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14957 SW 91ST AVENUE _ .� I-1��' - ,;lti' ail,:, ��,,�. ____ -- ---��— —�-- — �s� a V�� '+y. �` �/"�/"�-��`�" ^ems - /���✓ i'p �x` \e '>�'�'„ "�d!' +• i�' ,yA• per, w"'� �'""CF 's'++.�P"��zS.C�,i� RI y ���+7���r �., �'�°"'' 1 �kl ^.+R ��� ~`�.r,�t : - f�i ����4��„ •0�«.`,� ,y�'f:�Z�,7� .4.`e r .Y'1�„a k � R .anile< ria. 46 ,o►.,,� n {ep �Mr, ` ,ap ' ; ��►ul s � iii wr CU Ol �} In COI co cA r .. tc O a f u r 4. 7i `� u ., a, v grz P - a C) ., o 0o m a Kr M r co a lot, 7 S:ij � , G� , O1 fn talo 1 v Y + Ln b ... o xa #'i \ 13 to cd w Fo -! v u o of O lNe Ike �.. flu fr,4�¢ ,!��". !W► 1"J.�f +IN�;y .,f� n �s:!+g:.y ,�f�iv. wlµ. +� 'f �R7� wfl�. 1FrhR 'ti. 1�1 i `,Y 1�\'7 ��p,� i':':U �•. ,. �e ��' S1� �f' ti - .1� W� 'Nih.. ,�'q��,�fep�lc��'., � ill:" �""� � CA �,... •�..��,�nr � ,ice � °' 'k°b ` t f*yatYk��.;:'���... �`..�pYs.'ILa:Y'R,Iff•Il,Ri:.,".{�y'• ��¢.,,• rsT. '.:�'°' ,ac3t"'�' r`�." .• ,. 14957 SW 91st Ave. INSPECTION NOTICE City of Tigard Building Department P.O Box 23397 Tigard, Oregon 97223 Phone: 639-4176 Type of Inspection Date Requested / Time A.M.—__P.M. Address Permit Owner _ 7 _ Lot # Builder The following Building Code deficiencies are required to he corrected: 4"W-- -- r �– 44 — –--- Presented to Approved Inspector Disapproved Date CALL FO REINSPECTION 0 YE8 O No te► viiiirx + +oma W WFA INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 I Phone: 639-4175 1 Type of Inspection Date Requested. 114tt Y Time A,M. P,M. Address _ Permit #_ Owner_._L _.. t # Builder The following Building Code deficiencies are required to be corrected: Presented to --- - � Provdd Inspector Diapproved Date CALL FOR REINSPECTION 0 Y88 ❑ NO WLJ1LJ)3:N('.-; PEPM.'rT C'TYOFTIFARD PI:*HYMN: T NO. : E3(.1890' 65 CITYOF iWARD DATE J,.SGt.jED. Z-5/20/89 COMMUNITY DEVELOPMENT DEPARTMENT 01112GON P1,011117 .NO . 890365 13125 S.W.Hall Blvd.,P.O.Box 23397,Tigard,Omgon 97223,(503)634-4175 1--'195/ 1-5W Y1ST. AVI;:- "IX MAV-1/1-01 k.?!51. J.I.AD I.A1100 SUB: Mol-I-AND LAKI::,:i I AND USE: 11/4 -15M) LITT 53.21F.: VALUA7 10N: s Ej-7 ,z.179 STBAGI(S F-PONT : 20 PEAP : 2 8 WUPK NF.:*.W DWIE'l L .UNVTS : 1. LEFT - 1.0 P:LGHT : 115 USF: TYPE : 51.NGL.I;:. I-*'OM3:1.,.Y NO. HLUPOOMS : 3 r---:XT .WALL CONST : (:.'(:)N!5 T T'YI:4 VN NO. RIATFIS : 1*5 N: 5 : E* W OUIUIUI-J .GPP . P3 PPO T .('.)PEWENGS : N E W TOTAI APFA : 19159 NO . ST(PTE S : P. 1ST : 1-1-33, POOF C I-:JPV PET? r.?N 1) 826 APr-:,A 51::'PA-N't WATED; BASF,'Ml!"ISIT? 3PD: OCCUP. SI:I-"AAP'? PATCA): MV ZZONTISIL"? B A SE'M' 1' ITI OUP I OAD W) A el 2 F'PE" SPAKI-447 OLAPM? FLOW 1 11 1? YES HEAT TyPr.:- G1 AS I P AC.Cr-'S!.-17 C.10PA1? W4414 H* it 1, 14EMAPKS 14EISSUE OF NO. I. AST P1'r:T5St.jl17. 