ---------- – —The following B gilding Code deficiencies are required to be corrected:
3 - t�- I Z
Presented to L"pproved
i Inspector ! [� Disapproved
Date ---
CALL FOR REINSPECTION
❑ YES 0IVO
.� � ass sees .na a>t►
I
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of inspection
Crate Requested_ `� Time A.M. Iy P.M.
Address l .�� -� Cec,c r>> l�"� Permit #
Owner __ Lot #
Builder
The fq�lowinq Building Code deficiencies are required to be corrected:
1
C �/�►- _
GLS --
Prnsented to _ — r❑xx Approved
Inspector —_ -- I�- PP► `
Date —_— –E — —
CALL FOR REINSPECTION
❑ YES 0 NO
INSPECTION NOTICE
City of Tigard Building Department
P.O Box 23397
Tigard, Oregon 97223
Phone 639-4175
Type of Inspection -----
Date Requested _SL__�- 2 Time
Address _/ � — i MC-4A J-/-- Permit # n 07 a
Owner _ - -__—_ _ _ Lot #--- —�
Builder �Y1c --- —' ---- ��-
-
The foJowing Building Code deficiencies are reedhed to he corrected:
t
Ilk
cat f --
4 ,
I�& -
4Z4 1,
64. ctldk
40,
Presented to -�� -- _-- r� Approved
Inspector _
Bate --�
CALL FOR REIN PECTION
ES ❑ NU
law am
s�
INSPECTION NOTICE
City of Tigard Building Department
P.O Box 23397
Tigard, Oregon 97223 1
Phone: 639-4`1175
Type of Inspection
' Time A.M(Cc
Date R9quested P.M.�__. - U
3�J r GJ�.�---- —
Address _t Permit *
Lot #_
Owner �j�l ---
Builder � .L ' ' `1�--�-The following Building Code deficiencies are required to be corrected:
Presented to _ ❑ Approved
Inspector r ❑ Disapproved
Date
CALL FOR REINSPECTION
❑ YES ❑ NO
W .nr .. rsr .. .. s .. .. ■sr•
INSPECTION NOTICE -1
City of Tigard Building Department �� J
P.O. Box 23397 _. \
Tigard, Oregon 97223
Phone: 639-4175
Type of inspection -- -- —"�— —
Date Requested Thno A.M..---P.M.
/ 3
Address .� �-� a �V yx) rNLt – Permit
Lot # --
Owner _\
BuilderThe following Building Code deficie-icies are required to be corrected:
Presentedto L1 Approved
Disapproved
Incpertor
Date
CALL FOR REINSPECTION
El YES 0 NO
ssWX 1Wj IWA W sas
INSPECTION NOTICE
City of Tigard Building Department
P O. Box 23397 J
Tigard, Oregon 97223
Phone 639-4175
Type of I.ispection ___ /�._LI1- '&1ynUC
---------------- —
Date Requested _--1 Time__ A.M. �+ kP.MM.�/
Address�l i _ �2(f_Y1 7� _ Permit #SJ 10 7 Gt�p
Owner nom_ Lot
+#
i3uilder 1�C J i� f'_AJ� Q_ Q_ DC7
The following Building Co( + deficiencies are required to be corrected:
Presenter d to —_� pproved
pecto
Ins ____— ___ 11 Disapproved
-4-�7
Date — —--
CALL COR REINSPECTION
0 YES 1_7 NO
CITY OF TIOP RD 1.1' O0PERMNME80760
COMMUNITY DEVELOPMENT DEPORTMENT one" DAI'F--: VnSUED: 6/1,3/88
13125 SM Hall Blvd,P O.Box 23397.Tigard.Oregon 972.j,(503)639-4175
11'.11H ADDRIE.SS : 1.31.58 SW L.AUPM(7N'1' L)Q
1A MAP/LO'T' ISO. 33DC; 16900 Sk.h..' - V'11 I AGE: AT 5UMMEPLAK4:: PADK L T PA BK :
LAND USE: 1412po
LUXT NIZE:
ITEM NO : NO:
WOPK GLASS: NEW F:*L114NA(.',E:' <1.00K 1. AIP HANDL.P <10
USE TYPE: S'INGLE' FAMILY F*I,Jl*-INA(:,L-.*. 100K+ AIP HANOLM 10K
CON51' .I'YPE : VN FI-0014 F'(JPNA(:,E F VAP .(MOLErl
GAP. : R3 HEATE14 VEN'T FAN
VL:*N*T VEN'T . SYSTEEM
(3HI-.) 1+300
NO . STUPIUS : J. OLPMOMP XWUNEPATOW MOM
DWELL.UNITS : I M-PMUMP 1.:5---30HI*-" IN(:I NEPATOR(COM
FUEL TYPE: GAS BI-RM'OMP 30-50HP PEPATR UNI'T!;.)
