14532 SW 83RD COURT ■
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14532 SW 83RD COURT _
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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection — - -- -- - � �
Date Regaras.ed t Z Timf--r�� A.M. _ P.M.
Address __ L' 3 2 --- Permit #_
Owner_. __ �-- _ Lot #— --
Builder e.-- ---The following Building Code deficiencies are required to be corrected:
Presented to _ _ F1 Approved
Inspector
d 1pP
Date
CALL FOR REINSPECTION
YES ❑ NO
HUILUING PERM11
PIERMI'r No. : sufaeoels
CITY OF �I��� c,�60 DA,Tr! I tESSUED: ril I 1/86:1
COMMUNITY DEVELOPMENT DEPARTMENT FRIM. PM1, NO 880P_13
13125 S.W.Hall Blvd..P.O.Box 23397,Tigard,Oregon 97223.(50316394175
JUD ADDPF.5!�
5 .144,5E-
.32 SW 113PU C,I'
I'6X MAI /1 01 2S.1 11.114W'11� 6900 suo I u F.,t i,Y s Em.rily...o Acmr-:s L r P UK :
I..ANU 07
VALUATT ON 63,850 FIETL - GKS;
FFION"I : Vo REAR: 6
WORK CLASS : NLW OWEL.L. .UNI 1*5: 1 LEF T* : 0 P CZ-11+11' ! .137
"T NG - 13 F.,.x j- wm.i. (.,nNs,*i
051�.l, I Yl* A r.: FAMILY NO BEA)WOMS
CONS'r. TYPE: : VN NO 8411 Is N S W:
Pjl#O,J*
CICCLIV U14) 114 3
C)(:,'CIJP L.E)AO W S : E : bl
At,
NO 51'ORIES : I 1e67 noull;* cuNs r: G* FJ FIE 14L 11"?
6 PNV : i)Pr::-.A F)t-,PA17 P A'I F 1)
L-Wili MEN1,11 3AO: (XICILIP . tilwPAR7 QATEJ)
0%; Z;AN).NEI
Fl OUP L13AD: 010 GAPAGE: &1.40 F1 AL SPAKL.A7 ALAPM7
V L Ow GPM I
F115A,r 'iypF. A'i AC(.,%:FJ97
AE.MAOKS '
0 1,ta wdc- WTS511C UF 140 :<651.
LA931' PILISSUE' 7070
MILIVIISSE frE MN I!MI r I 4;
0 I)uNOX I 1^VN PF 1,11 P W
1W
partlaoid ar 97 F!Ve I I PIE DE:P I'
E s,i tvirc. i Ax
• R 0 T'HE I'll
CJPt41..N'I CHAP11"'14:5 :
MURISSIEVIV 0950 .00
'C
0 otx,j muwx 141.%v I i u. w.m.11')0154 1 NC 111111,50 00
N POC 11#L1 $950 tooT PC Box 19501 XIA 10 < $10 1'0�
R ptli A I NOW 97P3.9 PPW
C
A PHONE (503) 941—YA1.4
T NEI q3AA,*4 t CJ'I Aj $9,71 Plftl
14CCLIP'T, NO X181,646
This permit is Issued subject to the regulations containeu,.-.Title 14
of the TMC, State of Oregon Specialty Codes.zoning regulations
.and all other applicable codes and ordinances, and it If hereby 1 (111,14 it'll" Sh F.WK$4
'."ogreed that the work will be done In accordance with the,31ans and V UUNDATION WAI. I PAIN DPAINti
.specifications and In compliance with all applicable code,4 and & FtFoM Wir)'T L-P I., 'I.1,1F_
ordinances The issuance of this permit does not waive restrictive I 1:4-6 ,I hNUF'.R5"L AIR CITY A111PP11111141/41W
covenants Contiactor and subcontractors shall have current citv t,1 614 F!r t NAI
-ousiness tax permits. This permit will expire and become null and I it, E :urou r
troll if work is not started within 180 days,or if work is suspended or
;,abandoned for a period of 180 days any time eller work has I I$Ali I HI-1
"commenced shell be the tesponsibilit of the permittee to assure.
