8542 SW LUCILLE COURT l
ADDRESS:
1
i:\records\micro ltlm\targets\building.doc
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CERTIFICATU III F
OCCUPANCY
PERMIT #. . . . . . . 9 MGT93- 0044
CITY OF TIGARD
COMMUNITY DEVELOPMENT DVEPARTMENT C'ATF ISSUEDI Q#8,103/93
13125 SW Hall Blvd,Tigard,Oregon 97223.8199 (503)639-41,71
PARCELs 1S135DD--L.UC07
S t TE ADDRE5S. 08542 SW LUC I LLE CT
SUBDIVISION. . . . LUCILLE. ZONINGi
BLOCK. . LOT. . . . . . . . . . . . . :7
TYrAE OF USE. 9F
OCCUPA14CY ORP. : 43
OCCUPANCY LOAI)i23 4
TENANT NAME. . :
Remarkst PATH 8
Owner:
NORTHLAND HOMES
1834 SW 58TH
PoFuLAND OR 97221
#1 292-3975
C o n t r ac t(3 r:
NORIHLAND HOMES
1,134 SW 58TH
PORTLAND OR 97221
Phone Ot 2.92-.3975
Ptsu #. . : 13727
OCCLIPRTIL-/ Of thy: above referenced buildinW it, hereby 4iyen, and c-ertifiosi
the compliance with the 9-tate Of Oregon 5pecialty Godef: for the rjruf.�'p,
anti .tse k.tncjev- which the referenred pey�mit was i'r;suod.
f'I
ENT WPECTOR
R C --iF�i
F I C I AL
POST IN CONSPIGIJOI GE.
S
C
INSPECTION NOTICE
City of Tiga-d •aull_iM Derowt sent !,
13125 SR Hall Blvd. Tigard, Oregon 97223
Inapection Line (Rec-O-Phone)c 639-41,75/,businessPhones 639-4171
Ineprction: /�1117�i �i�)
Footing P1bg. Undermlab Mach. Rough-in A r/Sdwlk
Found. Plbg, Top Out Gam Linn FINAL, 1
Poet/Beam Strcct. San. Sewer Frawing eldq
Pont,/Beac, Mach. Reiss Drrin Insulation -Plumb.
Plbg. Underfloo- Nater Line Z Gyp. Rd. -Hoch. �
Dara. Roquented:_._ n /�+ �TLanet _ ,QUI PN
Address s L_' i L(1 �•l.�_y-( (�' —— Per-nit #s r --
Builder:
THE FOT.UMIWQ CORRECTION? ARE REQUIRED,
Inspector
s _ Date:
PPROVED DISAPPROVED APPROVRD SUBJECT TO ABOVE
Call. For Reinsp.
l
r-
r
VaPECTT ON NOTICI.
C.lty of Tigard Building repartatent
13125 Mv" Nell Blvd. Tigard, Oregon 97223 /♦
Inspection Linw (Rac-r.-Phone): 639-4175 Businotes Ph 39-4111
InspectLon t
Footing Plbg. Underelab Hoch. Rough-in Appr/Bdwlk
Found. Plbg. Top Cut Gas Line ! FINALs
Post/Bean Strur_t. San. Sewer Framing -Bldg,
Post/BeAm Meeh. Rain Drain Insulation -plumb
Plbg. Underfloor Water Line
Gyp. Bd.
q"
Date Requwatedt__ 1 � _ Tlma:
Addreset �=
I•r•'q�i-Lis 3-610e
� �
Buil ers arnt� / �� -4�Z 5 / /7LJ
4 THE FOLLOWING CORRECTIONS ARE REQCIRE7:
OPA
�Y
t
T is
Inspector _- Date7,
APPROVED _ nISAPPROVBD APPROVED 3UR,IECT To ABOVg
Call For Reinsp.
