16349 SW 107TH COURT i
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MECHANICAL
CITY OF TIGARD PERMIT
COMMUNITY DEVELOPMENT D�PA)RT,41�YT PERMIT #. . . . . . . : MEC94—��054
DATE ISSUED: 02/16/94
13125 SW Hall Blvd.'rigard.Oregon 97223*8199 (503)639-4171
PARCEL: 2SI15AA-06800
5 i I L I abD R E!z)S 1b`49 SW 107TH CT
SUBDIVISION. . . . : BERKLEY ESTATES ZONING:
BLOCK.. . . . . . . . . . : LOI . . . . . . . . . . . . . 0. '0
CLASS OF WORK. . :ADD F-'LOOR FURN. . . . EVAP COOLERS:
I YPE OF USE. . . . :SF UNIT HEATERb. . : VENT FANS. . . :
OCCUPANCY GRr-I. . -.R--2 VENTS W/O APPL-. VENT SYSTEMS:
STORIES. . . . . . . . :2 BOILERS/'COMPRES"'ORS HOODS. . . . . . .
FUEL 0-3 HP. . . . -. 1. DOMES. INCIN:
: /ELE/ 3-13 HP. . . . COMML. INCIN:
ly'1AX INPUT: BTU 15-30 HP. . - . REPAIR UNITS:
FIRE DAMPERS?. . : 30--50 HP. . . . . WOODSTOVES. . ,
GAS PRESSURE. . . 50+ HP. . . . : CLO DRYERS. . :
NO. OF AIR HANDLING UNITS OTHER UNITS. :
FURN ( 100K BTU: 111100@ cfnl : GAS OUTLUTS. -
FURN ) =100K BTU- 1.0000 cfm :
Remal,1(s . AIR CONDITIONER
Owner. FEES
C. J. STONE type amount by date r,ecpt
16349 SW 107TH CT PRMT $ 25. 00 JV4 02/18/94
5PCT f 1. C5 JH 02/18/94
TIGARD OR 97224
Phone #.-
Contr-actoi--:
SCHL09SER CON1*RPCTlrV6
PO BOX 431
NORTH PLAINS OR -----------------------------------------
Phone #: $ 26. 25 TOTAL
Req #. . . 842.32
REQUIRED INSPECTIONS
This permit is issued subject to the egulations contained in the Mechanical Insp
Tigard Municipal CodE, State of Ore. Specialty Codes and all other Final Inspection
applicable laws. All work wili be done in accordance with
approved pians. This permit will expiry if work is not started
within 180 days of issuance, or if work is suspended for more
than 180 days.
Ppi-,m i t t e Si gnat ut-e
Issued BY :
Call—11 f--—at-T—i inspection— ------. —6,39-4175
J I Y (it- 't I.T.4141:) 4E CU )F"i OF I-llyllt N1 RIA.1 j I, I NO »1)4 c'414.1 i'9
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UMN"I'MM"TINH CACA-1 AMI It IN r IA. 01111
PAYMF N1 DATT 17IR/.1 I-A 9 4
RF !:AJBD.i V 1 16 1 ON
IIF PAYMF-141 $1110I.IN U PA 1(1) pl.)Rpf-)i-'F
Off. PlAYMENT
1341- PR 131-1 IIA) PER
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C-0
16.3491 SW tOl' III (J
-G)7 A1_ AMOUNT PAID P6. P5
City of Tigard MECHANICAL PERMIT Planck/Rec. # _
13125 sw Hall Blvd. APPLICATION P•:rmit # Ppe /ll��
Tigard, OR 97223
(503).639-4171
Description
Table 3A Mechanical Code QTY PRICE AMT
Job •Y ,`'� / �(� y 1) Permit Fee -0- -0- 10.00
Address ,r•
2) Supplemental Permit 3.00
umaceto —
,T s- 7-V c. 1) incl.ducts&vents 6.00
»� F um ace 100,000 B I U . —
Owner 2) incl.ducts&vents 7.50
Floor urnance
3) incl. vent 6_00
a^•^� Suspended ater,waTf ei
4) or floor mounted heater 6.00
e"—V�not inclTn--
Occupant Vent
5) appliance permit 3.00
W ��CZ. Hepair o eating, reng
6) cooling,absorption unit 6.00
comp,heat pump,air con
4 7) to 3 HP absorp unit to 100K Dru 6.00 Oed
Boiler or comp, eat pump,--air J
6) 3-15 HP absorp unit to 500K BTU 11.00
Contractor ——
&PBoiler or comp, ea pufnp,air cond.
