Case File A
1
ADDRESSW
e•j�••o. .
1039b— Av4ENutow Ab
1
�1
• • • • ! ••
CITY OF TfGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 9722398199 (503)639-4171
UURTII !Ck "
1)(7c)JI-J.
XKHX PE"14 111 T #. . . . .. . . .
630-4171
. 11-C ADDRE&Q. . . : 16074 SW 103RD AVI:. il,i L:
SUDDIVISM01. . . . RIVERVIEW ESTATES ZONING: P- 7
. . . . . . . . . . .. . . . . . . . . . . . . :3
Of WURK. :NLW
TYPE Or-- USE. . . I 9F
Of-CUPPI'4GY GRP. -P:F
nCr(A-'nNU,Y 1.001)tj.,21 4
T E 1111AI IT 110M '.
Ppmarkoi
Owner:
�-.KYLIIAII 1311.11 .1)UR", GO
V, 0 PO
LARE 01."U_100 Uk ')7031-3
Phalle #- t
Cant rr-.ic.,t oir
SKYI-IGHT HLIML. BUILIA-I"'..) t,0
P U BOX d315
1-441«E O14F.'00 UR 97035
Phone 14>t 1503- -636--�:Y)
f?erj . t 34086
(J(x-.t.ipanc,y of the above reftrenced building ig hereby qlvpri, and cc , I
the compliano" with the State Of Oregon Specialty Codes for the group,
rtc(-,ur)ency, A!,H !.�%e under which the reforeticet.1 i ,rmtf; was isst.ted.
f-ME OEPORIAENI'
DUILI)ING OFf-ICIAL
Pr,)!',I' TN EMN:3131(;I1OUS PLAICE'
INSPECTIO NOTICE
City of Tigard Building Department
13125 SW Hall. Blvd. Tignrd, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Rueinesa Phone: 639-4171
Inspection-_
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Flbg. Top out Gas Line FINAL:
Past/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Inoulation -P1
U erf r Water Line Gyp. Bd. Nec
Date Requesteed: /� a�.� __Times AM / PM
Address: / (tom Q � V r� � Permit /:�—
Builder:
FOLLOWINGOp IOM 118E REQUIRED:
a _
rr
ca
w
Inspec or: Date
APPROVED Y_ DISAPPROVRD APPROVED Sf.ajxCI' TO ADM
`Call For Reinap.
INSPECTION NOTICE
City of Tigard Building Department
13125 Sq Ball Blvd. Tigard, Otegon 97223
Inspection Line (Rec-O-Phon : 649-4175 Business Phone: 639-4171
Inapectiun:
Footing ?Ibg. erelab Mech. Rough-in Appr/Sdw1k \
Found. Plbg./Top Out Gas Line FINAL.,
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Dcain Innulation -Plumb.
Pllxl. Underfloor Water Line Gyp. BO. -Neth.
Date Requested: _ Time: AM _ _PN
� r
Address:_�.L(LY/� LTJ' Permit is � `'153—/4
Builder:
THS FOLLOWING CORRECTIONS ARE REQUIRED:
d
V)
Inspect or: --�.. _—.� . . -_ ... / Oatet
APP14OVED DISAPPROVRD APPROVED SU.7TECT TO ADM
Call For Reinep.
NSPECTION NOTICE
City of Tic.ard Builds-ng Department
13125 SM Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4111
Inspection: __
Footing Plbg. Underelab Mech. Rough-in Appr/Stwlk
Found. Plbg. Top Out Gas Line FLNAL:
Post/Beam Struct. San. Sewer ?raining -Bldg.
Poet/Beam Mech. Rain Drain insulation -Plumb.
Plbg. Underfloor Water Line \ Gyp. Rd. -Mech.
Date Requested:, `� e�-- Time: AM _PM
Addrese:.__-.�_. ' `� � Permit
Builder s aAt�G�II���
TRE FOLLOWING CO IONS/ARE REQUIRED:
Se
1J .4�defi_ c N _
��'� T� N C�iPP�� C rrc'.3 _� oyTr>•
2
4 41 N,1E
w
J
Inspector:
APPROVEI) DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INSPECTION NOTICE
City of Ti3ard Building Department
13125 Sit Ball Blvd. Tigard, Oregon 97223 ���✓✓✓"
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plb9. Underslab Mrch. Rough-in Apor/Sdwlk
Pound. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. :;ewer Framing -Bldg.
