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R
INSPECTION N07 ICE
City of Tig:4rd Building '7epartment
P O. Box 23337
Tigard, Oregon 97223
Phone, 639-4175
r
Type of Inspection Y'' L�l ---
Date Requested_ �� �, _. Time r_�A.M._. P.M. i
Address � Z()_ yl �/`�-t'.�� Permit M-' G
Owner.__ e_ _ _ — Lot #
Builder / --� .�
The f,//.Illo//wing Bu=iding Code deficiencies are required to be corrected:
_15 1.0 •�,_ � _
T."" r
Presented to '"7 _. L I Approved V� `
Inspector ~_, -__ I Disapproved
----
CALL FOR REINSPECTION
❑ YES 0 NO
rte.
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 9/223
Phone: 639-4175
Type of Inspection-.
Date Requested "L�� . ime A.M. _�^P.M. y�
Address 7c'C��:lfa �1 Permit
Owner -__-- —�-- __.�
Lot
Builder
The following Building Code deficiencies are required to be corrected:
Presented to Approved
Inspector U Disapproved
Date
CALL FOR REINSFF,CTION
C� YES [_) No
ss:r .. sssr �. si. e: ss:r sssr ss:r wr
INSPECTIOV NOTICE
City A Tiga�d Building Department
P.U. Box 23397
Tigard, Oregon 97123
Phone 639-4175
Type of Inspection
Date Requested---� -') Z — Ti/me/J__D'v✓K A.M.—P.M.
Address __Z-2 yd 7- Zr-= - Permit
Owner Lot #
Builder
The following Building Code deficiencies are required to he corrected:
Presented to Approved
I r Spector Y — �isepproved
Date -4- --
�CALILtR REINSPECTION
INSPECTION NOTICE
City of Tigard Building Dgrartment C1119
P.O. Box 23397
Tigard, Oregon 97223 pro
Phone: 639-41.75
Type of Inspection Uj
f
Date Requested 3— Time-- A.M.---P.M.
Address e� '-�2 C-4, Permit
Owner Lot #
Builder
The following Building Code deficiencies are required to be corr,icted:
J
r
Presented to Approved
ln".ctor disapproved
Date
CALL FOR REINSP�EION
El YES No
INSPECTION NOTVE
City of Tigard Building Departrient
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested— Sj Time A.M. P.M.
Address
--,-) t/'�) -2 Permit
Owner Lot
Builder CLZ
The following Building Code deficieiJes are required to be corrected:
17
Presented to �Approved
Inspertor Disapproved
Dot*
CALL FOR REINSPECTION
0 YEP ONO
.. ss■ sssr en .. ■. s
i
INSPECTION NOTICE
City of Tigaid Buildiog DV,,artrnent
P O. Box 23397
Tigard, Oregon 97223
Phone: 6391-4175
��ypf pention _// /u�G�/ ��Le—
Date Paquesteu_ —�� - Time A.M• P.M.
Address _,��`�<� ermlt #_
b 'vy�G
Owner Lot #
Builder ��
The following Building Code deficiencies are required to he corrected:
Presented to __ _ Fr Approved
Inspector u Disapproved
Date s L p
CALL FOR REINSPECTION
0 YEs C] No
INSPECTION NOTICE r
City of Tigard Building Department /�`o
P O Box 23397
Tigard. Oregon 97223
�
Phone: 635 i75
hype of Inspection '/ _ ���,�r� �:�?f•�
Date. Requested o�p 91 — Time A.M. P.M.
Address Permit
Owner_-- - _- _ r Lot # M
Builder
The following Building Code deficiencies are required to be coridcted:
F resented to ._ .__ .__ —_— _____ I"I Approved
Inspector y� - —�_—_ Disapproved
Date
CALL FOR REINSPECTION
YES I___1 NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection CF - Post & 6eam and__ echani�a 1
Date Requested 5/2/69 Time A.M.—P.M.
Address1'2427 SW Morning Hill Driv� _— Permit # Q9-QA66
Owner—_K.D. Lee Bldrs. - 620-4100 Lot #�_ —
Builder _(Requested AhC .�1u P 11f�b_ E�ain D��31IL�dBI _ `tSdL't-k ')
The following Building Codp deficiencies are required to be corrected:
Presented to �__� Approved
Inspector +� f _ [� Disapproved
Dei". --
CALL FOR REINSPECTION
El YES ❑ NO
IWWJLW
JLW
INSPECTION NOT.CE L/
City of Tigard Buiiding Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested Time A.M. P.M.
