11879 SW 125TH COURT I
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11879 SW 125th Ct _
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INSPCTION NOTICE
city of Tigard Building UePartsent
13125 SW Hall :Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O- 1u••►e)s 639-4175 Business Phones 6?9-4171
Inspections
Footing MaPlbg. Underela� ch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet!Beam Struet. San. Sewer
Framing -Bldg.
Post/Beam Mm—h. Rain Drain
Insulation dumb.
Plbg. Underfloor. Water Line Gyp. Bd. -Hoch.
/
Times
Date Requested:
Permit is` � —
Address:
Buil.ders-
7.'[IE FOLIAMING OORRECTIONS ARE REQUIRED:
r
I �/z
Inspector^` Date r�•C__
APPROVED DISAPPROVRD APPROVED RDRJECT Tn ABOVE
Call For Reinsp.
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t
CITY OF TIGA RD
C1 ( T16ARD�1
COMMUNITY DEVELOPMENT DEPARTMENT ORIGON
13126 SW Hvl Blvd. P.O.Boot 23397,Tigud,Oregon 97223(6W)MAI 75 i
—-- ------ — ---- -------— _ -- —------ PERMIT #. . . . . . . : PLM9 1 --01�3:3
63CI-••4171 DATE ISSUED: 08/29/91
SITE ADDRESS. . . : 11879 SW 125TH CT PARCEL: 1S133DD-11300
SUBDIVISION. . . . : VILLAGE AT SUMMER LAKE PARK 4 ZONING: R-4. 5
BI-OCK. . .. . . . . . . . . LOT. . . . . . . . . . . . . . 150
CLASS OF WORK. . :NEW GARBAGE_ DISPOSALS. . : MOBILE HOME SPACES.
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : BACKFLOW PREVNTRS. . : 1
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . : TRANS. . . . . . . . . . . . . . :
STORIES. . . . . . . . ..2 WATER HEATERS. . ., . . . : CPTCH BASINS. . . . . . . :
FIXTURES-------------- LAUNDRY TRAYS. . . . . . : SF RAIN DRAINS. . . . . :
SINKS. . . . . . . . . . : URINALS. . . . . . . . . . . . . GREASE TRAPS. . . . . . . .
LAVATORIES. . . . . : OTHER FIXTURE:S. . . . . :
TUB/SHOWERS. . . . : SEWER LINE (ft ) . . . . :
WATER CLOSETS. . : WATER L.-INE ( 'Ft ) . . . .
DISHWASHERS. . . . : RAIN DRAIN ;ft ) . . . .
Remarks : SPRINKLER SYSTEM
Owner: _____________.__.________.-------____.___.. -_________.___..____ FEES -------- -- -_.___
DON MORISSET•TE BUILDERS, INC. type ainol.Ant by date recpt
15355 SW PANGY RD. PRMT• $ 15. 00 JLH 08/29/91 -
#201 SPCT $ 0. 7�; JI-1-4 08/29/91 _
LAKE OSWEGO OR 97035
Phone #: 620-75.38
Contractor. --------------------------------
DIVERSIFIED LANDSCAPE CONTR.
18805 CAMELOT LANE
HILLSBORO OR 97123 --- --_._-
Ph on e # : 628-8158 $ 15. 75 TOTAL_
Ret( #. . : 5877
------ - REQUIRED INSPECTIONS
This perait is issued subject to 'the regulations contained in the Top-uLtt Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicabie laws. All work will be dare in accordance with
approved plans. This pewit will expire if work is not started
within 160 days of issuance, or if work is suspended for wore
than 190 days. -�
F'e r•m i t t P e 5 i g n a t�-1 r e : � �_�_._.�_._._��_� ^.� ..Y.- ____--. ..
By :
I Call for inspection - 639•-4175
CERTIFICATE OF
C'TYOFTIGrARD 0CCUF*,ANC Y
CffYOFTWA I-E.PMIT #. . . . . . . s M5T9 1-005-,'
COMMUNITY DEVELOPMENT DEPARTMENT owoan
13126 SW FI Blvd. P.O.Box"U1307,TIN&M,OmgDn 020(60I99044 76 S Ed IF L Qi 7 ' 10119 1
,SITE. ADDRESS. . . : 11879 SW 125TH CT P()RCELi IS133DD-11300
7--')UBDIVISION. . . . -. VILLAGE AT SUMMER LAKE PARK 4 ZONING: P--4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . 190
CLASS Of-- WORK. :NEW
TYPE OF USE. . . —13F
OCCUPANCY GRP. :R3
FlUCLIPANCY LOADir'.2'8`5 4
FE-7.11ANT NAMF-.
