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16722 SW JORDAN WAY I 1 ADDRESS: L KI ra M, f I I C' i:'\records\micrcflm\targets\building doc j c � , 'r CERTIFICATE R T I F:1 LATE OF CITY OF TIGARD OCCUPANCY a COMMUNITY DE'fELOPMENT QEPAA-tMENT 13125 8W Hall Blvd.Tlp.rd,Oregon 97223.8190 (50i)`09.4171 DATE I SSUF LI e 1713/23/9.3.1 PARCEL: L611f~AD...BED 1:3 '- 14D1'lfiEUk.=;. GW JC RDON W SUBD I V I ION. . : SE`.DrORD GLEN 11 N ZON I NS a BLOCK. . . , . : LCIT. . • ^ „ - , . . : 13 CLASS OF WQRIi. :IVE W TYPE OF USF. . . :SF OCCUPANCY GRP. 1113 1 OCCUPANCY LOAD:2=.'fir 4 i TENANT NAME.. . . : Rem..,r-, asr PATH I OAKWOOD CONSTRUCTION CO INC F�h o n Ep �k c OAKWOOD c:ONS'rRUCTTON 4`LAO SW KRUSE WAY #100 iI...AKF nSWEGO OR 97035 Phone #e 635•-973 Reg #. . 1 :32'734 Uc:c�_� aanc of the above refer-anced building is Frerpt f P Y � Y :liven, rknd c-:er,tifier, J the Compliancewith the Stato Of Oregon Specialty C-'ode's for, the group. occupancy, and Ule umiwr which the vefereiiced per'm:it was issuo'c,. - _-.�mrr-? F BI.JII_DINC (7 F- _..._...___. _... _._ ...___,. POST IN GONSP I CUOU a PI-ACE i IVY F 4 I I z' (I J 9ata ��,� 5ir �, �• INSPECTION NOTICE i City of Tigard Building pepartment 13125 SW Hall Blvd. Tigard, Oregon 97223 Inspection Li (Rec-O-Phone): 639-4175 Business Ph - 171 . Insp action i _� � Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk Found. P1bg. Top Out Gas Line FINAL' Poet/Beam Struct.. San. Sewer Framing -Bldg. Post/Beam Moch. Rain Drain Insulation lumb. Plbg. Underfloor Water Line Gyp. Bd. �-Mech. Dates Regtteaniedi.— _�_,' _ /_y,—/ Time: _AM PM —,_ Address: _ } N_t Permit i; L -v��" • � �--- 1 Aui lder:_i., T a ■ THE FOLLOWING CORRECTIONS ARE REQUIRED: Inspector__ Date:_ 1 i _—APPROVED —_ DTS PPR( APPROVED SUBJECT TO ABOVE l d i Call For Reinnp.. t JNSPECTION NOTICE City of Tigard Building Departawnt 13125 SW Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-417` easiness P e: �-4171 Inspection: Footing Plbg. Underslab Mach. Rough-in Appr/Sdwih 1 ( Found. Plbg. Top Out Gad Line FINAL: Poet/Beam Strurt. San. Sewer Framing -Bldg. Poet/Beam Mach. Rain Drain Insulation -Plumb. Flbg. Underfloor Water Line /Gyp. Bd. -Mach. Drte Rgquestpds i� ! �- Time: AM PM Addreees�__ !7' Permit k' THE rOLLOWING CUORECTIOh. ARE REQUIRED: "i. --- -- — —. TIS z a,� Inspectors _ Datws APPROVED DTSAPPROVED APPROVED SUBJECT To ABOVE k .d _ Call For Reinap. r i• �?i� INSPECTION NOTICE City of Tigard Building Department 13125 SW Hall Blvd. Tigard, Oregon 97223 Inspection Line (Ree-O-Phone): 639-4375 Busine©e Phone: 6 9-4171 Inspection:�� _ -- Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk Found. Plby. Top Out Gas Line FINAL: R d Poet/Beam Struct. Sai. Sewer Framing -Bldg. ,1 lost/Ream Hoch. Rain Drain