'y
h
T'!/A'. r a�; '.�?si➢t�.,,r 7r 'ncl'"�^"�1','*H!!21 S•lMal.!9":p:""Y1'r�:rl`iMil".'i"�AB '�Ji. '�,
INSPECTION NO'T'ICE
Litt of Tigard Building Dapartnont
1312! SW Hall Blvd. Tigard, orelon 9722
Inepectinn Lina ;Rec-O-•Phone): 639--4175 Business Phone: 639-4171
Inspections --- --_--�.� ---
Footing Plbg. Underslab Mech. Rough-in Apps/Sdwlk
Foind. Plbg. Top Out Gas Line FINALS
Post/Beam Struct. San. Sewer :raining -Bldg.
Lost/Beam Mech. Rain Drain Insulation -Plumb. 41
Plbg. Underfloor pater Line /G, yp. Bd. -Mech.
Date Requestcdc�_ _J .� Times AM PM
Address3Permit
f�
THE FOLLOWING CORRECTIONS ARE MUIRED:
Inspector `_-- nates
APPROVED _— DISAPPROVEn _-_ APPROVED ltUBJRCT To ABOVE
Cal.l For R, inep.
�1
N�� l
jNSFE(Z[XOh NOTICE l
City or Tigard Building DePartseot e a
13125 Be Ball Blvd. Tigard, Oregon 97223(
Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Unde-alab Mach. Rough-in Appr/Sdwlk
Found. PTbg. Top Out ;na Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Pcet/Beam Mach. Rain DraLn C Insulation -Plumb. I
PLLg. Underfloor Nater Line Gyp. Rd. -Mach.
Drtte Recpsasteds.
73 Times AM PM
Address:
Peroit it
Builders
TRE FOLT,OW:NG CORRECTIONS ARE R6QUIREDs
Inspectors Dates
X
APPROVED --- DISAPPROVED APPROVED EDBJECI ITO ABOVE 1irl,f
Call For Reinsp.
is
SEE
I
zrs��CT10A NOTICE �ry
City of 'Tigard Building Department
13125 all Ball Blvd. Tigard, Oregon 972"3 S5"
Inspection Line (Rec-O-Phone)z 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Und r lab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam St:ruct. San. Sower racing -Bldg. •
Post/Beam Hoch. Rain Drain Insulation -plumb.
Plbg. Underfloor `Water Line
Line Gyp. ad. -Hoch.
Date Requestedt L! Id
-� Timss AM _4PM
Address: Permit 1f -� '-�L'`
Builder:
THR FOLLOWING CORRECTION'S ARE REQUIRED:
IW
Al to Al
L 7? it
iris �chy3 } v;.
A Com'
�IYI /�� t � � Q 1 G,�1 w�T•t��l l_�}I �� i$'��
fb ,�yy
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1 ti
Ins pec nor: Data
APPRom DISAPPROVED APPROVED SUBJECT To MME
--Call For Reinsp.
�IK�tiitWge• ., .vt�a*w+ 1BYv°E1+19�BIfbI�yMR77�nwaF�X'+w.n+a+i.u><i.m�re..nrwr.+i...-ter,-..,• ,..
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7
INSPECTION NOTICE
City of Tigard Building Deparhment
13125 Be Ball Blvd. Tigard, Oregon 9':223
Inspection Line (Rec-O-Ph,;ne)s 639-4175 Business Phone: 639-4171
Inspectiont_
Footing 7_— i
Plbg. Underslab R h. Rough-in ; Appr/Sdwlk
---
Found. Plbq. Top Out Gas Line FINAL: I
Post/Beam Struct. San. Sewer Framing Bldg.
Post/Beam Hoch. ,.i.in Drain Insulat.lon -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. —Hoch.
Date Requested: r._Til" PN
�I Addraess � �.J L' ` ( � �-- Permit #t
i
Builders _ _ ■
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspectors_ -fes, Dates
APPROVED _ DISAPPROVED APPROVBD ST)WNCT To ABOVR
_-call For Rainey.
s
L —'
INGPECT ON NOTICE
city of Tigard BulldiOg Departaent
13125 rM Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec--O-Phone)s 639-4175 Business Phones 639-4171
Inspect ions ---------
plpg. Underelab — ---- I
rooting
n7wh. Rough-in Appr/S[SwIk
Prnsnd. Plbq. Top
Out ds FINALS
-•Bld
post/Beam Struct. San. Sewer Fri n9 g
post/Beam Meeh. Rain Drain
Insulation -Plumb.
plbg. Underfloor Nater Line Gyp. Bd. -Hoch.
