Case File 1
1
r
I
1
i
I
I
7415 SW ASHFORD STREET _ �
INM TION NOTICE t '
Ci-t:y of Tigard Building Department
13125 SN Ball Blvd. Tigard, Oregon 9722.
Inspection Line (Rec-O-Phon s 639-499175 Business Phnne: 539-4171
I'aspection:—___
Footing Plbg. , nderelab Me,7h. Rough-in _ppr/Sdwlkk
Found. Plbq:Top Out Cas Line iINALs
Post/Beam Struct. San. Sewer Framing -Eldq.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbq. underfloor Nater Line Gyp. Sd. -Hoch.
Date Requested: "/ �' — Time: AM /PQM
Addreans_2 Z r Permit #:.
Puilders f/
THE FOLLOWINQ CORRECTIONS ARE REQUIRED:
Inspectort_ �^ 7 `'�%!(�/ / - --- Dates
APPROVED -_ DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinep.
CERTIFICATE OF
C1rf0FT1FARP,, a
OCCUPANCY
CRYOFT16 RP
PERM T if. . , . , . » t MC;T91 -0�7E3
' COMMUNITY D).'IW'ELOPMCN�' DEPAFRT#II�Nf onooN
13126 SW HWI Blvd. P.O.111 r,',r3y1,Tiyad,crayon 67223(6W)639-4175 DATE_ I SSUFU r. 09/14/9i
ADDRESS. , . c 0741!5 yW h+:.; it j,(V S1 'S l 1 i ch
I1jbD I V I S I ON. . . t ENO 1'3$ANGE WOOD'; Z ON I NG s R--4. 5
BLOCK. . . . . . . . . . s Lt T. . . . . . . . . . . . . r ter:,
GLASS OF I,'IPK. I NEW
TYPE DF USF.. . . s w;
OCCUPr4NC'Y CiltP. I R3
OCCUPANCY LOAD 12�2''S 4
[EN(-,NT N"MF'.
Rem ark6a
Owner2 __...,. ._.4....., ..._.._._.__..__ __...._.-._......_. -...
SAM GAR1CW CONSTRUGI1ON INC
6455 SW NYBE=RG LN 1 -103
1'UALAT I N OR 97062
Phone. #1 503 -692-7iEVA
(.ontrac tor.I
SAM SARICI•i CONSTRU(::TIUN INC.
C)45!5 SW NYBE RG LN 1 - 103
T l)!EI_AT'IN OR 9-7062'
ilhone Eit !j@3- 69P--720S
NeR N. . I 61P67
Occupancy of the Tuve rofer••enr_ed building Is hereby given, arlri r_ert ifi en
the compliance with the !7tate Of Oregon Specialty Cndv-,4 For- the yral..1p,
oct-upancy, and use ►sndpr which the referen ,*d permit was iaC ..►ac(.,
FIRE DE PARTME3'NT
SU I E_ NCa ®F i C M-
SCIb T IN CONSPICUOUS 1='LACf
'7
LMSPECTION NOTICE -
City of "igard Building Dcpartaent
13125 SN Ball Blvd. Tigard, Oregin 97223
Inspection Line (Rec-O-Phone): 539-4175 Business Phone: 639-4171
Inspection:_---------- - -- - - -
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINALS
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poe-,00.= Mach. Rain Drain Insulation -Plumb.
-TJ �
Nater Line Gyp. Ed. -Hoch.
Date Requestads fff /
PTi'mei �AM
L er
Addreasz� 4 — Permit
Builders -
TETE FOLLOWING LORRECTIONS ARE REQUIREDt
inspecto
APPROVED _ DISAPPROVED APPROVRD BUBIEf'T TO ABOVE
Call For Rainsp.
anr�
INSPECTION NOTICE
City of Tigard Building Depart."t
13125 811 Rall Bled. Tigard. Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: ____ _— -�
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINP.L:
Poet/Beam Struct, San. Sewer Framing -dg�
Post/Beam Mech. Rain Drain Insulation Plumb.