Address I-jt ermit
Owner Lot #
Buil
The following Building Code deficiencies are required to be corrected:
Presented 't Approved
tor -.51rpll;r
Inspector d
Date
r,,AL FOR REINSPECTION
E-I YES U3 NO
1'1:�'PIMT'r NO . : PLA190565
CI1Y OF TIVA RD CITYOFTWARD
COMMUNITY DEVELOPMENT DEPARTMENT 01110014 89
13125 SA Halt Blvd. P.O Box 23397,Tigard,Oregon 97223,(503)639-01 75 Q
ADDPI;:SS : 1.r.- 11W M(*)PNJ:N(.; I-13A.L. I)P
16X 01 1,0100 UK :
NO : NO
WONK NI:W 1.41)1 F P (.1-05EI, P 1 Pf',I,,
1.41.1 NAL. U K F I OW PV4VN*VW
k VN 1 111 V()1:11(0 0 P y
)CA IIA! G,f!1 1:431-10 W 1:::1:4
C,ell R V!1)G 1% 0.1!�l VIOGAI
NC) iii,I I.I I, I I
D 14 FA L (J N I I I LA UND11Y V PAY I ULM('., DPATN D 1:A
I'l-00P DWAIN
1. EVRM-M/PAIN (11- 1
CiIIICI; :I.
4
'q c'r
V.cl� -,)A /v
ril 11P Pv DUMV,
0
IN
N :1 0 Y 1.:.;14 1-101A. I:A k)1)
E
R i''I 1.4 1!�!:i
I F I Ax 11117 . 00
C
0
N
T 11, I K D Lill_1.)1','!r;
R 11'()Y1I."-5CM 1-401. 1 1:11 V D
A
C C
T
O
Ci I I IA'l I ON ND. 1.3/17 1 1113 9 11)
P1.'-:f"ETP1' NO .
This permit is issued subject to the regulations cc, ,wined in Title 14 ............. .......
of the TMC, State of Oregon Specialty Codes,zoning regulations
and all , ther al plicable codes and ordinances, and It Is hereby I'ONS)
agreed that the work will be done In accordance with the plans and [A Li [ANDLAIIJ-01.i.,
specifications and In compliance with all applicable codes and I' & 0V AM
ordinances The issuance of INN permit does not waive restrictive WAll';A-4
covenants, Contractor and subcontractors shall have current city
business tax permits This permit will e,,pire and hecome null and
void if work Is not started withio 180 days,or if work is suspended or PA'.I:N DPATWI
absnooned for a period of 180 days any time after work has Fl:NA L.
commenced, It shall be the responsibility of the permittee to assure
all required inspections are requested and approved.
Permittee Signature
Issued By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
P.U.wx ,-.fl
CITY OF TIGARD PLUMBING 1:1125 -cWE>3u Wvd.
Applicants must hold Oregon Registration to conduct a plumbing PERMIT Tigard
CR 9723
busi"s or must be property owner/operator not hiring outside help.
Name n1 Development
Plumbing Permit No. ---
Address Deacription
CRS 614-21.610 WOW PRICE AMT.
Job
Tax Lor Map,No.
