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6690 SW VENTURA DRIVE 1/F NTuR ?c �RW� I ADDRESS: /Poo �, vevlk re �V,� i:\records\microtlrn\targets\buiIding.doc CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 - - TV _Date Requestedd4 'f AM_ PM —_ BLD �p� — Location— %f! 7L� !�(`!�I (./1�(.iC��,� — Suite r -- Omit )1sZ Contact Person --_ Ph PLM _- - - Ccntractor---_ i_ _ — _ J�rr(,,�' SWR _ BUILDING Tenant/Owner �7�- ELC - Retaining Wall ELR Footing Access. FPS 1, Foundation — Ftg Drain SGN Crawl Drain Inspection Notes: Slab -�o-ue SIT -_ --- ...-- ---. _ --- Post R Beam Ext Sheath/Shear ------ ----------- Int Sheath/Shear Framing ---- --- Insulation Drywall Nailing ---- Firewall Fire Sprinkler _ -- --�- ----- _. Fire Alarm Susp'd Ceiling Roof Misc _ __ _ --- - - -------- Final — PASS PART FAIL_ PLUMBING Pnst&Ream -- -- --- ---------- - Under Slab Top Out Water Service --- Sanitary Sewer Rain Drains ----- --- — --- Final PASS PART FAIL -- ---- --—. -------- _ MtCHANICAL PoslBBeam ------- — --- --- ---------_.r-__----------. Rough In a sLir� --- Smoke Dampers t — P PART FAIL ELECTRICAL — Service _- -- - '-- Rough In UG/Slab - — Low Voltage Fire Alarm _— -- -- —- -- FinRI PASS PART FAIL --_ -- - -SITE ---- -- - Backfill/Grading -- Sanitary Sewer Stogy^^Drain [ j Reinspection fee of$ --__required before next inspection. Pad/at City Hall, 13125 SW Hall Blvd Catch Basin inspect-no access Fire Supply Line Unable to ins( j Please call for reinspection RE: ___-_ [ j P ADA ) Approach/Sidewalk Date - ( � r� � InapeetorAC_.�r� _ N � Ext _ Other - Final 'SASS PART FAiL DO NOT REMOVE this inspection record from the jab site. L Inman CITY CSF T I G A R D MFC,'HANTCA1_ RMIT PE DEVELOPMENT SERVICES PERMTT MFC'98-0408 13125 SW Hall Blvd,, Tigard,OR 97223(503)639-4171 DATE` ISSLJED: 09/t8/q' S r-0RCFL,. IS1,25DD-03400 'ITE ADDRESS. . . oc:&,,30 SW VENTLJRA DR ZON TNG: R-4. "1 ;IjBf)I Y IS ION. . . . : WASHINGTON S0.LJARE ES'TATES NO. LO(]K. . . . . . . . . . . LOT . . . :042 J1JRISDICTION: TT r, ,L ASSor- WORK. . .Ai T FLOOR 1"1IRN. . . . 0 E VnP ("OOLERS: 0 0 'YPE Or USr. . . r F . 3t,JNIT HEnTFRS. VFN"T' FANc.;.0 �'Irr,L)PANCY ORP. R3 VENTS W10 AFFIL : 0 VENT SYS17MG: 0 -7,TOR!Eq. . . . . . . . .. 0 BOTLERS/COMPRE'SSORS HOODS. . . . . . . : 0 0-3 HP 0 DOME'S. INCTN: 0 3-115 HP. . . . : 0 C.',,OMMI-. INCIN, 0 MAX INPUT: 0 DTLI 15-30 HP. RFPATR 1,1NITS: 0 30-50 HP. . . . V, WOODSTOVES. . : 0 "TRF ,DAMPERS% - : 504 0 rL..n DRYERS. - AG I..RES01JRE. . . : nTP VIPNnl ING tJNTTc3 nTHFP UNITS. 0 .10. OF 10000 cfm : 0 GAS OIATLEJ'S. 1, -7tJRN =1001? BTLI-: 0 > 10000 C-fm - mav't4 S : Add gis piping to and existing dwelling. FEES I77RIC G KENT t t) d�it,e t,ecpt r:&,90 SW VENYL]Rn PR r,PMT 00 C:jFo T'InARD OR 9722:31 '2,5 GEO 09/18/98 98 "-`harle #: t3 R W j)'GTIT KFI I NC; 73E.' MARBLE RD pf _ 25 TOTAL. W(.)Sj-jOLj(.1jAl,_ bJA 360-835 -7,516 Reg *I. REDtJIRED 1NSV"ECTT0N!--i This pervit is issued s.