11515 SW SHOREVIEW PLACE U515 SW Shore •iea Placa --
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INSPECT_SION_NOTIC C`,
City of Tigard Building Depiartment
13125 ON Ball Blvd. Tigard, Orogon 97223
pection Line (Roc-ll-Pno[s.t 539-4175 Business Phone: 639-4171
Inspectionz�_
Yruutinq Plbq. nderalab Mach. Rough-in Appr/5dwlk
i
Found. Pilg. Top Out Cas Line FINAL:
Pont/Beam "truct. San. Sewer Framing -Bldg. d
Pont/Beam P.ech. Rain Drain Inavlation -Plumb.
Plbg. tsnd-erfloor Nater Line / Gyp. Bd. -Mach.
Date 'Regaeeteds � r[ — TiMe AM
AddresF fJ !s .Q.�1 (�.LLI�•� PeruLt #f
Bui der%L1211, _�_
T,III. FOLLOWING CORRECTIONS ARE REQUIRED:
1 ll
r
Inapecf-.s (',��l=-L' _��c — _._ Dater_
AFYROVED �r� DISAPPR D _ _ A.'PROVED SUBJECT To ABOVE
CLtall For Rainap.
INSP6C1'If7N NOTICE
City of Tigard Building Departmeat
C 13125 M Pall Blvd. Tigard, Orogon 97•s23
'1 '_1191 action Line (Rec-O-Phone): 639-4175 Bunineas Phone! 639•.4171
Inrpection:
Footing Pibg. Underolab Mech. Ro, gh-in Appr/Sewlk
Found. Plbg. Top Out enn Lim PJFAL:
Pont/Ream Struct. San. Sewer Frsml .y -Bldg.
Poet/Ream Mech. Rain Drain Inaulation -Plumb.
Plbq. Underflooi Mater Lire ;yp. Bd. -Hoch.
Date RequeCLeds _q_69 2_61 _Time: AM
Adarena• /5/5 _„ t„ .-moo . __1Wr0_t:�Q-[)�4f7
Rui.lder: C)ry i ____
TBE FOLLOWING CORRECTIONS ARE REQUIREDt
L-32jv.r � �?!fi✓L_
'S"1 c=��r+.✓�:t.`•.. h.o Aim 5.o...�c 'C. �3 caT3t.1�-:� �.rJ-r'7,�)/
10 ..r c`3- L�Tia/a G 1,L f an&u test -A- 0 A. ALCiJ I`lTr.4r
A b6ie-- _`-erlex
Inspectors _ Deter
APPROVED DISAPPROVED APPR`OVXb SUBJECT ^'O ABOVE
_Call For Reinep.
ro or.
CITYOFTIGrARD CERTIFICATE OF
COMMUNFTY DEVELOPMENT DEPARTMENT om�ooN gCt,Uf'ANi"Y
13125 SW FWI Blvd. P.U.Box 2W(%7,T}pud.cx,pon 972M(5W)OW4175 PURM I T M. . . . . . . c MST'-#O .0349
DAIS ISSMIZI)c 04/ 2/91
3I T C Flnl)F�L S` . . . a l 151 SW1 Lf1RC V I l=W 1=L. PARCEL.t
;URDIVISION. . . . : VILLAGE Al SUMMER LAKE: PARK 3 ZONING: R 4. 5
t3L.00ii. . . . . . . . . . : LOT. . . . . . . . . . .
CLASS OF WORK. :-NEW
FYPF" OF U E.. . . :SF
jCCUPANCY GRP. s FF.3
17CCUP(INCY LUAD:22LA 4
TENANT NAME. „ .
i�emArk9 L
Owner.p _._».._.._..__._ ... _. .._._..._.__...._..w_
UON MDRlssF::-fTE ULDER S, INC.
►' 0 BOX 19524
1OF.TL.AND OR 97 R 19
'hnnv *1 503-4:20-7538
Cant ra tar: _...__. _............ __.,_.
UUN MORISS TTE n4JILDERC, INC.