Plbq. Underfloor Water Line Gyp. Bd. -Mech.
Pate Roqueetedt� ' ---- ---T� ti.
PM
�r fr S/��.�r Permit
Address: �y � '
Builder:—
TRX
uilder=—TR? FOLLOWING 00RRECTIION6 ARE, REQUIRED:
rYY1
Inapsrtort �-S WJE Date:
Z.
APPROVED DISAPPROVED APPROVRD SUBJECT TO ABOVE
1
Call lh:r 1leinsp.
INBPltri:^N NOTICE \ /
City of Tigard Building Department.
13125 BW Ball Blvd. Tigard, Oregon 97223 Y
Inspection Line (Rec-O-Phone): 639-4175 Buniness Phone: 639-4171
Ir spectton:
Footing Plbg. Underalab Mach. Rough-in —Appr/Bdwlk
Found. Plbg. Top Out Gas Line FINALS
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plby. Underfloor Water/Line Gyp. Bd. -!Mach.
Date Requestedt ' - C �TjSmM"�'�_ - PM
Address: `7r
Builder:
TOE FOLLOWING CORRECTIONS ARE REQbV(ZD:
�w tC
-7-1 -7 t v
1 _ 'L �. �-
Ise tors �- � Dates ��--
APPROVED DISAPPRO APPROVED SUBJECT TO ABOVE
- Call For Rainap.
INgFSGT O. NOTICB �4
City of Tigard building Department 1
13125 SW Hall Blvd. Tigard, orogon 97223
Inspection Line (Rec-O--Phone): 639-4175 Business Phone: 634-4171
Inrpection:_
Footing Pl.bg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out ran Line FINALt
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/9eam Mach. Rain Grain Insulation -Plu,ab.
t
Plbg. Underfloor Mater Line Oyp. Bd. -Mech.
Date Requestedt -_ 4 Z- Times —AM _PM
_PM
_ - r _
Address: Permit �t
THR FOLLOWING CORRECTIONS AAA REQUIRED,
i
rnepectori / "j /� _ nate: ?+ �
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call for Reinsp.
INSCTION
City of Tigard Building D"r-tewnt /
13125 &W gall B1R1. Tigard,Inspection Line Blvd.
: 9 �n 97223
Inspections 6.39-4175 BusinWea Phones; 639-417
Footing — —-
Plbg. Underelab Hach. Rough-in
Found. APPr/Sdwik
Post/Beam 3truct. Plbq. Top out Cee Line
PINALI
San. Sewer Framing
Post/Beam
Hoch. -Bldg.
Rain Drain
Ineulwtion -Plumb.
Plbg. Underf`o°r water Line
GYP- 9d' -Nech.
Daces Requaet�cdt - �
Timet
Addreen:_ G//�'�
Porm
Butidoc:
THE MLLONINC CORAF,CPIONS ARB RBQUIRISDt --
•a
Inspector,
APPROVED DISAPPRovaD ��•+ -_
APPROVED SUBJECT To ABOVE
call For lbinep.
.4,
ncd rrr
I-NSP IO NOTICE
City of Tigard Bu_ldlnq Depart,,Mt
13125 Bit Ball Blind. Tigard. Oregon 97223
Inspection Line (ROC-0-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing _-'_'�.----
Plbg. UnderelabMeoh. Rough-in,/ AP:-/Bdwlk
Found. Plbg. To Out --
Top cies Line 1ZKALt
Post/Beam Struct. San. Sewer
Preening _Bldg.
Post/Beam Meeh. Rain Drain
Insulation _plumb.
Plbg. Underfloor Water Liffe
Qyp. Dd. -Mech.
DAte Requested: !. 7 l'
Time: 11M p!1
Address:
partir
Builders
TRF FOLLOWING CORRECTIONS ARE LSQUIREDs
7�
Inspectort —
�— Date:
------------
__—APPROVEDD
ISAPPROVED APPROVED SUB,IIRCT 'Irl ABOVE
—Call For Reinsp.
