11595 SW 91ST AVENUE I
11595 SW 91ST AVENUE
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INSPECTI0'1 NOTICE
City of Tigard [Audi"" Department
13125 SW Hall Ov.d. Tigard, Oregon 97223
Inspection Line (Re:: O-Phone)s 639-4175 Business Phcme: 639-4171
Inspections
Footing Plbg. UnderelebMech. Rough-in, Aper/Sdwlk
Found. Plbg. Top Outa� u Line
Fant/Beam struct. San. Sewer Framing -Bldg.
Poet/Baam Hoch. Rain Drain Insulation -Pllur_.
111bg. Underfloor Water
Line Gyp, Bd. -Much. y
Date Requesteds_ /'f�JQ' � )/' J � J Tin.et AM
Address: � Permit #I
Builder: rlezzeTHE FOLLOWING .ORRACTIONS ARE REQUIRED-.
1
Inspectors -`-----— D
-—APPROVRD D18APPROVRD APPROVRD SUBJECT TO ADCVE
_call ror Reinsp.
PERMIT
CITYOFTIFARD Cffy - 7mRD ERMIT #. . . . . . . : MEC91-0050
COMMUNITY DEVELOPMENT CEPARTMENT anaxs
13125 SW HWI Blvd. P.O.Bak 2.%3W,Tqmd,Oregon 97ZZ3(5W)639-4175 DATE ISSUED: 03/13/91
,ITIS: -!RL, A PARCEL: 1SI35DC-0710V,
SUBDIVISION. . . . CHI-;RBt:N ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 10
r:LASS OF WORK. . oADD FLOOR FURN. . . . i EVAP COOLERS:
TYPE OF USE. . . . :SF UNIT HEATERS. . : VENT FANS. . . - I
OCCUPANCY GRF-,. . - R3 VENTS W/O APDL: VENT SYSTEMS:
GTOR I 1ZS. . . . . . . . BOILERS/COMPRESSORS 1--tOODS. . . . . . .
0-3 HP. . . . DOMES. INCIN:
: /GAS/ 3-15 HP. . . . COMML. INCIN-
MAX INPUT: BTU 1.5-30 HP. - - - REPAIR UNITS:
FIRE DAMPERS?. . : 30-50 1AP. . . . WOODSTOVES. . :
GAS PRESSURE— i 50+ HPI. . . . CLE) DRYERS. . :
1\10. OF PIR i4ANDLINC3 UN I TS OTHER UNITS. :
FURN ( 100K BTU: 1 < 10000 cf'm: 385 ou"rLETS. -. 1
1,URN ) =,100K 131'U.- 100I'10 t m
Hemsr'ks : Adding gas f,Arnace FEES
Owner,: ----------------
MARYLF1" LOWRY type amot.int by date ecoV
11595 SW 91ST PAYM $ 18. 90 31-H 03/13/91
1--;F2MT 1, 18. 00
IGARD OR 97,2;:'3 0. 90
+hnne At.-,
ant or
OLUMBIA HEATING
i)900 SW BURNHAM
i1 ACE E-1. 10
1IGARD OR 97223 ------------
; ,hone #: 624-2704 f 18. 90 TOTAL
4g #. . - 38026 REQUIRED INSPECTIONS
',is perait is iss-jed subject tr 'np rqtlat:n^s contained in the Final Inspection
licard Municipal Code. State o' Om Specialty Coots and all other ------
applicable laws. All work wi' l be done in accordance with
,moraved plan:, This oerr.t Mill txpire if work is not started
.4thin 18@ days of iisua,,v. or if work is suspended for eare
than 161 days,
i 14 11 At
1-e a By I
Call for inspection 639-4175
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P
CITY OF TIGARD RECEIPT OF PAYMENT RECE I T rNOj-
.91 .- _1!"601
CHECK AMOUNT y 18. 130
NAME GOI.UMBIA HEATING CASH AMOUN'r 0. 00
ADDRESS PAYMENT DATE 03/13/9t
SUBD I V T S 1 ON
11595 sw gis r
PURPOSE OF PAYMENT AMOUNT PA 11.) PURPOSE OF' PAYMENT AMOUNT PA I r.
