12808 SW FALCON RISE DRIVE UMYYIYMMa+et'W uwnw.W�+;�'riMM wrW+WMMWr�a+iMUWiWrirwMuG rwM+�rrhrYrw�.F+��NW�fwoaW�W4iiL�++� �.M1w�M - •.•��L�' ,
i
A
/f
f
I
w,
12808 SW F b LCON RISE DRIVE _
CITTYO1 TIFARD CERTIFICATE OF
cnY
COMMUNITY DEVELOPMENT DEPARTMENT onlem OCCUPANCY
'13126 SW HWI Btod. P.O.Box 23307.TOW,Orepon 07223(6M)A"78 t-)FFSM j T #. . . . . . . a MST91 0107
OWE ISSUE'De 02/12/92
31TF. ADDRESS. . . : 1280a SW FALCON RISE OR PARCEL: IS133DD-14600
SURD IVISION. — P VILLAGE AT SUMMEP LAKE PARK 4 ZONINGi R-4. 5
RLOCK. . . . . . . .
L01.. . . . . . . . . . . . . 1183
,LASS OF WORK. vNEW
'TYPE OF USE. . . :8F
OCCUPANCY GRP. oR3
0 1
CUPnNCY LVAD%225 4
1 ENAN I* NAME. . .
0 r.rl;-.,"kb
OON MORISSETTE OLDERS, INC.
0 0 BOX 19524
171ORTI...AND OR 97219
503-620-7538
00N MORISSE74 TE SUILDERS, INC.
150355 SW BANGN RD.,
4201
AKE OGWFGO OR 97035
;-:,hone #s 620.-.75758
!"e!4 #. . - 35533
OL'Lupancy of the above refer enc buildirqj is herebygiven, antir-
acert ifiv
- he comPlia"ce with the State Of Oregon Specialty C."odes. for the proup,
oct,upancy, and use under, which the referenced permit wab issk.tp(j.
rJRr_ DEPARTMENT 71-7.PuL pING INSPECTOR
nult-171% 0
POST IN CONSPICUOUS PLACE
�r �w W PM "W �mr �n
INSPECTION NOTICE
City of Tigard Building DePartt*•nt
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phones 639-1171
Inspection, ------- -- ---
Footing
Plbg. Undorelab Mach. Rough-in Appr/adwlk
Found.
Plbg. Top Out Gas Line FIMALs
�.�--
Bldq.
Poet/Beam Struct. San. Sewer Framing
Past/Beam Mech. Rain Drain
Insulation -Plumb.
plbg. Underfloor Water Line / 1 Gyp. Rd.
-Mach.
Date Reque
-/ '6/I-- Times All
Addr.osa:-_ateds/� r
Builder: !
THE FOLLOW NG CORRECTIONS ARE REQUIRED: /
ice="
0)
t
- ' Date,
Inspector:_
APPROVED DISAPPROVED _ ~ APPROVED SUBJECT To ABOVE
call For Reinsp.
INSPECMOV NOTICE,
City of Tigard Building Department
13125 SO Ball. Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone y 639-4175 Business Phones 639-4171
Inspection: C - \\
Footing Plbg. U slab Mach. Rough-in ` Appr/Sdwlk``I
Found. Plbg. Top Out Gas Line FINALt
Poet/Beam Struct. -an. Sewer Prami.rg -Bldg.
Poet/Bo.rm Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. --Meeh.
Date Requesteds G� �� �--- Times 11!! PM
Addresss_L O �i / ��7 2 / —,.-�l�r=it #s GZ� /
Builders-
THE
uilders_THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: _t ` Dates ! "�
y APPROVED `! DI>sAPP APPROVED SUBJECT TO ABOVt
Call for Reinsp.
'
PECT Ow NOTICE
Ci.y of 71-gard Building Department ''•'?"'�
13125 Sw Ball Blvd. Tigard, Oreyon 97223
Inspection Line (Rec-o-phone): 639-2175 Business Phone: (39-4171
Inspection:
Footing Plbg. Unders ab
' Mech. Rough-in A r
pp /Sd•rlk
Found. Plbg. Top out Gas Line
FINAL:
Poet/Beam Struct. San. Sewer
Framing -Bldg.
Poe1-/Ream Mech.
Rain Drain Insulation
Plumb, �
Plbg, Un•ferfloor Water Lifla
GYP• Bd. -Mech.