d/Y' 2'��� 9) 15.30 HP absorp unit.5-1 mil BTU 15.00
/ i or—or oom�ieat pump,air con
C G7 Z
' 2 Yf ;26j j/ 10) 30-50 HP absorp unit 1-1.75 mil BTU 22.50
ere y-acknowledge that I have rea is appitcation, ,a-TVT5— r ---boiler or comp, e�at pump,air cond.
information given is correct,that I am the owner or authurized agent11-11) >50 HP absorp unit 1 75 mil BTU 31.50
of the own ,that plans submitted are in compliance with State v an mg unit to v�
laws,that 1 am registered with the Construction Contractor's Board, 12) 10,000 CFM 4.50
that the number given is corre--L (If exempt from State registration, X r an uV
please give give reason below.) 13) 10,000 CTM. 7.50
Non port`55 -
14) evaporate coder 4.50
er`V-Ti ancconnecte�---" — -
-7 15) to a single duct 3.00
-Tenti ati-"T on system not
/j• fes-- �- 16) included in appliance permit 4.50
H36d sery
17) mechanical exhaust 4.50
scn-'�e work —riev a�ii it"ron—U-aTteratan (T repair — o�mmercw�T or indu�tT—
to be done residential Q non-residential O 18) type incinerator 30.00
xis ng—use-7o '— bier i.e.,woodstove,water
building or property _ 19) heater,solar,clothes dryers,etc. 4.50
Proposed use of 20) Gas piping one to four outlets 2.00
N building or property
21) More than 4-per outlet
Type of fuel oil O natural gas O LPG(D electric O
LL �— Minimum Fee$25.00 SUBTOTAL �S'
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARrE
IF CONSTRUC TION OR WORK IS SUSPENDED OR —�— —
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL
AFTER WORN,IS COMMENCED. — -- -
TOTAL
Special Conditions -- --—
�- Date issued by
wv�+oe�t
IN�_ECTION NOTICE
City of Tigard Building rkipartowmt
1112S 811 Hall Blvd. Tigard, ()Y.vgon 9722
Inspection Line (A G-O-Phone)t 639-4175 Business Ph 39-41
Inspection:__
Footing 71bg. Onderslab /!Tech. Rough-in Appr/sdwlk
Found. Plbg. Top Out Gas Lino C C FINAL:
Post/Beam struct. San. 8awar Framing -Bldg.
Post/Beam Mech. Rain Drtin Insulation -Plumb.
Plhg. Underfloor Nater Line Gyp.
Gyp. ed. -Mach.
Date Requested: /)_ Y /Times
Addrons: / ��y-'- Olit �t 7r
Builder:^ a T
TRE FOLLOWING CORRECT;oNB ARE RxQuIREDt
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InspactortDatet � /7 C�'
v� PROVED D78APPROVED APPROVED SU CT
TO to VE
_ _Call For Reinap.
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I_ISPECTION NOTICE
city of Tigard Building Departsient
13125 OW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): /:39-4175 Business Phone: 639-4171
Inspect tont --
looting Plbg. Underelab Hech. Rough-in Appr/SdwLk
round. Plbg. Top Out Gas Line FINALS
Post/seam St.uct. San. Sewer Framing -B1QQ.
