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8372 SW DEEANN COURT ADDRESS: 132Q le ala COCA rt _ 1 i:Vecords\microflm\targets\buiIding.doc l'rif OF TIGAOD CERTIFICATE Of' COMMUNITY DEVELOPMENT DEPARTMENT OCCUPANCY A125 SW Hall Blvd.Tigard,Orogon 97723*8190 (503)639-4171 '-, (;-, -i PERMIT 0. . . . . . . i MSTI)4-911.88 6:3 3•-4171 DATE ISSWEI)x 08/3194 PARCEL: 2SIOPWD-03400 STYC'' ADDRE — SS : 00372 SW DEEANN C1 qUeDIVISION. . . . : FINL-EV PARK 7 nN 1 NQ s R- 7 ViLOCK. . . . . . . . . . .. LOT. . . . . . . . . . . . . owle CLASS OF WORK. :NEW TYPE OF USE. . . tSF OCCUPANCY GQP. tR3 OCCUPANCY LOAD 0227 TENO:4t\JT NAME. . . t hem�.krkvx PATH I Owne-; NF."WCASTIX 140MES P 0 Box e3291 TIGARD OR 97PS1 Phone #t 639-3608 Contract or I - NEWCASTLE HOMES PO BOX 23291 i'mnw) t3p 97281 Phone #1 Reg #. . 1 59667 Occupancy of the above refer-enced building is hereby given, and certifier- the compliance with the State Of Oregon Specialty Code,. for- the gromp, OCIC-upanry, And use under whi,-,h the referenced parmit wAff, issued. L P ECTOR VI INS BI.. 1. I. I-DI FJ OFFICIAL. POST IN CDNSPiCIJOUS PLACE. LMSfEGT_CONsNOTICLI i City of Tigard Buildinv nepartisent 13125 BW hall Blvd. Tigard, Oregon. 9722 Inspection Line (Rec-O-Phonr)t 639-4175 Husinqu+ Phone: 639-4171 Inspections Footing Plbg. Underelab Mach. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line C1 Post/Beam Struct. San. Sewer Framing las Post/Beam Mech. Rain Drain Insulation -P)umb. Plbg. Underfloor Nater Line Gyp, Bd. / Mach Date Requestedt `til 7 i Times _ AM PM 1 Addreas s L > .'„�1� Permit s � Builder: THE FOLLOfl,*O OORRECTIONS ARE REQUIRED: r--r— �Z Insoper_tor Dates 1 APPROVED DISAPPROVED APPROVED SOBJECT To ABOVE __ Ca; Por Reinsp. INSPFCTIOK NOTA , / City of Tigard Building Department 13125 Sa' Rall. Blvd. Tigard, Oregon 97223 Inspection Line por-o-Phoneys 639-4175 Rusineas Phone: 639 4171 Inapectionc____` _— _ ,_._—_� --� Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out. Gas Line FINA�.ii Post/Ream .4truat. San. Sewer Framing Poet/ream Mech. Pain Drain I_neulation r� -Plumb. Plbg. underfloor Water Line / Gyp. Bd. 3� y ._--- nate Requestedt"'� �� �,, Time: AM PN Address:-,3/ i\LI�Qq.�71Permit 1: l Builder: THE FOLLOWING CORRECTIONS ARE REQUIRHD: r; e I e-� L r r +.� Cvy_1 - __- ` .- .,,cam TQC • w. I 0A--IAAA-r OCInspector: Date: —APPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE /P`j8 gall For Reinap. xNSPF�I'TION_NOTICE �._�" City of Tigard Building Department 13,.25 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Ppe-­,-Phone)r 639-4175 ausiness Phone, 639-4.71 Inspection:.__.__.-----_.