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10855 SW PARK STREET i 10855 SW PARK STREET N (U a 3 Ln U) Lr) ci INSPECTION NOTICE City of Tigard Building Department P O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection rLLfd,L_��h�/ ihcaCG� Date Requested c�l�s 8� Time A.M. /P.M. Address f s .S Cl/ �G/"�C �[/ rurmit *-1<1 Owner Lot # Builder _LLQ/ 1Qt ✓1�� 'c= , zznC, 1 Thq following Building Code deficiencies are required to be corrected: Presenter, to n flppfoved Inspector - - - -- Disapproved Date CALL FOR REINSPECTION 0 YES ❑ NO ME:C:HANIC:Al- PERMIT �- CITY OF TI17A RD � FyF.:t?MI:'T" NO. ME:(3'�1%?1 cm C)Al'E' ISSUED: £1/14/69 COMMUNITY DEVELOPMENT DEPARTMENT PRIM, PSS.NO . E�8/14/ 13125 S.W.Hell Blvd.,N.O.Box 23397,Tigard,Oregon 97223.(S03)639-4175 91721. JOB ADDftH'SS : 1069:1 SW PARK AVE 'T'A;, MAP/1_01* SUB: LT: !_.AND USE: I...OT SIZE : i'T'I.M: NO: NO WORK CLASS : AL..TEPA'TION FURNACE <100K '1 AIR HANDLR <10 USiiH TYPE::: SINGL..h, FAMILY FURNACE: 1.00K+ AIR HANDLR 10K CONST .'TYPE:: VN FLOOR FURNACE* E:VAP .COOLEA (:)I::(::t. P . t,"RP. : R:3 FiE:A'T'E"R VENT' FAN VENT VENT . SYSTEM 8L.P./COMP <311P HOOD NO. STORIES : 1 BL.R/C:OMP ;3—:1.."'lFII+ :I:NC:I:NE:RATOR(DOM DWE:I...L .UNIT'S , BLP/COMP 19--;301•4P INCT,NE:RA'T'OR(COM 1::*UH:1._ 'T'YPE: CAS DI._P/CuMP :30--50HP REPAIR UNITS MAX . INPUT 90000 I31-11:T/('•;OMP 50+HP I:; IRE DMPRS'c NO (.-,AS PIPING OUTLETS ]. HIGH PRESS'? NO 1...(:)W PPE'.:551r YE:S fit:_;IAFiK'.ii r e lit . •N l.t rrl iikcr te I<I:tl It".tt Petr.4 PERMIT $1.0 00 O PLAN REVIEW W N F"IXTI.IPF.5 Ei 00 R STATE TAX � .90 I:)l'FiE:FT C 0 N T R A T TOTAL : 11116.90 O R RE:CE:T k NO. :1.b444H This permit is issued subject to the regulations contained in Title to RF::QIlIRE:C) INSP 'C'1'I(:)NS _ .. of the TMC. State of Oregon Specialty r cies,zoning regulations (sA L.INI: , and all other applicable codes and ordinances, and It Is herehy agreed that the work will be done in accordance with the plans and ME::(:HANI:L. . ':iYSTEM specifications and In compliance with all applicable codes and ordinances The issuance of this permit does not waive restrictive covenants. Contractor and subcontractors shall have current city business tax permits. This permit will expire and become null and void if worl, not %tatted within 180 day.. ,r if work Is suspended or abandoned for n period of 180 days any tirne after work has commenced. It shall be the responsibility of 1h,permittee to assure all required inspections are requested and epproved. Permiltee Signature CALL. 1.011 INSPECTION 639--4179 IF!, ted By 4/ _ 1 -- _. — ----- ' SEPARATE-- PERMITS REQUIRED FOR WORT( OTHE"l THAN DESCRIBED ABOVE -� -7 -71 UNIFIED SEWERAGE AGENCY No. __ 116U --- WASHINGTON _-WASHINGTUI`J COUNTY DATE _ 1-97-71---- CITY OF_ Tsard -_ e I APPLICATION FOR SEWER CONNECTION PERMIT k i OWNER: ___Pete Kol_1©as - --- OWNER'S ADDRESS: 10055 SW Park St._ STREET -- -- --- --- CITY STATE Z I P BUILDING SITE: LOT ----__ B' OCK --____-____...— ADDITION --- ----- Tax Map 2S1-30A residence TAX LOT NO. -__3600TYPE OF OCCUPANCY ___ ADDRESS _10855 SW Perk St. DWELLING UNITS----. 1 - _._ __ -- --_ _ FIXTURE UNITS ----_------_ SURCHARGE IF APPLICABLE ---- -- PERMIT FEE -_-300*-__. INSPECTION FEE . 25e__ TGTAL DEPOSITED ;NEW) 1E.&L51 .Nfl) a �I�jNr SEWER SYSTEM ..