11730 SW TIGARD STREET 11730 cw TIGARD SUMPI -
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INSPECTION NOTICE
Citi• of Tigard Hui ding Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone F39-4171
!address_ -- ------ 1 . . --- Permit # -----
Type of Inspection _
Thr, following Building Code deficiencies are required to be coirecied:
Presented to_ - __.------___ _-_- Inspector
Da'e
CALL FOR REll1l57oE(MON
❑ YFs ❑ NO
City of Tigard Mechanical Permit Permit__
Fee__
New Installation l Replace L_l Rel ration E__1 Addition ❑ Alteration U 3%State
TOTAL
CONTRACTOR _ OWNER -
ADDRESS —_--- ,--�_-_ ,-- �'iORK A DRESS -----
PHONE ------. --_ _- -- - APPI ICANT ----___------
Heat Input Rating (BTU Per Hour;_ _-M-_-- bye it Size _- =1ue Size
FLEL OIL ❑ GAS C 7 FLECT 1-1 OTHER
ITEP:A NO. FEE ITEM NO. FEE
For Issuance of 'ermit -�- 3.00 Air Condition Compressor 1:i to _ __ 10.t�U
New- Uncle, 100,300 BTU _ _4.00 _
_ __ rAir Handling_10,000 CFM v 3.00
New-- 100,000 BTU&over 5.00 AiHandling Over 1U,600 CFM _ 5.011
Floor Furnace - 4.00_ -_Eva_porative Cooler _ 3.00
Wall • Floor •Suspa nded - 4.00 Range Vent Fan - 2.00
Install Vents Only _ 2.00 V_e it System 3.00
Repair- Heat&Cooling_ 4,00_ Huod Commercial __ 3.00_
Air Condition Compressor Under—3HP 4.00 Commercial Duct System - - 10.00
Air Condition Compressor 3 to 15 HP 7.50 -� -- -u
INSPECTOR'S COMMENTS
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS -
APPROVED BY DATE -- - ISSUED BY------ - _— DATE
RECEIPT N0. ~�
77e Signmts,re )f Applicant -
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N9 11. 56 DATE
PT1tMIT IS GIVEN TO
or
TO CO.TYECT A .j'� 'Ar
TO THE SYSTEM OF TIGARD SANITARY DISTRICT V —
AT
THIS PERMIT MUST BE POSTAL ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION Of CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID �.... --. ............VGARD SANITARY DISTRICT
By /
CONNECPION IN'.VFCITFD AND APPROVED
-- -Date -- - Bupeclntendetlt
4,
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Address /? �,r �'"��A,��j,� ? Permit No.
Permit charge
Owner �,� �s,.� , _ Connection fee
Paid by
Type of Building � Date connected
Service Rate Inspection fee /D
Contractor _ _— Paid by` ^_ Date
Size of connection_�L_�� _� _� Assessment Paid`