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CEriTIJ IGAIE Ov E
CITY OF TIC—rA11r% OCCUPANCY
1 [17MIT 0MST9:,-009
COMMUNITY DEVELOPMENT DEPARTMENT DATE I SSUE:D s 07/12/94
13125 SW Hall Blvd.Tigard,Cragon 97223.8199 (503)839.4171 I
I PARGELs 2S109BA -01000
I'TE:: ADE3WC-Br i. . . r 1:367,:i W MOUNTAIN RIDGE C1
f-UADI V I S I ON. . . . s THREE MOUWA I N I,STATS ZON I NO i R•-7
BLOCK. . . . . . . . . . s L01. . . , . . . . . . . . . a 1 fI
CLASS OF WORK. eNE'W �
. YPE: O USE::. . . s SF
OCCUPANCY GRP. r R3
I OCCUPANCY LOAD s 231 a:1
E--.NAN'r NAME". . . s
Remavlfs. PATH 'I f
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)wner s
`:SCOTT NEWCOMB
"03 10 SW u AOU I 1 H RE.)
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N WBERG OR r:l'7132 �
''hone #s 62S-0614
.,untrartor'r __._.,..____. _.. ._
NE'WCOMPE. INC, CUSTOM 110ME 6
c'121500 SW ,JAGW I TH RD
I JEWBERG 00 9713-'--'
''hnnery #o 880. 0614
IWe,g #. . . 66f .-.41
'cc—ranr.y of: the .above r•^eferenved 1:1Ul 100—Ig iq bet-eby given, and c:ev,tifies
t '.,+., -)Mpliance wi th the Stato Of Oregon Specialty Curies for- the gr^oup,
"r,' tkA ancy, and use l.mde►- which the r•eferNriced per-mit as it6supd.
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ALIlC` .INEW"rECTOR
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INSPECTION :IOTIC`E 039�4'Sl
City of Tigard Building Departwmt
13125 Sit BallBlvd. Tigard, oregou 97223
Inspection Line (Rec-O-Phone;: 639-4175 Business Phone:
Inspections --- ----- _ —
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line 1INALt
Poet/Beam Struct. San. Sewer Framing -Bldg. �
Ponr/Beam Mech. Pain Drain Insulationlumb• )
Pl,,g. Underfloor Water Line Gyp. Bd. --Koch.
Date Requested: � �� (r>��lr' Times G� AN
Address: 1 7 /s��3- r�.1.L�L"`C ti Permit
Builder: d CI N
THE FOLLOWING CORRI;VTIONS ARE REQUIRED:
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Inspecto _ _ Dates t
PROVED DISAPPROVED l PROVED SUBJECT TO ABOVE
Call For Reinsp.
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INSPECTI NOTICEfid!
City of Tigard Building Departs:ent
1312S 811 Ball Blvd. Tigard, Orsi-n 97223
Inspection Line (Rec-O-Phcne): 639-4175 Business Phone: 639-4171
1 Inspection:_
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Due Gas Line !'INAi,1 J
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Ner_h. Rain Drain Insulation -Plumb. a
k rjs FkbltVi Iui ; _.-
+fi , .4i� � � 'i�� Plbg. Underfloor slater Lin& Gyp. Ed.by
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Data Requested: ��7
i Time:
yt ro� J PM
Address e Permit (y
Builders - zl��![j- jZt'�I
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THE FOLLOWIN
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RABCTIONS ARE REpvrJt AY
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Inspector: Date:
V APPROVED DISAPPROVED` APPROVED 5UBJECf TO ABOVE
Call For Rninep.
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INSPECTION NOTICEl ° riN
City of Tigard Building Department �•
13125 OW Hall Blvd_ Tigard, Oregon 977.23
Inspection Line (Rec-O-Phone)s 639-4175 Business ''hone: 639-4171
Inepecti.on• _
Footing Plbg. Underelab ` Mech.�Qygb- ' Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer aurin / -Bldg.
Poet/Beam Mach. Rain Drain 2nsulation -Plumb.
Plbg. Underfloor Nater Line/ Q,Gyp. Bd. -Nech.