Remarks, :
Owner:
DON mopissuTTE SUILDERG, INC.
1.5555 sw BANGY RD.
#801. 1
LAKE OSWEGO nR 97035
Ph o n e #1 &;:.10 .7538
YON MORMSETTE SUILDERS3, INC.
15'
555 SW SANDY RD.
#j--10 I
LAKF OSWEGO OR 97035
Phone 44: 620-7538
ReM #- - : 3"J33
Qr,v. .tpmncy t.f the above v,eforenced building is hereby give", '-kncl cel-t1fil1F,
the compliance with ttiq State Of Oregon Specialty CodPs for the group,
OCC'Upfktlrry, and mNe under which the referenced permit wav, i9supd.
...........
FIRE DEPARTMENT
" IL.L)Ij9G
lie
5e'000
BUILDIN -FICIAL
POST IN CONt'PICUUIJG PLACE
s 111111iff111111ilLM F
INSPECTION NOTICE
City of Tigard Building Department
%3125 SW Ball Blvd. Tigard, Oregon 97223 i
Inspnction %ire toec-n-Phone): 639-4175 Business Phone: 639-4172,; r
Inspection:
Footing Plbg. Un arslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FIAALs
-�1
Pcet/'seam Struct. San. Sewer Framing
Pon /B,iam Mech. Rain Drain Insulation -Plumb..
Plbg. Underfloor Water Line Gyp. Bd. / -!(doh.
Date Requested`:` // lQ �� TLaMt A/!I, PM
Address: �/ O 7% Permit
Builder:_J {�j
THE FOLLOWING CORRECTIONS ARE RRQUIREDs
V
Inspectors
APPRO{RD DISAPPROVED _ APPROVED SUBJECT in AROVF
- Call For Reinap.
Rim � w (w w w sw w ■r
INSPECTION NOTICE
:i.ty of Tigard Buildings DepartMent
131.25 SA Hall Blvd. Tigard, oregon 97223
Inspection Line (Rec-O-Phone) 639-4175 Business Phone: 639-4171
Inspection:___ c-
Footing Plbg. D slab Mech. Rough-in �ppl;Bd-Ik
Found. Plbg. Top Out Gas Line FINALt
Post/Beam Struc`_. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Date Requested: '2 _C7 _TLmeI pM
Address:�� O
-71 ! - - Permit #:
Builder:
TBS FOLLOWING COBBNCTIONS An PJWINSD:
L' 4i V, /f
Inepecto C� 'L ��'C c �" -- Date:_-
A�pROVED plgApp�APPROVRD SUBJECT TO ABOVE
Call For Ileinsp.
IlISPECTION NOTICE
_ !,
City of Tigard Wnildiog Department
13125 tiff Ball Blvd. Tigaro, Oregon 97223
Inspection Line (pec-O-Phone): 639-4175 Buaine se Phone: 639-41'71
Inspection:
Footing Plbg. Underalab Mech. Rouqh-i.n Appr/Sdwlk
Found.
Plbg• Top Out Gas Line FINAL:
post/Beam Struct. San. Beaver
Qraming -Bldg.
Insulation �
poet/Beam Neth. Rain Drain �,_-P1umb_-Mech.„�....0-/
plbq. Underfloor Mater Line Gyp. Rd. x
����� Time: ✓
PH
Date
Date Requesteds —' _7
Actdsees: ��O / I�S Permit �t
Builder: /1
THZ FOLLOWING CORRECTIONS ARE PXQUIREDt
Inspector: / Datet�_-_L_
APPROVED DISAPPROVED APPROVED SUBJECT TO ASOVE
Call For Reinsp.
ww 11/[ w Iw
_
INSPECTION_NOTICIi
City of Tigard Building Departskent
13125 Sw Ball Blvd. Tigard, Oregon 97223
Inapection Line (Rec-O-Phone): 639-4175 Busineas Phone: 639-4171
Inspect:ion __
Footing Plbg. Underalab Mach. Rough-in Appr/Sdwlk
Found. P1bg. Top Out Gas Line FINAL:
Poet/Beam St:rurt. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Pl.bg. Underfloor /_Water Line Gyp. Bd. --Much.
