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11461-11549 SW 98TH AVENUE-1 w I ADDRESS- 6 woo mr*9 Ava J c7 11; J " INecotds%rrnicrollm\largelsV)uilding.doc MASTER P,ERMIT 7 IDERMIT MST116­0233 V C IT`1 OF TIGARD DATE ISSUED: 05/14/96 COMMUNITY DEVELOPMENT DEPARTMENT PARCEL-: IS135CD-00901ZI * TIg old,f�to'qor -4171 lj3lft"�t� IS39 SIT.- SUBDIVISION. . . . : BURLWOOD ZONING: R-12 BLOCI-:. . . . . . . . . . L.D I . . . . . . . . . . . . . Remarks: ADDING I BATH AND ONE BED ROOM 315SO FT PATH I --------------------------------------------------------------- BUILDING ------------- ---C------------------------------------ REISSUE: STORIES.......: I FLOOR AREAS---------- BASEMENT...: 0 sf REQUIRED SETEACKS---- REQUIRED------------- CLASS OF WORK.:ADD A,HEIGHT........: 13 FIRST....: 315 sf GARAGE.....: 0 sf LEFT........... 0 SMOKE DETECTRS: i TYPE OF USF...;SI<r FLOOR LOAD—.: 40 SECOND...: 0 sf FRONT...,.....: 0 PARKING SPACES: 0 TYPE OF CONST.:5N DWELLING UNITS: I FINBSMENT: 0 sf RIGHT.........: 0 OCCUPANCY GRP.:R3 BDRM: I BATH: I TOTAL------: 315 sf VALUE.. 20368 REAR..........: 27 --------------------------------------------------------------- PLUMBING ----------------------------------------------------- SINKS......... 0 WATER CLOSETS.: I WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: LAVATORIES....: I DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: I CATCH BASINS..: 0 TUB/SHOWERS...: I GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE it: 0 BLKFLW PREVNTR: I 6R-ASE TRAPS..: 0 OTHER FIXTURES: 0 -----------------------—--------------------------------------- MECHAN!CAL ----------------------------------------------------------------- FUEL TYPES----------- FURN ( 100K 0 BOIL/CMP ( 3HP: @ VENT FANS.....: I CLOTHES DRYERS: @ /GAS/ I FURN 1=100K 0 UNIT HEATERS..: 0 HOODS.........: 0 OTHER UNITS...: 0 MAX INP. 0 BTU FLOOR FURNACES: 0 VENTS.........: 2 WOODSTO',IES.... 0 GAS OUTLETS...: 0 ---------------------------------------------------------------- ELECTRICAL ---------------------------------------------------------------- --RESIDENTIAL UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- ----BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADDIL IN91ECTIONS-- 1it!A SF OR LESS: 1 0 - 200 amp..: 0 0 200 amp..: @ 4/SVC OR PDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0 EA ADDIL 500SF.: 0 201 - 400 amp..: 0 211 400 amp..: 0 1st WIG SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR......: 0 LIMITED ENERGY.: 0 401 600 amp..,, 0 401 600 amp..: 0 EA PDDL BR CIA: 0 SIGNAL/PANEL...: 0 IN PLANT......: 0 MANIF HM/SVC/FDR: 0 601 1000 amp.: 0 601+81ps-1800 v: 0 MINOR LABEL -10; 0 IN@+ amp/volt.: 0 ----------------------------------- PLAN REVIEW SECTION ---------------------------------- Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR1=225 A.: ) 600 V NOMINAL, CLS AREA/SPC OCC: --------------------------------------------------- ELECTRICAL - RESTRICTED ENERGY ------------------------------------------ ----------- A. SF RESIDENTIAL--------------------------- B. COMMERCIAL----------------------------------------------------------------------------- AUDIO A STEREO.; VACUUM SYSTEM,.: AUDIO I STERE".: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM..: 0TH: BOILER....... . HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OP'ENZR.,: CLOCK........ . INSTRUMENTATION: MEDICAL........: OTHR: HVAC...........: DATA/TELE COMM.: NURSE CALLS....: TOTAL # SYSTEMS: Owner: ----------------------------------Contractor: ----------------------------- TOTAL FEES:$ 460.11 CAHN PROPERTIES LIMITED PART. OWNER 5795 SW CRANBERRY LT BEAVERTON OR 97007 'hone #: 627-0151 Phone Reg a� !his permit is issued subject to the rey,ilptions contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other to applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days, -----------——--------------—--------------- REGOIRPD INSPECTIONS ------------------------------•---------------------------- Erosion Contol Underfloor insul Electrical Servi Rain drain Insp Footing Insp Crawl Drain Electrical Rnugh Electrical Final Foundation Insp PLM/Underfloor Framing Insp Mechanical Final Post/Beam Struct Mechanical Insp Insulation Insp Plumb Final Post/Beam Mechan Plumb Top Out Gyp��o Insp Building Final Pet-m i t t e --;I on-it I-We I -,s 1-i e d By 3 Call for inspection - 639-4175 14 -�' �t�'CZj 05(G`l(v ��''n Clkfti (zC-Ct f7 Residential Building Permit AApplication. City of Tigard 13115 SW Mall Blvd,, Tigard, OR 97223 l�PJ�' v (503) 639-4 f 79 11 - �qtl Jobsite Address: � � Offire Use Only Subdivision: A' �cWnIUI3`�i �a,�tifs Lot L � Contact Date -/ / .t? Initials ('T� Valuation: Result _ 1 C 1' + 1-1,(5 127• New Construction Only: (Square Footage) Planck/Rec # V y Permit # r)s-- -L?..?3 Rouse Garage: _ Reissue of Garner Lot? Y Flag Lot? Y Map pe& TL ZI`�I Plat # A_V"ko ` Owner: C Ft N Arca Tt E� i _ fi Ar vi h C f\vcty lr,F_cv Approvals Required Address: q E S W C e Fl H cr E.V Y CT �. Planning Setbacks _ Solar LEAU c 2 S G c.► CSR_ ��1Oc�rl- Enginee,ing � Phone: j .rte G 3" ) (, �.,rI L l 3 Other _ Contractor: Items Required �wl�. E,R _ Subcontractors Address: _ Truss Details Other Notes Phone: Contractor's Licenr,e # -- Mn tattach copy of current Oregon license) Contact Name. 1=1��,'J +'_k r, IN y� Contact Phone: L 6 .1� Subcontractors: Architect/Engineer: �� �F_ ��dr;:�s_o ►. _ = Plumbing- Address: ? Mechanical: _�r3�-Lc� h Z-) �- (attach copy of current OR Contractor's License) Phone: 6 ��8 co iLD JOB D E S C gI PT I O N: zr t)cl a o S`� t t std►T j,�j_►�-�-n E,k F i i*,,V_, j ty Ig ��T M_ '� Applicant Si nature Applicant Phone number Received by: _ `��.:_.,�' Date Received: L; �. N p hnfCO Permit# Account Description Amount Amt. Pd. Sal. Due, MtL6 . 