12262 SW LANSDOWNE LANE sx s 4. + gr ..w ee+r.«�gwlrr�MfMA7MRM�MMi+MMM�+IMt Iy,w 1� A�tYy. ' - ,gyp, f�w•v�yMN M, +Mrrxe+*
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cINOF NiTIGARD
COMMUNITY DEVELOPMENT DEPARTMENT I
13 t 25 SW Hall Blvd.Tlgard,n,,:jon 97223.8199 (503)839.4171 GC'R f I FI LATE n4
OCCUPANCY
XXKX PERMIT M. . . . . . . a MGV.%1:?p 0086
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639--4171 DATE: I S'SUEI)e
►'•ARCEL : 2SI0313C—01 00
`MTC ADDRESS. . . a 12262 i3W UANSDOWW.. LN
GLIODIVISION. . . . I FYRESTONE 2ONINGiR--4.
� CLASS Or WL"1RK. a NEW_._....._._...__....._...._.__ .__....... ... ...__....__,....__._ ______.__.......w.__._._...,_.._ ... ...,......._�..�w_._...�
rYPE OF USE. . . .-SF
OCCUPANCY GRP. :Ru
OCCUWCiNC.Y L W)D a X125 jr
TENANT NAME=:. . z
Remaarks o C AI-H I
MAJESTIC: HOMES INL:
! 82NO DR
Phalle #I
MAJES11C HOMES INC i
,.'15 82ND DR SUITE 10� I
YLAD-81 ONE OR f
Phone * v 503`-•655,...C,Z-+C,3
ITey #. . : 59266
I..1vcupaanc:y of the -�kbove referenced building as hereby given, aalyd r_:ertifiee,
the compliance with tt. a State I'.)f Or^srlon 1.11pecialty Crudes for the group,
:iccmipanc:y, and usr under whirr they referenced pHrmit wdAq Issued.
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MF I REy MDEPARTMEN"F 'k►b1I-L 1 i NO N PEC:I OR
uOFFICIAL
POr.T IN C.ONSP I C 1.101 a;; PLACE
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�NSPECTYON NOTA I
City of Tigard Building Department
13115 811 Hall Bltd, Tigard, Oregon 97223
Inspection Line (Rec-O--Phoue)e 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbq. Underaiab Hoch Rough-in Appr/Sdwlk
Found. Plbg. rop Out Can Line
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Post/Ream Struct. San. sewer Framingldq.
Post/Beam Mach. Rain Drain Insulation _P1umb.
Plbg. Underfloor Nater 'Line Gyp. Bd. -N4ioh. j
/ � S
Date Requestedt lJ _.�� TL s: �Am QPM 4
Address: 1 LP� e—L
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Builder:—I `A ii,�/A I(. 1,Lw f
TBE FOLLOWING CORREGTIOfNS ARE REQUIRED:
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Inspector: —p--
-_` Date,
_`.—"PROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INSPBCTIQq nark$ ,��-'
City of Tigard Beildiog Department
13125 BO Ball Blrc.. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)t 639-4175 Businege Phonba 639-4171.
Inapections___
Footinc; Plby. Underslab Mach. Rough-in 7►ppr/alk `!
''t - �s._
Pound. Plbg. Top Out nas Line FTVAL=
Post/Beata Struct. San. Sewer Framing -Bldg.
Post/Beam Much. Rain Drain Insulation -Plumb,
P.lbg. Underfloor. Water Line Gyp. Bd. -Hoch.
Date Requested//t"� it �r - G( -1 _Time:
Addresst -ZU'� G�v``��lo�)y�c� �V�.� Cj
1, Permit #s-
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Builder: 1� cJ��� fiL �Li(j ; ll C (,�,L� LnLI.RJ
THIC OOR1!lCTIOltA ARE REQVIREDt
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• LET</.�1 Tt-�r.�i�I r fJ T �/ =��i' ¢/ 7/ �"
Inspector=__ L , ��7.'iYt�cf Date:
_APPROVED DISAPPROVEV APPROVED SUBJECT TO ABOVE
Call For Rei.nsE..