Date Requested: LF 1:5— // ter/ Time: AM •�7_PM
Address:_ �Lk^ 2l _1c__ �_ Permit #:
Builder:
THE FOLLOWING CORRECTIONS A.'+.E REQUIRED:
C N_ c
.i
(
Inspectors _ Date:
APPROVED nTSAPPROVED L� APPRO1•11D 'JUBJNVI TO ABOVE
rail fror Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 BW Hall Blvd. Tigard, Oregon 97223
Inspection .Gine (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:_ --- J
Footing Plbg. Underslab Mech. Rough-in Appr./Sdwlk
Found. Plbg. Top Out. Cas Line FINAL:
Poet/Beam Strutt. San. Sewer ✓ Framinq , -Bldg.
Poet/Beat: Mech. Rain Drain `Insulation .' -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Meeh.
Date Request/e�d:orJ 1 /� Times AM ___^ _PM
Address: f /�/ }r'2 1 �d 5� �� l� Permit 'i s
Builders 10 N/ 1
THE FOLLOWING CORRECTIONS ARE REQUIFED:
Inspectors_ / !. Dates
A�PPRMD DISAPPROVtD APPROVED 811BJECR TO ABOVE
Call For Reinep.
INSPECTjO-N NOTICE
City of Tigard Building DepartAent
13125 am Ball Blvd. Tigard, Oregon 97223
Inspection Line (R3c-O-Phone): 639-4175 Businees Phone: 639-4171
Inspection: - ——
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwl.k
Found. Plbg. Top Out � e LL[le FINAL:
Poet/Beam Struct. San. Sewer Frami.nq -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested: �- 2 Y-Y/ __Time: -AMPM
q ^ T�
Address: II g 7 ! ___--- Permit #: "��-�— -.-�----
Builder: 0":011. s .- rsa= ------- ----_
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector:____ bate:
` 11FPROVrJ DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinap.
I
i
0F rw W 0,
EME-0
INSPECTIQN NOTICE
city of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Ree-o-Phone): 639-4175 Buskness rhone: 639-4171
Inspection• --_
g
Footin plbq. Und.ralab Mech. Rough-in Appr/Sdwlk
Found. Gas Line FINAL:
Plhq. 'Pop
r
Post/Beam Struct. San. Bawer Framing -Bldg.
Post/Beam Mech. Rain Drain
Insulation -Plumb.
ploy. Underfloor Water Line Gyp. Bd.
-Mech.
/. "—/� Times AM pM
Date Requested:
P.rmit 1:C�
Address:
Builder%
THE FOLLOWING CORRECTIONS ARE REQUIREDs
r r
_ 4
1
-- t
Inspector/ —_-
Dates
_APPROVEI+ filRAPPROVED APPROVED SUBJECT TO ABOVE
rail POI 11, ''wi
UMINUM
INSPR_CT ION NOTICE
City of Tigard Building Departmnt
13125 SW Ball Blvd. Tigard, orogon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections_ ---- ----—
Footing Plbg. underelab mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Pos1$g s atruct, San. Sewer Framing -Bldg.
Pott/BaeID Keoh. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Koch.
Date Requested, -/ r _Times AN n^,_.��__P14
Add re s e: _ -�4L�
Permit
Builders O
THE FOLf.ONING CORRECTIONS ARE REQUIRED:
U NPO C v Alt'tt�2 1.4 r r� - -
-'Pb s
Inspectors �- Dates
APPROVED DISAPPRnvRD -__ APPROVED SUBJECT TO ABOVE
Call Fnr Rainsp.
ff it s � a IN
INSPECTION NOTICE
City of Tigard Building Department
13125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection*
--------_— ---—
Foot in9 Plbg. Underslab Mech. Hough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Stcurt. San. Sewer Framing -Bldg.
poet/Beam Mech. Rain Drain
Insulation -Plumy•
Plbg. Underfloor � Water Line Gyp. ad. -Koch.
/ i l T ime: __kAK PM
Date Requesteds'7 41/ / — / 7
1
Addresesi / / r Permit ls�,�`dU-�
Builders _
THE FOLLOWING CORRECTIONS ARE REQUIREDs
Inspectors_T� /'/ --- Dates
/�pPROVeD DISAPPROVED APPROVID BUBJNM TO ABOVE
-•� Call For Reinsp.
