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16750 SW 124TH AVENUE ADDRESS: I la tl d' In J I rd�r\micr-offrn\taugcts\building.doc c.� w CITY OF TIGARD BUILDING INSPECTION DIVISION �) 24-Hour Inspection Line: 639.4175 Business t hone: 639-4171 C, C� Date Requested: l l l _ A.M. _�-- P.M. MST: Location: ���U / 1- -.-� BUR — Tenant: _ Suite:. Bldg: MEC: Contractor: _ _�--Phone: _ PLN Owner:_ L7 ELC: -- r— ELR: SIT: BUILDING BL' /on't) PLUMBING ELECTRICAL SITE Site - ost/Beam Post/Beam ost/Beam Cover/Service Sewer/Stone Footing Roof UndFJSlab Rough-In L L)6)0 P Ceiling Water Line Slab Framing Top Out Cas LineRough-In UG Sprinkle- Foundation Insulation Sewer I IaxbT)uct S J`�Rec:otmect aulti Bsnit Damp I)rwall Stone Furnace Temp Service L 'C. Masonry Ceiling Rain Thain A/C UG Slab ',I4 Shear/Sheath Firc Spj jr/Alm Crawl/Found Dr I teat Ihunp Low Volt w _C,pp,ovedApproved Approved,, Approved Approved Appr/Sdwlk o ved Not Approved oved Not Approvci 1 v� ` Not Approved If INAFINAL *1 N" FINAL t rf FINAL i IV a - cc Un J Y C7 J _ O Call for reinspection D Reinspection fee of S — quirai eforcnext impection D Unable to inspect Inspector: 1 Date: I ` Page of _ CITY OF TIGARD BUILDING IN:CTIO I'Q'DIVISION 24-Hour Inspection Line: 6394175 Bus.ness Phone: 639-4171 c � Date Requested: _ - �_� / /a.M� P.M. _ MST: c// -C�9 Location: �, _ � /� y�� ( (/ BUP: Tenant: — Suite: _Bldg: MEC:— Contractor: Phone: Y Vy " -3 5-Y LM: _ (honer: .�li,�'yj,(,,rly, Phone: t_ t Q I I,C: N LR:_ SIT: _ BURRING LDG(coni) PLUMBING MECHANICAL ELECTRICAL SITE Site eam Post/Beam Post/13eam Covcr/Service Sewer/Storm Footing Roof Undl'I/Slab Rough in Ceiling Water Line Slab Framing Top Out Gas Line Rough-'In 11G Sprink!cr Foundation Insolation J ewer l low/)ucl Reconnect Vault 13smt Damp va�1r2�����J Storm Fumace 'Temp Service MISC. Masonry Ceiling // Rain Drain A/C UG Slab Shear/Sheath Fire Spklr/Alm Crawl/Fowid Dr Heat Pump Low Volt Approved Approved Approved Approved Approved [Al,pr/,',dwlk Not Approved Not Approval Not Approved Not Approved Not Approved FINAL FINAL, FINAL FINAL FINAL n. L c� w J All - A6ra-1-1 for rein. D Reinspection fee of S__ _--- required before next inspection O I lnable to inslxc1 Inspector: ( I'Age____of CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Phone: 639-4171 � 1 i Date Requested: ' I' A. Q. \ P.M. _ MST: Location: _ •�J 'I _ BLIP: Tenant: Suite: Bldg: Contractor: Phone: 1 � PLiv Owner: Phone: a ? ELR:_ SIT: _ BUILDINGBLDG(coni) PLUMBING MECHANICAL ELECTRICAL SITE Site VosdBefffii PostAleam PostlBeam Cover/Service Sewer/Storm Footing Roof Undl'b h Rough-la Ceiling Water Line Slab Framing Top Out Gas Line Rough-In UG Sprinkler Foundation Insulation .Sewer I food/Duct Reconnect Vault Bsnrt Dampt all NA IE %Storm Furnace Temp Service MISC. Masonry Rain Drain A/C UG Slab Shear/Shcath Fir eNin Ctawl/Found Dr I leat Runp Low Volt Approved Approved Approved Approved Appr/Sdwlk o ppioved Not Approved Not Approved Not Approved Not Approved FINAL FINAL, FINAL FINAL :iNAL CC Lin J C7 C]Call for reinspec T Reinspection