11038 SW 131ST PLACE YF
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INSPECTION NOTICE
City of Tigrxd Building Depertasmt\\\ �C K
13125 SN Ball Blvd. Tigard, Oregon 97223
Inspec-:iun Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections
Footing Plbg. Underalab Mach. Rough-in Appr/Sdwlk
i
Found. Plbg. Top Out Gas Line FINALS
Post/beam Struct. San. Sewer. Framing -Bld-I.
Post./Beam Mach. Rain Drain Insulation -Plumb
Plbg. Underfloor / Nater Line Gyp. Bd. -Mgch.
Date Requested:!_ _2 D f S Times AM Jl PM
`� ��2 <w
131
3
Addreee: L� ���• Permit t: ' Q
Builder: -�� ���� ��✓""3 - -
THE FOLLOWING CORRECTIONS ARE REQUIRIDs
Inspectors -.57 Dater
APPROVED DISAPPROVED APPROVED SUBJECT TO hBOYE
_,Call For Reinep.
COMMUNITY CITYOFT167ARD
- CMOF7
DEVELOPMENT DEPARTMENT WARD
13125SWHwjREGON CERTIFICATI-7 Or--
r.;jvd. P.O.P0BOX 233Q7,rq&id,0,.j,,,,jr,223(603)SW4175 ()CCOPANCY
G-1 TF ADDRESS_ j 11038 SW 131,sr PL
SU131)1VIF,j0N. . . ,. r CASTLES (41' BRiT-rAi,4v V"ARCELs IGI331)B-091'
BLOCF. . . . . . . . LOT. . . . . . . . . . . . . s4 ZONING$ R—I.? pus
CLASS OF-- WORM. xNEW
TYPE OF USF-. . . acjF
(:)Cr-UPAN(-y GRP. sR,3
OWUPAINICY LOAD.222 4
TE."NANT NAME. . . 3
l'i&mark s : PATH i 1AC+-'D TRUSS c3pEC, BEFORE rROM ING
Owner,
L. 'IC ND HOMES,
Phone 03
Garitractar:
I-EGEND HOMES CORPORATION
7160 SW HAZkL1`-17-R14 riD.
90I1'E I oo
TIOARD 014 c)72p4
Phane
0r:c-,upmknc-y ()f tf'P M-10ve referenced bWlding Is hereby 4
theCulapHance withtl)@ v"ItAt given, am.1 certiflo,
. La Of Olre!4011 Sp@4ZJajty Ct)(-JeS for- tile q► 01_1p,
or.,utipancy, and Liao under w1lic:11 the referenced pet,mit Wes isttierf.
FIRE VEVIORTMFicr
BUILDING IWOVCTop
POST" 1N CONSPICUOUS
a�
INSPECTION NOTICE
City of. Tigard Building Department
1312ti SA Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gan Line FINAL:
Post/Beam Struct. San. Sewer Frawing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. UnderE!-)or Water Line
Gyp. Bd. -Koch.
Date Requested: `/ Time: _AM :L, M
Addreser ,�1CJ� 5 �.: Permit #:C/,
Builder:
THE FOLLOWING CTIONS ARR REQUIRED:
Inspectors Y �' " _ __- Date:
APPROVED DISAPPROVED APPROVED BO@-TECT TO ABOVE
-_--Call For Reinsp.
i
INSPECTION'AiOTIC-
City of Tigard Building Department
13125 Sir Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-U-Phones 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/seam Struct. San. Sewer Framing rBldg.
Post/Beam Mach. Rain Drain Insulation -Plumb. 1 /
Plbg. Underfloor Water Lind Gyp. Bd. �i Nech. yry
Date Reyuented:_ — / �� Times --AN— PN
Addrese: / --� Permit
Builder:
TRE FOLLOWING M �CJTIO1 91 ARE REQUIR
E
D:
Inspector: / _ Date:_/'/ Z�
APPAOVXD DISAP"D APPROVED SUBJXrT To ABOVE
(//Call For Reinsp.
