12388 SW KING GEORGE DRIVE Iwo
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INSPECTION NOTICE
City of Tigard Building Departmentw _
1312;' SR Ball Blvd. Tigard, oragon 97223 �
Inspection Line (Rac-0-Plione)1 639-4175 Basinoss Phone: 639-4171
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Inspection:
Footing Plbg. Underslab Mech. Rough-in App-.'Sdwlk
Found. Plbg. Top Out Gas Line FIN;tL
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water ins Gyp. Bd. -Mech.
Data Requested: / _� ".'Imes AN PM
Address: 0 Permit :���t'� 7 3z�
1 1ilder:
THE FOLLOVaNG CORRECTIOUS ARE REQUIRED: A�JJ r
(�_��. .•ice F �.�•_.
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9��� ��C i.�'[`.�r��/ Y� L�Y. /SACC-cC"•� �.,
Inapertor: Dete:
_APPROVED DISAPPROVED APPROVED SUBJR(`T TO ABOVE
Cell For Reinep.
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�I ' ,�V �f,z TION N01'ICE V
City of Tigard Building Departamt
13175 BR Rall Blvd. Tigard, (sragoD 97223
Inspe^tion Line (Rec-O-Phone): G39-4175 •Ainess Phone: -4171
1 5 In■Pec tions
Footing Plbg. Underslab MsOh. Rough-in Appr/sdwlk
Found. Plbg. Top Out Gas Line FINALS
Post/Beam Struct. San. sewer Framing -Bldg.
Post/Beam Neeh. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line
Gyp. Bd. -Neth,
Date Raquestedt Times AM PM
hddrese:_� i (1Y! `-'� Permit #1
Buildare Lr�a` Z r
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THE FOLLOWING CORnZCTIONS ARE REQUIRSDs
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APPROVlLD L'DISAPPROVED _y APPROVED SUBJECT TO ABOVE
Call For Reinep,
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MECHANICALPERt
CITY OF TIGARD PERMIT #. . . . . ... MEC93--0323 I
COMFOUNITY DEVELOPMENT DEPARTWNT DATE= ISSUED: 11/19/93
13125 3W Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171
PARCEL.: c'S 1 10CC--20300
SITE ADDRESS. . . : 12388 SW KING GEORGE DR
SUBDIVISION. . . . : ZONING:
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . .
CLASS OF' WORK. . :ADD FLOOR TURN. . . . : EVAP COOLERS:
TYPE OF USE. . . . :SF UNIT HEATERS. . : VENT FANS'— :
OCCUPANCY GRP. . .-R3 VENTS W/O APDL: VENT' SYSTEMS:
STORIES. . . . . . . . ..2 BOILF_RS/COMPRESSORS HOODS. . . . . . . :
FUEL TYPES _._.__.____..__._ 0-3 HP. . . . : DOMES. I NC I N: e
. /GAS/ / / 2-15 HP. . . . : COMMI_. INCIN:
MAX INPUT: BTU 15-30 HP. . . . : REPAIR UNITS:
cIRE DAMPERS' . . : 50-50 HP. . . . : WOODSTOVES. „ :
IAG PRESSURE. . . : 50+ HP. . . . : CLO DRYERS. . : e
KI'J. OF UNITS---- ------ AIR HANDLING UNITS OTHER UNITS. : 1
FURN ( 100K BTl_': <= 1.0000 cfm : GAS OUTI_ETS. : 1
FURN )=10:-'K BTU- > 10000 r_f n
Remarks :
Owner.: _.____..________.___.________.___..________.__.-------------- FEFS
DONNA KLOSTER type ama:'nt by date rl-cpt
12388 SW KaNG GEORGE PRMT t 25. 00 JH 11/19/93 -
!f-PCT $ 1. 25 JH 11/19/93
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KING CITY OR 97224
Phone #:
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Contractor:
HOT SPOT F I REPL.-)CF & PATIO C
11525 SW CANYON RD
BEAV'17RTON OR 9.7005 __-_--_.__.-_ ______.__---_.___.__..,---_----- ..__
Ph a n e #: 626-4652 f 26. 25 'TOTAL
Reg #. . : 71782
---•----- REOU I REIT INSPECTIONS
This permit is issued iubject to t: regulations contained in the Gas Line In. p
Tigard Municipal Code, State of Ore. Specialty' Codes and all other Final Inspection
di,plicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 188 days of issuance, or if work is suspended for more
than 180 days.
P e r m i.t t e e S i g n a t i-ire: / -
I s s tt e d B y :
Call for inspection 639•--4175
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City of Tigard MECHANICAL PERMIT Plancl,JRec. #
13125 sw Han Blvd. APPLICATION 'ermit #
l PO Box 23397
Tigard, OR 97223
(503) 639-4171 _
• Table 3A Mechanical Code OTY PRICE AMT
Jt,. µ 2� ) l 1 6'a- A e V, - I; Permit Fee -0- -0• 10.00
Address '1 tj V"Jdo�` 2) Supelernental Permit 3.00
.m.r-I" > . Furnace to 100,00 BTU
� •„L�J y �V r• 1) incl-ouws&vents 6.00
w.q�..]s'�«.stJ » -rnace 100.000 BTU+—
Owner G t� SPC r" P Y . 2) incl.ducts 8 vents —_ 7.50
I —Floor urnanco
/ r a 3) incl. vent 6.00
.m.
