16655 SW KING CHARLES AVENUE +
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CITY OF TIGARD BUILDi.NI'a INSPECTION NOTICE 9
Inspection Line (R a O-Phone): 639-4175 Business Phon 639-4171
C
Inspection: —
Footing Susp. Ceiling Sprink. Rough-in Ar/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. UndArfloor Rain Drain Framing -Plumb. +
Insulation �c
Alarm Water Line n
Underilr. Insul. Shear Wall Gyp. Bd. -Elect. #,1 "` �++4 t1, .
Date Requested: Time: AM
Address: U
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Builder: r k r
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THE FOLLOWING CORRECTIONS ARE REQUIRED: } � 1 ,
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Inspector. Date:
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ROVED DISAPPROVED APPROVED SUBJECT TO ABOVE !
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Call For RPinsp. �' 5i1' r.
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0ML.CFIAN I CAL
.; C0, OF TIGARD FERMI 1` #. r'ERMI :
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A COMMUNITY DEVELOPMENT DEPARTMENT DATE IS,.�UCD: 08" /14/95
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13126 SW Hall BKS.Tigard,Oregon 91223.8199 (503)630.4171
PARCEL.. 251 I1_`,SC--05600
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ADDRESS, . » t 166155 CW KING C:HARL.FwS AV F
SUBDIVISION. . . . : ZONING:
. . . . . . . . . . . LO1.. . . . . . . . . . . . . .
CLASS OF WORT%. . :NEW FLOOR FEJRN. » . . : LVAI COOLERS:
TYPE OF' USE. . . . UNIT HEATERS. . : VENT' FANS. . .
p'
OCCUPANCY GRP. . :R.:3 VEI'y•T'S W/O APDL. VENT SYSTEMS:
STORIES. . . . . . . . e FOILERa/COI PRCS'SORS HOODS. . . . _ c
e
FULL TYPE:;_..._....._ _.._..___._ 03 I•tF', » . . : 1 DOMES. I Nc rN. �
: /GAS/ / / 315 HP. . » . : COMML. INCIN:
MAX %Ni''U7"; BTU 15-30 I•'iF'. . . . : [;Er,(I I R UN I TEi:
ii
FIRE DAMPER0% . .. . 311 50 HP. . . . : WOOD5TOVES. . :
1 GAS PRESSURE.' . . : ;y414- HP. : CLO DR'Y.'R5. .
NO. OF UNI7�i—__.-..__.____., AIR HANDLING UNITS EITHER UN. TS. : t.
r'URN 100K STU: 1 ( - 10000 c:fm : C;(1 a C.1UTI._1.'T5. :
URN ) '-1ti qK RTU: > 10000 cfm :
Remar"I•cae Replace existing yasi fj.crnac:e and initall. new air conditioner r.mit.
Owner: _..._. __ ______._,_._._._..___.....,_..__,__.____._____._._..._._._..___..___.--•-- ...___. FEES
"_;EiliiLE*.' JACOBSON type Amc,r.lnt by date r~ecpt
16655 SW KING CHARLES AVENUE PRMT $ 25. 1Z10 JDA 06/, r/95 KIIVG CITY
`.�F,FT $ 1. 2`'i ::TDA OB/14/95 IiING CIT..Y
KING CITY CCR '37u214
Cont race or e
SPECTC4L.T ' HEAT:IN(;/FAJ3RIC0TIOI4 '
p
9528 SW TIGARD sT
TIGARD OR 97223
r n e
I . C E0- :iC 4.'s $ c6. 25 TOTAL
Re y t#. , 66576
REOUI RED INECPE__L'i 10Id1, -_.... ...._...._.
This persit is issued subject to the regulations contained in the Mec:trarrical Insp
Tigard Municipal Code, State of Ore, Specialty Odes and all other Final Irr,5pvc.t ion
applicable laws. All work will be done in accordance with
approved plan;. This pervit will expire if 43r•k is net started
tiithin 160 days of issuance, or if work is suspended for More __• _.• __,_ __ _._ _ ___.
di 180 days. ..� _.._
P a r•m i t t e e A,i&n a t;-+r'r? r //1 A// C I2
T s s _red By . VLGfG( _
A Caul r or- inspection e:39 % 175
=AN-15-'00 SUN 00:53 ID: FAX N0: #0 P0?
Post-It"brand fax transmittal memo 7671 0 of POW
KING CITY IDipt. --I QPFa1e
INN SW.116th Avenue,Hina City,OrWnn 97224 ��� �" Fax � �7� 4
13UIL.DING pE;F2d _TZ+ PPPL2CATIUN
DATE ��' S KING CITY AUSTNESS LICENSE NO.
NAME OF APPLICANT 1/'�
�yC1S:�,.� PHONE NO.,;��
ADDRESS ��o` -.Jt.� &"d/✓i'
NAME AND /ADDRESS OF PROP,DSED IMPROVEMENT_1140 n7- f. .J 00��.Illi e
oil
M.
