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12609 SW SORREL DOCK COURT i r rn n �e fD 7c' O rt 12609 SW Sorrel Dock Court TIFICAIE CI Y OF TI ARD CEROCCUPANCYOF IC WA PERMIT #. . . . . . . I BUP891045 COMML'NrTY DEVELOPMENT DEPARTMENT OREZ 11126 SW 4 dl Blvd, P.O.Box 23397,ilgard,Oregon 97223(503)"-4175 DATE ISSUE:Ds 12/17/90 SITE ADDRESS. . . v J-2609 SW FW(JRRLL r)(:)Irl L, I PfIRCEL: 191 33A D 134 SUBbIVISION. . . . c SUMMERLAKE ZONINGs R--7 PI) FLOCKo . soo . . . . . K LOT. . . . . . . . . . . . . Wir .I...ASS OF' WORK. e4EW T'4E OF USE. . . s-7 OCCLUANCY GRP., wk OCCUPANCY LOADa TFHANI W)ML. . . I R e-in-A rk a v Owl-lerl D014 MORISSETTL PO IRDX 19524 PORTLAND OR 97219--0000 Phone #v 503-244-0449 Contractors DOH PIORISSETTE ELDERS, INC. P 0 DOX t9524 PORT'LM-11) OR 97219 phol)p be 503-620-75.3s l-c-q O. . t 35533 OVOUpallCy Of the ,above referenced buildiriq is hereby givevi, And ceutific, the compli.armn. with the State Of Or -gon 5pecialty Code% for the grocip., 0C.'M4pmncy4p and use under which the referevi-ed permit was Imou"d. FIRL DEPARIME.NT1-JILDINO INSPECTOR POGT IN CONSPICUOUS VILACE. .*�.'r10-.y k aT',} •�:- v..+r. ^�A�i_+ ��ty °'�""d �r�c „��tt� � .. r � ,�T'' '.•«".�+�_ .¢.._..:..h�~ '�,,�a.�..y�.,`.,� ,, ��ta �a� �a.Tja. "4� �'t�:.. �,w°��b INV_- ' i'3• "` �.� { 'k` ��-. .} -'tRt.-. ..:�.F,,, :• .� .. A�,�zJ ".Y�: '.'"g a y " i X� sVq �s� �`9Ap1• � / . /� 111. 33.* q OF OC ; . EM-ORARY Com'= �T C'y CEs CITY OF TIGA t: Owner: Don Morissecte Permit Lo. R91,X45 ]i :address: PO Box 19524, Portland, OR 97219 } ! Building address: '2609 Sri Sorrel Druck Ct R3 Land Use Zone: R12Pr Bldg. Type vat _ Occupancy:_ T � , Comments: A0 DAY TEMPORARY =TP N 190,0 Certificate's hereby given this 9th day o. ` that said building may be occul-+epi and that it complies with all ,1 I requirements of the Building Code for the City ot'1iga:d, as ttp>✓=oyed �.,, '•'` 't by the Tigard City Council. Fire De t. But ng Ins or P _ } �' �t Buiidin ficial a J r - ' p' .: Post ( Certificate in Conspicuous Pliceff V40 t \' , n tA 010 4MV�4� r mi # •:�, :'lil.•�'.e...,� S!. .{Y� "� �•--1. _ �,c"w .•i 'O?yy..'..r.�..'� �${4 .. ` �/�./� O��� ��__ SAN ��- —INSPECTION—N-0-1, {CE City of Tigard Building Department RO, Box 23397 Tigard Orogon 97223 Phone: 639-4175 Type of Inspection Date Requested Time A.M. P.M. Address Permit #Y4iIC-X� Owner Lot Builder Thr "ollowing Building Code deficiencies are required to be corrected: 7A v CAC Y CC��?Awxy Presented to F1 Approved Inspector 10111upproved Date CALL FOR REINSPECTION VES Cl NO INSPECTION NOTI^.E City of Tiq�rd Building Departmunt N.O. Box 23397 Tlgard, Oregon 97223 Phone: 639-4115 Type of Inspection —��`; _. L r��✓ --- r� Date Requested r d i� Time A.M.Z,—a-�.M. Address _� �� Permit Owner _ Lot # Builder The following Building Code deficiencies are required to be co-rested: I AI ScJ"Ar to iU Os fz'i i gC/a'r1- — r.4 VL:IfM S-,2-w-•Jc Nv Ft�� j,'r9J✓�/seC'T"�OC� "Dcai.�-ts—TJ,ic/J"ii.t. g 5-// (""17A raz ��, �[tir�/�� -�'i�o v/S/an, "�'T=o7 c.