15535 SW LaANCY RD.
1*i:'L71 l
.AKU ll�.iWEGO OR 97035
0hone #: f 20. 713LA
Rv 4 40. . : 355%03
1..Iecup.-All y ar' the 'Above refprenved building is hereby given, A.nd r_ertxfies
.hr compliance with tha Mate Of Orerinn Specialty Codes for the gr-oun,
uc.cupency, and us" lAnde+r which the ref-erenced permit wA,.s iscuf-cl.
F=I RF" I)t_-,ARTMENT E;1►I t_1)I N I NSPU MR
PI..)ILfti I N(:; r1F C I AL.
POST "N CON�,F'I CUOU'.3 PLACE
INSPECTION NOTICE
City of Tigard Building Department
13121 811 Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)t 639-4175 Business Phone. 639-4171
Inspect i.on t
Footing Plbg. Unders_ab Mesh. Rough-in Appr/8dwlk
Found. Plby. Top Out Gas Line BINALi
Post/Ream Struct. San. Sewer Framing -Bldg.
Post/Ream Mcx h. Rain Drain Insulation Plumb.
Plbg. Underfloor Water Linn Gyp. Bd. -xech.
Date Regw%stedt_ -1/ i'll __`Tlmse __L_AM PN
Addreees ,�_�Permlt it
Bulldert�
TNR PCLI,OWING CORRECUONS ARE REQUIREDt
Inspectors Dates! �
Z�91PPROVED --- DISAPPROVED APPROVED SUBJECT�TTTTo--ABOVE
_-Call For Rrinsp.
INSFECTION NOTICE '"
City of Tiqard Building Department
13125 an Hall Blvd. Tigard, Oregon 47223
Inspection Line (nec-O-Phone): 639-4.175 Business Phonsc 639-4171
Inspection: __-- -----
Footloq Pibg. Underaleb Mech. nough-in AFpr/Sdwlk
Faun,!. plbg. Top Out Gag Line FINAL: '
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Be+tm Mech. Rain Drain Inouiation -Plumb.
Pl.bq. Underfloor Nater Lina Gyp. Bd. -Mech.
Date Requested: o ___� Time.
Address: '�'� �- permit #1
Builders ►'� —
THE FOLLONINO CORRtCTIONS ARE RNQUIRM
RCUCI2 f 'Y e-L
(
I
Inspector: ? ? Date: S _ 2�—)' I
APPROVED nI6APP APPROVER SUBJECT TO ABOVE
Call For Reinsp.
INS
ECTION NO
MICE
1
City of Tigard P•ailding Department
13125 SW Hall Blvd- Tigard, Oregon 97227 f
Innpection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 1(
i
Inspection:___
Footing Plbg. Underalab Mech. Rough-.in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Poet/Boom struct. Sen. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Tnaulation -Plumb.
Plbg. Undertloor Water Lina C Gyp. 1ld. Nech.
Date ' qunsted: ` p / Times AM PM
Address:
_- /;�- _ �./ Permit
Builders
THE FOIXOWING CORRECTIONS ARE REQUIRED:
inepectars.
- APPROVED T DISAPPROVED APPROVED SUBJECT To ABOVE
,_Call For Re:nap.
IISPI'V71ON NOTICE
City or TiQud Unilding Department
13125 ON Hall Blvd. Tigard, Oregon X7223
Inspe^.tion Line (R 639-4175 HuBine � Phone: 639-4171
; c J
Inspection:_
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Pl.bg. Top Out Gaas Line FINALt
Poet/Ream Struct. San. Sewer /F-'� TCaslin ..% -Bldg.
poat/Ream Mech. Rain Dre_r :, "ULAU.91 -Plumb.
Plbg. Undnrfloor Hater Line Gyp. ad. -Meeh.
Date Requested: At --P,-`I I _._ 'Mmes AM `PM
I.Itic��U Permit t: '?C
t
Builder aw, XUc' Z l� "1 --
'CMN. FOLLOWING 0. ONS ARE RRQUIREDt
Inspectort _...__..... — Date:
��'APPROVID DTSAPPROVRD APPROVED SUBJECT TO ABOVE
Call For Reinep.
1NkpECT O NOTICE
City of Tigard Building Ov4o rtweot-
13125 571 Ball Blvd. Tigard, Otogon 97223
Inspection Line (Ritc-O-Phone)s 639-•417b Business Phone: 639--4171.
