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CITY OF TIGARD BUILDING INSPECTION NOTICE �\
Inspection Line (Roc 639-4175 Business Phonej 6 9-4171 V
i
i Inspection:
Footi,,q Susp. Ceiling Sprink. Rough-in or/Sdwlk
Foundation Plbg. Underslab -0e—ch. Rougl n Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/'team Mech. San. Sewer Gas Line -Bldg.
Plbg. Jndertloor Rain Drain Framing -Plumb
Alarm Water Line Insulation
�M�h
Underilr. Insul. Shear Wall Gyp. Bd. Iect.
Date Requested: --- j I 2 Time: AM PM
Address:
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P jilder: rmit #(/ � C C
THE FOLLOWIN(', CORRECTIONS ARE REQUIRED:
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Inspector: -- -- Date:
PROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp,
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APR-i8-'94 MON 13:41 ID:CITY OF KING CITY FAX NO:503 539-3771 ti398 P01
Post-It'"brand fax transmittal memo 7671 0.1 ..g...
To l Fro
IVNING CITYCo. rrQQ Tm
J L `
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15:
",i14:116th Avenue,King City.Oregon 071124 Phnnr �APt p Phone N
APR 1. 1, COMMUNITY 1 .ah A
t, �-l-�
T �^ Few - —
APPLICATION FOR �.
CCMMUNIIY D L �-, (Instructions on ree
DA r�%
1. NAME OF APPLICANT: 10�2611'
Pharie No.
ADDRESS:� ,pt r f Geo✓c• / +
ADDRESS OF FROPOSED IMPROV510T1l_7 D w
2. TYPT OF C33ANGE, 'MFRAVEHM OR CONSTRUCTION FOR WHICH PERMIT IS
DESCRIBE BRIEFLY - ATTACH TWV COPIES OF PLANE OR DRAWINGS OF REQUESTED.
PROPOSED PROJECT:_S�-� 4t1q
3. NAME AND ADDRESS OF COIYTRACTp �' r
-- PYONE N0. 1,LT CENSE NO-._21 ,s-�
4. NEIGHBORS WHO MAY BE AFFECTED BY THIS PROJECT WILL BE NGTIFIED BY THE CITY.
y
5. APPLICANT UR HER/HIST REPRESENTATIVF MUST BE PRESENT AT THE PLANNING COMMISSION
MEIT?NG NEXT HELD ON _
REPRESENTATIVES —
PHONE NO.
(The Ring City Planoin omi ion will C, m y applicatinns received at least five (5) ceys
prior to a meeting.
SIGNATURE
APPLICATION RECEIVED BY -'flfl. �Q �I� 'DATE
APDL I(ABLE FEE RECEIVED
PLANNIN(3 COWISSION DECISION: ApproVect
CONDITIONS -
V.ti^ _ C
Approved ippkicaWns Ive valid for si.r months on y
signature44h
- Date_
10TV Oregon Novae dens L v requires that all persons Who contract for vrrk on their residence be
registered with the Builders Board which means the contractor is bonded and insured on the job site.
For your protection, be certain your contractor is registered by calling City Ball Ph: 639.4082.
NOTE: A permit must also be obtained from the City of Tigard Department of
Cc1m'NRity Development Yes No�_
CITY CF TIGARD INSPDCTI_ON___MpORT
The above listed prosect has been inspected Ind Approved_ Denied
Date Cam-ents
Signature
(" J itd nq .tn ep¢rtxm PLeaw- a.Rtwut one ; 1) copy to King City j
MECI C:AL �
CITY OF TIGARD PERM I T #. 1. .. I f: ME C94--0099
COMMUNITY DEVELOPMENT DtPARtMtNT nArc r.Sl ' v; 04/08/94
13125 SW H}II Blvd.Tigard,Oregon 97223.8199 (503)639-4171
PARCEL: 13115BC-03500
SIT[ APnRE s:;. . . : 1 ' 7 6 SW 1<ING CHARLES AVE
SUBDIV1CION. . . . . ►'l� 4�J . ZONING: �
. . . . . . . . . ( . . . . . . . . . .
