12130 SW PAR 4 DRIVE ADDRESS:
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INSPECTIOY NOTICE
City of Tigard Building Departmer,
13125 SW Ball Blvd.. Tigard, Oregon 97223
Inspection Line ,(Rec-O-Phone): 639-4175 Business Phonq1 619-4171
Inspection:_ /�—�2',.�'.� -/
Footing Plbg. Underslab Mach. Rough-i � Appr/Sdwlk
Found. Plbg. Top !lut Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Blug.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plb7. Underfloor Water Lire Gyp. Bd. -Asch.
Data Requeeted:^ 1-_ --4-C-%— Time: AM p/M
Address:--_— ��s^`r-�L� _�'Q•Q/ �Per`mit /s �� ��Cj �/
Builder:
TIM FOL.LYiING CORRECTION^u APE REQUIRED:
Inspectors_. Oates_
APPROVED _ _ DISAPPROVED APPROVED SUB.IECP To ABOVE
Call For Ralnsp.
INSPFCTION NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Innpection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underelab ,6ch. Rough-i Appr/Sdwlk
Found. Plbg. Top Out /Gan Line_ rINAL,
Post/Beam Struct. San. Sewer Framing -91dt;.
Post%Beam Mec;,. Rain Drain Insulation -Plumb.
Plbg. Underfloor. Water
/Line Gyp. Bd. -Meeh.
Date Requested: a_�T �'7 7 yAam_-' Time: AM _LPH
Address, Z F,- U —�fL/` �/ Peerrmitc#:.
Builder:_,. -
TBE FOLLOWING CORRECTIONS ARE REQUIRED,
Innpectoryl /� _! Date:_? ��
,�PAPPROVED DISAPPROV3D APPROVED SUBJECT TO ABOVE
Call Fo; Reinsp.
MECHAN I CAI-
CITYOFTIOARD RD PE R14 1 T
COMMUNITY DEVELOPMENT DEPARTMENT 011MM . . . . . . .
N
13125 SW Nall OW. P.O.Box 2337;,TWLrd,Ompii 97223(603)619 4176
si'rE ADDRESS. . . : 121:-o0 SW PAR 4 DR PARCEL-:
SUBDIVISION. . . . : . . . . . . . . . . . . .A,416 cj+y Z 01\1 I NG-
.
BLOC�.. . . . . . . . . . . LOI.
UI-PSS OF WORK. . :ALT FLOOR FURN. . . . EVAP COOLERS:
TYPE OF' USE. . . . :GF UNIT HEATERS. . VENT FANS. . . -
OCCUPANCY BRP. . : R3 VENTS W/O APP1._: VENT SYSTEMS:
STORIES. . . . . . . . . s n1I._ER5/(701v1PRE9GOR7. HOODS. . . . . . .
FUEL TYPES___..________.__ 0-3 Hr.. . . . DOMES. INCIN:
/GAS/ 3-1 Hl" . COMML. INCIN:
MAX INPUT: PTU 15-34) HP. . . REPAIR UNITS:
FIRE DAMPERS?. 30--50 HP,. . . . WJOD'n-1 OVES.
GAS PRESSURE. . . : 50+ HP. . . . CLO DRYERS.
NO. OF UNITS--------- ------ AIR HANDLING UN I T�-7, OT14ER UNITS. : :;.
FURN ( LOOK BTU. 1 <= 10000 afm: GAS OUTL_ETS.
PURN BTU: 10000 (...fm:
'temar-ks : EL.EC,rRIC TO GAS CONVERSION FOR FURNACE & WATER HEj-iTER. ALSO Nr.W AIR
GOND JT J nNER.