Post/Bram Rech. Rain Drain Inaulation -Plueb.
Plbg. ondarfloor star Line Gyp. Rd.
Date Requestedt Tite: AN PM
1L _
Addresst f1Z7-dy'y7 J _ Permit It
Builders
THE FOLLOWING CORRICTIONS AR! PJWIRIDt
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44
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------ �< r --- -
Inspectors-4f.2101- _ Dates_ Z '
APPROVEDy DISAPPROVID _ APPROVED SUBJECT TO ADO"
' L'- Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
1.3125 SWBall B rd. Tigard, Oregon 97223
Inspection Lina (Rec-O-rho )t 639-4175 9uninese Phone: 639-417.1
Inspections ----__.—_--
rooting Plbg. UtSderslab Mech. Rcugh-in r/8trrlk '
Found. Plbg. Top Out Cap Line 7IA11Lt
Post/Ream Struct. Ban. sewer Framin3 -Bldg.
Post/Beam Mach, Rain Drain Insulation -Plumb.
Plbg. Underfloor ///Nater LLM Gyp. Bd. -Mach.
` Date Requestedt _ / -_�' —Time: AM PN
Addreset /LJ'�L�'/ �ZD Permit #t
Bul:der:
THE FOLLOWING CORRECTIONS ARE REpUTRSJt
CL
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Inspector:__ ��7�7 M 1 hl�nL Date:_ �^
_/APPROVMD DISAPPROVED APPROVED SUBJECT TO rBOVE
-- Call For Rainep.
I tLSSg_EC PUON- NOT_
City or Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Businege Phone: 639-4171
Inepoction:__— _
Footing Plbg. Underelab Mach. Rough-in '�JawlxFound. Plbg. Top Out Gas Line
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet./Beam Mech. Rain Drain Insulation Plumb.
P1bjj. Underfloor Water Line Gyp. Rd. 4ftch.
Dato Requested: 5 } __TiM PM
Addi:nee: /LO �7 �a Permit #s
T—e -
nuilders
THE FOLLOWING COMMONS ARE RRQUIRED:
41tmU11L SUGAR 1c
' To 92e TE C-r_ /ZINGS L
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N
47
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Inspector +42�.---_.-- ---- Date:-5- z-J -!2
APPTAOVBD DISAPPROVED _APPROVED StIBJECT TO ABOVE
_Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
1312'5 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Hoch. Rough-in Appr/s,dwlk
Found. Plbg. Top Chit _as Line FIN>LL:
Post/Beam Struct. San. Sewer trasfing -Bldg.
Post/Beam Hoch. Rain Drain Insulation, -Plumb.
Plbg. Underfloor Nater Line Gyp. •d 1 -Hoch.
Date Requested: / G!��
Time a �AM�/ p PM
Acldrews: A L tr' r Permit #s 2
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Builder: —
TRE FOLLOWING CORRECTIONS ARE REQUIREi?s
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Inspeotore - - Data.
APPROVED DISAPPROVED APPROVED SUBJECT TO APX"
Call For Reinsp.
iw�w�nwe
INSP =_ ON NOTICE
Citr of 'Tigard Buildi-ng W;4mrtment
13125 SW Ball Blvd. Tigard, Oregon 97223
Inopection Line (Rec-O-Phone{: 639-4175 Business Phone: 9-4171
Inspect ion:_.__ _—_—
Footing Plbg. Underelab beth. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct., San. sewer Framing -Bldg.
Post/Beam Meeh. Rain Drain <�Insulation -Plumb.
Plbg. Underfloor Nater Line gyp. Bd. -Mweh.