�bjtct to the regulations contain:-" in the Car line I n c,,I-) --- Tigard Municipal Code, State of Ore. Specialty Ccdrs and ill' other Final ItIspectiorl applicable laws. All work will be done in a.r.ordance with approved plans. this pervit will expire if work is not stirted within 180 days of issuance, or if w0 is suspended for tooe than 180 days. ATTENTION: Oregon low requires you to follow -"Its ated by the Oregon Utility Notification Center. Thc-e rules are forth in OAR 911+2-001-0010 through OAR 952401-0080. You lay ain copies of thesp rvilps or dimt questions to "I by calling 13)2A6-0 87, + + + 4 f 4- + h 4 +++4-4-4,+4-4-4-+++4-+ +4-4-+++'+++'++++ P. M. iier,,ded the tiext + 4.4 1-+..1-+4 f 4-+ t+++++4 Plan Check P _ CITY OF TIGARD Mechanical Permit Application Recd By 13125 SW HALL BLVD. Commercial and Residential Date Recd Date to P E. TIGARD, OR 97223 _ RECEIVEn Date to DST (503) 639-4171, x304 Permit# Print or Type Called_ Incomplete or illegible applications will n6t 616'acdepted Name of DeveopmeipPro)ectDescription �,�/,ytr y�asJ k fLE jPA9es J N^ Table 1A Mechanical Code Cr PRICE AMT Job ;trees Address Surto# , A) Permit Fee 0 0- 1000 Address La) 'DY Ue) Bldg# City)state ZI _ _ 1 ) Furnace to 100,000 BTU 6.00 Tt C�t J Z- including ducts&vents _- Name for name of business) 7 \ 2.) Furnace 100.000 BTU+ 7.50 O Nnery y" t • IC c_r1A" CFx/Gp including-") ducts&vents Mailing Address 3 1 Floor Furnace 6.00 I-- ray___ ncludin vg ens City/State Zip Phone 4) Suspended heater,wall heater � 6.00 or floor mounted heater Name or name of business) 5) Vent not included in appliance permit — 3.00 Occupant Mailing Address r6) Boiler or comp,heal pump.air cond. — 2!t to 3 HP,absorb unit to 100K BUT— City/Slate zip Phone 7) Boiler or comp,heat pump,air cond 11.00 — 3-15 HP:absorb unit to 500K BTU" — Contractor Name 8) Boiler or comp,heat pump,air cond. 1500 — �^ 15-30 HP,ab3orb unit.5-1 and BTU" Pnor to permit Mailing Address 9) Boiler or comp,heat pump,air cond. 22 50 issuance,a copy —7 12 �r�.C1-��Q 30.50 HP,absorb unit 1-1_75md BTU" A _ of all licenses city/state /� z1p Phone 3(.3 10.) Boder or comp,heat pump,air cond 37.50 are required if f Q'�Itl1 cW u�A tv� ` Sit 50 HP,absorb unit 1.75 mil BTU" expired m COT Oregon Cons ons BoarLlc.# E p Date 11.) Air handling unit to 10,000 CFM _4_50_ database_ Architect Neme 13.) Non-portable evaporate roaler 450 or Mailing Address 14.) Vent fan connected to a single dud 3.00 J Engineer Crty)5mtn. Zlp Phrne T 15.) Ventilation system not included in 450 appliance permit _._. Describe work New O Addition K Alteration O Repair O 16.) Hood served by mechanical exhaust- 450 to be done Residential O Non-residential O Additional De*7tion of work. 17) Domestic incinerators 7 50 �'n�-t (I C Ott r•-�-r t,�'' �u� un S�r� t C�- G+' _ J 1-_1 18) Commercial or industrial type 30.00 SG ' pLp�-� 4�pCISLIfA -7T- — Incinerator _ Existing use of 19) Repair units 450 building or property — — —� r20) Wood stove 450 Proposed use of 21 ) Clothes dryer,etc building or oruperty — — - 22) Other units 450 Type of h-el-oil O natural gas LPG O electric O 23) Gas piping one to four outlets 2.00 1 I hereby acknowledge that I have read this application,that the 24) More than 4-per outlets leach) t 50 information given is correct,that I am the owner or au'horized agent of _ I owner,that plans submitted are in compliance with Oreyon State OTY SUBTOTAL Signature, er1Agent Date 'SUBTOTAL 5%SURCHAFGE rCo!n:�tac:,,on Name Phone PUAN REVIEW 25%OF SUBTOTAL rt� i V•nechp .doe (rev 9 'Minimum permit fees 525+5%surchar ~Rest<ferrtiatAVG-fequlres site plan s_ranw rff placemew of unit TNSPE�'TION NOTICE City of Tigard Building Department 13125 BN Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inapectiont—___ Footing Plbg. Underellb Appr/Sdwlk Pound. Plbg. Top Out /'tae Line FINALt Post/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mach. Raln Drain Insulation -Plumb. Pibg. Underfloor Water Line Gyp. Bd. -Mach. i Date Reauested:� ' c Ti AM ,—�.PM AddreeA: �L�L7�LL��2Q� Permit fr! TRR FOLLOii1s4G CORRECTIONS ARE REQUIRRDt a dj Inspectors 4 — — Date:_�_� _ =�=- 11PP D CI8APPROV82U APPROVED SUBJECT TO ABOVE 7PO -Call For Relnsp. s Paye No. 1 CASE HISTORY FOR CASE NO.: MEC92-0315 ERIC HENT 06690 SW VENTURA DR 11/25/98 Action Description Req/ Schd/ End/ Action Notes Jisp by Update Upd Code Sent Done Done Date By MECA010 Plan check by / / / ! 11/20/92 11/20/92 JH MECA060 (F) Issue permit / / / / 11/20/92 PASS JLH 11/20/92 JH MECA705 Gas Line Insp / / / / 11/23/92 APP GS 11/23/92 GES MECA715 Mechanical Insp / / / / 11/23/92 N/R OS 11/23/92 GES 14ECA800 Case Finaled / / / / 11/08/93 11/08/93 GES C17Y OF TINA RD �y��1>►�A� MECHAN I GAL COMMUNrTY DEVELOPMENT DEPARTMENT' PERMIT 131;'5SWHall Blvd. P.O.Box 23397,Tqard,OrsVn 97223 (503)&19-4175 PERMIT #. . . . . . . I MEC92-0;s15 6,39-4171 DATE ISSUED: 11/20/92 SITE ADDRESS. . . : 06690 SL, VENIURA DR PARCEL: IS125DD-03400 SUBDIVISION. . . . : WASHINGTON SQUARE ESTATES NO. 2 ZONING: R-4. 5 BLOCK. . . . . . . . . . a LOT. . . . . . . . . . . . . :42 CLASS OF WORK. . :ALT FLOOR FURN. . . . a EVAP COOLERS: TYPE OF USE. . . . tSF UNIT HEATERS. . c VENT FANS. . . : OCCUPANCY GRP. . cR3 VENTS W/O APPLil VENT SYSTEMS: STORIES. . . . . . . . :2 ROILERS/COMPrtESSORS HOODS. . . . . . . : FUEL TYPES------------ 0-3 HP. . . . a DOMES. INCINs I/GAS/ 3-15 HP. . . . : COMML. INCIN: MAX INPUT: BTU 15-30 HP. . . . : REPAIR UNITS: FIRE DAMP'E'RS?. . : 30-50 HP. . . . : WOODSTOVES. . : GAS PRESSURE. . . 50+ HP. . CLO DRYERS. . : NO. OF AIR HANDLING TS OTHER UNITS. : FURN < LOOK STU: 1 <= 10000 cfm, GAS OUTLETS. : 1 FURN )-LOOK BTU: ) 10000 cfmt Remarks: ELECTRIC TO GAS CONVERSION Owner., FEES ERIC KFN*r type amount by date V.eupt 6690 SW VENTURA DR PRMT* $ 25. 00 JH 11/20/92 — TICARD OR 9*7223 5PCT $ 1. 25 JH 11/20/92 — Phone #I Contractor: ------------------------------- COLUMBIA HEATING 8900 SW BUR14HAM SPACE E-110 11CARD OR 91223 -------------------------------------- Ptione #: $ 26. 25 TOTAL Reg #. . .- 76359 REWIRED INSPECTIONG 1his permit is issued subject to the regulations contained in the Final Inspection Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans, This permit will expire if work is not started within 18e days of issuance, or J work is suspended for more th-,-.i 180 days. Issued By : ., Call for inspection 639--4175 'WIN INSPECTION NOTICE City of Tigard Building Department 13325 BN Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection:__.