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12890 SW VILLAGE PARK LANE c G i —12890 SW VILLAGE PARK LANE — IN5 ECTICH NOTICE City of Tigard Building D_partmeut 13125 ON Ball Blvd. Tigard, Oregon 97223 Inspect-ion Line (Rec-O-P ne►: 639-4375 Business Phone: 639-4171 Inspection: Footing Pl Onderelab Meeh. Rough-,n Appr/sdwlk Found. Plbg. 'top Out Gas Line FIBALt Post/Ream St.ruut. San. Sewer Framing -aldg. Post/Beam Hoch. Rain Dratn insulation -Plumb. Plbg. U.0o rfloor Water Line Gyp. Bd. -Mach. _ Date Requenteds Ad,.ress a B,ii-lder: THE Ft,,TOWTNG CORRECTIONS ARE REQUIRED: Inspector: r% ^--- ---- --------_---- Dater_[ i t PROVEn DISAPPRrn'F.D APPROVED SUBT'CP TO ABOVE Call For Reinap. MUW-A'WA lux W� Wj Wi Wj OP' ll WqF w UA�W 1-1 A WT C;A L CIN OF 716A RDFIERI`l I' T* lCRYOFTWARD E-.*R M1'r W. , , ., . "- '. N L"(*,9 0 -0182 COMMUNITY DEVELOPMENT DEPARTMENT 0110M F)R111. 13125 SW FWf SW_ P.O.Box 23397,rqwd,Oregon 9729 4pn),aW4175 D A*rE .1 S'SUEl)- 09 -07/90 A0' R E S S W W,L L 14 tj i::, 1-,(4 N i L..I'l :1S133DD--- 7(4L VILLAGL '3UI'IrIE'R L A K E Z 0 N.1 N 6 B L 0 C K. . . . . f.,0 (,'LASS OF WORK. . :ALA' FLOOR FURN. . F*.,Vf)rl COOLERS. TYPE: OF USE. . . . .SF Mi j' HEATERS. . W-*-'*N7* F"AMS. GRP'. . 'R3 k'EN'1*9 W/o APP"L. -, V Ebl'' 9 y ST q S 3TOR-'ES. . . . BOTLER3/COPIPRESSORS HOODS. . » . . ,. »C4f L. .......... ..........- 0-3 DOMES. :1*14(*,1.Iq /W0D/' 3-'I r:j HP' 0 M III L N C 114 Ilf-A INPUT': U J.5 130 1-:EPPIR DAMPERS`?. 11 30-50 1.4P. .. WOODs*rOVES. . - .1 GAS PRILSSLIRF. » » 04. IAP. CLO DRYFRS., I'l C)- aFP U 1111 I'S t-)J`R HANDLING UNITS 01'HER UN11'S.. F'URN < 1.001, ECTU: <-- 1.000)0 (--.f n I ( AS ('.)lJTL.E'rS. 1.)R N 0 0 K B'I*U 10000 cfmu cl-l'ase a-rc7k.11-1(j stc)ve f.','HI (*,HA0 C'HEN type i.1 n)0 t.()I t by "date -r e c.p 1.2890 SW VILA AGE LANE P A y 11 $ 1.5. 23 JL.H 09107190 P R 11 T $ 1.4., .''.'i0 f TGOR11) OR 91223 '3 PC T 111101)p 44- 1 HW 1`101141'ENANCIIE SERVIC."V 121-6,2 SW SCHOLA 6 FERRY kP 11(30RD OR 97223 ....... 11 C)I-)P t1!: $ 13. 23 TOTAL .......--- RECAUIRLD INSPEU11ONS This Permit is issued sttb)tct to the regulations contained in the Final 1rispeetj(:)jj Tigard Municipal Code. State of Ore. Specialty Codes and all other applicable laws. All worP will be done in accordance W' approved plans. This permit will expire if work is not started within 188 days of issuance, or it work is suspended f--r more ....... than 180 days. ........ ......... ............... Pey'l.liAtee ............. ................. .......... 1,s3 r..;1.1 L's d F, ......................................... .......- ................... fo-r il-IsPectiavi 4.;39•-•41.75 "'ITY OF TIGARD - CLEC! iF,r OF PAYMENT RECEIPT NO. :90-20450-3 (".HECK AMOUNT : 15.'23 NAME NW MAINTENANCE SERVICE, E'.