INSP cTION narICT
City of Tigard Bu.11dfng Do"rtment
13125 SW rill Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone): 539-4175 Business Phone: 39-4171
Inspection: I /t?ee
FootingPlbg. Undarelab !:. Rough-i Appr/Sdwlk
Pound. Plbg. Top Out Gas Line FINALS
Post/Beam Struct. San. Sewer raaiinq -.Bldg.
Post./Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underflocr Water Line Gyp. Bd. -Nath.
Date Requested: Time: AM PM
Address i/;l� S S rs1 _�[���; Permit is
tJ
Builder:
TNS FOLLOWING CORRECrIONS ARE REQUIRED:
Inspector Date:_
"PROVED DISAPPROVED APPROVRD SUBJRCT TO ABOVR
Call For Retnsp.
aspg�71qq_NOTION
City of Tigard Build'
13128 BA 1 Blvd.
Inepeetion Line jam Tigard. 0re9— 997223 (`fir✓
bon.)t 639-4173 Buaineaa Phone•
InaP�tiona 639-4171
Footing --
�. Und slab Her_h. ugh-
Roin
Fannd• Appr/Ddwlk
lbg. Top Out Cee Line
post/Roam 3truct. FINALt
San. 99orgr
Framing
Poet/Beam Mech. -Bldg.
Rain Drain
Tnauintio,i
Plbq, Underfloor -Plumb,
Water Line i
Date Requenj GYP• Bd.
-Meeh.
Addreoe: `_ AN _PM
Builder- I Permit I:LL��
G
roRRECTIQNS ARE REQUIRED:
TRE FOLLOWING ---- - — --
-------------
---- oato:
APPROVED DISAPPROVED
APPROVED SUBJECT TO A£OVE
_ Call Por Iteinap•
INSPECTION_99TLq-4
City of Tigard Building Departaent
131.25 SW Hall Blvd_ Tigard, Oregon 97223 Y
Inspection Tine (Rec-O-Phone): 639-1175 Business Phone: 639•4171
Inspections_� ---
Footing Plbg Un lab Hoch. Rough-in Appr/sdwlk
Found. �� Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Lirse Gyp. Bd. -Hoch
ch.
Date Requested: -/� (/ Ti�� AX _PM
Address: �✓ , '_L � Pero t�jti :
Build x___4 LCG' a) — /,;L U!J
THE FOLLOWING CORRECTIONS ARE REQOIREDI
Inspector:_ nate:r 47
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INS CTION_NOTILK
City of Tigard building DApartlept
13125 SN Ball Blvd. Tigard, Oragrr. 47x'.:63
Inspection Line (Ree-O-Phone): 639-4175 tyusi-, s Phouer 634-4117
Inspections__ ..._ ------- --
Footing Plbg. Underslab Mach. Rough-gin A6.,. /se,lk
Found. Plbg. Top Out Gas Lines T..RALs
/ 8t Cts Sen. Sewer Framing Bldg.
Post/Beast Hoch. Rain Drain Insulation -P'' :du.
Underfloor Nater Line Gyp. Bd.
Data Requesteds % �� Tir=i
Addreae: Permit 1: �—
Builders
THE FOLLOMINO ooRR$CTIORS ARE REQUIRZDs
}
Inepector:�
Dates
I-APPROVZD DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
NI SPEgT ON IiOTICE
City of Tigard Building Depart-meant
13125 SII Hall Blvd. Tigard, �_regorA 97223
Inspection Line (Rec-O-Phone): 639--4175 Business Phone: 639-4171
Inspection: ___.—�
Footing Plbg. Underelab Notch. Rough-.in Apprj'Sdwlk
Found. Plbq. Top Out Gin Line FINAL..
Pont/Ream St n:ct . Ban. Bawer Framing -Bldg.
Poet/Beam Hec":. Rain Drain Insul.etlon -Plumb.
Plbg. Underfloor Line Gyp. Rd. -Necn.