.1 PIL 01. At.';I:.,'.
h1l require in.% tions ar requested proved Is I I t4li
I, nnmw)
L F 0A TNS PFEC'T I ON 6 4 -At (5
Issued By:
SEPARATE PERMITS REOUIRED FOR WORK OTHER THAN DESCR!BED ABOVE
Y
upffAm-M
CITY OFT167ARD Cff��AIW
Y OF T16
COMMUNITY DEVELOPMENT DEPARTMENT PERMTT NO . - MLM0021-5
1312. S.W.Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223.(503)639-4175 D I)'(F�, T',-.s S UE U 1P OR
PWIM PMT NO . 88001.3
,108 ADORES$ : 141532 SW H3110 C'T* i ,
IAX MAP/1-01, P.%J. 11.20t, 6900 $11AF! CE I I YS ra:tlr-*1 r.) Acr,..t- 0K
LANO USE:
1.(,:11' SIZEK:
J:TEM: NO: NO
W(*)I')K Nr;.:W FL':PNAW. <11-00K I A]'P' HANULP <11-0
USE TYPE: SINGLE FAMILY FURNACE 10OK4- AIA HANDLR 10K
(30NS1 TYPF : UN F*1-130141 F*-I1F4NACr:* EVAP,OOOLEP
GRP. : 113 HH"ATER VENT FAN
VKNI kPE,*w* sys,rEm
SLA/COMP (3HP HOOD
NO, S*1 U141 E'S : 1. nt.rvcamr) 3--inw INGINERAI OP(DOM
DWF-LL .UNITS : I 8I...R/G1QMP 15-301-IP INCINERATOR(com
r..JI..r.4/C;(3MP 7)0".# PEP161,P 1.11NI: I S
FUEL, TYPE GAS �Ojrjl.)
MAX. INPUT 1831-.Pi/COMP 50+HP OTHEP
FlAIE: UMPFIS"I (;A% "PTP1NG (JGIIIJEIS
1 ife-H
I..EIW
101
W
N , f.:.k::Sii
E I MORES. $10 .00
S&T TF' I)ON PEPA I T*
R PIJ "UX '1.95>~A1 PLAN PE.V-.KF.'.-:W 111117 13
i.)ar t1and Do-, YfRtY FIXTURES $10. 50
()..4) ,y I A'I-931 01 $1. 13
C S1 ATE I AX
0 a'n-wn
N
T
A
C BE1.1- HEATING INC .
T t5550SE PIAZZA AVE
0
R at.,It III in 0 to ts 1. 970111$
oril,IS1 WAI .1'1:114 NO IleFf
This permit is issued subject to the regulations contalned,i Title 14
of the 1 MC. State of Oregon Specialty Codes. zoning regulations PF-'.rIETPV NO
and all other app"cable codes and ordinances, and it is hereby
agreed that the work will be done In accordance with the plans and
specificati.)n3 and In compliance with all applicable codes and 11EQUIPCD INSPECTIONS
ordinances The issuance of this permit does not waive restrictive (;A% LINE
covenants C amtractor and subcontractors shall have current city POST It SEAM
business tax permits.This permit will expire and become null and
void if work Is not started within 180 days,or it work is suspended or nOUGH-- IN
abandoned for a period of 180 days any time otter work has F*I NAL.