-_ Footing Plbg. Undersiab Koch. Rough-in Appr/Bdwlk Pound. Plbg. Top Out Gas Line �'1TNl►bti Poet/Bever, Struct. San. sewer Framing _Bldg. Post/Beam loch. Rain Drain Insulation t umb. 1 Piby. Underfloor Mater Line Gyp. Bd. -lleoh. Date Requested: o Timet AM PN Address: kvaeIM-w%, + _ Lil Permit 1t Builders ­7 $' ` 21.55 11M FOLIAMING CORRECTIONS ARR REQUIRED: — — -- - Oe — Inspector: / APPROVED DISAPPAOVRD APPRGVRD SUBjZCT To Aar,,z call For Relnap. a_ PNSPGCTION NOTICE _ // 0 City of T.lgar.l Building D"rtaont 13125 SR Hall Blvd_ Tigard, Oregon 97223 (nepection Line (Roc-O-Phone): 639-4175 Uuninena Phone: 639-41'11 JnepPct.icinc Pcx,tinq Plbg. Underelab Nech. Rough-in Appr/Sdwlk Pound. Mg. Top Out Gas Lina FINAL: Poet/neam ."truct. San. Sewer FrawLnq -Rldg. Poet/Ream Nech. Rain Drain Insulation -Plumb. Plbg. Underfloor Nater Lina (� Gyp. Bd. -Meeh. Date Rs9gwiscxt-.4dr �' F 1 / /', / Tunes- AM —PH Acldreens�.��� 1( � �r� 4/��T. Permit Builder,L'LK /� c L /r �/ /f-�/ 7L1 TBR FOLUMING CORRECTIONS ARE REQ17IREDt rkInspectors ¢�O � bate:�(.�� _APPROVE --�DIBAPp0ovRD APPROVEb SUBJECT TO ABOVE --.k/—/Call For Rainsp. 1NS1iSCSION NOTLCE City of Tigard Bailding Department 13125 M Ball Blvd. Tigard, Cragon 9'i123 Inspection Line (Roc-O-Phone): 639-4375 Business Phone: 639-4171 Inspection: ----�_ \ v-- - — Footing PI��1I relab Meeh Rough-Ln Appr/-Iwlk Pound. Plbg. Top Out Gas ine FINAL: Podt/Beam Struct. Ban.. Bawer Fra.Lnq !J -Bldg. Post/Rgam Mach. Rain Drain Insulation .-Plumb. Plbq. Underfloor Water Line C� gyp. Bd. -Mach. Date Requested!_ TL"I AM PM Address: �/ Dec1717 Cl,, le�t7rit �t !�/�1 Builder: THE FOLLONINO CORRIXTIONS ARF. RF,QUIRED: nate: --.,--APPROVED DISAPPRr1VED Al.- APPROVED SUBJECT TO ABOVE --Call For Reii,np. _�7 INSPECTION NOTICE City lard Building Department 1312S SR h. Blvd. Tigard, Oregon 97223 Inspection Line (Ree- •Phcns): 6 9-4175 Dusinens Phone, 639-4171 1 Inepsction: _ Footing Plbq. Underslab Mach. Rough-in Apvr/Sdwlk Pound. Plbg. Top out Gas Line PINAL: Post/seam Struct. Ban. sewer raw!. 'e -Bldg. Post/Ream Mech. Rain Drain Insulation -Plies, Plbg. Underfloor Nater Line ,yp. lid. -Mach. y�/ Date Regue ed:__ L, TLoss /1►1 /' pK Address: 3 P.rw:t Ruiide THE FOLLOWING 03RRE(;'TIONS ARE REQUIRED: Co - `- - J &,A Fj) L&,A ckc f< Inspector: v � �^ q4 "PROVED ✓ DIS"P-ROVED APPROVED SUBJECT TO ABOVE '_ Ca11 For Reinsp. TNSPECTJUN NC1ICE City of Tigard Building Department 13125 aM Hall Blvd. Tigard, Ore,on 97223 ` 'I Inspection Line (Rec-O-Phone): 639-4175 Business Phones 639-4171 Inspection: Footing Plbg. Under4lab Neth. Rough-in Appr/>dwlk Found. Plbg. Top Out (Sar Lina FINALt Post/Beam S4ruc't. Elan. Sewer Framing -Bldg. Post/Beam Hoch. Rain Drain Insulation •-Pluq:i Plbg. Underfloor Water Line AGyp. Bd. _Hoch. Data Requested: `} Tim.; AH F'N hddreass O3-1 'v)�kt S ! � '� Permit !:_!"