Date Requested: _5 `� _ Time: AN CIL,
Address:_ / Permit
Builder: •
THE FOLLOWING CORRECTIONS ARE RBQUIRED:
Inspector: y DaterG —
APPROVED DISAPPROVED APPPOVBD SUBJECT TO Awn
Call For Reinsp.
IN6PECTIt1N�OTgj /
City of Tigard Building DeWtaent
1. 125 8.11 Ball Blvd. Tigard, Oregon 97223
Inspection Lire (Rec--O-Phnne): 639-4175 Business Phone: 639-4171
Inspection:`--- _-- _.--- -- ---- ---
Doting Plbg. Underslah Mech. Rough-in Appr/Sdwlk
r
ound. Plbg. Top Out: Gas Line FINAL:
i
Post/Beam Struc,c. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Undbrfloor Water Line Gyp. Bd. -Mech.
L _ 7
Date Requested: , _� —�7 Times �_TM — PM
Address. Permit �s
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: ^_ Date: 1 z 7 -7 Z,
__ APPROVED — DISAPPROVED APPROVED SUBJECT To ABOVE
___Call For Reinsp.
CITYOFTIOrARD (Cffy#'�FTLRD
MASTER PERMI
PERMIT #. . . . . . . : M ST9 1-0278
COMMUNITY DEVELOPMENT DEPARTMENT \onooee
13125 SW HWI Btvd. P.O.Bax 23397,npud,Orepr n 97223(SM)639.4175
DATE= ISSUED: 03/18/92
SITE ADDRESS. . . : 07415 SW ASHFORD ST r'ARCEL: 2S 1 12CA-1 X11DOO
SURD I V I S I ON. . . , : RENA I SSANCE WOODS -l.nN I NG: R-4. 5
BLOCK. . . . . . . . . • . LOT. . . . . . . . . . . . . ..26
--- BUILDING
RI I SSUE: DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 s f
CLASS OF WORK. :NEW BEDRMS:3 BATHS:3 GARAGE. . . . . . . . . . :475 mf
TYPE OF USE. . . :5F FLOOR AREAS---- ___.__ REQUTRED SE'TPACKS------------
IYPE OF CONST. :5N FIRST. . . . : 1412 st L_EFT. . :5 ft RIGHT. :; ft
OCCUPANCY GRP. :R3 SF.C;ON1). . . : 1345 !sf i=-FRONT. :210 Ft REAR. . :40 ft
STORIES. . . . . . . t2 TH I RD. . . . :0 s f REQUIRED--------------------
HE I GHT. . . . . . . . :
EQUIRED--------__._.___-----
HEIGHT. . . . . . . . : 15 Ft TOTAL----- ---- :2757 s SMOKE DETECTORS. :Y
FLUOR LOAD. . . . -40 ps f VALUE. . . . . 1.35.372' PARKING SPAGFS. . :0
Remarks :
PLUMBING ----------------------------------------
SINKS. . . . . . . . . . : 1
•---------------._-___--__-_--_-_-.-_.-SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PPEVNTRS. . :0
LAVATORIES. . . . . :4 WATER HEATERS. . . : i TRAPS. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . :3 1.A(JNDRY TRAYS. . . . 1 CATCH BASINS. . . . . . . :0
WATER CLOSETS. . :3 SEWER LINE (ft ) , :0 GREASE TRAPS 0
DISHWASHERS. . . . : 1 WATER LINE (ft ' . : 100 OT14E:R FIXTURES. . . . . . 71
GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :0
WA 5H I NG MACH. . . : 1 SF RAIN DRA I P;S. . : 1
___.__T_._________. ME CHAN I CAL -._____._._._____-- ------_______.__.__.._ FEES ----_-___----
F= .-.-
UEL YPES- --___ ._._...___. UNIT HTRS. . :kt) type amol.tnt by date r^ecpt
/GAS/ / 1 VENTS . . . . . :0 TIF $ 1380. 00 JLH 03/ 18/92 -
MAX INPUT :17.1 PTU VENT C=ANS. . :4 PPRT $ 523. 110 JLH 03/18/9= -
F=URN i 100K . . :0 HOODS. . . .. . . : 1 FPLC sl .339. 95 JLH 12/30/91 221322