3,3 Bldg. Permit (BUILD) Plumb. Permit (PLUMB) ,�� ' Mecr. Permit (MECN) .2 J' Uabl6Zau.-. "XI G � Bldg: _._1: -�}_ -17, 3,Y Plumb: 3 3 v Misch: / Z F: 5 3 Flan Check (PLANCK) Bldg: S .� Plumb: Mech: Sewer Connection (SWUSA) Sewer Inspection (SWINSP) Parks Dev Charge (PKSDC) Residential TIF MF-R) Mass Transit TIF (TIF-MT) Commercial TIF (TIF-C) Industrial TIF (TIF-1) Institutional TIF Office TI,: (TIF-0) Water Quality (WQUAL) Water Quantity (WQUANT) Fire Life Safety (FLS) Erosion Cntrl Permit (ERPRMT) Erosion Planck/USA (ERPLAN) Erosion Planck/COT (EROSN) L TOTALS: �� ' ' y�V Permit Address: S Slt) Issued by: V -1,t Date: rj — Statement: Information Notice to Property owners About Construci`ion Responsibilities Note: Oregon Law, ORS 701.055(4), re(p,ices residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following.statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registratiot7 under ORS 701.010(7), need not submit this statement. This statement will be fr/cd with the permit. Fill in the appropriate blanks and initial loxes 1 and 2,and either box 3A or 313: R11. i own, reside in. or \\ill reside in the completed structure. EY] 2. I understand that 1 must register as a convtruction contractor if the structure is sold or offered fol sale ��''==�� before or upon completion. 3A. My general contractor is (Name) Contractor regis. # i will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR i23B. I will be my own general contractor. Ifi hire subcontractors. I will hire only subcontractors registered with the Construction Contractors Board. if i change my mind and hire a general contractor. i will contract with a contractor who is registered with the CC13 and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certifN that the above information is Correct and that I have read anal do understand the Information Notice to Property i ners�hout Co struction Responsibilities on the reverse side of this form. (Signature of permit applicant) (bate) (White copy to issuing agenct,permit file, pink copy to applicant) A, H186> vg-cq-;&.z 0 W o� LL ;v n — -- 0 0 44 .� c o" -- a 0 'o W C 00 "00- rl fo y w L V IiI L LO .._ r 0 L- 0 U [� �— ro o -= 0 � N U) N Lia r 9� it vi A W Z CL K i 0 6' n ° J ou44g� �- to w z y � �L n'Sh — f 0.81 � i t :9 Lr CP � s z dr o t Z LA O (,f.l it 1 11,11 It I I Ild III 11 'Ix tl Ip. P)I fl,11 A I I tOIN IN I Ih1Ifl it 1 J.l.i(4PO PI 1.A a► 1 111 t-HYIhf .N1 I<L(A It,I ('JIJ NFllhk: l HIIN F'ROI-'F HI I.I.A; (..1t41 ir.4:� Is1:-+1i t. lul11'd( 1-1111Mh:.Sti a t'NFt I NF IgSI i 11-1 t-1 Yh1L 14 1 01-11 F s 01:- 1 � ;' �. 5'i'41 Sw -suLAI)I.o on IN , BF 14 V F H I I IN !1Ft w lV. 0 i I VUI•'' I( 1. OV P(IYMF-N I t11*1!rt Ihl I PHAD D t-'UFiI-UL-it- (A tIfIYI1IF:N I Pin itJrd I t'Fi, 1) l�111 I�1Ni.t I'F.Ft1+1 146. `50 I'LUMBIN(+ PI NPI 00 1.11 1.1 11IN i f.,NL. fJE- r.:"i. NW 1:1.._k I.:'I H l l,Nl.. PF.ftlh l I I t W. IAVI i . BUILD t'F_H f l. .fili i I 1 ' l .1 l I:W 9811t 111,11 I(1 I i 11 i�IMI_.II IPJ 1 ('1.1 11► - •-t �3h4. kif� CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639-1':'5 Business Phone: 639-4171 Footing in Dralnnn Cover/Service FINAL: Foundation Water Line Ceiling Plumbj PosVBeam Mech. Shear/Sheath Framing Mach. Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect. Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg. San. Sewer ,� Gas Line ppr/Sdwlk Reins. Other: Date: /� � A.M. `.P.M. Entry: Address: 1-4) QG4k �+ Tenaot: d�- ---�y _ Ste: MST: G_ BUP: Con/Own: �� �6-1 PLM: ELC: THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: �,: J W - t�1 l.. In,,pector:' _ _ _ _ __ Date: d APPROVED __. DISAPPROVED/CALL FOR REINSP. CSF CO CITY OF TIGARD BUILD;NG INSPECTION NOTICE Inspection Line: 639-4175 Business Phone: 639-4171 Footing Rain Drain Cover/Service FINAL: Foundation Water Line Ceiling -Plumb. Post/Beam Mech. Shear/Sheath Framing -Mech. Plbg.Und/Fir/Slab Plbg. Top Out Insulation -Eiech Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg. San. Sewer Gas Line Appr/Sdwlh Reins. Other: ---- Date: ?-" ]j q 6— A.M. _'a�P..M. Entry: Address: I 5 S n-) ` b - Tenant; L-"44 - syt— Ste: _ MST: _ BU P: _ Con/Own J�L; 6 0 `l 6 MEC:_ PLM: 'GICLGLG�' Ci'-� ELC: THE FOLLOWING CORRECTIONS ARE REQUIRED: EL.R: Al rel c2 f�k Inspector: -, — DH APPROVED __DISAPPROVED/CALL FOR REINSP, CF CO CITY OF TIGARD BUILDING INSPECTIO1I NOTICE / In ction Line: 639-4175 Business Phone: 939.4171 Footi in Drain Cover/Service FINAL: oundatf Water Line Ceiling -Plumb, Post/Beam Mach. Shear/Sheath Framing -Mech. PIbg.Und/Flr/Stab Plbg.Top Out insulation -Elect. Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg. San. Sewer Gas }Line D Appr/Sdwlk Reins. Other: Date: A.M. P''.M. Enlry. Address: , �1�1 `M�7.►_ __ ,�� Tenant: _ _ Ste: _ MST. BLIP: Con/Own:— MEC: PLM: ELC: .__� THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: Date: APPROVED _DISAPPROVED/CALL FOR REIN SP. CF CO CITY OF TIGARD BUIL ING INSPECTION NOTI!'� Inspect;^^ ' ine: 639-417F Business Phone: 639-4171 Footing Rain Drain Cover/Service FINAL: Foundation Water Line Ceiling -Plumb. Post/Beam Mech. Shear/Sheath Framing -Mech. rr� PPlbbg�.UUnnd//Flr/S Insulation -Elect. sUBeam Str Mech, Flouyh-in Gyp. Bd. -Bldg. San. Sewer Gas Line Appr/Sdwlk Reins. Other. _ Date: � cq , A.M. _�/PQM. Entry: Address: � f J�� —�_g Th _i Tenant: Ste: MST: bZ BUP: _ Conry? MEC: PLM: ELC: THE FOLLOWING CORRECTIONS ARE REC"1IRFD: ELR: I I�nspee r: Dater APPROVED __DISAPPROVED/CALL FOR REINSP. CF CO CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk Foundation Plbg. Underslab Mech. Rough-in Fireplace Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL: Post/Beam Mech. San. Sewer Gas Line Bldg: Plbg. Underfloor Rain Drain Framing -Plumb. Alarm Water Line Insulation -Mech. Underflr. Insul, Shear Wall //..Gyp. Bd. -Elect. Date Requested: — ✓Time: AM PM Address: Builder: Permit t1:�. L l THE FOLLOWING CORRECTIONS ARE REQUIRED: In.pector: Date: Z— L PROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE _Call For Reinsp. INSPECTION NOTICE City of Tigard Bni.idiog Departae 13125 SW [call Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phune): 639-4175 Business Phone: 639-417 7 i Inn tion:_ Fcw)tinq Plbg. Underslab Nech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Cas Line FINAL: Post/Ream Struct. San. Sewer Framing -Bldg. Post/Beam Mech. Rein Drain Insulation -Plumb. Plbg Underfloor Water Line Gyp. Bd. -Mech. Date Requested: > Time: _PM Address:. �' a T / �. ' Permit #06 Hsu t dor: THE Fc)LLOWINO CORRECTIONS ARE REQUIRED: rL f.Y J m W J Inspector: Date: l / APPROVED DISAPPROVED` APPROVED SUBJECT TO ABOVE Call For Reinsp. / 5 INSPECTION NOTICE ^ ` City of Tigard Building Department 13125 SW Hall Blvd. Tigard, Orogon 97223 v` Inspection Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171 4,t Inspections„ • �__y_ Footing P1Gg. Underelab Nech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Cas Lines�jr Post/Ream Struct. San. Sewer Framing -Bldg. Post/Ream Mech. In Draln y Insulation -Plumb. Plbg. Underfloor Water ``��Line Gyp. Bd. -Neth. Ante Requested: i — -1 ;L7 j f zz Time: AM PN / �i�i� ) Acl.lr.,3es / 1 �c�-r /Q 5 (�Q " Permit j. THE F(.ILLOWING CORRECTIONS ARE REQUIRM __ '-�/.�,a,-,L,,.I(�l.c�.�. �.�) •,.-t,..�-Biu•-�_.•t',.t�..�-...Nr t= s� G Inspector: ,/ -_-- - - - AAte: t- i% APPROVED N DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinnp. INSPCCTION Nn1'ICE / City of Tigard Building Department 13125 SW Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: Fmt,J.ng Plbg. Underelab Mech. Rough-in Appr/sdwlk Found. Plbg. Top out Gas Line FINAL: Post/Beam struct. San. sewer raining -Bldg. Poet/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Mech. Date Requested: / Time: AM �JPM Address: Ir /o r U /f li —_ Permit Builder: �"' --- -- TIM FOLLOWING CORRECTIONS ARE_REEQUIREDx Ole j C._ H V) J C� Inspector:___��/ APPROVED DISAPPROVEDy APPROVED SUBJRr"T TO ABOVE ----Call For Reinap. �Z�T.ION NOTICE A f city of Tigard Building Department 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639 175 Bu inese Phone: 639-4171 Inspections Footing Plbg. Underslab Mech. Rough-in (/Appp�rr//Sdwlk Pound. Plbg. Top Out Gas Line fL14fe+�s^^ Post/Beam Struct. San. Sewer Framing Post/Beam Mech. Rain Drain Insulation -Plumb. Plbq. Underfloor Water Line Gyp, Bd• -Hoch. Date Requestedt_ -� _Time AM PM qq Address Permit ��-J C� • r Builder: c'? 7 Z- V !