fee of S required before next inspection C]Unable to inspect Inspector: ,_ Date: / _ Z I'a _of 1 / 5P6C_7-0/z : Acyls EJEFF POO e T) r-1 V,,f - CITY OF TIGARD BUILDING INSPECTION DIVISION / 24-H%)ur Inspection Line: 639-4175 Business Phone: 6394171 Date Requested: C D'��� A.M. P.M�, MST: 1,0c3tion: i s�) o� 1 BIJP: Tenant:_ — -- Suite: y 2 Bldg: _ NEC: -- — _ — - Contractor:_ Phone: PLM: Phone: ELC: __ _ SIT: BUILDING_ /�BLDcom7t) _PLUMBING MECHANICAL ELECTRICAL SITE Site Post/Beam Post/Beam Cover/Service Sewer/Stonn Footing Roof UndFl/Slab Rough-In Ceiling Water Line Slab <I-rain Top Out Gas Line Rough-in U(i Sprinkler Foundation Insulation Sewer IIood/Duct Reconnect Vault Bstnt Damp Drywall Storni Furnace Temp Service MISC, Masonry Ceiling Rain Drain A/C IJG Slab Shear/Sheath Fire S klr/Alm Crawl/round Dr Heat Pump I,ow Volt r Approved Approved Approved Approved Approved Appy/Sdwlk �tiT7Cpploved Not Approved Not Approved Not Approved Not Approved FINAL FINAL FINAL FINAL FINAL C,C r QDS !1 W C a H— L� W O Call for reinspection 0 Reinspection fee of S_ required before next inspection 0 1 Enable to inspect Inspector: Date: �U -��� �� _ _ Page__—of____ i CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 6394175 Business Phone: 639-4171 Date Requested: ) I-L 1�J -� _ M. P.M. — MST: C) � Locatiol:_ /� -7-S- —_� �`�` _ BUP: _ Tenant: Suite: Bldg: �_—� MEC:_ Contractor.` Phone: _� __�3 PLM: Owner: — 5 (✓ Phone: � � 7 _'61 ELC: ELR: SIT: _ BUILDING BLDG(con't) PLUMBING MECHANICAL ELECTRICAL SITE site Post/Beam Post/Aeiun Post/Beam Cover/Service Sewer/Storm Footing Roof llndFl/Slab ]cough-In Ceiling Water Line Slab Framin Top Out Gas Line Rough-In UG Sprinkler Foundationnsula Sewer Ilood/Duct Reconnect Vault Bsmt Damn Drywall Stonn Furnace Temp Service MISC. Masonry Ceiling Rain]?rain A/C UG Slab Shear/Sheath Lire Dr/Alm Crawl/Found Dr cleat Pump Low Volt Ap1mov Approv�Kl Approved Approved Approved -- Appr/Sdwlk pprovcd Not Approved Not Approved Not Approved Not Approved FINAL FINAL FINAL FINAL FINAL Of Ln Y c w J 0 Call for reins ion O Reinspection fee of S_ required before next inspection C3 Unable to inspect Inspector -Li __` fate - `A Page of T� P00 ?�I '0 CITY OF TIGAkD BUILDING INSPECTION DIVISION 24•Hour Inspec,cion Linc: :,?I)A 175 Business Phone: 539-4171 Date Requested: C ' D ' ( CAM P.M. _ MST: �„� � Location: _n 1 a BUP: Tenant: Suite: Bldg: MEC: Contractor:_ Phone: -� PLM: _ Owner. _— Phone: { _ ' r ELC: ELR: SIT: C$ riC 1 DLNr BLDG(con't) PLUMBING MECHANICAL ELECTRICAL SITE Sit, Post/Beam Post/Beam Post/Beam Cover/Se-vice Scwer/Storm 'ootin Roof UndFl/Slab Rough-In Ceiling Water Line Framing Top(hit Gas Line Rough-In UG Sprinkler -oundation _ Insulation Sewer Ilood/I)uct Reconnect Vault BsTnt Damp Drywall Storm Fnnace Temp Service MISC. Masonry Ceiling Rain Drain A/C I IG Slab Shear/Sheath Fire Spkir/Alm Crawl/Found Dr I teat Pump Low Volt _ Gpank,rL) Approved - Approved Approved Approved Appr/Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved FINAL FINAL FINAL FINAL FINAL _J - ..