Address
FIXTURES
t.tN Block Subdiviskmrm
Sink 7.50 _
ems or name of siness Lavatory
Tub or Tub/Shower Comb 7.50
Shower Only 7.50
Owner t•Iry/ re water Closet 7.50
Dishwasher 7.50
_ _ . _
Garbage Disposal -'~7.50`
Name Washing Machine 7.50
Floor Drain v, -- - -_ _ - 7.50 -- -
l�eilirig less - Phone Water Heater 7.50
OCCU an! Laundry Room Tray-------- - - 7.50 - -
P City/Still" Zip
Urinal 7.50
erne ,/ Other Fixtures f SpecHy) - ----^_ -� 7.50
17
ea I - &' L"/ 7.50
ren
2 -2 // 7.50
Contractor ! 1� ZIP — 7.50
MISCELLANEOUS
City Bus Tax No. Sewer 1st 100'
tate -s ETcia►3No--�Iete�Aium�ersgiis Ic . a Sewer-ea.Addd i00 ---- ---- — 15.00
(Residential) Water Service 1 st 100 20.00
I hereby acknowledge that I have road this application,that the Information Waler Service ea.Addit."' 15.00
given to coned,that I am repsiered with the Slate Builder's Board,and also Storm 8 Rain L rain I st 100' 30.00
have a State Pkrmbkmg lice wa that the numbers given are oorrect,that all - - -- —
plumbkmg work will be done in a(xordance with applicable provkuons nr C"- Storm&P Jn Drain Addit.100' _ - _ 15.00 -
gon Revised Statutes Ctumplers 447 and 693 and egmplkable(xxdes n.nd that Mobile Home Span+ 25.00
no help will be employed unless licensed under ORS 663, (ti exempt from --- ----
Stals rrQistrat0n.please give reason below), Back Flow Prevention
HOME OWNERS _.1 hereby certify that I am the owner of the properly ie Devise or Anti-Pollution Device - 7.50
scribed above,al whidm locabon 1 propose to make a plur ibing lnstaNatlon for Any Trap or Waste Not
my own use and this mop"Is not tMkq ar"trmrded for sale,leave or rent Cdr»[,yed to a Fixture 7.50
CaikXm Basin 7.50 ---
Insp of Exist.Plumbing 40.00 Per He
__ -_ ------.__-
Specialty Requested Inspectloru 40.00 Pei Hr
--- - __- z Aller of Plumbing wMhMm
�� an E'detlnp Bldg ----- 15.00 ruin. _--
�_._ m Now B cr Build.Addition 96.00 fron.
AUTFIpRIZED SI(3hU1TUR� Dam � _
- -- Pain Qrain,sirnLe family
beRcribe work now[ ) addition altembon repair[] cWllirg 15.W
tem be done residential( ) non-reekiwitial
Existing use of
bl.rk*V or Property___ _ _ --. _---__ OWTOTAL
b�utps of
g1RCliAl101E - -
PY
NOTICE - _ .-._TtJTAI 1_
Ttri pw, bsoornea ni irl and viid N work oroon*vuallon*Ahoffxad ienot corrin
111101111111111 d wMNMt 1t�0 dappr ilm omudlam ar worlit M uspa or dIandoin d for L
a P~of 100 dare ar any&t»~wxk Is aorrwhi need.
IM<p{Al.C10NQITIOfttll_.,. __�____-__�r..� -_-- -_ --__.__ �
Dale 119nled ?/79 -. by
- - - -
rmflh 449 111 W,Ire
INSPECTION-NOTICE
City of Tigard Building Department d
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspdcticn
Date Requested r Time A.M. �c'r-1 t P.M.
Address c r� � �,?(I 1 liY�1 _ Permit # (7'6')
Owner / Lot #
BuilderThe following Building Code deficiencies are required to be corrected:
Presented to _ ____. _ Approved
Inspector _ Cl Disapproved
�__ ✓
Date
CALL FORCREINSPECTION
L7 YE8 El NO
I
r, NOR
I:)I—tJMFs:I:N(� PEAMiT
CITY OF T16A RD k--c I- EAWIT NO. : IN 890,565
CITYOFTWAltr
COMMUNITY DEVELOPMENT DEPARTMENT
o"90"
13125 S.W.Hall Blvd..P.O.Box 23397,Tlgara.Oregon 97223.(503)6394175 D AM 14: T�')51[A":A) (1/1.'P
ID W M W 14 3, W Q 6444W444--
I,i
-47 151611 MORISITNC, I I fl I . OP
"I H F) :1.'L6100 1 L: : MOPINITNG, 1-111..A.
1'T C'M: NO:
ER
WAI CI WiE'T' 2 "1 PAP
K.: FAM11-Y UPTNAL
11 UN LAVOPATUAY R 1ROW,
TIAR 51-10WEP 2 GPEASE.* TPAP15
WAYATINIC. MOCA-11NE-' :1.