0 $39*7. 00 W FILAN P IF:V I EW *P50 . W15 N UE VI E R !YI AT P 114 X 11111.9 . 811111 (11.)ME'N'T CHAPLvES C R P I GTOL. I STOPM �.2 5 0 0 0 0 13PTS10I... I.l(3Mll::!:) 50C I 53114.11-1, ) $600 00 N T BOX 1*1111 fllr'!50 . 00 R we%l, 3A IIII IV 060 PAF.PATE) < di:1.00 00 A I'.1I-I0NF*1 i.'W3) 6313-6610 JIl I I 1 [401 1(IN NO . 999 '110 T $1. 06741.90 PUCET[::'T NO This permit is issued stiblect to the regulations contained In Title 14 of the TMr- State of Oregon Specialty Codes.zoning regulations and all other applicable codes and ordinances, and R is hereby TNG SEWEP nqre-,:d that the work will be done n accordance with the plans and [40t.JNDAl':I'.ON WAL.L. PAXN 11PAINtS specifications and in compliance with all applicable codes and POST t* BEAM WATER LINF-.. ordinances The issuance of this permit does not waive restrictive 1:)1-131 .(.1NDFsPI.M.,A1:4 CITY APPACHISW covenants Contractor and subcontractors shall have current city St An F TNAL. business tax permits. This permit will expire and become null and void if work is not started within 180 days,or If work is suspended or R . ITWOU T* abandoned for a period of IA0 days any time after work has r:FIAM 1 W20 commenced It shall be the responsibility of the permittee to aSSUrp. 1. [W-3:1-ACE all iequired inspections are requested and approved GA15 I.J NE I NSI,4 ATT LIN HOAM.) Pormittee S e I [TIP Iwir'Lc T ION 639-41.75 SEPARATE PERMITS REQUIRED FOR WORK OTHER T4AN DESCRIBED ABOVE M WX ff1 1WX WX Sr:::W1:::P PEPPIXI' I' NO. 43 E'a 9 /4.'J-1, C11YOFTIFARD (CI'rY0tFTIGAIt)D 1:)6*1'1:--' ISSUED: 3 8 20/ 9 ONIGON COMMUNITY DEVELOPMENT DEPARTMENT [:'PIM PH(' .NO. $390".565 1312:E.W.Hall 8:.d.,P.O Box 23397,T.9ard,Oregon 97223,(50.1)639A175 ADI)PLIS5 : 171957 AVE: USA NUMIA"J.'2 : 03,741217 'TAX MAP/1-01 2SA, 11AD 11:11,00 SUID : MALA.-APE) I. OND L)SIF : I (TV !:;:I:zl:..: SEX11JON: IVVI : ZN1 FING: 1.w IAI(:)r4l< IIA AliiS : Nl:.:W 05E.'. 'TYI*)j::': GIN(A...V: Fir-l-WEL'ir witli -1.1"J. l'l.l:Leqj1 01.1-11d (:)+ the oqlenc: y . rl-le expir'elf; 120 dayla 411--tlim tVie c:ljILt(j,1 'T'he tcitttai W:j.'[:I' 1:)e if ti-leat+x ants . y 91.1111" ? A. tj 4.1 1 it; 010 4COM l"HiC.y (.1-F isewc"I" TT ti-io? mower, 1.9i 111:1 L :1 1:1c:Ijtl,ibitj lit,k, inloaki.4 t I I-opine 1.11. (Aitftoll AJ)e J.nI4­t'n1J.1.er' 14 11 UJ.:1. 1:)r'Umplec't :3 4-"v..?et ill f"'0111 tl"vo cli%tiftric:e (jiven ' 1p ricit, lim 1.43c.-IlL.LeW , the A.nllitoLl I e r, Ishiii I I al i'llid Nicle.-I 1.1-le will. ----------- __J DWA.,LJ N(,*; U141 I TE;AAW TMPN(.)Vl:;':MI;:,N1 TIM- A11 1 ndi:3..1 . 00 W Ei 0 X 13/1 (A.)NNE'(:'F':I'(*)N CAAAFIGE 1.0(> 0 N Iinli 1:11 L J.N1: F R 1 1AL44 C I f 11 0 (A. IAOMF:iii N TI 1 DOX 8411 R cir. 970 A C 50'3) V el 6 410 T NO . 