-ASH AMOUNT (). 0(1) ADDRESS PAYMENT DATE 09/0.'.*)7/9() SLJPD I V 11:3 1 ON TIGARD., OR 7722:1- PURPOSE or PAYMFKIT AMOUNT PAID OF PAYMENT AMOUNT PA I D MECHANICAL PE MEC90-0102 14. i0 ST. BUJU PER 7 SW FApk, I'OTAL. AMOUNT P011) t 151. 2'il CITY OF TIGARD MECHANICAL PERMIT )If 13125 SW HALL BLVD. Permit # P. 0. BOX 2 3 39 7 u� Description — T IGARD, OR 97223 J ' Table 3A Mechanical Code _ OTY PRICE AMT (503,1639-4775 1) Permit Fee -0- -0- 10.00 Name of DewbrxneM 2) Supplemental Permit 3.00 f .lob "Address — Furnace to 100,000 BTU Address C) oct_, r > _ 11 incl.ducts&vents -_ — E•00 Tax Lot Map ) Furnace 100,000 BTU 4 incl.ducts&vents 7-50 l.ot Blork sube�tslon 2 Name(«Iname of busi(twss) , 1 3) Floor Furnace 6.00 ^ y( C' V l�i 1 c Cl1 E IV -- incl.vent -- MAdder Pfwrra Suspended heater,wall heater Owner � �O� � III �l �� 4) or floor mounted heater -- -6.ik1 City/stale ap 5) Vent not ind.in 300 -Z appliance permit Name(«name d twsiness) 6) Repair of heating,refr ig., 6 cooling,absorption unit _ .00 Mailing Address. Phone 7) Boiler or comp to 3 H P 6.00 Occupant absorp.unit to 100,000 BTU _ City/Stale - zip - 8) Boiler or comp to 3 f IP-15 HP 11.00 W absorp.unit to 500,( BTU 00 Name - 9) Boiler or comp 15-30 HP - - 15.00 --- \j �(� Lj - absorp.unit 112-1 million Malting address 10) Holler or comp to 30-50 HP 2-2.50 7 w ` _ absorp.unit 1-1.75 million Contractor CttyiState zip 1 1 1 Boiler or coma to 50 HP 31.50 absorp.unit 1,750,000 BTU Slate Registration No. - City Bus.Tax No 12 Air handling unit to 4.50 C� �r (�, ) 10,000 CFM --- -- -- - 1 hereby acknowledge that 1 have ve r read this applicaticx,that the inlormatirx,given rs Air handling unit 13) 10,000 CFM + 7.50corrod,that 1 am tho ower or auttvxized agent of the owner,that Plans tu�bmilled are in compliance with Stale taws,that I am registered with the State Builders'Board,fhnt the14) Non portable 4.50 raxrd"given K rotted (11 exemrA from Stale registration please give Mason below), evaporate cooler Vent fan connected 15 to a single duct � - Ventilation system not - — 16) 4.50included in appliance permit 17) Hood served by 4.50 _ mechanical exhaust _ signahxe(owner or agent)— -- Dale Domestic type 18) 7,50 Describe worts O addition U alteration } repair ❑ incinerator to be done residential® - non-residential I]- 19) Commercial or industrial type Incinerator30.00 use of neralor -- I building or properly _-__-- - --- 20) Other i.e.,woodstove,water 4.50 r ,1 Proposed use of - heater,solar,clothes dryers,etc.