Date Requestadt / TSMt AM �) /CPN
Addrean: PYIOit ft
Builder:
THE F?LL(7WING OORRECTIONS ARE REQUIREDt
Inspectors -------------_-_-- hates ���
APPROVED V DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INSPECTION NO`T'ICE
city of Tigard Building Department
13125 SN Ball Blvd. Tigard, Oregon 97
Inspection Line (Rec-4-Phone)s 639-4175 Business P e 639-
I nspect ions
Footing Plbg. Underelab fBoh. Rough-ill Appr/Sdwlk
Found. P.Ibq. Top Out au L,in FINAL:
Post/Bat-. Struct. San. Sewer lreminQ -Bldg.
Post/Beam He-h. Rain DraLn Insulation -Plumb.
Plbg. Underrloor Nater Line oyp. Bd. -Koch.
Date Requesterd& �{^-I V ��J- Tlmes /� PH
Address: l ldI I V ! Permit 1: I I I
Buildort_L � 7� ✓��' I
THE FOLLOWING COPPACTIONB ARE REQUIRF.Dt
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Inspector: Datet C
AlpwOV/D DISAPPPrMRD APPROVED SDQ'!"T TO ABOVE
Call For Relnep.
INSPECTION NOTICE
City or Tigard Building D"rtwent
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-•Phone)s 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mach, Rough-in Appr/Sdwlk
Found. Plbg. Top out gas Line FINALS
l
Post/Beam Struct. Sfin:-A6w6r Frami,:g -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Ed. - h.
Data Requestedt �� (Y-`' _Timet AN ply
'''_Z- T�Z /y9
Address• -! ( Permit t�
Builders
THE FOLLONINO CORRECTIONS ARE R1QD21llaDt
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to - ---
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Ls./
rnspacto �_Z _ _ ----- _-- Oatet _ a
APPROVED _^_ DISAPPROVED APPRCYED AUBJRCT To Ago"
Call For Reinep.
INSPECTION NOTICE
City of Tigard Bulldin; Department
13125 SW Ball Blvd. Tigard, Grogan 97223
Innk�ectian Line (Ree-O-Phone): 639-4175 Busi.neas Phone: 639-4171
Inspection:
Footing Plbg. Unders).ab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top out Gas Lina FINAL:
i
Post/Beam Struct. ion: SeWor Framing -Bldg.
Past/Beam Mach. �a �Dta n Insulation -Plumb.
Plbg. Underfloor DE , Oyp. Id, -Meth.
Date Raquested: (� o Tunas AN PH
Addresaz ��,,� JM�j &n /6- Permit #x
Builder: I
1 " 0\ 1
THE FOLLOWING OORRECTIONS ARE REQUIRED:
VA--j
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Inapec tor:f?
Dates
%— VE
_ APPROD DrdAPPROVED APPRd1RJ EDEJlCT To AEDVE
��//���///����" Call for MLnap.
j.NSFECTION NOTICE
city or Tigard Building Department
137.25 SA Bali Blvd. Tigard, Oregon 47223
Inspection Line (Roc-O-Phone): 639-4175 Business Phone: 639-4171
I nsk�+ct ion:
tooting Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
round. Plbg.
Plbg. Top Out Gas Line FINhL:
�Oeclesasn at�t@ San. Sewer Framing -Bldg.
c �
et/Same l�ip� Rain Dra).n Insulation -Plumb.
!]I�q Dnleirt1 c Nater Line oyp. Rd. -Hach.
Date Requested! -L//% 3 _ Time: A�1
Addrese: 3' }' O? Permit to 3—d I ri 9
Buildern� �(
TM POLLMM 001tw-TIONS ARE REQUIRED:
fY
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Inspecto
r: � _ Date: �7
�L.__APPROVED DISAPPROVED *PPR()VED SUBJECT TO ABOVE '
call For Rsinsp.
INSPECTION NOTICE
City of Tigard Building Depart--nbm
13125 SW Ball Blvd. Tigare, Oregon 9'7223 C
Inspection Line (Rec-O-Phone): 639-4175 5usinesst Phone: 639-4171
Inspections
ye'o�t_i q) Plbg. Underelab Mech. Rough-in Appr/suwlk
-found. ilbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Iueulation -Plumb.