_l�Q 1� Builders— THE t'OMONINO CORRECTIONS ARE REQUTRED: QST" ✓'� ` > �c�-c_. -���.�1�-moi ,: r,�-�a► . . Inspector: \ _ Data: / q 4f �—APP""1+ —]`IDIBAPPROVEO APPROVED SUBJECT To An Call For Rainsp. City of Tigard Building Depa:rtieent 13175 SR Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phona). 639-4175 Busineas Phone: 639-4171. Inspartion:___ Rooting Plbg. Underalab Wch. Rough-in Apar/gdwlk ut Found. Plbg. Top GO+aa Line PINALe Post/Beam Strict. San. Sewer Framing ..alft, Post/Beam Mech. Rain Drain Inbulation -Ply, Plbg. Underfloor Water Line Gyp. Rd. -Meoh. Date Re.;uesteds- lY - AI-9 (' r /Tia/'e t AN PM Address s _2 `-'2�. Permit Builder: I �' c TRx ro OORRECTIONS ARE RRpUIRFD: �Ly Coq != t 3> G_v C—A Dir 3 0 I�C A Cl , —� *-70 1 t, J S ��-�—C C ��1.`�- Q + `moi -l/ �vcil ! U VvAeL cam• S e—r °`' Inspectors `�4j Date: APPROVlD I/ DISAPPROIRD APPRovg- SUB.TEC.r To 11BOyd QZ Call For Reinap. IL' 1?:,,(5 `2�- 1f-i �,� c, aT F`—rZA441 0 G� IA"Ag MN NOTICE / city or Ttqard Building Departssont 13125 $t Hall 131vd. Tigard, Oregon 9723 Inspection Line (Rec-O-Phone): 639-4175 Rueinees P e: 639-4171 Inspection.—____ Footing Plbg. Onderelab Hoch. Rough-in Appr/Sdwlk Found Plbg. Top out Gaa Line FINAL: oat/Beam struet San. $ewer Framing -Bldg. Post/Seam Meeh. > Rain Drain rneulati.on -Plumb. rLbq. Ondertloer�� Nater Line / Gyp. Rd. -Meeh. Date Reyuesteds �//�� 7 C��/ Tiffa�:t _AM _k_PH Addreest � oZ De �y���717/I�� Pe&i" t to�Y— C) �< Ruildere_ < / / �;/LX r 7L'/ 9/,5 THE FOLLOWING ODRRF"PIONS ARE REQUIRED! Inspector:_ — .. — -- -- Date: PPROVED DI-sy, O -7" -- --_-- R VED APPROVED SUAJSCP To ABOVE _call For Reinsp. IASPECTION NOLICB City or Tigard Building Department: 13125 SW Hall Blvd- Tigard, Oregon 9722.3 Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: Inspection:_ Footiny Plbg. Onderelab Mach. Rough-in Appr/Sdwlk Found. Plbq. Top Out Gag Line FINAL: Post/neam Struct. an. 8ewer Framing -.Bldg. Post/Beam Mach. Rain Draln Insulation --Plumb. Plhg. Onder!loor Nater Line Gyp. Bd. -MR-h. Date Reques ted: ~�'" / /l T1J0e1 AM I PM Address! r/ / Porolt7#-s 9 L Builder! Q z; TM FOLLOWING CORRECTIONS ARE REQUIRED: � i i Inspector: Dater __APPROVED ^^ DISAPPROVED APPROVED SUBJECT TO A Call for Reinep. ZNSPE-1'ION NOTI('E City of Tiga, 1 Building Department 13125 SR He11 B'.ed. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone;: 639-4175 Business Phone: 639-4171 Ina pact ion t_��L.!