Case File ADDRESS :
isVecords\microMm,,targetcI,buiIding dor,
CITY OF TIGARD
CER' 1L KATE OF
OCCUPANCY
COMMUNITY DEVELOPMENT DEP jR�`�tfVT FERMI T M. . . . „ . . r M910'93-03t.13125 SW Hall 61vd Tigard,Qragon 97223.11140"( 03$'g 0.4171 DATE T GSUEU t 12!27/93
PARCEL: 161:34CO—1540 1
R I T t- ADDRESS. . . s 12,-:-"91 aW ANTON DR
SUBDIVISION. . . . s AN'rON PORK I I Z ON I P!6 r R-7 PD
ALUCM(y_.._. . ._..,r.________LOT
____________ e081
_— _..._
CLAUS Or WOPK. iNE=W
'TYPE OF USE. . . :SF
OCCUPANCY GRP. i R3
OCCUPANCY LOAD s c^c'`.°j 4
TENANT NAME. . . s
Raarar"ksi PATH I
MELVIN 0 WOYMIPE
P O BOX 2•131264
TIGARD OR 97281
Phone #s 639-6742
Lont Tact or s
MELVIN WAYMIRE
►1r7 41OX 23'. 164
164
f Il-)ARD r7R 97281
Ph nrl x #r 6.39--6742
35976
of lj1e above referrnc:ed building is hereby given, and certifies
the compliaincP with the '=+tato C.lf Oregon GpecAmIty Code= for the group,
occupancy, anis use under which i-he referenced permit was iggr_ird.
FIRE DEF'AF1TME:NT_......_.___.._._ E — D),0131 £PE
BUIL_DING O.FICI 1-
w
POST IN CONSPICUOUS PLACE
1
i
City of Tigard Building Depertmmot=
13135 BR Hall Blvd. Tigard. Oregon 97223
Inspection Line (Roc:-O--Pho�nno))s 639-4175 Busineve Phones 639-4171
Irwpsct ion s
Footing Plbg. Dnderslab Mach. Rough-in Appy/"wlk
round. Plbg. Top Out Can Lina GIRALs
Post/Beam 8truct. Bart. Bower Framing
Post/Roam Mech. Rain DraLn Insulation -Plumb.
Plbg, Dnderileser Mater Line (;yp. Bd.
Date Requestead$ 1 Z 2-7- q-3 z Times A -",*1N PM
Addreu, nn1,,7.. ^21)5 U}/� � , Permit O/s'"\47(, /15"CS35L
Bu.Llders L�� �<.L1V1jY� Lx?-0' -67 /�.
TUB rOLLO11INei Ompg-MICAS ARM RRQOIRRDs
i
% I
,i
ti
i
Iso pesters _ Date: �'7 _a7--`73
APPROti►gp DISAFPROVRD APPROVEO Susirr-I TO ABOVE
Call Por Rsinep.
P
City of Tigard Building Departakmt
13125 SM Hall Blvd. Tigard, Oregon 97223
Inspection Line (ROC-o-phone)t 639-4175 Ovskness Phones 539-4171
r
Inspection:__-- � Q - h-")
Rooting :'H-i. Underslab Mach. Rough-in
AppC/BdNlk
Round. Plbq. Top Out Gas Line BINIILt�
Post/Beam struct. San. Sewer Framing -Bldg,
Post/Beam Mach. Rain Drnin Insulation
Plbq. Underfloor Water
^iLine
. Gyp. Rd. -Naoh.
Date Requasteds �G-- > Times
Address s t ZZ°LS� / t��Vr — Permit7 ,
Buil:ers �V - e
TBE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspectors Dates
APPROVED DYSAPPROVED _ APPROVED SUBJECT To ApOViS
7� __Call For Reinsp.
IK6P8CTIO�LIO�'� �/��,
City of Tigard Building Department
13125 M Sall Blvd. Tigard, Oregon 97223
Inspection Line (Roc-O-Phone)s 639-3175 Business Phones 639-4171
Inspections_^
Footinq Plbg. Underslab Meeh. Rough-in Appr/Sdwlk
Pound. Plbg. Toy Out Gas Line PIKAL:
Pont/Beam Struct. San. Sewer Framing •-61dg.
Post/beam Koch. Rain Drain Insulation -Plumb
Plbg. UndarTloor Nater Line Gyp. Bd. -Koch.