commenced. It shall be the responsibility permittee to assure
all required I tion are requested Pd a roved
Permittee ign re
Issued By
SEPARATE PERMITS REQUIRED FOA W9P* OTMWINOW WGROND AIM
CITY OF TIGA RDItD
CITYOFTWARD ';;E:WE:P PI-.1141MI T
COMMUNITY DEVELOPMENT DEPARTMENT 1'-*1F.PM1'T NO. SEG80216
13125 S.W.flail Blvd.,P.O.Fiax 23397,Tigard,Oregon 97223.(503)6394173
88
I_`lQIM . PM F .NO 8002213
JUS ADUPESS : 1453P. SW 133RU (-"r USA NUMBEF,': 3495/
l'AX MAP/1.0,11, er-111. te.181C 6900 SLIS: UIQ UTYi*. EME.RALI) AUPE'S 1. 1 1 ell UK :
LAND USI;'. :
1.04' SIZE :
12 I'WP: 26 PNG. tw
WUPK C3,ASS : NEW
USE 7-i'PE. SINGLE FAMILY
j-1*1., al 1.);)JJ call 1. asgi,wieti; Lt.i k) w:l t,ii oil. rLi1em alld I'Mot-0 iist:i 1:)rl!!' (IT I-110t
"sewer-age Agency T'he per,mit oxpl.rrvi% 120 days Trom the date The total.
1.)&:Ld Wj I1. L)rA 4' The slut
antee the aeemii-aczy cf-F the 10c'm 1A.(iry of then later-al.m . I f tJie
lint JOLflit.0-IIJ lilt. 11hra P1'ait1i;)(.-v
all. dir-cooti.ariiii fr-arff 010 dl.atwsioe giveii . if not %a 1ac.-ated t h e :L n'a t ft:L CP P 1-1 in.1.1.
—p I 11,C I I it)to C. if " I at I.. ;J1(i(J 51:1 d6) S ewc�I Pe I.,in 1. t fit rl d t110 A U F-41 1 f. u W I lit, IN,L IN
F
INS TAL L - 'TYPE. 611J11-DING 51eUER IMPERVIOUS AREA:
F IXTURIL, U141 111.) T'C_NAN*T IMPPOVEMEN'T'
C Nn I IN L r
0
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N
E 11011:1.h)in 1,-: 1 F E: DUN VE PM 1: 1 1113115 00
R P13 Box t9.5241 CONNECTION CHARUL $1. , 1.00 00
1:)t I 1, 1,3 ot I 10 al., 97e 3.9 LINr-.: TAP INSIAIA
C PHONE 150J) P.2IT-79W. -I
0 O'THE A
N
T
R MUR I SSE T TE KIN
A UUN MCIPISSE.I IE: t)011.A")EPsF- I.W.
C
T BOX 1.9.524
0 0 r.)n 1,t I'm liti 97P1.9
R
I+rl o r4(.Nl TON NO .A.5",5. .3 1(11 Al.. oil
This permit is issued subject to the regulations contained In TKI-
of the TMC. State of Oregon Specialty Codes.toning regulations Rncj�xv,-r NO 26966
and all other applicable codes and ordinances. and It is hereby
agreed that the work will be done in accordance with the plans End
specifications and in compliance with all applicable codes and HEQUIRED INSPEC-TIONS
ordinances The issuance of this permit does not waive restrictive POUGH IN
covenants Conti actor and subcontractors shall have current city
business tax permits This permit will expire and become mull and
void it work is not started within 180 days.or if work is suspended or
abandoned for a period of 180 days any time after nrk has
commenced It shall be the responsibility of the permittee r assure
till required inspections are requested an roved
pp?m,tl
Issued By
SEPARATE PERMITS REWIRED F60 4VdW 6TWL"It" MCM1120 ABOVE
cITYofTIVARD,
CITYOFTWARn I
COMMUNITY DEVELOPMENT DEPARTMENT VIFJOVI: I' NO . : PLF38021A
13125 S.W.Hall Blvd.,P.O.Box 23397,Tigard.Oregon 97223.(303)6394175
P11T.M . PMT.NO. 880211.3
,108 ADDRESS: 1,4532 sw (33ru ci,
TAX MAP/LOT E!Sl 'U-4812 41-ro0 SUB: GETIYS EMERALD ACRES 1.
