7134 SW MAPLELEAF STREET � ♦irn.w wehww�
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' INSPECTION NOTICE
p City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223 `
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-1171
Inspect ion s
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line PINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg. I!
Poet/Beam Mech. Rain Drain Insulation Q Plumb._)
P: bI Underflo) Water Line Gyp. Bd. -Mech.
1 r ( J Times AM _PH
Data Requ'"n�eted s �''
Address: / 1 —��/ 21X- \Q ` " "Permit /:q _"" JQ
Builder: '✓t. —
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inepect.o
APPROVED DISAPPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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MEMEMEN-
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INSPECTION NOTICE
city. of Tigard Building Department
13125 S* Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)t 639-4175 Business Phone: 639-4171
Inspections
Footing Plbg. Underslah Mach. Rough -in APp c/Sdwlk
Found. Plbg. Top Out Gas Lina �!Itl1Lt
Post/Beam Struct. San. Sewer Framing (-e'J_
�.
Post/Beam Mech. Rain Drain Insulation
-Plumb.
Plbg. Underfloor Nater Line gyp. Bd.
Date Requesteds
`iAN _ PM
Addreset„
Permit #I ,
Buildert� ' ✓� _Ij lC`�\ (�`1 / ��
TBR FOLLOWXMG OORRECTIONS ARE REQUIRED:
I
Ine ctor:
_ Date s�
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t
v APPROVED DISAPPROVED APPROVED BUBJRCT TO ABOVE
For Retnep.
5
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II
CITY OF TIGARD
i COMMUNITY DEVELOPMENT DEPARTMENT CERTIFICATE IFIC'ATE OF
13125 nW Hell Blvd.Tigard,Oregon 97223.8199 (503)839.4171 OCCUPANCY
x x x x PE RM 1 T i1. . . . . . . a M5Tc3 3 .00CbE3
639-4171 00'TE ISSUED1 08/19/9:7,
PARCEL:
m
SITE ADDRESS- - : 07134 SW MAPLE' LEAF ST
SURD I V I 5 I CIN. . . ., z MAPLE LEAF ZONING li
BLDCK. . . . . . . . . . L.UT. . . . .a . . . . . . . . a a
CLASS OF WORK. a NEW
i
TYPE OF USE. . . o SF ■
OCCUPANCY GRP. s R3
OCCUPANCY LOAD 1225 4
TENANT NAME. . . a �
Remarkso PATH I
Owner:
!' nIYI GA R I CH CONSTRUCTION INC:
4 515 Sw SALIM wly
TUALAT I N OR 97062
Phone #.- 692-•7r-08 j
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C.ontractorl _...__ ,_.... -..._. ._...._. .._........._,... __._..._
i
SAM aAR I C:lI CONSTRUCT I ON It-It"
1. 6455 ^W IN'YBE RG LN 1 .103 �#
TUALAT I N OR 97060
1
Phone #a 5fi3- 69c '7c'.0f3 r
14*9 #. . : 61267
Occupancy of thl, above referenced building is hereby given, and certifie% l
the compl lance .oith the !-)tate C7f Oregon Specialty Code% for the group,
1.1rcupancy, and use under which the referenced d C,er rnit Was issued.
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FIRE IfCAARTME<N7' JIJ; 1. , IN:IAf:C'TC7R
BU FL. VQF"F"I C I AL.
POST IN CONSP I LUOUS PLACE
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INSPECTION NOTICE
City of Tigard Building Department
133.25 BW Hall Blvd. Tigard, Oregon 97223
" Inopectki;n Line (Rec+-O-Phone)s 639-4175 Busineas Phones 639-4171
Inspections\ t- 1.1 z -1
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out cats Line lINALs )
_-
Post/Beam Struct•. San. Sewer Framing (' -aldi{r.�)
Past/Beam Hoch. Rain Drain insulation -Plumb.
Plbg. Underfloor Mater Line Gyp. Ed. / Maeh ■
Date Requestedt _ .P11
Addreses !_).,_f. �o,.r; ,Permit 1s2. -Ani.� 0
Builders
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V
THE FOLLOWING oORRECTIONG ARE REpUIREDS F.
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Inspectors t. DatAr /
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
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L Call For Reinap.
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INSPECTION NOTICE
City or Tigard Building Depart j ent ;R
13125 811 Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. 'lnderslab Hoch. Rough-in Appr/8dwlk
Lound. Plbg. Top Out Can Line FINAL:
Post/Beam Struct. San. Sewer Framing --Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hoch. .