Data Requestedco Times —p�AM PM
Address: Z- 7 3 Permit #1
Builder:—
THE FOLLOWING (MRRECTIOKS ARE REQUIREDs
IT'S?ectdr4 ��-- Dates --
APPROVED DISAPPROVRD APPROVSD SUBJECT To ABOVE --
Cull For Relnap,
INBFEC ivff NOTIcB \1
City of Tigard BaUdiny Department
13225 BA 'loll Bled. Tigard, Oregon 97223
Inspection Line (Roc-O-Phone): 639-4175 Business Phone, 639-4171
Inspoction,__r �v
700tlup Plbg. Underslab Mach. Rough--Ln Appy/idW1k
found. Plbq. Top Out Gas Line �jM11Lt J ?t
C r
Post/Ream Strvct. Ban. sewer V-aatnq
Post/Beam Mach. Rain Drain Insulation
Plbg. Underfloor Mater Line Gyp. Bd. Meop, r'
Date Requestad t_- [� _Timor 7� PH
Addressr �Li /�� -�l A _ Permit
Builder% l7y`
TRE POLLOw111G 7PZORA ARElRROUIRED,
43 Qg-r
.p.�
Irt Ost
APPROVED �` DrsAPPROVED APPROVED SUBJECT To ABOV=
V , �,� L call For Reinsp.
'l
INSPECTIj NOTJL k-
13125
City of Tigard BuilditV Depart &nt BW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Busi.neas Phones 639-4171
Inspections_
Tooting Plug. Underalab Hoch. Rough-in C ABp /Milk
Pound. Plbg. Top Out Can Line lINALs
Poet/Beam Struct. San. Sower Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Pltg. Underfloor Nater Lino Gyp. Rd. -Hoch.
Cate Requestodt 0 1 1 -�
Address, P 1 At -Am& i/1 s Msttit #t�j
M YOM== CORRnECTIONS ARE REQUIRED,
� 2/'2 G/N4- 70 w/Lk
1AILLIEs_ -rOf cG cz,1,eA
646t*1 960 7Z' f lz , i t'iNrsy
In.pwctortrhcjilQ.S Dates_1
AfTR011AD DISAPPROVED ! APPROVED SUBJECT TD ABOVE
- (77411 For Rdinep.
IN�P1tCTION �r0�CS 1�' .
City of Tigard Building Departasnt
13125 W Hall Blvd. Tigard, OrQ9CM 97223
Inspection Line (Rec-o--Phone): 639-4175 Business Phone: 639-4171
_.—
Inspections �
rooting Plbq. Underalab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top out Gas Line rINALs
Post/Ream Struct. San. Ssww Framing -Bldg.
Post/Beam Howl,. Rain Drain Insulation _Plump,
Plbg. Underfloor peter Line Gyp. Sd. '/' _Kph,
Date Requested_
yy n T Tines pK
Addrasec_ 1111Qj/ ` Permit
Ru i lder s- )A_A MA V C C//r.-V I-A --
TAE rOLLOWTNG Mp"..CTIONS RltpUIRED:
Inspectors Dates_
—`_APPROVZD DISAPPROVED APPROVKD SuWRCT TO ABOVE
Call For Reinsp.
INSPECTION NOTL(29
City of Tigard Building Department
13125 sN Hall Blvd. Tigard, Oregon 97223
Inspection Line (Roc-O-Phons)i 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab / h, Raugh_i`/ hppr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam struct. San. Sewer Fruinq -Bldg.
Post/Seim Hach. Rain Drain f' Insulation ) -Plumb.
fir...,"-�.--..�.--•'
Plbg. Underfloor Water
cLine Gyp. ad. h.
Date Requestedt�_� - L —Time: __;�7AN ______PM
Addresss ;e =s^ f1, ./�(. Permit 14� ��.✓��a�
Builders
THE FOLLOWING CO IONS ARE REyUIREDt
y
Inspectors_. — Date / J
:.PPROVED DISAPPROVED APPPCV73D SUBJECT TO ABOVE
h Call Cor Reinsp.
��G" l
IN4PECPION NMa
City of Tigard duildi.ng Depertasent
13125 SW Ball Blvd. Tigard,ig os.'egon 97223
Inspection Line (Rec:-O-phoney: 639-4175 Business Phonal 639-4171
Inspectlon:
PootIng Plbg. nnderslab \,- Rough-in ' Appr/Sdwlk
s= "�
Pound. Plbg. Top out Line
PINALt
Post/Beam Struct. Ban. Sewer `Jrraming J -Bldg.
