Loading...
16408 SW 107TH COURT ADDRESS: 116408 s w ojar## ou 4 a rc w V" r� ua 1:lreoordsl7iicrotlmltn rgels u.)uiiding.doc CITY CSF TiGARD COMMUNITY DEVELOPMENT DEPARTMENT CERTIFICATE". OF 13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (a03)63H-4171 OCCUPANCY xxxx PERMIT #. . . . . . . n u39--4171 DATE ISSUED: 02/03/93 PARCEL: 2 S1 13AA--IZ0400 T.TL. ADDRESS. . . : 16408 SW 107TH CT JPJIVISION. . . . a BERKLE:.Y ESTAT-S ZONING: +111-K. . . . . . . . . . . LOT. . . . . . . . . . . . . ..0116 .ASS OF WORK. -NEW I Yt-"L OF USE. . . :Sr:.- OCCUPANCY F.OCCUPANCY GRP. :133 OCCUPANE.Y !-.OAD: i 18 4 TENANT NAME. . . : Remarks: PATH I JAY MILLER BUILDER INC P. F.J. BOX 2 291 LUARD LIFT 97281 ;lone #: 8847543 ontractnr: _..__._..__.._..__._.-_..._._. .__...__......_.. ._.._..._..__.__...._... QY MILLER 13 BOX c!30459 IGAPD OR 17281 horse #: 68-4-7543 q g it. . a 30109 ccupancy of ti,e mbove r•efew-enced building is hereby given, and cei-tifie Ise cumpliance with the Otate Of Oreyon Spec.-ialty Codos for, the yr^outs, -cupancy, and uee under which the referenced permit we+s isF1..ked. -4 1:tiU L.DIN(� ISPECT X183JILDINO C]FF"1C ► 1. POST IN C:I:.NS)P I CI..IOUS PLgC►w a 1) J INSPECTION NOTICE City of Tigard Building Departasene< - 1317.5 SW Hall Blvd. Tigard, Oregon 9122 Inspection Line (Rec-o-Phone): 639-4175 Buaine©s Phone: 639-4171 Inspection: Footing Plbg. Underslab Mach. Rough--in Appr/Sdwlk Found. Plbg. Top Out Cas Line FINAL: Poet/Beam Struct. San. Sewer Framing - ld . Poet/Beam Much. Rain Drain Innulation -•Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Lech. Date Requested: / /' /, n -Time: _^AM _PJM Address: /!J ` Permit Builders 22 i:t--� / THE FOLLOWI:': CORRECTIONS ARE REQUIRED: ! to n. F-- N - J 111 J Inspectors APPROVRD DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinap. INSPECTION NOTICE City of Tigard Building Department 13125 SA Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-41 Inspection: r/N/I �_ Footing Plbg. Underelab Hoch. Rough-i:: Appr/Shc.lk J Fo+md. Plbg. Top Out Cas Line FIP'nL: Pust/Beam Srruct. San. Sewer Framing -Bldg. Post/Beam Hoch. Rain Drain [neulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Hach. Date Requentedi �` 3 ✓ 6 Time: ---AH PH Address:— 40 7-C, y C) 7, C/ �— Permit f:--ola, Builder:— THE FOLLOWING CORRECTIONS ARE REQUIRED: �-,`'• ��G'ISL`. <�'�NCti'ET� F.�GN� /�/�C'UN�J _. _ 3 5L) 6 G EST Hozp/NG-- C. QF c- . GANnL _ M IgE. C4.5 Lei! Ir vx Inspector:- L /1A 7110MLj'_�. Date: '7-- --r' -- APPROVED _�D SAPPROVRD APPROVED SUBJECT TO ABOVE �L'ell For Reinsp. INSPECTION NOTICE City of Tigard Building Department. 13125 Sit Hall Blvd. Tigard, Oregon 97223 Inspection. Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: Footing Plbg. Underal.ib Mech. Rough-in Appr/Sdwlk1 Found. Plbg. Top Out Gas Line FINAL: Post/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mech. Rain Drain Insulation Plumb. Plbg. Underfloor Water Line 7 Gyp. 8d. -iiech. Date Request//e__dt 1-4" `_� _I_-_Tisoes -XAM 11'Z_PN Address: l�L.1 l� (� I c 1 Permit f s`�>_ OZ20 Builders THE FOLLOWINO CORRECTIONS ARE REQUIRED: N f- U' Imo! Inspectors Lf� 04 nes /LS _._.. Dato �APPRO{(t0 DIBAPPROVED APPROVED SUBJECT TO ABOVE Call Por Reinnp. INSPECTION NOTICE City of Tigard Building Department 13125 SW Hall, Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: -- Footing P1.bg. Urderelab Mech. Rough-in (, v ARpr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post/Beam Struct. San. Sewer Framing -Bldg. Poat/Deam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor water Line Gyp. Bd. -Nech. Dare Requeot/ed-s I ( � _ Z- Times J111 �1-1"—PH Address: IIL�a75� 7I b� Permit 012 B::ilder: T1lE FOLLOWING CORRECTIONS ARE REQUIREDs 4 a — - Y m w J Intl zctors ✓t//! _ Date:._ APPROVED DISAPPROVED �PPROVED SUBJECT TO ABOVE Ca 11 For Reinsp. INSPECTION NOTICE City of. Tigard Building Department 13115 SW Hall. Blvd. Tigard, Oregon 97 Inspection Line (Rec-O-Phone): 639-4175 Business qPde: 639-4171 Inspection:__ -___ booting Plbg. Underelab Hoch. Rough-in 71ppr/Sdwlk Found. Plbg. Top Out Gas Line :LNAL: Poet/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Water GyGyp. Bd. -Hoch. Date Requested:- G•� - 2-- Times ) PH Address: L �y ? � Permit d Builder:_ �L.•L+ / �` THE FOLLOWING CORRECTIONS ME REQU [i v'1 H cc 1 11U1 i Inspecto s _ ----- --- nate: --- _- -_ APPROVED DISAPPROVED APPROVED SUBJECT TO ADOVE __Call For Rei.nsp. INSPECTION NOTICE_ City of Tigard Building Department 13125 TW Ball Blvd. Tigard, Oregon 97223 Inspection. Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: --- Tooting Plbg. Underslab Mech. Rough-in Appr/Sdwlk 1 Found. �bg. Top Out Cas Line FINAL: Post/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mech. Rain Drain Insulation �� -Plumb. Plbg. Underfloor Wat,3r Line Gyp. --Mech. Date Requested: . `� 2 Time: _ AM _ PM Address.-___� / }l / Permit t:� -� 1 Builder: �t.(��`/ THE FOLLOWING CORRECTIONS ARE REQUIRED: Inspecto Date: APPROVED DISAPPROVED APPROVRD SUBJECT To ABOVE C,11 For RPinsp. INSPECTION NOTICE ' City of Tigard Building Department 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639--4175 Business Phone: 639-4171 Inspection: Footing Plbg. Underelab )_e—�h. Rough-in Appr/Sdwlk Found. lbg. Top Out Gas Line FINAL: Post/Beam Struct. San. Sewer Framing g -Bldg. Poet/Bean Mech. Rain Drain Insulation -Plumb. P1bg. Underfloor Water L1ne Gyp. Bd. "�}✓"r G/I�/-Nech. Date Requested:_/ / �. �'I ime` // 7�_AH PH Address: 7 Permit is Builder:— THE FOLLOWING CORRECTIONS ARE REQUIRED: —��c�-'' — �'' •rim Y Impactors` Data: APPROVED —_ DISAPPROVED APPROVED BU&'ECT TO ABDVt Call For Rainsp. INSPECTION NOTICE �f" City of Tigard Building Department 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: v_ _._ —_ Footing Plbg. Gndersl.nb Mech. Rough Appr/Sdwlk Found. Plbg. Top Out Gsa Line FINAL: Poet/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mech. Rain Drain Insulation -Plumb. Plbq. Underfloor slater Line Gyp. Bd. -Mech. Date Requested: _Time: -2�t-AM PM Morena: (/ �� Builder: THE FOLLOWING CORRECTIONS AOC REQUIRED: Inepectori / Date,/_ C �Y _APPROVED -_ DISAPPROVED —— APPROVED SUBJECT TO ABOVE Call For Reinsp. INSPECTION NOTICE City of Tigard Building Department 13125 ON Hall Blvd. Tigard, Oregon 9722 Inspection Line (Rec-O-Phone): 639-41.75 Business Pho : 639-4171 Inspection•_ — — Footing Plbg. Underelab Mach. Rough-in Appr/Sdwlk Found. _ Plbg. Top Out Gas Line FINAL: at/Beam Etruct. San. Sewer Framing -Bldg. at/Beam Meoh. Rain Drain Insulation -P1s•mb. IInderfloor Water Line Gyp. Bd. -Mach. _ I /C -� ^� / Date Reesteds qu � /� Tom° Addrees:��yo� //� 7 ✓ `�- Permit !: Builder:_ �22z1f � —THE FOLLOWING CORRECTIONS ARE REQUIRED: Inepector: APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE, Call For Reinnp. INSPECTION NOTICE City of Tigard Building Department 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-0-Phone): 639-4175 Business Phone: 630-4171 Inspection:_^ rboting \ Plbg. Underelab Heca. Rough-in Appr/Sd.wlk , ou� Plbg. Top Out Gas Line SINAL: Poet/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain Insulation -Plumb. Plhg. Underfloor �)Watec Line Gyp. Bd. -Hoch. Date Requested: /(f �� ��� T1.me�-i'�4 —PM `_. Q Address: /(fes �U it 9 L/i� 7 � � Permit ���L Builder:� l���u-! -- — THE FOLIAMING CORRE(.'TIONS ARE MQUIRED: i" Inspector Date: ROVED DISAPPROVED APPP(WFD SURJEC'r TO ABOVE Cell For Reinap. 1NSPECTION NOTICE !�Y City of Tigard Building Department 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639•-4171 Inspection: _ Footing P1bg. Underalab Mach. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL- Pont/Beam Struct. San.-bower--- Framing -Bldg. Post/Beam M.ech. ain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Mech. Date Requestedss�� �+�!`,��•7r _ Time Am —PM Address: �/� L7� O " �- Permit Builder-_ THE FOLLOWING CORRECTIONS ARE REQUIRED: Inspector: - Dates APPROVED DISAPPROVED APPROVED SUEJWT TO AEOVE Call For Reinsp. INSPECTION NOTICE City of Tigard Building Department 13125 Sit Hall Blvd. Tigard, Oregon 9722 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639- Inspection: Yonting Plbg. Underslab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: /Beam 8truct. San. Sewer Framing --Bldg. /Post/Beam Mech.1 Rain Drain Insulation -Plumb. Underfloor` Nater Line Gyp. Ud. -Meeh. Date Requested: �� U " Time: _ 1N �i PH Address:_ ' O �1 Permit #:-/ Z L Z I Builder: 777 THE FOLLOWING CORRECTIONS ARE REQUIRM: -- .ice inspector: _APPROVED DISAPPRO`/ED APPROVED SUBJECT TO ABOVE Cell For Reinsp. CITYOF TIFARD CnYCF so COMMUNITY DEVELOPMENT DEPARTMENT �Inron r'LUM>~+1 NG PERMIT 1312SSWHdl6W.P.O.Elm 23397,Tigeud,Onogw 07723(6W)639-4175 PERMIT ##. . . . . . . o MST'92--012::1'01 DATE ISSUED: 10/12/91: SITE ADDRESS. . .. : 16408 SW 1.07TH CT PARCEL: 2S115AA-BE16 '3UBDIVISIO14. . . . I BE:RKLEY LSTATES ZONING: BL.00K. . . . . . . . . . r, LOT. . . . . . . . . . . . . : 16 CLA'S'S OF WORK. . :NEW GARBAGE D I SPO SALS. . : 1 TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : 1 BACKFLOW PRFVNTRS. . :O OCCUPANCY GRP. . I R3 FLOOR DRAINS. . . . . . . :0 TRAPS- - . . . . . . . . :0 :STORIES. . . . . . . . : 1 WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . uO FIXTURES---____-_...