� Footing Plbg. Underelab MPch. Rough.-in AQPt:/Sdwlk Pound. Plbg. Top Out Gas Line FINALt Poet/Beam Struct. San. Sewer Frnming -Bldg. Past/Beam Mach. Rain Drain Insulation _Plumb, Plbq. Underfloor Nater Lino q Gyp. Rd. h, Date Requesteds` PM Vn/im�Ies �LPM Address: � /� ��C �j7�� l..-T_ PerM I %q-CSL_�_ 110.1der: _ ` , Ler 351- 6,561 Lean THS FOLLOWING CORRECTIONS ARE REQUIRED: -41 Inspect _ Datot�,�3 . APPROVRD DISAPPROVED _�OVED SUBJECT To ABOVE _ Cell For Reinsp. $FE9T19N NOTIl City of Tigard Building Department 13125 BW Ball Blvd. Tigard, Oregon 97223 IMpection Line (Rev--O-Phone: 639-4175 Buei..jess Phone: 639-4171 Inspections _ Footing > Plbg. Underelab Mach. Rough-in Appr/sclwlk nn Plbq. Top Out Gas Line FINAL= Post/[team Struct. San. sewer Framing -Bldg. Post/Beam Ms#ch. Rain Drain insulation -Plumb. ` Plbg. Underfloor Mater Line Gyp. Bd. Aech. Data Requeetedt_— Q-�y _ _ _Tiros: AN Addraes:_' �� P rm'it I: � ppPM Builderl TNR FOLLOWING'—OOORRRR-CTTIIO-NS AR! REQUIREDs 71, Inspector:_ 1 ROVED RD--- DISAPPROVRD -- APPROVSU •1O "fi" �� Cal Por Reinnp. MASTcR PERMIT C17Y OF TIGA_ DATETT SUED: 05/13/94 5 3/94 -0188 COMMUNITY DE_VELOPMiENT D90h HSTF ISSUED: 05/1,"x/94 13125 BW Hall Blvd.Tg1ard,Oregon 97223.6199 (503)639-4171 PARCEL: 2a 1 OEDD-03400 SITE ADDRESS. . , : 0837c 5W DEEANN CT SUBDIVISION. . . , : FINLEY PARK ZONING: R-7 RI_-OCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :018 BUILDING --- RCISSUE:MST133-9558 DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 sf CLASS OF WORK. :NEW NEDRMS:3 BATHS:3 GARAGE. . . . . . . . . . :440 sf TYPE OF USE. . . ;SF FLOOR AREAS--__.__.__._._ . REG?UIRED SETBACKS------ TYPE OF CONST. : 5N F I RST". . . . : 1056 s f LEFT. . :7 ft RIGHT- a b ft OCCUPANCY GRP. : R3 SE;-'OND. . . :980 sf FRONT. : _0 ft REAR. . .-28 ft STORIFF;. . . . . . . :2 THIRD. . . . :0 sf REOUIRED-- HE I GGT. . . . . . . . : 27 ft TOTAL._._ --- --:2036 s f SMOKE DETECTORG. :Y FLOOR LOAD. . . . : 40 psf VALUE". . . . . $ : 101576 PARKING SPACES. . : 1 Rremarks: PATH .` PLUMBING SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :O LAVATORIES. . . . . :4 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0 TUB/SHOWERS. . . . :3 LAUNDRY TRAYS. . . 11 CATCH BASINS. . . . . . . :0 WATER CLOSETS. . :3 SEWER LINE (ft) . :0 GREASE TRAPS. . . . . . . :0 DI5HWASHERS. . . . - I WATER LINE (ft ) . : 100 OTHER FIXTURES. . . . . :P GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :O WASHING MACH. . •. : 1 SF RAIN DRAINS— - 1 ILUHNNICAI ______.____..__..-._____________________ FEES FUEL TYPES-•-_-.._. __-- UNIT HTRS. . a0 type amount by date rec_pt /GAS/ / / VENTS . . . . . e0 1IF $ 1520. 