Date Raquerteds
PM
Address: -7 �iV /�✓��_ p ` �? Permit i e
Builders / �-
TBE VOLLOWING CORRECTIONS ARE REQUIRED:
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To
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5 L Fob < F� f,/SAKTI c q l �
Inspector:Lf-f� Dote:
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--rABPROVED DISAPPROVED __L,- APPROVED SUBJECT TO ADOVE
).
Call For Reinap.
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INSPECTION NOTICE
City of Tigard Buildi"g Department
13125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec••O-Phone): 639-4175 Business Phone: 639-4171
i
Inspectlons
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
i
Found. Plbg. Top Out Gas Line FINAL:
5.
Poet:./Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Innulatlon -Plumb. ■
Plbg. Underfloor Water Line Gyp. ed. - Bch.
Date Requested: -Time: AM _PN
Address• � Pec'mit #s
111
Builder-:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: Date: �_ .Z '�
--- �-_
APPROVED DISAPPROVED 'G APPROVED SUBJECT TO ABOVE
Call For. Reinap.
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INSPBCPION_ NOTICE
City of Tigard Building Departae:nt
13125 BW Ball Bltd. Tigard!, Orogen 97223
Inspection Line (Rec-o-Phone)e 639-4175 Business Phones 639-4171
Inspection:
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer ` Framing ' -Bldg.
Post/Beam Hoch. Rain Drain CY Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Rd. --Hoch.
Date Requested: l/ -1
' I ��^_ Times AM.rGG��JPH
Address: ,--� / Permit 1:
Build wrs
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors '7
� - Date:.
APFRUVED DlgpppROVED APPROVED SUBJECT To ABO"
Call. For Reinep.
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ws ECT-lON NOTICE
City of. Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rw---o--Phone): 639-4175 Business Phones 639-4171
Inspection:
Footing Plhg. Underslab Hoch. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewerrsminy 1 -Bldg.
Post/Beam Mach. Rain DrainInsulation ) -Plumb.
Pl.bg. Underfloor Water Line GYP• Bd. -Hoch.
Date Requested: /(�' __Time:
_AM P '
AddresesV Yid�a/G el�Permit �: " 0 _ 1IUCl
Builders
THE FOLLOWING MRRRCTIONS ARE REQUIRED:
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Inspector:
Date:
i
--APPROVED Z-�DI3APQROVEU APPROVED AUBJECT TO ABOVE
Call Por Reinsp.
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INSPECTION NOTICE
City of Tigard Building Department
13125 SW Mall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-PhonP) . 639-4175 Business Phone: 639-4171
Inspection:__
Footing Plbg. Underalab Mech. Hough-in ) Appr/Sdwlk
Found. Plbg. Top Out Gas Line P114AL:
Post/Beam Struct. San. Sewer Framing -Bldg.
i
Post/Beam Mach. Rain Drain Insulation --Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Meeh. ( '. '.
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Date Requested:— �� — Tin AM PM er
ySw s+'
Address:— Permit is-`7 �yVU�
Builder: —
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector:_ /f---{ '--�
------_------- Dates
APPROVED v DISAPPROVED APPROVED SUBJECT TO ABOVE
all For Reinnp.
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I-NSPECTION NOTICE Q7 �
City of Tigard Building Departmnt
13125 8W Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: --
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Pound. ,,PiZg. Top Out ` Gas Line FINALS
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Boam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested:__ Ll --- // Time: —AM PM
Address• ' �'`y_-2y , /Permit #s `'Y Q�Q r�
Builder: `,1�GJ
Th-_ FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector:•_ _ / DAte:�- -1
APPROVED- DISAPPROVED APPROVED SUBJECT TO ABOVE
—`Call For Reinep.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Hell Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)t 639-4175 Business Phone: 619-4171
Inspection:
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gan Line FINAL:
7Postlee&n
struct. SanFraming -Bldg.
Post/Beam Mech. ` aiInsulation -Plumb.
Plbg. Underfloor. _ater Line Gyp. Bd. -Mech.
Data Requested: rZ _ —_Times AM __.PM
r
Addrees: , Permit r1 6,31
Builder: /21
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: Date://_
APPROVED DISAPPROVED APPROVED SU
RJSCT TO ABOVE f
Mt
Cell For Reinsp.
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INSPECTION NOTICE
City of Tigard Building Department
13125 M Hall Blvd. Tigard, Oregon 97223
Ineper_tlon Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection;
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
o'Beem Struct.j San. Sewer. Framing -Bldg.
