10665 SW DERRY DELL COURT-1 ADDRESS:
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i.Vecords\microflm\targeWbuilding.doc
CITY OF rIGARD BUILDING INSPECTION NOTICE
Inspection Line (116c-O-Phone). 639-4'75 Business Phone: 639-4171 0�
Inspection:��-
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab �pc Rough-io," Fireplace
Post/Bearn Struct. Plbg. Top Out Elec. R_ ouch-in FINAL:
Post/Beam Mech. San. Sewer Cas Lin, -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation
Underflr. Insul. Shear Wall Gyp. Bd. Eilect
% — /D--
Date Requested: `! Tirne: - AM PM
Address: .1 C;_ LC 1_'1„x,
Builder:_ Permit
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Le
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Inspector. Uate: 1
APPROVED —DISAPPROVED _APPROVED SUBJECT TO ABOVE
e7) _ _Call For Reinsp.
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CITY OF TIGARD ME_PERMICAL
�'ERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . : MEC95-04v
13125 SW Hall Blvd,Tigard,Oregon 97223.6192 (503)639-4171 DATE. ISSUED: ' 1/29/95
PARCEL : 2S103DA--01300
I TE ADDRESS. . . : 10665 S11 DERRY DELL C1
._SUBDIVISION. . . . : DERRY DELL PLAT 2 7.0NING: R--3. 5
BLOCKS. . . . . . . . . . . L01.. . . . . . . . . . . . . . 13
CLASS OF WORK. . .-AL! FLOOR FURN. . . . : 0 EVAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS, . : 0 VENT FANS. . . : 0
OCCUPANCY C3R1-'. . :R3 VENTS W/O APDL: rlC VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS, . . . . . . : 0
FUEL TYPES- _-_--- - -- - 0-3 HP. . . . : 0 DOMES. I NC I N: 0
: /G,-IS/ / / 3--15 HP. . . . : 0 COMML. INCIN: 0
MAX INPU`T'.- 0 BTU 15-••30 HP. . . . : 0 REPAIR UNITS: Qt
FIRE DAMPERS'?— : 30-50 HP. . . . : 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 50+ f iF'. . . . : 0 CLO DRYE=RS. . : 0
NO. OF UNITS•--------•--- AIR HANDLING UNITS OTHER UNITS. : 0
FURN < 100K BTU- 1 <= 10000 c f m: 0 GAC OUTLETS. : t
FURN ) -100K BTU: 0 ) 10000 cfm: 0
Remarks : Oil to gas ronversion
_-__.__.-•- _-._- _-_._ --
ALLEN
___--__._--------- ----__-_-------- --- FEES
AI_I_EN.MILLER cvpe amot.(nt by date re(-pt
10665 SW DERRY DELL CT VIRMT $ 25. 00 JED 11/9/95 95-:73346
5P(-1 T $ 1. 25 JSU 11/29/95 95-273346
TIGARD OR 972:;=3
Phone #:
Contract or:
SPE'C.IALTY HEATING/FABRICATION
9528 SW TIGARD ST
TIGARD OR 97223
Phone #: b20-5643 E 26. 23 TOTAL
Req #. . : 66578
REQUIRED INSPECTIONS -•-----
This permit is issued sub iect to the regulations contained in the Mectianir_-al. Insp _ _�_ •..__,___.-.__.._.�..
Tigard Municipal Code, State of Rrp. Specialty Codes and all other Final Inspection
applicable laws. All work will he done in accordance with _______ __ _�� _��_ ._ _ •, _�_
aporoved plans. This oermit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
than 180 days.
Perm mit Lee Si tt•-rtt_tre �
I s 5 l.t e d l?'
Call for inspection - 639-4175
City o. Tigard MECHANICAL PERMIT Planck/Rec. #
13125 SW Hall Blvd. APPLICATION permit #
Tigard, OR 97123
(503) 639-4171 0!