00 SW 05/13/94 - MAX INPLITsO PTIJ VENT FANS. . .-4 DPRT i 438. 00 5W 05/13/94 - FURN ( 100K . . s1 HOODS. . . . . . : 1 BPLC $ 50. 00 SW 05/11/94 94-25264 FUR14 ) -=100K . . :0 WOODST'OVES. :O B5PC 0 21. 90 W 05/13/94 - FLOUR FURN. . . . :0 CLO DRYERS. : 1 SSDC $ .:80. 00 SW 05/13/94 BOIL/CMP ( 3HP:0 01-HER UNITS: 1 F-'ARK 1' 500. 00 SW 05/13/94 GAS OUTLETS: 1 MPRT t 43. 50 SW 05/13/94 - Owner _._-__-_______._...-•--_-.----.._._._._..----._._.__ ___-ir1F'LC $ 10. 88 SW 05/13/94 - NEWCASTLE HOMES M5PC $ 2. 18 SW 05/13/94 - P O PDX r:3291 PPRT E 155. 00 r_YW 05/13/94 - P5PC f 7. 75 SW 05/13/94 - TIGARD OR 97281. Phone #: 639--:3608 Car,tractor~: NEWCASTLE HOMES INC P. O. BOX e3291 1 1.GARD OR 972E I 1,hone #: 639-:3608 #. . s 59667 f 3029. 2'1 TOTAL 'his pereit is issued subject to the regulations contained in the -- - ---- REQUIRED INSPECTIONS -- ---- Tigarl Municipal Code, State of Ore. Specialty Codes and all other Foot/for-Ind Insp Fireplace Insp applicable laws. All work will be dons in accordance with approved Post/BPam Strutt Gas L.ir!e Insp plans, This permit will expire it work is not started within 180 Posh/Beam Meehan In itlation Insp days of issuance, or if work is suspendrd for more than 188 days. Plm/undslab Insp Gyp Board Insp PLM/Underfloor, Rain drain Insp Pr r-mittee! 5lgnatr_rre : _- _� Mechanical. Insp Water Line Insp ' P11.1mb "Fop OLtt Appr• /Sdwlk Insp rred Sy: __. _._ Framing Insp Mechanical F n,t0 - Cal for•, inspection - 639-4. 75 �EWER CONNECTION PERMI7 CITY OF TIGA. clr% PERMIT #. . . . . . . : F)WR94-0186 COMMUNITY DEVELOPMENT DEkUWT DATE ISSUCD: 05/1.3/94 13125 SW He.?ON&Tigard,Crogon 97223*8109 (603)639-4171 PARCEL: 2SI02DD-03400 SITE ADDRESS. . . : 083702 SW DEEPNN CT SUBDIVISION. . . . : FINLEY PARK ZONING: R-7 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :018 TENANT NAME. . . . . : USA NO. . . . . . . . . . : FIXTURE UNITS. . . CLASS OF WORN,. . . :NEW DWELLING UNITS. . : 1 TYPE OF USE. . . . . :SF NO. (IF BUILDINGS-. 1 INSTALL TYPE-. . . . :BUSWR IMPERV SURFACE. . : fi Rpmai­ks : PATH I Owner— FEES NEWCASTLE HOMES type amol_tnt by date t-ecpt P 0 BOX 23291 PRMT $ 2L00. 00 SW 05/13/94 INSP $ 35. 00 9W 05/13/94 TIGARD OR 97281 Phone #: 639--3608 Contractor. ------------------------------- CONTRACTOR NOT ON FILE -------------- F'h on v $ 2235. 