L hUNIAW 'Y'PAY I*-A.A)(.-). 17P ATN i IAA
G J:NK
WA'J 1;1! 11411:.:(), 0 1 !i'I'(:)PM/RATN (FT'
1-1 I.t in b On 1-,
W 1 1 1 It.r.-*.V TN M11' V 15
N
E ',ld 111'11 .1. 1111..-V1:)
R k'l I I (I F 1 XTI I PC,'i:S
!:;'T'A'T1: TAX
011-IIER
n
N
T
R
A
ce
I his permit is issued subject to the regulations contained in Title 14 111 ,111 1 till
of the TIVIC. State of Oregon Specialty Codes,:-oning regulations .......... .... .....
and all other applicable codes and ordinances, and it is hereby 1 r 111 1 1!1 1) T.N'51*:(�"VTONS
aqrF-Pd that the work will be done In accordance with the plains and )'1 1,:: UNDE"ASI A 13
specifications and in compliance with all applicable codes and
ordinances The issuance of this permit does not waive restrictive ruci 1* & 1;4�11m
covenants Contractor and subcontractors shall have current city WA'T[:-P 1 1'.N E I
hisiness tax permits This permit will expire and become null and VII-P . I )'T
\,old it work is not started within 180 days,or If work Is suspended or PA.I.N 1)['411
at-laodonpil for a period of 180 days any time aftrr work has
r ninmenred It shall be the responsibility of the permit Ise to assure
all requited inspections are tequested and approved
Pwm,ttee Signature
Is%Iied By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
-AM
ME -11ANICAL,
T' NO , : ME.890566
C'�OF �I��RD
CrTyiL ID
00100"
COMMUNITY DEVELOPMENT DEPARTMENT41/12/89
131125 S.W.Hall Blvd,,P.O.Box 23397,Tigard.Oregon 97223,(503)639-4175 DATE: 1 5
1-11'11j4 I"IM4, MCI
SW M0PNTN(.; 11-11I.A... UP
(Ax 10131 11.000 MORNING,
i N(:) N1.) 1
NE-.:W FUIPINACE: <.1.00K 1. AITI VIANE)ILP <1
1'YPE: !11N(A-A;:: FAMIL-Y FL)IINAGAi: J-0010- o1A HANDI-P 101(
UN FLOOD FJJPNACA.-.*. EA)AP . C001 E P
1:43 I-11EATEN4 WKISIT FAN
WKISIT VE'N'T
P/(�OHP <'31-41".1 HOOD
NO :1.
I)WI: I.1. 1 IMA'S : I INCINERATOR(COM
C."As 8LAWCOMP Pl-'VAIR U1,41TS
M 0 X T 14 11-:'(J I FA P/G10111") 504-1-41
1: 111• E DIMPWV? (3ASi PITIPTI14(3 01ITTLEK'M
I III, number.
04110 . 00
W K E.VT N
N 1.091!"11 15W HALL I ON PIEVIEW $11.0 .50
E PE.,IS IV3R . 00
TAX 10 :11.0
ON
T
R
A
0
R TOTAL.
This permit is issued subject to the regulations contained In Title 14 PEXAil"PT NO . 103cl 2
............. .......
of the TIVIC. State of Oregon Specially Codes, zoning regulations
rind all other applicable ;odes and ordinances, and It is hereby i!i%(AIJTPED INSPIECTICINN,
agreed that the work will be done In accordance with the plans and GAS 1-1114E:
specifications and in compliance with all applicable codes and & r-AKAM
ordinances The issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have current city 14 T N
business tax permits This permit will expire and become null and
void it work 15 not started within 180 days.or If work is suspended or
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all required inspections are requested end approved
I*-
- ,�—A-
iie—rmiit'ee Signature
C
Issued By:
I N5 Pl-.;'(:,I J.UN 63V
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
:
CITY OF TIGA RD cirf OF 111G '111D VILMMT
A1 :UNO . i EA.1113904166
COMMUNITY DEVELOPMENT DEPARTMENT 0110ow
13125 S.W.Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223,(503)639-4175 0 01,11,1: 1.L,S I W.1) 'el :1.f.? 89
' !I3 ADIoJ.:!51.J - '1127 SW M(JF-MMG H11...1.. 1:)1�
I 6X MAI 1 (:),( I /11]4.1 1.1-800 SUB: M014N.1-NIC', 1,411 L L'r: 1.,r!17 8K .