INSPECTION_Nt7 ICF. ���17�
City of Tigard Building DWwrtxw,6t
13125 SRI Hull Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections —-- —
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Post/Beam Strutt. an. Sewer Framing -Bldg.
Post/Beam Mech. in Drain Insulation -Plumb.
Plbg. Underfloor ater Line Gyp. Bd. -Mech.
Date Requeateds �`� _T_Timet / AN PN
Address:
I� `/ __ Permit #t
Builders
0
THE Forl"INO CORRECTIONS ARE REQUIRED:
-- - 1
"—T
i
Inspectors -- — ---------------- Date-
/ w
APPROVED DISAPPROVED APPROVED SUBJRCI' TO AW)V1P
i.
Call For Polnep.
INSPECTION !OTIp—a
city of Tigard Building Department
13125 811 Hall Blvd. Tigard, Oregon 9722_
Inspection Line (nec•-O-Phone): 639-4175 Business Phone: 639-41.71
Inspection:
Foot.lnq P1�3g. Underslah Mach. Rough-its Appr/:Sdwlk
Found. 'I Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbq. Underfloor Nater Line Gyp. Bd. //,,-Koch.
y a� / Time: /L�— PN
Date Requested: —
Addrer,e:--- /f 21
! _ Permit #:
Builders -
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Innpnotorl -- DAte:_L Z-. 1
f/ APPROVSD DISAPPROVRD APPROVED .SUBJECT TO APA)VE
Call Pur Wasp.
CITYaF TIGARD NIP-0TER PERMIT
CrFYOFTWARD PFRI111- fi. . . . . . . : MST 9 1 005.7
COMMUNITY DEVEL OPMENT DEPARTMENT MOM
13126 SW Hell Blvd. P.O.Box 233io. T4pml,Orogon 97223(503)630-4175 r,oTr Tc;-,llyn-
i 7E A D D H LS 5. . . 1 :16*/9 SW I ':j 1-H I PARCEL:: 1,713,3DD-
SUBDIVISION. . . . VILLAGE AT summER LAKE PARK 4 ZONING- R-.4. 5
13LOCK. . . . . . . . . . . LOI.. . . . . . . . . . . . . : 150
BUILDING
REISSUE: DWELLING UNITS- 1 BASEMENT . . . . . . . . .0
CLASS OF WORK. :NEW BEDRMS:5 BATHS:3 GARAGE_. . . . . . . . . . :410 s
TYPE OF USE. — :SF FLOOF REQUIRED
TYPE OF CONST. :5N FIRST. . . . . 1490 sf LEFT. . -5 ft RIGHT. -5 ft
OCCUPANCY GRA. : R3 `SECCOND. . . 1224 G f FRONT. :'30 ft REAR. . :45 ft
SIURIES. . . . . . . ..2 THI RI). . . . 0 S f REQUIRED----------------------
HEIGHT. . . . . . . . .25 ft TOTAL. -_._--_._._:;x-714 � IF SMOKE DE'TEC'TORS. :Y
FLOOR LOAD. . . . :Orr psf VALLIE. . . . . 132224 PARKING SPACES. . .0
Remarks :
PLUMBING
S 1 Nl-',S. . . . . . . . . . .. I FLOOR DRAINS. . . . -.0 DACKFLOW PREVNTRS. . :O
LAVATORIES. . . . . :3 WATER HEATERS. . . : 1 TRAPS. :0
I Uv,)/GI-IOWERU. . . . :4 LAUNDRY TRAYS. . . :0 C A T("I-j A�3 :0
WH I LH CLOSETS. . :a SEWER LINE (ft ) . -0 ".REASE TRAPS. . . . . . . :0
DISHWASHER . . . . . 1 WATER LINE (ft ) . - 100 OTHER FIXTURE G. . . . . ..0
UARBAGE DISPI. . . : l RAIN DRAIN (ft ) . :O
WASHING Ml')CIJ. . . : 1 SF RAIN DPAII\I!7.). . I
MECHANICAL FEES ---------
VUEL T`YPES------------------ UNIT HTRS. . -0 type 'Prnomfit t)v date V,0
/605/ VENTS . . . . . :0 PAYNI $ 100. 20 JLH 03/2'6/91
1117iX INPUr:0 BTU VENT FANS. . . 14 BPR 1 $ "115. 50
FURN ( MAK . . -0 HOODS. . . . . . : 1 8 97'L C $ 335. 08
l-JJRN ) -100K . . ! I. WOODSTOVES. :0 11__1 P C $ TES
FLOUR TURN. . . . :0 CLO DRYERS. i I SSDC $ 375. 00
11OTI_/CMP ( 3HP1:0 OTHER UNITS:C PARK $ 250. 00
uAs OUTLETS: i MPRT $ 40. 50
Owner. MPLC $ 10. 13
DUN MUR I SSE ( I L. LAL)i LDL RES, I NC. Mbl-,L $ e'. LA
155r�J5 914 BAN(�)Y PD. PPRI f 147. 50
#201 P5plc- $ 7. 38
LAKE OSWEGO OR 9 712135 TIF t 1350. 00
Phone #: 620-.7538 PAYM $ 2958. 90 JLH 03/29/91
Co,ltroAl:t or:
DON MORISSETTE* BUILDERS, INC.