Owner: FEES
i-U WAYNE type AMOI.Int 13y dite recj.)t
12,130 SW PAR 4 DR PRMT $ 33. 50 JLH 04/01/92
5PC T + 1.. 6B JLAA 04; /01 /9,2
KING C.-TTY OR
ilhane #:
L"Crltr-actot-:
HOSE HEPI-ING CO
4945 NE ETH DR
0ORTLAND OR 97c'?' 1
1-11-10ne #:
02084
FRE OUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Fitia.l lrispectinn
Tigard Municipal Code, State of Ore. Soecialtv Codes and all other
aoplicable laws. All work will be done in accordance with
auaroved plans. This aersit will expire if wo, is not started
w,thin 189 days of issuarce, or if work is suspended for more .......
than 180 days,
e v,m i t t,e P S i 13 n ck t tt r-e
L-alt tot, int.,1)ect1oo 639-41
. iJ , , -
. Q BOY - 397 � r-14m
scfiption
r 3A Mechanical Cafe CITY PRICE AMT
IGP,RD, OR 97223 / L � -�- -
503)639-4175 ,j �,, "�U t) hermit Fee -0 0- 10.00
2) Supplemental FArmit I 3.00
Job Address 1 c - t 1 Furnace to 100,000 BTU 1 6.00
Address 1-2A A1p'_:�Icf '4 D� incl.ducts&vents 1
Tax W Map No2) Furnace 100,000 BTU 7.50
+
Block Subdwmoon incl.ducts&vents
Narr1e(o nwrb of b usmess) 3) Floor Furnace 6.00
0
L_L M &U Y-1� incl.v.nt
"„rw qhs Pitons - )4 Suspended heater,wall heater 600
Owner - or floor mounted heater
(1/stateVent not incl.in
A tu - 1 ? 5) appliance permit 3.00
Name(« of buai ) 6) Repair of heating.refrig., 600
emling,absorption unit
Mailing Address PhoneBoiler or comp to 3 HP
Occupant 7) absorp.unit to 100,000 BTU 6.00
City/State zo 8) Boiler or comp to 3 HP-15 HP 1100
absorp.unit to 500,000 BTU
Boiler or corn 15-30 HP
a t 9 absorp.unit 1/2-1 million
MarFnoAddress t 5'�
' ,E^ Boiler or corn to 30-50 HP 22'50
ffi4-5- �F~1'1 ��� 10) absorp.unit 1p 1.75 million
Contractor �,_r_ /�p 1 t Builer of Gimp to 50 HP 31.50
t7 Ll D '"1 ?Z I ) absorp.unit ;,750,300 BTU
State Registration No. City taus.Tax No. 12) Air handling unit to
4.50
10,000 CFM
(EA-1 - Air handling unit
I h6reby admewledge that I have read this application that the information given is 13) 10,000 CFM + 7.50
correct,Out I am the owner«audvxized agent of the o-mer,Out plans submitted ar a in
compliance with State laws,Out I am regislared with t a State Builders'Soard,tha',the 14 Non portable 4.50
mxttt>wr given is correct.(if exempt from State registration please glue reason b:.wv). ) evaporate cooler
Vent fan connected
- - ---- 15 to a single duct 3.00
Ventilation system not
e l — t b) included in appliance permit 4'�
t 7) Hood served by 4.50
mechanical exhaust_
�I «agwd) -4 Date 18) Domestic" 7.50
Describe work ❑ ad /tIon ❑ alteration ' repair ❑ Incinerator
to be done residential r non-resident al ❑ 19) Commercial or industrial 30.00
Existing use of ��, v�r/�j type incinerator -
building or property 20) Other i.e.,woodstove,, 4.50
Proposed use of heater,solar,clothes dryers,etc. Y
building or property_ ���� _
-- 21) Gas piping one to tour outlets 2.00
Type of fuel- oil ❑ natural gas LPG O electric ❑
22) More than 4-per outlet
NOTICE SUS-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON-
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 5%SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25°x+OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER -
WORK IS COMMENCED. TOTAL
Special Conditions — _-
Date issued_ by
ClITY OF TIGARD RECTIVIT OF PAYPIFNT RECAEAPI NO.
cHr".cK nmoUNI 35. 1:a
NAME a POSE HEATIN(i CC.). IN(: CASH HMOUNT c 0. W
A D D R E'E;S s 31.)4`'; NF' Si I X M C}I? f7l(:)YM5N7' DATE = 04io1/9E.
SUBD I V 17I ON i
PORTLAND, OR
PURPOSF OF PAYMENT AMOI.MT f-)Al D rl.JRPo9F Or' PAYIIEM AMOUNT ["'FIM
..........
33. crpo �-I , BUILD PlFR 1. f'-A
121.'30 SW PAR 4 DR
TOTAL 0010I.INT PAID Is