FURN ) =100K . : 1. WOODSTOVES. :0 B SPC t 26. 1'5 JLH V1; /18/92 --
FLOOR FURN. . . . :0 CLO DRYERS. : 1 SSDC $ 280. 00 JLH 03/18/92 -
"nTL./CMP ( 3HP:0 OTHER UNITS:O PARK $ 500. 00 JLH 03/ 1.8/92 -
GAS QUTLE'TS: 1 MPRT $ 40. 50 JLH 03/18/92 -
::,er^ : 11PILC $ 10. 13 JLH +13/18/92 -
SqM SAR I CH CONSTRUCTION INC MIJPC $ c-'. 03 JLH 03/18/92 -
64`,a5 SW NYBERG LN 1 -103 P P R T $ 155. 00 JLH 0,3/ 18/912 -
F!`,F'C: t 7. 75 JLH 03/18/92 -
TUALATIN OR 9'7062
Plh a rt e #: 503--692--7208
SAM SAR I CH CONbTRUCT I ON INC:
6455 SW NYBERG LN 1--103
IUNLATIN OR 97062
Phone #: 503_•692•-7208
Rea_ #. . : 61267 __.________._______.-_____-----.-_-_-__---__
t 3264. 51 TOTAL_
This pertut is issued subiect to the regulations contained in the -- ----- REQUIRED INSPEC-f IONS ---- -- -
Tioard Municipal Code, State of Dre. Soecialtv Codes and ali other Foot/foi.ind Insp Fireplace Insp
applicable laws. All work will be done in accordance with approved Post/B,�am Stt-lAct Gas Line Insp
plans. This oerait will expire if work is not started wi in 180 Post/Beam Meehan Instilat ion Insp
days of issuance, or if work is suspended for ere th N days. Plm/Ltndslab Insp Gyp Board Insp
F4_M/Underfloor• Rain rir^ai.n Tnsp
1-,ermittpe '?,i.ynat�_ire /' ��' .tel Mechanical Insp Water Line Insp
Plumb Top Out Appr/Sdwlk Insp
i5y _ied Pyx- Fr-aminq Insp Mechanical Final
Call `•or insper-tion - 639-4175
SEWER CONNE(.,'TION
C' OFTYTIFARD r---,ER M I T
Cff0FUMRD PERMIT #. . . . . . . . SWR92-0055
COMMUNITY DEVELOPMENT DEPARTMENT 06141*"
13126 SW 14WI Blvd. P.O.BCK 23397,TOW,Or"M 97223(503)1 6304176
i ; naTp mniiFil,
It' ADDRESS. . . : 07415 SW ASHFORD ST PARCEL: 29112CA-10000
SUBDIVISION. . . . : RENAISSANCE WOODS ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . :26
----------------------
TENANT NAME. . . . . :
USA NO. . . . . . . . . . : F I XTURE UN I'm. . . -
CLASS OF WORK. . . :NEW DWELLING (JNITG. . : 1
TYPE OF USE:. . . . . :SF* NO. OF BUILDINGS: 1
INSTALL TYPE. . . . :BLJSWR TMPERV SURF ACE. . : Isf
Owner,. ------------------------------------- FFES --------------
GnM 9ARICH CONSTRUCTION INC type amoi.tnt by cate t-eept
6455 SW NYBERG LN 1- 103 FIRMT s 1900. 00 JLH 03/18/92-1
INSP $ 35. 00 JLJA 173/18/92
JUALATIN OR 97062
Phone #: 503-692-7206
Contv,Actor-:
CONTRACTOR NOT ON FILE
t 19
---------------------
35. 00 TOTAI-
RFQUIRED INSPECTIONS -------
This Applicant agrees to comply with all the rules and regulations Sewer, Inspection
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. The total amount paid hill he forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement ----— -
given, the installer shall prospect 3 feet in all directions from
the distance civen. If not so located, the installer shat urchast
"Tap and Side Sewer" Permit and the Ag gen n 11 ins a lateral.