Plbq. Underfloor Water Li • Gyp. Bd. -Mech.
Dat" Re estedt� f/��--Times�.�C/cx _PM
t�- C_
Addraest_ z t �� �� l Permit
Builder:
THE FOLLOWING CORRECTIONS ARE RSQUIRMot
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Inspector: —Det �J
__ APPROVEC DISAPPROVED _4 APPROVED BUBJRCT TO A
__Call tar Reirep.
INSPECTION NOTICE � Tv
City v,f Tigard Ruilding Department
13125 SW Hall Blvd. Tigard, Oregon 972
Inspection Line (Rec-O-Phone): 639-4175 Bueinems Phone: 631-4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwik
Found. Plbg. Top Out Gas Lina K�_ PINns
Past/Beam Struct. San. Sewer FramingBldq.�
Poet/Roam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line
0". Bd. -Mech.
Date Requested: f 6 -24-13 Times AM Q PK
Address: I lit J�i� I0-7f�N (/(/ Permit f:
7CjBuild..r: l— qS-7y
THE FOLLOM?NO CORRECTIONS ARE REQUIRED:
V)
F-
:In-pect;
J
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APPROVED DISAPPROVED APPROVED STJM7-F T TO ABOVE
__Call For Reinsp.
CI TM OF T i GARD CERTIFICATE OF
COMMUNITY DEVILOPMRINIT DEPARTMENT OCCUPANCY
13th 4W Hall IW4,T190d,0mW PERMIT #. . . . . . . i MST93-0191a
6 3 DATE ISSUED: 06/28/93p
PARCEL: 2GI150A-08800
I I E ADURESS. 16 349 SW 107TH CT
SUBDIVISION. . BERKLEY ESTATES t ZONINGt
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :020
C:1_A53OF WORK. sNEW
TYPE OF USE. . . :8F
OCCUPANCY ORP'. :R3
OCCUPANCY LOADi224 4
TVINANT NAME. . . :
Remarkni PATH I
Owners
JOY MILLER
F-1hone #i
Contractor:
JAY MILLER
PO BOX 23291
ITGARD OR 97281
Phone #s 664--7'543
1, ,y #. . : 30109
uucupancy of the above refert-mced building Is hereby given, and certifies
the c-,omplianup with the State Of Oregon Specialty Codes for the group,
occupancy, arld Use under which the referenred permit was issitpd.
FIRE DEPARTMENTin-ING k, CTOR
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lg%bI L I ~ I AL
POST IN CON9PICUOUS PLACE
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CITY CSF T I GARDRIFFS ER PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERlylli'
13126 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639-4171 DArE iSSUED: 04/1e/14
231
ZONING:
)LI,. . . . . . . . . . . LUT. . . . . . . . . . . . . .OLO
BU11 DING
1.ii:-UL:M 13)T 9 2-0,_-,,;0 DWEI-LING UNIIIS-. 1 DASEIILNT . . . . . . . ;0
WORI&,,. NEW BEDRIISi:4 El AT F IS):3 GARAGE. . . . . . . . . . ..438
REQUIRL D
OF: !.;Fora.. . . SI' `L00 R ORLAS
OF (_OkEil'. :5N F*IRST. . . . - 1034 5f LEF T 5 IF t FRIGHT, b ft:
JIPCINL'y GNP. .ti,.3 SECOND. . . :696 F4,,,)NT LO f-t R E A F<.
�1 LS. . . . . . . : TH I RE). . . . :0 S-F REUU I RED--
,31 . . . . . . . . . s_'4 ft TUTAL - ---- 1930 5 1 i;11 KE D ET FEL T 0 R 53.