Date Requested: '-// ���
/ -� 5--,/) p � Times ✓� AM �,�PM
Addrees: b-/) e_ /J}7� G•�QE—�6e �/ /9 �/�
rmit #1 L`
Builder: 3 �� f
THE FOLLOWING OORRSCTIONB An PRQBIREDt
Inepertor• ���,
APPROVED DISAPPROVED APPROVRD SUBJECT To ABO
VE
_Call For Foinap.
INSPECTION NOTICE
Citic of Tigard Building Departmnt
13125 SN Ball. Blvd. Tigard, Oregon 97223
Inspection Line (Roc-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: —
Footing plbg. Underslah Mech. Rough-i-n < Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL=
Poet/Beam Struct. San. Sewer Framing -51dq.
Poet/Beam Mach. Pain Drain Insulation -P111b.
Plbq. Underfloor Water ,Lying Gyp. ed.
-Mach.
l — (� Time: AM
Date Requestedf --- _
CQrv �-
Address:—a,3Permit #Iff /•�
Builder: 4L�1-����
TRE FOLLOWING CORRECTIONS ARE REQUIRED:
�� •`
y
e
xnapac
tori LCA("fit Dater=� 1ST
TPROVED DISAPPROVC, PROVED SUBJECT To ABOVE
Call For Reinap.
i
Iw 4
INSPI_C Ox N ROTICL 1
City of Tigard Building Dep-*tnent
13125 SW Ball. Blvl. Tigard. j)r Kffw 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phones 639-4171
----
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Pibg. Top Out Gas Line FINAL-
Post/Beam Strurt. San. Sewer Framirg -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Coyp. Bd.-', -Nech.
C7 _( _
Date Requested:_ p� rte_- Time: /—�
T.ddreae:
ermit 4z C�
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: _ _ ,— Date
PPROVED DISAPPROVSt APPROVED SUBJECT TO ABOVE.
Call For Reinsp.
INSPECTION NOTICE
City of 'Tigard Buildi wj ne6>artMMent
13125 SM Ball Blvd. 7'igarrd, Oregon 97223
Inspection Line (pec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:—_—_ —__� �_.-------_-------
Footing
Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Gas Line FINAL:
Pound. Plbg. Top Out
Framin -Bldg.
Poet./Beam Struct. San. Sewer J, 4'
Past/7eam mech. Rain Drain
Insulation -plumb.
Plby. Underfloor Nater Lina
Gyp. Bd. -Hoch.
/` ___ TisOas ,�_� PM
Date Requested:, —
t #t_G
Address:
Builders
THE FOLLOWING CORRECTIONe ARM RMQUIRMDs
(/ APPROVMD DISAPPROVED APPROVED SUB"CT TO NW"
Call For Reinsg.
INSPECTIGN Nth
City of Tigard Building Depart=Mut
13125 SW Ball Blvd. Tis,-"J, Oregon 97223
Inspection Li"e (Rec-o-Phone)s 639-405 Business Phone: 639-4171
Inspections �—
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plbq. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer ing ) -Bldg.
Post/Beam Hoch. Rain Drain iisation 1 -Plumb.
Plbg. Underfloor Water Line gyp. Bd. -Hoch. y!
Date Roq iatods Time: -----,�-_AM J\ PM
Address: I JG G)� � lD] /�/ Permit itf2/' �J�U
Builder:�� _
THE//FOLLOWING CCO/RRECTIONS ARE REQUUIRED t
1-L".—.a.f •y/�.d_�-_.fj-.1�e't-.:v
1.J
Inspectors_-._"/l_.L- - Dates 31—
APPROVED 1). ?APPROVED APPROVED SUBJECT TO ABOVR
Call For Reinap.
IN-SRAM-0-A BQT--CR
City of Tigard tuitdLng Department
13125 OW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 619-4175 Business Phone: 639-4171
Inspections
Footing Mg. Underslab Mech. Rough-in Appc/Sdwlk
Pound. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water. Line Gyp. Bd. -Mech.
Date Requested: /�� 2 -2- ' Time: >-"/ M PH
Addresss�1'4 c/ Permit f: 7
1 -DI 0 !
Builder:
TBE FOLLOWING CORRECTIONS ARE REQUIRF.71
tnopectore_ � Oates_ /?.-�
APPROVED DIr?PPROVED A,--*'APPROVIM BIIRJECT TO ABOVE
_--Call For Reinsp.