� J O Call for reinspection C3 r einspeclion fee of S required before next inspection 0 t Inablc to inspect Inspector Tim�0�� i—I)–Ste: _� tt ey 7 ___ Page,L__of�L_ V-ltl CITY OF TIGARD MECHANICAL DEVELOPMENT SERVICES PERMIT -, PLRMIT #. . . . . . . : MEC97-0486 13125 SW Nall Blvd., Tigard,OR 97223 (503)639-4171 DATE ISSUED: 12/18/97 PARCEL: 25115BC-14900 SITE ADDRESS. . . . 16750 SW 124TH AVE SUBDIVISION. . . . : ZONING: BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTION: KIN ------------- ( CLASS OF WORK. . :NEW--- -_---FLOOR FURN. . . . : 0 EVAP COOLERS: 0 TYPE OF USE. . , . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0 OCCUPANCY GRP. . :R3 VENTS W/O APDL: 0 VENT SYSTEMS: 0 STORIES. . . . . . . . : 0 POIL_ERS/COMPRESSORS HOODS. . . . . . . : 0 FUEL TYPES----------- 0-3 HP. . . . : 0 DOMES. T NC I N: 0 3-15 HP. . . . : 0 COMML. INCIN: 0 MAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR UNITS: 0 FIRE DAMPERS''. . : 30-50 HP. . . . : 0 WOODSTOVES. . : 1 GAS PRESSURE. . . - 50+ HP. . . . : 0 CLO DRYERS. . : 0 NO. OF UNITS------------- AIR HANDLING UNITS OTHER UNITS. : 0 FURN < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS. : 0 FURN > =100K BTU: 0 > 10000 cfm : 0 Remarks : Install new wood Stove to existing SFD. Owner.: `!------------------------------------- FEES ---------------- NANCY SCHMIDT-R JERRY- type am�i.tnt by date recpt 16750 SW 14TH AVENUE PRMT $ 25. 00 TJH 12/18/97 KING CITY KING City OR 97 :24 5PCT $ 1. 25 TJH 12/18/97 KING CITY Phone #: 503-598-7687 Contractor-: -----------------._.___---..__--___--- ------------------------------------ $ 26. 25 TOTAL Phone #: Reg #. . : _ _-------- REQUIRED INSPECTIONS - ------ This permit is issued subjet-t to the regulations contained in the Final Inspection _ Tigard Municipal Code, State of Ohre. Specialty Codes and all other - appl�cable 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. ATTENTION: Oregon law requires you to follow rul►5 ta- adopted by the Oregon Utility Notification Center. Those rules are ___,. ___.______ ---• Ce set forth in ou 952•-001-010 through OAA 952-901-0080. You may _ - -- V) obtain copies of these rules or direct questions to OLW, by cAlling > 15031246-9187. J _j ty�--- Permittee S�ignati_tre : 11L1 �/�+/�i.-s -, _L I s 5 ll a B y: �.. _._.—� T {.{.+.}.}•++•}.}++++.++++++++++++++++++++++....+t+.+++++- .7-+++++++-+++++++4+++++++++tt+ Call 639-4175 by 7:00 p. m. for- inspections needed the next b,.tsiness day ++++-• 4.+++++++++++++++++++++++++++++t+++t t+++t++++ •+++++++-}.+++++++++-h++++++++ DEC-15-'97 MON 14: 14 I L: FAX NO: 4706 F'O' -- - Plan Check A CITY 6F T'IGARD Mechanical Permit Application Reed ey r 13125 S1N' HALL BLVD. Com,nercial and Residential Date Reed 5 9 TIGARD, OR 97223 Dow to P.E.__ T (503) 639-4171, X354 Date to DST Print or Type Permits ' Inco_ mpcalled Incomplete-or illegible applications will not be accepted - Name ut De"bfan ni lined_ Dear rlption /4 Table 1A Mechanical Code QTY PRICE Job Susan narnaoa sunaaw A) Patmit FPA ¢ 10 00 Address Bldg# ChyrState x - 1.) Furnace to 100,000 UM) `I 1�0 C) 7' Including duds 3 vents Nrmn(cx named buain*u) , 2� Fumeoe 100,000 Bl u* 7,S0 ------- Owner �.