LAND 05E:
L.04 51'ZIE :
I TEM: NO: NO :
WORK CLASS : 14EM WATEP EX-ClSiE I F .1 RAI-,
USE TYPE: SINGLE FAMILY URINAL BKFLOW PPVNTR
L'UNST . TYPE - VN LA VOPATOrW R TRAP 1,4111mr-44
OCCUP.CARP. : P3 TUB S11OWEP a GREASE TRAPS
01�;HWASHFP 1.
GARBAGE DISPOSAL 1.
NO . S1 URTR ; 1. WASH INC MACHINE. 1.
DWELL .UNITS : I I-A%JNDPY PRAY BLDG, DPF41N DIA
1:1.00P URWN
SINK t SEWL"R.:R (F 11-
V)I VIE 1!
0
W
N
E
R M0 Wr S 5 ETTE DON PERM 111 111 1.1 f !'1 0
C 1-1140NE 50 3 'r'44 93J.-1 S1 ATE TAX
0 ari-wo
N
T
R 444011RMAKEJ: HAPOL D
A
C SHOEMAKER' S PUJMBINC
T DOX ;.'-150
0
R vxqi tacndm. C11- 970F.K3
1-1-IfFINFT t;6107,1 V1110-71713
PE'CIrEst'PATTUN NO 39P.8 TOTAL: $1e3 .38
This permit is Issued subject to the regulations contained in Title 14
of the TMC. State of Oregon Specialty Codes,zoning regulations
.and all other applicable codes and ordinances, and it Is hereby PEX'X1P*f NO P-0960)
agreed that the work will be done in accordance with the plans and
specifications and in compliance with all applicable codes and INSPECTIONS
ordinances. The issuance of this permit does not waive restrictive PLB . kJNUF.RSLA8
covenants Contractor and subcontractors shall have current city
business tax permits. This permit will expire and become null end rins't, It BEAM
void if work is not started with,n 180 days,or if work Is suspended or WArFP L INF
abandoned for a period of 180 days any time after work has PLO 1111:11POUT
commenced. It shall be the responsibility of the permittee to assure PAIN DRAINS
all tequired inspections Are requested pproved, F I NAI.
Ilk
Pew Itim, til atwl•
Isswid By
SEPARATE PERMITS REQUIRED Fg%.V.V
q.FK q
k44CJy4qD ABOVE
OFTIGAPUN CHECK APPLICATION
CITYRD CRYUF TSGARD
PLAN CHECK f /2
COMMUNITY DEVEI-OPMENT DEPARTMENT OREGON
13125 SW Nall Bk,&P.O.Bac 23:47.Tlpud.Or*6*n vrm(603)6304175 PERMIT 1 CJ
-.. DhTE ISSUED
JOB hODRESS: Iy S 32 S W 31--C/ C I _ TAX MAP/LUT: 5/' f 4110
SUB: !'11`f S�ihc� �i ,/1LyPS LOT: — LAND USE:
VALUATION: - .!o a� ;l _ SETBACKS: YRONT:-AQ REAR: LEFT: RIGHT:
WORK CLASS: i ul HEIGH'i: / TOTAL AREA:
USE TYPE: S' F FLOOR LOAD: � 6 1ST:
CONSTR TYPE: - .S HEAT TYPE: 2ND:
OCCUP GROUP: P,:� DWELL/UNITS1 i 3RD:
OCCUP LOAD: - NO BEDROOMS i BASEMENT: �, D
NO STORIES: �— NO BATHS: .L GARAGE:
IMP SURFACE:
APPROVALS REQ•D SPECIAL NOTES _ITEMS RE UTRED
PLANNING: REISSUE OF: _ LIST SUBCONTRACTORS:
ENGINEERING: LAST REISSUEi_ZA2' BUS TAX:
FIRE DEPT. : FLOOD PLAIN/ CAI-CULATIONS:
OTHER: SEN LND.: TRUSS DETAILS: _
-- PARKING PIAN: _
LANDSCAP? PLAN: -
PLAN CHLCK BY: OfHER:
COMMENTS:
CCT I DESCRIPTION AMOUNT
OWNER A f 10-432 Building Permit Fees
NAME:�1 1' IISst_ 1 1-% �N� 10-431-600 Plumbing Permit Fees
ADDRESSs 1 10•-431-601 Mechanical Permit Fees gE L, :o
10-230-501 State Building Tax (5x)
10-433 Plan-, Check Fee
PHONE: 30-443 Sever Connection (202) t �.