Ppit/deam Mach. Rain Drain Insulation -P. ,nb.
Plbq. Und&rfloor Water Line Gyp. Bd.
Date Requesf.eds_ __ i Time: — AM
Address:-2/ Permit #s _Q4'�u
Builder:-='e `� ^ •
T&M FOLLOWING CORRECTIONS ARE REQUIRED:
y
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Inspector:_______ Date:,
—_APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_____Call For Reinep.
INSPECTIQN N07lcF_.
City of Tigard Building Department
13125 SW Ball Blv4. Tigard, Oregon 97223
Inspection Line (-ec-O-Phone): 639-4175 Business Phone: 639-4171
i
Inspection:
Footing rtbg. Underelab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beata ,truct. n r Framing .-Bldg.
POWBeam Mech. a r in' Insulation -Plumb.
-Kn
�Pl Underfloor Water LineCyp. Bd. -Mach
1'
.
Date Requeetedt �J Time=
'7777 7py L` ` PM 1
Permit
5
Builder: "'_111
THE FOLLOWING, CORRECTIONS ARE REQUIRED-
Inspector:-.C��?�
�` _ Date:
_APPROVED DISAPPROVED J APPROVED SUBJECT TO ABOVE
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call For Reinep.
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INSPECTION NOTICE t
J City of Tigard Building DepaN-.pnt ,
13125 SW Ball Blvd. Tigard, Oregon 97223 C
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
J 1
Inspection: — —
i Doti Plbg. Underalab Mach. Rough-in Appr/Sdwlk i
f f
ound. Plbg. Top Out Cas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg. f
r
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp.yp. Bd. � -Mach.
� r
Date Requested: [ `��y�7�p�, K//7� Time AM —• PM
Address: � �//Gw��1_. r 1,- Permit #.4/
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
i
Inspectors— /1^r �" Date: /`•-�$� -
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
--Call For Reinap.
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CITYOFT167ARD � PLUMPING PERI+II'1
COMMUNITY DEVELOPMENT DEPARTMENT man o ► RItI I + #• • • • • • • : I�+�'r'� - �Vae
131268W FWI BMd. P.O.Sam 23997,Tlpiud,OnVon 97229(603)639-4175
5.L..F.E ADDRESS. . .. : 071:34 SW 11(4)LE L.11AF ST PARCEL: 1S136A8---1T1L008
SUBDIVISION— . - il.'V`LE: LEAF" ZONING:
BLOCK. . . . . . . . . . . Lor.. . . . . . . . . . . . . :8
CLASS OF WORK. . :1*\1EW GARBAGE DISPOSAL_S. . : 1
TYPIE OF USE. . . . :SF= WASHING MACH. . . . . . . : 1 BACKFLOW PREVIVT RS. . :0
OCCUPANCY GRP". . :R3 FLOOR DRAINS. . . . . . . :0 -IRAP,s. . . . . . . . . . . . r . :0
ST ORIES. . . . . . . . .2 WAI-ER HEE:ATERS. . . . . . : .L CATCH BASINS. . . . . . . :0
F 1 X'1 URES - __.____..______. LAUNDRY FRAYS. . . . . . :M SF RAI+v DRAINS. . . . . ' 1 �
S I NKS. . . . . . . . . . .. 1 GRE ASE T'R(-*_'S. . . . . . . :0
LAVATORIE5. . . . . ..4 OTHER FIXTURES. . . . . :ili
TUCK/SHOWERS. . . . a SEWER LINE ( ft ) . . . . :0
WATER CLOSETS. . :.3 WATER LIME (ft ) . . . . : 100 �
DISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . . . :IZi
Remarks : PACH I
a
OWNER c
SAM SARICH CONSTRUCT:LOI\1 INC' TIF $ 1460. 00 JH V.11/25/9,3 -
4515 SW SAUIrI WAY BF'RT A, 4:3 V.I. 00 JH 01/25/93 -
L;F'LL 1, 279. 51,71 ,JL_11 12/21/92 92-c''34868
i4F368
TUALATIN OR '317062 8 5PC $ El. jO JH 11711/25/93 -
Phone #: 69C'--7&:'06 5SDC $ f34?x. 00 JH 01/25/9;3 -
PARK $ 500. 00 JH 01/25/93
Plumbing Con ty ar.�tor-, _ --- .._.__.........._._._.... 1y1F'RT $ 43. 50 JH 01/x::5/9 i -
-__. Q MPLC $ 10. 88 JH 01/25/93 _ C
Name . __.._._.. L �� vrl�J-C ►LIY15PC $ 2. 16 JH 01/1`:;/93
Address:���_ .. 1,�"D8 Y PPRT $ 140. V10 JH CA1/2519:timq City : Nc�. _ _ '=jtate : P5PI" `h 7. 00 JH 0.1/25/93
v •_51'1.._.__.. t`1.Q........__....__.___
Z i p:_e) 5: ._ _ F'h o n e# ...__—
R e q #:.1619 �k! .. "J`�`�?1.._P�b_t._._._......_..
