13274 SW Toland Street 1
— 11174 SW Toland St.
II9SPECTION 'VOTICE
16 61/44
J t-' y of Tigard Buildini Department.
llllll C ������JJJJJJ
11/./Lar— P O Box 233b'
Jt i Tigard. Oregon 97223
•0( Phone 639-4175 (.
pe Of Inepectbn _ G
Dare Requested /'�(/'3 /S --�7 U Time A.M._11._GP./M.
Address / 3.• 1 / t��/ 'Lf�1�.� Permit 0 iF117 v 7
Owner_ _— _ Lot o
Builder 7 The following Building Code deficiencies ere required to be corrected:
/4/, '")
:::
to _ _ I Disapproved
Date
CALL FOR REINSPECTION
Cl YES L i NO
`1141..-/ INSPECTION NOTICE l
City. of of Tigard Building Department ✓�
v � P.O Cox 23397
G L �,e ,, gerd, Oregon 972�j
/ v Phone 639-4175
��. / -
Tyfe of Inspection
Dade Requested_ _ �77 71/
/- ---- eilme A.M.._ 4 P.M.
Address - "l_!.._ _ _ Permit *kJ/2I G 7
Owner ` Lot *
Builder ,
,!_ , l tP-6-7— ;The following Building Code deficiencies are required to be corrected:
` 7 /
6T2 L_
Presented to Approved
Inspector -/:- 1"-° Disapproved
Date
('ALL PO Rl:'1NSPECTIO,\
VII Li NO
1
7
INSPECTION NOTICE
City of Tigard Building Department
P 0 Box 23397
Tigard. Oregon 97223 ---
Phone 639-4175
Type of Inspection t= ?lI h-' -_ L�
:)ate Requested 3-7 3t--L
q / Time -__-.— A.M. P.M.
�h (1
Address _ �
Ls
Owner /r-//G4
Builder ./21_ZeSeo _ — --
The following Building Code deficiencies are required to be corrected:
—
Preseisted to , _ Approved
Inspector _ , .� Disapproved
Date
('ALL FOR REINSPECTION
[7 YES LJ NO
1
INSPECTION NOTICE // /7.
City of Tigard Building Department
P O. Box 23397
Tigard. Oregon 97223
Phone: 639-4175
Type of Inspection _gyp
Date Requested _._ 3- 7 ft) Time A.M. P.M.
7�
Address I 741 .,.. -461 ..),474-- Permit #S % /LiIi 7
Owner Lot *
Builder )? (I.�
The following Building Code deficiencies ire required to he corrected.
•
I I f�! .-moi-? -.e? L'.iGf�U .^-- �"?Cr G..-.J�
r�
I /A
4" -, ?",--, /4 ,,,P" ......„..,,et 0.__....."----70.re-e__
s"
�.` 1`a ---/ /
Presented to _. .. -- Approved
'
Inspector ---,j,7 ...._ Ki Disapproved
IIP`
Date . 47 - ?,6
CALL FOR REINSPECTION
0 VU i_..l NO
•
- r
�`,
CITYOF
CERTIFICATE OF
OCCUPANCY
PERMIT N s BUP891425
COMMUNITY DEVELOPMENT DE HENT o too«A�
'14 PRIM. PERMIT N. s 891425
3125 SW lie Blvd PO Bs 23397,rp.rd,a.�ar223 (�)e3G-4,7 DATE ISSUED: 03/09/90
Sill ADDRESS. . . s 13274 !:,W TOLAND Si PARCEL.. 251 4AB- 1160
SUBDIVISION. . . . , MORNINGNILL ZONINU,
BLOCK : LOT .145
CLASS OF 4ORK. :NEW
TYPE OF USE. . . 15F
OCCUPANCY URP. ,R3
OCCUPANCY LOAD,
TENANT NAME. . . :
Remarks: $15 for red line copy DAN E: ANDERSON
9363 SW BEAVE.RTUN--HILLSDALE
N HWY.