999 0 TO'TAl :1.35 00 R PEGEIP"T 140. 3/z 3 I his permit is issued subject to the regulations contained in Title 14 .1 ON of the IMC. State of Oregon Specialty Codes, toning regulations and all other applicable codes and ordinances, and it is hereby agreed that the work will be done in accordance with the plans and specifications and in compliance vilth all applicable codes and ordinances The Issuance of this permit does not waive restrictive covenants. Contrartor and subcc ntractors shall have current city business tax permits This permit will expire and become null and void it work Is not started within 180 days,or if work is suspended or abandoned for a period of 180 days any time after work has commenced It shall be the responsibility of the permittee to assure all required Inspections are requested and aproved rermittee Signature 1 UP 1.019 639 A:k,l ti Issued By c—,1,dt,(- SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE IJRXRTF,. PLAMD'ING PERMA:T 14111 T' NO . : 1:)1..(3904?9 CITYOFT167ARD CITYOF WARD TSSUED : '3/20/f:9 otttww COMMUNITY DEVELOPMENT DEPARTMENT rnu:m rm'r . NO. 890365 13125 S.W.flail Blvd..P.O.Box 23397,Tigard,Oregon 97223.(503)6394175 (.114MIt"L.,-.15 : :1./19 7 .5 Q 9 T!:)1 (7)17 A X N A 1:'-,/L OT ci!:;J. 1.1.6[) :l.AJ'I.()() IJ I I.: MIA A1.41) LA, I D 11, AND I ST NO: J)11 WOPK Cl-ASS : NEW WATE P CLOSE,T TPAV, K 11. UPINAL. H -.0W PRVNIA:4 GONST VN I AVOPAI OPY e.1 TI:*qA1::, VIPIMLA 0(:"(.NJP .G'PI-1 . 113 1 MR !iii OWE"Al 4-2 GPEW51i" TPAPS DT EilAWASHEA:4 WASI-11W.-i MACIATNE (.1N.1''1!:i 1. LAUNDPY I HAY 1. RLDG. DPAMA ( DIA 1::.J..0014 151NK 1. SEEWEF-4 (FT) WATFIA:4 I-1116,11-:A-4 I. )TO 1:4 M P,61 N F T I. (.')'I 111i::1" W 0 1.0 BOX Rel N lilt rill E R LAX iII I; C 0 fil 'id 1!'J -I 111llJN(*.,' N it:1 T R I I A I )0l 'O"All 63 10'.. '10 1. C T ld l I I I r , I I(IN W) 1.0 1 TITTAL : 411 '151 .1:01 0 NEAM-1.P*1 NI'll , ............... ............... ................. This permit is Issued subject to the regulations contained in Title 14 1:; P U.C,1' 1. r4 of the TMC. Stale of Oregon Specislty Codes, toning regulations - 1) 1W I INI.A.I ff,I and all other applicable codes and ordinances. and It Is hereby agreed that the work will be done in accordance with the plans and & specifications and in compliance Wth all appilcable codes and IJF I 1 1,1 ordinances I he Issuance of this permit does not wave restrictive PLA) . 