- building or property — - 21) Gas piping one to four outlets 2.00 Type of fuel- oil I-1 natural gas O LPG O electric I 1 22) More than 413er outlet NOTICE SUB-TOTAL THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 S%SURCHARGE i DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER ---— -- WORK IS COMMENCED. TOTAL J -� Special Conditions - -- Date i-sued by — ' CER'TIFICATE OF CITYOFTIFARDj OCCUPANCY �,�; OFTWARD PE:RM1 T N. . . . . . . i MST 0 00116 COMMUNITY DEVELOPMENT DEP T, 1�' MOON PRIM. PERMIT 0. % MS7`.�0 0016 !;►t26SWHail BW. P-A.Box 2M97,Tipwd,Ore n 97223( l -415 DATE ISSUED# 07/02/90 SITE ADDRESS. . , c 12890 SW VILLAUE PARK LN PARCE;Le IS133DD-.02100 SUBDIVISION. . . . a VILLAGE 0 SUMME:RLAKE ZONINGS HL..00K. . . . . . . . . . I LOT. . . . . . . . . . . . . s60 CLASS OF WORK. oNEU 'TYPE OF USE. . . sSF OCCUPANCY ORP. sR3 .00CUPANCY LOAD a 2PFI 4 TENANT NAME.. . . o Remarksr PON MORISSE:TTE BLDERS, INC. P 0 BOX 19524 PORTLAND OR 97219 Phones Ns 50.3--244--9314 Contr-actnr a DON MORISSETTE ELDERS, INC. P 0 PDX 195P4 PORTLAND OR 97219 I Phonrp Ns 503--6VO-7538 Rep ". . t 35533 Occupancy of the above referrer►r_-ed, bUildinp in het•eb), nivurn, and certifies the compliance with the State Of OTegon ''3p2*c:i4lty Coder for the group, or_cttp.*ncy, and us& under which the referevic:ed permit was issued. FIRE DEPARTMENT DINOI INS IP77 -;If BUILDI OFFICIAL POST IN CONSPICUOUS PLACE gig I � 1 INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 i Type of Inspection,­—z--L/ Date Requested- .7 _�(: /�/lJ 71�JrM. ' P.M. Address _- �.� r f°�J Cl/ P=� � Qermit #L 50-16 Owner __ Lot #_ BuilderThe following Building Code deficiencies are required to be corrected: Presented to _. ,Y'q�L -Approved Inspector Disapproved Date �— CALL FOR REINSPF.CT10N ❑ YES O NO M o rw ISIS, ri� INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 �- Tigard, Oregon 97223 Phone: 639-4175 Tynn of Inspection Date Requested._, Time A.M._ P.M. Address l_: _ ��/!��' tea��r1�Permit *a Owner Lot Builder The following t3uilding Code deficiencies are required to be corrected: callct— Presented to ❑ Approved ;nspector _z��_ � _. biapproved Date -- CALL. FOO? REINSPECTION f ''fEE 0 NO INSPECTION NOTICE City of Tigard Building Department 6� P.O. Box 23397 Tigard, Oregon 972.23 Phone: 639-4175 Type of Inspection Date Requested __.._�v —�� ermne�-XK A.M. P.M. Andress / ��� j' Permit � , Owner —---- —�—===—�of #- ---- guilder ._-- — — -- -------- The following Building Code deficiencies are required to be corrected: Presented to Approved Inspector Disapproved Date lof CALL FOR REINSPECTION ❑ YEs ❑ No INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard. Oregon 97223 Phone: 639-4175 Type of I n spection _���—4. S'/ Date Requested 4/—2— �U _ Time A.M.