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15270 SW CROWN DRIVE-1 ADDRESS: i:\records\microflm\targets\buiIding.doc i ( KING CITY 15300 SW.116th Avenue,King City,Oregon 97214 Phone:G39-408? COMMUNITY DEVELOPMENT APPLICATION FOR BUILDING PERMIT (Instructions on reverst) DATFi _ IJ 1. NAME OF APPL I{'.ANT: P _ IT- ADDRESS: Jo p 0.3 ADDRESS: . ADDRESS OF PR(Nr—VD IMPR.OVEHENT � 4��EIV E 7 At A 2. TYFE OF CHANGE, IMPROVEMENT OR ODNS'MCT I ON FOR WHICH PF_RM I T IS REI UES=. DESCRIBE BRIEFLY - ATTACH TWO COPIES ' F PLAN3 OR DRAW I NGS OF PROPOSED PROJECT: ..T.�4L11'�! -a, aA7J— ZI)JI.tftIt/v/ 3. Ni AND ADDRESS OF CX)NTRACPOR_ leuNte ,� ������ (p 4. b.Q.Fl�dtfo_ L . _... PHONE NO .0-3.1-?, ICENSE NO.—,rAZJ�;2� — 4. PIEIGHBORS WHO MAY BE M'P,-*M BY THIS PROJEUr WILL BE NOTI:IED BY THE CITY. S. APPLIC.AN'1' OR HER/HIS REPRESENTAT1VE MUST BE PRESENT AT THE PLANNING axmISSION 1EE T I NG NFXr HELD ON REPRESENTATIVES NAME _ PfIONE NO. — (The King City Planning Coraission will consider onl those applications received at least five (5) Mals prior to a seeting,) j a7CNATUA."E APPLICATION RECEIVED BY APPLICABLE FEE RECEIVED PLANNING CCHMISSION DECISION: AFproved,--_-Y-- Denied_ . CONDITIONS Approved ap,lica;ioss are valid ':or sir months only ,! 7 Signature eC � �i '-��r Date'U NOTE: Oregon llosebuilders Law !equires 311 persons Oho contract for woA on their residence be registered with the Builders lotd"vhich aeans the contractor is borded and insured on the job site. For your protection, be certain your contractor is registered by ca'"ling City Ball Ph' 639-4012. NOTE: A permit t tst also 1--e- obtained from the City of Tigard Department of Can, mitt' Development Yes__--r-L No CITY OF TIGARD INSPECTION REEM The above listed project has been inspected and Approvec�_�iec� Date _ Cormtents_ -- Signature! _ (� 9 InAPerAlm Pteff-". ARAUAm ono_ ( 1) e-ohy Z.o King CLty 1 CD 2 11 I i FTI ARD PLUMBING PERMIT WYOF TWORD V,E.R M 11 N. . . . . . . .. PLM90--007'/ fr COMMUNITY DEVELOPMENT DEPARTMENT oRMon PRIM. PERMIT M. . PILM90-0077 13125 SW HWI Blvd. P.O.Box 23397,Tgaird,Oregon glp.� r4)71 1)01"EISSUED: 04/24/90 S IT E ADDRESS— : 1.5270 SW CROWN DR PARCELt 29110CA-90084 SUBDIVISION. . . . : CONDO ASSOC. (IF KING (;TTY ZONING: FILOCK. . . . . . . . . . CLASS OF' WORK. ALT GARBAGE DISPOSALS. . » MOBILE HOME SPACES. TYPE OF USE. . . . :MF WASHING MACH. . . . . . . : BACKFLOW PREVNTRS.— I OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . .. . TRAPS. . . . . . . . . . . . . . .. STOR I E'S. . . . . . . . n DOTER twwrERS. . . .. . . CATCH BASINS. . . . .. . .. L LAUNDRY TRAYS. . . . . . SF RAIN DRAINS. . . . . : MINKS. . . . . . . . . . : URINALS. . GREASE TRAP'S. . . . . . . . LAVATORIES. . . . . : OTHER F I XTURKS. . . TUE!/SHOWERS. . . . ... SEWER LINE:. (ft) . . . . WATER CLOSETS. . WATER LINE* (ft) . — 1)1�.-)1-1 W A S H E'R S. . . . . R'0 IN 1)R 0 1 N (ft) . Reniarkss Cando Association of King City Owner: ............. FEES CONIFFF' GROUP' type a MO Ll 1-1 t by date rec r)t ;l140 SE HAW'rHORNE PAYM $ 26. 25 JLH PIRM I' $ 25. 00 PORTLAND OR 97x214 P'(:T s 1. 25 r1lolle #-. Contractors MODERN PLUMBING PO PDX 23307 T ,IGORD OR 97PP3 P[lal-IF7 4.- 3zol $ 26. 25 TOTAL ReEl #. . .- 181 REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the lop-ottt 11-1sp ..1-1...... ....... Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspe(:t.ion ............. applicable laws. All work will be done in accordance with approved plans. This permit will expire if wort, is not started within 180 days of issuance, or if work is suspended for more than 180 days. Pernii t t e e SigiiAtt.tre-.- ............ ----—----- Byt `��✓ Call for iiispeetion 639--4175 CITY OF TIGARD PLUMBING ITRMIT 13125 SW HALL BLVD. P. O. BOX 23397 Applicants must hold Oregon Registration to conduct a plumbing T I GARD, OR c 7 L 2 3 business or mart be property owner/o"tator not niring outside help. d Development (503) 639-417 5 �• - PlumbinI !-rmit No. Address CW' ` �, �/- Description 15'-_,Z_7() tL.1 1/W Q �1.i ORS 814-21610 DUAN. PRICE MAT. job Tax Lot Map.No. Addmes ---- FIXTURES tnl Block Subdivision Si7.50 nk -- ams a name sutess Lavatory --'7.50 Tub or Tub/Shower(', xnb. 7.50 Shower Only 7.50 Mailing� 9 C,AddressSEEE Water Cbsel 7.50 Owner / te ` J r) 9 �. � Dish,iasher 75..r0 Phone Garbage Disposal - _ _ 7.50 - Name Wastr-q Machine 7.50 Floor Drain 7.50 _ i ung ress Phone Waley Heater - 7.50 - -Laundry Room Tray 7.50 Occupant City/Slaty, Zip - 7.50 Urinal _ -�-_ ams n Other Fixtures(Specify) 7.50 _ vy)()C� �IJ" �� - 7.50 Address Phos 7.50 CoMrarlor /StaN ZIP _ (3 c)f .Z MI_SV CELLANE0US City Sue.Tax No. sewer I at,00' 30.00 U Q G �-2Sewer•ea.Add t.100' 15.00 Slat* tale s. -No. (Resdential)-i< l _ 3�_ 1'� ah Water Service 1 st 100' 10.00 1 hereby sdumwWdg@ that I tum ooy this application.Brat ttrs krbrmation Water Service ea Addit r 15.00 given is eomaet.that 1 am reoisfen a' .ith 0-#State 8uikWs Hood.and also Storm b Rain Drain 1 sL 100' 30.00 have a State Pkxnbino linemen 0.r �.ti• `,ere given are Dorr"(1.Cat all plumbing work will be done in aec-, -u• .h apdirable provisioms of Cue- Storm 6 Prin Drain Addh.100* 15.00 gon Revised Statutes ChaMent"t - ind applicable codes and that Mobile Home Space 25.00 no help will be ernployed unless amnro Inn ORS 683.(If exempt from State registration.pbese gwo reason tw-4-r. Back Flow Prevention HOMEOWNERS-1 hereby certify that I am the owner of the property do Device or Anti-PotiMion Device 7.50 scribed above.at%Ikh location 1 pn)pose b maks a pkxnbkup lrwtaaatbn F-,, Any Trap or W axle Not mry own use and this prop"h not bekrp conshu cW for sats.base or rent Connected to a Fixture 7.50 Catch 6asln - 7.50 -- --- - - - - Insp.of Eidet.Plumbing 40.00 Per Hr. Specially Requested Inspections 'IO.OD Per Hr. Rain Drain, - 15.00 ---- ----- -- -- single tram. Dw19. work addition❑ alkKabon(] MPalr❑ done resiclerilial rton reeldentlel Exh ^Q use of MINIMUM PERMIT FEE 25.00 hWdkVorproperly -- - SUB-TOTAL aPmpoved u"nt 5% SURCHARGE tx ply-- - - 'J-5i- PLAN REVIEW This permit bsoomes null and voldl It work or oonstrucllon nthOri:ld is not con TOTAL fnenced WM Jn 150 dayapr K oeneMxlbn or work 4s su perded or aberitl-ed kw �•�--- "� a period of 180 days at arry t1mo aftw wrxk Is oomwtonmd. Date Issued _-- _-_-- - by --- --- -- -- i 1� CII"Y OF TIGAS'D = C;FZIPT f_IF= F'AYMENT F'ECk-IPT NO. :'HCl-•-;"WCj 64 CHECK AMOUNT' a a_b. 25 f JAMC a MCDE PN PLUMBING C rl'o lhl AMOUNT (3.00 ADDRESS r P© no 432.0- PAYMENT w.'aE s 04/2`4 /90 SUBDIVISION x T I BARD, OR 97227— 1"P270 SW CROWN DR PUF'%'POSE OF PAYMENT AMfJUNT PAID PURPOSE Of" PAYMENI AMOUNT PAID 5.UU ST. FAJIL..D_PERMIT TAX 5% _._�..1 . :Z.,5 Tn-TW►... AlICLINT : I i 1