IWXRKM
'.N3PEC'TION NOTICE .
City of T.lgazd Building Dovpnrtawmw
13125 SW Ball Blvd. Tigard, Oregon 9722iAZa
I ,epection Line �R.ec-O-Phone): 639-4175 Gueineee Phone: 639-4171
Inspection-
Footing
nspection:Footing P11,g. Underelah h. Rouph�-i Appr/3dw1k
Found. Plbg. Top Out Gas Line FINAL-
Pont/Beam Struet. Sar:. Sewer Framing -Bldg.
Poet/Bedm Mech. Rain Drain Insulation -Plumb.
Flbg. Underfloor /yWater Line Gyp. Bd. -Mach.
Date Requested:�.1 _Timor AM PM
Addrese: ��i `Jd a �� ,f� „ /Permit is
Builder:
TBE FOLLOWING CORRECTIONS ARE REQUIR6t
Inapecto _ Date:,� ��
_—APPROVED DISAPPROVED APPROVED SUgTECT TO ABOVE
Call I:• Reinep.
;NSgEC -L NOT"E
City of Tigard Building Depart,"'Ont
13125 SW Mall Blvd- Tigard., Oregon 47223
Inspection Line (RAc_o-Phone)t 639-6175 Business Phone: 639-42.11
Inspections— — --------
Footing
4lbg. Underslab Mecil. Rough-in Appr./Sdwlk
� Plbg Top Out ) Gas Line FINALt
Found.
I _...^,'
Post/Beam Str.uct.. Sen. Sewer Framing .-Bldg.
Poet/Beam Mech. Rain Drain
Insulation -Plumb.
Plb9. Underfloor. Water Line
C�/ Gyp. Rd. -Mec:h.
`� _L./ Timet _—,L�---meq PM
Date Regs:seted: T,�,_ ---
Address-_.— [,�;n�/,D^/� Permii�t i!�/�/�
Builder:-----+`-' �Z�"
THE FOLLOWING CORRECTIONS ARE REQUIRED:
12
Inspectort. Date 1.
—jam—l
/APPROVED M— DISAPPROVED APPR.`VED SUBJECT TO ABOVE
Call For Reinsp.
_.-
i
INSPRf.'_Ioro N97_L'E '"a
City of Tigard Building Department
13125 BW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)t 639-4175 Business Phones 639-4171
Inspection:_
Footing Plbg. Underelab Meeh. Rough-in A,pprjSdwlk
Found. Plbg. Top Out Gas Li.e FINALt
Post/BAAm Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
Date Roquested: /.O� -,4 — 'L'i1Mt AH PN
Address:_.. ' ?��- o mit? 42 i1-y f D7
Builder: � � � 72.E
THE FOLLOWING CORRECTIGNS ARE REQUIRED:
Ok
Inspector:��
�APPROVEL JCS DISAPPROVED APPROVED SUBJECT To ABOVE
-W Call Pot Rainsp.
INSPFCCIO___N NOTAC
WBu7.ldi ag DOPart-°ent
City of T- 7
Ti,ard, p,reyon 97223
19]25 SN Rall blvd. Phone: 639--4171
9
Inspection Line (Roc-O-Phone): 639-4175 Business
Inrpection rP r/Sdwlk
Plbg. Underelab Mectr. Rough-in PF
Footing FINAL%
To Out Gan Line
Found. Plbo p
-- Framing -Bldg.
San. Sewer
st/Beam StNat. -plumb.
_ Insulation
Rain Drain
_cyst/Beam Meoh. -Mach.
1 -- Nater Line - Gyp. ad.
plbg. Underfloor --pM
Timet
Date Roquoa.ed•
G s` permit is --�-
Address: d U
Bui lder:Za?,Z.-----... --
TME MLLOWING CORRECTIONS ARE RMUIREDt
--------------
---
Date i_—
Inspector: -- --- —_- --
b18APPROVF.D RPPPOVF.D SUBJECT TO ABOVE
�- APPROVED _`--
Call For Rainsp.
1.9PNCTION NOTICE
City of Tigard Building Depart—t
13125 5W Hall HIM. Tigard, Oregon 97223
Inspection Line (Roc-O-Phone)s 639-4175 Business Phone: 639-4171
Inspection: -
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. ear Framing -Bldg.
r
Post/Beam Mech. n Liral.n� Insulation --Plumb.
Plbg. Underfloor ater Line Gyp. Pd. -Meeh.