—4----PM, Address __ l_ g�� ll���A�Y�-- Permit #�iL dvl Owner —_ Lot # Builder The following Bui'ding Code deficiencies are required to be corrected: Presented to Infpdetor � ] Disapproved Date ('ALL FOR REINSPECTION ❑ Y18 ❑ NO INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone. 639.4175 Type of Inspection AZ ' Date Requested T 9 ,�( Time_ A.M. P.M. Address Owner The following Building Code deficiencies are required to be corrected: — 1 Presented to 11<0proved Inspector ___. ❑ Disapproved 2S �� Date S -- CALL FOR REINSPECTION 0 YE8 ❑ NO 1 1 1WBlum-API INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard Oregon 97223 Phone: 639-4175 Type of Inspection _- —.— _ Date Requested �i _ .��"_��_ Timm&&& .M. P.M. Address l d %�} l��®���.C11armit Owner _ _ _ Lot # Builder The following Building Code deficient-es are required to be corrected: , -or410 .. Presented toApproved I1"spector _ �. % ` ❑ Diapproved , Date CALL FOR REINSPECTION YES 9� Nn INSPECTION NOTICE City of Tigard Building Department J P O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 ol 2�- Type of Inspection 1- Date Requested_ "� Time A.M. P.M. Address _ ______---___ _ Permit Owner - -------_-_-- --�—_ Lot # Builder The following Building Code deficiencies are required to be corrected: J�7 _V_ �,� 2 ---- ---- Presented to - __-_- ____ ___->Approved Inspector .� _ _� f 1 Disapproved Date - CALL FOR RE,GVSPECTION 0 YES [� NO W 4b 4VXW mi INSPECTION NOTICE City of Tigard Building Departmert P O. box 23397 Tigard, O•egon 97223 Phone: 639-4175 Type of Inspection kc- Data Requested 1 7U Time A.M. P.M. Address/, 6/0 GL —.-::., __.— Permit #7/��0 "e Lot # Cl0`C1i?/CO _ Builder .110 2 iThe following Building Code deficiencies are required tc hi corrected: f Presented to _� NApproved Inspector ( � Disapproved Date CALL FOR REINSPECTION 0 YES ❑ NO INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97' 23 Phone: 639-4175 Type of Inspection --- Date Requested-__1� Time� P.M. �,� A.M. Address __ /�� ��–" permit # (� Owner...-.--__ _ Lot BuilderThe following Building Code deficiencies are required to be corrected: �, Presented to 7 _ Approved Inspector `� — ❑ Disapproved Date -- CALL FOR REINSPECTION Cl YE8 0 NO os s� s W111M IM, �e INSPECTION NOTICE City of TigardBuilding Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 A Type of Inspection � Date Requested Timed_ A.M. __ P•M- ```` Address C7 ZjOC_._ Permit #��LL Owner,------,-- __. Lot Builder The following Building Code deficiencies are required to be corrected: Presented to � —._—__._-- _- � Approved 1 Inspector ____ -- ❑ Disapproved Date ---— CALL FOR REINSPECTION YES [7 NO i INSPECTION NOTICE City of Tigard Building Department P.O ©ox 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection ----- Date Requested tL��� Time A.M. P.M. Address _ ���� -- ! �ermit # � Owner——— _.— ---- —.— Lot #---TBuilder he following Building Code deficiencies are required to be corrected: Presented to - Approved Inspector ❑ Disapproved ... c Date _ CALL FOR REINSPECTION W] YES L1 NO INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection --- Date Requested _ 3 l�U _- Time A=A.M.