00 TOTAL Rerj REQUIRED INSPECTIONS This Applicant agrees to comply with all the rules and regulations Sewer- Inspection of the Unified Sewage Agency. ibe permit expires 180 days from the date issued. The total amount paid will be forfeited if tht. permit expires. The Agency dnes not guarantee the accuracy of the side sewer laterals. if the sewer is not located at th- measurement giytn, the installer shal' prospect 3 feet in all directions from the distance given. If not so located, the installer shail purchase a 'Tap and Side Sewer" Permit and the Agency will install a 13teral. Pet­mittpe Siqnato_n e : 1 s s tj e d B y Call for inspection 639-4175 CC -- PLUMNINU t-'k_RMS'f CITY OF TIGARD DATE PERMTISSUED: ^ 05/13/944 0180 COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Hall Blvd.Tigard,Oregon 97223.8199 ((B03,,834.4171 PARCEL: 2510i_DD 03400 SITE ADDRESS. . . : M372' SW DEEA�IN CT SUBDIVISION. . . . : FINLEY PARK ZONING: R•--7 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :018 CLASS OF WORK. . :NEW GARBAGE DISF'OSALS. . : 1 YYPE OF' USE. . . . SF WASHING MACH. . . . . . . 11 BACKFLOW PkEVNTRS. . .0 OCCUPANCY GRP , . ;Ru FLUOR DRAINS. . . . . . . SO TRAPS. . . . . . . . . . . . . . :0 STORIES. . . . . . . . :L' WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :0 FIXTURES- - -- ----- - LAUNDRY TRAYS. . . . . . : 1 SF RAIN hRA I NS. . . . . : 1 SINKS. . . . . . . . . . : 1 GREASE TRAPS. . . . . . . :0 LAVATORIES. . . . . :4 OTHER FIXTURES. . . . . :0 TULA/SHOWERS. . . . : SEWER LINE (ft ) . . . . :0 WATER CLOSETS. . :3 WATER LINE. (ft ) . . . . : 100 DISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . . . :0 k,emar-ks: PATH I OWNERs -.______•____._._______...___________ ____________._,_..__--FEES______•_------•__--- NEWCASTLE HOMES TIF $ 1520. 00 SW 05/.1.3/94 - R O BOX 23291 HPRT $ 438. 00 SW 05/13/94 — BPL C $ 50.. 00 SW 05/11/94 94-252,6► TIGARD OR 97281 B5PC $ t1 . 90 SW 05/13/94 -• Phone w: 639-3608 SSDC $ : 80. 00 SW 05/13/94 - F'ARK $ 500. 00 SW 05/ 13/9zf - Plumbing„ Cant i,actor:--_._--- _.______._._ MPRT $ 43. 50 SW 09/13/94 -- 1 MPLC $ 10. 88 SW 05/13/94 Name : M5PC $ 2. 18 SW 05/13/94 Addresss _ _ PPRT $ 155. 00 SW 05/13/94 - City: State :—�—_- P`PC $ 7. 75 S4I 0E­/13/94 - Zips Phone#:- _ Reg #: -- --- ------- REUU I RED I NSF'LCT I ONS -- -_This permit is i. .:,sued suhject to the r-ey-- ulations contained in the Tigard Municipal Foot/found Tnsp Rain drain Insp Code, �3tate of r,,e. SpecijAlty Codes and all Post/Ream !;t ^uct Water Line Insp other applicable laws. All work will be done Post/Beam Mechan Appr••/Sdwlk Insp in accordance with approved plans. This Plm/undslab Insp Mechanical Final permit will expire if work Is not started FILM/Underfloor Plumb Final within 180 days of issuance, or• if work is Mec:.hanical. Insp Building Final suspended for more than 180 days. Plumb Top Out Erosion Contr,o) Framing Insp Crawl Drain Fir-eplace Insp __• I r Gas Line Insp Insulation Insp X - - ".