Date Requesteds /_Time: _141K—AM PH
,7/ /, ■
5"
Address$ J Permit Is v
Builders
TRE FOLLOWING WRRECTIONS AAE REQUIRED:
77
Inspsatorf �7 ---- Dates
APPROVItD DISAPPROVED APPROVED SUBJECT To ABOVE
Call For Reinsp.
t
City of Tigard Building Departenat
13125 811 Ball Blvd. Tigard, Oregon 97223
Inspection Line (Roc--O-Phone): 639-4175 Business Phone: 639-4171
Inspections^_ ---
Footing
Footing Plbg. Underslai Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Past/Beam Struct. San. 8ewec� Framing -Bldg.
Post/Beam Moen. Rain Draln Inaul.ation -Plumb.
Plbg. Underfloor �itetor Lin'e Gyp. Bd. -Mach.
Date Requested:��C - _ _Time: AM ,PM
Addraaas--1 J Permit.
Builder— _-- -�—
TRE FOLLOWING CORRECTIONS ARE FSQUIREDs
Inspectors /�� �� -�— Dates
y ROVED DISAPPROVED __ APPROVED SUBJECT TO ABLY"
Call For Reinsp.
t
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INS PENT11 N AOTICF
City or Tigard Building Depirtme
1.3125 SW Hall Blvd. Tigard, Oregon 9 i' /
Inspection Line (Ree-O•-Phone)s 639-4175 Business I`66h : 639-4171
inspection: ---- -
Footing Plbg. Underalab Mach. Rough-in Appr/Sdwlk
Found. phi g. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -bldg.
fJ t
Post/Bgam Hoch. Rain Drain Insulation -Plumb. tN ,
� tf f flPf
Plbg. Underfloor Water Liffe GYP• Rd. .-Mer-h. 114
�T101st _ AM �P11 5 u e;
Date Requested // ,
Addreass C _ Permit #1-/ 7' �LJ`1"/-- Y
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r
Builders
f
TBE FOLLOWING CORRECTIONS ARE REQUIRED-
s
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Jf eY �`�SI
Inepector3 _
Date:
APPROVID DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinap. jY
I 1.
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CITY OF TIGARD
OREGON �
March 22, 1933
Northland Homes
10211 SW Barbur Blvd. , Room 202
Portland, OR 97217
Re. Lucille Subdivision
This letter is to confirm previous conversations with the building
inspector from the City of Tigard, a `.th Larry, field representative
from Northland Homes.
The following are minimum requirements due to the type of sail
�--onditions found on-site, and the way construction methods are
F being employed installing utilities, streets, etc. , at the same
time that footings are being constructed, which is resulting in a
large amount of undesirable soils, rock, etc. being moved and
depo,Ated randomly on the job site.
• All lots are required to be tested by an independent test lab
showing soils will meet minimum standards (UBC I & 2 family
Code.
Also, footings already poured on Lot #1 appear to be substandard
with poor consolidation of concrete; poured without proper forming,
etc. This footing will also need to be tested to meet minimum
standards of 3,000 psi.
Tom Pl.escher
Building Inspector
br/NorthtaM.ltr
J�irJ �
M,
AIL
jNSPEGTION NOTICE
Citi or Tigard Building Departoenk
13125 811 Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-4-Phone%t 639-4175 Business Phone: 639-4171
Inspection:— ---
- 1
Footing Pibg. Underelab Mach. Rough-in Appr./Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
ppot Beam strlct.' San. Sewer Pre Ing -Bldg.
i
h. Rain Drain Insulation -Plumb.
i
1bq.�Odili>*tioor Fater Lina Gyp. Rd. -Hoch.
