11495 SW 90TH AVENUE-1 11405 SW 90TS AVENUE
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!N!:0ECTION' NOTICE
City of Tigard BUildi ig Department
P.C. Box 23397
Tigard. Oregon 97223
Phone: 639-075
Type of Inspection
Date kequested_ y �— � _ Time— ;A M.—' P.M.
Address _� y4 s -c% _� �S — Permit # C>3ZZ—
Owner __—- _
Lot #
builder
The following Building Code deficiencies are required to be corrected:
Presented to L It Approved
Inspector —� --- -- - U Disapproved
Da',-
CALL FOR REINSPECTION
YES ❑ NO
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TIFA RDME::(::FIniva:CAL.. )��E::rx1�1:r.T'
PPKItMI T NO. : ME080322
C:rYOF7WARD
COMMUNITY DEVELOPMENT DEPARTMENT OREGON DATE, 2 2 ell, 60
13125 S.W.Hall Blvd..P.O.Box 23397,Tigard,Oregon 97223,(503)639-4175 PRIM, PMT .NO .
JOB ADDRESS . 11495 SW 90TH AVE
'TAX M A P/I...OT SUH I-'T' 6l<
LAND USE:
LOT ITEM: NO: NO :
WORK CLASS : Al-TEPATION FURNACE <100K ATP I-I^NI)L.F:l 0.0
USE TYPE: SINGLE FAMILY FURNACE 1.00K+ AIR HANDI-P 10K
CONST .'TYPE : VN Fill OOW FUI4NA(.',E: V'VOP . (:,OOLJ.::P
OCCUII'." . GAP : 1.13 HEATER VEN,r FAN
VENT VF.:'N'T . SYS'11-:M
BLP/COMB <3HP HOOD
NO . STORIE.S : BI-R/ClOMP 3-15+ip I NC :KNF-".PA*Y'(:)V.l(DOM
DWELL .UNITS : BLP/COMP 3.5-30HIn, IN(,'INEPATOR(COM
FUEL 1 Yl:)I::: WOOD HLP/(':OMP 30--,`+OHP 1:4 E-.:P A:1'1:4 UNIA'S
MAX. INPUT SLP/COMP 30+1-IP OTHER9.
FIRE: DMI-AW-.0 GAS 1:31PING OUTI-ETS
HIGH PPESS7
I Ow PPR5SI?
I4I:.:MARKS
iiivilkiori 903. inser-t into br,iok bb(4
FEES :
0 whits I-,.w.1.11 1:)Ill.1-,1:)P.t r Of I-"ERMIT 00
W J.1.495 ow 90th lliviiiD PLAN REVIEW
N t,i r-d lar 9 7 2 3 F; 3:XT 1.)1:1 r-_:S 5
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R PHONE (50'3) 639---5605 STATE TAX 1111 .73
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N CHIMNEY C;Anf-.: INC
T 1.e.4PPSE. 1,eI1*7TH
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A poi,t1al.nd or, 97P-36
C 1:)I-I(.)Nk: 25,5--1.515
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RATION NO. 52A7A TOAL :
PECL-KIPT NO. EJ.9858
This permit is issued subject to the regulations contained In Title 14
of the TMC, State of Oregon Specialty Codes,zoning regulations PECAUIPFA) I.N5PECTIONS
and all other applicahl- -odp- and ordinances, and it is hereby IF I Dr.-"P L AC r--:
agreed that the Wf7,K will be done In accordance with the p!ins and
specifications a id in compliance with all applicable codes and
ordinances The Issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have current city
business tax permits. This permit will expire and become null and
void if work Is not started within 180 days,or If work Is suspended or
abandoned for a poriod of 180 days any time after work has
commenced. It shall be the responsibility of the permittee to assure
all required inspections are requested and approved
Permittee Signature
Issued By I n.-2� GALL FOR INSPECTION 639--f4il'i
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CIT` ' OF TIGAHD MECHANICAL PERMIT Receipt� _!
Permit#
Description
Table 3A Mechanical Code CITY PRICE .1MT
City of Tigard
13125 S.W. Nall Blvd. 1> Perni;Fee Y a -0 10.00
P.O. Box 2331,4/
Tigard, OR 97223 2) Supplemental Hermit 3.00
639-4175 1) Furnace to 100,000 BTU 6.00
incl.ducts&vents _
2) Furnace 100,OOC•r7TU + _ 7.50
incl.ducts&vents
Name of Development �� Floor Furnace 6.00
_ incl.vent _ _
Job Address 41 Suspended heater,wall heater 6,00
Address 14 Q, :'>'% - . ,Y /;v- or floor mounted heater
Tax Lot Map vo 5) Vent not incl.in 3.00
Lot Block subdivision appliance permit —
Name for name of business) 6) Repair of heating,refr ig., 6.00
>` ALI Z � y1/ld r r E _ cooling,absorption unit
Meiling Address phone 7) Boiler or comp to 3 HP 600
Owner /r.�S- $w Wy /1 er absorp.unit to 100,000 BTU
atyrs�:ts Zip 8) Boiler or comp to3HP-15 HP 11.00
T 'rPA) Q absorp.unit to 500,000 BTU
Boiler or comp15-30 HP
Name' /1 r xr YV, C4 v Q 13 absorp.unit 1/2-1 millin 15.00 —
Mailing Address Phone 10) Boiler or Comp'o 30-50 HP 22.50
1;
Zr 14 7 W - 4s l absorp.unit 1-1.75 million _ -
ContractorcitWstete , 11 Boiler or comp to 5n HP 1 50
l I/Q f j hR 1-72 ) absorp.unit 1,750,600 BTU _ `
State Registration No. City Bus.Tax No 12) Air handling unit to 1.50
10,000 CFM
K N Air haru!ing unit
I hereby acknowledge that I have read this application that the information given is 13) 10,000 CFM 4 7.50
correct,that I am the owner or authorised agent of the owner,that plans submitted are in --- - -- ---
compliance with State laws,that I am registered with the State Builders13oa(d,that the t 4) Non portable 4.50
number given"is,orreci.(II exempt from State regiutration please give reason below) evaporate cooler
) Vent fan connected
/ - 15 to a single duct 3.00
- -
18) Ventilation system not 4 50
Included in appliance permit
/ 17) Hood served by 4.50
mechanical exhaust
Signature(owner or agent) �~ Date ftt Domestic type 7.50
Describe work G addition ❑ alteration (2 repair [j , incinerator -�
to be done residential ❑ non-residential CJ1 g) Commercial or Industrial 30.00
Existing use of type incinerator
building or properly µD 20 Other i e.,woodstove,water 450
Proposed use of ) heater,solar,clothes dryers,etc. 4 5
building or property f'
----- - 21) Gas piping one to tour outlets 2.00
f
Type of fuel- oil natural gas 11 LPG ❑ electHv- n
-- - 22) More than 4-per outlet
NOT14� SUB-TOTAL 14.,5c
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON-
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 5610 wt.SURCHARGE 173
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 28%OF SUB-TOTAL
ABAIJDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
WORK IS COMMENCED. TOTAL j I
l
SI►ec)al Conditions
Date issued by_