15760 SW 76TH AVENUE -- 1.5760 SW 76TH AVENUE --
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CI OF TIGARD 17Y OF TWARD PEXIMIT NO MEB91.e92
COMMUNITY DEVELOPMENT DEPARTMENT
13125 S.W.Hall Blvd..P.O.Box 23397.Tigard,Oregon 97223.(503)639A 175 9
PHIM
JUH ADDRESS : 1-5760 SW 76TH
TAX PIAP/L.OT c,I.IE LT . BK .
I-ANr, USE -
I-O'T
I-01 SIZE :
ITEM : NO: NO :
W014K CLASS : ALTF.-.:Ao,'T'1ON F'(JRNA(:,E (1001( AIA HANDLP (10
USE TYPE: SINGLA-;-* FAMILY FURNACE 10010 1 AIR HANULP 10K
CONST . TYPE: FLOOR F'I*PNACEEVAP . COOLEA
01[71C1JP.GRP. WATER VENT FAN
VENT VE-N 1* . SYSTE M
BLA/COMP (3HP HOOD
N S T 0 R 3:E'S BLR/Gump 74-1.51--V) INCINERPTOR(DOM
1).WELL - UNITS : BI-R/COM1-" 1-5-30HP 1E
N(..TNPAT0R 4(.(:)M
'T'YPE: al-P/Glump 'SO-50HP PEPAT11- LNITS
MAX . INPtJl BLP/(.,OMP 1-50+11-4ri OTHER
DMPPS'J GAS OUTI T ':)
1-41G1.1 PPE SS
"I lip
0
W k [)iarvey
N PEPMIT Ai 1.0 . 00
E 11303 13W 111111C.-JUPIand PLAN REVIEW
9721PAI FIXTURES 9 °i0
5 TATE: TAX
C 0 THE P
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T
R ATLAS HEATW'
I. , INC.
A 61.4(8 SF'. 11.1TI.1
C
T 1:)r.)I"t 1.fit.11 Cl tar 97266
0 PI. ONI::: 4503) 760-5561,
P . 1-4LGISTWATION NO. 236FJ2 TOTAL. *F?0 AH
This permit is Issued subject to the regulations contained in title 14 NO.
of the'rmc. State of Oregon Specialty Codes. toning regulations
and all other applicable codes and ordinances, and it 1!3 hereby RE-QUIPEL) .1Nt3PEr.-T-1(:)NS
agreed that the work will be done In accordance with the plains And GAS LINC.".
specifications and In compliance With 811 applicable coder and
ordinam,s The issuance of this permit does not waive restr wive P09 HE:AM
covenant3. Contractor and subcontractor, ,hall have current ,ity N
business tax permits This permit will expire And become null and F: 1:NAL
void If work is not started within 180 days,or if work is Suspended or
abandoned for a period of 180 days any time after work has
commenced It shall be thr responsibility of the rermittee to assure
all required inspections are requestr I and approved.
Sig ure
Issued By
OPI Nti PF::(','I'I(')N A39—LTi -7!I;i
BEPAIRATIE PERMITS REQUIRLD FOR WORK OTHER THAN DESCRIBED ABOVE
WX
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspe.ti,:)n
Date Reques id_ - "o— V—ZF Z Tirre A.M. P.M.
Address '��:'dC'% fie. % _ Permit
Owner Lot #
- i
Builder_
Thp following Building Code deficiencies are required to be corrected:
F
i
— � I
Presented to _-� Apprr.ved
Inspector
-- _--. — Disapproved
Date
CALL FOR REINV E'CTION
C-1 YES C7 Nr
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7 SEWER PERMIT N! 2049Unified Sewerage Agency CITY OF DATES
of Washington County --
OWNER : PHONE :
)f;!
OWNER' S ADDRESS: �� d S f✓C'_ ��A��,L_
TYPE OF INSTALLATION:
P BUILD? NG SEWER U LINF TAP AND BUILDING SEWER Q LINE TAI
TYPE OF OCCUPANCY:
❑ NEW ED EXISTING SINGLE FAMILY ❑ COMMERCIAL
L_1 MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS e DWELLING UNITS
ADDRESS OF STRUCT'jRE :
Permit Conditions: The applicant agrees to comply with all rules and regulations of the Unified
Sewerage Agency. Whei calling for an inspection, please refer to the Permit Number. The Permit
expires one hundred twenty (120) days fron the date of issuance. The total amount paid (vermit
fee, connection charg,t, line tap fee and/or ither charge) will be forfeited if the permit expires.