`�� ' _ - _ Gyp Boar-d Insp Auhorized Plumbing Contractor Signature Call for- insper_tion -- 639 -4175 Conti^actor" Notes : soft i-,vri oi-, -i LoAro RECEIPT OF PAYMENT RECEIPT NO. 194-2! CHE("f--` AMOUNT 5:21 JV-4. JAY !'11i-LfCA91H AMOUNT PQ PDX 2 ,,..:,91 F-AYMENT DAT'[;;. s Or, TIGARV, OR simplylgTm AM(.'IIJN*T PAIL) PlJppf',lEr.-. Or Prlymc.111- f)MOUNT PAID OIP PAYMEI'VI VAL. PE 113.150 ST . DOWD PEN: WECK FE lo. soUEWFP USA UWP14-0186 Mo. %) IMSPECT 35. C41 PAPIAl 1M 500.0, OWN SM2 PF.-'MlDf: Nl TAL l+'(.9Vf-f.0 114) 7nANSIT 11F FIER I 10. V, DEEANN C 'r L-C-7 I'cl PAID -5/12 Ree;dential Building Permit Application ° City of Tig;ird 13125 SW Nall Blvd. C W_ Tigard, OR 97223 (5173) 639-4171 %/Jobsite Address: <� � Vel rye hyi (-4— Office-ALse qE11 Subdlvlslon:F�� ! Lot# Planck/R(,,(, Valuation: Permit # Reissue of Address: J� r f� a` Map'& 'rL # rovafs Required App Phone: r 'J I — _ Planning Contractor: _ Engirleiing Address: —..-- _ _ Other —_-- — - ------- < Items i;ecn+lred Phone: Sutx,ontractors --- - —_.. Contractor's L.K:anse (attach copy of current Oregon license) Tiuss Details Subcontractors: I Other W. V Plumbing: V� Mechanical: TA !I A- I V (attach copy of current 017 Contractor's License) Architect/Engineer: — Address: Phone: — —�_ COMMENTS-. — ------ - Applicant Signature & Phone number Received by: __ Date Received. _— Permit # Account Description Amount Amt. Pd. Bal. Due Bldg. Permit (BUILD) Plumb. Permit (PLUMB) l S,� , `"` _ �_ /SS, °' ✓ Mech. Permit (MECH) .s� .ra_ 3-S State Tax (TAX) J Bldg: y0 ✓ Plumb: 7 )S '/ Mech: �C�, I `/ Plan Check (PLANCK) 60 o v S U IO Bldg: 0 .� U ✓ Plumb: Mech: GS4qd•UI Sewer Connection (SWUSA) `��o �^�����_ SewE r Inspection (SWINSP) Parks Dev Charge (PKSDG) Storm Dri; .age Chg (SDSCC) Residential TIF (TIF-R) 1_Z� L' _ _ /Q i Mass Transit TIF (TIF-MT) _ V Commercial TIF (TIF-C) _ Industrial TIF (TIF-1) _ tnstMinnal TIF (TIF-IS) Office TIF (TIF-0) Water Quality (WOUAL) _ Water Quantity (WQUANT) _ Fire District (FIRE) _ TOTALS: �� Jay Miller Bldr Incl�OI3�L91 ,Tigard,Or 97241 1 trot FIN 0.00 PARI< ..._ . �N&AS�rr��t>�1�°t�lz�r�lo1° ' / �Q111 j_Q 0 LlneL,tild lk3_au�1711Y€ri�aY�k,'Is�aclLL llX loo od FL- 0.00 L 0.00 r°w I. ��, �Jr�n �ro 5 a 1 I ± �\ Q h orc��N ,srrQs os rpt, q1 CI U 0 6-6 4c1.-n tr tl` \j leS. 30 (0 3, lo TT �L T , A ' C FA i i I I' !v E C,F I[''1' 14 CHFICK AMOUNT CASH f-)MOUN'T IAT DAI I— P.0. PDX 2 ..NI PAYK' PORTLAND.. Or4 Ll R D I ,,,I c.��t ?72S I AllciLftfl PAID PUPFCV+. (ff" PAYMENT t"11101JPJT ISSUE 17,72 -A0 ll[.f' idlil