Insulation -P.luml`• i. Plbg. Underfloor Wator Line Gyp. Rd. l -Mach. Date Requeetedt i, ` ! Ti Time —PH }}ZIP Aaareee: -� C� L Pe.mit Builder: L — THE FOLLOWING CORRECTIONS M. :tEQUIRED: aI' n �y 4, 1 iYi ' 1 tl i n Inspectors Date:�1_� �=�/' , APPR(tiVED DISAPPROVED APPROVI3D SUBJECT TO ABOVE S' Call For Reinep. ,' 4c f r INSPECTION NOTICE City of Tigard Building Department '/ ti 13125 SR Hall Blvd_ Tigard, Ore lon 97223 ?' Inspection Line (Rec-O-Phone): 539-4175 Business Phones 639-4171 Inspoction: Footing Plbg. 'Jnderalab Mech. Rough-in AppriSdwlk ', Found. Plbg. Top Out Gas Line FINAL: ; r r.. Poet/Beam Strucf_. San. Sewer Framinr -Bldg. . Poet/Beam Mech. Rain Drain InaulatiOn \ -Plumb. y 4�'i Plbg. Unc;erfloor Water Line Gyp. Bd. Mech. . Data Request d: PM is / Addreses L heLO e /i ./2 U Or? Builders— THE uilders—THE FOLLOWING CORRECTIONS ARE REQUIRED: yy rI4 : J 9 }f��f'JJ��r�Sf a ♦t �— 7 r �fly Inspector.:\ �tr--- Dates � `► APPROVED DISAPPROVED �- APPROVED SUBJECT TO ABOVE Call For Reinsp. (' li+•. r :' rile., 1., llt�` 4' ` fly }1 . 17 INSPECTION NOTICE City of Tigard Building Department 13125 SW Ball Blvd. Tigard, Oregon 97223 „ Inspection Line (Rec-O-Phone): 639-4175 Business Phones 9-417: Inspection:_ Footing Plbg. Underalab Mech. R, Ligh-i.n Appr/Sdwlk Found. Plbg. Top Out Gas L no FINAL: Past/Beam Struct. San. Sewer Framing 1 -Bldg. Post/Beam Mech. Rain Drain Insulation -plumb. Plbg. Underfloor 1,.ater Line Gyp. Bd. -Mech. z, Date Requested_:� _ � Time: _ AM — PM r Address: 1 1 � Builder: — � y C ' TF[C FOLLOWING CARhiCTION$ ARE AEQUTRED: F � 1 Inspector: Dates�� __ PPROVED -_ DISAPPROVED APoRO'VF.D SUBJECT TO ABOVE i Call For Reinap. I 1; +¢ �� � .1 IN'uPF.CTION NOTICE City of 'Tigard Building Department 13125 RN Nall Blvd. Tigard, Oregon 97223y Inepectj^a Line (Rec-O-Phone): 639-4175 Duainens P!:one: 639-4171 } Inspection: _.___------- '' Plbg. Unaerelab r h. gh- r/Sdw Rouin PP { lk Footing Gas Line FINAL: f; Found. Pg. Top Out 1- ___ Poet/Beam Struct. San. Sewer Framing -Bldg. Insulation -Plumb. Poet/Beam Meeh. Rain Drain P1Cq. Underfloor Water Line Gyp. Bd. -.Mer.h. 1� 7­7 2— Time: .--AM _.--PM Onto Requeeteds� / Permit is • Address: Buildec• THE FOLIAi/ING CORRECTIONS ARE R RED: ,ye. 4 _ —---- -- -------- .,is Y - Date: ar. Inspector:. APPROVED — DISAPPROVED V APPROVED SUBJECT TO ABOVE -- call For Reinep. . !' .. ....... .... ,. i 'L1 X01 } INSPECTION FOTICE h� Cita: City of Tigard Building Departent (3 1 Uj 13125 SW Bell Blvd. Tigard, Oregon 97223 / p'ction Line (Rec-O-Phone): 639-4175 Buninean Phone: 639-4171 Inspection• Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk ' Found. Pl.bg. Tip Out Gas Line; FINAL: Poet/Beam Struct. San. Sewer Framing -Bldg. i Poet/Beam Mech. Rain Drain