Pnst/Ream ka^h. Rain Drain Insulation -Plumb.
pibg. underfloor Nater Llna gyp. 8d, -Koch.
nW_e Requestods- _ >(�q�
Address: fn�� ,� C/Y Permit ft
Builders `" ` ��� (92 ,��q
TIBC POL.O1►IRG OORRRCTIONB ARB RR UIRRD: � ' �
2 ►'11,,Q k -
n.sem�-,,•q
/ `j- ►.► ter_ ��.o��, V,
. -120 Q
121
A'lig S x L!
Inspector: ' S
Dates
APPROVED DIAAP/Pdwm APPROVED evai" TO ADM
Jh V call For Reinsp.
1N5PEMION NCTICF_.
City of Tigard Building Department �
7.37.25 SW Ball Blvd. Tigard, Oregon 97223 -fir
Inepea.-tion Line (Rec-O-Phone): 639-4175 Bunineas Phone: 639-4171
Inspection:_____
Footing Plbg. UndetslablR,ah. Rough-in Appr/Sdwlk
5 _
Poun:i. P1bq. Tap Out Ga• Line FINALt
Poet/Beam 5truct. San. Sewer Framing -Bldg.
L
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Pl.bg. Underfloor. hater Line Gyp. Bd. -Hoch.
` - �i5 _
Date Requested: /1\ Times AM PM
AAdreea: ` Z Z 1 /�� L-✓� \� _ Permit t J Z--
Builders G�
THE FOLLOWING OORR^CTIONS ARE REQUIRED:
a
� v ►' �� fie__ 11 vw
_�,l 1�?c� ale�d crv� � v`,�,-. �-r L,�r�►-cf
772' Z.^,, �-
?� r-0 'a--."
t watl
�- s s T Z �r 7 k� N S'�-2..•• 5 o a<Q
AA
30
VA
Inspector:_ _ nate:
APPROVED ✓0I9"PROVED APPROVED SUBJECT To ABOVE
-� _ll For R9inap.
.P!W CT ION NOTICE (�\
City of Ti.gtucd Building Depnrtxant.
.13125 Sol Ball B7rd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspect ion:
Footing Plbg. Underelab Mach. Rough-i) Appr/Sdwlk
—
Found. Plbg. Top out �O'ne FINAL:
Poet/Ream Struct_ San. Sewer Framinq -Bldg.
Pont/Ream Mach. Rain Drain Insulation -Plumb.
Plbg. Unierfloor. �7Water Line Gyp. Bd. -Meeh.
Date Requested: I � ' Timet AM
Address:_1._L-cam Permit
BuUder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
` 1
Inspector: L —; Date: 7 I —
APPROVED - DISAPPPOVRD ,p APPROVED SUBJRCT To ABOVE
/l
Call For Reinsp.
1t�PECTION NUT�CE /
CLL7 of Tigard Building Departaftat •.�
13. �S SM Ball Blvd. Tigard, Oregon 97223
Trs A• .
)")n j '.no (Rec-0
1.-Pham)s 639-4175 Business Phones 639-4171
Footing Plbq. 7e:derslab Neoh. Rough-in Aper/Bdwlk
Fouril. Plbg. Top Out gas Lina PIMALs
Post/Beam Struat. San. Sewer Framing -Bldg.
Port/Beam Mach. Rain Drain Insulation -Plumb.
01bg. Underfloor Nater Line gyp. BMe
d. - eh.
Date Requested:
9 -Z S Times yAK PM
Addreass �pZyZ�I�Il Permit 11
��''��-ffS�
Builders _l It II VIA 790
TBT FOLLOMING CORRECTIONS ARE REQUIRED:
� 4v
y
Inspectors Dates
vvy APPROVED DiSAPPROVED APPROVED SUR.TECT TO AgrM
' t � —_Cell for Ref.nep.
I
1NSPaguop NgTjCgl
City of Tigard Building Department
1312S BR Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone)i 639-4175 Business Phones 639-4171
Inspection s
Footing Flbq. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plb4• Gas Line FINALS
Post/Beam struct. San. Sesser Framing -Bldg.
I
Post/Beam Mach. Rain Drain Insulation -Ply.
i
Plbq. Underfloor Nater Line Gyp. Bd. -Mech.
Date Requestods SLd
Tlmst __M
Address: Permit
t!u l lder t
TBE 10LLONING OORRECPIONS ARE VJVJUIREDs
Tnnywcter: `_
Data.
APPROVED
DISAPPROVED APPROVED 8UBJ1tC1' TO ABDVs
rill For Reinsp.