Cate Requested::— Sf— Time: / AM —PH
Address: 016') 7
Builder:v—���_� '{�—_ — —
THE FOLLOWING CORRECTIONS ARE REQUIRED:
—
s/
I
Inspectors --_.._ — -- - -- Date: w
�APPF.OVED �— DISAPPROVED ^^R APPROVED SUBJECT TOL .ABOVE
Call For Rainap.
INBYIiCTiON NQ 1
city of Tiga•:,A 6nildinq Depart—t
13125 811 Bail. Blvd. Tigard. Oregon 97223
Inspection Line (Rec-O-Phone)c 639-4175 Business Phone: 639-4171
Inspections
Footing Plbg. Undarelab Mach. Rough-in Appr/Sdwlk
round, Plbg. Top Out Gas Line FIMALs
Post/Beam Struct. Sen. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulati a -Plumb.
lbg Underfloor Water Li-le Gyp. Bd. -Mach.
l T ime: ,AM __Pq
Date Requested c— -7Adoresa:1 - 2" hermit 1:�/ -J�d
Builder: _ -- -
I
THE FOLLOWING CORRECTIONS ARE REQUIRED:
09-1
Inepactor: Date,, _ ---- —
APPROVED DISAPPROVED �(/ APPROVED SUBJECT TO ABOVE
Call For Reinep.
INSPECTION NOTICE J
City of Tigard Building Mspartsment
13125 811 Ball Blvd. Tigard, Oregon 97223
Inspection Line (Pec-O-Phone): 639-4175 Business Phones 639-4171
Inspection,_
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out. Gas Line FINALt
�\
F&it/Beam Struct. Sen. Sewer Framing -Bldg.
to
t/Blom Raln Draf� Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Date Requested:_ / ,/ �L!/ l / Tuna, AN PM
Addreast�i:'1��sem— R�rmit f,
Builder,
THE FOLLOWING CORRECTIONS ARE REQUIRED:
�� �{�., t�/ � fie/►y.4,1_ /�{ _
Inspector:.._ of Date, //—/ 7 - /gz
APPROVED DISAPPROVED RPPROVFC SUBJECT TO ABOVE
r/ Call For Reinap.
City of Tigard Building Dopartsent
13125 S11 Ball Blvd. Tigard, oregon 97223
Inspection Line (Ree-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Inoulation -Plumb.
Plbg. Underfloor hater Line Gyp. Bd. -Mach.
Date Rsqueste:: ZZ- 7 `/ � Timet /�.AM __PM
Address:
"
�tir1��-�71T
Builder:_ 2�L �_-
TME FOLLOWING CORRECTIONS ARE REQUIRED:
Z.4.�.t :.'
i
Inspector.•., _ Date: Zz "
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Rei.nsp.
C17YOF TIFARD FMASTER PERMIT
CY0IGARD ERMIT #. . . . . . . :
MST91 -0107
COMMUNITY DEVELOPMENT DEPARTMENT n
13125 SW FW I Blvd. P.O.Bax 23397,Tlpud,a►.pon 9? DATE ISSUED: 11/04/91
11 L (aL;DRESci. . ., „ 1.:'808 SW FALCON RISE. DR PARCEL: 15133En-141:Z10
SUBDIVISION. . . . :. VILLAGE: p-1 SUMMER LAKE PARK 4 ZONING: R-4,, 5
BLOCK. . . „ . . . . . . LOT. . . . . . . . . . . . . . 1.f3 ;
---_--------.-----------__.-_.------ BUILDINu
REISSUE:MST91-0072 DWELLING 1JNTTS: 1 BASEMENT. . . . . . . . :0 sf
CLASS OF WORK. -NEW BEYDRMS:S BATHS:3 GARAGE. . . . . . . . . . :600 s
TYPE OF USE. . . :SF' FLOOR AREAS----------- REQUIRED SETBACKS----•--------- ----
1 YPE OF CONST. :5N F I RST. . . . : 1427 s f LEFT. . :5 ft RIGHT. - 10 f t