MAX. INPUT l:)Ll1/('.;OM1:) 50+1-11:) OTHED 2
FTW.:: DMPP17 GAS PIPING (:UTLET'S 1.
HIGH PlIESS7
I C-1w
AFMAPKS :
1---'L E S
0
W M01111 SS L.T-Tr-..' DON PEIIM:!'.T !1;1.0 . 00
N P c) BOX 191"52-11 PI AN REVIEW $9 . 36
E
R F)n It I ia 1-1(1 car 51'7R1.9 F I X TUPES
PHONE., (503) 24el-93141 51,01'VE TAX
OTHER
C
0
N
T HELL HEAT'IN(a INC:—
R
A 1311550SE: PIAZZA AW
C clatckamain tir, 9,701.5
T
0 PHONE (503) PA3- 1
18A
R I NO. 4117 'TOTAL $.e4e
This permit is Issued Subject to the regulations contained in Title 14 PF('I;;'IPT' NO. 3Z)0
of the TMC. State of Oregon Specialty Codes, zoning regulations
and all other Applicable codes and ordinances, and it Is hereby PEQUIPEO IN!WEll."Y'TUINS
agreed that the work will be done in accordance with the plans And 13ALs L-1:NE
specifications and in compliance with all applicable codes and I'DOST & REAM
ordinances The issuance of this permit does not wale ,restrictive A(J1.111".W.1:N
covenants. Contractor and subcontractors shall have jurrent city
business tax permits This permit will expire and ecome null and r:'T NAL
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 asbure
all required (--ctions are requested and,appro,ed.
Permittknatur
Issued By 5,40 rAn.. ron TNM)F-:(:-T1:(:)N 639-411.15
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
P1 UMBING PIEPM11'
A,ftlt. PEWMI't Nu. : PI-880767
CITY CSF T IFA RD (cr%=Al1D
COMMUNITY DEVELOPMENT DEPAriTMEN'r
13125 S.W.HnII Blvd..P.O.Box 23397.Tigard,Oregon 97223,1503)639,1175 DA-T-E ISSUE:O: 6/13/88
-- PAIM. PMENQ. IM0766
JOU ADMIESS : SW J.-AUPMONT' DP
'TAX MA1"-1/L-U'T' 1.51. 3.500: :1.6900 SUR . VILA A'T' SUMMEMI-AKE PAQK LT :24 UK :
L.AND USE: P1;.,NDD
1-01* SIZE :
111' -M: NCJ : NO:
WOPK CL-ASS : NEW WAIIA:4 CI 2 TPAP
USE 'T'YPE : FAMI.L.Y 0141NA1 8KFL.0W PPVN7'P
CONS'Y' . I*YPE : VN LAVC)PAI OPY P. PRIME:p
C)CC1UP . C;A- 1*-" . : P3 JIM SHOWEI-1 114APS
01C.,)HWASHE'A 1.
GA,-1:441IGE D.LiPOSAIL. I
N(:) . 5*T'0P1F.:S : I WASHING MA(:,HJ'.N1,-*. :1.