Permittee Siqnatl-ire . ! - ----------
lssuer) By :
Call fot- inspection 639-4175
�{ ~
| .
| !
|
' CITY OF' TIBARAD - RECLlPT � oAYMEmT RECEIPT NO. 192-224794 �
| CHECK AMOUNT x 4949. 51
( NAME x 8ARlCH, GAM CONSTRUCTION CASH AMOUMT , 0. 00 �
| ADDRESS o 6455 SW NYBERB LM PAYMENT DATE v 0,1/ 18/92 �
| x �
|
FUALATIN, OR 97062-
908DIV%SION
/
PURPOSE. OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMO0N[ PAID
|
| ---------- --'--- ---------'-- -------
AUlLnING PERM 523. 01h PLUMBING PERM i55. 00
| MECHANICAL PE 40. 50 ST. BUILD PER 35. 93
|
PLAN CHECK FE 1Oct. 08 SEWER USA 1900. N0
|
SEWER INSPECT 3a.5. 'DO RESIDENTIAL TRAFFIC FELS 1280. W0
PARKS SDC 500. 00. STORM DRAIN SDC 280, 00
/
MASS TRANSIT TIF FRES 1oft,' 00
/
|
|
|
/
| 7415 8W ASHFORD ST
|
/
' TO7AL
AMOUNT PAID ' - - -> 4949. 51
|
|
/
�
� -
�
� � �
'3123 SW Iiall liNd. PLNCK/RLCT #
v
- orTIGARDt'OF3�R?3397 PERMIT #
Tigard,Orcgon 97213 --
c)�t�1t1N111' 1)I:�'ELO1'�tl?N'I DI;PAR1'hIEN'f (501)639-4171 DATE ISSUED ---
TAX MAP/LOT Z
JOB ADDRESS: �5 .5 i✓/�5� ��--------- _____--_------_ -
LAND USE:
SUB: I 1pVQ�S LOT: ��--- ---
VALUATION: SSD poo
SPECIAL NOTES
OWNER REISSUE OF: ----------
NAME: LAST REISSUE: ---
ADORESS: Z FLOOD PLAIN/
—
u ' _Q3 SENSITIVE LAND: —_----
PHONE: �cIZ - O
s
APPROVALS k09-1—REW 4
CONTRA_ CTR .
PLANNING: ----
NAME: _ ^' ENGINEERING:
ADDRESS: , FIRE DEPT: ---
93V 1765 OTHER: -f _
PHONE:
L41 2 6 -7 EXP DATE:
BOARD a: ITEMS REQUIRED.
LIST/SUBCONTRACTORS:
/ice !
SUIiCONT �i RACTORS: PLUMB: -- --_-�—
BUS TAX:
MECH: � .0 � .i
CALCULATIONS: -- --
A{tCH�GINEER / TRUSS DETAILS: __�----- -----
NAME:
OTHER:
r - w0
ADDRESS: 7//0
_ .-.T. yL9 72 —
PHONE: _ D G
PROPOSPD BLDG. USE: —�--�—
COMMENTS: — —
j�
PPLICANT GNAT E c
t- Date Received:
Received By: —
CI'T'Y OF T I GARD RECE^I F."T OF POYMENT RF C.,E f PT NO.
fCHECK AMOUNT D 24,50. 6Z 0
NPME 6AM SAR T.CN (:i7WI RUCTION CASH AMOUNT a 0. 00
ADDRESS 6455 SW NYBERG LN PAYMENT DATE: u 12/30/91
TUC)LAT I M, OR SIJ9n I Y I S I ON D
PlPli:`OSE. OF PAYMENT AMOUNT PA 11) VIUF2(POSE OF' PAYMENT AMOUNT PAID
C
i
f
I
1
PC-NO I S)SANCF WO(3DS LOT .?6
I
' WOL AMOUNT PO I D � ._. _. ....� ,,.
r...aH. 00