The Agency does not guarantee the accuracy of the location of side sewer laterals. If the sewer
is not located at the measurement given, the installer shall prospect three feet in all directions
from the alstance given. If not so locdtr'd, the installer shall purchase a "Tap and Side Sewer"
Permit at the current chaije and the Agvnrr will install a lateral.
FEES:
PERMIT rf=F $ 3
CONNECTION CHAW,F 3 C-P
LINE TAP INSTALLATION
ISSUED BY
OTHER
TOTAL $
APPLICANT DATE:
AL
TI -___- bAVFROM THi
AED' SEWER PERMIT W
J[ DATE, SEWER SERVICE
E
CHARGE Wltk BEGIN FOR THIS PERMIT.
ADDRESS OF STRUCTURE
TAX MAP E / `/c ( 7-') TAX LOT QUARTER
--- --
SECTION
LOT BLOCK OF
APPROVED EiY DATE ISSUED BY r DATE OF ISSUANCE
D. 1', ' S REMARKS /`:;,.- ti ' J' � ��'>'C 4/V
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City of Tigard
13125 S.W. Hail Blvd. MECHANICAL PERMIT Room11�
P.O. Box 23397 Permit
Tigard, OR 97223 I T.W�7A�/decriankalCorle
639- 175 onr PRICE AV
1) Permit Fee 4)- -0- 10.00
Name of lxwbp,>e"
2) Supplemental Permit 3 00
Job Aldress Fumace to 100,000 BTU
Address 7 1) incl_ducts&vents 6.00
TaxW , Lisp NO. y m
Fuac�e100,000BTU + 7.50 ) 7
Block �0 2) ind.ducts&vents _
Name(or Cattle of tx+aYtaaq 3) Floor Furnace
inclvent �— 6.00
,-, SS _
MaktDAd*m 4) Suspended heater,wall heater
Owner or�l v`rJ� r / t// --or floor m9unted boater ---- 600
� CRY/statep Vent not incl_in
— '), C;7L C 5) aAf>iianoepennit
r�p - ' 6) Repairof heating,refrig.,
It Boling,absorption unit 6.00
Ackires-s— pts 7) Boiler or comp to 6.00
absorp.unit to 100,000 BTU
OccupantGh/Stale Zip 8 Boiler ofcomp to 3 HP-15 HP- —
absorp.unit to 500,000 BTU t 1.00
Boiler or ootttp 15-30 HP ____----
' absorp_unit t/1-1 million 15.00
MalrkgAddren 140 10) Boiler or comp to 30-50 HP --
"lSAE., �� X60 SS absorp.unit 1-1.75 million 22.50
Contractor CRYis aw �~ ZIP 11) Boiler or comp to 50 tip
��7t_ absorp.unit 1,750,000_BTU 31.50
Gl Slew tasplslrallon No. City ea.Tau No. 12 Air handling unit to ---
10,000CFM 4`i0
1 hereby ad nuw4odge Our I nave read ays arNiWAtion aur Ens k4orme6on geven k 13) Air handling unit
correct —
correctoral I am ab wRwx Or auaxxired"it »r
d the owr ,aur Pur.br
Put=snit(ed ue M 10,000 CFM i 7.50
----
ON14*.nne«Rale Sul"caws.that I am registered with ab slate nullMm*Board.aul are 14) Non portable -
nurTrrer U's c""'Pct (lel @KemrN Irom Stale registration phase pive reason below) evaporate cooler 4.50
-- - 15Vent fan connected
)
to a single duct 3.00
- Ventilation system not
t 6) included in appliance permit 4.50
Hood served by
s t/ sf 17) mechanical exhaust <.50
__ Slptiatiee( q og°"'1 o■Is Domestictype ------- --
Describe Woof ❑ addition F1 alteration [3 repair (I 18) incinerator 7.50
to be donlb residential La' non-residential U Commercial or industrial
-.— — �-- 19) 30.00
Existing use of type incinerator —
ImAding or properly__- 2 Other i.e.,woodstove,water -
Pr%mod use of ---- U) heater,solar,clothes dryers,etc. 4.50
building or property_—
-- 21) Gas piping ogle to four outlets 2.00 cv
Type of fuel- oil [] natural gas O LPG O elof l(If I I - '— -
-- 22) More than 4-per outlet
NOTICE -
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- — SUB-TOTAL
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 5% SURCHARGE
DAYS, OR IF CONS•l-RUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER — —.
WORK IS COMMENCED, TOTAL (__1 1_Ir-
Special Conditions