INSPECTION N,TICE
City of Tigard Dzild g Department
13325 RM (tall Blvd. Tigard, Orw,gon 97223 '
Inspection Line (Rec-b-phone): 639-4171 Business Phone: 639-4171
Inspection:
Footing Plbg. Uacerelab Mech. Rough-in Appr/adwlk
Pound. Plbg. Top out Can -Ane 1INALt!
Poet/Seem Strutt. San. Sower. Framing ld
I� q• 6
Post/Beam Mach. Rain Drain Insulation tAlumb•
Plbg, Underflo-r Water Line Gyp. Bd. -MBCh•
Date Requeatedt l ' 6Q- 1 J ■
I Time: �-ZJW PM
Addreso:_C2 Z� Permit ft
Builder: �� ( K.'I✓
THE FOLLOWING WRREr_TION■ AR• REQUIRED:
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Inspectors_._ /� --- —`
_ [late:_/
-_A1-r RtryED DISAPPROV'!D APPROVEi� SUBJECT Tv i v)VE
-"Call Por Reinep.
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IMECTION N ICE
City of Tigard Building Departaant
13125 SM Ball Bled. Tigaird, Oregon 97221
Inspection Line (Rec-O-phone)s 639-4175 Business Phone, 639-4171 r'
Ias)?ection:
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gas Line FINALt
Post/neem Struct. San. Sewer Framing rgldg,
Post/Ream Hech• Rain Drain Insulation _ply .
Plbg. Underfloor Water Line Gyp. ed.
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o'l, Date Requestedt �
TLoot AN pH
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Addresst
a 1 _ PatmLt #i _
Hulldort
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TBEFOLLOWING CORRECTIONS ARE
REQUIRED:
"" r t'.ti,v_� '1w wLf'�T ���'�•'1.•✓L�-ti�%KG3C,.�
Inspector:_�� �_ e
- - Date:
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_APPROVED DISAPPROVED APPROVED SUBJECT TO ATONE
t/_Call For Reinep.
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INSPECTION NOTICE
• ''ity of Tigard Building Department:
"t25 SW Ba11 BLvd. Tigard, Oregon 97223
Inspection Lite (Rae-0-Phone). ti1Q-4175 Business Phone: 639-4171
Inspection j
Footing Plbg. Underslab Mech. Rouqh-in Appr/Sdwlk
Found. Plbg. Top out Cas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
poet/Beam M"Ca. Rain Drain Insulation -PIL.ab
I
Plbg. :n:derfloor Water Line__ i Gyp. Rd. -Much.
—_ _��_1���� Timet M
Date Requested:_7 � AM PM
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Adure9s: Z LC Z_(✓..L-�-t c� ��_� permit #t q'j
Builder:
THE FOLLOWING CORRECTIONS ARE RKQUIRED:
tiff J� ys`A
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Inspector:
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
----Call For Reinsp.
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INSPECTION NOTICE /C'c
City of Tigard Building Dapar+.vent 1
13125 M Ball Blvd. Tigard, Or-jon 47223 t
Inspection Lina (Rec-O-Phone): 639-4175 Business Phone: 639-4171 ` "
Inspections — -- '
Footing Plbg. Underelrb Hoch. Rough-in Appr/Sdwlk
round. Plbg. Top Out Can L'.ne FINAL:
Post/Beam Struct. San. Sewer Framii:g -Bldg.
Post/Beam Hoch Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line gyp. ad. -Hoch.
Date Requosted: /" / �% Tim -AH
Address:
Bull'ir •: -- --
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inepector: � t7'f .� 1'Y. _ Date: '—�
-� -APPROVED DISAPPROVED / ,h4fROVED SUBJECT TO ABOVE
Call For Rainsp.
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INSP99TI2N NOTICE _
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Orson 97223
Inspection Line (Rec-O--Pnone)s 639-4175 Bisiness Phone: 639-4171
Inspections _
Footing Plbg. Underslab Hoch. Rough-iii Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Post/Beam Struct. San, Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb, F
i
Plbg. Underfloor `Nat or Lin* Gyp. Bd. -Hoch. g
Data ResT:ostadt Times —PM
Fddresss PJsrmit 0.4L ? �� �� �.
_3r= L �T-
builders
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TBE FOLLOWING CORRECTIONS ARE REQUIRRDs
Inspector:
� �
- APPROVED DISAPPROVED
APPROVED SUBJECT TO J►gOyg
--Call For Reinsp.