Inspection. -- --'
''ootin9 Plbg. Underelab Mach. Rough-in Aper/Sdwlk
Found.
Plbg. Top Out Gas Lina FINAL:
----_.`
Post/Bean Struct. Sail. Sewer
-Bldg.
Poor./Beam Hoch. Rain Drain Inrulrtion
-Plumb.
Plhq. '
tnderfloor Water Line oyp. Rd. -Hoch.
—�5 I� �--?M
Date Requested' Time t —AM.�
Address: Permit 1'
Buf.Ldert_z2)2
THE FOLLOWING CORRECTIONS ARE REQUIRED'
. �nT-r+��-'r� C`a� "'Prz� oT ��'�i?i� •+.�% _AQP l.�c�...�z-'
Inspector'(
APPROVED DISAPPROVED APPROVED SUR.TF.CT TO ABOVE
Call For Reinap.
w
INSPECTION__N[OTICE
City of Tigard Building DepartmenL
13125 Sit Ball Blvd. Tigard, Oregon 9727.3
Inspection Line (Rec-O-Phono): 639-4175 Buein�se None- 639-4171
Inrpectioni _--
Footing Plbg. Underelab Mech. Rough--in Appr/Sdwlk
Found. Plbq. TopOut Gas Liue FINAL:
Poet/Beim Strurt. San. Sewer Framing -Bldg.
Poet/Rearm Mech. .ain Drain Insulation -Plumb.
P).bq. Underfloor Water Line Gyp. Rd. -Mech.
Date Requested:_ G/ -_ TLMI _ AM ,_PN
Address: I * 1� �`mil;<� P"M #I �, 1
THE FOLLOWING COPREC'fIONS ARE RRQUIREDt
l - _
l
Innpect_or: _ Date.
APPROVED LiSAPPROVED ^� APPROVSD SUB.IRCf TO AROVR
Call F,r Raines.
INSPECTION NOTICE
City of Tigard Building Department
13125 SM Bail Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone): 639•-4375 Business Phone: 639-417 �
Inspections -
Footing Plbq. Underslab � Hach.. Rough-in Appr/Sdwlk
Found. Plbg. Top Out ` "Ga/ Lines FINAL:
Post/Beam Struct. San. Sewer Framing .-Bldg.
Poet/Beam Rech. Rain Drain Insulation -plumb.
P3bg. Underfloor Water Line / Gyp. Bd. -Mech.
Dare
Dare Requested: — / I Timer AM PH
Address: Permit ir1D Q
Builders �T
THE FOLLOWING CORRECTIONS ARE/ IREDr
Inspectors
Dates
PPROVRD DIShPPROVED _ APPROVED SUBJErT TO ABOVE
Call For Rein/p.
INSP11 ION NOTICE
City of Tigard Buildi.nq Departuent
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec`-O-Phone): 639-4175 Buainees Phor✓,: 639-4171
Inspection: I
Foot,.'.ng Plbg. Underelab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top 3-1. Gas Line FINAL:
P08C,e ae ltruct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbq. Underfloor Water bine Gyp. Bd. -Neah.
Gate Reyuested: 1 -�--Time:
Add rvr:e: ' (� Permit A:�(�
Htj
THE FOLLOWING CORRECTIONS AAE REQUIRED:
Inspector:_ Date:
APPROVED DISAPPROVRD _ _ APFROVED FUBJRCT TO AnovF.
_Call For Relnsp.
I
it
i
�i
�wggerrzoN�"�
City of Tigard Building DepsrtAwML
13125 SW Bell Blvd. Tigard, Oregon Q7223
Inspection Line (Rec-O-Phone): 639--4175 Business Phone: 639-4171
Inspects-n:_ ---
Footing Plbg. Under;wlab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINALE
Post/Beam 8truct San. Sewer Framint -Bldg.
Yost/Beam NechRain Drain Insulation -Plumb.
Plbg. Underfloor "star Line Gyp. Bd. -Hoch.