�/ . THE FOLI.OWING CORRECTIONS ARE REQUIRED: a rr ' J CD W J Inspectors nater' APPROV=D L--VTSj pPROVEL� D APPROVED SUBJECT To AHOV 4-It-all-For Reinsp. INS CTION NOTI('E � city of Tigard Building Departaent 13125 SW Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phones 3 -41 1 Inspection:— !!ootina Plbq. Underslab Mech. Rough-in Appr/Sdwlk und. Plbg. Top Out Gas Line FINAL: Poet/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Hech. Rain Drain Insulation -Plumb. Pibg. Underfloor Water Line Gyp. Bd. -Hech. Dnte Reque)s/t/eddt—_ 2L12 & / - T;met I'00AH PH Addrasa: /( "j(��11 �"-Z. v- 'jPermit f 16(_"-7 Mil I der: TIM FOLLOWING CORRECTIONS ARE REQUIRED: d`y _ - �- �a - ------- - _ m.._------- ----- Cx] U Li) Inspect - Date A - I-e'APPROVED i- DISRPPROVRD ✓ "PROVED SUBJECT TO ABOVE -_--Call For Reinsp. CITY OF TIGARD T # . . . PERMIT F'C.'(,'MI #. . . . . . . BUF'9..1.-0221 COMMUNITY DEVELOPMENT DEPAR,TME71 DATE ISSUED: 06/05/9405/94 13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)"639-41' 1 PARCEL: 1 S 1 3 5CD-00900 SITE ADDRESS. . . : 11461 SW 98TH AVE SUBDIVISION. . . . : 8URLWOOD ZONING: R-12 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . REISSUE: F=LOOR AKEAS---------- E=XTERIOR WALL CONSTRUCTION- CLASS OF WORK. :ADD FIRST. . . . :400 sf N: S: E: W: TYPE OF USE. . . :MF SECOND. . . : 5f PROTECT ----- TYPE OF CONST. :5N THIRD. . . . : Sf N: S: E: W. OCCUPANCY GR[-,. :Ml TOTAI-------: 400 sf ROOF CONST: FIRE RET? : OCCUPANCY LOAD:2 BASEMENT. : sf AREA SEP. RATED: `.: TOR. : 1 HT— 11 i. 1 ft GARAGE. . . : sf OCCU SEF,. RATED: PIMT? : MEZZ?: REDD SETBACKS-------- REUUIRED--- - FLOOR LOAD. . . . : Psf LEFT: ft RGHT: ft FIR GPKL:N SMOK DET. . :IU DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM:N HNDICF' ACC:Y 13EDRMS: BATHS: IMP SURFACE:00 PRO CORK:N PARKING: VALUE. $ : 6500 Remarks : Garage/storage addition for a apartment (2omplex. Owner.: ------------------------- -.--_-___.-.-.-.-.---_.----_------..-__•- FEES -___-_.._-_-._-.__..-._._.- LAHN PROPERTIES LIMITED PART. type amount by date reept ' 795 SW CRANBERRY CT PRMT $ 62:. 50 JF 08/05/94 -- PLCK $ 40. 63 - 07/26/94 94-254912: 11E.AVER'TON OR 97007 F112E $ 25. 00 - 07/26/9 F 94-2'54912 !'!-lone #. 62.7--0153 5PCT $ 3. 13 JF 08/05/94 - TIF $ 162. 00 JF 08/05/94 - ontractor: -------_.-__.-.----_-_---_-.____-----. HWNER ------------------------------------ Phone #: $ 29;3. 26 TOTAL Reg A. . : 00000 ------- REQUIRED INSPECTIONS ---- --This pe-sit is issued sub)ect to the regulations contained ,n the Foot/Found Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Slab Insp applicable laws. All work will be done in accordance with Framing Insp approved plans. This persit will expire if work is not started Final Inspection within 180 days of issuance, or it work is suspended for sore Roof n a i 1 n g Insp than 180 days. f'e r••m i. t t e e Signature : 41 � f - issued By : J Call for inspection - 639-4175 J Commercial Building Permit .Application City of Tigard 1312.5 SW Hall Blvd. Tigard, OR 97223 (503) 639-4171 Jobsite Andress: TI TV l Office use Only Tenant: Suite# Planck/Rec# - valuaticn Owner: y-J4, Lrw'L) Map s, TL# i , ;Addrass: I:L3 ?5' r• c,- ^-t_ Approvals Regulred j Planning t/t Phone: :o 2 f, h- o 3 Engineering btttor Contractor: 1 Address: Types^ of const: r rr Occupancy class: Phone: Sprinklered? Yes (No) Contractor's License # (attach copy of current Oregon license) Sq. ft. of project: Story (1 st, 2nd, etc.) I / Arcrltect/Englneer: ke,�^v�' �' �� < n` ' ? Proposed use: Address: gG3asJET.