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INSPECTION NOTICE I
City of Tigard Building Depertsaunt
13125 SR Ball Blvd. Tigard, Oregon 97223
Inspect Lon Line (Rec-O-Phone): 639-4175 Business Phone: 639-41.71
Inspection:_—`
Footing Plbg. Und-ce'sb Hoch. Rough-in Appr/Sdwlk •
Found. Plbg. Top vut Gas Line FINAL:
Post/Bohm Struct. San. Sewer Framing -Bldg.
Post/seam Mech. Rain Drain Insulation -Plumb.
Pl'meg. Undorflocr Nater Line ( Gyp -Noah.
Date Requested: - Time: IL—
Addruosa 7 .� r1.4��1/�A7il1 Permit
Builders
THE FOLLOWING CORRECTION; ARE REQUIRElit
--_ �� —�—_wry—/� ,�_A--/J— __ _ •. r i.
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Inspectors
;;;APPROVED
-.__APPROVED DISAPPROVED � APPROVED SUBJECT TO J►gpyE
--Call For Reinsp.
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INSPECTION NOTICE
City of Tigard Building Departs—t
13125 811 Hall Blvd. Tigard, Oregon 97,123
Inspection Line (Rs O-Phones 639-4175 Business Phone: 639-4171
Inspections__
looting Plbq. Underalab . Match. Roug� Appr/Sdwlk
round. Plbq. Top Out Gas ine FINALS
Post/Beam Strict. Ban. Sewer Framing -Bldg.
Post/Beam Moth. Rain Drain nsulatio -Plumb.
■
Plbg. Underfloor Watur Line Gyp. W. -Mph.
Date Riquestede / 11l1 PQM
Address: 1.�.- �7.•� '''�*�j�'4 61LT11 � Permit ft=1 —420k /
.su i lde r s
THE rOLLOWINO OORRECTIONS ARE R.EQUIREDs
ovven
Inspectors — Date:y�
—_APPROVED DTSAI-PROVEDr!_ APPROVRD SUBJECT TO ABOVE
-` Call Por Re(nap.
11?Rc4!:Wta MM�S,,�.N :arq. ..lam' I
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INSPECTION NOTICE
City of Tigard Building D"rtmmt
13125 6W Hail Bled. Tigard, Oregon 97223
lnepection Line (Rec-O--Phone), 539-4175 Ausinuss Phcne: 639-4171
Inspection[ ,
[rooting Plbg. Qnderelab Mach. Rough-in Appr/Sdwlk
Pound.
FA'
Gas Line F,XALt
Port/Beam Struct. San. Sewer Framing -Bldg.
Poet/&spm Neth• Rein Drain Insulation _ply,
Plbg. Underfloor Nator Line Gyp. Bd. -Hoch.
Date Requested[ ��-i �'�
Ti01et AM PM
Address:
w13�
Budde,:
TBE FOLLOWING CORRECTIONS ARE REQUIRED:
_._—. ------ — Dates Z.�-�_-7�T�"/
APPROVRD DISAPPROVED
_ _---� APPROVED SUEONCT TO ABOVE
--___Cal! For Reinap.
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INSPECTION ROTICE
City of Tigard Building Department
13125 SW Hall Ulvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:._
looting Plbg. Underelab Mech. Rough-in pr/Sdwlk i
Found. �__ Plbg. Top-!91AGas Line f
i I
Poet/Ream Struct. San. Sewer Rraming W- dg.
Post,,beam Merh. Rain Drain Insulation WMh.
Plbg. Und9rfloor Watcr Line Gyp. Bd. �
Date Requests d: Times AM PFI
4ddress: G- 1�. }C�J�(La., Patmit 12
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRPD: ( ,
--------------
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Inspector: 1>3
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__APPROVED L—DISAPPROVED APPROVED SURjECT TO ABOVE
Call For Rai.nsp.
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INSPECTION NOTICE
City Of Tigard Building Departments "
131.25 SII Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
i
InepectLon: �
--- -
Footing Plbg. Underalab Mach. Rough-in Appr/Sdwlk
i Fouts. Plbg. Top Out Gas Line
FiNALe
I
Poet/Beam Struct.
r ' Ban. Sewer`J Framing -Bldg.
