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City of Tigard Building Department
P O Box 23397
Tigard, Oregon 972.23
Phone: 639-4175
Type of Inspection
Date Requested�_� --�-�—
Mime A.M .P.M.
Address � P mtt17
' Lot �
Owner
Builder
The following Building Code deficiencies are required to be corrected:
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Presented
y _
Presented to _ �P-Approved
❑ D"approved
Inspector
Date -L�y
CALL FOP. RFINSPECTION
❑ YES 0 NO
1
INSPECTION NOTICE —� I
City of Tigard Building Department
P O Box 23397
1'igard, Oregon 97223
Phone: 639-4175
Type of Inspection (S.4" -_ _
�,. Ny
Bate Requested_]����� Time A.M._ P.M.
M
Address J/L/.5 , �1�1� �w t� -- -__-- Permit #_ _Uie2�_
Owner -------— -- --- Lot
1
Builder ---
r
The following Building Code dt,ficiencies are required to be corrected:
^ne-�wgLr,4.� %A,e.r1�
Presented to _ Arproved
'nrpector _ -- _- Disapproved
Date
CALL FOR RNIMPECTION {
YES L�] NO
INI 1 C A L.
CITYOFTIIFARD
COMMUNITY DEVELOPMENT WYOF R�D -- PIE.L90 0126
DEPARTME
NT ORIGON I1T vir.:C90 01.,_m,
13126 SW He i3iv,i 1'0 Box 23397 11gard,Or9gon Q7=(5m)M-, M DATE"
:- :Cf-)�;U 0 6, 2 9/9 0
HWY
Fk,I
FI I 13CK„ I CH 21
............. ............ ... .........................
W U.)1.ti 1:. A I.. F.I F_URH.
I.YPF- oF, - — "REL U N T f 1-4 L A I E'R S C,00LER!3:
VENT FANG'. . .
0 C,('U P`A N C,Y G 1_�P` B 2 V E N'T S W/0 'n F"P L
sysn:.
PIS.
H(JIM-3. .
T Y r,I..
....................... 0....3 HP. .
IN C.1 N
IIAX BT0 5 0 VIP— . RL-PAYR 1.)111:,
DAIIPEW(.;' . :,- TG
G A Fi) I::'R Ei*(31 8 U R F, 30--50 HI::,. . W00DST'C)vES_ 1
. . 5 0+ HI:'. . . .
14 1 Tc, 1. 1 1.............. A.1 R H A 14 1)L H(,7 tj -t T- L 0 1)R Y I.:.R(3.
I ul:m < jqT,IJ,- OTHER U1,11 11-6.
10000 cfnl::
I`:URhI )= I-00K 11-11J.- I 10000 G W.3 C)U T*L F,
Is.
R
UNION GMSPEJ.. HIN - GTRIFFIG 1
type A ni u ii t. :)y (iate
SE. ANKEMY 'rec,pt
PAY11 �?:30. 4(3JLH 06 g,"
12go
P(JRTL,AND OR `)7214 P R ITI 1, 9. `.i0
2.35 4481-3 `)PCT' 9 0- 1.98
.................
Re.q (.)WI,II T� 20. 48 TDTAL
This permit is issued subject to the regulations contained in the REOU-TRED 1H!3PU,'T10NS
Tigard Municipal Code, State of Ore. Specialty Codes and all other ............................ ..............
Applicable laws. All work will lip done in accordance with ..................................................... .....
approved plans. this r1preit will expire if work is not started '......................w._."....._. ..............
within 180 days si issuance, or if work. is Suspended for sore .... .............. ........
than 180 day,,.
................................................... ...........
...........
Pe"110.t-tee G i 14 14�tU VC1
. ...............
u e d BY .......... ...........
..............I................................. ................. ............. ........