BEAVERTON OR 00000 16000
Phone Mt 000-000-0000
Contractor: - - -_ _ _-. .. . --
D. F. ANDERSON INC
9363 SW BEAVERTON HIGHWAY
BEAVERTON OR 9700:5
Phone N. 297-7666
Req N. . : 46344
Occupancy of the above referenced building is hereby given, and certifiers
the compli,ince with the State Of Oregon Specialty Codes for the group,
occupancy, and use under which the referenced permit was issued.
FIRE DEPARTMENT / LDINO IN
�
BUILDI 6F77l—
POST IN CONSPICUOUS PLACE
L -- _— - — -- -- -
INSPECTION NOTICE
City of Tigard Building Department
P 0 Box 23397
Tigard. Oregon 97223 .a
Phone: 639-4175 / )
Type of In%pectii)n _ "..--L- ---Jx_-/---- T-d�j� l/
Date Requested _ -/J --7 Time___. A.M. P.M.
Address c3 74/ of at Permit 1'P*1l 6 7
Owner Lot
`
Builder / .-delt.,'L/"l.L►L`7c.-
The following Building Code deficiencies are required to be correct,d:
Presented to ______... _ 41 Approved
y
Inspector —. -- [ Disapproved
Date — -+--_- - --..
CALL POR REINSPECTION
H VE$ 1:1 No
INSPECTION NOTICE
City of Tigard Building Department `�!
P O. Box 23397
Tigard. Oregon 97223
Phone: 639-4175
Type of Inspection — -
Date Requested __..-- ! Z— ,- Tints_ . A.M. P.M.
Address _ /33.7 L Permit *1? 1(2S-
Owner — -- - -- Lot *
Builder
The following Building Code deficiencies era required to be earected:
4 ' !z T
c.?/ ---
Presented to - lJ Approved
Inspector . -- _--- ❑ Disapproved
Date —_ i_ 4CALL FOR REINSPECTION
❑ YI$ 111 No
i
INSPECTION NOTICE
City of Tigard Building Department
P 0 Box 23397
Tigard. Oregon 97223
Phone 639-4175
Type of InspectionDate Requested � �'� _ t Ti P.M.
Address f "2.). 4/ .z;../ ! -" Permit e` 011e
Owner /_ Lot * _
Builder _), 1 C2 Gtelt'`.,_--
-
rhe following Building Codr deficiencies are required to be corrected:
Presented to ---- (TApproved
Inspector _ Disapproved
Date
CALL FOR REINSPECTION
_ I VU NO
INSPECTION NOTICE
City of Tigard Building Department
P 0 Box 23397
Tigard, Oregon 97223
Phone 639-4175
Type of Inspection
Date Requested — // T1Te A'M. G /P.M.
Address _ -.!� 77 Permit *O_�l ya}r.5—
Owner Lot st
_ - _.—
Builder t``/
TNfollowing Building Code deficiencies are required to be corrected:
Presented to — ' "' ov
/
Inspector � „
-J [ Disappreved
,
Date / L u 4CALL FOR REINSPECTION
Li its LI NO
INSPECTION NOTICE
City of Tigard Building Department
P 0 Box 23397
Tigard. Oregon 97223
Phone 639-4175 •
�1
Type of Inspection
Date Requested / / 7 4 Time _ A.M. P.M.
Address --_ Permit * 21-/ !/
2-5-
Owner
Owner Lot # 11,25
A
Builder 1 ' r C''"Z4724
The following Building Code deficiencies are required to he corrected
Pres..'nted to � ( Approved
Inspector s.„2?(11:• j,e/Disapproved
X4"7 Date.
CA!.1. POR REINSPECTION
e rUt f l No
- 1
INSPECTION NOTICE
City of Tigard Building Department ' '
P 0 Box 23397
Tigard, Oregon 97222
Phone 639-4175
Type of Inspection //_
lLJ
Date Requested __— I /� Ims _ A.M.AM ._ P.M.
