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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 Requested4 �— Time A.M. P.....M..
_
Address ^ ( Z �31�'7 permit
Owner-- -�C-1-
---- ---
Builder -!- _ -----.__-- _
The following Building Code deficiencies are required to he corrected:
Presentee to _ i- '- "roved
Inspector _J_ _ - U r ;sapproved
-- ~/✓�_ —
Date ._�.�.
CALL FOR REINSPECTION
DYES ❑ NO
I
44
CITY OF TIGpARD MECHANICAL PERMIT Receipt # � _
Permit
Description
1,•ble 3A Mechanical Code_ __ _ CITY PRICE AMT
City of Tigard — ---
13125 S.N Hall Blvd. 1) Permit Fee -0- -0- 10.00
P.O. Box 23397 --
Tigard, OR 97223 2) Supplemental Permit 3.00
639-4175 Furnace to 100,000 BTU
1) incl.ducts&vents 6.00
Furnace 100,000 BTU +
z) incl,ducts&vents 7.50
F Namr,of Development Floor Furnace 6.00
r( � , S ti0 e 3) incl,vent
Job Address Suspended heater,wall hater
Address 4) or floor mounted heater 6.00
Tax Lot Map No. Vent not incl.in -
_ Lot Block Subdivision 5) appliance permit - 3.00
Name(or name of business) Repair of heatin,;,refr ig.,
3 "N Q� �N,y\� 6) cooling,absorption unit v 6.00
Owner Melling Address Phone 7) Boiler or comp to 3 HP r 6.00
V —�3 a 3 absorp,unit to 100,000 BTt
City/State Zip 8) Boiler or comp to 3 HP-15 HP 11.00
absorp.unit to 500,000 BTU
Name Boiler or comp 15-30 t M9) absorp.unit 112.1 million 15.00
V Jing Address Phone 10) Boiler or comp to 30.50 HP 22.50
absorp.unit 1-1.75 million
Contractor City!State ZIP 11) Boiler or comp to 50 HP
absorp.unit 1,750,000 BTU 31.50
State Registration No. City Bus Tex Nn. 12) Air handling unit to 4.50
10,000 CFM
Air handling unit
I he,cl, acknowledge that I have read this application that the information given Is 13) 10,000CFM # 7'50
correct,that I am the owner or authorized agent of the owner,that plans submitted are in
compliance with State laws,that I em registered with the State Builders'Board,that the Non portable
number given Is correct. If exempt from State,�alstration lease give reason below) 4.50
9 ( P P 9 ) evaporate cooler
.G de-- / ;;r= r A Vent fan connected
15) to a single duct 3.00
.Z 161 Ventilation system not 4.50
included in appliance permit
Hood served by
17) mechanical exhaust --� 4.50
Signature(owner or ogent) Date 18) Domestic type 7.50
Describe work Fl addition r7 alteration V,1 repair i-1 incinerator
to be done residential ❑ non residential (-] Commercial or indust tat
- 19) 30.00
Existing use of type Incinerator
building or plopsrly 20) Other i.e.,woodstove,water 4.50
heater,solar,clothes dryers,etc.
Proposed use of
building or property 11) Gas piping one to four outlets 2.00
Type of fuel- oil [-] natural gas I I LPG f I electric LI
22) More than 4-per outlet
NQTICE SUB-TOTAL
THIS Pi7AM1T BECOMES NULL AND VOID IF WORK OR CON- - - -----
STRUC7;ON Alil'HORIZED IS NOT COMMENCED WITHIN 180 4%SURCHARGE
DAYS, OR II': CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONEU FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER --
WORK IS COMMENCED. TCTAL
Special Conditions
--- -- Date issued _---__----by
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INSPECTION NOTICE i
City of i igard bUddln0 Department
12420 S.W. Main St.
Tigard,Oregoo 97223
Phone: 639.4171
Type of Inspection
Date Requested _f _ Time _ _ A.M.--D.M.
Address '? .S —— Permit
Owner !-- _ _ Lot #
Builder _ _—
` The following Building Code deficiencies are required to be corrected:
41
f
Presented to __— Approved
Inspector __- _ � —/ Disapproved
Date
CALL FOR REINSPECTION
I� YES 1!� NO l
i
I
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigan_,Oregon 97223
,Phone: 639-4171
Type of Inspection —'yo 46w/"
Date Requesteds�'� `���P y Time A.M.—e-P.M.
Address .. / f r� Gv -Ben L� x5 a Permit #___...___—_
Owner_-� /.i1 — Lot #—__----
Builder _
The following Building Code deficiencies are required to be corrected:
_ )^I d In
Presented to
� ❑ Approved
Inspet3or � �+---`_ � s'""
❑ Disapproved
Date .2
CALL FOR REINSPECTION
❑ YES ❑ NO
i
1�3UILDINGPERMIT APPLICATION TIGARD DATE --tnber isi��a 5052
THE UNDEHSlGNED HEREBY APPLIES FOR A PERMIT FUR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE �_—
LOS NO. —
OWNER �sY j�c;C--_ JOB ADDRESS b9i1d?t«---- —. _.. iSf]!ld__CaCL
ARCHITECT
ENGINEER
B_ IU LDER _s v,. _._.._._._ ADDRESS N.U.-binx 23291 DESIGNER
STRUCTURE NEW U REMODEL ElADDITION ❑ REPAIR _ _❑ RENEWAL 13FIRE DAMAGE ❑ DEMOLITION
jQ,RESIDENCE 0 COMM F-3 EDUCATIONAL ❑ GOWT ❑ RELIGIOUS ❑ PATIO FJ CAR PORT ❑ GARAGE-❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY —IL-J-LAND USE ZONE --R-12-BLDG.TYPE -_-51L-F;RE ZONE -- PLAN CHECK BY -kCR_--HEAT Q
a
---Unstruct single 6fanily dwell'r. w ' ciiecf _-_---
[�C--JssUe of Pcroit 114740, See Lut Lim Adjuat.ment H 6.a-`14 -
3 Bitfirgula 3 L$ druirg
SEWERPERMITM 2q981_— _ t;llra j6 449.--
OCC.
4143 _OCC.LOAD FLOOR LOAD �U - HEIGHT 21 NO.STORIES ARE vu;3 NO.BEDROOMS 3 VALUE {93 ;
BUILDING DEPARTMENT SETBACKS FRONT , — REAR LEFT SIDE RIGHTSIDE
Permit-- , THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check_ ( WORK WILL BE DONE. IN ACCORDANCE WITH THE P?_ANS AND SPECIFICATIONS AND IN COMPLIANCE
%"TH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total 3uu.uij RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax C
13.60 SD —
SDC- ��
Total _ 393.bJ -- - _
PDC I1150.O11 I4VPLICANI 0R AGENT
By _ CI LII: 250.00
Receipt No.
Approved ADDRESS PHONE
-—l3i;R ���
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