Insulation -Plumb. �k Plbg. Underfloor Water Line Gyp. Bd. -Mech. Date Requested: ? Q—), Tlsne: �� AM ___ PM ddreae: — ' /L ermlt 1:�=s2 - Builder.: TRE FOLLOWING CORRECTIONS ARE REQUIRED: Date: APPROVED DIS PPROVED APPROVED SUBJECT TO ABOVE. ___,rCall For Reinsp. u INSPECTION NOTICE City of Tigard Building Department 13125 Sit Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rae-0-Phone): 6(3^9-4175 Business Phone: 639-4171 Inspect'on: r•�1 A -IU I-_ - - —` Fcoti.ng Plbg. Underelab Me0 Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Lira FINAL: ' Poet/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Mech. main Drain Insulation -Plumb. �i J Plbg. Underfloor Water Line Gyp. Bd. -Mech. AN ��PM Date Requested: Time: ^� Addresei ad 'J 4N aAA wPermit 1:. a C' L� Cf Buili dert 1�Lr ' r u r i,rr �t (r ■ THE FOLLOWLNG CORRECTIONS ARE REQUIRED: r l r t - S -'NII Inspect �_____��i__ Date: A r APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinep. '1 r. ML i ,.1 i Y P , 1104 �I� ` _INSpZCTIO"1 NOTICE city of Tigard Building Department 13125 S•a Ball Blvd- Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inupection:_---- F,'�oting Plbg. Underelab Mech. Rough-in—R ough-i: Appr/Sdwlk 1 b9. Found. Pl T Out Gas Line FINAL: { �P Poet/Beam Struct. Ban. Sewer /��y� -Bldg. j Post/Beam Mech. Rain Drain Ineu tio-) -Plumb' Plbg. Underfloor Water Line Gyp. Bd. -Mech. �C/ �--1 7 Timet PM _ Date F.eyueeted//:_ //1�� � �� �i yl�'-�/�Q/!1L�"� Permit Butlder: LL��-�: /�/ l71 �l7 S ! 7 3 - - r THE 1'OLLOWING CORRECTIONS ARE REQUIRED: s a 1 `e �r y + Inspectors Date:�(i� / y_ --/---APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE �Call For Reinsp. � i1 f. I T' 1 - - : INSPECTION NOTICE i City of Tigard BuildingDepartment r I 13125 S%y Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business PF..on939-4171 Inspect ion: Footing Plbg. Underslab Much, Rough-in Appr/Sdwlk Found. _ Flbg. Ton out Gae Line FINAL: at/Beam Struct. San. Sewer Framing -Slrg• POat/Beam Mech. Rain Drain Insulat'on -Plumb. Plbq, erf:oor eter Line / Gyp. Bd. -Mech. Date Requesteds _% Time- PM Addreses Permit Builder: is c/��� • Builder:, THE FOLLOWING CORRECTIONS ARE REQUIRED: C/moi 1 11. . f�4 } Inspector•__ . Date: __APPROVED DISAPPROVED —�/APPROVED SUBJECT TO ABOVE —call For Reinap. ,l a : 3 Ir�� �����.P1� ��ti J�rvn,o�r,,.t ,.�,• ._ .. '�rd ��rt pt�' w ti dk �`� 1 INSPECTION NOTICE City of Tigard Building Department r7, •s y 13125 SW Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone' . 639-4175 business Phone: 639-3171 Inspection: _ rti lY„ pr t Foo cing Plbg. Underelab Mec':. Rough-in Appr/Sdwlk FO-And. Plbg. Top Out Gas Line FINAL: E(c 4/.t/M am ,. Sar.. Sewer Framing -Bldg. 'ri';t Poetlsam Mech. Rain Drain Insulation -Flumb. #j 4�rk 6ali6ia!'