INSIE&CTION NOTICE t ` /
City of Tigard Building Depart,nt � l/
13125 SW gall Q +_*.garde Oren 97223 �
Inspection Line (pec-O-Pho 639-4175 Buniness Phone: 639-4171
Inspections
Footing _�- --
Plbg erelab Fisch. Rough-in
/�ppr/Sdalk
Pound. y
Plbq op Out Gas Line
FINALS
Poet/Beam Struct. San. Sewer
Framing -Bldg.
Poet/Beam Mech. Rain Drain
Insulation _plumb.
Plbg. Underfleor Nater Line
Cyp. Bd. -Mech.
Date Requentedt--/ 3
—•-��� Times AM PM
Address: / —
permit �j �--
Builder:_
THE FOLLOWING CO IONS ARS RSQUIREDs
Inapectors,� i`—
Dates
/
—APPROVRD DISAPPROVED
APPROV6ll SUBJRCT TO ABOVR
--,Call For Reinep.
INpPEM"LON NOTICE
City of Tigard Building Department
1'125 811 Ball Blvd. Tigard, Oregon 97223
inspection Ll:,a (Rec-O-Phone): 639-4175 Busineas Phone: 639-4171
Inspection: _—
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwll:
Found. Plbg. Top Ont Cas Line FINAL:
poet/Beim Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain DrAln Insulation Plumb.
Plbg. Underfloor water Linos Gyp. Bd. -Mech.
Date Requested: /— —__Time:
Address: Permit #: a
Builder:
THE FOLLOWING CO CTIONS ARS REQUIRED:
l
Inspector _ -- — —_ Date:
APPROVED DISAP/PROVED _/ APPR(InD SUBJlt T TO ABOVE
For Refnap.
UIUM oN NOTIcc /
City of Tigard Bui)ding Deprrt:e.nt
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underelab Mech. Rough-in r/Sdv/,lk�
Y
Found. Plbg. Top Out Gas Line
FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/team Mech. Rain Drnin Insulat.'.on
-plumb.
Plbg. Underfloor Water Line
, 1 Gyp. Bd. -Mach.
Date Requested: - 14-j Z
.PM
Addreee:_�1}?j� �Zj� ��• _ PAarmit
Buildersl�
ThE FOLLOWING CORRF-.7IONS ARE REQUIRED:
11-41
Inssector: 7,
__APPROVED _-, DISAPPROVi" VAPPROVED SUBJECT TOABBOVE-E t
Call Fuer Reinsp.
a �n
INSPECTION NOTICE
CitT of Tigard P•tildinq 13apar tment
13125 811 Hall Bled.. Tigard, Cregon 97223
Inspection Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171
Inspection:
--------_-----
Footing Plbg. 11nderslab Mech. Rough-in g Appr/Sdwlk
Pound. Plbg. Top out Cain LJne
FINALt
Poet/Beam Stract. San, Sewer
Framing -Bldg.
Poet/Beam Mach. Rain Drain
Insulation _ply.
Plbg. Und*rfloor Nater Lino
t( �_ -Mech.
Date Requeatedt - 2. �C
—TimetAM PM
Addreest,—
Buildert
� I
THE FoLLOMIJ10 Corjv>L-Tron Am ARQUIRED:
-__
Inspector:--^ __- // 4
(. —--- Date:-
APPROVED DISAPPROVED
APPROVED BUBJRCT TO A80VR
call Fc- Reinap.
i
i
INSPECTION NOTICE
city of Tigard Building Department
1.3125 SR Bell Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections___--
9
Tootin Plbg. Underelab Mech. Rough-in Appr/Sdwlk i
�
Found. Plbg. Top Out ( Gas Lin) FINAL:
Poet/Beam Struct. Ban. Sewer Framing -Bldg.
Poet/Beam Mech. Rain D:aie
Insulation -plumb.
Plbg. Underfloor Nater Line Gyp. Bd• -Mech'
Iv'I' PH
�� - Times
Date RequestedS-1Z 1z: —`
Addrenes ' I Js� ( � �� Permit #e
J
Builders
THE FC)LLONIRC OORRZCTIONS ARE REQUIRED:
Inspectors_ _ Dates ` C
`APPROVED rISAPPROVED !, APPROVED SUBJNCT TO ABOVE
call For Reinsp.