__ P.M. Address ____j �U �Permit Owner _ ------- Lot Builder –_ �L� --- -------- — The following Building Code deficiencies are required to be corrected: Presented to _--.,-- -_--- Approved Inspector _ Disanpr^ved Date CALL FOR REINSPECTION YES [-1 NO INSPECTION NOTICE City of Tigard Building Department m� P.O. Box 23397 q Ij Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection --"VI -_--- -- Date Requested Time – G / , 7 Address ( .-1.A—'-- Permit OwnerLot #-- — BuilderThe following Building Code deficiencies are required to be corrected: l,�i ��"�-scilr iri= /JAL 5o1C7 /til/-�1�t�1�.�.-Q•wt � �Ovr�J� �l>s!Ti►rE �Eyc✓�y Presented to --_-----_-_ --- ^, j Approved -- Inspector — �. ❑ Disapproved Date CALL FOR REINSPECTION ❑ YE8 ❑ NO 1 MASTER PERMIT PERMIT #. . . . . . . : MST90-0016 xxxx PRIM. PERMIT #. : MST90-0016 639-4171 DATE ISSUED: 03/08/90 I SITE ADDRESS. . . : 128IO SW VILLAGE PARK LN PARCEL: 1S133DD- SUBDIVISION. . . . : ZONING% BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . -------------------------------- BUILDING --------...---•-----------------•--------- REISSUEt892621 DWELLING UNITS:1 BASEMENT. . . . . . . . t0 of CLASS OF WORK. :NEW BEDRMS:4 BATHS:3 GARA^7F. . . . . . . . . . :390 of TYPE OF USE. . . :SF FLOOR AREAS---------- REQUIRED SETBACKS---------- TYPE OF CONST. :5N FIRST. . . . :1560 of LVFT. . :5 ft RIGHT. :5 ft OCCUPANCY GRP. tR3 SECOND. . . t1614 of FRONT. t20 ft REAR. . :36 ft STORIES. . . . . . . :0 THIRD. . . . :0 of REQUIRED-------------------- HEIGHT. . . . . . . . :22 ft TOTAL------:3174 of SMCKE DETECTORS. :Y FLOOR LOAD. . . . t40 pot PARKING SPACES. . tO Remarks: ---------------------------------- PLUMBING ------------------------------------ SINKS. . . . . . . . . . ..2 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :O LAVATORIES. . . . . 13 WATER HEATERS. . . :1 TRAPS. . . . . . . . . . . . . . :0 TUB/SHOWERS. . . . :3 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . :0 WATER CLOSETS. . :3 SEWER LINE (ft) . :0 GREASE TRAPS. . . . . . . :0 DISHWASHERS. . . . :1. WATER LINE (ft) . :l OTHER FIXTURES. . . . . :1 GARBAGE DISP. . . :1 RAIN DRAIN (ft) . :O WASHING MACH. . . :1 SF RAIN DRAINS. . :1 -•-------------- MECHANICAL ------------•-- ---------------- FEES --------------- FUEL TYPES----------- UNIT HTRS. . :O type amount by date recpt /GAS/ / / VENTS . . . . . :0 PAYM $ 0.00 MAX INPUT:O BTU VENT FANS. . :3 PRMT $ 0.00 FURN < 100K . . :0 HOODS. . . . . . .1 PRMT $ 535.50 FURN >=100K . . :1 WOODSTOVES. :O PLCK $ 40.00 FLOOR FURN. . . . tO CLO DRYERS. :1 5PCT $ 26.78 BOIL/CMP < 3HP:0 OTHER UNITStl PAYM $ 40.00 DEW 01./04/90 