RL_.I:�UIRECi 11VSF�'EL'1-I('NS
This permit is issued tiubject to the r,eq
ulatinns contained in the Tigard Municipal. Foot/found Insp Rain drain insp
Code, State of Ur•e. '.:ipec :alty Codes and all Post/Beam Gtruct Water Line Insp
other, applicable laws. All wor^k will he done Post/Seam IyLechan Appr/Sdwlk .Insp
in accordance with approved plans. This Pim/Lind,,fah Insp IvIe(::,han i ca I h inaI
permit will expire iiwork is riot started FILM/Under^fluor-• Plumb F=inal
within 181h clays of issuance, or if work is Mechanical Insp Bt.lilding Final
suspended for more than :180 days. Plumb 7'r-o Out Er-osion Control
Ft-a.miny Insp Crawl Drain
F i r e p l a c e Insp
Gas Line Insp
Insulation Insp
`<.____..__......
Gyp Board Iny )
Flitl.�o iced F'tumtoing Contractor SignatUr-e
Call for, inspection - 6:39-4175
Lontrac:tor, Notes :__
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'd-1. ANf^I 'PA�'f'MIOO¢i*S0ijf0(Y�� ',. .. .. .., .... -,... .- _. .. .._,. • _
MASTER PE-:.RMIT
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CITYOFTIGARD T='E:RrI]. T I#. . . . . . . Ih,T9s...0008
cmroFn�+aw �
COMMUNITY DEVELOPMENT DEPARTMENT onsoN
1a1x6swHIM erra P.O.Sm 21W.Tro.rd,or.00r,9W�l�n)�i'� DATE ISSU[-_D: Qr:t/2�i/93
SITE. ADDRESS- - Q17134 SW IIIAV'LL. LEAF J.I_ PARCEL. 1S136AB••-M!.1606
SULtD I V 15 I ON. . . , : 11APLE: LEAF ZONING:
PLUCK. . . . . . . . . . LO . . . . . . . . . . . . . :6
------._- NU I LD I IVCs
'T
REISSUE: DWELL I NG UN IT'S: 1, BASEME:NT. . . . . . . . :0
CLASS CIF WORK. :NEW BEDRrIS:4 BATHS. s GARAGE. . . . . . . . . . :460 s f
l"YPE OF: USE:. . . :SF FLUOR AREIic;_______.-......-__ REQUIRED SE TBAC.KS•----.._--...---_--._
TYPE OF CONST. :5N F'I RG F. . , . :940 s f LFF T'. . « 19 f t R I GHT. :40 f t
OCCUPANCY GRP. : R3 SECOND. . . : 1013 s F'RON_I. :25 ft REAR. . .38 ft
ST OR 1 LIS. . . . . . . :2 TH I RD. . . . :0 s f REQU 1
HE I GH1.