Poet/Beam Meeh. Raf.n Driin insulation -Plumb.
Plbq. Underfloor Hater Liue Gyp. Bd. ech.
Date Requested: / c- � L _T � PM
Addruee:_ / /(,� `CZ Permit- 1: (J _/t/
Builder! 2
THE FOLLOWING RRECTIOtI ARE REQUIRED:
F-
N
ti
CO
h i
LD
w
�-
APPROVED DISAPPROVED P.PPROvrn SUBJECT TO ABOVE
Call For Reinsp.
INSPECTION NOT.CE
City of Tiyard 'Building Department
13125 SM Hall Blvd. Tiga-d, Oregon 97223
Inspection Line (Roo-O-Phone): 639-4175 BunineBs Phone: 639-4171
Inspections
Footing Plbq. Underslab nsh.ar* ugh-in Appr/sdwlk
Found. Plbg. Top out Gas Line ) FINN.:
Poot/Ream St_ruct. San. Sewer FrnmLny -Bldg.
Pont/Beam Mech. Rain Drain ;noulation -Plumb.
P'.bg. Underfloor Water Line .;yn. ad. -Mech.
Date Requasteds /�i� C�c� �7�L� _-Tines AM PN
AL.dresa:_ / ` Permit #s�
Builder•
THE FOLLOWING CO1aCTXON8 ARE REQUIRED:
l
ri
Inepectors�� ___ nate: L/�_
APPROVED DISAP7,ROVRD_ APPROVED SUP-1-RCT TO AROV>r
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building DepartasenL
13125 OW Ball Bled. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 3 -4171
1
Inspection: r."m Y V
Footing Plhg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain �net�!
ion -Plumb.
Plbg. Underfloor Water Line Oyp. ad. -Mach.
Date Requested:_ J
7` 2-- Times _ / AM PM
Address:, tot) Permit fs
Builders
Tn". ?OLLOWING CORRECTIONS ARE REQUIREDs
F_
Inspectors _ _ 1) .tet
APPROVED DISAPPROVED APPROVE) SUBJECT TO ABOVE
Lail For Reinsp.
INSPECTION NOTICE
City of Tigard Bu).ldinq Depart-went
13125 SW Ball Blvd. Tigard, Oregon 9722
Inspection Line (Rec-O-Phone): 635-4175 Business Phone: 639-4
Inspection: —
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer (iraming,) -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd.
1
Date Requested:_ �O f 7 �/ Z � Timet _AM --"Y,—PM
,// C
AdArens: A-
_ U�Y ) -33,/K1 Perms 17�T-
0=3 U
Builder:
TME FOLLOWING CORR$CTIr"' ^vn ':SQUIRED:
TnapPctor:- -- -_-_-�- Date:_"
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reins
INSPECTION NOTICE_
City of Tigard &wilding Department
13125 SR Halt Blvd_ Tigard, Oreqon 97223
Inspection Line (Rec-O-Phone: 639-4175 Business Phone: 639-4171
Inspection:___ —__ _
Footing Mg. Underalab Mech. Rough-in Appr/Sdwlk
_-
Found. K Plbg Top Out Gas Line FINAL-
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
Date Aequestede ---,z, �_A Time: r? AN _SPH
Address: 41) Permit f s�/ Z
Builder: zjz--1-
TILE FOLLOWING CORAEGTIONS ARE REQUIRED:
i
Inspect�r: Y -- — —_ Dater 3
APPAOVED DISAPPROVED APPR()VED SUBJECT TO ABOVE
Call For Reinep.
INSPECTION NOTICE
City of Tigard Building Department
1.3125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phones 639-417
Inspection:
Footing Plba. Underslab !tech. Rough-1.n Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Str;t. -a5n.Sewer Framing -Bldg.