„�'1' Underfloor Water Lima Gyp. Bd. -Mach. kri Y Date Roque ad: Time: AM PM Addrend: Permit #i_ �( , t ` 1 t Bulhlar:_---'��`G� �1A� I a : THE FOLLOWING CORRECT S ARE REQUITED: Fsr . rW. :. 4. � r e. r Y 1 ny -- --� - --------- S >f 'sl! :`k l' S 7y ra i}�d�Cr6aJtT bLL p Mfr k 'K .• -. —� —_ .—. _ _ 1 �f lig! Innpectorc-JrL /�_E -- Dater -� - APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE r Call For. Reinsp. t r 1Ft f � A �I;3�"��e'> I� ”°�• d tl(� r ti�r.n yY, afo� r v av( �t I s , (+�,�pF rr ��, i� ,{+,. if Al" w �YFa1 pV '- k, ,r. P � e'r'r Y� ��•IEIM Jd+� ;� • " �' Ail r a^�{r 3w ez t I �+� 4 a� a I: �4 e 1 fl� 1*w �, "�il,� Ar � ��t�'�4, nr °•u ttF�tan r �1�'rnil�� I ate tit#A. 1 ^ F�itt�U✓mA �tl�i(�aa'� ��A ar '�b t �U i} , .o- 7. mIs H.i 1 a W,f N. dh V ('15P �RAf !'3'rM x. {' C�q�, . 'F• ; 1 PI iii u I k�h.4�' � u Pi bf,\M1 � 7' In' 'M1S'fW.ilH;'if}rt 'h'z5•k't,o-]w 'k'rt#ritC{^rIDi n t•.., ���tr d ,INSPECTION NOTICE City of Tigard Building Department 13175 SW Ball 81ud. Tigard, Oregon 97223 g Inspection Line .Rec-o-Phone): 639-4175 Business Phone: 639-4171 Inspection:--,— -_.—. ---- r Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk Found. Plby. Top Out Gas Line FINAL: Poet/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mech. Rain Drain insulation -Plumb. r' Plbg. Underfloor j Water Line Gyp. Bd. -Koch. 112 l -�.� T LNeLY AM PK n Date Requoatgds Addrese• // zrr Z < 1 1. Permit h` Builder: )/t THE FOLLOWING CORRECTIONS ARE REQUIRED: �1 r IL L4 q 40 i 4 I- r p Inspec'-• — Date.-e? / — i / APPROVED DISA ROVED _ APPROVED SUBJECT To ABOVE ' N Call For P:inep. I INSPECTION NOTICE • City of Tigard Building Department 13125 BW Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec--O-Phona): 639-4175 Business Phone: 639-4171 Inspection: Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Mach. k Date Requested: ���� _TimbalAH ---PH 'y. Address: 'V L ___qrmit /: � Builders ` THE FOLLOWING CORREMIONS ARE REQUIRED: r Inspector: r Date:_".? }, APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE --Call For Rainsp. i �yp�j}r�'.�r',.be��'G1P,t::baa'.yi;+ne'+1N�'.A'e=,,.hr...=.•':,.. :. . -_,„ ,,.-,. ,... .:.,n.. .....,.,,..,.. .4 - 4 i CITYOFT11FARD OR MASTER IT C6MMUNITY DEVELOPMENT DEPARTMENT oo PERhIiT #. . . .. . . : hIST92-0196 13126 BWHWIBW&P.O.Ba23W.DOMM,OrsFn 67 2 (60 )4744176 h 639- 4171 DATE ISSUED: 09/14/92 /y�72Z SITE ADDRESS. . . : -#ft2-1--SW JORDAN WY F'ARCE_L: 25116AD-BED1 SUBDIVISION. . . . : BEDFORD GLEN ZONING.