. . . . . . . . :25 ft TO _.,_...._.._: 1957 s f SIhOKL: DETECTORS. :Y
F"I._OUR LOAD. . . . :L►Qr psf VALUE:. . . . . 4 : 1.)8302 PARKING SPACES. . « 1
ReinarFis: PATH I �
PL.U1+I1A. ING ------
SINKS. . . . . . . . . . . I FI.._OIJR DRAINS. . . . :0 BACKFLOW F'RF_VNTRS. . •Y0
LAVATORIES. . . . . :4 WAIF_R HEATERS— - 1 TRAPS. . . . . . . . . . . . . . :V1
TUB/SHOWERS. . . . LAU1\IDRY `TR AYS. . . :0 CATCH BASINS. . . - . '0
«0 ,
WATER CLOSETS. . :a SEWER LINE (ft ) . :Qr GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . : 1 WA'T'ER LINE ( ft ) . : 100 OTHER FIXTURES. . . . . :0
UARBAGE DIS.IP. . . : 1 RAIN DRAIN (ft ) . :QI
WASHING NACH. . . - 1 SF' RA l Irl DRA I NS. . : 1
ME:CHI.INICE.'aL -____________..__._......____..___._.---.___._..__.__ FE'LC7
FULL TYPES-•• •--•_------------•- UNIT PIT RS. . .0 type amor.rnt by date rer_pt
if3F15/ / / VL_NTS . . . . . :0 TIF $ 1460. 00 JH 0.1/x'5/9,3 - j
MAX INPUT':0 DJ _J VLN F FANS. . - 4 BPRT $ 430 00 J14 01 25/93 -
F URN ( 100K . . : I HOODS. . . . . . : 1 BI'LC: $ 279. 50 JLH 1c'/&.,l/92 92-2348613
FURN ) =100K . . :0 WOODS TOVES. :0 DSPC $ 21. 50 J11 01/25/9.3 --• r
F-LOOP FURN. . . . :0 CLO DRYERS. : 1 SSDL': $ 280. 00 ,IH Q)1/25/93 -
BOIL/GNP ( :31AP:QI 01-HER LiNIIS: 1 PARK $ 500» 00 JH 01/25/93
GAS OUTLETS: 1 MPRT $ 43. 50 JH 01/25/93 -
Ovjner; -_._..___.______.__._...____._._.__..._..___.._...__...__..._.__....__-IrIF'LC $ 10. 88 JH 01/25/93
SAM SARICH CONSTRUCTION INC I15VIC $ 2. 18 JH 01/25/93 f
451.5 SW if-ll.lrl WOY F,PRT' $ 140. 00 JH 01/iw5/'3 3
P5I.'C $ 7. 00 JH 01/25/93 -
1UALATIN OR 97062
Phone #: 692•--7208 r
Contractor:
S('&I GAR I CH CONST RUC"F I ON INC,
6,455 SW NYBF RG LN 1-10.3
1 UAL_AT I N OR 97062 i
Phone i1: 503-••692-7 :08
Reg #. . : 61267
$ 3174. 56 TOTAL-
This permit is issued subject to the regulations contained in the --- _-- REDUIRE.D INSPECTIONS - ----- -
ligard Municipal Code, State of Ore. Specialty Codes and all other V trot/foLrnd Insp Fireplace Insp
applicable laws. All work will be done in accordance with approved F'n st/Beam Strl_ret Gas Line Insp
plans. This permit will expire if work is no sta-te ht 1 b F'ost/beam Mec:Iran Insl_rlation Insp
days of issuance, or if work is suspended r more 1 days. f.'lm/I_rndslab lnsp Gyp Board Insp
PL..IA/Underfloor~ Rein drain Insp
Permittee 5irin�:rtl_rr e l _. ' rlechanical In=.p Water Line Insp
• __. .._ P l,_r m b Top O I.r t A p p r/S d w l lk Insp
I s s u ed By Framing Insp M e r_t-r a n i c a l Fi n a l
Call for inspection -41 7;a
CITY OF TIFA RD
SEWER C(:INNECTIUiV
COMMUNITY DEVELOPMENT DEPARTMENT \mane N F'E_RI,,II'T •
13126 0M/Hdl Blvd.P.O.Ba 23307,Tip�d,Oregon 97 (603)630.4176 \ PE 14111 T #. . . . . . . : SWR 9 3•—000 7
639—•4171 ` DATE ISSUED: 01/25/93
S1 f ADDRESS. . . : 07134 SW h'If-'aPLE LEAF ST PARCEL: 15136AB--11L008
SUBD I V I S I OIV. . . . .. MAPLE. LEAF' ZONING:
BLOCK. . . . . . . . . . . LOI.. . . . . . . . . . . . . :8 +�
TENANT NAME.. . . . .
USA NO. . . . . . . . . . : F IXTURE: UNITS. . .
CLASS OF WORK. . . ::NEW DWELL I NG UN ITS. . ; 1
TYFIE OF USE. . . . . :SF IVO. OF HU 1 L_D I NGS: 1
INSTALL TY'F'E:. . . . .BUSWR I MPF RV SURF ACE. . :
Remar-ks : PATH 1
Owner. ---__ .______.___.---------______________.__________.__.___.__.._._..- F=EES
SAM SARICH CONSTRUCTION 1NC type --AinaI.rrlt by date recpt 1
4515 SW SAU11 WAY PRIrIT K L100. 00 JH 01/25/93 —
.11V5P $ 017.1 JH 01/25/93 —
TUALAT I N OR 97QI62
Phone it. 692—•7208
C:arltractar•: ------.—.------_..__.__._.___.__...___._....__...._.______ `
CONTRACTOR NOT ON FILE'.