Z l 1'
Date Requ®9t_odfTime:
- s
Address: (�6 6 JV iwe the i- Permit #.100_/ 1
Builders
T8E FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector:_,/„ _ Date:
4_2 _
APPA7'tD DISAPPROVRD _ APPROVED SUBJECT TO IOL,"
Cal.l For Reinsp.
JAR ECTIUN —NOT ICE
city of Tigard Building Depart&'mt
13US SM Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-41.71
Inspection:— _—_. —__--__ --- —•— "�
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
Poat/Beam Ftruct. 5Sewer Framing -Bldg.
Post/Beam Mech. Ineu1.ation -Plumb.
Plbg. Underfloor Oyp. Bd. -Nech.j
Times AN PN
Date Requeoted�t� �
Address:
��—_—/��= �— / 9�����✓ Permit
guilder:—4QM -
THE FOLLOWING CORRECTIONS AAE REQUIRED:
t� c
?nepector: �— -- —
Let-
APPROVICD _— DISAPPROVED APPROVED SUBJECT T BOVE
--—Call For Reinsp.
Y
INSPECT)ON NOTICE
City of Tigard Building Department
13125 OW Ball. Blvd. Tigard, Oregon 97223 y-
Ins,iection Line (Rec-O-Phoie): 639-4175 Business Phone: 539-417`/ \
Y
Inspectiont-__ _—� --- — ------- —
looting Plbg. Underelab Mach. Rough-in Appr/Sdwlk
?Mn Plbq. Top Out Gen Line PINAL:
Poet 8 m Struct. San. Sealer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Pl-umb-
Plbq. Underfloor Water Line Gyp. Bd. -Hoch.
D to Pe ';nested: —_ PN
Address: ��_ ��L4�- Permit f t�& _
Builder-_ — ---
1110 IOLLOWING CORP'BCTIONS ARE REQUIRED:
fig j!j uJAG -
y P�u i�aLcs��i.�c� /►i'��.t �1 S � r�.0 __—�
---
iy; l
��It��Ltl �O"7Z�/✓f GD� 4�11'OS/vim' �fJ•crTiQdL
Ineneotort _ Dates, "'Z
APPROVIlD DI811PPROVBD �.-APPROVRO RUBJECT TO ABOVE
Call !or PALnep.
PLUMBING PERMTT
PE=RMIT #. . . . . . . . MST90-0345
CITYOFTIGARD CRYOFTWARD
COMMUNITY DEVELOPMENT DEPARTMENT \ OREGON DATE I SSUEU t 01/09/91
13125 SW Hell Blvd. P.O.Bot 23397,Tige rd,Oregon 97223(SM)639-417561T6
PL--
SUBDIVISION. . . .
ySUBDIVISION. .. . a VILLAGE AT SUMMER FILAKF_ 3 Zf IN I NG:
BLOCK. . . . . . . . . . n LOT. . . . . . . . . . . . . A89
CLASS OF WORK. . :NEW GARBAGL DISPOSALS- 11
-TYPE OF USE. . . . :SF" WASHING MACH. . . . . . . 11 BACKFLOW PRE=VNTRS. . :O
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . 10 TRAPS. . . . . . . . . . . . . . t0
STORIES. . . . . . . . :2 WATER HEATERS. . . . . . II CATCH BASINS. . . . . . . 10
FIXTURES-----'-'-------- LAUNDRY TRAYS. . . . . . :0 SF RAIN DRAINS.. . . . . : 1
KINKS„ . . . . . . . . . : 1 GREASE TRAPS. . . . . . . :0
I-AVATORIES. . . . . ax OTHER FIXTURES. . . . . :0
IUB/SHOWERS. SEWER LINE i f t ) . . . . :0
WATER CLOSETI�. . ' WATER LINE ( ft ) . . . . : 100
U I S'IWASHE RS. . . . RAIN DRAIN (ft ) . . . . 10
Remarks-
OWNER'
DON MORISSETTE BLDER:i, INC. PAYM • 40. 00 JLH 10/25/90
D 0 BOX 19524 BPRT $ 495. 50
BPLC ! 322. 08 ! /
PORTLAND OR 97 .1 a 9 B5PC h 24. 78
Plinne #t `..503•-620-7538 E;SDC $ 375. 00
MPRT $ 34. 50
Plumbing Contractora--__..__. _____,__-- MPLC ! 8. 63
M5PC $ 1. 73 ! /
Name:_ _._ _-..__._ _.__� _.__._. PPRT $ 1,32. 50
P5PL $ 6. 63 !