- BLOCK. . . . . . . . . . ONING:BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . : 13 BUILDING RE I SSUE: DWELLING UNITS: 1 BASLIYIENT. . . . . . . . :0 s f CLASS OF WORK. :NLW BEDRMS:3 BATHS:3 GARAGE. . . . . . . . . . :452 Is f TYPE OF USE. . . :SF FLOOR AREAS---- ---- - REDUI RED SETBACKS----------- "TYPE ETBACKS----------- TYPE OF CONST. :5N FIRST. -911 s f• LEFT. . :6 ft RI GHT. :5 ft UCCUPANCY GRP. :R3 SE LOND. . . :830 s f FRONT. -20 ft REAR. . :43 ft STORIES. . . . . . . ..2 TH I RD. . . . :0 s f REQUIRED-------------------- HF_IGHT. . . . . . . . ..25 ft 'T OT•AL---•---: 1741 s f SMOKE DETECTORS. :Y FLOOR LOAD. . . . :40 ps f VALUE:. . . .. . $ : 88222 PARK I NG SPACES. . : 1 Remarks: PATH I F='LUMBING SINKS. . . . . . . . . . . I FLOOR DRAINS. . . . :0 BACKFLOW PREVN'TRS. . :0 ! LAVATORIES. . . . . ..4 WATER HEATERS. . . : 1 1RAF'S. . . . . . . . . . . . . . :0 'TUB/SHOWERS. . . . :2 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . :0 WATER CLOSETS. . :3 SEWER LINE (ft ) . :0 GREASE TRAVIS. . . . . . . .0 DISHWASHERS. . . . : 1 WATER LINE (f t ) . : J 00 OTHER FIXTURES. . . . . :0 GARBAGE DISP. . . : 1 RAIN DRAIN (f•t ) . :O WASHING MACH. . . : 1 SF RAIN DRAINS. . : 1 _-_---------•------- IhEC:HANICAI_ ___----____ __._._._ _._._._..._.._.__-___.__.__--•- FEES FUEL TYPES-------- UNIT HTRS. . :0 type amount by date recpt I /GAS/ / / VEN'T'S . . . . . :0 BPRT $ 400. 00 JH 09/04/92 - t NAS( INF='UT':0 Bl'U vE,4r FANS. . : 4 BPLC $ 260. 0) JLH 09/01/92 231157 R FURN ( 100K . . : 1 HOODS. . . . . . . I B5PC $ 20. 00 JH 09/04/92 - FURN ) =100K . . :0 WOODSTOVES. :0 IYIF'RT $ 43. 50 JH 09/04/92 - FLOOR FURN. . . . :0 CLO DRYERS. : 1 hIF'LC $ lei. 88 JH 09/04/92 BOIL/CMP ( :3HP:0 QMBF'-BUWNr%.Tf' , 1 MORT $ 140. 013 JH 09/04 /92 _ f_Jwner.: ____.___.____,.__._..__---_._._______.__.__-__.___- PbPC $ . OV.i JH 09/04/9 : - U►-lKWODU CUNSTRUCTIUN LCI INCL I+IISC $ .35. 00 JH 09/04/92 - Phone #: C.ontractor: OAKWOOD CONSTRUCTION 4500 SW KRUSE. WAY #100 I LAKE: OSWEGO OR Pt1one-- 635-9733 Reg #. 3d: $ 918. 56 'TOTAL This permit is issued su t to regula contained in the - - --- - REQU; RED INSF'EC1 IONS -- - --- Tigard Municipal Code, State e. Specialty C es and all other F=oclt/found lnsp F=fireplace Insp applicable laws. all work Mill a one i acc ce with approved F'ost/Beam btruct Gas Line Insp plans. This permit will expire i wo i star d within 180 post/Beam Iher_han Insi.rlation Insp days of issuance, or if work is su a or more th n I80 days. Plm/Undslab Insp Gyp Board Insp f='Lhl/Underfloor Rain drain In'ap F-'e r m i t t e e 5.L y r1 a t:�_r r e : lyl e c h a n i c a l Insp 'Water Line Insp PIUMb -Fop UUt Appr/Sdw1k Insp lssI_red By : _ Framirly Insp Ilechaniral Final , Call 1'or inspection - 639--4175 F Y i PLNCKRECT # c �IGAR.D 13125 5W1ixll l7 / CITY OF I'O[i�xZ39PERMIT # � O COMMUNITY DEVELOPMENT DEPARTMENT rgard,o1egon97223 (503)631.4171 DATE ISSUED _ JOB ADDRESS: n_._.f TAX MAP/LDT Q S 1624d 13 .3 SUB: �a:�tQ��7 r _�- LOT: I:� LAND USE: '� VALUATION: i3 OWNE , SPECIAL NOTES NAME: ��ku)L, L)6 1. i1: �C 'l_t�. r.. REISSUE OF: ADDRESS: ) LAST REISSUE: YL �'. ' r_,I FLOOD PLAIN/ SENSITIVE LAND: 'PHONE: CONTRACTOR _ APPROVALS REQUIRED NAME: X►ti-�-+ c::_.,-:, G�. L1:��_U. PLANNING: — ADDRESS: _ _ ENGINEERING: FIRE DEPT: PHONE: OTHER: CONTR. BOARD #: �� ' EXP DATE: ITEMS REQUIRED SUBCONTRACTORS: PLUMB: ( � L' '� �►.