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Case File 12558 SW Br Idge✓i.ew Court U O O U N 5 as T1 u Ln �r MIKA ME INURCTION NOTICE 'l City of Tigard Buildbn Department (� 137.25 SN Ball Blvd. Tigard, Oreogon 9/223 inspection Lina (Rec-O-bho ): 63Q-4175 buainesi Phone: 639-4171 Inspections__ _— Footing Plbg` deralab M . s. Rough-inAppr/Sdwlk Round. Plbg. Top out G^a Lino FINAL: Poet,/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Nw.h. Rain Drain Insulation -Plumb. "Ibq. Underfloor Nater Line Gyp. Bd. -Meeh. Date Aequesteds� —_ Times •77 c� .7 Ad.resas. /r7� ✓ ya�E� V =�/�ILC!!-�Permit 1:_l_L�1.LSL�� .uilders TIDI FOLLOWING CORRECTIONS ARE REQUTAZ is U L. i Yum Inspector.s----(�LlB�faL_ — Dates �PROVBD �— DISAPPR APPRrsVED sUBiwr TO ABDV"i __Call For Puinsp. � 4 f CITYOFTIGrARD *111MRD CERT I F I CATC OF OCC(JPPNCY COMMUNITY DEVELOPMENT DEPA"EK PERMIT M. . . . . . . : MST91 �•00 ;' 13126 SW Nall Btvd, P.O.Box 23'197,Tgevd,Oregon 97223(503)639.4176 -- -- —_-- DATE ISSUED, O I TL ADDRESS. ---'558 Std BR I U(JL V I E W (-'T SUBDIVISION. . . . : V I L.L AGE: AT SUMMER LAKE 'ARK 3 PARCEL s 1 S 133DD--04000 BLOCK. . . . . . . ZONINGs P.--4. 5 . . . r LOT. . . . . . . . . . . . t79 CLASS OF WORK. 'NEW TYPE OF USE~. . . i 5F OCCUPANCY GRC'. 'R3 OCCUPANCY LOOD s c?'2 3 4 TENANT NAME'. . , r Remar'Ns; e Owners -._..___..__..____.......___ .__.__ .....__._._.__.__. DON MORIZGETTE BLDERS, INC. il) () BOX 19524 PORTLAND OR 97219 Phone *r 503-620--7538 Contractors DON MORISSETTE BUILDERS, INC. 1 S'455 SW BANDY RD. #r"_01 LAKE OSWEGO OR 97033 Phone Ms 620-7530 Rep #. . s 35533 Occupancy of tti., above referenced bt.lilding is hereby given, and certifies the compliance iich t, 'P State Of Oregon Specialty Codes for the grotip, or.empancy, Wid under whir_h the referenced permit was issued, r F`I RE DE'PAFiTMEF1T IL INE3 I BUrt-n Or* ILIAL POST IN CONSPICUOUS PLACE i ^ 1NRPFCTION NOTICE City of Tigard Bu.ildiaq Department 13125 M Sall Blvd. Tigard, Oregon 97223 Inspection Line (Roc-4-Phone): 539-41.75 Business Phone: 639-4171 Inspections, ____ } Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Liao FINALs Post/Beam Struct. San. Sewer Framing . Bl / Post/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Undorfloor Niter Line Gyp. Bd. Date Requested: ��_-�T� Time: --AM �__,j<.PM Address:� 0&� Permit #:';J THE FOLLOWING CORRECTIONS Ar" REQUIRED: V J Inspectors Data ' �APPROVEb DISAPPROVED hPPROVED SUBJECT TD ABOVE Call For Reinsp. ME IN6PECTIQN SICU f l► �� City of Tigard Onilding Department 13125 E11 Hall 31vd. Tigard, Oregon 97223 Inspection Line (Rac-O-Phone)t 639-4175 Business Phone: 639-4171 Inspection: Footing Plbg. Underelab Marti. hough-in Appr/Sdwlk Found. Plbg. Top