Post/Beam Mach. Rain Drain J Insulation -Plumb.
i Plbg. Underfloor ater Llna�
f` Gyp. Bd. -Mach. j
Date Requested: _Time:
_ AM PM M
Address:_ ` � �/J��dJ jl�rtf(It t i —
Builders /1�7 K �'•'
THE FOLLOWING COARE REQUIRED:
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Inspector.:
Date: r
APPROVED ^_ DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinep.
INSPECTION NOTICE
City of Tigard Building Departesent
1 13125 Sit Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: --
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found.` Plbg. Top Out Gas Line FINALS
Post/Beam Struct. San. Sewer Framing -Bldg. ,
Poet/Beam Mach. Rain Drain Insulal.ion -Plumb. -;
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Date Requesteds / /- �.� Tilue�`- AM PM
Address s 02 ��-- C `a
ermit is—
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Builders
THE !►OLLUiiING CORK$ IONB AItE RBQUIREDs
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Inspector:, � __—
Date:
A! COVED DISAPPROVED APPROVED SUBJECT TO ABOVE —
Call For Reinsp.
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CITYOF TIFARD
CrIYOF>WID
COMMUNITY DEVELOPMENT DEPARTMENT o:>tem PLU111,31M.., PI-kr11 l
13126 SW Hail Blvd. P.O.Scm 23377,TOW,Oregon 77223(603)6304176
PERI11T Fk. . . . . . . .. IIST93-0088 •:•
I
DATE ISSUED: 02/18/93
SITE ADDRESS. . . : 12252: SW LANSDOWNE l_IV PARCEL: 261038C-07500
SUBDIVISION. . . . : FYRE5TONE zOIV11VG: R-4. 5 ■
---------------a1 - 1
_____-__- --_--------_-_- ~___________._________-,--_________._._____._....
CLASS OF WORK. . 3 NEW GARBAGE DISPOSALS. . : 1 ■
TYPE. OF USE. . . . :SF WASHING MACH. . . . . . . . 1 BACKFLOW PREVNTRS. . :O
OCCUPANCY GRP. . :R3 FLOUR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . :2 WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :0
FX'TURES- -_______._ __--- Lf:1UIVDRY TRAYS. . . . . . .0 SF RAIN DRAINS. . . . . : I m
SIIUKS. . . . . . . . . . : 1 GREASE: TRAPS. . . . . . . :0
LAVE'(TORIES. . . . . :`i OTHER FIXTURES. . . . . 10
I UN/SHUWE:RS. . . . : SEWER LINE: (ft) . . . . :O
WATER CLOSET'Si. . :3 WATER LINE (ft) . . . . : 100
DISHWASHERS. . . . : 1 RAIN DRAIN (ft) . . . . SO
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Remarks: PATH I I
OWNER: --___._____._______.___._________ ------------------FEES----------------
MAJESTIC
-----__--_____-.MAJ'ESTIC HOMES INC T IF' $ 1460. 00 JH 02/18/93 -
25 82ND DR BPRT $ 463. O0 JH 02/16/93 -
BPLC $ ,300. ' 5 JLH 11/10/92 92-2 33588
B5V`C $ d3. 15 JH 02/18/93 -
Phone i#: SSDC 280. 00 JH 02/18/93 -
PARK t 500. 00 JH 02/18/93 - j
Plumbinq Contr•ac^tot-,-----------------.----..-- 11PRT f 45. 00 JH 02/18/9::3 -
�/� -< < MPLC $ 11. 25 JH 02/18/93 -
IVame :_ ._.� ._..__ _G�� . `�� �• M5GC; i 2. 25 1H 02/18/93 -
Address . __ ___.__......... T'PRT $ 155. 00 JH 02/18/93 -
City :_ State : r _ P5PC $ 7. 75 JH 02/18/9
Zip: .-Ph o 11 a f1
- - _-- REQUIRED I NSPECT I k1NS ----__
this perm. t is issued subject to th+' rrey.••..