I_N_E_gEGTI
City of Tigard BuildLAZ Dep., :t
13125 M Hall Blvd. Tiger:-d, Oregon 97223
Inspect Lon Line (Rec-O-Phone): 639-4175 Bueinees Phone: 639-4171
Inspection:
Footing Plbg. Underelab
Mech. Rough-in App:•/Sdwlk
Pound.
Plbg. Top Out GAO Tine FINAL:
Post/Beam Struct. San. Sewer
Framing -Bldg.
Poet/Boom Mech. Rain Drain
\� Insulation _ply•
Plbg. Underfloor Water Line
GYP• Bd. ... -Mech. �,�•
Date Requested:_ 1. l.:
` ---•�_. Time: AH
Address: / 1 51L_
i
/ Permit #:
Builder: ?-
THE FOLLOIiIflfi CTIONS IRE REQUIRED:
USPOolor e
Dates_
APPNDVsp DIiApP110Vlp
7. APPROVRD SUBJECT TO ABOVE
-Call Por Mlnmp.
OF
INSPEPXI_ON NOTICE
City of Tigard Building Department
13125 Sit Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 63^-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab -Much. Rough-in Appr%Sdwlk
Found. Plbg. Top Out Gas Lino CINALt
Poet/Beam Struct. San. S wer Dr"inq -Bldg.
Poet/Beam Mech. Rein Drain Insulation -Plumb.
Plbg. Underfloor Waiter Line On. ed. -Koch.
Date RequeeCedt Times AN PN
Address ice• / rmit t Z e6
9 � /
Builders _4 it
THE FDLLONINO CO CTIONS AhE REQUIREDs
Inspector:----.eL Dates
.-APPROVED __ DIpAp 'w�V7SU "PROVED 9U9JBCT TO ABOVE
__Call For Reinsp.
NS CTIpN pTICE �,��,,,y
City of Tigard Building Departm,,t
13125 SW gall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-4Phone): 639-4175 Business Phone: 639-4171
InFnect ioj.:
Footing Plbg. Underslab Mnz
_ _ Rough-in Appr/Sdwlk
Found. Top Outpas bine FINALc
Poet/Beam stru?��an. r Framing -Bldg.
Post/Beam Mech. Rain Drain
Insulation _ply•
Plbg. Underfloor wnte: Line Gyp. Bd.
Bch.
Date Requested:-L--�.�
Addreee:
-_ Permit is
Builder: U
THE FOLIA W CORRECTIONS Am REQUIRED: --
Inepectort_ / d /- �.
---- Date a f/-b�(--
,�APPROVRD DISAPPROVED
APPRt7VRD StIBJECT To ABOVt
call For Rainsp.
JOE A", ILMEj
INSPECTION NOTICE A z_�
C'.ty of Tigard Buildir • Department
13125 Sit Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O--Phone): 639-4175 Busin' a Phone: 639-4171
i
Inspection:
Footing Plbg. Underelab Mech. Rough-in Appr/Sdw_k
Found. Plbg. Top Out Gas Line FINAL=
Past/Beam Strcct. �atr:" Ewe Framing -Bldg.
Poet/Beam Mech. in kn Insulation -Plum-3.
Plbg. JnderfloorNlfttar Lin Gyp. Bd. _yid,
Date Requesteds �y C: Time= hT ph
Address: �lG 3lS !� ���# c;' fj
Permit is___
Builder:
TNR FOLLOWING CORRECTIONS ARE REQUIRED:
i
I
I
Inepactor:_ _ _ Datesijd _�
APPROVED _-- DISAPPROVED APPROVED SUO.IECT To ARM
___Call For Reinep.
1
a
4
xNSPECTION KOTICE
/ City of Tigard Building Department
,�/�/1v 13125 811 Ball Blvd. Tigard, Oregon 97223
L In8FT6 On Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
t i In•_
/ �' --
Footing Plbg. Underelat Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINALS
LP _
San. Sewer Framing -Bldg.
I6am Rain Drain Insulation -Plumb.