L,it 5t at e :- _ TIF i 1350. 00 /
Z i p a �. .-Phone#a ___ PARK $ 250. 00 / 1
Reg M a _ _ __._____� _ _ _ _.____.__ PAVM f 2961. 35 JLH 01/09/91
REQUIRED INSV'EC:I IONS
This permit is issued st-1b.,ject to the, r^eg-
itiations contained in the Tigard Municipal Foot/found Insp Rain drain Insp
r;t?dp, State of ore. rper-ialty Codes and all. PostlBeatlE 8truct Water Line Insp
other applicethle laws. All work will be done Post/Beam M1?chan Appr/Sdwlk In;:[1
in accordance with approved plans. This plm/ondslab Insp Mechanical FinAl
(jermit will expire if work is not started PLM/Underfloor Plumb Final
within 180 days of issuance, or if work is Merhanic-al Insp Building Final
,at_tspended for more than 180 days. Plumb Top Out Erosion Control
Framing Insp Pest /Beam Mechan
Fireplace Insp P:m/Underfloor
U,as '-inp Insp Crawl Drain
Insulation Insp Plt..lmbing lop Out
Gyp Board Insp Pll..tmb Final
X
At.lthorized F-Ilumbing Contractor, Stgna.F:ttre
Call. far inspection - 6.09-41'75
Contractor N a t e s t_ ---
InA T E R PE-R111 T
49
CIIOFTIFARD CITYOFTWARD E-R,III I T 0 1". 13
COhMUNITY DEVELOPMENT DEPARTMENT OREGON
,L 1,W Hell Blvd. P.O.Box 23397,Tigard,Orep"07924 I.OW 176 T I TA 1 9/91
5 SW GIAOR'EVII-EW
CI D 1)R ES S 22 115 1 ZON 11,16:
l),I*V I(�)10)IN.. : V1 L�L A G E. A T S U 11 M ER L.A 14,L 3
. . . . . . . . . . . . . . . . I. . . . . .
....... ....... BUIL..PING
U --, DWE I.-I-IN G UMI I'S- I H A G)E Ijf7 N I.. . . . . . .. . u0 f
I]F W 0 R K NF--W ISEDRIIS C 4 E(A TH S; 3 6 A 1`411 A G E... . . . . . . . .1 . -.646 Sf
i 1!:'E OF U S U. Or 1: 1:1,U 0 R A R EA 9.......- SETDOCKC
Yl::,E OF:' N F"IRST. . .. . : 1179 is f I-L.F 1'. 5 ft RIG)HT. *5 f 1:
SEX,01,1D.. 1265 f F:'R 1)N 2H f t R E-J.)R. 5 f'(';
1,:(-UPANL1Y GRF". -.�1;.,13 1
TO R I ES. . . . . . . 2 THIRD. 9i f R E 14 U I 1--t E D
I * S 110 11,E D T EX T 0 RG. 9 Y
4:1.6 HT. R f 1 1 -.2444 f
Pf VAL..UE-
184052 [:'ORKINU EPACES- - :0 40 $A D. . . .
