11435 SW 91ST AVENUE 11435 SW 91ST AVENUE
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INSPECTION NOTICI.E
City of Tigard Building Department
P.O. Box 23397 ��-
Tigard, Oregon 97223
Phone. 639-A175
Type of Inspeztinn
Date Requested_ _.__ Time ,• A.M. P.M.
Address Permit # �
Owner _ C _ Lot #
Builder U
The following Building Code deficiencies are required to be corrected:
- - - - --- --
Presented ,n /
_ —`��i}- �Approved
Inspectr+; �� �� Disapproved
Date
CALL, FOR REPISPECTLON
0 YES 01IVO
ME(�'HANICAI 1::11;:'RM Ff
ITNOFTIFARD F EPM:E'T* NO. ME09.1.190
C17YOFMARD
COMMUNITY DEVELOPMENT DEPARTMENT 7
OWN
13125 S.W.Hall Blvd.,P.O.Box 23397.Tigard,Oregon 97223.(503)6394175 1 �
—P 44.1 1"AN I' NO _149 I I si)0
j3..q3,,j jiW 91!;'j, Avt.*.,
JOR ADDRESS :
TAX MAP/L(JT SUB : LA, BK :
I AND USE :
LOT SIZE :
NO: NO:
WORK CLASS : All FLIANACE <100K 1. A3:r2 HANULP (1.0
U 5 1:.:: 'T'Y I.)r-.:: SINGLA-*_ FAMILY F-1.1114NACIL: :LO0K+ AIR HANCLA 10K
CONST .TYPE: 1:1-00114 FUPNACE E'VAP.('.;0OLEP
(7CCUP.GAP. VEN'T FAN
VENT VE'.Nl*. "iY5*TLM
BLA/COMP (31-11:) 1-4001)
NO. STOP 3:FK 5 ; I:.4I_P/C(:)MP ;3..-:I T-1 P INCINEPA1134(DOM
DWIFI.A...UNITS : BLIAl/COMP 1.11.)__'3 0 14 P INrI14E-'J1ATOI3.(COM
'1*YF-'I:.'. GAS RLW/COMP ;30•";` OHP Rli:*PAIR LINT'S
MAX . INPUT F)l A/CLIMP _50+11P (:l1,11-11EN4
1*-":I:F4L:.* 1:)MPr4S'? GA!-5 PI.PING OUTLETS
HIGH PPIES57
1:4EMAP!�S :
01I.- FURNACE; WITH NEW GAS FILINNACE.
01
W DYKE.MAN QC)y P F:-*P MI T $ Lii 00
N
E IIA33 SW 9:Lo!ii1* AVE PLAN PI;--.VII:_-'W
R I .11.4.APD ON 10*721:.'-3 F*I X1 LJ P E:'L.j Fl 0
VJI-AINIE (503) c...749 O;'.V� 5 5*TA*T*F_ I'AX
01'HIli'::P
C
0
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T AN(:,"TII LjHr-.-.E*T' MCRA'AL.
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A 43PO N. WILLIAMS AVE
C p ci r t'l.;-.L n ti cl 1. 97 r.?17
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0 PH(:)Nl-"_-: (50 3) 28 1.....0 7Cti2
R I ror.caSTRATION NO . 8897 'TUFAL i R . 9
This permit is issi,ed subject to the regulations contained in Title 14 Rr-rr-:IP'T- NO.
-)f the TIVIC, Stat D of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances, and It Is hereby rff::QkJIr*.D INSPECT '-ONS
agreed that the work will be done in accordance with the plans and GAS LINE:
specifications and In compliance with all applicable codes and POSI' & DEQ AM
ordinances The issuance of this permit does not waive restrictive POUGH IN
covenants ContrFir-loor and subcontractors shall have current city
business tax per-ods This permit will expire and become null and F I NZ.
