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12365 SW CORYLUS COURT
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INSPECTION NOTICE
City of Tigard Building Department
P O Box 23397
Tigard, Oregon 97223
Phone. 639-4175
Type of Inspection
Date Requested Time AM.���P�M:
Addrw,s Permit
Owner c C- f 't ' _ _ Lot #
Buil-ler
The following Building Code deficiencies are required to be corrected:
Praantati to -- L*Approved
Inspector f ❑ Disapproved
Date b
CALL FOR REINSPECTION
❑ YF.• ❑ 140
Receipt#
CITY OF TIGARD MECHANICAL PERMIT Permit#
Description
Table 3A Mechanical Code _ OTY PRICE AMT
City of Tigard 1) Permit Fee -0- -0- 10 00
13125 S.W. Hall Blvd. _ _ _
P.O. Box 23397
Tigard, OR 97223 2) Supplemental Permit 3.00
639-4175 1) Furnace to 100,000 BTU 6.00
_ incl ducts&vents_ _
Furnace 100,000 BTU i
2 incl.ducts&_vents 7.50
Name of Developmeit ) Floor Furnace
3 incl.vent 6.00
Job Address 4) Suspi-idec:neater,wall heater 6.00
Address . r( --'j or floor mounted heater
Tax Lot Map No — ) Vent not incl.in 3.00
Lot Block S,r,droision 5 appliance permit _
Name for name of business) 6) Repair of heating,retr ig., 6.00
cooling,absorption unit
Meiling Addrose ,_ _ phone Boiler or comp to 3 HP
Owner 7) absorp.unit to 100,000 BTU 6.00
city state —� Z;p - 8) Boiler of comp to 3 HP-15 HP 11.00
absorp.unit to 500,000 BTU
Name Boileror,;omp 15-30 HP
g) absorp.unit 112-1 million 15.00
�Mailing Address Phone - - 10) Boiler or comp to 30-50 HP 22.50
Contras-tor
absorp.unit 1 -1.75 million
---�� -- -- - ---
�Ity State dip ) Boiler or comp to 50 HP
11 absorp.unit 1,750,000 BTU 31.50
State Registration No city Bus Tax No1�,) Air handling unit to 4.50
10,000 CFM
Air handling unit
I hereby acknowledge that I nave toad this application that the information given is 13) 10,000 CFM + 7.50
correct,that I am the owner or authorized agent of the owner•that plans sutmitted are in --- -- —
compliance with State laws,that I am registered with the State Builders Board that the14) Non portable 4.50
number given Is correct.o exempt from Slate registration please give reason below) evaporate cooler
15) Vent fan connected ----- — -- 3.00
..«x---, ✓ to a single duct
16 Ventilation system not 4.50
included in appliance permit
17) Flood served by 4.50
mechanical exhaust
Signe utr(owner or sprit) - cede ) Domestic type —�---W------ -
_ incinerator 7.50
Describe work D addition C I alteration W repair 1 I --
to be done residential U non-residential 1 1 _ 19) Commercial or industrial 30.00
Existing use of _type incinerator ,—
building or proper) .._ -_ _ ) Other i.e.,woodstove,water 4,50
Proposed use of 20 heater,solar,clothes dryers,etc. --
building or property - 21) Gas piping one to lour outlets — 2.00
Type of fuel-- oil ' 1 natural gas I I LPC 0 electric ❑ - — - -- --
22) More than 4-per outlet
NQTICE
SUB-TOTAL
THIS PERMIT BECOMES HULL AND VOID IF WORK OR CON-
STRUCTION
ON STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 4%SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL -
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER -- --- --�-
V'JONK IS COMMENCED.
TOTAL
Special Conditions ___•-.___-_.__.. '�` �_.___._
—._--- - =='?,,. �-- ----- - - Date'ssued i by -� --
its
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BUILDING [DEPARTMENT, TIGARD N°
PyUMBING PERMIT
holder of a valid plumbing contractors license is hereby
cause I rribing work as herein noted to be installed in accordance with the plumbing code of
authorized to P l
Tiga,d. Such installations require inspection by the City Inspector w,ho shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors. / �,
DateE _-
L_
NUMBER OF TOTAL
TYPE OF PERMIT ITEMS FEE ON EACH AOT
MOUNT
��` 25.00 � -----___._._. �•�
Sinal! Family-1 hath-•each - — --
Dupl..--Each 1 bath unit � _ _ Y. __ _______25,00 _
Additional bathrooms-each _____._.__ --
10.00 d
Mobile Home Spac!-each — 15.00 _— —•
INDIVIDUAL FIXTURES CQf'1(�iERCIAI
I to 50 Fixtures it,-' buildirtg_lach _, _ 3.00
51 to 100 Fixtures in 1 building-each ��..�_ ___25a _- —-- -
f 200
101 to 200 Fixtures in building
1 ----
( 201 or more Fixtures In 1.buildinj:-�ach 1___._50-— _-- -----.- —
MISCELLAN_EO US_�,_—_,_
5ywer-each additional 100 ft
_Water Service to buildin 5.00 -4 _
f Other (So'!6f)tIt ---
l PERMIT For Plumbing Inspection Phone?639-4171
4°;State _ �^ Plumbing Contractor By
TOTAL _—�-_ RECEIPT NO, Issued By
BUILDING PERMIT APPLICATION "'y TIGARDDAI E
79
OF
THE UNDERSIGNED HEREBY APPLIES FOR APE RM IT FCR THE WORK HEREIN INDICATED BUILDER PHONE
ORAS SHOWN AND APPROVED IN -f HE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE.