Date Requested: .--PH/T Times AH .— PM
Address 1 �V � � ��-C�/�Pjermit z
Builders-fO s/ (1 —3 yet
THE FOLLOWING CORRECTIONS ARE REQUIREDs
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G—�?ti r � .ems 1 -t- � S�j-= vz
Inspectors Dates
APPIOVBD DISAPPROVED APPROVED SUBJECT TD ABOVE
Call For Ret.nsp. i
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lNEPECT.LON NOTICE
i city of Ti.9ard Buildia9 Department
1.3125 RW Hall Blvd. 119ard, Oregon 97223
Inspection Lino (Rec-o-Phones: 639-4175 Business Phono: 639-4171
Inspection:-
Footing P1bg. Underalab Hoch. Rotyh-in Appr/Sdwlk
Found. Mg. Top out Gas Line
FINAL:
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Post/Beam Struct. SM. sewer •me
l`raming -Bldg.
Post/Beam Hech. Rely--Drain Insulation
- -Plumb.
Plbq, Underfloor ( Netter Line Gyp. Bd. -Hoch.
Date Requa.:t.dl
p AN px
Address: Permit
Bullder:_ ,.�.
THE FOLLOWING CORRECTIONS ARE RF.QUIRpns
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Call For Reinsp.
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INS,-ECPION NOTICE V
City of Tigard B+:ilding Departaent _
1.3125 OW gall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o--Phone): 639-4175 Business Phone: 639-4171
Inspection:
!outing Plbg. Underslab Mech. Rou h-in A 40
4 ppriSdwlk
Pound. Plbg. Top out Gas Lina FINAL:
Poet/Beam Struct. San. Sewer Frum.ing / -Bldg. .e
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Lina Gyp. Rd. -Meeh_
Date Requested: -' I /L./
__Ttme
i ___AM _`PM
Address:_ 1 (" V,� Permit IJ
Builder:
TBi FOLLOWING CORD(.. "R RSQUIRMs
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Inspector: Dates _ ( S
APPRON=D DIISAPPPROl7D ApPRO1RD 808JB11 TO ABM
IV� •�h ✓ Call For Aeinep.
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? k+ r cit? of Tigard Building DePartiment 1
13125 Sp Nall Bled. Slgardn Oregon 9722�r/
Inspection Line (Rec-o-phone): 639-41758uaineae Phone: 639-4171 1
Inspection:_
Footing Plbg. Underelab Mach. Rough-in APP r/Sdwlk
Found, `Plbg. Top OUt
Gan Line
FINAL:
Poet/Ream St:ruct.
�15"r
Framing -Bldg.
Post/Beam Mach. Rain Drain
Ineulatlon -Plumb.
Plbg. Underfloor Nater Line
�/ OYP. Bd. -Mach.
Data Requestedt 4- q '�� 7
/ Times AM PM
Addreass J � ' ?7
f -— Permit AJ
Bulkier._
THE n)T-LOWTNl? CORRECTIONS ARE REQUI"M
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Inspector: Datet
ROVED DISAPPROVED APPROVED i9UBJECf To ABOVE
�_ Call For. Reinsp.
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INSPECTIOtj NOTICE
Cit- of Tigard Building Departaeat
13125 SW Hall Blvd. Tigard, Oregon 97223
Initpection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections ,� ----- _----
4E0
Footing Plbg. Underalab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out ( .Fg9 Lino A �
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Post/Beam Struct. San. Sewer Framing -Bldg. �r
P..ay t/Beam Me< V Rain Drain Insulation -Plumb.
Plbg. Undortloor Water Line Gyp. Bd. -Koch.