'I(A T.A.)T- covenants Contractor and subcontractors shah have current city lV-)].N D14AING business tax permits. This permit will expire an,. become null and —I NAL void If work Is not started within 180 dayn,or if wor!,,,s suspended or abanduned for a period of 180 days any time offer work ha3 commenced It shall be the responsibility a;;the pprmittpe to assure all required inspections are requested and approved Permittee Signature Issued By: "zc P41114 INSPELIJON SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE M;:*'(:,1-IAN:L(:;AI... A CITY OF TIGA RDr•,I�I�M:c'r NO. . ME890-130 ,1 4A*T*E 155UP-:1) : 3/20/89 Y OF TWARD L) COMMJNITY DEVEL,(-)IDMENT DEPARTMENT 0110ON V`1:4 J:M. PKT .NO. (3190365 13115%W 'IAII Blvd.,P.O.Box 23397,14gard,Oregon 97223,(503)639-4175 1.1 V 1::' AldW,-777 1.719,51 5W 917,IL ( ... TAX MAI:."/I.('.)l 2s:1. JA.AD 1/111.00 SUD: MALLW417 DK : LAND USE.' ! Po.l.5PD NO: NO: W(:)r4K (::I..A1 0;i : NUM 0.00K J. AT.14 FIANDLP <10 115;EE 'TYPE : 511411*31 1*-." I:I'AM:I:L.Y 1:1.11ANACK 1.00K+ AIP HANDI—P 10K IYI:'11:;: : VN F1 OOP F4.)RISIM.111 EVAP.GOOLEP r,43 VE'N'T' FAN V F N'T VITN'T . t-iY!-'is'1'1:.- M 13L.P/cOMP <311113 HOOD NO . INCUNEAWTOP 11 DOM 1� IN(�INEiPAJ'Orl((-..Om DWE."I L. UNI'T 1-5 :L 301-4) 1: LWI. (?AS PFJ:'ATP LINI T*5 MAX GA5 P:1'1'*':I:N(.', C)(.11*1..I:—;'I*4a F'I AN $1.0 .08 W N car V I X41.11AL t.i $33..50 11'I'F: 'Tox P. . :1.11:11 0 14LIM11:101 D AND A114 N1* il - T 42()0!1 45 HE'AWA-4 C'I:'1I..J:.DI< 1:41) R (-.�:i i,t.j A C T 140 , 1.1-11'16 i i I 1 AI. 15 el 15 44, 0 ........... This permit is Issued sublet to the regulations contained in 1 itio 14 W TWWEG. of the TMC. State at Oregon Specialty Codes,zoning regulations t and all other applicable codes and ordinances, and it I� hereby agreed that the work will be done in accordance with the plana and I I.P.t I "i, 1:;I.:AM specifications and in compliance with all applicable codes and N ordinances The issuance of this permit does riot waive restrictive l.NA1 covenants Contractor and subcontractors shall have current city business tax permits This permit will expire and become null And void If work is not started within 180 days,at if work Is suspended or abandoned for a period of 180 days any time after work has commenced It shall be the responsibility of the permittee to assure all required inspections are requests and approved "'red Inspection,,are requests Permittee Sig ure N5VILUTTON 639—el I 7t5 it I 1 0114 .1. Issue SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE F 1• CITY OF TIVARDPLAN CHECK APPLICATION cPLAN CHECK # -?dC _— C;OMMUNITY DEVELOPMENT DEPARTMENT � PERMIT N _4�j�3r,_ S 1312 ',.W.Kali Blvd.,P.O.Box 23797,Tignd..ney..,9722:1.(SM)63"17s _� DATE ISSUED - _ s-r JOB ADDRESS: ( cI 7 i AX MAP/LOT SUB: LOT: � - LAND USE: VALUATION: — -- OWNER SPECIAL NOTES 'DAME: REISSUE OF: --------.._ LAST REISSUE: FLOOD PLAIN/ SENSITIVE '.AND: —_- —,— PNONE: ---- APPROVALS REQUIRED CONTRACTOR - _ J PLANNING: NAME: ENGINEERING: _ --------- ADDRESS: FIRE DENT _ __.