1.ANI 1 1, 1
1 (:l11 VAI LIA11:ON : 146 ,93'1 I.A.'JUAGI(S
F140IS11' : 230 ArEW2 1.15
WOPK GI AK), NE.W 06JEA.L. .ON I'll'15 3. L.EF,T : 1.3 1-41(:.I-TT P
I PAV. t F: C, I AM1l.'( NO . WEUR001,15 : 2 1::X'T' WAIL.L. MIINS'f :
VN W.I . F,3611-IS : 2 N S R : W
OPENT'NGS :
N
5 :
1:1: : W
101 AL ARE,:A : :L8PA'J
1`10 9,11,011U.S . 1. 1.!YT I 02-e4 (MNST: (, F-114E FIE.'J"?
18 PNE) APE.A SEPAW'? PA1,111):
31-4) . (N."CA.)1:1 . 5F:PAA1? I:4A'Tl*-,A):
t1NT NV F-Wif.':M"T
A P A(3,F '135 F114E. Sfl*-11;41(1 PI? Al AWK?
FLOW(GMM)
f
Pi. AN h
C)FW.I .
0 11
K E:V 1:N
N
E 1 91.5 SW I.11A I I Ul V 0. VII AN I:*,VJA-.*:W *P56 1.(f
R i,:I
!'i 1'A'1 U, 'TAX
1:-
C l 'i'HEN'T (;1-1ARGF:.!:1 :
c"),V.,M $P.1150 00
N
T • V U.1 111600 00
R
A 1 (19.15914 HAL L 111, VD $.?50 00
C 1.11 AT D < Ili J.()0
T
C) 1:4.4 )NE (5013) 6,0o 41.00
R I j:"l '101 All.. 11;1. ,6A9 0c,
This permit Is issued subject to the regulations contained In Title 14 PECE).P I' NO
of the TMC, State of Oregon Specialty Codes,zoning regulations ...............---....•""'•"
and all other applicable codes and ordinances, and it Is hereby 1:'41-.Ql.J1J:1r-.:X) 1N!:0::+:1(:,T'T0NL,".J
agreed that the work will be dome in accordance with the plans and :l:W', 5-F-:WlYP
specifications and in compliance with all applicable codes and F(ANDA FTON WAI L. I-4AJ:N 1:)l-*4AJ*.N5
ordinances. The issuance of this permit does not waive restrictive
covenants. Contractor and subcontract yrs shall have Current city HE:AH
—
husiness tax permits This permit will expire and become null and PLD . (.IN()J:::WA-613 CIXTY APF)ACI-1/sw
void if work Is not started within f80 days,or If work is suspended or Cil.,AI: F A,
abandoned for a period of 180 days any time after work has FAL.F? 1111A.111,11
commenced. It shall be t.ie responsibility of the permittee to Fissurf, F P A 1`13.N G
all required Inspectir-.is are requested and approved. 1!4r-.PL.ALF.
Permittee Signatun.
Issued B
/ — __-.. ____ _.-_�__
J— i I I ON 639----41.75
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
SEWEEP PERMIT
CITY OFT167ARD k!!'t PMTT' NO. : Fir..89C!
CITYOF MM
COMMUNITY DEVELOPMENT DEPARTMENT
13125 S.W.Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223,(503)6394175 DATE T!ii SUED: 4/1,2 819
1..'24r.17 SW M'.111'.41NING 1111..A DP USA NUMBE.F-1: 0374103
16AX AM :1.1.800 SUD: MORNING HILL L.T : 147 Hie
I. AND USE' : RIP
1, ITT SIZE: :
Vti EiTITION: A 1*14F'l . F.!M I.w
WORK C'A.Af-55) NE::W
(JIG E TYPE : FAMITLY
! IIe. atp P I J.1.::lit I I t a Q r oraw 5; t 13 (.:0 In r)1.y with 1:x:1.:1. r-ci v; litnJ r e cl u a t:1.c)ri% a-P -I,h e e cl
)(71141'el"13Age The p(el"Init, expire.-I!:i '1.;.20 clittylli Truln -0)0 chitte imsmovd. T'he tl3tm.1
11111JIIIVL pill-i'd W:11.11 L)e Tcw+eitecl :f.•P the pir'q±rinit exp irc'.)% ' n9v'l-If."y (1c)(jow lint qI'latr
lrit'taol I'he (1.1" the Im.�!IlLt'J.431t 4:111 Lhcrc fiide %ewt,:%r sawer is
Inum"t,ed P-.11' the Itit-omi6ill"01MIFillit, 131vir11.1 , -t'he inintia1ler vd-)OL1.3. Prt:)q;P%)cA 3 -Feel, in
i. dirrmctiorlIii fran) 0-1 e, clinit'lis.ric.'e given E41 liat mc.1 the irliatall.filar M-IMAJ,
iii. "'Imr) imild Side, Sri-ilwiel", Permit, the. At4ency wil.1 instol.11. a
D1JTI..'0:[NG� !MTWEA '.I'MI")FRV"LOt.JS AREA. :
UN.I. 1 1.