`_` ^+__� _- Footing Plbg. Underalab Mach. Rough-in Appr/Sdwlk Found. Plby. Top Out Gas Line FINAL: Post/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mach. Rain Drain Insulation -Plumb. Plbg. Underfloor Nater Line / `Gyp. Bd. Mech. Date Requested:- 3-7� Tlmef AM PN Address: --- 62 (P GZ Permit f s Builders THE FU G CORRECT'IliS ARE REQUIREDs Inepactor.: zz Datar_�_Z _ 9 v APPROVED _ DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Rninup. NSPECT12N NOTICE City of Tigard Building Department 13125 SM Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone)s 639-4175 Business Phonei 639-4171 Inspections Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk Pound. P1bg. Top that Gan Line PINALs Poet/Beano Strutt. San. Sewerlram� ing) -Bldg. Poet/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor.- Water Line Gyp. Bd. -Meth. Dace Requesteds� // Times _`ipl( /'QPM Address:_ Builder.. � 'C `// 5�c �� i THE FOLLOW_ CORRECTIONS ARE REQUIRED: Inspector: ----�� _ Do-of __iAPPROVBb DISAPPROVEDv",APPROVED SUBJECT TO ABOVE _� Call For Reinsp. 4 INSPEC'CION NOTICE city of Tigard Building Departsesn7223 13175 Sw Hall Blvd. Tigard, Oregon Inspection Line (Rec-D-nhone): 639-4175 Business Pho : 639-4171 ne Z . Inspections. -- — looting P1'jig. Underslab Hech. Rough- n Appr/Sdwlk Found Gas Line FINAL:Plbg• Top Out �- Framinq -Bldg. poet/Beam Struct.. San. Sewer i Post/Beam Mech. Ral.n Dram I�eulation -Plumb' -Mach. plbg. Underfloor water Line Cy-2' Bd. PM xrr.41 s AM Date Reyueeteds Address: Builder: THE FOLLOWING RRECTIONS ARE REQUIRED: _ Date: Inspectors_ APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinsp. Page No. 1 CASE HISTORY FOR CASE NO.: BIJP92-0074 ERIC KENT 06690 SW VE14TURA rR 11/25/98 Action Description Req/ Schd/ End/ Action Notes Drop By Update Upd Code Sent Done Done Date By SUPA007 Application received / / / / 03/1E192 PASS JLH C3/25/92 BLT BUPA010 Plan check, deposit paid / / / / 03/16/92 PASS 71,I1 03/25/92 BLT BUPA020 Plan check by / / / / 03/26/92 PASS RT 03/25/92 BLT SUPA030 Check for prcl, restrict. / / 03/25/92 03/26/92 PASS RT 03/25/92 BLT BUPA090 (F) Issue building permit / / / / 04/17/92 PASS JLH 04/17/97. JLH BUPA725 Framing Insp / / / / 05/OB/92 PART GS 05/11/92 GES BUPA725 Framing Insp / / / / 06/10/92 APP GS 06/11/92 GES BIJPA740 Insulation Insp / / / / 06/10/92 APP GS C6/11/92 GES BUPA745 Gyp Board Insp / / / / 06/23/92 APP GS 06/23/92 GES SUPA970 Case Finaled / / / / il/OB/93 11/08/93 GES BUPC740 Framing Insp / / / / 05/20/92 PART GS 05/20/92 GES a DUILDTNG PERMI" CITY"OFTIGARD Ale , (7CM0ZFTWAO PERMIT #. . . . . . . : BLJF-":),- COMMUNrri DEVELOPMENT DEPARTMENT ORIGION 13126 SW FW!Blvd. P.O.Box 2:097,Tigard,Oragm 97223(503)639-4176 DATE ISSUED: 04/17/92' =E ADDRESS. . . 6690 SW VENTURA DF, PARCEL: 1S125CID-0340171 c �:3USDIVISION. . . . . WnSHINGTON SOUPRE ESTATE"S NO. 2 ZONING: R-4. 5 !3LOCK. . . . . . . . . . L07.. . . . . . . . . . . . . .42. iEISSUE: FLOOR AREAS--------- - EXTERIOR WFI-.L CONSTRUCTION— .LASS OF WORK. :ADD FIRST. . . . : Is f N: 6 c E- 4s TYPE GF USE. . . :SF SECOND. . . :3411 Sf PROTECT OPF11INF3G"-—--------- TYPE OF CONST. :5N THIRD. . . . : sf N.- G. E. W: OCCUPANCY GRP. :R3 TOTAL.. ----.-.—: 7148 sf ROOF CONST: FIRE RETI : UCCUPANCY LOAD: BASEMENT. : sf AREA SEP. RATED: 'iTUR. ;2 1-11-. :2`7 Ft GARAGE. . . : sf OCCU SEP. RATED: 135MT? .* ME Z Z"- REDD SETBACKS--------- REPUI !-,'LOOR LOAD. . . . :40 psf LEFT: 12 ft RGHT: ft FIR SPKL: SMOK DET. . : DWELLING UNITS: FRN' : ft REAR: ft FIR PLRM: HNDICP ACC: 1`.EDRMS: BATH IMP, SURFACE: PIRO TORR: PARKING: ,)ALUE. 11, 16008 RemaiIks: addition Of second floor- of 346 sq Owner— FEES ERIC KENT type amount by date recpt. 