.Pflq. Underfloor slater Line Gyp. Bd. - h.
Date A � v�
equsstad: � ._. [� Ti PM
1
Address:
Permit
��
Builder: L
i ---
THE FOLLOMINo CO CTr')NS ARE REQUIRED:
ti
I
Inepect.ors, ✓ —_�—w--_ Dates
11pPwDVlD DISAPPROVED APPROVED SUBJECT TO ABOVE
Call Por Reinep.
C
f
INSpECTIOl1 pOTl�
City of Tigard Duildloq pepar�nt
13125 sW Ball Bltd. Hgard, Oregon
Inspection Line (Rec-O_phone): 97223639-4175 Business Phone: 639-4171
inspection:
Footing
Plbg. Underslab Mech. Rough-in
APPr/Sdwlk
Found: Plbg. Top Ck,t
Gas Lina FINAL:
9truat•
San. Sewer
Framing -Bldg.
Koch• Rain Drain
_ Insulation _ply.
Plbg. Underfloor /Nater Line -Koch.
GYP. Bd.
Date Requeetedi C
__Tio►e= AM —PK
Address: /� ! i�
Permit t1a.2
Builder:
�-
THE FOLLOWINGS CORRE ONE ARE rlQUIREDs
------ -----
—�_�.-------—__—'----- ----ter
Inspectors-� �/ — --_—.. -- --
-------�—� Dots s
APPROVED DISAPPROVED -- -----
APPROVED SUBJECT TO ABOVE
Call For Reinsp.
r.� -
7
7�1
INSPECTI W NOTICE
City of Tigard Building Departatent
13125 811 Hall Blvd. Tigard, Oregon 97223
inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top out Gas Line FINALS
Post/Beam :.cruet. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
�lbg. Underfloor Water Line gyp. Rd. -Meeh.
Date Requesteds — Time: __,&AN __PH
Addresssl/ �/1 St Permit f sq,)- (
Builders !^_
THE FOLLOWI RRECTIONS ARE REQUIRED:
-/z 7
Inspectors ..�— _ Dates.Z.
APPROVED DISAPPROVED APPROVED SUBJECT To ABOVE
Call For Reinap.
Iy9pg TIONNQTICE ofr
city of Tigard Building Depart'sent
13125 SW Hall Blvd. Tigard. Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
Inspection:
F6otinq�
Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Plb Top Out Gas Line FINAL:
Pound. g'
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Rech. Rain Drain
Insulation -plumb.
Plbq. Underfloor � Water Line Gyp. Bd. -Mech.
-� - -�- Timb� .�/� •�i�y PM
Date Requested: / ,��/�
Addrass:�i� .� l � -.�= Permit t:
Builders- '
7 7
THE FOLLOWING RECTIONS ARE REQUIRED:
Inspectors _ Dets:�1-„�
APPROVED DISAPPROVED NPPR:"D SUBJECT TO ABOVE
Call For Reinsp.
a IRA WMJLAK
CITY SOF TIGA RD �-
M
C"YOFT16AIM
COMMUNITY DEVELOPMENT DEPARTMENT ORNION
13126 SW HWI Blvd. P.O.Box 23307,Tigad,Or"on 97223(603)639-4176
PERMIT t#. . . . . . . MST92-0200
1 ,9-4171 DATE ISSUED: 09/10/92
SITE ALIDRESS. . . : 11038 SW 131ST PL PARCEL: IS133DB–CB4
SUBDIVISION. . . . : CASTLES AT BRITTANY ZONING: R-12 PD
BLOCK. . . . . . . . . . g LOT. . . . . . . . . . . . . : 7
------------------------------------ BUILDING
REISSUE: DWELLING UNITS: I BPSEMENT. . . . . . . . ..0 sf
CLASS OF WORK. :NEW BEDRMS:3 BATH5:3 GARAGE. . . . . . . . . . :418 sf
TYPE OF USE. . . :SF FLOOR AREAS---_--_.-_– REUUIRED SETBACKS----------
TYPE OF CONST. :5N FIRST. . . . : 1100 sf LEFT. . :5 ft RIGHT-5 ft
OCCUPANCY GRP. -.R3 SECOND. . . :680 s f F RON T. :20 ft REAR. . :40 ft
STORIES. . . . . . . v2 TH I RD. . . . :0 s',= REUU I
HEIGHT. . . . . . . . s22 ft TOTAL------: 1780 sf SMOKE DETECTORS. sY
FLOOR LOAD. . . . :40 psf VALUE. . . . . $: 89404 PARKING SPACES. . : ]
Remarks: PATH I NEED TRUSS SPEC BEFORE FRAMING INSPECTION
--------------------------------- PLUMBING
SINKS. . . . . . . . . . 11 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . -.0
LAVATORIES. . . . . :4 WATER HEAIERS. . . - I TRAPS. . . . . . . . . . . . .