IMspECTjON NOTICE
City of Tigard Building Department
13125 aw Hall Blvd. Tigard, OragOm 97223
Inspection Lina (Roe-O-Phone)t 639-4175 Business Phone: 639-4171
Inspections
Footing Plbg. Undorslab Mach. Rough-in Appr/sdwlk
Found. Plbq. Top Out gas Line
� FINALt
Post/Beam struck. an. /swsr ) Framing -Bldg.
Post/Beam Hoch. in Drain '� Insulation -Plumb.
Plbg. UnderfloorMater Lin gyp. Bd. -Neah. {{
Date Requested t —`�1� �[
loot / PM
Address: Zz j
� Permit I:
Balldert
THE FOLLOWING CORRECT ONs ARE REQUIRED:
4
Orr
� L
c
J
7 /
Inssectort ��
Datet
MPROM nIsAPPROVED APPROVED BUBJECT TO ABOVE
/ Call For Reinsp.
INSPECTION NOTlC
City or Tigard Building Department
13125 BW Bail Blvd. Tigard, Oregon 97223
Ina ion Line (Ree -Phones 639-4175 Business Phone: 639-4171
Inspections
Footing P1bg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
�as Btrusrt) Ban. Sewer Framing -Bldg.
t--t/==—')"Ch
t/Bea' Meoh. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. _Meeh,
Date Requesteds —/AV—Ll 13 ,Times PM
Addrese i 1 c ���L_S_7'-� z�YC�' �" Permit 0,
Builders
THE FOLLOWING TIONS ARE REWIRED:
Inspector: Date
V APPROVED Y _ DISAPPROVRTI "ED SUBJECT TO ABOVE
For RnlneP.
city or Tigard Building Department V
13125 BW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)r 639--4175 Business Phone: 639-4171
Inspection: `
(f;;otinq} Plbg. Underslab Mach. Rough-in Appr/Sdwlk
nd. ! Plbg. Top out pas Line FINALt
Post/Boom Struct. San. Sewer framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbq. Underrloor Washer Lined Gyp. Bd. -Mech.
Data Pequerteds_� TLee
i
Address �� 45 Permit
Builders �-
i
THE ■'OLLONING OD !IONS ARE REQUIRED-
.
Inspectors I / Dater I _—
r^APPROVzTJ DISAPPROVED — APPROVED SUBJECT TO ABOVE
��Call Per Reinsp.
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hell Blvd.Tigard,flagon 972230199 (503)639-4171
♦ }w.. „F.{�.,...�:,........... . z.,.4... � ..iN til. „ .,i. 'I•i l�( _.�;,..L r. ..,ii._ ..._ -
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ty il�,' i+ 'r • i:;} ;`aH 1IVC� ►�1�'CH. , . . . . . 1 t}�aL'};r LU4J {•.E
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6aC•:WF 4 L INF t f•r. i . , . , U;64A 11-*R C'k-t1`_ic,'i ;:i. . . .5 Wig i'EK L!N)i.
RAIN DROSN ; t ', . - :4
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)t)(tr;F ar: i .s'1 - `r"w 6SllC: .280. 01b JH 07/
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tt r re(•. SO Jit 07. 4
11 . 63 JH 07 ,.A 71`i
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p 7�'..s i,♦g a 1' !t r" N e c i ea.I t.y L e�r!e:5 e�e`,ei all c .i s t/[..i p,-,k m . v, i; b,,:+t," i .
applicAt"Ple .laws. All ,sur.}t wi f � 'ne d(il e;sttk)eaal AI:�Nr/::rc1wi
WLth 24rpY'CIVgr'. pi"1 Y1'_ 1!I., f !` 7r1(ifil':+1' 1
will expire if Mark ).y r)ut atea.-ti?(l _ rllt.ir,der"f: ..!' PI .lmb Fi-1,-.
iiw �f' i+)suan�.Ea1., : t wo; iM i.: chil
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CITY OF TIGARD 111 ,
". .
COMMUNITY DEVELOPMENT DEPARTMENT f� ; �� '{
13125 SW Hall Blvd.Tlpard,Oregon 07223.11199 (503)030-4171
SW raW,cii iild rrAlll_E.L:' 151 34C,1a i`
ANTI ON P1')R t I I 7.UNI NCSs '`fit--7 F 1'
DUILVINGs
i)WLL.1.. 1146 UPI i J'L-;: I Y)Fl.ii'�I.:i, )' . , . . . t
` -�C)CiF i,;�tii' •,. .ivF W f1E::Utt PLAN-Ji�f,,i IRC::�+._..Flia l'4a.i 33 ' ISE:t;JIJ T f�L D f�"aE:"i'B�i:;F<s:•i���
1:1F` ;,:;NLA . ::JN . . .884 b f LEFT. . s 6 'f't RIGHT. 16 t {.