106725 GAS OUTLETS:l STDG $ 000.00 Owner: ---------------------------------- SSDC 250.00 DON MORISSETTE BLDERS, INC. PARK $ 250.00 P 0 BOX 19524 MISC $ 30.00 BLT 01/08/90 PRMT $ 42.00 PORTLAND OR 97219 PLCK $ 10.50 Phone #: 503-244-9314 5PCT $ 2.10 Contractor: ------------------------------ PRMT $ 147.50 SHOEMAKER'S PLUMBING 5PCT $ 7.38 P 0 BOX 250 PAYM $ 1901.76 BCR 03/08/90 ESTACADA OR 97023 Phone #: 503-630-7728 Reg #. . : 56.135 ------•------------------------------- $ 1941.76 TOTAL This permit is issued subject to the regulations contained in the ------- REQUIRED INSPEC Tigard Municipal Code, State of Ord. Specialty Codes and all other Foot/found Insp Gyp B applicable laws. All work will be done in accordance with approved Post/Beam Insp Sewer plans. This permit will expire if work is not started within 180 Plm/undslab Insp Rain days of issuance, or if work is nuspended for more than 180 days. Mechanical Insp Water � �j�f Framing Insp Appr/Sdwlk Insp Permittee Signature: k �P (.111 Fireplace Inop Final Inspection Gas Line Insp Issued By: Insulation Inep V� W W W iar ais iv !■A SEWER CONNECTION xxxx PERMIT 639-4171 PERMIT #. . . . . . . : SWR90-0005 PRIM. PERMIT #. : MST90-•0017 DATE ISSUED: 03/08/90 SITE ADDRESS. . . : 12890 SW VILLAGE PARR LN PARCEL= 18133DD- SU©DIVISION. . . . : ZONING: BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . . TENANT NAME. . . . . : USA No. . . . . . . . . . :40477 FIXTURE UNITS. . . : CLASS OF WORK. . . :NEW DWELLING UNITS. . :1 TYPE. OF USE. . . . . :SF NO. OF BUILDINGS:1 INSTALL TYPE. . . . :BUSWR IMPERV SURFACE. . : :sf Remarks: Owner: ------------------- ---------------- ---------------- S -------------- DON MORISSETTE BJ,DERS, INC. type amount by date recpt P 0 BOX 19524 PRMT $ 1250.00 INSP $ 35.00 BLT 01/08/90 PORTLAND OR 97219 PAYM $ 1285.00 BCR 03/08/90 Phone #: 503-244-9314 Contractor: ------------------------.----- CONTRACTOR NOT ON FILE -------------------------------------- Phone #: $ 1285.00 TOTAL Reg V . : ------- REQUIRED INSPECTIONS ----•---• This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency. The permit eyr.ires 120 days from the (late .issued. The total amount paid will 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 measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase — —--- _—__ a "Tap and Side Sewer" Permit and the Agency will. install a lateral. Permittee Signature: Issued By: Call fog inspection - 639-4175 CITY OF TIGARD RECUPT OF PAYMENT RF-'C Wis 00107696 CHECK AMOUNT s 'A136.76 NAME: DON MORH)SEVE Cf4SH AMOUNT uo 0 V L,R E PO BOX 19524 PAYMENT DATE s 05-013-1�0 POFTLAND. ON 97219 BLOC1. NO/ADDR: PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF P'AY'MENT AMOUNT PAID FUTLDING PEFMIT 575.50 PLUMPING FERMIT 147.50 MECHANIC,k.. PERMIT 