Date Requoxtedt L - 1, -c C/ —_Time= Am pK
Address: �(A 1 �1( � d Permit tt 1• l eo-My /
guil.der:l\cl�c�f��/l�
THE FOLLOWING CORRECTIONS
TNS ARE REQUIRED-
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Inspector- L
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APPROVED DISAPPROVED - 1 APPROVRD SUBJECT TO ABOVE
1 Call For Rel.nsp.
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INSPECTION_N6TICE r l
City of Tigard Building repartment 1 �/
13125 3p Ball Blvd. Tigard, Oregon 9774,')
Inspection Line (Rea-0-Phones 639-4175 Business ?:toner 639-4171
Inspection:-- N1,l �t`1n4 t� �II(�'�Il�• ��
Footing � R
Plbg. Underalab Hoch. Rough-in Appr/Sdwlk
Found' Plbg. Top out Cas Line
FINAL:
Post/Ream Strnct• San. Hewer Framing -Rld
g.
Port/Ream Mesh. Rain Drain Insulation - 'lumb.
Plbg. Underfloor Nater Line Gyp, g4,
J 1 l! -Neth.
12 111.
Date Requested, I` 1 -�I _ —Time:
"- AM
Addross:. PN
Permit
Builder:_
TME MIJOWIN:"CORRECTIONS ARE REpULREDt
--' - - -r_
Inspectors
Dates
__APPROVED D28APPROVEp APPROVED SUBJECT TO ABOVE-L-_
` l Call For Reinap. {
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"NSEECTION NOTJCE
City of Tigan! Building Department
13125 671 Hall Blvd. Tigard, Oregon 97223
Inspection Line (Ree-O--Phone): 639-4175 Business Phone: 639-4171
Inspections^ __
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top out Gas Liner
FINAL:
Poet/Beam Struct. San. Se,.er Framing -Bldg.
Post/lleam Mach. Rain Drain Insulation -Plumb. M
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
Date Requestedt--- 1.7 nn Tli:e: _AM PM
Addrese: 7, Permit 1t '
Builder:_ ,
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: ✓r/ --�'—` q
Date:
APPROVED DISAPPROVED APPROVED SUUJECT TO ABOVE }
Call For Reinep. E
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. e 1 INSPECTION NOTICE
"J" City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
(19 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
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SYY� dl Inspection:
!t ti�c ,;rtr Footing Plbg. Underalab Mech. Rough-in ).ppr/Sdwl.k
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Found. Plbg. Top Out Cas Line FINAL:!, t/Beam Struct. San. Sewer Framing -Bldg.
Rain Drain Insulation -Plumb.
Water )tine Gyp. Rd. -Rech.
Date Requeetedt �—_Time: �—_AM PM
Address" 7 /7 / / rmit #:
DuJIder:
i i l�r�r
THE FOLLOWING CORRECTIONS ARE ROQUIRED.
-�Inspector.: ,v Dates
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE r
Call For Reinap.
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INSPECTION NOT:CB l 7--�✓
City of Tigard Building Depertaant
13125 OW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phons)s 639-4175 Busineea Phones 639-4171
Inspections
Footing Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Found, Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. Sen. Sewer Framing .-Bldg.
Post/Beam Mach. Rain Drainl Insulation -Plumb.
Plbg. Underflou - Water Line Gyp. Rd. -Hoch.
Date Requested: �J �� �. _Times AM �r PM
--r
Addreees� Permit #e_LL� —dG=S-
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED:
464
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Inspectors Dates
'APPROVED DISAPPROVED APPROVED SU8.7ECP TO ABOVE
Cell For Reinsp.
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INSPECTION NOTICE I
City of Tigard Building Department
13125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Buoinens Phone: 639-4171 I
Inspection:
Footinq ) Plbq. Underelab Mech. Rough-in Appr/Sdwlk
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Found. Plbq. Top Out Cas Line FINAL: I�
Poet/Beam Struct. Ban. Sewer Framing -Bldg.
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Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Mech.
Date Requested:_ ?f , �� ^' Timet AN PM
Address: 7 1O / 11 / � `� /CNkmit
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Builder: "
E THE FOLLOWING CORRECTIONS ARE REQUIREDt
�/ ti•v1--•Qe � di i't /riL.-�...�
In"ctort_ _- i_ Dates
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
W __Ca?1 For Reinsp.