Po3t/Beam Mech. Ra n Drain Insulation -Plumb.
Plbg. Underfloor aver Line Gyp. Bd. -Mech.
Date Requested I- 7� Times�✓11M _--PM
Addrese: �(✓�1 7y_ �(J �� y Permit r>s e/- U31 U
Builder:
THE FOLLOWING CORRECTIONS MR REQUIRED:
F--
Ln
J
n]
l.7
LLl
J
Vz
Inspectort _ _ -_ UAte• _ /
V APPROVED DISAPPROVED APPROVES SUBJECT TO ABOVE
Call For Reinsp.
INSPECTION NOTICA
City of Tigard Bailding Departa:�nt
13125 SN Hall Blvd_ Tigard, Oregon 97223
rnspec:ion Line (Rec-O-Phone): 639-4175 Business Phone: 6 9-4171
Inspection%
Foot!.ng Plbg. Underslab `tech. Rough-in Appr/Sdwlk
1
round. _ Plbg. Top Out Gas Line FINAL:
-�6at/Beam Struc San. Sewer Framing -Bldg.
Rain Drain Insulation -Plumb.
Plbg Underfloor Water Line Gyp. Bd. -Hech.
Date Requested% r Z Tlmviv: AM PM
Address:7��SA�/ / �-G�L� � _ PerSAinl/t �f s� 631Q
Builder: C-�-
THE FOLLOWING RECIIONS ARE REQUIRED: -Y
1-
v'7
y
J
f,7
11
J
Inspector% Date
14
APPROVED DISAPPROVED APPROVED SUBJECT To ABobt
Call For Rel.nap.
INSPECTION NOTICE
City of Tigard Building Department
13122 SM flall Blvd. Tigard, Oregon 97223
� _,n action Line (Rec-O-Phone): ,39-4175 Busineso Phone: 639-4171
Inspections -
Footing Plbg. Underslab Me i Rough-in Appr/Sdwlk
Qound. Plbg. Top Out Gan Line FINALS
Post/Beam Strvct. San. Se er Framing -Bldg.
Post/Beam Mach. Rain Drain Ineulatien -Plumb.
P11$4.'Dnderfloo:: \ Water Line Gyp. Bd. -Mach.
DateRwgvesteds /l % _Time: AN PK
Addresss --.z-&a7
/7 &Z //),-3 Permit !!:92-a zi E)
Builder: �iLJ LG/l L� 7
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspectors G� _ _ Dates
hrPROM DIBAPPROVED APPROVED SOH.YECT TO A9OVR
call For Roinop.
INSPECTION NOTICE
City of Tigard Building DeP4 --nt
13125 Sit Ball Blvd. Tigard, Oregon 972
Inspection Line (Rec-O-Phone): 639-4175 Business Ph 639-4171
Inspections ---
Footing ) Plbg. Underslab Mach. Rough-in Appr/sdwlk
Found. Plbg. Top Out Gas Line FINAL-
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line/ Gyp. Bd. -Hoch.
Date Requested: -.� ��'Y �_. T� P31
Address: ��. ��� Permit fs Q�/ei
Builders
THE FOLLOWING CTIONS ARE REQI'IPS'D:
InspectorDates
7-21714
'
APPROVED DISAPPROVED APPROVED SUBJECT 70 ADM
Call For Reinep.
