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11895 SW 95TH AVENUE-1 --- 11895 SW 95TH AVENUE I v C d' d s: ll l() Q� 3 n 1 RNMRARALM INSPECTION TOTIH City c:,f Tigard Building Department P.O. Box 23397 t Tigard, Oregon 97223 Phone: 839-4175 L-j' f JType of InspectionC. -—T----_--- Date Requested Time_ A.M.----P.M. Address -. � _ 25 --_.-_ Permit Owner ­­-- _-_-- -- ---- Builder The following Builuing Code deficiencies are required to be corrected: i Y � i I i Presented to 4��pproved Inspector - �-- -- H Disapproved Date ---- ---- --- CAG OR REIN^PECTION ❑ YE: ❑ NO a I CITY OF TIGARD MECHANICAL. PERMIT Permit # Description City of Tigard Table 3A Mechanical Code _ CITY PRICE AMT � 13125 S.W. Hall Blvd. 1) Permit Fee -0- -U 10.00 P.O. Bax 23397 Tigard, OR 97223 2) Supplemental Permit 3.00 639-4175 Furnace to 100,000 BTU �) incl.ducts&vents 6.00 Furnace 100,000 BTU + 2) incl.ducts&vents 7,50 Name of Development Floor Furnace 3) incl.vent 6.00 Job Address 4) Suspended heater,wall heater 6.00 Address _ or floor mounted heater Tax Lot Map No. Veit not incl.in _ Lot Block Subdivision 5, appliance permit 3.00 Name(or name of husiness) Repair of heating,refrig., 6 (Q.t 8) cooling,absoi,+aon unit 6.00 Mailing Address Phone Boiler or comp to 3 HP Owner C, c' 7) absorp.unit to 100,000 BTU 6.00 _ City/Stalleed ©r Zip Boiler or comp to 3 HP-15 HP 7 p 8) absorp.unit to 500,000 BTU 11.00 Na 9) Boiler or comp 15-30 HP A- F N�� n Gj absorp,unit 112-1 million 15.00 Mailing AddressPhone, Boiler or comp to 30-50 HP 22.50 q 1.5 56t1 7,1" ,"� ,bq_ 5 SS 10) absorp,unit 1-1.75 million Contractor City'state Zi Boller or comp to 50 HP z, a 11) absorp,unit 1,750,000 BTU 31.50 Staieepletratlon No^^� City Bus.Tax No. 12) Alr handling unit to 4.50 :1 i;?)3C 10,000 CFM I hereby acknowledge That I have read this application that the iniorma!ion given is 13) Air handling unit 10,000 CFM + 7.50 correct,that I am the owner or authorized agent of the owner,that plans submitted are m -- compliance with State laws,that I am registered with the State Builders'Board,that the Non portable number given Is correct.(If exempt from State registration please give reason below) 14) evaporate cooler15) 4.50 `,ant fan connected to a single duct 3.00 -- Ventilation system not 16) Included in appliance permit 4.50 17) Hood served by fvC �L0 G 7• mechanical exhaust 4.5J Signature(owner or agent) Data Domestic type Describe work [I addition El alteration Nil' repair [I18) Incinerator 7.50 to be done y residential 41 non-residen(ial ❑ Commercial or industrial Existing use of I 19) type incinerator _ 30.00 building or properly 1 F`�1 c� 'h '' Other i.e.,woodstove,water Proposed use of 1 20) heater,solar,clothes dryers,etc. 4.50 building or property__ t P�i����-� )^i 21) Gas piping one to four outlets 2.00 Type of fuel— oil LI natural gas k-T LPG i I electric I I 22) More than 4-per outlet NOTICE SUB-TOTAL (` THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- " STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 .06 SURCHARGE DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%nF SUB-TOTAL ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTF R WORK IS COMMENCED. TOTA L Special Conditions Date Issued __ by _ p i k d'tr n a Address ,S.11/ . 9S^"` . Permit No. Nam of Occupant Permit charge cam' Connection}fee 4 Paid by — ---- ----- Date connected Type of Building_ SL ' - Inspection fee Service Rate Paid bq, a Jg�Date 113 Cc—)/, f Contractor _7 uJ'Assessment C _Paid Size of connection 4K WW APPLICATION FOR SEWER SERVICE The unlersigned agrees, in consideration o.( the s,,�;or service connection by the ? j,. Tigard Sanitary District, to abide by and comply with the ordinances, regulations and rules of the Dist- rice presently in effect or hereinafter enacted and to pay sewer service charges as the same may lie im- posed from time to time when due and before such charges 1,ecome delinquent, I fully understand that all unpaid sewer service charges become a lien upon tbn property served as stipulated in O. R. S. 224.220. Connections to the District's system must be madby bonded contr`ac ors and/or bonded and licensed plumbers. `�f�,ti -I& C .APPROVED BY Superintendent TIGARD SA141TARY DISTRICT 8841 S.W. Commercial St. Tigard, Oregon ji I PERMIT TO CONNECT Tigard Sanitary District PER AT Nc) 686 DATE `�-�►�. �� PERMIT IS GIVEN TO OF J � ,� 3 ' o '�--�_ - _ 7 ' TO CONNECT A N n t e i TO THE SYSTEM OF TIGARD SANITARY DISTRICT AT �'r f THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON- NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM- P!.ETED. i� PERMIT FEE PAID $._..`..........................TIGARD SANITARY DISTRICT BY .,wft r w CONNECTION INSPECTED AND APPROVED ` ?ate Supetl:fte de t