�L1tiY�i'x ti �t' _ LIST/SUBCONTRACTORS: MECH: BUS TAX: CH ENGI EER CALCULATIONS: • '. '1l TRUSS DETAILS: NAME. � a�__� « �, A �l:�l� ^ �— ADDRESS: _. OTHER: PHONE: I . PROPOSED BLDG. USE: L _ U&A -_ COMMENTS: APPLICANT S GNATURE Received By: 4L _ ___ Date Received: r :22- .W111- nµSgdill(.: BWaµ..+tiiNa/p•n..kr.oXwOwr...,.....,... .....,w. ._>.vMMw>w.,w,ww�.n..,...w.. �-. PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE t&Ift- 10-432 00 Building Permit Fees 0 Q0' 10-431 ^O Plumbing Permit Fees 10-431 01 Mechanical Permit Fees q3 0 q3. s� 10-230 01 State Building Tax (5Y) Building t L f Plumbing Mechanical 10-433 00 Plans Check Fee _.2 /0, Building C, ./ Plumbing Mechanical _Z0, �Y 10-230 06 Fire _ 30-202 00 Sewer Connection �1 _ 30-444 00 Sewer Inspections 25-448-02 Commercial TIF Fees _ 25-448-04 Industrial TI1- Fees 25-448-06 Institutional lir Fees 25-448-03 Office TIF Fees _. 25-448-01 Resid,atial Traffic Fees 25-448-05 Mass Transit TIF Fees 52-449 00 Parks Sysl-em Dev Charge (PDC) 31-450 00 Storm Drainage Syst Dev Chrg (SSDC) 24-445-01 Water Quality (Fee in lieu of) — 24-445-02 Water Quantity (Fee in lieu of) TOTAL nm/3581P.WPF r I, 31 E, a� Of T I GARP _ FtF.0 E:I F' I' OF F"'AYME=N.r RECEIPT N). ,G+3« �JE� CHECK AMOUNT : f ,8. !J6 !,,►AME a OAKWOOD CONSTRUCTION CASH AMOUNT DAT x PAYMENT DATE a ViDDRErL,•.S x ilUBU I V I S T[)N x t F i.:,URPOSE OF PAYMEN1 AMOUNT PAID PURPOSE OF PAYMENT AMOUN-f PAID m_ 1�4�Z1« 00 rkUll,_DING�PERM400. 00 PLUMBING PERM r 18 . ITEC".HANICAL PE 43. 50 ST. BUILD PER PLAN C 1-IECK FE ":10. 86 SF:.WER INSPECT :�, 00 1.3 BEDFORD GLEN "i 1 SW JORI44Y WAY PMOUNT PAID ... ._.. ._. _.> 668. 56 y I .�I it CITY DF' TIGARD RECEIPT OF PAYMENT RECEIPT NO. a9c''_.'-c';31167 CHECK AMOUNT a F;01A« 00 it rIf'iMh. x OAKWOOD CONSTRUCTION CASH AMOUNT a +b. 00 rr PAYMENT DATE 09/01 /9P � SUBDIVISION t PtJRPOc3'F: OF 1='AYMk,.61T AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PA 11) 1'I..AN l"HE�CE4 Ft"- �+ 850. 00 1=t-AN CHECK FE" ese. 0Qi w 4 M F 0 I { !i N LOT 13 BEDFORD BL.EN, 12611 SW JORDAN WAY LOT 1 S BEDFORD GLEN, 1-731 E3W JOIEt!)AN WAY � TOTAL. AMOUNT PAID _. __� ,p)0, 00 a }6` 1 h r t r. I i IIIA'► r+ KING CITY Baa. ",n0 S.W.118th Avenue,King City,Oregon 97224 Building Permit No. COUNTYWIDE a TRAFFIC IMPACT FEE Planning File No. PAYMENT OPTION FORM / A1,21 1 � Tax Map&Lot No. Date Project N e ; I realize that I must