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� O TIGARDcny L�LUMBIIV(:� PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT o w� #• . • • • • . : MST93-OL4e-7
13126 BW HNI Rlvd.P.O.Bac 23397,Towd,OrMw 97223(603)634-4176
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SITE ADDRESS. . . : 13673 SW MOUNTAIN R I UGE CT PARCEL: ES 109BA--01000
SUBDIVISION. . . . : THREE MOUNTAIN ESTATES ZONING: R--7
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .. 18
CLASS OF WORK. . :IVEW GARBAGE DISPOSALS. . : 1
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : 1 BACKFLOW PREVNTRS. . s0
OCCUPANCY GRP. . aR3 FLOOR DRAINS. . . . . . . :0 TRAVIS. . . . . . . . . . . . . . .0 s,
STORIES. . . . . . . . ..2 WATER HEATERS. . . . . . : 1 COTCH BASINS. . . . . . . v0
FIXTURES----.-------------- LAUNDRY 'T'RAYS. . . . . . s 1 SF RAIN DRAINS. . . . . : 1
S.IIVKS. . . . . . . . . . : l GREASE: TRAVIS. . . . . . . :0
I LAVAIURIES. . . . . .4 OTHER FIXTURES. . . . . .0
t TUB/SHOWERS. . . . : SEWER LINE: (ft) . . . . :0
WATER CLOSET'S. . ::s WATER LINE ( Ft ) . . . . : 10147
DISHWASHERS. . . . : 1. RAIN DRAIN (ft) . . . . :Q1
Remarks: -PTH I
UIJNER. ---------------------------------- ___..._______..__.----FEEF;----------------
SCOTT NEWCOMBE
____-.____-___-SCOTTNEWCOMBE TIF $ 1461. 00 JH 02/22/93 -
20500 SW JAUUiTH RD BVIRT $ 535. 50 JH 02/22/93 --
BPLC $ 348. 08 JLH 02/00/93 93-236444
NE:WBE.RG OR 9-7132 BSPC $ 26. 76 JH 02/22/93 -
Phone #: 628-0614 SSDC * `80. 00 JH 02/22/93 -
r)1-1RK `}; 500. 00 JH 02/22/93 -
Plumbing Contractor:------------------- MPRI' $ 45. 00 JH 02/22/93 -
1 MPL,� 4, 11. 25 JH 02/22/93 -
I NG-�me :_. � Q X�.e__.�.._ ._ _ 115,r'c b 2. 25 JH 02/22/93 -
Addreir. —,/Vz fo � PFIRT $ 155. 00 JH 02/22/93 -
Citys t q St ate:- 1� PSPC `l' '7. 75 JH 02/22/93 -
Z i P s— 7.1.x.--7- --Phone#s
Req #:
RE'(AUIRED INSPECTIONS
phis permit is issued subject to the rey--.
ulations contained in the Tigard Municipal Foot/found Insp Rain drain Insp
Code, ytate of Ore. Specialty Codes and all Post/'Be;-ram Strilct Water Line Inso
other applicable laws. All work will be done Post/team Mechan Appr/Sdwlk Insp
in accordance with approved Flans. This Plm/undslab Insp Mechanical Final
permit will expire if work is not started Pl_II/Underfloor Plumb Final
within 1130 days of issuance, or if work is Mechanical Insp
Building Final
suspended for more than 180 days. Plumb Top Out Erosion Control
Framiny Insp Crawl Drain
Fireplace Insp
Gas Line Insp Insulation Insp
x _ _ Gyp Board Insp
Auth iced C'1�.�mbing ontractnr�Sigriat�.�re
Call Por inspection - 639--4175
Contractor Notes :
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� OF TIGARD► �.