✓�t-r'�� G'�.�rT7���-,� Presented to —_. — — ❑ Approved Inspector.�/ ... Ivepproved Date -- CALI, FOR REINSPECTION 0 yea C� No INSPECTION NOTICE City of Tigard Buildincl Department F.O. Box 23397 Tigard, Oregon 97223 'c- Phone: 639-4. 15 Type of Inspection Date Requested / —� Time A.M. P.M. Address �6rmit Owaer Lot Builder The following Building Code deficiencies are required to be corrected: l 1�, Presented to _----__—�_- � Approved Inspector __.__I __`_= _. _..�._ I I Disapproved Date — CALL FOR REINSPECTION C] YES 0 NO A A I INSPECTION NOTICE_ City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Ph ane: 639-4175 Type of Inspection Date Requested Z i"may^ Time _ A.M._' P.M. Address L'�- _� �.�-_�� .�:•'<< ��'��C Permit #_Azfz*_s— r Owner—_ --- Lot # Builder --------- -_ __—__—------ -- The following Building Code def;.;iencies are required to be corrected: Presented to - _ l�t'Approv d Inspector ❑ Disapproved Date " CALL FOR REINSPECTION 0 YE8 ❑ NO INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone 639-4175 Type of Inspection -�2�LLSLIIZ. Date Requested Time A 1�-- Address w /Z f0�Y 1�(/t.-Perm't # Owner Lot Buildnr The `ollowing Building Code deficiencies are required to be corrected: Presented to .._-. - Approved -s Inspector .f - ❑ Disapproved C ' Data CALL FOR REINSPECTION ❑ YES ONO INSPECTION NOTICE City of Tigard Building Department L P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type r„ Inspectirn Date Requested___ __ rime A.M. P.M. Address __,La^`�L7� � Permit # Owner /T _-.._--l_�.._�_ — ------_ Lot Builder --�� �- -- j --`----- -.— ;:,e following Building Code deficiencies are required to be corrected: Presented t-2 Approved Inspector — F.I Disapproved Date - CALL FOR REINSPECTION ❑ YE' Cl NO W if N i INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 type of Inspection Date Requested Time _L A.M._ P.M. Address �1Cj Permit # G ,'-j;-;ner_ Lot #-- Builder --- ' --- The following Building Code deficiencies are required to he corrected: L Presented to Approved Inspector j Disapproved Date 1,e-1 CALL FOR REINSPECTION YES 0 NO INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97221) Phone: 639-4175 Type of Inspection / a Date. Requested._ /1/ _ Time A.M. /��-��P�M Address -Permit *LEI / Owner l _ Lot # Builder The following Building Code deficiencies are required to he corrected: Presented to App,oved Inspector Disapproved Date 9 CALL FOR REINSPECTION 0 YES Cl NO INSPECTION NOTICE City of Tigard Building De?artment P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Data Requestedy�1 — Time _A.M. P.M. Address Owner __ — Lot Builder 4 -A" — -- The following Building Codu deficiencies are }r-equirrd to !+a corrected: / :y Presented to ❑ Approved inspector p 9 uisapproved Date CALL FOA REINSPECTION L'1 YES ❑ NO !fi INSPECTION NOTICE City of Tigard Buildmq Department P O Box 23397 Tigard, Oregon 972?3 Phone 639-4175; Type of Inspection Date Requested---- l T' _._P.PP i. Address , _ Permit #,FfL U� Own, --- _ — Lot # Builder The following Building Code deficiencies are required to be corrected: Presented to _ L-Approved Inspector ❑ I)iappro"d Date CALL FOR REINSPECTION C] YES O NO INSPECTION N01 ICE City of Tigard Building Departme.