ulations contained in the 'Tigard Municipal Foot/found Insp Rain drain Insp
Code, State of lire. Specialty Cosies and all Post/Beam Struct Water Line Insp
other-, applicable laws. All work will be done Post/Beam Irlechan Appr/Sdwlk Insp
In accordance with approved plans. This P1m/1_(ndslah Insp Mechanical Filial
permit will expire if work is nut started PLM/Underfloor, Plumb F'iral
within 180 days of issuance, or if work is Nechanir_al Insp Building Final
suspended for more than 180 days. Plumb "Top Out Erosion Control
Framing Insp Crawl Drain
Fireplace Insp
Gas LineeInsp
Insulation -.---._._.._____ _.Insulation Insp
x Gyp Board Insp -_.........__.._....__ --- _
Authorized Plumbing Co tract r Signature
Call far inspection - 639-41 /5
Contractor (Votes: '
..........
CITY OF TIGA RD */7;7
COMMUNITY DEVELOPMENT DEPARTMENT �30014bw
15125 SW HWI Blvd. P.O.B=23M.Tip m,OmWn 97 (609)630-4175 MASTER PERMIT
#
639-41'r`1 DATE ISSUED: 02/18/93
61 [".- ADDRESS. . . . 12262 SW LANSDOW14L. L.14 PANUELt 2SI03LAL-07300
SUBD I V 11,1 ON. . . . : FYRESTONE ZONING: R- 4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . s 12
BUILDING
REISSUEv DWELLING UNITS: i BASEME14T. . . . . . . . 10 s
CLASS OF* WORK. :NEW BEDRIIS.4 BATHS 13 UARAGE. . . . . . . . . . 8638 S f
TYPE OF USE. . . cSF FLOOR AREAS----------- REQUIRED SETBACKS----------
TYPE OF' CONST. i 5N F'I RST. . . . -. 1094 S f L6 Fr. . - 15 f t R I GHT. 15 ft
OCCUPANCY GRP,. sR3 SECOND. . . s 1090 S f FR(31\11 . :20 ft REAR. . s93 ft
STORIES. . . . . . . 12 THIRD. -.0 sif RE 611.1 RED-
HE:IGHT. . . . . . . . ..25 ft TOTAL-- ---- .-%=_,l84 5f SMOKE DETECIORS. IY
FLOOR LOAD. . . . 140 psf VALUE. . . . . $ j 111948 PARKING SPACES. . : l
Remarks: PATH I
PLUMBING
SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVN'TRS. . 90
LOVATORIES. . . . . :5 WATER HEATERS. . . 1i TRAPS. . . . . . . . . . . . . . 10
IUBISHOWERS. . . . :3 LAUNDRY 'TRAYS. . . s0 CATCH BASINS. . . . . . . &0
WATER CLOSET S. . 93 SEWER LINE (ft) . :0 GREASE 7 RAPS. . . . . . . 10
D I SHWASHERS. . : i WATER LINE (ft) . . 1*1111 OTHER FIXTURES. . . . . s 0
GARBAGE DISP. . . el RAIN DRAIN (ft) . iO
WASHING* MACH. . . : 1 SF RAIN DRAINS. . : 1
MECHANICAL ------------------------------------ F:'r:.'ES
TYF-'ES---------,---- UNIT HTRS. , !0 type amril.tnt by date
/GAS/ VENTS . . . . . :0 TIF $ 1460. 00 JH 02/18/93
MAX INPUTsO BTU VENT FANS. . 14 BPRI $ 463. 00 JH Q12/18/93
FURN ( 100K s HOODS. . . . . . c RpLC $ 300. 95 JLH I I/10/92 42-233580
FURN ) =100K . . il WOODSTOVES. 10 B5PC * 2 3. 15 JH 02/18/93 —
FLUOR FURN. . . . e0 CLO DRYERS. i I SSDC $ 260. Wi2i JH 02/18/93 —
BOIL/CMP ( 3HPoO OTHER UNITSo I PARK $ 500. 00 JH 02/18/93
GAS OUTLETS: l MPRT $ 45. 00 JH 02/18/93
Own et--- $ 11. 05 JH 02/18/93
MAJESTIC HOMES INC M5PC $ 2. 25 JH 02/16/93
2:'5 82ND D R PPIR 1 $ 155. 00 JH 02/18/93
p5pc $ 7. 75 JH 02/18/93
Lontractors
MAJESTIC HOMES INC
25 SEND DR SUITE 102
GLADSTONE OR
Phone #o 503-655-6263
Reg #. . t 59286
$ 3248. 355 TOfAL
This permit is issued subject to the rMMations contained in the REQUIRED INSPECTIONS