-----------
.... ----
F*L-0 0 R 1)R A IN -(0 P 0 C K 1 1-0W PR EV N TR S ^0
04 n R I E S i WATER HEATERS- 0 1 R A PS- 1. . . . . . . . . . . . . ..0
1 ,*;1 10WE-.RS I OUNDPY TRAYS. 04 CATCH W)INS. . � -- -, - -, ^(]
'['WER L..INL (ft) - -0 GREASt`-� TRAPS. , . . . . . .�O
% 0 TI-1 F P F-I X T U R ES 0
40TER CLOSEIS. . 1`5 S %
I--IWASHEPG,. 61074.'.R I-INE
F-11 0 G)E DI S P. L RAIN DRAIN (ft) - 10
13 P 0 1 N 1)R 01 N!:,$. - a I r: $`3
MECHAhAXAL .......---- -*-'*-*-- ----- hey date e 1:)t
UNIT IATI'0�;. . ",0 -v o e a1110 u 1-1t
V T E. . . . . . :0 r,nyltl $ 40. 00 JLJA 10/25/90
D T LJI V171111 2 TWRT 4-.)S.50
N I."1YT 0
-100K HHOD[-;. . . . . . : 1 El P L I C $ 322- 08
)-100K WOODS1.OVES. 0 rq5I-C $ i..-4 1 1 a
F'URN, -- 90 U.0 DRYERS.: I. MAW $ ::1'15. 00
:3H1' 0 LjTI-jI:::R UNITG)".0 11 1--'R I' t 34. 50
(RAS OUTLETS" I MPL-C' $ 8. 63
1. 3
110RISSEITE' INC:. PPRT $ 1.32. 50
TiOX 195P4 6 3
T I F:* $ :1.350.. 00
11-l"11-ID OR 1-,API/ 111; 2 5 W. 0 0
5P)3---(.*-,20 7538 1-1 A Y 11 $ 21961. 35 JI-H 01/09/91
)OH NORISSETTE:
PDX 1.9524
j,m,- ii OND OR 97219
cq] 0
3- 01— ' 5 13 If)Tot
*
it is issued sub iect to the regulations contained in the REO .1.NSPECI IDIIIS
TSU
Tigard Nuilicipal Code, State of Ore. specialty Codes and all other F:*oOt/-f0UYId 111Sf-, Fi-rep).Ac.-e IvisI:)
applicable laws. All work will be done in accol"ja ce with approved r.:,r)�,jt/BPam St-rUCt GAS 1--i-Ile Insir)
clans. This permit will expire if work is not st -ted wi , I Illpchari Ilivm.[Atioll II-Ist
days of issuance, or if wort- is sus ed fo moa ths 80 days. PIM/Ltvidsil,.0 111sr) G y p D o A-r d I ms I-)
r,I In/U v,d I*-r f 100T• Rain drai.11 I 11s;rl
C7,r,I-1 P W VI 17;t)
Pl.imb 70P OtAt Appr/Sdw1V
1.' r ci,,m-i ii q I ii S r.) III e r.ha ii j.c,a.1
f(I i.ci!1 63 9-41-7
ER CCJNI,,Ec,rIUN
CITY OFTIGrARD P E'R',:'T 0 1-, K.R I,111'.. . .I
G)WR90-0406
OF 11GAitD
COMMUNITY DEVELOPMENT DEPARTMENT ORIGODN
11125 SW Hell Blvd.P.O.Box 23397,TIpM,Oregon 97223("=4175 1)A I E IS S I J 1-":D 0:1. 0 9
,,iYrE ADDRESS. 1153.5 SW SHORLVIE.W PL PARCEL: 1S133DD--0',::)00(,)
GLIBI)1:V 3:S I ON. VI L.1 001:7 WT SIJIIIIIERLAKE 3 ZONING..
FI L 0 C K.. . . . . . . . . . A LOI.. . . . . . . . . . . . .
T*EKNANJ' HAM:".
L230 NO. . . . . . . .. . . 943138 F*IX*TURE ',JNITS.
CLASS OF' WORK. cNEW DWELLIK! Ljl,*rJG. . - 1
T'YP'E' OF Lj 1;1::,. . " .SF' 110. OF' I.WILDINGS: 1
Vi'l 11:::. FAJ13WR Illr'ERV SLJRFACE. . 9 -sf
R Fa III A r P.S I
C.)W Y)el 1. FEES
DC)1,,I 11ORTGSE'T1'E DLDERS, INC. tyl:)e A III(:)t.t ri t 1:)),, d x t v! -f-e c.,17,
F, C) D 0 X 191,1:2 4 PRI1*T 1.500. 00
I N S V' 3`S,. 00
VI(1WTIAND OR 9721-9 1JAYM $ ir535. 00 ITLIA 01/09/91
Pl-ic)),e #.-, 503-620-7538
Cr)iA-r.Artci-r . ...................... .............. ........ .......