OCCUPANCY GRP, :R3 SECOND. . . : 126 1. s f FRONT. :,R0 ft REOR. . :37 f t
a10RlE::,. . . . . . . :c
THIRD. . . . :0 s f
HEIGHT. . . . . . . . :25 ft TOTAL---------:268B s f SMOKE DGTF=CTORS. :Y
FLOOR LOAD. . . . :40 ps f VALUE. . . . . $ : 1:34448 PARKING SPACE~;. . :0
Remar^1<a : check for- cold spots in front room
PLUMBING
SINKS. . . . , . . . . . : 1. FLOOR DRAINS. . . . :0 BACKFLOW F'REVNTRS. . :V1
LAVATQRIES. . . , WATER HEATERS. . . : 1 1RAF'S. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . :4 LAUNDRY TRAYS. . . :0 CAT':H BASINS. . . . . . . ..0
WATER CLOSETS. . :5 SEWER LINE (ft) . :0 GRE=ASE TRAP'S. . . . . . . :0
DISHWASHERS. . . . : 1 WATER LINE (ft) . : 100 O fH1'_R FIXTURES. . . . . :0
GARBAGE DISP. . . : 1 RAIN DRAIN (ft) . :0
WASHING MACH. . . : 1 SF RAIN DRAINS— : 1
--------------- MECHANICAL - -_______.____-- ------------------ FEES
FUEL TYPES-•.._..--------- UNIT HTRS. . :0 type amount by dale recpt
/GAS/ / / VENTS . . . . . :0 TIF $ 1350. 00 J1. 4 11 /x:,4/91 -
MAX INPUT:V1 BTU VENT FANS. . :4 BF'RT $ 1.720.. 50 JLH 11 /04/91 -
F-URN ( 100K . . :0 HOODS. . . . . . : 1 BPLC $ 40. 00 JLH 06/06/91 214068
F"URN ) =100K . . .- I WOODSTOVES. :0 B SPC s 21 6. 03 JLH 11/04/91 --
FLOOR TURN. . . . 10 CLO DRYERS. : 1 BF'LC $ 30. 00 JLH 11/04/91
-
BOIL/CMP ( 31JP:O OTHER UNIT5:0 SSDC $ 3.75. 00 .TI-H 11/04/91
GAS QU T LETS: 1 PARR, $ 250. 00 JLH 1. 1/04/91 -
Owner: -. _---------------------------------- MF'RT $ 40. 50 JLH 11/04/91
DON MORISSETTF BLDE:RS, INC. MPLC $ 11. 13 JLH 11/04/91 -
P O BOX 1 ,524 M PC $ . 03 JLH 11/04/91 -
PPRT $ 147. 50 JLH 11 /04/91
-
PORTLANL OR 97219 P5PC $ 7. 38 JLH 11 ./04/91
F)h o n e #: 503-620-7538
r,ont V-aC:!;or:
DON MORISSETTE BUILDERS, INC.
x.5555 SW BANDY RD.
0201
I..AKE OSWEGO OR 97035
,,hone #2 620--7538
Rea #. . 35533 _----____.-___----_----__--____------
$ 2799. 07 TOTAL
This permit is issued subject to the regulations contained in the -------- REQUIRED INSPECTIONS --------
Tigard Mvnir.inal Code, State of Ore. Specialty Codes and all other Foot/Found Insp Fireplace Insp
applicable laws. All work will be done in accordance with approved POE-t /Beam Str^Uct Gas Line Insp
plans. This permit will expire if work is not started within 188 Post/Beam Mechan Insulation Inrsp
days of issuance, or if work is suspInded for sore than 188 days. Pim/undslab Insp Gyp Boarcl Insp
PLM/Underfloor- Rain dv,ain Insp
(�rI-,et^mittee Signat�.tre: � a_I���_� Mechanical Insp Water Line Insp
Plumb Top Out Appr/Sdwlk Insp
Issued By: Framing Insp Mechanical Final.
Cat1 for inspection - 639-4175
i
io woo*
k
� CITY OF TIC3ARD � ,.
q, — RFCE 1 F 7 OF PAYMENT RECEIPT NO.