J Si-A' IND. . . .`4s:, s°. �'f�Uh)T. .:�V� ft I'?LF�ti1r .
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A 'FU VFaL l 311. s f (.ih1Ul,rw,r;r,0F..c"C i:'.)RS. s Y'
i, ti_U�;.: . . . >a : L3 c,0 s�F�Ftr:INCi aF�Hi: S,
e..U0N i7P IPS i..1. . . . .0
� 111F~►P E:' . . . . . WATER I ILA I EW, . „ : 1 TRAPS. . , . . . . . . . . . . ..
_t r:.:?t1;• !_; ' . . L_HUNDN Y I i'AY : i 1"(41 i,_H
LINC� (ft ) . tall fyFtEAS)E l i4-i; ;i. . . . . . .
„ ._,.. WA P—R L.I I fi. t 4 't. ' . ; ' i I I iF_q i
l c2�l�1u L)RAiN t t
�=i,, iSl`d(•i i � i `�I- 'f�4�i ,-i i.ii2AIlti.:.i. s r
J44 07/07M,,
1„ ill; l_ ..�i: �'{:f'i I"f 'v r�,. . •"i }�a K'f f $ -;i+... q."� J!i
4111. 1-10 JI—P
1. :'t' ,alt 0"'/;.
C. f 1-'60. 00 JH 0+7/4{,
Af "I_;.. i -,IPRT 6 4ti. `,',0 JH at
r.._liiyt (,� Wr-1'r' •il :t: I'rl:�i-'(..: 9+ i.�..� JN L►7/1717%"1�
; 11A F`r.N1 1, 155. 00 .ii ; 07/Q.I;'fIZ
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04. 01 OL
his .M ltit it Issurr A, ec= tz the r•egu:ationl centaintd in the -- RE .a:F,L.Ii 1 P•1'it=t_t:,i 11JP1�.
1a , `4unitt iw; Le.ef State as 0-1. ipeclalty Codes anc ay. ot�e,• f ,ut/fu-mid Insp Fireplace Insp
All m4rk wAI be done In accardenCe with approved PUSt /Se a In Str"t.kc?t Gas vie Ir, L)
r,*v. Miii ivire if ado te Mti�il i8$ Fug'::/Fie1-gym t'1@C.'l1e`x Tl IrIr1.Ml�ttt'm w;.1SF',
&{'f J .4' J"3me, i,v if kor :S 9U!�eihlltC '� r "=v! I,.im,'und� la li Iiisp Gyp Board i
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it
CITY OF TIGARD
1 -y
4 �•Li���l � Ott • v A • . .7ryT'���J"'i(
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Nail(Blvd.T!Oard,Oregon 07223.6109 (503)e30-4171 :i `K. i
�- ii li:'�1 t yW G�"v'rC14 Ufa r'ARC!•_1_s 1'31�34C): •-1:r40t'
fiNil"(3h{ i"+i1r�l.� Lid!I IN("i E f >
�, 1L L.i, , . . . . , . . . ..i!t . n . • . . . % a .061
A-4 NO. . .;. . . . . . . :
NO. LJ ,1i.l1LD.!,,,A
14e4L L- i Yr C , , , . x'61-1'1,!WK c illi t iti- i1Jt'i �� ,
Aaar,k s : PO H i
f",t,=_�'1.r•i C WWrlfii.l•:i_. type afnC'Alli: t)y dat,i' 1 ec:pt
r' 0 b(3X 231164 PRMT $ "'F00.100 J'1'1 @;'/07/93
Ti�.stl ti 3��. ®li:t ,7}-1
It1rie Ma 6334614E
,r.N1'RAC i iiid i' (J7. UN i'
1, 41 00 OTHL
i i,pl,ijcar,f ayreae to caapiy with alai tN 1.-ulks and reglaaation's r,a Fiat.i i4)11
.he Flflec :ip"gt Agenzy. the permit expiret lu days free
date 'scuta ",e total amount paid will be forfeited if the
mit e>:pives, "e Mercy does nut guarantee the ac,uracv of ttM
e 5twei iaterais. If Ot Stover is not i^dated at the eeasurellent
enl the .nstai ter shat i prospect 3 feet in all directions from __
distance giver, if not se ;ocatedl thy: instailer shall purchase
Tap 6-4 Side Sevier' Permit and ttre enoy 1 anrta)i a interni. ____�.r_.__._ _
<' CA i I fo- inspection F 3) 41'7`..,
o?y� 0��.
