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PAN I CAL
P,ErRI411
P,ERMIT #. . . . . . . : MEC95-0,393
- CITY OF TIGARD DATE ISSUED: 11/21/95
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oreron 97223.8199 (503)639.4171 PIARCE1L: IS135DB-04500
1i;34'j:_ '—'W ')END i=iVE
DOGWOOD RIDGE ZONING: R---4. 5
.. . . . . . . . . . ILO . . . . . . . . . . . . -4
CLASS OF WORK. . :ADD FLOOR TURN. . . . : 0 Vk;AP, COOLERS: 0
TYPE_ OF USE. . . —SF UNIT HEATER;.. : 0 VENT FANG. . . : C.,
OCCUPANCY GRP'. ,, - R:7, VENTS W/O APP,1 : 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMP,RESSORS HOODS. . . . . . . ; 0
1_:UEL TYF:,ES--------- 0-3 Hp,, 0 DOMES. INCIN: 0
3-13 HP'. 0 COMML. JNCIN: Q)
MAX INVIUT: 0 BTU 15-30 fqr-,. 0 REPAIR UNITS: 0
F I RE DA11P,ERS?. . - 30-50 HP,. 0 WOOD!:3TOVES. . : 0
GAS P'RESE',URE. . . : .10+ HP,. 0 CLO DRYERS. . : 0
NO. OF UNITS------.— AIR HANDLING UNITS OTHER UNITS. o
r--L)RN ( I00K BTU: 0 <= 10000 cfm: 0 GAG) OUTLETS. I
i URN > =100K B7U,. 0 > 10000 cfm -
Pelnair-ks : Install yes piping/ol.tt -. ets
Uwner: FEES
DAVE ORTHELL type amol.int by date V-e C f3 t
5 SW 92ND P,Rt4T $ L5. 00 JSD 11/20/95 COMP, DOWN
5PCT $ 1. 25 JGD 11/20/95 COMP, DOWN
I' lGARD OR 972,23
!-Dhoyie #:
Contractor:
,JACOB S HEATING & A/C
1421 SE HOLGATE BLVD
PIURTLAND OR 97202
1--Ihonp #- 234-7331 $ 26. 25 TOTAL
Reg #. . .- 001441
REQUIRED INSPIECTIONS
This permit is issued subject to the reglilations contained in the Mechanical Trisp ................
Tigard Municipal Code. State of Dre- Spe, alty Codes and all other FiTial Inspect ion
applicable laws. All work will be done in accordance with
approved plans. This permit wiil expire if work is not started
within 180 days of issuance, or if work is suspended for more
than IN days.
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Call for-, inspect ion 639--4175
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CI?y of Tigard MECHANICAL PERMIT P)ancwReCA
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13125 sw Hall Blvd. APPLICATION Permi! #
PO Box 23397
Tigard, OR 97223
(503) 639-4171 _ _
ascription
Table 3A Mechanical Code Q1Y PRICE AMT
•« 6 rid 1) Permit Fee 0- -0- 10.00
,lob j,- • � J � C� _
r _—
Addreas J-lcl L rd OF) 2) Supplemental Permit v 3.00
_" Furnace to 1
1> Nj r l hell 1) incl.ducts&vents 6.00
Furnace 100,000 +
Owner i( :l�� J� L Ph"
• I 2) incl.ducts 8 vents 7.50
aw 22 Moumance
C I 1 C 7�ZJ 3) incl.vent 6.00
«�« of bwwmN Susp"n ad heater.waJI heater
t C r bc,J e 4) or floor mounted heater 6.00
-ftn •« ant not int.in
Occupant 5) appliance permit 3.00
nRepair of heating,re ng.
6) tooting,absorption unit 6.00
Boiler or comp,heat pump,air conn.
7) to 3 HP absorp unit to 100K BTU 6.00
of er or comp,heat pump,air con .
1.0111f8CtOf I Jl-" I �'— ? 3 8) 3 ,-15 HP absorp unit to 500K BTU 11.00
■«1 of er or comp, eat pumpair con .
r"r l I(( ��I 71QZ 9) 15.30 HP absorp unit.5.1 mil BTU 15.00
�• «�^ WYWA. Boiler or comp,heat pump,air coed.
