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9837 SW KIMBERLY DRIVE m E fes. 3 U (D H N H N• G (D I r r 5 N a i r J i RAIM XMEPAiN MS L£46 CTY OF TIGARD COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hell Blvd.Tigard,Oregon P7223.8199 (503)330-4171 I I �" (� A j� 1312SSw Fiyu 111v& PLNCK/RE-CT # CIINOFT 1_tJARD � COMM UNM'DI,V[-"I.OPMF.NTDEPARTME,NT To&".Oregon 9nPERMIT #l3 rn tj (503)639-'1" DATE ISSUED JOB ADDRESS: 37 5�, K�h lx,,,�y ��, _ TAX MAP/LOI" I I C SUB: LOT: _ LAND USE: VALUAT ION: OWNER SPECIAL NOTES WE: REISSUE►ate,. �1l�ta��c, REISSUE OF: .__------- --- ADDRESS: 1331 t-AST REISSUE: Tl �a,,d p„ , X17 z2¢ _— FLOOD PLAIN/ PHONE: SENSITIVE LAND: CONTRACTOR APPROVALS REQUIRED �k NAME: Lcx-.d C., s1LK�f�� t"v.c. PLANNING -- ADDRESS: /4725- ENGINEERING- V ,,, cjv FIRE DEPT: PHONE: _ZIL�rb e 8 _ OTHER: CONTR. B0/'RD #: v Z`I _ _ EXPD E: ILI ITEMS REQUIRED SUBiONTEJICTORS: P�ux: Co i1�(u�.�7� � LIST/SUBCONTRACTORS: MECH: BUS TAX: ARCH ENGINEER CALCULATIONS: NAME: TRUSS DETAILS: ADDRESS: OTHER: PHONE: PROPOSED BLDG. USE: COMMEN FS: APPI (CANT SIGNATURF Received By: l�'� _ _ _ Date Re,-e i ved: PERMIT k ACCT # DESCRIPTION — AMOUNT /,AMOUNT 10. BAL. DUE M54 .3-vq IC-432 00 F3uilding Pernit Fees I q0, j - _ 10- 431 00 Plumbing Permit Fees 10-431 01 Mechanical Permit Fees �a a5,ou - 10-230 01 State Building Tax (5%) Building Plumbing 4'b Mechanical 10-433 00 flans Check Fee Building >� ' Plumbing Mechanical 10-230 06 Fire - — 30-202 00 Sewer Connection — 30-444 00 Sewer Inspection - 25-448-02 Commercial TIF lees — 25-448-04 Industrial TIF Fees -- 25-448-06 Institutional IIF Fees 25-448-03 Office TIF Fees 25-448-01 Residential Traffic fees — -- - 25-448-05 Mass Transit TIF Fe+s — ----- 52-449 00 Parks System Dev Charge (POC) _- 31-450 00 St.onn Drainage Syst Dev Chrg (SSOC) -- -- - —__ 24-445-01 Water Quality (iee in lieu of) - 24-445-02 Water Quantity (Fee in lieu of) TOTAL W.lG ,��_� �� nm/3587P.W11F