Date Requestedt Timet AM --AIPM
Address:
Permit is _
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED: fir,
Inspector Dates
APPROVED _ DISAPPROVED _ APPROVED SUBJECT To ABOVE
_—Call For Reinep.
I
w
1
;x
5;
MILE_CTk0_r NOTICE e
City of Tigard Building Department
13125 SK Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rea-o-Phone: 6)39-4175 Business Phone: 639-4171
Inspection: — — ,7, '� —�
Tooting Plbg. Underslab Koch. Rough-in Appr/Sdwlk I
Found. Plbg. Top Out Can Line FINAL: '
Post/Beam Struct. Ban. Sewer Framing -Bldg.
Post/Beam Hoch. Rair Drain Insulation -Plumb.
tlbg. Underfloor Nater Line Gyp. Bd. -Hoch.
Dat Requested: / r �� Tlmef AN PH
Address: / L- - �-�L�� -- Pirmit t �-�^ }� ■
Builder:_ ,I _I J
TRE FOLLOWING OORRECTIONS ARE REQJIRED:
VL)
vc S
L)
Inspectors Date:
APPROVED DISAPPROVED APPROVED SUB.T6CT TO ABOVE
Call For Reinep.
Gay �
F
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1 '6I lfl
} � le
N
TIVARD
Aus
CITYOF My Rp PLUMBING FERMI T
COMMUNITY DEVELOPMENT DEPARTMENT omm PERMIT #. . . . . . . .. IvIST93•-0049
13126 8W HWI BWd P.O.Boz 23397,Tlp M.OreWn 67223(603)6304176
SITE ADDRESS. . . : 08542 SW LUC I LLE CT PARCEL : L S 1:'5DD--LUC(ZI7
SUBDIVISION. . . . . LUCILLE ZONING-
BLOCK. . . . . . . . . . :
ONING:BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :7
ci_______... __.--_.-__-____-___-----___-___-_.-__
CLASS OF WORK. . :IVEW GARBAGE DISPOSALS. - : 1
T'YP'E OF USE. . . . :SF WASHING MACH. . . . . . . .. 1 BACKFLOW PREVNTRS. . :O
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . ;0 TRAPS. . . . . . . . . . . . .. . :0