TUB/SHOWERS. . . . :3 LAUNDRY TRAYS. . . :0 CATCH BASI S. . . . . . .
WATER CLOSETS. . :3 SEWER LINE (ft) . lo GREASE TRAPS. . . . . . .
DISHWASHERS. . . . : 1 WATER LINE (ft) . 1100 OTHER FIXTURES. . . . . .Vi
GARBAGE DISP. . . : 1 RAIN DRAIN (ft) . 10
WASHING MACH. . . -. 1 SF RAIN DRAINS. . el
--------------- MECHANICAL -------------- FEES
FUEL TYPES------------ UNIT HTRS. . go type amount by date recPt
/GAS/ VENTS . . . . . :o 'TIF $ 1460. 00 JH 09/10/92
MAX INPUT:0 BTU VENT FANS. . :4 BPRT $ 403- 00 JH 09/i0/92
FURN ( 100K . . : J. HOODS. . . . . . cl BPLC $ 261. 95 JLH 09/04/92
FURN ) =100K . ,, :o WOODSTOVES. :@ BSPC $ 20- 15 JH 09/10/92
FLOOR FURN. . . . :0 CLO DRYERS. : I SSDC $ 280. 00 JH 09/10/92
BOIL/CMP ( 3HP:O OTHER UNITSPI PARK * 500. 00 JH 09/10/92
GAS OUTLETS: l MPRT $ 43. 50 JH 09/10/92
Owner: ------------------------------------ MPI-C $ 10- 88 JH 09/10/92
LEGEND HOMES M5PC $ 2. 18 JH 09/ 10/92
PPRT $ 147. 52 JH 09/10/92
P5PC $ 7. 38 JH 09/10/92
Phone
Contractors
LEGEND HOMES CORPORATION
7160 SW HAZELFERN RD.
SUITE 100
TIGARD OR 97224
Phone #: 620–Bose
Reg #. . .- 60563
3136. 54 TOTAL
This persit Is issued subject to the regulations contained in the ------- REQUIRED INSPECTIONS -------
Tigard Municipal Code, State Of Ore. Specialty Codes and all other Foot/found Insp Fireplace Insp
applicable laws. All worts wil'. be done in accordance with approveii Pnst/Beam Struct Gas Line Insp
plans. This pervit will expire if worff is not started within 18@ Post/Beam Meehan Insulation Insp
days of issu2nce, or if work is suspended for sort than 11W days. Plm/Linds lab Insp Gvp Board Insp
PLM/Underfloor Rain drain Insp
Permittee SiLplat 111-P Mechanical
Insp Water Line Insp
Issued By ..
Plumb TOP Out Appr/Sdwltc Insp
raming ins
C17YOFTIGARD CITYOF1mom �
COMMUNITY DEVELOPMENT DEPARTMENT 01200" SEWER CONNECTION
13126 8W FWI Blvd. P.O.Bax 23307.TOA,Oregon 07223(603)e30 4176 rE R M I T
639-41.71 DATE ISSUED: 09/10/92
S I' E ADDRESS. . . : 11038 SW 131ST PL PARCEL: 1 S 133DB-CB4
SUBDIVISION. . . . : CASTLES AT BRITTANY ZONING: R-12 F'D
BLOCK. . . . . . . . . : LOT. . . . . . . . . . . . . :7
iFNANT NAME. . . . .