rJAME 7 MORISSE'TTEr :9.1 -� 19 303
i IDDRESE, x DAN C"�IEC�K AMOIJNT : :'759. 07
Cn011 AMOJNT n 0. 00
PAYMENT DOTE 11/04/91
SUHU I V I;;I ON
P"PI OSE OF PAYMENT
AMOUNT PAID ENURE?A:3E
__._.. OF. PAYMENT
BUILDING PERM
TM' _ AMOUNT 1�FIIp
I ME CHAN 1 C'AE_ PE _ ..` ao. s0 E;y_UMN I NCi PERM T . _ _ —_ -
II-"LAN CHECK FI--- 40. 50 5T• WILD PF:-R Z4'7. �0
Ih�Atii6. l"RETNSII 7IF FEE»$ 40. 13 RES IDE=NTIAL rRAFF ►C FEES �`�'• �+4
STORM DRAIN SDC 10$. 00 00 PARKS SDC 1 ~6�4�. 04�
I
I
I
1"1308 SW FALCON R 19E
I 'rfl rAL.. AMOUN-r FSA 1 n _
►E759. A7
I
CITYOF
TIGARD EWER ERMIC:'tIGhl
Gly 71MRD F Rl+f T
COMMUNITY DEVELOPMENT DEPARTMENT o:nom E.RMI'r *. . . . . . . : SWR91 -0116
13126 BW FWI Bbd. P.O.Bm 23347,T*M,Or*Wn 97223(603)&04176
---- --- --+ri-r+-x- -- -- L8 fF9 .-- ". --
r
S I TF: ADDRESS. . . : 12808 SW FALCON RISE DR PARCEL.: 1 S 1,33DD--146ft,
SUBD I V T S I ON• . . . : V I LLAGS AT SUMMER LAKE PARK 4 Z 0611 N63. R-4. 5 9
BLCICR. . . . . . . . . . . LUT. . . . . . . . . . . . . : 183;
TENANT NAME. . . . . :
LSA NO. . . . . . . . . . . FIXTURE. UNITS. . . :
CLA`=;S OF WORT;. . . :NEW DWELLING UNITS— : 1.
I YPE UFF Uyt:.. . . . . :bF NO. Of BU I LD I NGS: 1
INS I-(ALL TYPE. . . . ;BUSWR IMPERV SURFACE:. . : :sf
Remarks: check for cold spats in front room
flwner. ___.__.._•.....__......_..._....._._.__.__......_.._.._.,_-.--...._ _ _..__.___._.____._-_.._._ FEES
DON MORISSETTE ELDERS, INC. type amount by cyte
P 0 BOX 19524 171 RMT $ 1500. 00 BCR 06/21:1/91 O
INSP $ 35. 00 PCR 06/28/91 O
PL)R'1l_I`1ND OR 97219
-pont., *1 503-620-75:38
QUN,r RACTOR.NOT ON FILE:
Phone iF: t 1.5:.35. 00 TOTAL
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Insaect i on
of the Unified Sewage Agency, The permit ewpires 129 days from
the date issued. The total amount paid will be forfeited if the
perait expires. The Agency does not guarantee the accuracy of the
siJe sewer laterals. If the sewer is not located at the measurement
eiven. the installer shall prasoect 3 feet in all directions from
the distance eiven, If not so located. the installer shall purchase
a "Tap and Side Sewer" ;ermit and the Agercy will install a lateral.
p0rinittee! Siunat .ir,e:
T ss3u ed By --.....__._._._..._.__.
Call for inspection - 2::39-417`,
SHOEMAKER'S PLUMBING INC. ? _ �\ _ C
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 1 AY CONCERN,
SHOEMAKER'S PLUMBING INC. GIVES THEIR PERMISSION TO
LET DON MORISSETTE HOMES INC. SIGN ALL PLUMBING
PERMITS FOR SHOEMAKER'S PLUMBING INC.
SINCERELY,
HAROLD
�B.nSHOpE�MAKER PRES.
630-7728
I ; ' I
ENT RECEIPT NO- 19(-)-"204922
CITY OF I '
RF--�UEIPT OF PAYN (;HE-Cl,- AMOUNT 37o4.39
CASH 'AMOUNT (.1.cw)
NAME i DEVELOPMENT NORTHWEST PAYMENT DATE 09/19/90
ADDRESS SUBDIVISION
122; 74 I.-ANSI)OWNE
PORTLAND, OR
AMOUN
AMOUNT PAID 1:,UPPOSE OF PAYMENT T PA 11)
pt.jRPOSE OF* PAYMENT
15 0
C -FE'i�m MST9('0::(' Buiti) PER
j 4i .5 0 1500.QQ
Mh*CHANlCAL PE 224.08 SEWER USA 600.(10
PLAN CHECK F r-- 00 STRE-FT 9DC -
375. QQ
13E.WER INSPECT 2!;C). STORM GRAIN SDC
F,Arjhi.S SDC
l �
l �
[01AL. AMOUNT PAID 17 0 4