10255 SW KABLE STREET 1 1
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INSPECTION NOTICE
City of Tigard Building Dtpartnent
13125 BW Ball Blvd. Tigard, �3regon 97223
Inspection Line (Rec-O-Phone)z 639-4175 Business Phone: 6.3-4171 `
Inspectiont__
Footing Plbg. Unders Lab ^Hoch.
Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cae Line FINAL:
Post/Ream Struct. San. Sewer Framing -Bldg. ■
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Wa or Line Gyp. Bd -Hjch.
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Date Requested: Timet —AH PH
Addresn: I C I Permit r= MF
i builder:
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TBR FOLLOWING CORRECTIONS ARE anurRED:
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Inspector:
Js _ Date
APPROVED DISAPPROVED APPROVED SUBJECT To ABOVE
C-111 For Painap. i
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CITYOF TIFARD MECHANICAL. L/ 0
CIiYOF?I6ARD
F;Li:Zrr I T ■
OOMMUNITY DEVELOPMEW DEPARTMENT \WYOFT N
13126 8W Hrl 6W. P.O.Boos 23307,Thud,Orpon W=(603)e34-a176 t"'k ! i'"t. #. . :
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' t -- -- F,-:o 1.71 DATE ISSUED: 04/06/92
I'TF ADDRESS. . . : 10255 SW rattl__E. S I PARCEL: 1
SUBDIVISION. . . . : ZON I NQ— —
< BLOC'K. . . . . . . . . . : LOT. . . . . . . . . . . . . :
CLASS OF WORK. . :NEW FLOOR TURN. . . . : EVAP COOLERS:
TYPE OF' USE. . . . :GF UNIT Hf'ATERS. . : VENT FANS. . . :
OCCUPANCY GRFI. . : R3 VENTS W/0 APPL: VENT SYSTEMS:
STORIES. . . . . . . . . BOILERS/COMPRESSORS I-HOODS. . . . . . . :
FUEL T'YF,ES--____-__._._.___— 0-3 HFA. . . . : DOMES. INCIN:
:/GAS/ / / 3--1 1IP. . . . : COMML_. I NC I iV:
MAX INPUT: 1001700 BTU :15-30 HP. . . . : REPAIR UNITSr ,e
F7 IRE DAMPERS?. 50--50 Pil°. . . . : WOOD°STOVES. . : I
! GAS PRESSURE. . . : 512)•4- HP. . . . : CL.O DRYERS. . :
NO. OF UNITS _._._._.._.__.____ AIR HA1,01-11AG UNITC., OTHER UNITS. :
TURN ( 100K BTU: ( i0000 c f m: CAS OUTLETS. : 1
FURN ) =100K ST(J: 1 i 1 V10 Q)0
Remarks : replacinq fLtrn�,,ce
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Gwnere ---_.___._.__.___...._._____.___._______----____. _ _._____.____._..__.__. FEES ________--_-__--
I APURICE LUCAS tvrse amol_int by date recpt
1.0255 5W KABLE E=RMT $ 25. 00 BLT 04/06/92
15PCT t 1. 2,a CAI_T 04/06/92
T I GASRD OR 97224
phone! #: 684--9366
Contractor-
COLUMBIA
COLUMBIA HL ATING
8900 SW BURNW—)0; ('
SPACE E-110
TIGARD OR 97223
Phone #: 624-2704 ; . 6. 25 'TO TIAL
Req #. . : 76359
REQUIRED 1 NSPCCT I ONS -- -- -This permit is issued s,ibiect to the regulations containeJ in the Final InsF:)ection
Tigard Municipa' rode, State of Ore. Specialty Codes and all other
applicable laws, All work will be done in accordance with
approved plans. This permit will expire if work is not started
within t8b days of issuance, or if work is suspended for more
than 188 days.
P e r-m m t t e e S i o n a t l- -f,
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Cali. For inspection - 639--4175
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C"1 l Y Or" r PE:r.I I IST OF F'IAYME-.N T' FtFlX. I P T NC). :'►;�.w��",� T �
NOME a COLUMBIA HEATING 8. GASH PMOUN T s CtsOA�', ill I I,
ADDRESS � 1":;�Ca...T NO ! I NC PAYMENT DA t a rrA 0'�t r
8900 SW I:URNWIll T. or..110 SUBDIVISION
TICvARD, oR 9r7223--
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{'1 IRPCfc3F" Of PAYMENT AMOUNT PAI D PURPOSE' OP PAYMU NT OMOUNT PA I I:)
MF:�t";r"If#NTCwF#L. PF" .._.....,.... _........-....M. ST.._._.BUILD
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SE1,1VER PERMIT
Unified Sewerage Agency
of Washington County CITY Or __T__—,. DATt
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OWNER: LOkI Ian PHONE : 3o� �
OWNER 'S ADDRESS: gal IV— �1_------ '
TYPE OF INSTALLATION:
SIDE SEWER [] LINE TAP AND SIDE SEWER DINE TAP
TYPE OF OCCUPANCY:
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❑ NEW EXISTING SINGLE FAMILY ❑ COMMERCIAL
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❑ EXIST, (PRIOR TO 7- 1-70 ) ❑ MULT. RES. ❑ INDUSTRIAL i
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FIXTURE UNITS— DWELLING UNITS
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ADDRESS OF STRUCTURE : 46o
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Pe-mit Conditions: The applicant agt.,es to comply with all rt,-les and regulations of the Unified Sewerage Agency,
z Wien calling for Inspection, please refer to the Permit Number. The Application expires In one hundred twenty (120)
1 days. The amount paid will be forfeited should expiration occur,
The Agency does not guarantee the accuracy of the location of side sewer laterals. If the sewer Is not located at
the measurement given, the Installer shall prospect three feet In all directions from the distance and depth given.
It not so located, the Installer sha;l purchase a 'Tap and Side Sewer' Permit at the current charge and the Agency
will Install a lateral at the locztion specified by the installer.
FEES:
PERMIT FEE � 39.0
CONNECTION CHARGE
LINE TAP INSTALLATION
,�-- ISSUED BY
OTHER
TOTAL $ &
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APPLICANT ------ --- DATE' -
SEWER PERMIT
ADDRESS OF STRUCTURE t)
TAX MAP C1 TAX LOT I�,�z SYSTEMHHo
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LOT — -_BLUCK _ A OF �dtL Se_ r
APPROVED BY DATE ISSUED BY DATE
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D. U . ' S �L. REroAR KS M+�h.1_TQ.Qs 744"
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INSPEi,TICaN NOTICE
City of Tigard Building Department fI I
12420 I.W. Main St.
Tigard,Oregon 97223
Phone: 639.4171 '
Tyne of Inspection _ /Lr<�(/ 64--
Date Requested Time
A.M. P.M.
Address
Permit #
3 --
Owner
Lot #—_
Builder
The following uilding Code deficicncies are required to be corrected:
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Presented to —
— Approved
Inspector
Mate Disapproved
CALL FOR RF,INSPE('TION ! 1
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