Oitt Cas Line FINALt Post/Seam Struct. San. Sewer Framing -Bldg. Post/Beam Mech. Rain Draiu Inau:ation Plumb Plbg. Underfloor water Line Gyp. Bd. -Koch Date Requested: �l lJ� Timet Am PH i Permit. - i THE FOUR KING CORRECTIONS ARE REQUIRED: yr Inapectore_���E � _ y Date s APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Neinsp. City of Tigard Building Departerent 13125 SW Ball Blvd. Tigard, Oregon 97223 Ineper.tion Lina (Rec-O-Phone)s 639-4175 Business Phone: 639-4171 Inspections__ Footing Plbg. Underalab Mach. Rough-in ��17k Pound. Plbg. Top Out Gas Line FINALr Post/Beam Struct. San. Sower Framing -Bldg. Poet/Beam Mesh' Rain Drain Insulation -Plumb, Plbg. Underfloor Nater Line Gyp. Bd. -Meth. ,date Re estehdt Time: AM Address: Buil.derr_j� THE FOLLOWING CORRECTIONS ARE REQUIRED: APP11OVED DISAPPROVEDyAP q{IED SUBJECT TO !►BpVE _Call For Reinep. i i INSPI ONCE City of Tigard Building Department 13125 BW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone: 639-4175 Bunineee Phone: 6'19-4171 i Inspections Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk Pound. Plbg. Top out Gas Line FINAL: Past/Beam Struct. San. Sewer Framing -Bldg. Past/Beam Hoch. Rain Drain Insulation -Plumb. Plbq. Underfloor Water Line s yp, Bd, DatP Requested:_ r�y� �/ T tmP: SAM PM Address:_ ��.�� u 1-¢Prmit is60 Builders 9 THE FOLLOWING CORRUCTIONS ARE REQUIRED: rf Oft rbc Ie y a t y i r t I 4 i r Inspectors i _ natal_i 11PPROVlD DI/RPPROVan APPROt'QD SUBJECT TO ABOVE Call For Reinsp. t t INSPECfSON City of Tigard Building Departaeent r 1 131AS SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Ree-o-Phone)s 639-4175 Buuiness Phc.ne: 639-41JI Inspection: il r// PLS. Underelab ` Mech. Rough-in Appr/Sdwlk _ Footing v round. Plbg. Top Out oae Lin FINAL: Poet/beam st::uct. sun. sewer Framing -Bldg. Post/Beam Mech. Rein Drain insulation -Plumb. Plbg. Underfloor �7 Nater ]Line Gyp. Bd. -Mach. Date Requested: It Builders_2� --------- THE lOLLONING CORRECTIONS ARE REQUIRED: /r, Ot/91� 0�++ �i4S I' F� ',�,,c���d�L /�,-rC'M�•.. ---;za..ic�..` Inepectore Dates, V APPROVED DISAP!'ROVED _ APPROVED SURJECT TO ABOVE Call For Reinsp. INSPECTION NOTICE City of Tigard Building Department 131.25 80 Ball Blvd. Tigard, Oregon 97223 Inopection Line (Ree-O-Phone): 639-4175 flueineas Phones 639-4171 Inspection: _ Footing Plbg. Underslab Mach. Itough-in AFpr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Poet/Beam Struct. San. Bawer Lr-7n -Bldg. Poet/seam Mor_h. Rain Drain ion -Plumb. Plbg. Underf - bq Loor Nater Line Gyp. Bd. Mech. Date Requesteds� V - % _T1mslA_�AM PN ,e)—BAddreenz '2,�� �� p rmit #t —Z/2 7,e)— Builders D uildersy h 1 THE FOLLOWING CORRECTIONS ARE RBQUIREDs r S r-a I JZ'--4Z,S:4 Inspector: Date c —._APPROVED DISAPPROVED T APPROVED SUBJECT TO ABOVE --_Call For Reinsp. INSPECTION NOTICS City of Tigard Building Depart-t 1.3125 BM Ball. Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Ins ►ction: Footing P.lbg. Underslab Hach. Rough-in' hpFr/Sdwl Found. Pl.bg. Top Out Oas LiM FINAL: Post/Beam Struct. San. Sewer Framing --Bldg. Post/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Leine cyp. 8d. -Hoch. Date Requested: /L Tim: AM PM Address: l�c S Sd ~ Permit Builder: THE FOLLONINO CORRECTIONS Ak7 REQUIRED: �.?3 r / s�,c �/� "Y',vTr; �.S 2 P Po izT/ i n N Inspectors X�4_ _Date: APPROVED DISAPPROVED IfAPPROVRD SUBJECT TO ABOVE Call For Reinap. { Ils-PSCTION NOTICE--1 City of Tigard Building Delariasat 13125 811 Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phones 639-4171 Inspection: Footing Plbg. Underelab Hoch. Rough-ir Appr/Sdwlk Found. Plbg. Top 0-1tJ Gas Line FINAL: - =-- Post/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mach. Rain Drain Insulation -plumb. Pibg. Underfloor Nater Line Gyp. Bd. _Noch. Date Requested,,—� � �f Time: __—AM PN Addresri: Builderi THE F01.110W 7ORRECTIONS ARE REQUIRED: Inspector:_ Date: (� rll — „APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE ��Call For Reinep. .w INSPt)¢,ON NOTICE City of Tigard Building Department. 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspections Lino (Roc-O-Phone)s 639-4175 Business Phone: 639-4171 Inspections_-7r- X1,0 Footing Plbg. Underelab M Rough-Ln Appr/� lk Found. Plbg. Top Out Gas Line FINAL: Post/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mach. Rain Drain Insulation -Plumb. Plbg. Underfloor Nater Line G Gyp. Bd. /-Mach. Date Requested: _ l• —Time: Jl AM PM Address:— Bu i Ider: ddress:Builder: THE FOLLOWING COn.RRCfIONS ARE REQUIRED: Inspector: Date: Com' 25; T APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Roinep. h city or TLgn d DaUding +e191y t w•Sc 13125 BW Ball B.'104. T1 VWFY� 32",.n, 9727.' Inspection Line (Rec-o-Phone`: .3ines- Pskune: 639-4171 Inspections _— Footing Plbg. Underslab Mech. Re-, .. In P :r/Sdwl.k Found. Plbg. Top Oct Cas Lin, FINALt Post/Beam Struct. San. Sewer. Framing -Bldg. Post/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Onderlloo Nater Line Gyp. Bd. -Mech. CP! 01 Date Requestedt �( WQ,-� ��_ l I Timet 'k—AMPM Address: L 2� V r �Il,4l/ s Permit is Builder: - zI M'e* ISs THE FOLLOWING CDRRRCTIONS ARF. REQGIRRDt Inspector/,&42- Dates , C APPROVED DI8APPR0VED APPROVED SUBJECT TO ABOVE call For Reinsp. _fff+PMCTION NOT CE yL city or Titlard Building Departstent 13125 sw Ball Blvd. Tigard,q Oregon 97223 IANP00tion Line (Ree--o-Phone): 639-4175 Business Phone: 639-4171 Inspection. footing Plbg. Underelab Mach. Rough-in Appr/Sdwlk �• Plbg. Top out Cas Lino _ PINALe Rt/Beam Strutt San. Sewer Framing -Bldg. Po Beam Kec Rain Drain Insulation -Plumb. Plbg. Undo rWater Line Gyp. Bd. -Koch, Data Requestede_ 77` I _Time= Addresq: M�1.