CLASS OE ,ORK. . :OLT FLOOR FURN. . . . F_VAP COOLERS:
TYPE OF 1E. . . . :SF UNIT HEATERS. . : VENT FANS. . . :
OCCUPANCY GRP. . : RU VENTS W/O APDL: VENT GYSTEMS:
STORIES. . . . . . . . : BOILERS/COMPRESSORG HOODS. . . . . . . :
FUE!_ TYPES- -- _.___._.____.._._ 0 HP. . . . numt-_:3. INCIN:
:/GRS/ / / 3-•15 HP. . . . : COMML. INCIN: i
MAX INPUT: BTU 15-30 14P. . . . . REPAIR UNITS:
FIRE DAMPERS?— : 30-50 HP. . . . WOODSTOVES. . r
GAS PW77i.,SURE. . . : 50+- HP. . . . : CLO DRYERS. . :
NO. OF UNITS-------------- AIR HANDLING l_1N I TS OTHER UNITS. :
F URN � 1 00K BTU: 1 (= 10000 c f m : GAS OUTLETS. : 1
TURN > =100K BTU: > 10000 cfm :
Remarks
Owner: --- --___.______.____.____._______...__.._..__.___._.._.__._._____--____-_- FEES -
JEORGE: JE::FFCOTT type amo"rnt by date recpt
16726 SW KING CHARLES PRM'T $ 2t. 00 JG 04/08/94 -
5PCT $ 1. E5 JG 04/011/94 -
KING CITY OR 97,224
Phone #:
Contract -r:
SUNSET FUEL CD k►
PO BOX 42287
,
PORTLAND OR 97242
Phone #: 234-0611 4 26. 25 TOTAL
RVq #. . : 02374•
REQUIRED INSPECTIONS --------
This permit is issued subject to the regulation contained in the Gas Line I n-sp
Tigard Munirinal Code, State of Ore. Specialty Codes and all other Mer_manical Insp
applicabl. laws. All .cork will be done in accordance with Final Inspection
approved plans. This permit will expire if work is not started
withir, 180 days of issuance, or if work is suspended for rare
than 180 days,
Permittee
Tssi..ted B,,
Call far^ inspection 639-4175
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 sw Han Blvd. APPLICATION Permit #
TiC 3rd, OR 97223
(503) 639-4171
—_ Table 3A Mechanical Code OTY PRICE AMIT
Job C OCC )u-, 1) Permit Fee -0- -0• 10.00
Address W
CY CI—A71�C— 2) Supplemo permit 3.00 `
i e_ Furnace to 100,000
e C'C H `71 1) incl.ducts&ve—ts 6.00 L'•61-)
Furnace 100,000 BTU +
Owner 2) incl. ducts&vents 7.50
u W. Ploor -urnance
Alf-ICAa > r
�i C'rY'` C'� - _ 3) incl. vent 6.00
Suspended heater, +vall heater ,
4) or floor mounted heater 6.00 r
Occupant a .f.. �_.._ en'not incl.in
p — 5) appliance perrni' 3,00
Neparr or heating,rerrnt,.i,
6) cooling,absorption unit 6,00
,may_ Boiler or comp, eat pump,air cond. C 1:'i'Y OF i )C f1F;X1 t01.1:11'11 ('IG F''F1 Yl`il Id 1' 12w 1':F'7 b'1 I ICM. U 96r 1.5 1,C�1f 4
� F—L C)"t l 7) to 3 HP absorp unit to 100K BTU 600 C HU"CK MOON'( :t ;.(6 .25
"'v"°""` oiler on comp, eat pump, air cond. JfdMF' ''illhti3F'.)' F'OE. . C'0 +;faryH AMOUNT I,
eu>£L� 8) . ,
,,.` X)X)hU. s > 1s P1'i BOX �i(�P8 7
3-15 HP absorp unit to 500K BTU 1100
Contractor F''f1 Ylhw:hl't X)FiTM` n N4i Fil�f':'i�i
Boiler or comp, eat pump, air cond. :3ilii+1)I V.0 rl 10
?(/ CHS 9) 15.30 HP absorp unit.5 1 mil BTU 15.00 I I•aC'1Fi i'!.�ildi)y 111 ')'/r. i7'� -(r) f)
s'"• "•°°^"° a u ° Boder or comp,heat pump, air cond.
�_�� SQ>l 10) 30-=J HP ebsorp unit 1.1."5 mil BTU 22.50 ;.LIIr 4'C)Gil:, OF* i'EaYI"Ik':tl i (-1t+If U tt•I'l G't 1 +:l') !•'I Ir(I''(t;,C !')F' I''111'Mi:hl l rtl't1 t1►hl i I'�1T i
hereby ac +ow ge that have read is app ication,that the I! e or comp, eat pump, air con .
information givon is correct,that I am the owner or authorized agent 11) >50 HP absorp unit 1.75 mil BTU 31.50
y.
of the owner,that plans submitted are in compliance with State Au handling unit!o
�I i ,'i!r i CAL. 11,4'
laws,that I am regist3(ed with the Construction Contractor's Board, 12) 10,000 CFM 4.50
that the number given is correct. (If exempt from State registration, it handing ting unit — 1
please give reason below.) 13) 10,000 CTM+ 7.50 j
Non portable
14) evaporate cooler 4.50 f
Vent fan connecter
15) to a single duct 3,00 r
Ventilation system not iI
16) included in appliancepornit 4.50 II
Hood served y
17) mechanical exhaust 4.50
Describe work new 0 Addition U a terabo repair Coma
me. a o;industrial ,bJ K I N11 1'HAkI. 4 1i
G3
tc be dcne ro:ida^ non-residential t6;''
18) type incinerator
Existing use o er i.e.,w stove,water
building or property— i 19) heater,solar,clothes c'ryers,etc. 4.50
_.._ - X'C)i t•11_. Fll'itllJhd 1 PhD)
Proposed use of 20 Gas piping one to four outlets
building or p:cperty ) P P 9 2.00 i C'
I.
21) More than 4-per outset I
Type of fuel•of
yp O natural gas , LP3� electric Q ----------- y
L — -- ;
G ICE '
Minimum Fee$25.00 SUBTOTAL �5.U(-
PERMITS BECOME VOID IF WORK OR CONSTRUCTION -- —
,; i AUTIiORIZED IS NOT COMMENCED WITHIN tea DAYS,OR 5%SURCHARGE
IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PEr c100 OF 180 DAYS Al ANY TIME PLAN REV!cW 25%OF SUBTOTAL_
r
AFTER WOR„IS COMMENCED.
// '/ TOTAL '
Special Conditions r,�/ / L�c�72
Date issucrj^_ by
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