11005 SW 74TH AVENUE i
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I11SPECPIOU NOTT-S
City of Tigard Building Departannt
13US SII Ball Blvd. Tigard. tregoo 97223
Inspection Line (Rec-O-Phone): 639-4175 Business 0hone, 639-4171
Inspections __
Footing Plbg. Underelab Mach. Rough-in' Tppr/Sdwlk
Found. Plbg. Top Out Gas Eine FINAL:
rust/Beam Struct_ San. Sewer Framing -Bldg.
Post/Beau Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line gyp. Bd. -Mech.
Date Requestedi�y: ) .ime: - AN / PH
Address:_L1//[�� /�.� Permit 1:�_2M,�) BOO
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Builder:
TAR FOLLOWING CORRECTIONS ARE VZVtREDt
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Inspectors f Date:
APPROVEDDTSAPPROVEn J APPROVED 9UBJECf TO ABOVE
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all For Reinsp.
CITY OF T I CSARD
COMMUNITY DEVELOPMENT DEPARTMENT
1, 25 SW Hall Blvd.Tigai-d,Oragon 97223@8199 (503)639-4171
MECH ANICAL
PERMIT
PERMIT #. . . . . . . . MEC9 3- Q1 1 17,
639-4171 DATE ISSUED: 07/08/93
SITE ADDRESS. . . : 11005 SW 74-FH AVE PARCEL: 16136DEA-01100
SUBDIVISION. . . . : ZONING: R--4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . .
CLASS OF WORK. . :ALT FLOOR FURN. . . . - EVAP COOLERS:
TYPE OF USE. . . . :SF UNIT HEATERS— : VENT FANS. . . :
OCCUPANCY GRr'. . : R3 VENTS W/O APPL : VENT SYSTEMS:
ST0131ES. . . . . . . . : 1 B 0 1 L E R S/C 0 M P R E S S 0 R 13 HOODS. . . . . . . :
FUEL 0-3 tip. . . . DOMES. INCIN:
: /GAS/ 3-15 HP. . . . COMML. INCIN-
MAX INPUT: BTU 15-30 HP. . . . .- REPAIR UNITS:
. --'�-1,)
FIRI'-- DAMPERS?. . : 3 L71 5 _ 1.1pl. . . . WOODSTOVES. . :
GAS PRESSURE. . . 504- HP. . . . CLO DRYERS. . :
NO. OF AIR HANDLING UNITS OTHER UNITS. :
FURN ( 100K BTU: 1 10000 C'fm : GAS OUTLETS. : I
FURN BTU: 1.0 2.10 10 c--f m
Remarks :
Uwner.- FEES
KATHRYN SIMONSON type amol-tnt by date r P
11005 E-.)W 74TH PRMT' q 25. 00 J11 0-/08/93
`,PCT 1; 1. 25 JH 07/08/93
TIGARD OR 97223
Phone #il
OWNER
M-
Phone 26. 23 TOTAL
Req #. . : 00000
REQUIRED INSPECTIONS
This pervit is issued su�)Fct to the regulations contained in the Gyas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Ilectianical lnsp
applicable laws. All work will be done in accordance with
th Final Inspectionapproved pla,,- This pervit will expire if work is not started
within 18@ days of issuance, or if work is suspended for more
than 180 days.
PF!rmittee
A fur, 111I.M.1tom 2 1—4 1 i,5
CITY OF TIGARD REC.F.Tpr OF PAYMENT RECEIVIT Nn. 03-24c-,143,
ci-iF-cK Amouicr n 26. .=5
it'IME 531MON93ON, KATHRYN A CASH AMOUNT 0. (awl
4)DRESS P,nYMFN1* DATE: 07/08/93
11005 SW 74TH SUBDIVISION
TIGARD, OR 97 c'3
JRPOSF OF* PAYMENT AMOUN T PA I D PURPOSE OF PAYI,lF--Nl' AMOUNT r-,ATL)
HAN I CPL PE .f-.5. 00 EST. BUILD PFR 1. 85
V)
&--CHANICAL PERMIT
O'l AL AMOUNT PAID
City of Tigard MECHANICAL PERMIT Planck/Rec.
1 01 25 svv Hall Blvd. A P P L I CATION Permit # —
PO Box 23397
Tigard, OR 97223
(503) 639-4171
Table 3A Mechanical Code QTY PRICE AMT
AdjobdressL l,J (�! 7 L�C/ ---7— 1) Permit Fee -0- -0- 10.00
1�/+� ("/ �?� ,;� 2) Supplemental Permit 3.00
.a,.. 90
... ) Furnace to 100,000
l �[/�C`/c 1) incl. ducts 8 vents 6.00 '
-% 1 umace 100,000 +
7.50
)tl' �l� �l r ` 2) incl. ducts&vents
Ownerzo
Floor Furnanco
11;xw-:�5 3) incl. vent _ 6.00
« Suspended heater,wall heater
4) or floor mounted heater 6.00
.h ant not incl.in
Occupant •" 5) appliance permit / 3.00
Repair of heating,refng.
6) cooling,absorption unit 6.00
Boiler or comp,heat pump,air cond.
7) to 3 HP absorp unit to 100K BTU 6.00
.q « Boiler or comp,heat pump,air cond.
8) 3.15 HP absorp unit to 500K BTU 11.00
Contractor Boiler or comp,heat pump,air con .
9) 1530 HP absorp unit.5m1 mil BTU 15.00
swi. .p...•m +aCAy -N. of er or comp,FRat pump,air cond.
10) 30-50 HP absorp unit 1-1.75 mil BTU 22.50
hereby ac.now a ge that lave read this app kation,that l e ----Toiler or comp, heat Pump,air con
information given is correct,that I am the owner or authorized agent 1 1) >50 HP absorp unit 1.75 mil BTU 31.50
of the(,wnr ,r,that plans submitted are in compliance with State it handling unit to
laws,that I am registered with the Construction Contractor's Board, 12) 10,000 CFM 4.50
that the number given is correct. (If exempt from State registration, it handling unit
please give reason below.) 13) 10,000 CTM+ 7.50
Non portable
14) evaporate cooler 4.50
Vent an connected
15) to a single duct 3 n0
-- -Ventilation system no,,
16) included in appliance permit 4.50
p... .N„',= •. Hood serve( y
17) mechanical exhaust 4.50
Describe work new a iti m alteration —repair Commercialor inclustiiaF--
to be dome residentialG7
no residential p 18) type incinerator 30.00
Existing use o �(/ yy ter i.e.,wo stove,water
building or property /y�///-C i 19) heater,solar,(lotttes dryers,etc. 4.50
Proposed use of / n ,may, 20) Gas piping one to lour outlets 2.00
F- building or property f // /// - -�
N
21) More than 4-per outlet
Type of fuel-oil() natural gas t LPG Q electric O
J
C7 NOTICE
Minimum Fee$25.00 SUBTOTAL 2 Sid
PEF;MITS BECOME VOID IF WORK OR CONSTRUCTION
-J AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE ! L!
IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL
AFTER WORK IS COMMENCED.
TOTAL 2442-5-
Special Conditions
Date issued _by