42.DO GTAIF 80,1L.1) PERMIT TAX 26 PLAN CHECK PEE 40.50 SEWER USA 1,250.00 SEWER I NSPEC I ON 35.00 STREET SDC 600.00 PARKS SYSTEM DEVELOFMENT CH 250.00 STORM DRAIN SDC. 250.DU 1"L AN CHECA. I—] R MST ?0-0016 1'H(V0, itXf TOTAL AMOUNT PA III .1r, I H6. '76 CITYOFTIGrARD cny now PLAN CHECK APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT ° PLAN CHECK p J l JA' 13125 S.W.HaN Blvd.P.O.Box 23397,119ard.OmW 97223.(503)639. 175 PERMIT N DATE ISSUED JOB ADDRESS: _ 1Z ��y •S t^ U I TAX MAP/LOT SUB: Ui�l Jl( e 111 Syn ,ti -Cv71C� LOT: _ LAND USE.: VALUATION: /4lC.?a j'•%y' — OWNER SPECIAL NOTES p NAME: / DJC. . _ _ REISSUE OF: d 9a 4'd1 ADDRESS: �) 'c _ LAST REISSUE: 1}r' (�/ — FLOOD PLAIN/ _ SENSITIVE LAND: PHONE: �_—� L � -- APPROVALS REQUIRED CONTRACTOR PLANNING: — ---- NAME: ENGINEERING: — ADDRESS: FIRE DEPT OTHER: PHONE: __ ITEMS REQUIRED BUILDERS BOARD �: v EXP DATE: _ LIST/SUBCONTRACTORS: BUS TAX: _ ARCH/ENGINEER CALCULATIONS: NAME: �/� I C 7� -_ TRUSS DETAILS: ADDRESS: _ OTHER: PHONE:----_ --- COMMENTS: tl ��- _12r- �'& i L'd SUBCONTRACTORS: PLUMB: MECH: PIRMII IN ACC1 N DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE 10-432 00 Building Permit Fees 10-431 00 Plumbing Permit Fees y 4 10--431 01 Mechanical Permit Fees ,/ (�Z,v✓ Lr 10-230 01 State Building Tax (5%) r' Building Plumbing — 7,3 6 Mech _ ,2- I U 10 433 00 Plans Check Fee Hui 1dirNl -/D 1'lum!jing Moch j , I-V # c., �-v0Of 30-202 00 Sewer Connection ��� � 1 � 30-444 00 Sewer Inspection 51-448 00 Street System Dev 01arge (SDC) a �' • 52--449 00 Parks System Dev Charge (PDC) _ 31-450 00 Storm Drainage Syst Dev Chrg (SSDC) ?S 10-230 06 Fire 7 IO 1 AI_ y1�/1 RFC N i r - <�- Qu - (Pill I L,ANT ATURF Received Hy l ` Date Received: j �" CITY OF T16rA RD PLAN CHECK APPLICATION I�� oFttc�van PLAN C1tECK /! ID •-S� Crstr OMMUNITY DEVELOPMENT OEPARTM[NT 1' / �� PERMIT It r��•y1.a'�L u+zssw.wiae.e_Po_ao.zsnr,rs.�oKo�srm.tsa�lu�•�rs DATE ISSUED _ r YAX MAP/LOT /S/ .33 Do JUt3 AOORESS: 12- s '�`� UII I,AL!! ¢',at OK L � LAND USE: _ Sun:: 1 lrl(' Y��,�t-� l.✓IL� LOT: D 7 k' '' •--- _ _ VALUATION: y - SPECIAL._(VOTES OWNER Tc( o2S IuC REISSUE -- NAtIE: LAST REISSUE: ADDRESS: (�' q 5,- — FLO00 Pl. N/ S[NS VE LANG: a PI#ONE: _ 2�I - ---- -- — - - --- APP OVALS RE�UIRE-0 PLAN G: _ CONTRACTOR ENGI RING: NAME: FIRE -- ADDRESS: — - OTHER: - - _ -- ITEfIS REQUIRED P110NE: - 5T/SUGCOUMACTORS: GUS TAX: _ -- ARC11OENGINEER CALCULATIONS: N(UE.; 2 C- !T� - -_ TRUSS 01-TAILS- -A_-_-:� ADDRESS: - PARKING PLAN: _ - 1-ANOSCAPE PLAN: PI{ E: ---- �� a,� c- OTt1ER: _ --- - ON -'--- " COMIE=NTS: PERMIT 6 ACCT If \� f1F...;CRIPT ON � AMOUNT AMOUNT 1)0. BA� � - S At ;� 10-437 00 ©u`f-ldin�U it Fees ; u j rj 1l!