-it P.O. Box 23397 �gard, Oregon 97993 Phone: C'-'n-4175 Type of Inspection Date Requested �' —.�l® _ Tim -0 M. I P.M. i Address OwnerLot # Builder The following Building Code deficiencies are required to be corrected: Presented toApproved Inspector ,�/ ------ ❑ Disapproved Date CALM. FOR REINSPECTION C] YES 0 NO �I i ap v INSPECTION NOTICE City or Tigard Building Department o n. Box 223397 Tigard, v Egon 97223 Phone: 633-4175 Type of InspectionX-) �l Date Requested—--1 -/`i' "O / Time n' ,' _� A.M. P.M. Address _ .__ �� L� F�r/' Permit - Owner _ Lot # Builder The followhig Building Code deficiencies are required w be cgrrected: Presented tolt�_ - - - - ---- proved Inspector0 Diss �! .._. - pproved Date CALL FOR REINSPECTION 0 YES ❑ NO dam FAJI:I DING PEAM.11' CITY OF TIFA RD CITYOrTWARD V,E,I M:E*T* NO : BUIIA91.045 COMMUNITY DEVELOPME;qT DEPARTMENT ONIGON 13125 S.W.Hall Blvd. P.O Box 23397,Tigard.Oregon 97223.(503)639-4175 DA-IT'. 1:551JE:D: 6/249/09 JOR ADDPIESS : le'.2609 SW SOPPE-1. DO(:,K CT MAP/[..(:)'T, 1.S3. 33AI:) j.je:j()o SUB: SUMMEPLAKE: L.'T : E.W , I AND USE' : Atapl) I.fY1 51ZE: VAL-L)A1JON: $ :1.:31. a1.El E.1,1*-3 A C,K F, F'RON'T' : (2 0 PEAR : "I.) WORK CLASS : NE"1611 IWELL . UNITS : I LEAXT -. 15 PTG.1-FT : Ile, USE TYPE::: S I W.41 I;" FAMI I Y NO. BEDPOOMS A EXT .WAI L. CONST G,ONS T . TYPIE : VN NO . BATHS : 3 N: E.: W . (:K.1(:1tJP.GPP. : P'.3 P P UT .0 P F.:.NX N G Si : O0(:111.117, LOAD N G : E W 'TOTAL.. AREA : 13069 NO. !'5T01"-!]:I:rS : is IST : 1.'519 POOF* (:,ONS)* : C FiRIE-i- 1:4--l"? 1: 0 21SID: 1.550 AI*-4F.:*A 1:4 A'TE::1) IC ? - E D R A!i k:'MF:N1-? 3RD; (3(:1 tip. 11C PfA' 1:4AT MF:'/ZANI NE HASEM T F-I 0OP I OAD . X-10 '(1100 !1PPI(I 07 ALARM7 FLAW(GPM) DE111J71"? YIES H Alf, V'l AN RY 1-1 t 16::MAPK5 , $'30 F'01:11 P I.X1144A COPIF..*S (:)I::' I-ILAWI PEISSUE: OF NO. 860604 E'.X1*PA (:,L)P:LF.5 ON 171...1') PLAN WEVIE-W I WIT PF*K.'l:55LJE: 0 IF E:E.S; : —1 IN MUPJ*A1SF::T1,E DON PI;-"RM T.T 11%.115 1.3 00 N E HOX J.9115192-ell PLAN REVIEW $40 00 R P 1.1 r,t J.lik 1-1 d a 1-- 9'721.9 F*X*141.3. DE:PT 1-4-10NE: U50311 'r.44--T STA-11rK 1,01IX $P-5 . 6!5 OTHEA1 40-5 0 , 0 0 C DE:VEI.OPMEN'T 0 N MORIWIETTE DON S1,(:)PM) W?50 . 00 T [XIIN MOIATSSE.1-Tiii: F.3111.13-1 :I:N(:, . 51,PKEA, $600 . 00 R A 131:1 BOX 1.95r.?/l *e.*-50 . 00 C p1:)1- t,:I.ift I.)d 1:11-- 197'R 1.9 PREJ4.1(110 < 0 . 00> T O PHONK. (503) 241,41 9 3 1.,el I R I Pr.i.(..1!i014ATJAIIN NO. Xl!-533 'TOTAL..: 11111 1 688 . 