���,� �Zre-y pI t�lx' including duds d vents —MeWnq Aelares, tk 3.� Floor Pinnace 6 n0 �D 7`57 _�_ L 1q r W L includl vent Clty%3tate ZIP Pitons 4.) Suspended heater,wall Mater 6.00 or floor mounted heater -`-"-` Ne f7A&Nemodif b U- r',a) 5.) Vent not included inaoiiancn permh­ .5 33 /1©om�. occupant maurp Aa reaa B.) Eicher or camp,heat pump,air rand. 8.00 in 3 HP;absore unit to 1UOK BUT" crty(sraea Zip Phone 7.) Boiler or camp,heat pump air cone. - 1 1 00 _ 3.15 HP-absorb unit to 500K E TU" contractor Na "° B-) Boiler or oofnp,heat pump,air sono. 15 DO Al O 15-30 HP;absorb unR5.1 mill BTU- Prior to pertra mono peteln11�_� 8.) Boiler ar comp,hemt pump,air cued. 2250 ir,suanoe,a copy 30-50 HP;absorb unit 1-1 75mil BTU"" _ of all Ilaensen cayr;uae Zip Phar. 10.) Buller or stamp,heat pump,air Gond 1750 are required r >50 HP;absorb unit 1.70 mil BTU`^ ey,iiranl In rt"'T OaYuai Gcwtal Gard Hoard llc d _ Ctip bait 11.) Air handling unt to 10,000 CFM 4,50 \ Architert N"^" 13,) Non-portable evaporate woler 4.50 or Mailing Addreaa -- -- 14) Vent fan connected to a single dun 300 --- E.nginner Cdyista„p alp P1ome 15.) Ventilation system not included in 4.50 appliance permit beam. b n work New Q Addition A Aftratior, Repair o 10.) Hood served by mechankt:exhaust 4.50 to be done Residential Nun-ree,ldential O -- Arldnional 016mcutplion nt wnrk• 17.) Domeatk Incineretom 7.50 LL J 181 Camrllereial or induxhlai type ;).on Indnerator .siFting umn of 19.) Papal units 4.50 hulldiny nt rvnlusrty �" !O-N_i ©V►t`a� - - — --- ---- �V4 ) Wood stove !50 Map esod use 73f 21.) Clothes dryer,etc- 4.50 — building or prnporty 22) f}lher units- -- 4.90 Type of fuel-uil O natura—lg-a-sW LPG O elecWc O 23) Gas piping one to four ouilets 200 I hnrnby a&-Ywwledge that I have read this application,that the T 24) More than 4-oer outlets(each) 50 - information given Is correct,that I am the owner cr authorized aqent trio owner,th. ?tans submntea are to compliance won ofegun State i CITY.SUUfUTAL Inwq Signature of l'Nvner/Agarri— ---- Dato - - 'SUBTOTAL 56A SURCHARGE / Con-rt Persa)n Name Phone PLAN REVIEW 28%OF 3U OTAI_ SAL f\mer-hpmt 7(rev C 'Mlnlmune permit fto S26 "ResMeMlal A/C fequirns sin plan Rhordng plaermont of unit CITY ® TIGARD MASTER PERMIT DEVELOPMENT SERVICES P'ERMI'r #. . . . . . . : Ms r97-•r 349 DATE ISSUED: 09/02/97 t 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 I='ARCEL: 2S 1 1 bBC-14900 SITE ADDRESS. . . : 16750 SW 124TH AVE SUBDIVISION. . . . : ZONING: BLOCK.. . . . . . . . . . LOT. . . . . . . . . . . . . JURISDICTION: K.IN Remarks: ALT to SFD --------------------------------------------------------- BUILDING ------------------------------------------------------------ RE15SlIE: STORIES.......: 1 FLOOR AREAS---------- BASEMENT...: 0 sf kEOUIRED SETBACKS---- REOIIIRED------------- C1AES OF WORK.:ALT HEIGHT........: 0 FIRST....: R sr GARAGE.....: 0 sf LEFT..........: 0 SMOKE DETECTRS: Y TiPE OF USE...:SF FLOOR LOAD....: 40 SECOND...: 0 sf FRONT.........: 0 PARKING SPACES: 0 TYPE OF CONST.:5N DWELLING UNITS: 0 FINBEMENT: 0 of RIGHT.........: 0 OCCUPANCY GRP.