of TIFARD PLUMBING PERMIT
Cny0F1WRDj PE Rfyl I T #. . . . . . . : ms791-0310
COMMUNRY DEVELOPMENT DEPARTMENT
13126 SW Hell Blvd. P.O.Box 23397,TkpM,Oregon 97 (603)63a4176
DATE r., D, 07/27/4-'
aTE ADDRES'Si-r.-'s 16074 SW 103RD AVE PARCEL.- 2S 14BB,-RV3
SUBDIVISION. . . . : RIVERVIEW ESTATES ZONING: R-7 PD
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . .. . :3
----------------------------------------------------- --------- ------
CLASS OF WORK. . iNEW GARBAGE DISPOSALS— : 1
TYPE OF USE. . . . :SF WAS14ING MACH. . . . . . . : 1 BACKFLOW PREVNTRS. . i0
OCCUPPNCY GRP. . :R3 FLOOR DRAINS. . . . . . . tO TRAPS. . . . . . . . . . . . . . ..0
STORIES. . . . . . . . ..2 WATER HEATERS. . . . . . : 1 CATCH BAS7NS. . . . . . . :0
F I XTtJRES--------- LAUNDRY TRAYS. . . . . . :1b SF RAIN DRAINS. . . . . : 1
SINKS. . . . . . . — : 1 GREASE TRAPS. . . . . . . :0
LAVATORIES. . . . . :4 OTHER FIXTURES. . . . . :0
TUB/SHOWERS. . . . : SEWER LINE (ft ) . . . . :0
WATER CLOSETS. . :3 WATER LINE (ft ) . . . . : 100
DISHWWSHERS. . . . : 1 RAIN DRAIN (ft ) . . . . :0
Remarks:
OWNER: ___-_-___-____-__FEES- -------____.____
SKYLIGHT
--------- ------
SKYLIGHT HOME BUILDERS CO TIF $ 1380. 00 JH 07/27/92 -
P 13 BOX 2315 SPRT $ 433. 00 JH 07/27/92 -
BPLC $ 281. 45 JLH 12/31/91 22t38P
LAKE OSWEGO OR 97035 B5PC $ 21. 65 J14 07/217/92
Phone #1 503-636-2994 SSDC.- $ 280. 00 JH 07/27/'z,2
PARK $ 500. 00 JH 07/27/92
Plitmbing MPRT $ 39. 00 JH 071/27/92
MPLC $ 9. 75 JH 07/L*.'/92
Name , M5F_*'C $ 1- 95 JH 07/27/92
Addresa I PPRT $ 147. 50 JH 07/2'7/92
C i t Y States P5PC $ 7. 38 JH 07/27/92
Z i P.- Ph o n e 0 P
pet]
REQUIRED INSPECTIONS
This permit is issued subject to the reg -
UlAtiOTIS contained in the Tigard Muniripal Foot/found Insp Rain drain Insp
Code, State of Ure. Specialty Codes and all Post/Beam Str'Ar_t Water, Line Insp
other applicable laws. Al ' work will be d,,ne Post/Beam Mechan Appr/Sdwlk Insp
in accurdance with approved plans. This Plm/undslab Insp Mechanical r-'Jnal
permit will expire if work is riot started PLM/Underfloor Plumb Final
- -within 180 days of issuance, or if work is Mechanical Insp Bu ' 1 d i n g F.i naj
Lon suspended for more than 1130 days. Plumb Top Out Erosion Control
Framing Insp Crawl Drain
Fireplace Insp
Gas Line Insp
Insulimtion Insp
W --- Gyp Board Insp
-J r� lthrr iced Plumbing Contractor
ACtOV- SignatIAV-P
Call for, inspection 639-4175
t,antractor Notes :_
CMASTER PERMIT
CMOF TWRD
COMMUNITY DEVELOPMENT DEPARTMENT MOM . . . . . . : MST91 -0311:
13126 SW Hidl 8W. P.O.Elax 23397,7)gwd,orogDn g7223(6o3)SW41 76 "7r
ITE ADDRESS. 16074 SW 103RD nVE PORCEL: 2S1148B--PV'3
SUBDIVISION. . . . : RIVERVIEW ESTATFS ZONING: R-7 PD
FLOCK. . . . . . . . . . L01.. . . . . . .