PHONE NO---
NAME OF CONTRACTOR.��/G fj���y PRONE NO. � � .� -/.5/6 3
RDnRESS_ ZB ✓ c � - a ~CCB LICENSE NO. foafvS�"'v
TYPE OF CHANGE OR IMPROVEMENT FOR WHICH PERMIT IS REQUESTED.
DESCRIBE BRIEFLY - ATTACH A COPY OF THE PLAN OR DRAWIN3 OF PROPOSED
PROJECT t2//V�'gZio
SIGNATURE OF APPLICANT`
*APPROVED APPLICATIONS ARE VALID FOR S7V MONTHS ONLY*
NOTE: Oregon Homebuilders Law requires that all persons who contract for work on
a residence be registered with the Builders Bin-zrd which means the
contrac*7r is bonded and irsu►ed on the job site. For your protection, be
certain your contractor is registered by callsng the ConstructionI'
Centractor-s Board at 1-303-378-4621 Bxtensiar. 5,100.
FOR OFF T CE U9E ONLY
APPLICATION RECEIVED BY�� nP_TE E-
APPLICABLE FEE RECEIVED $ U _ CONDITIONG/CO_►MM-ENTS
i
APPROVED BY_
DATE
Note. A permit rmtAt alio be obtained from the City of and Department of
Coamunity Development Yes No
CITY OF TIGARD INSPECTION REPORT '--
This project has been inspected and: Approved _-�er_ied
Comments i
Signature Date `
(Building inspector please return one copy to King City)
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416" W
r __ �JAN- @@ SUN 00:54 IL: FAX N0: #036 P02
yMECHANICAL PERMIT Planck/Rec. #
city of Tigard APPLICATION Permit #�.C�
13125 SW Hail Blvd.
Tigard, OR 97223
(503) WS-4171
OTY PRICE AMT
Table 3A Madt ieW Code
--- permit Foe 0- 0• 10.00
Job (o to�S S /may Gh�`r/�Fav 1)
Addren 2) Supoomentsl Pwmk 3.00
t „mx. j C.00
5 /t/P� 1) Ind.duct a vents
r. txnau ' 7.60
S A4-1- 2) Ind,ducts A vents
Owner umanm
/ICl�✓ / �� z 9.00
3) irrcl.vent e
G' .w eater
spa a.00
t) or ow mmwmd hesMr
vent:siw in
3.00
Occupant 5) appliance pon' "
ape o slung, n9. 6,00
6) among,absorption unit
- er or aemp, a pump. oo . / 0
i ts7lt to 100K BTU
6.00 G'
G�7`1 d�' 7) to 3 Hp a!WV
�f1 (� �o e�or comp, Pu P. 11.00
fov / + � �_yr...---- 8) 3.1S HP sbsorp unit to 30oK BTU
Contractor of camp, pump,air o0
W.v J A DY c' Z�.3 9) IS•30 HP absop unk.5.1 mil BTU 15.00
/ Owo y _22— c- or camp. a Pump,a coi
e; to) 3450 HP sbsorp unit 1.1.76 mA B'N 22.50
`r` S yr or camp. pump.a r con .
r y ac va ra is toe 11) �5o NP absorp unit 1.76 mil OTU
37.50
information given is cam",that I acct dw owner or authorized went r handling U of the owner.ftl Plans submita.d she N eompllarwo with&rale 12) 10,000 CFM 4'SO
laws,that I am regislered wits the C.Mutnactian Conawmes 8cwrd, ���u�___,
that the number given is correat- (If mwmPt I mm StAle registm4an, 13► 10,000 CTM t 7.50
please give reason below.) lQunRUM_---
14) gvapm0m cooler a'�
IS) to a single duct 3.00
en wtioniysTaM no -- _
_ 16) included In appliance Permit d-50
It
v(l+ry
"rsdsery
17) medhonlud exhaust �.SO
son w new e s ratan repair -t merc:Tw+n s e 30.00
t to be dons resWen nan-rosidential 17 _ -- 1B) tYPa inein�rnstor —
su 19) homier,s4:klw,dotleit dryers,eco, d.50
bui"or proNerty --
20) Gas p%ping ato tour outlets
Proposed,)s*of 2.(10
ne
buldng or pmpwV —' 21) More than A-per outlet _
Type of fuel•oil 0 netursl 924"k—I-PG 0 aleruir:O
Minim•im Fee$25.00 SUBTOTAL _ v? add
PERMITS SecOME VOID IF WORK OR CONSTRUCTION �— 5�SURCHARGE
�'Z
AUTHORIZED 13 NOT COMMENCED WITHIN 190 DAYS,OR
IF CONSTRUCT"OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL 00
-
AFTER WORK 1.9 COMMENCED r — TOTAL
Special Conditions
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JAN'-15-100 SUN 00:54 ID: FAX N0: mm P03
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