Address =� Permit # /yds
Owner.--- — Lot *
Builder 72 EAG ZAA-1` Jjt ' ---
The following Building Code deficiencies ere required to be corrected:
L:�--���L L��`L 4. - _L•.���� _ �Ls.�4�' Lfrir
_� �_ i�-:3/t t.t.rt.L� V7CIACA,,Lea.f •`
! [ L L i V _r SCr-
Presented to L 1 Approved
Inspector Riiisapproven
Det'f /1 " � �.. l
CALL FOR REINSPECTION
Kills O No
INSPECTION NOTICE
City of Tigard Building Depart
P.O. Box 23397
Tigard, Oregon 97223
Phone 639-4175
—
Type of Inspection / -
Date Requested < A.M. _ P.M.
/�"1 Tim.
—--- � /14.)
Address Permit * 4/1
_
Lot
Owner ,
Builder
The following Building Code deficiencies are required to be corrected:
— T-
/ %' d 1
Approved
Presented to -4 -
_ '+ Disapproved
Inspector '
Date
CALL FOR REINSPECTION
VU (I NO
1
INSPECTION NOTICE
City of Tigard Building Department
P 0 Box 23397
Tigard, Oregon 97223
Phone 639-4175
Type of Inspection __---
Date Requested —_ i/ 1,3 _I! _ Time `__ A.Moior . _P.M.
Address f,3� 71x '` d1 Prrmit ttt> *4yled,
Owner _ Lot
BuilderThe following Building Code deficiencies are required to tv corrected:
/1;12-4--441.4 74-4./e-f,
_ _ 'FAQ_
Co"
lir,.. ;"-r1:0 r- 4
14( L rad
4efey4. . t 4 del _ -t<. V l i -C I:.
� L_ p, t_lit i:( IZ .t- L 14 s..it .4,47/11.6.4
r I L �L - 44s.,„,./6-_, �r d 4'4-4 Vt-4. _..
J
Presented to V Approved
Inspector .. I J Disanproved
Date / — L,,S' A
CALL FOR REINSPECTION
L I YU r NO
INSPECTION NOTICE
City of Tigard Building Department
P 0 Box 23397
Tigard, Oregon 97223
Phone 639-4175
Type ',f Inspection __. / L 1 x 4.--f _
Date Requested _ lU 5 S. Time _ A.M. sCP.M.
Address / �,�V Z'Z L�i.j�"�- Permit xk q/e7 2_5-
Owner Lot u
► L —
Builder �j:1��17-7
The follirving Building Code deficiencies are required to be corrected.
Presented to /f/ [Li-Approved
Inspector _. _ L] Disapproved
Date _— _
CALL FOR REINSPECTION
El YES Ll NO
INSPECTION NOTICE
City of Tigard Building Department
P 0 Box 23397
Tigard, Oregon 97223
Phone 639-4175
Type of Inspection / /�-` 4 4- a�ti7 /64. , ,, Gl.Date Requested 7 :.) 2 J- _- — Time I_ A.M. P.M.
Address 16'. „woe,' _a, „4 t-- Permit 11/4!'-2,5
Owner k) 3 7 41 Lot I CC,l2/ /4. Y
-7_ -
The following Building Code deficiencies are required to be corrected:
LL ti '-G / n 5/....-1.4.4-.% c.•. 6}"i L (t .:-!./3
Sl.2h .c..-.c2i-C,7 C Uig,• f
II
Presented to ---- -- --
/ r) Approved
Inspector ( 4_____ _ or
Date r ( 2
( `� --
CALL FOR REINSPECTION
C) YES Li NO
INSPECTION NOTICE
City of Tigard Building Department
P 0 Box 23397
Tigard Oregon 97223
Phone 639-4175
Type of Inspection 1/tr
Date Requested Time _ A.M. P.M.
Address -20/-32 (/ _ Permit * 9/4' S
Owner /, Lot t0
Builder
The following Building Code deficiencies ere required to be corrected:
Presented to .t. _. 4 Approved
Inspector �_
- Li_ LJ Disepprnved
Dwe )
CALL FOR REINSPECTION
O YES U No
..._._
CITY OF TIRDSEWER PERMIT
�"`�• PERMIT NO SF891469
cmatt UD
COMMU, ,ITY DEVELOPMENT DEPARTMENT
13125 S W 1/811 Blvd P 0 Box 23397.Tigard.Oregon 97223 1503)639-4m --7/ DATE ISSUED . B/22/89
-- - ----- -- — ----- - - . -- 1lT�'14 --__
•JOH ADDRESS : f£+?,*'t SW TOL_ANI.) SU USA Nl.1MBE:R• 39038
I AX MAP/LOT PS1 4AB 1.1600 SOB . MORNINGHXL.I_ L T : 149 BK :
LAND USE . W4 . 5
LOT SIZE.