(ZC 10) 30.50 HP absorp unit 1-1.75 mil BTU 22.50
hereby acknowledge that I have road is application,that the Boiler or comp,heat pump,air cond.
information given is correct,that I am the owner or authorized agent 11) >50 HP absorp unit 1.75 mil BTU 31.50
of the owner, that plans submitted are in compliance with State Air handling unit to
laws,tliat I am rogiste..ed with the Construction Contractor's Board, 12) 10,000 CFM 4.50
that Cie number given is correct. (If exempt from State registration, Air handling unit _
please give reason`:plow.) 13) 10,000 CTM+ 7.50
Non portable
14) evaporate cooter 4,50
Vent Ian connected
15) to a single duct 3.00
anti ation system not
16) included in appliance permit 4.50
Hood sere by — - ---
17) mechanical exhaust _ 4.50
escn worknew a n alteration pair Commercial or In ustria W
to be done msidertial 01 non-residential L7 18) type incinerator 30.00
Existing use o er i.e.,woodstove,water
building or properly 19) heater,solar,clothes dryers,etc. 4,50
a-
rz Proposed use of 20) Gas piping one to four outlets ' 2.00
tj building or property
�. 21) Moro than 4-per outlet
F— Type of fuel -oil Q natural gas Q LPG Q electric Q
J
m NOTICE
0 Minimum Fee$25.00 SUBTOTAL
U-1 PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE
IF CONSTRUCTION OR WORK IS SUSPENDED OR _710-
ABANDONED
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL
AFTER WORK IS COMMENCED.
TOTAL
Special Conditions 2a• Z S.
Date issued �_ by
4,wr —jw,,c C> �� HEj%"
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINt,!.:
Post/Beam Mech. San. Sewer aas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Watei Line Insulation Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: Z Z/ �r/ Time:-XAM PM
Address: >n/S_ _541LI
Builder: 2 3,/_ 7.33/ ,Permit #:ly)eC
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: _ , Date: 19
APPROVED DISAPPROVED APPROVED SUBJECT TO ABC'VE
_Call For Roinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection•_
Footing Plbg. UnderslabMech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Litt FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mich. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. �)-Hh.
Date Requeetleds _Times `�-� AH PM
Addresas /�. �7 5 q,=r� fK Permit
Builder:
THE FOLLOWI; CORRECTIONS ARE REQUIRED:
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Inspectors_ _��,�-- - _ __-- nnt_e:..
4 APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
--call For Reinsp.
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CITYOFTIGARD I!EGHAN 1 CAL JE3cnY� '�� PE RIVI I T
COMMUNITY DEVELOPMENT DEPARTMEur onooM PERIYIIT . . . . . . .13126 SW Hell Blvd. P.O.Box 23397,T4md,Oregon 97223(603)639.41766.39-4171 DATE ISSUED: 01/19/SITE ADDRESS. . . : 11345 SW SEND AVL. PARCEL: IS1�3`
SUBDIVISION. . . . : DOGWOOD RIDGE ZONING: R--4. '-=)
BL.00K. . . . . . . . . . , LO T.. . . . . . . . . . . . . :4
CLASS OF WORK. . :ADD FLOOR FURN. . . . : EVAP COOLERS:
TYPE OF USE. . . . :SF UNIT' HEATERS. . : VENT FANS. . . :
OCCUPANCY GRP. . :R3 VENTS W/Cl APDL: VENT SYSTEMS:
STORIES. . . . . . . . : E1OI LERS/COI1PRESSORS FOODS. . . . . . . :
FUEL TYPES--------------- 0--3 HC'. . . . : 1 DOMES. I NC I N:
, /GAS/ / ! 3-15) HP. , . . : COMNIL. I NC I N:
MAX INPUT : BTU 15-30 HP. . , . : REPAIR UNITS:
FIRE DAMPERS?. . : 30-50 HP. , . . : WOODSTOVES. . :
GAS PRESSURE, . . : 50+ [41". . . . : CLO DRYERS. . :
NO. OF UNITS- -- -- - -- AIR HANDLING UNITS OTHER UNITS. :
FURN ( 100K BTU: i (- 10000 cfm: GAS OUTLETS. : I
FURN > -100K HTU. > 10000 cfm.
Reliar,ks :
Uwner.• -______._____. .----..___.___________.___.______..___-________ FEES
DOVE ORTHELL type am01_111� by date r,ecpt
11345 SW 92ND PRrIT $ 25. 00 JH 01/19/93 -
5PCT b 1. 25 JH 01/19/93 -
TIGARD OR 97223
Ph ane #:
Contractor:
JACOBS HEATING
1421 SE HOl_GATE BLVD
PORTLAND OR 9720
Phone it: 234•-7331 $ 26. 25 T'O'TAL
Rey #. . . 01441
_.________-• REUUI RED I INSPECT I ONS -- ---
This permit is issued subject to the regulations contained in the Final Inspection
Tigard Municipal Cole, State of Ore. Specialty Codes and all other _
applicable laws. All wor•!1 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 IN days.
I germ i t t ee S i gnat etre-
Call f--or inspect i on - 639-4175,
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CITY 01- '110ARD kF(ILIPIT OF POYMP41 RECEIPT NO.
CHECK AMOUNT
NAME .tw.,uss WEA ro4n CASH AMO-IN r
PAYMLN'r DAI L
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PIJRI--'OSE OF PIQYWENT (-&IOUNT Pf'411) PIJRP ' of Ps4YMENT AMOUNT PAT.I.)
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