____ LAUNDRY TRAYS. . . . . . :0 SF RAIN DRAINS. . . . . : i i11VKS. . . . . . . . . . : 1 GREASE TRAPS. . . . . . . :0 l._AVATORIES. . . . . :2 OTHER FIXTURE3. . . . . :0 1 UB/SHOWI=RS. . . .-I S SE'WE'R L:I'NE -(ft) . . . . 01 14ATF_R CLOSETS. . -.2 WATER LINE (ft ) . . . . 1 100 - 1,I SHWASHE RS. . . . 1 1 RA 1 Iv DRAIN (ft) . . . . A M remark, : PATH I 1 OWNER: JAY MILLER Bl.1tI....DE.R INC rIF t 1` 60. 00 JH 10/12/92 — ti P. Cl. BOX 23291 BPRT ! 364. 00 JH 10/12/92 — BPLC: f 40. 00 X-1-1 09/-:5/92 232,41.38 i IGARD OR 97a81 B5PC 113. 20 it-I 1011211. — Phone #1 68475)43 SSDC 260. 00 JM 10/12/92 -- PARK 500. 00 JH 10/12/92 — �'lumbing MPRT ! 40. 50 JH 10/ .12/92 MPL.0 ! 10. 13 JH 10/12/92' — " lames _ i,Ql�.__.Sd.L t �rt�_. �..._ 015PC ! 2. 03 JH 10/12/92 — ,Ll1..1r•-I:!ee1 ._._ _ >VIRT 3 .117. 50 JH 10/X/92 .. :ity1 _ ~State : P5PC ! 5. 68 JH 10/12/92 _.'i PA REQUIRED INSPECT4014S this permit is issued 1sub,ject to the 'reg--- l.1laati,o-rts containpi in the Tigard hluniCipal Foot/found Insp Rairl drain Inst. i:ooe, Stat e , Ore. Specialty Cades and all Past/beam StV-?art Water Line Inst.) other applicable lawn. All work will be donp Post/Beam Iviec-han At'ipr•/Sdwlk Insp in accordance with approved plans. This P1m/und!slab Insp Mechanical Final V) permit: will expire 1.f work is not strart pd PLM/Underfloor Plumb Fi n€11 within 1.80 days of is3e_iance, or if work is Mee:hanical Insp Buildinq FinFl suspended for more than 180 dAys. Plumb Top Out Et- oafon Control Framing Insp (:trawl Drain Fireplace insp ✓`� (Sas Line Insp Inaulmtion Insp x (3yp Board Insp ,'A1.0!h.)-i2ed Pl�tml>>nq Contractor Signature Call for, in-Ijef-kion - 539-4-175 nntralrtor CRY TIGN OF RD D1 COMMUNITY DEVELOPMENT DEPARTMENT MlooN 13125 SW Hrl Blvd. P.O.B.t 23397.Tlpad.Orepon 97223(5M)&30-+175 MASTER PERMIT PERMIT ,2---a2 639-4171 DATE ISSUED: 10/12/92 SITE ADDRESS. . . : 16408 SW 107TH CT PARCEL: 2S115AA--BE16 SUBDIVISION. . . . : BERKLEY ESTATES ZONING: FLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 16 --------------------------------- BUILDING -------------------------------------- REISSUE:MST92-0153 DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 sf CLASS OF WORK. :NEW BEDRMS:3 BATHS:?_ GARAGE. . . . . . . . . . ..635 sf TYPE OF USE. . . :SF FLOOR AREAS---------- REQUIRED SETBACKS----------- TYPE OF CONST. .-5i4 F I RSI-. . . . : 1424 sf LEFT. . -.9 ft R I GHT. : 10 ft OCCUPANCY GRP. :R3 SECOND. . . :0 sf FRONT. :20 ft REAR. . :25 ft STORIES. . . . . . . : 1 TIIRD. . . . :0 sf REQUIRED- ----------------- - HEIGHT. . . . . . . . .. 18 ft TOiiL------: 1424 sf SMOKE UETECTURS. :Y FLOOR LOAD. . . . :40 psf VALUE. . . . . 1: 76934 PARKING SPACES. . : 1 Remarks: PATH I ------------------------------------ PLUMBING SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTR5. . :0 LAVATORIES. . . . . :2 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0 TUB/SHOWERS. . . . :2 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . :0 WATER CLOSETS. . :2 SEWER LINE (ft) . :0 GREASE TRAPS. . . . . . . :0 DISHWASHERS. . . . : 1 WATER LINE (ft) . : 100 OTHER VIXTURES. . . . . :0 GARBAGE DISP. . . : 1 RAIN DRAIN (ft) . :0 WA13H I NG MACH. . . : 1 SF RAIN DRA I NS. . : 1. -- ---___ .