USA IJO. . . . . . . . . . : FIXTURE. UNITS. . . :
CLASS OF WORK'. . . :NEW
!)WELLING UN I tS. . : 1
"1 YF'E OF USE. . . . . :GF NO. OF BU'1 LD I NGS: 1
INSTALL TYF'E. . . . :BUSWR IMF'ERV SURFACE. . : : af
Remarks: F'AlH I
FEES ------------------
L_L.GE: ND HOMES type amount by date recpt
pFalhl $ L100. 00 JH 09/10/92 -
INSp 35. 00 JH 09/10/92 -
I-4ione #:
L.ontractor:
L:OPJ T RfaC. I OR NOT ON FILE
P,h ori e #: t 2J35. 00 TOTAL
key #t. .
------- REOUI REL I NSFILC;T I ONS -..------. - _
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires I60 days from --- --the date issued. The total amount paid will be forfeited if the ------
permit expires. fhe Agency does not guarantee the accuracy of the -- — ~
side sewer laterals. if the sewer is not located at the measurement -
given, the insta.ler 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 nstail a lateral.
1 ermi.t,tee SiLinatureI
Call for inspection - 639-4175
CITY OF TTGARD RECEIPT OF PAYMENT RECEII!7*11' NO. 9e-231488
CHECK AMOUNT 51.61. 54
NAME s LEGEND 140MES CASH AMOUNT 0. 00
ADDREGS PAYMENT DATE a 09!10/917!'
SUBDIVISION
PURPOSE OF PPYMRNT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT I-'.,AID
4103. ov) PL.UMBING PERM 147. 50
MeCHANICAL PF 4.3. °50 ST. BUILD PER 20. 71.
PI-AN CHECK FE 162. 613 SEWER USA 2100. 00
SEWER INSPECT 35. (A 0 PARKS SDC
500. ovi
STORM DRAIN SDC C-180. 00 RESIDENTIAL TRAFFIC FEES I.XbO. lain
MASS TRANSIT TIF FFFE,; 110. 00
Lill 4 CASTLES AT SRITTANY
1 )038 SW 131ST
TDIAI.- AMOUNT PA:D 5 16 1. 54
.... .......
Wi6--
TIuvs sw 11au nwe PLNCK/RECT — 7IrITYOFGAARD 1'O N,x Z1397
COMMUNITY DItiELOPMENT DEPARTMENT lllgar,.Orcgon 9TM PERMIT # ELS yZ- 0 v()
(507)679.4171 DATE ISSUED
JOB ADDRESS: I2D ..5 c� sC�� �.3/ S�j-
TAX MAP/LOT p 13 _fi 13 i j
SUB: e /LOT: LAND USE:
VALUATION:
OWNER SPECIAL NOTES
NAME: �P S
REISSUE OF:
ADDRESS: LAST REISSUE
FLOOD PLAIN/
PHONE: _ �„ -�� SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME:
-- PLANNING:
ADDRESS: ENGINEERING:
-- FIRE DEPT:
PHONE: OTHER: �—�—�-
CONTR. BOARD #: _ _ EXP DATE: - ----
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: 1� . � '�'`--'. LIST/SUBCONTRACTORS: _
MECH: `> C �,����� BUS TAX:
ARC�ENGIN�ER CALCULATIONS: _
NAME' -- - TRUSS DETAILS:
ADDRESS: OTHER:
PHONE:
PROPOSED BLDG. USE:
COMMENTS: -
r � _
I I U Z Y
APPIIfANI SIGNATURE
Received By: Date Received:
—„
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10-432 00 Building Permit Fees
03,
sip
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees
I0-230 01 State Building Tax (5"'.) 1. 2,
Building _2 0•/S `
Plumbing •5
Mechanical
I
2, �
10-433 00 Plans Check Fee ��-�=; 00
Building
��,z•
Plumbing
Mechanical -
10-230 06 Fire / --
/��
t-u�� �� 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 Fees52-449 00 00 Parks System Dev Charge (PDC) S — cz
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
� l� l, sy
nm/3581P.WPF