-- _ Aj -- ]U 6 ' _ OTHE.R PHONE: �_ _ ITEMS RE UIRED LIST/SUBCONTRACTORS: !/ ARCH/ENGINEEQ_f- r BUS TAX: - = f/� �►+.---yam� _J CALCULATIONS: NAME : --�.� ADDRESS: — ^— TRUSS DETAILS: — PARKING PLAN: - --- - - LANDSCAPE PLAN: 11 16N1 : -- ---- OTHER: COMMENTS: -- -- - ------- PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. DAL. DUE d�,U A& 10--422 00 Building Permit Fees �� , o✓ ���% 0 ° 2 10-431 00 Plumbing Permit Fees p cr3 (1 10-431 01 Mechanical Permit Fees 10--230 01 State Building Tax (5%) It 41 Bu i Id i rig r _ Plumbing �7 Mach 10-433 OU Plans Check Fee 9ui lding 1;?-A*W4},47 .'158.0•S �— Plumbing _ Mech ) " / (/Qf 30 ?0? 00 Sewer Connection 30--444 00 Sewer Inspection __ _-- 51--448 00 Street System Dev Charge (SDC) 52-449 00 Parks System Dev Charge (PD(:) .�_� _ . .__.. __ 'O 31•-450 OU Sturm Drainage Syst Dev Chrg (GSDC) 10-230 09 1-RFD 10--230 06 Washington County Fire #1 (911X) 10-220 00 Amart/Wodgewood -` RLC a LIC Received 11y : Date Received: ----- cn/3587P/18P to d' LO ul J I'd Li LD Q ►- W CL d1 -J U .3^� 1S (Fi •f�^s �� o � x N � Q to i V M � I Y •.vMan.rQ a to Z u CL � ~ O •,ZL o mLi In 39 IR w N N n.nc ¢ LU z � r 1 W m61 rD a z 0 0 0 0 In rnf1 frl a .., �-• IWO 4 ,J Cf irls p g XQ a o m N N m � '+ s A C71 r4 c ro w u enc I � p F ru gds r ro m o •-1 w in. � a p r a a m •.e x CL C.3w .Ea 5ss ^¢3 n ` cn W 14 x to u a) u qua P 6 QJI' 73 H N a. 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O GI N iv r� N 4 o W In ® PLAN CHECK APPLICATION CITYOF TIGARD CMOFTWARD f COMMUNCTY DEVELOPMENT DEPARTMENT MOON PLAN CHECK 13125SwHdIBlvd D.o.Rat2SC7.n�a.a.flo�arrrr(sao)s�w»c PERMIT / DATE ISSUED JOB ADn'�FSS: _ TAX MAP/LOT ;5 / ���I, SUB: LOT: LAND USE: �4� VALUATION: ,.r i' _ SETBACKS: FRONT:` REAR: LEFT: RIGHT: WORK CIA:..:: HEIGHT: TOTAL AREA: USE TYPE: �.n FIAE OR LOAD: h' IST: CONSTR TYPE: HEAT TYPE* 2ND: � OCCUP GROUP: r DWELL/UNITS:. 3RD: _ OC(UP LOAD: NO BEDROOMS: BASEMENT: T— oo STORIES: NO BATHS: - GARAGE: IhP SURFACE: APPRCIVALS REQ'D SPECIAL NOTES ITEMS REQUIRED PLANNING: REISSUE OF: LIST SUBCONTRACTORS: ENGINELUNG: LAST REISSUE: BUS TAX: FIRE DEP".: FLOOD PLAIN/ CALCULATIONS: OTHER: SEN IND.: _-- TRUSS DETAILS: PARKING PLAN: LANDSCAPE PLAN: PLAN CHECK BY: OTHFF COMMENTS:�L- ACCT f DESCRIPTION AMOUNT 7,_ .