-R3 BDRM: 0 BATH: 0 TOTAL------: 0 sf VALUE..t: 11000 REAR..........: 0 ---------------------------------------------- PLUMBING -------------------------------------------------------------- SINKS.........: 0 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: 0 LAVATORIES....: 0 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE it: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0 TUB/SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LIME ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0 OTHER FIXTURESt 0 ------------------------------------------ ----------- MECHANICAL -- - --------•-----------------------------------------._ FUEL TYPES------------ FURN ( ION ..: ° BOIL/CMP 13HP: 0 VENT FANS.....: 0 CLOTHES DRYERS: 0 FURN )=ION ..: 0 UNIT HEATERS..: 0 NDODS..... ...: 0 OTHER UNITS...: 0 MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 WOODSTOVES....: 0 GAS OUTLETS...: 0 ------- ELECTRICAL ------------------------------------------------------------ --RESIDENTIAL UNIT--- ---SERVICE/FEEDER----- --TEMP SRVC/FEEDERS-- ---BRAKH CIRCUITS--- ---MISCELLANEOUS---- --ADD'L INSPECTIONS-- ;000 SF OR LESS: 0 0 200 amp..: 0 0 - 200 amp..: 0 W/SVC OR FDR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0 FA ADD'L 500SF.: 0 201 - 400 amp., : 0 201 - 400 amp..: 0 1st W/0 SVC/FDR: 0 SIGN/OUT LIN LT: 0 PER HOUR......: 0 LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 amp..: 0 EA ADDL BR CIA: 0 SIGNAL/PANEL...: 0 IN PLANT......: 0 MANE HM/SVP,/FDR: 0 601 - 1000 amp.: 0 601+amps-1000 v: 0 MINOR LABEL -10: 0 1000+ amp/volt.: 0 ------------------------------------ PLAN REVIEW SECTION -------------------------------- Reconnect only.: 0 )=4 RES UNITS..: SVC/FDR)=2r-5 A.: ) 600 V AONINAL: CLS AREA/SPC OCC: --------------------------- _ ---- ELECTRICAL - RESTRICTED ENERGY --______---- -------- ------------------- - ---- A. SF RESIDENTIAL-------------- ----------- B. COMMERCIAL----------------------- ----------------------------- --------- AUDIO 6 STEREO.: VACUUM SYSTEM..: AUDIO I STEREO.: FIRE ALARM.....: INTERCOM!PAGING: OUTDOOR LNDSC LT: BURGLAR ALARH..: OTH: :: BOILER.........: HVAC...........: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER..: CLOCK........... INSTRUMENTATION: MEDICAL........: OTHR: .IVAf............: DATA/TELE COMM.: NURSE CALLS....: TOTAL A SYSTEMS: 0 Owner: ----------------------------------Contractor: ----------------- ------------- TOTAL FEES:$ 147.06 NANCY 5Pt11IDT I JERRY SCHMIDT CRAFT BUILT CONST This permit is subject to the regulations contained ii the 16750 SW 124TH 18890 SW CHRISTOPHER Tigard Municipal Code, State of Ore. Specialty Codes and all TIGARD OR ALOW, OR other applicable laws. All work wilt be done it arceirdance with approved plans. This permit 4ill expire if work is Phone II: ?hone M): 848-3585 not started within. 