�1� L?,r.� Previous use: r r Note: Plumbing R n,:chanical plans must be submitted at time of Phone: - C `{ i - 75 114 building permit application. COMMENTS: �� Z ^C*• -h 6.� urv., ,.A CrW c;IA--I A � 1 C n � Applic nt Signature & Phone number Received by: Date Received: ) (v- 9 T Permit# Account Description Amount Amt. Pd. Bal. Due �j v Bldg. Permit (BUILD) J Plumb. Permit (PLUMB) _ Mech. Permit (MECH) State Tax (TAX) �• / Bldg: Plumb: Mech: Plan Check (PLANCK) Bldg: Plumb: Mech: Sewer Connection (SWUSA) Sewer Inspection (SWINSP) Parks Dev Charge (PKSDC) Storm Drainage Chg (SDSLC) Residential TIF (TIF-R) Mass Transit TIF (TIF-MT) , )2• � Commercial TIF (TIF-C) Industrial TIF (TIF-1) Institutional TIF (TIF-IS) _ Office TIF (TIF-O) _ Water Quality (WQUAL) Water Quantity (WQUANT) Fire Life: Safety (FLS) Erosion Cntrl Permit (ERPRMT) Erosion Planck/USA (ERPLAN) _ Erosion Planck/COT (EROSN) TOTALS: I I Y 11V IA 0ORD -- RE—CE I P I (It PO t rylf-.N I RE,.i.I- I I NO. e 9 4 1 I.AW-VAIN MOUN f f"AIAN PROPKIJIRS Uf4SH 14MOt IN 1 1 til, U1t4t 5795 OW C:WINkAi-.RHY UJUR I PAYMEMI 1441L. i kALA/0b/'%),4 8P.14VV-R'TT1N, OR [A)A W)I Y I41 ON 14114-10cliE (IF PAY MF N I AMOON 1 V'Al D P(IWW-11. (it 1114yWill 11MOUN I PAI 1 "Ll.11A)INO Pf RM )AJP94----171P*'I 6R,. 50 1.1 . I I I I it Pt I: CHECK FE 11. 70 I u,-JA r 1 i 11 1 M 11.1 11" 1 1.1 00 J RAN J I I J U IV, 00 1 1 Ifl- L I I f- lz+)l t Y PLHN 1 1, f-4111111N) I=41 11! i:46. L-)3 1.;1'f Y PF: IJ I FIT OF I'A V ly11:N r RI ( I J P I NO, 04 5 !:l Il, CR HMOLIN r PiliiMF a C.U.4111 PRnpl�.RTIF.Zj 1':ft,;14 1111OUNI, RV-S)S9 I POR ME 0610 P I DO'l 1, a 0 57cY" SW CRANBERTlY 9 1."1(LIN BEAVU,PlCoN, (IP 47t )0/---0.1 ,4"% li'd fit. PAYMI-M' OWIR'll 1-11-110 P11111111!lil , lit 1'sW,Vf11 s'#MoI.INI 141111 M-, 1 71 (1N V) rr CIO I. 0 LLY 11[461- 11451 96TH AVE 4h. 1%& DATE: PLANS CHECK NO.: PROJECT TITLE: COUNTYWIDE TRAFFIC IMPACT FEE APP,UCAN : WORKSHEET (FOR NON-SINGLE FAMILY USES) MAILING ADDRESS. C!. /ZIP/PHONE: RATE PER -�.� .! l C7L)/)-7 13, LAND USE CATEGORY TRIP TAX MAP NO.- RESIDENTIAL $155.00 / 3, c, L) "0 !� BUSINESS AND COMMERCIAL $39.00 SITUS NO.ADDRESS: OFFICE143. S l L INDUSTRIAL $150.00 INSTITUTIONAL $64.00 PAYMENT METHOD: CREDIT INSTITUTIONAL ONLY: BANCROFT PROMISSORY NOT LAND USE CATEGORY IDESCRIPTION OF USE EKDAY AVG. TRIP RA VYEEKEND AVE TRIP RA DEFER TO OCCUPANCY BASIS: L CALCULATIONS: / - L PROJECT TRIP AENEAATION: FEE4 16, L!U ADDITIONAL NOTES: FOR ACCOUNTING PURPOSES ONLY: t `� ROAD AMT. r TRANSIT AMT.: PREPARED BY: / CC WASHINGTON COUNTY % TIF NOTEBOOK �, form tlilo