SECTION q TWP Ps PNI:: - tw
WORK CLASS : NF W
USE: TYPE : SINGE' FAMILY
1116.1 applicant agrees tri ( limply with all rules arid r•eagulation% of the Unified
Sewerage Agency The permit eexpire% .20 days from the data issued . The total
a►mr►ur►t pair) will he forfeeiteerl if the permit expires . the Agency dues; not guar-
antee: the, accuracy of the location of the side sewer laterals . if the sewer is
rtr:11. 1r.)cute0 at the measurement givsn , the installer shall prospect 3 feet in
all directions from the distance given if not so located , the installer shall
purchase ar "Tap and Side Sewer" Permit ,rnrl the Ager,cy will install a lateral
INSTALL_ TYPE BUILDING ':iEWVP I..MPEPVI(1(JS AREA: 1
FIXTURE UNITS TENANT IMPROVEMENT
11
I./WE:I...L_ING UNITS I
N(.1 OF FILMS . . .1 J
FEES :
0
W ANDERSON RAN F:: PERM1 I S. 00
E 9.163 SW FF.*'AVP TON---HIL.LSDAI.-.E. CONNECTION II.)N CHARGE $1 ,250 00
R he14Vi- •ruin re LINE IAP INS1'AI,L
WHIR
R
C
O ANIII.I+i3ON DAN E.
T MI ADOWBR00K DEVELOPMENT
A 9:563 SW FcF..AVF•R TON-•H1.1-.1.5L)ALF.
C beeaveerton or 9006
0CHI INF. (503/ P97-/666
Fl I+I G I S I PA I I ON NO . 46344 I DIAL *1 ,285 00
�`�.
RECEIPT NO /LJ�LZS
This permit is issued subtect to the regulations contained in Title 14
of the TMC State of Oregon Specialty Codes toning regulations
and all other applicable codes and ordinances and it is hereby PEW 1 RE:.D INSPECT IONS;
agreed that the Work will be done in accordance with the plans and POUGI I IN
specifications and in compliance with all applicable codes and
ordinances The issuance of this permit does not waive restrictive
covenants Contractor and sut ontrectors shall have current city
husmess laic permits Tlus permit will expire and become null and
void if work is not started within IRO days or if work is suspended or
abandoned for a period of IRO days any time after work has
commenced It shall he the responsibility of the petmittee to Assuri,
411 required ,nspe ns_Axe requested And a oved
- . 0 --
permittee Srrinature
:1:4----1.1"e"----4.
ti
Issued Ay .7/V _ trmrt'f'TTflN A -let?143- _
SEPARATE PERMITS REQUIRED FOP WORK OTHER THAN DESCRIBED ABOVE
J
P
PLUMBING PERMIT
CITY OF TI M RDP,ITya A
.)(a—
�►!.r PERMIT NO : PL891467
COMMUNITY DEVELOPMENT DEPARTMENT °NOo"
DATE ISSUED: 8/22/8917115 S W Ho Blvd P 0 Box 73397.Tigard Oregon 97223.1503)639-4175 PRIM. PMT.NO. 891425
.JOB ADDRESS •t-23f4 SW TOLANO ST
TAX MAP/LOT 2Si 4AB 11600 SUB . MORNINGH1:L I.. LT : 143 BK .