DWEiI.I.. . UNT'T'N : 1. 1 AUNDPY 'I PAY Rl
FLUCIP MAIN
SINK I 5E.WEVI (r-,*T')
WA*T'EP FIFE'ATI-ER 1. (iiTIMM/PAIN (1: 1-
1AE'1-4
1-4::HAPKiii :
0
W ML)P1 5 S E*A,I F DON PE.PMVI,
N lila I' 1.9!-')P-A
E
R P Cl r-tl fit n C1 to 1- 177'21. FIX'TURES
PHONE: (50.15) 24el-931d1l 90'Al'IF: 'T'A X *5A ,(
C
0 �:i H(:)E-M A K E'P HAMRA)
N
T Sll`40EMAKER' S PLUMPING
R
A P13 BOX P.50
C e.stl;tc:�ndpt cor, 9,701*23
T
0 PHONE. (50.31 630--?--;eZj
R i-qE(*.,.:rs*T'r4A'T10N NIU. 3922 'T'GTAI–: $1e3.38
This permit Is Issued subject to the regulations contained in Title 14 NECEIP'r NU.
of the TMC, State of Oregon Specialty Codes.zoning regulations
and all other applicable codes and ordinances, and It is hereby Pr-.-QLJTRED INSPEC-1.111INS
agreed that the work will be done in accordance with the plans and PI-D.LINUEASLAH
specifications and In compliance with all applicable codes and POSI, & REAM
ordinances The issuance of this permit does not waive restrictive WAIIi.4 1 INE.
covenants. Contractor and subcontractors shall have current city
business tax permits. Tjil;permit will expire and become null and MCI. 1,L)POU'r
void It wcrk is not sta,red within 180 days,or if work Is suspended or PAIN DPA INS
abandoned for a period of 180 days any time after work has F I NAL.
commenced. "all be the rei,�onsibiljty of the permittee to assure
p c ns are requested and approved.
all
required
quired nnso 'ti
a
C -
Farmitt gni L.rP
Issued By: 1 1:9 1 P7-71,N dirt CT I(JN–7--�—(7-4T
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
,�'�'�.
Pk-'.RM:E'T* NO. : BUS00766
C'� OFTIIFARD 13(.JTL.. I: :, F-'k::R,'1:1:'T' /
C17YOFTWARD
OalOOM
COMMUNITY DEVELOPMENT DEPARTMENT I.MN'TE ISSUED: 6/11.3/88
13125S.W Hall Blvd.P.O,Box 23397,Tigard,Oregon 97221(503)63941175 [-"Q*I'tA MAX
JOH AIN)WE!IS : 13158 SW I.A(.01MON'T ORTAX :24 BK :
IMIAP/1-01' ISI 33DC 16900 SUB: V:KL.I-.AGF;: A'T' !.iUMMEPLAKF-'. PAPK LT
LAND USE : 1112F)I)
SIZF..." VAI UA'TION: $ 66,000 SE'FHA(.'K5
F'r40NT : 20 REAP :
WORK CLASS : NEW DWEL L. .UNI'T'S LEFT : 6 1-4 1 GPH'T' :
USE' 'TYPE : SIM.4L.F. FAMILY ND - DEDPOOM5 : 3 EX'T .WALL. GONSI :
*TYPE : VN N(J. BA THS : 2 N: S : E W
0CLIP.GAP. P3 PAO'T .OPENINGS:
OCICUP.LOAD N: S : E: W:
'I OTAL APF A: 1,f:106
N(:1 S'T'O Al F:5 1ST'' 1408 RUM CONS I' : C IX1AF.;.' RE'T7
16 OND: APk..A 51 PAf0
13ASEMr--'N'T"? 3RD: (:1MIJI.) . SEPA117 RAI'ED:
MEZZAN'1NV7 BASr--.M'I'
F"LOOP 440 FIWE- SPRIKILP"? A L.ARM'?