639-4
-
(OF ';'11Y.1RD PF,c.r-:ir"r cF7 P-ECEIPT 1'10. o 4C';
CHECF;.' o-MOUITT
CASH AMOUNT
NAME a UNION Cjf)ISPEL MINISIPIES
PPiYMENT DATE 1 1',16 4.9
A ID D P E S n SUBD I v I s I ON I
1161*5 pA,,-,IFIC HWY
POPTI-AND. OP
rIJPPOSE OF PA'YMP-il FAjF*'T'OSE OF PAYMENT AMOUNT FIA I
1,jEcHAt4l CAL PE MEC 9 1 4-6 50 (yr. BUILD PEP
2Q. 48
r0TAL. AMOUNT
I
CITY OF TIGARD MECHANICAL PEWAIT Receipt # _--- ----_-_-_ __
Permit #
131-25 SW BALL BLVD.
P. O. BOX 23397
T IGARD, OR 97223 of 151
Table 3A Mechanical Code — OTY PRICE AMT
(503)639-4175 1) Permit Fee -o- -0- 10.00
Name of rh+velotynent 2) Supplemental Permit 3.00
�� u t in i S �E�'— 1) Furnace to 100,000 BTU
Job ti.00
Address nos
o S P ci 11 W µ� incl.ducts&vents _
Tax Lot rt Map No. 2) Furnace 100,000 BTU + , 7.50
incl.duds&vents _
frit Bloelt Subdivision -
Furnace
Na (or nerne a incl.vent buskon) — 3) Floor vent
nta 6.00
'Y� � Ph" 4) Suspended heater,wall heatermaiiiing 6
� orfloormountedheater -_ —
.00
--=��M Vent not incl.in zip r
�, .00
� 3
flan 0/ �K 9 7� ,y _)-appliance permit _
--- 1 Repair of heating,ref rig.,
Name(or name of business) 6) 6.00
cooling,absorption unit
- -- Boiler or romp to 3 HP
_
OccupantOccupantMarling Address P1io^° 7) absorp.unit to 100,000 BTU 6.00
-_— - -- —
CitylSiate Tip - 8 Boiler or comp to 3 NP-15 HP r500
absorp.unit to 500,000 BTU
— ) Boiler or comp 15-30 HP
Name — 9 absorp.unit 1h-1 million _
_Tu �in:S�izi�S Boiler or comp to 30-50 HP .
Mailing Address �K'^a d Vt absorp.unit 1 -1.75 milli.-in __.
Contractor CltyfState ZIP 11) Boilero. compto , HP 31.50
absorp.unit 1,750,000 BTU —
state Registration No. City B .Tax No. 12) Air handling unit to 4.50
10,000 CFM -
I Air handling unit
I hnreby adcnowledgo that I have read this application that the information given is 13) 10,000 CFM + 7.50 -
coned.thet I am the cw,nter or autori
hzed agent of the owner,that plans submitted are in ( --
rximpl-anx+with State laws,that 1 am registered with the State Builders'Board,that the 14) Non pon3ble 450
number giv in is vred (If exempt from State registration please give reason bnbw) evaporate cooler -
15) Vent fan connected 3.rw
- - to a single dud
--- - _ - _-_ -- - Ventilation system not
16) 4.50
included in appliance permit
— 17) Hood served by 4.50
mechanical exhaust
Signature(owner or agent) Dale- 18) Domestic tv,;,a 7.50
Describe work ❑ addition [Ialteration f4 repair El Commercial
to be done res!_3ntial ❑ non-residential 11i 19) Commercial or industrial 30.00
ttrpe incinerator _--
Existing use of (� 1 t Other i.e.,woodstove,water
building or properly 4 R� 1 __ 20) heater,solar,clothes dryers,etc. _
50
Proposed use of (� l
building or property IS 4 �ar 1 21) Gas piping one to four outlets 2.00
Type of fuel-- oil I 1 natural gas ❑ LPG ❑ electric ❑ -
-. - -- 221 More than 4-per outlet
Nf�TfCE - SUB-TOTAL // 5t
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON-
STRUCTION
ON -- - SX SURCHARGE
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 _... _ -__-__
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN OEV1EW 25°X.OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER - - TOTAL L+ Ell
WORK IS COMMENCED. _ ,.-
Special Conditions
_-- -.---__-- Dade i3sued_. _—_-- _- by
�'— sexst