LAND USE • R4 `:r
LOT SIZE :
ITEM: NO: NO:
WORK CLASS : Ni:W WATER CLOSET 2 TRAP
USE. TYPE: : 5I:NGI_I• FAMILY URINAL BKFLOW PRVNTR
CONS:I TYPE : 1JN L..AVOWATOIY 3 TRAP PRIMER
OI;(:UP. GRF' . P3 IOU SHOWER 2 GREASE TRAPS
DISHWASHER 1
GAW BA(:;E DISPOSAL. 1
NI.) STORIES .. 1 WASHING MACHINE: 1
DWEL.L .(.1NITS : L LAUNDRY TRAY BLDG . DRAIN (DIA
FLOOR DRAIN
SINK 1 SEWER lET)
WATER HEATER 1 %l(IWM/RA.LN (FT 1
OTHER
11E.11Ala,S,
11►`et1 c'L l)1. ••oa(. t.ur number
0 ANDERSON DAN E. PERMIT $125 . 00
W 9.. 6.1 SW HEAVE:PION—HILI %DACE.
N
E beavertnn or FIXTURES
R
SPATE. 'TAX $6 . 25
OTHER
C
0
N WUI..C(11T PI. I.IMBING CONI WS INC
R P(JRo*H7E?
A (;f'a!%hMa OR W/0:30
c PHONE.: (503 661-1781
C RE:l..1sIRAI 1CIN NI) P384/ TOTAL. $131 P
R
REl:E I PT NO. /056`3'
This permit is issued subject to the regulations contained in Tale 14 --.-._---»--_.._ ........ ._ ....__...._.._....._.
of TMC State of Oregon Specialty Codes zoning regulations •FUIJIRED INSPECT 1 ONS
and all other applicable codes and ordinances and it is hereby Pt..B IINDE:PE5I AR
agreed that the work will be done in accordance with the plans and
specifications and in compliance with all applicable codes and post K HE.AM
ordinances The issuance of this permit does not waive restrictive WA 1 ER I.. 1 NE
covenants Contractor and subcontractorsshall have current city PL.B 1 OPUU I
business tax permits Thus permit will expire and become null and PAIN DRAINS
void if work is not started within 180 days or if work is suspended or .F. I Ni iL
abandoned for a period of 180 days any time after work has
commenced It shall he the responsibility of the permittee to assure
all require �Pct�ueste nd approwid
Permittee Signalure
•
sued Ay - .IHiaPI CI I f Illi 6.39-41.4:1_
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CI1vt' OF TIRDF211T1 r1TNr' OFPMTT
arstimPERM 1 T Nfl • RI 11491 z1Pn
mem
COMMUNITY DEVELOPMENT DEPARTMENT nAl K= T CiS11Fn• rt/PP/R9
i 1125 S W Hall Blvd..P.O.BON 23391 Tigard.Oregon 91223 003)63q-4I7'.
1M PMT Nn fig t AP',
),A 7 /
.II1R AnnRF,c • •4 011!7/1 ,W Till AND S T
TAX MAP/I nT P,1 AAP 1 1 r,nn ,I IP Mf'WWI WWI I I T 1 4'1 RK
I ANn I I,F • 174 '"i
I ni ST 7F' • UN I IA1 7f1N Ii R"i . 4774 riFTRAr'KS
FPfNT • Pfl PFAR ''%
Wr1RK r'1 A„ • NFW nWK:'I I I INT 1', 1 I FFT • 1 % RTMAT 1 !S
t I,F' TYPF c,TNf:I K: f AMTI Y Nil RFnpnflMti - * FXT WAI I 1:nNST •
I"f1Nc;T' 'T'YDr • UN Nn ftATNS P N• , • F • W
iit r'i IP ruin PA pnn'r npF'NTNr,, •
cirri in I nAn N S • F W •
TnTAI ARFA 'I 9P'.%
Nil ,TM)TFS 1 1,'T • i 9Pt% Rnf1F rnNST • F FTPF PFT7
1-IK' TI1HT • I R, PNn• APFA SFPAD7 RATFn
RA,FMFN•T7 Arin riril Ili SF PAP7 PATFl1 •
MP'?7ANTNF 7 RA,FM'T
Ft MP I flAl" /Ifl f:APAr:F .11-0.1 K'TRF ,PPKI P7 Al APM7
FI f1W f 1;PM 1 nFTFr.T7 YFS
NF A'T' •T'YPt' f:AS Nn1'P Arm t'f1DD7
I rel AN r'NFrif PY• r•1 I.