�/ 7, 10-431 00 Plumbing permit_ Fees 10-431 01 Mechanical Permit Fees — 10-230 C1 State Building Tar. (SX) nu i Id i nq Plumbiml Meeh 14--433 00 Plans Check Fee„ Ocilding 'f' J0 Plumbing Meth / - �G 30-207 OU Sewer Connection 30-444 00 Sewer Inspection 51-44(1 0n Street Sy%t.em Oev Charge (SOC) Ji c u ��- 5'L-449 00 Parks System Oev Charge (PO(:) 1Sy 31-450 UU Storm Drainage Syst Dev C1trg (SSOC) t0-230 09 TRU-0 - 10-230 06 4tashington County Firms III (9SX) _ - 10-220 00 nmart/Wedgewood — � 101111 31 At PI_ICnNT SIGNnTURE Received By: _. Date Received: cn/3587P/1111) &DING/! ROti10N CON'1'K 1, INFOMMI-1V_ ION GENE-RAL NO.:_ RAL CONTRACTOR NAME& ADDRESS: PERMIT NO.: I)1 _-T r u rlj4 A i r 1X ` "7—,2-1-1 — APP (CANT NAME AND ADD -SS: EXCAVATION CONTRACTOR -- t NAME& ADDRESS: - -Lill -J� -�— OWNER NAM ANDADDRESS: TELEPHONE NUMBERS. PROPERTY DESCRIPTION: APPLICANT' 1 I K a � ' �� STREET ADDRESS AND CROSS STREET/I.00ATED GENERAL.CONTRACTOR: -- _ EXCAVATION CONTRA(TOR: — SITE/JOB: LEGAL DESCRIPTION: /S i 24 IIR/AFTER HOURS EMERGENCY 'FAX LOT NO.: LEPHONE: 1/4 SECTION CONTACT PE[Z$QN TITI E,TE gay•-�1 .�I,-( — SITE SIZE,ACRES: DISTURBED/WORK AREA,ACRES: LOCATION&ADDRESS WHERE SPOILS SITE RUNOFF DRAINS TO:(CIRCLE ONE) LEAVING SITE WILL BE TAKEN �_�ATCH-BA IN ,DITCH PIPE CREEK (NOTE:PERMITS MAY BE REQUIRED) (CIRCLE ONE) PRLY"E PROPERTY PUBLIC RIGHT OF WAY' �RQanNSS.EDIMLNTA'I'ION CONTROL BSLMEASUR_Lia MINIMUM ESC REQUIREMENTS MINIMUM ESC REQUIREMENTS DURING CONSTRUCTION. FOLLOWING CONSTRUCTION: SEDIMENTATION FACILITIES STABILIZE EXPOSED SURFACE STABILIZED CONSTRUCTION ENTRANCF REMOVE AND RESTORE TEMPORARY ESC PERIMETER RUNOFF CONTROL FACILITIES CLEARING AND GRADING RESTRICTIONS CLEAN AND REMOVE ALL SILT AND DEBRIS COVER PRACTICES ENSURE OPERATION OF PERMANT FACILITIES CONSTRUCTION SEQUENCE OFHER—_ ___ PLAN FOR EROSION CONTROL PREPARED AND SUBMITTED IN ACCORDANCE WITH'TECHNICAL GUIDANCE HANDBOOK". EROSION CONTROL.PLAN DRAWING,AS REQUIRED,HAS PLAN CONSTRUCTION NOTES COMPLETE,INCLUDING EMERGENCY PHONE NUMBER, SCHEDULFISTAGING FOR INSTALLATION AND REMOVAL OF EROSION CONTROL MEASURES,AND APPLICABLE STANDARD NOTES. I HAVE READ AND WILL COMPLY WITH THE ABOVE AND WILL CONSTRUCT AND MAINTAIN ESC MEASURES AS NECESSARY TO CONTAIN SEDIMENT ON THE CONST CTIION SITE. OWNER SIGNATURE —� APPLICANTSIGNATURE • • • • • • • • • • • • • • • • • • • • • • • • • a •OFF 00AL USE UNI.Y • • • • • • • • • • • • • • • • • • • • • w • • • • s RECEIPT DATE ACCEPTED NUMBER RECEIVED BY Il.E -- -- I ' I 1 P.O.Box 19524 ' Portland,OR 97219 1 (503)244-9314 The Foundation ForAtiordO' wines 4 i y (Y'�IaSGN iTrc �dc � P-pOF �''T pj j, wIWP L- ILL D K C A 'JE T.S L'u c_vN)4 L IL C o F TI",4,�D I� i) � To 0 U ANT I �J�'� J ��,ucRa•tZ' ,�,� F, V111; -� ry 13 419c) -- DovBLt= FFA ro'Z 2174 0� gr3�o�eoor� SAT , z'' 4'1 VC, �!