STORIES. . . . . . . . :2 WATER HEATERS. . . . . . : .1 CATCH BASINS. . . . . . . :0
FIXTURES--------_.___-_-- LAUNDRY TRAYS. . . . . . :0 SF' RAIN DRAINS. . . . . : 1
SINKS. . . . . . . . . . . I GREASE TRAPS. . . . . . . :V1
LAVATORIES. . . . . :2 OTHER FIXTURES. :21
TUB/SHOWERS. . . . a SEWER LINE (ft) . . . . :N m
WAVER CL..OSETS. . -2 WATER LINE (ft) . . . . : 100
DISHWASHERS. . . . : 1 RAIN DRAIN !ft ) . . . . :Vl
Remarks: PATH 8
OWNERa
______________..___.__._.___..._._______.___ -----------------FEES_____.________.__....
NORTHLAND HOMES TIF $ 1460. 00 J'H 02/10/93 -
1834 SW 58TH BPRT' $ 316. 00 JH 02/10/93 -
i
BPLC $ 40. 00 JLH 08/26/92
PORTLAND OR 97221 B5PC $ 15. 80 JH 02/10/93 -
Phon+a #: 292--•3975 BPLC $ 15. 00 JH 02/10/93 -
SSDC $ 280. 00 JH 02/10/93 -
Pli.lmbing CoTit rar-tor :----- _____.____.._ PARK $ 500. 00 JH 02/10/93 -
Q MPRT $ 37. 50 JH 02/10/93 -
Name:_ k-- Ct Q� � C.�I' MPLC $ 9. 36 JH 02/10/93 -
Pddress : aff ...��x....� t11�'_ � M5PC $ 1. 88 JH 02/10/93 -
1 C,t y: . -- State : f` hJL PPRT $ 110. 00 JFI 02/10/93 -
r I='IionriY: . 'r' ' �.� P'5FT, $ `.,. 50 JH 02/10/93 -
-.------ REQUIRED INSPECTIONS ------
'This permit is issued subject to the reg--
ulations contained in the Tigard Municipal Foot/found Insp Rain drain Insp
Code, State of Ore. Specialty Codes and all Post/Beam Struct Water Line Insp
other applicable laws. All work will be clone Post/Beam Meehan Appr/Sdwlk Insp
in accordance with approved plans. This Plm/undslab Insp Mechanical Final
permit will expire if work is not started PLM/Underfloor- Plumb Final t
within 180 days of issuance, or if work is Mechanical Insp Building Final
suspended for, more than 180 days. Plumb Top Out Erosion Contra].
Framinq Insp Crawl Drain
Fireplace Insp
Gas Line Insp
Insulation Insp
_. Gyp Board Insp
-
horized I'],._ mL�in Lvrltractor Signat�_lre
Call for inspection - 6:39-4175 !
Contractor Notes :
f
a ,'y
llw OF TIGARD
IhASrER PERMIT
ff COMMUNITY DEVELOPMENT DEPARTMENTL�j'4' FERMI'r #. . . . . . . : hi,T93-0049
CrIYOFT13126 BW FWI Bbd. P.O.Ba 23307,T19",OWw 97W3;t(F it 1 5
DATE ISSUED: 02/10/93
SITE ADDRESS. . . : 06542 SW LUCILLE CT PARCEL : IS135DD-LUCO7
SUBDIVISION. . . . : LUCILLE ZONING:
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :7
BUILDINCa
REISSUE:MST93-0048 DWELLING UNITS: 1 BASEMENT. . . . . . . . :O S
CLASS OF WORK. :NEW BEDRMS:3 BATHS:2 GARAGE. . . . . . . . . . ::353 sf
TYPE OF USE. . . :SF FLOOR AREAS----------- REQUIRED SETBACKS-----------
TYPE OF CONST. .51\1 FIRST. . . . :582 S 1_EFT. . : 12 ft RIGHT. :S ft
OCCUPANCY GRP. :R3 SECOND. . . :586 sf FRONT. :20 ft REAR. . :20 ft
STORIES. . . . . . . :2 'THIRD. . . . :0 5f REUU I
HEIGriT. . . . . . . . .23 ft TOTAL------: 1168 sf SMOKE DETECTORS. :Y
FLOOR LOAD. . . . :40 ps w VALUE. . . . . : 6OV182 PARKING SPACES. . : 1
Remarks : PATH 8
_. _,....._--.____--_---.----.____-_--____- PLUMBING •--_-__--__._________----.___._____________
SINKS. . . . . . . . . . . I FLOOR DRAINS. . . . :0 BACKFLOW PREVN1R5. . :0
LAVATORIES. . . . . :2 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :O
TUB/SHOWERS. . . . : 1 LAUNDRY TRAYS. . . 0 CATCH BASINS. . . . . . . :0
WATER CLOSET'S. . :2 SEWER LINE (ft ) . :O GREASE TRAP'S. . . . . . . :o
DISHWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXTURES. . . . . ..0