FL .OW(GPM) YL--S
Cuuw
Pl-.()N CHIECK 0y : I'l-t
11k;.MAPK4-3 : PEISSUE OF:' NO. 6906
I"AS'T' REISSUE 1",80762
F F EES
$331 . 00
HOPISSEl"TE DON PF.
"(:)X j.q.ni24 PI AN REVIEW 111111410 . 00
,
a i-t I ia.ri(J ci r 97 2:1.9 FIPE, DEPI
PHONE 11 "503) 2-f114-9-33-A S'I*A*I'F'.-' I'AX $16 . 55
0 THEP
C 1*)EVI;.'1.OPMEN*T* CHAPII;k:S :
0MORISSErf-rz: DON !if:)(:,(S'TOPM) 21.5 0 . 00
N MOPILSSEl'I'L 811-1111 DLIPIS IN(— SOC(S'TPF-*:FJ ) $600 . 00
1 .3 .
A
R PDC(211111 $250 . 00
BOX 1.95211
C 1:)ti r t 1.at n cl Li r 1972!19 P PF--*:PA I D < 4140 . 00>
Oril-iONE (303) 24141-9314
R r-4F:.G:FS'TPATI(:)N NO. 35533 CYTAL: $1. Z147 , 55
PECEIP'T NO. 3,-,�0 7
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 nE(l u'.I.f*'A) IN5PECI'lONS
agreed that the work will be done in accordance with the plans and FOCYTIN11', S E W V'..A
specifications and In compliance with all applicable codes and FOUNDAIJON WALL PAIN DPAIN1.5
ordinances The issuance of this permit does not waive restrictive POST' & 13t--AM WAI'E1l LINE
covenants Contractor and subcontractors shall have current city PL .UNDERSLAH APPRIt.111-41SW
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 SLAB F I NAL
abandoned for a period of 180 days any time after work has I'-)I F3.TOPOU'l,
commenced. t a the responsibility of the permittee to assure F41AMM3,
all required I pact ns are requested and approved 1--1.14-KIL"LACE
commenced. It I b
'I red I n
GAS LINE
INSUI A'T*I(IN
(.,Yr' . HUMID
Permittee S ore
Issued By M111-1- T N 5 PF-C T T UTN A*T9-----A-f75
SEPARATE PERMI rS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
Id
St.*w1-:14 Pk;44MA:.1.
CITY OF T'GA RDCmo�FTWARD PEXIMI T NO - : SEP00769
DATE*.: ISEiUED: 6 :IA/08
COMMUNITY DEVELOPMENT DEPARTMENT PRIM. PM'T .N(:). 6807(:,0)
13125 S.W.Hall Blvd..P.O.Box 23397.Tigard,Oregon 97223,(503)6394175
,JOB ADOPE.55 : 13138 SW I-ALIPMONT 1:)1.1 USA NUMBEA :
'TAX MAP/LOT 1,51 33DC 16900 st.)H : VILA AT SUMMEA1 A K Fi. P A P K LT : P-A HK :
LANL) (.)5F.: RIP.P0
L(,)T 51ZE::
IMG : 1w
SIEC"TION: 33
WORK CLASS : NEW
USE 'TYPE:: SINGLA"- FAM1LY
akgr,etain tcl WAAVI I•iilc.4% nirld r-O)Q141MAJ
iI
U20 (11ILY19 11'I"(3m thIffl, (1111-t-V4 :I.14,ii I- h%(:I tc)tin.l.
lain"t.11-It. pa:IA WJ.*1A. 1:)" I.f. tflei j:)lF"vMJ.t Ageric!q cicicm!1 1.1cit
aLrIte)c? thre 4:1.11 I'l-lore 1cleni-I.C11-1 (:)-P I'l-liv.q BI1.(1411 ine-iw(--,?r, fit . :E-P th-, %V?!W(i^.r. JIB
loc) lciclakoocl , thch
th*-
rt —Tpq) AILI-Icl Plinvivi.t RLII(J the Aq(,-�rlvy WJ.1.1. J.Ilultmll ;B, J.ilk t,c)I,ial .