OF" IA''IJC' I
W I i I 1 1 11{;:5"5 . 00
N 1,(1`!'1 ',1,1 1 1 1 1 TON (
1 J111APUT
E $3, 1.00 . 0o
R t. i f; 1 u i OP INSTAL.L .
C
0
N I<E:V:E N
T
R
A 11-091,5SW HAI 1'. 11:41".VD.
C 97r.?R"l
T
0
R I Yi,I I*ON Nt") I-A/'I,- I TOTAL : 11111 U15 . 00
T ils permit is issued stibiect to the regulations contained in Title 14 WELIF'.I P'll NO.
of the TMC. State of Oregon Specialty Codes, zoning regulations .............
ano all other applicable codes and ordinances. and it Is hereby I!; INSPLA",TIONS
Figreod that the work will be done In accordance with the plans and N
specifications and in compliance with all applicable codes and
ordinances The issuance of this permit does not walve restrictive
covenants Contractor and subcontractors shall have current city
business tax permits. This permit will expire and become null and
void If work is not started within 180 days,or if work 15 suspended or
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all required Inspections are requested and approved
Permlttee�._
Issued By:
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
i
C1Tf0FT1G7ARD ( PLAN CHECK APPLICATION
� 1 PLAN CHECK 11 3- -26 Jci
COMMUNITY DEVELOPMENT QEPARTMEN � �� / PERMIT NSI
13125 s.w." W eird.,ao.eon 7=7.Tlpind.ons srm.(sow)6"41.rs .../// DATE ISSUED
JOB ADDRESS: _.,,. '�" /� f.l.�. r1�1�/t'('i'(;s !�'c, -i AX MAP/LOT c�S �S //11 C,U
SUB: —� LOT: LAND USE
' VALUATION:
OWNER
SPECIAL NOTES
NAME: MA /am/'� � �� y F' REISSUE OF:
ADDRESS: /tic roil. �a�• � LAST REISSUE: —
FLOOD PLAIN/
-- SENSITIVE LAND: —
PHONE:
APPROVALS RE UQ IRED
CONTRACTOR PLANNING:
NAME: ��, (U. ��" L�L.�� 1 rP/c't - —•-- -- ENGINEERING: _
ADDRESS: ��? �S// .!" !✓ /�� /a v -'- FIRE DEPT
E4 ���1' _. OTHER:
PHONE: i - /�' _ /3U _ ITEMS REQUIRED
-
L.IST/SUBCONTRACTORS:
ARCH/ENGINEER BUS TAX: _
NAME: �.o�Cut � Otiiti�° _ CALCULATIONS: _
/lt �� ,//o t' TRUSS DETAILS:
ADDRESS: O
PARKING PLAN:
LANDSCAPE PLAN
PHONE: OTHER:
COMMENTS: _7J4 k
PERMIT N ACCT DESCRIPTION AMOUNT WUNT PD. BAL. DUE
10-432 00 Building Permit Feessz?-4_
Sra5 10-431 00 Plumbing Permit Fees =_ _lzj
� Q•SGC 10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%)
Building
Plumbing
Mech
IG-433 00 Plans Check Fee
Building
Plumbing
Mech _ /0, >Z _
30-202 00 Sewer Connection -
30-444 00 Sewer Inspection 35 -
51--448 00 Street System Dev Charge (SD(:) _��o _
52-449 00 Parks System Dev Charx3e (PD(',)
31-450 00 Sturm Drainage Syst Dev Chr-eI (SSf►C)
10--230 09 I-RFD ------
10--230 OCA Washington County fire H1 (9 )X) _-
10-22.0 00 Amar-t./Wedgewood _
1011 At .5
R f.C N
APPLICANT :,1GNATU E
c
Received Isy —_-%I�'�-► Date. Received:
cn/!'`87P/1 All %y