LDOD. . . . .40 psf VALUE. . . . , 96664 PARKING SPALES. . : I
. . . . . . . I'LJOR DRV � 0 BACKV'LOW PRIEVIITRI.': . :0
,)TORIES. WAT _R HEATc.Ps. I TRAPS. . . . . . . . . . . . . . ..0
131 QWLRa. . . . RAY6., I CATCH :-AASIN6. . . . . . . ..0
CLOSE' I S. .3 SEWER LINE: ( ft ) . .0 GRE PSE TRAPS. . . . . , . -0
HWASIHER�3. WATEP LINE (ft ) . 1.00 Q T i i EJR F''I X T U R E 2. . . . . ..Vk
AAGE D 1 1ar-,. - I RAIN DRAIN (f-t ) . s0
3117 N 1)R(q I
FELE
UNIT HTRG. . cVo type _R m u un t to 'mL tlpr4j
VENTS cO TI i $ 1460. 00 JH 04/IL/93
I I\lr-1,J i 0 1:1 T U VENT' f-PN5. .4 LAP ij T $ 4EII4. 0111 iH 04/1"'/')a
10 < HOODS. . . . . . a DPLL $ 40. LAO J L i- 04/011 9 y 133E.;,jj
:40OL)STOV .0 LA 11:1,ID c $ c'-I- k_'O JH 04/1c?/9:.
11-0 DRYERS. : a 15SIXIL it L80. 00 JH 04/1:/9,i
ati'-1r-41, U,!J,"1 33: 1. P.,A FT 1/, 1 i00- 00 Ji 1 114/1. "1'.),L
GAS 0UTL_L ': ;'.4: i MPRI 4,a. SO .11-4 04/1 /43
10. 86 J1,1 04/ lall)
m 5 r",c E. 16 JH 0,1- ,,I IL/'.,
PIP R T 15A1- V,li, JH 04/ 10:/9.5
P5PC 3 7. 75 JH 12114/1a/93
v.
TOIAL.
1: 14 16 k ,L;.F-rt t I t; I !egulat Wig contained in the RLOUIRIED INSPEL4101\Ilb
I CD girl_ Ywnicqal LjdF, 3tatf of G11. Specialty Coots mo all other r:'onct/found Insp Fiv,eplaLF? ITISI
at;c law-. i,.' mark will be im in accordance With approved V"OSt/Flearl) Struct. Gas Line Insp
i,5. mis P1.11 expire if ",-rk is not started within IN Post/Beam "echan Insulatio-i Ins
i S P, ci if wcrk, 15 susottjdfd f 61, We t4an 186 days. Plm/undslatj Insp flyp Boat-d Ins,
I 1�,�Umdei f I uot, Rail, dr-ajj�j Ill,%p
i�j 1116P Wa t e v- L i 71 e ns P
Top Out fimtrl
t- M(z
639 -417:::
CITY OFTIGARD PERM I #.._... i . .. . . . . .
COMMUNITY DEVELOPMENT DEPARTMENT OATL ISCZUED:
13126 SW Hall Blvd.Tlgari,Oregon 97223*8199 (503)839-4171
E J4,ij1)RL8cL. . . : 16, 49 SW k O..'TH C' PARCCL; LS115AA-
JPVIVISION. . . . � ZONING-
.li—OLV. . . . . . . . . . .. LU I.. . . . . . . . . . . . . lzi 2 Of
'NAiqT NAME:. . . . .
P NU. . . . . . . . . . : FIXTURE 01'W'S. . . I
OF, WORIJ11. . . .Nr-W DWEt-L I NO UNI 1-6. . : 1.
,T,L OF USE. . . . . SF NO. OF FAUILDINGS: 1
Pr:,. . 111PERY SURFACE. . 5 1,
FEES
MILLED type famul.,lit by dAt e I'e P
PRMT $ 2100. 00 JH 04/12/93
—
I NSP $ Z5. 00 JH 04/ la"L,/ 03
!011e
are #. Is 21"35. 04) 10 1,01-
REUUIRED IN(bPECTIONS
,5 Applicant agrees to czaply with all the rules and regulations ":.'eWer- Irlspec:tic)n
the UnifiaG 5ew;ge Agency. The Fe,mit expires 160 days free ---
tate iss,ied. itiv total amount paid Mill be forrcited o, the
empires. ',,it Agency does not guarantee the accuracy of the
ewer laterals. If the sewer is not located at the measuresent
4eil, the installer shall prospect 1 feet in all directiu�,s fioe
e diszarci giver. V not sr, located, the installer shall purchase
7&p and G;de Sewer" Perait and the A4, y will initail a lateral.
