13500 SW PACIFIC HIGHWAY STE 30 �o
ADDRESS:
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i:\records\microfilm\targets\building.doc
I
C17YOF TIFARD
7OFTWAW� I I I hi I
COMMUNITY DEVELOPMENT DEPARTMENT 011100hrain i I st. . M4 l y -1[II�If
131 5 SW 1-1x11 Blvd. P.A.Bou M97,1'Kpid,Orwon 97223(603)"-4175
;11 EM F^Df(E.SS. . . : 1 A 500 SW PAC I F=I C HWY #S. :,21 F'ARCFL: ''IS000X X,-00011!%
JSDI S[ON. . . . : RIQF..--RVICW ESTATES R-7 PO
1L OCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :
i_'LAiaS OF WORN. . :ALT Fl-()OR FURN. . . . : EVAP COOLERS.
f Yp'C OF USE. . , °COM UNIT HFAT'''-_-P!.;, . ., VENT F ANa. „ . - I
UCCUGANCY GRP. VENTS W/O APDL^ VENT GYST,=Mc+:
STORIES. . . . . . . . . HOODC.i. , . . . . ,. .
FUEL TYPES-- -__.__._.____ 0_3 HP. . . . DOMES. I NC;I N:
HP, . . . C(JhIIhL. INC" r`i
MAY, INPUT: PTU 15-30 HP. . . . : REPAIR Uh
FIRE DPMF-t RS''. . :N a0-50 HP. . . . WO(.1Li510Vl-
GAS PRESSURE. . . :M 50+ HP. . . . : Ct_0 DRYERS. .
NO. OF UNIT,- -----•-- _.. _. .. _ AIR IIf1N01-11,43 t)iNTT OTHER UNTT5., r
TURN ( LOOK E{'f(1: 10000 cfm: GAS OUTLETS. :
FURN ) =14.)OK STIJ- > 100+10 e:t rr LL
Remarks: Tenint Imr-r-. Int nat-titionst smo:(er•n walk--in r-1r-j etc fo. - meal; m�At-kF
OWner s _ _.._. _ ._ _....._. ..._... _.- - - - - _ _ . ..___ - FLI_S ---- -- - _....._.
WITOL.D LUNKIEWIC:T. t:vL)v e?,moUnt by date * et,r)t
21813 SW DLOCKI 001' (?F'?.VF: I-,I"MT $ 25. 00 JFE 06/04/9
I.'L_CK E 6. 25 JH 08/04/9"
TUAI_ATIN OR ') 706r `(='(: I' R 1. . c`7 .IH 08/04/')a
Phone
-
Phone #:
Contractor-:
CONTPACTOR 1V10T C1hl is 11 f=
:3,3. 51Z1
Re #. .
REQUIRED INSPECTIONS.,
This permit is issued slib)ert to the repulations remained in the Mer~t1,Anic-al. Insp
Tigard Municipal Code. State of Ore, Speria:+.v Codes and all other t-teat Intl (_int Insp
�oolicable laws. All work will be done in accordance with Pf.tct Inspect ion
vtroved plans. This oersit will expire if work is not started F i nA l T n c ripc-t i r,n -
rithin 188 days of issuarce, or if work is suspeeded for more
than 188 days.
Permittee Sinn'+: -1re !�)��.(�� �
call fear 1,-: E.C.nt 1 oi-.
Vol +
s
(:TTY OF' T.,I CAF?D RE:CEA F•T OF PAYMENT RE CE I PT NO. t 92--,?.30P03
GHFM AMOUNT a 32. 50
NAME c I._UNK,I EW I C.7., V I TOLD rASH AMOUNT a 0. 910
'IDDREEi ; 21813 SW BLAGKFODT DR F'!AYMFNT DATE:• A 08/04/90'
I0 Sl.iSD I V I g I ON
1 / TUAI,.,AT I N, OR 9,70.. 2--
PIJRPO E OF PAYME:N-T AMOUNT PAID PURM-3F=: OF PAYMF NT AMOUNT VTA I Tj
MELFIANICAL GSE: 25. 00 FLAN CHECK FF pr)
4 OT. BUILD PEP, 1. 25
1
i
I
1
f 'J I1 T']fIi 8
EUROPEAN MEAT WIT
3 767) !REFI F'AC:I F":i C HWv
TOTAL... AMOUNT PAID > . 00
t`
U
ri W-e INSPECTION NOTICE
C . City of Tigard Building Department
13125 fM Ball 131vd- Tigard, Oregon 97223
Inspection Line (Rec--o-Phone): 639-4175 Dual+,eve Phone: 639-4171
Inspection:
Footing Plhg. Underelab Mech. Rough-in Appr/Sdwlk
?ottnd. Plbg. Top Out Gas Line FINAL.
Poet/Beam Struct. San. Sewer Framing --Bldg.
Poet/Beam Hech. Rain Drain Insulation -P1�u-b.
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
Date Requested: J ��-i ! Time: -`_Alf PH
Addressr'<96 V ermit
Builder-
THE FOLLOWING CORRF.C`TIONS ARK. REQUTREPt
Inspector: Dates
APPROVED DISAPPROVED APPROVED SUBJECT TO MOVE
Call For Reinap.