PFMARKS
$15 for red hits' c'rlpy REISSUE. OF NO. I
LAST REISSUE ---- I 1
EE'i 1w ANDERSON DAN E P1-IiMI T $391. 00
N 936:i SW HEAVE'RTUN--HILLSDAI_E. PLAN RF.VJ.E:.W 4140 . 00
E boat veer tun or F IPE:: DEPT
R
STATE TAX $19. 5n
(:1T'HEW $17 00
C F VF L..OPME N 1 CHARGES
O ANDERSON DAN I 5aDC(STORM 1 $250 00
N ME•ADOWHPU1.)K DEVELOPMENT SDC:I STREET 1 $600 00
R 9363 'SW l F AVE:IiT•UN -HIL..LSDAL.E 1-DC($1 1 *250 . 00
C hw'eavr-i'triri or 97006 PREPAIL) < 11110 00)
C
T PHONE (:x0,31 ;'.97 -1666
O RL i.;1 S T RAT T CIN NO 46344
R 'TOTAL *1 ,`.i Y_"i "1"_1
-- I
RECEIPT NO . /L)5- e, -_, 47
T his permit is issued s1 hlect to the regulations contained in Title 14 __._.._._..___-._.._......._.____-.
of the IMC State of Oregon Specially Codes zoning regulations f4 i1UIREiD INSPECTIONS
and all other applicable codes and ordinances and it is hereby
agreed that the work will be done in accordance with the plans and VOWING SEWER
specifications and in compliance with all applicable codes and FOUNDATION WALL RAIN DPAINS
ordinances The issuance of this permit does not waive restrictive PO',I i E3E:.AM WATER LINE
covenants Contractor and subcontractors shall have current city PL.i UNDERSEAS CITY APPRCH/SW
business tax permits This permit will expire and become null and
Joid it work Is not started within 180 days 31 it work is suspended or SL.AEi FINAL
abandoned for a period of 180 days any time after work has PLR . T(.1POU T 1
commenced 't shall he the responsibility of the permittee to assure FRAMING
all real wed invecti are requested and
a
pproved E' 1PEPL.ACE
/ 7°6. -- - GAS LINE./C/' 4— INSULATION
� � GYP . BOARD
Perrmiha' 'nature
-Su1iN;
eii , J I. ._ 1 t 44 T ' NF f'f i`HM--1 rib"4?TT
_J
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO"E
C lY OF TI RD MECHANICAL PERMIT
trt�ar��rm MECHANICAL
T" NO. MEH9146H
COMMUNITY DEVELOPMENT DEPARTMENT
131255.w Hall Blvd P 0 Bow 23397.Tigard Oregon 97223.15031 139 417S DATE' ISSUED: B/22/139
— - 2423
/4,4 7'
..lUH ADDRESS >L f44 1,W 1OLAND ST
TAX MAP/1.0T PS1. 4AB 11600 SUES: MOTINTNGHl.1 1... L.T : 1415 OK :
I...AND USE : R4 9
LOT SIZE •
I TEM • NO NO
WORK CLASS : NEW FURNACE <100K 1 AIR HANULR <10
USE TYPE : SINGLE'. FAMILY FURNACE 100K+ AIR HANDI._R 10K
CONST . TYPE:. : VN F LOOP FURNACE EVAP .COOLER
OCCI.IP GPP . 143 HE.AT'E R VENT FAN 3
VENT VENT . SYSTEM
HLR/CO11P <3HP HOOD 1
N(1 STORIES 1 RLR/COMP 3•-15HP INCINE.RATO)i(DOM
OWl-I..L UNITS . 1 F1LR/COMP 15-30HP INC I NERATOR I COM
FIJEI.. TYPE. (.;AS $L..R/(.:OMP 30--7OHP REPAIR UNITS
MAX . INPUT BLP/COMP 50+HP OTHER a
F• IRE DMPI(S'/ GAS PIPING OUTLETS 1
H.LGH PRESS'/
1_(JW P14G.11117 — — -- ---- -- —
1(1- MARKS
114•a•r) r•iirttr iact.or•. t►t ebeer•
0 l E
W ANDE:ERSUN DAN E. PERMIT •10 . 00
N 9363 SW BEAVER ION -HII.1 (4)AI E PLAN REVIEW
E. •10 . 1.3
R bexvar•ttiii Dr F'IXTL.IRE:S *30 50
STATE TAX •2.03
— — -- (TT HF:R
C
C)
N