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COMMUNITY DEVELOPMENT DEPARTMENT on ON MASTER PERMIT
13125 SW HWIBkd. P.O.BOR 23397,TIMM.Or"m97223(SM)e3wl75 PERMIT 4. . . . . . . . 1N15T93--00B7
639-4171 -------____ DATE ISSUED: 02/22/93
SITE ADDRE=SS. . . : 1,3673 SW MOUNTAIN RIDGE CT PARCEL: 2S 109BA-01000
SUBDIVISION. . . . : THREE MOUNTAIN ESTATES ZONING: R-7
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . c18
BUILDI14G _.--
REISSUE: DWELLING UNITS: 1 BASEMENT. . . . . . . . c0 sf
CLASS OF WORK. :NEW BEDRMS:3 BATH5:3 GARAGE. . . . . . . . . . 9700 sf
TYPE OF USE. . . :SF F=LOOR AREAS----------- REQUIRED SETBACKS----_--_---
TYPE OF CONST. :SN F"I RS T'. . . . : 1183 s f LE FT. . :20 f 1; R I GHT. : 10 f t
OCCUPANCY GRP. :R3 SECOND. . . : 1:197 sf FRONT. :22 ft REAR. . -.36 ft
STORIES. . . . . . . :2 THIRD. . . . :0 sf REQUIRED-----______________.
HEIGHT. . . . . . . . :31 ft TOTAL------:2780 sf SMOKE DETECTORS. sY
FLOOR LOAD. . . . :40 psf VALUE. . . . . $ : 141714130 PARKING SPACES. . ci
Remarksc PATH E
SINKS. . . . . . . . . „ : 1 FLOUR DROINS. . . . ..0 BACKFLOW PREVNTRS. . :O
LAVATORIES. . . . . :4 WATER HEATERS. . . : i TRAPS. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . -3 LAUNDRY TRAYS. . . : 1 CATCH BASINS. . . . . . . tO
WATER CLOSETS. . :3 SEWER LINE (ft) . c 171 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . : 1 WATER LINE (ft)" . : 100 OTHER F I X TUREV.S. . . . . :0
GARBAGE DISP. . . : 1 RAIN DRAIN (ft) . :O
WASHING MACH. . . C1 SF RAIN DRAINS. . : 1
---------------- MECHANICAL ________.________._....._._.___._________._ FEES
FUEL TYPES ___.__.___._.__. UNIT E-I'T'RS. . :0 type anlor_1nt by date recpt
/GAS/ / / VENT'S . . . . . :0 TIF $ 1460. 00 JH 02/22/93 -
MAX INPUT:0 B7 VENT' FANS. . :4 B1=R'l_ $ 535. 5111 JH 02/22/93 -
FURN ( 100K . . -0 HOODS. . . . . . : i BVILL. $ 348. 08 JLH 02/08/93 93-2,;,L,,+4,4
TURN ) -10171K . . : I WOODS'TOVES. :0 851=1C $ 2:6. 78 JH 02./22/93 -
FLOOR FURN. . . . :0 CLO DRYE:RS. : 1 SSDC: $ 280. 00 JH 02/2.2/93 -
BOIL/CMP ( 3HP.0 O'fHER UNI'T'S: 1 PARK $ 500. OCA JH 02/22/93 -.
GAS OUTLETS: ) MPRT $ 45. 00 JH 02:/22/93 -
Owner s ____._..___._.__._......__._. __. ._ .___._..__.________._IYIF'LC $ 11. 25 JH 02/22/9.3 -
SCOTT NEWCOMBE 115PL: $ 2. 25 JH 02/22/93 -
20500 SW JAG?UI TH RD PPRT $ 155. 00 JH 02/22/93 -
IVEWBERG OR 9 713v F='SPC f 7. 75 JH 02/22/93 --
Phone #: 628-0614
Contractor:
NEWCOMBE INC CUSTOM HOMES
20500 SW JAQUITH RD
NrWBE RG OR 9713;:'
Ptione #: 880-•1614
Reg #. . . 86241 ___._-._--.._._.-----_--_-___---_._____________
$ 3371. 61 TOTAL
This permit is issued subject to the regulations contained in the ----•--- REQUIRED INSPECTIONS ;------•-
Tigard Municipal Lode, State of Ore. Specialty Codes and all other Foot/found Insp