65 This permit is issued subject to the regulations contained in Title 14 of the TIVIC. State of Oregon Specialty Codes, zoning regulations and all other applicable codes and ordinances, and It is hereby RE-EQUIPEA) INSPRCTIONS agreed that the work will be done in accordance with the plans and 001-E Nll*.; specifications and in compliance with all applicable codes and F'11*111.1NE7A'TJON WALL, 14AIN 1:11PA11SIL's ordinances The issuance of this permit does not waive restrictive covenants Contractor and subcontractors shall have current city PO51* A E.0-i-AM WA*11:14 L INE'. business tax permits phis permit will expire and become null and 171...4 UNDI-i'lliiLAR CITY APPI:11(71-4/45W void if work is not started within 180 days,or if work Is suspended or AP F1 N A L. abanduned for a period of 180 days any time after work has commenced It shall be the responsibility of the permittee to assure 171...13 . 7*01"JOUT all required inctions are requested and approved r-:'P A M:1:N C..s I A C I E.: 'T N5 U I A'TJON y P Permittee nature 114 . ROADD Issill. C61 1. 1`011- :1 N5Pl*-.(',-T J:(:)N 6310 11.75 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE N.-- CITY OFTIFANOSIE . : "910148 �tftjf' RD PE Cirf011'tWAINT) 01190N DAIE' 15Sk.JE*J) : 6/p-)P/89 COMMUNITY DEVELOPMENT DEPARTMENT I'*'PJ*M­J)M*T* .N(:). 89101q!,;) 13125 S W Hall Blvd,P.O Box 23397.Tigard.' egon 97223.(503)639-4175 ADDRE--SU : 1-2609 5161 5014PE1. 1)0(,K t-15A NUMBIEW 37,565 TAX VAj:)jj,.C)'T' 1!i0. :1.34100 SUD. GUISIME111:411...A. l<l;; 1 *1* : 15 13K : I AND tJb"l::: : 1:4 P 1) !.-'sEC t*1(IN : 1*5 Z' T*wl::, : 13:; PN('., : J.w worw (:,I-.ASS : NEM USI-K 1'Yl::'E: : G:I:N(A-+;: F'AW.I.A.-Y 'The ii&j.)p:I1A.c)s:Lrlt tis With ill.11 rUIORS P.incl Agnnc�q . nic., pviirrooit c: xI:)ii-vP14 12-0 (Jin.-Ju; 411-cim tlue chatV4 iulnit.le(J . 'F c)V,ia J. ill.1"CII.Int plvi.cl will be. the expic-pl?!:: 'Tht.-.1 Aqhrlc.y (11:101:; l"Ic)t' (-11.1 cl.I-.- litntole') thci? cif the 04' thl.-I-4 Nicllv riewei-, liativAr-iiiIia . If t1*1C.? 1-30AW"r. J.'!, I-Int lcic:ol.tk-nl act the tI1(*ib invitilo.110.41" qshiiLll 3 F*-i)V.'±t J.I t at 1.11. d 1.1-c.7 c,t i to ri in -P or.c)in t[-I(.-.I (J:1.1%t al.n(...!e (J:1.V r•;.I-1 1T u)cl't. vin I.4:)Qate(J t h vA J.n%t al 3.3. 1- %1-,.49,1. 1 pl.lrc-'halse iii. "I'vo.p iarlcl !:iJ.clie, !:l(owe)r•" Pral.-Init vollicl ths-i-I Agerlc!y wil.]. J I-Itati:0.1 as Tiikte)l•ia'l. I F-'.N A N T T M F."r4 0 V F;.M E:N I' DWI`:.'1—I.-:I:NC, UN1'T'F-.i NO I F.F:1:i 00 0 M(J 1,41 15 CiE*11,F.". 1:1 E rim T 1, 5 W 130 DOX 1.9542-1 (N)NNEX-TJON N p to r t:l.iii,n(1 9721"7 1 '.1.'NF--: 'T'AI" INS'TALL. . E 1:)HUNE: (1503) 't?d4,q9'.,S I q 01 HE:P C M0 14 V5 I:i I.-!.'TTE: WIN '7) MIN MOR15tiEl"I'li. I4(.J:IAJ)I*-.:R!--o INC N T p to MIX 1.952-1 R p to r 1.1 iii,n cI tir 9,7219 A C P"HUNEK (503) 2414-9314 T 0 MI. 3,5533 $ PE.X'E.I P'T' NO . This permit is issued subject to the regulations contained in Title 14 of the TMC. State of Oregon Specialty Codes,zoning regulations and all other applicable codes and ordinances. and It Is hereby agreed that the work will be d(.