DON MOPISSETTE PLDE.RS, INC.
V, 0 B('.)X J."1524
POWTLOND OR 97219
r11 '::,03----6 F2 0 --11"J 3 6
355133
RE17111RE'D INSPECI—FAN,19
This Applicant agrees to coopiy, with all the rules and regulations Sewe-r lvir4p(-c-tiari
of the Unified Sewage Agency. Tre permit expires 128 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 locate! at the measurement
given. the installer shall prospect 3 feet in all. directions from
the distance qiven. If not so located. the insti'ler/shall pv— .......
a "Tap and Side Sever" Permit and the A fenry 41 iffstall A I.
............ ......
r:liprniitt-ee Sigiii +--
.At.kre IU,41 Z2 ................. .......
Byl .. ........ ................ .... ................................
CaLl. fo-r j.iisr.)ec�tic)i 639--,4t75
KNEW
CITY OF TIHARD RECEIPT OF PAYMENT RECEIPT NO. 1. -2 Q Fj 4,.�
LHECV. AMOUNT 449&. 15
DON 110RISSE'TTE CASH AMOUNT e ()1 ()
PAYMENT DATE 1 ('11,109/171
SUDD I V I S I ON
11515 SW '7)FIOFREVIEW
1:'URPOSE. OF PAYMENT AMOUNT PAID 1-1-IRPOSE. OF PAYMENT t."MMINT PAID
PUILDING r"E'RM 115190-0349 1199.5(:) V"LAMBING PERM 13-9 .ToO
MECHANICAL PE '..)4.,30 GT. BUILD PrM 3,3. 14
r1l .AN CHE:CK FE 296. 71 U-MER lJ9A t 500.
II P I NGPEC T 00 R t-.",SlD1--"NTlAL TRAFFIC F-EES 1250. (10
SDC oo .'.)l0FNM DRAIN 5L)G :S75.Q(
', R AN S)I T TIF rEVE) 00
0t AMOUNT PAID 4496. 5
CIWOFTWA' RD � PLAN CHECK APPLICs:FION
amr
NT orw PLAN CHECK
SMUNITY DEVELOPMEDEPARTMENT � PERMIT a
�_ sMr.w.w.a.��o_ee.uis�.ny-.a u.�vo^•rm cS+vlcs.�rs OATS ISSUED
JOB AOORESS: 5 W ' ( i' i AX MAP/LOT
;�A ('11YI 111 OT: LAND USE:
SUB: ani _
OWNER
VALUATION: '� �� -
SPECIAL NOTES
NAME: Y�'0215sFil� I-Li2L�1'�� REISSUE OF:
c> r , LAST REISSUE:
` ADDRESS: FLOOD PLAIN/
-- Sti.M1ISITJ:VE LANG:
Pi40NE; 13
—
APPROVALS REQUIRED
PLANNING: _
MNTRACPOR ENGINEERING:
_ FIRE DEPT - - --
MORE.SS: OTHER:
P1i(){UE: _� ----- ITEMS REQUIRED
LIST/.SU000NTRACTORS: "
ARCH/ENGINEER BUS TAX:
NAftE: TIZ I i; I T 1 � _ CALQILA'(IONS: _
ADDRESS: TRUSS DETAILS:
PARKING PLAN:
-- LANDSCAPE PLAN:
')NE: �9 -- 0T11ER:
CXk?1F]11T5: `f� 'r �i�r/�'_ � �- � `7•� � � L L 9_ �L� .,� (�_Q l
ter.