669LA SW VENTURA DR PRMT d. I 1 5 0 JIJA 04/17/92 - PI-CK $ 79. 63 JLH 03/16/9eE' TIGARD OR 97r_'i-_-'3 SPCT $ 6. 13 JLH 04/17/9-L-- 0hone #.* uontvactot-.. OWNFIR hone #v S i?121113. L& TOTAL Rpq #. . - oi7@00 REQUIRED :NSPECTIUNS This perait is issued subject to the regulations contained ii the Framing Insp Tigard Municipal Code, State of Ore. Spfl-,Ialtv Codes and a!' e1her Jv-.sulatiori Insp applicable laws. All work will be dw- in accordance with Gyp Board Insp approved plans, Tills pereit will eyoirp if stark is not started Rain clrain lnsFi within 1N days of issuance, or work is suspended for sore Final Inspection than 180 lays. e in t t e 9 1 I d 1) Call for- inspection 6;39--4175 r Permit No: Address: Issued by:__ __ Date: FOR OFFICE USE ONLY_ STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4) , requires residential construction permit applicants who are not registered with the Construction Contractors Board to sign the foliowing statement before the building permit can be issued. ]his state- ment is required for residential building, electrical, mechanical, and plumbing permits. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), nE_.: not submit this statement This statement will be filed with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 3B: 1 . I own, reside in, or Will reside in the completed structure. 2. i understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3. A. My general contractor is_ __ Contractor registration number I will instrur' 'ny general contractor that all subcontractors who work on the struc- ture must bt :gistered with the Construction Contractors Board, OR 3. 13. 1 will be my own general contractor. If I .ire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. If I change my mind and do hire a general contractor. I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and understaira the Information Notice to Property Owners about Construction Resporsibilities on the reverse side of this form. 4 Signature of Permit Applicant Date CONSTRUCTION CONTRACTORS BOARD 0244J 8191 WHITE COPY TO ISSUING AGENCY PERIVII'1 FILE PINK COPY TO APPLICANT INFORMATION NOTICE TO PROPERTY OWNERS ABOUT- CONSTRUCTION RESPONSIBILITIES NOTE. This Information Notice to Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), � passed by the 1989 Oregon Legislature. If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities anu areas of concern. EMPLOYER RESPONSIBILITIES: If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvement of a residential structure, you will, in most instances, be ruled to be an .'emplover" and the people you hire will be ''emplovees". As the employer, you must comply with the following: Oregon's Withholding Tax Law_ As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees For more information, call the Oregon Department of Revenue at 378-3390. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees, For more information, call the Oregon Employment Division DHR at 378-3224. Vorkers' Compensation Insurance: As an employer. you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees If you fail to obtain workers' compensation insurance, you may be subject to penalties and will be liable for all claim costs if one of your employees is injured on the lob. For more information, call the Workers' Compensation Division DIF at 373-7434. IJ.S Internal Revenue Service. As an employer, you must withhold federal income tax from employees' wages. You wlllhe l6_61e forthe tax Pa/ment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service at 221-3960. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: -ode Compfiince: As the permit holder for this project, you are responsible for resolving any failure to meet .ode requireonents that may be brought to your attention through inspections. Liability and Property Damage Insurance: Contact your insurance agent to see if you have adequate insurance coverage; for accidents and omissions such as falling tools, paint overspray. water damage from pipe punc- tures, fire, or work that must be re-done. Time to Supervise Employees: Make sure you have sufficient time to supervise your employees. Expertise: Make Sure you have the expertise to act as your own general contractor. to coordinate the work of rough-in and finish trades, and to notify building officials at the appropriate times so they can perform the required inspections. If you have additional questions, write to: Construction Contractors Board 700 Summer St NE. Suite 300 Salem, OR 97310-0151 Phone 503.378-4621 0244J 10/24/89 lowu U1uSw11au[11vd. PLNCK/RECT CITYOF T I GARD PO lox 23397 PERMIT # COMMUNITY DEVELOPMENT DEPARTMENT ligarcL Oregon 977Z3 (503)639-4171 DATE ISSUED ', JOB ADDRESS: v%�?�Q �J�1��1�dL TAX MAPAOT SUB: umm 54 LOT: 6 y LAND USE: VAl UAT I ON: (11_0 OWNER SPECIAL NOTES _ REISSUE NAME: UE OF �i�G - ------ ADDRI=SS: ! '�"�' v�'' `1�P _ _ LAST REISSUE: FLOOD PLAIN/ PHONE: — __ — SENSITIVE LAND: CONTRACTOR APPROVALS REQUIRF_D NAME: PLANNING:` _—_ -��--- ADDRESS: ENGINEERING: —__-__-- FIRE DEPT: PHONE: __ OTHER: NO —___-- CONTR. BOARD #: EXP DATE: ITEMS REQUIRED SUBCONTRACTORS: PLUMB: _ _-._...-_____. ___ ---- LIST/SUBCONTRACTORS: MECH: ._� _ _ _ BUS TAX: — RC�I ENGII�NEER CALCULATIONS: --__—_- �{ NAME: VIFI"� >L� 1J �d _. ---_._.__M_ TRUSS DETAILS: _ --------- - ADDRESS: .�• �LnNp - ----_�— OTHER: _--._- -- - --- - 11110NE: PROPOSED BLDG. USE: __� J�• ---- --- COMMENTS: APPE_ICANT SIGNATURE Received By: _. % _._ Date Received: ��- PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT P0. BAL DUE �3H uJ'?y 10-432 00 Building Permit Fees 122 -— 10-431 00 Plumbing Permit Fees _---- ---- 10-431 01 Mechanical Permit Fees ---- — // 10-230 01 State Building Tax (5%) Building Plumbing —__-— Mechanical _— 10-433 00 Plans Check Fee - ZL-- Building _ 3 _ P1 umb i rig - Mechanical 10-2.30 06 Fire -- --- -- 30-202 30-202 00 Sewer Connection ----- - --- - ^�---- 30-444 00 Sewer Inspection -- ---- -- -- 25-448-02 Commercial TIF Fees _- ----- ------- ------ 25-448-04 Industrial TIF Fees _- 25-448-06 Institutional TIF Fees — ------ - 25-448-03 Office TIF Fees -- ----- - — - 25-448-01 Residential Traffic Fees - 25-448-05 Mass Transit TIF Fees ---- 52-449 00 Parks System Dev Charge (PDC) - -- 31 -450 OO Storm Drainage Syst Dev Chrg (SSDC) 24-445-01 Water Quality (Fee in lien of) --- -- 24-445-02 Water Quantity (Fee in lieu of) TOTAL nm/3587P.WPF