FAlorle 4- 2135. 00 TOTAL
Reg #. . .
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Irispectian
of the UniFied Sewage Agency. The permit expires 160 days from
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does 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 111insta lateral.
P e r'm i t t e e
1 _ Lied E{v
Call far, .ins.pection - 639-.4175
1' .. .
r ' PLNCK RECT >I
CITY OF TIGARD �3125SW�ia���l�va. /
COMMUNITY 1)EVGLOI'MGNT 1)EPA RTM11EN•I Tip(5J,Orc9-4171 23
PERMIT N
(503)639-4171 DATE ISSUED
JOB ADDRESS: TAX MAP/LUT 4V3G A.e- I1 L 01'
SUB: Y(', -1/u. LOT: LAND USE:
VALUATION: 1� Z
OWNER SPECIAL NOTES
NAME: Lebo REISSUE OF:
ADDRESS: _ LAST REISSUE:
FLOOD PLAIN/ ■
PHONE: _ SENSITIVE LAND:
CONTRACTOR J� APPROVALS REQUIRED
NAME: Lk L, I !(fir 1 . -1; C.. PLANNING:
ADDRESS: 4-1 1 -� Slt� `�a/I CL'I 1ti A Y ENGINEERING: _
C12 y7C.''bl -- FIRE DEPT: _
PHONE: _66(2 - OTHER: 'T( F
CONTR. BOARD #: W/Zt; "7 EXP DATE: _
rLUMB'
ITEMS REQUIRED
SUBCONTRACTORS: / l 'l�a��i�i�,)G iVr- r y •� LIST/SUBCONTRACTORS:
r
MECH: T. r C�-, ,�llv /k ,/trl�V4,-- -3l6 BUS TAX:
ARCHZENIGINEER CALCULATIONS:
NAME: ,( kj/I %?ILIJC��� TRUSS DETAILS:
- a
ADDRESS.. LlS /lel,/ Z>•c
l Alw•zr4e _ OTHER:
do, fit, t d or, y )Z,I J
PHONE: az'> • 1/&/ _
PROPOSED BLDG. USE: A?esrcw176ed Aioll, t.
COMMENTS:
'4
KPMCANT S GNA RE
Received By: -' cDace Received: 2--
I
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
A15r<��oc'y�J' 10-432 00 Building Permit Fees r�
10-431 00 Plumbing Permit Fees ' u.
_ 10-431 01 Mechanical Permit Fees j � ' _ �j' 'y
10-230 01 State Building Tax (5%) 3o' r� 7o'6Y
Building
Plumbing
Mechanical
10-433 00 Plans Check Fee
Building
Plumbing
Mechanics.', /v.;?K
10-230 06 Fire —
gwe4?o-, l 30-202 00 Sewer Connection off/0 0
30-444 00 Sewer Inspection 3S- 3��
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 -js
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC) SO 0 Sou
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) :2 dy T_ �
24-445-01 Water Quality (Fee in lieu of) ---
24-445-02 Water Quantity (Fee in lieu of) _
TOTAL =5 s r'1 S 5-0 SZ' 56
I
nm/3587P.WPF
I!
`,dfr
Yt .
•'i
till �
wlw-m:-r7-mw MEW
J7,
.. r;
IW1
OF TI CarWD — NEUL I FST C+F PAYMENT RECEIPT NO. e'.►3— .,.3.9 54
U4ECY, AMOUN f 3059. 5
NAM GARICH, GAM0. 0th
C.;A:;H f-�IhUIJNT
^r PAYMENT DATE. a 0l 25,193
61E?97RE C~,.� E
SUBDIVISION
FIURPUS-E OF Pn*Vh1F:NT' AMOUNT PA.CD PURPOSE UF PAYMENT AMOUNT PAID
1 u I I_E7 I Nt F'E--Rm 430. 00 PL_..MPINLS PERM 1.40. 00
1,117C HANILAL.. PF, 43. 50 s,"r. BUILD PER :irk. 68
'''I. AN CHECK FC- 4V.i. USA 2:1Q)0. 0(A
61FR INSF'E:CT 35. 00 C NEVI{Ea M)( 51110. 00
T ORM DRAIN '':C)t: .'FJVt. 00 Rr';.3 T DE NT T Wl.. T RAf'f=I r FEIE'S 1 S50. 011
TRANISIT TYF FFLS 110. 00
y
I...CiT a 14Ap1_r L.E.AF
5
7134 G;W MAF'l.E' 1._F-AF +s`r
TOTF)1_. AM0UN'r v4)I )