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22280 Si4 PAR 4 AVENu
KING CITY -
11ECHANTLAL
CITYOF TIFARD Cffy T16ARD P E R M IT
COMMUNITY DEVELOPMENT DEPARTMENT OREGON F,E111*1 N. . . . . . . :: 111L.,C 9 0---01,3 L
13125 SW KW BW P.U.Box 23397,T•pM,Oregon 97223(5031839.4176 PE:RMTT 0. :: MEC 90 01.3
SITE ADDRE a. . . : 12280 SW PAR 4 AV PARCEL.-. 2SIIOCD--0170.,e
SUBDIVISION. . . . .. 6 ZONING:
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:
—.ASS OF' WORK. .. s ALT F]..00R TURN. . . . : EVAP COOLERS
TYPE OF USE. . . . SF UNIT FlEATERS. . : VENT FANS.
OCCUPANCY GRP. . .-R3 VF"NTS W/O APPL" VENT SYSTEMS.-.
"TO R I E
S 29. , . . . . . . .. BOILERS/COMPRESSORS.; H C)C)1)S. . . . . . . .
FUE.A.- 'T*YF-"ES------,----------- .... 0-3 141.-.,. DOMEE. INC TN:
:/GAS/ 3-15 HP. COMML . INCIN:
MAX INPUT: If 11.) 1.5....30 1.11:1. R E P A:1:Fk UNITS-. I
FIRE DAMPERS?— : 30-50 WOODSTrVES. . :
(3AS 50+ HF.I., CLO DRYERS--.
MO. OF UNTTS---------- AIR HANDLING UNITS OTHER UWITS. .-
F.-0 14:Iq < 1.00K. D T U-. 1 10000 cfm: GAS OUTLETS). '. 1.
FURN )=100K BTU: 10000 cfm::
Remarks:
Ownern ------------------- --------- ---- ---------------- FEES -------------- -
W H T TL: type amOUnt by date r e c p
12230 SW Pf-iR 4 DRIVE PAYM 25. 20 JLH 07/10/90
PRMT 24. 00
KING CITY OR 97224 1.5 P CT $ 1. 20
Phone H:
Contractors
LYLE BOOM
ROSE HEATING CO. INC.
9945 NE (:,TF1 DF
PORTLAND OR 1.97211 0000 .............-
Phone if: 503 283---5183 6 25. 20 TOTAL.
Reg N. . : 2084
- ------ REWIRED INSPECTIONS
This nemit is issued subject to be regulations contained in the F- inal Inspection
Tigard Municipal Code, Statt of Ore. Specialty Codes and all other ....................
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 189 days of issuance, or if wo-k is suspended for more
than 180 days.
..................
P e r m t t t e e 9 i q n a t u. a i .... ... .............
......... ....
ISSUed By:
Call for inspection 639-4175
:;1 TY OF TIG-r4RD PECUAPT OF PAYMENT RECEIPT NO. :9 7) 20"!4 647
CHECI AMOUNT t
POSE HE'ATINO CO CASH AMOUNT
A 0 1)P'E 1"i S o 994E
5 NE 6TH OP PAYMNT DATE s 07/ 1 res,.,
SUBD I V I Sj 7 ON
F'OPTUAND. OR 9 7'1*2 1 1— 0 0 r.A R A D R I
PUT"POSE OF P,4YMENT AMOUNT PAID PljRPOSE OF PAYMENT
(K) S 0
PE PUILD F-E�,'
TOTAL AM01.10 ' PAID '21.r**,
INSPECTION NOTICE
City of Tigard Building Department
P.O Box 2.3397
Tigard, Oregon 97223
Phone: 639-4175
— r J
Type of Inspection .
Date Requested _� Tlm�A.M. P.M.
Address ! �.� D y.�i�� �--`/ Permit
Owner L Lot
Builder
The following Building Code deficiencies are required to be corrected:
Presented to _ Approved
Inspector LSf!1' _ ❑ Disapproved
Date ,� —
CALL FOR REINSPECTION
❑ YES 1_1 NO
KING CITY
a■t��i I5:100 S.W.I lfith Avenue,King(.it)•,Uregnn A722.1 i'hono:lia9•IOR2
COMMUNITY DEVELOPMENT
APPLICATION FOR BUILDING PERMIT
(Instructions on reverse)
DAT, Cly ` IU
1. NAME OF APPL I CANT: Y I A 10, c Phone No.
ADDRESS: 1 2 Z'r F C t
ADDRESS OF PROPOSED IMPROVEMENT 1 -12 ti3C `-21 1 21 r 1
2. TYPE OF (MANGE, IMPROVD04T OR CONSTRUCTION FOR WHICH PERMIT IS REQUESTED.
DESCRIBE BRIEFLY - A7TACF1 'IWO COPIES OF (LAPS OR DRAWINGS OF
PROPOSED PROD�T:'?-,\ 1 1 _ ___ _t y �_u_` l l ~
3. NAME AND ADDRESS OF C VMCTORL' I- , 161 -
I CENSE NO. 4L.0-It
4. NEIGHBORS WHO MAY BE AFFECTED BY THIS PROJE1:17 WILL BE NOTIFIED BY THE CITY.
5. APPLICANT OR ITER/HIS REPRESENTATIVE MUST BE PRESENT AT THE PLANNING CO MISSION
EE
MTING NEXT HFLD CN �_1 1 1 C_ 17, +t t _ '; /9"
REPRESENTATIVES NAME Lt t 1;' -t r'.•t l PHONE NO.,_Z`c''�,3
('(he King City Planning ^•Immi Il.will cons'der only those applications received at least five (5) days
prior to a meeting.)
SIGNATURE U
APPLICATION RECEIVED BY
APPLICABLE FEE RECEIVED $� � -�" TOTAL
PLANNING COMMISSION DECISILM: Approved,� Denied _
CJONDITIONS _
Approved oppiication: re valid for sit months only
Signat,Ltrey C Date - ��'�0
(J0'1 . 0reg n Aomebuilders Low requires that all persons who contract for work on their residence be
reg'stered with the Builders Board thich means the contractor is bonded and insured on the job site.
For your protection, be certain your coli►ractor is renistercd by calling City Ball Ph: 639-4082.
NOTE: A permit must also be obtained ran tl_e City of Tigard Department of
Ccvm snit; Development Yes No
CITY OF TIGARD INSPECTION REPORT
The above listed project has been inspected and Approvec__penied
Date Camtents _.
Signature
(/3ttAtA ng itVap c t_apt, pl. n," 4e tuAn o►,9- ( 1) copy #.e King City)
��•.., ��.e.y r ..2. � � ��►••�...��?.-Q.✓ 7G11•ex.e ..f'e'd ���