Tigard Municipal Code, State of Or . verialty L-00 a 11 r Foot/found Insp Fireplace Insp
applicable laws. All work will b d ne n a, v e Hit. r,n Plost/Be.im Strcict Gas Line Insp
plans. This permit will expire i ori �L at a t d in avi Plost/Beatn Median InSUlation Insp
days of issuance, at, if work is s send at, m re ian v r1lin/LindslaU Insp Gyp Board Insp
F311 -11_11/Under,f loot- Rain drain In3p
41)at'A' 11 eullanical Insp Water Line Insp
PILimb Top Ot.it Appr/Sdwlk Insp
IssLted D : .. /
y IT-Isp Mechanical Final
La I I lot-, inc,pectiLin 6.:9-4175
I.F
CITYOFTIFARD
COMMUNITY DEVELOPMENT DEPARTMENT SEWER CONNECTION
13126 BW Hell Blvd. P.O.Bait 23307,TOW,Oregon 07229(603)630.4176 PERMIT
DATE_ ISSUED: 02/18/$3
S11L ADDRESS. . . c 122E+2 SW i..rllJ;iDOWNE: I_N PARCEL: 25103L1C-07;yr1rlii
SUDD I V I S I ON. . . . c F YRESTUNE Olu I NG a F2- �+. J
1
BLOCK. . . . . . . . . . c LOT. . . . . . . . . . . . . 112
FE:NON'T NAML.. . . . . c
USA IVO. . . . . . . . . . : FIXTURE UNITS. . . I
CLASS OF WORK. . . :NEW DWELL I NO UN ITS. . I 1
f YPE OF USE. . . . . s SF IVO. OF PUI!_DINGS a 1
INS'T'ALL T'YPE. . . . IBUSWR IMPERV SURFACE. . a : sa f
Rema.1is: PATH 1
Uwn er s ________.__. _—__ FEES
IYoiLSTIL HOMES INC type amor.int by date recpt
i 25 8214D DR PRMT $ 2100. 00 JH 02/18/93 —
I1dSF' $ 35. 00 JH 02/18/93 —
Phone #e
Contractor:
CONTRACI OR NOT ON FILE
$ c135. 00 1 O'TAL
r'E?H #. . .
-- - - --- REUU I REL" INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer, Inspec-tion _
of the Unified Sewage Agercv. fhe pet-tit expires 18d days from
the date issued. The total amount paid will be forfeited it the
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. if the sewer s no located at the asurement
given, the instal ler shall pr ospec 3 et in 1 i e t;
the distance given. If not so Ice er he =_i ler hal pu hase
a "Tap and Side Sewer" permit and t a wi i it a a oral
Digi mi(; t. e?e Signat;i.tr-e :
Issued Hv : A
Call for•• inspecticin - 639-4170
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CITY O TI ARD 13125Tigard.Tigard.Box 23397
Orcsw Hall Blvd. PLNCK/RECT b
Po Oregon yon 9772) PERMIT N
COMMUNITY DEVELOPMENT DEPARTMENT
(503)639-'1" DATE ISSUED
JOB ADDRESS• l Z�(2 _,J `An 5�:�4.n o -21 TAX MA AOT
Sue: F,Ir? E LOT: I Z LAND USE:
VALUATION: ��•'� �v
OWNER SPACIAL NOTES
1
NAME- _yv��Y�n c AO-Al REISSUE OF:
ADDRESS: _ -S 'e f h.e-f✓6 LAST REISSUE:
_ E LAID 5*�•�.� c ct`jo'z- 3 _ FLOOD PLAIN/
PHONE- S - (-'Z SENSITIVE LAND: _
CONTRACTOR APPROVALS REQUIRED
NAME: 6 PLANNING:
ADDRESS: ENGINEERING: _
FIRE DEPT:
PHONE: — �-_ OTHER:
CONTR. BOARD 0: �`i-2 8 G EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: L Z1 P,pr�,4 poA, LIST/SUBCONTRACTORS: -
MECH: m A A BUS TAX.:
CH ENGINEER CALCULATIONS:
NAME: nJ Vt -_ ��� _ TRUSS DETAILS:
ADDRESS: N'^� Z "� OBER:
PHONE:
PROPOSED BLDG. USE:
COMMENTS:
APPLICANT SIGNATUR
Received By: Date Received: �Z-
pr
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dKiaSdN�. !.tmr�,.;wm,s.4o-tnwrmar•+.r+.,un�w..,...,-...-.....•. .