f 1:11.1R 51-4151:IN5 HF:Ai I.NI: AIR t,r:1Nf)
b'01)0e66109
A
C Par tr1 And (Ir 91266
TO PHI INE (.`)0.4 I I%:r- :'x919
R (TEG ii I ON NO 4H2H3 TOTAL : S52.66
T his permit is issued subject to the r.golatu,ns contained,n Title 14 RE CLIP 1 NO . /65235
as�1
of the TMC State of Ore.lnn Specialty Codes zoning regulations • —
and all ether applicable codes and ordinances and it is hereby {•iIUIRE:D INSPECTIONS
agreed that the work will be dome in accordance with the plans and GAS L.INE
specifications and in compliance with alt applicable codes arid nOr:r R Elk:AM
ordinances The mall/MCe of this permit does net waive restrictive•
covenants Contractor and suhcontractois shall have current city ROUGH- 1N
business tax permits This permit will expire and become null and T 1NAl..
void if works 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 reouired ins c c Eirverepuested and rived
Permittee Signature
Issued By It--
C
_ . • TNst-'F.t..T ITTR 619- 1175
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
1
PLAN CHECK APPLICATION
CI1YOFTI&ARD clrrorrw�uo PLAN CHECK N � - /Lir<' •
`1
COMMUNITY DEVELOPMENT DEPARTMENT , PERMIT N g1�h
m
urnsw.K.oMed,•.o.e.tlr.no.�o.eae^sim•(5-3I ITS ` �� /1------ DATE ISSUED
300 DRESS:/eZ 7f .►✓ f ems'# _- � --- ri AX MAP/LOT .25 1- 4 A Q- /I C.c. O
SU w
z4-•�jj t�� LOT: 7! J LAND USE: F 4, 5-
VIALUATION:
OWNER
�� 2 SPECIAL NOTES
NAME:
,i::' ..• — _ _ _ REISSUE OF:"
AOORES`i: N' ...e.„ LAST REISSUE:
FLOOD PLAIN/
--- - __ SENSITIVE LANG:
PHONE: - - .7- ,rGAPPROVALS REQUIRED
PLANNING:
NAME: �„ � ..4 ,/CONTRACTOR ENGINEERING:
NAME; —
_ FIRE DEPT
ApORESS: OTHER:
PHONE: - ITEMS REQUIRED i /
LIST/SUBCONTRACTORS: f/ _
ARCH/ENGINEER BUS TAX: _ _.
NAME:
_ CALCULATIONS:
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- - PARKING PLAN: _
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PHONE:
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PERMIT N ACCT N DESCRIPTION AMOUNT AMOUNT PO. BAL. OUf,
10-432 00 Building Permit Fees it) - 3 91-J 10-431 00 Plumbinq Permit fees /;. '" /25 ^y
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yam.__ 10-431 01 Mechanical Permit 1%.1s!s 1)' ' __ p�
10-230 01 State Building Tag (5X) -
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Plumbing
Mrch .7 - c3 _ G J- L��, ' ,�s
10-433 00 Plant Check Fee
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30-207 00 wer Co • t i inn . --- - -,,y
30-444 OO Sewer Inspection S - - '? _
51-44B 00 Street System Ow Charge (SDC) J- _ Z yn�_
52 --4k , 00 Parks System Dev Charge (POC) 4, ' L _ --
31-450 00 Storm Drainage Sysi. Deur Chrg (SSUC) + . P ../:'' -
10-230
'10-230 09 IRFD -- ____ __-
10-230 C6 Washington County fire N1 (957) __
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APPI ICANI S1(..NAIURI
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cn/3587P/18I'
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