make a decision on payment of the Traffic Impact Fee (TIF) at this time. Therefore I request the following (Choose whichever option or options are applicable): FCash or Check ElCredit Voucher Bancroft or Installment Payments and/or The Ordinance allows for deferral of payment of the TIF until Issuance of the occupancy permit if the TIF is greater than$5,000.00„ If the TIF meets this requirement, I also request this option. I under stand tho TIF must be paid prior to issuance of an occupancy permit. I also understand that the TIF will be rf�calculated based on the prevailing rates at bine ment. Please be advised that TiF rates may increase up to six percent each July 1 st. This ra incr se Is not subject to appeal. OWNER-APPUCANT OWNER/AP U 1 CC: Building Permit File Payment Option Notebook torn W02 . .r*ry,1P'+WPbfAdMAltlo4Kf�Mtii�itl�dWaBaro,.,, , t� DAT PLANS CCK NO.: PROJECT TITLE: COUNTYWIDE ell TRAFFIC IMPACT FEE APPLICANT: , WORKSHEET MAILIN ,ADDRESS: ` (FOR NUN-SINGLF.FAMILY USES) /4 CI . / ,/P NE: • RATE PER O� 97c3s ATEGORY TRIP TM MAP Np.: /3 RESIDENTIAL $146.00 /_!,� QUaINESS-AND COMMERCIAL 37.00 SITUS NO.ADDRE OFFICE _113100 Dl TS RIAL 141.00 INSTITUTIONAL $60.00 G PAYMENT METHOD: CASH/ HECK 4 CREDIT INSTITUTIONAL ONLY: BANCROFT PROMISSORY Nl..,:El LAND USE CATEGORY DESCRIPTION OF USE rEEKDAYAVFIP RAT WEEKEND AVE TRIP RAT DEFER TO OCCUPANCY l BASIS: ' i t CALCULATIONS: x PROJECT TRIP GENERATION* FEE: IJ. ADDITIONAL NOTES: FOR ACCOUNTING PURPOSES ONLY: PREPARED BY: CC: WASHINGTON COUNTY TIF NOTEBOOK (Ofm tl{10 4' i— , . o unif sewerage . SAN ITARY• D no • Uf agency 9TH N. First Ave.,Suite 270,Hillsboro,Or,97124 SURFACE WAFER 1 N 503 648.882 CONNECTION 'PERMIT .TSSUE DATE ,OY1492 EXPIRATIUN 'DATE Oaa393- - + .1P R"� 63187 I RUCTURE ADDRESS 12611 '_,•'j [ !� ;tai �CIr1: 0�'i'` �.JRUCTURE STREET GW -JORDAN WAY LO'i `1 BEI] Kiat' Atli is i ) :-'E CONNV.CTIUN— NEW , � ORD GLEN.;NO4 1 l F'E INSTALLATION- ( 19) BLIT SWR/ERO CUN%S11C ' 1 NC OCCUPANCY— ( 1 ) SINGLE FAMILY PAkdtL 2S1 tb' ADS 64700 j. RT,R SEC :47,16,;.,+ MH 18024 uWNER UAKWO D CONSTRUCTIN t� " oDDRESS 4500 , SW,•KRUSE ,WA 1,.8. 100 7FcEATM �I L N�C,''DU�;HAM LAKEO$41EOC1 q ` 5�y035-2!5�b�,+9>•° t�x',t4tV7h' 1P . .i � PHONE 635-9733 '__. . .._ .'._..` °', �, I — +:? 'sat .`tp►aJr , fc7 ,�GX�i7Y ......« rrw.. . ,,•C.•-• — _r.."�#!. . • r1!r^I+ iii �7r ilb 7.-77 ��....•. ......—_, , FIXTURE E 0 U I V A L NTr DW LLlNb ' , �' 4" ESibeNTIAL 11NT'S SERVICE . UNITS 0.0 UNITS 1V:, y+r�ci� BL60JMCE, UNITS 1 CONNECTION FEES 8URFAGE WATER DEV LOPMEN!` 'FEES WATER QUALITY 1804100 LESS CREDIT < 160.00 WATER QUANTITY 100.00 LESS CREDIT < 0.00> EROSION CUNTROL INSPECTION 40.00 . PLAN CHECK 16'►00 SUHT'0 rAL 0 .00 SUBTOTAL 46►.