�7�;5 I� /��(� /� !1 Permit #:� 7 ►uilders_�� 7. ] _ SG�_—) 1A4n II JAL. TAT• FOLLOWING CORRECTIONS ARE REQUIRED: i Insprctnr:_ Date:_ L l PROVED DISAPPROVRD APPROVED SUBJECT To ABOVE Call For Reinep. I INSPECTION NOTiCR �J�( � city or Tigard Bnildiag Department y l/ 13125 DR Ball Blvd. Tigard. Oregon 97223 Inspection Line (Rer_-O-•Phr-.e): 639-4175 Business Phone: 639-4171 Inspections Footing Plbg. Underalab Mach. Rough.-In A ppr/edwlk Found. Plbg. Top out Gas Line I+INAL t Post/Beam Btruct. n. Sewed Framing -Bldg. _ g• Poat/Beam Mach. Rain Drain ., Insulation -Plumb. Plbg. Vnderlloor Nater Lines. Gyp, per, -Mmoh. 1 Date Requesteds ,i,�I 0 AM PM Address:at4�i It 1t C4 Buildere THE FOLLOWING ODRRECTIONS AAE REQUISIEDt Inepoctort�/ ✓� ----------__ Dates APPROVED DISAPPROVED APPROVED B['BJECT TO ABOVE Call For Reinap. ��EM-LILME-UL-Mm-qA-M-m��M-M-AILMM-LMLM-%ALMe�=N� INBPSCPION NOTICE City of Tigard Building Department 13125 ON Ball Blvd. Tigard, Oragon 97223 Inspection Lina (Rea-O-Phone): 639-4175 Business Phones 639-4171 Inspections rooting Plbg. Underelab Mech. Rough-in Appr/Sdwlk Found.' i Plbq. Top Out Gas Line FINALS `,�_r Post/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mech. Rain Drain Insulation _Plump, Plbg. Underfloor Nater Line Gyp. Bd. Date Requested: /._ t Times /L AN PN Address---,�t11yZ -�Permit Builders_ D?.CSa=TTC TBE FOLLOWING CORRECTIONS ARE REQUIRED: Ll/of L L T�;, "�C.tJ4!•S —` -- — Inspector: Datovi 4—XW OVICD _— DISAPPROVED APPROVED SURJECf TO ABOVE Call For Reinsp. Iw �! . --- ------- *canffY0F1D aE:►�;E R Ct�tdNEC"rICiN �CIT"1PQFTIC��R!� PERMIT I=�EF?MIT #. . . . . . . : SwR91-0076 COMMUNITY DEVELOPMENT DEPARTMENT t3t26SWFWIBNdP.O.Bac23W.TIOnd,Ormpon91 (6o3;#.J&4176 SUED: 05/29/91 ti — j ,1TE ADDRESS. . . 12556 SW RR I DGEV I EW CT PARCEL: 1 S 133DD 0-4000 iUBD'Y I S I ON. . . . : VILLAGE AT 'SUMMERL_AKE. ZONING: HLOCK,. . . . . . . . . . 3 LOT. . . . . . . . . . . . . :79 ---------------------- TE'NPNT NAME. . . . . s J1,P NU. . . . . . . . . . . FIXTURE UNITS. . . 3 OSS OF WORK. . . :NEW DWELL_I NG UN 1',S. . : 1 1='E OF USE. . . . . :SF NO. OF BUILD 1 NGS: 1 ,"s",TALI_ TYPE. . . . -BUSWR IMPERV SURF=ACE. . :Sf aemarks: check for cold spots in front room lwner. ____.__.___W________.._.________._----.___-- ________________ FEES DON MORISSE=TTE BLDERS, INC. type armor.rnt by . "At recpt O BOX 19524 PRMT $ 1500. 00 JI-11 - INSP $ 35. 00 JLH 05/c9/91 - PORTLAND OR 97219 'holle #: 503-620-7538 DON MOR I SSET'rr BUILDERS, INC. 15555 SW RANGY RD. 4201 LAKE: OSWEGO OR 97035 ______...