30-202 Sewer Connection (80X)
CONIRA.CTOR 30-444 Sever Inspection
NAME: .51--448 Street System Dev. Charge (SDC)
ADDRESS: '52-449-61.0 Parke I System Dev. Charge (PDC) $
52-449-620 Parks II System Dev.. Charge (PrG:) 3
31-450 Storm Drainage Syst Dpv Chrg(SSDC)
PHONE: _ 10-2.10-505 TRFD (95x) s
30--435 TRFD (5x)
ARCH/ENGINEER 10-230-506 Washington County Fire I1 (95X)
NA►U. _ 1.0-435 Washington County Fire 11 (5X)
ADDRESS: 10-22.0 Amart/Wedgewood �
TOTAL
PHO::,R,: — --�
PREPAID
RFu
�-� 1ALANCE OUR t
APPLI NT S CN R
ecEived By: � \ Date Received: �-
-�rrr to r\ Nu
for inspections call 6*)9 -4 1'S
PERMIT NO.--�-�--e7
CITY OF TIGEACIQ 639.4171 DATE `�_ ---I°-- 5 Try r
BUILDING
Box 233971, T..gard OR 97223 TAXMAPV' l AL1 LOT NO. _�_, SUBDIVISIONLzL�'�
1
OWNER l�ti V YICf�(SSc� �i� �yl� ' - JOB ADDRESS i S ` J✓u
BUILDER STATE REG.NO. - EXP.DATE —
OUILDER'S PHONE
ARCHITECT -
PHONE_ OTHER_
SSTflIn-UREEW ❑ REMODEL ❑ ADDITION (I REPAIR ❑ MOVE ❑ OTHER L) DEMOLITION
C7 RE11ol HCE G Comm C1 EDUCATION
❑ IND ❑ REUGIOUS, O ACCESSORII U GARAGE ❑OTHER ❑ FENCE
OCCUPANCY 111
_.,_LANG USE ZONE BLDG TYPE �FIRE ZONF NLnN CHECK 3Y
Construct single family dwelling w/attached garage. -all-per ap roma iiIii
L Cs
SEWER PERMITil. r �'y' (Idu) baths. trai)s 41/4-A Ca9P ares
OCC.LOAD F1.00q LOAD _ HEIGHT t` NO.STORIES 2- AREA �� NO.BEDROOMS r VALUEk
L BUILDING DEPAP.fMENT SETBACKS FRONT REAR LEFT SIDE ��`� RIGHT 510E
?�sm1t THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE 31JILDING CODE. ZONING
REGULATIONS AND ALL I►PPLICABLE CODES AND ORDINANCES.AND IT IS HERE&Y AGREED THAT THE
PlanC1»ck Z O -� WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS ANO SPECIFICATIONS AND IN Cr aAPLIANCE
WITH ALL APPUCABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DGeS NOT WAIVE
PI CIL F" RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CYARENT CITY BUSINESS
TAX PERMRS.SEPARATE PERMIT�4mulnED FOR SEWER. G PLUMBIN4 AND HEATIN
Stale Tai i'j-� 5Sx a
_ SOC- � / "I—,/-_- ---- -- - - --
TOId �/�j� • - J L APDL T A N -
Po"
- Z/
Rwce+pl No ADDRESS
Bal.Ous 7 ��..► S Z-
lsgued Oy - - -- __.Appraved By
SSUC --- $ *L -
SOC - � —
RECEIPT q
PDC -� ��- � �
DATE PD.