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PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
/�sf _oob'Y 10-432 00 Building Permit Fees —
_ 10-431 00 Plumbing Permit Fees - --
10-431 01 Mechanical Permit Fees
10-230 ui State building Tax (5q)
Building 3 /5
Plumbing
Mechanical
/ 7 rill —
��/z �v
10-433 00 Plans Check Fee _--
Building _
Plumbing
Mechanical
10-230 06 Fire
5,,,r2j3-ova 30-202 00 Sewer Connection Cru a�
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees —
25-448-06 Institutional TIF Fees —
i
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees -35 U ZI v
25-448-05 Mass Transit TIF Fees / (' 110 —
52-449 00 Parks System Dev Charge (PDC) Svc)
31-450 00 Storm Drainage Syst Dev Chrg
c.
(SSDC) X42
� ;. 24-445-01 Water Quality (Fee in lieu of) _
f; 24-•445-02 Water Quantity (Fee in lieu of) _ ---
TOTAL . 3 •.�U /�j/�j. .3�
nm/3587P.WPF
L ". 4• _ i
(w 1 T Y OF 116'iRO kL GE II-'T r,.1F F'A"t'MF'N"( RLC LJII '1 PIU.
CHL-"G'K MUM r a ti 1:33. :3'5 f
I'dFllht a MAJ EliT I C I'IUMES CASH AMOUNT' a 0. 00
ADDRE b") t PO FSU}: E''.65 ''AYME NT Dir ITS a 0i�!/10 r-)
iUBDIVI!:iTllN a
GL.f iC;KAMA;.", OR 97015—
PURPOSE OF PAYMF"N'T AMOUNT PAID F'URWC'11 E OF PAYMENT ONOUNT RAID
1r1uIElf 46 T'E'RM 463. 00 PLUMSINLi PFRM 155. 00
MECHANICAL DF 45. 00 ST. SU I LD F'E R 33. 1.'",
I'll-AN CHECK FE 6 :. .20 SFW[—.R UtiA 21(h0. 00 �
SEz'WE9 II`J!?,E='ECT 35. 00 PARKS OC 500. 00
=11 O RM DRAIN : 17t ':E10. 00 RESIDENTIAL 1 ROFF I C FEES 1350. 00
rlw:,S; TRANSIT Ttr' FEES 110. 00
V
4
I r
1
tT 12 FYRE STCINE
SW LAWiDUWNt. LN ;a
TOTAL AMOUNT r."AID _ > 51:'s31, •1,!;
}
(`TTY OF 'T' I C'ARD PE (`:F.l("'T OF PAYMENT PE."."Cl 1 P r' NO. 3'J k
(71.4-C V. AMCI(..II\IT : 750 00
NAME s Mfa. FST I C' HOME-9 CIWa 44 AMOUNT 0. 00
t r-1)1)R '9c,' t 25 SE' 9 :Nl.:) DRIVE PHYME� :N I� DfY1 a I 1 i 10/981
I:L.AD4STUME., OR SURD I V 1 S I ON a r.
i
I''URPOSE or PAYMENT AMI) N( r•A T U r''URr-.)Oc3*. 017 ciOYME-NT AMOI INT PA 10
PLAN C HF•Cmi rF: 1 1-1 h R! "r1t. vlo 1"-ON r,i-i(-I i 11 1 i 1 7 P c50. 0G1
PLAN CHECK FE. 1 1—1ARi '-"50. 00
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1
v.t ti4 I
f-'YRF.9T(lNF,. l,C)I 0711 It, 1''
F1MCT(JN-r ps4I1) w ... 750. 00,
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