__.____.----.___________________._-. Phone #: 620•-7538 $ 1bS5. 00 IOTAI_ Reg #. . 35533 ---- --- REQUIRED INSPECTIONS This Applicant agrees to comply with all tre rules and regulations Sewer Inspection of the Unified Sewage Agency. The permit expires 120 days from the date issued. The total amount paid wAl be 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 measureeent given, the installer shall prospect 3 feet in all directions from the distance given, If not so located, the installer shall purch a "Tap and Side Sewer" Permit and the A en yWill install a lateral. l l e r'm i t t e t+ -red By : Ceell for inspection - 639-4175 crTyOFTIVAw RD � � MASTER PERMIT' COMMUNITY DEVELOPMENT DEPARTMENT F k RM I'1 #. . . . . . . M`: ! CJ 1-Idtt97c: 13126 SW FWI Blvd. P.O.Box 23307,r9wd,o vgon 07223(603)8304176 DATE ISSUED: 05/29/91 l ;RL_._,.. . . : ,..-353 �. ,_i;i.1:amu:; itW C1 PARCEL: IS1.33DD �I141[`tti►M, ;1..1BDIVISION. . . . : VILLAGE: AT SUMMERLA;-(E ZONING: BL_OCV.. . . . . . . . . . . LOT. . . . . . . . . . . . . ..79 _.._.._---_-____.-------------------- BUILDING -------------- __-_`_r __ _ .?C I SSUE:MST91--001 S DWELL I NG UN I'rS: 1 BASEMENT . . . . . . . :05 f _._- GLASS OF' WORK. :NEW BEDRMS:5 BATHS:3 GARAGE. . . . . . . . . . :600 s YPE OF USF_'. . . :SF FLOOD AREA,____..______.._ REOU I RED SETBACKS-.---.._..____.._. ,L OF CONST. :5N FIRST. . . . : 1427 sf LEFT. . -5 ft RIGHT. :?5 ft f.)(.=(.:IJr'ANCY GRA. : F; SECOND. . . .- 1261 s f F*RONT. :20 ft REAR. . :c..6 Ft STORIES. . . . . . . :P. THIRD. . . . :0 s f REQUIRED--------------------- HEIGHT. . . ., . . . . :2`.i ft 1`OTAL--•----:2688 S GMOI�E DETECTORS. -Y LOON LOAD. . . . :40 psf VALUE. . . . . fe 1;34448 PARKING SPACES. . :0 Rematr,ks : Check for" Cold spots in front room PLUMBING FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :0 4VATORIES. . . . . cS WATE=R HE.ATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0 TUD/SHOWE:RS. . . . :4 LAUNDRY TRAYS. . . :O CATCH BASINS. . . . . . . :0 WATER CLOSETS. . :3 SEWER LINE (ft) . -0 GREASE TRAP'S. . . . . . . :0 !i I SHWASHERS. . . . : 1 WATER LINE (ft ) . r 100 OTHER F I XJ`URES. . . . . .0 t:(4HPAGE .UISP. . . : 1 RAiI4 DRAIN (ft ) . :0 140C�-lINB MACH. . . : 1 5F RAIN DRAIAS„ . : 1 MECHFNICAL --------- ______._._.____._____ FEES !.JE"I_ rVpFg_._._____.____• UNIT HTRS. . :0 t1)pe amount by date t,vept VENTS . . . . . ;0 BPRT $ 520- 50 JLH 05/29!91 - MAX INPUT:O STI-1 VENT FANS. . :A BPLC f 4.0. W0 .JLH 04/12/91 0001x'.000 FURN ( 100K . . e@ HOODS. . . . . . .. 1 BSPC f 2:6. 03 JLH 05/L-,9/91 - F URN ) =100K . . : I WO0DGT0VE5. :01 TIF= to 13501. 00 JI_1•t 05/;7,9/91 ► l_.OUH F-URN. . . . :0 CLO DRYERS. : 1 SSDC 41 375. 