15555 SW RANGY RD.
#&LAI
LOKE _A�WEUO OR 97035
I:"M o r e # 75
098. 90 TOTAL
This pervit it issued subject to the regulations contained in the REQUIRED INSPECTIONS
Tigard Municipal Lode. State of Ore. Specialty Codes and all ither Foot/for_tnd Insp FireDlave Insp
applicable laws. All work will be done in accordance with approved Post /Beam St rLict lies Line Insp
plans. this persit will expire if work is not started withir 181 Post/Seam Meehan I n s 1 t 1�At i on Insp
,!a, s of issuance, cr if work 15 j! Plm/lAndslAb .Insp Gyp Board Insp
PLM/Under fl.00r Rain drain Insp
let.-flan'leal. Insp Water Line Insp
F-,11_tmb 'lop 0.tt Appr/Sdwlk Insp
1. 1•Arlir�11 I)qp M e 010.T1 1 -2,11 1- L I 1P
irig.�pw-Ljrin (Vi it ;'j
SEWER CONNECTION
t_ ,� PERMITCITYOFTIFARD ��� FERMIT #. . . . . . . : SWR91-x7+064•
CITY'OF'TMRD
COMMUNITY DEVELOPMENT DEPARTMENT oleo"
13126 SW HWI Blvd. P.O.Boot 23397,Tige d.Oregon 97223(503)639-4176 DATE ISSUED: 03/29/91
:�I TE:: ADDRESS. . . : 11879 SW 1:--'5TH CT VIARCEL: 1 S 133DD-•1 1;300
LjUDDIVISION. . . . a VILLAGE AT SUMMER LAKE PARK 4 ZONING: R 4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 150
TENANT NAME. . . . . :
USA NO. . . . . . . . . . :43609 FIXTURE UNITS. . . :
CLASS OF WORK. . . :NEW DWELLING UNITS-:1
TYPE OF USE. . . . . :SF NO. OF BUILDINGSa1
INSTALL TYPE. . . . :BUSWR IMPEPV SURFACE. . : : sf
Remarks :
Uwner. ---••-____-___--_.____.__._________._.____ FEES - ___-_- _-.__- _•-__
DON MORISiSETTE PUIl_DER S, INC. type imoi.xnt by date r,ecpt
15555 SW RANGY RD. PRMT t 1500. 00
#210 1 I NSP $ -5. 00
LAKE O SWE:GO OR 97035 PAYM t 1535. 00 JL.I-I 03/29/91
1-11-;nne #: 62QA--75-,-18
-ontractora -•___.__________._._.__._..___......---.._ ._._.__.
DON MOR I S3SETTE: BUILDERS, INC.
155bb SW MANGY RD.