F.L.
IlILS SW Hap Blvd. PLNCK/RLCT # �`7 o`1 _
CITY OF TIGARD
COMMUNITY OrWELOPMENT DEPARTMENT Tipnd.Oregon 97n)
PERMIT � Z
(503)63"171 DATE ISSUED
JOB ADDRESS: 12295 S.W. Anton Dr. , Ti.gard_ TAX MAP/LOT .._l`�� 3y��1
SUB: 1�n, nn-Parr ? �_ LOT: _ #81 __��--- LAND USE: —
VALUATION:
OWER SPCCIAL NUT ,
NAME. Melvin_ G. Wavmire, Jr. REISSUE 0 X93-0155 �
c LAST KISS- -J
ADDRESS: P.O._I�s�x 2;�11Sz4 ___ ___ _.�� —
Tiaard, OR 97281 FLOOD PLAIN/
PHONE: . 639-6742 _ __ SENSITIVE LAND:
CONTRACTOR APPROVALS REQU I RED
NAME: Jr. PLANNING: '1
DA�
ADDRESS: same ENGINEERING:
_ FIR"c DEPT:
PHONE: 6393 t x4? OTHER:
CONTR. BOARD #: 35976 EXP DATE: 3/11/94
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: Harmony P1_Lmk�ing Co. _ LIST/SUBCONTRACTORS:
MECH: General Furnace BUS TAX: _
ARCH ENGINEER CALCULATIONS: -
NAME: Lar ,y Taft Designers _ —_ TRUSS DETAILS: --
ADDRESS: 1_865 N.W. 169th Place #lU0 OTHER:
Beaver-exOR 97006 _
PHONE: 645-0202
PROPOSED BLDG. USE: —�; ngl P Fnm; 1 v Res i d n(- —
COMMENTS: Path 1E•tn-
LICANT SIGNATURE
Received By: — Oat�e Received:
•
K
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
fjs 3��.3SL 10-432 00 Buildinq Permit Fees 3Sz ;j 2• ��
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees '► �/G.��
10-230 01 State Building Tax (5%)
Buildingu '
Plumbing
Mechanical
i 10-433 00 Plans Check Fee
i //• 63
Building _1/ 0 /
Plumbing
Mechanical //•03
10-230 06 Fire
> 30-202 00 Sewer Connection
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 /3.5 o v
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Pev Charge (POC) S G
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) ,2SV
24-445-01 Water Quality (Fee in lien of)
24-445-02 Water Quantity (Fee :n lieu of)
TOTAL_ Su
5 �)
nm/ 3`;971; WV1
CITY OF TIGARD — RECEIPT OF PAYMENT RECEIPT NO. s93-241308
CHECK AMOUNT s 40. 00
NAME r WAYMIRE, MEL CASH AMOUNT s 0. 00
ADDRESS r PAYMENT DATE a 06/ 15/93
SUBDIVISION s
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE. OF PAYMENT AMOUNT PAIL"
KLAN CHECK FE .._._.4Q. 00
9w
LOT 81 ANTON PARK c
12295 SW ANTON
TOTAL. AMOUNT PAID — — — -> 40. 00
i
._ �+ ...v.u.mar...... _•__ _. .... .. _.. ___ — _. ._.. ____ _ _—_ _._
l
CITY OF TICARD — RECEIPT OF PAYMENT RECEIK'T NO. c93--242029 i
CHECK AMOUNT c 5099. 21
bAME a WAYMIRE, MEL CASH AMOUNT A 0. 00
IDDRE139 t PAYMENT DATE z 07/07/93
SUBDIVISION
'PURPOSE OF PAYMENT, AMOUNT PAID PURPOSE". Of" P,lYMENT AMOUNT PAID
UILUINQ PERM 3 . 00 PLUMAINd PERM _ ~+ 155. 00
ECHANICAL PE 46. 30 ST. BUILD PER 29. 06
'LAN CHECK FE 11. 63 SEWER USA ?200. 00
E WER 1NSPECT 35. 00 PARKS SDC 500. 00
'TORM rr`HiN 800, 280. 00 RESIDENTIAL TRAFFIC FEES 1350- 00
ASS TRANSIT TIF FEES 110. 00
12293 SW ANTON DR
OTAL AMOUNT PAID — - — —) 5099. 21