00 JLH 05/29/91 - la('IL_/(�Mc ( 3HP-0 OTHER UNITS-O PARK $ 2250. 00 JI-14 05/89/91 GAS OUTLETS: 1 MPRT E 40. 50 JLH 05/29/91 - lwn MPLC 41 10. 13 ,Tl H 05/29/1)1 DnN MORISSETTE BIL-DERE, INC. M5PC $ 2. 03 JLH 05/29/91 - 0 BOX 195E4 i-PRT s 147. 50 .JLH 05/29/91 P5PG $ 7. 38 JLH lib/29/91 — F,ORTLAND OR 97219 PpRT t .31D. Oka ..JI_I-I 1j1'_•5/r''9/91 - 1-rl o n e 08 503-620-7538 !,ON MORISSE ,'TE BUILDERS, INC. 1"5555 SW RANGY RD. 0; 01 I_.AKFF: O,WFGO OR 97035 r1h on e #! 620-7530 35533 t 2799. 07 TOTAL. �.s aerait is issued subject to the regulation] cmitainad in the --- --- RECIUIRED INSPECTIONS -- ----_ Flea.•+ M6,11Ctoal Code, State at Ore. Specialty Codes and all other Foot/fol_lnd Insp Fi*-eplace Insp applicable lass. All work will be done f^ iccordane, with approved Post/Beam Strutt Gas Line Insp clans. This perait will expire if work is not starteo "!,thin 180 Post/Beam Meehan Insulation Inse BMs of iAsuance, or if work is su pe 4d or are ar 180 days, Film/ttncis.lab Insp Gyp Board Inso pl__M/Under-floor^ Pain drain Ins EJ F,, mittee SitlnA( ' -- than ieal Tnsp W�Ater Line Tnsr, '� 1�-tmb Top O�_tt Appr s: /Srlw1k Ins B!' r,aminq Insp Mec,hanic,1l Final I� Call fare ins oer:t ion - 639-4175 t� i CITY OFF ilGARD FiECE%*lPl OF P- IYMLNT REU' IC='T NO. a91-213689 ` CHECK AMOUNT a 4612. 09 ht!li i a DON MORISSE'TTE BLDRS. CASH AMOUNT a 0. 00 PAYMENT DATE a 05/29/91 SUBDIVISION IRPOSE OF PAYMENT AMOUNT PAID PURPOSE: OF P'AYME'NT AMOUNT PAID P! I I I_D I NG PERM —520. 50 PLUMBING PERM 147. 50 >n.:C:HAN I CAI_ PF 40. 50 ST. SU I L D PER 35. 44 !..AN CHECK FE; 40. 13 SEWER USA 161500. 00 E WE R I NSPECT� 3R. Q4(l RES I DENT I AL T RAi=F'1 C FEES► 1 F.`10. 00 --,ARKS SDC: 6_250. 00 S CORM DRAIN SDG 375. 00 MASS TRANSIT TIF FEES 100. 00 PLAN CHECK FE :31 a. 02 i i 12556 SW BRIDGEVIEW i TOTAL 0110UNT Pn I D — — — -- 09 I - m SHOEMAKER'S PLUMBING INC. 350 S.W. ZOBRIST ESTACADA, OR. 97023 (P.O. BOX 250) TO: CITY OF TIGARD 13125 S.W. HALL BLVD. P.O. BOX 23397 TIGARD, OR. 97223 TO WHOM IT MAY CONCERN, SHOEMAKER'S PLUMBING INC. GIVES THEIR PERMISSION TO LET DON MORISSETTE HOMES INC. SIGN ALL PLUMBING PERMITS FOR SHOEMAKER'S PLUMBING INC. SINCERELY, HAROLD B.nSHOEMAKER PRES. 19 GU� '(7 t 6.30-7728 i i I CITY OF TT[aORD R1:.CEIPT OF F•AYMENT RECE'I.P1' I►i:!. ;�►:> �u;,;� ;� 1 P1AME: : MOR I SSE:T TE::. DUN CASH AMOUNT : 00 ADDRESS : F.O. FOX 1.97'24 PAYMENT DATE. : 10/! 2.5 PORTLAND. OR SUBDIVISION : � I Jf:.PI]SE OF PAYMENT AMOI..INT r I T► r'•URPOSE: Or— PAYMENT AMOUNT PAID (,IJ—C:HECIt F'F. 1�'► ..� Fc __ _1`►r►Y C►t► _____..__ _ .________.�. __.._— —... 3W BPlDf3EV1'F'.W CT'. iEC1T 79 LLAGE AT SUMMEM-AlcE #3 _i'f_.l:al. AMOUNT PAID _ .._ _ 100.00 ' I I i i