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INSPECTION NOTICE q /l
i City of Tigard Building Department
13125 bV Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Undsrslab -14 Rough-in Appr/Sdwlk
Pound. Plbg. Top Out (aLine� FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
Dote Requested; , 1 J___ Time: AM _ `PM
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Address: Permit
Builder:__
THE FOLLOWING rORRECTIONS ARE RRQUIRED:
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Inspector: Date:,
APPROVED DISAPPROVED APPROVED SUBJECT TO ADM
—call For R.,insp.
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C11YOFTIOARD cny TWARD MECHANICAL
commuhrTY DEVELOPMENT DEPARTMENT001000H PE Rtyl I T
13126 SW HmIl Blvd. P.O.Box 23397,TOW,O"Pgon 97223(503)M4175 T—_7 PERMIT #. . . . . . . : IYIEC93-41044
639-4171 DATE_ ISSUED: 0,3/08/93
SITE ADDRESS. . . : 11200 SW 79TH AVE PARCEL: IS136CA-03900
SUBDIVISION. . . . : FRIENDLY ACRES ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :9
CLASS OF WORK. . :ALT FLOOR FURN. . . . e EVAP LOOLERS3
TYPE OF USE. . . . :SF UNIT HEATERS. . : VENT FANS. .. . :
OCCUPANCY GRP. . - R3 VENTS W/O ADPL: VENT SYSTEMS:
STORIES. . . . . . . . : BUILERS/COMPRESSORS HOODS. . . . . . . :
FUEL 0-3 HP. . . . - 1 DOMES. INC IN:
c/OIL/ELE/ 3-15 HP. . . . c COMML. INCIN:
MAX INPUTs BI LJ 15-30 lip. . . . REPAIR UNITS:
FIRE DAIYIPERS?. . - 30-50 HP. . . . : WOODSTUVES— :
GAS PRESSURE. . . : W0+ HP. . . . : CLU DRYERS. . i
NO. OF UNITS------------ AIR HANDLING UNITS OTHER UNITS. e
TURN ( I OOK BTU.-1 <= 10000 cfmc GAS OUTLETS. : 1
FURN ) =1016K BTU: > 10000 cfm :
Remarks : OIL.. 1U GAS CONVERSION FOR FURNACE. AIR CONDITIONER
Owner. FEES
LVIE-RETT ROLLS type amount by date recpt
112,210 SW 79TH PRMT $ 25. 00 JF-1 03/08/93
5PCT $ 1. 25 JH 03/08/9.S
TIGARD OR r'72123
Phone #:
BE HEATING
15550 SE PIAZZA AVE
CLACKAMAS OR 9711.115
P11-ione if: $ Ea. 2s i ariii-
Req 00447
RE LWINED INSPECTIUNS
This permit is issued subject to the regulations contained in the Gas Line Ins
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
than 161 days.
-
Permittee 5 i qnit itt e
Lall for inspection 639 -4175
Cll' ' O► - 'I IUAkV - NE:.ULIPT uc• PA1 MENT R rL IP7 NO. t 93—c--'3751 1
CHECK AMOUNT t c:6. 255
NAME t SELL HEATING. INC L:A'3H AMOUN f i lb. 00
ODDRESI., t IbS50 SE NTAllO AVE PAYMENT DNTL t 03,108/93
:-il.lDUIuI`.�Il1N n
L.LOC CAMAS, OR ')'7th
P1.JW;,Ogr.. OF PAYMFN1 RMC u_1NT Fifa T D PIAW-11.)FiE UP r-'A'v'MF Nl FOIU INT PAID
r i'ii r I IF1M1I T,l FtL F'E' r:`:. 00 ST. FU I L_D PER __ __.•.__ l• 210;!;
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TU r OL. AMOUN r' PA t D 25
I CITY OF TIGARD MECHANICAL PERMIT
13125 SW HALL BLVD.
Permit;Y
P. O. BOx 23397 Description
it I GA RD,. OR 97223 Table 3A Mechanical Code CITY PRICE AMT
503)639- -4175 1) Permit Fee -0-l Permit
-0 10.00
�
2) Supplementae
Yam.e of Development _ 3.00
Address — I Furnace to 100,000 BTU 6.00
`fob 1) incl.ducts 8 vents
Address 7r 6 S 627�
Tax trot Map No. 2) Furnace 100,000 BTU - 7.50
incl.ducts 8 vents
Lot Bock �urbdmsion
Name for rume of business) 3) Floor Furnace 6.00
incl.vent
Mailing Address Plane 4) Suspended heater,wall heater 6.00
Owner - or floor mounted heater
City/State zip 5) Vent not incl.in 3.00
� appliance permit _
N 7e(or name of busines,l 6) Repair of heating,refr ig., 6.00
cooling,absorption unit
Fr-.,y
Aridress P!1!w, 7) Boiler or comp to 3 HP � �, / 6.00 6,
O-ccupent absorp.unit to 100,000 BTU jA /
ate zip — 8) Boi,er or comp to 3 HP-15 HP 11.00
absorp.unit to 500,000 BTU
Name 9) Boiler or comp 15-30 HP 15.00
Zai absorp.unit'/ 1 million
Mailing Address Plane 10) Boile;or comp to 30-50 Hit 22.50
absorp.unit 1-1.75 million
Z) ✓
/ y Ste' a• �,•yid i
Contractor Boiler or comp to 50 HP
cnyiSute I1p11) � 31.50
absorp.unit 1,750,000BTU
State Registration No City Bus Tax No. 12) Air handling unit to 4.50
10,000 CFM
Air handling unit
I hereby acknowledge that I have read this ap Acation that the information given is 13) 10,000 CFM + 7.50
cprect,that I cm the owner or authorized agent o1 the owner,that plans s Aimitted are in
axrpliance with State laws,that I am registered with the State Builders'Board,that the 14) Non portable 4.50
number given is correct (If exempt from State registration please give reason beknv) evaporate cooler —_
Vent tan connected
15) 3.00
to a single duct
Ventilation system not
16) inJuded in appliance permit 4.50
Hood served by 4.50
17) mechanical exhaust
Sgna�kr or-agent) Date 18) Domestic type 7.50
Describe work ❑ addition ❑ alteration 0- repair ❑ incinerator _
to be done residential ❑ ,ton-(esidential ❑ 1 g) Commercial or industrial 30.00
Existing use of
type Incinerator
---
building or properly ie20) Other i.e.,woodstove,wale, 4.50
heater,solar,clothes dryers,etc.
Proposed use o1 ��
building or property_ 21) Gas piping one to four outlets 2.00
Type of fuel- oil ❑ natural gas E}—" LPG O electric O
22) More than 4-per outlet
NOTICE , SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON-
STRUCTION
ON STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 S%SURCHARGE ,Zj
DAYS, OR IF CONSTRUCTION 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 Zb?�
Special Conditions
Date issued by _