__F-enno -Creek___ The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency. APPLICANT �- / .4 SEWER PERMIT THIS PERMIT AUTHORIZES CONNECTION 10 THE SEWER SYSTEM. LINE SIZE RECEIVED BY..-� i.- f (AGENCY OROTS AGENT) COMMENTS:. Per U.S. A. order #70-12 Premises existed prior to 1970- Sauer facilities became available 1-77 - This Application and permit expires in one hundred and twenty (120) days. The amount paid will be forfeited should expiration occur. City of Tigard I� tpt,r 13125 S.W. t-iafl Blvd. MECHANICAL PERMIT Pcrmit � 9?,/ ZZY P.O. Box 23397 Tigard, OP 97223 Table 3A Mechanksl co« QTY PRICE AMT M9-4175 - 1) Permit Fee -0- -0- 10.00 ramie ur Development ---- - 2) Supplemental Permit 3.00 Fumace to 100.000 BTU G.00 Job — --^ - - t) ind.ducts&vents % l/ Address Furnace 100.000 BTU+ ru.lot map N'0. 2) incl.dur is&vents 7.50 Let ©IO& 'woe Floor FUrrtace Marne a nasrte of t/xes/itrss) 3) 6.00incl.vent Suspended heater.heater,wall heater 6.00 f � " eu �1Df° O 4) or floor mounted heater Ownef �a�"r �� Jy~ ���' Verret not ind.in — - -- /SYab zip 5) appGar10e 3.00 —._ Name �� �,� ' 1' Repairofh eating.refrig., 6.00 Cooling,absorption unit Address- --- Ptar�e boiler,)r comp to 3 HP - 6.00 absorp.unit to 100,000 BTU -_ Occupant cityfStale ZP 8) &Tiler or romp to3HP-15 HP 11.00 absorp.unri'o 500,000 BTU Boiler or comp 15-30 HP 1500 `-- Uanke -�^ g) absorp.unit'h-1 million �'•A - rKat ova c t_ , _L N c Boiler or comp to 30-50 HP Ma&V Address Phone 10) n absorp.unit 1-1.75 million 22-50 Contractor ;7 yyo �• (��Yc/' . �.T J—1/l gofer or comp to 50 HP — - cltyrstate zo _ 11) L�`, �,✓ - absorp 31.50 unit 1,750,000 BTU --._-- eg sue,Registration NO. (;Ry But.Tax No. 12) Air tuindling unit to 450 10,000 CFM _ Air handling unit 7.50 heresy 1 ocknowtedge that I have read this aprAicaran that 04% ird re orrnaGon given Is 13) 10,000 Cf-M 4- axrr.d.tivA 1 am tlu owner or atmxuized,Kt r at em owner.mat r*un submitted are in compianos with�Suta taws.that I am registered with the State rkr0.yrs'Board,OW toe Non portable /.50 number given is comers.(it exemrx trom Stet 3 fegistr-ion pease give reason be"o t 4) evaporate Cooler _ `----_— -.--.._ 15) Vent fan connected -100 to a single dud --- __-- — -- 10) Ventilation system not 450 included in appliance permit -- 17) Hood served by 4.50 mechanical exhaust svwk n(owner r agenq-- --�� —pate 16) Domestic type 7.50 Descn'be work ❑ addition-0 alteration lj repair Q w^pnerato( to be none _ residential non-residential O -- 19) Comrnercia,i K industrial 30.00 type incinr fakx --- _--__- _ Existirwr use of buffing of property -- 20) Other i.e..woo Istove,water 450 heater,solar,twthes di yens,etc. _ Proposed use of building or property 21) Gas piping one to four outlets 2.00 1 rV C Type of fuel- oil Q natural gas Q LPG O electric ❑ - 22) More than 4-per outlet NOTICE SUB-TOTAL — A9,00 THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- STRUCTION AUTHORIZED IS NOT COMMENCED WIT14IN 180 Sy SURCHARGE DAYS. OR IF CONSTRUCTION OR WORK IS SUS' .NDED OR PLAN REVIEW 257 OF SUB-TOTAL ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER TOTAL WORK IS COMMENCED. Special Conditions r m ADDRESS 1 ����51'c� r PERMIT NO. f/(� � / ___�• PERMIT CHARGE none OWNER )� oja. !J-_o-QSLa CONNECTION FEE 3 D-v PAID BY TYPE OF BUILDING n DATC CONNECTED " SERVICE RATE S� INSPECTION FEE , ,l `., c CONTRACTOR PAID BY DATE SIZE OF' CONNECTION _ ASSESSMENT _r PAID �r