X.MPF.11- VIDLIq AREA:
FIX'TURF: UN]1`5 I-F.-'NANI* IMPROVEMEN'T' :
DWELLIN(.11 UNI'1*15 .
NO. OF HLAX*45 .
FEE:S
0 MOPT'StiEl"TE: PF--Pmll, *35 , 00
W P0 BOX 1.9,1%'?-'1 CONNECTION CHARGE*.
N p tj I,t 1.a n d ci r- 972:1.9 1-TNE' TAP INSTAL.A.. .
E
PHONE: (503) Y31.q
$360 . 00
C H(*.)P1S!iF.-T`TE: DON
0
N E)(*.)N M(:)1-1TS)5F%'7TF HUIA-DEA5 I.N(.; .
T p ci BOX 1.95?A
R
A p ri I,t].41111(1 ti r- 972.1.19
C Pl-U)NE- (,"50 3) 2A4 9314
T1,01 Al 9 15 . 0 0
0 REGISTRA'I'lON NO . 315Z3
PE(:,EA1-'T NO .
This permit is issued subject to the regulations contained In Title 14
of the TMC. State of Oregon Specialty Codes,zoning regulations PF.QU1PEF) T.NSPEC'rT.ONS
and all other applicable codes and ordinances, and it Is hereby POUGH-IN
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
business tax permits. This permit will expire and become null and
void it 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 s^Le the responsibility of the permittee to assure
all required lins cti ns are(r ;uested And ved
Permittee S'
-CIALA- FOR INSPEe'rioN 639•-A175issued By.
PERMITS REQUIRED FOR WORK 0 fHER THAN DESCRIED ABOVE
�r r Y ter- I IUAHU MECHANICAL PERMIT
Permit N
Deseriptfon
Table 3A Mechardcal Coda CITY PRICE AMT
City of Tigard --
13125 3.W. Hall Blvd, 1) Permit Fee -0• -0- 10.00
P.O. Box 23397
Tigard, OR 97223 2) Supplemental Permit 3.00
6;39.4175 Furnace to 100,000 BTU
1) incl.ducts&vents 6.00
Furnace 100,000 BTU +
2) incl.ducts&vents 7.50
No"WFloor Furnace
1 ► r r\ L /l I`),t -1) 3) incl __vent 6.00
,lob Address v _ Suspended heater,wall heater
Address I � 5 S S W L c a i A r I ti, m I �( 4) or floor mounted heater s•oo _
Tart Lot Map NoVent not incl.in
Lot Back subdivision 5) appliance permit 3.00
Nam.(or name of buskrosslrepair of heating,refr ig.,
6) cooling,absorption unit 6
7
Mfsihng Address Ph" Boiler or comp to 3 HP
Owner ) absorp.unit to 100,000 BTU_ 6.00
cityist.0 Zip Boiler or comp to 3 HP-15 HP
8) absorp.unit to 500,000 BTU 11'00
N 1 Boiler or comp 15.30 HP 15.00
CJI 1 iol ( �I 9) absorp.unit 1h-1 million
NMV Adftfs Ph" Boiler or comp to 30-50 HP
10) absorp.unit 1-1.75 million 22.50
Contractor ��� S C SLI
gtda Boiler or comp l0 50 HP
�,. 1�� ipi 1;)_ 11) absorp.unit 1,750,000 BTU 31.50
State RegbtraIW No. CJr f City Bus.Tar No 12) Air handling unit to 4.50
}I � 10,000 CFM
I heroby acknowledge that t have read Mil application that the information given is 13) Air handling unit 750
10,000 CFM +
oonect.that I am the owner orautfgrlced spent or the owner,that plana submitted ars in .,_
0("puarx's with State laws,that I am registered wtth the State Builders'Board,that the Non portable