SEWER CONNECTION $ 9 7,5— AMOUNT PD._ —
5EWER INSPECTION S
SEWER SURCHARGE_ 5
:ommente: --- - --
P.O.Pr x 2.3397
CITY OF T[GA R r_) PLUMBING 13125 EY HELU Blvd-
Applicants
ld-
Applicants must hold Oregon Registration to conduct �� (.R 97223
a plumbing PERMIT 1a39-9_'75
business or must be property owner/operator not♦•firing outside help.
rams of Dewlopmenl
Plumbing Permit No. ✓ L
Address� Description
ORS 8V-21-610 JUAN. PRICE AMT.
Job Tax LM Map.No.
Address
Sink
W
BIOr'k SUbdrviPf1 4�
Sink _ � 7.50
arrre�ix risme ef business) Lavatory Z 7.50 s�
Tub or Tub/Shower Comb - 7.50
ai ing Address -Shower Only _ 7 So
Owner CMy State Tip - -Water Closet _- - - 7.50 r�
Dishwasher 7.50
— - - -
Phone Garbage Disposal- ---- _ - 7.50 •Sr1
Name Washing Machine 7.50 +-f d
Fl(r r Drair 750 _
Mang Address Water Neater �- - - - 750 _ S
Oc u ant cny�slate Tp - L:!!:dry Room Tray - --- -7.50 -
Urinal 7 50
-Name Phone Other Fixtures(Specify) - 7.50
u7.50 _
ai�irq ress 7.50
Contractor (,NytStale 27p �- 7.50
MISCELLANEOUS _
Bus Tax No Sewer 1 at 100' _ 30.00 _
states. o -- usle�ii Ziis is is o He0_
Hewer-es.Addit.10 - _- 15.00 -
(Residential) Water Service 1st 100' _ 20.00 j9•='
I hereby ack,x wledga that 1 have mad this applicriMon,that Ity'Mlorrni4on Water Service ea.Addit.2M - 15.00
given is correct,that 1 am roos!ved with the State Builders Board,and also Storm 8 Vain Drain 1 d.100' 90.00
taw a Stat(,Pkxnbkrg lican,b tlat Itw mmnbers given ire our vd,Mat all
plurrrbing work will be done in s-.wrdance with applicable provbk)ns of Ore Stone 8 P•}n D-am AddN.100` - 15.00 --
gon Revised Statutes CVAgXers 447 and 693 and applicable codes and that MobGe t iome c� 25.00
no help wig be employed unless Ikwnsed under ORm
S 693 (If exempt from ------- ---_.. -- --- - - -
State reglstrstion,please give reason bstcw) Back Flo r Pro%w*on
HOMEOWNERS- 1 hereby owtMy t al I am the owner of the pmperty do Device or knb Pollution Dewce 7.50
salted above,et which location I pmpows to rrakw a plumbkV kwtaMetion for Any Ti spa W,V a Nof
my own use and this properly Is not bsktg r :ristrucsed to►sale.;ease or rent Gxvaeled%i a Fi rbure-- - 7.50 -
------ ----- - T—--
Cath Basin -- 7.50 -
kip.Of 1-.1.4.P. i 41inq 40.00 Per Hr - -
SpadNly Pall id Inepeotlorts 40.00 Per Hr
Allier.of Pluini t<I wt"'ln an Exieting Bldg 15.00 min
AUT110RQEU SIGNATURE -- ------ - _ hate New Bldg.or tAAd.Aoati-. 25.00 mkt.