BJILDING -----------------------------------------
1-0'EISSUE: DWELLING UNI Tri: 1 TAnSEM!1_-,.T. . . . . . .. . :0 s
r_'(_ASS OF WORK. :NEW BEDRMS:4 BATHS:3 GARAGE_. . . . . . . • . . :456 S f
I YPE OF USE. . . SF FLOOR REOUIRFD SETBACKS--_...._-_-_._
IYPE:
ETBACKS-----------
IYPE OF CONST. :5N FIRST. . . . -914 sf LEFT. . -5 ft RIGHT. :5 ft
OCCUPANCY GRP. :R3 SECOND. . . : 1068 Sf FRONT. :20 ft REAR. . :`JO f-t
SrORIES. . . . . . . :2 THIRD. . . . CA s
HEIGHT. . . . . . . . :21. ft 11.48121 S f SMOKE DETECTnRS. :Y
FLUOR LOA .,— . :40 P f VALUE. . . . . $: 99380 PARKING SPACES. . 'O
PLUMBING --------------------------------------
5INKS. . . . . . . . . . : 1 FLOOR DRAINS. -0 BACKFLOW PREVNTRS. :0
LAVATORIES. . . . . :4 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . :QA
ttJB/SHOWERS. . . . 1 11 LAUNDRY TRAYS. . . !0 CATCH BASINC3. . . . . . . ..0
WWER CLOSETS. . .3 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . : 1 WPT17-:.R I-INE (ft ) , : 10171 OTHER FIXTURES. . . . . ..0
GARBAGE D I SP. . . : 1 RAIN DRAIN (ft ) . :lit
WASHING MACH. . . : 1 SF RAIN DRAINS, . z1
--------------- MECHANICALFEES
FUEL TYPE53--.- UNIT HTRS. . :0 type AM 0 Un t tj y date recap
%GAS/ VENTS . . . . . :0 TIF $ 1380. 0111 JH 07/27/92
MAX INPUT:0 STU VENT PANG. . -4 PPRT $ 43:3. 001 JH 07/27/92
FURN ( 100K . . : I HOODS. . . . . . . I BPLC $ 281. 45 JLH 12/31/91 3 344
r-'.JRN > =100K . . .0 WOOI)r:)'TOVES. -0 89PC f 21 . 65 JI-4 0'7/2'7/9.°
Fi.00R FURN. . . . :0 CLO DRYERS. - I SSD[: $ ;_:E10. 00 JH 07/27/92
1-t'JIL/CMP ( 3HP.0 OTHER UNITS%0 1'*APK $ 500. 00 JH 07/1?7/9;:-!
GAS OUTLETS: 1 MPR'( $ 39. 00 JH 07/27/92
ovonar: 11PI-C 9. 75 JH 07/27/9i?
bKYLlGHT HOME BUILDERS CO M5PC 4 1. 95 JH 07/27/92
0 BOX r-1311i PPRT f 14/. .`7!71 ,JH 07/217/9i'
P5PC $ 7. 36 JH 07/27/92
LARP OSWEGO OR "37035
Phone #: 503-636-2994
SKYLIGHT HOME BUILDERS CO
P 0 PDX 2315
LAKE OSWEGO OR 97035
Phitne #: 503-636-2994
Rpq #. . : 34086 __._._._.._.__....__----_.._.__------_...-__---_._._...__
E '1101. 68 TOTAL
This pervit is isstied subject ttrI he r egillat ns contained in the REOUIRED INSPECTIONS
cc
T;card P"icipal Code. State of Ore. t
slecill Codee and all other root/found Insp FirppliAcp Insp
applicable laws. All work will be doneip ordane@ with approved Post /Beam Struct (3-as Line Insp
claps. This portit will evDire if warup. is rt etarted within IN Past /Seam Merhan InSLIlAtion Insp
s
deve of isonce, or if work is s-�itpv tt fo- tore than 180 days. PIM/UndSlAb Insp Gyp Hoard Insp
PLM/1.1nderf I oor Hain drain Insr,
wittee Sign Merhnntril). Insp WAtpr I-inp In-,p
Plumb Top Out Appt,/Sdwlk Insp
I I for intrpect i o,) 639-4175
CIt'Y OF TIGARD -- RECEIPT OF PAYMU.'NT RECEIPT NO. C92-229920
CHECK AMOUNT 1871. 613
NOME SHYI-103HT HOMEBUILDEW3 CASIA AMOUNT ti 0. 00
ADDRESS a PAVMFNT DATE 07/E'7/92
SUAD 11)1 S I ON
PURPOSE OF PAYMENT AMOUN ' PAID PURPOSE OF-' PAYMENT AMOUNT PAID
ct BUILDING Vl E R M 433. 00 PLUMBING PERM 147. 50
Ln MECHANICAL Pr 39. 00 ST. BUILD PER 30. 98
,A-- PLON CHECK
CK FE 441. 20 PARKS SDC 000. 00
STORM DRAIN 61)(700
UJT 3 RIVERVIEW ESTATES
16074 cW 103RD AVE
TOT-Al- AMOUNT' P,AID 1871. 68
TRAFFIC IMPACT FEE
Installment Payment Application and Disclosure Statement
In the Matter of the Traffic Impact Fee for Skylight Home Builders Co.