Suspended eater,wall eater
4) or floor mounted heater 6.00
.vW. �- �--Venl not i—ncfin I
Occupant ��� YL L, 5) appliance permit 3.00
Repair of healing,re ng.
G) cooling,absorption unit 6.00
�- '—TO er or comp,heat pump,air cond. I
7) to 3 HP absorp unit to 100K BTU 6.00
,".,0116T SPOT FIREPLACE °fiATIO moiler nr comp, heat pump,air cond.
c�na r_. 8) 3-15 HP absorp unit to 500K BTU 11.00
�tctic
Contractor �-- Boiler or comp,heat pump,air coni . I{
Beaverton, OR 97005 9) 15-30 HP absorp vnit.5-1 mil BTU 15.00
•d1.R.9,•...,,F4. MUT - V •• • i er or comp,heat pump,au Gond.
10) 30-50 HP absorp unit 1-1.75 mil BTU 22.50
hereby acknowgo that I have reaa this app ieaben,t hat a .her or comp,heat pump,air cond.
Information given Is correct,that 1 am the owner or ruthorized agent 11) >!i0 HP absorp unit 1.75 mil BTU — 31.50
of the owner,that plans submitted are in compliance with State Air handling unit to
laws,that I am registered with the Construction Contractor's.Board, 12) 10,000 CFM 4.50
that the number given is correct. (If exempt from State registration, -- r� inn
please give reason below.) 13) 10,000 CTM 4 __ - .50
Non portable
11) evaporate cooler 4.50
-" ect an connected
15) to a single duct 3.00
enb abon system not
16) included in appliance permit - 4.50
(L 17) mechanical exhaust 4.50
w new addition U-11talleration repairo Commercialor to u,�tri
to be done residential y non-re ntial O 18) type incinerator 30.00
xtsbng use o r er i.e.,w66a tove,water
building or property -• l� 19) heater,solar,dothes dryers.etc. 4.50
Proposed use of r 20) 13as piping one w four outlets 2.00 <`
building or property_ ,f ��
21) More than 4-per outlet _
Type of fuel -oil O natural gas, LPG Q electric Q J —
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NOTICE--
Minimum Fee$25.00 SUBTOTAL
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PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT%.;OMMENCEI;WITHIN 180 DAYS,OR 5%SURCHARGE
IF CONSTRUCTION OR WORK IS SUSPENDED On
I ABANDONED FOR A PERIOD OF 180 DAYS Al ANY TIME PL/,N REVIEW 25%OF SUBTOTAL
AFTER WORK IS COMMENCED.
TOTAL
Special Conations )h
1( ( �( - �l ; Data i-sued - --- _by
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MON 12:37 I D:CITY OF KING CITY FAX NO:503 639--3771 tf 131 P01 ,
rn E'G Gr Z3 Post-It"brand fax transmittal memo 7671 wotpsyss►
rem ltS
KING CITY co. Ck 1! a.r-d CO.
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Dept. hone
—es 15300 RW 116th Avenue,King City,O,rgon 97-9194l 4 Phone �l 'r)e r,-\li _.Z
COMMUN I TY' I Fwx 0 Fax N
APPLICATION FOR.
(Instructions on reverse)
DATE U- n9-43
1. NAME OF APPLICANT: Phone No.�$�1
ADDRESS:
ADDRESS OP PROP09M IMYRL7V1M1T _._f�W- V1,Q— ■
2. TfPE OF CHANCE, IMPROVUMU OR CONSTR MION FOR MICH FAIT IS P2WESTED.
DESCRIBE BRIEFLY - ATTACH 'IWO COPIES OF PLANS OR DRAWINGS OF
PRO .JROJDCT: ' r' ■
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3. movz AND DRESS CF CQNTPAf.'MR2i4,z J,,&'T i-r
, ad l J,,k, L,r- ?1,00 S PHONE NO. LIr,7NSE NO. '71 r
4. NEIGHBORS WHO Mp.Y BE AFF..c M BY THIS PROJECT WILL BE NOTIFIED I3Y THF CITY.
5. APPLICANT OR HER,/HIS REPRESENTATIVE MUST BE PRESENT AT THE PLANNING CCW1SSIQN
KK9PING NEXT HELD ON
REPRESEN'PATIVES NAME PHGNE NO._
(TE.: King City Planning Commission will consider only those applications re^eived at least five (5) days
prior to a meeting 9 ^
SIGNATJRE
APPLICATION RECEIV® sY ��_ .�l��P�-� DATE I.�/�? - 23
APPLT(MBLE ?EE R=IVED $ TOTAL L
PLANNING Ca-ttISSION DECISI��OecN Approved- X Denied
CONDITION'S /IJ ri d (4
Of 0
1ppr ved plication rtc", for sir ea 001� _
Signature 2�4 Date _>
1(0TI: 0 on fiom ill d"s Lar requires that ell pernans Vbo contract cork o0 sir rig dente be
registered vith the Buillers Board vhich eeaas the contractor is bo0ded a d insured on the job site.
For your protection, be certain your contractor is registered by calling City mall Ph: 639-4081.
0
NOPE: A penult mmt also be obtainedthe City of Tigard Department of
Ccirmnu ty Development Yes__ No
CITY OF TIC;AR _ INSR]=I0:4_RFO,t-T
The above listed project has been inspected and Approved Denied_
_ Date Gam)ents
Signature _
(E1JUAi.ng -inbpectm ptwAe , non.¢. ( 1) copy to K4-" C:4.4)
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