180 days of issuance, or if the work is Reg C.: 001070 suspended for mare than 180 nays. ATTENTION: Oregon law -----------------—---------- _ —_------------ requires you to follow rule( adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 95241i'l-92110 through OAR 952-001-0080. You may obtain ropier of these rules or direct questions to OUNC by calling (503)246-1981. ------ ------------------ - REOU?RED INSPECTIONS -----------------------------------------------------•----- h- Erosion Contol Building Final Framing Insp --- ,, insulation Insp -- "� Gyp Board Insp — - -- Rain drain Insp Issi.ted By : `t i Vvl4A L___ Permittee Signator ++++++++++++++++++++++•.r+++++++++++++++++4-w-+++++++++ ++ + +-++++++++++++++ Call 639-4175 by 6:00 p. m. for an inspection need e n t bos. iness day Plan ChechOF TIGARD Residential Building Permit Application Recd BY SW HALL BLVD. New Construction Additions or Alterations Date Recd - .�- ARO, OR 97223 Single Family Detached or Attached (Duplex) nate to P.E. )3-639-4171 pats to OSTF-•! 9 7 13-684.7297 Peme�t a,M�i73�9 Print or Type called ZET�Z Incomplete or illegible applications will not be accepted r.T ,►^';5 �""""''` 1 Name of Prot Narrttl Job ­�11141110 Address sre, — Architect Mailing Address N e City/:tate Zip Phone Owner Mailing Address Name City/State Zip Phone Engineer Marling Address _ City/State Zip Phone -'@neral Describe work New O Addition O Alteration O Repan O ontractor Mar ss.. _ to be done: / fill Additional Descnption of Work: C Zip Phone. Oregop Const Cont. Board Lia* Exp.Oat ,act,Copy of Current COT Business ax or Metro* ; Exp. Dais PROJECT �G Licenses i�•1 { VALUATION $ A Name, ,echanical N ___.. NEW CONSTRUCTION ONLY: _ Sub- Mailing Address Sq. Ft House: Sq. Ft. Garage :ontractor „omen Lot YES NO Flag Lot YES NO c.ty/State _ Zip Phone (check one) (check one) Oregon Const.Cont Board Lic.* Exp.Date Restrcted Audio/Stereo Burglar -vch Copy of Energy System Alarm �:urrvnt COT Business Taxor Met,o,* Exp. Date Installation Garage Door HVAC _.cones Name Opener Systems IUmbin (check.all that Other 9 apply)pP ) _ Sub- Mailing Address — Will the electrical subcontractor wire for all YES NO itractor restricted energy installations? C,tytState Z!P Phone Has the Stab(jlvtston Plat recorded? N/A YES NO act,co>v or Cregon Const. Cont. Board L.c. I Exo. Date Reissue of MST#: Solar Compliance _ (Calculation Attached) Currant Ptum�tng Lia Y Exp. Date I heart acknowledge that I have read this application, that the Licenses Y g pp COT Business Tax or Metro# Exo nate information given is correct,that I am the owner or authorized agent of the owner• and that plans submitted are in compliance Name — wtth Ore on State laws. Sigof Cwner/Ageht iectrical Sub- Mailing Address Contf!15 Perion No a ,. Ph9ne N C.tyr;;ate Zip Phone FOR O ICE USE ONLY: Plat 0: Map/TLk Cregon CansL Cont Board L c# Ext) Date ?.S (3C. Bch Copy of : _.. � -urrent E:euncat L:c # Ext). Date Setbacks: Zone5oler. tenses IEngineering Approval: i Planninq =pproval: TIF: COT Business Tax or Metro# Exp. Date '.IDL DOC tDST) 3/9i Permit W AccE Descintpion mount Amt. Pd. al. Due MST. Permit (BUILD) (UBUILC� V'QIP Plumb. Permit (PLUMB) (UPLUMB) Mech. Permit (MECH) (UMECH) ELL/ELR Permit (ELPRMT) (UEL;:)MT) _ (TAX) (UTAX) —�-3 State Tax ' BLDG: PLUMB: MECH: ELVELR: Plan Check MST: (BUPPLN) (USUPLN) Plumb: (PLUMB) (UPLUMB) Mech: (MECPLN) (UMEPLN) CDC Review (BUILD) (CDCBLD,; (UCDC) CDC Review(PLN) (CDCPLN) N/A Sewer Cannon (SWUSA) (USWUSA) Reimbur. District ( ) ( ) Sewer Inspection (SWINSP) (USWINS) Parks De- Charge (PKSDC) N/A Residential TIF (TIF-R) (UTIF-R) — Mass Transit rIF (TIF-MT) (UTIF-M) Water Quality (WQUAL) (UWQUAL) — Water Quantity (WQUANT) (UWQANT) Erosion Control Print (ERPPMT) (UERPMT) a Erosion Planck.'USA (ERP! ".l (UERPI_N) Ln Erosion Planck/COT N) (UEROSN) FN J Fire Life Safety (FLS) (UFLS) o H/ Q 23 "' TOTALS: -- I:SFREMULDOC (OST) 6197 I f I m I r K.A.+f 1'r Nu C'Hki t'*K OM01.4 I p t- f LAI 1 1,. 1" jljj,j l:,W E11)MMAJ T, 0 1. 10 R OV I'AYMEN I 111-4-1 0.:. Mfr 'Lil JLA L)I V I :.)I I IN '(WI-1014- lit I'll VOR NI I i It I 11) S1 . W.11LA) PI: ft 0 1 GARD - PI I I I r4 I HVILA- 1 1,1 lAf 1. CHO", f-11,11MI141 1 I Nr; r'a.-N I io 41 1 lt)890 C P R I I jW1 If.R 1.)N 01-181i I V V'-.,I lip CO. PAYMkN I n- 1101,114) PAIL, V'tJRI'L!'-%L 'JI- I kt.I j 1. D I I"ll'i t it om cl E'::ill 14 1,7'4f11 Fel-VIN UILUIll t;on -1 rU-Tt4l- t,4MUIJNT PAIL) R3 ,x7 f iCUd 17:29 Ill: FH; HO: 4316 P02 KING CITY 15406 SW 11sth Avenue.King City,Oregon 9T.24-2893 Phune:(rA)8)699-4682•F Y from 6i39.3i71 Notice To Contractors WorkiDg In King City Due to an int,rgovernmental ageement with the City of Tigard. mars building related permits for projects in ping City are issued and inspected by the C of Tigard. ;f your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the appropriate application legibly and submit it to the King City staff. The King City staff will collect all fees and Fax the application to the City of Tigard- Cit; of Tigard staff will then create the permit, issue the permit, and perform inspections. Please indicate ort the permit application whether v ou would like the Tigard staff to call you when the permit is read-,., for issuance or whether you prefer it to be mailed without any notification. Any incomplete or illegible ippiieation will be returned to lvng City staff for correction and no processing will occur until a ,.ompletc, legible application is received, if your permit application DOES RCQUIRr "LAN REVIEW. this form must he signed by a King Cite staff person. tong City staff will 5unply sign this form indicating land use approval. Take tais signed fomi to the City of Tigard Dercloprnont Services Counter located at 13125 SW Hall Blvd, Tigard, to submit applications and plans. Development Services Technic iars are available at 639-4171 Ext. 304 should you hal'c any question'; concerning submittal ::1�,irements. All pemiic fees X01 br assessed and collected at the City of Iigard. 1 rL The City of Icing Citv hereby authorizes applicant to pursue permits at the City of Tigard v~i l;uildini Depariment for the follo-Aing project: tz Z4� J t_3 King City Representative I L)STS'KCINSTDOr