GARBAGE DIST'. . . : 1 RAIN DRAIN (ft ) . :0
WASHING MACH. . . : 1 SF RAIN DRAINS. . : 1
MECHANICAL ------------------------------------- FEES
---------------
FUEL TYF�ES--__.__..____._.__ UNIT EITRS. . :0 type amount; by date recpt
/GAS/ / / VENTS . . . . . :0 TIF 1 1460. 00 JH 02/10/93 -
MAX INPUT:O B'TU VENT FANS. . :2 BPRT 1, 316. 00 JH 02/10/93 -
FURN ( 1O0K . . : .1 HOODS. . . . . . . I BFILC 1• 40. O0 JLH 08/26/92
FURN ) -=100K . . :0 WOODSTOVES. :0 BSPC $ 15. 80 JH 02/10/93 -
FLOOR FURN. . . . :0 CLO DRYERS. : 1 BPLC 4 15. 00 JH 02/10/93 -
BOIL/CMP ( 3HP:0 OTHER UNITS: 1 SSDC $ 260. 00 JH O2i10/93 -
GAS OUTLETS: 1 PARK E 500. 00 JH 02/10/93 -
Owner; __..__._.._-_______....____..__.__.____.__._.__.___r;T�R'T' $ 37. 5O JH 02/10/93 -
NORTHLAND HOMES HPLC $ 9. 38 JH 02/10/93 -
1834 SW 58 rWr
I15FC t• 1.. 88 JW 02/10/93
:IPRT $ 110. 00 JN 0,:/11+/93 -
PORTLAND OR 97221 P5PC $ 5. 50 JH 0r/10/93 -
Phone #: 292-3975
Contractor:
NORTHLAND H01v1FS
1834 SW 58TH
PORTLAND OR 97221
Phone #: 292-3975
Reg #. . . 13727
2791. 06 TOTAL
This permit is issued subject to the regulations contained in the ------- REQUIRED 111SPECTIONS -------
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Ins- Fireplace Insp
applicable laws. All work will be done in accordance with approved Post/Beam Strr_tr_t Gas Line Insp
plans. This permit will expire if work is not started within 180 Post/Beam Mechan Insulation Insp
days of issuance, or if work is suspen r more t n 100 days, Plm/undslab Insp Gyp Board Insp
l F1LhI/Underfloor Rain drain Insp
1 'F�r miLtee 5i.ynat�_rr .�r
/0.// Mechanic:•al Insp
Water Line Insp
Plumb Top Out Appr/Sdwlii Insp
Issued By : Fr aming Insp Mechanical Final
Call for inspection - 639-•4175
a
CITYOFTIV
A
SEWER CONNECTION
RD
C11YOF11frgRp PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT cinooN PERMIT #. . . . . . . a 5WR93-0045
13126 SW HWI Blvd P.O.Boor 23307,TIPM.Or@90n 07223(603)&394176
i
5Il`F: ADDRESS. . . 08542 8W I._UCILLE GT
PARCEL: 1 S 135DD--LUC1117
SUBDIVISION. . . . : LIJC I LLE --- ZONING:
1 BLOCK : LOT. . . . . . . . . . . . . :7
1 TENAfJTpNAME. . . . . .
USA 1\10. . . . . . . . . . » FIXTURE UNITS. . . :
CLASS OF' WORK. . . :NEW
DWELLING UN I T5. , : 1
I YPE OF USF:. . . . . :`—IF NO. OF BUILDINGS: 1 �
INSTALL TYF'E:. . . . :BU5WR IMPERV SURFACE. . :
Remarks : PATH 8
owner: _________________._____ ______.-•---__.__.___.________.___._____ FEES _•______.___._.__._.....
NORTIIL(1ND I UPIEb type amol_1nt by date rec.:pt
T f 2100. 00 JH 02/10/93 —
1834 SW 56TH PRM
INSP 35. 00 JW 02/10/93 --
PORTLAND OR 972e 1
P11•ione #: 292-3975
CONTRACTOR NOT ON F=ILE
I
1'Irr�ne tT: $ 2135. 010 TOTAL
Reay #. .
----- _— REQUIRED INSPECT"IONS
This Applicant agrees to cosply with all the rules and regulations Sewer~ Inspe%.•tion ____•___� .,___
of the Unified Sewage 'Agency. The peroit expires M days from _.._ _.__....__.._.e
the date issued. The total arount paid will be forfeited if the
perpit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the measl..eient
given, the installer shall prospect 3 feet in all directions froe
the distance given. If not so located, the installer shall p!nchase
a "Tap and Side Sewer" Perait Znd will i all a lateral�t+.1 r _.._ ........___.....__..