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Table 3A Mechanical C do QTY PRICE AMT
-
JJbey t)
-J�1 (� ,r r ; { Permit Fee -0- -0- MOO
Address / Y I -L-' o -�
l z- 3 2) Supplemental Permit 3.00
urnace -lIIi'f;0('D�TTTJ - / --
all �ALG�2- 6'; -/ -ij 1) incl. ducts 3 vents 1 6.00 umace i -WnWF3T1T+—
—_
Owner o64-s- Sw �-ry �Cll C 2) Incl. ducts a vents 7.50
Floor umance - - - -
/ hrct? .0v ZL 3 --- 3) Incl.vent - 6.00 -
p `J JZ- 41 or flus mounted heater 6.00
Occupant
Vent not i607o'n-
5) appliance permit 3.00
apatr o qa ing,re ng.
6) cooling,absorption unit 6.00
a er or comp,heat pump,air cond. -_-
c 7) to 3 HP absorp umt to 100K BTU 6.00 W
—�oifP�or comp,heat pump,air cond.
9s 2-- S l,��/ fl 8) 3-15 HP absorp unit to 6WK BTU 11.00
Gontractor ---alr- Boller or comp, he�pump,air co .
9) 15-30 HP absorp unit.5-1 mil BTU 15.00
Boller or comp,heat pump,av conT — -
�p 10) 30-50 HP absorp unit 1-1.75 mil BTU 22.50
ere•y ac owT ge a iavoroad this pprora ion,1 itf 9 Boiler or ccx ip-heat pump,air co . -- —
inforrnAtion given is correct,that I am the owner or authorized igont 11) >50 HF ab-torp unit 1.75 mil BTU 37.50
of ttia owner,that pIAnA submitted are in compliance with Stals Air un rng unit o - --
laws,that I am registered with the Construction Contractor's Board, 12) 10,000 CFM 4.50
that the number given is correct. (11 exempt from State registration, ig`utnl— -_-
please give reason below.) 13) 10,000 CTIV,+ 7.50
14) evaporate cooler 4.50
-Vent fan connec -
15) to a single dud 3.00
iVientilabon sys ern no
16) included in appliance permit — 4.50
17) mechanical exhaust 4.50
--Describe work new ''''rradX�addition f alteration repair - ommorciA in
or in ,
to be done residentWnon-residential Q 18) typo incinerator 30.00
xis ng use o (' -------- ---mar`i.e.,wn0o sem, —
building or propoity J � 19) heater,solar,clothes dryers,etc. 4.50
Proposed use of 20) (Sas piping one to four outlets ! 2.00
building or property_-_-� -- - ------— -
Typo of fuel ori Q natural gas/lefLPLPGQ e1e.1M21) More then 4-per outlet
c U - -----
Minimum Fee$25.00 SUBTOTAL f7
PERMITS P":COME VOID IF WORK OR CONSTRUCTION - -
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE , �7
IF CONSTRUCTION OR W09K IS SUSPENDED OR - ---- —
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN 14EVIEW.25%OF SUBTOTAL �
AFTER WORK IS COMMENCED. - ----- -
TOTAL
Special Conditions �-_ __----._---
- Ditto issued by
MrMEdIPMT
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U 11 Y OF T I ARD kF:l J I PT OF Pio YMf-N l Ri l JA P 1 NO. 9:i-e/,",13 4 Et
1.4-IE:C'.F4 AMOUNT a P6. ::5
NAME 7 SPEC I AlA Y HEAT I NU & AMULINT 014;
Ai')DRL'.gS a FABRICATION INC P%IYMF;NI' Irf IL a 11/r.'y/115
9528 SW V I CARD ti'T SLOAD I V 18 UN d
'I WARD OR 972P,4--
PURPOSE
72P,4--PUF2F7l7SE OF PAYMENT AMI.IUN7 PAID PURI.1-ISF=, CIF WiY111-N I i►M(ft IN I Pf I 1 t)
M ETAG N I C'AI... F f: MEC95--040/ .._ .P5. 00 ST.
PU I I:..n_PEA E ..._..__._._... _._._..._...z.__,
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