-ie In accordance with the plans and spPcIfIcatlons and in compliance with all applicable codec and ordinances The Issuance of this permit does not waive restrictive covenants Contractor and qubcontractors shall have current city business tax permits This permit will expire and become null and void it work Is not started within 180 days.or It 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 nLisurn all required peclions are requested and approved C- - P-rinitte nature Issued By SEPARATE PERMITS REQUIREU FOR WORK OTHER THAN DESCRIBED ABOVE "LUM111NI'a Pl:'RM'.I*.',, F-JE-1141MA''I" NO. CCITY OF TI6A RD ClrY0F nMPD DA'T'E 155UED: 6/�.29 1: 9 COMMUNITY DEVELOPMENT DEPARTMENT 1:)M*T*. NO . 1.0,W5 4 113125SM Hall Bl id..P.O.Boy 23347,Tigard.Oregon 97223.(503)6394175 TAX MAP/L.,01- 351- 53AE) 1.3d'400 SUB G L)M M E 1:1 L-A K AE LND USE 1.5 RK . L k:)'T' !ii 1ZE: NO: WOW CA -45Si : NF-.'.WNO WA11:11 C.A.-OSE:1' 3 (-J!•rF: 'T*yl:)F--: 51NGI E. FAM 1:L.Y U1141NA-L. C,'(JNS'T' . 'T'yr)E: SKF*I.A.)W PPVN'T'P .: : VN LAVOPA TOPY 3 1*14AP i-.'P1MI::1'j:;i occur' . (.111P . R3 T1.113 GHOWE-A 2 CVPI:.::ASE. JAAP`ri D1:SI--IWA5H1:::R 1. GAI-40AGEK 11115POSAI.- NC) . 5111 PJ'r.:'tj WAiiiVENG, DWEI L . tJN1*T'S : I AI.;NI')PY -T*PAY 1-31-DG. UWAIN (DIA 1:1-00141 DPAYN 5 LINK i SI WEP (F-F) WA*TEP S11JAM/PAJA (F"T PF-AAM(si ; MOPT 5SE'll-TIH: DON PEPKE"I ) 0 1:1'41 1:3(:1X Vipzic?dll W N 1301"VI-1141-14:I PHONE: (50,S) 9 I. 1.1 .e.1 R 'TA X 51A71- !li6 . 6 3 011-4UP C til HAP01-5 0 SI-1(: E.MAKEP ' S PLUM91W..', N T 1.1(3 F.1 0 X 12 Ir.',% R C-I v;t iilr.c!oi(,I Ilk cli r 9 0 2 Z.5 A C PI-IONE: (303) 630--7728 t PF-1*41"I'TPA'I'TON NO. 39p'? 0 7131 AI... : C.1.3 9 . 1. PELEIP'T' NO. I his permit is issued subject to the regulations contained in Title 14 qkyj:pif: of the TMC, State of Oregon Specialty codes,zoning regulatiuns pF ..A.) -y'TUNS and all other applicable codes and ordinances, and it is hereby PI 11 - (.1NDEPSI...AF.) agreed that the work will be done In accordance with the plans and POS1, a 1:31:AM specifications and In compliance with all applicable codes and WA'1'1:::P 1.. :I"NE*. ordinances The issuance of this permit does not waive restrictive PI-J). 11:111"CAYT covenants Contractor and subcontractors shall have current city PA:I:N L)PAINts hiisiness tax permits. This permit will expire and become null and void it work Is not started within 180 days,or if work Is suspended or F—TNAI abandoned for a period of 180 days any time after work has commenced. It shall be the responsibility of the permittee to assure all requir Inspections are requested and approved Permittee Signature Issued By 1_- CALL.. Ft:)p TWWEC"TJON SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE W ff CITY OF TIGA RDG>F:f7M I: TN('.) . : ME691OZ17 CITYOFTWARD I DATE 15SUED: P9/01-2 COMMUNITY DEVELOPMENT DEPARTMENT Otto<* PRIM . I--'M'T' .NO 1:)5'i.01•:5 13125 S W.Hall Blvd..P.O.Boy 23397,Tlgard.Oregon 97223.(503)6394175 ,.Jou) A D 1.)1:4 E 5 5 : 1e.?6C9 15W 1)L)(7,K MAI-:'/13_01' 151. 33AD 1.31(100 SUB 'inUMMEJ-11 AKi-:', LA, :1(35 HK . L.AND (.15FE. 141'.':P1) LUT !i5:1:1:4.:: NO N(3 WOW C'I AL.)G : NEW FUPNACE.: (1.00K A144 HANDLA4 ('10 U5E 'TYPE: : 5'.I:N(.,l F: F'AMTI._Y F'UWNA(:,I::: 100K+ 1 AJ:P HANDI 1:4 10K CONST , TYPE VN F*I-.O(:)P FURNACE': EVAP . GOOLEP (NNIILIP . GAP. P3 HEWTEX4 WHIN T FAN VENT VI; N*Y* . 