Tax Map 2S114BB Lot Number(s) 3 Building Permit # MST91-0310
Site Address 16074 SW 103rd Ave. Subdivision Riverview Estates _
_Case File # SUB90-0014 TIF Land Use District R-7 PD
To Be Billed To: Skylight Home Builders Co.
Addresr: PO Box 2315 Lake Oswego OR 97035 Phone#: 636-2994
To the City of Tigard:
In accordance with the provision of Oregon Revised Statute 223 208 and Washington County Ordinance
No. 379 which relates to the imposition of a traffic impact fee for the financing of major collector roads and
arterials of Washington County, I!we HEREBY MAKE APPLICATION AND AGREE, JOINTLY AND
SEVERALLY, to pay my/our traffic impact fee, as has been determined by Washington County Ordinance
No. 379 in 10 semi-annual installments of the amount financed together with one-half of one year's
interest thereon at a rate of 7.63 annual percentage rate on the unpaid amount owed. The lien date is the
first day of the month following the date the application is signed. The first payment is due six months
thereafter and at six (6) month intervals thereafter for a period of 5_years. Each installment payment will
include principal and interest.
If kwe neglect or refuse to pay any part of the installments provided herein, including interest, within one
(1) year after the same shall have become due and payable, then the whole amount of the unpaid
assessment shall become due and payable at once and shall be colleciwd in the manner provided by law
including foreclosure on the above-described real property.
The traffic impact fee, akrnual percentage rate of Interest (7.63%) and finance charges which [/we agree
to pay are as follows:
HIGHWAY TRANSIT
1) Amount of Traffic Impact Fee . . . . . . . . . . . . . . . . . $ 1280.00 100.00_
2) Amount Financed . . . . . . . . . . . . . . . . . . . . . . . . $ 1281.00 100.00 _
3) Equal Semi-Annual Principal Payments . . . . . . . . . $ 128.00 10.00
4) Interest on Balance at Rate of 7.63% _ %
I\We understand tat the amount owed, as stated above, shall be a lien on the above-described subject
property pursuarj(to Washington County Ordinance No. 379 Section 6 (D) and ORS 223.230.
SATED this 27th day of July , 1992.
NSigna a ofProperty Owner(s) Signature of Property Owner(s)
—� STATE OF OREGON ) Name (Please Print): re )a
Address: S,1 S- CAKC 0-f1Lx ti o el q Z v Ir
County of Washington 1
SUBSCRIBED AND SWORN TO BEFORE me this ? day of
Notary Public for Oregon
My Commission Expires:
10gmW,01AVA
, .
c'�O� TI���� SEWER CONNECTION
OOMMUNITY DEVELO',IPAEN? DEPARTMENT o f N D PERMIT
13126 SW Fill Blvd. P.O.Bax 23307,TOW,0 wgorr 9=(603)630.4176 E•R M I T #. . . . . . . : SWR 9 2--015 6
—639-4171 uP,,'iE: j9sul_r : o6/3-o/9c':
SITE ADDRESS. . . : 16074 SW 103RD AVE PARC!--L: 2S1141.A1:ti--RVQ
SUBDIVISION. . . . : RIVERYIEW ESTATES ZONING: R--7 PD
BLOCK. . . . . . . . . . % LOT. . . . . . . . . . . . . :3
I HNAN-F NAME. . . . . :
USA NO. . . . . . . . . . . F'I X TU RE UNITS. . . .