C,.k.; l fui- iiisperm tioti 639-41*751
rL,
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CITY Of TIGARD — RPUEIPT OF POYMENT RECEIPT NO. -93-�-301)30
CHECK AMOUNT s 5039. 51
NAME : JAY MILLER Bl_DR, INC CASH WOUN-F 0. 016
ADDRESS c PO BOX P3891 PAYMENT DATE s 04/12/93
T WARD, OR, SUBDIVISTON
l?
VURPOSE OF' PAYMFNT AMOLIN't, r,f)I D PURPOSE OF PAYMENT AMOUN I' Pf
BUILDING PEQ'Im 4G'4. 00 PLUMBINS, PERM 151:0. IMA
MFCHANICAI- PE 43. 50 ST. SUll.-D PER '31. 1:3
VILAN CHECK FE 10. 88 SEWER. USA 100. 00
';EWER I WiVIEUT 55- 00 PARKS SDC 500. 00
Lo 'Y ORM DPA IN GDC 880. 00 RCS IDENT IAL FRAFFIC FEES 1.2,50. 00
MASS TPANS IT I IF FEFG, 110. 00
TOTAL AMOUNT P41 5039. 51
CITY OF
TI GARD „PO Box H23397
PLNCK/RECT
COMMUNITY DEVELOPMENT DEPARTMENT Tsgsr4Oregm9n13 PERMIT #
(SM)61""1 DATE ISSUED
JOB ADDRESS: L 2-)41 ���' -\`� �1� (`- _ TAX MAP/LOT S 1 1 5-119 -- 0 5700
SUB: _ ( ' \ ItT� Mry) LOT: ?-0 LAND USE:
VALUATION:
OWNER SPECIAL NOTES
NAME: Y� V-)Vu REISSUE OF: M5 �9Z.v 230
ADDRESS: ' �JC}1( �'�'c. LAST REISSUE: _
�� Cl-,. 1`7'-g k FLOOD PLAIN/
PHONE: (L�P 4 SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME: ,)` -\ C PLANNING: 6'4"-
ADDRESS: ENGINEERING:
FIRE DEPT:
PHONE: OTHER:
CONTR. BOARD #: -_ 1 EXP DATE: 2 `�
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: _h-yn \Ya-ki rbL LIST/SUBCONiRACTORS: —
MECH: 1'_ 11 HCLIX-unS4 BUS TAX:
ARCH/ENGINEER 0 CALCULATIONS:
NAME: TRUSS DETAILS:
ADDRESS: OTHER:
PHONE: _
PROPOSED BLDG. USE:
COMMENTS: l'
n r t_ �.
APPt (CANT SIGNATURE
Received By: A, Date Received: �_` 3
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
3- ( y 10-432 00 Building Permit Fees 41.2 .vv
I0-431 00 Plumbing Permit Fees 5�, �0�
10-431 01 Mechanical Permit Fees it 3•)7) _ 3 >Z
10-230 01 State Building Tax (5%) 3113 1.� 3
Building
Plumbing
Mechanical _ ,�. I Y!/
10-433 00 Plans Check Fee
Building
Plumbing _
Mechanical /
10-230 06 Fire
30-202 00 Sewer Connection s i j _ — J21U d
30-444 00 Sewer Inspection .3> _ _ 3 7
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 13S U 13.50
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC) �� �u
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 Sp • ', ��� SG
nm/3587P.WPF