PERMIT,(0 ACCT a DESCRIPTION AMOUNT AMOUNT PO. SAL. ovE
10-437 oo Building Permit Fees
1-21 z
_ _ _ 10-x331 00 Plumbing Permit Fees: S -
_ 10--431 01 Mechanical Permit Fees Tel
10-230 01 State Building Tax (5X) X33 1Y
Building �i��7
Plumbing
nech 1 -7 --2�
10-433 00 Plans Check Fee
Building
11)umbir
nn v
_
h c-Y/' C7��' 30-202 00 Sewer COnnectiOn
30-444 00 Sewer Inspection 37 —
51-448 00 Street System Oev Charge (SOC) {�•- SU �ZSu
52-449 ',60 Parks System Oev Charge (POC)
31--450 00 Storm Ora►n,-+ge Cyst Oev 0%1-vg (SCLC) t' ,'3 Z j i
10-230 09 TRFO
10--230 OG Washington County fire 111 (9S7_)
10-220 00 Amart/Wedgewood r t.1 _
101At
Rft: 11
APPLICANT S GN^:t1RE
hr�nivPd Qv: Uat� Received: �fL� 7 ``•�4 __ {
N(� -
GENERAL CONTRACTOR NAME 6c ADDRESS' CASEFIPERMI'CASEFIt.E E .
c APPLICANT NAME A.ND ADDRESS:
EXCAVATION CONTRACTOR
NAME dr ADDRESS' _ )
�' �NAJa- DRESS:
Li
—_ Pi��'IcAf-�t Orr' �3
TELEPHONE NUMBERS: PROPERTY DESCRUrIION:
APPLICANTL.i\:
� - -z'I?• STREE f ADDRESS AND CROSS ST1tI:ET/LACATED
GENERAL CONTRACT'OR:112 1 r�1( ►,-t` _� T'7 f'*t ( -
EXCAVATIONCONnACfOR..j�'_jLj_i_l L\,
srw- JOB: LEGAL DESCRIP7I0N:
_—. —
Zq tWAFMR HOURS EMERGENCY TAX LUT NO.:-
l�q SECTION:PERSON,TI11-E,TEL.EPHUNE: SITE SIZE,ACRES:___
DISTURBED/WORK AREA,ACRE
LOCATION& ADDRESS WHERE SPOILS SITE RUNOFF DRAINS TO:(CIRCLE ONE)
LEAVING SITE WILL BE TAKEN A-�}EgASIN DITCH PIPE CREEK
(NOS PERMITS MAYBE Rf.QUIRED) ,—
__ ---- (CIRCLE ONE) PRJVATE PR_OPERTf
— �UBUC iffam OF WAY
EROSION/SEDIMENTATION -ONTR�LL (FSC)NIEASUK�
MINIMUM ESC REQUIREMENTS
NIININIUM ESC REQUIREMENTSMINI
CONSTRUCTION:
DURING CONSTRUCTION:
SEDIMENTATION FACImus STABILIZE EXPOSED SURFACE
STABILIZED CONSTRUCTION ENTRANCE REMOVE AND RESTORE TEMPORARY ESC
PERIMETER RUNOFF CONTROL FACILITIES
CLEARING AND GRADING R.KSTRIC11ONS CLHr. ' AND REMOVE ALL SILT AND DEBRIS
COVER PRACTICES ENSURE O.ERATION OF PERMANT FACILITIES
r0NSTRUCTION SEQUENCE OTHER-
()THFR -- ----
PLAN FOR EROSION CONTROL PP.EPARED AND SUBMI I I ED IN ACCORDANCE WrIll"TECHNICAL GUIDANCE HANDBOOK-.
EROSION CONTROL PLAN DRAWING,AS REQUIRED,HAS PLAN CONMUCTION NOTES COMPLETE,INCLUDING EMERGENCY
PHONE NUMBER, SCHEDULEJSTAGING FOR 114a FALAPPLICABLE STANDARD NO155LOF EROSION CONTROL MEASURES,AND
I HAVE READ AND Wal.COMPLY I D�ABOVE AND
EDN"f OIN TNN CONSTRUCT
TRUCTCONSTRUAn m wrAN ESC MEASURES AS NECESSARY
To
OWNER SIGNATURE yAPPLICANT SIGNATURE
• • • • • • • 10 • • • • • • • • 0400 • • ! • • *DEFT CIAI 11SEONLY. • • • • • • • • 0 • • • • • • • & 000 • • • • • • 0
RECEIPT DATE DATE ACCEPTED
FILE NUMBER RECEIVED BY`_
i
1
NMI 1M66 S.W. Rangy Road, Suite 201
Lke Oswego, Oregon 97036
Phone:(608) 620-7688
FAX:(608)620-7486
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