;'I._ASy OF WORK. . . :NEW DWELL_It 1(3 UN I TS. . : 1
1 YPE OF USE.. . . . . :SF NO. OF L U I LD I NGS: :1
114STALL TYPE. . . . :E3USWR IIYIPF_FIV SURFACE—
Remarks :
Owner. -------------------------------------- ____...__.____.___._-_ FEE,
SKYLIGHT HOME BUILDERS CO type am(jr_1n•t by date rer,pt
P 0 BOX 2315 roRr4T $ 1900. 20 Jli 06/30/92 —
INSP $ 35. 0Q) JH 06/,:, /92 —
...AKE OSWEG0 013 97035
F-`hone" #: X03-•636-2994
L_1]NTRALTOR NOT ON FILE
Flh(ine tt: $ 1935. 00 TOTAL_
Rey 0. .
--- --- REOU I RE'D INSPECTIONS
-This Applicant agrees to comply with all the rules and regulations :rwer Inspection
of the Unified Sewage Agency. Thr permit expires 180 days from
the date issued, The total amount paid will be forfeited if the
r-ermit expires. The Agency does not guarantee the accuracv of the
side sewer laterals. if the sewer is o located at the measurement
given. the installer• shall prospe 3 met in all directions from
the distance given. If not so 1� '= the installer shall purchase �_ _ _ __._•_ __._-�..��_,--_��
"Tap and Side Sew- De "it �%eo^cv will inst lateral.
1 'e'-mittee Lyn•_at,
sgrred Sys
Call far inspection — 639-4175
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COMMUNITY DEVELOPMENT DEPARTMENT Tigard,0rcgon97ZL3 PERMIT N &SL!�j- U:3/ D
(503639-4171 DATE ISSUED
JOB ADDRESS: IGr�'7� ;W ��� IZ�. _ TAX MAP/LOT _,_ZS/-/yfjff- kill
SUB: R1✓�av�Ew �'r�p?mss LOT: LAND USE:
VALUATION: .
OWNER SPECIAL NOTES
NAME: )40Y)),E fL1)LOFKS CO, REISSUE OF:
ADDRESS: R D /3ui( Z3/s- LAST REISSUE: _
_ LOKf_ OZ 70S-5- FLOOD PLAIN/
PHONE: (5 s') 63b._Zr19y SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME: CO. PLANNING• SSE-�s ne
ADDRESS: PO L3o?< 73,13' ENGINEERING:
(g.Ke ost_"o. aft ")7931' FIRE DEPT:
PHONE: _� _S70 -79g _ OTHER: -riff 1R!-
CONTR. BOARD #: 3 +086 EXP DATE: !1 Z 9 Z
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: INdL 01 r PC -n119�,4 LIST/SUBCONTRACTORS: _
MECH: fbvr HN ' WTb CO E. BUS TAX:
ARCH/ENGINEER CALCULATIONS:
NAME: V C�bH'r IaomC 1�usCdl%:'ts'r i TRUSS DETAILS: _
ADDRESS: ,eO 9p,-4 ?3Js ' OTHER:
n
PHONE: Zg9`l
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PROPOSED BLDG. USE:
�? COMMENTS: Azk uwm, s od ?,o-00/V CONdS, 44E SA7/sFieJ
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APPLICANT SI NATURE
Received By: 1 ��- _ Date Received:
i
PERMIT R ACCT A DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
j�t�X! v3iv 10-432 00 Building Permit Fees ✓ �f ''
10-431 00 Plumbing Permit Fees " 5
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%)
Building 'Al.
Plumbing
Mechanical
10-133 00 Plans Check Fee
Buildingy
Plumbing _
Mechanical 9
10-230 06 Fire
,,wz- 1st 30-202 00 Sewer Connection
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Feus
25-448 06 Institutional TIF Fees
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees /-zb� _ /Z"
25-448-05 Mass Transit TIF Fees j u O _ /C•t)
52-449 00 Parks System Dev Charge (PDC) SZ u 54Q
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC)
24-445-01 Water Quality (Fee in lieu of) _
F-
24-445-02 Water Quantity (Fee in lieu of)
L.,
J TOTAL .503 a2 11—V
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