ST. B J I L—D —PE—R 0. 90
tOTAl AMOUNT PAID I.S. 90
-_.--- -----
!< 11� ;faf E 1I� MIF tilir t>1!
CITY OF '.'IGARD MECHANICAL PF I:&MIT Receipt#
13125 SW HALL BLVD. Permit
P. O. BOX 23397 IDescription
T I GARD, OR 97223 Table 3A Mechanical Code _QTY— PRICE AMT
U
(503 )639-4175b�! 1) Permit Fee -0- -0- 10.00
Name of Development V 2) Supplemental Permit 3.00
Furnace to 100,000 BTU
Jots address 1) / R.00
Address I ��'C75 �''�� � � s-�, incl.ducts&vents _ <<
Tax Lot Map No. 2) Furnace 100,000 BTU + 7.50
incl,ducts COX vents
Lot Block Subdivishm -- -
-- Name(or name of business) 3) Floor Furnace 6.00
�� incl.vent
Main),Add 1`-v v L bane 4� Susponded heater,wall heater C.00
Owner / 15- tL/ C/ S"j 1 ' orifoormounted heater ---
city/ah s Zip _ 5) Vent not incl,in 300
1 et Y n om"S appliance permit
Name(cW name of business) 6) Repair of heating,ref rig., 6.00
cooling,absorption unit
Ma,ling dress Pitons -- 7) Boiler or comp to 3 HP 6.00
Occupant ! i absorp.unit to 100,000 BTU —
city/State Zip 8) Boiler or comp to 3 HP-15 HP 11.00
absorp.unit to 500,000 BTU
NameBoiler or comp 15-30 HP 15.00
O'D `� �(�t � 7 9) absorp.unit 1/2-1 million
Malllrt Addrtla} 10) Boiler or comp to 30-50 HP 22.50
Tcx 1-1 _ absorp.unit 1 -1.75 million
Contractor Cl /Sts a Zi — 11 Boiler or comp to 50 HP
!y ^ , p 11) absorp.unit 1,750,000 BTU 31 50
State Req4tream R, 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 application that it,,,information given is 13) 10,000 CFM 1 7.50
correct,that I am the owner or authorized agent of the owner,that plans submitted are In -
compliance with Slat i laws,that I am registered with the State Builders'Boatd,that the 14) Non portable 4.50
number given is,.orrect,tit exempt from State registration please give reason below). evaporate cooler
15) Vent fan connected 3.00
to a single duct �-
-— --- - --- 16) Ventilation system not 4.50
Included in appliance permit _ ---
17) Hood served by d.50
,a( mechanical exhaust _
Signature(owner or e;,:nt)) Date 18) Domestic type- 7.50
Describe work ❑ addition ❑ alteration n. repair ❑ ncir.erator
to be done residential Q non-residential ❑ 191 Commercial or industfial 30.00
Existing use of type incinerator
building or properly _ 20) Other i.e.,woodstove,water 450
Proposed use of
heater,solar,clothes dryers,etc.
- --
building or property- _ _ 21) Gas piping one to four outlets 2.00 7
Type of lust- oil (l natural gas LPG ❑ electric ❑
22) Morethan- er outlet
NOTICE SUB-TOTAL 1 C
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON -_.
STRUCTION AUTHORIZED IS NOT COMMENCFD WITHIN 180 5%SURCHARGE (1
DAYS OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVM W 25%OF SUB-TOTAL�i
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER -- __---- — -
WORK IS COMMENCED. AFTER ----TOTAL
Special Conditions
Date issued_---- _ _by —
.lt�
Address Permit No. _ Zd to
Name of Occupant Permit charge
l�
---- __ Paid by _
-- — Bate connected �
Type of Building s ,,�/moi _ Inspection fee
Service Hate—2 , l/ _ Pi-,;d by Bate
Contractor
- --- __ Aesessmenl _J'L , !�' (' Paid
Size of connection 4�24 _