�, OWNER 10-432 Building Permit Fees Lel 4- NAME: -431-600 Plumbing Permit Fees = y_�,S A ADDREg, __ _ 10-431-601 Mechanical Permit Fees �- ��.S o _ 10-230-501 State Building Tax (5%) q/ 10-433 Plans Check Fee $ 16 el `,> PHONE: 30-443 Sewer Connection (201) 30-202 Sewer Connection (80X) CONTRACTOR 30-444 Sewer Inspection OAME: .51-•448 Street System Dev. Charge (SDC) fop -- ADDRESS: *52-449-610 Parks I System Dev. Charge (PDC) _ 52-449--620 Parke II System Dev. Charge (PDC) _ 31-4 50 Storm Drainage Syst Dev Chrg(SSDC) S a ' PHONE: 1.0-230-505 TRFD (95X) _ 10-435 IM (5%) S� ARCH/ENGINEER 10-230-506 Washington County Fire fl (95X) s NAME: 10-435 Washin-vton County Fire /1 (52) ADDRESS: 10-220 Amart/Wedgewood TOTAL PHONE: PREPAID U 0 '- REC f BALANCE DUE APPLICANT SIGNAT'RE "ceived By: Date Received:. CITY OF TIGARD MECHANICAL FERMI 1 - o..«ab.. CITY PRICE AWT -0fl 0.00 City of Tigard 1) Permit Foo – --13125 $.1h'. Hall Blvd P.O. Box 23397 2) SupPlomontalPnm)rtI�Igard.OR 97223 Furnace10100.o0013TU J639-4175 ind-ducts&vents —! - --- Fumaoe 100.000 BTU 7.50 2) {ic{.duds 6 vents - 3) Floor Fumaoo 6.00 Nara d Oawlor+r+ a ind.vent —`_ - Sersp(n4odheater.wall heater 6.00 Job may.,, "- 4) or 1k)Or mounlod healer - Add(ess Vent not Ind.M 3.00 Tull I"t�NO. S) apoar)Ce(7enTlf�. !a __ okxk Repako(heat)ng.Mir lg.. 6.00 Nan"(or narrw of trsn.st) 6) coolik .ebsorl>�)unit _ -- 1AaRrgAddrau 6.00 o MCI- 7) abwM.unit f 100,000131'U Owner tiler 0cX,p k)3 HP-1£HP 11.(.0 Coyrsrata --^' ©) sbsciM.unit to 500.000 BTU _ Boilor a oortp 1530 HP 15.00 Nana 9) absorp.unit'/4-1 milfion "W oror )p to 30-50 HP 22.50 Address - P►`O^' 10) dL-,S p.unit 1-1.75 million - Boll or comp to 50 tip 31.50 Contractor cyfstaN— �_- L1, - 11) absM.unit 1.750.030 BTU -- Air handti(V trait 10 4.50 State P49ts don No. Gly Bis Tu No- 12) 10.1100 CFM Ak handling unit 750 1 t.«aby w*m.Udge hat 1 haw read 0*4 a1, kAllinn Nut M krormallon 13) 10.�CFM In C vTecl ewl I am ha owrw or autrrx(rad.p.nr d M owr.ar,hal plans �� Non VWtaWa 4.50 uT Lr. wnm with sutaws,thu I am n0,1,.d-W,tfw stat.&,#Oars' 1�) ate cooler r..n.txr ph•an is correct.IN aapt amkora Slate reowsom plat"0"reason below)- Ventevafan connected 3.00 to a single duct --____-- _ Ventilation system not 4.50 -- - - - -- - -,-.----- -- 16) le permit ir)duded in appyanc-._ -- tiood served by 4.50 17) r>wchanical exfiaust _ ------------- - - Lk-)mestrctypo 7 50 slpnaAna(owrW or apaA) _ l tl) irxanarator Descibewtxk 0 addition ❑ allerahon O repair 11 —Commerdalorindustrial 30.00 o be done residential O non residential O --- - --- - 19) typeincincralor - a<isting use of Other 1.e .woodstove.water Z ASO ' .uddrng or properly __ - 70) healer.solar.clothes dryers,etc 'roposod use of - q0 udding or prol)vdy 211 -Gels(141,11x,)Une Ir)lour Uuliel., �- Vpc of fuel - ud 1 I natural gas I I l('li I I cleclra I , Mnrr')Dart 4'111-1 a.u11"1 NOTICI i 5110 l UTAI IIS PENM11 LIECOMES NULL AND VOID It WOIiK ()11 CON 1�n omit. SUnCI4AI1Gt � /a MUCT10N AUT1101117.I:O IS NOT COMM[NCCD W111IIN 100 PLAN(IEVI[W 25%OF SUU TOTAL SYS. OR IF CONSTnUCT10N OR WORK IS SUSPENDED (111 615(v IANDONED FOR A PEnIOn OF 180OAYS AT ANY IIMF AFRI 11 - 101AI DnK IS COMMENCF0 - ocrnl Cnnrldrnn I w ! ! ! ! ! ! ! l•.