�4 " TOTnI 1'66.ow, iiPPL NAME RUN CHUNKS P11ONC —____—__—_ t�F F I LLl ON WNFR ` REMARKS PROJ# 9 — FORD GLEN--LUT t 13 424 HOMs TICE R ERI IUN CONTROL INSPECTIONS REQUIRED Permit tondo r,st The applicant a comply with all ruleli end re§ulatlons of the Unlfled Sewers Y , M Wh6n,callingg for an inspection, please refer to t Permit Number. The Perm1L expires ona hundred eighty (180),'-,d tf than„date of issuance. The total amount paid ,(permit e. connection charyo,r line tap fel and/or: other charge) w1) �k;fi rf�I ed If the permit expires, , ¢ D The Agency does not guarantee the accuracy of the location slde sewed'"+tite4il.`a if �he NWe11� f'�oteted at the measurement given, thh Installer shell prospect three feet In all directions ficin the dis"once qq van. IIQt io located. the Installer shell purchase a "Tap and Side Sewer" Permit at the current Charge and the Agency will.1nttal . . .. .,.. :. _ � ,,.. . ...rte.._', "190 WHITE — USA, BLUE — Accounting,' GREEN -Inspection, YELLOW,, —� ustomec , ...,,,w,., n+.wn•,........rr,w�rw�e�^'v ,t MMrlr';rrr 1 S r 00 1 1• KING CITY � i 15300 S.W. 116th Avenue,King City,Oregon 97224 Phone:6394082 COMMUNITY DEVELOP14ENT � APPLICATION FOR BUILDING PER.N'•T ( (Instructions on reverse) DATE_ 1. NAME OF APPLICANT: Phone No. ^� 753 ADDRESS:_4�l`>) ttr 1 r e- y A r i ADDRESS OF PROPOSED IMPROVEMENT +?-Ar, +-- S ­J C'L n Q­4 1(47 2--Z- 2. Z2. TYPE OF CHANGE, IMPROVEMENT OR CONSTRUCTION FOR WHICH PERMIT IS . DESCRIBE BRIEFLY - ATTACH TWO COPIES OF PLANS OR 17WINGS OF i PROPOSED PROJECT: "-/-j 3. NAME AND ADDRESS OF OONTRACTOP,— PH—VE NO.l03­,"'i X3) -JACFNSE NO. 4. NEIGHBORS WHO MAY BE AFFECTED BY THIS PROJECT WILL BE NOTIFIED BY THE CITY. 5. APPLICANT OR HER/F SENTATIVE MUST BE PRESENT AT THE PLANN:fNG CC1M�fISSION MEETING NEXT D ON RM IVE N NO. (The Ring C' scion will consider only those applications received at least tive (5) days prior to a ting SIGNATURE APPLICATIONRECEIVED BY—L— A DATE APPLICABLE FEE RECEIVED $ Q>? TOTAL PLANNING CCK4ISSION DECISION: Approved Denied -- CONDITIONS -� y ;e ications are valid for sir months only Signature Date_ �l Z MOTE; Oregon Momebu Law requires that all persons who contract for irk on their residence be registered with the Builders Board which means the contractor is bonded and insured on the job site. For your protection, be certain your contractor is registered b1 t;:l!in� City Ball Ph. 639-4082. NOTE: A permit must also be obtained from the City of. Tigard Department of Cormnmity Development Yes _ No ********************************************************************************** CITY OF TIGARD INSPECTION REPORT The above listed project has been inspected and Approved__ ied Date Conr+ents Signature (Hu,i,CeLi rrg .impec tan ptea-s¢ nAAuAn one ( 1) copy to King City) =s.,x