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— 12490 SW BROOKSIDE AVENUE
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INSPECTION N01'ICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
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Phone 639.4171
AddrGss_, r(. `;� t;� __.. ., .� ... . r .......... Permit ►
Type of I^
YP •w'd"tion
'rhe following Building Code deficiencies are required to be corrected:
s
PYPgPrvterl to Inspectcr
Data ---- ---
CAL L FOR REll1MEC770N
❑ VES ❑ NO
I
City of Tigard Mechanical Permit Permit
Fee— -----
New Installation ❑ Replace ❑ Relocation ❑ Addition ❑ Alteration 17 3%State__
TOTAL.—._ ------_ . _--
CONTRACTOR ,—__ OWNER _
ADDRESS ---- WORK AODRESS_�— --------..-_
PHONE_ APPLICANT,-----
Host
PPLICANT__.__ —_Hest Input Rating (BTU Per Hour) —,._—. Vent Size _ Flue Size -_.
FUEL OIL ❑ GAS ❑ ELECT C7 OTHER
ITEM NO. FEE ITEM NO. FEL
For Issuance of Permit 3.00 Air Condition Com.ressor 15 to 30 HP _ -To-.R
Now- Under 100,000 BTU 4.00 _Air Handling 10,000 CFM 3.00
New 100,000 BTU &aver 5.00 ,fir Handling Over 10,000 CFM 5•00
Floor Furnace —� 4.00 Evaporative Cooler 3•�
Wali - Floor -Suspended 4,00 Range Vent Fan +— 2•00
Install Vents Only _ 2.00 Vent System 3.0_
Repair-Heat&Cooling _ 4.00 Hood Commercial _ 3.00
Air Condition Compressor Under 3 HP __— 4.00_ Commercial Duct System _ 10.00
Air Condition Compressor 3 to 15 HP _ 7.50
INSPECTOR'S COMMENTS_i__
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS
APPROVED BY_ __ DATF ISSUED BY DATE _—
RECEIPT NO.
714 Signature of Applicant
`i BUILS)EI2
I,CCl.'lIOiI /�' �,LO_�d.t_ .._17�?�`���...�•..:''•� �. . .��'��lr� �����....T__��i��._..__....._
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.TOSS HY it I.G. u___.....,..,,..�...��j._,•..__,.__...�..�.__..__..........._._....�.___.....
PLUMBER
SE'r,l:R F'EP,UT # _ .FEF, I ir'Ci'i 'iACy;�T.tr ri.:!2"Ii it
DATA .._.. BY LRD
EXCAVATION PIIS._ ~ .l1II3 COMU'l'L4 II :
w FOOTINUS FOUTIATIOi3
FORMS __ SPRII•:KI FR SY37J:M
SI.IIBS _ IV � gt'golm FLUES
REIITORCII,".; SZTEL -
�STRUCTURAI. STFl*,L _ i ",Iu'CI r7.;►�.'R � ___.__-.__ _
1,11TCOING RRI. _ _._ '_'' T4^M'1"t .._..._... _..� �..._._ _.._
hT:ATIOU
WATER HEAALR _-__� .. _.�.
Address 'CU Permit No..--( .
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;;f Occupant Permit charge r �i /l �'` � Connection fee:f e.
Paid by
Date connected
Type of Building
Inspeciion fee-.--L6— '�
Service Rate__ '.Z Paid by w ��P���( Date�� y�
Contractor �QrltA Assesement.—;dt—l",Paid_.
q _
Size of connection-�� _
APPLI 2ATION FOR SEWER SERVICE
The undersigned agrees, in consideration of the sewer service connection by the '
Tigard Sanitary District, to abide by and comply with the ordinances, regulations and rules of the Dist-
rict presently in effect or hereinafter enacted and to pay sewer service charges as the same may be im-
p,)sed from time to time when due and before such charges become delinquent.
I fully understand tha, all unpaid sewer service charges become a lien upon the
property served as stipulated in O. R. S. 224.220.
1
Connections to the District's system ist be made by bonded contractors and/or
bonded and licensed plumbers.
Owner
APPROVED BY
Sup rintendent - -- — - —
TIGARD SANITARY DISTRICT
8841 S. W. Commercial St.
Tigard, Oregon
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PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N(, 684 ►)ATE _ __/�
PERMIT IS GIVEN TO <-.-�► /N r,% (.
OF
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711
TO CONNECT A_1l.__-t. ._t.- { ..� ;r. ', ! % 1 r•r2( .G`, _ _
TO THB '3YSTEid OF TIGARD SANITARY DISTRICT
AT 1 1; W f
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
! GJ
FERMIT FEE PAID ;...: ..........................TIGARD SANITARY DISTRICT
By
CONNECTION INSPECTED AND APPROVED
Date rintendent