(i.u„t .'_ilei! CITY OF TIGA R D PLUMBING l-q25 �M hill 111%A1 1,4u,j at 9-;2A A4tvl;cAnb mrrt( hold Orcdon Pcslsua(ion b canolf I a plumbing PER M IT GD-4175 txninctt or mutt be propefty owner/opera(ot no(hiring oawside hclp. Name d Deva(Opewnl 1'IumbrnK Prima Nn Addreu O.naipta)n ORS 014-21.010 SAN PRICE "AI Job Tai Lot Map.No. --- Addr..a _ FIXTURES (� Block Subdivision SMA 1.50 7 J aaw or name stn.0 Lavatory Y 7.50 Tub w Tub/Sh' cf Comb. _ 7.50 — 1.50 Shower Only -_.... _ Owner (e Wal«Cwel 7.50 / Zp -------- ---- Uithwasher r� 7 so --- , �1Of1° Garbage Disposal / - 7 7. 5 U Washing Madvne -� / - 1.50 Name - Floor Oram 1.50 Kg ass Phare Wale(Healer - - — 7.50 5 u Laundry Room Tray 7.50 S 7 Occupant City/Stale Lp7.50 Urinal Oth«Fi0wes(Spersty) _ 7.50 7.50 ass 7 W — �- -- Contractor Cay/State Zip - MISCELLANEOUS 7 S0 --f� — City GLANS Tax No Sews 161100' I 30W _ f. wa t x. -ala,A6dd-100 15.00- —-- (ResxlertGaq Wel«ServSrie 1 st 100 20.00 v 1 hereby adrr»wl.cfpe Vwd I have read raw.pplk--a .Crst rw htformatlort wet«$«vioa.a AddA�r -15 00� V"Is 0-0cf.that I am registered MMh r,.Stage OWd✓s 604111nf.ud.iso Storm i Rah Dram 1 at.100' 30.00 have a State Pkwnb(np tiortea rut fhv m,4,art gh"tan oorred.Out.A —' t"•coag walk vain be done,In.cowdence *h Wpfio bl.P vAlk"d t}* storm i A tin Drain Atk1A.100-- ---- — 1 S 00-- ---- Pon Revd«!St.ahtee Chapter N7 and W rid apt>tk@iw Modes and that 1.loblle 14orne Space 2500 - no t.a0-*be empbyed u ile-n rowr urd«ORS GQ3-(II aKMO hom S to 14 r09"aftprL rA—""rayon balmy. Back Flow Prevwtbw+ HOMEOWNERS-1#..by.0y hal I w.h.owtt«d h.prop"d.- Device or Anti Pt>tkRion Devio. 1.50 --- .nbed&bole,of vaftic h locallon 1 p,opw.to nuke a pkatt*V ksslalladw for Any Trop or W rile Not my owl usa rd IN$pap"is not trekq oorlafvol.d kr Dal..Meow of rens Cerwwiti"d lo.Fbctj e _ 7.50 - (melt Basin 7 50 trop d Eaiar Pk.ttMV 40 00 P«Nr SpeoaMy fieQtr.eted in •O 00 pe,No - Aaer of(1,lnttt4g w film an E Kleaq ukv 1 ((11 nv„ ----- - Naw•()L111 ur(klt.t AAOMIurt 230 W mrt AlJtl/thllj(U;i1C111�tUtl(----- _. (ler.. II.till: .11111, t,rn I%' [leechtw Mutt. rwhw( ] atidtli0rt( ) atMretlort U rwltAlr I ! (, I 1 1!1; I't.111 +s' •/ tM lT.?nM rnsklertlinl ncxl•reeld.rllttll1 ] -- — •uUr` uta ut ---- - - — n,>Itrn Of lxo(wtty --- - - --- - (true•roTAI ;�. d arvp•ttr TOTAL / •1►.rml beooma.Haft and null r«ork a oorwevoalm arAt.ona ad w nal Dom -.- - . *0*1 1W0 6"AW r oerwAtumon or wm*w a mperded or.b.ndorwd kx ►clod of 1 r0 C%"-r any skit,.tater weK4 w ootrtewwe.tt rr■tet <r>.artrtt.>.r