Fireplace Insp
applicable laws. All work will be done in accordance with approved Post/Beam Struct Gas Line Insp
plans. This permit will expire 1f work is not started within 168 Post/Beam Meehan Insulation Insp
days of issuance, or if work is suspended f r mn� )a 16P da PIM/undslab Insp Gyp Boar-d Insp
(-'Llvl(Underffloor ppa ' n d [ain f1ns
l='e; rnit: tee Uillrratr.lre : Ihec11an1Ca1 Insp Wa erry �ine Ins
Plr_imh Tap Out Appy^/5dwlt( Insp
Issued B y F r•a m i n y Insp h l e c F 1 a n i r_a l Final
Call for, inspection - 639-4175
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ITY
C OFTIFARD
tCRYOF116,�IRD S LWE R CONNECTION
COMMUNITY DEVELOPMENT DEPARTMENT M6001 PE Rhi I T
191268WFImIIBNd P.O.Baei2i397,Tlpud,Orpar WW(Fao)e3wr7e F'E011 T #. . . . . . . .. SWR93-0002
639-4171 DAI'E ISSUED: 02/22/9.3 '
SITE ADDRESS. . . . 1367- SW MOUNTAIIV RIDGE" (_:"T "
F'ARC:E:L: 25109BA-0100k, '
SUBDIVISION. . . . THREE= MOUNTAIN ESTATES ZONING: R-7
BLOCK. . . . . . . . . . : LO .. . . . . . . . . . . . . : 1H
USA NO. . . . . . . . . . . FIXTURE UNIT'S. . . t
CLASS OF WORK. . . -NEW DWELL I NG UN I.ro'S. . : 1 �.
TYPE: OF' USE:. . . . . :SF NU. OF BU I LD I IVG5: 1
INSTALL T'YF'E. . . . :BUSWR IhIF='ERV SURFACE. . : as:f
Remarks: F'AIH I
Owner: — ___ __..___..___._._._.._ ______.__.___..____..___ ___— FEES --------------
SCOTT NFwculvipE type amor.tnt by date recpt
20500 SW JAQUITH Rt' F'RIhT $ 2100. 0iA JH 02/22/93 -
INSF' $ 3''15. 00 JH 02/22/93 -
NEWBE:"RG OR 97132
R
Phone #: 6213-0614
Lontractor:
C,(]I'dTR()CTOR NOf ON FILE
-----------------------------------
Phune #c ciz-,135- oo 'TOTAL
Reg ft. .
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations viewer Inspection
of the Unified Sewage Agency. Phe permit expires 180 days from
the date issued. the total amount pard will he forfeited if the
permit expires. The Agency ioes 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
a "Tap and Side Sewer" Permit and the Agenc will sta a
i
1 ei-ni.i. l tee Si gnati-tr"e
T`_3511�[1 B
Ca1 .1 for- irrespection — 639-4175
/3w 364e
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rrs:.r;A;we.'wa.M+ar^.ww,.n- _,...w..:«.w
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� uluswllaunwPLNCKRECT #
d. / --r-----�—
CITY OF rIGARD Tigard,Orcgon97al PERMIT #
COMMUNITY DEVELOPMENT DEPARTMENT
(503)639-4171 DATE ISSUED
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JOB ADDRESS: v ,IJ / �� l _ TAX MAP/LOT
S 10914- �' Ove
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SUB: '�lC+�Szca�l; �;lrJS (=STATS LOT: 1 LAND USE:
VALUATION: D�±ld�
OWNER SPECIAL NOTES
NAME: _ '�oii !`I1=-L•1ct,wt�+�-. REISSUE OF: --
ADDRESS: 5�0 �� �A4�+STN :� LAST REISSUE: _ —
j , a�, , � � o� G 1►">Z FLOOD PLAIN/
PHONE: uZ8 351L SENSITIVE LAND: _
