11980 SW NORTH DAKOTA STREET-1 j-0
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is\records\microflm\targets\building.doc
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb. >;
Post/Beam Mach. Shear/Sheath Framing ec
Plbg.Und/Fir/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct. ec . Rough- Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins. I
Other: g ! 0 ■
Date: — 1 �P— A&Y P.M. Entry:
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Address:
Tenant: �- Ste: MST:
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BLIP: �
Confer MEC:
PLM:
LLC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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Ins ctor. — --- - - -- Date:;[
_— PPROVED DISAPPROVED/CALL FOR REINSP. CF CO
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F TIGARD
CITY ® MECHANICAL.
3 PERMIT
DEVELOPMENT SERVICESPERMIT #. . . . . . . : MEc96-0411
13125 SW Hall Blvd., 779ard,OR 97223 (503)639.4171 DATE ISS 1.1E D: 11/27/96
PARCEL: 1S134CA-03000
SITE ADDRESS. . . : 1 1980 SW NORTH DAI'10T0 ST
SUBDIVISION. . . . . BURLW00D NO. ZONING: R 4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .3 �
k —_—_______._.____._____.__._...____.__.._....._.__._.__.____.______________._—_________
CLASS OF WORK. . .-ADD FLOOR TURN. . . . : 0 E'VAP COOLERS: 0
TYRE OF USE. . . . :SF UNIT HEATERS. . : 0 DENT FANS. . . : 0
OCCUPANCY GRP. . : R3 VENTS W/O APPL.: 0 WENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOIL.ERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL TYF'E S---•-_._..__ ...__....__._.- 0-3 HP. . . • - 0 DOMES. INCIN. 0
: /GAS/ ! / ��- 1.5 HP. . . . : 0 COMML. INCIN: 0
MAX T NPUT: 4'_i 13TU 15 -:70 HP. . . . : 0 REP-AIR UNITS: 0
FIRE DAMPERS''. . : w0----50 HP. . . . : 0 WOODSTOVES. . : 0
CAS PRESSURE. . . : `,0+ IIF". . . . 0 CLO DRYERS. . : 0
NO. OF LIN I TS-- - ----- AIR HANDLING LIN T TS OTHER UNITS. : i.
F'URN t 1001; STU: 0 < 10000 r_f m : 0 GAT) OUTLETS. : 1
TURN > =100K FTU: 0 10000 cfm: 0
1 Remarks : Freestanding gas StaVF2 inStallati.ort.
Owner.: _._._._______.._._. ..___ ___..__..__.-.....__-__.___..__......________._.____..._.__..____._. FEES
]CIRRI ARRINGTON type .-Amo1an': by date recpt
11` 80 SW NORTH DAKOTA STREET PRMT $ 2_5. 00 DRA 11/27/96 96-247051
5F'CT $ 1. 2�5 DRA 1 1/`7/96 96 _c'E37051.
TIGARD OR 97
t Rhone #:
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Contr-actor:
CONTRACTOR NOT ON FTL
j Phone, #: $ 26. 25 TOTAL
Reg #. . :
_._._-• REQUIRED INSPECTIONS -- - -
This pereit is issued subject to the regulations contained in the f imkl Inspection
i Tigard Municipal Code, State of Ore. Specialty Codes and al! other
applicable laws. All work will be done in accordance with
approved plans. This pereit will expire if work is not started
y within 188 days of issuance, or if work is suspended for more
J than 18A days.
1'nr•mii,i:c� .iiy atktt c_ •
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Ca+.11 fminspect ion 639--4175
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Plan Checi
CITY OF TIGARD Mechanical Permit Application Recd B
13125 SW HALL BLVD. Commercial and Residential Date Recd A-a7-�1'(D
TIGARD, OR 97223 Date to P E
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(503) 639-4171, x304 Date to DSTPermit#
Print or Type Called
Incomplete or illegible applications_will not be accepter!
Name of DevelopmentiPro)ect Description
Table to Mechanical Code CITY PRICE AMT
Job Street Addresssunea A) Permit Fee -0- -0- 1000
Address llYKt S4) A•rpt'orA S% • f
Bldg/ cityl state Zip B) Supplemental Permit 3.00
`7 7L 3 _
Name for name of business) 1 ) Furnace to 100,000 BTU 6.00 n
Owner 1Gp\� f2 R(A G-M I incl.ducts&vents f`
Mailing Address 2.) Furnace 100,000 BTU+ 7.50
o -c, incl.duns&vents
Gtyrstate Zip Phone 3.) Floor Furnace 6.00
incl.vent v
Name for name of business) 4) Suspended heater,wall heater 6.00
< jL,rl or floor mounted heater y
Occupant Mailing Address 5.) Vent not incl ;n 3.00
appliance pefmit
Crtyrstate Zip Phone 6.) Boiler or comp,heat pump,air Gond. 6.00
to 3 HP;absorp unit to 100K BTU
N 7.) BotMr or comp,heat pump,air Gond. 11.00
� T car- 3-15 HP;absorp unit to 500K BTU
Contractor MaenyAS�dr�aa 8) Boiler or comp,heat pump,air Gond. 15.00
cj �- /O L) 15-30 HP,absorp and.5-1 and BTU
(Prior to vyrstate / Zip Phone 9) Boiler or comp,heat pump,air cond. 22.50
issuance a ropy � v ' `(Dili ' 30.50 HP;absorp unit 1-1.75 mil BTU f
of aN licenses are Oregon conn.cont.Board uc a Exp.Dine 10.) Boiler or comp,heat pump air Gond. 37.50 f
required if 3-14-97 >50 HP;absorp unit 1.75 and BTU I!
expired in C.O.T Co Bus as Tax or Metro a Exp onto 11.) Air handling unit to 4.50 !
data base) _ 10,000 CFM _ I
Architect Name 12) Air handling unit 750
_ 10,000 CTM+
or Mailing Address 13.) Non portable 4.50
evaporate cooler
Engineer cayrsime Zip Phone 14.) Vent fan connected 3.00
to a single duct
Ckmcnbe work New O Addition O Alteration Repair 0 15) Ventilation system not 450
to be done Residential Non-residential O included in appliance permit
Additional Description of work 16.) Hood served by mechanical exhaust 4.50
/qty a x HL.
aS�G16:_ 17) Domestic incinerators 7 50
Existing use of 18) Commercial or mdwtnaltype 30.00
building or property h�Cr ���G�c-� !� �- incinerator
19) Repair units 450
Proposer)use of 20) Woodstove 4 50
building or property
21) Clothes dryer,etc. 450
Type of fuel-oil O natural gaM LPG O electric O 22) Other units �4 50 rt/.50 f
I hereby acknowledge that I have read this application,that the 23) Gas piping one to four outlets 1 2.00 00
information given is correct.that I am the owner or authorized agent of
the own r,that plans suhmitted armin compliance with Oregon State 24) More than 4-per outlet (each) 50
laws 1 f
I Slg re of Owner Agent oto r aTY.SUBTOTA!_
SUBTOTAL
Contact Person Name Phone �J 5%SURCHARGE
PLAN REVIEW 25%OF SUBTOTAL
TOTALA5 a
i.`.dst\mechpmt.doc (rev 7/96) 'Minimum permit fee is S25+5%surcharge 1
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