5YG'1T.:M BL.A/CoME-1 (311P HOOD J. NO . STUIPUELn : is DL.P/CIOMP 3 1.:'.54.11' 1 NC I Nl:;,.RA*T*(:)P(DOM DWELL .UNry's, 1. ItIll-P4/COM P :1.5 301-11:) T N(.`,1 NE,PATO 1:4(CCIA F*LJI:I... 'TYPE: G,A 5 BL P/COM F' 30­50FIV" PEPATP UNI'T'S MAX . :I:NP(-I'T* al.-A I COMP ,50.4.1-1 FN ()THIEP f.? IXTPE Dmpwi,? GA!-i 1:)11:)]:N('.v OUT1...E'V5 .1. IDPE'SS7 1 (31,011 PI.dH:Ss,? PI:.:MAAKS : MOWLSSE111r.: DON 1:`E,1:1 MT 1, 111:1.0 . 00 0 W 131:1 HUX 1.9521el PL.AN PF.ViEW 1101.1.0 . 50 N p Ili i"t 3.vi n d FiX111PES *32. 00 E PHONE" (503) RZ44­93-1-1 51 ATF-.: TAX 0,71-111;:11 C 0 N T I"'T.AZZA AVE. R A (all Y 7 1.!,) C PI-IONI". (503) PA3 :1.1.13-e1 T NO. AZ17 $115y1 160 0 PECIF."[F-1T NO. lW36 This permit is Issued subject to the regulations contained in Title 14 of ;he TIVIC, State of Oregon Specialty Codes,zoning regulations and all other applicable codes and ordinances, and It is hereby (,A! I I.,N I::,. agreed that the work will be done in accordance with the plans and & I3I;::AM specifications and in compliance with all applicable codes and R(A.H.*7H I I I ordinances The issuance of this permit does not waive restrictive 1-1 NAI covenants Contractor and subcontractors shall have current city business tax permits. This i)ermlt will expire and become null and void If work is 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 Ins actloi,s are requested and approved, Permittee Signature Issued 13Y ("Al L. POP TWiPEUTTON 639-11.7,11.11 _J SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE PLAN CHECK APPLICATION C11Y OF TIGA RD C1 &IWARD PLAN CHECK H COMMUNITY DEVELOPMENT DEPARTMENT- , ,- PERMIT N q L17 13125 5 W.140 Olyd,P.O.Elo■7197,llg rtf,neya, 9rM.(53)G34Ir5 DATE ISSUED _ ' L✓ U W L � Oc_ IC c j "i AX MAP/t')T JOB ADDRESS: Z- �C7�� _ .•_-. COT. - LAND USC Sun: Sl1uM(l-a,L✓1�C� -- --- - _ -- 5 --- VALUATION: --_— -- SPECIAL NOTES OWNER REISSUC OF SAY_ �S —_ 1-AST REISSUE: ADDRESS: - FLOOD PLAIN/ - SENSITIVE LAND: PHONE: _ �-- APPROVALS REQUIRED_ PLANNING: OONTRACTOP ENGINEERING: NAM[: ------ I: FIRE DEPT ADDRESS: s _ OTHER: PHONE: - — ITEMS RE�f►UIP+.:�) LIST/SUDCINTRACTORS: ARC1t/ENGINEER EUS TAX: __— NAME: _ TC-1 C l,t� CALCULATIONS: TRUSS DETAILS: ADDRESS: -- PARKING PLAN: LANDSCAPE PLAN: r PHONE: �ir,� f �` 1 OTR: COMMENTS: PERMIT H ACCT It DESCRIPTION AMOUNT NMOUNT PD. BAL. DUE 8 s/3 si3 (,o /dyS 10-432 00 Building Permit Fees �- � .50/0 (, 10-431 00 Plumbing Permit: Fees L 10-431 01 Mechanical Permit Fees • &" 10-2.30 01 State Building Tax (5%) __3Y,,39 -- - Duilding Gs" ' Plumbing G.G3 � ('Q Mech l 10-433 00 Plans Chec:' Fee Building U le F411) � Plumbing Mech /D•SS11 �U (4 30-202 00 Sewer Connection v v __• -- �u 30-444 00 Sewer Inspection .33 51-440 00 Street ,system Dev Charge (C<l1C) _ 0 52-449 00 Parks System Dev Charge (PUC)31-450 00 00 Sturm Drainage Syst Dev Chrg (SSDC) _ 10-230 09 1 RI-D -- - - 10-230 06 Washington County Lire N1 (95X) - lU 00 nmarrt/Wedgewood 101 At., APPLICANT SIGNATURE s� Received By: --� � __ Date Received: cn/3587P/18P