LOT NO.
OWNER JOB ADDRESS 1231.,:-j jU CQty1U& Ltj.IOME-:ADDRESS
ARCHITECT
n
BUILDER tinctor, ADDRESS HY50 '.'`RJ Rurnhom ENGINEER
nEsIGNF9
STRUCTURE ONEW El Rt mnDEL CIADDITION El REPAIR ORENEWAL EIFIRE DAMAGE EIDEMOL ITION
CI RESIDENCE OCOMM DEDUCATIONAL CIGOV'T ORELIGIOUSEIPATIo EICARPORT OGARAGE CISTORAGECISLAF1 [:]FENCE
OBOND OMOVING DCONDITIONAL USE ODESIGN REVIEW CICOUNCIL APPROVED 0 S I G NS
OCCUPANCY—'-' LANDUSEZONE.— 10 BLDG. ILI 4 c
TYPE—.—. FIREZONE— PLAN HEAT
.'anstru t single family dwelling w/attechad garegs - 4 budroum6 - 4
9[t CORHELTION SHEET ATTACHED,
1 07 - 4621..I*00 "72 *Q.fts
U 21J < 072 4
HEIGHT
--- NO.BEDROOMS VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR .1.�u 70
I I FT SIDE RIGHT SIDE
Permit *iVi.00
THIS PERMIT 19 ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 1.37.!)b FAIEGULATION S AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE Pt ANS AND SPECIFICATION' I%ND IN COMPLIANCE WITH
Sub-total 4120 5Q L APPLICABLE CODES AND ORDINANCES, TNF ISSUANCE OF THIS RMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS CONTRACTOR AKIO S11113 CONTRACTORS TO HAVE ('11FIRENT CITY BUSINESS
State Tax t, 11.00 LICENSE. SEPARATE PE.jrITf
MEOUIRED FOR SIEW1711, PLUMBING AND HEATINu.
Total 142.33 5C
By
APPLICANT OR AGENT
A7 ,Quad p"'1-11,1 N,, 21
DATE INSP. TYPE INSPE47TION REMARKS PLUMBING DATE
Contractor J— —
Permit No. /G S >0 �O` --1 lr
Rough-in— ---- --
�.-1_1� _[ 1�1/ERl � t �I�yaZ.{1 S�Qdr— —_.—_-•---- Fixture -
-��_ Final _—
_—� rd hp x o Aj r# is y HEATING
Contractor
—
Ctt
- -
Permit No.
z� /p
-- -- - — =Ad A1C Ar vAps- A' Z fit,",*1�1it r (l
Gas or Oil
Final
SEWER
Final 7��-79
--— ------------ — -------
DRIVEWAY
Final
Stontl Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
- BLDG.DEPT.FINAL T9:TAPOPARY CERTIFICATE OCC—/�(J�Y
CERTIFICATE OCCI/PANCY � 'i`1 (l"/ Final
�='� —
�-- Landscaping
Zoning Final
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01-t—Y of Tibar�f MCChC7Y1?Cal Pcrt;>>t M Permit ��
Fee_ ?;
New Installation Replace 0 Relocation [ 1 Addition U Alteration
M•. .�atc__ �
RATING .c�a+L �;, . TOTAL .'d• ',.;Z._� i
Ci_rNTRACTOR �r�r� c OWNER
A:rDRES;;_c?01 /�---, � WORN. ADDRFSSI� �6 3 �:.. ��•µrq
PHONE-.3 �, /GV APPLICANT
Heat Input Rating (BTU Per Hour) Vent Site Flue Site
FUEL OIL ❑ GAS ❑ ELECT OTHER `
I
___ ITEM NO. FEE ITEM IVO. FEE
For Istra�u:a of Permit - EE ABOVE Air Condition Compressor 15 to 30_HP 10.00
New-up to & inc).,�OU�000 BTtJ 4.00 _Air_HandlinU 10,000 C_FM _ -" bo-
100,
- --
.. _ _ _ 3.00 . •, � E
100 001 BTU's & over 5.00 Air Handling Over 10 UOU CFh1 r -'
-- __� _._.�_._.�� . 5.00
f Ic r Finn :.0 - - - 0 -
._ �S.UU �_ Lva;.torativd Cooler 3.00
_Wali�Floor •Su;t,dnded -� 4.00_ Range Vont Fan __�.- �� ____ 2.00 ;
ins;all Vents Uniy -' - -
2.00 Vent System__ 3.00
Repair • FleT & Cooling'___ _ _ 4.00 _Hood Commercial _r _��_�~ _� 3.00
r Cunclition Cornpressor_Under 3_HP 4.00_ Commercial Duct System r 10.OU
Air Cgnditioi•t Carnprossnr 3 to 15 HP --"- 7.50 -----•-_—_.�
-�--
INSPECTOR'S COMMENTS
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUB CONTRACrORS _
APPROVED By DATE ISSUED BY _ DATE _
RECEIPT N0.
tri Signature o" Applicant ��