-- _ ' e fatal
Describe work new❑ addition(] alteration CI repair(� �3wel.ling 15.00 U
12 be done residential F] non-reeklair ial —._
Etdstlrlp use of
b1J k*V or ProPe-ty M!�•TOTAL
Prqppw U"(A IS KMOPAPM
NOTICE -TM per. becomes nut and wld M wastr or owwwud/0n at0wized it not cam
/1111110 d vAedn 160 daystar Iloo ve t Om er waR r Miialw o ed a sbw ddad for
a pentad 0f 160 Heys d arty fkns W*wtxk N 00nr"snoed
W<CIAL OONOMONS_-_---- ------
Daft "Mil
CITY OF TIGARD MECHANICAL PERMIT Receipt
Permil 0'M
Description
T--b4 aA Mechem cit code _ Gly PWE APET
City of Tigard �1) —
1312b S W. Hal' Blvd. 1Dertmit Fee -00 10.00
P.O.*Box 23397 -- ----__
Tigard, OR 97223 2) supplements;Permit 3_00
6"d-4175 1) Furnace to 100,000 BTU 600 (�
_
Ind.ducts 3 vents
2) Fumaco 100,000'BTU + 750
incl.ducts&ve_n:s
Na""r,;p&v@Wpn a f1Fbor Fumace
3 incl.vent 6.00
Job Daae — - 11) Suspended heater,wall heater 6.00
Address (0'fkw mounted heater
Tau Lot - Map No. 5) Vent not kid.In 3.00
Lot Bleck SubdFAsion appliance perrm
r-W&V
wm(or name d biaaneea) 6) R^nak oth Sating.reit ig., 6.00
cooling,absorption unit
— Phone — Bolkw or camp to 3 H P 6.00
Owner I sasorp.unit to 100,000 BTU
cyl,/Stay— ZIP ,s) Boiler or comp to 311' -15 NP 11.00
absorp.unit to 500,000 BTU
Boiler or banp 15-30 H P 15.00
9) absorp.unit tyle-1 million
Mel"Ady,ew -- Ph" 10) Boller or oomp!r 1&50 HP 22.50
absorp.unit 1.1.75 millkxt
Contractor absorp.
ZIP -11) Boller 6r comp t o 50 Hf` 31.50
absorp.unit 1,750.000 6TU
State Flepbl son No. rAy Bur.Tax No. 12) Air hwxftV unit to - - --- 4.50
� - - —.—
1 hereby ed—oledpe lhW 1 he"mad lire appke" ow vw kdorn"Mon plwn r 13) 10,000 CFM Alf har�dlinp unit 7.50
am, M 1 em Nle owrw or wCbApen
[sd @t d the owns.wort plana vA m ed ery in ---•-- ---
c wnpAlance with Stale laws.rim 1 em registered wtlh On Stow Culldws'Bond.VW the Non portable
numbs olden M corned.IN exempt hem Stale reglatnWo t plea"g"reason below). 14) evaporate 000let 4.50
15 Vent fan connected 3.00
— to a 912&duct -
--------- 16) Ventilation system not 4.50
_ included In mWilanne permit -
-— —
t 7) Hood served by
medwtk.,al exhaust 450
ftwkae I*w"0'aa.pent) - — Dsk' 18) Domestic"o 7.50
Descxbe%Kxk Q addition O aMerstkin O repak ❑ -- _—_ _---
b be done reskilentia) 0 non-residential D 19) Commerdal or Industrial 30.00
E)dstirq use of — --type iocklers for --—
WW kq py prof"—_ _ __ 20) Other Le.,woodsbve,water 4.50
Proposed use of heater,solar clothes dryers,etc.
Wkfhg 7 prop" _ -- 21) Gas piping one to four outlets 2.01
Type of fuel-• oil LI natural gas (A I-PG I_] electric p —_-
22) More then 4-per outlet
hone .��... _
SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID if. WORK OR CON ---
STRUCTION AUTHORIZED IS NOT COMMENCED ti1lIININ 180 -- S%Q 4%SURCHARGE
DAY,,-. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 184 DAYS AT ANY TIME AFTER -Y ---
WORK IS COMMENCED. TOTAL_
Special C wOitknns
---------- Vale Issued _ -- —