1 ,s!1e(I BV :
Call for inspect ion — 6:39--4115
i
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131uswtia0lstvd. PLNCK/Rf_CT #
CITY OF TIGARD PO[lox 23397 PERMIT # .5/-�;-3
COMMUNITY DEVI?LOPMENT DEPARTMENT Tigard,Oregon 9722.3
(503)639-4171 DATE ISSUED
f <IZ 4. ucf'%lo c� TAX MAP/LOT ! �/ 3> .L%�CG 7 r I
JOB ADDR�SS:�,� ff � ,
SUB:LSs _ LOT: LAND USE:
✓ VALUATION:
MO 'NER SPECIAL NOTES
NAME: _ �o� f� v n r co r`* _ REISSUE OF:
ADDRESS: LAST RLIJSUE:
i
FLOOD PLAIN/
PHONE: SENSITIVE LAND:
CONTRACTOR APPROVALS RE UQ IRED
NAME: __Sn rT� _ PLANNING: 6--fG�m
ACDRESS: _.� _ ENGINEERING: _ _—
FIRE DEPT:
PHONE: OTHER: F- l
CONTR. BOARD #: j? 2- EXP DATE:
` ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: /l/� `E S� LIST/SUBCONTRACTORS:
MFCH: ��o! ,i� �a/M1 I �'W'–' BUS TAX:
RCN ENGINEER CALCULATIONS:
NAME: TRUSS DETAILS:
ADDRESS: OTHER:
PHONE:
PROPOSED BLDG. USE: C.- Z __
COMMENTS: LUY&V -crx�s/��s�► ��ru�z�'!{ - _------
z
APPLICANT SIGNATURE
Received By: Date Received: l� ,
PERMIT N ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
/4-5ty3-vuUy 10-432 00 Building Permit Fees
_ 10-431 00 Plumbing Permit Fees
37 ,v
_ 10-431 01 Mechanical lermit Fees -
10-230 01 State Building Tax (5%) - I
Building
Plumbing
Mechanical,
r 3
10-433 00 Plans Check Fee
Building
Plumbing �.
Mechanical X7,38
10-230 06 Fire —
���/z 3 voq) 30-202 00 Sewer Connection c'u ��' ��U6
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees —
25-448-04 Industrial TIF Fees
25-448--06 Institutional TIF Fees — —
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees 4,00 — /,3 S-u
l
25-448-05 Mass Transit TIF Fees //0. 04 —/— v
52-449 00 Parks System Dev Charge (PDC) -S`
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) 19C -J_t,
24-445-01 Water Quality (Fee in lieu of) —
24-445-02 Water Quantity (Fee in lieu of)
TOTAL_
cr
nm/35B7P.WP1'
• �J
If
I
1
I
CITY OV T IC ARD H CTVT OF PPYMf.NT RLCEIPT NO. Y93-c_'3605 34
CHECK AMOUNT' a 4886. 06 I
NAME : N+:JRTHt_faND HOMES GASH AMOUNT 0. 00
�11?1lftE4;a n PAYMENT DATE 02/100193
SUL'DIVISION n
PlJRPOSE CIF PAYMENT AMOUNT PAID WURPC)GE OF PAYMENT t-W)UNT P(110
BUILDING PERM p 316. 00 PLUMSINO PERM 110. 00
Ii1E'CHANI C:AL PL. 37. bO bT. BUILD Pt-P. P3. 16
+ILAN CHECK F'E: 24. 38 SEWER U Gia 21 Q)0. 00
.,.iLWLR INSPECT s°". 00 PARKS SDC: 500. 00
'f IJf�M DRAIN E)C ;1a0. 00 RI-E.S I(ih':NT I Fal._ TPAFI-I C,, FEES 1350. 00
00
AS',; , '1 RANT I'T T I F F E'F_b 110. 00
I
I.11T 7 LOC I L_t_.E El=T
10542. F_cW L.UC:I LL.L. CT
'TIJTAt_ AMOUNT f='AID - 4AS6, Wfy