numt)w given is cxxract.(If exempt from Slate registration please give reason below) 14) evaporate cooler 4.50
Vent fan connected
1 to a single duct _ 3.00
--------- Ventilation system not
16) included in appliance pet., 4'50
Hood serveo..,y
` , '/'/� r7 17) mechanical exhaust— 450
Signature(niwwr or agent Date 15) Domestic type 7.50
Describe work ❑ addition p alteration ❑ repair ❑ incinerator------
to
ncinerator _tobe done residential O non-residential ❑ Commercial or industrial
-v 19) type incinerator
30.00
Existing use of -------- --
building or properly _ Other i e,woodstove,water
20) heater,solar,clothes dryers,etc. 4.50
Proposed use of --_—___ ___ _
building or property — 21) Gas piping one to four outlets 2.00
Type of fuel- oil ❑ natural gas d LPG ❑ electric n -
22) More than 4-per outlet
NOTIC ---- ----- --- --- SUB-TOTAL
---- -
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- - ----- - -- --
STRUCTION AUTHORIZED IS NUT COMMENCED WITHIN 190 S&10 44'SURCHARGE
GAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL ~
Ar3ANDONED FOR A PERIOD OF 180 DAYS At ANY TIME AFTER - - ---
WORK IS COMMENCED TOTAL
pec+a Conditions
—_ _ Uato Issued by
CITYOFTIFARD
PLAN CHECK APPLICA'110N
PLAN CHECK N
PERMIT N
COMMUNITY DEVELOPMENT DEPARTMENT 0014mm !DATE ISSUED
10126 6W Hd BML P.O.Ba 23197,Tkwd,Onp n arm 1603)639.41?S
JOB ADDRESS: lS .Sw aarm,_1 Dy TAX MAP/LOT /5/- a'3 D C_
SUB: U w f�'eMo./�/re r N LOT: 1 LAND USE:
OWNER i L H � ' SPECIAL NOTES
NAME: ..//� {7JD/t JS.It�� REISSUE OF: C.J ;
ADDRESS: LAST REISSUE: gra _
FLOOD PLAIN/
SENSITIVE LAND:
PHONE:
APPROVALS REQUIRED
CONTRACTOR PLANNING:
NAME: ENGINEERING:
ADDRESS: FIRE DEPT
OTHER:
PHONE: ITEMS REQUIRED
LIST/SUBCONTRACTORS:
ARCH/ENGINEER BUS TAX:
NAME: CALCULATIONS:
ADDRESS: — TRUSS DETAILS:
PARKING PLAN:
LANDSCAPE PLAN: _
PHONE: OTHER:
COMMENTS:
I
PERMIT N ACCT N DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
P' G 10-432 00 Building Permit Fees ;j 331
10-431 00 Plumbing Permit Fees S v
f:S tj 1 S 10-431 01 Mechanical Permit Fees i, 3 7. 3 u
10-230 01 State Building Tax (5%) a ._q, },i
Building
Plumbing
Mech l. _y
10-433 00 Plans Check Feet 7/ .J,y 3y
Building Iry
Plumbing
Mech -
30-443 00 Sewer Connection (20%) ,22fl 2 zt,
b� 30-202 00 Sewer Connection (80%)
30-444 00 Sewer Inspection _ 3j
51-448 00 Street System Dev Charge (SDC) (rte- �irC,
52-449 01 Parks I System Dev Charge (PDC)
52-449 02 Parks II System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg (SSDC) .2—
10-230 09 TRFD (95%)
10-435 00 TRFD (5%) -
10-230 06 Washington County Fire N1 (95%) _
10-•435 00 Washington County Fire N1 (5%)
10-220 00 Amart/Wedgewood
TOTAL
REC N
APPLICANT SIGNATURE ---
Received By: Date Received:
ht/3587P —_----- ___