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 work has
commenced It shall be the responsibility of the permittee to assure
all required Inspections are requested arid4pproveJ
Permittee Signature
Issued By L. FOI-1 INSPECTION 639-417.1
SEPARATE PERMITS REOU!..-"D FOR WORK OTHER THAN DESCRIBED ABOVE
MeREE
City of Tigard Rocoipt«
13125 S.W. Hall Bivd. MECHANICAL PERMIT PermilN ..�_Lr���
P.O. Box 23397
Tigard OR 97223 oesrnplion _ ---
r ULM 2A Mechar."t Code OTY PRICE AMT
639-4175 �— --- _
+) Pe-mir`=ee -0- -0 10.00
Name°r oeveloprlant 2) Supplemental Pcmiit 3.00
j ' :5 Fu mace to I Q ,JW BTU
Address
'job 1) in(I.ducts&venta &00
Adct•ass T—
I Furnace 100,000BTLI +
TuclotMopN°' 2) ��.dtrcts&vents 7'50
tat 13 :k SubdMWon — — — —
Naffs(or mor buskum! ;�) Floor Furnace
lin G.00
ind.vent _ _
A i I�rr k n 1 Q.L� - Suspended heater,wall heater
Owner S� 3`�' 4) or floor_mounted hooter 6.00
Vent not ind.in
Gyisrale ZIP 5) appliance permit _ 3.00
arta — - -----____-_- 6 Repair of heating.rafrg— 6.00
cooling,absorption unit
ressA ) (3oilerorcomplo3HP
Phone 7 -
absorp.unit to 100,000 BTU _ 6.0_
Occupant CirylSta(e 8) 6oilerorcompto3HP 15Hp 11.00
absorp.•,nit to 500,00013 TU _
-- Name ) k}oflerorcor+tr -3G HP
t l I J 9 absorp.unit lh-1 million - 15.00
„ Plan z*j le�5 10) Boiler or c.1mp to 30-50 HP 22.50
rrbsorp.unit 1-1.75 million
ContractorZIP 11 Boiteroccompto50HP 31.50
/ 7
) atsorp.unit 1,750,000 BTU
Stale taegisvatlon No. 7 aty&a.T"No. 12) Air Fran GFg unit to -- - 4.50 -
10,000 CFM
I hereby acknowledge tial I have road this application Owl thA irilonnabon g"+to 13) Air handling unit 7.50
cn reci that I am Na owner a auNnagent d Nle riied ageowner.Out pbuu uAmilled are in — 10,000 CFM – - --
oompli —with Stale laws,t.'I am registered%M Nie Stale(kAders"loard.'hal the Non portable
number given is coned (N exec 0 from Sate registration please 0"reason below, 14) evaporate cooler 4.50
Vent tan connected —
- - -- ----- - ---------- 15 to a single dud 3.00
-- - -- - ) Ventilation system not
16 included in appliance pemid 4
/ -
17) 4"'0
Hood served by - --
s-f�i li �`, `Lr• ?_�f- mechanical exhaust ---
1-7.ms —
s+geaaeef(ow�nr a 69") ( �r Date 18) Domestic type 750
Descnbe work U addition O alteration (J repair ❑ __ incinerator v
to be dorso residential 0 non-residential 0Commercial or industrial
Existing use.of 19) type incinerator 30.00
building or properly.._..___ _ 20) Other i.e..woodslove,water 4.50
Proposed use of
healer,solar,clothes dryers,etc.
--
building or property_ 21) Gas piping one to four outlets 2.00
Type of fuel- oil ❑ natural gas LPG D electric L. -
22) More than 4-per outlet
N-OTIC
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON -- SUB-TOTAL OC)—
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 5% SURCHARGE IF0
r,AYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PIAN REVIEW 25%G. SUB-TOTAL
ABANDONED FOR A PERIOD OF ISO DAYS AT ANY TIME AFTER - TOTAL -! C
WORK IS COMMENCED.
Special Conditions --`
1 r
Address Permit No. — 7
Name of Occupant Permit charge
---- Paid by —.—��----
--- __— --------- --- --- Date connected
Type of Buildingii � __.------�'-^---
- - Inspection fee
Service Rate 2- la !/
_ _ Paid by Date
Contractor_ Assn +sment__�'�' '� ! Paid
Size of connection