------ MECHANICAL ---------------- ---------------- FEES -------------- FU'-ZL YPES------------ UNIT HTRS. . :0 type amount by date reept /CAS/ / / VENTS . . . . . :0 TIF f 1460. 00 JH 10/12/92 - M,aX I NPUT:0 BTU VENT FANS. . :3 BPRT $ 364. 00 JH 10/12/92 - FURN ( 100K . . : 1 HOODS. . . . . . : 1 BPLC f 40. 00 JLH 09/25/92 232038 FURN ) =100K . . :0 WOODSTOVES. :O B5PC $ 18. 20 JH 10/12/92 - FLOOR FURN. . . . :0 CLO DRYERS. : 1 SSDC $ 280. 00 JH 10/12/92 - BOIL/CMP ( 3HP:0 OTHER UNITS: 1 PARK t 500. 00 JH 10/12/92 - GAS OUTLETS: l MPRT t 40. 50 JH 10/12/92 - Owner: ------------------------- -------•--- MPLC $ 10. 13 JH 10/12/92 - JAY MILLER :BUILDER INC M5PC t ?_. 03 JH 10/12/92 - F'. O. BUX 23001 PPRT t 117. 50 JH 10/12/92 - P5PC a 5. 88 JH 10/12/92 - TIGARD OR 97281 Phone #: 6847543 Contractor: -----------•------------------- JAY MILLER PO BOX 23291 ►'- T I GARD OR 97281 Phore #: 684-7543 Reg #. . - 30109 -------------------------------------- LL s 2838. 24 TOTAL - This permit is issued subject to the regulations contained in the --- --- REQUIRED INSPECTIONS ------- Tigard %ni_•ipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Fireplace Insp applicable laws. All Mork will be done in accordatce with approved Post/Beam Struct Gas Line Insp plans. This permit will expire if work is not started within 188 Post/Beam Mechan Insulation Insp days of issuance, or if work is suspended for more than 188 days. P1■/undslab Insp Gyp Board Insp / �C� PLM/Underfloor Rain drain Insp - Permittee Signaturer � ' - _PX M Mechanical Insp Water Line Insp Plumb Top Out Appr/Sdwlk Insp Issued By. Framing Insp Mechanical Final Call or inspection - 639-4175 CifiOFTIFARD COMMUNITY DEVELOPMENT DEPARTMENT ���� ;EWER CONNECTION 1317.,SWFWIBlvd P.O.Bac 23307, PERMIT ?i0rd,Onpon 07223(603)630-4175 PERM 92-0312 639--4171 DATE ISSUED: 10✓12/92 SITE ADDRESS. . . : 16408 SW 107TH CT PARCEL: 2S115AA—BE16 SUBDIVISION. . . . : BERKLEY ESTATES ZONING: BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 16 --------------------------------------------------------------------------------- TENANT NAME. . . . . : USA NO. . . . . . . . . . - FIXTURE UMTS. . . . CLASS OF WORK. . . :NEW DWELLING UNITS. . : 1 TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1 INSTALL TYPE. . . . :BUSWR IMPERV SURFACE. . : :sf Remarks: PATH I Owner: ------------------------------------- ---------•------- FEES -------------- JAY MILLER BUILDER INC type amount by date recpt P. O. BOX 23291 PRMT $ 2100. 00 JH 10/12/92 — INSP $ 35. 