#201
LAKE OSWE:GO OR 9703
Phone #: 62'0-7938 $ 1535. 00 TOTAL
Reg #. . : 35533
------- REQUIRED INSPECTIONS -------
This Applicant agrees to coaply with all the rules and regulations Sewer Inspection
of the Unified Sewage Aoency. The nereit expires 128 days fro•
the date issued. The total aeount paid will be forfeited if the �_ - _ _._• __�� _
permit mires. The Agency does not guarantee the arcurary of the
side scovr laterals. If the sewer is not located at the eeasurere;t
given, the installer shall prospect 3 feet in all directions froe
the distance given, if not so located, the installer shall purchase
A "Tao and Side Sewer' Pewit and the ge
Permittee Sign,:rti_xr~e:
B y a
Call for inspection - 639-4175
CITY OF TIGARD RECE.IPT OF PAVMFN V RECEIPT NO. :91--i2l 1395,
CHECK AMOUNT 4493. 90
NAME MORISSETTE, L)nN CAU9-1 AMOUNT 0. rAo
ADDRESS t PAYMENT DATE 03/29/91
SUBD I V I G I ON
11879 SW 125TH CT
PURPOSE OF PAYMI-ENT AMOUNT PA 10 PURPOSE OF PAYMENT AMOUNT PAID
147. 50
MECHONICAL PE 40. 50 ST. BUILD PER 3 i5. 19
PL ON (.'I--IECK FE 245. :"''1 SEWER USA 1500. 00
SEWER INSPECT 3g,--). 00 RESIDENTIAL TRAFFIC' FEES 1250. 00
PORKS SDC 2510. 00 STORM DRAIN SDC 37,--j. 00
MASS TRA1431T TIF FEES 100. 00
TOTAL AMOUNT PAID 44'x3. 991
CITY OF TIGARD RE.CEICST OF PAYMENT RECE I P*T Ne.. .9 1—2112.1
CHECK AMOUNT - 180. 00
NAME : DUN MOR ISSETTE CASH AMOUNT 0. 00
ADDRESS c PAYMENT DATE 3 6 i 91
SUBDIVISION
V (b sl- #5
PURPOSE-'.' OF PAYMENT AMOUNT PAID PURPOSK OF PlAYMENT AMOUNT PAID
ISLA. 00
LOT 19 7, 190, 150
TOIAL, 01'(10UNT PAID 80. t7lo
13125 SW Hall Blvd. PLNCK/RECT
CITY 4F TIGARD PO Box 21397 PERMIT #
COMMUNITY DEVELOPMENT DEPARTMENT b'p'd'Oregon 9'°
(503)639.4171 DATE ISSUED
JOB ADDRESS: .� 5��1 ti � � C TAX MAP/LOT I5,j
SUB: �; ,A = ' ���fY1111�,Y�USW e' �� _ LAND USE:
VALUATION:
OWNER I,, / SPECIAL NOTES
NAME: j)Dn �Dc15SC ► L1t7� REISSUE OF:
ADDRESS: LAST REISSUE:
I ' FLOOD PLAIN/
Pf NNE: SENSITIVE LAND: —
CONTRACTOR APPROVALS REQUIRED
NAME: _ J_ __._ PLANNING:
ADDRESS: __ —___ _ _—_ ENGINEERING:
FIRE DEPT:
PHONE: —_ OTHER: _
CONTR. BOARD #: EXP DATE:
ITEMSRE UQ IRED
SUBCONTRACTORS: PLUMB: s f-matil—rs. LIST/SUBCONTRACTORS:
MECH: "f" 4 '1�US TAX:ARCH/ENGINEER CALCULATIONS:
NAME: Tp'L LI TRUSS DETAILS:
ADDRESS: _ __ OTHER: __-.- ---_--_ -
PHONE: _ ` - _--
PROPOSED BLDG. USE: r _
COMMENTS:
ADPL ANT SIG Ali
Received By: __ _ Date Received: -3 1-- `%/
SHOEMAKER'S PLUMBING INC.
350 S.W. ZOBRIST
ESTACADA, OR. 97023 (P.O. BOX 250)
TO: CITY OF TIGARD
13125 S.W. HALL BLVD.
P.O. BOX 23397
TIGARD, OR. 97223
TO WHOM IT MAY CONCERN,
SHOEMAKER'S PLUMBING INC. GIVES TIII:LR PERMISSION TO
LET DON MORISSETTE HOMES INC_ SIGN ALL PLUMBING
PERMITS FOR SHOEMAKER'S PLUMBING INC.
SINCF.REI.Y,
IIAROLD It. 1II0I:MAKER PRES.
0-30 - 772"
■ ■1W ■ ■ ■ ■ ■
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
y -w-5'/ 10-432 00 Building Permit Fees
K-431 00 Plumbing Permit Fees 1; 140, ac'
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%)
Building
Plumbing ,.
Mechanical
10-433 00 Plans Check Fee
Building -3
Plumbing
Mechanical
10-230 06 Fire
-0O�40-202 00 Sewer Connection
30--444 00 Sewer Inspection -
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 /Z 5Z' /2s Z)
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC) — - S—V
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 i� � 7Ju - moo
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15555 S.W. Bangy Road, suite 201
Lake Oswego, Oregon 97035
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