1
CONTRACTOR APPROVALS REQUIRED Stdj D Z-
14AME: _ r•l>±,, 'r""''�� 1i�IC. CvtSTy+✓I I ES PLANNING: S
ADDRESS: -A� `A- Qu+TA __— ENGINEERING:
FIRE DEPT:
PHONE: i�Pn Olid OTHER: -Pi
CONTR. BOARD #: _ s� Z4 I EXP DATE:
LI, U ��'�" '�`� I' ITEMS REQUIRED
N SUBCONTRACTORS: PLUMB: ar� -- +�-k �► YY�C�1-�J-Y'-- LIST/SUBCONTRACTORS:
MECH: BUS TAX:
�wy1�l ---�
CALCULATIONS:
1(�tCH/ENGINEER --
NAME: 4) TRUSS DETAILS:
ADDRESS: —�J11: 5u17e 1& ll hkO cK OTHER:
PHONE:
PROPOSED BLDG. USE:
COMMENTS: S.0•
APPLICANT SI NATU E
Received By: Date Received:
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a 1re y' ia'�t dnwyA
Apo v '
:fib
PLRMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE i
Y1.�L03 ' 7 10-432 00 Building Permit Fees 525.5 0 S,3;-,-0
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tar. (5%) �3 6,1 / � �3 o,
Building ��
Plumbing
Mechanical 0'2.2
10-433 00 Plans Check Fee •3S y 3 3 ��}C�� V CI, 3.5
Building .-3yk"e) '
Plumbing _
Mechanical
10-230 06 Fire
de Z 30-202 00 Sewer Connection ,;Z/uU �f
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
25-448-05 Mass Transit TIF Fees
52-449 00 Parks Systpm Uev Charge (PDC) 0 ,SU U
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) I;z k-V ---� G�, �U
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of) _A
TOTAL Es,p ro, -�S�J s�✓ —�l
nm/3587P.WPF
MYkaf^ .,.- Mf.-. .. -- .`S,,„ . . ..-. , •N "�Cfr � 'mom rrr: :rj�
.r`.R� ' ,�i j.Y:: Ih�,d�ks:�l ,c .�w,:"S+SR"l,�d;rH,,yn .. .T. ,.a mlr ar,r +•.x7 '�1 �'�� ..
Y
...—..Yus,,.r.eN'kW<CIMMWN.a�mv`Nt:N7lAr?Mkwa:':`=
1
1
i
CITY OF T I(''ARD - RECEIPT OF r-,FwmE,.rrr kE:.l';E I M-T Na. :93—Z,16981
CHECK AMOUNTa �J�:'.`=rh_,. f;1
(-)Df) s NEWC:UI+1E�t , I Nl CA161-1 AINIOUN r
(lC)1)Rf.'a`i� t PAYME:.N'f DAIS
53UBD I V 15 1 01\1
e
f='IJRP(JriE OF PAYMENT AMOUNT PAID PURPOSE Or= r-If4 MrrJT' MOUNT
sUll._C7ING t:wr rlm .9;35. 50 1='I...LIMI+ING PERM I S;;. IMP.)
MC`C.;HANTLAL PIE 4`�. 1210 !Y;T. BUILD PER 3t,. ,,a
1=4LEAN CHECIA Fl- 109. 3:3 ;tet:Wfmf3' tJtiar a 1100. (A 10
'WECF' I Nl�F,E"C;Tc,
:•.,. k1N P,44 VIS Srj(.' 500. 00 .
S'roml 1)RPIN SUC c'{.Ia. 00 RESIOENTIA1_. TRAFFIC F-F.E.S 1 0. 00
M/)F;F; '1 W.ANE;IT TIF FLEE; i 10. 00
L.0'r is T HRE G" t+'I f l4
.,
1 ,(.7-3, SW MCIUN.I i1IN RIDUE
I w I AL AMOUN r'
1
VI ..r OF rI(+faF+Cr I F. f F_.ta'1 of 1,4400 fiefI RL(.i IPT MI..).
t IiF't:'►'. GIIhIJI_!I.1T i'v
IdFa1NE:
If Nr wc,,omf,,, r:i i-.,,'r(JM f1(3mr., t I�.:ilt a1P1L1L1hJ f
(:1)r11tE:Fa; AY0It'.1141 DHTr��' ti k"� ;C,.
:'L1401 V 1*J I101V e ''
PLIPPIJOC.' OF AMOUNT PAID PLIRPW:�I- w ,I r,r r l� a r E�Mt:rtJPJ� r F�r Ci
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a�
l
,I
o- I._07' to THRITC MI)l.INT01I1 I'l-;r
;W Mcl101101'N R I DUE,
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