00 JH 10/12/92 — TIGARD OR 97281 Phone #: 6847543 Contractor: -------------------------------- CONTRACTOR NOT ON FILE 111)o n e #: $ 2135. @@ TOTAL -- ----- REQUIRED INSPECTIONS ------- This Applicant agrees to comply with all the rules and regulations Sewer Inspection of the Un-i<ied Sewage Agency. The permit expires 189 days frum the date issued. The total amount paid will be forfeited if the _ permit expires. The Agency does not guarantee the accuracy of the - side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase _ T a 'Tap and Side Sewer" Permit and the Agen,:y will install a lateral. PPrmitt;�e Signatureml 'C_ .PGS C' F Issued By:Ln � Call f=or inspection — 639-4175 w LD '1' i 1-2 CITY (IF TICARD RECEIPT CIF PAYMENT RECE I PT NO. -.92-2.32604 CHECK AMOUNT 2 4933. 24 NAlyll' MIL-lA-"Rq JAY CASH AMOUNT c 0. 00 ADDRESS a PAYMENT DATE : 10 lt' 92 I GUSD I V IS 1 ON 1-11ROOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID P E-RMww� 364. 01? PLUMBING PERM 117. 30 I COL PE 40. 50 ST. BUILD PER girl. I I AN CHECK FE 1.0. 1;3 SE 14ER USA 2100. ola f.WF.R INSPErr 35. 00 PARKS SOC 500. oel i0RM DRAIN SDC 280. 00 RESIDENTIAL. TRAFFIC FE 7 Q 1 LAO TRAW-'ilT TIF Fr-'ES 110. 00 LUT 16 r%ERKI EY ESTATES t6408 SW 107"m CT TOTAL AMOUNT PAID 4933. 24 C;I-FY OF TICARD RFCFIP"F' OF V'OYMPNT PFCEIPT NO. L"3 O38 CHECK Alvl(3[Jt\l1' 4.0. 00 NAME c JAY MILLER 81-DR, INC. COSH (-)MOLJNI' c 0. 00 A T)1.)R L.C,4 s : P(j BOX 23291 PAYMENT DATE:` 09 J,F9 -rlofi-Ro, OR SULAD 11)1 S f ON PURPOSE- OF PAYMENT AMOUNT PAID PURPOSE OF PAYMEN'r AMOUNT PAID Ln Pol.-AN CHECK rF 9-71 P 40. 00 E51 ATP:i 1 1.0 T I.IS ,-�UF OP MV11 THEW PARK, L.01- 17, 1-(3TAL. AMOUNT PAID 40. 00 »125SWH,urea. PLNCK/RECT OL-7/ 2- _2 3�USO CITY OF TI GARDPO Box 23397 COMMUNITY DEVELOPMENT DEPARTMENT TWrd.orcgon97S23 PERMIT # h157`�i _ (S0`)63"171 DATE ISSUED JOB ADDRESS: leaY Sk, 16 '7 1-% e . TAX MAP/LOT ;-516-411 - 13C 4 SUB: rbC I u �.�{a-ta LOT: I�p LAND USE: VALUATION: OWNER r` - 'slue a( 13- matti�w l=kLj v, SPECIAL NOTES NAME: -I Nn'Ll rt)tA(, . enc . REISSUE OF: ADDRESS: 1 • O. 1;,,X 2-32.91 LAST REISSUE: A C'(7 281 FLOOD PLAIN/ PHONE: LoLP4 - -759 SENSITIVE LAND: CONTRACTOR APPROVAL5 REQUIRED Sub NAME: _ GJaL ry-e- PLANNING: 'l- ADDRESS: I ENGINEERING: FIRE DEPT: PHONE: — OTHER: 71-r CONTR. BOARD #: _ 30109 EXP DATE: 12. 112- ITEMS REQUIRED SUCONTRACTORS: PLUMP: I'-cn Watt) (arae-• LIST/SUBCONTRACTORS: MECE: P-..e ct I-ka-6 na BUS TAX: AKH ENGINEER CALCULATIONS: NAME: _ TRUSS DETAILS: ADDRESS: _ OTHER: PHONE: PROPOSED BLDG. USE: COMMENTS: AA)4/&V(- 1yYz4e GoPy, D,c P 1T '��/�.a c►��c ems-- ho APPLICANT SIGNATURE Received By: ( -` `� e�4 Date Received: 2- PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE M 1-uzZ 10-432 00 Building Permit Fees (ocl.vu 10-431 00 Plumbing Permit Fees Jy 10-431 01 Mechanical Permit Fees yd )-v u. v 10-230 01 State Building Tax (5%) �61( _ �G• II Building /�'-u) Plumbing 5,*-.Y Mechanical ?,o3 10-433 00 Plans Check Fee q0 Building Plumbing Mechanical 10,e3 10-230 06 Fire , o 3iZ 30-202 00 Sewer Connection /V 30-444 00 Sewer Inspection 3�� i 3�� 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 /35-a•do 135u 25-448-05 Mass Transit TIF Fees �i0•Cd // � 52-449 00 Parks System Dev Charge (PDC) 31-450 00 Sturm Drainage Syst Dev Chrg a `, (SSDC) 24-445-01 Water Quality (Fee in lieu of) 24-445-02 Water Quantity (Fee in lieu of) TOTAL nm/3587P.WPF