10655 SW PARK STREET-1 ADDRESS:
i:\records\microflni\ta rgets\building.doc
CITY OF TIGARD BUiLDiNG INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-41175 Busin9ss Phone- 639-4171
Inspection. � G (��f�TGFiC�. ��
Footing Susp. Coiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Qiech. Rou h•' Fireplace
Post/Beam Struct. i Ibg. Top Out Elec. Rough-in FINA!
Post/Beam Mech. S+tn. Sewer G_a7s Li`ns -Bldg.
Plbg. Underfloor Rain Drain rFaming -Plumb.
Alarm Wafer Line Insulation M c
Underflr. insul. Shear Wall Gyp. Bd. Elect.
Date Requested:_ Time: AM�1— PM
Address:-„!
Builder: L2 76) > _Perm~ #:/yJe<t '5/S xx f l
THE FOLLOWING CORRECTIONS ARE REQUIRED:
r7 -
In pector: /-�� Date: _
i
PPROVED DISAPPROVED APPROVED SUBJECT T ABOVE
_Call For Reinsp.
CITY OF T I GARa . . . . . . .
A 3 0,�/,.)tj
COMMUNITY DEVELOPMENT DEPARTMENT )SU[--D 11
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13125 SW Hall Blvd.Tigard,Oregon 97223@8199 (503)639-4171 PARCEL: 25I03I)A-03290
_JIIL HoLikLbb. . . - 01-4 "kkv% L.) ,
z.)UBDIVISION. . . . : DERRY DELL PLfIT w ZONING': R-3. 5
LALULK. . . . . . . . . . LO-i . . . . . . . . . . . . . :3
LLASS OF WORK. . :ALT 11 LOOR FUIRN. . . . EVAP COOLERSt
YF-,L OF USE. . . . :SF UNIT HEATERS..: VENT FANS. . .
ULLUPANCY GHP. R3 VL-NTS W/i.) APPL: VENT YSTEIY15: 1
blul"IlEs. . . . . . . . BUILERS/LOMPRES5OR5 HOODS. . . . . . . *.
FUEL VA--3 HP. . . . : r�011E5. INCIN:
:/GAS/ 3-15 HP. . . . : CL!MML. INGIN:
MA), INPUT: 12,T 11 15—30 lip,. . . . : REPAIR UNITS:
IRL DAMPERG7. . 30-50 111. : WOODSTOVES. . :
fi,S' PRESSURL. . . 50+ HP. CLD DRYERS— :
.J. OF UNITS------ AIR HPNI)LINle UNITS OTHER UNITS. ii
.;RN ( 100K BIL!. -'0000 r:fm : GA'.-) OUTLE IS. - I
ikN ) =100K BTU: l > 10000 ctin :
qmarks; REPLACE GAS FURNACE
---------- FEES
'RREN KPAGER t Ypp ia M 0 n t by dtv
ae ecpt
Z*55 5W PARK PRMT L7
.10 COW 03/03/95
1. 25 SW 03/03/95
�LARI) OR 912�4
,,one #:
-)ntr,aCtot,3
!LUMLAIH 1-4k-A'l ING
SW bi-11!NH(AM
ACH E-110
1UHHU OR
10ne #- 624--E-704+ t ,.(x. 25 TOTAL
eq #. . .- 76359
FREQUIREAL) INSPECTIONS
,is pewit S issued Subject to the regulations contained in :he 6ac; Line Insp
igard Nqni-ipal Cude, State of Ore. Specialty Coots and all other Mechanical Insp
applicable laws. All wcrk will be done in accordance with 1-- inal lnsr)ection
?Dproyed plans. This permit will expire if work is not starter
1*
—hin 180 days of issuance, or if work is suspended for more
an 162- days.
�X iL
13 1A e Ll by
LeAll, fc+,, inspection 39-4175
City Of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 sw Han Blvd. APPLICATION Io ' Permit # A( -I`; Cwt 1
Tigard, C,". 97223
(503) 63�,-4171
escr'ipuon - - —
Table 3A Mechanical Code OTY PRICE AMT
J00 C ! C J n},• 1) Permit roe -0. 0- 1000
Address
l IZiL/ 2) Supplemental Permit 3.00
-» -7u n`ac-a to 100.000 E3 I U {
V e r 'r'.I l K -•C\C � t) incl. ducts 8 vents 6.00 1
Furnace 100,000 8TU +
Owner 2) incl. ducts&vents 7.50
�PFloor urnance --
31 incl. vent 6.00
Suspended renter,walleater
4) or floor mounted heater 6.00
r -'-`-9 -�nt not inc. in
Occupant 5) appliance permit 3.00
..Iceppair"of Wu'ng, re ng -
6) cooling,absorption unit 6.00
- .r. Boiler or comp,heat pump, air con .
7) to 3 HP;absorp unit to 100K BTU 6.00
-SbUer or comp,heat pump, air cond.
' (JX 7 ,7 Li �;` 8) 3.15 HP;absorp unit to 500K BTU 11.00
Contractor t er or comp,heaatpump, air conk.-
&r q� j 9) 1530 HP;absorp unit .5-1 mil BTU 15.00
t et or comp, heat pump,air cond.
1 z 10) 30-50 HP;absorp unit 1-1,75 mil BTU 22.50
ereb-y acknowledge- this application, t a -e boiler or comp,heat pump,air cond. - 1
information given i- correct, that I am the owndr or authorized agent 11) > 50 HP;absorp unit 1.75 mil BTU 37.50
of the ow inat plans submi',ted are in compliance with Staterr handling unit to
tr
laws, ,at I am registered wit's the Constriction Contractor's Board, 12) 10,000 CFM 4.50
that ,no number given is comoct. (If exempt from State rrugisrrntion, a an rng unit
pl-,ase give reason below.) 13) 10,000 CTM + 7.50
- -� - ---- on portable -
14) evaporate cooler 4.50
ean cor,nec era—'
15) to a single duct 3.00
entt aeon system not
�161 lincluded in.appliance permit + 4.50 C
Flooa seryy -
17) mechani,-al exhaust 4.50
escn work new addition alteration U repair U Gomrnerc-Vor in ust•ia
to by done residential Q nen-residential Q 18) type incinerator 30.00
xisttng us`e 7o— -Other ii.e.,woodslove,w5a er -
building or property 19) seater,solar, clothes dryers,etc. 4.50
Proposed use of 20) Gas piping one to four outlets I 2.00
building or property
Type of fuel -oil Q natural gasp LPG Q electric21) More than 4-per outlet Q -- - - —
Minimum Fee$25.00 SUBTOTAL
PERMITS BECOME- VOID IF WORK OR CONSTRUCTION -- -
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE
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
Special Conditions
Date issued1 .6 Ic
by
t�MECIL Mi �7TT�
rdd`.vrrvbr
CITY Clr7' fIDART) -- -If'
T F''r NO, R 4 Z 2
rHEM WMOUNT 26. 25
COLUMBIA CASH tIM('.'IIJN'I* 00
ADDRESS a E4900 !.,WW SoRWIntl STE E I 191F7
ORD, Op PAYM NT DATE'
TiG
q'JSD 14)1 S T m4
I
PPRP"ISE: OF AMOUNT Pf-JID I'l IRf'W,f ! r,- PAYMENT fltvll-ILjNT - 01r)
.0 0 4 9
II
10655 SW PARK